Immunogenicity and reactogenicity of heterologous immunization schedules with COVID-19 vaccines: a systematic review and network meta-analysis.

BACKGROUND: Data on the immunogenicity and safety of heterologous immunization schedules are inconsistent. This study aimed to evaluate the immunogenicity and safety of homologous and heterologous immunization schedules. METHODS: Multiple databases with relevant studies were searched with an end date of October 31, 2021, and a website including a series of Coronavirus disease 2019 studies was examined for studies before March 31, 2022. Randomized controlled trials (RCTs) that compared different heterologous and homologous regimens among adults that reported immunogenicity and safety outcomes were reviewed. Primary outcomes included neutralizing antibodies against the original strain and serious adverse events (SAEs). A network meta-analysis (NMA) was conducted using a random-effects model. RESULTS: In all, 11 RCTs were included in the systematic review, and nine were ultimately included in the NMA. Among participants who received two doses of CoronaVac, another dose of mRNA or a non-replicating viral vector vaccine resulted in a significantly higher level of neutralizing antibody than a third CoronaVac 600 sino unit (SU); a dose of BNT162b2 induced the highest geometric mean ratio (GMR) of 15.24, 95% confidence interval [CI]: 9.53-24.39. Following one dose of BNT162b2 vaccination, a dose of mRNA-1273 generated a significantly higher level of neutralizing antibody than BNT162b2 alone (GMR = 1.32; 95% CI: 1.06-1.64), NVX-CoV2373 (GMR = 1.60; 95% CI: 1.16-2.21), or ChAdOx1 (GMR = 1.80; 95% CI: 1.25-2.59). Following one dose of ChAdOx1, a dose of mRNA-1273 was also more effective for improving antibody levels than ChAdOx1 (GMR = 11.09; 95% CI: 8.36-14.71) or NVX-CoV2373 (GMR = 2.87; 95% CI: 1.08-3.91). No significant difference in the risk for SAEs was found in any comparisons. CONCLUSIONS: Relative to vaccination with two doses of CoronaVac, a dose of BNT162b2 as a booster substantially enhances immunogenicity reactions and has a relatively acceptable risk for SAEs relative to other vaccines. For primary vaccination, schedules including mRNA vaccines induce a greater immune response. However, the comparatively higher risk for local and systemic adverse events introduced by mRNA vaccines should be noted. REGISTRATION: PROSPERO; https://www.crd.york.ac.uk/PROSPERO/ ; No. CRD42021278149.

The role of lung macrophages in acute respiratory distress syndrome.

Acute respiratory distress syndrome (ARDS) is an acute and diffuse inflammatory lung injury in a short time, one of the common severe manifestations of the respiratory system that endangers human life and health. As an innate immune cell, macrophages play a key role in the inflammatory response. For a long time, the role of pulmonary macrophages in ARDS has tended to revolve around the polarization of M1/M2. However, with the development of single-cell RNA sequencing, fate mapping, metabolomics, and other new technologies, a deeper understanding of the development process, classification, and function of macrophages in the lung are acquired. Here, we discuss the function of pulmonary macrophages in ARDS from the two dimensions of anatomical location and cell origin and describe the effects of cell metabolism and intercellular interaction on the function of macrophages. Besides, we explore the treatments for targeting macrophages, such as enhancing macrophage phagocytosis, regulating macrophage recruitment, and macrophage death. Considering the differences in responsiveness of different research groups to these treatments and the tremendous dynamic changes in the gene expression of monocyte/macrophage, we discussed the possibility of characterizing the gene expression of monocyte/macrophage as the biomarkers. We hope that this review will provide new insight into pulmonary macrophage function and therapeutic targets of ARDS.

The Mediation Role of Self-Control in the Association of Self-Efficacy and Physical Activity in College Students.

Global COVID-19 lockdown measures have led to an apparent decrease in physical activity. This study aimed to explore the explanatory function of self-control's mediating role between self-efficacy and physical activity among college students. The analysis used the data of 1627 university students (aged 19.41 ± 0.66, range 17-28, 40.5% males) at Shanghai Jiao Tong University. Self-efficacy, self-control, and physical activity were tested, respectively, by the general self-efficacy scale, the new brief self-control scale, and the International Physical Activity Questionnaire (IPAQ) scale, which were analyzed by SPSS software. Correlation analysis showed that self-efficacy, self-control, and physical activity were related in pairs. Comparing the two dimensions of self-control, we found that self-discipline mediated the relationship between self-efficacy and PA, and impulse control did not mediate the relationship. Regarding the gender difference according to multi-group analysis, findings showed that females need higher self-discipline from the path of self-efficacy to physical activity improvement than males.

Analysis on the medication rule of traditional Chinese medicine in the treatment of COVID-19 patients

Objective: To describe patterns of utilization of traditional Chinese medicine (TCM) in the treatment of patients with coronavirus disease 2019 (COVID-19). Methods: Adult patients with COVID-19 who received TCM treatment were divided into a non-serious group (mild and moderate types) and a serious group (severe and critical types) according to their admission conditions. The medical records and prescriptions of these patients were investigated to determine their TCM utilization patterns. Results: In all, 3,872 COVID-19 patients were included. Oral Chinese traditional patent medicine (CPM) was the most commonly used type of TCM, followed by decoction. The proportion of multi-drug combinations was higher than single drug use (55.0% vs. 45.0%). Decoction combined with oral CPM was the most common combination (39.1%, 1,514/3,872). Orally administered, injected, and externally applied CPM were significantly more common in the serious group than in the non-serious, while decoction and non-drug TCM treatments were more common in the non-serious than in the serious group. Multi-drug combinations were used for the majority of patients in both groups, mainly in the form of decoctions combined with oral CPM. Among the serious patients, injected CPM was more often used in patients who died during treatment (35.0%, 36/103). The two most common medication patterns were decoction combined with oral CPM and oral CPM alone in the two finally discharged groups. Oral CPM alone or used in combination with injected CPM were seen most commonly in the death group. Significant differences were established in TCM utilization and medication patterns among patients in three groups who had different prognoses and outcomes. Conclusions: The treatment measures and medication patterns of TCM commonly used in COVID-19 patients with the range of conditions found in this study should be further explored in the future to provide a more complete reference for COVID-19 treatment.

Correlation and Change in Physical Activity and Physical Fitness across Four Years of College Students after One Year of COVID-19 Lockdown.

The relationship between physical activity (PA) and physical fitness (PF) has been well established among college students. However, the impact of this relationship after 1 year of COVID-19 pandemic lockdown measures is unclear. This study aimed to test the relationship between PA and PF, exploring the trend across four years, the different components of PF related to PA, and their determinants, by analyzing specific items. A total of 1506 university students (19.48 ± 1.35 years old, 55.8% male) in years 1-4 at two comprehensive universities in Shanghai were recruited after one year of COVID restrictions and asked to complete the PF measurements and International Physical Activity Questionnaire (IPAQ Chinese Short version). The PA level is categorized into three types of intensity (low-moderate-high), and the level of PF is represented by the total test score of each item. Results show that PA was significantly positively correlated with PF; PA levels significantly predicted 1000m-run, 50m-sprint, and standing-long-jump in males, and 800m-sprint and sit-ups in females. Males predominantly had high-intensity PA, whereas females maintained moderate-intensity PA over four academic years. Meanwhile, PA and PF both trended downward as academic years increased in males and females, which could be attributed to a decline in high-intensity PA. The following two recommendations were obtained from the study: first, college students should engage in high-intensity PA activities after the end of the epidemic. Second, colleges offer physical education classes for four academic years of college students to promote PA and PF.