Causal associations between COVID-19 and Atrial Fibrillation: A bidirectional Mendelian randomization study

BackgroundObservational studies showed that coronavirus disease 2019 (COVID-19) attacks universally and its most menacing progression uniquely endangers the elderly with cardiovascular disease (CVD). Whether COVID-19 is causally related to increasing susceptibility and severity of atrial fibrillation (AF), the main form of CVD, remains still unknown. MethodsThe study aims to investigate the bidirectional causal relations of COVID-19 with AF using two-sample Mendelian randomization (MR) analysis. ResultsMR evidence suggested genetically predicted severe COVID-19 was significantly associated with higher risk of AF (odds ratio [OR], 1.041; 95% confidence interval (CI), 1.007-1.076; P = 0.017), while genetically predicted AF was not causally associated with severe COVID-19 (OR, 0.831; 95% CI, 1.619-1.115; P=0.217). There was limited evidence to support association of genetically proxied COVID-19 with risk of AF (OR, 1.051; 95% CI, 0.991-1.114; P=0.097), and vice versa (OR, 0.163; 95% CI, 0.004-6.790; P=0.341). MR-Egger indicated no evidence of pleiotropic bias. ConclusionOverall, severe COVID-19 may causally affect AF through independent biological pathway. Survivors from severe COVID-19 might be of high risk of AF in the future.

Policy analysis on targeted admission medical education program in rural areas / 中国卫生政策研究

This paper analyzes the document contents of targeted admission medical students in 16 provinces of China in 2016.Through analyses of the characteristics of the program, this study found that, 1) the number of admissions is determined by the national level and issued to the provincial level, where rural students are the main source of students, undergraduate program is the main enrollment category, and clinical medicine and traditional Chinese medicine are the main majors of admission;2) the number of admissions and the actual demand of health professionals of primary health care institutions do not match, the incubation period is too long, there is a shortage of targeted training model, contract signing is difficult to implement, and other problems.Therefore, in accordance with the problems, this paper suggests that, 1) the government should increase the number of admissions to match with the demands;2) a three-year bachelor's degree should be set up in order to shorten the incubation period;3) the training model of targeted admission medical students should be changed;and 4) various powerful measures should be carried out to attract and keep excellent health care professionals.