Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unpr...Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unprecedented complexity,particularly in the post-COVID-19 era.This review synthesizes evidence from the past decade(2015-2024)to systematically elucidate how key environmental drivers modulate pathogen emergence,transmission dynamics,and clinical outcomes,with a focus on underlying mechanistic pathways.Specifically,we highlight:(1)the temperature-and precipitation-dependent transmission of vector-borne diseases(e.g.,malaria,dengue)via expanded vector habitats and accelerated pathogen incubation;(2)the exacerbation of respiratory infections(including COVID-19)by particulate matter(PM2.5)and nitrogen dioxide(NO2)through impaired mucosal immunity and enhanced inflammatory responses;(3)the persistence of diarrheal diseases in low-and middle-income countries(LMICs)linked to water insecurity and climate-induced infrastructure failure;and(4)zoonotic spillover risks amplified by urbanization and deforestation-driven human-wildlife interface disruption.Integrating the One Health socioecological framework,we further summarize methodological advances from high-resolution genomic surveillance to climate-informed machine learning models that have improved causal inference and predictive accuracy.Our synthesis confirms that environmental factors are not merely contextual but central,modifiable determinants of infectious disease risk,with disproportionate impacts on vulnerable populations.To mitigate future threats,we emphasize the urgency of interdisciplinary collaboration,integrated environmental-health monitoring platforms,and climate-resilient public health policies tailored to post-pandemic challenges.This review provides a timely roadmap for translating environmental epidemiology insights into actionable strategies to strengthen global health resilience.展开更多
Objective:This review aimed to identify the barriers and facilitators to equitable coronavirus disease 2019(COVID-19)vaccine distribution in Nigeria using the consolidated framework for implementation research(CFIR).M...Objective:This review aimed to identify the barriers and facilitators to equitable coronavirus disease 2019(COVID-19)vaccine distribution in Nigeria using the consolidated framework for implementation research(CFIR).Methods:A comprehensive search strategy was applied across five databases—Web of Science,MEDLINE,EMBASE,CAB Direct,and CINAHL.The search,conducted as part of a scoping review,yielded 2,751 citations.Seven studies met the inclusion criteria after screening.Data were extracted and analyzed using CFIR constructs to identify key barriers and facilitators to equitable vaccine distribution.Results:Six barriers were identified:limited physical and socioeconomic access,bribery,nepotism,and insufficient availability of translated information.Facilitators included community involvement as local monitoring agents,unannounced staff inspections,healthcare worker training tailored to community needs,and localized outreach strategies such as jingles and call-in programs.CFIR constructs,including Local Conditions,Tailoring Strategies,Available Resources,and Physical Infrastructure,provided a framework for analyzing the findings.Conclusion:This review highlights significant barriers and promising facilitators to equitable vaccine distribution in Nigeria.Targeted interventions,such as community engagement,anti-corruption measures,and culturally tailored strategies,are critical to addressing these challenges and improving access.These findings underscore the need for localized,equity-focused approaches to enhance vaccine distribution systems in Nigeria and other low-resource settings.展开更多
Background and Objective:Vogt-Koyanagi-Harada(VKH)disease is a rare,multisystem autoimmune disorder affecting melanocyte-rich tissues such as the eyes,meninges,and skin.It is thought to result from an aberrant T cell-...Background and Objective:Vogt-Koyanagi-Harada(VKH)disease is a rare,multisystem autoimmune disorder affecting melanocyte-rich tissues such as the eyes,meninges,and skin.It is thought to result from an aberrant T cell-mediated immune response against melanocytic antigens,particularly tyrosinase-related proteins.This review discusses current therapeutic approaches for VKH and highlights emerging connections with coronavirus disease 2019(COVID-19),hepatitis C treatment,and pregnancy.Methods:A narrative review was conducted to examine VKH in relation to COVID-19,hepatitis C therapy,and pregnancy.PubMed was the primary database,with supplementary searches in Google Scholar.No time limits were applied;the last search was completed in April 2025.Search terms included“Vogt-Koyanagi-Harada disease”,“Vogt-Koyanagi-Harada syndrome”,“VKH”,“COVID-19”,“SARS-CoV-2”,“Hepatitis C”,and“Pregnancy”.Only English-language,peer-reviewed publications reporting original clinical data,case reports,or observational studies were included;non peer reviewed material was excluded.Two reviewers(M.S.and M.S.)independently screened titles,abstracts,and full texts,resolving discrepancies by consensus.Key Content and Findings:Conventional immunosuppressive therapy continues to be the cornerstone of VKH management;however,recent reports reveal unusual scenarios.Links with COVID-19,hepatitis C therapy,and pregnancy underscore the disease’s variability.Clinical evidence emphasizes the need for personalized treatment plans that consider patient demographics,comorbidities,risk factors,and the severity of the disease.Conclusions:While immunosuppression is central to VKH therapy,emerging cases emphasize the need for personalized approaches,which may improve understanding of VKH pathogenesis and patient outcomes.展开更多
Objective:To assess the effectiveness of COVID-19 vaccination in patients with rheumatic diseases undergoing biologic(bDMARDs)or targeted-synthetic disease-modifying anti-rheumatic drugs(tsDMARDs).Methods:This cross-s...Objective:To assess the effectiveness of COVID-19 vaccination in patients with rheumatic diseases undergoing biologic(bDMARDs)or targeted-synthetic disease-modifying anti-rheumatic drugs(tsDMARDs).Methods:This cross-sectional study was conducted at ten rheumatology clinics in Turkey between May 1,2021,and October 30,2022.Patients with rheumatic diseases on bDMARD or tsDMARD therapy who received at least two doses of an mRNA or inactivated SARS-CoV-2 vaccine were included.After vaccination,COVID-19 infection rates,adverse events,and rheumatic disease flares were recorded.Data were collected via face-to-face or telephone interviews.Results:A total of 963 participants were included in the final analysis;44%were male,and the median age was 49 years.The most frequently observed rheumatic diseases were ankylosing spondylitis and rheumatoid arthritis,accounting for 37.2%and 32.6%of cases,respectively.Adalimumab(19.2%)and infliximab(17.8%)were the most commonly used bDMARDs.Of the participants,634(65.9%)received an inactivated vaccine(CoronaVac)and 329(34.1%)an mRNA vaccine(BioNTech).A total of 502(52.1%)patients received a booster dose.Following the first,second,and third vaccine doses,adverse event rates were 19.9%,15.9%,and 26.7%,respectively.Forty-two(4.4%)patients experienced a disease flare within six months after their first vaccination dose.COVID-19 infection occurred in 79 participants(8.2%)after two vaccine doses;most cases were symptomatic but did not require hospitalization.The COVID-19 infection rate was lower in participants who received a booster dose than those who did not(3.4%vs.8.2%,P<0.001).Conclusions:Our study indicates that both mRNA and inactivated SARS-CoV-2 vaccines are effective in preventing severe COVID-19 outcomes,with an acceptable rate of adverse events and disease flares among patients with rheumatic diseases on bDMARD or tsDMARD therapy.展开更多
Background:Congenital heart disease(CHD)is the most common congenital anomaly,but whether the COVID-19 pandemic affects its prevalence is unknown.We aimed to compare the incidence of CHD during the COVID-19 pandemic w...Background:Congenital heart disease(CHD)is the most common congenital anomaly,but whether the COVID-19 pandemic affects its prevalence is unknown.We aimed to compare the incidence of CHD during the COVID-19 pandemic with that before the pandemic in China.Methods:This multicenter retrospective observational study involved all newborns in seven representative cities of China between 01 September 2019,and 31 December 2021.All the newborns underwent pulse oximetry monitoring combined with cardiac murmur auscultation in the first 6 h to 72 h after birth for CHD screening.We defined fetuses born in and beyond September 2020 as the exposed group,and before as the non-exposed group.The incidence of CHD and specific heart abnormalities,including atrial septal defect(ASD)and ventricular septal defect(VSD),before and during the COVID-19 pandemic were compared.Results:The study included 492,662 newborns;217,003 newborns born before September 2020 and 275,659 newborns born in and beyond September 2020.There were 3115 patients with CHD in total during the whole study period.Of those,1055(September 2019 to August 2020)and 2060(September 2020 to December 2021)were less and more affected by the pandemic,respectively.There was a significant increase in the incidence of CHD in the early stage of the COVID-19 pandemic(7.78 per 1000 births)compared to that before the pandemic(4.86 per 1000 births)(p<0.001).The birth prevalence of ASD and VSD significantly increased during the pandemic from 3.991 per 1000 births to 4.717 per 1000 births(p=0.008)and from 1.650 per 1000 births to 3.508 per 1000 births(p<0.001),respectively.Conclusions:The incidence of CHD increased during the COVID-19 pandemic,which was possibly related to the reallocation of medical resources,increased psychological pressure,and increased socioeconomic deprivation,though underlying mechanisms remain unclear.展开更多
The COVID-19 pandemic posed a challenge for clinical management of a new lung disease that was characterized by inflammation,endothelial cell dysfunction,and thrombosis,which occur after the replication phase of infec...The COVID-19 pandemic posed a challenge for clinical management of a new lung disease that was characterized by inflammation,endothelial cell dysfunction,and thrombosis,which occur after the replication phase of infection of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).There are many laboratory models of active SARS-CoV-2 infection in mice,reflecting an acute lung injury in an otherwise healthy animal,but there is a lack of accurate animal models of the postviral inflammatory phase of the COVID-19 lung reflecting severe disease.The monocrotaline(MCT)-treated rat is a widely used laboratory model of pulmonary hypertension(PH).Not often discussed,however,are the observed changes in inflammation,edema,fibrosis,and microthrombosis in the lung prior to PH.At the cellular level,there is loss of pneumocytes and endotheliopathy,and at the molecular level the MCT rat lung is characterized by a proinflammatory cytokine profile,namely elevated interleukin 6,transforming growth factorβand tumor necrosis factor,M1 macrophage phenotype,and dysregulation of the angiotensin converting enzyme(ACE)/ACE2 balance.The systems-level pathophysiology of the MCT-treated rat includes progressive cardiopulmonary dysfunction.The MCT-treated rat clearly differs from the COVID-19 lung in terms of the triggers for pathology,but there are many parallels apparent in both the MCT-treated rat and the COVID-19 lung.The MCT-treated rat lung as a model of the COVID-19 lung may provide an in-depth understanding of the factors that drive the lung to more severe pathology,treatments that benefit lung recovery,or the factors that prove a useful research platform for future emerging respiratory threats of similar pathology.展开更多
Coronavirus is a Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused by a novel coronavirus belonging to the family Coronaviridae. The disease was first discovered in December 2019 in Wuhan City, Hubei...Coronavirus is a Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused by a novel coronavirus belonging to the family Coronaviridae. The disease was first discovered in December 2019 in Wuhan City, Hubei Province, China. A few months later, the disease spread all over the world and became an epidemic. The infection for most people is mild to moderate but in Vulnerable groups, if they have the infections, they might experience severe COVID-19. Saudi Arabia initiated its response plan early, and all sectors and agencies worked in an integrated way to combat the disease. It has maintained proper communication during the pandemic and ensured community involvement, epidemiologic surveillance, and activation of rapid response teams. The COVID-19 pandemic significantly affected daily lives. Schools and daycares were closed, education was online, traveling stopped, work was suspended, gathering in social activities and practicing religious rituals, like praying or doing Umrah or Hajj, were banded. Changing lifestyles as a response to COVID-19 impacted whole communities with different categories of children, parents, and families. Women usually take the majority of daily responsibilities. The sudden change in lifestyle during COVID-19 put pressure on mothers, especially those who are working to balance work and family obligations. This study aims to identify the impact of Coronavirus disease 2019 on working mothers in Saudi Arabia. Method: Data of the study was collected through survey posted on social media and analyzed through Excel. It focuses on five aspects: health, lifestyle, social relations, work production and financial status. Our target population was working mothers in Saudi Arabia aged at least 25 years. Results: In this study, all factors affected working mothers categorized under two groups: Social Economic Status and Work suspension. For Social Economic Status factors, we find five factors which are monthly income, main breadwinner, number of children at school age, type of housing, and type of work. Almost all mothers include spiritual activities to their routine to cope with stress during this period. About half of our sample have negative impact on their mental health because they are the main breadwinner, and mothers with a smaller number of children at school age have more challenges to cope up. We found that mothers who own a house or work at governmental sector have better outcome of health. After analyzing data related to Work suspension, we found that mothers who have work support have better management for life circumstances, however their health outcomes were negatively affected. In addition, mothers working at education sector have the highest positive impact among other sectors. Our data shows that working mothers’ abilities to follow up with their children decreased. This study recommends that there is need to invest more in working mothers’ research and supportive programs and ensure collaboration globally to address working mothers’ needs and share experiences.展开更多
目的系统评价重症监护病房(ICU)患者新型冠状病毒感染(COVID-19)相关肺曲霉病(CAPA)感染危险因素。方法计算机检索PubMed、Cochrane Library、Embase、Web of Science、中国知网(CNKI)、万方数据、维普数据库(VIP)中关于ICU患者CAPA感...目的系统评价重症监护病房(ICU)患者新型冠状病毒感染(COVID-19)相关肺曲霉病(CAPA)感染危险因素。方法计算机检索PubMed、Cochrane Library、Embase、Web of Science、中国知网(CNKI)、万方数据、维普数据库(VIP)中关于ICU患者CAPA感染危险因素的研究,检索时限均为建库至2025年3月31日。由2名研究者独立筛选文献与提取资料,采用纽卡斯尔-渥太华(NOS)量表进行质量评价,使用RevMan 5.4软件进行Meta分析。结果共纳入38篇观察性研究,包括11312例患者。Meta分析结果显示,男性、年龄、吸烟、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ评分)、简化急性生理学评分Ⅱ(SAPSⅡ评分)、肝硬化、糖尿病、慢性阻塞性肺疾病(COPD)、心血管疾病、EORTC/MSGERC宿主因素、实体器官移植、血液系统恶性肿瘤、长期使用糖皮质激素、免疫缺陷、Charlson合并症指数、使用血管活性药物和/或正性肌力药物、接受机械通气、侵入性机械通气、机械通气时间、肾脏替代治疗、白细胞介素-6(IL-6)抑制剂治疗等因素均为ICU患者CAPA感染危险因素。身体质量指数(BMI)高和肥胖均为ICU患者CAPA感染的保护性因素(均P<0.05)。结论ICU患者CAPA感染危险因素较多,及时识别相关危险因素有助于尽早实施规范的抗真菌治疗,从而改善患者预后。展开更多
An acute respiratory disease,caused by a novel coronavirus(SARS-CoV-2,previously known as 2019-nCoV),the coronavirus disease 2019(COVID-19)has spread throughout China and received worldwide attention.On 30 January 202...An acute respiratory disease,caused by a novel coronavirus(SARS-CoV-2,previously known as 2019-nCoV),the coronavirus disease 2019(COVID-19)has spread throughout China and received worldwide attention.On 30 January 2020,World Health Organization(WHO)officially declared the COVID-19 epidemic as a public health emergency of international concern.The emergence of SARS-CoV-2,since the severe acute respiratory syndrome coronavirus(SARSCoV)in 2002 and Middle East respiratory syndrome coronavirus(MERS-CoV)in 2012,marked the third introduction of a highly pathogenic and large-scale epidemic coronavirus into the human population in the twenty-first century.As of 1 March 2020,a total of 87,137 confirmed cases globally,79,968 confirmed in China and 7169 outside of China,with 2977 deaths(3.4%)had been reported by WHO.Meanwhile,several independent research groups have identified that SARS-CoV-2 belongs toβ-coronavirus,with highly identical genome to bat coronavirus,pointing to bat as the natural host.The novel coronavirus uses the same receptor,angiotensin-converting enzyme 2(ACE2)as that for SARS-CoV,and mainly spreads through the respiratory tract.Importantly,increasingly evidence showed sustained human-tohuman transmission,along with many exported cases across the globe.The clinical symptoms of COVID-19 patients include fever,cough,fatigue and a small population of patients appeared gastrointestinal infection symptoms.The elderly and people with underlying diseases are susceptible to infection and prone to serious outcomes,which may be associated with acute respiratory distress syndrome(ARDS)and cytokine storm.Currently,there are few specific antiviral strategies,but several potent candidates of antivirals and repurposed drugs are under urgent investigation.In this review,we summarized the latest research progress of the epidemiology,pathogenesis,and clinical characteristics of COVID-19,and discussed the current treatment and scientific advancements to combat the epidemic novel coronavirus.展开更多
Coronavirus disease 2019(COVID-19)is a contagious disease caused by severe acute respiratory syndrome coronavirus 2.It was declared a global pandemic on March 11,2020,by the World Health Organization.An excessive infl...Coronavirus disease 2019(COVID-19)is a contagious disease caused by severe acute respiratory syndrome coronavirus 2.It was declared a global pandemic on March 11,2020,by the World Health Organization.An excessive inflammatory response is a severe respiratory manifestation of COVID-19,which becomes predominant in later stages.Due to its immunosuppressive and anti-inflammatory properties,dexamethasone is the first systemic glucocorticoid to treat severe COVID-19 patients.This editorial reviews the efficacy and safety of highdose vs low-dose dexamethasone in patients with COVID-19.Findings indicate that using low-dose dexamethasone is beneficial and emphasize the need for additional research on the use of high-dose dexamethasone.While the study provides a robust evidence base,it is limited by the lack of long-term data,focus on specific outcomes and heterogeneity of the included studies.Future research should focus on the long-term effects of dexamethasone and its impact across varying disease severities and patient populations to refine treatment strategies and improve patient care.展开更多
Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has spread rapidly around the world,posing a major threat to human health and the economy.Currently,long-term da...Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has spread rapidly around the world,posing a major threat to human health and the economy.Currently,long-term data on viral shedding and the serum antibody responses in COVID-19 patients are still limited.Herein,we report the clinical features,viral RNA loads,and serum antibody levels in a cohort of 112 COVID-19 patients admitted to the Honghu People’s Hospital,Hubei Province,China.Overall,5.36%(6/112)of patients showed persistent viral RNA shedding(>45 days).The peak viral load was higher in the severe disease group than in the mild group(median cycle threshold value,36.4 versus 31.5;P=0.002).For most patients the disappearance of IgM antibodies occurred approximately 4–6 weeks after symptoms onset,while IgG persisted for over 194 days after the onset of symptoms,although patients showed a 46%reduction in antibodies titres against SARS-CoV-2 nucleocapsid protein compared with the acute phase.We also studied18 asymptomatic individuals with RT-qPCR confirmed SARS-CoV-2 infection together with 17 symptomatic patients,and the asymptomatic individuals were the close contacts of these symptomatic cases.Delayed IgG seroconversion and lower IgM seropositive rates were observed in asymptomatic individuals.These data indicate that higher viral loads and stronger antibody responses are related to more severe disease status in patients with SARS-CoV-2 infection,and the antibodies persisted in the recovered patient for more than 6 months so that the vaccine may provide protection against SARS-CoV-2 infection.展开更多
The mental health effects of the coronavirus disease 2019(COVID-19)pandemic may shape population health for many years to come.Failure to address the mental health issues stemming from the pandemic is likely to prolon...The mental health effects of the coronavirus disease 2019(COVID-19)pandemic may shape population health for many years to come.Failure to address the mental health issues stemming from the pandemic is likely to prolong its impact.The COVID-19 pandemic has created a significant global challenge and,in lower-income countries,even a disruption of mental health services.Given our experience with previous pandemics,the present COVID-19 crisis can be expected to cause psychological trauma,and steps are needed to address this issue proactively.Policies focusing on the long-term mental health consequences of COVID-19 may equal the importance of those currently seeking to mitigate its physical effects.The implications of the GOVID-19 pandemic for mental health call for a greater focus on the needs of those with mental disorders and on mental health issues affecting health care workers and the general public.Timely preventive and therapeutic mental health care is essential in addressing the psychosocial needs of populations exposed to the pandemic.In addition to specialist care,"task-shifting"and digital technologies may provide cost-effective means of providing mental health care in lower-income countries worldwide as well as in higher-income countries with mental health services overwhelmed by the effects of the COVID-19 pandemic.In view of the ever-increasing pressure on global health systems resulting from the COVID-19 pandemic,adopting and adapting"task-shifting",i.e.,the delegation of psychotherapeutic interventions to trained non-specialists,as an element of the provision of mental health services,is overdue.Digital technologies can be used to enhance social support and facilitate resilience to the detrimental mental health effects of the pandemic;they may also offer an efficient and cost-effective way to provide easy access to mentalhealth care.展开更多
Severe pulmonary disease caused by the novel coronavirus[severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)],has devastated many countries around the world.It has overwhelmed the medical system.The priorities...Severe pulmonary disease caused by the novel coronavirus[severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)],has devastated many countries around the world.It has overwhelmed the medical system.The priorities of many institutions have changed to manage critically ill corona virus infectious disease-2019(COVID-19)patients,which affected the working style of many departments.Hepatologists and transplant surgeons look after a very sensitive patient group.Patients with liver disease need special attention and continuous follow-up.Similarly,transplant candidates also need special care.Healthcare professionals in the field of hepatology face the overwhelming task of taking care of COVID-19 patients with hepatic complications,liver disease or transplant patients who are SARS-CoV-2 positive,and the patients on routine surveillance who do not have COVID-19.This review will evaluate COVID-19 from the perspective of its effect on the liver and its possible effects on patients with liver disease.Furthermore,the level of care for liver transplant recipients during the pandemic will be discussed.展开更多
Coronavirus disease 2019(COVID-19)pandemic has proven to be tenacious and shows that the global commu nity is still poorly prepared to handling such emerging pandemics.Enhancing global solidarity in emergency prepared...Coronavirus disease 2019(COVID-19)pandemic has proven to be tenacious and shows that the global commu nity is still poorly prepared to handling such emerging pandemics.Enhancing global solidarity in emergency preparedness and response,and the mobilization of conscience and cooperation,can serve as an excellent source of ideas and measures in a timely manner.The article provides an overview of the key components of risk communication and community engagement(RCCE)strategies at the early stages in vulnerable nations and populations,and highlight contextual recommendations for strengthening coordinated and sustainable RCCE preventive and emergency response strategies against COVID-19 pandemic.Global solidarity calls for firming govemance,abundant community participation and enough trust to boost early pandemic preparedness and response.Promoting public RCCE response interventions needs crucially improving government health systems and security proactiveness,community to individual confinement,trust and resilience solutions.To better understand population risk and vulnerability,as well as COVID-19 transmission dynamics,it is important to build intelligent systems for monitoring isolation/quarantine and tracking by use of artificial intelligence and machine learning systems algorithms.Experiences and lessons learned from the international community is crucial for emerging pandemics prevention and control programs,especially in promoting evidence-based decision-making,integrating data and models to inform effective and sustainable RCCE strategies,such as local and global safe and effective COVID-19 vaccines and mass immunization programs.展开更多
Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 re...Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China.Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China.This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China.The comprehensive measures in China can be summarized as‘6P-approach’:public health emergency response,prompt learning from lessons,proactive measures of occupational health,precaution strategies against occupational hazards,personal protective equipment and medical devices supply,and professional networking.Through this 6P-approach,China was able to minimize the incidence of COVID-19 infection among HWs,while successfully containing the outbreak dxuing the first quarter of 2020.Although the COVID-19 vaccines have been rolled out,however,the COVID-19 pandemic is still under rapidly evolving situation.Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.展开更多
Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is considered the causative pathogen of coronavirus disease 2019(COVID-19)and has become an international danger to human health.Although respiratory transmis...Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is considered the causative pathogen of coronavirus disease 2019(COVID-19)and has become an international danger to human health.Although respiratory transmission and symptoms are still the essential manifestations of COVID-19,the digestive system could be an unconventional or supplementary route for COVID-19 to be transmitted and manifested,most likely due to the presence of angiotensin-converting enzyme 2(ACE2)in the gastrointestinal tract.In addition,SARS-CoV-2 can trigger hepatic injury via direct binding to the ACE2 receptor in cholangiocytes,antibodydependent enhancement of infection,systemic inflammatory response syndrome,inflammatory cytokine storms,ischemia/reperfusion injury,and adverse events of treatment drugs.Gastrointestinal symptoms,including anorexia,nausea,vomiting,and diarrhea,which are unusual in patients with COVID-19,and some digestive signs may occur without other respiratory symptoms.Furthermore,SARS-CoV-2 can be found in infected patients’stool,demonstrating the likelihood of transmission through the fecal-oral route.In addition,liver function should be monitored during COVID-19,particularly in more severe cases.This review summarizes the evidence for extra-pulmonary manifestations,mechanisms,and management of COVID-19,particularly those related to the gastrointestinal tract and liver.展开更多
The unprecedented healthcare demand due to sudden outbreak of coronavirus disease 2019 (COVID-19) pandemic has almost collapsed the health care systems especially in the developing world. Given the disastrous outbreak...The unprecedented healthcare demand due to sudden outbreak of coronavirus disease 2019 (COVID-19) pandemic has almost collapsed the health care systems especially in the developing world. Given the disastrous outbreak of COVID-19 second wave in India, the health system of country was virtually at the brink of collapse. Therefore, to identify the factors that resulted into breakdown and the challenges, Indian healthcare system faced during the second wave of COVID-19 pandemic, this paper analysed the health system challenges in India and the way forward in accordance with the six building blocks of world health organization (WHO). Applying integrated review approach, we found that the factors such as poor infrastructure, inadequate financing, lack of transparency and poor healthcare management resulted into the overstretching of healthcare system in India. Although health system in India faced these challenges from the very beginning, but early lessons from first wave should have been capitalized to avert the much deeper crisis in the second wave of the pandemic. To sum-up given the likely future challenges of pandemic, while healthcare should be prioritized with adequate financing, strong capacity-building measures and integration of public and private sectors in India. Likewise fiscal stimulus, risk assessment, data availability and building of human resources chain are other key factors to be strengthened for mitigating the future healthcare crisis in country.展开更多
The purpose of this review is to identify prevalent trends and risk factors in depression,anxiety,and eating disorders in the adolescent population in the post coronavirus disease 2019(COvID-19)scenario.We examined th...The purpose of this review is to identify prevalent trends and risk factors in depression,anxiety,and eating disorders in the adolescent population in the post coronavirus disease 2019(COvID-19)scenario.We examined the literature published on adolescent mental health since the COVID-19 pandemic.We chose to summarize studies published from 2019 to 2022,using bibliographic search tools.We developed criteria for selecting articles for our review using diagnostic indicators and keywords.Mental health conditions such as depression,anxiety and eating disorders are commonly prevalent in this population and have shown increasing rates in the past three years.Some risk factors associated with these diagnoses include reduction in social interaction,increased workloads,routine shifts,sleep quality,social media usage and parental involvement.Routines,sleep cycles,physical activity,and social media should all be considered as a part of prevention in this population.Approaches that seem to be successful include maintaining social ties and avoiding negative social media usage with harmful content.Increased global public awareness,as well as parental awareness,through media campaigns,is critical to slowing the spread of mental health challenges in adolescents and teenagers in the post-COvID-19 era.展开更多
基金the Natural Science Basic Research Program of Shaanxi Province,China[2023-JC-QN-0858]the Free Exploration Program of the Second Affiliated Hospital,School of Medicine,Xi’an Jiaotong University[2020YJ(ZYTS)605]the National Natural Science Foundation of China[81900620].
文摘Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unprecedented complexity,particularly in the post-COVID-19 era.This review synthesizes evidence from the past decade(2015-2024)to systematically elucidate how key environmental drivers modulate pathogen emergence,transmission dynamics,and clinical outcomes,with a focus on underlying mechanistic pathways.Specifically,we highlight:(1)the temperature-and precipitation-dependent transmission of vector-borne diseases(e.g.,malaria,dengue)via expanded vector habitats and accelerated pathogen incubation;(2)the exacerbation of respiratory infections(including COVID-19)by particulate matter(PM2.5)and nitrogen dioxide(NO2)through impaired mucosal immunity and enhanced inflammatory responses;(3)the persistence of diarrheal diseases in low-and middle-income countries(LMICs)linked to water insecurity and climate-induced infrastructure failure;and(4)zoonotic spillover risks amplified by urbanization and deforestation-driven human-wildlife interface disruption.Integrating the One Health socioecological framework,we further summarize methodological advances from high-resolution genomic surveillance to climate-informed machine learning models that have improved causal inference and predictive accuracy.Our synthesis confirms that environmental factors are not merely contextual but central,modifiable determinants of infectious disease risk,with disproportionate impacts on vulnerable populations.To mitigate future threats,we emphasize the urgency of interdisciplinary collaboration,integrated environmental-health monitoring platforms,and climate-resilient public health policies tailored to post-pandemic challenges.This review provides a timely roadmap for translating environmental epidemiology insights into actionable strategies to strengthen global health resilience.
文摘Objective:This review aimed to identify the barriers and facilitators to equitable coronavirus disease 2019(COVID-19)vaccine distribution in Nigeria using the consolidated framework for implementation research(CFIR).Methods:A comprehensive search strategy was applied across five databases—Web of Science,MEDLINE,EMBASE,CAB Direct,and CINAHL.The search,conducted as part of a scoping review,yielded 2,751 citations.Seven studies met the inclusion criteria after screening.Data were extracted and analyzed using CFIR constructs to identify key barriers and facilitators to equitable vaccine distribution.Results:Six barriers were identified:limited physical and socioeconomic access,bribery,nepotism,and insufficient availability of translated information.Facilitators included community involvement as local monitoring agents,unannounced staff inspections,healthcare worker training tailored to community needs,and localized outreach strategies such as jingles and call-in programs.CFIR constructs,including Local Conditions,Tailoring Strategies,Available Resources,and Physical Infrastructure,provided a framework for analyzing the findings.Conclusion:This review highlights significant barriers and promising facilitators to equitable vaccine distribution in Nigeria.Targeted interventions,such as community engagement,anti-corruption measures,and culturally tailored strategies,are critical to addressing these challenges and improving access.These findings underscore the need for localized,equity-focused approaches to enhance vaccine distribution systems in Nigeria and other low-resource settings.
文摘Background and Objective:Vogt-Koyanagi-Harada(VKH)disease is a rare,multisystem autoimmune disorder affecting melanocyte-rich tissues such as the eyes,meninges,and skin.It is thought to result from an aberrant T cell-mediated immune response against melanocytic antigens,particularly tyrosinase-related proteins.This review discusses current therapeutic approaches for VKH and highlights emerging connections with coronavirus disease 2019(COVID-19),hepatitis C treatment,and pregnancy.Methods:A narrative review was conducted to examine VKH in relation to COVID-19,hepatitis C therapy,and pregnancy.PubMed was the primary database,with supplementary searches in Google Scholar.No time limits were applied;the last search was completed in April 2025.Search terms included“Vogt-Koyanagi-Harada disease”,“Vogt-Koyanagi-Harada syndrome”,“VKH”,“COVID-19”,“SARS-CoV-2”,“Hepatitis C”,and“Pregnancy”.Only English-language,peer-reviewed publications reporting original clinical data,case reports,or observational studies were included;non peer reviewed material was excluded.Two reviewers(M.S.and M.S.)independently screened titles,abstracts,and full texts,resolving discrepancies by consensus.Key Content and Findings:Conventional immunosuppressive therapy continues to be the cornerstone of VKH management;however,recent reports reveal unusual scenarios.Links with COVID-19,hepatitis C therapy,and pregnancy underscore the disease’s variability.Clinical evidence emphasizes the need for personalized treatment plans that consider patient demographics,comorbidities,risk factors,and the severity of the disease.Conclusions:While immunosuppression is central to VKH therapy,emerging cases emphasize the need for personalized approaches,which may improve understanding of VKH pathogenesis and patient outcomes.
文摘Objective:To assess the effectiveness of COVID-19 vaccination in patients with rheumatic diseases undergoing biologic(bDMARDs)or targeted-synthetic disease-modifying anti-rheumatic drugs(tsDMARDs).Methods:This cross-sectional study was conducted at ten rheumatology clinics in Turkey between May 1,2021,and October 30,2022.Patients with rheumatic diseases on bDMARD or tsDMARD therapy who received at least two doses of an mRNA or inactivated SARS-CoV-2 vaccine were included.After vaccination,COVID-19 infection rates,adverse events,and rheumatic disease flares were recorded.Data were collected via face-to-face or telephone interviews.Results:A total of 963 participants were included in the final analysis;44%were male,and the median age was 49 years.The most frequently observed rheumatic diseases were ankylosing spondylitis and rheumatoid arthritis,accounting for 37.2%and 32.6%of cases,respectively.Adalimumab(19.2%)and infliximab(17.8%)were the most commonly used bDMARDs.Of the participants,634(65.9%)received an inactivated vaccine(CoronaVac)and 329(34.1%)an mRNA vaccine(BioNTech).A total of 502(52.1%)patients received a booster dose.Following the first,second,and third vaccine doses,adverse event rates were 19.9%,15.9%,and 26.7%,respectively.Forty-two(4.4%)patients experienced a disease flare within six months after their first vaccination dose.COVID-19 infection occurred in 79 participants(8.2%)after two vaccine doses;most cases were symptomatic but did not require hospitalization.The COVID-19 infection rate was lower in participants who received a booster dose than those who did not(3.4%vs.8.2%,P<0.001).Conclusions:Our study indicates that both mRNA and inactivated SARS-CoV-2 vaccines are effective in preventing severe COVID-19 outcomes,with an acceptable rate of adverse events and disease flares among patients with rheumatic diseases on bDMARD or tsDMARD therapy.
基金funded by Central Guiding Fund for Local Science and Technology Development Projects(No.2023ZY1058)the National Nature Science Foundation of China(No.82270309)both awarded to Weize Xu.
文摘Background:Congenital heart disease(CHD)is the most common congenital anomaly,but whether the COVID-19 pandemic affects its prevalence is unknown.We aimed to compare the incidence of CHD during the COVID-19 pandemic with that before the pandemic in China.Methods:This multicenter retrospective observational study involved all newborns in seven representative cities of China between 01 September 2019,and 31 December 2021.All the newborns underwent pulse oximetry monitoring combined with cardiac murmur auscultation in the first 6 h to 72 h after birth for CHD screening.We defined fetuses born in and beyond September 2020 as the exposed group,and before as the non-exposed group.The incidence of CHD and specific heart abnormalities,including atrial septal defect(ASD)and ventricular septal defect(VSD),before and during the COVID-19 pandemic were compared.Results:The study included 492,662 newborns;217,003 newborns born before September 2020 and 275,659 newborns born in and beyond September 2020.There were 3115 patients with CHD in total during the whole study period.Of those,1055(September 2019 to August 2020)and 2060(September 2020 to December 2021)were less and more affected by the pandemic,respectively.There was a significant increase in the incidence of CHD in the early stage of the COVID-19 pandemic(7.78 per 1000 births)compared to that before the pandemic(4.86 per 1000 births)(p<0.001).The birth prevalence of ASD and VSD significantly increased during the pandemic from 3.991 per 1000 births to 4.717 per 1000 births(p=0.008)and from 1.650 per 1000 births to 3.508 per 1000 births(p<0.001),respectively.Conclusions:The incidence of CHD increased during the COVID-19 pandemic,which was possibly related to the reallocation of medical resources,increased psychological pressure,and increased socioeconomic deprivation,though underlying mechanisms remain unclear.
基金College of Medicine and Public Health,MD,Advanced Studies ProgramAustralian National Health and Medical Research Council(NHMRC),Grant/Award Number:GNT2003683。
文摘The COVID-19 pandemic posed a challenge for clinical management of a new lung disease that was characterized by inflammation,endothelial cell dysfunction,and thrombosis,which occur after the replication phase of infection of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).There are many laboratory models of active SARS-CoV-2 infection in mice,reflecting an acute lung injury in an otherwise healthy animal,but there is a lack of accurate animal models of the postviral inflammatory phase of the COVID-19 lung reflecting severe disease.The monocrotaline(MCT)-treated rat is a widely used laboratory model of pulmonary hypertension(PH).Not often discussed,however,are the observed changes in inflammation,edema,fibrosis,and microthrombosis in the lung prior to PH.At the cellular level,there is loss of pneumocytes and endotheliopathy,and at the molecular level the MCT rat lung is characterized by a proinflammatory cytokine profile,namely elevated interleukin 6,transforming growth factorβand tumor necrosis factor,M1 macrophage phenotype,and dysregulation of the angiotensin converting enzyme(ACE)/ACE2 balance.The systems-level pathophysiology of the MCT-treated rat includes progressive cardiopulmonary dysfunction.The MCT-treated rat clearly differs from the COVID-19 lung in terms of the triggers for pathology,but there are many parallels apparent in both the MCT-treated rat and the COVID-19 lung.The MCT-treated rat lung as a model of the COVID-19 lung may provide an in-depth understanding of the factors that drive the lung to more severe pathology,treatments that benefit lung recovery,or the factors that prove a useful research platform for future emerging respiratory threats of similar pathology.
文摘Coronavirus is a Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused by a novel coronavirus belonging to the family Coronaviridae. The disease was first discovered in December 2019 in Wuhan City, Hubei Province, China. A few months later, the disease spread all over the world and became an epidemic. The infection for most people is mild to moderate but in Vulnerable groups, if they have the infections, they might experience severe COVID-19. Saudi Arabia initiated its response plan early, and all sectors and agencies worked in an integrated way to combat the disease. It has maintained proper communication during the pandemic and ensured community involvement, epidemiologic surveillance, and activation of rapid response teams. The COVID-19 pandemic significantly affected daily lives. Schools and daycares were closed, education was online, traveling stopped, work was suspended, gathering in social activities and practicing religious rituals, like praying or doing Umrah or Hajj, were banded. Changing lifestyles as a response to COVID-19 impacted whole communities with different categories of children, parents, and families. Women usually take the majority of daily responsibilities. The sudden change in lifestyle during COVID-19 put pressure on mothers, especially those who are working to balance work and family obligations. This study aims to identify the impact of Coronavirus disease 2019 on working mothers in Saudi Arabia. Method: Data of the study was collected through survey posted on social media and analyzed through Excel. It focuses on five aspects: health, lifestyle, social relations, work production and financial status. Our target population was working mothers in Saudi Arabia aged at least 25 years. Results: In this study, all factors affected working mothers categorized under two groups: Social Economic Status and Work suspension. For Social Economic Status factors, we find five factors which are monthly income, main breadwinner, number of children at school age, type of housing, and type of work. Almost all mothers include spiritual activities to their routine to cope with stress during this period. About half of our sample have negative impact on their mental health because they are the main breadwinner, and mothers with a smaller number of children at school age have more challenges to cope up. We found that mothers who own a house or work at governmental sector have better outcome of health. After analyzing data related to Work suspension, we found that mothers who have work support have better management for life circumstances, however their health outcomes were negatively affected. In addition, mothers working at education sector have the highest positive impact among other sectors. Our data shows that working mothers’ abilities to follow up with their children decreased. This study recommends that there is need to invest more in working mothers’ research and supportive programs and ensure collaboration globally to address working mothers’ needs and share experiences.
文摘目的系统评价重症监护病房(ICU)患者新型冠状病毒感染(COVID-19)相关肺曲霉病(CAPA)感染危险因素。方法计算机检索PubMed、Cochrane Library、Embase、Web of Science、中国知网(CNKI)、万方数据、维普数据库(VIP)中关于ICU患者CAPA感染危险因素的研究,检索时限均为建库至2025年3月31日。由2名研究者独立筛选文献与提取资料,采用纽卡斯尔-渥太华(NOS)量表进行质量评价,使用RevMan 5.4软件进行Meta分析。结果共纳入38篇观察性研究,包括11312例患者。Meta分析结果显示,男性、年龄、吸烟、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ评分)、简化急性生理学评分Ⅱ(SAPSⅡ评分)、肝硬化、糖尿病、慢性阻塞性肺疾病(COPD)、心血管疾病、EORTC/MSGERC宿主因素、实体器官移植、血液系统恶性肿瘤、长期使用糖皮质激素、免疫缺陷、Charlson合并症指数、使用血管活性药物和/或正性肌力药物、接受机械通气、侵入性机械通气、机械通气时间、肾脏替代治疗、白细胞介素-6(IL-6)抑制剂治疗等因素均为ICU患者CAPA感染危险因素。身体质量指数(BMI)高和肥胖均为ICU患者CAPA感染的保护性因素(均P<0.05)。结论ICU患者CAPA感染危险因素较多,及时识别相关危险因素有助于尽早实施规范的抗真菌治疗,从而改善患者预后。
基金by the National Natural Science Foundation of China(81870019)Guangdong Provincial Natural Science Foundation(2018A030313554)+2 种基金National Key R&D Program of China(2018YFC0910601)the National Medical Research Council,Singapore(NMRC/CIRG/1458/2016)a recipient of fellowship support from European Allergy and Clinical Immunology(EAACI)Research Fellowship 2019。
文摘An acute respiratory disease,caused by a novel coronavirus(SARS-CoV-2,previously known as 2019-nCoV),the coronavirus disease 2019(COVID-19)has spread throughout China and received worldwide attention.On 30 January 2020,World Health Organization(WHO)officially declared the COVID-19 epidemic as a public health emergency of international concern.The emergence of SARS-CoV-2,since the severe acute respiratory syndrome coronavirus(SARSCoV)in 2002 and Middle East respiratory syndrome coronavirus(MERS-CoV)in 2012,marked the third introduction of a highly pathogenic and large-scale epidemic coronavirus into the human population in the twenty-first century.As of 1 March 2020,a total of 87,137 confirmed cases globally,79,968 confirmed in China and 7169 outside of China,with 2977 deaths(3.4%)had been reported by WHO.Meanwhile,several independent research groups have identified that SARS-CoV-2 belongs toβ-coronavirus,with highly identical genome to bat coronavirus,pointing to bat as the natural host.The novel coronavirus uses the same receptor,angiotensin-converting enzyme 2(ACE2)as that for SARS-CoV,and mainly spreads through the respiratory tract.Importantly,increasingly evidence showed sustained human-tohuman transmission,along with many exported cases across the globe.The clinical symptoms of COVID-19 patients include fever,cough,fatigue and a small population of patients appeared gastrointestinal infection symptoms.The elderly and people with underlying diseases are susceptible to infection and prone to serious outcomes,which may be associated with acute respiratory distress syndrome(ARDS)and cytokine storm.Currently,there are few specific antiviral strategies,but several potent candidates of antivirals and repurposed drugs are under urgent investigation.In this review,we summarized the latest research progress of the epidemiology,pathogenesis,and clinical characteristics of COVID-19,and discussed the current treatment and scientific advancements to combat the epidemic novel coronavirus.
文摘Coronavirus disease 2019(COVID-19)is a contagious disease caused by severe acute respiratory syndrome coronavirus 2.It was declared a global pandemic on March 11,2020,by the World Health Organization.An excessive inflammatory response is a severe respiratory manifestation of COVID-19,which becomes predominant in later stages.Due to its immunosuppressive and anti-inflammatory properties,dexamethasone is the first systemic glucocorticoid to treat severe COVID-19 patients.This editorial reviews the efficacy and safety of highdose vs low-dose dexamethasone in patients with COVID-19.Findings indicate that using low-dose dexamethasone is beneficial and emphasize the need for additional research on the use of high-dose dexamethasone.While the study provides a robust evidence base,it is limited by the lack of long-term data,focus on specific outcomes and heterogeneity of the included studies.Future research should focus on the long-term effects of dexamethasone and its impact across varying disease severities and patient populations to refine treatment strategies and improve patient care.
基金supported by grants from the National Science and Technology Major Project of China(2018ZX10301202-003)the Collaboration and Innovation Health Care Major Project of Guangzhou(201803040013)。
文摘Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has spread rapidly around the world,posing a major threat to human health and the economy.Currently,long-term data on viral shedding and the serum antibody responses in COVID-19 patients are still limited.Herein,we report the clinical features,viral RNA loads,and serum antibody levels in a cohort of 112 COVID-19 patients admitted to the Honghu People’s Hospital,Hubei Province,China.Overall,5.36%(6/112)of patients showed persistent viral RNA shedding(>45 days).The peak viral load was higher in the severe disease group than in the mild group(median cycle threshold value,36.4 versus 31.5;P=0.002).For most patients the disappearance of IgM antibodies occurred approximately 4–6 weeks after symptoms onset,while IgG persisted for over 194 days after the onset of symptoms,although patients showed a 46%reduction in antibodies titres against SARS-CoV-2 nucleocapsid protein compared with the acute phase.We also studied18 asymptomatic individuals with RT-qPCR confirmed SARS-CoV-2 infection together with 17 symptomatic patients,and the asymptomatic individuals were the close contacts of these symptomatic cases.Delayed IgG seroconversion and lower IgM seropositive rates were observed in asymptomatic individuals.These data indicate that higher viral loads and stronger antibody responses are related to more severe disease status in patients with SARS-CoV-2 infection,and the antibodies persisted in the recovered patient for more than 6 months so that the vaccine may provide protection against SARS-CoV-2 infection.
文摘The mental health effects of the coronavirus disease 2019(COVID-19)pandemic may shape population health for many years to come.Failure to address the mental health issues stemming from the pandemic is likely to prolong its impact.The COVID-19 pandemic has created a significant global challenge and,in lower-income countries,even a disruption of mental health services.Given our experience with previous pandemics,the present COVID-19 crisis can be expected to cause psychological trauma,and steps are needed to address this issue proactively.Policies focusing on the long-term mental health consequences of COVID-19 may equal the importance of those currently seeking to mitigate its physical effects.The implications of the GOVID-19 pandemic for mental health call for a greater focus on the needs of those with mental disorders and on mental health issues affecting health care workers and the general public.Timely preventive and therapeutic mental health care is essential in addressing the psychosocial needs of populations exposed to the pandemic.In addition to specialist care,"task-shifting"and digital technologies may provide cost-effective means of providing mental health care in lower-income countries worldwide as well as in higher-income countries with mental health services overwhelmed by the effects of the COVID-19 pandemic.In view of the ever-increasing pressure on global health systems resulting from the COVID-19 pandemic,adopting and adapting"task-shifting",i.e.,the delegation of psychotherapeutic interventions to trained non-specialists,as an element of the provision of mental health services,is overdue.Digital technologies can be used to enhance social support and facilitate resilience to the detrimental mental health effects of the pandemic;they may also offer an efficient and cost-effective way to provide easy access to mentalhealth care.
文摘Severe pulmonary disease caused by the novel coronavirus[severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)],has devastated many countries around the world.It has overwhelmed the medical system.The priorities of many institutions have changed to manage critically ill corona virus infectious disease-2019(COVID-19)patients,which affected the working style of many departments.Hepatologists and transplant surgeons look after a very sensitive patient group.Patients with liver disease need special attention and continuous follow-up.Similarly,transplant candidates also need special care.Healthcare professionals in the field of hepatology face the overwhelming task of taking care of COVID-19 patients with hepatic complications,liver disease or transplant patients who are SARS-CoV-2 positive,and the patients on routine surveillance who do not have COVID-19.This review will evaluate COVID-19 from the perspective of its effect on the liver and its possible effects on patients with liver disease.Furthermore,the level of care for liver transplant recipients during the pandemic will be discussed.
文摘Coronavirus disease 2019(COVID-19)pandemic has proven to be tenacious and shows that the global commu nity is still poorly prepared to handling such emerging pandemics.Enhancing global solidarity in emergency preparedness and response,and the mobilization of conscience and cooperation,can serve as an excellent source of ideas and measures in a timely manner.The article provides an overview of the key components of risk communication and community engagement(RCCE)strategies at the early stages in vulnerable nations and populations,and highlight contextual recommendations for strengthening coordinated and sustainable RCCE preventive and emergency response strategies against COVID-19 pandemic.Global solidarity calls for firming govemance,abundant community participation and enough trust to boost early pandemic preparedness and response.Promoting public RCCE response interventions needs crucially improving government health systems and security proactiveness,community to individual confinement,trust and resilience solutions.To better understand population risk and vulnerability,as well as COVID-19 transmission dynamics,it is important to build intelligent systems for monitoring isolation/quarantine and tracking by use of artificial intelligence and machine learning systems algorithms.Experiences and lessons learned from the international community is crucial for emerging pandemics prevention and control programs,especially in promoting evidence-based decision-making,integrating data and models to inform effective and sustainable RCCE strategies,such as local and global safe and effective COVID-19 vaccines and mass immunization programs.
基金supported by the Project of International Expert Consultation for the National Occupational Health System Innovation funded by the Ministry of Science and Technology of China in 2020-2022(Grant No.G20200001489).
文摘Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China.Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China.This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China.The comprehensive measures in China can be summarized as‘6P-approach’:public health emergency response,prompt learning from lessons,proactive measures of occupational health,precaution strategies against occupational hazards,personal protective equipment and medical devices supply,and professional networking.Through this 6P-approach,China was able to minimize the incidence of COVID-19 infection among HWs,while successfully containing the outbreak dxuing the first quarter of 2020.Although the COVID-19 vaccines have been rolled out,however,the COVID-19 pandemic is still under rapidly evolving situation.Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.
文摘Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is considered the causative pathogen of coronavirus disease 2019(COVID-19)and has become an international danger to human health.Although respiratory transmission and symptoms are still the essential manifestations of COVID-19,the digestive system could be an unconventional or supplementary route for COVID-19 to be transmitted and manifested,most likely due to the presence of angiotensin-converting enzyme 2(ACE2)in the gastrointestinal tract.In addition,SARS-CoV-2 can trigger hepatic injury via direct binding to the ACE2 receptor in cholangiocytes,antibodydependent enhancement of infection,systemic inflammatory response syndrome,inflammatory cytokine storms,ischemia/reperfusion injury,and adverse events of treatment drugs.Gastrointestinal symptoms,including anorexia,nausea,vomiting,and diarrhea,which are unusual in patients with COVID-19,and some digestive signs may occur without other respiratory symptoms.Furthermore,SARS-CoV-2 can be found in infected patients’stool,demonstrating the likelihood of transmission through the fecal-oral route.In addition,liver function should be monitored during COVID-19,particularly in more severe cases.This review summarizes the evidence for extra-pulmonary manifestations,mechanisms,and management of COVID-19,particularly those related to the gastrointestinal tract and liver.
文摘The unprecedented healthcare demand due to sudden outbreak of coronavirus disease 2019 (COVID-19) pandemic has almost collapsed the health care systems especially in the developing world. Given the disastrous outbreak of COVID-19 second wave in India, the health system of country was virtually at the brink of collapse. Therefore, to identify the factors that resulted into breakdown and the challenges, Indian healthcare system faced during the second wave of COVID-19 pandemic, this paper analysed the health system challenges in India and the way forward in accordance with the six building blocks of world health organization (WHO). Applying integrated review approach, we found that the factors such as poor infrastructure, inadequate financing, lack of transparency and poor healthcare management resulted into the overstretching of healthcare system in India. Although health system in India faced these challenges from the very beginning, but early lessons from first wave should have been capitalized to avert the much deeper crisis in the second wave of the pandemic. To sum-up given the likely future challenges of pandemic, while healthcare should be prioritized with adequate financing, strong capacity-building measures and integration of public and private sectors in India. Likewise fiscal stimulus, risk assessment, data availability and building of human resources chain are other key factors to be strengthened for mitigating the future healthcare crisis in country.
文摘The purpose of this review is to identify prevalent trends and risk factors in depression,anxiety,and eating disorders in the adolescent population in the post coronavirus disease 2019(COvID-19)scenario.We examined the literature published on adolescent mental health since the COVID-19 pandemic.We chose to summarize studies published from 2019 to 2022,using bibliographic search tools.We developed criteria for selecting articles for our review using diagnostic indicators and keywords.Mental health conditions such as depression,anxiety and eating disorders are commonly prevalent in this population and have shown increasing rates in the past three years.Some risk factors associated with these diagnoses include reduction in social interaction,increased workloads,routine shifts,sleep quality,social media usage and parental involvement.Routines,sleep cycles,physical activity,and social media should all be considered as a part of prevention in this population.Approaches that seem to be successful include maintaining social ties and avoiding negative social media usage with harmful content.Increased global public awareness,as well as parental awareness,through media campaigns,is critical to slowing the spread of mental health challenges in adolescents and teenagers in the post-COvID-19 era.
