Chenyuan Qin

Long COVID-19 has emerged as a growing global public health challenge requiring patient-centred responses, yet its prevalence and management are often underestimated. We aimed to investigate the rehabilitation status and medical choice behaviours among patients with long COVID-19 in China during the Omicron wave. We conducted a national cross-sectional study and a discrete choice experiment (DCE) in China from 4 July to 11 August 2023. We used the modified COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm) to assess rehabilitation status. We collected preferences for medical choice behaviours of long COVID-19, demographics, health-related factors, and COVID-19 history. We assessed preferences for medical choice behaviours among people with long COVID-19 using mixed logit models. Among 2942 participants health status was significantly poorer than before COVID-19 infection. The prevalence of common symptoms assessed by C19-YRSm ranged from 21.52% to 72.67%, with fatigue (72.67%) being the most common, followed by breathlessness on walking up a flight of stairs (64.96%) and sleep problems (62.95%). Of these symptoms, the majority of participants (15.06-47.65%) reported mild problems. Of the five functional limitations, difficulty with other activities of daily living (31.03%) was the most common, followed by difficulty with communication (28.04%), while difficulty with personal care (9.65%) was the least common. The DCE results showed that the strongest attribute affecting preferences was medical distance (β = -1.135). While seeking healthcare for long COVID-19, people preferred lower out-of-pocket costs, a closer distance, a higher hospital level, nutritional supportive therapies or rehabilitation training, and medical services that integrate traditional Chinese and Western medicine. A substantial proportion of individuals developed long COVID-19 symptoms and functional limitations, most of which were mild. These findings highlight the importance of ongoing screening and comprehensive, tailored rehabilitation services to promote recovery and avert a public health crisis of long COVID-19.

Meteorological factors are known to influence the transmission of infectious diseases. Studying historical epidemics in ancient China provides valuable insights into how environmental stressors shaped public health, with implications for modern disease control. We aimed to quantitatively assess the relationship between meteorological events and epidemic severity in China from 674 BC to 1911 AD. We extracted data from 'A Compendium of Chinese Meteorological Records of the Last 3000 Years'. We digitised epidemic events, consequences, and associated meteorological conditions and categorised them into ordinal levels. We used descriptive statistics and multivariable logistic regression to analyse annual patterns and associations across historical periods. We identified 5338 epidemic-related records. While the number of reported epidemics increased over time, the proportion associated with meteorological events declined by 0.24% (95% confidence interval (CI) = 0.17-0.31) per decade between 1451 and 1911. Flood frequency was associated with higher epidemic severity: each additional flood increased the odds of moderate (vs. mild) consequences by 42% (95% CI = 8-87) and severe (vs. moderate) consequences by 46% (95% CI = 12-91). Droughts similarly raised the risk of severe consequences by 23% (95% CI = 7-41). Famines were also linked with heightened epidemic severity and were among the most commonly co-reported meteorological events, along with drought. As global climate intensifies, the historical relationship between environmental stressors and epidemic severity offers crucial lessons for modern public health. Regions vulnerable to climate extremes may require targeted, climate-informed epidemic preparedness and response strategies.

Background: Influenza is a significant global respiratory infection, and vaccinating reproductive-age women, particularly in densely populated countries like China, cannot be overlooked. In this study, we aimed to determine influenza vaccination coverage, vaccine hesitancy, as well as associated factors among Chinese women aged 18–49 years old. Methods: A cross-sectional survey among women aged 18–49 years was conducted in China from 15 to 30 March 2023. We collected information such as past-year influenza vaccination, demographic characteristics, health-related factors, COVID-19-related factors, and perceived susceptibility and severity of influenza. Influenza vaccine acceptance among participants who did not receive influenza vaccination in the past year was also investigated. Multivariable logistic regression analyses were employed to investigate the influencing factors of vaccine coverage and vaccine hesitancy. Results: A total of 1742 reproductive-aged women were included in the final analysis. The past-year influenza vaccine coverage among women aged 18–49 years old was only 39.32% in China. Age ≥ 35 years (aOR = 0.72, 95% CI: 0.56–0.94), renting accommodation (aOR = 0.57, 95% CI: 0.44–0.75), and history of COVID-19 infection (aOR = 0.65, 95% CI: 0.47–0.89) and COVID-19 vaccine hesitancy (aOR = 0.39, 95% CI: 0.29–0.54) were all identified as negative correlates of influenza vaccine coverage among Chinese reproductive-aged women, while participants with a history of chronic diseases (aOR = 1.57, 95% CI: 1.23–2.01) and noticeable pandemic fatigue due to COVID-19 (aOR = 1.45, 95% CI: 1.05–2.00) were prone to have higher vaccination rates. Among reproductive-aged women who did not receive influenza vaccination in the past year, the hesitancy rate regarding future influenza vaccination was 31.79%. Factors such as older age, urban residence, living with others, poor self-rated health status, absence of chronic diseases, completion of full COVID-19 vaccination, COVID-19 vaccine hesitancy, pandemic fatigue, and failure to perceive the susceptibility and severity of influenza might increase influenza vaccine hesitancy. Discussion: Overall, a lower coverage rate of influenza vaccine was notably observed among Chinese reproductive-age women, as well as the hesitancy regarding future vaccination. To effectively mitigate the impact of influenza and reduce the incidence of associated diseases, it is imperative to devise targeted intervention strategies and policies tailored to reproductive-age women.

Objectives To estimate the interaction between economic status (ES) and healthy lifestyle in long COVID among Chinese older people infected with SARS-CoV-2. Design A cross-sectional study based on the Peking University Health Cohort in Anning, Yunnan. Setting All primary health institutions in Anning, Yunnan Province, China, from April to May 2023. Participants A total of 4804 people aged 60 and older infected with SARS-CoV-2 were included in this study. Primary and secondary outcome measures Long COVID was measured by participants’ self-reported symptoms using structured questionnaires. ES was measured by last-month personal income, and participants’ ES was defined as low if their income was below the per capita monthly income of local residents. Lifestyle score was equal to the number of healthy behaviours (including smoking, drinking, weight, exercise and diet) and grouped using the median score as the cut-off point. Univariate and multivariate logistic models were employed to estimate the association of ES with long COVID. Interaction between ES and lifestyle in long COVID was assessed by multiplicative interaction term. Results We enrolled a total of 4804 participants infected with SARS-CoV-2, of whom 57.3% (2754 of 4804) had at least one long COVID symptom. Fatigue (1546, 56.1%), cough (1263, 45.9%) and muscle pain (880, 32.0%) were the top three common symptoms. Patients with low ES had a 48% (adjusted OR: 1.48; 95% CI 1.22, 1.82) increased risk of long COVID. A significant interaction was observed between ES and lifestyle (p value for interaction Conclusion The interaction between ES and healthy lifestyle in long COVID was prominent. Comprehensive strengthened economic support for patients recovering from COVID-19, especially for those with low healthy lifestyle, should be implemented to prevent and manage long COVID symptoms.

The pandemic of coronavirus disease 2019 (COVID-19) has posed a significant impact on global public health, particularly old adults who were more vulnerable to severe illness and complications following COVID-19 infection [1]. Although survivors recovered from the acute phase of COVID-19, many of them were facing various ongoing symptoms, which were defined as post-COVID-19 condition […]

Maternal infections encompass a wide range of conditions, such as urinary tract infections, chorioamnionitis, cervicitis, and postpartum uterine infections, which may lead to severe complications, including sepsis, multi-organ failure, and even death [1]. Maternal sepsis is defined as a life-threatening condition characterised by organ dysfunction resulting from infection during pregnancy, childbirth, postpartum, and post-abortion [2,3]. […]

Malaria remains a major public health challenge which impacts people’s health and livelihoods worldwide, despite being preventable and curable. According to the World Health Organization (WHO), an estimated 247 million malaria cases occurred in 84 malaria-endemic countries in 2021 compared to 245 million in 2020, with most of this increase coming from African countries [1]. […]

At present, the COVID-19 pandemic is still ongoing globally and the virus is constantly mutating. The herd immunity barrier established by past infections or vaccinations is gradually weakening and reinfections are occurring. To evaluate the pandemic fatigue and vaccine hesitancy among people who have recovered from COVID-19 in the post-pandemic era, we conducted an anonymous cross-sectional survey study in China from 4 July to 11 August 2023, nearly 6 months after the last large-scale nationwide infection. Basic sociodemographic characteristics, health-related factors (smoking, drinking, and chronic disease history), COVID-19 vaccination history, and self-reported long COVID were obtained as potential covariates. A series of logistic regression models were performed to examine the association between pandemic fatigue and vaccine hesitancy toward the next dose of COVID-19 vaccines via crude relative risks (cORs) and adjusted relative risks (aORs) with 95% CIs. According to our results, of the 2942 participants, 1242 (42.2%) were hesitant (unwilling or not sure) to receive the next dose of COVID-19 vaccines. The average score on the Pandemic Fatigue Scale was 21.67 ± 8.86, in which the scores of all items in the vaccine-hesitant group were significantly higher than those in the vaccine-accepting group. Additionally, the higher the pandemic fatigue level among people who have recovered from COVID-19, the more likely they were to be hesitant to receive the next dose of the COVID-19 vaccines (moderate: aOR = 2.94, 95% CI: 2.46–3.53; high: aOR = 6.88, 95% CI: 5.49–8.64). Overall, more than 40% of the recovered participants were unwilling or uncertain about the next vaccine dose, with varying degrees of pandemic fatigue. Pandemic fatigue is a potentially relevant factor for vaccine hesitancy and may hinder the translation of vaccination intention into behavior. Considering the ongoing reinfection situation, implementing a health education plan to reduce pandemic fatigue and prioritizing vaccination issues for people who have recovered from COVID-19 may be key to promoting the reduction of the COVID-19 disease burden and ensuring the health and well-being of the population.

Due to significant economic burden and disability from ischaemic stroke and the relationship between ischaemic stroke and SARS-CoV-2 infection, we aimed to explore the cost-effectiveness of the two-dose inactivated COVID-19 vaccination program in reducing the economic burden of ischaemic stroke after SARS-CoV-2 infection. We constructed a decision-analytic Markov model to compare the two-dose inactivated COVID-19 vaccination strategy to the no vaccination strategy using cohort simulation. We calculated incremental cost-effectiveness ratios (ICERs) to evaluate the cost-effectiveness and used number of the ischaemic stroke cases after SARS-CoV-2 infection and quality-adjusted life-years (QALYs) to assess effects. Both one-way deterministic sensitivity analysis and probabilistic sensitivity analysis were performed to assess the robustness of the results. We found that the two-dose inactivated vaccination strategy reduced ischaemic stroke cases after SARS-CoV-2 infection by 80.89% (127/157) with a USD 1.09 million as vaccination program cost, saved USD 3675.69 million as direct health care costs and gained 26.56 million QALYs compared with no vaccination strategy among 100,000 COVID-19 patients (ICER < 0 per QALY gained). ICERs remained robust in sensitivity analysis. The proportion of older patients and the proportion of two-dose inactivated vaccination among older people were the critical factors that affected ICER. This study suggests the importance of COVID-19 vaccination is not only in preventing the spread of infectious diseases, but also in considering its long-term value in reducing the economic burden of non-communicable diseases such as ischaemic stroke after SARS-CoV-2 infection.