The aim of this study was to investigate the correlations between serum calcium and clinical outcomes in patients with coronavirus disease 2019 (COVID-19). In this retrospective study, serum calcium levels, hormone levels and clinical laboratory parameters on admission were recorded. The clinical outcome variables were also recorded. From February 10 to February 28, 2020, 241 patients were enrolled. Of these patients, 180 (74.7%) had hypocalcemia on admission. The median serum calcium levels were 2.12 (IQR, 2.04-2.20) mmol/L, median parathyroid hormone (PTH) levels were 55.27 (IQR, 42.73-73.15) pg/mL, and median 25-hydroxyvitamin D (VD) levels were 10.20 (IQR, 8.20-12.65) ng/mL. The serum calcium levels were significantly positively correlated with VD levels (P =0.004) but negatively correlated with PTH levels (P =0.048). Patients with lower serum calcium levels (especially ≤2.0 mmol/L) had worse clinical parameters, higher incidences of organ injury and septic shock, and higher 28-day mortality. The areas under the receiver operating characteristic curves of multiple organ dysfunction syndrome, septic shock, and 28-day mortality were 0.923 (P <0.001), 0.905 (P =0.001), and 0.929 (P <0.001), respectively. In conclusion, serum calcium was associated with the clinical severity and prognosis of patients with COVID-19. Hypocalcemia may be associated with imbalanced VD and PTH levels.

The underlying reasons behind the unprecedented increase of the mortality rates due to the opioid epidemics in the United States are still not fully uncovered. Most efforts have been focused on targeting opioids, but there is little information about vulnerable populations at high risk of opioid abuse and death. In this study, we used data from the Ohio Department of Health for deaths caused by prescription opioids from 2010-2017 to analyze the spatiotemporal dynamics of the opioid overdose epidemic. Our results showed a rapid increase in prescription opioid death rates among the white male population aged 30-39 but also a considerable increase among the black male population with an exponential growth trend. Our geospatial analysis suggests that the increasing rates of the opioid overdose epidemic in Ohio were driven by the epidemic hotspot areas. Our findings highlight the relevance of prioritizing public health measures targeting specific locations and vulnerable populations to mitigate the current opioids crisis.The United States (US) is currently experiencing an opioid overdose crisis with an unprecedented magnitude. Adjusted for age, the opioid-related death rate of 21.7 deaths per 100,000 people in 2017, and 20.7 in 2018 were the highest worldwide 1 . According to the Centers for Disease Control and Prevention (CDC), 67,367 deaths by drug overdose occurred in the US during 2018, and 351,564 deaths were related to opioids resulting in 0.36 years of life expectancy lost in 2016 1,2 . The major cause of death among people under 50 years old in the US in 2017 was drug overdose, exceeding the rates of death caused by motor vehicle and firearms 3 . Opioids have become a widespread cause of accidental fatal overdose, which historically were attributed to heroin and prescription opioid pain relievers. Recent reports show that overdoses caused by synthetic opioids (e.g., fentanyl and analogues) are emerging as a national public health emergency, as declared by the US Department of Health and Human Services in 2018 4 .National data on opioid overdose mortality rates show that the epidemic is not homogenously distributed within the US. Twenty states and the District of Columbia have reported age-adjusted drug mortality rates that are statistically higher than the national rate. Among these, West Virginia (51.5 deaths per 100,000 inhabitants), Delaware (43.8), Maryland (37.2), Pennsylvania (36.1.3), Ohio (35.9), and New Hampshire (35.8) had the highest age-adjusted drug overdose rates in 2018 1 . Moreover, Ohio is one of eight states with a doubling of the opioid mortality rate every three years from 1999 to 2016, and recently has experienced an unprecedented number of deaths caused by unintentional drug overdose, especially deaths caused by synthetic opioids 2,5 . Specifically, there was a 169% increase from 1,544 deaths in 2010 to 4,157 deaths in 2017, and approximately 13,000 overdose events reversed by the use of naloxone.Several reasons are attributed to the geographical disparity of the opioid overdose mortality...

Self-rated health (SRH) has been shown to be a good predictor of mortality. Data on SRH and its associated factors in the Chinese general population are limited. This study aims to assess the epidemiology of SRH in rural Anyang, China. SRH (categorized as “healthy”, “fair” or “unhealthy”) was measured in a population-based study of 2,814 adults (including 697 couples) aged 25 to 69 who were recruited from rural Anyang in 2014. Of 2,814 subjects, 63.1% rated their health as “healthy”, whereas 28.1% and 8.8% rated their health as “fair” and “unhealthy”. Compared to males, females had a higher likelihood of reporting a better SRH. Health ratings declined with increasing age, unmarried status, lower education levels. Poor SRH was positively correlated with medical history as well as high levels of fasting plasma glucose and total cholesterol, but not with unhealthy lifestyle indicators including smoking, drinking, and obesity. High household income was predictive of better SRH in men but not in women. Among couples, a positive spousal SRH concordance was observed, although the strength of this concordance was low. These findings will be useful for formulation of appropriate strategies for improving risk perception and promoting general health in economically developing regions.