The outbreak of 2019 novel coronavirus disease (COVID-19) caused not only extraordinary public health concerns but also tremendous psychological distress. 1 Soon after the COVID-19 outbreak, the Chinese government has activated level 1 health emergency responses and Wuhan was locked down on January 23, 2020. During the quarantine period, cancer patients represented a significant vulnerable population confronting with high risk of infection and poorer outcomes after infection. 2-4 Public emotional impacts and psychological response have drawn increasing attention of researchers during the COVID-19 epidemic. However, most studies have focused on the mental health situations of general population or medical staff. 5,6 No study has yet specifically examined the psychological influence of COVID-19 in cancer patients, particularly cancer patients in the initial epicenter of this pandemic. Therefore, we conducted a survey to study the psychological impacts of COVID-19 epidemic on cancer patients in Wuhan, the epicenter of the epidemic in China. Fear of disease progression and psychological stress were investigated by analyzing the data on selfreport questionnaires of Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) from cancer patients, and correlated factors were also explored to help us set up potential appropriate interventions. 2 | METHODS 2.1 | Procedure and data collection Cancer patients from our cancer institute were contacted by their doctors-in-charge and were asked to respond to an Internet-based survey. Demographic data (gender, age, marriage status, reproductive history, educational level, income, concern degree about COVID-19 outbreak, cancer type, co-morbidity, living style, and impact of COVID-19 outbreak on cancer treatment), scores of FoP-Q-SF, SAS, and SDS were collected from April 15 to 17, 2020. A basic description of the three questionnaires was provided in the Supplementary Information. 2.2 | Statistical analyses Mann-Whitney U test or Kruskal-Wallis H test was used to compare quantitative variables between groups. Factors with univariate P < .05 or clinical factors that may have significance were included in the multiple linear regression model. The statistical analyses were undertaken using SPSS Statistics Version 25. All tests were two-tailed, and a P < .05 was considered statistically significant. 2.3 | Ethical issues The study was approved by the Ethics Committee of Zhongnan Hospital of Wuhan University (2020089K). Informed consent was Gaili Chen, Qiuji Wu, and Huangang Jiang are co-first authors.
A highly stable copper(II) microporous framework with cylindrical channels constructed from 1,4-di(1H-imidazol-4-yl)benzene (H(2)L) and CuCl(2)·2H(2)O is composed of Cu(II)-imidazolate tubes interconnected by the 1,4-phenylene group of L(2-), and shows temperature dependent selective gas sorption properties.
Background So far, there have been no published population studies on the relationship between a COVID-19 infection and public risk perception, information source, knowledge, attitude, and behaviors during the COVID-19 outbreak in China. Objective This study aims to understand the relationships between COVID-19 infection; four personal nonpharmaceutical interventions (NPIs; handwashing, proper coughing habits, social distancing, and mask wearing); and public risk perception, knowledge, attitude, and other social demographic variables. Methods An online survey of 8158 Chinese adults between February 22 and March 5, 2020, was conducted. Bivariate associations between categorical variables were examined using Fisher exact test. We also explored the determinants of four NPIs as well as their association with COVID-19 infection using logistic regression. Results Of 8158 adults included, 57 (0.73%) were infected with COVID-19. The overwhelming majority of respondents showed a positive attitude (n=8094, 99.2%), positive risk perception (n=8146, 99.9%), and high knowledge levels that were among the strongest predictors of the four adopted NPIs (handwashing: n=7895, 96.8%; proper coughing: 5997/6444, 93.1%; social distancing: n=7104/8158, 87.1%; and mask wearing: 5011/5120, 97.9%). There was an increased risk of COVID-19 infection for those who did not wash their hands (2.28% vs 0.65%; risk ratio [RR] 3.53, 95% CI 1.53-8.15; P=.009), did not practice proper coughing (1.79% vs 0.73%; RR 2.44, 95% CI 1.15-5.15; P=.03), did not practice social distancing (1.52% vs 0.58%; RR 2.63, 95% CI 1.48-4.67; P=.002), and did not wear a mask (7.41% vs 0.6%; RR 12.38, 95% CI 5.81-26.36; P<.001). For those who did practice all other three NPIs, wearing a mask was associated with a significantly reduced risk of infection compared to those who did not wear a mask (0.6% vs 16.7%; P=.04). Similarly, for those who did not practice all or part of the other three NPIs, wearing a mask was also associated with a significantly reduced risk of infection. In a penalized logistic regression model including all four NPIs, wearing a mask was the only significant predictor of COVID-19 infection among the four NPIs (odds ratio 7.20, 95% CI 2.24-23.11; P<.001). Conclusions We found high levels of risk perception, positive attitude, desirable knowledge, as well as a high level of adopting the four NPIs. The relevant knowledge, risk perception, and attitude were strong predictors of adapting the four NPIs. Mask wearing, among the four personal NPIs, was the most effective protective measure against COVID-19 infection, with added preventive effect among those who practiced all or part of the other three NPIs.
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