Background: Coronavirus Disease 2019 (COVID-19) is currently a global public health threat. Outside of China, Italy is one of the countries suffering the most with the COVID-19 epidemic. It is important to predict the epidemic trend of the COVID-19 epidemic in Italy to help develop public health strategies. Methods: We used time-series data of COVID-19 from Jan 22 2020 to Apr 02 2020. An infectious disease dynamic extended susceptible-infected-removed (eSIR) model, which covers the effects of different intervention measures in dissimilar periods, was applied to estimate the epidemic trend in Italy. The basic reproductive number was estimated using Markov Chain Monte Carlo methods and presented using the resulting posterior mean and 95% credible interval (CI). Hunan, with a similar total population number to Italy, was used as a comparative item. Results: In the eSIR model, we estimated that the mean of basic reproductive number for COVID-19 was 4.34 (95% CI, 3.04-6.00) in Italy and 3.16 (95% CI, 1.73-5.25) in Hunan. There would be a total of 182 051 infected cases (95%CI:116 114-274 378) under the current country blockade and the endpoint would be Aug 05 in Italy. Conclusion: Italy's current strict measures can efficaciously prevent the further spread of COVID-19 and should be maintained. Necessary strict public health measures should be implemented as soon as possible in other European countries with a high number of COVID-19 cases. The most effective strategy needs to be confirmed in further studies.

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Background: The discipline of anaesthesiology in China has undergone historical changes and development during the past century. However, nationwide comprehensive data on the current status of each hospital department providing anaesthesia care has been lacking since the discipline was first established in China. This information is essential for effective regulation of healthcare policies by both the professional associations and the government health ministry. Therefore, a nationwide survey was set up in 2018 to investigate the current status of Chinese anaesthesiology. This paper reports the findings of the survey. Methods: We performed a cross-sectional nationwide census survey of the current status of each hospital department providing anaesthesia care in 31 provinces across the Chinese mainland. The content of the survey included general information of the department, the hospital level and scale, the volume of the anaesthesiology department, the characteristics of anaesthesiologists, and the caseload of the anaesthesiology departments. Face-to-face interviews were performed by trained interviewers. The Chinese Anaesthesiology Department Tracking Database (CADTD) was established during the survey. Data quality control was undertaken by the investigation committee throughout the survey process. Findings: The nationwide census survey was completed by 11,432 hospital departments providing anaesthesia care throughout mainland China from June 1, 2018 to June 30, 2019. Among the 11,432 departments, 4591 (40 • 16%) belonged to specialised hospitals, while 6841 (59 • 84%) were affiliated to general hospitals. The proportion of independent anaesthesiology departments was 45 • 15% in mainland China. There was a total of 92,726 anaesthesiologists, or 6 • 7 per 10 0,0 0 0 of the population. Regions with better economic conditions had more anaesthesiologists per 10 0,0 0 0 of the population. From 2015 to 2017, the workload of anaesthesiologists has increased by 10%. Interpretation: The discipline of anaesthesiology in China has entered a rapid development phase. However, the current status of anaesthesiology is not well defined, which makes it difficult to meet the needs of the increasing Chinese healthcare demand. The evidence from this survey offers valuable information for policy makers and anaesthesiology associations to monitor the development of the discipline and regulate healthcare policies effectively.

Introduction This study aimed to determine whether there is a difference in the risk of death/critical illness between different stages of hepatitis B virus (HBV) (resolved hepatitis B, HBeAg (−) chronic hepatitis B [CHB]/infection, HBeAg (+) CHB/infection, and HBV reactivation) coinfected with coronavirus disease 2019 (COVID-19); and if there is a difference, whether it is due to abnormal liver function and to what extent. Methods This cohort study included all COVID-19 inpatients of a single-center tertiary care academic hospital in Wuhan, Hubei, China, between February 4, 2020, and follow-up to April 14, 2020. A total of 2899 patients with COVID-19 were included as participants in this study, and they were divided into five groups based on hepatitis B infection status. Follow-up was conducted for mortality and ICU admission during hospitalization. Results The median follow-up time was 39 days (IQR, 30–50), with 66 deaths and 126 ICU admissions. After adjustment, compared with patients without CHB, the hazard ratio (HR) for ICU admission was 1.86 (95% CI: 1.05–3.31) for patients with HBeAg (+) CHB/infection. The HR for death was 3.19 (95% CI: 1.62–6.25) for patients with HBeAg (+) CHB/infection. The results for the mediating effect indicated that the total effect of HBeAg (+) CHB/infection on death/ICU stay was partially mediated by abnormal liver function, which accounted for 79.60% and 73.53%, respectively. Conclusion Patients with COVID-19 coinfected with HBV at the HBeAg (+) CHB/infection stage have an increased risk of poor prognosis, and abnormal liver function partially mediates this increased risk of poor prognosis caused by the coinfection. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-022-00638-4.

Background: As evidence on depression and health-related quality of life (HRQoL) among the oldest-old is currently limited, this study aimed to re-examine the association between depression and HRQoL among centenarians. Methods:We analyzed cross-sectional data from the China Hainan Centenarian Cohort Study (CHCCS). The 15-item Geriatric Depression Scale (GDS-15) and three-level EuroQol five-dimensions (EQ-5D-3L) were used to evaluate depression and HRQoL, respectively. Poor health states were defined as EQ-5D index <0.665. Based on their GDS-15 score, individuals were categorized into three stages of depression: major depressive disorder (MDD; score ≥10), minor depressive disorder (MnDD; score between 6 and 9), and normal (score ≤5). Based on sex and comorbidity stratification, multivariable logistic regression was used to calculate the risk of poor health state in different levels of depression. We also used restricted cubic splines with a knot at 5 points (GDS-15) to flexibly model the association of GDS-15 scores with poor health states.Results: Totally, 1,002 participants were included in this study for analysis. Participants' median age was 102 years, and 82.04% were female. The median EQ-5D index was 0.68 (range: −0.149-1), and the mean VAS and GDS-15 scores were 61.60 (range: 0-100), and 5.23 (range: 0-15), respectively. Centenarians with MnDD and MDD accounted for 38.12 and 9.98%, respectively. While those with poor health states accounted for 45.11%. For every 1-point increase in GDS-15, the risk of poor health state increased by 20% (P < 0.001) after an adjustment for age, gender, ethnicity, marital status, education, residence type, smoking, drinking, weekly exercise, body mass index category, serum albumin, 25-hydroxyvitamin D, C-reactive protein, and comorbidities. MnDD and MDD were independent risk factors for poor health state (MnDD, OR = 2.76, P < 0.001; MDD, OR = 3.14, P < 0.001). The association was more prominent in centenarians without comorbidity.Conclusions: This study demonstrated a negative association between depression and HRQoL in Chinese centenarians, especially in centenarians without comorbidity. Large-scale prospective studies are needed to corroborate our findings and provide more information about the causal inference and internal mechanisms of this association.

Background and aims: Patients with multiple metabolic diseases are at high risk for the occurrence and death of COVID-19. Little is known about patients with underweight and metabolically healthy obesity. The aim of this study is to evaluate the impact of BMI and COVID-19 mortality in hospitalized patients, and also explore the association in different metabolically healthy (MHS) and unhealthy status (MUS). Methods and results: A retrospective cohort study based on 3019 inpatients from Wuhan was conducted. Included patients were classified into four groups according the BMI level (underweight, normal weight, overweight and obesity), and patients with at least one of the metabolic abnormalities (diabetes, hypertension, dyslipidemia) was defined as MUS. Multiple Cox model was used to calculate the hazard ratio (HR). Compared to patients with normal weight, the HRs of overweight and obesity for COVID-19 mortality were 1.91 (95%CI:1.02e3.58) and 2.54 (95%CI:1.22e5.25) respectively in total patients, and 2.58 (95%CI:1.16e5.75) and 3.89 (95% CI:1.62e9.32) respectively in the elderly. The HR of underweight for COVID-19 mortality was 4.58 (95%CI:1.56e13.48) in the elderly. For different metabolic statuses, both underweight, overweight and obesity had obviously negative association with COVID-19 mortality in total and elderly patients with MUS. However, no significance was found in non-elderly and patients with MHS. Conclusion: Not only overweight or obesity, but also underweight can be associated with COVID-9 mortality, especially in the elderly and in patients with MUS. More large-scale studies are needed for patients with underweight and metabolically healthy overweight or obesity.

Objective: To evaluate the combined effects of anemia and cognitive function on the risk of all-cause mortality in oldest-old individuals.Design: Prospective population-based cohort study.Setting and Participants: We included 1,212 oldest-old individuals (men, 416; mean age, 93.3 years).Methods: Blood tests, physical examinations, and health questionnaire surveys were conducted in 2012 were used for baseline data. Mortality was assessed in the subsequent 2014 and 2018 survey waves. Cox proportional hazards models were used to evaluate anemia, cognitive impairment, and mortality risk. We used restricted cubic splines to analyze and visualize the association between hemoglobin (Hb) levels and mortality risk.Results: A total of 801 (66.1%) deaths were identified during the 6-year follow-up. We noted a significant association between anemia and mortality (hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.14–1.54) after adjusting for confounding variables. We also observed a dose-response relationship between the severity of anemia and mortality (P &lt; 0.001). In the restricted cubic spline models, Hb levels had a reverse J-shaped association with mortality risk (HR 0.88, 95% CI 0.84–0.93 per 10 g/L-increase in Hb levels below 130 g/L). The reverse J-shaped association persisted in individuals without cognitive impairment (HR 0.88, 95% CI 0.79–0.98 per 10 g/L-increase in Hb levels below 110 g/L). For people with cognitive impairment, Hb levels were inversely associated with mortality risk (HR 0.83, 95% CI 0.78–0.89 per 10 g/L-increase in Hb levels below 150 g/L). People with anemia and cognitive impairment had the highest risk of mortality (HR 2.60, 95% CI 2.06–3.27).Conclusion: Our results indicate that anemia is associated with an increased risk of mortality in oldest-old people. Cognitive impairment modifies the association between Hb levels and mortality.