Startseite Impact of omicron wave and associated control measures in Shanghai on health management and psychosocial well-being of patients with chronic conditions
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Impact of omicron wave and associated control measures in Shanghai on health management and psychosocial well-being of patients with chronic conditions

  • Zhimin Xu , Gabriela Lima de Melo Ghisi , Xia Liu , Lixian Cui und Sherry L. Grace EMAIL logo
Veröffentlicht/Copyright: 28. März 2023
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Open Medicine
Aus der Zeitschrift Open Medicine Band 18 Heft 1

Abstract

The objective of this cross-sectional study was to investigate health management, well-being, and pandemic-related perspectives of chronic disease patients in the context of stringent measures, and associated correlates. A self-report survey was administered during the Omicron wave lockdown in Shanghai, China. Items from the Somatic Symptom Scale (SSS) and Symptom Checklist-90 were administered, as well as pandemic-related items. Overall, 1,775 patients (mostly married females with hypertension) were recruited through a community family physician group. Mean SSS scores were 36.1 ± 10.5/80, with 41.5% scoring in the elevated range (i.e., >36). In an adjusted model, being female, diagnosis of coronary artery disease and arrhythmia, perceived impact of pandemic on life, health condition, change to exercise routine, tolerance of control measures, as well as perception of future and control measures were significantly associated with greater distress. One-quarter perceived the pandemic had a permanent impact on their life, and 44.1% perceived at least a minor impact. One-third discontinued exercise due to the pandemic. While 47.6% stocked up on their medications before the lockdown, their supply was only enough for two weeks; 17.5% of participants discontinued use. Chief among their fears were inability to access healthcare (83.2%), and what they stated they most needed to manage their condition was medication access (65.6%). Since 2020 when we assessed a similar cohort, distress and perceived impact of the pandemic have worsened. Greater access to cardiac rehabilitation in China could address these issues.

Keywords: COVID-19; psychological distress; adaptation; psychological; mental health; self-management; chronic disease; surveys and questionnaires

1 Introduction

The coronavirus disease (COVID-19) pandemic, with its many unpredictable waves, has resulted in major negative impacts on economies, health systems, and citizens worldwide [1,2]. While the impact of COVID-19 on the health of all people has been of major concern, it has been a particular concern for those at higher risk of severe outcomes. This includes notably patients with chronic conditions, such as cardiovascular diseases (CVD). For instance, hospitalization rates and mortality rates are much higher in this population; in the United States alone, chronic diseases account for 75% of aggregate healthcare spending and are responsible for 7 out of 10 deaths [3]; in China, the deaths caused by chronic diseases account for 87% of total deaths [4].

Measures to control infection spread, such as physical distancing often necessitating closure of essential businesses [5], as well as diversion of healthcare resources for COVID-19 [6], have also had a negative impact. In the general population, this has resulted in reduced access to care [7] as well as increases in mental health conditions [8]. Despite their greater risk, there is only limited study of the impacts of the pandemic and associated control measures on the psychosocial well-being and self-management of patients with chronic conditions; we identified some abstracts only to date [9,10].

Government policy varies worldwide in terms of implementation of infection prevention and control measures. Based on the COVID-19 stringency index, such strategies are among the most stringent in China [11]. For example, in one of the world’s most populous cities of Shanghai, a strict “closed-loop” control system has been enforced. This involves home isolation except for medical reasons, with extra-household interpersonal contact and outdoor time forbidden, and transactions quickly moving online. This caused residents to become anxious and unsettled [12].

Given these unprecedented circumstances, assessment of the impacts of these strict control measures on chronic disease patients is needed, particularly in the context of some of the most stringent control measures globally, in one of the most densely populated cities in the world where risk of transmission is hence greater [13,14], and 2 years into the pandemic when these patients have thus been coping with isolation, economic impacts, as well as changed and inconvenient access to care and treatments for a prolonged period – specifically during the Omicron wave in Shanghai. Therefore, the objective of this study was to assess these impacts in terms of (1) psychosocial well-being, (2) health management, and (3) perceptions related to the pandemic and associated control measures. The associations of their health/well-being with the perceived impact of the pandemic on their health were also tested, as were the association of pandemic-related attitudes with psychological well-being.

2 Methods

2.1 Design and procedure

Study approval was secured from the Ethics Committee of Xinhua Hospital, affiliated with Shanghai Jiaotong University School of Medicine (XHEC-C-2022-042). The anonymous online survey in Simplified Chinese was created by the Cardiac Rehabilitation (CR) group, Health Risk Assessment and Control of the Chinese Preventive Medical Association. Data collection for this cross-sectional study was undertaken between March and June 2022. It was distributed via Wenjuanxing by family doctors who belonged to the Community Physician group of the Psychosomatic Medicine Special Committee of the Shanghai Association of Integrated Chinese and Western Medicine; this group cooperates closely with the Chinese Preventive Medical Association.

2.2 Setting and participants

During the Omicron wave lockdown in Shanghai, residents including patients with chronic conditions were to remain indoors and could not go outside to exercise or purchase groceries at the supermarket. They could receive care via telehealth or consultation in internet hospitals. Medication was available through online pharmacies with in-home delivery. This could be challenging for seniors who may have low digital literacy or who do not have access to a smartphone.

To receive in-person care, health codes had to be scanned. Daily nucleic acid tests were mandatory for in-patients and the one allowed family member who could accompany a patient.

Participant inclusion criteria were the following: outpatients with cardiovascular and cerebrovascular diseases, diabetes, kidney, or another chronic condition (e.g., cancer). Participant exclusion criteria were: (1) outpatients with severe cognitive impairments or any conditions that prevent them from being able to understand and agree to participate in the research; (2) outpatients unwilling to cooperate with the research protocol; and (3) outpatients with any missing data within questionnaire items.

2.3 Measures

All items were self-reported. Two relevant and validated psychosocial scales available for use in China were selected by the CR group, assessing depressive and anxiety symptoms, somatic symptoms, as well as sleep and cognitive issues. First, five items from the validated Symptom Checklist-90 were administered to assess depressive symptoms [15,16]. There is a 5-point Likert-type response option for each, with a maximal score of 25; higher scores indicate more severe symptoms.

The Chinese version of the Somatic Symptom Scale (SSS) was also administered [17]. It comprises 20 items, each assessed on a 4-point Likert-type scale. Items assess physical (e.g., half the items query each body system), depressive, and anxiety symptoms, and the final 2 items assess sleep and cognitive issues. Thus, the SSS assesses psychosocial well-being broadly. Total scores range from 20 to 80; scores ≥36 were considered elevated.

In addition, non-psychometrically validated items related to pandemic perceptions and health management were generated by the CR group, based on their knowledge and expertise. Response options were forced choice, with some where respondents could select all that apply. Participants were asked to respond these items based on their experience in the prior 2 weeks.

2.4 Statistical analysis

IBM SPSS statistics version 25.0 was used for all statistical analyses, with p < 0.05 considered statistically significant. Descriptive analysis was first performed. Perceptions of impact of the pandemic (at least minor vs none) on their chronic condition and psychosocial well-being were tested using chi-square and t-tests as applicable. The association of pandemic-related perceptions with SSS scores was assessed using the t-test and chi-square, as applicable. Finally, associations between participant sociodemographic and clinical characteristics with SSS scores were tested using logistic regression analysis as applicable. Then, an adjusted model was computed for the association of the SSS with those sociodemographic, clinical, and pandemic-related perceptions that were significant at p < 0.05.

3 Results

Of 1,775 responding patients, most were educated, working, married females living with family, and who had healthcare insurance (Table 1). As shown in Table 2, most participants had hypertension, over one-fifth had diabetes, and just under that coronary artery disease. Other conditions included cancer, as well as endocrine and immune diseases, and psychiatric conditions.

Table 1

Participant sociodemographic characteristics (N = 1775)

Characteristic n (%)/mean ± SD
Sex (female) 1,061 (59.8)
Age 57.69 ± 13.80
Marital status
 Married 1,489 (83.9)
 Widowed 111 (6.3)
 Never married 107 (6.0)
 Separated/divorced 68 (3.8)
Living situation
 With children and/or other extended family members 786 (44.3)
 With partner only 768 (43.3)
 Alone 221 (12.5)
Highest educational attainment
 Junior college or senior high school 818 (46.1)
 Bachelor and above 723 (40.7)
 Junior high school and below 234 (13.2)
Income status
 Has work income 1,501 (84.6)
 No fixed income (e.g., rely on children, state subsidies) 138 (7.8)
 Has additional source of income on top of salary (e.g., online) 136 (7.7)
Current or previous occupation
 City worker 557 (31.4)
 Civil servants 440 (24.8)
 Management (private or public) 289 (16.3)
 Health care provider 181 (10.2)
 Teacher 129 (7.3)
 Government 59 (3.3)
 Own business 44 (2.5)
 Farmer 34 (1.9)
 Research 34 (1.9)
 Other (e.g., Arts) 8 (0.5)
Healthcare insurance
 Employee 960 (54.1)
 Town residents 664 (37.4)
 Off-site 77 (4.3)
 Self-pay 74 (4.2)

SD, standard deviation.

Table 2

Participant physical and mental health and association with pandemic health impact (n = 1,775)

n (%)/mean ± SD Perceived impact of pandemic on health condition
No effect (n = 993) Minor or greater (n = 782) X 2/t p
Chronic condition
 Coronary artery disease 333 (18.8) 132 (13.3) 201 (25.7) 44.209 <0.001
 Heart failure 49 (2.8) 12 (1.2) 37 (4.7) 20.228 <0.001
 Arrhythmia 189 (10.6) 75 (7.6) 114 (14.6) 22.693 <0.001
 Hypertension 938 (52.8) 481 (48.4) 457 (58.4) 17.559 <0.001
 Cerebrovascular disease 98 (5.5) 37 (3.7) 61 (7.8) 13.923 <0.001
 Diabetes 405 (22.8) 210 (21.1) 195 (24.9) 3.565 0.059
 Renal disease 62 (3.5) 23 (2.3) 39 (5.0) 9.259 0.002
 Other 780 (43.9) 420 (43.7) 360 (44.2) 0.049 0.825
Years living with chronic condition
 <5 years 692 (39.0) 415 (41.8) 277 (35.4) 10.488 0.015
 5–10 years 510 (28.7) 273 (27.5) 237 (30.3)
 10–20 years 344 (19.4) 173 (17.4) 171 (21.9)
 >20 years 229 (12.9) 132 (13.3) 97 (12.4)
History psychiatric disorder
 Yes, being treated with meds 148 (8.3) 49 (4.9) 99 (12.7) 97.857 <0.001
 Yes, but untreated 116 (6.5) 29 (2.9) 87 (11.1)
 Yes, but remitted 97 (5.5) 45 (4.5) 52 (6.6)
 No 1,414 (79.7) 870 (87.6) 544 (69.6)
Major life event (n, % yes) 232 (13.1) 103 (10.4) 129 (16.5) 14.438 <0.001
 Somatic self-rating scale (/80) 36.07 ± 10.50 31.38 ± 7.68 42.03 ± 10.58 −23.666 <0.001
 Somatic symptoms (/36) 15.54 ± 4.65 13.52 ± 3.47 18.10 ± 4.69 −22.864 <0.001
 Anxiety symptoms (/20) 8.84 ± 2.95 7.68 ± 2.18 10.30 ± 3.14 −19.925 <0.001
 Depressive symptoms (/16) 7.59 ± 2.61 6.56 ± 2.12 8.90 ± 2.59 −20.437 <0.001
 Sleep and cognitive symptoms (/8) 4.10 ± 1.36 3.62 ± 1.17 4.72 ± 1.35 −18.017 <0.001
SCL-90 depressive items (/25) 9.94 ± 4.29 8.35 ± 3.28 11.95 ± 4.57 −18.563 <0.001
 Sadness (/5) 2.39 ± 1.02 2.07 ± 0.88 2.80 ± 1.03 −15.703 <0.001
 Suicidal ideation (/5) 1.45 ± 0.80 1.21 ± 0.54 1.75 ± 0.96 −13.882 <0.001
 Hopelessness (/5) 1.83 ± 1.02 1.50 ± 0.79 2.25 ± 1.12 −15.865 <0.001
 Feel empty inside (/5) 2.04 ± 1.03 1.70 ± 0.85 2.47 ± 1.07 −16.400 <0.001
 Anhedonia (/5) 2.23 ± 1.09 1.87 ± 0.93 2.69 ± 1.10 −16.622 <0.001

SD, standard deviation; SCL, symptom checklist 90.

Note: some items allowed single responses and others multiple.

The mean psychosocial well-being scores are shown in Table 2. Approximately 80% had no known psychiatric history. 41.5% of participants with elevated SSS scores indicating psychological distress (Table 3) was significantly more likely to be women, older, unmarried, living alone, with no fixed income, and had lower educational attainment than those with subclinical scores (all p ≤ 0.016). All chronic conditions except hypertension and diabetes were associated with significantly more distress on the SSS (all p ≤ 0.013), and they were living longer with their condition (p < 0.001). They were significantly more likely to have suffered a major life event (16.7% vs 10.5%; p < 0.001).

Table 3

Participant pandemic attitudes and impact on chronic disease management (N = 1,775)

n (%)/mean ± SD Association with somatic symptoms
Elevated (n = 736) Subclinical (n = 1,039) X 2/t p
Source of Pandemic-related Information
 Traditional and new media (e.g., WeChat) 1,624 (91.5) 651 (88.5) 973 (93.6) 16.124 <0.001
 Television and newspaper only (traditional media) 110 (6.2) 59 (8.0) 51 (4.9)
 No media, only family or neighbors 41 (2.3) 36 (3.5) 15 (1.4)
Impact of pandemic on life
 None 210 (11.8) 42 (5.7) 168 (16.2) 200.903 <0.001
 Only physical distancing 184 (10.4) 108 (14.7) 76 (7.3)
 Temporary 947 (53.4) 302 (41.0) 645 (62.1)
 Permanent changes 434 (24.5) 284 (38.6) 150 (14.4)
View of pandemic status in future and control measures
 Situation is serious, and worry about future 652 (36.7) 378 (51.4) 274 (26.4) 144.777 <0.001
 Think the strict measures will turn things around 403 (22.7) 144 (19.6) 259 (24.9)
 Always optimistic 397 (22.4) 85 (11.5) 312 (30.0)
 I am not worried about getting Omicron 323 (18.2) 129 (17.5) 194 (18.7)
How long strict control measures can be tolerated
 I cannot even endure 1–2 weeks 166 (9.4) 111 (15.1) 55 (5.3) 65.327 <0.001
 A month at maximum 847 (47.7) 367 (49.9) 480 (46.2)
 3 months maximum 258 (14.5) 79 (10.7) 179 (17.2)
 6 months maximum 23 (1.3) 9 (1.2) 14 (1.3)
 As long as I can get necessities, I can endure it for a long time 481 (27.1) 170 (23.1) 311 (29.9)
Impact of pandemic on health condition†
 No effect 993(55.9) 214 (29.1) 779 (75.0) 407.066 <0.001
 Minor 564 (31.8) 338 (45.9) 226 (21.8)
 Serious 218 (12.3) 184 (25.0) 34 (3.3)
Adherence to control measures
 Stayed home 772 (43.5) 315 (42.8) 457 (44.0) 10.330 0.016
 Only went out to get food and medicine 518 (29.2) 193 (26.2) 325 (31.3)
 Community sealed, so could not go out 460 (25.9) 215 (29.2) 245 (23.6)
 No change 25 (1.4) 13 (1.8) 12 (1.2)
Exercise maintenance when strict control measures†
 Changed to exercise in home 761 (42.9) 240 (32.6) 521 (50.1) 58.656 <0.001
 Stopped exercise because of pandemic 595 (33.5) 306 (41.6) 289 (27.8)
 Do not exercise as usual 366 (20.6) 169 (23.0) 197 (19.0)
 Exercise in residential area as before 53 (3.0) 21 (2.9) 32 (3.1)
Access to medication when strict control measures
 I was sure to stock up before 845 (47.6) 306 (41.6) 539 (51.9) 50.597 <0.001
 Someone else got my medication 360 (20.3) 165 (22.4) 195 (18.8)
 Discontinued use 310 (17.5) 170 (23.1) 140 (13.5)
 Internet dispensing 228 (12.8) 74 (10.1) 154 (14.8)
 Borrowed medicine from another 32 (1.8) 21 (2.9) 11 (1.1)
Available supply of chronic disease medication
 I discontinued 236 (13.3) 116 (15.8) 120 (11.5) 66.290 <0.001
 Not enough even for a week 309 (17.4) 168 (22.8) 141 (13.6)
 Enough for 1–2 weeks 469 (26.4) 213 (28.9) 256 (24.6)
 Enough for 2–4 weeks 393 (22.1) 138 (18.8) 255 (24.5)
 More than a month on hand 368 (20.7) 101 (13.7) 267 (25.7)
Greatest worries about chronic condition related to Omicron
 Being unable to access care due to control measures 1,477 (83.2) 640 (87.0) 837 (80.6) 12.625 <0.001
 Getting infected and deteriorating 747 (42.1) 372 (50.5) 375 (36.1) 36.913 <0.001
 The economic impact of the pandemic affects health resourcing 438 (24.7) 190 (25.8) 248 (23.9) 0.878 0.349
 Other 112 (6.3) 40 (5.4) 72 (6.9) 1.629 0.202
What needed during waves to manage chronic condition
 Easier access to medications 1,165 (65.6) 478 (64.9) 687 (66.1) 0.264 0.607
 Ensuring access to care regardless of control measures 1,147 (64.6) 512 (69.6) 635 (61.1) 13.451 <0.001
 Guarantee of emergency hospital and outpatient care access 992 (55.9) 450 (61.1) 542 (52.2) 14.079 <0.001
 Facilitating access to care even if I cannot use or do not have a mobile phone 760 (42.8) 335 (45.5) 425 (40.9) 3.742 0.053
 Greater availability of telehealth (year) 659 (37.1) 265 (36.0) 394 (37.9) 0.677 0.411

Note: some items allowed single responses and others multiple.

SD, standard deviation.

†Variables used for association tests in previous table.

3.1 Impact of pandemic

As shown in Table 3, most participants perceived the pandemic had a temporary impact on their lives, but almost one-quarter perceived changes would be permanent. In terms of the future, over one-third were very worried about it, and one-quarter each was optimistic or perceived the control measures would be successful in mitigating COVID-19 impact. Most commonly, participants reported that they could withstand the lockdown for a month.

Half perceived the pandemic had at least a minor impact on their health or more (Table 3). As shown in Table 2, those perceiving health impact were significantly more likely to be older, unmarried, and with lower educational attainment and income. Participants with cardiovascular, renal, and psychiatric diseases, who had their diseases for more years, reported major life events, and higher somatic and depressive symptoms (including all subscales) were also significantly more likely to perceive the impact of the pandemic on their health than their counterparts (Table 3).

Forty percent exercised at their home, but over one-third stopped exercising and one-fifth changed their exercise (Table 3). Participants who had their condition for fewer years (p = 0.009) and who had lower somatic (p < 0.001) were more likely to change their exercise due to the pandemic and associated control measures (no association with chronic condition).

With regard to medication, while almost half tried to stock up before the lockdown, almost one-fifth of participants discontinued use (Table 3). Only just over 10% of this older cohort used an internet-based pharmacy. Of those who still had medication, just under half had enough supply to last at least 2 weeks.

Participant’s greatest worries related to Omicron and their chronic condition are also shown in Table 3. Chief among them were fears around inability to access healthcare and medicines, as well as contracting COVID-19 and their health deteriorating. To best manage their chronic condition during the wave, participants most wanted guaranteed access to care and medication, particularly even if they do not have – or are not able to use – a mobile phone.

Pandemic perceptions were highly associated with SSS (Table 3). Participants who were significantly less likely to use new media to get pandemic-related information and more often relied on family or neighbours for information only and who were more likely to view pandemic impacts on their lives as permanent were less optimistic about the future, reported being able to tolerate control measures for a significantly shorter amount of time, perceived a significantly greater impact of the pandemic on their health, were less likely to go out even to get food or medicine, were more likely to stop exercise, and were more likely to discontinue medicine use or had less supply on hand, and had elevated SSS scores, indicating not only somatic but also anxious, depressive, and sleep-related symptoms. These participants with elevated distress were also more concerned about all but two of the worries related to the pandemic and were more likely to want assurances around access to in- and outpatient care regardless of COVID-19 wave status and associated control measures. An adjusted model is shown in Table 4.

Table 4

Model assessing correlates of SSS

Independent variable OR 95% CI p
Age 0.997 0.985–1.008 0.572
Sex
 Male 1
 Female 1.577 1.220–2.039 0.001
Marital status
 Married 1
 Widowed 0.898 0.502–1.606 0.716
 Never married 0.808 0.446–1.463 0.481
 Divorced 1.196 0.633–2.259 0.581
Living arrangement
 Alone 1
 With partner only 0.678 0.424–1.086 0.106
 With children and/or other extended family members 0.677 0.438–1.045 0.078
Educational attainment
 Junior high school and below 1
 Junior college or senior high school 1.021 0.693–1.503 0.918
 Bachelor and above 0.842 0.552–1.284 0.425
Income status
 No fixed income (e.g., rely on children, state subsidies) 1
 Has work income 0.696 0.433–1.118 0.134
 Has additional source of income on top of salary (e.g., online) 0.630 0.330–1.203 0.161
Diagnosis
 Coronary artery disease 2.006 1.439–2.797 <0.001
 Arrhythmia 2.588 1.731–3.870 <0.001
Pandemic media source type
 Traditional and new media (e.g., WeChat) 1
 Television and newspaper only (traditional media) 0.932 0.558–1.555 0.787
 No media, only family or neighbors 1.139 0.432–3.002 0.793
Perceived impact of pandemic on life
 None 1
 Only physical distancing 2.566 1.491–4.418 0.001
 Temporary 1.433 0.929–2.209 0.103
 Permanent changes 3.298 2.051–5.305 <0.001
Perception of future and control measures
 Situation is serious, and worry about future 1
 Think the strict measures will turn things around 0.632 0.456–0.876 0.006
 Always optimistic 0.418 0.291–0.600 <0.001
 I am not worried about getting Omicron 0.636 0.453–0.894 0.009
Duration can tolerate control measures
 I cannot even endure 1−2 weeks 1
 A month at maximum 0.534 0.341–0.835 0.006
 3 months maximum 0.415 0.245–0.706 0.001
 6 months maximum 0.623 0.199–1.951 0.416
 As long as I can get necessities, I can endure it for a long time 0.496 0.305–0.806 0.005
Adherence to control measures
 No change 1
 Only went out to get food and medicine 0.854 0.301–2.423 0.767
 Stayed home 0.972 0.343–2.756 0.957
 Community sealed, so could not go out 1.017 0.355–2.913 0.975
Perceived impact of pandemic on health condition
 No effect 1
 Minor 3.900 3.024–5.030 <0.001
 Serious 12.905 8.340–19.968 <0.001
Change to exercise routine due to pandemic
 Do not exercise as usual 1
 Stopped exercise because of pandemic 0.850 0.609–1.187 0.340
 Changed to exercise in home 0.596 0.432–0.822 0.002
 Exercise in residential area as before 0.938 0.445–1.981 0.868

SSS: somatic self-rating scale, including physical disorders, depressive, anxious, sleep and cognitive symptoms as well.

4 Discussion

This is the first or one of the first full studies to examine the impact of the COVID-19 pandemic and its associated control measures in a large sample of older adults with chronic conditions [18]. It was undertaken during the Omicron wave in Shanghai, where the population is dense, control measures were strict, and the pandemic had been ongoing for 2 years. Despite that few were living alone that could mitigate isolation during the lockdown, consistent with findings in the general population [19,20], overall results show elevated distress but also negative impacts on chronic disease management. We must ensure that those with chronic conditions have the resources they need to cope and manage their condition, such as is offered in cardiac rehabilitation.

The burden of distress was quite high, even when considering that rates of psychological distress are higher in those with chronic disease [21,22] and rates in the Chinese population. Generally, rates of distress decline with age, but the opposite finding was found herein, likely due to the increased risk of severe COVID-19 with age [23,24,25]. Many patients were very concerned about the impact of the pandemic on their health and their access to care if needed. Research has shown that much preventive and non-preventive care was avoided due to the fear of exposure to SARS-CoV-2, and thus periodic health examinations regarding chronic disease risk factors were likely also missed, likely leaving weight [26], blood pressure, lipids, and blood glucose less-optimally managed.

In terms of health management, despite the proven benefits of secondary prevention behaviours, such as exercise and medication adherence [27], many chronic disease patients discontinued them. Despite the availability of online pharmacies and patient’s low supply of medication, these were not widely used, likely due to low digital literacy or technology access in the elderly [28,29]. One-third stopped exercising, and another quarter changed their exercise rather than moving their exercise routine home. How outpatients were able to maintain a healthy diet with dwindling food supplies would be another important area for study [30], as would be impacts of pandemic-related lockdowns on tobacco access and use in chronic disease patients. Moreover, given the importance of relationship quality to health [31], the impact of prolonged lockdown on relationships in chronic disease patients warrants study.

In our earlier examination of the impact of the pandemic and associated control measures on older adults (many of whom similarly had hypertension, CVD, or diabetes) in the spring of 2020 [32], mean scores on the SSS were somewhat lower at 29/80 vs 36 herein (all mean subscale scores were somewhat lower as well). In terms of pandemic impact on life, only 6% perceived this would be permanent in 2020 vs 25% in 2022. Also in 2020, most participants (47%) reported they could endure strict prevention and control measures for a long time (well over 6 months with another third saying they could endure 6 months); in 2022, however, almost 10% said they could not even endure strict prevention and control measures for a week or two and most (48%) reported that they could endure them for a maximum of a month. Also in 2020, 94% reported no effect of the pandemic on their health condition; yet, this was only 56% in 2022. Overall, for the common measures across the two surveys, perceptions worsened with time.

Study implications relate to ensuring that patients have what they need to manage their condition. What they most wanted was easier access to healthcare and medications, regardless of control measures. This is despite quite fast and broad availability of telehealth in China and online pharmacies [33]. This could likely be due to lower digital literacy or device availability in older adults, or preferences for in-person services [34,35]. Efforts to close the age-related “digital divide” must continue. Greater access to virtual cardiac rehabilitation in China could address these issues as well [6,36].

Caution is warranted when interpreting these results. First, this is a cross-sectional study, so the design precludes causal determinations. Second, the results may not be generalizable beyond China with its political and cultural context, and the city of Shanghai more specifically where the stringency of control measures was high. Nevertheless, the population of Shanghai is very large, and findings can inform other governments when considering their control measures. Moreover, similarity of the sample to the larger population is not known given the recruitment strategy, designed to quickly secure data during the lockdown, but where full reach and number of non-respondents were not collated. Third, all data were self-report, and hence, there may have been socially desirable responding or other measurement error. Relatedly, psychiatric conditions and health status were not verified through structured clinical interview or medical records. Fourth, due to the exploratory nature of the study, multiple comparisons were performed, increasing the chance of type 1 error. Finally, whether patients had COVID-19 prior to or during the period of study was not considered; more research is needed.

In conclusion, 2 years into the pandemic in the midst of arguably the most stringent prevention and control measures globally, over 40% of chronic disease patients are experiencing elevated psychosocial distress, and this was associated with female, diagnosis of coronary artery disease and arrhythmia, perceived impact of pandemic on life, and impact of pandemic on health condition (Figure 1). Many patients stopped exercise and discontinued medication, and their greatest fears concerned access to healthcare. They were less able to tolerate prevention and control measures and had more negative perceptions related to the pandemic than at its beginning. Greater access to cardiac rehabilitation in China, including delivery supported by technology where patients are able, could address these issues.

Figure 1 Correlates of psychosocial distress in chronic disease patients during stringent COVID-19 prevention and control measures. CAD: coronary artery disease.
Figure 1

Correlates of psychosocial distress in chronic disease patients during stringent COVID-19 prevention and control measures. CAD: coronary artery disease.

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Acknowledgments

None.

  1. Funding information: None.

  2. Conflict of interest: None.

  3. Data availability statement: Data are available upon request.

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Received: 2022-11-21
Revised: 2023-01-19
Accepted: 2023-02-06
Published Online: 2023-03-28

© 2023 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  181. A comparative study on the overlapping effects of clinically applicable therapeutic interventions in patients with central nervous system damage
  182. Low intensity extracorporeal shockwave therapy for chronic pelvic pain syndrome: Long-term follow-up
  183. The diagnostic accuracy of touch imprint cytology for sentinel lymph node metastases of breast cancer: An up-to-date meta-analysis of 4,073 patients
  184. Mortality associated with Sjögren’s syndrome in the United States in the 1999–2020 period: A multiple cause-of-death study
  185. CircMMP11 as a prognostic biomarker mediates miR-361-3p/HMGB1 axis to accelerate malignant progression of hepatocellular carcinoma
  186. Analysis of the clinical characteristics and prognosis of adult de novo acute myeloid leukemia (none APL) with PTPN11 mutations
  187. KMT2A maintains stemness of gastric cancer cells through regulating Wnt/β-catenin signaling-activated transcriptional factor KLF11
  188. Evaluation of placental oxygenation by near-infrared spectroscopy in relation to ultrasound maturation grade in physiological term pregnancies
  189. The role of ultrasonographic findings for PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor-2-negative breast cancer
  190. Construction of immunogenic cell death-related molecular subtypes and prognostic signature in colorectal cancer
  191. Long-term prognostic value of high-sensitivity cardiac troponin-I in patients with idiopathic dilated cardiomyopathy
  192. Establishing a novel Fanconi anemia signaling pathway-associated prognostic model and tumor clustering for pediatric acute myeloid leukemia patients
  193. Integrative bioinformatics analysis reveals STAT2 as a novel biomarker of inflammation-related cardiac dysfunction in atrial fibrillation
  194. Adipose-derived stem cells repair radiation-induced chronic lung injury via inhibiting TGF-β1/Smad 3 signaling pathway
  195. Real-world practice of idiopathic pulmonary fibrosis: Results from a 2000–2016 cohort
  196. lncRNA LENGA sponges miR-378 to promote myocardial fibrosis in atrial fibrillation
  197. Diagnostic value of urinary Tamm-Horsfall protein and 24 h urine osmolality for recurrent calcium oxalate stones of the upper urinary tract: Cross-sectional study
  198. The value of color Doppler ultrasonography combined with serum tumor markers in differential diagnosis of gastric stromal tumor and gastric cancer
  199. The spike protein of SARS-CoV-2 induces inflammation and EMT of lung epithelial cells and fibroblasts through the upregulation of GADD45A
  200. Mycophenolate mofetil versus cyclophosphamide plus in patients with connective tissue disease-associated interstitial lung disease: Efficacy and safety analysis
  201. MiR-1278 targets CALD1 and suppresses the progression of gastric cancer via the MAPK pathway
  202. Metabolomic analysis of serum short-chain fatty acid concentrations in a mouse of MPTP-induced Parkinson’s disease after dietary supplementation with branched-chain amino acids
  203. Cimifugin inhibits adipogenesis and TNF-α-induced insulin resistance in 3T3-L1 cells
  204. Predictors of gastrointestinal complaints in patients on metformin therapy
  205. Prescribing patterns in patients with chronic obstructive pulmonary disease and atrial fibrillation
  206. A retrospective analysis of the effect of latent tuberculosis infection on clinical pregnancy outcomes of in vitro fertilization–fresh embryo transferred in infertile women
  207. Appropriateness and clinical outcomes of short sustained low-efficiency dialysis: A national experience
  208. miR-29 regulates metabolism by inhibiting JNK-1 expression in non-obese patients with type 2 diabetes mellitus and NAFLD
  209. Clinical features and management of lymphoepithelial cyst
  210. Serum VEGF, high-sensitivity CRP, and cystatin-C assist in the diagnosis of type 2 diabetic retinopathy complicated with hyperuricemia
  211. ENPP1 ameliorates vascular calcification via inhibiting the osteogenic transformation of VSMCs and generating PPi
  212. Significance of monitoring the levels of thyroid hormone antibodies and glucose and lipid metabolism antibodies in patients suffer from type 2 diabetes
  213. The causal relationship between immune cells and different kidney diseases: A Mendelian randomization study
  214. Interleukin 33, soluble suppression of tumorigenicity 2, interleukin 27, and galectin 3 as predictors for outcome in patients admitted to intensive care units
  215. Identification of diagnostic immune-related gene biomarkers for predicting heart failure after acute myocardial infarction
  216. Long-term administration of probiotics prevents gastrointestinal mucosal barrier dysfunction in septic mice partly by upregulating the 5-HT degradation pathway
  217. miR-192 inhibits the activation of hepatic stellate cells by targeting Rictor
  218. Diagnostic and prognostic value of MR-pro ADM, procalcitonin, and copeptin in sepsis
  219. Review Articles
  220. Prenatal diagnosis of fetal defects and its implications on the delivery mode
  221. Electromagnetic fields exposure on fetal and childhood abnormalities: Systematic review and meta-analysis
  222. Characteristics of antibiotic resistance mechanisms and genes of Klebsiella pneumoniae
  223. Saddle pulmonary embolism in the setting of COVID-19 infection: A systematic review of case reports and case series
  224. Vitamin C and epigenetics: A short physiological overview
  225. Ebselen: A promising therapy protecting cardiomyocytes from excess iron in iron-overloaded thalassemia patients
  226. Aspirin versus LMWH for VTE prophylaxis after orthopedic surgery
  227. Mechanism of rhubarb in the treatment of hyperlipidemia: A recent review
  228. Surgical management and outcomes of traumatic global brachial plexus injury: A concise review and our center approach
  229. The progress of autoimmune hepatitis research and future challenges
  230. METTL16 in human diseases: What should we do next?
  231. New insights into the prevention of ureteral stents encrustation
  232. VISTA as a prospective immune checkpoint in gynecological malignant tumors: A review of the literature
  233. Case Reports
  234. Mycobacterium xenopi infection of the kidney and lymph nodes: A case report
  235. Genetic mutation of SLC6A20 (c.1072T > C) in a family with nephrolithiasis: A case report
  236. Chronic hepatitis B complicated with secondary hemochromatosis was cured clinically: A case report
  237. Liver abscess complicated with multiple organ invasive infection caused by hematogenous disseminated hypervirulent Klebsiella pneumoniae: A case report
  238. Urokinase-based lock solutions for catheter salvage: A case of an upcoming kidney transplant recipient
  239. Two case reports of maturity-onset diabetes of the young type 3 caused by the hepatocyte nuclear factor 1α gene mutation
  240. Immune checkpoint inhibitor-related pancreatitis: What is known and what is not
  241. Does total hip arthroplasty result in intercostal nerve injury? A case report and literature review
  242. Clinicopathological characteristics and diagnosis of hepatic sinusoidal obstruction syndrome caused by Tusanqi – Case report and literature review
  243. Synchronous triple primary gastrointestinal malignant tumors treated with laparoscopic surgery: A case report
  244. CT-guided percutaneous microwave ablation combined with bone cement injection for the treatment of transverse metastases: A case report
  245. Malignant hyperthermia: Report on a successful rescue of a case with the highest temperature of 44.2°C
  246. Anesthetic management of fetal pulmonary valvuloplasty: A case report
  247. Rapid Communication
  248. Impact of COVID-19 lockdown on glycemic levels during pregnancy: A retrospective analysis
  249. Erratum
  250. Erratum to “Inhibition of miR-21 improves pulmonary vascular responses in bronchopulmonary dysplasia by targeting the DDAH1/ADMA/NO pathway”
  251. Erratum to: “Fer exacerbates renal fibrosis and can be targeted by miR-29c-3p”
  252. Retraction
  253. Retraction of “Study to compare the effect of casirivimab and imdevimab, remdesivir, and favipiravir on progression and multi-organ function of hospitalized COVID-19 patients”
  254. Retraction of “circ_0062491 alleviates periodontitis via the miR-142-5p/IGF1 axis”
  255. Retraction of “miR-223-3p alleviates TGF-β-induced epithelial-mesenchymal transition and extracellular matrix deposition by targeting SP3 in endometrial epithelial cells”
  256. Retraction of “SLCO4A1-AS1 mediates pancreatic cancer development via miR-4673/KIF21B axis”
  257. Retraction of “circRNA_0001679/miR-338-3p/DUSP16 axis aggravates acute lung injury”
  258. Retraction of “lncRNA ACTA2-AS1 inhibits malignant phenotypes of gastric cancer cells”
  259. Special issue Linking Pathobiological Mechanisms to Clinical Application for cardiovascular diseases
  260. Effect of cardiac rehabilitation therapy on depressed patients with cardiac insufficiency after cardiac surgery
  261. Special issue The evolving saga of RNAs from bench to bedside - Part I
  262. FBLIM1 mRNA is a novel prognostic biomarker and is associated with immune infiltrates in glioma
  263. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part III
  264. Development of a machine learning-based signature utilizing inflammatory response genes for predicting prognosis and immune microenvironment in ovarian cancer
https://doi.org/10.1515/med-2023-0674
Schlagwörter für diesen Artikel
COVID-19; psychological distress; adaptation; psychological; mental health; self-management; chronic disease; surveys and questionnaires
Creative Commons
BY 4.0

Artikel in diesem Heft

  1. Research Articles
  2. Exosomes derived from mesenchymal stem cells overexpressing miR-210 inhibits neuronal inflammation and contribute to neurite outgrowth through modulating microglia polarization
  3. Current situation of acute ST-segment elevation myocardial infarction in a county hospital chest pain center during an epidemic of novel coronavirus pneumonia
  4. circ-IARS depletion inhibits the progression of non-small-cell lung cancer by circ-IARS/miR-1252-5p/HDGF ceRNA pathway
  5. circRNA ITGA7 restrains growth and enhances radiosensitivity by up-regulating SMAD4 in colorectal carcinoma
  6. WDR79 promotes aerobic glycolysis of pancreatic ductal adenocarcinoma (PDAC) by the suppression of SIRT4
  7. Up-regulation of collagen type V alpha 2 (COL5A2) promotes malignant phenotypes in gastric cancer cell via inducing epithelial–mesenchymal transition (EMT)
  8. Inhibition of TERC inhibits neural apoptosis and inflammation in spinal cord injury through Akt activation and p-38 inhibition via the miR-34a-5p/XBP-1 axis
  9. 3D-printed polyether-ether-ketone/n-TiO2 composite enhances the cytocompatibility and osteogenic differentiation of MC3T3-E1 cells by downregulating miR-154-5p
  10. Propofol-mediated circ_0000735 downregulation restrains tumor growth by decreasing integrin-β1 expression in non-small cell lung cancer
  11. PVT1/miR-16/CCND1 axis regulates gastric cancer progression
  12. Silencing of circ_002136 sensitizes gastric cancer to paclitaxel by targeting the miR-16-5p/HMGA1 axis
  13. Short-term outcomes after simultaneous gastrectomy plus cholecystectomy in gastric cancer: A pooling up analysis
  14. SCARA5 inhibits oral squamous cell carcinoma via inactivating the STAT3 and PI3K/AKT signaling pathways
  15. Molecular mechanism by which the Notch signaling pathway regulates autophagy in a rat model of pulmonary fibrosis in pigeon breeder’s lung
  16. lncRNA TPT1-AS1 promotes cell migration and invasion in esophageal squamous-cell carcinomas by regulating the miR-26a/HMGA1 axis
  17. SIRT1/APE1 promotes the viability of gastric cancer cells by inhibiting p53 to suppress ferroptosis
  18. Glycoprotein non-metastatic melanoma B interacts with epidermal growth factor receptor to regulate neural stem cell survival and differentiation
  19. Treatments for brain metastases from EGFR/ALK-negative/unselected NSCLC: A network meta-analysis
  20. Association of osteoporosis and skeletal muscle loss with serum type I collagen carboxyl-terminal peptide β glypeptide: A cross-sectional study in elder Chinese population
  21. circ_0000376 knockdown suppresses non-small cell lung cancer cell tumor properties by the miR-545-3p/PDPK1 pathway
  22. Delivery in a vertical birth chair supported by freedom of movement during labor: A randomized control trial
  23. UBE2J1 knockdown promotes cell apoptosis in endometrial cancer via regulating PI3K/AKT and MDM2/p53 signaling
  24. Metabolic resuscitation therapy in critically ill patients with sepsis and septic shock: A pilot prospective randomized controlled trial
  25. Lycopene ameliorates locomotor activity and urinary frequency induced by pelvic venous congestion in rats
  26. UHRF1-induced connexin26 methylation is involved in hearing damage triggered by intermittent hypoxia in neonatal rats
  27. LINC00511 promotes melanoma progression by targeting miR-610/NUCB2
  28. Ultra-high-performance liquid chromatography-tandem mass spectrometry analysis of serum metabolomic characteristics in people with different vitamin D levels
  29. Role of Jumonji domain-containing protein D3 and its inhibitor GSK-J4 in Hashimoto’s thyroiditis
  30. circ_0014736 induces GPR4 to regulate the biological behaviors of human placental trophoblast cells through miR-942-5p in preeclampsia
  31. Monitoring of sirolimus in the whole blood samples from pediatric patients with lymphatic anomalies
  32. Effects of osteogenic growth peptide C-terminal pentapeptide and its analogue on bone remodeling in an osteoporosis rat model
  33. A novel autophagy-related long non-coding RNAs signature predicting progression-free interval and I-131 therapy benefits in papillary thyroid carcinoma
  34. WGCNA-based identification of potential targets and pathways in response to treatment in locally advanced breast cancer patients
  35. Radiomics model using preoperative computed tomography angiography images to differentiate new from old emboli of acute lower limb arterial embolism
  36. Dysregulated lncRNAs are involved in the progress of myocardial infarction by constructing regulatory networks
  37. Single-arm trial to evaluate the efficacy and safety of baclofen in treatment of intractable hiccup caused by malignant tumor chemotherapy
  38. Genetic polymorphisms of MRPS30-DT and NINJ2 may influence lung cancer risk
  39. Efficacy of immune checkpoint inhibitors in patients with KRAS-mutant advanced non-small cell lung cancer: A retrospective analysis
  40. Pyroptosis-based risk score predicts prognosis and drug sensitivity in lung adenocarcinoma
  41. Upregulation of lncRNA LANCL1-AS1 inhibits the progression of non-small-cell lung cancer via the miR-3680-3p/GMFG axis
  42. CircRANBP17 modulated KDM1A to regulate neuroblastoma progression by sponging miR-27b-3p
  43. Exosomal miR-93-5p regulated the progression of osteoarthritis by targeting ADAMTS9
  44. Downregulation of RBM17 enhances cisplatin sensitivity and inhibits cell invasion in human hypopharyngeal cancer cells
  45. HDAC5-mediated PRAME regulates the proliferation, migration, invasion, and EMT of laryngeal squamous cell carcinoma via the PI3K/AKT/mTOR signaling pathway
  46. The association between sleep duration, quality, and nonalcoholic fatty liver disease: A cross-sectional study
  47. Myostatin silencing inhibits podocyte apoptosis in membranous nephropathy through Smad3/PKA/NOX4 signaling pathway
  48. A novel long noncoding RNA AC125257.1 facilitates colorectal cancer progression by targeting miR-133a-3p/CASC5 axis
  49. Impact of omicron wave and associated control measures in Shanghai on health management and psychosocial well-being of patients with chronic conditions
  50. Clinicopathological characteristics and prognosis of young patients aged ≤45 years old with non-small cell lung cancer
  51. TMT-based comprehensive proteomic profiling identifies serum prognostic signatures of acute myeloid leukemia
  52. The dose limits of teeth protection for patients with nasopharyngeal carcinoma undergoing radiotherapy based on the early oral health-related quality of life
  53. miR-30b-5p targeting GRIN2A inhibits hippocampal damage in epilepsy
  54. Long non-coding RNA AL137789.1 promoted malignant biological behaviors and immune escape of pancreatic carcinoma cells
  55. IRF6 and FGF1 polymorphisms in non-syndromic cleft lip with or without cleft palate in the Polish population
  56. Comprehensive analysis of the role of SFXN family in breast cancer
  57. Efficacy of bronchoscopic intratumoral injection of endostar and cisplatin in lung squamous cell carcinoma patients underwent conventional chemoradiotherapy
  58. Silencing of long noncoding RNA MIAT inhibits the viability and proliferation of breast cancer cells by promoting miR-378a-5p expression
  59. AG1024, an IGF-1 receptor inhibitor, ameliorates renal injury in rats with diabetic nephropathy via the SOCS/JAK2/STAT pathway
  60. Downregulation of KIAA1199 alleviated the activation, proliferation, and migration of hepatic stellate cells by the inhibition of epithelial–mesenchymal transition
  61. Exendin-4 regulates the MAPK and WNT signaling pathways to alleviate the osteogenic inhibition of periodontal ligament stem cells in a high glucose environment
  62. Inhibition of glycolysis represses the growth and alleviates the endoplasmic reticulum stress of breast cancer cells by regulating TMTC3
  63. The function of lncRNA EMX2OS/miR-653-5p and its regulatory mechanism in lung adenocarcinoma
  64. Tectorigenin alleviates the apoptosis and inflammation in spinal cord injury cell model through inhibiting insulin-like growth factor-binding protein 6
  65. Ultrasound examination supporting CT or MRI in the evaluation of cervical lymphadenopathy in patients with irradiation-treated head and neck cancer
  66. F-box and WD repeat domain containing 7 inhibits the activation of hepatic stellate cells by degrading delta-like ligand 1 to block Notch signaling pathway
  67. Knockdown of circ_0005615 enhances the radiosensitivity of colorectal cancer by regulating the miR-665/NOTCH1 axis
  68. Long noncoding RNA Mhrt alleviates angiotensin II-induced cardiac hypertrophy phenotypes by mediating the miR-765/Wnt family member 7B pathway
  69. Effect of miR-499-5p/SOX6 axis on atrial fibrosis in rats with atrial fibrillation
  70. Cholesterol induces inflammation and reduces glucose utilization
  71. circ_0004904 regulates the trophoblast cell in preeclampsia via miR-19b-3p/ARRDC3 axis
  72. NECAB3 promotes the migration and invasion of liver cancer cells through HIF-1α/RIT1 signaling pathway
  73. The poor performance of cardiovascular risk scores in identifying patients with idiopathic inflammatory myopathies at high cardiovascular risk
  74. miR-2053 inhibits the growth of ovarian cancer cells by downregulating SOX4
  75. Nucleophosmin 1 associating with engulfment and cell motility protein 1 regulates hepatocellular carcinoma cell chemotaxis and metastasis
  76. α-Hederin regulates macrophage polarization to relieve sepsis-induced lung and liver injuries in mice
  77. Changes of microbiota level in urinary tract infections: A meta-analysis
  78. Identification of key enzalutamide-resistance-related genes in castration-resistant prostate cancer and verification of RAD51 functions
  79. Falls during oxaliplatin-based chemotherapy for gastrointestinal malignancies – (lessons learned from) a prospective study
  80. Outcomes of low-risk birth care during the Covid-19 pandemic: A cohort study from a tertiary care center in Lithuania
  81. Vitamin D protects intestines from liver cirrhosis-induced inflammation and oxidative stress by inhibiting the TLR4/MyD88/NF-κB signaling pathway
  82. Integrated transcriptome analysis identifies APPL1/RPS6KB2/GALK1 as immune-related metastasis factors in breast cancer
  83. Genomic analysis of immunogenic cell death-related subtypes for predicting prognosis and immunotherapy outcomes in glioblastoma multiforme
  84. Circular RNA Circ_0038467 promotes the maturation of miRNA-203 to increase lipopolysaccharide-induced apoptosis of chondrocytes
  85. An economic evaluation of fine-needle cytology as the primary diagnostic tool in the diagnosis of lymphadenopathy
  86. Midazolam impedes lung carcinoma cell proliferation and migration via EGFR/MEK/ERK signaling pathway
  87. Network pharmacology combined with molecular docking and experimental validation to reveal the pharmacological mechanism of naringin against renal fibrosis
  88. PTPN12 down-regulated by miR-146b-3p gene affects the malignant progression of laryngeal squamous cell carcinoma
  89. miR-141-3p accelerates ovarian cancer progression and promotes M2-like macrophage polarization by targeting the Keap1-Nrf2 pathway
  90. lncRNA OIP5-AS1 attenuates the osteoarthritis progression in IL-1β-stimulated chondrocytes
  91. Overexpression of LINC00607 inhibits cell growth and aggressiveness by regulating the miR-1289/EFNA5 axis in non-small-cell lung cancer
  92. Subjective well-being in informal caregivers during the COVID-19 pandemic
  93. Nrf2 protects against myocardial ischemia-reperfusion injury in diabetic rats by inhibiting Drp1-mediated mitochondrial fission
  94. Unfolded protein response inhibits KAT2B/MLKL-mediated necroptosis of hepatocytes by promoting BMI1 level to ubiquitinate KAT2B
  95. Bladder cancer screening: The new selection and prediction model
  96. circNFATC3 facilitated the progression of oral squamous cell carcinoma via the miR-520h/LDHA axis
  97. Prone position effect in intensive care patients with SARS-COV-2 pneumonia
  98. Clinical observation on the efficacy of Tongdu Tuina manipulation in the treatment of primary enuresis in children
  99. Dihydroartemisinin ameliorates cerebral I/R injury in rats via regulating VWF and autophagy-mediated SIRT1/FOXO1 pathway
  100. Knockdown of circ_0113656 assuages oxidized low-density lipoprotein-induced vascular smooth muscle cell injury through the miR-188-3p/IGF2 pathway
  101. Low Ang-(1–7) and high des-Arg9 bradykinin serum levels are correlated with cardiovascular risk factors in patients with COVID-19
  102. Effect of maternal age and body mass index on induction of labor with oral misoprostol for premature rupture of membrane at term: A retrospective cross-sectional study
  103. Potential protective effects of Huanglian Jiedu Decoction against COVID-19-associated acute kidney injury: A network-based pharmacological and molecular docking study
  104. Clinical significance of serum MBD3 detection in girls with central precocious puberty
  105. Clinical features of varicella-zoster virus caused neurological diseases detected by metagenomic next-generation sequencing
  106. Collagen treatment of complex anorectal fistula: 3 years follow-up
  107. LncRNA CASC15 inhibition relieves renal fibrosis in diabetic nephropathy through down-regulating SP-A by sponging to miR-424
  108. Efficacy analysis of empirical bismuth quadruple therapy, high-dose dual therapy, and resistance gene-based triple therapy as a first-line Helicobacter pylori eradication regimen – An open-label, randomized trial
  109. SMOC2 plays a role in heart failure via regulating TGF-β1/Smad3 pathway-mediated autophagy
  110. A prospective cohort study of the impact of chronic disease on fall injuries in middle-aged and older adults
  111. circRNA THBS1 silencing inhibits the malignant biological behavior of cervical cancer cells via the regulation of miR-543/HMGB2 axis
  112. hsa_circ_0000285 sponging miR-582-3p promotes neuroblastoma progression by regulating the Wnt/β-catenin signaling pathway
  113. Long non-coding RNA GNAS-AS1 knockdown inhibits proliferation and epithelial–mesenchymal transition of lung adenocarcinoma cells via the microRNA-433-3p/Rab3A axis
  114. lncRNA UCA1 regulates miR-132/Lrrfip1 axis to promote vascular smooth muscle cell proliferation
  115. Twenty-four-color full spectrum flow cytometry panel for minimal residual disease detection in acute myeloid leukemia
  116. Hsa-miR-223-3p participates in the process of anthracycline-induced cardiomyocyte damage by regulating NFIA gene
  117. Anti-inflammatory effect of ApoE23 on Salmonella typhimurium-induced sepsis in mice
  118. Analysis of somatic mutations and key driving factors of cervical cancer progression
  119. Hsa_circ_0028007 regulates the progression of nasopharyngeal carcinoma through the miR-1179/SQLE axis
  120. Variations in sexual function after laparoendoscopic single-site hysterectomy in women with benign gynecologic diseases
  121. Effects of pharmacological delay with roxadustat on multi-territory perforator flap survival in rats
  122. Analysis of heroin effects on calcium channels in rat cardiomyocytes based on transcriptomics and metabolomics
  123. Risk factors of recurrent bacterial vaginosis among women of reproductive age: A cross-sectional study
  124. Alkbh5 plays indispensable roles in maintaining self-renewal of hematopoietic stem cells
  125. Study to compare the effect of casirivimab and imdevimab, remdesivir, and favipiravir on progression and multi-organ function of hospitalized COVID-19 patients
  126. Correlation between microvessel maturity and ISUP grades assessed using contrast-enhanced transrectal ultrasonography in prostate cancer
  127. The protective effect of caffeic acid phenethyl ester in the nephrotoxicity induced by α-cypermethrin
  128. Norepinephrine alleviates cyclosporin A-induced nephrotoxicity by enhancing the expression of SFRP1
  129. Effect of RUNX1/FOXP3 axis on apoptosis of T and B lymphocytes and immunosuppression in sepsis
  130. The function of Foxp1 represses β-adrenergic receptor transcription in the occurrence and development of bladder cancer through STAT3 activity
  131. Risk model and validation of carbapenem-resistant Klebsiella pneumoniae infection in patients with cerebrovascular disease in the ICU
  132. Calycosin protects against chronic prostatitis in rats via inhibition of the p38MAPK/NF-κB pathway
  133. Pan-cancer analysis of the PDE4DIP gene with potential prognostic and immunotherapeutic values in multiple cancers including acute myeloid leukemia
  134. The safety and immunogenicity to inactivated COVID-19 vaccine in patients with hyperlipemia
  135. Circ-UBR4 regulates the proliferation, migration, inflammation, and apoptosis in ox-LDL-induced vascular smooth muscle cells via miR-515-5p/IGF2 axis
  136. Clinical characteristics of current COVID-19 rehabilitation outpatients in China
  137. Luteolin alleviates ulcerative colitis in rats via regulating immune response, oxidative stress, and metabolic profiling
  138. miR-199a-5p inhibits aortic valve calcification by targeting ATF6 and GRP78 in valve interstitial cells
  139. The application of iliac fascia space block combined with esketamine intravenous general anesthesia in PFNA surgery of the elderly: A prospective, single-center, controlled trial
  140. Elevated blood acetoacetate levels reduce major adverse cardiac and cerebrovascular events risk in acute myocardial infarction
  141. The effects of progesterone on the healing of obstetric anal sphincter damage in female rats
  142. Identification of cuproptosis-related genes for predicting the development of prostate cancer
  143. Lumican silencing ameliorates β-glycerophosphate-mediated vascular smooth muscle cell calcification by attenuating the inhibition of APOB on KIF2C activity
  144. Targeting PTBP1 blocks glutamine metabolism to improve the cisplatin sensitivity of hepatocarcinoma cells through modulating the mRNA stability of glutaminase
  145. A single center prospective study: Influences of different hip flexion angles on the measurement of lumbar spine bone mineral density by dual energy X-ray absorptiometry
  146. Clinical analysis of AN69ST membrane continuous venous hemofiltration in the treatment of severe sepsis
  147. Antibiotics therapy combined with probiotics administered intravaginally for the treatment of bacterial vaginosis: A systematic review and meta-analysis
  148. Construction of a ceRNA network to reveal a vascular invasion associated prognostic model in hepatocellular carcinoma
  149. A pan-cancer analysis of STAT3 expression and genetic alterations in human tumors
  150. A prognostic signature based on seven T-cell-related cell clustering genes in bladder urothelial carcinoma
  151. Pepsin concentration in oral lavage fluid of rabbit reflux model constructed by dilating the lower esophageal sphincter
  152. The antihypertensive felodipine shows synergistic activity with immune checkpoint blockade and inhibits tumor growth via NFAT1 in LUSC
  153. Tanshinone IIA attenuates valvular interstitial cells’ calcification induced by oxidized low density lipoprotein via reducing endoplasmic reticulum stress
  154. AS-IV enhances the antitumor effects of propofol in NSCLC cells by inhibiting autophagy
  155. Establishment of two oxaliplatin-resistant gallbladder cancer cell lines and comprehensive analysis of dysregulated genes
  156. Trial protocol: Feasibility of neuromodulation with connectivity-guided intermittent theta-burst stimulation for improving cognition in multiple sclerosis
  157. LncRNA LINC00592 mediates the promoter methylation of WIF1 to promote the development of bladder cancer
  158. Factors associated with gastrointestinal dysmotility in critically ill patients
  159. Mechanisms by which spinal cord stimulation intervenes in atrial fibrillation: The involvement of the endothelin-1 and nerve growth factor/p75NTR pathways
  160. Analysis of two-gene signatures and related drugs in small-cell lung cancer by bioinformatics
  161. Silencing USP19 alleviates cigarette smoke extract-induced mitochondrial dysfunction in BEAS-2B cells by targeting FUNDC1
  162. Menstrual irregularities associated with COVID-19 vaccines among women in Saudi Arabia: A survey during 2022
  163. Ferroptosis involves in Schwann cell death in diabetic peripheral neuropathy
  164. The effect of AQP4 on tau protein aggregation in neurodegeneration and persistent neuroinflammation after cerebral microinfarcts
  165. Activation of UBEC2 by transcription factor MYBL2 affects DNA damage and promotes gastric cancer progression and cisplatin resistance
  166. Analysis of clinical characteristics in proximal and distal reflux monitoring among patients with gastroesophageal reflux disease
  167. Exosomal circ-0020887 and circ-0009590 as novel biomarkers for the diagnosis and prediction of short-term adverse cardiovascular outcomes in STEMI patients
  168. Upregulated microRNA-429 confers endometrial stromal cell dysfunction by targeting HIF1AN and regulating the HIF1A/VEGF pathway
  169. Bibliometrics and knowledge map analysis of ultrasound-guided regional anesthesia
  170. Knockdown of NUPR1 inhibits angiogenesis in lung cancer through IRE1/XBP1 and PERK/eIF2α/ATF4 signaling pathways
  171. D-dimer trends predict COVID-19 patient’s prognosis: A retrospective chart review study
  172. WTAP affects intracranial aneurysm progression by regulating m6A methylation modification
  173. Using of endoscopic polypectomy in patients with diagnosed malignant colorectal polyp – The cross-sectional clinical study
  174. Anti-S100A4 antibody administration alleviates bronchial epithelial–mesenchymal transition in asthmatic mice
  175. Prognostic evaluation of system immune-inflammatory index and prognostic nutritional index in double expressor diffuse large B-cell lymphoma
  176. Prevalence and antibiogram of bacteria causing urinary tract infection among patients with chronic kidney disease
  177. Reactive oxygen species within the vaginal space: An additional promoter of cervical intraepithelial neoplasia and uterine cervical cancer development?
  178. Identification of disulfidptosis-related genes and immune infiltration in lower-grade glioma
  179. A new technique for uterine-preserving pelvic organ prolapse surgery: Laparoscopic rectus abdominis hysteropexy for uterine prolapse by comparing with traditional techniques
  180. Self-isolation of an Italian long-term care facility during COVID-19 pandemic: A comparison study on care-related infectious episodes
  181. A comparative study on the overlapping effects of clinically applicable therapeutic interventions in patients with central nervous system damage
  182. Low intensity extracorporeal shockwave therapy for chronic pelvic pain syndrome: Long-term follow-up
  183. The diagnostic accuracy of touch imprint cytology for sentinel lymph node metastases of breast cancer: An up-to-date meta-analysis of 4,073 patients
  184. Mortality associated with Sjögren’s syndrome in the United States in the 1999–2020 period: A multiple cause-of-death study
  185. CircMMP11 as a prognostic biomarker mediates miR-361-3p/HMGB1 axis to accelerate malignant progression of hepatocellular carcinoma
  186. Analysis of the clinical characteristics and prognosis of adult de novo acute myeloid leukemia (none APL) with PTPN11 mutations
  187. KMT2A maintains stemness of gastric cancer cells through regulating Wnt/β-catenin signaling-activated transcriptional factor KLF11
  188. Evaluation of placental oxygenation by near-infrared spectroscopy in relation to ultrasound maturation grade in physiological term pregnancies
  189. The role of ultrasonographic findings for PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor-2-negative breast cancer
  190. Construction of immunogenic cell death-related molecular subtypes and prognostic signature in colorectal cancer
  191. Long-term prognostic value of high-sensitivity cardiac troponin-I in patients with idiopathic dilated cardiomyopathy
  192. Establishing a novel Fanconi anemia signaling pathway-associated prognostic model and tumor clustering for pediatric acute myeloid leukemia patients
  193. Integrative bioinformatics analysis reveals STAT2 as a novel biomarker of inflammation-related cardiac dysfunction in atrial fibrillation
  194. Adipose-derived stem cells repair radiation-induced chronic lung injury via inhibiting TGF-β1/Smad 3 signaling pathway
  195. Real-world practice of idiopathic pulmonary fibrosis: Results from a 2000–2016 cohort
  196. lncRNA LENGA sponges miR-378 to promote myocardial fibrosis in atrial fibrillation
  197. Diagnostic value of urinary Tamm-Horsfall protein and 24 h urine osmolality for recurrent calcium oxalate stones of the upper urinary tract: Cross-sectional study
  198. The value of color Doppler ultrasonography combined with serum tumor markers in differential diagnosis of gastric stromal tumor and gastric cancer
  199. The spike protein of SARS-CoV-2 induces inflammation and EMT of lung epithelial cells and fibroblasts through the upregulation of GADD45A
  200. Mycophenolate mofetil versus cyclophosphamide plus in patients with connective tissue disease-associated interstitial lung disease: Efficacy and safety analysis
  201. MiR-1278 targets CALD1 and suppresses the progression of gastric cancer via the MAPK pathway
  202. Metabolomic analysis of serum short-chain fatty acid concentrations in a mouse of MPTP-induced Parkinson’s disease after dietary supplementation with branched-chain amino acids
  203. Cimifugin inhibits adipogenesis and TNF-α-induced insulin resistance in 3T3-L1 cells
  204. Predictors of gastrointestinal complaints in patients on metformin therapy
  205. Prescribing patterns in patients with chronic obstructive pulmonary disease and atrial fibrillation
  206. A retrospective analysis of the effect of latent tuberculosis infection on clinical pregnancy outcomes of in vitro fertilization–fresh embryo transferred in infertile women
  207. Appropriateness and clinical outcomes of short sustained low-efficiency dialysis: A national experience
  208. miR-29 regulates metabolism by inhibiting JNK-1 expression in non-obese patients with type 2 diabetes mellitus and NAFLD
  209. Clinical features and management of lymphoepithelial cyst
  210. Serum VEGF, high-sensitivity CRP, and cystatin-C assist in the diagnosis of type 2 diabetic retinopathy complicated with hyperuricemia
  211. ENPP1 ameliorates vascular calcification via inhibiting the osteogenic transformation of VSMCs and generating PPi
  212. Significance of monitoring the levels of thyroid hormone antibodies and glucose and lipid metabolism antibodies in patients suffer from type 2 diabetes
  213. The causal relationship between immune cells and different kidney diseases: A Mendelian randomization study
  214. Interleukin 33, soluble suppression of tumorigenicity 2, interleukin 27, and galectin 3 as predictors for outcome in patients admitted to intensive care units
  215. Identification of diagnostic immune-related gene biomarkers for predicting heart failure after acute myocardial infarction
  216. Long-term administration of probiotics prevents gastrointestinal mucosal barrier dysfunction in septic mice partly by upregulating the 5-HT degradation pathway
  217. miR-192 inhibits the activation of hepatic stellate cells by targeting Rictor
  218. Diagnostic and prognostic value of MR-pro ADM, procalcitonin, and copeptin in sepsis
  219. Review Articles
  220. Prenatal diagnosis of fetal defects and its implications on the delivery mode
  221. Electromagnetic fields exposure on fetal and childhood abnormalities: Systematic review and meta-analysis
  222. Characteristics of antibiotic resistance mechanisms and genes of Klebsiella pneumoniae
  223. Saddle pulmonary embolism in the setting of COVID-19 infection: A systematic review of case reports and case series
  224. Vitamin C and epigenetics: A short physiological overview
  225. Ebselen: A promising therapy protecting cardiomyocytes from excess iron in iron-overloaded thalassemia patients
  226. Aspirin versus LMWH for VTE prophylaxis after orthopedic surgery
  227. Mechanism of rhubarb in the treatment of hyperlipidemia: A recent review
  228. Surgical management and outcomes of traumatic global brachial plexus injury: A concise review and our center approach
  229. The progress of autoimmune hepatitis research and future challenges
  230. METTL16 in human diseases: What should we do next?
  231. New insights into the prevention of ureteral stents encrustation
  232. VISTA as a prospective immune checkpoint in gynecological malignant tumors: A review of the literature
  233. Case Reports
  234. Mycobacterium xenopi infection of the kidney and lymph nodes: A case report
  235. Genetic mutation of SLC6A20 (c.1072T > C) in a family with nephrolithiasis: A case report
  236. Chronic hepatitis B complicated with secondary hemochromatosis was cured clinically: A case report
  237. Liver abscess complicated with multiple organ invasive infection caused by hematogenous disseminated hypervirulent Klebsiella pneumoniae: A case report
  238. Urokinase-based lock solutions for catheter salvage: A case of an upcoming kidney transplant recipient
  239. Two case reports of maturity-onset diabetes of the young type 3 caused by the hepatocyte nuclear factor 1α gene mutation
  240. Immune checkpoint inhibitor-related pancreatitis: What is known and what is not
  241. Does total hip arthroplasty result in intercostal nerve injury? A case report and literature review
  242. Clinicopathological characteristics and diagnosis of hepatic sinusoidal obstruction syndrome caused by Tusanqi – Case report and literature review
  243. Synchronous triple primary gastrointestinal malignant tumors treated with laparoscopic surgery: A case report
  244. CT-guided percutaneous microwave ablation combined with bone cement injection for the treatment of transverse metastases: A case report
  245. Malignant hyperthermia: Report on a successful rescue of a case with the highest temperature of 44.2°C
  246. Anesthetic management of fetal pulmonary valvuloplasty: A case report
  247. Rapid Communication
  248. Impact of COVID-19 lockdown on glycemic levels during pregnancy: A retrospective analysis
  249. Erratum
  250. Erratum to “Inhibition of miR-21 improves pulmonary vascular responses in bronchopulmonary dysplasia by targeting the DDAH1/ADMA/NO pathway”
  251. Erratum to: “Fer exacerbates renal fibrosis and can be targeted by miR-29c-3p”
  252. Retraction
  253. Retraction of “Study to compare the effect of casirivimab and imdevimab, remdesivir, and favipiravir on progression and multi-organ function of hospitalized COVID-19 patients”
  254. Retraction of “circ_0062491 alleviates periodontitis via the miR-142-5p/IGF1 axis”
  255. Retraction of “miR-223-3p alleviates TGF-β-induced epithelial-mesenchymal transition and extracellular matrix deposition by targeting SP3 in endometrial epithelial cells”
  256. Retraction of “SLCO4A1-AS1 mediates pancreatic cancer development via miR-4673/KIF21B axis”
  257. Retraction of “circRNA_0001679/miR-338-3p/DUSP16 axis aggravates acute lung injury”
  258. Retraction of “lncRNA ACTA2-AS1 inhibits malignant phenotypes of gastric cancer cells”
  259. Special issue Linking Pathobiological Mechanisms to Clinical Application for cardiovascular diseases
  260. Effect of cardiac rehabilitation therapy on depressed patients with cardiac insufficiency after cardiac surgery
  261. Special issue The evolving saga of RNAs from bench to bedside - Part I
  262. FBLIM1 mRNA is a novel prognostic biomarker and is associated with immune infiltrates in glioma
  263. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part III
  264. Development of a machine learning-based signature utilizing inflammatory response genes for predicting prognosis and immune microenvironment in ovarian cancer
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Heruntergeladen am 8.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/med-2023-0674/html
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