Abstract Background Since its first appearance in Wuhan China in December 2019, the coronavirus disease 2019 (COVID-19) has become a worldwide pandemic. Although the COVID-19 is known to cause by human-to-human transmission, it remains largely unclear whether ambient air pollutants and meteorological factors could promote its transmission process. Methods We conducted a retrospective cohort study to understand the correlation between COVID-19 incidence and eight ambient air pollutants (PM2.5, PM10, SO2, CO, NO2, and O3-8 h) and three meteorological variables (temperature, humidity and wind level) in China’s two worst-hit cities, Wuhan and XiaoGan, between Jan 25th to Feb 29th in 2020. Results Our data showed that the COVID-19 incidence was constantly correlated with PM2.5, NO2 and local temperature in both cities. Specifically, in Wuhan, the tightest correlation was observed between NO2 and COVID-19 incidence (R2 = 0.329, p < 0.01). The PM2.5 and CO also present tight correlation with the incidence number, whose R2 equaled 0.174 (p < 0.01) and 0.203 (p < 0.05), respectively. In XiaoGan, in addition to the PM2.5 (R2 = 0.23, p < 0.01) and NO2 (R2 = 0.158, p < 0.05), a notable correlation was also observed between the PM10 and incidence cases (R2 = 0.158, p < 0.05). Moreover, temperature is the only meteorological factors that constantly correlated well with COVID-19 incidence in both Wuhan and XiaoGan, but in a negative pattern (R2 = 0.126 and 0.13, respectively, both p < 0.05). Conclusion Our data concludes that ambient air pollutants, especially PM2.5 and NO2, and temperature are three variables that could potential promote the sustained transmission of COVID-19. Thus, personal protective devices, especially the facial mask and eye goggle, shall be suggested to residents for SARS-CoV-2 protection in highly polluted regions.

OBJECTIVES:Although COVID-19 is known to be caused by human-to-human transmission, it remains largely unclear whether ambient air pollutants and meteorological parameters could promote its transmission.METHODS:A retrospective study was conducted to study whether air quality index (AQI), four ambient air pollutants (PM2.5, PM10, NO2 and CO) and five meteorological variables (daily temperature, highest temperature, lowest temperature, temperature difference and sunshine duration) could increase COVID-19 incidence in Wuhan and XiaoGan between Jan 26th to Feb 29th in 2020.RESULTS:First, a significant correlation was found between COVID-19 incidence and AQI in both Wuhan (R2=0.13, p<0.05) and XiaoGan (R2=0.223, p<0.01). Specifically, among four pollutants, COVID-19 incidence was prominently correlated with PM2.5 and NO2 in both cities. In Wuhan, the tightest correlation was observed between NO2 and COVID-19 incidence (R2=0.329, p<0.01). In XiaoGan, in addition to the PM2.5 (R2=0.117, p<0.01) and NO2 (R2=0.015, p<0.05), a notable correlation was also observed between the PM10 and COVID-19 incidence (R2=0.105, p<0.05). Moreover, temperature is the only meteorological parameter that constantly correlated well with COVID-19 incidence in both Wuhan and XiaoGan, but in an inverse correlation (p<0.05).CONCLUSIONS:AQI, PM2.5, NO2, and temperature are four variables that could promote the sustained transmission of COVID-19.

Background It has been widely understood that well-trained doctors are crucial for a high-quality public health system and safe patient care. Thus, in 2011, China initiated its first national residency training program, called the China Standardized Training for Resident Doctor (C-STRD), for medical graduates to prepare qualified doctors for the medical care system with increasing demands. So far, no studies have specifically address the prevalence of stress and its determinants among residents enrolled in the C-STRD. Participants and methods The research is performed in two stages. In stage I, the authors conducted a pilot study and met 112 C-STRD residents in person. Based on the preliminary data, a revised questionnaire was adopted in stage II, during which the authors conducted a multi-institutional, cross-sectional survey of 340 participants from 11 hospitals in Shanghai in a self-administered manner. Results The results showed that C-STRD residents were overall under severe stress as their mean PSS score was 27.5 ± 4.9, which was higher than the threshold of high stress (PSS = 20). Specifically, the PSS score for the residents with Bachelor (MB), Master (MM) and Doctoral of Medicine (MD) educational degree were 26.6 ± 4.1, 27.8 ± 3.5 and 27.1 ± 5.2, respectively (P>0.05). Their stress was mainly associated with their financial income status and workload, as these two factors caused more severe burden than other listed stressors (P<0.05). Specially, the residents indicated that their montly payroll amout were as low as $590.2 ± 127 while no benefit package and allowance were given. Surprisingly, wage arrears up to 5.3 month were reported by 36 (10%) participants. Workload survey showed the residents has high work intensity and inadequate rest. Since no stress management program was provided, the majority of residents tended to cope their stress with unhealthy strategies, such as mesmerizing in TV/computer (88.2%) and overeating (59.7%). Conclusion The C-STRD residents are at high risk of perceived stress. Although there was a difference in perception of stress for workload and career future among different educational degree owners, low financial income is the major stressor among all C-STRD residents. Unhealthy stress management strategies were adopted by all residents due to lack of appropriate stress-relieving intervention.