Background: The Covid-19 pandemic restricts children and adolescents from doing normal daily activities such as playing outdoors and going to school. The incidence and prevalence of myopia have increased during the COVID-19 pandemic. The aim of this study was to investigate and evaluate the impact of the home confinement during the COVID-19 pandemic on the progression of myopia among children and adolescents in Chongqing, China.Methods: The survey was conducted by using stratified samplings. Samples were randomly selected from the 2019 National Student Physique and Health Survey database, and their visual function and refractive data were compared with those in 2020. Vision-related behavior questionnaire including digital screen exposure was applied to investigate the correlation between eye parameter and eye health-related behavior.Results: A total of 1,733 and 1,728 students were enrolled in 2020 and 2019, respectively. The percentage of myopia students was 55.02% in 2020, which was higher than that in 2019 (44.62%). The mean uncorrected visual acuity (UCVA, LogMAR, 0.35 ± 0.42) in 2020 was higher than that in 2019 (0.27 ± 0.36, P < 0.001). The mean spherical equivalent (SE) refraction (−1.94 ± 2.13 D) in 2020 was lower than that in 2019 (−1.64 ± 5.49 D, P < 0.001). For students who used digital devices for online courses, the mean SE in the television group (−1.10 ± 1.49 D) was better than that in the computer group (−2.03 ± 2.37 D, P = 0.0017) and in the cell phone group (−2.02 ± 2.09 D, P = 0.0028). The average duration of online classes (r = −0.27, P < 0.0001), the number of online classes per day (r = −0.33, P < 0.0001), as well as digital screen exposure time (r = −0.20, P < 0.0001) were negatively correlated with SE, and the average time of outdoor activity (r = 0.20, P < 0.0001) was positively correlated with SE.Conclusions: Increased digital screen exposure contributes to myopic progression in children and adolescents of Chongqing during the COVID-19 pandemic. Suitable digital devices should be provided for online classes and outdoor activity should be advocated to prevent myopic pandemic.

The high infectivity of COVID-19 has led to a rapid increase in new cases and outbreaks since December 2019 (1, 2). A part of patients showed adverse outcomes from treatment, such as severe pneumonia, pulmonary edema, acute respiratory distress syndrome (ARDS) or even multiple organ failure. Recent studies have basically identified the correlation between the poor prognosis and outcome of COVID-19 patients with their own status (3). Based on the relationship between nutritional status and prognosis, the present study fully considered the nutritional status of patients in the acute phase of admission, and chose total cholesterol, total lymphocyte and serum protein count as CONUT score to reflect their nutritional status and immunological characteristics. Since the number of studies about the epidemiological characteristics of COVID-19 is scarce, the present study aims to analyze the correlation between the nutritional status and prognosis of COVID-19 patients, and their epidemiological characteristics with different nutritional status. Methods and materials The present study used a single-center, retrospective analysis method. 489 patients who were diagnosed positive for COVID-19 in Hubei Provincial Hospital of Traditional Chinese Medicine from December 2019 to March 2020 were recruited. However, 60 patients were excluded due to their missing score of CONUT, and 429 patients were finally included in the study. The diagnostic criteria was based on Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7) (4). The study was approved by the Ethics Committee of Hubei Provincial Hospital of Traditional Chinese Medicine, and the data was from the cases in our hospital during hospitalization. The average age of the included 429 patients was 58.29 ± 15.89 (The oldest: 92; the youngest: 19). The number of male patients was 212 (49.42%), and the number of female patients was 217 (50.58%). Evaluation index The demographics, medical history, signs, symptoms and inpatient lab examinations of COVID-19 patients were collected. The major indicator of adverse outcomes was the all-cause death of COVID-19 patients. Secondary indicators of adverse outcomes included transferring to ICU due to aggravation, acute heart failure or acute respiratory failure (5). The CONUT score (the highest score: 12; the lowest score: 0) of each patient was evaluated based on his/her serum albumin, peripheral blood lymphocyte count, and cholesterol concentration (6-9). CONUT score 4 was set as the critical

No abstract

No abstract

ObjectivesTo investigate myopia progression and associated factors of refractive status among children and adolescents in Tibet and Chongqing in China during the COVID-19 pandemic.MethodsA population-based cross-sectional study was conducted to compare rates of myopia and high myopia, axial length (AL), spherical equivalent (SE), outdoor activity time, digital device use, and frequency of visual examinations for children and adolescents affected by myopia in Chongqing and Tibet in 2021.ResultsA total of 2,303 students from Chongqing and 1,687 students from Tibet were examined. The overall prevalence of myopia and high myopia in these two groups were 53.80 and 7.04% vs. 43.86 and 1.30%, respectively in each case. The Chongqing students had a longer AL than the group from Tibet (23.95 vs. 23.40 mm, respectively; p < 0.001). The mean SE of the students with myopic parents in Tibet was lower than that of the students in Chongqing with myopic parents (−2.57 ± 2.38 diopters (D) vs. −2.30 ± 2.34 D, respectively) (p < 0.001). Conversely, the mean SE of the students from urban areas in Chongqing was lower than that of the students in Tibet (−2.26 ± 2.25 D vs. −1.75 ± 1.96 D, respectively; p < 0.001). The Chongqing students exhibited lower SE (−2.44 ± 2.22 D) than their Tibetan counterparts (mean SE: −1.78 ± 1.65 D (p = 0.0001) when spending more than 2.5 h outdoors. For example, 61.35% of the students in Tibet spent more than 2.5 h outdoors daily, compared with 43.04% of the students in Chongqing. Correspondingly, the proportion of students using digital devices in Tibet (64.43%) was lower than that in Chongqing (100%). For the latter, 38.62% of the students in Chongqing spent more than 2.5 h online using digital devices compared to 10.49% of the students in Tibet. Greater monitoring of visual status was observed for the Chongqing students (mean SE: −1.90 ± 1.98 D) compared with students in Tibet (mean SE: −2.68 ± 1.85 D) (p = 0.0448), with the frequency of optimal examinations being every 6 months. Outdoor activity time was identified as a common risk factor for myopia in both of the populations examined, with odds ratios (ORs) of 1.84 (95% CI: 1.79–1.90) in Chongqing and 0.84 (95% CI: 0.73–0.96) in Tibet. Digital screen time was associated with myopia and high myopia in Chongqing, with ORs of 1.15 (95% CI: 1.08–1.22) and 1.06 (95% CI: 0.94–1.77), respectively. Digital screen time was also found to be a risk factor for high myopia in Tibet (OR: 1.21, 95% CI: 0.77–1.61). The type of digital devices used was also associated with myopia and high myopia in Tibet (OR: 1.33, 95% CI: 1.06–1.68 and OR: 1.49, 95% CI: 0.84–2.58, respectively). Finally, examination frequency was found to correlate with high myopia in the Tibet group (OR: 1.79, 95% CI: 0.66–2.71).ConclusionBased on our data, we observed that the prevalence of refractive errors in children and adolescents was significantly lower in Tibet than in Chongqing. These results are potentially due to prolonged outdoor activity time, and the type and time of use for digital devices that characterize the group of children and adolescents from Tibet. It is recommended that parents and children in Chongqing would benefit from increased awareness regarding myopia progression and its prevention.