The number of COVID-19 patients in Japan is considered low, compared with U.S. and European countries. However, recent serological survey reported that several percent of population showed IgG positive to SARS-CoV-2. Specificity in the assays might influence the estimate, and possibility of overdiagnosis should be investigated. Serological tests for SARS-CoV-2 coronavirus were performed in pre-COVID-19 sera in Japan (400 healthy subjects in 2012–2015). Lateral flow assay (LFA) and enzyme-linked immunosorbent assay (ELISA) showed 1.5% (6/400) and 1.75% (7/400) IgG positives, respectively. Among those false positive samples, only one sample was positive in both LFA and ELISA (0.25%; 95% CI: 0.006–1.39%). Possible bias from pooling method was examined by Monte Carlo method and the possibility was unlikely at low false positive rate. Previous surveys might overestimate COVID-19 seroprevalence in several populations of Japan. These false positives could be excluded by combination of different diagnostics. Nonetheless, the result of seroprevalence should be carefully interpreted in less prevalent areas.

Isoflavones found in soy products are a promising class of nutrients that may have a positive effect on human health. In particular, the phytoestrogen metabolite equol is associated with a reduced risk of developing female hormone-related diseases. However, the effect of equol on estrogen remains unclear. Equol can modify blood and urinary estradiol (E2) levels. The aim of this cross-sectional study was to examine the associations between urinary estrogen levels, equol levels, and equol production status in Japanese women. We analyzed urine samples from 520 women by gas chromatography-mass spectrometry. Urinary E2 and 4-hydroxylated E2 levels were higher in equol producers (EQP) than in non-EQPs (P < 0.0001 and P=0.00112, respectively). After adjusting for age and tobacco use by analysis of covariance, the association remained significant (β = 0.299, P < 0.0001). Analysis of covariance demonstrated that equol levels in urine were also positively associated with urinary E2 (β = 0.597, P < 0.0001). The log equol concentration showed a significant, but moderate, negative association with the serum E2 concentration (β = − 0.0225, P = 0.0462). Our findings suggest that equol may promote urinary E2 excretion and modify blood E2 levels in women.

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Background: Healthcare workers (HCWs) employed personal protective equipment (PPE) during the COVID-19 pandemic, crucial to protecting themselves from infection. To highlight the efficacy of PPE in preventing environmental infection among HCWs, a systematic review was conducted in line with PRISMA guidance. Methods: A search of the PubMed and Web of Science databases was conducted from January 2019 to April 2021 using pre-defined search terms. Articles were screened by three researchers. The approved papers were read in full and included in this review if relevance was mutually agreed upon. Data were extracted by study design and types of PPEs. Results: 47 of 108 identified studies met the inclusion criteria, with seven reviews and meta-analyses, seven cohort, nine case-control, fifteen cross-sectional studies, four before and after, four case series, and one modeling studies. Wearing PPE offered COVID-19 protection in HCWs but required adequate training. Wearing surgical masks provided improved protection over cloth masks, while the benefit of powered air-purifying respirators is less clear, as are individual gowns, gloves, and/or face shields. Conclusions: Wearing PPE, especially facial masks, is necessary among HCWs, while training in proper use of PPE is also important to prevent COVID-19 infection.