Transformed Time Series Analysis of First Wave COVID-19: Universal Similarities Found in The Group of Twenty (G20) Countries

As of April 30, 2020, cumulative confirmed coronavirus disease 2019 (COVID-19) cases exceeded 3 million worldwide and 1 million in the US, with an estimated fatality rate of more than 7 percent. Because the occurrence patterns of new confirmed cases and deaths over time are complex and seemingly country-specific, estimating the long-term pandemic spread is challenging. I developed a simple transformation algorithm to investigate the characteristics of the case and death time series per nation and described the universal similarities observed in the transformed time series of 19 nations in the Group of Twenty (G20). A transformation algorithm of the time series data sets was developed with open-source software programs to investigate the universal similarities among the cumulative profiles of confirmed cases and deaths of 19 individual nations in the G20. The algorithm extracted and analyzed statistical information from daily updated COVID-19 pandemic data sets from the European Centre for Disease Prevention and Control (ECDC). Two new parameters for each nation were suggested as factors for time-shifting and time-scaling to define reduced time, which was used to quantify the degree of universal similarities among nations. After the cumulative confirmed case and death profiles of a nation were transformed by using reduced time, most of the 19 nations, with few exceptions, had transformed profiles that closely converged to those of Italy after the onset of cases and deaths. The initial profiles of the cumulative confirmed cases per nation universally showed 3 to 4-week latency periods, during which the total number of cases remained at approximately ten. The latency period of the cumulative number of deaths was approximately half the latency number of cumulative cases, and subsequent uncontrollable increases in human deaths seemed unavoidable because the coronavirus had already widely spread. Immediate governmental actions, including responsive public-health policymaking and enforcement, are observed to be critical to minimize (and possibly stop) further infections and subsequent deaths. In the pandemic spread of infectious viral diseases, such as COVID-19, studied in this work, different nations show dissimilar and seemingly uncorrelated time series profiles of infected cases and deaths. After these statistical phenomena were viewed as identical events occurring at a distinct rate in each country, the reported algorithm of the data transformation using the reduced time revealed a nation-independent, universal profile (especially initial periods of the pandemic spread) from which a nation-specific, predictive estimation could be made and used to assist in immediate public-health policymaking.

HIV infection among voluntary blood donors in Shijiazhuang, 2011-2021 / 中国输血杂志

【Objective】 To study the characteristics of HIV infection among voluntary blood donors in Shijiazhuang from 2011 to 2021, so as to provide reference for decision making in the control of HIV for blood centers. 【Methods】 The confirmatory results of HIV reactive samples in initial screening among voluntary blood donors from 2011 to 2021 in our center were statistical analyzed. 【Results】 A total of 2 008 299 samples from 1 667 315 blood donors were detected, among which 3 217 samples were HIV reactive and 234 were confirmed positive, with the positive rate at 11.65/100 000 and the prevalence of 14.03/100 000. The prevalence in men was higher than that in women (16.52/100 000 vs 1.39/100 000), in first-time blood donors higher than that in repeated donors (17.27/100 000 vs 8.12/100 000), in whole blood donors higher than that in plateletpheresis donors (12.01/100 000 vs 8.41/100 000), and the differences were statistically significant (P<0.05). The male homosexual transmission was the main routes of transmission, accounting for 62.39% (146/234). And 72% of double-reagent reactive samples were confirmed positive. Four samples were screened in the serological window period and 6 samples were from HIV positive confirmed donors. 【Conclusion】 The HIV prevalence among voluntary blood donors in Shijiazhuang was low. A certain percentage of repeated blood donors got newly infected. NAT could shorten the detection window period of HIV. Since some confirmed positive samples had not been detected out by NAT, publicity and education should be strengthened to reduce the probability of infected or high-risk groups to participate in blood donation.

Clinical profile of genetically confirmed Spinal Muscular Atrophy (SMA) Among Filipino children less than 18 years old

@#Spinal muscular atrophy (SMA) is the most common inherited lethal disease in children. Confirmatory diagnosis is based on molecular genetic testing of survival motor neuron (SMN) genes. We aimed to describe the phenotypic presentation of Filipino infants and children with SMA based on the copy number analysis of SMN genes. Medical records of 17 Filipino children were reviewed from January 2017 to December 2019. De-identified clinical data fulfilled the diagnostic criteria defined by the International SMA Consortium. Among Filipino children, the predominant SMA type by copy number was type I having two copies of SMN2 gene. The clinical severity based on symptom onset and highest functional motor capacity attained correlated with SMN2 copy number congruent with existing data. A significant time lag between symptom onset to confirmation of genetic diagnosis was noted. Nine out of the 17 (52%) children did not have a family history of the disease, raising the possibility of mutation carriers in these families since the incidence of de novo mutations in literature is about 2%. These data offered the first epidemiological pattern of genetically confirmed SMA among Filipino children; provided additional information for genetic counselling; and an avenue to consider pre-symptomatic newborn screening and carrier testing that would change proactive measures and opportunities for therapy. These measures unavoidably will decrease the incidence and prevalence of disease in the future.

Características clínicas y epidemiológicas de recién nacidos con COVID-19: Serie de casos / Clinical and epidemiological features of newborns with COVID-19: Case series

RESUMEN Fundamento: Los recién nacidos (menos de 28 días) es una población especialmente vulnerable, y los datos sobre la enfermedad por coronavirus 2019 (COVID-19) en este grupo etario no ha sido estudiada ampliamente, por lo que es necesario investigar su caracterización clínica y epidemiológica. Objetivo: Describir las características clínicas y epidemiológicas en una serie de neonatos ingresados, con infección por SARS-CoV-2 confirmada, en el servicio de neonatología del Hospital General Camilo Cienfuegos, entre el 1 de marzo de 2020 y el 31 de marzo de 2022. Metodología: Se realizó un estudio de serie de casos en neonatos ingresados con infección confirmada de SARS-CoV-2, en el servicio de neonatología. Se incluyeron 111 casos de recién nacidos con resultado positivo en la prueba de reacción de la polimerasa en cadena en tiempo real (RT-PCR) para la detección del SARS-CoV-2 en muestra nasofaríngea. Las variables principales fueron la procedencia, clasificación epidemiológica, el sexo, edad gestacional y peso al nacer, síntomas presentados, días de estadía durante su ingreso, alteraciones de su salud, estado del paciente, uso de antibióticos y exámenes complementarios realizados. Resultados: Predominó la procedencia de la comunidad, el recién nacido sospechoso, el sexo masculino, la condición de nacer a término y con buen peso, la forma asintomática, la estadía de aislamiento entre 5 y 10 días. Las alteraciones vistas fueron la neumonía, la sepsis no focalizada, la taquicardia supraventricular y miocardiopatía dilatada, el estado del paciente de cuidado, el no uso de antibióticos, alteraciones en el leucograma, la gasometría, el rayos X de tórax y el ecocardiograma, no hubo fallecidos. Conclusiones: La evolución de los recién nacidos con infección por SARS-CoV-2 confirmada fue favorable, no ocurrieron fallecimientos. La forma asintomática y la historia epidemiológica del paciente deben considerarse para un diagnóstico temprano de la enfermedad.

ABSTRACT Background: Newborns (less than 28 days) are a particularly vulnerable population, data on coronavirus disease 2019 (COVID-19) in this age group has not been extensively studied, so it is necessary to investigate its clinical and epidemiological characterization. Objective: To describe the clinical and epidemiological features in neonate series admitted, with confirmed SARS-CoV-2 infection, in the provincial neonatology service at Camilo Cienfuegos General Provincial Hospital, between March 1, 2020 and March 31, 2022. Methodology: A case series study was conducted in neonates admitted with confirmed SARS-CoV-2 infection, in the provincial neonatology service. 111 cases of newborns with positive result in the real-time polymerase chain reaction (RT-PCR) test for the detection of SARS-CoV-2 in nasopharyngeal samples were included. The main variables were origin, epidemiological classification, sex, gestational age and birth weight, symptoms presented, days of stay during admission, health changes, patient status, use of antibiotics and complementary tests performed. Results: Community origin, suspicious newborn, male sex, condition of being born at term having good weight, asymptomatic form, isolation stay between 5 and 10 days prevailed. The alterations seen were pneumonia, non-focal sepsis, supraventricular tachycardia and dilated cardiomyopathy, patient's state of care, the non-use of antibiotics, alterations in the leukogram, blood gases, chest x-ray and echocardiogram, there were no any deceased. Conclusions: The evolution of newborns with confirmed SARS-CoV-2 infection was satisfactory, no deaths occurred. Asymptomatic manifestation and patient´s epidemiological record should be considered for the early diagnosis of disease.

Comparative analysis of epidemiological trends of COVID-19 in Shanghai and New York City / 上海预防医学

ObjectiveTo assess the effects of countermeasures against coronavirus disease 2019 （COVID-19） in Shanghai from March to May 2022 in comparison with epidemiological trend of COVID-19 in New York City. MethodsDaily confirmed cases， asymptomatic SARS-CoV-2 carriers， and daily deaths were obtained in the Shanghai Municipal Health Commission and the Center for Disease Control and Prevention （CDC） of the United States. Descriptive study was conducted by using these data. ResultsFrom March 1 to May 17， the number of daily asymptomatic SARS-CoV-2 infections in Shanghai was up to 58 times as large as that of daily confirmed cases； however， the number of daily confirmed cases in Shanghai was generally less than that in New York in the same time period. At the peak of the COVID-19 epidemic， the growth of daily attack rate in Shanghai was significantly lower than that in New York （P<0.05）. Moreover， the number of daily death was evidently less than that in New York. In addition， the vaccination rate in the elderly （aged ≥60 years） in Shanghai was evidently lower than that in New York （aged ≥65 years）. ConclusionThe COVID-19 epidemics in Shanghai from March to May 2022 and in New York after December 2021 were both caused by the Omicron variant. Compared with the Delta variant， the Omicron variant has stronger replication ability and infectivity， resulting in challenges to the containment of the epidemic in metropolis such as Shanghai and New York City. The epidemic in New York City remained crucial due to absence of effective countermeasures， while that in Shanghai has been effectively contained with strict countermeasures. The prevention and control strategies may be adjusted along with the continual evolution of SARS-CoV-2 and increasing trend of imported COVID-19 cases.

Epidemiological characteristics of SARS-CoV-2 infection outbreak in Shanghai in the Spring of 2022 / 上海预防医学

ObjectiveTo investigate the epidemiological characteristics and analyze the incidence trend of SARS-CoV-2 infection in Shanghai， China， and compare with the characteristics of the infection in Jilin Province of China during the same period in 2022 and Wuhan at the beginning of 2020. MethodsInformation of new locally-transmitted confirmed SARS-CoV-2 cases， imported confirmed COVID-19 cases， local asymptomatic SARS-CoV-2 carriers and imported asymptomatic SARS-CoV-2 carriers in Shanghai from March 1 to April 18， 2022 was collected for descriptive analysis. ResultsFrom March 1 to April 18， 2022， a total of 397 933 locally-transmitted SARS-CoV-2 cases were reported in Shanghai. Of those， 27 613 were clinically confirmed cases and 21 were severe cases. Ten deaths were related to COVID-19. The pathogen is Omicron variant BA.2 of SARS-CoV-2. The number of the infected subjects increased rapidly after March 24 and lead to a disease outbreak. Severe and deceased cases had severe comorbidity and were mostly unvaccinated with SARS-CoV-2 vaccines. Asymptomatic SARS-CoV-2 carriers accounted for 93.06%， which is significantly higher than that in Jilin Province during the same period （48.07%， P<0.001）. Daily increase in the number of clinically confirmed COVID-19 cases in Shanghai in 2022 was much lower than that in Wuhan， Hubei Province， in 2020. Number of daily newly imported confirmed COVID-19 cases and imported asymptomatic SARS-CoV-2 carriers declined during this period. ConclusionThe Omicron variant in Shanghai 2022 is highly infectious and less pathogenic. Omicron variant BA.2 replicates rapidly in asymptomatic carriers， which makes the carriers the major source of infection. Full-term vaccination of inactivated SARS-CoV-2 vaccine might decrease the pathogenicity and fatality of SARS-CoV-2 variants. SARS-CoV-2 of the Omicron BA2 strain is likely transmitted through aerosols and droplets， which poses a great challenge to the control of the COVID-19 pandemic in large cities with high population density and sophisticated public transportation.

Clinical presentation and in-hospital prognosis of lung cancer patients presenting with suspected and confirmed COVID-19

We sought to compare the clinical presentation and prognosis of patients with lung cancer and confirmed COVID-19 infection to those with negative RT-PCR SARS-CoV-2 results. We included patients with confirmed lung cancer and suspected COVID-19 who presented to the emergency department. The primary outcome was in-hospital mortality and secondary outcomes included admission to intensive care unit (ICU) or mechanical ventilation. We analyzed the characteristics according to RT-PCR results and primary outcome. We constructed a logistic regression for each RT-PCR result group to find potential predictors of the primary outcome. Among 110 individuals with confirmed lung cancer (65±9 years, 51% male), 38 patients had positive RT-PCR and 72 patients had negative RT-PCR. There was no difference between groups for any clinical characteristic or comorbidities though individuals with confirmed COVID-19 had higher functionality in the ECOG scale. Leucocytes and lymphocytes were lower in individuals with positive tests. The primary outcome occurred in 58 (53%) individuals, 37 (34%) were admitted to the ICU, and 29 (26%) required mechanical ventilation. Although mortality was similar between the two groups, individuals with confirmed COVID-19 were significantly more likely to be admitted to the ICU or receive mechanical ventilation. Only lower lymphocytes and higher CRP were significantly associated with higher mortality. The clinical presentation of COVID-19 in lung cancer is not sufficient to identify higher or lower probability groups among symptomatic individuals, the overall mortality is high irrespective of RT-PCR results, and lymphopenia on admission was associated with the diagnosis and prognosis for COVID-19.

HIV antibody screening and confirmative tests of voluntary blood donors in a hospital in Beijing: A retrospective analysis / 中国输血杂志

【Objective】 To retrospectively analyze the epidemiological characteristics and regularity of HIV among voluntary blood donors in our hospital, so as to provide help for the formulation of effective coping strategies for voluntary blood donation, reduce the incidence of blood transmitted diseases, and improve blood safety. 【Methods】 HIV infection and population characteristics of voluntary blood donors in our hospital from January 2010 to December 2019 were statistically analyzed. 【Results】 A total of 330 000 blood donations occurred during 2010 to 2019, and 1 024 HIV-infected blood donors were screened out, with a positive rate of 0.31%. The detection rate was the highest in 2016, with 158 cases infected(158/35 889, 0.44%), followed by 151 in 2015(151/37 586, 0.40%), and 42 in 2010(42/20 824, 0.20%). The difference was statistically significant (χ2=88.754, P<0.001). Among the 1 024 HIV-infected patients, 876 were males and 148 females, with a gender ratio close to 6∶1. The majority were aged between 18~35 years old, accounting for 86.13%. 【Conclusion】 The HIV infection rate among voluntary blood donors had been increasing year by year in recent years. Major blood centers should strengthen the health information before blood donation, carry out HIV screening strictly, select blood donors appropriately, establish a stable blood donation team, so as to reduce the discarding rate of blood.

Epidemiological characteristics of 123 confirmed COVID-19 cases in Shangrao City， Jiangxi / 上海预防医学

ObjectiveTo describe the epidemiological characteristics of confirmed COVID-19 cases in Shangrao City， and provide scientific evidence for the development of prevention and control strategies. MethodsEpidemiological characteristics of 123 confirmed cases， such as time， sex， age， occupations， area， and source of infection， were analyzed by combining epidemiological investigation with laboratory testing. ResultsOf the 123 confirmed cases， 34 were imported cases and 89 were local cases. The sex ratio was 1.32∶1. Average time interval of the COVID-19 was （18.4±4.4） days， with a median time interval between the onset and final diagnosis of 5 days. There were 19 clustering cases， of which 89.5% were family clusters and 77.3% occurred in families. Majority of the cases were common type. The main source of infection was travelers from the epidemic areas. ConclusionHealth monitoring of travelers from epidemic areas and strict quarantine of close contacts are the main measures to control the spread of the COVID-19 epidemic.

Epidemiological characteristics of 123 confirmed COVID-19 cases in Shangrao City， Jiangxi / 上海预防医学

ObjectiveTo describe the epidemiological characteristics of confirmed COVID-19 cases in Shangrao City， and provide scientific evidence for the development of prevention and control strategies. MethodsEpidemiological characteristics of 123 confirmed cases， such as time， sex， age， occupations， area， and source of infection， were analyzed by combining epidemiological investigation with laboratory testing. ResultsOf the 123 confirmed cases， 34 were imported cases and 89 were local cases. The sex ratio was 1.32∶1. Average time interval of the COVID-19 was （18.4±4.4） days， with a median time interval between the onset and final diagnosis of 5 days. There were 19 clustering cases， of which 89.5% were family clusters and 77.3% occurred in families. Majority of the cases were common type. The main source of infection was travelers from the epidemic areas. ConclusionHealth monitoring of travelers from epidemic areas and strict quarantine of close contacts are the main measures to control the spread of the COVID-19 epidemic.

Asociación entre la pandemia de COVID-19 y las tendencias de búsqueda en internet en Latinoamérica / Association between the pandemic COVID-19 and internet search trends in Latin America

La enfermedad COVID-19 ha puesto en emergencia sanitaria al mundo. La búsqueda de información a través de internet refleja en gran medida el interés de las personas acerca de esta pandemia. El presente estudio tuvo como objetivo determinar la asociación entre el volumen relativo de búsqueda del término combinado [coronavirus + covid-19 + nuevo coronavirus + covid + SARS-CoV-2] y el número de casos confirmados y de muertes diarias por la COVID-19. Se utilizó Google TrendsTM para proporcionar datos sobre el volumen relativo de búsqueda en Google de los términos seleccionados y compararlos con el número de casos confirmados y de muertes diarias por la COVID-19 en los 10 países más afectados de Latinoamérica, reportados por el panel de control de la Organización Mundial de la Salud. El período de evaluación fue del 01 de enero al 14 de junio del año 2020. Para obtener la asociación de las variables cuantitativas se utilizó el coeficiente de correlación de Spearman, con un nivel de significancia (p≤ 0,05). Se encontró una correlación positiva y significativa (p< 0,001) entre el volumen relativo de búsqueda del término combinado con el número de casos confirmados y de muertes cada día por la COVID-19. Por lo tanto, se puede utilizar un modelo basado en el interés de búsqueda en internet para predecir el desarrollo y el momento pico del brote de la COVID-19(AU)

Coronavirus disease 2019 (COVID-19) has put the world in a health emergency. The search for information through the Internet largely reflects the interest of people in this pandemic. The present study aimed to determine the association between the relative search volume of the combined term [coronavirus + covid-19 + new coronavirus + covid + SARS-CoV-2], and the number of confirmed cases and daily deaths from the COVID-19. Google TrendsTM was used to provide data on the relative search volume in Google for the selected terms and compare it with the number of confirmed cases and daily deaths from COVID-19 in the 10 most affected countries in Latin America, reported by the control panel of the World Health Organization on COVID-19 disease. The evaluation period was from January 01 to June 14, 2020. To obtain the relationship between quantitative variables, the Spearman correlation coefficient was used, with a level of significance (p≤ 0.05). A positive and significant correlation (p< 0.001) was found between the relative search volume of the term combined with the number of confirmed cases and deaths by day because of COVID-19. Therefore, an interest-based internet search model can be used to predict the development and peak timing of the COVID-19 outbreak(AU)

Características clínico-epidemiológicas de los pacientes ingresados en el Hospital "Amalia Simoni" durante la pandemia Covid-19 / Clinical-epidemiologic characteristics of the patients admitted in the Hospital "Amalia Simoni" during the Covid-19 pandemics

RESUMEN Introducción: desde los finales del año pasado en Wuhan, se informó de una neumonía de etiología desconocida, que llevó a la Organización Mundial de la Salud a declarar la infección por SARS-CoV-2, como una emergencia sanitaria denominándola como enfermedad por coronavirus 2019 (COVID-19). En Cuba se confeccionó un programa de enfrentamiento, en el cual la atención hospitalaria, siguió un riguroso protocolo de atención a pacientes positivos de la COVID-19, en áreas de cuidados mínimos, intensivos o progresivos. Objetivo: caracterizar clínica/epidemiológica pacientes positivos de la COVID-19, ingresados en el Hospital "Amalia Simoni". Materiales y métodos: se realizó un estudio descriptivo, transversal de 1 066 ingresos en el Hospital "Amalia Simoni", de marzo-mayo del 2020. Se revisaron historias clínicas y se obtuvo: edad, sexo, procedencia, sintomatología, comorbilidades y evolución epidemiológica. Datos que se evaluaron mediante estadísticas descriptivas. Resultados: se halló un predominio de edad media, sin diferencias de sexo, predominaron los casos de la ciudad de Camagüey y de los municipios con mayor urbanización. Prevalecieron la tos y la fiebre, además de la mitad de los casos sin comorbilidades, con solo un pequeño porcentaje de casos confirmados. Conclusiones: con un enfoque basado en la medicina preventiva en los casos estudiados, predominó la edad media, de procedencia de áreas urbanizadas con mayor población y aglomeraciones sociales. Se destacó que el ingreso precoz, basada en la pesquisa de la Atención Primaria logró disminuir los casos confirmados a un pequeño porcentaje, al igual que los graves y un solo fallecido (AU).

ABSTRACT Introduction: from the end of the last year in Wuhan, China, it was informed an unknown etiology pneumonia leading the World Health Organization to declare the infection with SARS-CoV-2 a sanitary emergency naming it coronavirus disease 2019 (Covid-19). A confrontation program was elaborated in Cuba, in which hospital care followed a rigorous protocol to take care to Covid-19-positive patients in areas of minimal, intensive and progressive care. Objective: to clinically/epidemiologically characterize Covid-19-positive patients admitted in the Hospital "Amalia Simoni". Materials and methods: a cross-sectional, descriptive study was carried out in 1 066 patients admitted in the Hospital "Amalia Simoni" in the period March-May 2020. Clinical records were reviewed and data gathered were age, sex, origin, symptomatology, co-morbidities and epidemiological evolution, data obtained through descriptive statistics. Results: it was found the predominance of medium age, without sex differences; the cases of patients from the city of Camaguey and from the municipalities with biggest urbanization predominated. Cough and fever prevailed; half of cases did not have comorbidities, and only a little percent of cases was confirmed. Conclusions: with an approach based in preventive medicine, medium age, and provenance from urban areas with bigger population and social concentrations predominated in the studied cases. It was showed that precocious admission, based on the Primary Health Care screening, succeeded in diminish confirmed cases to a little percent, as diminished the seriously ill ones; only one patient died (AU).

Analysis of clinical characteristics of new coronavirus pneumonia patients in secondary epidemic areas / 中华危重病急救医学

Objective@#Understand the clinical characteristics of confirmed pneumonia patients infected with new corona virus in secondary epidemic areas and guide the diagnosis and treatment of novel pneumonia in secondary epidemic areas and provide a reference for clinical prevention and control of the epidemic situation.@*Methods@#The clinical data of 33 patients admitted with pneumonia caused by a novel coronavirus in the Second Affiliated Hospital of Wenzhou Medical University from January 15 to February 1, 2020, were retrospectively reviewed. At the onset of the disease, we analyzed the primary symptoms such as fever, cough, fatigue, chest tightness, chest pain and also a significant blood test results of the patients. According to the patient's contact history, it was divided into the direct infection group of the main epidemic area and the indirect contact infection group of the main epidemic areas. The difference between clinical manifestations among the two groups was analyzed.@*Results@#The main clinical symptoms of patients with novel coronavirus pneumonia in the secondary epidemic area were respiratory tract and systemic symptoms. After grouping according to the presence and absence of direct contact in the main epidemic area, there was no significant difference in baseline data between the two groups, and there was no significant difference in symptoms and signs between the two groups (P < 0.05). Some patients had serum amyloid protein (SAP) increased abnormall.@*Conclusions@#The respiratory tract and systemic symptoms are the primary symptoms of the patients with the new type of coronavirus pneumonia in the secondary epidemic area, which are not typical. The abnormal increase of serum amyloid protein (SAA) may be used as an auxiliary index for diagnosis and treatment.

Epidemiological characteristics of patients with coronavirus disease 2019 in Chenzhou City / 上海预防医学

Objective To identify the epidemiological features of COVID-19 epidemic in Chenzhou City, Hunan province so as to provide scientific evidence for effective containment of the COVID-19 epidemic. Methods Descriptive epidemiological method was used to retrospectively characterize the confirmed COVID-19 cases and asymptomatic cases in Chenzhou City from January 23 through March 10, 2020. Results A total of 39 confirmed COVID-19 cases and 6 asymptomatic cases infection were documented in the city, with no death.We identified 8 clusters of COVID-19, which were all familial transmission.There was statistical difference between the sources of different types of epidemic (χ2=15.996, P < 0.001), in which all the local COVID-19 cases were the secondary cases in the clusters.As the epidemic expanded, the trend shifted from imported-case-centered to local-case-centered.The epidemic has covered 81.81% of the city area; in each area, the first COVID-19 cases were all imported. Conclusion The COVID-19 epidemic has been effectively controlled.At present, we focus on the quarantine in the entry and exit to prevent the imported epidemic.

Retrospective Clinical Analysis on Treatment of Coronavirus Disease 2019 with Traditional Chinese Medicine Lianhua Qingwen / 中国实验方剂学杂志

Objective:To analyze the clinical effect of traditional Chinese medicine Lianhua Qingwen in the treatment of coronavirus disease 2019 (COVID-19) and provide the basis for medication guides through a retrospective study in a cohort of COVID-19 confirmed patients. Method:A retrospective analysis of clinical records was conducted in COVID-19 confirmed patients at The Ninth Hospital of Wuhan and CR&WISCO General Hospital including the treatment group (21 patients, basic treatment in combination with Lianhua Qingwen granules, 1 packet/time, 3 times/day) and the control group (21 patients, basic treatment). Comparison between the two groups was made in terms of the disappearance rates of cardinal symptoms (fever, cough and weakness), duration of fever, and disappearance rates of other symptoms (muscle pain, expectoration, nasal obstruction, running nose, dry throat, pharyngalgia, shortness of breath, chest distress, dyspnea, dizziness, headache, nausea, vomiting, loss of appetite and diarrhea). Result:The baseline data were similar between the two groups. When compared with the control group, patients in the treatment group had the higher clinical effect, including the disappearance rate of fever (85.7% vs 57.1%, χ2=4.200, P=0.040), the disappearance rate of cough (46.7% vs 5.6%, P=0.012), the disappearance rate expectoration (64.3% vs 9.1%, P=0.012), the disappearance rate of shortness of breath (77.8% vs 0, P=0.021), and the duration of fever [(4.6±3.2) d vs (6.1±3.1) d, P=0.218]. Conclusion:Lianhua Qingwen can significantly relieve cardinal symptoms in COVID-19 confirmed patients by inhibiting fever and cough, reducing their duration, as well as improving individual symptoms. All these results provide preliminary clinical evidence for Lianhua Qingwen granules in the COVID-19 treatment.

Further Analyses of Trends in Malaria Diagnoses and Incidence Rates (2014-2018) in Edo State, Nigeria

Background:The United Nations Inter-Agency and Expert Group on Millennium Development Goals (MDGs), established incidence rate as one of the indicators for monitoring progress on Malaria control. Data on malaria incidence rates in Edo State, Nigeria, 2006-2013 were published in 2015. The current study focused on incidence rates, 2014-2018. In addition, trends in malaria diagnoses were also investigated.Methods:Records of numbers of patients from the 18 Local Government Areas (LGAs) complaining of malaria, at LGA Health Centres, State Hospitals, etc. were obtained from the Department of Disease Control, State Ministry of Health, Benin City. Patients were placed in 3 categories: Fever, without malaria confirmation, confirmeduncomplicated, confirmed severe. Human population records over the 5-year period were obtained from the Nigeria Population Commission, Benin City. Incidence rates were calculated and relative proportions of patients in the 3 categories determined.Results:The numbers of fever cases, without malaria confirmation, varied across LGAs and constituted 58.00-68.00% of all fever cases annually. In confirmed cases of malaria, most were uncomplicated. The highest numbers of confirmed cases were in Egor and Oredo LGAs. The pattern was similar in uncomplicated and severe cases. The ratios of uncomplicated and severe cases of malaria varied significantly (p<0.05) annually. Malaria incidence rates varied among LGAs in each of the years: 2014 (0.75-5.48%), in 2015 (0.24-2.55%), in 2016 (1.44-5.21%), in 2017 (1.17-9.69%), in 2018 (0.63-4.03%). However, these differences were not significant (p>0.05). In the period 2014-2018, malaria incidence rates of 5.00% and above were recorded only 5times across LGAs: Egor, 2014 (5.48%); Esan Central, 2016 (5.14%; Ovia southwest, 2016 (5.21%), 2017 (9.69%); Uhunmwnde, 2017 (5.05%).Conclusion:The decline in malaria incidence rates, 2014-2018, over the 2006-2013 data indicates progress. However, there are still daunting challenges which have been detailed in the text. These results also highlight the need for malaria test confirmation rather than utilizing fever as the exclusive symptom for malaria. All stakeholders must intensify efforts to ensure that this downward trend in malaria incidence rates is sustained

Long-term safety follow-up of children from a randomized - Controlled phase II b proof - Of - concept efficacy study of the live, attenuated, tetravalent dengue vaccine (CYD - TDV) in Thailand

Objective: To investigate the long-term safety of a tetravalent dengue vaccine (CYD-TDV) in children in a phase Π b follow-up study in Thailand. Methods: In the phase Π b study, children aged 4-11 years were randomized (2:1) to receive three injections of CYD-TDV or serve as control at 6-month intervals, with 25 months' active follow-up (active phase). This study was an additional four-year passive surveillance for hospitalized virologically-confirmed dengue (VCD; hospital phase). Cases of hospitalized VCD, severe hospitalized VCD, vaccine-related serious adverse events, and deaths were reported for the total population, with post-hoc analyses by enrollment age (<9 and years). Results: Of 3 997 participants receiving injection, 80.1% were recruited to the hospital phase [2 131 (CYD-TDV); 1 072 (control)]. Eighty-five hospitalized VCD cases were reported in the CYD-TDV group and 46 in the control group during the four-year hospital phase [relative risk (RR): 0.93, 95% confidence interval (CI): 0.64-1.36]. The RR over six years of follow-up was 0.77 (95% CI: 0.57-1.05). In those aged ≥9 years, the cumulative RRs in the active phase, hospital phase, and entire six years were 0.28 (95% CI: 0.08-0.81), 0.51 (95% CI: 0.25-1.05), and 0.42 (95% CI: 0.24-0.75), respectively. In the overall population, there were ten severe hospitalized VCD cases in the CYD-TDV group and five in the control group over six years (RR: 1.00, 95% CI: 0.31-3.75). Conclusions: Over six years of follow-up, in children aged ≥9 years, CYD-TDV administration is associated with a reduced risk of hospitalized VCD.

Effectiveness of establishment of chest pain center and optimized process in the diagnostic and treatment progress and short-term prognostic value of acute non-ST segment elevation myocardial infarction patients / 中国胸心血管外科临床杂志

@#Objective    To investigate the effectiveness of establishment of chest pain center and optimized process in the diagnostic and treatment progress and short-term prognostic value of acute non-ST segment elevation myocardial infarction (NSTEMI) patients. Methods    This was a retrospective study. We included NSTEMI patients admitted in the Emergency Department in our hospital, 41 patients admitted before the establishment of the chest pain center (April 2015) were included as group A (30 males and 11 females at age of 64.7±11.8 years), 42 patients after the establishment of the chest pain center (April 2016) as group B (31 males and 11 females at age of 64.6±11.8 years), and 38 patients after the establishment of the chest pain center (April 2017) as group C (30 males and 8 females at age of 62.6±10.0 years). The clinical outcomes of the three groups were compared. Results     The time from admission to electrocardiogram was 20.0 (17.0, 25.5) min in the group A, 4.0 (2.8, 5.0) min in the group B, and 3.0 (2.0, 4.0) min in the group C (P<0.001). The first doctor's non-electrocardiogram advice time was 13.0 (10.0, 18.0) min, 9.5 (6.8, 15.3) min, and 9.0 (7.0, 12.0) min (P=0.001) in the three groups, respectively. The diagnostic confirmed time was 139.4±48.5 min, 71.1±51.5 min, 63.9±41.9 min   (P<0.001). The proportion of patients receiving emergency dual anti-platelet load dose treatment was 53.1%, 70.0%, 100.0% (P=0.001), respectively. The time of receiving emergency dual anti-platelet load dose treatment was 208.0 (72.0, 529.0) min, 259.0 (91.0, 340.0) min, and 125.0 (86.0, 170.0) min (P=0.044) in the three groups, respectively. Emergency percutaneous coronary artery intervention (PCI) start time was 60.9 (42.1, 95.8) hours, 61.3 (43.3, 92.2) hours, 30.5 (2.8, 44.1) hours (P<0.001) in the three groups, respectively. Among them, the moderate risk patients’ PCI starting time was 63.0 (48.1, 94.2) hours, 62.3 (42.1, 116.2) hours, and 40.1 (17.2, 60.4) hours (P>0.05), respectively. The high risk patients’ PCI starting time was 47.9 (23.7, 102.4) hours, 55.2 (44.0, 89.6) hours, 23.2 (1.7, 41.8) hours in the three groups, respectively (P<0.001). The hospitalization time of the patients was 7.0 (5.4, 9.4) days, 5.9 (4.9, 8.7) days, 4.7 (3.1, 6.2) days in the three groups (P<0.001), respectively. The hospitalization time of the moderate risk patients was 6.9 (4.9, 8.8) days, 6.4 (4.9, 8.0) days, 4.8 (3.2, 6.5) days in the three groups (P>0.05), respectively. The hospitalization time of the high risk patients was 7.1 (5.5, 9.9) days, 5.9 (4.6, 9.8) days, and 4.4 (3.0, 6.1) days, respectively (P<0.001). The fatality rate of inpatients was 4.9%, 0.0%, and 0.0%, respectively (P>0.05). The correlation coefficient of hospitalization time, diagnosis confirmed time and PCI starting time was 0.219 and 0.456 (P<0.05), respectively. Conclusion    The establishment and optimized process of chest pain center can accelerate the time of early diagnosis of NSTEMI, which is helpful to obtain stratified and graded standardized treatment for patients according to their conditions, to accelerate the specific treatment process of high risk NSTEMI patients, and shorten the hospitalization time.

Long-term safety follow-up of children from a randomized - Controlled phase II b proof - Of - concept efficacy study of the live, attenuated, tetravalent dengue vaccine (CYD - TDV) in Thailand

Objective: To investigate the long-term safety of a tetravalent dengue vaccine (CYD-TDV) in children in a phase Π b follow-up study in Thailand. Methods: In the phase Π b study, children aged 4-11 years were randomized (2:1) to receive three injections of CYD-TDV or serve as control at 6-month intervals, with 25 months' active follow-up (active phase). This study was an additional four-year passive surveillance for hospitalized virologically-confirmed dengue (VCD; hospital phase). Cases of hospitalized VCD, severe hospitalized VCD, vaccine-related serious adverse events, and deaths were reported for the total population, with post-hoc analyses by enrollment age (<9 and years). Results: Of 3 997 participants receiving injection, 80.1% were recruited to the hospital phase [2 131 (CYD-TDV); 1 072 (control)]. Eighty-five hospitalized VCD cases were reported in the CYD-TDV group and 46 in the control group during the four-year hospital phase [relative risk (RR): 0.93, 95% confidence interval (CI): 0.64-1.36]. The RR over six years of follow-up was 0.77 (95% CI: 0.57-1.05). In those aged ≥9 years, the cumulative RRs in the active phase, hospital phase, and entire six years were 0.28 (95% CI: 0.08-0.81), 0.51 (95% CI: 0.25-1.05), and 0.42 (95% CI: 0.24-0.75), respectively. In the overall population, there were ten severe hospitalized VCD cases in the CYD-TDV group and five in the control group over six years (RR: 1.00, 95% CI: 0.31-3.75). Conclusions: Over six years of follow-up, in children aged ≥9 years, CYD-TDV administration is associated with a reduced risk of hospitalized VCD.

Suspected occupational diseases report and diagnostic situation follow-up in Guangdong Province,2014-2017 / 中国职业医学

OBJECTIVE: To analyze the distribution of network reported suspected occupational diseases( SOD),and the follow-up of confirmed diagnosis of occupational diseases in Guangdong Province from 2014 to 2017. METHODS: In July2018,the SOD cases reported from 2014 to 2017 in the direct network of Guangdong Province were collected as study subjects through the Suspected Occupational Diseases Report Card,Occupational Disease Report Card and Pneumoconiosis Report Card from the subsystem of National Information Surveillance System for Occupational Disease and Occupational Health. And the institutions for occupational disease diagnosis were asked to collect related data of applying for diagnosis and to investigate the final confirmed diagnostic status through the report cards of occupational diseases and pneumoconiosis. RESULTS: A total of 10 155 SOD cases were reported in Guangdong Province from 2014 to 2017,with an average annual growth rate of 62. 2% and an increasing trend year by year. The top three SOD were: suspected occupational otorhinolaryngological oral diseases( 58. 9%), particularly the suspected occupational noise deafness( 99. 9%); suspected occupational chronic chemical poisoning( 24. 6%),particularly suspected occupational chronic benzene poisoning( 88. 4%); and suspected occupational pneumoconiosis( 12. 8%). In total,there were 3 514 SOD cases applying for occupational diseases diagnosis,and the appication rate was 34. 6%. The final confirmed diagnosis rate was 59. 5%( 2 090/3 514). The application rate of occupational otorhinolaryngological oral diseases,occupational chronic chemical poisoning,occupational pneumoconiosis was 33. 8%,31. 3% and 35. 7%,while the final confirmed diagnosis rate was 54. 0%,49. 9% and 89. 5%. The application rate and the final confirmed diagnosis rate were the highest in the occupational disease prevention and treatment institutions, with the rate of 58. 1% and 70. 2% respectively. The application rate and the final confirmed diagnosis rate from occupational health examination were lower than those from occupational disease diagnosis institution,outpatient department and hospitalization( P < 0. 005). CONCLUSION: There is a rapid increasing trend of SOD in Guangdong Province from 2014 to 2017,but the confirmed diagnosis rate is low.