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COVID-19 vaccination aims to help to both reduce the direct and indirect harms of COVID-10 in children. There are three types of COVID-19 platforms developed for children: mRNA, inactivated and protein subunit and viral vector vaccines. Monitoring systems are in place to review vaccine effectiveness and safety. © 2023 Elsevier Inc. All rights reserved.
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Background: Global evidence on the transmission of asymptomatic SARS-CoV-2 infection needs to be synthesized. Methods: A search of 4 electronic databases (PubMed, EMBASE, Cochrane Library, and Web of Science databases) as of January 24, 2021 was performed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies which reported the transmission rate among close contacts with asymptomatic SARS-CoV-2 cases were included, and transmission activities occurred were considered. The transmission rates were pooled by zero-inflated beta distribution. The risk ratios (RRs) were calculated using random-effects models. Results: Of 4923 records retrieved and reviewed, 15 studies including 3917 close contacts with asymptomatic indexes were eligible. The pooled transmission rates were 1.79 per 100 person-days (or 1.79%, 95% confidence interval [CI] 0.41%–3.16%) by asymptomatic index, which is significantly lower than by presymptomatic (5.02%, 95% CI 2.37%–7.66%;p<0.001), and by symptomatic (5.27%, 95% CI 2.40%–8.15%;p<0.001). Subgroup analyses showed that the household transmission rate of asymptomatic index was (4.22%, 95% CI 0.91%–7.52%), four times significantly higher than non-household transmission (1.03%, 95% CI 0.73%–1.33%;p=0.03), and the asymptomatic transmission rate in China (1.82%, 95% CI 0.11%–3.53%) was lower than in other countries (2.22%, 95% CI 0.67%–3.77%;p=0.01). Conclusions: People with asymptomatic SARS-CoV-2 infection are at risk of transmitting the virus to their close contacts, particularly in household settings. The transmission potential of asymptomatic infection is lower than symptomatic and presymptomatic infections. This meta-analysis provides evidence for predicting the epidemic trend and promulgating vaccination and other control measures. Registered with PROSPERO International Prospective Register of Systematic Reviews, CRD42021269446;https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269446. © 2022 The Author(s)
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Background: This study aimed to evaluate the efficacy and safety of preoperative PD-1 inhibitor tislelizumab combined with CRT in unresectable esophageal squamous cell carcinoma (ESCC). Method(s): This is a single-arm, phase II trial, planned to enroll 30 patients. Eligibility criteria include histologically confirmed unresectable thoracic ESCC stage at cT4bNxM0 (AJCC 8th). Radiotherapy was delivered to a total dose of 50Gy/25f, concurrently with cisplatin (25 mg/m2) and nab-paclitaxel (100 mg) (QW, at least 3 cycles). Then followed by two cycles of tislelizumab (200 mg, Q3W), cisplatin (75 mg/m2, Q3W) and nab-paclitaxel (150 mg/m2, Q3W). If curative resection was considered, esophagectomy was performed within 4 weeks. Patients with pathologically residual disease would receive tislelizumab (200 mg, Q3W) for 1 year. The primary endpoint is 1-year progression free survival rate. Result(s): From December 2021 to July 2022, 21 patients were enrolled. 16 patients completed chemoradiotherapy and received immunochemotherapy. Reasons for 5 patients who did not receive immunochemotherapy included patient refusal (n=1), progressive disease (n=1), esophageal fistula (n=2), waiting for immunochemotherapy (n=1). Finally, 13 patients proceeded to surgery, with R0 resection rate of 100%. Reasons for not undergoing surgery after immunochemotherapy were esophageal mediastinal fistula (n=1), surgery delay due to COVID-19 epidemic (n=2). The pCR and MPR rate was 61.5% (8/13) and 76.9% (10/13). G1, G2, G3 immune related pneumonia occurred in 3 patients, respectively. >=G3 AEs occurred in 9 (42.9%) patients. Postoperative complications included anastomotic fistula (2/13), pleural effusion (2/13), pneumonia (1/13), myocardial damage (1/13), delayed wound healing (1/13). Conclusion(s): Chemoradiotherapy followed by immunochemotherapy might be a useful conversional treatment option for unresectable ESCC. Esophagectomy after this could be safe with acceptable complications for unresectable locally advanced ESCC. Clinical trial identification: ChiCTR2100054327. Legal entity responsible for the study: The authors. Funding(s): Has not received any funding. Disclosure: All authors have declared no conflicts of interest. Copyright © 2022 European Society for Medical Oncology
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In the COVID-19 crisis, many economies suffered from sustainable energy production. The emergence of the COVID-19 crises, extreme volatility in oil prices, limited energy efficiency in energy systems, and weak form of financial stability were the key reasons for it. However, considering these issues, a recent study aims to analyze them. ASEAN countries' energy efficiency and crude oil price volatility are examined as a solution to how financial conditions might be utilized to handle energy efficiency issues and crude oil price volatility. Extending it, the study aims to identify the influence of financial stability on crude oil price volatility and energy efficiency issues. To do this, GMM is used. According to the study's findings, environmental mitigation was determined to be important at 18%, and financial stability and carbon risk significant at 21%. Global warming concerns have been raised due to the ASEAN nations' 19.5% link between financial stability and emissions drift. A country's financial stability is necessary for implementing green economic recovery strategies, among the most widely accepted measures to reduce energy efficiency and guarantee long-term financial potential on the national scale. The study on green economic growth also provides the associated stakeholders with sensible policy consequences on this importance.
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OBJETIVO: Describir las estrategias, manejo de emergencias y los procedimientos de control de infecciones de nuestro departamento durante el brote de la enfermedad por coronavirus 2019 (COVID-19). MeTODOS: Creamos un equipo de manejo de emergencias. El equipo establecio varias medidas: Reconfiguracion del flujo de trabajo en el departamento de radiologia, distribucion de material de proteccion personal y adiestramiento del personal, procedimientos para la obtencion de imagenes en pacientes sospechosos o confirmados con COVID-19, asi como para pacientes sin historial de exposicion o sintomas. Aquellos con sospecha o confirmacion de COVID-19 fueron escaneados en una unidad dedicada para ello. RESULTADOS: Del 21 de enero del 2020 hasta el 9 de marzo del 2020, 3,083 personas con sospecha o confirmacion de COVID-19 recibieron CT de torax. Incluyendo los examenes iniciales y repetidos, el numero total de CT fue 3,340. Como resultado de nuestras medidas de precaucion, ninguno de los miembros del personal del departamento de radiologia fue infectado con COVID-19. CONCLUSIoN: Las estrategias de planificacion y las protecciones adecuadas pueden ayudar a proteger a los pacientes y al personal contra una enfermedad altamente infecciosa. Y a la misma vez ayudar a mantener la capacidad de atender un volumen alto de pacientes.
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An epidemiological investigation was carried out on a local cluster of outbreak caused by imported cases of Coronavirus Disease 2019 (COVID-19) in rural areas of Chengdu in December 2020, to find out the source of infection and the chain of transmission. According to Prevention and Control Protocol for COVID-19 (Version 7), field epidemiological investigation was adopted, combined with big data technology, video image investigation, gene sequencing and other methods to carry out investigation into COVID-19 cases and infections source tracing, analyze the epidemiological association, and map the chain of transmission. From December 7 to 17, 2020, 13 local COVID-19 confirmed cases and 1 asymptomatic case were diagnosed in Chengdu, of which 12 cases (85.71%) had a history of residence and activity in the village courtyard of Taiping (TP), Pidu (P) District, Chengdu. From November 8, 2020 to November 28, 2020, a group of inbound people form Nepal were transferred to the designated entry personnel quarantine hotel of P District which was adjacent to the TP village. During quarantine, there were 5 cases who tested positive for COVID-19. Through gene sequencing alignment, genes of local cases and Nepalese imported cases from the same period are homologous, all belong to the lineage of L2.2.3 (B.1.36 according to Pangolin lineage typing method). According to the results of field epidemiological investigation and gene sequencing analysis, the index case was most likely infected by contact with household waste of quarantine site. Under the situation of normalization prevention and control of COVID-19, sentinel monitoring of fever clinics in primary medical institutions is the key to early detection of the epidemic. The multi-department joint epidemiological investigation and the application of gene technology are the core links of the investigation and traceability of modern infectious diseases. The allocation of public health resources in rural areas needs to be strengthened. We need to improve the capacity for early surveillance and early warning of the epidemic in rural areas.
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COVID-19 , Epidemics , Disease Outbreaks , Humans , Quarantine , SARS-CoV-2ABSTRACT
Introduction: Few previous studies have been well described the details of the clinical and virological course of illness among discharged patients. The study aims to study the epidemiological and clinical features of discharged patients with SARS-CoV-2 infection in Changchun, Northeast China. Materials and methods: We included all discharged patients with SARS-CoV-2 infection from Changchun Infectious Hospital, China, as 9 March 2020. We extracted and collected on data of demographic characteristic, clinical features, chest computed tomography (CT) scan, laboratory result, and treatment from the electronic medical records. Exact epidemiological information was obtained from the investigation of patients or close contacts by investigators of at all levels of the Center for Disease Prevention and Control in Jilin Province. Results: Of the 43 discharged patient retrospective studied, 38 were mild novel coronavirus pneumonia, only one with critical ill case and no health workers were infected. The median age was 41.0 years, and 25 were male. All cases were infected by person-to-person transmission and the median incubation period from exposure to illness onset was 8.0 days. 22 patients had comorbidities. The most common symptoms at illness onset were fever, cough, expectoration, myalgia or fatigue, chest tightness, nasal congestion or sneezing. Median duration of illness onset to hospital admission and discharged was 6.0 days and 22.0 days, the median duration of viral shedding after illness onset was 19.0 days (IQR: 14-22). Conclusion: Patients were imported and cluster cases by person-to-person transmission and relatively mild in Changchun, China. Our findings further confirmed the prolonged viral shedding among patients. © 2021 A. CARBONE Editore. All rights reserved.
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BACKGROUND: Accumulated evidence revealed that male was much more likely to higher severity and fatality by SARS-CoV-2 infection than female patients, but few studies and meta-analyses have evaluated the sex differences of the infection and progression of COVID-19 patients. AIM: We aimed to compare the sex differences of the epidemiological and clinical characteristics in COVID-19 patients;and to perform a meta-analysis evaluating the severe rate, fatality rate, and the sex differences of the infection and disease progression in COVID-19 patients. METHODS: We analyzed clinical data of patients in Changchun Infectious Hospital and Center, Changchun, Northeast China;and searched PubMed, Embase, Web of Science, and Cochrane Library without any language restrictions for published articles that reported the data of sex-disaggregated, number of severe, and death patients on the confirmed diagnosis of adult COVID-19 patients. RESULTS: The pooled severe rate and fatality rate of COVID-19 were 22.7% and 10.7%. Male incidence in the retrospective study was 58.1%, and the pooled incidence in male was 54.7%. CONCLUSION: The pooled severe rate in male and female of COVID-19 was 28.2% and 18.8%, the risky of severe and death was about 1.6folds higher in male compared with female, especially for older patients (> 50 y). © 2020 Zhijun Li, Lina Feng, Wenyu Cui, Jian Zhang, Yingxin Huang, Yunhong Zhao, Fei Teng, Donglin Wu, Bonan Cao, Hui Wang, Liquan Deng, Qiong Yu.
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Objective: To investigate the spectrum of pathogenic agents in pediatric patients with acute respiratory infections (ARI) during the outbreak of coronavirus infectious diseases 2019 (COVID-19). Methods: Three groups of children were enrolled into the prospective study during January 20 to February 20, 2020 from Capital Institute of Pediatrics, including children in the exposed group with ARI and epidemiological history associated with COVID-19 from whom both pharyngeal and nasopharyngeal swabs were collected, children in the ARI group without COVID-19 associated epidemiological history and children in the screening group for hospital admission, with neither COVID-19 associated epidemiological history nor ARI. Only nasopharyngeal swabs were collected in the ARI group and screening group. Each group is expected to include at least 30 cases. All specimens were tested for 2019-nCoV nucleic acid by two diagnostic kits from different manufacturers. All nasopharyngeal swabs were tested for multiple respiratory pathogens, whilst the results from the ARI group were compared with that in the correspondence periods of 2019 and 2018 used by t or χ(2) test. Results: A total of 244 children were enrolled into three groups, including 139 males and 105 females, the age was (5±4) years. The test of 2019-nCoV nucleic acid were negative in all children, and high positive rates of pathogens were detected in exposed (69.4%, 25/36) and ARI (55.3%, 73/132) groups, with the highest positive rate for mycoplasma pneumoniae (MP) (19.4%, 7/36 and 17.4%, 23/132, respectively), followed by human metapneumovirus (hMPV) (16.7%, 6/36 and 9.8%, 13/132, respectively). The positive rate (11.8%, 9/76) of pathogens in the screening group was low. In the same period of 2019, the positive rate of pathogens was 83.7% (77/92), with the highest rates for respiratory syncytial virus (RSV) A (29.3%, 27/92), followed by influenza virus (Flu) A (H1N1) (19.6%, 18/92) and adenovirus (ADV) (14.1%, 13/92), which showed significant difference with the positive rates of the three viruses in 2020 (RSV A: χ(2)=27.346, P<0.01; FluA (H1N1): χ(2)=28.083, P<0.01; ADV: χ(2)=7.848, P=0.005) . In 2018, the positive rate of pathogens was 61.0% (50/82), with the highest rate for human bocavirus (HBoV) (13.4%, 11/82) and followed by ADV (11.0%, 9/82), and significant difference was shown in the positive rate of HBoV with that in 2020 (χ(2)=6.776, P=0.009). Conclusions: The infection rate of 2019-nCoV is low among children in Beijing with no family clustering or no close contact, even with epidemiological history. The spectrum of pathogens of ARI in children during the research period is quite different from that in the previous years when the viral infections were dominant. MP is the highest positively detected one among the main pathogens during the outbreak of COVID-19 in Beijing where there is no main outbreak area.