ABSTRACT
ObjectiveThis study aims to characterize and evaluate the NIHs grant allocation pattern of COVID-19 research. DesignCross sectional study SettingCOVID-19 NIH RePORTER Dataset was used to identify COVID-19 relevant grants. Participants1,108 grants allocated to COVID-19 research. Main Outcomes and MeasuresThe primary outcome was to determine the number of grants and funding amount the NIH allocated for COVID-19 by research type and clinical/scientific area. The secondary outcome was to calculate the time from the funding opportunity announcement to the award notice date. ResultsThe NIH awarded a total of 56,169 grants in 2020, of which 2.0% (n=1,108) were allocated for COVID-19 research. The NIH had a $42 billion budget that year, of which 5.3% ($2.2 billion) was allocated to COVID-19 research. The most common clinical/scientific areas were social determinants of health (n=278, 8.5% of COVID-19 funding), immunology (n=211, 25.8%), and pharmaceutical interventions research (n=208, 47.6%). There were 104 grants studying COVID-19 non-pharmaceutical interventions, of which 2 grants studied the efficacy of face masks and 6 studied the efficacy of social distancing. Of the 83 COVID-19 funded grants on transmission, 5 were awarded to study airborne transmission of COVID-19, and 2 grants on transmission of COVID-19 in schools. The average time from the funding opportunity announcement to the award notice date was 151 days (SD: {+/-}57.9). ConclusionIn the first year of the pandemic, the NIH diverted a small fraction of its budget to COVID-19 research. Future health emergencies will require research funding to pivot in a timely fashion and funding levels to be proportional to the anticipated burden of disease in the population.
Subject(s)
COVID-19ABSTRACT
Understanding the pathogenesis of SARS-CoV-2 is crucial to respond to the current coronavirus disease 2019 (COVID-19) pandemic. Sputum samples from 20 COVID-19 patients and healthy controls were collected, respectively. During the isolation of infectious SARS-CoV-2 virus, EV-like vesicles were associated with virions under a transmission electron microscope. Next, the expression of IL6 and TGF-β increased in EVs derived from the sputum of patients, and these were highly correlated with the expression of the SARS-CoV-2 N protein. Further, proximity barcoding assay (PBA) was used to investigate the immune-related proteins in the EVs, and the relationship between EVs and SARS-CoV-2 N protein in COVID-19 patients’ samples. Particularly, to investigate the differential contribution of the specific EV subsets, the protein expression of a single EV was detected and analyzed for the first time. Among the 40 EV subpopulations, 18 were found to have significant differences. The EV subpopulation regulated by CD81 were most likely to correlate with the changes in the pulmonary microenvironment after SARS-CoV-2 infection. This study provides evidence on the association between EVs and the SARS-CoV-2 virus, give a deep insight into the possible pathogenesis of SARS-CoV-2 infection and the possibility of nanoparticles drug intervention in viral infection.
Subject(s)
COVID-19ABSTRACT
In response to the present coronavirus disease 2019 (COVID-19) pandemic, it is important to understand the infection pathogenesis of SARS-CoV-2. Sputum samples from 20 COVID-19 patients and healthy controls were collected, respectively. During the isolation of infectious SARS-CoV-2 virus, exosome-like vesicles were found associated with virions under transmission electron microscope. Next, the expression of IL6 and TGF-β increased in exosomes derived from the sputum of patients, and these were highly correlated with the expression of the SARS-CoV-2 N protein. Further, proximity barcoding assay (PBA) was used to investigate the immune related proteins in the exosomes, as well as the relationship between exosomes and SARS-CoV-2 N protein in COVID-19 patients’ samples. Particularly, to investigate the differential contribution of the specific exosome subsets, the protein expression of a single exosome was detected and analyzed for the first time. Among the 40 exosome subpopulations, 18 were found to have significant differences. The exosome subpopulation regulated by CD81 were most likely to correlate with the changes in the pulmonary microenvironment after SARS-CoV-2 infection. This study provides evidence on the association between exosomes and SARS-CoV-2 virus and promotes our understanding on possible pathogenesis of SARS-CoV-2 infection.Funding Statement: This work is supported by the emergency grants for prevention and control of SARS-CoV-2 of Ministry of Guangdong province (2020B111133001), the China Postdoctoral Science Project (2020T130025ZX and 2019M652860), the National Key Research and Development Program of China (2016YFC1304101), the Independent project of the State Key Laboratory of Respiratory Diseases (SKLRD-QN-201913), and the Local Innovative and Research Teams Project of Guangdong Pearl River Talents Program (2017BT01S155).Declaration of Interests: The authors have declared that no conflict of interest exists.Ethics Approval Statement: The present study obtained the approval of the Ethics Committee of the First Affiliated Hospital of Guangzhou Medical University (Guangzhou, China).
Subject(s)
Respiratory Tract Infections , COVID-19ABSTRACT
Background: Since December 2019, 2019-nCoV has emerged in Wuhan, China, the fast pace of transmission is wreaking global public health crisis. Country’s reaction speed is critical for the control of public health emergency (PHE), especially in the early stage of an outbreak. Compared with SARS pandemic, whether has the efficiency of initial public health emergency response to COVID-19 in mainland China been improved? And whether is there still existing vulnerabilities in current PHE system? Studies on this topic are relatively few. We tried to find the answers, evidences and alternatives. Methods: We conducted a retrospective comparative study. The speed of hospital reporting, pathogen identification and government decision-making between SARS and COVID-19 were compared by selecting 5 critical events from initial public health emergency response timeline. Besides, combining with the two pandemics' progress curves, we discussed the characteristics of their peak time.Results:(1) SARS completed the entire initial public health emergency response in 127 days, and COVID-19 completed in 44 days. Response speed has been shorted nearly by 3 times. (2) Both the first SARS and COVID-19 cases were reported in 19 days. It doesn't appear that hospital reporting speed becomes faster. (3) The accumulated time completing pathogen identification were 118 days for SARS and 31 days for COVID-19. The speed has been improved by more than 3 times. (4) 9 days after the completion of pathogen identification, national government made emergency policies for SARS while the interval between pathogen identification and national government's decision-making for COVID-19 was 13 days. (5) The peak time of SARS came about 80 days later than that of COVID-19. But both the two pandemics' peak occurred about 20 days after the national government's decision-making, and then the curves went down dramatically.Conclusions: The speed of initial public health emergency response to pandemic has been improved due to faster identification. However, some deficiencies and challenges in early alert and authorities' decision-making still remain. Therefore, Chinese government should put more stress on improving hospital's sensitivity to new emerging infectious diseases and timeliness of government's decision-making.
Subject(s)
COVID-19 , Communicable Diseases, EmergingABSTRACT
Background: The novel coronavirus disease 2019 (COVID-19) outbreak is spreading rapidly throughout China and the world. Hence, early surveillance and public health emergency disposal are considered crucial to curb this emerging infectious disease. However, studies that investigated the early surveillance and public health emergency disposal for the prevention and control of the COVID-19 outbreak in China are relatively few. We aimed to compare the strengths and weaknesses of early surveillance and public health emergency disposal for prevention and control between COVID-19 and H7N9 avian influenza, which was commended by the international community, in China. Methods: A case-comparison study was conducted using a set of six key time nodes to form a reference framework for evaluating early surveillance and public health emergency disposal between H7N9 avian influenza (2013) in Shanghai, China and COVID-19 in Wuhan, China. Findings: A report to the local Center for Disease Control and Prevention, China, for the first hospitalized patient was sent after 6 and 20 days for H7N9 avian influenza and COVID-19, respectively. In contrast, the pathogen was identified faster in the case of COVID-19 than in the case of H7N9 avian influenza (12 days vs. 31 days). The government response regarding COVID-19 was 10 days later than that regarding avian influenza. The entire process of early surveillance and public health emergency disposal lasted 5 days longer in COVID-19 than in H7N9 avian influenza (46 days vs. 41 days). Conclusions: The identification of the unknown pathogen improved in China between the outbreaks of avian influenza and COVID-19. The longer emergency disposal period in the case of COVID-19 could be attributed to the government's slower response to the epidemic. Improving public health emergency management could lessen the adverse social effects of emerging infectious diseases and public health crisis in the future.
Subject(s)
COVID-19 , Communicable Diseases, EmergingABSTRACT
[Objective] To analyze and judge the possibility of early control in Shanghai if COVID-19 begins in Shanghai. [Methods] Compare the process of early control of H7N9 avian influenza in Shanghai in 2013 and Wuhan COVID-19 in 2019. The early incidence data of Korean COVID-19 was simulated and analyzed to predict whether the medical resources needed in Shanghai were available. [Results] (1) It would take 22 days from the first case to the government's emergency response in terms of Shanghai. (2) It is estimated that there would be 602-763 patients with cumulative onset and onset after incubation period. (3) At least 500 beds of infectious diseases can be allocated in Shanghai in case of emergency. Through adding beds and resources reallocation in the whole city, patients can be fully admitted and treated. [Conclusion] If COVID-19 epidemic occurs in Shanghai, early control is possible.