Changes in Spectrum of Respiratory Pathogen Infections and Disease Severity Among Children in Hohhot: Impact of COVID-19 Prevention Measures (preprint)

Background Acute respiratory infections (ARIs) are caused by various pathogens, and the outbreak of the novel coronavirus has led to changes in the patterns of respiratory pathogen infections. Through long-term study of respiratory tract infection data in children from Hohhot, significant differences in the spectrum of respiratory pathogen infections, disease severity, and seasonal patterns have been discovered between 2022 and 2023.Methods Throat swabs were collected from 605 children with ARIs at the First Hospital of Hohhot, and pathogen detection was performed using microarray technology. Blood biomarkers, symptoms, and clinical diagnoses were evaluated.Results The study found that 56.03% of the patients were male, with an average age of 3.45 years. Pathogen dynamics revealed that SARS-CoV-2 was the most prevalent infection, accounting for 262 cases. It persisted from October 2022 to January 2023 and then disappeared. Influenza A virus (IAV) cases peaked in March 2023. Respiratory syncytial virus (RSV), Influenza B virus (IBV), Parainfluenza virus (PIV), Mycoplasma pneumoniae (M. pneumoniae), Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), and Group A streptococcus (GAS) were not detected after December 2022. The proportion of mixed infections was 41.94% among SARS-CoV-2 patients, while other pathogens had mixed infection rates exceeding 57.14%. Before December 2022, the mean value of white blood cell (WBC) count for Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae (H. influenzae), Epstein-Barr virus (EBV), and Cytomegalovirus (CMV) was 8.83*10^9/L, C-reactive protein (CRP) was 18.36 mg/L, and procalcitonin (PCT) was 1.11 ng /ml. After December 2022, these values decreased to 5.5*10^9/L, 6.33 mg/L, and 0.24 ng /ml, respectively. Similarly, the proportion of patients with cough, difficulty breathing, and running nose, as well as the diagnosis of lower respiratory tract infections, decreased in December 2022. However, the situation was different for SARS-CoV-2 infections.Conclusions Strict SARS-CoV-2 policies reduced the infection risk for S. pneumoniae, H. influenzae, EBV, and other pathogens before November 2022. However, patient symptoms worsened compared to after November 2022, possibly due to an excessive focus on SARS-CoV-2, neglecting other diseases, and reduced population immunity to respiratory infections.

Reconsidering treatment guidelines for acute myocardial infarction during the COVID-19 pandemic.

BACKGROUND: COVID-19 affects healthcare resource allocation, which could lead to treatment delay and poor outcomes in patients with acute myocardial infarction (AMI). We assessed the impact of the COVID-19 pandemic on AMI outcomes. METHODS: We compared outcomes of patients admitted for acute ST-elevation MI (STEMI) and non-STEMI (NSTEMI) during a non-COVID-19 pandemic period (January-February 2019; Group 1, n = 254) and a COVID-19 pandemic period (January-February 2020; Group 2, n = 124). RESULTS: For STEMI patients, the median of first medical contact (FMC) time, door-to-balloon time, and total myocardial ischemia time were significantly longer in Group 2 patients (all p < 0.05). Primary percutaneous intervention was performed significantly more often in Group 1 patients than in Group 2 patients, whereas thrombolytic therapy was used significantly more often in Group 2 patients than in Group 1 patients (all p < 0.05). However, the rates of and all-cause 30-day mortality and major adverse cardiac event (MACE) were not significantly different in the two periods (all p > 0.05). For NSTEMI patients, Group 2 patients had a higher rate of conservative therapy, a lower rate of reperfusion therapy, and longer FMC times (all p < 0.05). All-cause 30-day mortality and MACE were only higher in NSTEMI patients during the COVID-19 pandemic period (p < 0.001). CONCLUSIONS: COVID-19 pandemic causes treatment delay in AMI patients and potentially leads to poor clinical outcome in NSTEMI patients. Thrombolytic therapy should be initiated without delay for STEMI when coronary intervention is not readily available; for NSTEMI patients, outcomes of invasive reperfusion were better than medical treatment.

An Insight of the First Community Infected COVID-19 Patient in Beijing by Imported Case: Role of Deep Learning-Assisted CT Diagnosis.

In the era of coronavirus disease 2019 (COVID-19) pandemic, imported COVID-19 cases pose great challenges to many countries. Chest CT examination is considered to be complementary to nucleic acid test for COVID-19 detection and diagnosis. We report the first community infected COVID-19 patient by an imported case in Beijing, which manifested as nodular lesions on chest CT imaging at the early stage. Deep Learning (DL)-based diagnostic systems quantitatively monitored the progress of pulmonary lesions in 6 days and timely made alert for suspected pneumonia, so that prompt medical isolation was taken. The patient was confirmed as COVID-19 case after nucleic acid test, for which the community transmission was prevented timely. The roles of DL-assisted diagnosis in helping radiologists screening suspected COVID cases were discussed.

New coronavirus-infected pneumonia engulfs Wuhan

A review on new coronavirus-infected pneumonia in Wuhan, China.

A State-Level Socioeconomic Data Collection of the United States for COVID-19 Research

The outbreak of COVID-19 from late 2019 not only threatens the health and lives of humankind but impacts public policies, economic activities, and human behavior patterns significantly. To understand the impact and better prepare for future outbreaks, socioeconomic factors play significant roles in (1) determinant analysis with health care, environmental exposure and health behavior;(2) human mobility analyses driven by policies;(3) economic pressure and recovery analyses for decision making;and (4) short to long term social impact analysis for equity, justice and diversity. To support these analyses for rapid impact responses, state level socioeconomic factors for the United States of America (USA) are collected and integrated into topic-based indicators, including (1) the daily quantitative policy stringency index;(2) dynamic economic indices with multiple time frequency of GDP, international trade, personal income, employment, the housing market, and others;(3) the socioeconomic determinant baseline of the demographic, housing financial situation and medical resources. This paper introduces the measurements and metadata of relevant socioeconomic data collection, along with the sharing platform, data warehouse framework and quality control strategies. Different from existing COVID-19 related data products, this collection recognized the geospatial and dynamic factor as essential dimensions of epidemiologic research and scaled down the spatial resolution of socioeconomic data collection from country level to state level of the USA with a standard data format and high quality.

Self-Reported Taste and Smell Disorders in Patients with COVID-19: Distinct Features in China (preprint)

Background: Last December 2019, a cluster of viral pneumonia cases identified as coronavirus disease 2019 (COVID-19), was reported in Wuhan, China. We aimed to explore the frequencies of nasal symptoms in patients with COVID-19, including loss of smell and taste, as well as their presentation as the first symptom of the disease and their association with the severity of COVID-19.Methods: In this retrospective study, 1,206 laboratory-confirmed COVID-19 patients were included and followed-up by telephone call one month after discharged from Tongji Hospital, Wuhan. Demographic data, laboratory values, comorbidities, symptoms, and numerical rating scale scores (0-10) of nasal symptoms were extracted from the hospital medical records, and confirmed or reevaluated by the telephone follow-up. Results: From COVID-19 patients (N = 1,172) completing follow-up, 199 (17%) subjects had severe COVID-19 and 342 (29.2%) reported nasal symptoms. The most common nasal symptom was loss of taste (20.6%, median score = 6), while 11.4% had loss of smell (median score = 5). The incidence of nasal symptom including loss of smell and loss of taste as the first onset symptom was <1% in COVID-19 patients. Loss of smell or taste scores showed no correlation with the scores of other nasal symptoms. Loss of taste scores, but not loss of smell scores, were significantly increased in severe vs. non-severe COVID-19 patients. Interleukin (IL)-6 and lactose dehydrogenase (LDH) serum levels positively correlated with loss of taste scores. About 80% of COVID-19 patients recovered from smell and taste dysfunction in 2 weeks.Conclusions: In the Wuhan COVID-19 cohort, only 1 out of 10 hospital admitted patients had loss of smell while 1 out 5 reported loss of taste which was associated to severity of COVID-19. Most patients recovered smell and taste dysfunctions in 2 weeks.

Self-reported taste and smell disorders in patients with COVID-19: distinct features in China (preprint)

ObjectivesWe aimed to explore the frequencies of nasal symptoms in patients with COVID-19, including loss of smell and taste, as well as their presentation as the first symptom of the disease and their association with the severity of COVID-19. MethodsIn this retrospective study, 1,206 laboratory-confirmed COVID-19 patients were included and followed-up by telephone call one month after discharged from Tongji Hospital, Wuhan. Demographic data, laboratory values, comorbidities, symptoms, and numerical rating scale scores (0-10) of nasal symptoms were extracted from the hospital medical records, and confirmed or reevaluated by the telephone follow-up. ResultsFrom COVID-19 patients (N = 1,172) completing follow-up, 199 (17%) subjects had severe COVID-19 and 342 (29.2%) reported nasal symptoms. The most common nasal symptom was loss of taste (20.6%, median score = 6), while 11.4% had loss of smell (median score = 5). The incidence of nasal symptom including loss of smell and loss of taste as the first onset symptom was <1% in COVID-19 patients. Loss of smell or taste scores showed no correlation with the scores of other nasal symptoms. Loss of taste scores, but not loss of smell scores, were significantly increased in severe vs. non-severe COVID-19 patients. Interleukin (IL)-6 and lactose dehydrogenase (LDH) serum levels positively correlated with loss of taste scores. About 80% of COVID-19 patients recovered from smell and taste dysfunction in 2 weeks. ConclusionIn the Wuhan COVID-19 cohort, only 1 out of 10 hospital admitted patients had loss of smell while 1 out 5 reported loss of taste which was associated to severity of COVID-19. Most patients recovered smell and taste dysfunctions in 2 weeks.

Clinical features of 109 cases of novel coronavirus pneumonia / 中华传染病杂志

Objective@#To observe theepidemiology, clinical manifestations, laboratory tests, imaging findings, treatment and prognosis of patients with novel coronavirus pneumonia.@*Methods@#Clinical data of 109 patients with suspected and definite novel coronavirus pneumonia admitted to Wuhan Sixth Hospital from December 24, 2019 to January 28, 2020 were retrospectively analyzed. Statistical analysiswas performed by using t test or chi-square test.@*Results@#Among the 109 patients, 48 (44%) were male and 61 (56%) were female, with the average age of (52.5±10.8) years. Fifty-four patients (49.5%) had definite contact history. Among the 109 patients, 104 (95.5%) presentedwith fever, 37(33.7%) with headache, 78 (71.9%) with general pain, 88 (80.8%) with fatigue and poor appetite, 23 (21.3%) with diarrhea, 94 (86.5%) withcoughing, 23 (21.3%) with shortness of breath, 57 (52.8%) withpalpitation, 45 (41.5%) with chest distress, 4 (3.3%) with chest pain, 40 (37.0%) with lung rales. Forty-two cases (38.5%) had leukocyte count <4×109/L, 58 cases (53.2%) had lymphocyte count <1.5×109/L, 7 cases (24.8%) had hemoglobin <120g/L, 37 cases(33.9%) had LDH >230 mmol/L, 29 cases (26.6%) had brain natriuretic peptide precursor>300 ng/mL, 87 cases (79.8%) had hypersensitive C-reactive protein >10mg/L, 26 cases (23.9%) had D-dimer >0.5 mg/L, 35 cases (32.1%) had coagulation disorder. The leukocyte counts, LDH, brain natriuretic peptide precursor and D-dimer of severe/critical cases[(11.33±4.87)×109/L, (527.51±260.87) mmol/L, (722.88±189.56) ng/mL, (1.89±4.24) mg/L, respectively] were all significantly higher than those of common cases [(4.02±1.49)×109/L, (159.75±30.31)mmol/L, (428.22±124.76)ng/mLand (0.41±0.22)mg/L, respectively], while the lymphocyte count of severe/critical cases [(0.60±0.17)×109/L] was significantly lower than common cases [(1.13±0.43)×109/L] (t=11.36, 11.33,9.81,2.81 and 7.77,all P<0.05). On admission, chest CT showed that 27 cases (24.8%) of pneumonia were unilateral, 82 cases (75.2%) werebilateral, and most of them were ground glass. The pneumonia progressed in a short time and reached the peak within 10 days. The comprehensive treatment included antiviral drugs, prevention ofbacterialinfection and supportive treatment, and glucocorticoid and respiratory support treatment wereadministrated when necessary.@*Conclusions@#The novel coronavirus pneumonia is characterized by highly infectious, rapid progress, and diverse clinical and imaging features. Early diagnosis and active comprehensive treatment could improve theprognosis and reduce themortality.