Immediate and long-term changes in the epidemiology, infection spectrum, and clinical characteristics of viral and bacterial respiratory infections in Western China after the COVID-19 outbreak: a modeling study.

BACKGROUND: The impact of COVID-19 on the epidemiology, clinical characteristics, and infection spectrum of viral and bacterial respiratory infections in Western China is unknown. METHODS: We conducted an interrupted time series analysis based on surveillance of acute respiratory infections (ARI) in Western China to supplement the available data. RESULTS: The positive rates of influenza virus, Streptococcus pneumoniae, and viral and bacterial coinfections decreased, but parainfluenza virus, respiratory syncytial virus, human adenovirus, human rhinovirus, human bocavirus, non-typeable Haemophilus influenzae, Mycoplasma pneumoniae, and Chlamydia pneumoniae infections increased after the onset of the COVID-19 epidemic. The positive rate for viral infection in outpatients and children aged <5 years increased, but the positive rates of bacterial infection and viral and bacterial coinfections decreased, and the proportion patients with clinical symptoms of ARI decreased after the onset of the COVID-19 epidemic. Non-pharmacological interventions reduced the positive rates of viral and bacterial infections in the short term but did not have a long-term limiting effect. Moreover, the proportion of ARI patients with severe clinical symptoms (dyspnea and pleural effusion) increased in the short term after COVID-19, but in the long-term, it decreased. CONCLUSIONS: The epidemiology, clinical characteristics, and infection spectrum of viral and bacterial infections in Western China have changed, and children will be a high-risk group for ARI after the COVID-19 epidemic. In addition, the reluctance of ARI patients with mild clinical symptoms to seek medical care after COVID-19 should be considered. In the post-COVID-19 era, we need to strengthen the surveillance of respiratory pathogens.

A Survey of Survival Status of 601 Hemophilia Patients in Guangdong Region during COVID-19 Pandemic: Investigation and Implications

Objective:Investigation the survival status of patients with hemophilia in Guangdong during the COVID-19 pandemic, and exploring the effectiveness of coping strategies to provide some experience and inspiration for the management of rare chronic diseases such as hemophilia during public health emergencies. Methods:Retrospective analysis of the disease characteristics, lifestyle, treatment, psychological, EQ-5D life quality assessment, as well as participation and effectiveness of local response measure participation and effectiveness of 601 cases of hemophiliac patients in Guangdong area before and after the COVID-19 pandemic (October 23, 2019 to April 22, 2020). Results:The 601 patients were all males, Including 22.46% patients under 6 years old, 22.96% among 7-12 years old, 13.98% among 13-20 years old , 40.44% among 21-60 years old and 0.17% over 60 years old. Hemophilia A accounted for 86.52% (520 cases) and hemophilia B 13.48% (81 cases). There were 352 cases (58.57%) of severe hemophilia (FⅧ<1%), 219 cases (36.44%) of medium (FⅧ 1~5%), 17 cases (2.83%) of 13 cases (FⅧ 5~40%), and 13 cases (FⅧ 2.16%) is not clear. There were 50 patients had inhibitors. Before the COVID-19 epidemic, 54.58% of the patients had been working or studying at home for a long time. During the epidemic, the patient’s outing activities decreased. During the 3 months of the epidemic, the frequency of hospital visit was 3.40±4.09 times per month, which was significantly lower than 4.14±4.05 times per month in the 3 months before the epidemic (P=0.000)。6.00±8.34 clinical bleeding events developed during 3 months of the epidemic, which is significantly increased from 5.47±8.09 times 3 months before the epidemic (P=0.000). The patient’s self-assessment score about healthy decreased significantly (70.67±23.76 points vs 75.01±22.28 points,P=0.000). 74.71% of patients were able to maintain the original treatment, the changes in treatment were generally different (P=0.030), and 152 patients switched treatments. Only 34 (5.66%) patients often develop symptoms of anxiety. In the EQ-5D assessment, the proportions with no difficulty in mobility, self-care, and daily life were 55.57%, 73.88%, and 56.57%;the proportions without pain/discomfort and anxiety/depression were 35.27% and 44.26%, the proportion of patients with difficulty and severe pain and anxiety is not high. Regarding the participation of our response measures, 34.28~48.25% patients chose to use the “network platform” for diagnosis and treatment, and the number of patients increased significantly during the epidemic (P=0.000);the number of patients benefited from the medical insurance policy also increased (9.65% vs 13.48%,P=0.023). During the epidemic, the patient’s awareness of hemophilia knowledge (7.59±2.16 points) was significantly improved (P=0.000) compared to that of 3 months ago (7.17±2.34 points). Conclusion:The COVID-19 epidemic had a certain impact on the condition of hemophilia patients in Guangdong. Various measures by the Guangdong Hemophilia Center and the government, especially “the online diagnosis and treatment model”, and the “long prescription” medical insurance reimbursement policy has a positive effect on hemophilia patients in the region, make the disease generally controllable, and may bring long-term profound benefits for management of such rare disease in future. Disclosures No relevant conflicts of interest to declare.

Innovative Application of SERS in Food Quality and Safety: A Brief Review of Recent Trends.

Innovative application of surface-enhanced Raman scattering (SERS) for rapid and nondestructive analyses has been gaining increasing attention for food safety and quality. SERS is based on inelastic scattering enhancement from molecules located near nanostructured metallic surfaces and has many advantages, including ultrasensitive detection and simple protocols. Current SERS-based quality analysis contains composition and structural information that can be used to establish an electronic file of the food samples for subsequent reference and traceability. SERS is a promising technique for the detection of chemical, biological, and harmful metal contaminants, as well as for food poisoning, and allergen identification using label-free or label-based methods, based on metals and semiconductors as substrates. Recognition elements, including immunosensors, aptasensors, or molecularly imprinted polymers, can be linked to SERS tags to specifically identify targeted contaminants and perform authenticity analysis. Herein, we highlight recent studies on SERS-based quality and safety analysis for different foods categories spanning the whole food chain, 'from farm to table' and processing, genetically modified food, and novel foods. Moreover, SERS detection is a potential tool that ensures food safety in an easy, rapid, reliable, and nondestructive manner during the COVID-19 pandemic.

Pediatric asthma control during the COVID-19 pandemic: A systematic review and meta-analysis.

BACKGROUND: With the onset of the coronavirus disease 2019 (COVID-19) pandemic, many experts expected that asthma-associated morbidity because of severe acute respiratory syndrome coronavirus 2 infection would dramatically increase. However, some studies suggested that there was no apparent increasing in asthma-related morbidity in children with asthma, it is even possible children may have improved outcomes. To understand the relationship between the COVID-19 pandemic and asthma outcomes, we performed this article. METHODS: We searched PubMed, Embase, and Cochrane Library to find literature from December 2019 to June 2021 related to COVID-19 and children's asthma control, among which results such as abstracts, comments, letters, reviews, and case reports were excluded. The level of asthma control during the COVID-19 pandemic was synthesized and discussed by outcomes of asthma exacerbation, emergency room visit, asthma admission, and childhood asthma control test (c-ACT). RESULTS: A total of 22,159 subjects were included in 10 studies. Random effect model was used to account for the data. Compared with the same period before the COVID-19 pandemic, asthma exacerbation reduced (odds ratio [OR] = 0.26, 95% confidence interval [CI] = [0.14-0.48], Z = 4.32, p < 0.0001), the odds of emergency room visit decreased as well (OR = 0.11, 95% CI = [0.04-0.26], Z = 4.98, p < 0.00001). The outcome of asthma admission showed no significant difference (OR = 0.84, 95% CI = [0.32-2.20], Z = 0.36, p = 0.72). The outcome of c-ACT scores were not analyzed because of the different manifestations used. Overall, c-ACT scores reduced during the pandemic. CONCLUSION: Compared to the same period before the COVID-19 pandemic, the level of asthma control has been significantly improved. We need to understand the exact factors leading to these improvements and find methods to sustain it.

Etiological and epidemiological features of acute respiratory infections in China.

Nationwide prospective surveillance of all-age patients with acute respiratory infections was conducted in China between 2009‒2019. Here we report the etiological and epidemiological features of the 231,107 eligible patients enrolled in this analysis. Children <5 years old and school-age children have the highest viral positivity rate (46.9%) and bacterial positivity rate (30.9%). Influenza virus, respiratory syncytial virus and human rhinovirus are the three leading viral pathogens with proportions of 28.5%, 16.8% and 16.7%, and Streptococcus pneumoniae, Mycoplasma pneumoniae and Klebsiella pneumoniae are the three leading bacterial pathogens (29.9%, 18.6% and 15.8%). Negative interactions between viruses and positive interactions between viral and bacterial pathogens are common. A Join-Point analysis reveals the age-specific positivity rate and how this varied for individual pathogens. These data indicate that differential priorities for diagnosis, prevention and control should be highlighted in terms of acute respiratory tract infection patients' demography, geographic locations and season of illness in China.

Genomic epidemiology of SARS-CoV-2 in Pakistan (preprint)

Pakistan has been severely affected by the COVID-19 pandemic. To investigate the initial introductions and transmissions of the SARS-CoV-2 in the country, we performed the largest genomic epidemiology study of COVID-19 in Pakistan and generated 150 complete SARS-CoV-2 genome sequences from samples collected before June 1, 2020. We identified a total of 347 variants, 29 of which were over-represented in Pakistan. Meanwhile, we found over one thousand intra-host single-nucleotide variants. Several of them occurred concurrently, indicating possible interactions among them. Some of the hypermutable positions were not observed in the polymorphism data, suggesting strong purifying selections. The genomic epidemiology revealed five distinctive spreading clusters. The largest cluster consisted of 74 viruses which were derived from different geographic locations and formed a deep hierarchical structure, indicating an extensive and persistent nation-wide transmission of the virus that was probably contributed by a signature mutation of this cluster. Twenty-eight putative international introductions were identified, several of which were consistent with the epidemiological investigations. No progenies of any of these 150 viruses have been found outside of Pakistan, most likely due to the nonphmarcological intervention to control the virus. This study has inferred the introductions and transmissions of SARS-CoV-2 in Pakistan, which could provide a guidance for an effective strategy for disease control.

Comprehensive analysis of RNA-seq and whole genome sequencing data reveals no evidence for SARS-CoV-2 integrating into host genome (preprint)

SARS-CoV-2, as the causation of severe epidemic of COVID-19, is one kind of positive single-stranded RNA virus with high transmissibility. However, whether or not SARS-CoV-2 can integrate into host genome needs thorough investigation. Here, we performed both RNA sequencing (RNA-seq) and whole genome sequencing on SARS-CoV-2 infected human and monkey cells, and investigated the presence of host-virus chimeric events. Through RNA-seq, we did detect the chimeric host-virus reads in the infected cells. But further analysis using mixed libraries of infected cells and uninfected zebrafish embryos demonstrated that these reads are falsely generated during library construction. In support, whole genome sequencing also didn't identify the existence of chimeric reads in their corresponding regions. Therefore, the evidence for SARS-CoV-2's integration into host genome is lacking.

Spatial-temporal distribution of coronavirus disease 2019 in Jingzhou City

Objective • To explore the spatial distribution and spatial-temporal clustering of coronavirus disease 2019(COVID-19) in Jingzhou City. Methods • Data of COVID-19 cases in Jingzhou City from January 1 to March 12, 2020 were collected. Trend surface analysis, spatial autocorrelation and spatial-temporal scanning analysis were conducted to understand the spatial-temporal distribution of COVID-19 at town (street) level in Jingzhou City, and the spatial-temporal clustering characteristics of local cases and imported cases were compared. Results • Trend surface analysis showed that the incidence rate of COVID-19 in Jingzhou City was slightly "U" from west to east, slightly higher in the east, and inverted "U" from south to north, slightly higher in the south. Global autocorrelation showed that the incidence rate of COVID-19 in Jingzhou City was positively correlated (Moran's I=0.410, P=0.000). Local spatial autocorrelation analysis showed that the highly clustered areas and hot spot areas were mainly in Shashi District, Jingzhou District and the main urban area of Honghu City (Xindi Street) (P<0.05). Five clusters were found by spatial-temporal scanning of imported cases. The cluster time of the main cluster was from January 18 to February 3, 2020, and it was centered on Lianhe Street, covering 15 towns (streets) in Shashi District and Jingzhou District (LLR=174.944, RR=7.395, P=0.000). Five clusters were found by spatial-temporal scanning of local cases. The cluster time of the main cluster was from January 20 to February 24, 2020, which was located in Xindi Street, Honghu City (LLR=224.434, RR=16.133, P=0.000). Conclusion • Obvious spatialtemporal clustering of COVID-19 was found in Jingzhou City, and Shashi District, Jingzhou District and Honghu City were the most prevalent areas.