Quantitative evaluation of infectious health care wastes from numbers of confirmed, suspected and out-patients during COVID-19 pandemic: A case study of Wuhan.

The fight against coronavirus disease 2019 (COVID-19) is still running its courses. Proper management and disposal of health care wastes (HCWs) are critical to win the fight. To achieve aforementioned tasks, prediction of their production is highly desired. In this study, primary data of production of three kinds of HCWs collected from Wuhan, the first epidemic epicenter worldwide and a mega city with more than 10 million population who has went through a lockdown period of 78 days, were reported for their first time. HCWs were classified into routine HCWs, infectious HCWs (IHCWs) and infectious municipal solid wastes. Among them, infectious HCWs from designated hospitals for COVID-19 were recognized as the most dangerous one. A multiple linear regression (MLR) model was built to predict the production of IHCWs with high significance. Numbers of patients were demonstrated high correlations with the production of IHCWs in an order of confirmed patients ＞ out-patients ＞ suspected patients. By the MLR model, production rates of IHCWs by confirmed, suspected and out patients were determined as 3.2, 1.8 and 0.1 kg/patient, respectively. In addition, constant production of IHCWs during the pandemic period was determined as 13 tons/d. This is the first study on quantitative evaluation of infectious HCWs during COVID-19 pandemic. The achievements in this study have potentials to shed light on global efforts to the prediction, management and disposal of vast HCWs generated in the war against COVID-19.

Detection of SARS-CoV-2 in saliva and characterization of oral symptoms in COVID-19 patients.

OBJECTIVES: In order to provide a more comprehensive understanding of the effects of SARS-CoV-2 on oral health and possible saliva transmission, we performed RNA-seq profiles analysis from public databases and also a questionnaire survey on oral-related symptoms of COVID-19 patients. MATERIALS AND METHODS: To analyse ACE2 expression in salivary glands, bulk RNA-seq profiles from four public datasets including 31 COVID-19 patients were recruited. Saliva and oropharyngeal swabs were collected. SARS-CoV-2 nucleic acids in saliva were detected by real-time polymerase chain reaction (RT-PCR). Additionally, a questionnaire survey on various oral symptoms such as dry mouth and amblygeustia was also carried out on COVID-19 patients. RESULTS: ACE2 expression was present at detectable levels in the salivary glands. In addition, of four cases with positive detection of salivary SARS-CoV-2 nucleic acids, three (75%) were critically ill on ventilator support. Furthermore, we observed the two major oral-related symptoms, dry mouth (46.3%) and amblygeustia (47.2%), were manifested by a relatively high proportion of 108 COVID-19 patients who accepted the questionnaire survey. CONCLUSIONS: This study confirms the expression of ACE2 in the salivary glands and demonstrates the possibility of SARS-CoV-2 infection of salivary glands. Saliva may be a new source of diagnostic specimens for critically ill patients, since it can be easily collected without any invasive procedures. In addition, dry mouth and amblygeustia can be considered as initial symptoms of COVID-19 infection.