Duration of viable virus shedding and polymerase chain reaction positivity of the SARS-CoV-2 Omicron variant in the upper respiratory tract: a systematic review and meta-analysis.

OBJECTIVES: To assess the duration of viable virus shedding and polymerase chain reaction (PCR) positivity of the SARS-CoV-2 Omicron variant in the upper respiratory tract. METHODS: We systematically searched PubMed, Cochrane, and Web of Science for original articles reporting the duration of viable virus shedding and PCR positivity of the SARS-CoV-2 Omicron variant in the upper respiratory tract from November 11, 2021 to December 11, 2022. This meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO (CRD42022357349). We used the DerSimonian-Laird random-effects meta-analyses to obtain the pooled value and the 95% confidence intervals. RESULTS: We included 29 studies and 230,227 patients. The pooled duration of viable virus shedding of the SARS-CoV-2 Omicron variant in the upper respiratory tract was 5.16 days (95% CI: 4.18-6.14), and the average duration of PCR positivity was 10.82 days (95% CI: 10.23-11.42). The duration of viable virus shedding and PCR positivity of the SARS-CoV-2 Omicron variant in symptomatic patients was slightly higher than that in asymptomatic patients, but the difference was not significant (P >0.05). CONCLUSION: The current study improves our understanding of the status of the literature on the duration of viable virus shedding and PCR positivity of Omicron in the upper respiratory tract. Our findings have implications for pandemic control strategies and infection control measures.

Trends and disparities in 44 national notifiable infectious diseases in China: an analysis of national surveillance data from 2010 to 2019.

BACKGROUND: Research assessing the changing epidemiology of infectious diseases in China after the implementation of new health-care reform in 2009 was scarce. We aimed to get the latest trends and disparities of national notifiable infectious diseases by age, sex, province and seasons in China from 2010 to 2019. METHODS: The number of incident cases and deaths, incidence rate and mortality of 44 national notifiable infectious diseases by sex, age groups, and provincial regions from 2010 to 2019 was extracted from the China Information System for Disease Control and Prevention and official reports, and divided into six kinds of infectious diseases by transmission routes and three classes (A, B and C) in this descriptive study. Estimated annual percentage changes (EAPCs) were calculated to quantify the temporal trends of incidence and mortality rate. We calculated concentration index to measure economic-related inequality. Segmented interrupted time-series analysis was used to estimate the impact of the COVID-19 pandemic on the epidemic of notifiable infectious disease. RESULTS: The trend of incidence rate on six kinds of infectious diseases by transmission routes was stable, while only mortality of sexual, blood-borne, and mother-to-child-borne infectious diseases increased from 0.6466 per 100 000 population in 2010 to 1.5499 per 100 000 population in 2019 by 8.76% per year (95%CI: 6.88-10.68). There was a decreasing trend of incidence rate on Class-A infectious diseases (EAPC=-16.30%; 95%CI: -27.93 - -2.79) and Class-B infectious diseases (EAPC=-1.05%; 95%CI: -1.56 - -0.54), while an increasing trend on Class-C infectious diseases (EAPC=6.22%; 95%CI: 2.13~10.48). For mortality, there was a decreasing trend on Class-C infectious diseases (EAPC=-14.76%; 95%CI: -23.46 - -5.07), and an increasing trend on Class-B infectious diseases (EAPC=4.56%; 95%CI: 2.44-6.72). In 2019, the infectious diseases with highest incidence rate and mortality were respiratory diseases (340.95 per 100 000 population), and sexual, blood-borne, and mother-to-child-borne infectious diseases (1.5459 per 100 000 population), respectively. The greatest increasing trend of incidence rate was observed in seasonal influenza, from 4.83 per 100 000 population in 2010 to 253.36 per 100 000 population in 2019 by 45.16% per year (95%CI: 29.81-62.33), especially among female and children aged 0 - 4 years old. The top disease with highest mortality was still AIDs which had the highest average yearly mortality in 24 provinces from 2010 to 2019, and its incidence rate (EAPC=14.99%; 95%CI: 8.75-21.59) and mortality (EAPC=9.65; 95%CI: 7.71-11.63) both increased from 2010 to 2019, especially among people aged 44 - 59 years old and 60 or older. Male incidence rate and mortality were higher than females each year from 2010 to 2018 on 29 and 10 infectious diseases, respectively. Additionally, sex differences of incidence and mortality of AIDS were becoming larger. The curve lay above the equality line, with the negative value of the concentration index, which indicated that economic-related health disparities exist in the distribution of incidence rate and mortality of respiratory diseases (incidence rate: the concentration index = -0.063, P<0.0001; mortality: the concentration index = -0.131, P<0.001), sexual, blood-borne, and mother-to-child-borne infectious diseases (incidence rate: the concentration index = -0.039, P=0.0192; mortality: the concentration index = -0.207, P<0.0001), and the inequality disadvantageous to the poor (pro-rich). Respiratory diseases (Dec, Jan), intestinal diseases (May, Jun, July), zoonotic infectious diseases (Mar-Jul) and vector-borne infectious diseases (Sep-Oct) had distinct seasonal epidemic patterns. In addition, segmented interrupted time-series analyses showed that, after adjusted for potential seasonality, autocorrelation, GDP per capita, number of primary medical institutions and other factors, there was no significant impact of COVID-19 epidemic on the monthly incidence rate of six kinds of infectious diseases by transmission routes from 2018 to 2020 (all P>0.05). CONCLUSIONS: The incidence rates of six kinds of infectious diseases were stable in the past decade, and incidence rates of Class-A and Class-B infectious diseases were deceasing, because of comprehensive prevention and control measures and strengthened health system after the implementation of the new health-care reform in China since 2009. However, age, gender, regional and economic disparities were still observed. Concerted efforts are needed to reduce the impact of seasonal influenza (especially among children aged 0 - 4 years old) and the mortality of AIDs (especially among people aged 44 - 59 years old and 60 or older). More attention should be paid to the disparities on the burden of infectious diseases. This article is protected by copyright. All rights reserved.

The prevalence of functional gastrointestinal disorders related symptoms and the association with working place among healthcare workers who were in the fighting against COVID-19 in regional China.

Objectives: To investigate the prevalence of functional gastrointestinal disorders (FGIDs) related symptoms among healthcare workers (HWs) who were in the fighting against COVID-19 in Nanjing of China, and further to examine the association between working place and FGIDs-related symptoms among HWs during the period of COVID-19 epidemic. Methods: An online anonymous survey was conducted among those HWs without history of FGIDs, who took part in the fighting against the COVID-19 epidemic between July and September of 2021 in Nanjing, China. All the 15 FGIDs-related symptoms included in the Rome IV diagnostic questionnaire for adults were investigated in this study. The outcome variable was the presence of FGIDs-related symptoms ("Yes" or "No"), while the independent measure was participants' working place ("in-ward" or "out-ward"). Logistics regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the association of working place with FGIDs-related symptoms among those healthcare workers. Results: Totally, 336 eligible participants completed the survey. The prevalence of FGIDs-related symptoms was 48.8% (95%CI = 43.4%, 54.3%) among overall participants, with 40.7% (95%CI = 33.14%, 48.71%) and 56.3% (95%CI = 48.59%, 63.73%) for in-ward and out-ward HWs, respectively. Compared to their in-ward counterparts, those out-ward HWs were at a 1.88-fold likelihood (95%CI = 1.22, 2.89) to experience FGIDs-related symptoms during the period of fighting against the COVID-19 epidemic. After adjustment for potential confounders, such a positive association attenuated but still remained significant. Conclusions: A high prevalence of FGIDs-related symptoms was observed among those HWs who were without history of FGIDs during the fighting against COVID-19, and out-ward HWs were at a significantly higher risk to experience FGIDs-related symptoms relative to their in-ward counterparts in regional China. It has important implications that particular attention shall be paid to functional gastrointestinal issues for healthcare workers, especially those who are at uncertain risks of infectious diseases, when they participate in response to public health emergencies in future.

An electrochemical paper-based hydrogel immunosensor to monitor serum cytokine for predicting the severity of COVID-19 patients.

Analysis of cytokines levels in human serum is critical as it can be a "symptom diagnostic biomarker" in COVID-19, giving real-time information about human health status. Here, we present the construction and performance of a low-price immunosensor (∼US$0.428 per test) based on microfluidic paper-based system to detect cytokine for predicting the health status of COVID-19 patients. Interleukin-6 (IL-6) was selected as the detection model for the close relationship between IL-6 and COVID-19. The assay, which we integrated into foldable paper system, leverages the magnetic immunoassay, the streptavidin-horseradish peroxidase (HRP) associated with tetramethyl benzidine/hydrogen peroxide (TMB/H2O2) to amplify the signal for electrochemical readout. To improve the sensitivity of cytokine detection, a hybrid of gold nanoparticles (AuNPs) and polypyrrole (PPy) hydrogel was modified on the working electrode to increase the conductivity and improve the electron transfer rate. With our prototypic origami paper-based immunosensor operated in differential pulse voltammetry (DPV) mode, we achieved excellent results with a dynamic range from 5 to 1000 pg/mL and a lower detection limit (LOD) of 0.654 pg/mL. Furthermore, we evaluated the capability of the clinical application of the proposed immunosensor using human serum samples from a hospital. The results indicate that our proposed immunosensor has great potential in early diagnosing high-risk COVID-19 patients.

Atmospheric Hg(p) concentrations at various particles sizes before (2018-2019) and during (2019-2020 and 2020-2021) COVID-19 occurred periods in Taichung, Taiwan.

The main goal of this study is to compare concentrations of atmospheric Hg(p) for various particles sizes Total Suspended Particulates (TSP), PM18, PM10, PM2.5, PM1, PM<1 before (2018-2019) and during (2019-2020 and 2020-2021) COVID-19 occurred periods in central Taiwan. In addition, test the statistical differences concentrations of Hg(p) for various particles sizes before and during COVID-19 occurred periods in central Taiwan. Finally, calculate the Hg(p) health risk assessment before and during COVID-19 occurred period in central Taiwan.The result indicated that the mean Hg(p) concentrations in TSP and PM2.5 were higher during (2020-2021) the COVID-19 occurred period than that of the mean Hg(p) concentrations in TSP and PM2.5 before the COVID-19 occurred period. In addition, the Hg(p)concentrations PM18, PM10, PM2.5, PM1 and PM<1 were all increased during the COVID-19 occurred period. The Hg(p) concentrations in TSP were decreased during (2019-2020) the COVID-19 occurred period when compared with that of the before the COVID-19 occurred period. Moreover, significant mean Hg(p) concentrations differences were existed at PM18, PM10 and PM2.5 before and during (2020-2021) COVID-19 occurred periods. Finally, the HQ and HI values for Hg(p) were both increased during COVID-19 occurred periods when compared with before COVID-19 occurred period in this study.

Global Excess Mortality during COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

BACKGROUND: Currently, reported COVID-19 deaths are inadequate to assess the impact of the pandemic on global excess mortality. All-cause excess mortality is a WHO-recommended index for assessing the death burden of COVID-19. However, the global excess mortality assessed by this index remains unclear. We aimed to assess the global excess mortality during the COVID-19 pandemic. METHODS: We searched PubMed, EMBASE, and Web of Science for studies published in English between 1 January 2020, and 21 May 2022. Cross-sectional and cohort studies that reported data about excess mortality during the pandemic were included. Two researchers independently searched the published studies, extracted data, and assessed quality. The Mantel-Haenszel random-effects method was adopted to estimate pooled risk difference (RD) and their 95% confidence intervals (CIs). RESULTS: A total of 79 countries from twenty studies were included. During the COVID-19 pandemic, of 2,228,109,318 individuals, 17,974,051 all-cause deaths were reported, and 15,498,145 deaths were expected. The pooled global excess mortality was 104.84 (95% CI 85.56-124.13) per 100,000. South America had the highest pooled excess mortality [134.02 (95% CI: 68.24-199.80) per 100,000], while Oceania had the lowest [-32.15 (95% CI: -60.53--3.77) per 100,000]. Developing countries had higher excess mortality [135.80 (95% CI: 107.83-163.76) per 100,000] than developed countries [68.08 (95% CI: 42.61-93.55) per 100,000]. Lower middle-income countries [133.45 (95% CI: 75.10-191.81) per 100,000] and upper-middle-income countries [149.88 (110.35-189.38) per 100,000] had higher excess mortality than high-income countries [75.54 (95% CI: 53.44-97.64) per 100,000]. Males had higher excess mortality [130.10 (95% CI: 94.15-166.05) per 100,000] than females [102.16 (95% CI: 85.76-118.56) per 100,000]. The population aged ≥ 60 years had the highest excess mortality [781.74 (95% CI: 626.24-937.24) per 100,000]. CONCLUSIONS: The pooled global excess mortality was 104.84 deaths per 100,000, and the number of reported all-cause deaths was higher than expected deaths during the global COVID-19 pandemic. In South America, developing and middle-income countries, male populations, and individuals aged ≥ 60 years had a heavier excess mortality burden.

Association between meteorological factors and daily new cases of COVID-19 in 188 countries: A time series analysis.

By 31 December 2020, Coronavirus disease 2019 (COVID-19) had been prevalent worldwide for one year, and most countries had experienced a complete seasonal cycle. The role of the climate and environment are essential factors to consider in transmission. We explored the association between global meteorological conditions (including mean temperature, wind speed, relative humidity and diurnal temperature range) and new cases of COVID-19 in the whole past year. We assessed the relative risk of meteorological factors to the onset of COVID-19 by using generalized additive models (GAM) and further analyzed the hysteresis effects of meteorological factors using the Distributed Lag Nonlinear Model (DLNM). Our findings revealed that the mean temperature, wind speed and relative humidity were negatively correlated with daily new cases of COVID-19, and the diurnal temperature range was positively correlated with daily new cases of COVID-19. These relationships were more apparent when the temperature and relative humidity were lower than their average value (21.07°Cand 66.83%). The wind speed and diurnal temperature range were higher than the average value(3.07 m/s and 9.53 °C). The maximum RR of mean temperature was 1.30 under -23°C at lag ten days, the minimum RR of wind speed was 0.29 under 12m/s at lag 24 days, the maximum RR of range of temperature was 2.21 under 28 °C at lag 24 days, the maximum RR of relative humidity was 1.35 under 4% at lag 0 days. After a subgroup analysis of the countries included in the study, the results were still robust. As the Northern Hemisphere enters winter, the risk of global covid-19 remains high. Some countries have ushered in a new round of COVID-19 epidemic. Thus, active measures must be taken to control the source of infection, block transmission and prevent further spread of COVID-19 in winter.

Non-linear correlation between daily new cases of COVID-19 and meteorological factors in 127 countries.

Meteorological parameters are the critical factors of affecting respiratory infectious disease such as Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS) and influenza, however, the effect of meteorological parameters on coronavirus disease 2019 (COVID-19) remains controversial. This study investigated the effects of meteorological factors on daily new cases of COVID-19 in 127 countries, as of August 31 2020. The log-linear generalized additive model (GAM) was used to analyze the effect of meteorological variables on daily new cases of COVID-19. Our findings revealed that temperature, relative humidity, and wind speed are nonlinearly correlated with daily new cases, and they may be negatively correlated with the daily new cases of COVID-19 over 127 countries when temperature, relative humidity and wind speed were below 20°C, 70% and 7 m/s respectively. Temperature(>20°C) was positively correlated with daily new cases. Wind speed (when>7 m/s) and relative humidity (>70%) was not statistically associated with transmission of COVID-19. The results of this research will be a useful supplement to help healthcare policymakers in the Belt and Road countries, the Centers for Disease Control (CDC) and the World Health Organization (WHO) to develop strategies to combat COVID-19.

The Anticoagulant Therapy for Otogenic Sigmoid Sinus Thrombophlebitis: A Case Report and Literature Review.

Sigmoid sinus thrombophlebitis is a severe and potentially fatal intracranial complication of acute otitis media and middle ear cholesteatoma. Early administration of broad-spectrum antibiotics and immediate radical mastoidectomy are the recommended standard treatments; however anticoagulant therapy is always an option worthy of clinical consideration. Here, we report a case of middle ear cholesteatoma complicated with sigmoid sinus thrombophlebitis in a patient who received anticoagulant therapy for 1 year before the operation because of the coronavirus disease 2019 pandemic.

Effects of temperature and humidity on the daily new cases and new deaths of COVID-19 in 166 countries.

The coronavirus disease 2019 (COVID-19) pandemic is the defining global health crisis of our time and the greatest challenge facing the world. Meteorological parameters are reportedly crucial factors affecting respiratory infectious disease epidemics; however, the effect of meteorological parameters on COVID-19 remains controversial. This study investigated the effects of temperature and relative humidity on daily new cases and daily new deaths of COVID-19, which has useful implications for policymakers and the public. Daily data on meteorological conditions, new cases and new deaths of COVID-19 were collected for 166 countries (excluding China) as of March 27, 2020. Log-linear generalized additive model was used to analyze the effects of temperature and relative humidity on daily new cases and daily new deaths of COVID-19, with potential confounders controlled for, including wind speed, median age of the national population, Global Health Security Index, Human Development Index and population density. Our findings revealed that temperature and relative humidity were both negatively related to daily new cases and deaths. A 1 °C increase in temperature was associated with a 3.08% (95% CI: 1.53%, 4.63%) reduction in daily new cases and a 1.19% (95% CI: 0.44%, 1.95%) reduction in daily new deaths, whereas a 1% increase in relative humidity was associated with a 0.85% (95% CI: 0.51%, 1.19%) reduction in daily new cases and a 0.51% (95% CI: 0.34%, 0.67%) reduction in daily new deaths. The results remained robust when different lag structures and the sensitivity analysis were used. These findings provide preliminary evidence that the COVID-19 pandemic may be partially suppressed with temperature and humidity increases. However, active measures must be taken to control the source of infection, block transmission and prevent further spread of COVID-19.