ABSTRACT
The use of antibiotics is common in the treatment of COVID-19, but adequate evaluation is lacking. We aimed to evaluate the efficacy of antibiotic use in non-severe COVID-19 patients, particularly in patients admitted with low risk of bacterial infection. This is a multi-center retrospective cohort study. Patients are screened strictly according to the inclusion/exclusion criteria and are divided into two groups based on antibiotics exposure. The exposure is defined as the treatment of antibiotics prescribed within 48 hours after admission, with a course of treatment≥3 days; and patients in this group are classified as early antibiotic use group. Otherwise, patients are classified as the non early antibiotic use group. The primary end point of the study is progressing from non-severe type COVID-19 into severe type. This is the first protocol to put a focus on the transformation of the severity of the disease, based on a multi-center retrospective cohort design.
Subject(s)
COVID-19 , Bacterial InfectionsABSTRACT
The use of antibiotics is common in the treatment of COVID-19, but adequate evaluation is lacking. This study aimed to evaluate the effect of early antibiotic use in non-severe COVID-19 patients admitted with low risk of bacterial infection. The multi-center retrospective cohort study included 1613 non-severe COVID-19 inpatients admitted with low risk of bacterial infection. During the follow-up of 30 days, the proportion of patients progressed into severe type COVID-19 in the early antibiotics use group was almost 1.5 times than that of the comparision group. In the mixed-effect model, the early use of antibiotics was associated with higher probability of developing severe type, staying in the hospital for over 15 days, and secondary infection. However, it was not significant association with mortality rate. Analysis with propensity score-matched cohort displayed similar results. It is suggested that antibiotic use should be avoided unless absolutely necessary in non-severe COVID-19 patients, particularly in the early stages.
Subject(s)
COVID-19 , Bacterial InfectionsABSTRACT
Background: After the outbreak of Coronavirus disease in 2019 (COVID-19), stringent lockdown measures were imposed in Wuhan between January 23, 2020 and April 8, 2020. To provide evidence on the post-lockdown risk of COVID-19 epidemic in Wuhan, the city government conducted a citywide nucleic acid screening of SARS-CoV-2 infection between May 14 and June 1, 2020. Methods: All city residents aged [≥]6 years were potentially eligible to participate the screening programme. The rate of detection of asymptomatic infected cases was calculated, and their demographic and geographic distributions were investigated. ArcGIS 10.0 was used to draw a geographic distribution of asymptomatic infected persons. Results: The screening programme recruited a total of 9,899,828 persons (response rate, 92.9%). The screening found no newly confirmed patients with COVID-19, and identified 300 asymptomatic infected cases (detection rate 0.303/10,000). In addition, 107 of 34,424 previously recovered patients with a history of COVID-19 diagnosis were tested positive (relapse rate, 0.31%). Virus culture of SARS-CoV-2 was negative for all 300 asymptomatic cases and all 107 recovered COVID-19 patients. A total of 1,174 close contacts of asymptomatic cases were traced and all of them had a negative nucleic acid testing result. Conclusions: Prevalence of COVID-19 nucleic acid test positivity was very low in the Wuhan general population, in recovered cases and in contacts of asymptomatic cases, five to eight weeks after the end of lockdown. These findings help resolve concerns about the post-lockdown risk of COVID-19 epidemic, and promote the recovery of economy and normal social life in Wuhan.
Subject(s)
COVID-19 , Coronavirus InfectionsABSTRACT
BackgroundSo far, there has been no published population study on the relationship between COVID-19 infection and publics risk perception, information source, knowledge, attitude and four non-pharmaceutical interventions(NPI: hand washing, proper coughing habits, social distancing and mask wearing) during the COVID-19 outbreak in China. MethodsAn online survey of 8158 Chinese adults between 22 February to 5 March 2020 was conducted. Bivariate associations between categorical variables were examined using Fisher exact test. We also explored the determinants of four NPIs as well as their association with COVID-19 infection using logistic regression. ResultsOf 8158 adults included, 57 (0.73%) were infected with COVID-19. The overwhelming majority of respondents showed a positive attitude (99.2%), positive risk perception (99.9%) and high knowledge levels that were among the strongest predictors of four highly adopted NPIs (hand washing:96.8%; proper coughing: 93.1%; social distancing:87.1%; mask wearing:97.9%). There was an increased risk of COVID-19 infection for those who not washing hands (2.28% vs 0.65%; RR=3.53: 95%CI: 1.53-8.15; P<0.009); not practicing proper coughing (1.79% vs 0.73%; RR=2.44: 95%CI: 1.15-5.15;P=0.026); not practicing social distancing (1.52% vs 0.58%; RR=2.63:95%CI:1.48 - 4.67; P=0.002); and not wearing a mask (7.41% vs 0.6%; RR=12.38:95%CI:5.81-26.36; P<0.001). For those who did practice all other three NPIs, wearing mask was associated with significantly reduced risk of infection compared to those who did not wear a mask (0.6% vs 16.7%; p=0.035). Similarly, for those who did not practice all or part of the other three NPIs, wearing mask was also associated with significantly reduced risk of infection. In a penalised logistic regression model including all four NPIs, wearing a mask was the only significant predictor of COVID-19 infection among four NPIs (OR=7.20; 95%CI:2.24-23.11; p<0.001). ConclusionsWe found high levels of risk perception, positive attitude, desirable knowledge as well as a high level of adopting four NPIs. The relevant knowledge, risk perception and attitude were strong predictors of adapting the four NPIs. Mask wearing, among four personal NPIs, was the most effective protective measure against COVID-19 infection with added preventive effect among those who practised all or part of the other three NPIs.