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1.
Medicine ; 100(44), 2021.
Article in English | EuropePMC | ID: covidwho-1503237

ABSTRACT

Diagnosing influenza in children aged 5 years and under can be challenging because of their difficulty in verbalizing symptoms. This study aimed to explore the value of the triage heart rate (HR), respiratory rate (RR), and temperature, either alone or when combined with individual symptoms and signs, in predicting influenza infection in this age group. This was a retrospective study covering 4 influenza seasons from 2017 to 2019 in an emergency department (ED) in Hong Kong. We recruited patients ≤5 years of age who had an reverse transcription polymerase chain reaction influenza test within 48 hours of ED presentation. The diagnostic performance of the triage HR, RR, and temperature was evaluated as dichotomized or categorized values with diagnostic odds ratios (DORs) calculated based on different age-appropriate thresholds. Linear discriminant analysis was performed to assess the combined discriminatory effect of age, HR, RR, and temperature as continuous variables. Of 322 patients (median age 26 months), 99 had influenza A and 13 had influenza B infection. For HR and RR dichotomized based on age-appropriate thresholds, the DORs ranged from 1.16 to 1.54 and 0.78 to 1.53, respectively. A triage temperature ≥39.0 °C had the highest DOR (3.32) among different degrees of elevation of temperature. The diagnostic criteria that were based on the presence of fever and cough and/or rhinitis symptoms had a higher DOR compared with the Centers for Disease Control and Prevention influenza-like illness criteria (4.42 vs 2.41). However, combining HR, RR, or temperature with such diagnostic criteria added very little to the diagnostic performance. The linear discriminant analysis model had a high specificity of 92.5%, but the sensitivity (18.3%) was too low for clinical use. Triage HR, RR, and temperature had limited value in the diagnosis of influenza in children ≤5 years of age in the ED. Fever and cough and/or rhinitis symptoms had a better diagnostic performance than the Centers for Disease Control and Prevention influenza-like illness criteria in predicting influenza in this age group.

2.
Int J Environ Res Public Health ; 18(21)2021 10 24.
Article in English | MEDLINE | ID: covidwho-1480769

ABSTRACT

Social distancing restrictions for COVID-19 epidemic prevention have substantially changed the field of youths' social activities. Many studies have focused on the impact of epidemic-preventative social distancing on individual physical and mental health. However, in the field of social distancing for epidemic prevention, what are the changes in youth anti-epidemic action and states caused by their interpersonal resources and interactions? Responding to this question by studying the impact of the elements of social capital in youths' anti-epidemic actions and anti-epidemic states could help identify an effective mechanism for balancing social distancing for effective epidemic prevention and sustainable social-participation development among youth. Bourdieu's field theory holds that the elements of social capital change with a change in the field. Therefore, we introduced the specific elements of social capital as independent variables and used a multinomal logistic model to analyze and predict the levels of youth anti-epidemic action through an empirical investigation of 1043 young people in Guangdong Province, China. The results show that, first, level of social distancing for epidemic prevention shows differences by occupation status and income level and correlates with social support. Second, social support and social norms play positive roles in promoting youth participation in anti-epidemic activities when social distance is certain. Third, social capital has a significant positive effect on youth social satisfaction and core relationships; however, social trust has a significant negative effect on youth physical and mental health. This study emphasized that social distancing for epidemic prevention is a special social situational state, which is a field where social capital has an impact on the differential changes in the public-participating actions and habitus of youth.


Subject(s)
COVID-19 , Epidemics , Social Capital , Adolescent , China/epidemiology , Epidemics/prevention & control , Humans , Physical Distancing , SARS-CoV-2
4.
Technology Analysis & Strategic Management ; : 1-14, 2021.
Article in English | Academic Search Complete | ID: covidwho-1303844

ABSTRACT

Antimicrobial resistance (AMR) is one of today’s greatest public health threats and reducing antimicrobial use in livestock is essential to prevent its spread, requiring rapid diagnostic tests (RDTs) to ensure that the drug prescribed matches the sensitivity of the disease organism. However, despite decades of research on RDTs and a relatively permissive regulatory environment in the UK, few devices are in commercial use. Challenges discussed by RDT developers included identifying commercially-viable targets, and management of the innovation ecosystem, e.g. to create clear pathways to market supporting positive interactions between farmers, vets, and other actors along the value chain. Future support for RDT development could be provided through incorporation in: assured food systems;business service packages provided by centralised laboratories;or animal health monitoring packages related to the spread of AMR. Breeding stock sales could require an accompanying health package including RDTs, vaccines and/or antibiotics, linking to precision agriculture approaches. Unlike the example of RDT development for COVID-19, it seems that the urgency of the issue and the clarity of links between animal and human health outcomes are not yet sufficient to support a fast-tracking programme for the development of RDTs to combat AMR. [ABSTRACT FROM AUTHOR] Copyright of Technology Analysis & Strategic Management is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

5.
Virol J ; 18(1): 99, 2021 05 17.
Article in English | MEDLINE | ID: covidwho-1232429

ABSTRACT

BACKGROUND: Sensitive, rapid, and accessible diagnostics continue to be critical to track the COVID-19 pandemic caused by the SARS-CoV-2 virus. RT-qPCR is the gold standard test, and comparison of methodologies and reagents, utilizing patient samples, is important to establish reliable diagnostic pipelines. METHODS: Here, we assessed indirect methods that require RNA extraction with direct RT-qPCR on patient samples. Four different RNA extraction kits (Qiagen, Invitrogen, BGI and Norgen Biotek) were compared. For detection, we assessed two recently developed Taqman-based modules (BGI and Norgen Biotek), a SYBR green-based approach (NEB Luna Universal One-Step Kit) with published and newly-developed primers, and clinical results (Seegene STARMag RNA extraction system and Allplex 2019-nCoV RT-qPCR assay). We also tested and optimized direct, extraction-free detection using these RT-qPCR systems and performed a cost analysis of the different methods evaluated here. RESULTS: Most RNA isolation procedures performed similarly, and while all RT-qPCR modules effectively detected purified viral RNA, the BGI system provided overall superior performance (lower detection limit, lower Ct values and higher sensitivity), generating comparable results to original clinical diagnostic data, and identifying samples ranging from 65 copies to 2.1 × 105 copies of viral genome/µl. However, the BGI detection system is more expensive than other options tested here. With direct RT-qPCR, simply adding an RNase inhibitor greatly improved detection, without the need for any other treatments (e.g. lysis buffers or boiling). The best direct methods detected ~ 10 fold less virus than indirect methods, but this simplified approach reduced sample handling, as well as assay time and cost. CONCLUSIONS: With extracted RNA, the BGI RT-qPCR detection system exhibited superior performance over the Norgen system, matching initial clinical diagnosis with the Seegene Allplex assay. The BGI system was also suitable for direct, extraction-free analysis, providing 78.4% sensitivity. The Norgen system, however, still accurately detected samples with a clinical Ct < 33 from extracted RNA, provided significant cost savings, and was superior to SYBR green assays that exhibited reduced specificity.


Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19/diagnosis , Reagent Kits, Diagnostic , SARS-CoV-2/isolation & purification , Specimen Handling/methods , Humans , Nasopharynx/virology , RNA, Viral/isolation & purification , Sensitivity and Specificity
6.
Int J Environ Res Public Health ; 18(7)2021 03 28.
Article in English | MEDLINE | ID: covidwho-1154419

ABSTRACT

Government social media is widely used for providing updates to and engaging with the public in the COVID-19 pandemic. While Facebook is one of the popular social media used by governments, there is only a scant of research on this platform. This paper aims to understand how government social media should be used and how its engagement changes in prodromal, acute and chronic stages of the pandemic. We collected 1664 posts and 10,805 comments from the Facebook pages of the Macao government from 1 January to 31 October 2020. Using word frequency and content analysis, the results suggest that the engagement was relatively low at the beginning and then surged in the acute stage, with a decreasing trend in the chronic stage. Information about public health measures maintained their engagement in all stages, whereas the engagement of other information was dropping over time. Government social media can be used for increasing vigilance and awareness in the prodromal stage; disseminating information and increasing transparency in the acute stage; and focusing on mental health support and recovery policies in the chronic stage. Additionally, it can be a tool for controlling rumors, providing regular updates and fostering community cohesion in public health crises.


Subject(s)
COVID-19 , Social Media , Government , Humans , Macau , Pandemics , SARS-CoV-2
7.
Nat Commun ; 12(1): 1405, 2021 03 03.
Article in English | MEDLINE | ID: covidwho-1117349

ABSTRACT

Population scale sweeps of viral pathogens, such as SARS-CoV-2, require high intensity testing for effective management. Here, we describe "Systematic Parallel Analysis of RNA coupled to Sequencing for Covid-19 screening" (C19-SPAR-Seq), a multiplexed, scalable, readily automated platform for SARS-CoV-2 detection that is capable of analyzing tens of thousands of patient samples in a single run. To address strict requirements for control of assay parameters and output demanded by clinical diagnostics, we employ a control-based Precision-Recall and Receiver Operator Characteristics (coPR) analysis to assign run-specific quality control metrics. C19-SPAR-Seq coupled to coPR on a trial cohort of several hundred patients performs with a specificity of 100% and sensitivity of 91% on samples with low viral loads, and a sensitivity of >95% on high viral loads associated with disease onset and peak transmissibility. This study establishes the feasibility of employing C19-SPAR-Seq for the large-scale monitoring of SARS-CoV-2 and other pathogens.


Subject(s)
High-Throughput Nucleotide Sequencing/methods , SARS-CoV-2/growth & development , SARS-CoV-2/pathogenicity , COVID-19/genetics , COVID-19/immunology , COVID-19/virology , Humans , Molecular Diagnostic Techniques , Nucleic Acid Amplification Techniques , RNA, Viral/genetics , Reverse Transcriptase Polymerase Chain Reaction , Viral Load
8.
J Clin Microbiol ; 59(2)2021 01 21.
Article in English | MEDLINE | ID: covidwho-1043639

ABSTRACT

Surrogate neutralization assays for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that can be done without biosafety level 3 containment and in multiple species are desirable. We evaluate a recently developed surrogate virus neutralization test (sVNT) in comparison to 90% plaque reduction neutralization tests (PRNT90) in human, canine, cat, and hamster sera. With PRNT90 as the reference, sVNT had sensitivity of 98.9% and specificity of 98.8%. Using a panel of immune sera corresponding to other coronaviruses, we confirm the lack of cross-reactivity to other coronaviruses in SARS-CoV-2 sVNT and PRNT90, except for cross-reactivity to SARS-CoV-1 in sVNT.


Subject(s)
COVID-19 Serological Testing/methods , COVID-19/diagnosis , Neutralization Tests/methods , SARS-CoV-2/isolation & purification , Animals , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , COVID-19/blood , COVID-19/pathology , Cats , Cricetinae , Cross Reactions , Dogs , Female , Humans , Immune Sera/immunology , Male , Neutralization Tests/standards , SARS-CoV-2/immunology , Sensitivity and Specificity
9.
Nat Commun ; 12(1): 63, 2021 01 04.
Article in English | MEDLINE | ID: covidwho-1007631

ABSTRACT

The SARS-CoV-2 pandemic poses the greatest global public health challenge in a century. Neutralizing antibody is a correlate of protection and data on kinetics of virus neutralizing antibody responses are needed. We tested 293 sera from an observational cohort of 195 reverse transcription polymerase chain reaction (RT-PCR) confirmed SARS-CoV-2 infections collected from 0 to 209 days after onset of symptoms. Of 115 sera collected ≥61 days after onset of illness tested using plaque reduction neutralization (PRNT) assays, 99.1% remained seropositive for both 90% (PRNT90) and 50% (PRNT50) neutralization endpoints. We estimate that it takes at least 372, 416 and 133 days for PRNT50 titres to drop to the detection limit of a titre of 1:10 for severe, mild and asymptomatic patients, respectively. At day 90 after onset of symptoms (or initial RT-PCR detection in asymptomatic infections), it took 69, 87 and 31 days for PRNT50 antibody titres to decrease by half (T1/2) in severe, mild and asymptomatic infections, respectively. Patients with severe disease had higher peak PRNT90 and PRNT50 antibody titres than patients with mild or asymptomatic infections. Age did not appear to compromise antibody responses, even after accounting for severity. We conclude that SARS-CoV-2 infection elicits robust neutralizing antibody titres in most individuals.


Subject(s)
Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , COVID-19/immunology , SARS-CoV-2/immunology , Adolescent , Adult , Animals , Antibodies, Viral/blood , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Nucleic Acid Testing , COVID-19 Testing , Chlorocebus aethiops , Cohort Studies , Female , Hong Kong/epidemiology , Humans , Male , Middle Aged , Neutralization Tests , Pandemics , Vero Cells , Young Adult
10.
Emerg Infect Dis ; 26(12): 3076-3078, 2020 12.
Article in English | MEDLINE | ID: covidwho-890312

ABSTRACT

In March 2020, mild signs and symptoms of coronavirus disease developed in a healthy 33-year-old man in Hong Kong. His first infection did not produce virus neutralizing antibodies. In August, he had asymptomatic reinfection, suggesting that persons without a robust neutralizing antibody response might be at risk for reinfection.


Subject(s)
COVID-19/immunology , Reinfection/diagnosis , Antibody Formation/immunology , Hong Kong , Humans , Male , Pandemics , SARS-CoV-2 , Young Adult
11.
Can J Diabetes ; 45(2): 162-166.e1, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-764996

ABSTRACT

OBJECTIVES: Diabetes is associated with adverse outcomes, including death, after coronavirus disease 19 (COVID-19) infection. Beyond the lungs, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the etiologic agent of the COVID-19 pandemic, can infect a range of other tissues, including the kidney, potentially contributing to acute kidney injury in those with severe disease. We hypothesized that the renal abundance of angiotensin-converting enzyme (ACE) 2, the cell surface receptor for SARS-CoV-2, may be modulated by diabetes and agents that block the renin-angiotensin-aldosterone system (RAAS). METHODS: The expression of ACE 2 was examined in 49 archival kidney biopsies from patients with diabetic kidney disease and from 12 healthy, potential living allograft donors using next-generation sequencing technology (RNA Seq). RESULTS: Mean ACE 2 messenger RNA was increased approximately 2-fold in diabetes when compared with healthy control subjects (mean ± SD, 13.2±7.9 vs 7.7±3.6 reads per million reads, respectively; p=0.001). No difference in transcript abundance was noted between recipients and nonrecipients of agents that block the RAAS (12.2±6.7 vs 16.2±10.7 reads per million reads, respectively; p=0.25). CONCLUSIONS: Increased ACE 2 messenger RNA in the diabetic kidney may increase the risk and/or severity of kidney infection with SARS-CoV-2 in the setting of COVID-19 disease. Further studies are needed to ascertain whether this diabetes-related overexpression is generalizable to other tissues, most notably the lungs.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , COVID-19/complications , Diabetic Nephropathies/metabolism , SARS-CoV-2/metabolism , Acute Kidney Injury/virology , Adult , Aged , COVID-19/virology , Case-Control Studies , Diabetic Nephropathies/complications , Diabetic Nephropathies/drug therapy , Female , Host-Pathogen Interactions , Humans , Male , Middle Aged
12.
J Am Coll Emerg Physicians Open ; 2020 Jun 20.
Article in English | MEDLINE | ID: covidwho-609415

ABSTRACT

Objectives: Little is known about the value of routine clinical assessment in identifying patients with coronavirus disease 2019 (COVID-19) in the emergency department (ED). We aimed to compare the exposure history, signs and symptoms, laboratory, and radiographic features of ED patients who tested positive and negative for COVID-19. Methods: This was a case-control study in seven EDs in Hong Kong from 20 January to 29 February 2020. Thirty-seven patients with laboratory-confirmed COVID-19 were age- and gender-matched to 111 controls. We compared the groups with univariate analysis and calculated the odds ratio (OR) of having COVID-19 for each characteristic that was significantly different between the groups with adjustment for age and presumed location of acquiring the infection. Results: There were no significant differences in patient characteristics and reported symptoms between the groups. A positive contact history within 14 days (adjusted OR 37.61, 95% CI 10.86-130.19), bilateral chest radiograph shadow (adjusted OR 13.19, 95% CI 4.66-37.35), having prior medical consultation (adjusted OR 7.43, 95% 2.89 -19.09), a lower white blood cell count (adjusted OR 1.30, 95% CI 1.11-1.51), and a lower platelet count (adjusted OR 1.07, 95% CI 1.01-1.12) were associated with a higher odds of COVID-19 separately. A higher neutrophil count was associated with a lower odds of COVID-19 (adjusted OR 0.77, 95% CI 0.65-0.91). Conclusion: This study highlights a number of clinical features that may be useful in identifying high-risk patients for early testing and isolation while waiting for the test result. Further studies are warranted to verify the findings.This article is protected by copyright. All rights reserved.

13.
Euro Surveill ; 25(16)2020 04.
Article in English | MEDLINE | ID: covidwho-108708

ABSTRACT

BackgroundThe ongoing coronavirus disease (COVID-19) pandemic has major impacts on health systems, the economy and society. Assessing infection attack rates in the population is critical for estimating disease severity and herd immunity which is needed to calibrate public health interventions. We have previously shown that it is possible to achieve this in real time to impact public health decision making.AimOur objective was to develop and evaluate serological assays applicable in large-scale sero-epidemiological studies.MethodsWe developed an ELISA to detect IgG and IgM antibodies to the receptor-binding domain (RBD) of the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We evaluated its sensitivity and specificity in combination with confirmatory microneutralisation (MN) and 90% plaque reduction neutralisation tests (PRNT90) in 51 sera from 24 patients with virologically confirmed COVID-19 and in age-stratified sera from 200 healthy controls.ResultsIgG and IgM RBD ELISA, MN and PRNT90 were reliably positive after 29 days from illness onset with no detectable cross-reactivity in age-stratified controls. We found that PRNT90 tests were more sensitive in detecting antibody than MN tests carried out with the conventional 100 tissue culture infectious dose challenge. Heparinised plasma appeared to reduce the infectivity of the virus challenge dose and may confound interpretation of neutralisation test.ConclusionUsing IgG ELISA based on the RBD of the spike protein to screen sera for SARS-CoV-2 antibody, followed by confirmation using PRNT90, is a valid approach for large-scale sero-epidemiology studies.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections , Enzyme-Linked Immunosorbent Assay , Pandemics , Pneumonia, Viral , Seroepidemiologic Studies , Serologic Tests/methods , Spike Glycoprotein, Coronavirus/immunology , Adolescent , Adult , Aged , Animals , Betacoronavirus/immunology , COVID-19 , COVID-19 Testing , Chlorocebus aethiops , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Female , Humans , Male , Middle Aged , Neutralization Tests , Pneumonia, Viral/diagnosis , Real-Time Polymerase Chain Reaction , SARS-CoV-2 , Spike Glycoprotein, Coronavirus/analysis , Vero Cells , Young Adult
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