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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325071

ABSTRACT

Objective: Numerous cases of COVID-19 were confirmed in the world in succession. We reported the epidemiological and clinical features of 478 confirmed cases from a multicentre study outside of Wuhan, China. Methods : We collected patients who were transferred by Emergency Medical Service to the designated hospitals in four major cities including Beijing, Chongqing, Jinan and Nanning in China. We compared the characteristics between imported and indigenous cases, and calculated the fatality, and the rate of severe cases, mild and asymptomatic cases to generate the pyramid of COVID-19 infection. Results : The mean age of patients was 46.9 years old and 49.8% were male. The most common symptoms at the onset of illness were fever (69.7% ), cough (47.5%), fatigue (24.5%), dyspnea (8.4%) and headache (7.9%). In the study, most cases (313, 65.5%) were indigenous, while 165 (34.5%) were imported. During the early stage, the imported cases were dominant, which declined from Feb 1, when the indigenous cases rise sharply. Compared with the indigenous cases, the imported cases were significantly distinct concerning gender composition (P=0.002), classification of severity (P=0.006). Conclusions : On the basis of this study, we suggest that preventing import from outside and controlling spread inside should be a basic principle for resisting COVID-19 infection. If not, the region or area will face chaos.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325061

ABSTRACT

Background: Millions of cases of the novel coronavirus disease 2019 (COVID-19) have been reported in the world. Although it is known that the air travel has the potential to spread SARS-CoV-2, the risk of in-flight transmission is unknown.Methods We enrolled all passengers and crew suspected of being infected with SARS-CoV-2, who bounded for Beijing on international flights. We specified the characteristics of all confirmed cases of COVID-19 infection and utilized Wells-Riley equation to estimate the infectivity of COVID-19 during air travel.Results We screened 4492 passengers and crew with suspected COVID-19 infection, verified 161 confirmed cases (mean age 28.6 years), and traced two confirmed cases who may have been infected in the aircraft. The estimated infectivity was 375 quanta/h (range 274-476), while the effective infectivity was only 4 quanta/h (range 2-5). The risk of per-person infection during a 13 hours air travel in economy class was 0.56‰ (95% CI 0.41‰-0.72‰). Conclusion We found that the universal use of face masks on the flight, together with the plane's ventilation system, significantly decreased the infectivity of COVID-19.

3.
Ann Med ; 53(1): 1569-1575, 2021 12.
Article in English | MEDLINE | ID: covidwho-1379398

ABSTRACT

OBJECTIVES: To explore the potential of SARS-CoV-2 spread during air travel and the risk of in-flight transmission. METHODS: We enrolled all passengers and crew suspected of being infected with SARS-CoV-2, who bounded for Beijing on international flights. We specified the characteristics of all confirmed cases of COVID-19 infection and utilised Wells-Riley equation to estimate the infectivity of COVID-19 during air travel. RESULTS: We screened 4492 passengers and crew with suspected COVID-19 infection, verified 161 confirmed cases (mean age 28.6 years), and traced two confirmed cases who may have been infected in the aircraft. The estimated infectivity was 375 quanta/h (range 274-476), while the effective infectivity was only 4 quanta/h (range 2-5). The risk of per-person infection during a 13 h air travel in economy class was 0.56‰ (95% CI 0.41‰-0.72‰). CONCLUSION: We found that the universal use of face masks on the flight, together with the plane's ventilation system, significantly decreased the infectivity of COVID-19.KEY MESSAGESThe COVID-19 pandemic is changing the lifestyle in the world, especially air travel which has the potential to spread SARS-CoV-2.The universal use of face masks on the flight, together with the plane's ventilation system, significantly decreased the infectivity of COVID-19 on an aircraft.Our findings suggest that the risk of infection in aircraft was negligible.


Subject(s)
Air Travel/statistics & numerical data , COVID-19/epidemiology , Disease Transmission, Infectious/statistics & numerical data , Environmental Exposure/statistics & numerical data , COVID-19/diagnosis , COVID-19/prevention & control , Disease Transmission, Infectious/prevention & control , Female , Humans , Male , Models, Theoretical , Risk Factors , Risk Reduction Behavior , SARS-CoV-2/isolation & purification
4.
BMC Infect Dis ; 21(1): 406, 2021 May 03.
Article in English | MEDLINE | ID: covidwho-1215100

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic continues to expand. Herein, we report the epidemiological and clinical features of 478 patients with confirmed COVID-19 from a multicenter study conducted in four cities in China excluding Wuhan. METHODS: A total of 478 patients transferred by emergency medical services to designated hospitals in four major cities in China (Beijing, Chongqing, Jinan, and Nanning) were enrolled. We compared the characteristics of imported and indigenous cases and calculated the frequencies of fatal, severe, mild, and asymptomatic disease. The results were used to generate a pyramid of COVID-19 severity. RESULTS: The mean age of patients with COVID-19 was 46.9 years and 49.8% were male. The most common symptoms at onset were fever (69.7%), cough (47.5%), fatigue (24.5%), dyspnea (8.4%), and headache (7.9%). Most cases (313, 65.5%) were indigenous, while 165 (34.5%) were imported. Imported cases dominated during the early stages of the pandemic, but decreased from 1 February 2020 as indigenous cases rose sharply. Compared with indigenous cases, imported cases differed significantly in terms of sex (P = 0.002), severity of disease (P = 0.006), occurrence of fever (P < 0.001), family clustering (P < 0.001), history of contact (P < 0.001), and primary outcome (P < 0.001). CONCLUSIONS: Within the population studied, imported cases had distinct characteristics from those of indigenous cases, with lower fatality rates and higher discharge rates. New infections shifted from imported cases to local infection gradually, and overall infections have declined to a low level. We suggest that preventing import of cases and controlling spread within local areas can help prevent SARS-CoV-2 infection spread.


Subject(s)
COVID-19/epidemiology , COVID-19/etiology , Adolescent , Adult , Aged , Beijing/epidemiology , COVID-19/therapy , China/epidemiology , Cough/epidemiology , Cough/virology , Fatigue/epidemiology , Fatigue/virology , Female , Fever/epidemiology , Fever/virology , Humans , Male , Middle Aged , Patient Discharge , Time Factors , Treatment Outcome , Young Adult
5.
Nat Commun ; 12(1): 814, 2021 02 05.
Article in English | MEDLINE | ID: covidwho-1065864

ABSTRACT

On the basis of Covid-19-induced pulmonary pathological and vascular changes, we hypothesize that the anti-vascular endothelial growth factor (VEGF) drug bevacizumab might be beneficial for treating Covid-19 patients. From Feb 15 to April 5, 2020, we conducted a single-arm trial (NCT04275414) and recruited 26 patients from 2-centers (China and Italy) with severe Covid-19, with respiratory rate ≥30 times/min, oxygen saturation ≤93% with ambient air, or partial arterial oxygen pressure to fraction of inspiration O2 ratio (PaO2/FiO2) >100 mmHg and ≤300 mmHg, and diffuse pneumonia confirmed by chest imaging. Followed up for 28 days. Among these, bevacizumab plus standard care markedly improves the PaO2/FiO2 ratios at days 1 and 7. By day 28, 24 (92%) patients show improvement in oxygen-support status, 17 (65%) patients are discharged, and none show worsen oxygen-support status nor die. Significant reduction of lesion areas/ratios are shown in chest computed tomography (CT) or X-ray within 7 days. Of 14 patients with fever, body temperature normalizes within 72 h in 13 (93%) patients. Relative to comparable controls, bevacizumab shows clinical efficacy by improving oxygenation and shortening oxygen-support duration. Our findings suggest bevacizumab plus standard care is highly beneficial for patients with severe Covid-19. Randomized controlled trial is warranted.


Subject(s)
Bevacizumab/therapeutic use , COVID-19/drug therapy , SARS-CoV-2/drug effects , Aged , Angiogenesis Inhibitors/therapeutic use , Body Temperature/drug effects , COVID-19/virology , China , Female , Fever/prevention & control , Humans , Italy , Male , Middle Aged , SARS-CoV-2/physiology , Treatment Outcome
6.
Front Pharmacol ; 11: 615972, 2020.
Article in English | MEDLINE | ID: covidwho-1004690

ABSTRACT

Background: Interleukin-6 (IL-6) is known to be detrimental in coronavirus disease 2019 (COVID-19) because of its involvement in driving cytokine storm. This systematic review and meta-analysis aimed to assess the safety and efficacy of anti-IL-6 signaling (anti-IL6/IL-6R/JAK) agents on COVID-19 based on the current evidence. Methods: Studies were identified through systematic searches of PubMed, EMBASE, ISI Web of Science, Cochrane library, ongoing clinical trial registries (clinicaltrials.gov), and preprint servers (medRxiv, ChinaXiv) on August 10, 2020, as well as eligibility checks according to predefined selection criteria. Statistical analysis was performed using Review Manager (version 5.3) and STATA 12.0. Results: Thirty-one studies were included in the pooled analysis of mortality, and 12 studies were identified for the analysis of risk of secondary infections. For mortality analysis, 5630 COVID-19 cases including 2,132 treated patients and 3,498 controls were analyzed. Anti-IL-6 signaling agents plus standard of care (SOC) significantly decreased the mortality rate compared to SOC alone (pooled OR = 0.61, 95% CI 0.45-0.84, p = 0.002). For the analysis of secondary infection risk, 1,624 patients with COVID-19 including 639 treated patients and 985 controls were included, showing that anti-IL-6 signaling agents did not increase the rate of secondary infections (pooled OR = 1.21, 95% CI 0.70-2.08, p = 0.50). By contrast, for patients with critical COVID-19 disease, anti-IL-6 signaling agents failed to reduce mortality compared to SOC alone (pooled OR = 0.75, 95% CI 0.42-1.33, p = 0.33), but they tended to increase the risk of secondary infections (pooled OR = 1.85, 95% CI 0.95-3.61, p = 0.07). A blockade of IL-6 signaling failed to reduce the mechanical ventilation rate, ICU admission rate, or elevate the clinical improvement rate. Conclusion: IL-6 signaling inhibitors reduced the mortality rate without increasing secondary infections in patients with COVID-19 based on current studies. For patients with critical disease, IL-6 signaling inhibitors did not exhibit any benefit.

7.
SSRN; 2020.
Preprint | SSRN | ID: ppcovidwho-1226

ABSTRACT

Background: Millions of cases of the novel coronavirus disease 2019 (COVID-19) have been reported in the world. Air travel has the potential to spread SARS-CoV-

8.
9.
International Statistical Review ; 88(2):419-440, 2020.
Article | WHO COVID | ID: covidwho-740243

ABSTRACT

As the coronavirus disease 2019 outbreak evolves, statistical network analysis is playing an essential role in informing policy decisions. Therefore, researchers who are new to such studies need to understand the techniques available to them. As a field, statistical network analysis aims to develop methods that account for the complex dependencies found in network data. Over the last few decades, the area has rapidly accumulated methods, including techniques for network modelling and simulating the spread of infectious disease. This article reviews these network modelling techniques and their applications to the coronavirus disease 2019 pandemic.

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