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2.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-332380

ABSTRACT

Background: Epidemiological studies observed gender differences in COVID-19 outcomes, however, whether sex hormone plays a causal in COVID-19 risk remains unclear. This study aimed to examine associations of sex hormone, sex hormones-binding globulin (SHBG), insulin-like growth factor-1 (IGF-1) and COVID-19 risk. Methods: Two-sample Mendelian randomization (TSMR) study was performed to explore the causal associations between testosterone, estrogen, SHBG, IGF-1and the risk of COVID-19 (susceptibility, hospitalization and severity) using GWAS summary level data from the COVID-19 Host Genetics Initiative (N=1,348,701). Random-effects inverse variance weighted (IVW) MR approach was used as the primary MR method and the weighted median, MR-Egger, and MR-PRESSO test were conducted as sensitivity analyses. Findings: Higher genetically predicted IGF-1 levels were significantly associated with reduced risk of COVID-19 susceptibility and hospitalization. For one standard deviation increase in genetically predicted IGF-1 levels, the odds ratio was 0.77 (95% confidence interval [CI], 0.61-0.97;P =0.027) for COVID-19 susceptibility, 0.62 (95%CI: 0.25-0.51;P =0.018) for COVID-19 hospitalization, and 0.85 (95%CI: 0.52-1.38, P =0.513) for COVID-19 severity. There was no evidence that testosterone, estrogen, SHBG are associated with the risk of COVID-19 susceptibility, hospitalization and severity in either overall or sex-stratified TSMR analysis. Interpretation: Genetically predicted high IGF-1 levels may decrease the risk of COVID-19 susceptibility and hospitalization. Further studies are needed to explore whether IGF-1 could be a potential intervention target to reduce COVID-19 risk. Funding: We acknowledge support from NSFC (LR22H260001), CRUK (C31250/A22804), SHLF (Hjärt-Lungfonden, 20210351), VR (Vetenskapsrådet, 2019-00977), and SCI (Cancerfonden).

3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-331074

ABSTRACT

Objective We aimed to use mathematical models of SARS-COV-2 to assess the potential efficacy of non-pharmaceutical interventions on transmission in the parcel delivery and logistics sector. Methods We developed a network-based model of workplace contacts based on data and consultations from companies in the parcel delivery and logistics sectors. We used these in stochastic simulations of disease transmission to predict the probability of workplace outbreaks in this settings. Individuals in the model have different viral load trajectories based on SARS-CoV-2 in-host dynamics, which couple to their infectiousness and test positive probability over time, in order to determine the impact of testing and isolation measures. Results The baseline model (without any interventions) showed different workplace infection rates for staff in different job roles. Based on our assumptions of contact patterns in the parcel delivery work setting we found that when a delivery driver was the index case, on average they infect only 0.18 other employees, while for warehouse and office workers this went up to 0.93 and 2.58 respectively. In the large-item delivery setting this was predicted to be 0.83, 0.94, and 1.61 respectively. Nonetheless, the vast majority of simulations resulted in 0 secondary cases among customers (even without contact-free delivery). Our results showed that a combination of social distancing, office staff working from home, and fixed driver pairings (all interventions carried out by the companies we consulted) reduce the risk of workplace outbreaks by 3-4 times. Conclusion This work suggests that, without interventions, significant transmission could occur in these workplaces, but that these pose minimal risk to customers. We found that identifying and isolating regular close-contacts of infectious individuals (i.e. house-share, carpools, or delivery pairs) is an efficient measure for stopping workplace outbreaks. Regular testing can make these isolation measures even more effective but also increases the number of staff isolating at one time. It is therefore more efficient to combine these measures with social distancing and contact reduction interventions, as these reduce both transmission and the number of people needing to isolate. IMPORTANCE During the COVID-19 pandemic the home-delivery sector has been vital to maintaining people’s access to certain goods, and sustaining levels of economic activity for a variety of businesses. However, this important work necessarily involves contact with a large number of customers as well as colleagues. This means that questions have often been raised about whether enough is being done to keep customers and staff safe. Estimating the potential risk to customers and staff is complex, but here we tackle this problem by building a model of workplace and customer contacts, from which we simulate SARS-CoV-2 transmission. By involving industry representatives in the development of this model, we have simulated interventions that have either been applied or considered, and so the findings of this study are extremely relevant to decisions made in that sector moving forward. Furthermore, we can learn generic lessons from this specific case study which apply to many types of shared workplace as well as highlighting implications of the highly stochastic nature of disease transmission in small populations.

4.
Nat Biomed Eng ; 6(3): 286-297, 2022 03.
Article in English | MEDLINE | ID: covidwho-1751719

ABSTRACT

CRISPR-based assays for the detection of nucleic acids are highly specific, yet they are not fast, sensitive or easy to use. Here we report a one-step fluorescence assay for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in nasopharyngeal samples, with a sample-to-answer time of less than 20 minutes and a sensitivity comparable to that of quantitative real-time PCR with reverse transcription (RT-qPCR). The assay uses suboptimal protospacer adjacent motifs, allowing for flexibility in the design of CRISPR RNAs and slowing down the kinetics of Cas12a-mediated collateral cleavage of fluorescent DNA reporters and cis cleavage of substrates, which leads to stronger fluorescence owing to the accumulation of amplicons generated by isothermal recombinase polymerase amplification. In a set of 204 nasopharyngeal samples with RT-qPCR cycle thresholds ranging from 18.1 to 35.8, the assay detected SARS-CoV-2 with a sensitivity of 94.2% and a specificity of 100%, without the need for RNA extraction. Rapid and sensitive assays for nucleic acid testing in one pot that allow for flexibility in assay design may aid the development of reliable point-of-care nucleic acid testing.


Subject(s)
COVID-19 , RNA, Viral , COVID-19/diagnosis , CRISPR-Cas Systems , Humans , RNA, Viral/genetics , SARS-CoV-2/genetics , Sensitivity and Specificity
6.
China CDC Wkly ; 4(10): 207-210, 2022 Mar 11.
Article in English | MEDLINE | ID: covidwho-1716513

ABSTRACT

What is already known about this topic?: Coronavirus disease 2019 (COVID-19) outbreaks in the past were mostly caused by overseas transmission, but if control measures are not appropriately applied, domestic transmission could also cause large-scale local epidemics. What is added by this report?: This report covers all information of epidemic investigation processes, epidemiological characteristics and exposure history, transmission chains, sequencing results as well as public health measures taken for the COVID-19 cluster epidemic caused by the Delta variant in a cosmetic hospital in Yantai City in August 2021. What are the implications for public health practice?: The information provided in this report, including active case finding, community management, and mass testing, may assist public health professionals in dealing with local COVID-19 epidemics caused by domestic transmission.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-319519

ABSTRACT

Multiorgan injuries are a major complication of severe COVID-19;however, its pathogenesis is barely understood. Herein, we profiled the host responses to SARS-CoV-2 infection by performing quantitative proteomics of COVID-19 postmortem samples, and provided a comprehensive proteome map covering the protein alterations in eight different organs/tissues. Our results revealed that lung underwent the most abundant protein alterations mainly enriched in immune-/inflammation-related or morphology-related processes, while surprisingly, other organs/tissues exhibited significant protein alterations mainly enriched in processes related with organ movement, respiration, and metabolism. These results indicate that the major cause of lung injury was excessive inflammatory response, and subsequent intravascular thrombosis and pulmonary architecture/function destruction, while other organs/tissues were mainly injured by hypoxia and functional impairment. Therefore, our findings demonstrate the significant pathophysiological alternations of host proteins/pathways associated with multiorgan injuries of COVID-19, which provides invaluable knowledge about COVID-19-associated host responses and sheds light on the pathogenesis of COVID-19.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-311952

ABSTRACT

Background: Covid-19 was first reported in Wuhan, China in Dec 2019. Since then, it has been transmitted rapidly in China and the rest of the world. While Covid-19 transmission rate has been declining in China, it is increasing exponentially in Europe and America. Although there are numerous studies examining Covid-19 infection, including an archived paper looking into the meteorological effect, the role of outdoor air pollution has yet to be explored rigorously. It has been shown that air pollution will weaken the immune system, and increase the rate of respiratory virus infection. We postulate that outdoor air pollution concentrations will have a negative effect on Covid-19 infections in China, whilst lockdowns, characterized by strong social distancing and home isolation measures, will help to moderate such negative effect. Methods: We will collect the number of daily confirmed Covid-19 cases in 31 provincial capital cities in China during the period of 1 Dec 2019 to 20 Mar 2020 (from a popular Chinese online platform which aggregates all cases reported by the Chinese national/provincial health authorities). We will also collect daily air pollution and meteorology data at the city-level (from the Chinese National Environmental Monitoring Center and the US National Climatic Data Center), daily inter-city migration flows and intra-city movements (from Baidu). City-level demographics including age distribution and gender, education, and median household income can be obtained from the statistical yearbooks. City-level co-morbidity indicators including rates of chronic disease and co-infection can be obtained from related research articles. A regression model is developed to model the relationship between the infection rate of Covid-19 (number of confirmed cases/population at the city level) and outdoor air pollution at the city level, after taking into account confounding factors such as meteorology, inter- and intra-city movements, demographics, and co-morbidity and co-infection rates. In particular, we shall study how air pollution affects infection rates across different cities, including Wuhan. Our model will also study air pollution would affect infection rates in Wuhan before and after the lockdown. Expected findings: We expect there be a correlation between Covid-19 infection rate and outdoor air pollution. We also expect that reduced intra-city movement after the lockdowns in Wuhan and the rest of China will play an important role in reducing the infection rate. Interpretation: Infection rate is growing exponentially in major cities worldwide. We expect Covid-19 infection rate is related to the air pollution concentration, and is strongly dependent on inter- and intra-city movements. To reduce the infection rate, the international community may deploy effective air pollution reduction plans and social distancing policies.

9.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-311718

ABSTRACT

Background: The COVID-19 epidemic has had an extreme impact on society. This study aimed to discuss this epidemic in the U.S. and explore the association between COVID-19 daily incidence rate and influencing factors including people’s implementation of states’ quarantine policy and environmental factors including temperature, humidity and so on. Methods: . Data of 50 states in U.S. were used as the research subjects. A panel data model was established based on the daily incidence rate and influencing factors from 15 March to 30 September, 2020. The period was analyzed both unsegmented and segmented. The k-means clustering method was used to cluster the states, and panel linear regression method was used for correlation analysis. Results: . The characteristics of the daily incidence rate and factors of the three categories were different after clustering. The daily residents at home, proportion of travel people, humidity and incidence rate were negatively correlated, while the daily temperature and incidence rate were positively correlated after unsegmented multivariate analysis. While after segmented analysis, the air pressure and the temperature showed a trend that was negatively correlated with the daily incidence rate respectively in the first and the fifth segment, other indicators showed the analogous results. At the same time, this study also completed the regression analysis after classification of the three groups. Compared with results without classification, there was a decrease of the number of significant independent variables. Conclusions: . The spread of COVID-19 in 50 states in U.S. was related to quarantine measures, temperature and humidity. The progress of the epidemic would be relatively slow if people chose to stay at home. Besides, the increase in temperature (<84.2℉) could be conducive to the spread of the epidemic, while the increase in relative humidity (40~70%) might inhibit the spread of the virus to a certain degree.

10.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327241

ABSTRACT

Background: The emergence of SARS-CoV-2 triggered a chain of public health responses that radically changed our way of living and working. Non-healthcare sectors, such as the logistics sector, play a key role in such responses. This research aims to qualitatively evaluate the non-pharmaceutical interventions (NPIs) implemented in the UK logistics sector during the COVID-19 pandemic. Methods: We conducted nine semi-structured interviews in July-August 2020 and May-June 2021. In total 11 interviewees represented six companies occupying a range of positions in the UK logistics sector, including takeaway food delivery, large and small goods delivery and home appliance installation, and logistics technology providers. Inductive thematic analysis was completed using NVivo12 to generate emerging themes and subthemes. Themes/subthemes relevant to interventions were mapped deductively onto an adapted Hierarchy of Control (HoC) framework, focusing on delivery workers. Themes/subthemes relevant to the process of implementation were analyzed to understand the barriers and facilitators of rapid responses. Results: HoC analysis suggests the sector has implemented a wide range of risk mitigation measures, with each company developing their own portfolio of measures. Contact-free delivery was the most commonly implemented measure and perceived effective. In addition, a broad range of measures were implemented, including social distancing, internal contact tracing, communication and collaboration with other key stakeholders of the sector. Process evaluation identified facilitators of rapid responses including capacity to develop interventions internally, localized government support, overwhelming external mandates, effective communication, leadership support and financial support for self-isolation, while barriers included unclear government guidance, shortage of testing capacity and supply, high costs and diversified language and cultural backgrounds. Main sustainability issues included compliance fatigue, and the possible mental health impacts of a prolonged rapid response. Conclusions: This research identified drivers and obstacles of rapid implementation of NPIs in response to a respiratory infection pandemic. Existing implementation process models do not consider speed to respond and the absence or lack of guidance in emergency situations such as the COVID-19. We recommend the development of a rapid response model to inform the design of effective and sustainable infection prevention and control policies and to focus future research priorities.

11.
mBio ; : e0322721, 2022 Feb 15.
Article in English | MEDLINE | ID: covidwho-1685493

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) harbor mutations in the spike (S) glycoprotein that confer more efficient transmission and dampen the efficacy of COVID-19 vaccines and antibody therapies. S mediates virus entry and is the primary target for antibody responses, with structural studies of soluble S variants revealing an increased propensity toward conformations accessible to the human angiotensin-converting enzyme 2 (hACE2) receptor. However, real-time observations of conformational dynamics that govern the structural equilibriums of the S variants have been lacking. Here, we report single-molecule Förster resonance energy transfer (smFRET) studies of critical mutations observed in VOCs, including D614G and E484K, in the context of virus particles. Investigated variants predominately occupied more open hACE2-accessible conformations, agreeing with previous structures of soluble trimers. Additionally, these S variants exhibited slower transitions in hACE2-accessible/bound states. Our finding of increased S kinetic stability in the open conformation provides a new perspective on SARS-CoV-2 adaptation to the human population. IMPORTANCE SARS-CoV-2 surface S glycoprotein-the target of antibodies and vaccines-is responsible for binding to the cellular receptor hACE2. The interactions between S and hACE2 trigger structural rearrangements of S from closed to open conformations prerequisite for virus entry. Under the selection pressure imposed by adaptation to the human host and increasing vaccinations and convalescent patients, SARS-CoV-2 is evolving and has adopted numerous mutations on S variants. These promote virus spreading and immune evasion, partially by increasing the propensity of S to adopt receptor-binding competent open conformations. Here, we determined a time dimension, using smFRET to delineate the temporal prevalence of distinct structures of S in the context of virus particles. We present the first experimental evidence of decelerated transition dynamics from the open state, revealing increased stability of S open conformations to be part of the SARS-CoV-2 adaption strategies.

13.
Sustainability ; 14(3):1172, 2022.
Article in English | MDPI | ID: covidwho-1648330

ABSTRACT

To promote the United Nations’Sustainable Development Goals (SDGs), public awareness of the importance and urgency of sustainable development should be raised by providing relevant education programs. Although game-based learning has been confirmed to be one of the most effective routes to deepen public understanding of the SDGs and sustainable development in general, games for comprehensive sustainable development-based courses have yet to be popularized. Thus, we developed a game-based learning approach that delivers comprehensive conceptual information on SDGs. Based on Kolb’s theory of experiential learning, students understood the relevance of the SDGs by playing a board game designed to simulate the real world, including national and international policies. Furthermore, considering the suspension of in-person learning and shifts to digital instruction caused by the ongoing COVID-19 pandemic, a digital version of the board game was created to compare the effects of digital and non-digital game-based learning. A comprehensive sustainable development evaluation questionnaire was developed and optimized using the fuzzy Delphi method to assess the participants’knowledge of and attitudes toward the SDGs. Our results reveal that the digital and non-digital board game both improve students’knowledge and attitude toward sustainable development. However, the digital board game was more effective than the non-digital board game.

14.
Front Immunol ; 12: 627844, 2021.
Article in English | MEDLINE | ID: covidwho-1573949

ABSTRACT

BACKGROUND: The effective treatment of coronavirus disease 2019 (COVID-19) remains unclear. We reported successful use of high-dose intravenous immunoglobulin (IVIg) in cases of severe COVID-19, but evidence from larger case series is still lacking. METHODS: A multi-center retrospective study was conducted to evaluate the effectiveness of IVIg administered within two weeks of disease onset at a total dose of 2 g/kg body weight, in addition to standard care. The primary endpoint was 28-day mortality. Efficacy of high-dose IVIg was assessed by using the Cox proportional hazards regression model and the Kaplan-Meier curve adjusted by inverse probability of treatment weighting (IPTW) analysis, and IPTW after multiple imputation (MI) analysis. RESULTS: Overall, 26 patients who received high-dose IVIg with standard therapy and 89 patients who received standard therapy only were enrolled in this study. The IVIg group was associated with a lower 28-day mortality rate and less time to normalization of inflammatory markers including IL-6, IL-10, and ferritin compared with the control. The adjusted HR of 28-day mortality in high-dose IVIg group was 0.24 (95% CI 0.06-0.99, p<0.001) in IPTW model, and 0.27 (95% CI 0.10-0.57, p=0.031) in IPTW-MI model. In subgroup analysis, patients with no comorbidities or treated in the first week of disease were associated with more benefit from high-dose IVIg. CONCLUSIONS: High-dose IVIg administered in severe COVID-19 patients within 14 days of onset was linked to reduced 28-day mortality, more prominent with those having no comorbidities or treated at earlier stage.


Subject(s)
COVID-19/drug therapy , COVID-19/mortality , Immunoglobulins, Intravenous/administration & dosage , SARS-CoV-2/metabolism , Adult , Aged , COVID-19/blood , China/epidemiology , Disease-Free Survival , Female , Ferritins/blood , Humans , Interleukin-10/blood , Interleukin-6/blood , Male , Middle Aged , Retrospective Studies , Survival Rate
16.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-294889

ABSTRACT

As the SARS-CoV-2 virus mutates, mutations harboured in patients become increasingly diverse. Patients classified into two strains may have overlapping non-variant-defining mutations. Mutation calling by sequencing is relative to a reference genome . As SARS-CoV-2 mutates, tracking emerging mutant strains may become increasingly problematic if the reference genome remains Wuhan-Hu-1, because the comparison then becomes indirect : current dominant strain relative to Wuhan-Hu-1 versus emerging strain relative to Wuhan-Hu-1. The original Thermo Fisher’s TaqPath PCR test, on which the UK has standardized national testing of SARS-CoV-2 primarily, targets Wuhan-Hu-1. PCR targets appear readily updated, as TaqPath 2.0 now targets both currently known and future SARS-CoV-2 mutations, probing the N gene and ORF1ab but not the S gene, with 8 probes instead of the original 3 probes. Going forward, our statistical method can more directly compare current wildtype versus emerging mutants, since our new method can use any pair of probes updated to probe the current wildtype and anticipated mutations. The fact that patients harbour mixtures of mutations allows our statistical methods to potentially catch emerging mutants. Given a PCR test which targets the current dominant strain (current wildtype), our statistical method can potentially directly differentiate the current wildtype from an emerging strain.

17.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-294557

ABSTRACT

ABSTRACT Background Workplace transmission is a significant contributor to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks. Previous studies have found that infectious illness presenteeism could contribute to outbreaks in occupational settings and identified multiple occupational and organisational risk factors. Amid the COVID-19 pandemic, it is imperative to investigate presenteeism particularly in relation to respiratory infectious disease (RID). Hence, this rapid review aims to determine the prevalence of RID-related presenteeism, including COVID-19, and examines the reported reasons and associated risk factors. Methods The review followed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search approach and focused on studies published in English and Chinese. Database searches included MEDLINE, EMBASE, Web of Science, China Knowledge Resource Integrated Database (CNKI) and preprint databases MedRxiv and BioRxiv. Results The search yielded 54 studies, of which four investigated COVID-19-related presenteeism. Prevalence of work presenteeism ranged from 14.1% to 55% for confirmed RID, and 6.6% to 100% for those working with suspected or subclinical RID. The included studies demonstrated that RID-related presenteeism is associated with occupation, sick pay policy, age, gender, health behaviour and perception, vaccination, peer pressure and organisational factors such as presenteeism culture. Conclusions This review demonstrates that presenteeism or non-adherence to isolation guidance is a real concern and can contribute to workplace transmissions and outbreaks. Policies which would support workers financially and improve productivity, should include a range of effective non-pharmaceutical inventions such as workplace testing, promoting occupational health services, reviewing pay and bonus schemes and clear messaging to encourage workers to stay at home when ill. Future research should focus on the more vulnerable and precarious occupational groups, and their inter-relationships, to develop comprehensive intervention programs to reduce RID-related presenteeism.

18.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-293751

ABSTRACT

Background: Since December 2019, a novel coronavirus (2019-nCoV) associated pneumonia has emerged in Wuhan, China. The study aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia.<br><br>Methods: 99 cases admitted to Wuhan Jinyintan Hospital during January 1 to 20, 2020 and confirmed by real-time reverse-transcriptase polymerase-chain-reaction (RT-PCR) test were analyzed for epidemiological, demographic, clinical, radiological features, and laboratory data. <br><br>Findings: Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the South China Seafood Wholesale Market. The average age of the patients was 62.85 ± 11.99 years, including 67 males and 32 females. 2019-nCoV was detected in all patients by RT-PCR, and some of them also by serological testing, and metagenomics sequencing analysis. 50 cases (50.51%) had chronic basic diseases. Patients had clinical manifestations of fever (83%), cough (82%), shortness of breath (31%), muscle aches (11%), headache (8%), fuzzy confusion (7%), chest pain (2%), and diarrhea (2%). According to imaging examination, 74 patients showed bilateral pneumonia (74.75%), 25 patients showed multiple mottled and ground-glass opacity, and 1 patient had pneumothorax. Most patients received antiviral, antibiotics, supportive treatments, continuous renal replacement therapy (CRRT) and extracorporeal membrane oxygenation (ECMO), and had good prognosis. 17 patients developed acute Respiratory Distress Syndrome (ARDS) and among them, 2 patients worsened in a short period of time and died of multiple organ failure.<br><br>Interpretation: The infection of the 2019-nCoV can result in severe and even fatal respiratory disease like ARDS. It is very important to actively prevent complications and secondary infections, treat underlying diseases, and provide timely organ function support. Early diagnosis, early isolation, multiple treatment, and intervention of CRRT and ECMO when necessary can effectively reduce mortality caused by severe coronavirus pneumonia.<br><br>Funding: National Key R&D Program of China (No. 2017YFC1309700)<br><br>Declaration of Interest: The author reports no conflicts of interest in this work.<br><br>Ethical Approval: The study was approved by Jinyintan Hospital Ethics Committee and written informed consent was obtained from all patients involved before enrolment.

19.
Sci Rep ; 11(1): 23206, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1545645

ABSTRACT

This study investigates thoroughly whether acute exposure to outdoor PM2.5 concentration, P, modifies the rate of change in the daily number of COVID-19 infections (R) across 18 high infection provincial capitals in China, including Wuhan. A best-fit multiple linear regression model was constructed to model the relationship between P and R, from 1 January to 20 March 2020, after accounting for meteorology, net move-in mobility (NM), time trend (T), co-morbidity (CM), and the time-lag effects. Regression analysis shows that P (ß = 0.4309, p < 0.001) is the most significant determinant of R. In addition, T (ß = -0.3870, p < 0.001), absolute humidity (AH) (ß = 0.2476, p = 0.002), P × AH (ß = -0.2237, p < 0.001), and NM (ß = 0.1383, p = 0.003) are more significant determinants of R, as compared to GDP per capita (ß = 0.1115, p = 0.015) and CM (Asthma) (ß = 0.1273, p = 0.005). A matching technique was adopted to demonstrate a possible causal relationship between P and R across 18 provincial capital cities. A 10 µg/m3 increase in P gives a 1.5% increase in R (p < 0.001). Interaction analysis also reveals that P × AH and R are negatively correlated (ß = -0.2237, p < 0.001). Given that P exacerbates R, we recommend the installation of air purifiers and improved air ventilation to reduce the effect of P on R. Given the increasing observation that COVID-19 is airborne, measures that reduce P, plus mandatory masking that reduces the risks of COVID-19 associated with viral-particulate transmission, are strongly recommended. Our study is distinguished by the focus on the rate of change instead of the individual cases of COVID-19 when modelling the statistical relationship between R and P in China; causal instead of correlation analysis via the matching analysis, while taking into account the key confounders, and the individual plus the interaction effects of P and AH on R.


Subject(s)
Air Pollutants/adverse effects , COVID-19/epidemiology , Particulate Matter/adverse effects , Risk Assessment/methods , SARS-CoV-2/isolation & purification , COVID-19/pathology , COVID-19/transmission , COVID-19/virology , China/epidemiology , Cities/epidemiology , Humans , Incidence
20.
Bioimpacts ; 12(2): 139-146, 2022.
Article in English | MEDLINE | ID: covidwho-1539100

ABSTRACT

Introduction: With the outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the interaction between the host and SARS-CoV-2 was widely studied. However, it is unclear whether and how SARS-CoV-2 infection affects lung microflora, which contribute to COVID-19 complications. Methods: Here, we analyzed the metatranscriptomic data of bronchoalveolar lavage fluid (BALF) of 19 COVID-19 patients and 23 healthy controls from 6 independent projects and detailed the active microbiota landscape in both healthy individuals and COVID-19 patients. Results: The infection of SARS-CoV-2 could deeply change the lung microbiota, evidenced by the α-diversity, ß-diversity, and species composition analysis based on bacterial microbiota and virome. Pathogens (e.g., Klebsiella oxytoca causing pneumonia as well), immunomodulatory probiotics (e.g., lactic acid bacteria and Faecalibacterium prausnitzii, a butyrate producer), and Tobacco mosaic virus (TMV) were enriched in the COVID-19 group, suggesting a severe microbiota dysbiosis. The significant correlation between Rothia mucilaginosa, TMV, and SARS-CoV-2 revealed drastic inflammatory battles between the host, SARS-CoV-2, and other microbes in the lungs. Notably, TMV only existed in the COVID-19 group, while human respirovirus 3 (HRV 3) only existed in the healthy group. Our study provides insights into the active microbiota in the lungs of COVID-19 patients and would contribute to the understanding of the infection mechanism of SARS-CoV-2 and the treatment of the disease and complications. Conclusion: SARS-COV-2 infection deeply altered the lung microbiota of COVID-19 patients. The enrichment of several other pathogens, immunomodulatory probiotics (lactic acid or butyrate producers), and TMV in the COVID-19 group suggests a complex and active lung microbiota disorder.

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