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1.
J Clin Hypertens (Greenwich) ; 24(4): 521-522, 2022 04.
Article in English | MEDLINE | ID: covidwho-1752589
2.
BMJ Open ; 11(9): e047227, 2021 09 07.
Article in English | MEDLINE | ID: covidwho-1398666

ABSTRACT

OBJECTIVE: To evaluate epidemiological characteristics and transmission dynamics of COVID-19 outbreak resurged in Beijing and to assess the effects of three non-pharmaceutical interventions. DESIGN: Descriptive and modelling study based on surveillance data of COVID-19 in Beijing. SETTING: Outbreak in Beijing. PARTICIPANTS: The database included 335 confirmed cases of COVID-19. METHODS: To conduct spatiotemporal analyses of the outbreak, we collected individual records on laboratory-confirmed cases of COVID-19 from 11 June 2020 to 5 July 2020 in Beijing, and visitor flow and products transportation data of Xinfadi Wholesale Market. We also built a modified susceptible-exposed-infected-removed model to investigate the effect of interventions deployed in Beijing. RESULTS: We found that the staff working in the market (52.2%) and the people around 10 km to this epicentre (72.5%) were most affected, and the population mobility entering-exiting Xinfadi Wholesale Market significantly contributed to the spread of COVID-19 (p=0.021), but goods flow of the market had little impact on the virus spread (p=0.184). The prompt identification of Xinfadi Wholesale Market as the infection source could have avoided a total of 25 708 (95% CI 13 657 to 40 625) cases if unnoticed transmission lasted for a month. Based on the model, we found that active screening on targeted population by nucleic acid testing alone had the most significant effect. CONCLUSIONS: The non-pharmaceutical interventions deployed in Beijing, including localised lockdown, close-contact tracing and community-based testing, were proved to be effective enough to contain the outbreak. Beijing has achieved an optimal balance between epidemic containment and economic protection.


Subject(s)
COVID-19 , Beijing/epidemiology , China/epidemiology , Communicable Disease Control , Disease Outbreaks , Humans , SARS-CoV-2
3.
J Clin Hypertens (Greenwich) ; 23(9): 1651-1663, 2021 09.
Article in English | MEDLINE | ID: covidwho-1329010

ABSTRACT

Since the COVID-19 pandemic, physicians concerned about the potential adverse effects of angiotensin converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs). To explore the relationship between ACEIs/ARBs and the risk of mortality and other clinical outcomes in COVID-19 patients, the authors conducted a systemic review and meta-analysis. An electronic search was performed from inception to November 12, 2020 in PubMed, Medline, EMBASE, ClinicalTrials, TRIP, the Cochrane Library, CNKI, Wanfang, and CBM database. Risk of bias was assessed using the Risk Of Bias In Non-randomized Studies of Interventions tool. The primary outcome was in-hospital all-cause mortality. Secondary outcomes included all-cause mortality measured at 30-day or longer term, mechanical ventilation, length of hospital stay, readmission, and cardiac adverse events. A total of 28 studies with 73 465 patients was included. Twenty-two studies with 19 871 patients reported the incidence of all-cause mortality. Results showed no association between using ACEIs/ARBs and risk of mortality crude odds ratio (OR) of 1.02, 95% CI 0.71-1.46, p = .90, I2  = 88%, adjusted OR in 6260 patients of 0.96, 95% CI 0.77-1.18, p = .68, I2  = 0%. While six studies with 10 030 patients reported a lower risk of mortality in ACEIs/ARBs group hazard ratio (HR) of 0.53, 95% CI 0.34-0.84, p = .007, I2  = 68%. Similar association (for HR) was found in hypertension subgroup. There was no significant association for the secondary outcomes. Based on the available data, we concluded that ACEIs/ARBs is not associated with the risk of in-hospital all-cause mortality in COVID-19 patients, but may be associated with a decreased risk of 30-day all-cause mortality. Patients with hypertension may benefit from using ACEIs/ARBs.


Subject(s)
COVID-19 , Hypertension , Angiotensin Receptor Antagonists/adverse effects , Angiotensin-Converting Enzyme Inhibitors/adverse effects , Humans , Hypertension/drug therapy , Pandemics , SARS-CoV-2
4.
BMJ Open ; 10(10): e043411, 2020 10 15.
Article in English | MEDLINE | ID: covidwho-873549

ABSTRACT

OBJECTIVE: To compare the epidemiological characteristics and transmission dynamics in relation to interventions against the COVID-19 and severe acute respiratory syndrome (SARS) outbreak in mainland China. DESIGN: Comparative study based on a unique data set of COVID-19 and SARS. SETTING: Outbreak in mainland China. PARTICIPANTS: The final database included 82 858 confirmed cases of COVID-19 and 5327 cases of SARS. METHODS: We brought together all existing data sources and integrated them into a comprehensive data set. Individual information on age, sex, occupation, residence location, date of illness onset, date of diagnosis and clinical outcome was extracted. Control measures deployed in mainland China were collected. We compared the epidemiological and spatial characteristics of COVID-19 and SARS. We estimated the effective reproduction number to explore differences in transmission dynamics and intervention effects. RESULTS: Compared with SARS, COVID-19 affected more extensive areas (1668 vs 230 counties) within a shorter time (101 vs 193 days) and had higher attack rate (61.8 vs 4.0 per million persons). The COVID-19 outbreak had only one epidemic peak and one epicentre (Hubei Province), while the SARS outbreak resulted in two peaks and two epicentres (Guangdong Province and Beijing). SARS-CoV-2 was more likely to infect older people (median age of 52 years), while SARS-CoV tended to infect young adults (median age of 34 years). The case fatality rate (CFR) of either disease increased with age, but the CFR of COVID-19 was significantly lower than that of SARS (5.6% vs 6.4%). The trajectory of effective reproduction number dynamically changed in relation to interventions, which fell below 1 within 2 months for COVID-19 and within 5.5 months for SARS. CONCLUSIONS: China has taken more prompt and effective responses to combat COVID-19 by learning lessons from SARS, providing us with some epidemiological clues to control the ongoing COVID-19 pandemic worldwide.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Population Surveillance/methods , Adult , COVID-19 , China/epidemiology , Disease Outbreaks , Female , Humans , Incidence , Male , Middle Aged , SARS-CoV-2 , Survival Rate/trends , Young Adult
5.
Int J Hyg Environ Health ; 230: 113610, 2020 09.
Article in English | MEDLINE | ID: covidwho-730640

ABSTRACT

The ongoing pandemic of 2019 novel coronavirus disease (COVID-19) is challenging global public health response system. We aim to identify the risk factors for the transmission of COVID-19 using data on mainland China. We estimated attack rate (AR) at county level. Logistic regression was used to explore the role of transportation in the nationwide spread. Generalized additive model and stratified linear mixed-effects model were developed to identify the effects of multiple meteorological factors on local transmission. The ARs in affected counties ranged from 0.6 to 9750.4 per million persons, with a median of 8.8. The counties being intersected by railways, freeways, national highways or having airports had significantly higher risk for COVID-19 with adjusted odds ratios (ORs) of 1.40 (p = 0.001), 2.07 (p < 0.001), 1.31 (p = 0.04), and 1.70 (p < 0.001), respectively. The higher AR of COVID-19 was significantly associated with lower average temperature, moderate cumulative precipitation and higher wind speed. Significant pairwise interactions were found among above three meteorological factors with higher risk of COVID-19 under low temperature and moderate precipitation. Warm areas can also be in higher risk of the disease with the increasing wind speed. In conclusion, transportation and meteorological factors may play important roles in the transmission of COVID-19 in mainland China, and could be integrated in consideration by public health alarm systems to better prevent the disease.


Subject(s)
COVID-19 , Humans , Meteorological Concepts , Pandemics , SARS-CoV-2 , Temperature
6.
Innovation (N Y) ; 1(2): 100026, 2020 Aug 28.
Article in English | MEDLINE | ID: covidwho-693467

ABSTRACT

Recently, considerable efforts have been focused on intensifying the screening process for asymptomatic COVID-19 cases in the Chinese Mainland, especially for up to 10 million citizens living in Wuhan City by nucleic acid testing. However, a high percentage of domestic asymptomatic cases did not develop into symptomatic ones, which is abnormal and has drawn considerable public attention. Here, we aimed to investigate the prevalence of COVID-19 infections in the Chinese Mainland from a statistical perspective, as it is of referential significance for other regions. By conservatively assuming a development time lag from pre-symptomatic (i.e., referring to the infected cases that were screened before the COVID-19 symptom onset) to symptomatic as an incubation time of 5.2 days, our results indicated that 92.5% of those tested in Wuhan City, China, and 95.1% of those tested in the Chinese Mainland should have COVID-19 syndrome onset, which was extremely higher than their corresponding practical percentages of 0.8% and 3.3%, respectively. We propose that a certain false positive rate may exist if large-scale nucleic acid screening tests for asymptomatic cases are conducted in common communities with a low incidence rate. Despite adopting relatively high-sensitivity, high-specificity detection kits, we estimated a very low prevalence of COVID-19 infections, ranging from 10-6 to 10-4 in both Wuhan City and the Chinese Mainland. Thus, the prevalence rate of asymptomatic infections in China had been at a very low level. Furthermore, given the lower prevalence of the infection, close examination of the data for false positive results is necessary to minimize social and economic impacts.

7.
Nature ; 583(7815): 282-285, 2020 07.
Article in English | MEDLINE | ID: covidwho-17844

ABSTRACT

The ongoing outbreak of viral pneumonia in China and across the world is associated with a new coronavirus, SARS-CoV-21. This outbreak has been tentatively associated with a seafood market in Wuhan, China, where the sale of wild animals may be the source of zoonotic infection2. Although bats are probable reservoir hosts for SARS-CoV-2, the identity of any intermediate host that may have facilitated transfer to humans is unknown. Here we report the identification of SARS-CoV-2-related coronaviruses in Malayan pangolins (Manis javanica) seized in anti-smuggling operations in southern China. Metagenomic sequencing identified pangolin-associated coronaviruses that belong to two sub-lineages of SARS-CoV-2-related coronaviruses, including one that exhibits strong similarity in the receptor-binding domain to SARS-CoV-2. The discovery of multiple lineages of pangolin coronavirus and their similarity to SARS-CoV-2 suggests that pangolins should be considered as possible hosts in the emergence of new coronaviruses and should be removed from wet markets to prevent zoonotic transmission.


Subject(s)
Betacoronavirus/genetics , Betacoronavirus/isolation & purification , Eutheria/virology , Evolution, Molecular , Genome, Viral/genetics , Sequence Homology, Nucleic Acid , Amino Acid Sequence , Animals , Betacoronavirus/chemistry , Betacoronavirus/classification , COVID-19 , China/epidemiology , Chiroptera/virology , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Disease Reservoirs/virology , Genomics , Humans , Malaysia , Pandemics , Phylogeny , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Recombination, Genetic , SARS-CoV-2 , Sequence Alignment , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/genetics , Zoonoses/virology
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