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1.
Curr Pediatr Rep ; 10(2): 19-30, 2022.
Article in English | MEDLINE | ID: covidwho-1820681

ABSTRACT

Purpose of Review: A multisystem inflammatory condition occurring in children and adolescents with COVID-19 has become increasingly recognized and widely studied globally. This review aims to investigate and synthesize evolving evidence on its clinical characteristics, management, and outcomes in pediatric patients. Recent Findings: We retrieved data from PubMed, EMBASE, Cochrane Library, WHO COVID-19 Database, Google Scholar, and preprint databases, covering a timeline from December 1, 2019, to July 31, 2021. A total of 123 eligible studies were included in the final descriptive and risk factor analyses. We comprehensively reviewed reported multisystem inflammatory syndrome in children (MIS-C) cases from published and preprint studies of various designs to provide an updated evidence on epidemiology, clinical, laboratory and imaging findings, management, and short-term outcomes. Latest evidence suggests that African black and non-Hispanic white are the two most common ethnic groups, constituting 24.89% (95% CI 23.30-26.48%) and 25.18% (95% CI 23.51-26.85%) of the MIS-C population, respectively. Typical symptoms of MIS-C include fever (90.85%, 95% CI 89.86-91.84%), not-specified gastrointestinal symptoms (51.98%, 95% CI 50.13-53.83%), rash (49.63%, 95% CI 47.80-51.47%), abdominal pain (48.97%, 95% CI 47.09-50.85%), conjunctivitis (46.93%, 95% CI 45.17-48.69%), vomiting (43.79%, 95% CI 41.90-45.68%), respiratory symptoms (41.75%, 95% CI 40.01-43.49%), and diarrhea (40.10%, 95% CI 38.23-41.97%). MIS-C patients are less likely to develop conjunctivitis (OR 0.27, 95% CI 0.11-0.67), cervical adenopathy (OR 0.21, 95% CI 0.07-0.68), and rash (OR 0.44, 95% CI 0.26-0.77), in comparison with Kawasaki disease patients. Our review revealed that the majority of MIS-C cases (95.21%) to be full recovered while only 2.41% died from this syndrome. We found significant disparity between low- and middle-income countries and high-income countries in terms of clinical outcomes. Summary: MIS-C, which appears to be linked to COVID-19, may cause severe inflammation in organs and tissues. Although there is emerging new evidence about the characteristics of this syndrome, its risk factors, and clinical prognosis, much remains unknown about the causality, the optimal prevention and treatment interventions, and long-term outcomes of the MIS-C patients. Supplementary Information: The online version contains supplementary material available at 10.1007/s40124-022-00264-1.

2.
J Hazard Mater ; 432: 128667, 2022 06 15.
Article in English | MEDLINE | ID: covidwho-1788119

ABSTRACT

Wastewater-based epidemiology (WBE) approach for COVID-19 surveillance is largely based on the assumption of SARS-CoV-2 RNA shedding into sewers by infected individuals. Recent studies found that SARS-CoV-2 RNA concentration in wastewater (CRNA) could not be accounted by the fecal shedding alone. This study aimed to determine potential major shedding sources based on literature data of CRNA, along with the COVID-19 prevalence in the catchment area through a systematic literature review. Theoretical CRNA under a certain prevalence was estimated using Monte Carlo simulations, with eight scenarios accommodating feces alone, and both feces and sputum as shedding sources. With feces alone, none of the WBE data was in the confidence interval of theoretical CRNA estimated with the mean feces shedding magnitude and probability, and 63% of CRNA in WBE reports were higher than the maximum theoretical concentration. With both sputum and feces, 91% of the WBE data were below the simulated maximum CRNA in wastewater. The inclusion of sputum as a major shedding source led to more comparable theoretical CRNA to the literature WBE data. Sputum discharging behavior of patients also resulted in great fluctuations of CRNA under a certain prevalence. Thus, sputum is a potential critical shedding source for COVID-19 WBE surveillance.


Subject(s)
COVID-19 , Wastewater-Based Epidemiological Monitoring , COVID-19/epidemiology , Humans , RNA, Viral , SARS-CoV-2 , Waste Water
3.
Water Res ; 218: 118451, 2022 Jun 30.
Article in English | MEDLINE | ID: covidwho-1783834

ABSTRACT

As a cost-effective and objective population-wide surveillance tool, wastewater-based epidemiology (WBE) has been widely implemented worldwide to monitor the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA concentration in wastewater. However, viral concentrations or loads in wastewater often correlate poorly with clinical case numbers. To date, there is no reliable method to back-estimate the coronavirus disease 2019 (COVID-19) case numbers from SARS-CoV-2 concentrations in wastewater. This greatly limits WBE in achieving its full potential in monitoring the unfolding pandemic. The exponentially growing SARS-CoV-2 WBE dataset, on the other hand, offers an opportunity to develop data-driven models for the estimation of COVID-19 case numbers (both incidence and prevalence) and transmission dynamics (effective reproduction rate). This study developed artificial neural network (ANN) models by innovatively expanding a conventional WBE dataset to include catchment, weather, clinical testing coverage and vaccination rate. The ANN models were trained and evaluated with a comprehensive state-wide wastewater monitoring dataset from Utah, USA during May 2020 to December 2021. In diverse sewer catchments, ANN models were found to accurately estimate the COVID-19 prevalence and incidence rates, with excellent precision for prevalence rates. Also, an ANN model was developed to estimate the effective reproduction number from both wastewater data and other pertinent factors affecting viral transmission and pandemic dynamics. The established ANN model was successfully validated for its transferability to other states or countries using the WBE dataset from Wisconsin, USA.

4.
Environ Monit Assess ; 194(5): 342, 2022 Apr 07.
Article in English | MEDLINE | ID: covidwho-1777746

ABSTRACT

The present study tracked the city-wide dynamics of severe acute respiratory syndrome-corona virus 2 ribonucleic acids (SARS-CoV-2 RNA) in the wastewater from nine different wastewater treatment plants (WWTPs) in Jaipur during the second wave of COVID-19 out-break in India. A total of 164 samples were collected weekly between February 19th and June 8th, 2021. SARS-CoV-2 was detected in 47.2% (52/110) influent samples and 37% (20/54) effluent samples. The increasing percentage of positive influent samples correlated with the city's increasing active clinical cases during the second wave of COVID-19 in Jaipur. Furthermore, wastewater-based epidemiology (WBE) evidence clearly showed early detection of about 20 days (9/9 samples reported positive on April 20th, 2021) before the maximum cases and maximum deaths reported in the city on May 8th, 2021. The present study further observed the presence of SARS-CoV-2 RNA in treated effluents at the time window of maximum active cases in the city even after tertiary disinfection treatments of ultraviolet (UV) and chlorine (Cl2) disinfection. The average genome concentration in the effluents and removal efficacy of six commonly used treatments, activated sludge process + chlorine disinfection (ASP + Cl2), moving bed biofilm reactor (MBBR) with ultraviolet radiations disinfection (MBBR + UV), MBBR + chlorine (Cl2), sequencing batch reactor (SBR), and SBR + Cl2, were compared with removal efficacy of SBR + Cl2 (81.2%) > MBBR + UV (68.8%) > SBR (57.1%) > ASP (50%) > MBBR + Cl2 (36.4%). The study observed the trends and prevalence of four genes (E, RdRp, N, and ORF1ab gene) based on two different kits and found that prevalence of N > ORF1ab > RdRp > E gene suggested that the effective genome concentration should be calculated based on the presence/absence of multiple genes. Hence, it is imperative to say that using a combination of different detection genes (E, N, RdRp, & ORF1ab genes) increases the sensitivity in WBE.


Subject(s)
COVID-19 , Wastewater-Based Epidemiological Monitoring , Biofilms , Bioreactors , COVID-19/epidemiology , Chlorine , Environmental Monitoring , Humans , RNA, Viral , RNA-Dependent RNA Polymerase , SARS-CoV-2 , Waste Water
5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325087

ABSTRACT

Abstract Background. We aimed to analyze the influencing factors of virus duration and virus clearance in coronavirus disease 2019 (COVID-19) in Shenzhen, China, and to provide our experience in the treatment and management of COVID-19. Methods. The clinical data and laboratory test results of COVID-19 inpatients admitted to the Third People's Hospital of Shenzhen, Guangdong Province from January 2020 to March 2020 were retrospectively collected. In COVID-19 rehabilitation patients, two consecutive negative RT-PCR results on nasopharyngeal swabs were defined as virus clearance. The time from onset of the disease to virus clearance was defined as the virus duration. We analyzed the virus clearance rate at different time points and the impact of clinical features and treatments on virus clearance. Results. A total of 201 patients with COVID-19, including 89 women (44.3%) and 112 men (55.7%), were included in our study. According to the severity of the disease, the patients were divided into no severe patients and severe patients. The overall median virus duration for all patients was 17 days. The overall virus clearance rates within 1, 2, 3, 4, 5, and 6 weeks after onset were 1.5%, 36.6%, 73.4%, 90.2%, 97.3%, and 100%, respectively. A multiple linear regression model was performed to analyze the factors influencing virus clearanc.The factors influencing virus clearance within 2 weeks were treatment timing and glucocorticoid usage. The influencing factors for virus clearance within 4 weeks were treatment timing, glucocorticoid usage and age. Conclusion. Treatment timing was related to virus clearance. The earlier the treatment was initiated, the faster the virus clearance. For COVID-19 patients, early detection and early treatment strategies should be adopted. Glucocorticoid usage may be detrimental to virus clearance and should be more restricted. Age > 60 years may also be a detrimental factor for virus clearance.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323564

ABSTRACT

Background: The novel coronavirus disease 2019(COVID-19) broke out globally. Early prediction of the clinical progression was essential but still unclear. We aimed to evaluate the timeline of COVID-19 development and analyze risk factors of disease progression.Methods In this retrospective study, we included 333 patients with laboratory-confirmed COVID-19 infection hospitalized in the Third People's Hospital of Shenzhen from 10 January to 10 February 2020. Epidemiological feature, clinical records, laboratory and radiology manifestations were collected and analyzed. 323 patients with mild-moderate symptoms on admission were observed to determine whether they exacerbated to severe-critically ill conditions (progressive group) or not (stable group). We used logistic regression to identify the risk factors associated with clinical progression.Results Of all the 333 patients, 70(21.0%) patients progressed into severe-critically ill conditions during hospitalization and assigned to the progressive group, 253(76.0%) patients belonged to the stable group, another 10 patients were severe before admission. we found that the clinical features of aged over 40 (3.80[1.72, 8.52]), males (2.21[1.20, 4.07]), with comorbidities (1.78[1.13, 2.81]) certain exposure history (0.38[0.20, 0.71]), abnormal radiology manifestations (3.56[1.13, 11.40]), low level of T lymphocytes (0.99[0.997, 0.999]), high level of NLR (0.99[0.97, 1.01]), IL-6 (1.05[1.03, 1.07]) and CRP (1.67[1.12, 2.47]) were the risk factors of disease progression by logistic regression.Conclusions the potential risk factors of males, older age, with comorbidities, low T lymphocyte level and high level of NLR, CRP, IL-6 can help to predict clinical progression of COVID-19 at an early stage.

7.
BMC Med Genomics ; 14(Suppl 6): 289, 2021 12 14.
Article in English | MEDLINE | ID: covidwho-1571758

ABSTRACT

BACKGROUND: Virus screening and viral genome reconstruction are urgent and crucial for the rapid identification of viral pathogens, i.e., tracing the source and understanding the pathogenesis when a viral outbreak occurs. Next-generation sequencing (NGS) provides an efficient and unbiased way to identify viral pathogens in host-associated and environmental samples without prior knowledge. Despite the availability of software, data analysis still requires human operations. A mature pipeline is urgently needed when thousands of viral pathogen and viral genome reconstruction samples need to be rapidly identified. RESULTS: In this paper, we present a rapid and accurate workflow to screen metagenomics sequencing data for viral pathogens and other compositions, as well as enable a reference-based assembler to reconstruct viral genomes. Moreover, we tested our workflow on several metagenomics datasets, including a SARS-CoV-2 patient sample with NGS data, pangolins tissues with NGS data, Middle East Respiratory Syndrome (MERS)-infected cells with NGS data, etc. Our workflow demonstrated high accuracy and efficiency when identifying target viruses from large scale NGS metagenomics data. Our workflow was flexible when working with a broad range of NGS datasets from small (kb) to large (100 Gb). This took from a few minutes to a few hours to complete each task. At the same time, our workflow automatically generates reports that incorporate visualized feedback (e.g., metagenomics data quality statistics, host and viral sequence compositions, details about each of the identified viral pathogens and their coverages, and reassembled viral pathogen sequences based on their closest references). CONCLUSIONS: Overall, our system enabled the rapid screening and identification of viral pathogens from metagenomics data, providing an important piece to support viral pathogen research during a pandemic. The visualized report contains information from raw sequence quality to a reconstructed viral sequence, which allows non-professional people to screen their samples for viruses by themselves (Additional file 1).


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnosis , Computational Biology/methods , Genome, Viral , Genomics , Metagenomics , SARS-CoV-2/genetics , Algorithms , Animals , Automation , Coronavirus Infections/genetics , High-Throughput Nucleotide Sequencing , Humans , Mass Screening/methods , Pandemics , Pangolins , Reference Values , Software , Transcriptome , Workflow
8.
Comput Biol Chem ; 96: 107613, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1549716

ABSTRACT

Coronavirus Disease 2019 (COVID-19) is an ongoing global health emergency that has caused tremendous stress and loss of life worldwide. The viral spike glycoprotein is a critical molecule mediating transmission of SARS-CoV-2 by interacting with human ACE2. However, through the course of the pandemics, there has not been a thorough analysis of the spike protein mutations, and on how these mutants influence the transmission of SARS-CoV-2. Besides, cases of SARS-CoV-2 infection among pets and wild animals have been reported, so the susceptibility of these animals requires great attention to investigate, as they may also link to the renewed question of a possible intermediate host for SARS-CoV-2 before it was transmitted to humans. With over 226,000 SARS-CoV-2 sequences obtained, we found 1573 missense mutations in the spike gene, and 226 of them were within the receptor-binding domain (RBD) region that directly interacts with human ACE2. Modeling the interactions between SARS-CoV-2 spike mutants and ACE2 molecules showed that most of the 74 missense mutations in the RBD region of the interaction interface had little impact on spike binding to ACE2, whereas several within the spike RBD increased the binding affinity toward human ACE2 thus making the virus likely more contagious. On the other hand, modeling the interactions between animal ACE2 molecules and SARS-CoV-2 spike revealed that many pets and wild animals' ACE2 had a variable binding ability. Particularly, ACE2 of bamboo rat had stronger binding to SARS-CoV-2 spike protein, whereas that of mole, vole, Mus pahari, palm civet, and pangolin had a weaker binding compared to human ACE2. Our results provide structural insights into the impact on interactions of the SARS-CoV-2 spike mutants to human ACE2, and shed light on SARS-CoV-2 transmission in pets and wild animals, and possible clues to the intermediate host(s) for SARS-CoV-2.


Subject(s)
Angiotensin-Converting Enzyme 2/chemistry , COVID-19/veterinary , COVID-19/virology , Mutation, Missense , SARS-CoV-2/chemistry , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/genetics , Angiotensin-Converting Enzyme 2/genetics , Animals , Animals, Wild/genetics , Animals, Wild/virology , COVID-19/transmission , Computational Biology , Host Microbial Interactions/genetics , Host Specificity/genetics , Humans , Molecular Dynamics Simulation , Pandemics/veterinary , Peptidyl-Dipeptidase A/chemistry , Peptidyl-Dipeptidase A/genetics , Pets/genetics , Pets/virology , Protein Interaction Domains and Motifs/genetics , Risk Factors
9.
Sci Total Environ ; 813: 151919, 2022 Mar 20.
Article in English | MEDLINE | ID: covidwho-1531803

ABSTRACT

Recent outbreaks caused by coronaviruses and their supposed potential fecal-oral transmission highlight the need for understanding the survival of infectious coronavirus in domestic sewers. To date, the survivability and decay of coronaviruses were predominately studied using small volumes of wastewater (normally 5-30 mL) in vials (in-vial tests). However, real sewers are more complicated than bulk wastewater (wastewater matrix only), in particular the presence of sewer biofilms and different operational conditions. This study investigated the decay of infectious human coronavirus 229E (HCoV-229E) and feline infectious peritonitis virus (FIPV), two typical surrogate coronaviruses, in laboratory-scale reactors mimicking the gravity (GS, gravity-driven sewers) and rising main sewers (RM, pressurized sewers) with and without sewer biofilms. The in-sewer decay of both coronaviruses was greatly enhanced in comparison to those reported in bulk wastewater through in-vial tests. 99% of HCoV-229E and FIPV decayed within 2 h under either GS or RM conditions with biofilms, in contrast to 6-10 h without biofilms. There is limited difference in the decay of HCoV and FIPV in reactors operated as RM or GS, with the T90 and T99 difference of 7-10 min and 14-20 min, respectively. The decay of both coronaviruses in sewer biofilm reactors can be simulated by biphasic first-order kinetic models, with the first-order rate constant 2-4 times higher during the first phase than the second phase. The decay of infectious HCoV and FIPV was significantly faster in the reactors with sewer biofilms than in the reactors without biofilms, suggesting an enhanced decay of these surrogate viruses due to the presence of biofilms and related processes. The mechanism of biofilms in virus adsorption and potential inactivation remains unclear and requires future investigations. The results indicate that the survivability of infectious coronaviruses detected using bulk wastewater overestimated the infectivity risk of coronavirus during wastewater transportations in sewers or the downstream treatment.


Subject(s)
Coronavirus , Waste Water , Biofilms , Humans , Kinetics , Sewage
10.
J Infect Public Health ; 14(11): 1693-1700, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1446869

ABSTRACT

BACKGROUND: Severe COVID-19 caused by SARS-CoV-2 should closely be cared because of the relatively high mortality rate. If SARS-CoV-2 could be cleared as soon as possible, the mortality rate might lower. In the present study, we analyzed factors which might be related to the clearance of SARS-CoV-2. METHODS: One hundred and twenty-eight severe COVID-19 cases were enrolled. All of them had been isolated and treated at Shenzhen Third People's Hospital because they were positive for nucleic acid of SARS-CoV-2 tested by qRT-PCR. Their baseline clinical characteristics and antiviral regimens were collected and analyzed, respectively. RESULTS: Of the 128 enrolled severe COVID-19 cases, unfortunately 3 died. The mean viral duration of all patients was 23.5 (range 17-32) days. All patients achieved viral clearance during 9 weeks. 13.4% of patients achieved viral clearance within 2 weeks, and 63.0% of patients achieved viral clearance within 4 weeks. The combined regimens of three or more antiviral drugs, the use of invasive mechanical ventilation, and late admission might be related to the delay of viral clearance within 2 weeks. The use of arbidol, the use of invasive mechanical ventilation, and late admission might be related to the delay of viral clearance within 4 weeks. Patients often had a prolonged course of COVID-19 and hospitalization, and were more likely transferred to intensive care unit (ICU) for treatment, if they could not clear SARS-CoV-2 during 23 days. CONCLUSION: Severe COVID-19 cases should be admitted to hospital as soon as possible. The combined regimens of three or more antiviral drugs might not be useful for viral clearance, and should be performed carefully and cautiously.


Subject(s)
COVID-19 , Antiviral Agents/therapeutic use , Hospitalization , Humans , Respiration, Artificial , SARS-CoV-2
11.
Sci Total Environ ; 806(Pt 2): 150572, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1433810

ABSTRACT

Current studies have confirmed the feasibility of SARS-CoV-2 RNA detection by RT-qPCR assays in wastewater samples as an effective surveillance tool of COVID-19 prevalence in a community. Analytical performance of various RT-qPCR assays has been compared against wastewater samples based on the positive ratio. However, there is no systematic comparison work has been conducted for both analytical sensitivity and quantitative reliability against wastewater, which are essential factors for WBE. In this study, the detection performance of four RT-qPCR primer-probe sets, including CCDC-N, CDC-N1, N-Sarbeco, and E-Sarbeco, was systematically evaluated with pure synthetized plasmids, spiked wastewater mocks and raw wastewater samples. In addition to confirm RT-qPCR results, Nanopore sequencing was employed to delineate at molecular level for the analytical sensitivity and reproducibility of those primer-probe sets. CCDC-N showed high sensitivity and the broadest linearity range for wastewater samples. It was thus recommended to be the most efficient tool in the quantitative analysis of SARS-CoV-2 in wastewater. CDC-N1 had the highest sensitivity for real wastewater and thus would be suitable for the screening of wastewater for the presence of SARS-CoV-2. When applying the primer-probe sets to wastewater samples collected from different Australian catchments, increased active clinical cases were observed with the augment of SARS-CoV-2 RNA quantified by RT-qPCR in wastewater in low prevalence communities.


Subject(s)
COVID-19 , SARS-CoV-2 , Australia , Humans , RNA, Viral , Reproducibility of Results , Waste Water
12.
Vaccines (Basel) ; 9(9)2021 Aug 31.
Article in English | MEDLINE | ID: covidwho-1390807

ABSTRACT

Anaphylactic reactions were observed after Singapore's national coronavirus disease 2019 (COVID-19) vaccination programme started in December 2020. We report the clinical and laboratory features of three patients in our institution who developed anaphylactic reactions after receiving the Pifzer BNT162b2 vaccine. IgM and IgG antibodies, but not IgE antibodies to the Pfizer BNT162b2 vaccine, were detected in all subjects. Similarly, mild to high elevated levels of anti-polyethylene glycol (PEG) IgG (1035-19709 U/mL, vs. vaccine-naive < 265 U/mL, vaccine-tolerant < 785 U/mL) and IgM (1682-5310 U/mL, vs. vaccine-naive < 1011 U/mL, vaccine-tolerant < 1007 U/mL) were detected in two out of three patients via commercial ELISA. High levels of serum anaphylatoxin C3a (79.0 ± 6.3 µg/mL, mean ± SD, vs. normal < 10 µg/mL) were observed in all three patients during the acute phase of the reaction, while tryptase levels, a marker of mast cell activation, were not elevated. Finally, one patient with the highest levels of anti-PEG IgG, IgM, and anti-Pfizer BNT162b2 IgG and IgM exhibited an enhanced Th2 cytokine serum profile during an acute reaction, with high levels of IL-4 (45.7 pg/mL, vs. vaccine-naive/tolerant < 2.30 pg/mL), IL-33 (86.4 pg/mL, vs. vaccine-naive/tolerant < 5.51 pg/mL) and IL-10 (22.9 pg/mL, vs. vaccine-naive/tolerant < 12.49 pg/mL) diminishing over time following corticosteroid treatment. Taken together, we propose these cases of anaphylaxis described are driven by a complement activation-related pseudoallergy (CAPRA), rather than classical IgE-mediated mechanisms.

13.
Gynecologic Oncology ; 162:S198-S198, 2021.
Article in English | Academic Search Complete | ID: covidwho-1366738

ABSTRACT

Collection of an accurate and comprehensive family cancer history (FCH) can help to identify millions of individuals at risk-for familial cancer syndromes. However, there are no formal guidelines for FCH collection and, as a result, there is wide variability in in strategies employed and accuracy of family health history across medical systems. Information technology (IT) provides a promising solution, a tool that has been shown to improve clinical documentation, workflows, quality of care, patient safety, communication and clinical decision support, and that can be completed remotely and safely during a pandemic. The aim of this study is to evaluate the literature on existing strategies whereby medical providers utilize information technology (IT) to assemble FCH. A systematic search of online databases (PubMed, EMBASE, MEDLINE, and the Cochrane Library) between 1980 and 2020 was performed. Meta-analysis was used to estimate pooled results across studies. Statistical heterogeneity was assessed through the chi-square test (i.e., Cochrane Q test) and the inconsistency statistic (I2). A random effects analysis was used to calculate the pooled proportions and means. The comprehensive search produced 4005 publications. Thirty-two peer-reviewed studies met inclusion criteria. Twenty-seven distinct IT tools were evaluated which included the following categories: electronic survey administered prior to visit (21, 65.6%), electronic survey administered via tablet in the medical office (6, 18.8%), electronic survey via kiosk (4, 12.5%) and animated virtual counselor (1, 3.1%). Among the 196,566 included patients, 87.0% completed the FCH tool (electronic survey prior to the visit - 85.0 %;electronic survey in the medical office - 89.0 %). The time required for survey completion was 35.2 minutes (CI 14.3 -56.2). Twelve percent of patients (n=11,093) were referred for genetic assessment based on the output of the FCH tool. Among the studied methods of FCH collection, 7 (21.9%) had the capacity to interface directly with the patient's electronic medical record. [Display omitted] The rapidly advancing field of germline cancer genetics coupled with a growing emphasis on disease prevention and incorporation of technology into medical care algorithms prior to and accelerated by the COVID-19 pandemic make utilization of IT strategies for collection of FCH a promising option. Our systematic review and meta-analysis found that electronic FCH collection can be completed successfully by patients in a time efficient manner. This information may be useful as many healthcare systems continue to restructure the way in which patients interact with their healthcare teams. [ABSTRACT FROM AUTHOR] Copyright of Gynecologic Oncology is the property of Academic Press Inc. 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.)

14.
Therap Adv Gastroenterol ; 14: 17562848211035670, 2021.
Article in English | MEDLINE | ID: covidwho-1348281

ABSTRACT

BACKGROUND AND AIMS: Currently, there are no definitive therapies for coronavirus disease 2019 (COVID-19). Gut microbial dysbiosis has been proved to be associated with COVID-19 severity and probiotics is an adjunctive therapy for COIVD-19. However, the potential benefit of probiotics in COVID-19 has not been studied. We aimed to assess the relationship of probiotics use with clinical outcomes in patients with COVID-19. METHODS: We conducted a propensity-score matched retrospective cohort study of adult patients with COVID-19. Eligible patients received either probiotics plus standard care (probiotics group) or standard care alone (non-probiotics group). The primary outcome was the clinical improvement rate, which was compared among propensity-score matched groups and in the unmatched cohort. Secondary outcomes included the duration of viral shedding, fever, and hospital stay. RESULTS: Among the propensity-score matched groups, probiotics use was related to clinical improvement rates (log-rank p = 0.028). This relationship was driven primarily by a shorter (days) time to clinical improvement [difference, -3 (-4 to -1), p = 0.022], reduction in duration of fever [-1.0 (-2.0 to 0.0), p = 0.025], viral shedding [-3 (-6 to -1), p < 0.001], and hospital stay [-3 (-5 to -1), p = 0.009]. Using the Cox model with time-varying exposure, use of probiotics remained independently related to better clinical improvement rate in the unmatched cohort. CONCLUSION: Our study suggested that probiotics use was related to improved clinical outcomes in patients with COVID-19. Further studies are required to validate the effect of probiotics in combating the COVID-19 pandemic.

15.
Environ Res ; 203: 111839, 2022 01.
Article in English | MEDLINE | ID: covidwho-1340650

ABSTRACT

This review discusses the techniques available for detecting and inactivating of pathogens in municipal wastewater, landfill leachate, and solid waste. In view of the current COVID-19 pandemic, SARS-CoV-2 is being given special attention, with a thorough examination of all possible transmission pathways linked to the selected waste matrices. Despite the lack of works focused on landfill leachate, a systematic review method, based on cluster analysis, allows to analyze the available papers devoted to sewage sludge and wastewater, allowing to focalize the work on technologies able to detect and treat pathogens. In this work, great attention is also devoted to infectivity and transmission mechanisms of SARS-CoV-2. Moreover, the literature analysis shows that sewage sludge and landfill leachate seem to have a remote chance to act as a virus transmission route (pollution-to-human transmission) due to improper collection and treatment of municipal wastewater and solid waste. However due to the incertitude about virus infectivity, these possibilities cannot be excluded and need further investigation. As a conclusion, this paper shows that additional research is required not only on the coronavirus-specific disinfection, but also the regular surveillance or monitoring of viral loads in sewage sludge, wastewater, and landfill leachate. The disinfection strategies need to be optimized in terms of dosage and potential adverse impacts like antimicrobial resistance, among many other factors. Finally, the presence of SARS-CoV-2 and other pathogenic microorganisms in sewage sludge, wastewater, and landfill leachate can hamper the possibility to ensure safe water and public health in economically marginalized countries and hinder the realization of the United Nations' sustainable development goals (SDGs).


Subject(s)
COVID-19 , Water Pollutants, Chemical , Humans , Pandemics , SARS-CoV-2 , Solid Waste/analysis , Waste Disposal Facilities , Waste Water , Water Pollutants, Chemical/analysis
17.
Front Med (Lausanne) ; 8: 655231, 2021.
Article in English | MEDLINE | ID: covidwho-1285310

ABSTRACT

Background: The ongoing COVID-19 pandemic has brought significant challenges to health system and consumed a lot of health resources. However, evidence on the hospitalization costs and their associated factors in COVID-19 cases is scarce. Objectives: To describe the total and components of hospitalization costs of COVID-19 cases, and investigate the associated factors of costs. Methods: We included 876 confirmed COVID-19 cases admitted to 33 designated hospitals from January 15th to April 27th, 2020 in Guangdong, China, and collected their demographic and clinical information. A multiple linear regression model was performed to estimate the associations of hospitalization costs with potential associated factors. Results: The median of total hospitalization costs of COVID-19 cases was $2,869.4 (IQR: $3,916.8). We found higher total costs in male (% difference: 29.7, 95% CI: 15.5, 45.6) than in female cases, in older cases than in younger ones, in severe cases (% difference: 344.8, 95% CI: 222.5, 513.6) than in mild ones, in cases with clinical aggravation than those without, in cases with clinical symptoms (% difference: 47.7, 95% CI: 26.2, 72.9) than those without, and in cases with comorbidities (% difference: 21.1%, 21.1, 95% CI: 4.4, 40.6) than those without. We also found lower non-pharmacologic therapy costs in cases treated with traditional Chinese medicine (TCM) therapy (% difference: -47.4, 95% CI: -64.5 to -22.0) than cases without. Conclusion: The hospitalization costs of COVID-19 cases in Guangdong were comparable to the national level. Factors associated with higher hospitalization costs included sex, older age, clinical severity and aggravation, clinical symptoms and comorbidities at admission. TCM therapy was found to be associated with lower costs for some non-pharmacologic therapies.

18.
Invest Ophthalmol Vis Sci ; 62(7): 25, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1280514

ABSTRACT

Purpose: The ocular surface is considered an important route for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. The expression level of the SARS-CoV-2 receptor angiotensin-converting enzyme 2 (ACE2) is vital for viral infection. However, the regulation of ACE2 expression on the ocular surface is still unknown. We aimed to determine the change in ACE2 expression in inflamed corneal epithelium and explore potential drugs to reduce the expression of ACE2 on the ocular surface. Methods: The expression of the SARS-CoV-2 receptors ACE2 and TMPRSS2 in human corneal epithelial cells (HCECs) was examined by qPCR and Western blotting. The altered expression of ACE2 in inflammatory corneal epithelium was evaluated in TNFα- and IL-1ß-stimulated HCECs and inflamed mouse corneal epithelium, and the effect of resveratrol on ACE2 expression in HCECs was detected by immunofluorescence and Western blot analysis. Results: ACE2 and TMPRSS2 are expressed on the human corneal epithelial cells. ACE2 expression is upregulated in HCECs by stimulation with TNFα and IL-1ß and inflamed mouse corneas, including dry eye and alkali-burned corneas. In addition, resveratrol attenuates the increased expression of ACE2 induced by TNFα in HCECs. Conclusions: This study demonstrates that ACE2 is highly expressed in HCECs and can be upregulated by stimulation with inflammatory cytokines and inflamed mouse corneal epithelium. Resveratrol may be able to reduce the increased expression of ACE2 on the inflammatory ocular surface. Our work suggests that patients with an inflammatory ocular surface may display higher ACE2 expression, which increases the risk of SARS-CoV-2 infection.


Subject(s)
Angiotensin-Converting Enzyme 2/genetics , Enzyme Inhibitors/pharmacology , Epithelium, Corneal/enzymology , Gene Expression Regulation, Enzymologic/physiology , Keratitis/enzymology , Resveratrol/pharmacology , SARS-CoV-2/physiology , Adult , Angiotensin-Converting Enzyme 2/metabolism , Animals , Blotting, Western , Cells, Cultured , Epithelium, Corneal/drug effects , Gene Expression Regulation, Enzymologic/drug effects , Humans , Inflammation/drug therapy , Inflammation/enzymology , Interleukin-1beta/pharmacology , Keratitis/drug therapy , Male , Mice , Mice, Inbred BALB C , Mice, Inbred C57BL , Microscopy, Fluorescence , RNA, Messenger/genetics , Real-Time Polymerase Chain Reaction , Receptors, Virus/metabolism , Serine Endopeptidases/genetics , Serine Endopeptidases/metabolism , Tumor Necrosis Factor-alpha/pharmacology , Up-Regulation
19.
World J Pediatr ; 17(3): 263-271, 2021 06.
Article in English | MEDLINE | ID: covidwho-1279501

ABSTRACT

BACKGROUND: The aim of this study is to explore the characteristics of Kawasaki disease (KD) and concurrent pathogens due to a stay-at-home isolation policy during coronavirus disease 2019 (COVID-19) epidemic. METHODS: All patients with KD admitted between February and April in 2015-2020, were classified into before (group 1, in 2015-2019) and after (group 2, in 2020) isolation groups. A total of 4742 patients [with KD (n = 98) and non-KD (n = 4644)] referred to Mycoplasma pneumoniae (MP) and virus detection were analyzed in 2020. Clinical characteristics, laboratory data, and 13 pathogens were analyzed retrospectively. RESULTS: Group 2 had a significantly increased incidence of KD (0.11%) with 107 patients compared to that of group 1 (0.03%) with 493 patients. The comparisons of oral mucosal change, strawberry tongue, desquamation of the fingertips, cervical lymphadenopathy and neutrophil percentage decreased in group 2 compared to group 1. The infection rate of MP increased significantly in group 2 (34.7%) compared to group 1 (19.3%), while the positive rate of viruses decreased significantly in group 2 (5.3%) compared to group 1 (14.3%). In 2020, the positive rate of MP infection increased significantly in patients with KD compared to the increase in patients with non-KD. The infection rate of MP for younger children aged less than 3 years old was higher in group 2 than in group 1. CONCLUSION: Compared with the characteristics of KD from 2015 to 2019 years, the incidence of KD was increased in 2020 and was accompanied by a high incidence of MP infection, especially in younger children (less than 3 years old) during the isolation due to COVID-19 pandemic.


Subject(s)
COVID-19/epidemiology , Mucocutaneous Lymph Node Syndrome/epidemiology , Physical Distancing , Pneumonia, Mycoplasma/epidemiology , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/microbiology , Adolescent , Child , Child, Preschool , Female , Humans , Incidence , Infant , Male , Pandemics , Retrospective Studies , SARS-CoV-2 , Virus Diseases/epidemiology , Virus Diseases/virology
20.
Environ Res ; 200: 111457, 2021 09.
Article in English | MEDLINE | ID: covidwho-1258365

ABSTRACT

Although strict lockdown measurements implemented during the COVID-19 pandemic have dramatically reduced the anthropogenic-based emissions, changes in air quality and its health impacts remain unclear in China. We comprehensively described air pollution during and after the lockdown periods in 2020 compared with 2018-2019, and estimated the mortality burden indicated by the number of deaths and years of life lost (YLL) related to the air pollution changes. The mean air quality index (AQI), PM10, PM2.5, NO2, SO2 and CO concentrations during the lockdown across China declined by 18.2 (21.2%), 27.0 µg/m3 (28.9%), 10.5 µg/m3 (18.3%), 8.4 µg/m3 (44.2%), 13.1 µg/m3 (38.8%), and 0.3 mg/m3 (27.3%) respectively, when compared to the same periods during 2018-2019. We observed an increase in O3 concentration during the lockdown by 5.5 µg/m3 (10.4%), and a slight decrease after the lockdown by 3.4 µg/m3 (4.4%). As a result, there were 51.3 (95%CI: 32.2, 70.1) thousand fewer premature deaths (16.2 thousand during and 35.1 thousand after the lockdown), and 1066.8 (95%CI: 668.7, 1456.8) thousand fewer YLLs (343.3 thousand during and 723.5 thousand after the lockdown) than these in 2018-2019. Our findings suggest that the COVID-19 lockdown has caused substantial decreases in air pollutants except for O3, and that substantial human health benefits can be achieved when strict control measures for air pollution are taken to reduce emissions from vehicles and industries. Stricter tailored policy solutions of air pollution are urgently needed in China and other countries, especially in well-developed industrial regions, such as upgrading industry structure and promoting green transportation.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Air Pollutants/analysis , Air Pollution/analysis , China/epidemiology , Communicable Disease Control , Environmental Monitoring , Humans , Pandemics , Particulate Matter/analysis , Particulate Matter/toxicity , SARS-CoV-2
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