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1.
BMC Infect Dis ; 22(1): 296, 2022 Mar 28.
Article in English | MEDLINE | ID: covidwho-1765439

ABSTRACT

BACKGROUND: The global pandemic of coronavirus disease 2019 (COVID-19) has attracted great public health efforts across the world. Few studies, however, have described the potential impact of these measures on other important infectious diseases. METHODS: The incidence of 19 major infectious diseases in Zhejiang Province was collected from the National Notifiable Infectious Disease Surveillance System from January 2017 to October 2020. The entire epidemic control phase was divided into three stages. The government deployed the first level response from 24 January to 2 March (the most rigorous measures). When the outbreak of COVID-19 was under control, the response level changed to the second level from 3 to 23 March, and then the third level response was implemented after 24 March. We compared the epidemiological characteristics of 19 major infectious diseases during different periods of the COVID-19 epidemic and previous years. RESULTS: A total of 1,814,881 cases of 19 infectious diseases were reported in Zhejiang from January 2017 to October 2020, resulting in an incidence rate of 8088.30 cases per 1,000,000 person-years. After the non-pharmaceutical intervention, the incidence of 19 infectious diseases dropped by 70.84%, from 9436.32 cases per 1,000,000 person-years to 2751.51 cases per 1,000,000 person-years, with the large decrease in the first response period of influenza. However, we observed that the daily incidence of severe fever with thrombocytopenia syndrome (SFTS) and leptospirosis increased slightly (from 1.11 cases per 1,000,000 person-years to 1.82 cases per 1,000,000 person-years for SFTS and 0.30 cases per 1,000,000 person-years to 1.24 cases per 1,000,000 person-years for leptospirosis). There was no significant difference in the distribution of epidemiological characteristic of most infectious diseases before and during the implementation of COVID-19 control measures. CONCLUSION: Our study summarizes the epidemiological characteristics of 19 infectious diseases and indicates that the rigorous control measures for COVID-19 are also effective for majority of infectious diseases.


Subject(s)
COVID-19 , Communicable Diseases , Epidemics , COVID-19/epidemiology , Communicable Diseases/epidemiology , Disease Outbreaks/prevention & control , Epidemics/prevention & control , Humans , Incidence
2.
Int J Environ Res Public Health ; 19(6)2022 03 14.
Article in English | MEDLINE | ID: covidwho-1742453

ABSTRACT

We aimed to assess the prevalence of elevated depressive symptoms and its associated factors during the coronavirus disease 2019 (COVID-19) pandemic among primary students in China. We included 386,924 students aged 6-12 years from three cities in Henan province, China, over the period 21-27 May 2021. The overall prevalence of depressive symptoms was 5.8%. Participants with high depressive symptoms were more likely to be senior urban primary students, and exhibited an insignificant increase in hand washing frequency, non-mask wearing behavior, higher error rates of cognition tests, and greater levels of worry and fear. The associated factors for high depressive symptoms were found to include age, sex, grade, location, worry level, fear level, cognitive status, and change in lifestyle after gaining knowledge about COVID-19. Our results suggest that governments need to focus on factors affecting the mental health of school-age children while combating COVID-19, as it would facilitate better decision making on the international and national level.


Subject(s)
COVID-19 , COVID-19/epidemiology , Child , China/epidemiology , Depression/epidemiology , Depression/psychology , Humans , Pandemics , Prevalence , Students/psychology
3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-313368

ABSTRACT

Current explosive outbreak of COVID-19 around the world is a complex spatiotemporal process with hidden interactions between viruses and humans. This study aims at clarifying the transmission patterns and the driving mechanism that contributed to the COVID-19 epidemics across the provinces of China. Thus a new dynamical transmission model is established by ordinary differential system. The model takes into account the hidden circulation of COVID-19 virus among/within humans, which incorporates the spatial diffusion of infection by parameterizing human mobility. Theoretical analysis indicates that the basic reproduction number is a unique epidemic threshold, which can unite infectivity in each region by human mobility, and can totally determine whether COVID-19 proceeds among multiple regions. By validating the model with real epidemic data in China, it is found that (1) if without any intervention, COVID-19 would overrun China within three months, resulting in more than 1.1 billion infections;(2) high frequency of human mobility can trigger COVID-19 diffusion across each province in China, no matter where the initial infection locates;(3) travel restrictions and other non-pharmaceutical interventions must be implemented simultaneously for disease control;and (4) infection sites in central and east (rather than west and northeast) of China would easily stimulate quick diffusion of COVID-19 in the whole country.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-311009

ABSTRACT

Purpose: To evaluate the clinical features and outcomes of rhabdomyolysis (RM) in patients with COVID-19. Method: A single center retrospective cohort study of 1,014 consecutive hospitalized patients with confirmed COVID-19 at the Huoshenshan hospital in Wuhan, China, between February 17 and April 12, 2020. Results: : The overall incidence of RM was 2.2%. Comparing with patients without RM, patients with RM tended to have a higher risk of deterioration, representing by higher ratio to be admitted to the intensive care unit (ICU) (90.9 % vs 5.3%, P <0.001), and to undergo mechanical ventilation (86.4 % vs 2.7% P <0.001). Compared with patients without RM, patients with RM had laboratory test abnormalities, including indicators of inflammation, coagulation activation and kidney injury. Patients with RM had a higher risk of hospital death ( P < 0.001). Cox proportional hazard regression model confirmed that RM indicators, including peak creatine kinase (CK) >1000 IU/L (HR=6.46, 95% CI: 3.02-13.86), peak serum myoglobin (MYO) >1000 ng/mL (HR=9.85, 95% CI: 5.04-19.28) were independent risk factors for in-hospital death. Additionally, patients with COVID-19 that developed RM tended to have a delayed virus clearance. Conclusion: RM might be an important factor contributing to adverse outcomes of patients with COVID-19. Early detection and effective intervention of RM may help reduce deaths of patients with COVID-19.

6.
Nonlinear Dyn ; : 1-15, 2021 Oct 29.
Article in English | MEDLINE | ID: covidwho-1605601

ABSTRACT

Current explosive outbreak of COVID-19 around the world is a complex spatiotemporal process with hidden interactions between viruses and humans. This study aims at clarifying the transmission patterns and the driving mechanism that contributed to the COVID-19 prevalence across the provinces of China. Thus, a new dynamical transmission model is established by an ordinary differential system. The model takes into account the hidden circulation of COVID-19 virus among/within humans, which incorporates the spatial diffusion of infection by parameterizing human mobility. Theoretical analysis indicates that the basic reproduction number is a unique epidemic threshold, which can unite infectivity in each region by human mobility and can totally determine whether COVID-19 proceeds among multiple regions. By validating the model with real epidemic data in China, it is found that (1) if without any intervention, COVID-19 would overrun China within three months, resulting in more than 1.1 billion clinical infections and 0.2 billion subclinical infections; (2) high frequency of human mobility can trigger COVID-19 diffusion across each province in China, no matter where the initial infection locates; (3) travel restrictions and other non-pharmaceutical interventions must be implemented simultaneously for disease control; and (4) infection sites in central and east (rather than west and northeast) of China would easily stimulate quick diffusion of COVID-19 in the whole country. SUPPLEMENTARY INFORMATION: The online version supplementary material available at 10.1007/s11071-021-07001-1.

7.
J Psychosom Res ; 153: 110709, 2022 02.
Article in English | MEDLINE | ID: covidwho-1587152

ABSTRACT

AIM: To evaluate the association between mask wearing practice and the risk of anxiety symptoms during the COVID-19 epidemic among Chinese students aged 12-18 years old. METHODS: Totally, 386,432 junior and senior high school students were recruited using a cluster sampling method across three cities of Henan Province in China during February 4-12, 2020. Mask wearing practice was defined according to its type and the behavior exhibited in relation to wearing a mask. Presence of anxiety symptoms was determined by Generalized Anxiety Disorder tool (GAD-7). Multiple logistic regression was performed to estimate the association between mask wearing and anxiety symptoms. RESULTS: Among the participants, compared with students who completely adhered to the all the mask wearing practice, students who did not adhere to all the mask wearing practice had 1.97 times more likely to suffer from anxiety symptoms (adjusted odds ratio (aOR) = 1.97; 95% confidence interval (CI): 1.74-2.22). Furthermore, compared with students who did not know the proper type of mask, students who knew the proper type of mask had a lower risk of anxiety symptoms (aOR = 0.78; 95%CI: 0.76-0.80). Students who adhered to proper behavior of mask wearing was associated with 34% decreased odds for anxiety symptoms (aOR = 0.68; 95%CI: 0.62-0.74). CONCLUSIONS: To conclude, proper mask wearing may be an important attribute that play a significant role in reducing the risk of anxiety symptoms among junior and senior school student. However, since this study is a cross-sectional study, prospective studies are needed to further verify.


Subject(s)
COVID-19 , Adolescent , Anxiety/epidemiology , Child , China/epidemiology , Cross-Sectional Studies , Depression , Disease Outbreaks , Humans , SARS-CoV-2 , Schools , Students , Surveys and Questionnaires
8.
Open Forum Infect Dis ; 8(11): ofab499, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1584163

ABSTRACT

Background: Community-acquired pneumonia (CAP) is a leading infectious cause of hospitalization and death worldwide. Knowledge about the incidence and etiology of CAP in China is fragmented. Methods: A multicenter study performed at 4 hospitals in 4 regions in China and clinical samples from CAP patients were collected and used for pathogen identification from July 2016 to June 2019. Results: A total of 1674 patients were enrolled and the average annual incidence of hospitalized CAP was 18.7 (95% confidence interval, 18.5-19.0) cases per 10000 people. The most common viral and bacterial agents found in patients were respiratory syncytial virus (19.2%) and Streptococcus pneumoniae (9.3%). The coinfections percentage was 13.8%. Pathogen distribution displayed variations within age groups as well as seasonal and regional differences. The severe acute respiratory syndrome coronavirus 2 was not detected. Respiratory virus detection was significantly positively correlated with air pollutants (including particulate matter ≤2.5 µm, particulate matter ≤10 µm, nitrogen dioxide, and sulfur dioxide) and significantly negatively correlated with ambient temperature and ozone content; bacteria detection was opposite. Conclusions: The hospitalized CAP incidence in China was higher than previously known. CAP etiology showed that differences in age, seasons, regions, and respiratory viruses were detected at a higher rate than bacterial infection overall. Air pollutants and temperature have an influence on the detection of pathogens.

9.
Risk Manag Healthc Policy ; 14: 5005-5014, 2021.
Article in English | MEDLINE | ID: covidwho-1581548

ABSTRACT

BACKGROUND: The quarantine in dedicated hotels has become an inevitable safety measure due to the frequent cross-border travel since the outbreak of COVID-19. The aim of the present study was to explore the trends in the psychological status of individuals entering from high-risk areas of COVID-19 coronavirus while quarantining in dedicated hotels. METHODS: A total of 591 individuals who isolated in dedicated hotels were recruited between March and June 2020. Participants self-reported mental symptoms [Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS)] every three days during the quarantine. A mixed-effects linear regression model was used to assess the trends. RESULTS: Participants reporting anxiety and depression symptoms at least one time during quarantine accounted for 4.5% and 18.4%, respectively. Their psychological status was alleviated during some first 9 days, and then it slightly deteriorated, which was suggested by SAS and SDS scores that were negatively correlated with the days of quarantine (T) (adjusted coefficient [ß] -0.81, 95% CI -1.00 to -0.62; and ß -0.75, 95% CI -0.97 to -0.53, respectively), and were positively correlated with the square of T (ß 0.04, 95% CI 0.02 to 0.06; and ß 0.04, 95% CI 0.02 to 0.06, respectively). The unemployed and 18~30-year-old participants were prone to greater levels of psychological distress. No significant difference in the trend of mental health was found among different subgroups. CONCLUSION: The mental health of the people entering Guangzhou from high-risk areas of COVID-19 coronavirus resulted positive during the early period of quarantine in dedicated hotels, after which it deteriorated. The psychological status of individuals should be closely monitored at the beginning and after more than 9 days of quarantine, especially for individuals who are unemployed and 18~30-year-old ones.

10.
Psychiatry Res ; 305: 114251, 2021 11.
Article in English | MEDLINE | ID: covidwho-1559298

ABSTRACT

This study was conducted on elementary school students in Henan Province, China, from February 4th to 11th, 2020, during the coronavirus disease 2019 (COVID-19) epidemic. The purpose of the study was to examine the prevalence of anxiety among students and identify the related risk factors contributing to anxiety. Demographic information and psychological status were assessed by using self-reported measures. The generalized anxiety disorder tool (GAD-7) and a multiple logistic regression model were used to assess anxiety and identify potential influencing factors. Cross-sectional data indicated that the overall anxiety prevalence was 13.4%. The prevalence of anxiety symptoms was highest among rural primary school students and lowest among city students. Three groups of students in different regions were surveyed, and the prevalence of anxiety symptoms was significantly higher among students with poor knowledge of COVID-19 than among students with good knowledge of COVID-19. After adjusting for potential confounding factors, it was found that location, knowledge, and practice were related to anxiety. This study showed that the prevalence of anxiety symptoms was higher among Chinese primary school students. The influencing factors found in this study may help relevant staff improve the mental health of children during the epidemic.


Subject(s)
COVID-19 , Anxiety/epidemiology , Anxiety Disorders/epidemiology , Child , China/epidemiology , Cross-Sectional Studies , Depression , Disease Outbreaks , Humans , Internet , Prevalence , SARS-CoV-2 , Students , Surveys and Questionnaires
11.
Nonlinear Dynamics ; : 1-15, 2021.
Article in English | EuropePMC | ID: covidwho-1489730

ABSTRACT

Current explosive outbreak of COVID-19 around the world is a complex spatiotemporal process with hidden interactions between viruses and humans. This study aims at clarifying the transmission patterns and the driving mechanism that contributed to the COVID-19 prevalence across the provinces of China. Thus, a new dynamical transmission model is established by an ordinary differential system. The model takes into account the hidden circulation of COVID-19 virus among/within humans, which incorporates the spatial diffusion of infection by parameterizing human mobility. Theoretical analysis indicates that the basic reproduction number is a unique epidemic threshold, which can unite infectivity in each region by human mobility and can totally determine whether COVID-19 proceeds among multiple regions. By validating the model with real epidemic data in China, it is found that (1) if without any intervention, COVID-19 would overrun China within three months, resulting in more than 1.1 billion clinical infections and 0.2 billion subclinical infections;(2) high frequency of human mobility can trigger COVID-19 diffusion across each province in China, no matter where the initial infection locates;(3) travel restrictions and other non-pharmaceutical interventions must be implemented simultaneously for disease control;and (4) infection sites in central and east (rather than west and northeast) of China would easily stimulate quick diffusion of COVID-19 in the whole country. Supplementary Information The online version supplementary material available at 10.1007/s11071-021-07001-1.

13.
Results Phys ; 28: 104632, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1347813

ABSTRACT

Current explosive outbreak of the novel coronavirus (COVID-19) pandemic is posing serious threats to public health and economics around the world. To clarify the coupling mechanism between this disease and economic development, a new dynamical system is established by ordinary differential equations (ODEs). It is theoretically proved that the basic reproduction number is a nonlinear combination of parameters regarding disease transmission, intervention and economy effect, which totally determines the stability of the disease-free and endemic equilibria. Further analyses indicate the existence of interaction and mutual restraint among transmissibility, quarantine and economics, in which (1) COVID-19 would cause a long-term impact on halting economic progress; (2) strong coupling of COVID-19 and economics would easily trigger disease outbreak, cause more human infections and alleviate the intervention effects of quarantine; and (3) there exists optimal strategy of time-varying quarantine for disease control and economic development. It is highlighted that adaptive isolation (rather than constant isolation) of at-risk population (rather than random individuals) is highly effective in reducing morbidity at the cost of least economic loss.

14.
Innovation (N Y) ; 2(3): 100139, 2021 Aug 28.
Article in English | MEDLINE | ID: covidwho-1275767

ABSTRACT

The evidence for the effects of environmental factors on COVID-19 case fatality remains controversial, and it is crucial to understand the role of preventable environmental factors in driving COVID-19 fatality. We thus conducted a nationwide cohort study to estimate the effects of environmental factors (temperature, particulate matter [PM2.5, PM10], sulfur dioxide [SO2], nitrogen dioxide [NO2], and ozone [O3]) on COVID-19 case fatality. A total of 71,808 confirmed COVID-19 cases were identified and followed up for their vital status through April 25, 2020. Exposures to ambient air pollution and temperature were estimated by linking the city- and county-level monitoring data to the residential community of each participant. For each participant, two windows were defined: the period from symptom onset to diagnosis (exposure window I) and the period from diagnosis date to date of death/recovery or end of the study period (exposure window II). Cox proportional hazards models were used to estimate the associations between these environmental factors and COVID-19 case fatality. COVID-19 case fatality increased in association with environmental factors for the two exposure windows. For example, each 10 µg/m3 increase in PM2.5, PM10, O3, and NO2 in window I was associated with a hazard ratio of 1.11 (95% CI 1.09, 1.13), 1.10 (95% CI 1.08, 1.13), 1.09 (95 CI 1.03, 1.14), and 1.27 (95% CI 1.19, 1.35) for COVID-19 fatality, respectively. A significant effect was also observed for low temperature, with a hazard ratio of 1.03 (95% CI 1.01, 1.04) for COVID-19 case fatality per 1°C decrease. Subgroup analysis indicated that these effects were stronger in the elderly, as well as in those with mild symptoms and living in Wuhan or Hubei. Overall, the sensitivity analyses also yielded consistent estimates. Short-term exposure to ambient air pollution and low temperature during the illness would play a nonnegligible part in causing case fatality due to COVID-19. Reduced exposures to high concentrations of PM2.5, PM10, O3, SO2, and NO2 and low temperature would help improve the prognosis and reduce public health burden.

15.
Int J Environ Res Public Health ; 18(9)2021 05 07.
Article in English | MEDLINE | ID: covidwho-1224004

ABSTRACT

BACKGROUND: Knowledge of the impact of COVID-19 on the mental health of college students remains limited. Our aim is to investigate the prevalence of anxiety and explore the potential risk and protective factors of anxiety. METHODS: A cross-sectional survey was adopted and a total of 24,678 college students were included from Zhengzhou, Henan Province, China, during February, 2020. Anxiety was assessed by using the Generalized Anxiety Disorder tool (GAD-7). Multiple logistic regression models were established for exploring potential factors of anxiety. RESULTS: The overall prevalence of anxiety was 7.3%. After adjusting for potential confounders, sex, place of residence, worried level, fear level, cognitive levels, and behavior status were found to be associated with anxiety (p < 0.05). Students with positive preventive behaviors showed a protective effect against the anxiety symptoms compared to those with negative preventive behaviors. In contrast to the high-cognition category, participants at a low cognitive level were 14.9% more likely to present anxiety symptoms. CONCLUSION: This large-scale study assessed the prevalence of anxiety and its potential influencing factors among college students. It suggests that the government could strengthen health education related to COVID-19 and supervise the performance of preventive behaviors to handle anxiety.


Subject(s)
COVID-19 , Pandemics , Anxiety/epidemiology , Anxiety Disorders , China/epidemiology , Cross-Sectional Studies , Depression , Humans , Prevalence , SARS-CoV-2 , Students , Surveys and Questionnaires
16.
J Affect Disord ; 288: 17-22, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1174333

ABSTRACT

BACKGROUND: The increasing menace of the COVID-19 epidemic led to an atmosphere of anxiety around the world, however the evidence among Chinese students aged 12 to 18 years has been limited. METHODS: A total of 373216 junior and senior high school students were recruited using a cluster sampling method in Zhengzhou, Xinxiang, Xinyang city of Henan Province, China, during February 4-12, 2020. Presence of anxiety symptoms was determined by Generalized Anxiety Disorder tool (GAD-7). Multiple logistic regression was performed to estimate the potential risk factors. RESULTS: Among the participants, junior and senior high school students were found to have anxiety symptoms, producing an overall prevalence of 9.89%. The prevalence was lower in female than in male (9.66% vs. 10.11%) and the prevalence was higher for junior high school students than senior high school students (13.89% vs. 12.93%). The prevalence of anxiety symptoms was highest among rural students and lowest among urban students (11.33% vs. 8.77%). The cognitive level was negatively associated with the prevalence of anxiety symptoms. After adjusting for potential confounders, age, gender, residential location, worried level, fear level and behavior status were found to be associated with anxiety symptoms. LIMITATIONS: Prevalence may be skewed by assessing anxiety symptoms using self-reported scales rather than clinical interviews. CONCLUSIONS: This large-scale study assesses the prevalence of anxiety symptoms and its potential influencing factors in junior and senior high school students. These findings suggest that governments need to pay more attention to the mental health of young people in combating COVID-19.


Subject(s)
COVID-19 , Adolescent , Anxiety/epidemiology , Child , China/epidemiology , Cross-Sectional Studies , Depression , Disease Outbreaks , Female , Humans , Male , Prevalence , Risk Factors , SARS-CoV-2 , Schools , Students , Surveys and Questionnaires
17.
Clin Infect Dis ; 71(16): 2045-2051, 2020 11 19.
Article in English | MEDLINE | ID: covidwho-1153144

ABSTRACT

BACKGROUND: The unprecedented outbreak of corona virus disease 2019 (COVID-19) infection in Wuhan City has caused global concern; the outflow of the population from Wuhan was believed to be a main reason for the rapid and large-scale spread of the disease, so the government implemented a city-closure measure to prevent its transmission considering the large amount of travel before the Chinese New Year. METHODS: Based on the daily reported new cases and the population-movement data between 1 and 31 January, we examined the effects of population outflow from Wuhan on the geographical expansion of the infection in other provinces and cities of China, as well as the impacts of the city closure in Wuhan using different closing-date scenarios. RESULTS: We observed a significantly positive association between population movement and the number of the COVID-19 cases. The spatial distribution of cases per unit of outflow population indicated that the infection in some areas with a large outflow of population might have been underestimated, such as Henan and Hunan provinces. Further analysis revealed that if the city-closure policy had been implemented 2 days earlier, 1420 (95% confidence interval, 1059-1833) cases could have been prevented, and if 2 days later, 1462 (1090-1886) more cases would have been possible. CONCLUSIONS: Our findings suggest that population movement might be one important trigger for the transmission of COVID-19 infection in China, and the policy of city closure is effective in controlling the epidemic.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , China/epidemiology , Cities/epidemiology , Confidence Intervals , Humans , Pandemics
18.
Shock ; 56(3): 360-367, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1028641

ABSTRACT

PURPOSE: Rhabdomyolysis (RM) has been associated with many viral infectious diseases, and associated with poor outcomes. We aim to evaluate the clinical features and outcomes of RM in patients with coronavirus disease 2019 (COVID-19). METHOD: This was a single-center, retrospective, cohort study of 1,014 consecutive hospitalized patients with confirmed COVID-19 at the Huoshenshan Hospital in Wuhan, China, between February 17 and April 12, 2020. RESULTS: The overall incidence of RM was 2.2%. Compared with patients without RM, those with RM tended to have a higher risk of deterioration. Patients with RM also constituted a greater percentage of patients admitted to the intensive care unit (90.9% vs. 5.3%, P < 0.001) and a greater percentage of patients undergoing mechanical ventilation (86.4% vs. 2.7% P < 0.001). Moreover, patients with RM had laboratory test abnormalities, including the presence of markers of inflammation, activation of coagulation, and kidney injury. Patients with RM also had a higher risk of in-hospital death (P < 0.001). Cox's proportional hazard regression model analysis confirmed that RM indicators, including peak creatine kinase levels > 1,000 IU/L (HR = 6.46, 95% CI: 3.02-13.86) and peak serum myoglobin concentrations > 1,000 ng/mL (HR = 9.85, 95% CI: 5.04-19.28), were independent risk factors for in-hospital death. Additionally, patients with COVID-19 that developed RM tended to have delayed viral clearance. CONCLUSION: RM might be an important contributing factor to adverse outcomes in COVID-19 patients. The early detection and effective intervention of RM may help reduce mortality among COVID-19 patients.


Subject(s)
COVID-19/complications , COVID-19/mortality , Hospital Mortality , Rhabdomyolysis/complications , Rhabdomyolysis/mortality , Adolescent , Adult , Aged , Aged, 80 and over , China/epidemiology , Female , Hospitalization , Humans , Incidence , Intensive Care Units , Male , Middle Aged , Muscle, Skeletal/physiopathology , Proportional Hazards Models , Respiration, Artificial , Retrospective Studies , SARS-CoV-2 , Treatment Outcome , Young Adult
19.
Atmos Environ (1994) ; 246: 118083, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-938762

ABSTRACT

BACKGROUND: Nine COVID-19 (Corona Virus Disease, 2019) cases were observed in one community in Guangzhou. All the cases lived in three vertically aligned units of one building sharing the same piping system, which provided one unique opportunity to examine the transmission mode of SARS-CoV-2. METHODS: We interviewed the cases on the history of travelling and close contact with the index patients. Respiratory samples from all the cases were collected for viral phylogenetic analyses. A simulation experiment in the building and a parallel control experiment in a similar building were then conducted to investigate the possibility of transmission through air. RESULTS: Index patients living in Apartment 15-b had a travelling history in Wuhan, and four cases who lived in Apartment 25-b and 27-b were subsequently diagnosed. Phylogenetic analyses showed that virus of all the patients were from the same strain of the virus. No close contacts between the index cases and other families indicated that the transmission might not occur through droplet and close contacts. Airflow detection and simulation experiment revealed that flushing the toilets could increase the speed of airflow in the pipes and transmitted the airflow from Apartment 15-b to 25-b and 27-b. Reduced exhaust flow rates in the infected building might have contributed to the outbreak. CONCLUSIONS: The outbreak of COVID-19 in this community could be largely explained by the transmission through air, and future efforts to prevent the infection should take the possibility of transmission through air into consideration. A disconnected drain pipe and exhaust pipe for toilet should be considered in the architectural design to help prevent possible virus spreading through the air.

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