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1.
Infectious Disease Modelling ; 2022.
Article in English | ScienceDirect | ID: covidwho-1796729

ABSTRACT

Numerous studies have proposed search engine-based estimation of COVID-19 prevalence during the COVID-19 pandemic;however, their estimation models do not consider the impact of various urban socioeconomic indicators (USIs). This study quantitatively analysed the impact of various USIs on search engine-based estimation of COVID-19 prevalence using 15 USIs (including total population, gross regional product (GRP), and population density) from 369 cities in China. The results suggested that 13 USIs affected either the correlation (SC-corr) or time lag (SC-lag) between search engine query volume and new COVID-19 cases (p <0.05). Total population and GRP impacted SC-corr considerably, with their correlation coefficients r for SC-corr being 0.65 and 0.59, respectively. Total population, GRP per capita, and proportion of the population with a high school diploma or higher had simultaneous positive impacts on SC-corr and SC-lag (p <0.05);these three indicators explained 37–50% of the total variation in SC-corr and SC-lag. Estimations for different urban agglomerations revealed that the goodness of fit, R2, for search engine-based estimation was more than 0.6 only when total urban population, GRP per capita, and proportion of the population with a high school diploma or higher exceeded 11.08 million, 120,700, and 38.13%, respectively. A greater urban size indicated higher accuracy of search engine-based estimation of COVID-19 prevalence. Therefore, the accuracy and time lag for search engine-based estimation of infectious disease prevalence can be improved only when the total urban population, GRP per capita, and proportion of the population with a high school diploma or higher are greater than the aforementioned thresholds.

2.
J Immunol ; 208(8): 1857-1872, 2022 Apr 15.
Article in English | MEDLINE | ID: covidwho-1776405

ABSTRACT

Pregnant women are at increased risk of adverse outcomes, including preeclampsia and preterm birth, that may result from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Pregnancy imprints specific maternal immune responses that can modulate host susceptibility to microbial infection; therefore, recent studies have focused on the humoral response against SARS-CoV-2 in pregnant women. However, the pregnancy-specific cellular immune responses triggered by SARS-CoV-2 infection are poorly understood. In this study, we undertook an extensive in vitro investigation to determine the cellular immune responses to SARS-CoV-2 particles and proteins/peptides in pregnant women. First, we show that SARS-CoV-2 particles do not alter the pregnancy-specific oxidative burst of neutrophils and monocytes. Yet, SARS-CoV-2 particles/proteins shift monocyte activation from the classical to intermediate states in pregnant, but not in nonpregnant, women. Furthermore, SARS-CoV-2 proteins, but not particles or peptide pools, mildly enhance T cell activation during pregnancy. As expected, B cell phenotypes are heavily modulated by SARS-CoV-2 particles in all women; yet, pregnancy itself further modified such responses in these adaptive immune cells. Lastly, we report that pregnancy itself governs cytokine responses in the maternal circulation, of which IFN-ß and IL-8 were diminished upon SARS-CoV-2 challenge. Collectively, these findings highlight the differential in vitro responses to SARS-CoV-2 in pregnant and nonpregnant women and shed light on the immune mechanisms implicated in coronavirus disease 2019 during pregnancy.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Premature Birth , Female , Humans , Immunity, Cellular , Infant, Newborn , Pregnancy , Pregnancy Outcome , Pregnant Women , SARS-CoV-2
3.
Journal of Organizational and End User Computing ; 34(6):1-22, 2022.
Article in English | ProQuest Central | ID: covidwho-1766023

ABSTRACT

This study focuses on the restorative effects of immersive virtual reality (VR) forest experiences on elderly people during the COVID-19 lockdown. A field experiment with 63 elderly participants was conducted in an elderly care institution in China. The results showed that a five-minute VR forest experience with three minutes of subsequent reliving can bring immediate psychological improvements (i.e., increased positive affect, decreased negative affect, and enhanced stress recovery) to elderly individuals. The negative affect decrease and stress recovery enhancement were more obvious among introverted individuals. Furthermore, participating in three VR forest experiences over 3 consecutive days can bring continuous psychological improvements. Moreover, short VR forest experiences were unable to significantly decrease the blood pressure of participants. The effects of three VR experiences over 3 days on blood pressure improvement were also nonsignificant. Additionally, VR forest experiences can increase elderly participants’ intentions to undertake real forest therapy.

4.
China CDC Weekly ; 4(10):1-4, 2021.
Article in English | China CDC Weekly | ID: covidwho-1716514

ABSTRACT

< -type="Summary"> <sec> What is already known about this topic? In 2020, the implementation of non-medical interventions during the coronavirus disease 2019 (COVID-19) epidemic has created a negative impact on tuberculosis (TB) control. It is unclear if the prevalence of TB among students in Guizhou Province was also affected.</sec><sec> What is added by this report? Among TB cases, the proportion of student TB was 19.91% in back to school period in 2020, which was higher than the 13.36% in 2017–2019. The interval between symptom onset and care-seeking of the student TB patients was the shortest in the back-to-school and physical check-up periods.</sec><sec> What are the implications for public health practice? TB active screening was effective for timely detection and diagnosis of TB among students, which could prevent TB outbreaks in schools.</sec>

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324440

ABSTRACT

The sudden outbreak of the Coronavirus disease (COVID-19) swept across the world in early 2020, triggering the lockdowns of several billion people across many countries, including China, Spain, India, the U.K., Italy, France, Germany, and most states of the U.S. The transmission of the virus accelerated rapidly with the most confirmed cases in the U.S., and New York City became an epicenter of the pandemic by the end of March. In response to this national and global emergency, the NSF Spatiotemporal Innovation Center brought together a taskforce of international researchers and assembled implemented strategies to rapidly respond to this crisis, for supporting research, saving lives, and protecting the health of global citizens. This perspective paper presents our collective view on the global health emergency and our effort in collecting, analyzing, and sharing relevant data on global policy and government responses, geospatial indicators of the outbreak and evolving forecasts;in developing research capabilities and mitigation measures with global scientists, promoting collaborative research on outbreak dynamics, and reflecting on the dynamic responses from human societies.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323595

ABSTRACT

Background: Cigarette smoking (CS) is a global public health problem and a high-risk factor for various diseases. In December 2019, a novel coronavirus (HCoV-19) was identified in Wuhan, China. Because ACE2 has been identified as a receptor for HCoV-19, we hypothesize that CS affects the expression pattern of ACE2 in respiratory tract, causing differences in susceptibility to the virus. Methods: Three datasets (GSE994, GSE17913, and GSE18344), were downloaded from the Gene Expression Omnibus (GEO) database. Correlation and enrichment analysis were used to evaluate the function of ACE2. Also, the different expression of ACE2 in different groups of three datasets were analyzed. Results: Genes associated with ACE2 were enriched in important biological processes such as viral processes and immune response. Elevated ACE2 were found in intrapulmonary airways (GSE994) and oral epithelial cells (GSE17913) of smokers but not those of non-smokers or former smokers. Significant dose- and time-dependent relationships between CS and ACE2 expression were observed in mouse lung tissues, and long periods without smoking were found to significantly reduce ACE2 expression. Conclusions: Both human and rat data confirmed that CS could induce increased ACE2 in the respiratory tract, indicating that smokers have a higher susceptibility to HCoV-19.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323529

ABSTRACT

Background: Whether coronavirus disease 2019 (COVID-19) pandemic would affect pregnancy-associated factors of uninfected pregnant women was rarely reported.Methods: A total of 32,277 pregnant women from six sites (Hubei Province, Guangdong Province, Hebei Province, Shandong Province, Yunnan Province and Beijing City) were finally recruited. We conducted a retrospective combined cohort study to analyze the associations between the number of prenatal examinations (NPE), delivery gestational week (DGW), the risk of caesarean section (CS), stillbirth, neonatal weight, preterm birth, macrosomia, small for gestational age (SGA), large for gestational age (LGA) and the COVID-19 in two time-periods, the pre-pandemic period (P-2019, 1/1/19-5/31/19) and the pandemic period (P-2020, 1/1/20-5/31/20).Findings: After adjusting for other covariates, we found the NPE, DGW, and SGA were negatively associated with the COVID-19 pandemic, whereas the CS and preterm birth rates were positively associated with the COVID-19, with adjusted relative risks (aRRs) of 1.11 [95% confidence interval (CI) 1.06–1.17] and 1.37 (95% CI: 1.02–1.84) respectively in Hubei. For Guangdong, the associations of CS and preterm birth with the COVID-19 were similar in Hubei. In contrast, limited associations were evident in other areas, except for a positive association with macrosomia [aRR = 1.26 (95% CI: 1.03–1.55)] in Beijing.Interpretation: The CS and preterm birth rates increased slightly in areas that were more affected by the pandemic than other areas among uninfected pregnant women. NPEs were not significantly interrupted and most maternal and neonatal clinical characteristics were within the normal ranges.Funding: National Key Research and Development Program, National Natural Science Foundation of China and National Health Commission Capacity Building and Continuing Education Center.Declaration of Interests: All authors declare to have no conflict of interest.Ethics Approval Statement: The study was approved by the Peking University ethics board (no. IRB00001052-20025).

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322630

ABSTRACT

Background: Computed tomography (CT) and reverse-transcription polymerase chain reaction (RT-PCR) are the recommended tools for the diagnosis of coronavirus disease 2019 (COVID-19). The present study aimed to investigate the correlation between chest CT and RT-PCR while describing the atypical CT imaging features of COVID-19. Methods: In this study, 418 patients in Jiangsu, China, clinically diagnosed with COVID-19 from January 10 to February 17, 2020, were included. Patients who fulfilled the following conditions were evaluated further: (1) Patients had positive RT-PCR and negative CT;(2) Patients had initial negative RT-PCR and positive CT, and follow-up PT-PCR tests were positive;(3) Patients had atypical CT findings. Results: Of the 418 initial chest CT scans, 30 (7.2%) patients had normal CT presentation, and 6 (1.4%) patients had initial negative RT-PCR results and positive CT scans. Next, 10 (2.4%) cases of patients showed atypical CT findings, including 2 case of solid nodule, 4 cases of halo sign (solid nodule or mass surrounded by ground glass opacity), and 4 cases of predominant fibrous stripes. Conclusions: False-negative results can be found on both chest CT and RT-PCR;hence, the diagnosis of COVID-19 should consider both CT and RT-PCR. CT manifestations, such as solitary nodule, halo sign, and pulmonary fibrous stripes, might indicate the possibility of COVID-19 to the radiologists.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-313391

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spreads rapidly and has attracted worldwide attention. Methods: : To improve the forecast accuracy and investigate the spread of SARS-CoV-2, we constructed four mathematical models to numerically estimate the spread of SARS-CoV-2 and the efficacy of eradication strategies. Results: : Using the Susceptible-Exposed-Infected-Removed (SEIR) model, and including measures such as city closures and extended leave policies implemented by the Chinese government that effectively reduced the β value, we estimated that the β value and basic transmission number, R 0 , of SARS-CoV-2 was 0.476/6.66 in Wuhan, 0.359/5.03 in Korea, and 0.400/5.60 in Italy. Considering medicine and vaccines, an advanced model demonstrated that the emergence of vaccines would greatly slow the spread of the virus. Our model predicted that 100,000 people would become infected assuming that the isolation rate α in Wuhan was 0.30. If quarantine measures were taken from March 10, 2020, and the quarantine rate of α was also 0.3, then the final number of infected people was predicted to be 11,426 in South Korea and 147,142 in Italy. Conclusions: : Our mathematical models indicate that SARS-CoV-2 eradication depends on systematic planning, effective hospital isolation, and SARS-CoV-2 vaccination, and some measures including city closures and leave policies should be implemented to ensure SARS-CoV-2 eradication.

10.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-328671

ABSTRACT

An ultrasensitive assay for the detection of antibodies to SARS-CoV-2 is critically needed for evaluating the adaptive humoral immune response and infection rates in immunocompromised subpopulations. Here, we report an Ultrasensitive CRISPR-based Antibody Detection (UCAD) assay that translates the detection of serum antibodies against the receptor binding domain (RBD) of SARS-CoV-2 spike protein into CRISPR-based nucleic acid testing in a homogeneous solution and is thus 10,000 times more sensitive than the commercial immunoassay. The UCAD assay, which has been validated with 65 clinical anti-RBD-positive and 72 anti-RBD-negative sera collected from the general population, achieves 100% sensitivity and 97.2% specificity. We finally deployed UCAD to evaluate the levels of serum anti-RBD IgG and IgM in a cohort of 85 vaccinated kidney transplant recipients (KTRs), an especially vulnerable patient population with reported seroconversion rates of only 4-48%. Among the 85 vaccinated KTRs, UCAD successfully identified 68 seroconversion positive sera that were previously determined to contain “undetectable” levels of anti-SARS-CoV-2 using a clinical chemiluminescent immunoassay (CLIA) and has revealed significant differences in the levels of plasmablasts, type-2 T helper (Th2) cells, and type-17 T helper (Th17) cells between the UCAD-identified seroconversion positive and negative groups. As UCAD is a solution-based ultrasensitive assay that does not require specialized equipment or tedious operational and washing steps, we anticipate that it will find wide applications for clinical uses in both centralized laboratories and point-of-care settings.

11.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-326156

ABSTRACT

Ultraviolet-C light-emitting diodes (UVC-LEDs) have great application in pathogen inactivation under various kinds of situations, especially in the fight against the COVID-19. Unfortunately, its epitaxial wafers are so far limited to 2-inch size, which greatly increases the cost of massive production. In this work, we report the 4-inch crack-free high-power UVC-LED wafer. This achievement relies on a proposed strain-tailored strategy, where a three-dimensional to two-dimensional (3D-2D) transition layer is introduced during the homo-epitaxy of AlN on high temperature annealed (HTA)-AlN template, which successfully drives the original compressive strain into tensile one and thus solves the challenge of realizing high quality Al$_{0.6}$Ga$_{0.4}$N layer with a flat surface. This smooth Al$_{0.6}$Ga$_{0.4}$N layer is nearly pseudomorphically grown on the strain-tailored HTA-AlN template, leading to 4-inch UVC-LED wafers with outstanding performances. Our strategy succeeds in compromising the bottlenecked contradictory in producing large-sized UVC-LED wafer on pronounced crystalline AlN template: The compressive strain in HTA-AlN allows for crack-free 4-inch wafer, but at the same time leads to a deterioration of the AlGaN morphology and crystal quality. The launch of 4-inch wafers makes the chip fabrication process of UVC-LEDs matches the mature blue one, and will definitely speed up the universal of UVC-LED in daily life.

12.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324964

ABSTRACT

Background: COVID-19 had caused more than 2.8 million deaths globally, and the epidemic will persist for an extended period of time. We analyzed clinical features of patients in the early stage of the epidemic, so as to deepen the understanding of the disease. Methods: : In this retrospective study, we included 84 confirmed cases of COVID-19 during February 1, 2020 and March 31, 2020. Baseline data were used to classify patients as moderate (57%) or severe/critical based on Chinese protocol. We focused on analyzing the differences in chest computed tomography (CT) between the two groups. Results: Of the 84 cases, 50 were male and the median age was 69 years. 55 (65%) patients had comorbidities at admission, more in the severe/critical group (P=0.040). 94% patients had bilateral lesions on CT, up to 68% had lesions involving all lobes. Ground glass opacification (GGO) (96%), consolidation (44%), Linear opacities (50%) and Air bronchogram (23%) were the mainly lesions. The lesion was gradually absorbed over time, but imaging abnormalities can persist for a long time. Compared with moderate cases, the severe/critical group had more pulmonary consolidation changes (P=0.044) and significantly higher CT severity Score (CTSS) (P=0.040). Lymphocyte counts were significantly lower (P=0.011) and NLR were higher (P=0.029) in severe/critical cases. Conclusions: : Chest CT showed bilateral and multiple GGO and consolidation mainly. After treatment, pulmonary lesions were gradually absorbed over time, and imaging abnormalities can be persistent for a long time. Lung consolidation, CTSS, comorbidity, lymphocyte counts, and NLR may be predictors of severe COVID-19.

13.
Nat Commun ; 13(1): 320, 2022 01 18.
Article in English | MEDLINE | ID: covidwho-1632529

ABSTRACT

Pregnant women represent a high-risk population for severe/critical COVID-19 and mortality. However, the maternal-fetal immune responses initiated by SARS-CoV-2 infection, and whether this virus is detectable in the placenta, are still under investigation. Here we show that SARS-CoV-2 infection during pregnancy primarily induces unique inflammatory responses at the maternal-fetal interface, which are largely governed by maternal T cells and fetal stromal cells. SARS-CoV-2 infection during pregnancy is also associated with humoral and cellular immune responses in the maternal blood, as well as with a mild cytokine response in the neonatal circulation (i.e., umbilical cord blood), without compromising the T-cell repertoire or initiating IgM responses. Importantly, SARS-CoV-2 is not detected in the placental tissues, nor is the sterility of the placenta compromised by maternal viral infection. This study provides insight into the maternal-fetal immune responses triggered by SARS-CoV-2 and emphasizes the rarity of placental infection.


Subject(s)
COVID-19/immunology , Immunity/immunology , Infectious Disease Transmission, Vertical , Placenta/immunology , Pregnancy Complications, Infectious/immunology , SARS-CoV-2/immunology , Adult , COVID-19/blood , COVID-19/virology , Cytokines/blood , Cytokines/immunology , Cytokines/metabolism , Female , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Immunoglobulin M/blood , Immunoglobulin M/immunology , Infant, Newborn , Placenta/virology , Pregnancy , Pregnancy Complications, Infectious/blood , Pregnancy Complications, Infectious/virology , RNA, Viral/genetics , RNA, Viral/metabolism , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/genetics , SARS-CoV-2/physiology , Young Adult
14.
Innovation (N Y) ; 3(1): 100181, 2022 Jan 25.
Article in English | MEDLINE | ID: covidwho-1595417

ABSTRACT

Most COVID-19 convalescents can build effective anti-SARS-CoV-2 humoral immunity, but it remains unclear how long it can maintain and how efficiently it can prevent the reinfection of the emerging SARS-CoV-2 variants. Here, we tested the sera from 248 COVID-19 convalescents around 1 year post-infection in Wuhan, the earliest known epicenter. SARS-CoV-2 immunoglobulin G (IgG) was well maintained in most patients and potently neutralizes the infection of the original strain and the B.1.1.7 variant. However, varying degrees of immune escape was observed on the other tested variants in a patient-specific manner, with individuals showing remarkably broad neutralization potency. The immune escape can be largely attributed to several critical spike mutations. These results suggest that SARS-CoV-2 can elicit long-lasting immunity but this is escaped by the emerging variants.

15.
COVID ; 2(1):5-17, 2022.
Article in English | MDPI | ID: covidwho-1580968

ABSTRACT

Human coronaviruses (HCoVs) are associated with a range of respiratory symptoms. The discovery of severe acute respiratory syndrome (SARS)-CoV, Middle East respiratory syndrome, and SARS-CoV-2 pose a significant threat to human health. In this study, we developed a method (HCoV-MS) that combines multiplex PCR with matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS), to detect and differentiate seven HCoVs simultaneously. The HCoV-MS method had high specificity and sensitivity, with a 1–5 copies/reaction detection limit. To validate the HCoV-MS method, we tested 163 clinical samples, and the results showed good concordance with real-time PCR. Additionally, the detection sensitivity of HCoV-MS and real-time PCR was comparable. The HCoV-MS method is a sensitive assay, requiring only 1 μL of a sample. Moreover, it is a high-throughput method, allowing 384 samples to be processed simultaneously in 30 min. We propose that this method be used to complement real-time PCR for large-scale screening studies.

16.
Preprint in English | bioRxiv | ID: ppbiorxiv-470392

ABSTRACT

The SARS-CoV-2 B.1.1.529 variant (Omicron) contains 15 mutations on the receptor-binding domain (RBD). How Omicron would evade RBD neutralizing antibodies (NAbs) requires immediate investigation. Here, we used high-throughput yeast display screening1,2 to determine the RBD escaping mutation profiles for 247 human anti-RBD NAbs and showed that the NAbs could be unsupervised clustered into six epitope groups (A-F), which is highly concordant with knowledge-based structural classifications3-5. Strikingly, various single mutations of Omicron could impair NAbs of different epitope groups. Specifically, NAbs in Group A-D, whose epitope overlap with ACE2-binding motif, are largely escaped by K417N, G446S, E484A, and Q493R. Group E (S309 site)6 and F (CR3022 site)7 NAbs, which often exhibit broad sarbecovirus neutralizing activity, are less affected by Omicron, but still, a subset of NAbs are escaped by G339D, N440K, and S371L. Furthermore, Omicron pseudovirus neutralization showed that single mutation tolerating NAbs could also be escaped due to multiple synergetic mutations on their epitopes. In total, over 85% of the tested NAbs are escaped by Omicron. Regarding NAb drugs, the neutralization potency of LY-CoV016/LY-CoV555, REGN10933/REGN10987, AZD1061/AZD8895, and BRII-196 were greatly reduced by Omicron, while VIR-7831 and DXP-604 still function at reduced efficacy. Together, data suggest Omicron would cause significant humoral immune evasion, while NAbs targeting the sarbecovirus conserved region remain most effective. Our results offer instructions for developing NAb drugs and vaccines against Omicron and future variants.

17.
ISPRS International Journal of Geo-Information ; 10(9):627, 2021.
Article in English | MDPI | ID: covidwho-1430889

ABSTRACT

The Coronavirus disease 2019 (COVID-19) has been spreading in New York State since March 2020, posing health and socioeconomic threats to many areas. Statistics of daily confirmed cases and deaths in New York State have been growing and declining amid changing policies and environmental factors. Based on the county-level COVID-19 cases and environmental factors in the state from March to December 2020, this study investigates spatiotemporal clustering patterns using spatial autocorrelation and space-time scan analysis. Environmental factors influencing the COVID-19 spread were analyzed based on the Geodetector model. Infection clusters first appeared in southern New York State and then moved to the central western parts as the epidemic developed. The statistical results of space-time scan analysis are consistent with those of spatial autocorrelation analysis. The analysis results of Geodetector showed that both temperature and population density were strong indications of the monthly incidence of COVID-19, especially in March and April 2020. There is a trend of increasing interactions between various risk factors. This study explores the spatiotemporal pattern of COVID-19 in New York State over ten months and explains the relationship between the disease transmission and influencing factors.

18.
China Journal of Social Work ; : 1-33, 2021.
Article in English | Taylor & Francis | ID: covidwho-1142592
19.
Preprint in English | medRxiv | ID: ppmedrxiv-21253228

ABSTRACT

Inpatient COVID-19 cases present enormous costs to patients and health systems. Many hospitalized patients may still test COVID-19 positive, even after resolution of symptoms. Thus, a pressing concern for clinicians is the safety of discharging these asymptomatic patients if they have any remaining infectivity. This case report explores the viral viability in a patient with persistent COVID-19 over the course of a two-month hospitalization. Positive nasopharyngeal swab samples, analyzed by quantitative reverse transcription polymerase chain reactions (qRT-PCR), were collected and isolated in the laboratory, and infectious doses were analyzed throughout the hospitalization period. The patient experienced waning symptoms by hospital day 40 and had no viable virus growth in the laboratory by hospital day 41, suggesting no risk of infectivity, despite positive RT-PCR results, which prolonged his hospital stay. Notably, this case showed infectivity for at least 24 days from disease onset, which is longer than the discontinuation of transmission-based precautions recommendation by CDC. Thus, our findings suggest that the timeline for discontinuing transmission-based precautions may need to be extended for patients with prolonged illness. Additional large-scale studies are needed to draw definitive conclusions on the appropriate clinical management for these patients.

20.
Aging (Albany NY) ; 13(1): 27-60, 2020 12 31.
Article in English | MEDLINE | ID: covidwho-1068117

ABSTRACT

The COVID-19 pandemic causes severe morbidity and mortality. This multi-country study aimed to explore risk factors that drive mortality in COVID-19 patients who received neither dexamethasone nor remdesivir. We analyzed a cohort of 568 survivors and 507 non-survivors from China, European regions, and North America. Elderly males ≥70 years accounted for only 25% of survivors, but this rate was significantly higher in non-survivors from China (55%), European regions (63%), and North America (47%). Compared with survivors, non-survivors had more incidences of comorbidities such as cerebrovascular disease and chronic obstructive pulmonary disease (COPD, p-values<0.05). Survival analyses revealed age, male gender, shortness of breath, cerebrovascular disease, and COPD as mortality-associated factors. Survival time from symptom onset was significantly shorter in elderly versus young patients (median: 29 versus 62 days), males versus females (median: 46 versus 59 days), and patients with versus without comorbidities (mean: 41 versus 61 days). Mortality risk was higher in elderly males with comorbidities than in young females without comorbidities (p-value<0.01). Elderly male survivors with comorbidities also had longer hospital stays than other survivors (25 versus 18.5 days, p-value<0.01). Overall, the high mortality risk in elderly males with COVID-19-associated comorbidities supports early prevention and critical care for elderly populations.


Subject(s)
Aging , COVID-19/complications , COVID-19/mortality , Cardiovascular Diseases/complications , SARS-CoV-2 , Tuberculosis/complications , Adolescent , Adult , Aged , COVID-19/epidemiology , Cerebrovascular Disorders/complications , Child , Child, Preschool , Cohort Studies , Comorbidity , Female , Global Health , Humans , Infant , Liver Diseases/complications , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/complications , Respiratory Tract Diseases/complications , Risk Factors , Young Adult
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