Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 25
Filter
1.
Jpn J Infect Dis ; 75(2): 209-211, 2022 Mar 24.
Article in English | MEDLINE | ID: covidwho-1761196

ABSTRACT

Nonpharmaceutical interventions (NPIs) for COVID-19 can affect the current and future dynamics of respiratory syncytial virus infections (RSV). In Tokyo, RSV activity declined by 97.9% (95% CI: 94.8%-99.2%) during NPIs. A long period of NPIs could increase susceptible populations, thus enhancing the potential for large RSV outbreaks after the end of NPIs.


Subject(s)
COVID-19 , Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , COVID-19/epidemiology , Disease Outbreaks , Humans , Infant , Japan/epidemiology , Pandemics/prevention & control , Respiratory Syncytial Virus Infections/epidemiology , SARS-CoV-2 , Tokyo/epidemiology
2.
Environ Res ; : 113134, 2022 Mar 17.
Article in English | MEDLINE | ID: covidwho-1748017

ABSTRACT

Numerous studies have been conducted worldwide to investigate if an association exists between meteorological factors and the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection incidence. Although research studies provide conflicting results, which can be partially explained by different methods used, some clear trends emerge on the role of weather conditions and SARS-CoV-2 infection, especially for temperature and humidity. This study sheds more light on the relationship between meteorological factors and SARS-CoV-2 infection incidence in 23 Italian and 52 Spanish cities. For the purposes of this study, daily air temperature, absolute and relative humidity, wind speed, ultraviolet radiation, and rainfall are considered exposure variables. We conducted a two-stage meta-regression. In the first stage, we estimated the exposure-response association through time series regression analysis at the municipal level. In the second stage, we pooled the association parameters using a meta-analytic model. The study demonstrates an association between meteorological factors and SARS-CoV-2 infection incidence. Specifically, low levels of ambient temperatures and absolute humidity were associated with an increased relative risk. On the other hand, low and high levels of relative humidity and ultraviolet radiation were associated with a decreased relative risk. Concerning wind speed and rainfall, higher values contributed to the reduction of the risk of infection. Overall, our results contribute to a better understanding of how the meteorological factors influence the spread of the SARS-CoV-2 and should be considered in a wider context of existing robust literature that highlight the importance of measures such as social distancing, improved hygiene, face masks and vaccination campaign.

4.
Clin Infect Dis ; 73(11): e4073-e4081, 2021 12 06.
Article in English | MEDLINE | ID: covidwho-1560481

ABSTRACT

BACKGROUND: No effective treatments for coronavirus disease 2019 (COVID-19) exist. We aimed to determine whether early treatment with hydroxychloroquine (HCQ) would be efficacious for outpatients with COVID-19. METHODS: Multicenter open-label, randomized, controlled trial conducted in Catalonia, Spain, between 17 March and 26 May 2020. Patients recently diagnosed with <5-day of symptom onset were assigned to receive HCQ (800 mg on day 1 followed by 400 mg once daily for 6 days) or usual care. Outcomes were reduction of viral load in nasopharyngeal swabs up to 7 days after treatment start, disease progression up to 28 days, and time to complete resolution of symptoms. Adverse events were assessed up to 28 days. RESULTS: A total of 293 patients were eligible for intention-to-treat analysis: 157 in the control arm and 136 in the intervention arm. The mean age was 41.6 years (SD, 12.6), mean viral load at baseline was 7.90 log10 copies/mL (SD, 1.82), and median time from symptom onset to randomization was 3 days. No differences were found in the mean reduction of viral load at day 3 (-1.41 vs -1.41 log10 copies/mL in the control and intervention arm, respectively) or at day 7 (-3.37 vs -3.44). Treatment did not reduce risk of hospitalization (7.1% control vs 5.9% intervention) nor shorten the time to complete resolution of symptoms (12 days, control vs 10 days, intervention). No relevant adverse events were reported. CONCLUSIONS: In patients with mild COVID-19, no benefit was observed with HCQ beyond the usual care.


Subject(s)
COVID-19 , Hydroxychloroquine , Adult , COVID-19/drug therapy , Humans , Hydroxychloroquine/therapeutic use , SARS-CoV-2 , Treatment Outcome
5.
Lancet Infect Dis ; 21(5): 629-636, 2021 05.
Article in English | MEDLINE | ID: covidwho-1510471

ABSTRACT

BACKGROUND: Scarce data are available on what variables affect the risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the development of symptomatic COVID-19, and, particularly, the relationship with viral load. We aimed to analyse data from linked index cases of COVID-19 and their contacts to explore factors associated with transmission of SARS-CoV-2. METHODS: In this cohort study, patients were recruited as part of a randomised controlled trial done between March 17 and April 28, 2020, that aimed to assess if hydroxychloroquine reduced transmission of SARS-CoV-2. Patients with COVID-19 and their contacts were identified by use of the electronic registry of the Epidemiological Surveillance Emergency Service of Catalonia (Spain). Patients with COVID-19 included in our analysis were aged 18 years or older, not hospitalised, had quantitative PCR results available at baseline, had mild symptom onset within 5 days before enrolment, and had no reported symptoms of SARS-CoV-2 infections in their accommodation or workplace within the 14 days before enrolment. Contacts included were adults with a recent history of exposure and absence of COVID-19-like symptoms within the 7 days preceding enrolment. Viral load of contacts, measured by quantitative PCR from a nasopharyngeal swab, was assessed at enrolment, at day 14, and whenever the participant reported COVID-19-like symptoms. We assessed risk of transmission and developing symptomatic disease and incubation dynamics using regression analysis. We assessed the relationship of viral load and characteristics of cases (age, sex, number of days from reported symptom onset, and presence or absence of fever, cough, dyspnoea, rhinitis, and anosmia) and associations between risk of transmission and characteristics of the index case and contacts. FINDINGS: We identified 314 patients with COVID-19, with 282 (90%) having at least one contact (753 contacts in total), resulting in 282 clusters. 90 (32%) of 282 clusters had at least one transmission event. The secondary attack rate was 17% (125 of 753 contacts), with a variation from 12% when the index case had a viral load lower than 1 × 106 copies per mL to 24% when the index case had a viral load of 1 × 1010 copies per mL or higher (adjusted odds ratio per log10 increase in viral load 1·3, 95% CI 1·1-1·5). Increased risk of transmission was also associated with household contact (3·0, 1·59-5·65) and age of the contact (per year: 1·02, 1·01-1·04). 449 contacts had a positive PCR result at baseline. 28 (6%) of 449 contacts had symptoms at the first visit. Of 421 contacts who were asymptomatic at the first visit, 181 (43%) developed symptomatic COVID-19, with a variation from approximately 38% in contacts with an initial viral load lower than 1 × 107 copies per mL to greater than 66% for those with an initial viral load of 1 × 1010 copies per mL or higher (hazard ratio per log10 increase in viral load 1·12, 95% CI 1·05-1·20; p=0·0006). Time to onset of symptomatic disease decreased from a median of 7 days (IQR 5-10) for individuals with an initial viral load lower than 1 × 107 copies per mL to 6 days (4-8) for those with an initial viral load between 1 × 107 and 1 × 109 copies per mL, and 5 days (3-8) for those with an initial viral load higher than 1 × 109 copies per mL. INTERPRETATION: In our study, the viral load of index cases was a leading driver of SARS-CoV-2 transmission. The risk of symptomatic COVID-19 was strongly associated with the viral load of contacts at baseline and shortened the incubation time of COVID-19 in a dose-dependent manner. FUNDING: YoMeCorono, Generalitat de Catalunya. TRANSLATIONS: For the Catalan translation of the abstract see Supplementary Materials section.


Subject(s)
COVID-19/transmission , SARS-CoV-2 , Adult , COVID-19/epidemiology , Cohort Studies , Female , Humans , Incidence , Male , Middle Aged , Spain/epidemiology , Viral Load
6.
Nat Commun ; 12(1): 5968, 2021 10 13.
Article in English | MEDLINE | ID: covidwho-1467102

ABSTRACT

There is conflicting evidence on the influence of weather on COVID-19 transmission. Our aim is to estimate weather-dependent signatures in the early phase of the pandemic, while controlling for socio-economic factors and non-pharmaceutical interventions. We identify a modest non-linear association between mean temperature and the effective reproduction number (Re) in 409 cities in 26 countries, with a decrease of 0.087 (95% CI: 0.025; 0.148) for a 10 °C increase. Early interventions have a greater effect on Re with a decrease of 0.285 (95% CI 0.223; 0.347) for a 5th - 95th percentile increase in the government response index. The variation in the effective reproduction number explained by government interventions is 6 times greater than for mean temperature. We find little evidence of meteorological conditions having influenced the early stages of local epidemics and conclude that population behaviour and government interventions are more important drivers of transmission.


Subject(s)
COVID-19/transmission , Meteorological Concepts , SARS-CoV-2/pathogenicity , Basic Reproduction Number , COVID-19/epidemiology , Cities , Cross-Sectional Studies , Humans , Meta-Analysis as Topic , Pandemics , Regression Analysis , Seasons , Temperature , Weather
7.
Jpn J Infect Dis ; 75(2): 209-211, 2022 Mar 24.
Article in English | MEDLINE | ID: covidwho-1389796

ABSTRACT

Nonpharmaceutical interventions (NPIs) for COVID-19 can affect the current and future dynamics of respiratory syncytial virus infections (RSV). In Tokyo, RSV activity declined by 97.9% (95% CI: 94.8%-99.2%) during NPIs. A long period of NPIs could increase susceptible populations, thus enhancing the potential for large RSV outbreaks after the end of NPIs.


Subject(s)
COVID-19 , Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , COVID-19/epidemiology , Disease Outbreaks , Humans , Infant , Japan/epidemiology , Pandemics/prevention & control , Respiratory Syncytial Virus Infections/epidemiology , SARS-CoV-2 , Tokyo/epidemiology
9.
Sci Total Environ ; 726: 138540, 2020 Jul 15.
Article in English | MEDLINE | ID: covidwho-1386594

ABSTRACT

Lockdown measures came into force in Spain from March 14th, two weeks after the start of the SARS-CoV-2 epidemic, to reduce the epidemic curve. Our study aims to describe changes in air pollution levels during the lockdown measures in the city of Barcelona (NE Spain), by studying the time evolution of atmospheric pollutants recorded at the urban background and traffic air quality monitoring stations. After two weeks of lockdown, urban air pollution markedly decreased but with substantial differences among pollutants. The most significant reduction was estimated for BC and NO2 (-45 to -51%), pollutants mainly related to traffic emissions. A lower reduction was observed for PM10 (-28 to -31.0%). By contrast, O3 levels increased (+33 to +57% of the 8 h daily maxima), probably due to lower titration of O3 by NO and the decrease of NOx in a VOC-limited environment. Relevant differences in the meteorology of these two periods were also evidenced. The low reduction for PM10 is probably related to a significant regional contribution and the prevailing secondary origin of fine aerosols, but an in-depth evaluation has to be carried out to interpret this lower decrease. There is no defined trend for the low SO2 levels, probably due to the preferential reduction in emissions from the least polluting ships. A reduction of most pollutants to minimal concentrations are expected for the forthcoming weeks because of the more restrictive actions implemented for a total lockdown, which entered into force on March 30th. There are still open questions on why PM10 levels were much less reduced than BC and NO2 and on what is the proportion of the abatement of pollution directly related to the lockdown, without meteorological interferences.


Subject(s)
Air Pollution , Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Air Pollutants , COVID-19 , Environmental Monitoring , Particulate Matter , SARS-CoV-2 , Spain
10.
Lancet ; 395(10238): 1705-1714, 2020 05 30.
Article in English | MEDLINE | ID: covidwho-1217628

ABSTRACT

BACKGROUND: Concerns have been raised about the possibility that inhibitors of the renin-angiotensin-aldosterone system (RAAS) could predispose individuals to severe COVID-19; however, epidemiological evidence is lacking. We report the results of a case-population study done in Madrid, Spain, since the outbreak of COVID-19. METHODS: In this case-population study, we consecutively selected patients aged 18 years or older with a PCR-confirmed diagnosis of COVID-19 requiring admission to hospital from seven hospitals in Madrid, who had been admitted between March 1 and March 24, 2020. As a reference group, we randomly sampled ten patients per case, individually matched for age, sex, region (ie, Madrid), and date of admission to hospital (month and day; index date), from Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria (BIFAP), a Spanish primary health-care database, in its last available year (2018). We extracted information on comorbidities and prescriptions up to the month before index date (ie, current use) from electronic clinical records of both cases and controls. The outcome of interest was admission to hospital of patients with COVID-19. To minimise confounding by indication, the main analysis focused on assessing the association between COVID-19 requiring admission to hospital and use of RAAS inhibitors compared with use of other antihypertensive drugs. We calculated odds ratios (ORs) and 95% CIs, adjusted for age, sex, and cardiovascular comorbidities and risk factors, using conditional logistic regression. The protocol of the study was registered in the EU electronic Register of Post-Authorisation Studies, EUPAS34437. FINDINGS: We collected data for 1139 cases and 11 390 population controls. Among cases, 444 (39·0%) were female and the mean age was 69·1 years (SD 15·4), and despite being matched on sex and age, a significantly higher proportion of cases had pre-existing cardiovascular disease (OR 1·98, 95% CI 1·62-2·41) and risk factors (1·46, 1·23-1·73) than did controls. Compared with users of other antihypertensive drugs, users of RAAS inhibitors had an adjusted OR for COVID-19 requiring admission to hospital of 0·94 (95% CI 0·77-1·15). No increased risk was observed with either angiotensin-converting enzyme inhibitors (adjusted OR 0·80, 0·64-1·00) or angiotensin-receptor blockers (1·10, 0·88-1·37). Sex, age, and background cardiovascular risk did not modify the adjusted OR between use of RAAS inhibitors and COVID-19 requiring admission to hospital, whereas a decreased risk of COVID-19 requiring admission to hospital was found among patients with diabetes who were users of RAAS inhibitors (adjusted OR 0·53, 95% CI 0·34-0·80). The adjusted ORs were similar across severity degrees of COVID-19. INTERPRETATION: RAAS inhibitors do not increase the risk of COVID-19 requiring admission to hospital, including fatal cases and those admitted to intensive care units, and should not be discontinued to prevent a severe case of COVID-19. FUNDING: Instituto de Salud Carlos III.


Subject(s)
Angiotensin Receptor Antagonists/adverse effects , Angiotensin-Converting Enzyme Inhibitors/adverse effects , Antihypertensive Agents/adverse effects , Coronavirus Infections/epidemiology , Hospitalization/statistics & numerical data , Pneumonia, Viral/epidemiology , Renin-Angiotensin System , Aged , Aged, 80 and over , COVID-19 , Comorbidity , Coronavirus Infections/complications , Female , Humans , Male , Middle Aged , Mineralocorticoid Receptor Antagonists/adverse effects , Pandemics , Pneumonia, Viral/complications , Renin/antagonists & inhibitors , Risk Factors , Spain/epidemiology
11.
Environ Epidemiol ; 5(2): e146, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1191614

ABSTRACT

Supplemental Digital Content is available in the text.

12.
Air Qual Atmos Health ; 14(7): 1071-1079, 2021.
Article in English | MEDLINE | ID: covidwho-1173996

ABSTRACT

The preventive and cautionary measures taken by the UAE and Abu Dhabi governments to reduce the spread of the coronavirus disease (COVID-19) and promote social distancing have led to a reduction of mobility and a modification of economic and social activities. This paper provides statistical analysis of the air quality data monitored by the Environment Agency - Abu Dhabi (EAD) during the first 10 months of 2020, comparing the different stages of the preventive measures. Ground monitoring data is compared with satellite images and mobility indicators. The study shows a drastic decrease during lockdown in the concentration of the gaseous pollutants analysed (NO2, SO2, CO, and C6H6) that aligns with the results reported in other international cities and metropolitan areas. However, particulate matter (PM10 and PM2.5) averaged concentrations followed a markedly different trend from the gaseous pollutants, indicating a larger influence from natural events (sand and dust storms) and other anthropogenic sources. The ozone (O3) levels increased during the lockdown, showing the complexity of O3 formation. The end of lockdown led to an increase of the mobility and the air pollution; however, air pollutant concentrations remained in lower levels than during the same period of 2019. The results in this study show the large impact of human activities on the quality of air and present an opportunity for policymakers and decision-makers to design stimulus packages to overcome the economic slow-down, with strategies to accelerate the transition to resilient, low-emission economies and societies more connected to the nature that protect human health and the environment. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11869-021-01000-2.

13.
One Health ; 12: 100239, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1157643

ABSTRACT

The transmission of coronaviruses can be affected by several factors, including the climate. Due to the rapid spread of COVID-19 and the urgent need for rapid responses to contain the pandemic, it is essential to understand the role that weather conditions on the transmission of SARS-CoV-2. We evaluate the influence of meteorological factors on the incidence of COVID-19 during the first wave of the epidemic in Catalonia. We conducted a geographical analysis at the county level to evaluate the association between mean temperature, absolute humidity, solar radiation, and the cumulative incidence of COVID-19. Next, we used a time-series design to assess the short-term effects of meteorological factors on the daily incidence of COVID-19. We found a geographical association between meteorological factors and the cumulative incidence of COVID-19, from the end of March to June 2020, and a lesser extent in the short-term on the daily incidence during the first wave of the epidemic in Spain. Our findings suggest that warm and wet climates may reduce the incidence of COVID-19 in Catalonia. However, policy makers must interpret with caution any COVID-19 risk predictions based on climate information alone.

14.
N Engl J Med ; 384(5): 417-427, 2021 02 04.
Article in English | MEDLINE | ID: covidwho-963653

ABSTRACT

BACKGROUND: Current strategies for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are limited to nonpharmacologic interventions. Hydroxychloroquine has been proposed as a postexposure therapy to prevent coronavirus disease 2019 (Covid-19), but definitive evidence is lacking. METHODS: We conducted an open-label, cluster-randomized trial involving asymptomatic contacts of patients with polymerase-chain-reaction (PCR)-confirmed Covid-19 in Catalonia, Spain. We randomly assigned clusters of contacts to the hydroxychloroquine group (which received the drug at a dose of 800 mg once, followed by 400 mg daily for 6 days) or to the usual-care group (which received no specific therapy). The primary outcome was PCR-confirmed, symptomatic Covid-19 within 14 days. The secondary outcome was SARS-CoV-2 infection, defined by symptoms compatible with Covid-19 or a positive PCR test regardless of symptoms. Adverse events were assessed for up to 28 days. RESULTS: The analysis included 2314 healthy contacts of 672 index case patients with Covid-19 who were identified between March 17 and April 28, 2020. A total of 1116 contacts were randomly assigned to receive hydroxychloroquine and 1198 to receive usual care. Results were similar in the hydroxychloroquine and usual-care groups with respect to the incidence of PCR-confirmed, symptomatic Covid-19 (5.7% and 6.2%, respectively; risk ratio, 0.86 [95% confidence interval, 0.52 to 1.42]). In addition, hydroxychloroquine was not associated with a lower incidence of SARS-CoV-2 transmission than usual care (18.7% and 17.8%, respectively). The incidence of adverse events was higher in the hydroxychloroquine group than in the usual-care group (56.1% vs. 5.9%), but no treatment-related serious adverse events were reported. CONCLUSIONS: Postexposure therapy with hydroxychloroquine did not prevent SARS-CoV-2 infection or symptomatic Covid-19 in healthy persons exposed to a PCR-positive case patient. (Funded by the crowdfunding campaign YoMeCorono and others; BCN-PEP-CoV2 ClinicalTrials.gov number, NCT04304053.).


Subject(s)
Anti-Infective Agents/therapeutic use , COVID-19/prevention & control , Hydroxychloroquine/therapeutic use , SARS-CoV-2 , Adult , Anti-Infective Agents/adverse effects , COVID-19/transmission , COVID-19/virology , Disease Transmission, Infectious/prevention & control , Double-Blind Method , Female , Humans , Hydroxychloroquine/adverse effects , Male , Middle Aged , Patient Compliance , Treatment Failure , Viral Load
18.
BMC Med Res Methodol ; 20(1): 235, 2020 09 21.
Article in English | MEDLINE | ID: covidwho-781441

ABSTRACT

BACKGROUND: Data analysis and visualization is an essential tool for exploring and communicating findings in medical research, especially in epidemiological surveillance. RESULTS: Data on COVID-19 diagnosed cases and mortality, from January 1st, 2020, onwards is collected automatically from the European Centre for Disease Prevention and Control (ECDC). We have developed a Shiny application for data visualization and analysis of several indicators to follow the SARS-CoV-2 epidemic using ECDC data. A country-specific tool for basic epidemiological surveillance, in an interactive and user-friendly manner. The available analyses cover time trends and projections, attack rate, population fatality rate, case fatality rate, and basic reproduction number. CONCLUSIONS: The COVID19-World online web application systematically produces daily updated country-specific data visualization and analysis of the SARS-CoV-2 epidemic worldwide. The application may help for a better understanding of the SARS-CoV-2 epidemic worldwide.


Subject(s)
Betacoronavirus/isolation & purification , Computational Biology/statistics & numerical data , Coronavirus Infections/epidemiology , Data Visualization , Pandemics , Pneumonia, Viral/epidemiology , Algorithms , Betacoronavirus/physiology , COVID-19 , Computational Biology/methods , Coronavirus Infections/transmission , Coronavirus Infections/virology , Europe/epidemiology , Global Health/statistics & numerical data , Humans , Incidence , Internet , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Population Surveillance/methods , SARS-CoV-2
19.
Environ Res ; 191: 110177, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-753601

ABSTRACT

BACKGROUND: The risk of infection and death by COVID-19 could be associated with a heterogeneous distribution at a small area level of environmental, socioeconomic and demographic factors. Our objective was to investigate, at a small area level, whether long-term exposure to air pollutants increased the risk of COVID-19 incidence and death in Catalonia, Spain, controlling for socioeconomic and demographic factors. METHODS: We used a mixed longitudinal ecological design with the study population consisting of small areas in Catalonia for the period February 25 to May 16, 2020. We estimated Generalized Linear Mixed models in which we controlled for a wide range of observed and unobserved confounders as well as spatial and temporal dependence. RESULTS: We have found that long-term exposure to nitrogen dioxide (NO2) and, to a lesser extent, to coarse particles (PM10) have been independent predictors of the spatial spread of COVID-19. For every 1 µm/m3 above the mean the risk of a positive test case increased by 2.7% (95% credibility interval, ICr: 0.8%, 4.7%) for NO2 and 3.0% (95% ICr: -1.4%,7.44%) for PM10. Regions with levels of NO2 exposure in the third and fourth quartile had 28.8% and 35.7% greater risk of a death, respectively, than regions located in the first two quartiles. CONCLUSION: Although it is possible that there are biological mechanisms that explain, at least partially, the association between long-term exposure to air pollutants and COVID-19, we hypothesize that the spatial spread of COVID-19 in Catalonia is attributed to the different ease with which some people, the hosts of the virus, have infected others. That facility depends on the heterogeneous distribution at a small area level of variables such as population density, poor housing and the mobility of its residents, for which exposure to pollutants has been a surrogate.


Subject(s)
Air Pollutants , Air Pollution , Coronavirus Infections , Pandemics , Pneumonia, Viral , Air Pollutants/analysis , Air Pollutants/toxicity , Air Pollution/adverse effects , Air Pollution/analysis , Betacoronavirus , COVID-19 , Environmental Exposure/analysis , Humans , Nitrogen Dioxide/analysis , Nitrogen Dioxide/toxicity , Particulate Matter/analysis , Particulate Matter/toxicity , SARS-CoV-2 , Spain/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL