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1.
Sci Rep ; 10(1): 15058, 2020 Sep 14.
Article in English | MEDLINE | ID: covidwho-766138

ABSTRACT

Coronavirus disease 2019 (COVID-19) is an important and urgent threat to global health. Inflammation factors are important for COVID-19 mortality, and we aim to explore whether the baseline levels of procalcitonin (PCT), C-reaction protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) are associated with an increased risk of mortality in patients with COVID-19. A retrospective study was conducted and a total of 76 patients with confirmed COVID-19 were included between January 17, 2020 to March 2, 2020, of these cases, 17 patients were dead. After adjusting covariates, PCT (≥ 0.10 ng/mL) and CRP (≥ 52.14 mg/L) exhibited independent increasing risks of mortality were used hazard ratio (HR) of 52.68 (95% confidence interval [CI]: 1.77-1571.66) and 5.47 (95% CI: 1.04-28.72), respectively. However, NRL (≥ 3.59) was not found to be an independent risk factor for death in our study. Furthermore, the elevated PCT levels were still associated with increasing risk of mortality in the old age group (age ≥ 60 y), and in the critically severe and severe patients after adjustment for complications. Thu Baseline levels of PCT and CRP have been addressed as independent predictors of mortality in patients with COVID-19.

2.
J Med Virol ; 2020 Sep 05.
Article in English | MEDLINE | ID: covidwho-743672

ABSTRACT

Coronavirus disease 2019 (COVID-19) poses a serious threat to human health and lives. The virus is still spreading throughout the world, and the cumulative number of confirmed cases is increasing. After patients with COVID-19 are treated and discharged, some have repeated clinical symptoms and become positive for nucleic acid tests a second time. Through analysis and review of the existing literature, the proportion of re-positive patients in the discharged patient population and their clinical characteristics were systematically described for the first time. Furthermore, an in-depth analysis of the causes of re-positive nucleic acid tests and the potential transmission of the disease provides the basis for the management and protection of discharged patients with COVID-19. This article is protected by copyright. All rights reserved.

3.
Media Int. Aust. ; 2020.
Article in English | ELSEVIER | ID: covidwho-719497

ABSTRACT

During the recent outbreak of coronavirus, the concern about proliferation of misleading information, rumours and myths has caused governments across the world to institute various interventionist steps to stem their flow. Each government has had to balance the dichotomy between freedom of expression and people’s right to be safe from the adverse impact of inaccurate information. Governments across the world have implemented a number of strategies to manage COVID-19 including issuing public advisories, advertising campaigns, holding press conferences and instituting punitive regulations to combat the distribution of false and misleading information. We examine the two most populous countries’ governments’ response to the scourge of fake news during COVID-19. China and India are the most challenging nations to govern in terms of their sheer size and diversity of their population. Each country’s government has taken several steps to minimise the impact of fake news during COVID, within its own political system.

4.
Int Breastfeed J ; 15(1): 68, 2020 08 06.
Article in English | MEDLINE | ID: covidwho-696998

ABSTRACT

BACKGROUND: In China, mothers with confirmed or suspected COVID-19 pneumonia are recommended to stop breastfeeding. However, the evidence to support this guidance is lacking. There have been relatively few cases reported about direct breastfeeding an infant by a mother with SARS-CoV-2 pneumonia. Therefore, it is necessary to assess the safety of breastfeeding and the possible protective effects of breast milk on infants. CASE PRESENTATION: This report analyzes the case of a mother who continued breastfeeding her 13 month-old child when both were diagnosed with confirmed COVID-19 pneumonia. We describe the clinical presentation, diagnosis, treatment, and outcome. The presence of SARS-CoV-2 nucleic acid was determined in maternal serum, breast milk, nasopharyngeal (NP) swabs and feces, and in infant serum, NP swabs and feces. IgM and IgG antibodies against SARS-CoV-2 were assessed in maternal serum and breast milk and in infant serum. SARS-CoV-2 nucleic acid was not detected in the breast milk, and antibodies against SARS-CoV-2 were detected in the mother's serum and milk. CONCLUSIONS: The present case further confirms that the possibility of mother-to-child transmission about SARS-CoV-2 via breast milk alone was very small, and breast milk is safe for direct feeding of infants.


Subject(s)
Antibodies, Viral/analysis , Betacoronavirus/isolation & purification , Breast Feeding , Coronavirus Infections/transmission , Milk, Human/virology , Pneumonia, Viral/transmission , Coronavirus Infections/prevention & control , Female , Humans , Infant , Infectious Disease Transmission, Vertical , Pandemics/prevention & control , Pneumonia, Viral/prevention & control
5.
JAMA Netw Open ; 3(7): e2016924, 2020 07 01.
Article in English | MEDLINE | ID: covidwho-684790

ABSTRACT

Importance: There is insufficient evidence on the efficacy of masks in the general population for the prevention of coronavirus disease 2019 (COVID-19) in public areas. Therefore, it is imperative to investigate the association of mandatory mask-wearing policies with behaviors associated with the transmission of COVID-19. Objective: To assess the association of mask wearing with face-touching behavior among the general population in public areas. Design, Setting, and Participants: This cross-sectional study used videos recorded in public transportation stations, streets, and parks among the general population in China, Japan, South Korea, Western Europe (ie, England, France, Germany, Spain, and Italy), and the US to analyze mask-wearing and face-touching behavior in public areas. Videos before the COVID-19 pandemic were defined as those recorded from January 2018 to October 2019, and those during the COVID-19 pandemic were defined as those recorded during February 2020 to March 2020 in China, Japan, and South Korea and during March 2020 in Western Europe and the US. Individuals who clearly displayed their face and face-touching behavior were included, and those whose behaviors were influenced by filming or public events were excluded. Exposures: Mandatory mask-wearing policies enacted at various time points in China, Japan, South Korea, Western Europe, and the US. Main Outcomes and Measures: Proportion of individuals wearing masks and incidence of face touching. Results: This study included 4699 individuals before the COVID-19 pandemic and 2887 individuals during the pandemic. During the periods studied, mask wearing increased in all regions except the US, from 20 of 1745 individuals (1.1%) to 1090 of 1097 individuals (99.4%) in mainland China (P < .001), 44 of 1422 individuals (3.1%) to 346 of 893 individuals (38.7%) in Japan (P < .001), 6 of 717 individuals (0.8%) to 277 of 324 individuals (85.5% ) in South Korea (P < .001), 1 of 546 individuals (0.2%) to 6 of 379 individuals (1.6%) in Western Europe (P = .02), and 1 of 269 individuals (0.4%) to 4 of 194 individuals (2.1%) in the US (P = .17). Surgical masks were predominant in China (989 masks [89.1%]), and fabric masks were predominant in the other regions (Japan: 371 masks [95.1%]; South Korea: 240 masks [84.8%]; Western Europe: 6 masks [85.7%]; US: 5 masks [100%]). Face-touching behaviors decreased from before COVID-19 to during COVID-19 among individuals in China (72 incidences of 1745 observations [4.1%] to 12 incidences of 1097 observations [1.1%]; P < .001), South Korea (80 incidences of 717 observations [11.2%] to 7 incidences of 324 observations [2.2%]; P < .001), and Europe (62 incidences of 546 observations [11.4%] to 23 incidences of 379 observations [6.1%]; P = .01). Logistic regression found that mask wearing was associated with a reduction in face touching in China (odds ratio [OR], 3.91; 95% CI, 2.11-7.24) and South Korea (OR, 6.69; 95% CI, 2.69-16.69) and of touching the nose, mouth, and eyes (China: OR, 8.60; 95% CI, 2.65-27.86; South Korea: OR, 29.27; 95% CI, 1.79-478.22). Conclusions and Relevance: The findings of this cross-sectional study suggest that mandatory mask-wearing policies were associated with increased mask wearing during the COVID-19 pandemic. Mask wearing was associated with reduced face-touching behavior, especially touching of the eyes, nose, and mouth, which may prevent contact transmission of COVID-19 among the general population in public areas.


Subject(s)
Coronavirus Infections/transmission , Disease Transmission, Infectious/prevention & control , Face , Habits , Masks , Pandemics , Pneumonia, Viral/transmission , Touch , Betacoronavirus , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Europe/epidemiology , Far East/epidemiology , Humans , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , United States/epidemiology
6.
Am J Physiol Gastrointest Liver Physiol ; 319(2): G245-G252, 2020 08 01.
Article in English | MEDLINE | ID: covidwho-637284

ABSTRACT

In addition to the typical respiratory response, new coronavirus disease 2019 (COVID-19) is also associated with very common gastrointestinal symptoms. Cases with gastrointestinal symptoms are more likely to be complicated by liver injury and acute respiratory distress syndrome (ARDS). If not treated in time, coma and circulatory failure may ensue. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects the human body through the combination of angiotensin-converting enzyme 2 (ACE2) in the gastrointestinal tract, the mechanism underlying the gastrointestinal symptoms may involve damage to the intestinal mucosal barrier and promotion of the production of inflammatory factors. Indeed, after cells in the lungs become infected by SARS-CoV-2, effector CD4+ T cells reach the small intestine through the gut-lung axis, causing intestinal immune damage and diarrhea; early extensive use of antibacterial and antiviral drugs can also lead to diarrhea in patients. Thus, treatment options for COVID-19 patients should be promptly adjusted when they have gastrointestinal symptoms. As SARS-CoV-2 has been detected in the feces of COVID-19 patients, future prevention and control efforts must consider the possibility of fecal-oral transmission of the virus.


Subject(s)
Betacoronavirus/physiology , Coronavirus Infections , Gastrointestinal Diseases , Gastrointestinal Tract , Pandemics , Pneumonia, Viral , Antiviral Agents/pharmacology , Coronavirus Infections/metabolism , Coronavirus Infections/physiopathology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/physiopathology , Gastrointestinal Diseases/therapy , Gastrointestinal Diseases/virology , Gastrointestinal Tract/metabolism , Gastrointestinal Tract/physiopathology , Gastrointestinal Tract/virology , Humans , Incidence , Infection Control/methods , Pandemics/prevention & control , Patient Selection , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/metabolism , Pneumonia, Viral/physiopathology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission
7.
J Med Virol ; 2020 May 21.
Article in English | MEDLINE | ID: covidwho-326885

ABSTRACT

Since the outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, a series of confirmed cases of COVID-19 were found on the Qinghai-Tibet plateau. We aimed to describe the epidemiological, clinical characteristics, and outcomes of all confirmed cases in Qinghai, a province at high altitude. The region had no sustained local transmission. Of all 18 patients with confirmed SARS-CoV-2 infection, 15 patients comprising four transmission clusters were identified. Three patients were infected by direct contact without travel history to Wuhan. Of 18 patients, 10 patients showed bilateral pneumonia and two patients showed no abnormalities. Three patients with comorbidities such as hypertension, liver diseases, or diabetes developed severe illness. High C-reactive protein levels and elevations of both alanine aminotransferase and aspartate aminotransferase were observed in three severely ill patients on admission. All 18 patients were eventually discharged, including the three severe patients who recovered after treatment with noninvasive mechanical ventilation, convalescent plasma, and other therapies. Our findings confirmed human-to-human transmission of SARS-CoV-2 in clusters. Patients with comorbidities are more likely to develop severe illness.

8.
Sci Total Environ ; 732: 139282, 2020 Aug 25.
Article in English | MEDLINE | ID: covidwho-268426

ABSTRACT

The outbreak of COVID-19 has spreaded rapidly across the world. To control the rapid dispersion of the virus, China has imposed national lockdown policies to practise social distancing. This has led to reduced human activities and hence primary air pollutant emissions, which caused improvement of air quality as a side-product. To investigate the air quality changes during the COVID-19 lockdown over the YRD Region, we apply the WRF-CAMx modelling system together with monitoring data to investigate the impact of human activity pattern changes on air quality. Results show that human activities were lowered significantly during the period: industrial operations, VKT, constructions in operation, etc. were significantly reduced, leading to lowered SO2, NOx, PM2.5 and VOCs emissions by approximately 16-26%, 29-47%, 27-46% and 37-57% during the Level I and Level II response periods respectively. These emission reduction has played a significant role in the improvement of air quality. Concentrations of PM2.5, NO2 and SO2 decreased by 31.8%, 45.1% and 20.4% during the Level I period; and 33.2%, 27.2% and 7.6% during the Level II period compared with 2019. However, ozone did not show any reduction and increased greatly. Our results also show that even during the lockdown, with primary emissions reduction of 15%-61%, the daily average PM2.5 concentrations range between 15 and 79 µg m-3, which shows that background and residual pollutions are still high. Source apportionment results indicate that the residual pollution of PM2.5 comes from industry (32.2-61.1%), mobile (3.9-8.1%), dust (2.6-7.7%), residential sources (2.1-28.5%) in YRD and 14.0-28.6% contribution from long-range transport coming from northern China. This indicates that in spite of the extreme reductions in primary emissions, it cannot fully tackle the current air pollution. Re-organisation of the energy and industrial strategy together with trans-regional joint-control for a full long-term air pollution plan need to be further taken into account.


Subject(s)
Air Pollution , Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Air Pollutants , China , Environmental Monitoring , Human Activities , Humans , Particulate Matter
9.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 49(2): 270-274, 2020 May 25.
Article in Chinese | MEDLINE | ID: covidwho-238993

ABSTRACT

OBJECTIVE: To investigate the clinical outcome of patients with moderate type of coronavirus disease 2019 (COVID-19) after discharge by retesting viral nucleic acid. METHODS: Seven patients with moderate COVID-19 met the discharge criteria enacted by National Health Commission were quarantined in hospital for 7 days, then continuously quarantined at home for 4 weeks after discharged. During the quarantined period, the symptoms and signs were documented, and sputum or nasal swab and feces samples were collected to test SARS-CoV-2 nucleic acid by RT-PCR method. RESULTS: There was no symptoms and signs during the quarantine period in all 7 patients. However, respiratory swabs from 3 patients were confirmed positive of SARS-CoV-2 nucleic acid at 5 to 7 days after they met the discharge criteria. CONCLUSIONS: There is a relatively high incidence of positive viral nucleic acid in patients met the discharge criteria, and it is suggested that patients met the current discharge criteria should be quarantined in hospital for another 7 days and the follow-up viral testing is necessary.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , RNA, Viral , Betacoronavirus/isolation & purification , Coronavirus Infections/diagnosis , Feces/chemistry , Feces/virology , Follow-Up Studies , Humans , Patient Discharge/statistics & numerical data , Pneumonia, Viral/diagnosis , Quarantine/statistics & numerical data , RNA, Viral/analysis , Reverse Transcriptase Polymerase Chain Reaction , Time Factors
10.
BMC Infect Dis ; 20(1): 329, 2020 May 07.
Article in English | MEDLINE | ID: covidwho-197493

ABSTRACT

BACKGROUND: Although people of all ages are susceptible to the novel coronavirus infection, which is presently named "Coronavirus Disease 2019" (COVID-19), there has been relatively few cases reported among children. Therefore, it is necessary to understand the clinical characteristics of COVID-19 in children and the differences from adults. CASE PRESENTATION: We report one pediatric case of COVID-19. A 14-month-old boy was admitted to the hospital with a symptom of fever, and was diagnosed with a mild form of COVID-19. The child's mother and grandmother also tested positive for SARS-CoV-2 RNA. However, the lymphocyte counts were normal. The chest computed tomography (CT) revealed scattered ground glass opacities in the right lower lobe close to the pleura and resorption after the treatment. The patient continued to test positive for SARS-CoV-2 RNA in the nasopharyngeal swabs and stool at 17 days after the disappearance of symptoms. CONCLUSION: The present pediatric case of COVID-19 was acquired through household transmission, and the symptoms were mild. Lymphocyte counts did not significantly decrease. The RNA of SARS-CoV-2 in stool and nasopharyngeal swabs remained positive for an extended period of time after the disappearance of symptoms. This suggests that attention should be given to the potential contagiousness of pediatric COVID-19 cases after clinical recovery.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus , Feces/virology , Fever/etiology , Lung/diagnostic imaging , Nasopharynx/virology , Pneumonia, Viral/diagnostic imaging , Adult , Betacoronavirus , Clinical Laboratory Techniques , Coronavirus/genetics , Coronavirus/isolation & purification , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/epidemiology , Family Characteristics , Humans , Infant , Lymphocyte Count , Male , Pandemics , Pneumonia, Viral/epidemiology , Polymerase Chain Reaction , Severe Acute Respiratory Syndrome/transmission , Tomography, X-Ray Computed
11.
J Med Virol ; 2020 Apr 20.
Article in English | MEDLINE | ID: covidwho-88430

ABSTRACT

BACKGROUND: With the effective prevention and control of COVID-19 in China, the number of cured cases has increased significantly. Further monitoring of the disease prognosis and effective control of the "relapse" of the epidemic has become the next focus of work. This study analysed the clinical prognosis of discharged COVID-19 patients by monitoring their SAR-CoV-2 nucleic acid status, which provided a theoretical basis for medical institutions to formulate discharge standards and follow-up management for COVID-19 patients. METHODS: We included 13 discharged COVID-19 patients who were quarantined for 4 weeks at home. The patient's daily clinical signs were recorded and sputum and faecal specimens were regularly sent for detection of SARS-CoV-2 nucleic acid. RESULTS: The time between initial symptoms and meeting discharge criteria was 18 to 44 days with an average of 25 ± 6 days. The faecal samples of two patients still tested positive after meeting the discharge criteria and the sputum samples of four patients returned positive 5 to 14 days after discharge. The rate of the recurring positive test result in samples from the respiratory system was 31% (4/13). CONCLUSION: Under the present discharge criteria, the high presence of SARS-CoV-2 nucleic acid in faecal and respiratory samples of discharged COVID-19 patients indicates potential infectivity. Therefore, we suggest that faecal virus nucleic acid should be tested as a routine monitoring index for COVID-19 and a negative result be added to the criteria. Simultaneously, we should strengthen the regular follow-up of discharged patients with continuous monitoring of the recurrence of viral nucleic acid.

12.
Psychiatry Res ; 288: 112955, 2020 06.
Article in English | MEDLINE | ID: covidwho-46183

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which appeared in early December 2019, had an atypical viral pneumonia outbreak in Wuhan, Hubei, China. And there is a high risk of global proliferation and impact. The sudden increase in confirmed cases has brought tremendous stress and anxiety to frontline surgical staff. The results showed that the anxiety and depression of surgical staff during the outbreak period were significantly higher and mental health problems appeared, so psychological interventions are essential.


Subject(s)
Anxiety Disorders , Coronavirus Infections/psychology , Depression , Personnel, Hospital , Pneumonia, Viral/psychology , Anxiety , Anxiety Disorders/epidemiology , Anxiety Disorders/virology , Betacoronavirus , China/epidemiology , Coronavirus Infections/epidemiology , Depression/epidemiology , Depression/virology , Disease Outbreaks , General Surgery , Humans , Mental Health Services , Pandemics , Personnel, Hospital/psychology , Pneumonia, Viral/epidemiology , Stress, Psychological
13.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 49(1): 0, 2020 May 25.
Article in Chinese | MEDLINE | ID: covidwho-19908

ABSTRACT

OBJECTIVE: To investigate the clinical outcome of patients with moderate type of corona virus disease 2019 (COVID-19) after discharge by retesting viral nucleic acid. METHODS: Seven patients with moderate COVID-19 met the discharge criteria enacted by National Health Commission were quarantine in hospital for 7 days, then continuously quarantined at home for 4 weeks after discharged. During the three weeks of quarantined period, the symptoms and signs were documented; and sputum or nasal swab and feces samples were collected to test SARS-COV-2 nucleic acid by RT-PCR method. RESULTS: There were no symptoms and signs during the quarantine period in all 7 patients. However, respiratory swabs from 3 patients were confirmed positive of SARS-COV-2 nucleic acid at 5 to 7 days after they met the discharge criteria. CONCLUSIONS: The study indicates that there is a relatively high incidence of positive viral nucleic acid in patients met the discharge criteria, and it is suggested that patients met the current discharge criteria should be quarantined in hospital for another 7 days and the follow-up viral testing is necessary.


Subject(s)
Betacoronavirus , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Pandemics , Patient Discharge/standards , Pneumonia, Viral/diagnosis , Reverse Transcriptase Polymerase Chain Reaction , Asymptomatic Diseases , Betacoronavirus/genetics , China , Coronavirus Infections/virology , Follow-Up Studies , Humans , Pneumonia, Viral/virology , Quarantine , Time Factors
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