Neurologic presentations of COVID-19: a case series

Introduction: The new pandemic of coronavirus disease 2019 (COVID-19) has evolved certain neurologic syndromes as a presentation of this disease that should be integrated into the whole disease process. Case Presentations: We present cases of neurologic involvement in adult patients with documented bronchopulmonary COVID-19. Certain signs and symptoms are introduced, including new onset seizures, ischemic stroke, and altered mental status in otherwise minimal clinical signs and symptoms of COVID-19. Conclusions: Many neurologic presentations are diagnosed in resolving COVID respiratory infections or in an otherwise asymptomatic individual.

Demographic and clinical profile of patients with COVID-19 infection during first and second wave in a tertiary care hospital of South Assam

BACKGROUND: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was first detected in Wuhan, China in 2019 and since then has engulfed the entire globe at an unprecedented pace. The virus has infected all age groups, both males and females with or without symptoms and with significant variations. In this study, we wanted to analyse the data related to demographic features of COVID-19-infected patients mainly focusing on their age, gender and symptoms. METHODS: This was a hospital-based retrospective study that included all laboratory-confirmed COVID-19 cases which were declared SARS-COV-2 real-time RT-PCR positive by VRDL, SMCH, Silchar from March 2020 to August 2021. Data related to the demographic characteristics of patients with COVID-19 infection was retrieved from the ICMR-COVID-19 portal of the laboratory and analysed. RESULTS: The study included 8065 laboratory-confirmed COVID-19 cases which involved 5605 cases during the first wave and 2460 cases during the second wave of COVID-19, diagnosed from different districts of South Assam. The majority of infected patients were of the younger age group of 20-30 years. The mean age of the patients was almost similar in both waves i.e. 35.9 and 38.4 years. Of the total enrolled patients, 91.7% were reported asymptomatic while 8.3% were symptomatic with fever and cough being the commonest ones. CONCLUSIONS: The COVID-19 pandemic is a huge burden on healthcare facilities. The majority of the infected patients presenting to our hospital were young and asymptomatic, thus posing risk to the community. Hence, it is crucial to practice proper hygiene, wearing of masks and complete the vaccination schedule to achieve better vigilance to combat the COVID-19 pandemic more efficiently and effectively.

Transmission of SARS-CoV2 and Strategies for Control of Infection: Lessons Learnt

Coronavirus has affected all spheres of human life;physical, mental, and social aspects to the limit which has never been experienced before. The major symptoms of COVID-19 infection are fever, cough, respiratory distress, loss of taste, loss of smell, body aches diarrhea, vomiting, and so on. Those having symptoms are tested for their COVID-19 infection status either by Rapid Antigen test or real-time polymerase chain reaction (RTPCR)/Gene Xpert method. Those found COVID-19 positive are shifted to COVID care centers or home isolation for 17 days. The epidemiological triad includes an agent (strains of SARS-CoV-2), host (immunocompromised person), environment (overcrowding, temperature, humidity, contaminated surfaces). Various strategies have been implemented from time to time to break the chain of transmission to contain the spread of infection. Various strategies at an individual level and the community level are implemented. Strategies such as wearing mask, frequent handwashing, maintaining a distance of minimum 2 m between two people, screening for risk factors, quarantine, isolation, surveillance, and contact tracing, defining high-risk areas into hotspots/containment zones or micro containment zones, issuing heating, ventilation, and air-conditioning guidelines, work from home and introduction of vaccine as prophylaxis for prevention against the infection were introduced by India as well as globally. The introduction of infection control measures has some good affects such as lowering air pollution level and controlling the unnecessary plight of the vehicle on roads but the people have faced some serious effects also such as, it pushed people more into poverty and more down in nutritional graph raising country rank in hunger index. Whatever the strategy be proposed it should be implemented keeping to view the pros and cons of each strategy. © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. 2021.

Correlation between laboratory findings and clinical severity among the COVID-19 patients in the tertiary care centre

Background: Coronavirus is a highly infectious novel virus we are in urge to know more about their clinical characteristics and laboratory findings for the characterization and selection of treatment protocol. Methods: Prospective, single centre study. Two months data was collected, clinical characteristics data from patient case sheet and the laboratoryvalues from the Hospital Information System (HIS) for the month of July and August 2020. Results: Of 462 patients, 55 (11.9%) are falls under asymptomatic category, 194 (42%) are in mild category, 167 (36.1%) are in moderate category and 46 (10%) in severe category. Fever 230 (49.8%) and cough 211 (45.7%) was most common clinical symptom with p value < 0.01. Non-severe vs severe, 340 (73.6%) and 201 (43.5%) showed decreased in eosinophil count and absolute eosinophil count, 125 (27.1%) and 80 (17.3%) patient showed decrease in lymphocyte count and absolute lymphocyte count, 200 (43.3%) showed increase in neutrophil count with a significance of p value >0.05.186 (40.3%) patients had one or more co-morbidities. Laboratory findings between Asymptomatic VS symptomatic, showed significance changes in neutrophil, lymphocyte, Aspartate aminotransferase, Alkaline phosphatase, globulin values (p value <0.05). Conclusion: Clinical severity categorization at the time of admission was very helpful for the treating doctors in proper understanding of disease progression and appropriate treatment of the patient. Presence of co-morbidity, abnormal laboratory values, old age group patients, higher Computed Tomography score, higher mortality rate are seen more in patients who were in clinical severity grade severe category than in non-severe category patients.

Comparative analysis of epidemiological trends of COVID-19 in Shanghai and New York City

ObjectiveTo assess the effects of countermeasures against coronavirus disease 2019 (COVID-19) in Shanghai from March to May 2022 in comparison with epidemiological trend of COVID-19 in New York City. MethodsDaily confirmed cases, asymptomatic SARS-CoV-2 carriers, and daily deaths were obtained in the Shanghai Municipal Health Commission and the Center for Disease Control and Prevention (CDC) of the United States. Descriptive study was conducted by using these data. ResultsFrom March 1 to May 17, the number of daily asymptomatic SARS-CoV-2 infections in Shanghai was up to 58 times as large as that of daily confirmed cases;however, the number of daily confirmed cases in Shanghai was generally less than that in New York in the same time period. At the peak of the COVID-19 epidemic, the growth of daily attack rate in Shanghai was significantly lower than that in New York (P < 0.05). Moreover, the number of daily death was evidently less than that in New York. In addition, the vaccination rate in the elderly (aged 60 years) in Shanghai was evidently lower than that in New York (aged 65 years). ConclusionThe COVID-19 epidemics in Shanghai from March to May 2022 and in New York after December 2021 were both caused by the Omicron variant. Compared with the Delta variant, the Omicron variant has stronger replication ability and infectivity, resulting in challenges to the containment of the epidemic in metropolis such as Shanghai and New York City. The epidemic in New York City remained crucial due to absence of effective countermeasures, while that in Shanghai has been effectively contained with strict countermeasures. The prevention and control strategies may be adjusted along with the continual evolution of SARS-CoV-2 and increasing trend of imported COVID-19 cases.

Excreción de SARS-CoV-2 infeccioso en dos niños asintomáticos

Asymptomatic infections with SARS-CoV-2 are associated with viral transmission and have a key role in the propagation of the pandemic. Understanding viral shedding during asymptomatic infections is critical. Unfortunately, data on asymptomatic SARS-CoV-2 infection in children is extremely limited. To determine the presence of viral viable shedding, we prospectively followed two healthy children of a family where both parents developed mild COVID-19 (April 2021). SARS-CoV-2 detection was made by RT-PCR and virus isolation by cell culture from saliva samples. Positive samples were sequenced to identify variants of SARS-CoV-2. Serum samples were evaluated to determine the presence of antibodies using a single enzyme-linked immunosorbent assay (ELISA, COVIDAR IgG). Both children were SARS-CoV-2 positive and asymptomatic. In addition, the virus grew in cell culture from saliva samples. Furthermore, one child showed viable SARS-CoV-2 for at least 17 days after the onset symptoms from his father. The recommended isolation period for asymptomatic contacts during the acquisition of data had been established for 10 days;however, this child remained with viable virus beyond that period. The positive samples from both children were consistent with B.1.1.28.1 lineage (Gamma). In both asymptomatic children, anti-Spike IgG was detected. Asymptomatic children may represent a source of infection that should not be underestimated during this pandemic. Las infecciones asintomáticas por SARS-CoV-2 están asociadas a la transmisión viral y tienen un papel clave en la propagación de la pandemia. Comprender la excreción viral durante las infecciones asintomáticas es fundamental. Desafortunadamente, los datos sobre la infección asintomática por SARS-CoV-2 en niños son extremadamente limitados. Para determinar la presencia de excreción de virus viable, se siguió prospectivamente a dos niños sanos de una familia en la que ambos padres desarrollaron COVID-19 leve (abril 2021). La detección de SARS-CoV-2 se realizó por RT-PCR y el aislamiento del virus por cultivo celular a partir de muestras de saliva. Las muestras positivas se secuenciaron para identificar variantes de SARS-CoV-2. En las muestras de suero se determinó la presencia de anticuerpos utilizando un ensayo de ELISA (COVIDAR IgG). Ambos niños fueron positivos para SARS-CoV-2 y asintomáticos. Además, el virus creció en cultivos celulares a partir de muestras de saliva. Uno de los niños mantuvo SARS-CoV-2 viables durante al menos 17 días después de la aparición de los síntomas de su padre. El período de aislamiento recomendado para contactos asintomáticos durante la adquisición de datos se había establecido en 10 días, sin embargo, este niño permaneció con virus viable más allá de ese período. Las muestras positivas de estos niños correspondieron al linaje B.1.1.28.1 (Gamma). En ambos niños asintomáticos se detectó anticuerpos IgG anti-Spike. Concluimos que los niños asintomáticos pueden representar una fuente de infección que no debe subestimarse durante esta pandemia.

Polymorphisms of leukocyte genes human and congenital antigen immunity associated with different the severity of the course of the new coronavirus infections

The most significant single nucleotide human leukocyte antigen genes polymorphisms and innate immunity genes associated with varying degrees of acute respiratory infection severity are considered-COVID-19 caused by the SARS-CoV-2 coronavirus. As data accumulated, it became clear that the SARS-CoV-2 virus exhibits significant regional, ethnic, and individual specificity. This is due to the population groups' genetic characteristics. This is necessary to reliably know the human genotype relationship with the COVID-19 course severity (asymptomatic, mild, moderate, severe, and extremely severe up to fatal outcomes) for more successful therapy and vaccination. At the same time, it was also known that the innate immunity system is on the first line of defense against the pathogenic penetration into the body, and the human leukocyte antigen system encodes molecules of the same name on the surface of cells that present various antigens, including viral infection pathogens, and determine the severity of the course of many diseases;therefore, these systems' genes. This approach makes it possible to assess the likelihood of a severe and extremely severe disease course in healthy and infected people, which in turn contributes to the correct therapy strategy, pharmacotherapy, and vaccination, as well as to create new antiviral therapeutic and preventive medicines. The genetically determined immune response heterogeneity to SARS-CoV-2 infection requires further study, since there is no unambiguous opinion about the leading mechanism that determines disease severity.

Study of asymptomatic norovirus infection in kitchen workers in key places in Tongzhou district, Beijing, 2019-2021

Objective: To investigate the prevalence of asymptomatic norovirus infections status in kitchen workers in schools, child care settings, and catering service units and other key places in Tongzhou district of Beijing from 2019 to 2021, and provide evidence for scientific prevention and control of norovirus infection. Methods: The simple random sampling method was used to select the kitchen workers, especially the kitchen workers preparing cold dish, from catering service units, schools, childcare settings, construction sites, hotels as study subjects, and their anal swabs or stool samples were collected for norovirus nucleic acid detection by fluorescence quantitative PCR. Descriptive method was used to analyze the asymptomatic norovirus infection status of the kitchen workers. Results: A total of 3880 samples were collected from 552 units, and 15 norovirus positive cases were detected, including 1 sample positive for GI and 14 samples positive for GII. The asymptomatic norovirus infection rate was 0.39% (15/3880), in which 0.30% (5/1656) in man, and 0.45% (10/2224) in women. No asymptomatic infections were detected in age groups < 18 years and > 60 years, and 2055 cases were detected in age group 19- years, with a positive rate of 0.34% (7/2055), and 1637 cases were detected in age group 46- years, with a positive rate of 0.49% (8/1637). In 2019 when no COVID-19 epidemic occurred, the asymptomatic norovirus infection rate was 1.00% (1/100), but the asymptomatic norovirus infection rate was 0.39% (11/2805)in 2020 and 0.31%(3/975)in 2021 in the context of COVID-19 epidemic. Conclusion: The asymptomatic norovirus infection rate in kitchen workers in key places in Tongzhou was similar to the average level in Beijing during the same period. In COVID-19 epidemic period, the asymptomatic norovirus infection rate was lower than that before the epidemic.

Epidemiological and etiological analysis of a case cluster caused by norovirus in a nursing home in Lanzhou

Objective: To understand the epidemiology and etiology of a cluster of cases with gastroenteritis in a nursing home in Anning district of Lanzhou, and to provide a scientific evidence for the prevention and control of norovirus diarrhea in community nursing centers. Methods: From January 28 to February 4 2021, an epidemiological investigation was conducted on all diarrhea cases, nursing staff and chefs in a nursing home in Anning district, Lanzhou city. Samples of patients' anal swabs, feces, vomitus were collected for norovirus detection by real-time fluorescent PCR. ORF1/ORF2 junction region of norovirus in some selected positive samples(Ct value 25) was sequenced. MEGA-X software was used to construct a phylogenetic tree for genetic evolution analysis using the neighboring method. Results: The first case was confirmed on January20,2021, and the number of cases peaked during January 25and 29.A total of 58 clinically diagnosed cases were reported,57were older people, with an incidence of(57/360,15.83%). Diarrhea(50/58,86.21%),vomiting(35/58,60.34%),nausea(13/58,22.41%)and abdominal pain(6/58,10.34%)were common symptoms, all cases were mild. Fifty-three asymptomatic cases were detected among chefs, housekeepers and nurses.A total of 163specimens were tested, the positive rate of norovirus GII was 49.08%(80/163). The positive rate of fecal samples collected from nurses, chefs and housekeepers was 48.62%(53/109), and was11.11%(2/18)in environmental surface swabs. The possibility of other pathogenic infections such as SARS-CoV-2was ruled out by further tests. Thirteen positive samples were selected for sequencing, and 9were successfully sequenced, they were all recombinant GII.4Sydney_2012 [P16]genotypes, forming an independent cluster, while in a large evolutionary branch with the 2020GII.10 [P16]and 2019GII.2 [P16]virus strains in Lanzhou city, showing a relative close genetic connection. Conclusions: GII .4Sydney_2012[P16]genotype of norovirus is found to be causative pathogen of this outbreak, and close contact is the main reason of the outbreak and persistence of the infection,so asymptomatic infections of norovirus play an important role in the disease spreading. Therefore, public health management in nursing homes and other centralized nursing facilities should be strengthened especially for asymptomatic workers in order to prevent virus transmission.

Genetic pattern of the COVID-19 course and reinfection

A new coronavirus infection (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out at the end of 2019 in Wuhan (China). The disease has become a global pandemic and claimed more than 6 million lives after spreading rapidly around the world. Issues related to the complicated course of COVID-19 mechanisms continue to be the subject of active study. It is known that morbidity and mortality increase dramatically with increasing age and concomitant diseases, including obesity, diabetes, cancer, and cardiovascular diseases. Although most infected people recover, even young and otherwise healthy patients can get sick with this disease. In this regard, an urgent task is to search for specific genetic factors that can explain the predisposition of people to infection and the development of a severe COVID-19 form. Human genetic determinants can provide the scientific basis for disease prediction and the development of personalized therapies to counteract the epidemic. In addition, cases of repeated infection with SARS-CoV-2 are increasingly being registered, which occurs 1-6 months after initial infection on average and depends on the virus genome structure. Studies conducted on sequencing viral genomes have shown that some patients were re-infected with the same strain of coronavirus, while others were different. This, in turn, causes researchers concerns about the effectiveness of immunity after infection and vaccine reliability. The genetic characteristics of a person and a virus commonly determine the tendency for reinfection. It is difficult to determine the true COVID-19 reinfection prevalence, which is explained by the low detectability of asymptomatic reinfection and the fact that many patients with a mild course of the disease were not tested at an early stage of the pandemic. Therefore, the true prevalence of reinfection with COVID-19 does not reflect the current reality. There are many more cases of reinfection than are described in the literature. In this regard, the true contribution of a virus' genetic features to reinfection of COVID-19 can be determined only after population studies, and when developing immunization programs against a COVID-19, it is necessary to take into account the prevalence of reinfection in the population.

Estimating spatially disaggregated probability of severe COVID-19 and the impact of hand washing interventions: the case of Zimbabwe

The severity of COVID-19 disease varies substantially between individuals, with some infections being asymptomatic while others are fatal. Several risk factors have been identified that affect the progression of SARS-CoV-2 to severe COVID-19. They include age, smoking and presence of underlying comorbidities such as respiratory illness, HIV, anemia and obesity. Given that respiratory illness is one such comorbidity and is affected by hand hygiene, it is plausible that improving access to hand washing could lower the risk of severe COVID-19 among a population. In this paper, we estimate the potential impact of improved access to hand washing on the risk of respiratory illness and its knock-on impact on the risk of developing severe COVID-19 disease across Zimbabwe. We use a geospatial model that allows us to estimate differential clinical risk at the district level. Results show that the current risk of severe disease is heterogeneous across the country, due to differences in individual characteristics and household conditions. This study demonstrates how household level improved access to handwashing could lead to reductions in the risk of severe COVID-19 of up to 16% from the estimated current levels across all districts. Taken alongside the likely impact on transmission of SARS-CoV-2 itself, as well as countless other pathogens, this result adds further support for the expansion of access to hand washing across the country. It also highlights the spatial differences in risk of severe COVID-19, and thus the opportunity for better planning to focus limited resources in high risk areas in order to potentially reduce the number of severe cases.

Seroprevalence of COVID-19 Antibodies and Factors Associated with Seropositivity: A Population-based Study

Background: Currently, COVID-19 is a global public health problem. This study aimed to estimate the seroprevalence of antibodies related to Covid-19 in the general population in southern Iran. Methods: This cross-sectional population-based study of the seroepidemiological type investigated the serological prevalence of COVID-19 from October to December 2020 in Jahrom, Fars province, Iran. A total of 612 participants were selected using multistage cluster random sampling regardless of age or gender. The dataset in the study included the participants' demographic information, the history of exposure to COVID-19 patients, the history of PCR tests, and the history of COVID-19 symptoms in previous months. In addition, this study examined the raw and survey-weight adjusted estimates with Stata version 14. Finally, logistic regression was performed to identify risk factors for serum prevalence. Results: The participants' mean age was 38.88±13.91 and the majority were 30 to 49 years (51.4%), with a female preponderance (58.7%). The estimated adjusted seroprevalence was 32.66 (95%CI: 28.93-36.63), with 207 positive cases for either IgG or IgM. The results of multivariable logistic regression showed that seropositivity in the participants was 4.95 times more likely associated with a history of positive PCR test (OR: 4.95, 95%CI: 2.46-10.90) and 2.14 times in patients with a history of muscle pain in previous months (OR: 2.14, 95%CI: 1.03-4.47). Conclusion: The actual number of patients with COVID-19 is significantly higher than the number of cases confirmed by the disease monitoring system based on PCR tests. Therefore, tracking individuals' contact with confirmed patients using extensive testing and segregation of asymptomatic patients can help control the epidemic. © Journal of Health Sciences and Surveillance System. All rights reserved.

Epidemiological characteristics of a local COVID-19 outbreak caused by omicron variant (BA.2) in Qinzhou, Guangxi

Objective: To analyze the epidemiological characteristics of a local COVID-19 outbreak in Qinzhou, Guangxi Zhuang autonomous region, and provide reference for the prevention and control of COVID-19 in the future. Methods The epidemiological and clinical information, analysis reports and laboratory test results of the COVID-19 cases were collected for a descriptive epidemiological analysis. Results A total of 97 COVID-19 cases, including 79 asymptomatic cases and 18 confirmed cases, were reported in Qinzhou during 12-24 March, 2022. Forty nine cases were males and 48 cases were females. The median of age of the cases was 32 (17.0, 44.5) years. The median of incubation period was 3 days. The median of latent period was 2 days. A total of 3841 close contacts were screened, in whom 61 were infected. The secondary attack rates in 3841 close contacts was 1.59%. The secondary attack rate in household contacts was 65% in 8 family clustering (95% CL: 20%-100%). Three mass gathering were identified in a local recreation center box, a wedding ceremony and a family feast for new home, in which the attack rates were 63.64%, 9.38% and 12.16%, respectively. Transmission firstly occurred in the people attending the activity in the recreation center box. At least 5 generations of transmission were identified in the outbreak. The results of genome second generation sequencing of the isolates from 20 infection cases revealed that the pathogen of the outbreak was SARS-CoV-2 Omicron variant (BA.2). Conclusion Analysis on the cases caused by Omicron variant (BA.2) indicated early prevention measures are important for the control of further spread of COVID-19.

Epidemiological characteristics of a large-scale outbreak of SARS-CoV-2 omicron variant infection in Sanya, Hainan in 2022

Objective: To analyze the endemic characteristics of SARS-CoV-2 Omicron variant in Sanya, and to provide reference for the prevention and control of the Omicron variant. Methods: The information of coronavirus disease 2019 (COVID-19) infected persons (asymptomatic infected persons and confirmed cases) in Sanya City from August 1 to September 19, 2022 was collected through the Infectious Disease Reporting Information System of the Chinese Information System for Disease Control and Prevention. SPSS 25.0 software was used to analyze and compare the epidemiological characteristics of this Omicron variant outbreak between confirmed cases and asymptomatic infected persons. Results: A total of 15 651 cases of COVID-19 infection were reported in Sanya including 9 057 asymptomatic infections (57.87%) and 6 594 confirmed cases (42.13%), there were 0 deaths. The age ranged from 0 to 107 years old in which 0 to 5 years old, 6 to 18 years old, 19 to 64 years old and above 65 years old accounted for 5.64%, 15.03%, 71.83% and 7.51% respectively. The mean age of confirmed cases was (43.26..0.27) years old, which was significantly older than (31.89..0.16) years old of asymptomatic infection (Z=-37.89, P < 0.001). Sex ratio between men and women was 1:1.12. The occupation was mainly business service (8 239, 52.64%). The districts were mainly concentrated in Gangmen Village community of Jiyang District (10.02%), Danzhou Village community of Tianya District (9.69%) and Linchun Community of Jiyang District (8.11%). Asymptomatic and confirmed cases were 57.87% and 42.13% respectively. The differences between asymptomatic infected and confirmed cases in terms of gender, occupation and detection method were statistically significant (X2=17.63,1 632.44, 179.35, P all<0.001);the length of hospitalization of asymptomatic infected and confirmed cases was statistically significant (Z=-12.467, P < 0.001). Conclusions: This novel coronavirus outbreak was caused by Omicron BA.5.1.3 variant, which was discovered for the first time in China. The epidemiological mode is an outbreak mode, and the new Omicron variant is more insidious and infectious, and fast and decisive measures are needed to prevention and control the epidemic.

Dynamic characteristics of specific antibodies IgM, IgG and viral RNA in patients with COVID-19

Objective: To study the changed trend of IgM and IgG specific antibody with chemiluminescent immunoassay (CLIA) and RT-PCR in SARS-CoV-2 infection patients during hospitalization. Methods: A total of 100 hospitalized patients with SARS-CoV-2 infection who admitted to the First People's Hospital of Zhaoqing were divided into vaccinated group and unvaccinated group according to whether they were vaccinated COVID-19 vaccine or not. The unvaccinated group was further divided into severe, normal, mild and asymptomatic groups. The nucleic acid test results, the positive rate of IgM and IgG antibodies measured by CLIA, and the dynamic trend of S/CO values of all SARS-CoV-2 infected patients since admission 0-<8 days, 8-<15 days, 15-<22 days, 22-<29 days, 29-<36 days and36 days were monitored, and the statistical differences between different groups were compared. Results: The positive rate of IgM antibody in the unvaccinated group 55.6% (15/27) and 0 (0/27) were all significantly higher than that in the vaccinated group 68.5% (50/73) and 49.0% (36/73) at 8-<15 days and 36 days of hospitalization (X2=11.048, 20.805, P < 0.05). The positive rate of IgG antibody in the vaccinated group 96.3% (26/27) and 100% (27/27) were all significantly higher than that in the unvaccinated group 45.2% (31/73) and 78.1% (57/73) at 0-< 8 days and 8-<15 days of hospitalization (X2=21.268, 7.576, P < 0.05). The positive rate of RNA in the unvaccinated were all significantly higher than that in the vaccinated group at 8-<15 days 76.7% (56/73) and 29.6% (8/27), 15-<22 days 65.8% (48/73) and 14.8% (4/27), 22-<29 days 42.5%(31/73) and 7.4% (2/27), 29~<36 days 26.0% (19/73) and 7.4% (2/27) of hospitalization (X2=18.694,20.490, 10.957, 4.119, all P < 0.05). The S/CO value of IgG antibody in the vaccinated group were all significantly higher than that in the unvaccinated group at differentperiods of hospitalization (t=2.841, 7.135, all P < 0.05), but there was no significant difference in the S/CO value of IgM antibodyat different periods of hospitalization in pairwise comparison (P > 0.05). The IgM and IgG antibody levels of severe patients in the unvaccinated group were significantly higher than those in the normal, mild, and asymptomatic groups at 22-<29 days and 29-<36 days of hospitalization (F=17.694,15.116, 4.037, 4.115, all P < 0.05). Conclusion: IgM and IgG antibody levels in severe patients are more activated by immune defense during recovery. In the case of vaccination, IgM antibody can well reflect the whole course of SARS-CoV-2 infection.

Performance of the PanbioTM COVID-19 Ag rapid test in a health care setting in Ouagadougou, Burkina Faso

This study aimed to evaluate the performance of the PanbioTM Covid-19 Ag Rapid Test (Abbott) in a medical center in Ouagadougou. The PanbioTM COVID-19 Ag test was evaluated from January 26 to March 31, 2021 in symptomatic and asymptomatic patients in the medical Centre of Kossodo. A total of 268 individuals were tested by both SARS-CoV-2 RT-PCR, and antigen RDT. Of these 268 individuals, 52 were positive and 216 were negative for COVID-19 RT-PCR. The performance parameters of the test and its Kappa agreement with the RT-PCR were calculated according to the presence or absence of symptoms in the patients on one hand, and according to the time onset of symptoms on the other hand. The sensitivity of the PanbioTM COVID-19 Ag Rapid Test ranged from 29.63% (95% CI: 13.75 to 50.18) among COVID-19 asymptomatic patients, to 87.5% (95% CI: 52.91 to97.76) among symptomatic patients with symptom onset time of 1-5 days. Similarly, the PanbioTM COVID-19 Ag Rapid Test specificity was 97.3% (95% CI: 90.58 to 99.67) and 96.4% (95% CI: 91.81 to 98.82) in symptomatic and asymptomatic RT PCR negative patients. The PanbioTM COVID-19 Ag Rapid Test shows good performance in detecting COVID-19 cases in patients with a symptom onset time of less than seven (7) days. This performance is even better when the symptom onset is reduced to five (5) days. The results show that the antigen RDT is not suitable for COVID-19 detection among asymptomatic patients.

A review on global pandemic corona virus: current status of diagnosis, treatment and prevention

Coronavirus or Covid-19 is a new kind of viral respiratory tract disease which was declared as a lethal pandemic for the world. COVID-19 affects different people in different ways. The most common symptoms include fever, sore throat and dry cough. But some patients are asymptomatic also which somehow increases the risk for transmission. More than 210 countries are currently facing this disease and are fighting from COVID-19 but better approaches of diagnostics and medical facilities have helped some countries to recover at some extent. Some vaccines are under development for SARSCoV-2 infection and once it will be approved and available for human use, it will help a lot in controlling this pandemic.

Characteristics and containment of the outbreak caused by the SARS-CoV-2 Omicron variants in Shanghai, China: a retrospective study

Objective: The study aimed to describe the characteristics and containment of the Omicron variants in Shanghai compared with the previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants in China. Methods: We summarized the data retrieved from the Shanghai Municipal Health Commission from January to June 2022 and the National Health Commission of the People's Republic of China from March 2020 to August 2021. Epidemiological analysis was utilized to describe the differences among SARS-CoV-2 variants and the infection situation in the outbreaks in China. Results: The Omicron variants had the characteristics of high insidiousness, rapid transmission, high infectivity, and short incubation period, which were consistent with the characteristics of outbreaks caused by Omicron in other regions in China and abroad. There were 568978 asymptomatic infections in Shanghai from Feburary 26 to June 30, 2022, accounting for 90.73% of the SARS-CoV-2 infections in this outbreak wave. It's significantly different from a total of 23277 SARS-CoV-2 infections in China between March 31, 2020 and August 8, 2021, of which 41.97% of the cases were asymptomatic infections. Conclusions: Compared with previous outbreaks emerged in China, the Omicron outbreak in Shanghai was characterized by multiple point dissemination, wide coverage, a large number of close contacts of confirmed infections and asymptomatic carriers, and difficult source tracing. The lessons from Shanghai's response to Omicron showed that the dynamic zero-COVID policy is still the most suitable response to the virus which can quickly find the infections and curb the transmission route.

Management strategies for pediatric wards of designated hospitals for omicron variant BA.5.1.3 infection in south area of Hainan

OBJECTIVE: To describe the experience of comprehensive management of pediatric COVID-19 cases in designated hospitals under 'mixed management mode' during the '0801' epidemic in Sanya. METHODS: A pediatric comprehensive ward of children and parents has been specially opened in the designated hospitals to carry out comprehensive treatment and management of pediatric children. RESULTS: From Aug 1, 2022 to Oct 1, 2022, Sanya Central Hospital(Hainan Third People's Hospital), as the designated hospital for the treatment of COVID-19 cases in South area of Hainan, a total of 251 children aged between 0 and 14 year old and 195 aged more than 14 years old were treated for COVID-19 in the pediatric comprehensive wards. Among children under 14 years old, including 10(4.0%) neonates aged between 0 and 28 days, 32(12.7%) cases aged between 29 days and 1 year old, 87(34.7%) cases aged between 1 and 3 years old and 122(48.6%) cases aged between 3 and 14 years old. There were 16(6.4%) cases of common type, 223(88.8%) cases of mild type, 12(4.8%)asymptomatic cases and 7(2.8%) re-positive cases. There were 246(98.0%) children with accompanying care and 5(2.0%) children without accompanying care and 23(9.2%) children complicated with underlying diseases. The youngest age was 11 days, and the oldest age was 77 years old. The large age span and poor compliance with treatment brought unprecedented challenges to the diagnosis and treatment of children in the designated hospitals. The mixed model of comprehensive management and multidisciplinary diagnosis and treatment helped to achieve the ultimate goals of 'zero death of patients and 'zero infection' of health care workers. CONCLUSION: The comprehensive management means such as optimization of flow, stress on prevention and control of nosocomial infection, multidisciplinary collaboration and support of information platform offer strong guarantee for the mixed mode of management as well as scientific experience for centralized diagnosis and treatment of respiratory infectious diseases in children.

Epidemiological study and health management of an imported incident of COVID-19 asymptomatic cases in Haikou, China: a retrospective case series

Background: To control the imported risks brought by all international arrivals, China Customs has implemented strict closed-loop health management policy called "three checks, three screenings and one transfer". This study provides epidemiological evidence for prevention and control measures on imported cases of asymptomatic infections and describes the current COVID-19 prevention and control system on imported risks in China. Methods: We retrospectively analyzed an imported incident of three asymptomatic carriers. Serum SARS-CoV-2 IgM and IgG antibodies were detected by chemiluminescence and gold immnnochromatography(GICA). Results: Three cases were reported positive for SARS-CoV-2 nucleic acid on their arrival, total antibodies and IgG, but negative for IgM. The Ct values of cases A, B and C were 34/36/36, 32/33/32 and 25/31/29, respectively. There were 10726434 pair-end reads sequenced for case C, and approximate 80% reads were aligned to the hCoV-19/Wuhan/IVDC-HB-01/2019 genome (EPI_ISL_402119). The viruses of case A and C were homologous and came from the SARS-CoV-2 variant. Conclusion: Serum antibody IgM and IgG tests are recommended for international travelers from epidemic areas. The "three checks, three screenings and one transfer" policy implemented at custom's entry points was effective in COVID-19 prevention and control.