Trace elements: role in the development of severe forms of COVID-19 and the possibility of correction

The COVID-19 pandemic has set tasks for health professionals, in particular, related to the rapid diagnosis of the disease and the provision of medical care to patients with a new coronavirus infection. All over the world, scientific work is being carried out on the study of the clinical and epidemiological characteristics of the dis-ease, the development of new means of its prevention and treatment. Epidemiological studies have identified a number of physiological and other factors that increase the risk of developing severe forms of the disease. Among them: old age, as well as concomitant diseases, including diabetes mellitus, cardiovascular diseases, chronic kidney disease and others. Changes in the balance of trace elements (ME) are considered as a risk factor for the development of severe forms of COVID-19. It is especially important that this factor can potentially be influenced, especially given the potential for replenishing the ME deficit in patients with COVID-19 for the purpose of early recovery and faster rehabilitation.Copyright © 2022 Tomsk Polytechnic University, Publishing House. All rights reserved.

Changing spatiotemporal patterns for hepatitis of unspecified aetiology in China, 2004-2021: a population-based surveillance study.

Objectives: As global efforts continue toward the target of eliminating viral hepatitis by 2030, the emergence of acute hepatitis of unspecified aetiology (HUA) remains a concern. This study assesses the overall trends and changes in spatiotemporal patterns in HUA in China from 2004 to 2021. Methods: We extracted the incidence and mortality rates of HUA from the Public Health Data Center, the official website of the National Health Commission of the People's Republic of China, and the National Notifiable Infectious Disease Surveillance System from 2004 to 2021. We used R software, ArcGIS, Moran's statistical analysis, and joinpoint regression to examine the spatiotemporal patterns and annual percentage change in incidence and mortality of the HUA across China. Results: From 2004 to 2021, a total of 707,559 cases of HUA have been diagnosed, including 636 deaths. The proportion of HUA in viral hepatitis gradually decreased from 7.55% in 2004 to 0.72% in 2021. The annual incidence of HUA decreased sharply from 6.6957 per 100,000 population in 2004 to 0.6302 per 100,000 population in 2021, with an average annual percentage change (APC) reduction of -13.1% (p < 0.001). The same result was seen in the mortality (APC, -22.14%, from 0.0089/100,000 in 2004 to 0.0002/100,000 in 2021, p < 0.001). All Chinese provinces saw a decline in incidence and mortality. Longitudinal analysis identified the age distribution in the incidence and mortality of HUA did not change and was highest in persons aged 15-59 years, accounting for 70% of all reported cases. During the COVID-19 pandemic, no significant increase was seen in pediatric HUA cases in China. Conclusion: China is experiencing an unprecedented decline in HUA, with the lowest incidence and mortality for 18 years. However, it is still important to sensitively monitor the overall trends of HUA and further improve HUA public health policy and practice in China.

Epidemiological features and trends in the mortality rates of 10 notifiable respiratory infectious diseases in China from 2004 to 2020: Based on national surveillance.

Objectives: The aim of this study is to describe, visualize, and compare the trends and epidemiological features of the mortality rates of 10 notifiable respiratory infectious diseases in China from 2004 to 2020. Setting: Data were obtained from the database of the National Infectious Disease Surveillance System (NIDSS) and reports released by the National and local Health Commissions from 2004 to 2020. Spearman correlations and Joinpoint regression models were used to quantify the temporal trends of RIDs by calculating annual percentage changes (APCs) in the rates of mortality. Results: The overall mortality rate of RIDs was stable across China from 2004 to 2020 (R = -0.38, P = 0.13), with an APC per year of -2.2% (95% CI: -4.6 to 0.3; P = 0.1000). However, the overall mortality rate of 10 RIDs in 2020 decreased by 31.80% (P = 0.006) compared to the previous 5 years before the COVID-19 pandemic. The highest mortality occurred in northwestern, western, and northern China. Tuberculosis was the leading cause of RID mortality, and mortality from tuberculosis was relatively stable throughout the 17 years (R = -0.36, P = 0.16), with an APC of -1.9% (95% CI -4.1 to 0.4, P = 0.1000). Seasonal influenza was the only disease for which mortality significantly increased (R = 0.73, P = 0.00089), with an APC of 29.70% (95% CI 16.60-44.40%; P = 0.0000). The highest yearly case fatality ratios (CFR) belong to avian influenza A H5N1 [687.5 per 1,000 (33/48)] and epidemic cerebrospinal meningitis [90.5748 per 1,000 (1,010/11,151)]. The age-specific CFR of 10 RIDs was highest among people over 85 years old [13.6551 per 1,000 (2,353/172,316)] and was lowest among children younger than 10 years, particularly in 5-year-old children [0.0552 per 1,000 (58/1,051,178)]. Conclusions: The mortality rates of 10 RIDs were relatively stable from 2004 to 2020 with significant differences among Chinese provinces and age groups. There was an increased mortality trend for seasonal influenza and concerted efforts are needed to reduce the mortality rate of seasonal influenza in the future.

Contagion of coronavirus disease-the first family cluster of Pakistan: a case series.

Coronavirus Disease has resulted in public health crisis all over the world. We describe the case series of a family, who travelled together to a mass gathering in Iraq, toured Syria, Lebanon, and Doha and returned to Karachi. The data describes the demographic and clinical features of these six members. There were three males and three females. One developed severe disease and died. Incubation period was between 8-14 days. Four patients were symptomatic, had diabetes mellitus and hypertension; and presented with fever. They also had bilateral airspace opacifications on chest X-ray. Our study describes familial clustering of SARS-CoV-2 and its person-to-person transmission.

Comparison of the epidemiological features of COVID-19 patients in the first and second waves: A study from South India.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has seen multiple surges globally since its emergence in 2019. The second wave of the pandemic was generally more aggressive than the first, with more cases and deaths. This study compares the epidemiological features of the first and second COVID-19 waves in Kozhikode district of Kerala and identifies the factors associated with this change. Methods: A comparative cross-sectional study was conducted in Kozhikode district. A total of 132,089 cases from each wave were selected for the study using a consecutive sampling method. Data were collected from the District COVID-19 line list using a semistructured proforma and analyzed using Statistical Package for Social Sciences (SPSS) ver. 18. Results: The second wave had a higher proportion of symptomatic cases (17.3%; 20.1%), cases with severe symptoms (0.3%; 0.6%), intensive care unit (ICU) admissions (11.2%; 17.9%), and case fatality rate (0.69%; 0.72%). Significant difference was noted in the age, gender, locality, source of infection, comorbidity profile, symptom, and the pattern of admission in various healthcare settings between the first and second wave. Among the deceased, gender, duration between onset of symptoms and death, comorbidity status, and cause of death were significantly different in both waves. Conclusion: The presence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant, as well as changes in human behavior and threat perception as the pandemic progressed, resulted in significant differences in various epidemiological features of the pandemic in both waves, indicating the need for continued vigilance during each COVID-19 wave.

Nationwide descriptive epidemiological study of patients with COVID-19 evacuated from Wuhan, China, to Japan from January to February 2020.

We investigated epidemiological findings regarding the route of coronavirus disease 2019 (COVID-19) and infection prevention and control (IPC) measures among returnees in the emergent evacuation from Wuhan, China to Japan under the COVID-19 outbreak in 2020. A total of 12 of 14 returnees (median age [range]: 49.5 years [29-65 years]; 9 men [75%]) were confirmed COVID-19. The proportions of returnees with COVID-19 were 12/566 (2.1%) in the 1-3 flights and 2/263 (0.8%) in the 4-5 flights. Six patients were asymptomatic on admission, while three patients developed symptoms thereafter. None reported a specific history of contact with animals, going to seafood markets, or visiting medical facilities. Two patients contacted with an individual confirmed or suspected to have COVID-19, respectively. Most patients resided in hotels in the center of Wuhan city, taking taxis and trains to work and supermarkets. Patients relatively adhered to IPC measures such as wearing a mask and hand hygiene. However, emphasis on IPC measures such as universal masking and more rigorous avoidance of exposure risk may have been necessary to prevent infection. In addition, forced social distancing due to lockdown might contribute to the lower infection rates in Flights 4 and 5, compared to Flights 1-3.

Trace elements: role in the development of severe forms of COVID-19 and the possibility of correction

The COVID-19 pandemic has set tasks for health professionals, in particular, related to the rapid diagnosis of the disease and the provision of medical care to patients with a new coronavirus infection. All over the world, scientific work is being carried out on the study of the clinical and epidemiological characteristics of the dis-ease, the development of new means of its prevention and treatment. Epidemiological studies have identified a number of physiological and other factors that increase the risk of developing severe forms of the disease. Among them: old age, as well as concomitant diseases, including diabetes mellitus, cardiovascular diseases, chronic kidney disease and others. Changes in the balance of trace elements (ME) are considered as a risk factor for the development of severe forms of COVID-19. It is especially important that this factor can potentially be influenced, especially given the potential for replenishing the ME deficit in patients with COVID-19 for the purpose of early recovery and faster rehabilitation. © 2022 Tomsk Polytechnic University, Publishing House. All rights reserved.

Main epidemiological features of COVID-19 cases admitted in a first line defence hospital from Bucharest, Romania

In this retrospective unicenter study we aimed to outline the key features of the first 100 cases of COVID-19 hospitalized in our clinic after designation of it as front line unit for hospitalization of these cases. Thus, the average age of cases was 44.7 years (SD: 15.9) and the prevalence of female was 57.4%. By age groups, prevalence of young patients (7.8%) was significantly (p < 0.05) lower than the prevalence of adult patients (77.2%). The most prevalent occupation (31.7%) was healthcare worker. The most frecvent exposure to source of infection was represented by attending healthcare facilities (44.6%), followed by having contact with COVID-19 confirmed/suspect case (30.7%), and recent international travel (18.8%). Of the 30% of cases in which at least one health precondition was recorded the most prevalent (13.9%) of such condition was chronic cardiovascular disease including high blood presure. In regard with severity, to note that 6 patients died within 14 days of hospital admission, all fatalities have occurred in very old patients and 83.3% of them had chronic kidney disease. In the end, we express the hope that data outlined in this paper will help for better management of COVID-19 pandemic. © 2020, Amaltea Medical Publishing House. All rights reserved.

Clinical characteristics and predictors of death among hospitalized patients infected with SARS-CoV-2 in Sicily, Italy: A retrospective observational study.

Since late December 2019, severe acute respiratory syndrome coronavirus 2 has spread across the world, which resulted in the World Health Organization declaring a global pandemic. Coronavirus disease 2019 (COVID-19) presents a highly variable spectrum with regard to the severity of illness. Most infected individuals exhibit a mild to moderate illness (81%); however, 14% have a serious disease and 5% develop severe acute respiratory distress syndrome (ARDS), requiring intensive care support. The mortality rate of COVID-19 continues to rise across the world. Data regarding predictors of mortality in patients with COVID 19 are still scarce but are being actively investigated. The present multicenter retrospective observational study provides a complete description of the demographic and clinical characteristics, comorbidities and laboratory abnormalities in a population of 421 hospitalized patients recruited across eight infectious disease units in Southern Italy (Sicily) with the aim of identifying the baseline characteristics predisposing COVID-19 patients to critical illness or death. In this study, older age, pre-existing comorbidities and certain changes in laboratory markers (such as neutrophilia, lymphocytopenia and increased C-reactive protein levels) at the time of admission were associated with a higher risk of mortality. Male sex, on the other hand, was not significantly associated with increased risk of mortality. Symptoms such as fatigue, older age, a number of co-pathologies and use of continuous positive airway pressure were the most significant contributors in the estimation of clinical prognosis. Further research is required to better characterize the epidemiological features of COVID-19, to understand the related predictors of death and to develop new effective therapeutic strategies.

Time course and epidemiological features of COVID-19 resurgence due to cold-chain food or packaging contamination.

Contaminations in frozen food imported from countries with ongoing COVID-19 epidemics have been reported in China. However, the epidemiological features of the outbreaks initiated by material-to-human transmission were less reported. The risk of this route of transmission remains unclear, and strategies to prevent resurgence could be flawed. We aimed to demonstrate the existence of cold-chain food or packaging contamination transmission and describe the time course and epidemiological features associated with the transmission in China. This review was based on the official reports or literature for resurging COVID-19 events that were related to cold-chain food or packaging contamination in China and other countries. Although SARS-CoV-2 on the material surface is not the main source of infection, the closed and humid environment for food packaging and transportation is a place favoring the material-to-human spread of SARS-CoV-2. In this transmission mode, patient zero is often hidden and difficult to detect, such that the outbreak usually can only be perceived after a period of a secret epidemic. Regular testing for high-risk populations and imported cold-chain products, proper disinfection of imported products, and protection of susceptible population while working remain an effective way to detect and prevent SARS-CoV-2 spread.

Outbreaks of covid-19 in medical organizations

Relevance. Prevention of the outbreak of a new coronavirus infection in medical organizations (MO) is one of the tasks facing the Rospotrebnadzor service and practical health care. Analysis of the causes and conditions of the spread of SARS-CoV-2 in the MO allows us to determine the most effective measures to contain the infection and prevent the occurrence of subsequent diseases in the focus. The aim is to characterize the epidemiological features of a new coronavirus infection during its nosocomial spread in medical organizations based on the analysis of outbreak incidence. Materials and methods. The data of the reporting forms «General information on patients with positive COVID-19», «General information on patients with community-acquired pneumonia with positive COVID-19» (138 pieces of information), copies of «Acts of epidemiological investigation of foci of infectious (parasitic) diseases with the establishment of a causal relationship» (57 pieces of information), copies of extraordinary reports on an emergency of a sanitary and epidemiological nature (57 pieces of information) were analyzed. The work uses epidemiological and statistical methods of research. Results. When analyzing 57 COVID-19 outbreaks in 30 medical organizations, it was found that the outbreak incidence was more often registered in multidisciplinary hospitals – 70.2% compared to 12.3% in specialized organizations of non-infectious profile, 10.5% of outbreaks were in polyclinics, 1.8% at emergency medical stations. The total number of people affected by the spread of the infection was 961, with a small proportion of children (15 people or 1.7%). Among those who fell ill with the spread of infection in the foci, the share of employees of medical organizations was 62.6%, including doctors – 16.6%, middle and junior medical workers-50.6% and 11.3%, respectively, and other categories – 21.5%. In nosocomial outbreaks of COVID-19, the focality index corresponded to 16.9, and the average duration of the focus was 32.4 days. The construction of the so-called «combined» outbreak diagram in the course of the epidanalysis allowed us to establish its total duration, which was 71 days, with the peaks of morbidity within the outbreak at intervals of 3–7 days, the greatest number of cases in the 1st and 8th days, and the gradual «extinction» of its activity in dynamics. Conclusions. The outbreak of COVID-19 in medical organizations usually occurred when there was an epidemic problem with COVID-19 in the territory. The peculiarity of nosocomial outbreaks was a significant proportion of adults (98.3%), mainly employees of medical organizations, who were often active sources of infection, as well as the involvement of structural units and hospitals for adults in the epidemic process, a high frequency of etiological interpretation of outbreaks (95.9%), a significant proportion of asymptomatic forms of infection and carrier, and the complexity of differential diagnosis of cases of out – of-hospital and nosocomial infection. The patterns of occurrence and spread of morbidity in medical organizations can be used in practical anti-epidemic work. © 2021, Numikom. All rights reserved.

COVID-19 in the paediatric population of Kazakhstan.

Background: To date, there have been no studies of COVID-19 infection in children in Central Asia, particularly the Republic of Kazakhstan. This report analyses the epidemiological data on COVID-19 infection in children in Kazakhstan.Methods: The study included 650 paediatric patients diagnosed with COVID-19. Demographic and epidemiological data and the symptoms and radiological evidence of complications were collected and analysed. Children were sub-divided into four groups: neonates/infants, young children, older children and adolescents.Results: All of the 650 children were under 19 years of age, 56.3% of whom were male, and 122 (18.8%) were newborns and infants. The majority of cases (n = 558, 85.8%) were asymptomatic and only four cases were severe (0.6%). The symptoms were as follows in descending order: cough (14.8%), sore throat (12.8%), fever (9.1%) and rhinorrhoea (5.5%). Diarrhoea (2%), dyspnoea (1.8%) and muscle pain were rare (1.1%). Only three children required intensive care, including invasive ventilation. One patient had acute respiratory distress syndrome. There were no deaths.Conclusion: Most cases of COVID-19 infection in children in Kazakhstan were asymptomatic or the symptoms were mild. Only three patients required intensive care.

Quarantine at home may not enough!-from the epidemiological data in Shaanxi Province of China.

OBJECTIVES: A pneumonia associated with 2019 novel coronavirus (2019-nCoV, subsequently named SARS-CoV2) emerged worldwide since December, 2019. We aimed to describe the epidemiological characteristics of 2019 coronavirus disease (COVID-19) in Shaanxi province of China. RESULTS: 1. Among the 245 patients, 132 (53.9%) were males and 113 (46.1%) were females. The average age was 46.15 ± 16.43 years, ranging from 3 to 89 years. 2. For the clinical type, 1.63% (4/245) patients were mild type, 84.90% (208/245) were moderate type, 7.76% (19/245) were severe type, 5.31% (13/245) were critical type and only 0.41% (1/245) was asymptomatic. 3. Of the 245 patients, 116 (47.35%) were input case, 114 (46.53%) were non-input case, and 15 (6.12%) were unknown exposure. 4. 48.57% (119/245) cases were family cluster, involving 42 families. The most common pattern of COVID-19 family cluster was between husband and wife or between parents and children.

Epidemiological Features of 105 Patients Infected with the COVID-19.

OBJECTIVE: To investigate and evaluate the clinical features of patients infected with the 2019 novel coronavirus (COVID-19) outside of Wuhan. METHODS: 105 patients admitted to our hospital with clinical- and laboratory-confirmed COVID-19 infection were studied. Data were collected from January 17, 2020 to March 5, 2020. RESULTS: 105 patients (57 male and 48 female) were confirmed to have COVID-19 infection. Among the 105 patients, 55 (52%) had made short trips to Wuhan during the two weeks before the onset of illness, and these were the first-generation confirmed cases. An exact date of close contact with someone in Wenzhou with confirmed or suspected COVID-19 infection from Wuhan (the second-generation confirmed cases) could be provided by 38 (36%) patients. Of the remaining patients, six (6%; the third-generation confirmed cases) were familial clusters of the second-generation confirmed cases, three (3%) had no definite epidemiological features, and 16 (15%) were from the same location as for the case report. CONCLUSION: Due to the infectiousness of COVID-19, patients with infections should be diagnosed and treated as early as possible after developing fever symptoms or showing other clinical characteristics or imaging features. With respect to high-risk cases, we must focus on any complications that arise and take effective measures to treat them immediately. This will significantly improve the prognosis of patients with severe infections.

Clinical and epidemiological features of COVID-19 family clusters in Beijing, China.

BACKGROUND: Since its discovery, SARS-CoV-2 has been spread throughout China before becoming a global pandemic. In Beijing, family clusters are the main mode of human-human transmission accounting for 57.6% of the total confirmed cases. METHOD: We present the epidemiological and clinical features of the clusters of three large and one small families. RESULT: Our results revealed that SARS-CoV-2 is transmitted quickly through contact with index case, and a total of 22/24 infections were observed. Among those infected, 20/22 had mild symptoms and only two had moderate to severe clinical manifestations. Children in the families generally showed milder symptoms. The incubation period varied from 2 to 13 days, and the shedding of virus from the upper respiratory tract lasted from 5 to over 30 days. A prolonged period of virus shedding (>30 days) in upper respiratory tract was observed in 6/24 cases. CONCLUSION: SARS-CoV-2 is transmitted quickly in the form of family clusters. While the infection rate is high within the cluster, the disease manifestations, latent period, and virus shedding period varied greatly. We therefore recommend rigorously testing contacts even during the no-symptom phase and consider whether viral shedding has ceased before stopping isolation measures for an individual.

COVID-19 in a designated infectious diseases hospital outside Hubei Province, China.

BACKGROUND: The clinical characteristics of novel coronavirus disease (COVID-2019) patients outside the epicenter of Hubei Province are less understood. METHODS: We analyzed the epidemiological and clinical features of all COVID-2019 cases in the only referral hospital in Shenzhen City, China, from January 11, 2020, to February 6, 2020, and followed until March 6, 2020. RESULTS: Among the 298 confirmed cases, 233 (81.5%) had been to Hubei, while 42 (14%) did not have a clear travel history. Only 218 (73.15%) cases had a fever as the initial symptom. Compared with the nonsevere cases, severe cases were associated with older age, those with underlying diseases, and higher levels of C-reactive protein, interleukin-6, and erythrocyte sedimentation rate. Slower clearance of the virus was associated with a higher risk of progression to critical condition. As of March 6, 2020, 268 (89.9%) patients were discharged and the overall case fatality ratio was 1.0%. CONCLUSIONS: In a designated hospital outside Hubei Province, COVID-2019 patients could be effectively managed by properly using the existing hospital system. Mortality may be lowered when cases are relatively mild, and there are sufficient medical resources to care and treat the disease.

2019 novel coronavirus (2019-nCoV) and 2019-nCoV pneumonia / 中华微生物学和免疫学杂志

In the middle of December in 2019, a pneumonia outbreak caused by a new coronavirus, 2019 novel coronavirus (2019-nCoV), emerged in the populations in Wuhan city of China. The epidemic spreads rapidly and has been disseminated throughout the country and to 13 other counties in Asia, Europe, Oceania and North America. To accurately and deeply understand the biological characteristics, epidemiological features and pathogenicity of 2019-nCoV and related immunological characteristics, microbiological examinations and public protection measure, this study reviewed 2019-nCoV and 2019-nCoV pneumonia based on the newest relevant literatures and the newest version of National Diagnosis and Treatment Scheme of 2019-nCoV pneumonia.