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1.
Annals of Translational Medicine ; 10(7), 2022.
Article in English | EMBASE | ID: covidwho-1822669
2.
Infection ; 2022.
Article in English | EMBASE | ID: covidwho-1821023

ABSTRACT

Objective: The aim of our study was to build a predictive model able to stratify the risk of bacterial co-infection at hospitalization in patients with COVID-19. Methods: Multicenter observational study of adult patients hospitalized from February to December 2020 with confirmed COVID-19 diagnosis. Endpoint was microbiologically documented bacterial co-infection diagnosed within 72 h from hospitalization. The cohort was randomly split into derivation and validation cohort. To investigate risk factors for co-infection univariable and multivariable logistic regression analyses were performed. Predictive risk score was obtained assigning a point value corresponding to β-coefficients to the variables in the multivariable model. ROC analysis in the validation cohort was used to estimate prediction accuracy. Results: Overall, 1733 patients were analyzed: 61.4% males, median age 69 years (IQR 57–80), median Charlson 3 (IQR 2–6). Co-infection was diagnosed in 110 (6.3%) patients. Empirical antibiotics were started in 64.2 and 59.5% of patients with and without co-infection (p = 0.35). At multivariable analysis in the derivation cohort: WBC ≥ 7.7/mm3, PCT ≥ 0.2 ng/mL, and Charlson index ≥ 5 were risk factors for bacterial co-infection. A point was assigned to each variable obtaining a predictive score ranging from 0 to 5. In the validation cohort, ROC analysis showed AUC of 0.83 (95%CI 0.75–0.90). The optimal cut-point was ≥2 with sensitivity 70.0%, specificity 75.9%, positive predictive value 16.0% and negative predictive value 97.5%. According to individual risk score, patients were classified at low (point 0), intermediate (point 1), and high risk (point ≥ 2). CURB-65 ≥ 2 was further proposed to identify patients at intermediate risk who would benefit from early antibiotic coverage. Conclusions: Our score may be useful in stratifying bacterial co-infection risk in COVID-19 hospitalized patients, optimizing diagnostic testing and antibiotic use.

3.
Journal of Forensic Medicine and Toxicology ; 38(1):102-106, 2021.
Article in English | EMBASE | ID: covidwho-1818625

ABSTRACT

In view of the ongoing pandemic, healthcare workers are rightfully concerned about performing autopsies, due to the risk of infection. An autopsy surgeon and his/her team can inadvertently be exposed to infectious diseases. Use of appropriate personal protective equipment (PPE) and mortuaries equipped with negative pressure are essential to protect the autopsy team from exposure to potentially infected bodies, bodily fluids, tissues, and aerosolized particles. Unfortunately, in a developing country like India, due to a lack of funding most mortuaries have only the bare minimum facilities. Taking these issues into consideration, the authors have developed a prototype of a Low-Cost Infection Containment Chamber (LCICC) within which autopsies or sample collection from suspected or confirmed highly infectious cadaver can be performed. This innovation could provide infectious disease experts and pathologists a safer alternative to collect specimens to aid in the management outbreaks of highly infectious diseases.

4.
International Journal of Environmental Research and Public Health ; 19(9), 2022.
Article in English | EMBASE | ID: covidwho-1818138

ABSTRACT

Background: COVID-19 vaccine hesitancy is a global concern. Many individuals are concerned about the potential side-effects of the COVID-19 vaccine and vaccine boosters. The purpose of this study was to assess attitudes and satisfaction concerning COVID-19 vaccines and vaccine boosters in the population in Bangkok, Thailand. Methods: A cross-sectional online survey measuring COVID-19 vaccine attitudes and satisfaction was distributed from September to December 2021. Multiple linear regression was used to explore associations between demographic variables and questionnaire results. Spearman’s correlation analysis was used to examine associations between attitude and satisfaction scores. Results: A total of 780 questionnaire responses were obtained. The largest groups of participants reported having obtained a first vaccination dose via viral vaccine (52.8%), a second vaccination booster via viral vaccine (49.5%), and a third vaccination booster via mRNA vaccine (28.8%). Multiple linear regression revealed a lower association between vaccine attitude scores and having earned less than a bachelor’s degree (β −0.109;95% CI −2.541, −0.451) and infection risk without self-isolating (β −0.154;95% CI −4.152, −0.670) compared with attaining a bachelor’s degree or higher and never having being at risk of infection, respectively. Higher vaccine satisfaction scores were more closely associated with being married than being single (β 0.074;95% CI −0.073, 3.022), whereas lower vaccine satisfaction scores were less closely associated with non-healthcare workers (β −0.143;95% CI −4.698, −0.831) and infection risk without self-isolating (β −0.132;95% CI −6.034, −0.502) compared with non-healthcare workers and never being at risk of infection. There was weak but significant positive correlation between attitude and satisfaction scores (r = 0.338, p-value < 0.001). Hence, a gradual decline in protection following vaccination and the positive effects of a booster dose after primary vaccination have made the decision to administer booster doses. Conclusion: The results suggest that policymakers need to develop more effective strategies to raise awareness about the importance of vaccination.

5.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816909

ABSTRACT

COVID-19 is leading to a global pandemic and invades human cells via ACE2. ACE2 was found to abundantly expressed in many organs and cells. However, there is no evidence about the potential risk of various types of cancer patients vulnerable to the infection of COVID-19. To obtain a risk map which indicating the novel coronavirus vulnerability of different types of cancer, so in this work we analyzed the RNA sequencing datasets of cancer patient. By interrogating the datasets, we not only identified the cancer types which vulnerable to COVID-19 attacks, but also we reported that variations in the mRNA expression level of ACE2 correlate to various prognosis phenomenon in different types of cancer cohorts and illustrated the underlying mechanism involved in may be related to lymphocytes infiltration. From these discoveries, we constructed an infection risk map which indicate the vulnerability of different types of cancer to COVID-19 infection, also elucidated the correlationship between ACE2 and the prognosis of cancer. We found that high ACE2 expression levels leading high risk of COVID-19 infection and poor prognosis of BRCA while better prognosis in OV patient cohorts. Moreover, our study demonstrated that this different pattern may correlate with the immune infiltration level. Note: This was not presented at the conference.

6.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816908

ABSTRACT

Background and Purpose: Until a vaccine is widely available, adherence to COVID-19 preventive behaviors is the most effective way to prevent the spread of the COVID-19 pandemic. While there is a general paucity of information on COVID-19 infection and its impact on cancer patients, immunocompromised individuals, such as cancer patients, are likely at greater risk for both COVID-19 morbidity and mortality. In addition, a cancer diagnosis can cause stress, anxiety, depression, psychological distress, and poor quality of life. While the recommendations for COVID-19 parallel the common recommendations for managing infection risk, the enhanced social isolation and limited social distancing can be even more difficult for patients resulting in increased risk for psychological distress and deteriorations in health outcomes. Depressive disorders frequently result in substantial functional impairment, as well as increased emotional, economic, and productivity costs. It is important to understand how the COVID-19 pandemic impacts psychological and psychosocial factors, as well as health behaviors of cancer patients and survivors, and how various contextual factors may play risk and protective roles. The purpose of this study, therefore, is to determine differences in stress, mental health and coping behaviors, and adherence to COVID-19 preventive behaviors during the COVID-19 pandemic among three groups of adults (in active cancer treatment, cancer survivors, and those without a history of cancer). This study focuses on determining how sociodemographic characteristics and cancer status influence COVID-19 mental health/coping mechanisms, as well as how mental health/coping mechanisms and cancer status may predict adherence to preventive COVID-19 behaviors. Methods: Panel survey firm Qualtrics was used to administer an online survey among 897 U.S. adults in May of 2020. Quota sampling was utilized to ensure a sample consisting of approximately one-third: cancer patients currently in treatment (32.0%, n = 287), cancer survivors not currently in treatment (33.6%, n=301), and respondents with no cancer history (34.4%, n = 309). Survey items assessed demographic variables, depression, coping, and adherence to COVID-19 preventive behaviors. Results and Discussion: Preliminary analyses show that cancer patients report higher levels of depressive symptoms than survivors and the control group. In addition, cancer patients in active treatment use both avoidance and approach-focused coping more frequently than both survivors and the control group. Regression analyses show that avoidance coping predicts lower adherence to COVID-19 preventive behaviors, while approach-focused coping predicts higher adherence. Analyses are ongoing.

7.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816895

ABSTRACT

Background: Cancer therapy may put patients at risk of mortality from COVID-19. The impact of abbreviated treatment courses on outcomes in the setting of COVID-19 is unknown. We incorporated COVID-19-associated risks in re-analysis of practice-defining randomized trials in oncology that compared different radiation therapy (RT) regimens. Methods: We extracted individual patient level data (IPLD) from published survival curves from randomized trials in rectal cancer (Dutch TME, TROG 01.04), early stage breast cancer (CALGB 9343, OCOG hypofractionation trial, FAST-Forward, NSABP B-39), and localized prostate cancer (CHHiP, HYPO-RT-PC). Trials were simulated with incorporation of varying risk of SARS-CoV-2 infection and mortality associated with receipt of therapy. Results: IPLD from 14,170 patients were re-analyzed. In scenarios with low COVID-19-associated risks (0.5% infection risk per fraction [IRF], 5% case fatality rate [CFR]), fractionation did not significantly affect outcomes. In locally advanced rectal cancer, short-course RT appeared preferable to long-course chemoradiation (TROG 01.04) or RT omission (Dutch TME) in most settings. While moderate hypofractionation in early stage breast cancer (OCOG hypofractionation trial) and prostate cancer (CHHiP) was not associated with survival benefits in the setting of COVID-19, more aggressive hypofractionation (FAST-Forward, HYPO-RT-PC) and accelerated partial breast irradiation (NSABP B-39) were associated with improved survival in higher risk scenarios (≥5% IRF;≥ 20% CFR). In settings where RT can be omitted, such as favorable early stage breast cancer in the elderly (CALGB 9343), RT was associated with worse survival in higher risk pandemic scenarios (≥5% IRF, ≥ 20% CFR). Conclusions: Our framework, which can be adapted to dynamic changes in COVID-19 risk, provides a flexible, quantitative approach to assess the impact of treatment recommendations across oncology. The magnitude of potential benefit from abbreviated RT courses depends on the degree of hypofractionation and local COVID-19-associated risk. Abbreviated RT courses should be prioritized when possible and are increasingly beneficial in higher risk pandemic settings. With increased understanding and precautions against COVID-19 that can minimize risks for patients, our results support the continued use of evidence-based treatments for cancer patients in the COVID-19 era.

8.
Muscle and Nerve ; 65(5):498-507, 2022.
Article in English | EMBASE | ID: covidwho-1813581

ABSTRACT

Spinal muscular atrophy (SMA) is a group of neurodegenerative disorders resulting from the loss of spinal motor neurons. 95% of patients share a pathogenic mechanism of loss of survival motor neuron (SMN) 1 protein expression due to homozygous deletions or other mutations of the SMN1 gene, with the different phenotypes influenced by variable copy numbers of the SMN2 gene. Advances in supportive care, disease modifying treatment and novel gene therapies have led to an increase in the prevalence of SMA, with a third of SMA patients now represented by adults. Despite the growing number of adult patients, consensus on the management of SMA has focused primarily on the pediatric population. As the disease burden is vastly different in adult SMA, an approach to treatment must be tailored to their unique needs. This review will focus on the management of the adult SMA patient as they age and will discuss proper transition of care from a pediatric to adult center, including the need for continued monitoring for osteoporosis, scoliosis, malnutrition, and declining mobility and functioning. As in the pediatric population, multidisciplinary care remains the best approach to the management of adult SMA. Novel and emerging therapies such as nusinersen and risdiplam provide hope for these patients, though these medications are of uncertain efficacy in this population and require additional study.

9.
Journal of Hepato-Biliary-Pancreatic Sciences ; 29(SUPPL 1):5, 2022.
Article in English | EMBASE | ID: covidwho-1813537

ABSTRACT

The spread of novel severe acute respiratory syndrome coronavirus SARS-CoV- 2 (COVID-19) has led to a strain on health care resources. Colorectal malignancy were affected by pandemic and significantly alter treatment for patients. Standards of cancer care may have to be modified or trimmed to protect and prioritize the life of others. The right strategy might be to discuss this on a case-by- case basis, because resources, such as personal protective equipment supply, need to be maximized to allow the delivery of safe and effective care to surgical patients and minimize the infection risks for medical personnel. Elective surgery should be postponed or rescheduled if needed, and all patients need to screen for COVID-19 infection. Studies regarding delay of surgery for resectable and curable colorectal cancer are not surprisingly difficult to extrapolate. Delays of 30 days appear to have no negative influence. Established guidelines require modifications for optimal timing and type of surgery for colorectal cancer during an unrelated pandemic. Multidisciplinary and individualized treatment planning is recommended to determine the best course of action.

10.
Building and Environment ; : 109118, 2022.
Article in English | ScienceDirect | ID: covidwho-1800175

ABSTRACT

Prevention of nosocomial infections is particularly important for the control of COVID-19 pandemic. We conducted a field study and performed extensive numerical simulations of infection transmission in a fever clinic during pandemic through an agent-based model with pedestrian dynamic and an infection transmission model. Furthermore, we evaluated the cross-infection risk of the patients influenced by the patient inject flow, medical service capability and plane layout. The service capability of fever clinic is determined by the least efficient medical session. When patient inject flow exceeded the service capability, the average dwell time, contact time, exposure dose, and risk of infection of patients all increased dramatically. With the patient inject flow exceeding the service capability, the growth rate of the contact time between patients and the cross-infection risk increased by 11.5-fold and 29.5-fold, respectively. The plane layout of the fever clinic affected the exposure dose and risk of infection. The waiting areas in the fever clinic had the highest risk, where the cumulative exposure dose of virus occupied up to 66.5% of the total. Our research will help to evaluate the biosafety of hospital buildings used for the diagnosis and treatment of infectious diseases.

11.
Journal of Building Engineering ; : 104544, 2022.
Article in English | ScienceDirect | ID: covidwho-1799814

ABSTRACT

A computational fluid dynamics (CFD) simulation was performed to model and study the transmission risk associated with cough-related SARS-CoV-2 droplets in a real-world high-speed train (HST). In this study, the evaporating of the droplets was considered. Simulation data were post-processed to assess the fraction of the particles deposited on each passenger's face and body, suspended in air, and escaped from exhausts. Firstly, the effects of temperature, relative humidity, ventilation rate, injection source, exhausts' location and capacity, and adding the physical barriers on evaporation and transport of respiratory droplets are investigated in long distance HST. The results demonstrate that overall, 6–43% of the particles were suspended in the cabin after 2.7 min, depending on conditions, and 3–58% of the particles were removed from the cabin in the same duration. Use of physical barriers and high ventilation rate is therefore recommended for both personal and social protection. We found more exhaust capacity and medium relative humidity to be effective in reducing the particles' transmission potential across all studied scenarios. The results indicate that reducing ventilation rate and exhaust capacity, increased aerosols shelf time and dispersion throughout the cabin.

12.
Animals ; 12(8), 2022.
Article in English | EMBASE | ID: covidwho-1798911
13.
Building and Environment ; : 109067, 2022.
Article in English | ScienceDirect | ID: covidwho-1797108

ABSTRACT

The aerosol transmission was academically recognized as a possible transmission route of Coronavirus disease 2019 (COVID-19). We established an approach to assess the indoor tempo-spatial airborne-disease infection risks through aerosol transmission via real-time CO2 field measurement and occupancy monitoring. Compared to former studies, the proposed method can evaluate real-time airborne disease infection risks through aerosol transmission routes. The approach was utilized in a university office. The accumulated infection risk was calculated for three occupants with practical working schedules (from occupancy recording) and one hypothesis occupant with a typical working schedule. COVID-19 was used as an example. Results demonstrated that the individual infection risks diversified with different dwell times and working places in the office. For the three occupants with a practical working schedule, their 3-day accumulated infection risks were respectively 0.050%, 0.035%, 0.027% and 0.041% due to 11.6, 9.0 and 13.8 hours exposure with an initial infector percentage of 1%. The results demonstrate that location and dwell time are both important factors influencing the infection risk of certain occupant in built environment, whereas existing literature seldom took these two points into consideration simultaneously. On the contrary, our proposed approach treated the infection risks as place-by-place, time-by-time and person-by-person diversified in the built environment. The risk assessment results can provide early warning for building occupants and contribute to the transmission control of air-borne disease.

14.
Journal of Building Engineering ; 48:17, 2022.
Article in English | Web of Science | ID: covidwho-1796459

ABSTRACT

During the ongoing COVID-19 pandemic period, the airborne transmission of viruses has raised widespread concern as daily activities are resumed in public buildings. It is essential to develop mitigation strategies of infection disease transmission (e.g., increase of ventilation rate) in different scenarios to reduce the infection risk. For classrooms in schools, natural ventilation is generally used to provide outdoor air into rooms. However, the supply air volume depends strongly on the local conditions, e.g., window opening size and outdoor wind speed. In this study, the optimal design of classroom window openings is investigated, based on which low-cost window-integrated fans are then employed to enhance the efficiency of natural ventilation and infection disease control. Taking infected students as pollutant sources, numerical simulations are carried out to predict the pollutant concentration under various scenarios of pollutant sources and window opening modes (with/without fans), and to calculate the infection risk. It is found that by redesigning window openings, the airflow distribution performance index (ADPI) can be increased by 17% with corresponding infection likelihood decreased by 27%. The window integrated fan has a significant effect on improving ventilation performance and prevention of infection disease transmission, leading to an ADPI of 99% and minimum infection probability of 11% for students sitting near the windows. This work can help to develop low-cost and effective mitigating measures of infection disease in classrooms by using hybrid ventilation systems.

15.
Sci Total Environ ; : 155173, 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1783747

ABSTRACT

Proper air distribution is crucial for airborne infection risk control of infectious respiratory diseases like COVID-19. Existing studies evaluate and compare the performances of different air distributions for airborne infection risk control, but the mechanisms of air distribution for airborne infection risk control remain unclear. This study investigates the mechanisms of air distribution for both overall and local airborne infection risk controls. The experimentally validated CFD models simulate the contaminant concentration fields in a hospital ward based on which the airborne infection risks of COVID-19 are evaluated with the dilution-based expansion of the Wells-Riley model. Different air distributions, i.e., stratum ventilation, displacement ventilation, and mixing ventilation, with various supply airflow rates are tested. The results show that the variations of the overall and local airborne infection risks under different air distributions and different supply airflow rates are complicated and non-linear. The contaminant removal and the contaminant dispersion are proposed as the mechanisms for the overall and local airborne infection risk controls, respectively, regardless of airflow distributions and supply airflow rates. A large contaminant removal ability benefits the overall airborne infection risk control, with the coefficient of determination of 0.96 between the contaminant removal index and the reciprocal of the overall airborne infection risk. A large contaminant dispersion ability benefits the local airborne infection risk control, with the coefficient of determination of 0.99 between the contaminant dispersion index and the local airborne infection risk.

16.
Age and Ageing ; 51(2), 2022.
Article in English | EMBASE | ID: covidwho-1778875
17.
Respiration ; : 1-8, 2022 Mar 31.
Article in English | MEDLINE | ID: covidwho-1770074

ABSTRACT

BACKGROUND: Gender differences in vaccine acceptance among health care workers (HCWs) are well documented, but the extent to which these depend on occupational group membership is less well studied. We aimed to determine vaccine acceptance and reasons of hesitancy among HCWs of respiratory clinics in Germany with respect to gender and occupational group membership. METHODS: An online questionnaire for hospital staff of all professional groups was created to assess experiences with and attitudes towards COVID-19 and the available vaccines. Employees of five clinics were surveyed from 15 to 28 March 2021. RESULTS: 962 employees (565 [72%] female) took part in the survey. Overall vaccination acceptance was 72.8%. Nurses and physicians showed greater willingness to be vaccinated than members of other professions (72.8%, 84.5%, 65.8%, respectively; p = 0.006). In multivariate analyses, worries about COVID-19 late effects (odds ratio (OR) 2.86; p < 0.001) and affiliation with physicians (OR 2.20; p = 0.025) were independently associated with the willingness for vaccination, whereas age <35 years (OR 0.61; p = 0.022) and worries about late effects of vaccination (OR 0.13; p < 0.001) predicted vaccination hesitancy; no differences were seen with respect to gender. In separate analyses for men and women, only for men worries about COVID-19 late effects were relevant, while among women, age <35 years, worries about late effects of vaccination and worries about COVID-19 late effects played a role. CONCLUSIONS: There was no overall difference in vaccination acceptance between male and female HCWs, but there were gender-specific differences in the individual reasons on which this decision-making was based.

18.
Embase; 2021.
Preprint in English | EMBASE | ID: ppcovidwho-331114

ABSTRACT

Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to escalate worldwide and has become a pressing global health concern. This article comprehensively reviews the current knowledge on the impact of COVID-19 over pregnant women and neonates, as well as current recommendations for their management. We also analyse previous evidences from viral respiratory diseases such as SARS, Middle East respiratory syndrome, and influenza that may help to guide clinical practice during the current pandemic. We collected 23 case reports, case series, and case-control studies (18 from China) comprising 174 pregnant women with COVID-19. The majority of mothers showed a clinical presentation of the disease similar to that of non-infected adults. Preliminary evidences point towards a potentially increased risk of pregnancy adverse outcomes in women with COVID-19, with preterm delivery the most frequently observed (16.7%) followed by fetal distress (9.77%). The most commonly reported adverse neonatal outcomes included respiratory symptoms (7.95%) and low birth weight (6.81%). A few studies reported other maternal comorbidities that can influence these outcomes. Mothers with other comorbidities may be at higher risk of infection. Mother-tochild transmission of SARS-CoV-2 appears unlikely, with no study observing intrauterine transmission, and a few cases of neonatal infection reported a few hours after birth. Although the WHO and other health authorities have published interim recommendations for care and management of pregnant women and infants during COVID-19 pandemic, many questions remain open. Pregnant women should be considered in prevention and control efforts, including the development of drugs and vaccines against SARS-CoV-2. Further research is needed to confirm the exact impact of COVID-19 infection during pregnancy. To fully quantify this impact, we urgently need to integrate the current knowledge about viral characteristics, epidemiology, disease immunopathology, and potential therapeutic strategies with data from the clinical practice.

19.
Microb Risk Anal ; : 100215, 2022 Mar 31.
Article in English | MEDLINE | ID: covidwho-1768421

ABSTRACT

There is a need to evaluate and minimise the risk of novel coronavirus infections at mass gathering events, such as sports. In particular, to consider how to hold mass gathering events, it is important to clarify how the local infection prevalence, the number of spectators, the capacity proportion, and the implementation of preventions affect the infection risk. In this study, we used an environmental exposure model to analyse the relationship between infection risk and infection prevalence, the number of spectators, and the capacity proportion at mass gathering events in football and baseball games. In addition to assessing risk reduction through the implementation of various preventive measures, we assessed how face-mask-wearing proportion affects infection risk. Furthermore, the model was applied to estimate the number of infectors who entered the stadium and the number of newly infected individuals, and to compare them with actual reported cases. The model analysis revealed an 86%-95% reduction in the infection risk due to the implementation of face-mask wearing and hand washing. Under conditions in which vaccine effectiveness was 20% and 80%, the risk reduction rates of infection among vaccinated spectators were 36% and 96%, respectively. Among the individual measures, face-mask wearing was particularly effective, and the infection risk increased as the face-mask-wearing proportion decreased. A linear relationship was observed between infection risk at mass gathering events and the infection prevalence. Furthermore, the number of newly infected individuals was also dependent on the number of spectators and the capacity proportion independent of the infection prevalence, confirming the importance of considering spectator capacity in infection risk management. These results highlight that it is beneficial for organisers to ensure prevention compliance and to mitigate or limit the number of spectators according to the prevalence of local infection. Both the estimated and reported numbers of newly infected individuals after the events were small, below 10 per 3-4 million spectators, despite a small gap between these numbers.

20.
Cities ; 125: 103676, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1757210

ABSTRACT

The Covid-19 pandemic, with its epicentres in cities, came as the most severe social, economic and financial shock of the 21st century. The reconstruction of the pandemic spread in cities, the determination of factors conducive to and preventing from SARS-CoV-2 virus infections as well as searching for the ways to combat it and its effects have become the subject of many studies and analyses. The results presented in this article are part of this research. The study covered 20 large Polish cities with different functions, in the set of which: (1) the course of the infection process (by means of a rarely used trajectory method) was determined as well as its temporal variation (variance), (2) cities were classified in terms of the similarity of the epidemic process (correlation analysis), and (3) the factors conducive to infections presented in the literature (using a multivariate regression method) were verified. In this case the investigation was also carried out on the set of 66 large cities. Generally, the relative number of infections (per 10,000 inhabitants), i.e. the intensity of infections, was used as the basis for the analysis. The research has shown that the size, function and location within the country have no influence on the course and intensity of the epidemic in particular cities. Unfortunately, it was not possible to identify factors that could be responsible for infections, or at least that could determine the risk of infections (no confirmed impact on infections of population density, the level of poverty, the proportion of a post-working age population or the level of people's health). Thus, the obtained results testify to the individual nature of the spread of the epidemic in each city and to the possible influence of other explanatory features on the infection level than those considered in this investigation, or to the level of infections as the effect of the synergetic interaction of more than just socio-economic features. The solution to this issue remains open, as it seems, not only in the case of Polish cities.

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