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1.
MMWR Morb Mortal Wkly Rep ; 69(28): 918-922, 2020 Jul 17.
Article in English | MEDLINE | ID: covidwho-1389847

ABSTRACT

To limit introduction of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), the United States restricted travel from China on February 2, 2020, and from Europe on March 13. To determine whether local transmission of SARS-CoV-2 could be detected, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) conducted deidentified sentinel surveillance at six NYC hospital emergency departments (EDs) during March 1-20. On March 8, while testing availability for SARS-CoV-2 was still limited, DOHMH announced sustained community transmission of SARS-CoV-2 (1). At this time, twenty-six NYC residents had confirmed COVID-19, and ED visits for influenza-like illness* increased, despite decreased influenza virus circulation.† The following week, on March 15, when only seven of the 56 (13%) patients with known exposure histories had exposure outside of NYC, the level of community SARS-CoV-2 transmission status was elevated from sustained community transmission to widespread community transmission (2). Through sentinel surveillance during March 1-20, DOHMH collected 544 specimens from patients with influenza-like symptoms (ILS)§ who had negative test results for influenza and, in some instances, other respiratory pathogens.¶ All 544 specimens were tested for SARS-CoV-2 at CDC; 36 (6.6%) tested positive. Using genetic sequencing, CDC determined that the sequences of most SARS-CoV-2-positive specimens resembled those circulating in Europe, suggesting probable introductions of SARS-CoV-2 from Europe, from other U.S. locations, and local introductions from within New York. These findings demonstrate that partnering with health care facilities and developing the systems needed for rapid implementation of sentinel surveillance, coupled with capacity for genetic sequencing before an outbreak, can help inform timely containment and mitigation strategies.


Subject(s)
Betacoronavirus/genetics , Betacoronavirus/isolation & purification , Community-Acquired Infections/diagnosis , Community-Acquired Infections/virology , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Sentinel Surveillance , Adolescent , Adult , Aged , COVID-19 , Child , Child, Preschool , Community-Acquired Infections/epidemiology , Coronavirus Infections/epidemiology , Emergency Service, Hospital , Female , Humans , Infant , Male , Middle Aged , New York City/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Sequence Analysis , Travel-Related Illness , Young Adult
2.
Emerg Microbes Infect ; 10(1): 1515-1518, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1313723

ABSTRACT

We show a shift in the prevalence of respiratory viral pathogens in community-acquired pneumonia patients during the COVID-19 pandemic. Our data support the efficiency of non-pharmaceutical interventions on virus circulation except for rhinoviruses. The consequences of an altered circulation on subsequent winter seasons remain unclear and support the importance of systematic virological surveillance.


Subject(s)
COVID-19/epidemiology , Community-Acquired Infections/epidemiology , Pneumonia/epidemiology , Respiratory Tract Infections/epidemiology , Adult , Aged , Bacteria/classification , Bacteria/genetics , Bacteria/isolation & purification , COVID-19/virology , Community-Acquired Infections/microbiology , Community-Acquired Infections/virology , Female , Germany/epidemiology , Humans , Male , Middle Aged , Pandemics , Pneumonia/microbiology , Pneumonia/virology , Prevalence , Prospective Studies , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/virology , SARS-CoV-2/genetics , SARS-CoV-2/physiology , Viruses/classification , Viruses/genetics , Viruses/isolation & purification , Young Adult
3.
J Med Virol ; 93(10): 6008-6015, 2021 10.
Article in English | MEDLINE | ID: covidwho-1298507

ABSTRACT

INTRODUCTION: Coronavirus disease-2019 (COVID-19) is a respiratory disease whose clinical manifestation ranges from asymptomatic to severe respiratory failure. The purpose of this study was to investigate the place of serum surfactant-D (SP-D) and angiopoetin-2 (Ang-2) levels in predicting severity of disease in patients diagnosed with COVID-19. METHODS: Sixty-four patients diagnosed with COVID-19 between September 2020 and February 2021, 50 patients diagnosed with community-acquired pneumonia and a 50-member healthy control group were included in the study. Plasma samples and clinical data were collected within 72 h after admission, during hospital stay. Serum SP-D and Ang-2 concentrations were measured using the enzyme-linked immunosorbent assay. RESULTS: SP-D and Ang-2 levels were significantly higher in the mild-moderate pneumonia and severe/critical patient groups compared to the asymptomatic and noncomplicated COVID-19 patients (p < 0.001 for all groups). Serum SP-D and Ang-2 levels of severe-critical COVID-19 patients were significantly higher than CAP patients (p < 0.001). Powerful correlation was present between clinical severity of COVID-19 and SP-D and Ang-2 levels (r = 0.885 p < 0.001 and r = 0.913 p < 0.001, respectively). Cut-off values of 37.7 ng/ml (AUC = 0.763, p < 0.001, 95% confidence interval [CI] = 0.667-0.860) for SP-D and 4208.3 pg/ml (AUC = 0.659, p = 0.004, 95% CI = 0.554-0.763) for Ang-2 were identified as predictors of COVID-19 disease at receiver operating characteristic curve analysis. CONCLUSION: SP-D and Ang-2 are predictive factors in differentiating COVID-19 patients and determining severity of disease. These data may be important for the initiation of treatment in the early stage of the disease in patients with COVID-19.


Subject(s)
Angiopoietin-2/metabolism , COVID-19/diagnosis , COVID-19/metabolism , Lung Injury/metabolism , Pulmonary Surfactant-Associated Protein D/metabolism , Adult , Aged , Biomarkers/blood , Community-Acquired Infections/diagnosis , Community-Acquired Infections/virology , Diagnostic Tests, Routine , Female , Humans , Lung Injury/virology , Male , Middle Aged , Prognosis , Prospective Studies , ROC Curve , Severity of Illness Index
4.
Am J Respir Crit Care Med ; 203(9): 1070-1087, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1223640

ABSTRACT

Background: This document provides evidence-based clinical practice guidelines on the diagnostic utility of nucleic acid-based testing of respiratory samples for viral pathogens other than influenza in adults with suspected community-acquired pneumonia (CAP).Methods: A multidisciplinary panel developed a Population-Intervention-Comparison-Outcome question, conducted a pragmatic systematic review, and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations.Results: The panel evaluated the literature to develop recommendations regarding whether routine diagnostics should include nucleic acid-based testing of respiratory samples for viral pathogens other than influenza in suspected CAP. The evidence addressing this topic was generally adjudicated to be of very low quality because of risk of bias and imprecision. Furthermore, there was little direct evidence supporting a role for routine nucleic acid-based testing of respiratory samples in improving critical outcomes such as overall survival or antibiotic use patterns. However, on the basis of direct and indirect evidence, recommendations were made for both outpatient and hospitalized patients with suspected CAP. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was not addressed in the literature at the time of the evidence review.Conclusions: The panel formulated and provided their rationale for recommendations on nucleic acid-based diagnostics for viral pathogens other than influenza for patients with suspected CAP.


Subject(s)
Community-Acquired Infections/virology , DNA, Viral/analysis , Pneumonia/virology , Societies, Medical , Viruses/genetics , Community-Acquired Infections/diagnosis , Humans , Pneumonia/diagnosis
5.
J Microbiol Immunol Infect ; 54(2): 253-260, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1203183

ABSTRACT

BACKGROUND/PURPOSE: Transplant recipients are vulnerable to life-threatening community-acquired respiratory viruses (CA-RVs) infection (CA-RVI). Even if non-transplant critically ill patients in intensive care unit (ICU) have serious CA-RVI, comparison between these groups remains unclear. We aimed to evaluate clinical characteristics and mortality of CA-RVI except seasonal influenza A/B in transplant recipients and non-transplant critically ill patients in ICU. METHODS: We collected 37,777 CA-RVs multiplex real-time reverse transcription-polymerase chain reaction test results of individuals aged ≥18 years from November 2012 to November 2017. The CA-RVs tests included adenovirus, coronavirus 229E/NL63/OC43, human bocavirus, human metapneumovirus, parainfluenza virus 1/2/3, rhinovirus, and respiratory syncytial virus A/B. RESULTS: We found 286 CA-RVI cases, including 85 solid organ transplantation recipients (G1), 61 hematopoietic stem cell transplantation recipients (G2), and 140 non-transplant critically ill patients in ICU (G3), excluding those with repeated isolation within 30 days. Adenovirus positive rate and infection cases were most prominent in G2 (p < 0.001). The median time interval between transplantation and CA-RVI was 30 and 20 months in G1 and G2, respectively. All-cause in-hospital mortality was significantly higher in G3 than in G1 or G2 (51.4% vs. 28.2% or 39.3%, p = 0.002, respectively). The mechanical ventilation (MV) was the independent risk factor associated with all-cause in-hospital mortality in all three groups (hazard ratio, 3.37, 95% confidence interval, 2.04-5.56, p < 0.001). CONCLUSIONS: This study highlights the importance of CA-RVs diagnosis in transplant recipients even in long-term posttransplant period, and in non-transplant critically ill patients in ICU with MV.


Subject(s)
Community-Acquired Infections/etiology , Respiratory Tract Infections/etiology , Transplant Recipients , Adult , Aged , Cohort Studies , Community-Acquired Infections/mortality , Community-Acquired Infections/virology , Critical Illness , Disease Susceptibility , Female , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Immunocompromised Host , Male , Middle Aged , Organ Transplantation/adverse effects , Republic of Korea/epidemiology , Respiratory Tract Infections/mortality , Respiratory Tract Infections/virology , Retrospective Studies , Risk Factors
6.
J Trop Pediatr ; 67(1)2021 01 29.
Article in English | MEDLINE | ID: covidwho-1171572

ABSTRACT

INTRODUCTION: The SARS-CoV-2/COVID-19 may produce neurological manifestations, including its occurrence in children, and newborns, which has been little reported so far in newborns with COVID-19. CASE: We present a case in Colombia, of community-acquired neonatal infection of SARS-CoV-2, with suggestive symptoms, such as fever, and showing neurological findings, such as drowsiness, poor suction and mild hypotonia for a short time. DISCUSSION: The clinical manifestations of SARS-COV-2 in neonates are beginning to be described in detail. We report a case of SARS-COV-2-associated neurological compromise in a newborn, with features of drowsiness, poor suction and hypotonia.


Subject(s)
COVID-19/complications , Community-Acquired Infections/virology , Nervous System Diseases/virology , COVID-19/diagnosis , Colombia , Community-Acquired Infections/diagnosis , Fever/virology , Humans , Infant, Newborn , Muscle Hypotonia/virology , Sleepiness
7.
Clin Infect Dis ; 71(16): 2222-2226, 2020 11 19.
Article in English | MEDLINE | ID: covidwho-1153139

ABSTRACT

This is the first known community transmission case of the novel coronavirus disease (COVID-19) in the United States, with significant public health implications. Diagnosis of COVID-19 is currently confirmed with PCR based testing of appropriate respiratory samples. Given the absence of travel or known exposure history, this patient did not meet the criteria for testing according to CDC guidelines at the time of her presentation. Since this case, any patient with severe disease (eg, ARDS or pneumonia) requiring hospitalization without an explanatory diagnosis can be tested even if no clear source of exposure is identified. While influencing national health policies for revising screening criteria, this case also highlighted significant knowledge gaps in diagnosis and treatment and a desperate need for early, widespread, fast and cheap testing for COVID-19.


Subject(s)
COVID-19/diagnostic imaging , Community-Acquired Infections/virology , Respiratory Distress Syndrome/virology , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , Adult , Alanine/analogs & derivatives , Alanine/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/complications , COVID-19/drug therapy , Community-Acquired Infections/drug therapy , Female , Humans , Middle Aged , Respiratory Distress Syndrome/diagnostic imaging , Risk Factors , Shock, Septic/etiology , Thorax/diagnostic imaging , Tomography, X-Ray Computed , Treatment Outcome , United States/epidemiology
8.
Can Respir J ; 2020: 8715756, 2020.
Article in English | MEDLINE | ID: covidwho-1066954

ABSTRACT

Background: Nonresponding pneumonia is responsible for the most mortality of community-acquired pneumonia (CAP). However, thus far, it is not clear whether viral infection plays an important role in the etiology of nonresponding CAP and whether there is a significant difference in the clinical characteristics between viral and nonviral nonresponding CAP. Methods: From 2016 to 2019, nonresponding CAP patients were retrospectively enrolled in our study. All patients received bronchoalveolar lavage (BAL) and virus detection in BAL fluid by multiplex real-time polymerase chain reaction (PCR), and clinical, laboratory, and radiographic data were collected. Results: A total of 43 patients were included. The median age was 62 years, and 65.1% of patients were male. Overall, 20 patients (46.5%) were identified with viral infection. Of these viruses, influenza virus (n = 8) and adenovirus (n = 7) were more frequently detected, and others included herpes simplex virus, human enterovirus, cytomegalovirus, human coronavirus 229E, rhinovirus, and parainfluenza virus. Compared with nonviral nonresponding CAP, only ground-glass opacity combined with consolidation was a more common imaging manifestation in viral nonresponding CAP. However, no obvious differences were found in clinical and laboratory findings between the presence and the absence of viral infections. Conclusions: Viral infections were particularly frequent in adults with nonresponding CAP. The ground-glass opacity combined with consolidation was a specific imaging manifestation for viral nonresponding CAP, while the clinical and laboratory data showed no obvious differences between viral and nonviral nonresponding CAP.


Subject(s)
Bronchoalveolar Lavage Fluid/virology , Multiplex Polymerase Chain Reaction , Pneumonia, Viral/diagnosis , Real-Time Polymerase Chain Reaction , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Community-Acquired Infections/diagnosis , Community-Acquired Infections/virology , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Pneumonia, Bacterial/diagnosis , Pneumonia, Bacterial/drug therapy , Pneumonia, Viral/virology , Retrospective Studies , Young Adult
9.
QJM ; 113(12): 841-850, 2020 Dec 01.
Article in English | MEDLINE | ID: covidwho-1066397

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a novel virus with continuously evolving transmission trends. Contact tracing and quarantining of positive cases are chief strategies of disease control that has been accepted globally, though scientific knowledge regarding household transmission of the COVID-19 through contact of positive case is sparse. Current systematic review was planned to assess global statistics and characteristics of household secondary attack rate (SAR) of COVID-19. Eligible articles were retrieved through search of-MEDLINE, SCOPUS and EMBASE for the period December 2019 to 15 June 2020. Search terms were developed to identify articles reporting household SARs in various countries. After initial screening of 326 articles, 13 eligible studies were included in the final evidence synthesis. We found that SAR varies widely across countries with lowest reported rate as 4.6% and highest as 49.56%. The rates were unaffected by confounders such as population of the country, lockdown status and geographic location. Review suggested greater vulnerability of spouse and elderly population for secondary transmission than other household members. It was also observed that quarantining and isolation are most effective strategies for prevention of the secondary transmission of the disease. Symptomatic status of the index case emerged to be a critical factor, with very low transmission probability during asymptomatic phase. Present review findings recommend that adequate measures should be provided to protect the vulnerable population as only case tracing and quarantining might be insufficient. It should be combined with advisory for limiting household contacts and active surveillance for symptom onset.


Subject(s)
COVID-19/transmission , Community-Acquired Infections/transmission , Family Characteristics , Family Health , Pneumonia, Viral/transmission , Community-Acquired Infections/virology , Humans , Pneumonia, Viral/virology , Risk Factors , SARS-CoV-2
10.
Int J Infect Dis ; 102: 316-318, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1060468

ABSTRACT

The ongoing worldwide COVID-19 pandemic has become a huge threat to global public health. Using CT image, 3389 COVID-19 patients, 1593 community-acquired pneumonia (CAP) patients, and 1707 nonpneumonia subjects were included to explore the different patterns of lung and lung infection. We found that COVID-19 patients have a significant reduced lung volume with increased density and mass, and the infections tend to present as bilateral lower lobes. The findings provide imaging evidence to improve our understanding of COVID-19.


Subject(s)
COVID-19/diagnostic imaging , Lung/physiopathology , Big Data , COVID-19/physiopathology , COVID-19/virology , Community-Acquired Infections/diagnostic imaging , Community-Acquired Infections/physiopathology , Community-Acquired Infections/virology , Female , Humans , Lung/diagnostic imaging , Lung/virology , Male , Middle Aged , Pandemics , Respiratory Function Tests , Retrospective Studies , SARS-CoV-2/physiology , Tomography, X-Ray Computed/methods
11.
J Hosp Infect ; 107: 91-94, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1036511

ABSTRACT

This study aimed to determine whether nosocomial coronavirus disease 2019 (COVID-19) has a worse outcome compared with community-acquired COVID-19. This was a prospective cohort study of all hospitalized patients with confirmed COVID-19 in three acute hospitals on 9th April 2020. Patients were followed-up for at least 30 days. Nosocomial infection was defined as a positive swab after 7 days of admission. In total, one hundred and seventy-three patients were identified, and 19 (11.0%) had nosocomial infection. Thirty-two (18.5%) patients died within 30 days (all cause) of a positive swab test; there were no significant differences in 30-day all-cause mortality rates between the three groups (i.e. patients admitted with suspected COVID-19, patients with incidental COVID-19 and patients with nosocomial COVID-19): 21.1% vs 17.6% vs 21.6% (P=0.755). Nosocomial COVID-19 is not associated with increased mortality compared with community-acquired COVID-19.


Subject(s)
COVID-19/mortality , COVID-19/transmission , Community-Acquired Infections/mortality , Cross Infection/complications , Cross Infection/mortality , Aged , Aged, 80 and over , Community-Acquired Infections/virology , Comorbidity , Cross Infection/virology , Female , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Prospective Studies , Risk Factors , Socioeconomic Factors , United Kingdom
13.
Med Image Anal ; 68: 101910, 2021 02.
Article in English | MEDLINE | ID: covidwho-943426

ABSTRACT

The coronavirus disease, named COVID-19, has become the largest global public health crisis since it started in early 2020. CT imaging has been used as a complementary tool to assist early screening, especially for the rapid identification of COVID-19 cases from community acquired pneumonia (CAP) cases. The main challenge in early screening is how to model the confusing cases in the COVID-19 and CAP groups, with very similar clinical manifestations and imaging features. To tackle this challenge, we propose an Uncertainty Vertex-weighted Hypergraph Learning (UVHL) method to identify COVID-19 from CAP using CT images. In particular, multiple types of features (including regional features and radiomics features) are first extracted from CT image for each case. Then, the relationship among different cases is formulated by a hypergraph structure, with each case represented as a vertex in the hypergraph. The uncertainty of each vertex is further computed with an uncertainty score measurement and used as a weight in the hypergraph. Finally, a learning process of the vertex-weighted hypergraph is used to predict whether a new testing case belongs to COVID-19 or not. Experiments on a large multi-center pneumonia dataset, consisting of 2148 COVID-19 cases and 1182 CAP cases from five hospitals, are conducted to evaluate the prediction accuracy of the proposed method. Results demonstrate the effectiveness and robustness of our proposed method on the identification of COVID-19 in comparison to state-of-the-art methods.


Subject(s)
COVID-19/diagnostic imaging , Community-Acquired Infections/diagnostic imaging , Diagnosis, Computer-Assisted/methods , Machine Learning , Pneumonia, Viral/diagnostic imaging , Radiographic Image Interpretation, Computer-Assisted/methods , Tomography, X-Ray Computed , China , Community-Acquired Infections/virology , Datasets as Topic , Diagnosis, Differential , Humans , Pneumonia, Viral/virology , SARS-CoV-2
14.
J Infect Dev Ctries ; 14(10): 1125-1127, 2020 Oct 31.
Article in English | MEDLINE | ID: covidwho-918915

ABSTRACT

Sharing a common land border with China, Vietnam has faced a high risk of transmission of Coronavirus Disease 2019 (COVID-19). Rapid decision making and robust public health measures were established by the Vietnamese Government to control the situation. As of 17 May 2020, Vietnam reported 320 total confirmed cases of COVID-19, of whom 260 had fully recovered, while the remaining 60 cases were still under treatment. Noteworthy, the current data still confirms zero deaths and within the last 32 consecutive days prior to this submission, there have been no new infections in the country. Valuable lessons from Severe Acute Respiratory Syndrome in 2003 such as use of quarantine, early recognition and quick response to the infection, and increased awareness of its citizens have put Vietnam in a somewhat better position against COVID-19 compared to other places. Vietnam, at the current time, mulls declaring an end of the current COVID-19 outbreak.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Betacoronavirus , COVID-19 , Community-Acquired Infections/epidemiology , Community-Acquired Infections/virology , Humans , Quarantine , SARS-CoV-2 , Vietnam/epidemiology
15.
Mem. Inst. Oswaldo Cruz ; 115: e200183, 2020. tab, graf
Article in English | LILACS (Americas) | ID: covidwho-750955

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly spread around the world during 2020, but the precise time in which the virus began to spread locally is difficult to trace for most countries. Here, we estimate the probable onset date of the community spread of SARS-CoV-2 for heavily affected countries from Western Europe and the Americas on the basis of the cumulative number of deaths reported during the early stage of the epidemic. Our results support that SARS-CoV-2 probably started to spread locally in all western countries analysed between mid-January and mid-February 2020, thus long before community transmission was officially recognised and control measures were implemented.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Community-Acquired Infections/epidemiology , Pneumonia, Viral/transmission , Americas/epidemiology , Coronavirus Infections/transmission , Community-Acquired Infections/transmission , Community-Acquired Infections/virology , Europe/epidemiology , Pandemics , Betacoronavirus , SARS-CoV-2 , COVID-19
16.
J Int Med Res ; 48(8): 300060520949039, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-739220

ABSTRACT

OBJECTIVE: This study was performed to investigate the clinical characteristics of patients with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: We analyzed the electronic medical records of 405 hospitalized patients with laboratory-confirmed COVID-19 in the Third Hospital of Wuhan. RESULTS: The patients' median age was 56 years, 54.1% were female, 11.4% had a history of smoking, and 10.6% had a history of drinking. All cases of COVID-19 were community-acquired. Fever (76.8%) and cough (53.3%) were the most common clinical manifestations, and circulatory system diseases were the most common comorbidities. Gastrointestinal symptoms were present in 61.2% of the patients, and 2.9% of the patients were asymptomatic. Computed tomography showed ground-glass opacities in most patients (72.6%) and consolidation in 30.9%. Lymphopenia (72.3%) and hypoproteinemia (71.6%) were observed in most patients. About 20% of patients had abnormal liver function. Patients with severe disease had significantly more prominent laboratory abnormalities, including an abnormal lymphocyte count and abnormal C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, D-dimer, and albumin levels. CONCLUSION: SARS-CoV-2 causes a variety of severe respiratory illnesses similar to those caused by SARS-CoV-1. Older age, chronic comorbidities, and laboratory abnormalities are associated with disease severity.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus Infections/pathology , Gastrointestinal Diseases/diagnosis , Pneumonia, Viral/diagnosis , Pneumonia, Viral/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Aging/physiology , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Betacoronavirus , C-Reactive Protein/analysis , COVID-19 , China , Community-Acquired Infections/diagnosis , Community-Acquired Infections/pathology , Community-Acquired Infections/virology , Comorbidity , Coronavirus Infections/transmission , Female , Gastrointestinal Diseases/pathology , Gastrointestinal Diseases/virology , Humans , Lymphocyte Count , Male , Middle Aged , Pandemics , Pneumonia, Viral/transmission , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index , Young Adult
17.
Infect Dis Poverty ; 9(1): 118, 2020 Aug 26.
Article in English | MEDLINE | ID: covidwho-730582

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is currently the most serious infectious disease in the world. An accurate diagnosis of this disease in the clinic is very important. This study aims to improve the differential ability of computed tomography (CT) to diagnose COVID-19 and other community-acquired pneumonias (CAPs) and evaluate the short-term prognosis of these patients. METHODS: The clinical and imaging data of 165 COVID-19 and 118 CAP patients diagnosed in seven hospitals in Anhui Province, China from January 21 to February 28, 2020 were retrospectively analysed. The CT manifestations of the two groups were recorded and compared. A correlation analysis was used to examine the relationship between COVID-19 and age, size of lung lesions, number of involved lobes, and CT findings of patients. The factors that were helpful in diagnosing the two groups of patients were identified based on specificity and sensitivity. RESULTS: The typical CT findings of COVID-19 are simple ground-glass opacities (GGO), GGO with consolidation or grid-like changes. The sensitivity and specificity of the combination of age, white blood cell count, and ground-glass opacity in the diagnosis of COVID-19 were 92.7 and 66.1%, respectively. Pulmonary consolidation, fibrous cords, and bronchial wall thickening were used as indicators to exclude COVID-19. The sensitivity and specificity of the combination of these findings were 78.0 and 63.6%, respectively. The follow-up results showed that 67.8% (112/165) of COVID-19 patients had abnormal changes in their lung parameters, and the severity of the pulmonary sequelae of patients over 60 years of age worsened with age. CONCLUSIONS: Age, white blood cell count and ground-glass opacity have high accuracy in the early diagnosis of COVID-19 and the differential diagnosis from CAP. Patients aged over 60 years with COVID-19 have a poor prognosis. This result provides certain significant guidance for the diagnosis and treatment of new coronavirus pneumonia.


Subject(s)
Community-Acquired Infections/diagnostic imaging , Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Adolescent , Adult , Aged , Aged, 80 and over , Betacoronavirus/isolation & purification , COVID-19 , COVID-19 Testing , Child , Child, Preschool , China/epidemiology , Clinical Laboratory Techniques/methods , Community-Acquired Infections/virology , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Retrospective Studies , SARS-CoV-2 , Sensitivity and Specificity , Tomography, X-Ray Computed/methods , Young Adult
18.
Emerg Infect Dis ; 26(10): 2489-2491, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-696601

ABSTRACT

Whether a healthcare worker's severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is community or hospital acquired affects prevention practices. We used virus sequencing to determine that infection of a healthcare worker who cared for 2 SARS-CoV-2-infected patients was probably community acquired. Appropriate personal protective equipment may have protected against hospital-acquired infection.


Subject(s)
Betacoronavirus , Community-Acquired Infections/virology , Coronavirus Infections/transmission , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Occupational Diseases/prevention & control , Pneumonia, Viral/transmission , RNA, Viral/analysis , COVID-19 , Coronavirus Infections/virology , Health Personnel , Humans , Pandemics , Personal Protective Equipment , Pneumonia, Viral/virology , SARS-CoV-2 , Sequence Analysis, RNA
19.
Lancet Infect Dis ; 20(11): 1273-1280, 2020 11.
Article in English | MEDLINE | ID: covidwho-623256

ABSTRACT

BACKGROUND: 10 days after the first reported case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the Netherlands (on Feb 27, 2020), 55 (4%) of 1497 health-care workers in nine hospitals located in the south of the Netherlands had tested positive for SARS-CoV-2 RNA. We aimed to gain insight in possible sources of infection in health-care workers. METHODS: We did a cross-sectional study at three of the nine hospitals located in the south of the Netherlands. We screened health-care workers at the participating hospitals for SARS-CoV-2 infection, based on clinical symptoms (fever or mild respiratory symptoms) in the 10 days before screening. We obtained epidemiological data through structured interviews with health-care workers and combined this information with data from whole-genome sequencing of SARS-CoV-2 in clinical samples taken from health-care workers and patients. We did an in-depth analysis of sources and modes of transmission of SARS-CoV-2 in health-care workers and patients. FINDINGS: Between March 2 and March 12, 2020, 1796 (15%) of 12 022 health-care workers were screened, of whom 96 (5%) tested positive for SARS-CoV-2. We obtained complete and near-complete genome sequences from 50 health-care workers and ten patients. Most sequences were grouped in three clusters, with two clusters showing local circulation within the region. The noted patterns were consistent with multiple introductions into the hospitals through community-acquired infections and local amplification in the community. INTERPRETATION: Although direct transmission in the hospitals cannot be ruled out, our data do not support widespread nosocomial transmission as the source of infection in patients or health-care workers. FUNDING: EU Horizon 2020 (RECoVer, VEO, and the European Joint Programme One Health METASTAVA), and the National Institute of Allergy and Infectious Diseases, National Institutes of Health.


Subject(s)
Betacoronavirus/genetics , Community-Acquired Infections/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Cross Infection/epidemiology , Health Personnel , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Adult , Aged , COVID-19 , Community-Acquired Infections/virology , Coronavirus Infections/virology , Cross Infection/virology , Cross-Sectional Studies , Female , Genetic Variation , Hospitals, Teaching , Humans , Male , Mass Screening/methods , Middle Aged , Netherlands/epidemiology , Pandemics , Pneumonia, Viral/virology , SARS-CoV-2 , Whole Genome Sequencing , Young Adult
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