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1.
Transbound Emerg Dis ; 68(6): 3443-3452, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1526424

ABSTRACT

The recently emerged novel coronavirus, SARS-CoV-2, is phylogenetically related to bat coronaviruses (CoVs), specifically SARS-related CoVs from the Eurasian bat family Rhinolophidae. As this human pandemic virus has spread across the world, the potential impacts of SARS-CoV-2 on native North American bat populations are unknown, as is the ability of North American bats to serve as reservoirs or intermediate hosts able to transmit the virus to humans or to other animal species. To help determine the impacts of the pandemic virus on North American bat populations, we experimentally challenged big brown bats (Eptesicus fuscus) with SARS-CoV-2 under BSL-3 conditions. We inoculated the bats both oropharyngeally and nasally, and over the ensuing three weeks, we measured infectivity, pathology, virus concentrations in tissues, oral and rectal virus excretion, virus transmission, and clinical signs of disease. We found no evidence of SARS-CoV-2 infection in any examined bat, including no viral excretion, no transmission, no detectable virus in tissues, and no signs of disease or pathology. Based on our findings, it appears that big brown bats are resistant to infection with the SARS-CoV-2. The potential susceptibility of other North American bat species to SARS-CoV-2 remains to be investigated.


Subject(s)
COVID-19 , Chiroptera , Coronaviridae , Animals , COVID-19/veterinary , Humans , North America/epidemiology , Phylogeny , SARS-CoV-2
2.
Infect Genet Evol ; 95: 105087, 2021 11.
Article in English | MEDLINE | ID: covidwho-1442480

ABSTRACT

The novel coronavirus SARS-CoV-2 was first detected in China in December 2019 and has rapidly spread around the globe. The World Health Organization declared COVID-19 a pandemic in March 2020 just three months after the introduction of the virus. Individual nations have implemented and enforced a variety of social distancing interventions to slow the virus spread, that had different degrees of success. Understanding the role of non-pharmaceutical interventions (NPIs) on COVID-19 transmission in different settings is highly important. While most such studies have focused on China, neighboring Asian counties, Western Europe, and North America, there is a scarcity of studies for Eastern Europe. The aim of this epidemiological study is to fill this gap by analyzing the characteristics of the first months of the epidemic in Ukraine using agent-based modelling and phylodynamics. Specifically, first we studied the dynamics of COVID-19 incidence and mortality and explored the impact of epidemic NPIs. Our stochastic model suggests, that even a small delay of weeks could have increased the number of cases by up to 50%, with the potential to overwhelm hospital systems. Second, the genomic data analysis suggests that there have been multiple introductions of SARS-CoV-2 into Ukraine during the early stages of the epidemic. Our findings support the conclusion that the implemented travel restrictions may have had limited impact on the epidemic spread. Third, the basic reproduction number for the epidemic that has been estimated independently from case counts data and from genomic data suggest sustained intra-country transmissions.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Genome, Viral , Models, Statistical , SARS-CoV-2/genetics , SARS-CoV-2/pathogenicity , COVID-19/virology , China/epidemiology , Epidemiological Monitoring , Europe/epidemiology , Humans , Incidence , North America/epidemiology , Phylogeny , Physical Distancing , SARS-CoV-2/classification , SARS-CoV-2/isolation & purification , Travel/statistics & numerical data , Ukraine/epidemiology
3.
Virus Res ; 305: 198551, 2021 11.
Article in English | MEDLINE | ID: covidwho-1440397

ABSTRACT

Samples from complete genomes of SARS-CoV-2 isolated during the first wave (December 2019-July 2020) of the global COVID-19 pandemic from 21 countries (Asia, Europe, Middle East and America) around the world, were analyzed using the phylogenetic method with molecular clock dating. Results showed that the first cases of COVID-19 in the human population appeared in the period between July and November 2019 in China. The spread of the virus into other countries of the world began in the autumn of 2019. In mid-February 2020, the virus appeared in all the countries we analyzed. During this time, the global population of SARS-CoV-2 was characterized by low levels of the genetic polymorphism, making it difficult to accurately assess the pathways of infection. The rate of evolution of the coding region of the SARS-CoV-2 genome equal to 7.3 × 10-4 (5.95 × 10-4-8.68 × 10-4) nucleotide substitutions per site per year is comparable to those of other human RNA viruses (Measles morbillivirus, Rubella virus, Enterovirus C). SARS-CoV-2 was separated from its known close relative, the bat coronavirus RaTG13 of the genus Betacoronavirus, approximately 15-43 years ago (the end of the 20th century).


Subject(s)
COVID-19/epidemiology , Evolution, Molecular , Genome, Viral , Mutation Rate , SARS-CoV-2/genetics , Animals , Asia/epidemiology , COVID-19/history , COVID-19/transmission , COVID-19/virology , Chiroptera/virology , Europe/epidemiology , Genomics/methods , History, 20th Century , History, 21st Century , Humans , Middle East/epidemiology , North America/epidemiology , Phylogeny , Polymorphism, Genetic , SARS-CoV-2/classification , SARS-CoV-2/pathogenicity , South America/epidemiology
4.
Oral Dis ; 27 Suppl 3: 684-687, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1434800

ABSTRACT

The COVID-19 pandemic is a major public health crisis for countries around the world. In response to this global outbreak, the World Health Organization declared a public health emergency of international concern. Dental professionals are especially at high risk of contracting the COVID-19 virus due to the unique nature of dentistry, more specifically, exposure to aerosols and droplets. When it comes to dental emergencies, it was crucial to maintain urgent dental care services operational to help reduce the burden on our healthcare system and hospitals already under pressure. The COVID-19 pandemic has significantly impacted how dentistry is practiced in North America in both the private practice and academic settings. This article shares the perspectives of dentists practicing in private practice and clinician-researchers in academic dental institutions. More specifically, we discuss about measures implemented to minimize risks of disease transmission, challenges in emergency dental care, impact on patients, as well as impact on the professional and personal lives of the dental team during the COVID-19 crisis.


Subject(s)
COVID-19 , Pandemics , Dentistry , Humans , North America/epidemiology , Private Practice , SARS-CoV-2
5.
Acad Radiol ; 28(7): 950-952, 2021 07.
Article in English | MEDLINE | ID: covidwho-1375876
6.
Neurol Neuroimmunol Neuroinflamm ; 8(5)2021 09.
Article in English | MEDLINE | ID: covidwho-1371991

ABSTRACT

BACKGROUND AND OBJECTIVE: To describe the impact of coronavirus disease 2019 (COVID-19) on people with neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD). METHODS: The COVID-19 Infections in Multiple Sclerosis (MS) and Related Diseases (COViMS) Registry collected data on North American patients with MS and related diseases with laboratory-positive or highly suspected SARS-CoV-2 infection. Deidentified data were entered into a web-based registry by health care providers. Data were analyzed using t-tests, Pearson χ2 tests, or Fisher exact tests for categorical variables. Univariate logistic regression models examined effects of risk factors and COVID-19 clinical severity. RESULTS: As of June 7, 2021, 77 patients with NMOSD and 20 patients with MOGAD were reported in the COViMS Registry. Most patients with NMOSD were laboratory positive for SARS-CoV-2 and taking rituximab at the time of COVID-19 diagnosis. Most patients with NMOSD were not hospitalized (64.9% [95% CI: 53.2%-75.5%]), whereas 15.6% (95% CI: 8.3%-25.6%) were hospitalized only, 9.1% (95% CI: 3.7%-17.8%) were admitted to the ICU and/or ventilated, and 10.4% (95% CI: 4.6%-19.5%) died. In patients with NMOSD, having a comorbidity was the sole factor identified for poorer COVID-19 outcome (OR = 6.0, 95% CI: 1.79-19.98). Most patients with MOGAD were laboratory positive for SARS-CoV-2, and almost half were taking rituximab. Among patients with MOGAD, 75.0% were not hospitalized, and no deaths were recorded; no factors were different between those not hospitalized and those hospitalized, admitted to the ICU, or ventilated. DISCUSSION: Among the reported patients with NMOSD, a high mortality rate was observed, and the presence of comorbid conditions was associated with worse COVID-19 outcome. There were no deaths reported in the patients with MOGAD, although these observations are limited due to small sample size.


Subject(s)
Autoimmune Diseases of the Nervous System/mortality , COVID-19/mortality , COVID-19/therapy , Myelin-Oligodendrocyte Glycoprotein/immunology , Neuromyelitis Optica/mortality , Registries , Adult , Aged , Autoimmune Diseases of the Nervous System/immunology , COVID-19/diagnosis , Comorbidity , Female , Hospitalization , Humans , Immunologic Factors/administration & dosage , Intensive Care Units , Male , Middle Aged , Neuromyelitis Optica/drug therapy , North America/epidemiology , Outcome Assessment, Health Care , Respiration, Artificial , Rituximab/administration & dosage
7.
Innovations (Phila) ; 16(4): 350-357, 2021.
Article in English | MEDLINE | ID: covidwho-1282223

ABSTRACT

OBJECTIVE: We report the impact of the coronavirus disease 2019 (COVID-19) pandemic on cardiac surgery trainee education in North America. METHODS: A survey was sent to participating academic adult cardiac surgery centers in North America. Data regarding the effect of COVID-19 on cardiac surgery training were analyzed. RESULTS: Responses were received from 53 academic institutions with diverse geographic distribution. Cardiac surgery trainee re-deployment to alternative clinical duties peaked at the height of the pandemic. We stratified institutions based on high (n = 20) and low burden (n = 33) of patients hospitalized with COVID-19. The majority of institutions have converted didactics (high burden 90% vs low burden 73%) and interviews for jobs/fellowships (high burden 75% vs low burden 73%) from in-person to virtual. Institutions were mixed in preference for administration of the licensing examination, with the most common preference for examinations to be held remotely on normal timeline (high burden 45% vs low burden 30%) or in person with more than 3-month delay (high burden 20% vs low burden 33%). Despite the challenges experienced during the COVID-19 pandemic on trainee clinical experience, re-deployment, and decreased operative volume, institutions expected their trainees to graduate on schedule (high burden 95% vs low burden 91%). CONCLUSIONS: Our study demonstrates that actions taken during the COVID-19 pandemic has led to disruptions in cardiac surgery training with transition of didactics and interviews virtually and re-deployment to alternative duties. Despite this, institutions remain optimistic that their trainees will graduate on schedule.


Subject(s)
COVID-19 , Cardiac Surgical Procedures/education , Education, Medical, Graduate/statistics & numerical data , Pandemics , Adult , COVID-19/epidemiology , Humans , Internship and Residency/statistics & numerical data , North America/epidemiology , Surveys and Questionnaires
8.
Eur J Epidemiol ; 36(6): 629-640, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1265531

ABSTRACT

We estimated the impact of a comprehensive set of non-pharmeceutical interventions on the COVID-19 epidemic growth rate across the 37 member states of the Organisation for Economic Co-operation and Development during the early phase of the COVID-19 pandemic and between October and December 2020. For this task, we conducted a data-driven, longitudinal analysis using a multilevel modelling approach with both maximum likelihood and Bayesian estimation. We found that during the early phase of the epidemic: implementing restrictions on gatherings of more than 100 people, between 11 and 100 people, and 10 people or less was associated with a respective average reduction of 2.58%, 2.78% and 2.81% in the daily growth rate in weekly confirmed cases; requiring closing for some sectors or for all but essential workplaces with an average reduction of 1.51% and 1.78%; requiring closing of some school levels or all school levels with an average reduction of 1.12% or 1.65%; recommending mask wearing with an average reduction of 0.45%, requiring mask wearing country-wide in specific public spaces or in specific geographical areas within the country with an average reduction of 0.44%, requiring mask-wearing country-wide in all public places or all public places where social distancing is not possible with an average reduction of 0.96%; and number of tests per thousand population with an average reduction of 0.02% per unit increase. Between October and December 2020 work closing requirements and testing policy were significant predictors of the epidemic growth rate. These findings provide evidence to support policy decision-making regarding which NPIs to implement to control the spread of the COVID-19 pandemic.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Masks/statistics & numerical data , Organisation for Economic Co-Operation and Development , Physical Distancing , Quarantine/statistics & numerical data , Asia/epidemiology , Australasia/epidemiology , Europe/epidemiology , Humans , Longitudinal Studies , North America/epidemiology , Pandemics , Quarantine/methods , SARS-CoV-2
10.
Br J Nurs ; 30(10): S8-S14, 2021 May 27.
Article in English | MEDLINE | ID: covidwho-1244357

ABSTRACT

The challenges presented by the global COVID-19 pandemic have intensified the stressors placed on nurses, leading to burnout. Oncology nurse burnout is likely to be an increasingly significant issue for cancer services as the true cost of the pandemic is revealed. Delays in diagnosis and treatment of cancers are reported widely, inevitably leading to poor prognosis and more aggressive treatments for patients. Gaining a better understanding of oncology nurse burnout, its prevalence and causes as well as strategies to reduce or prevent it will help to improve patient care and support staff wellbeing during and after the pandemic. Methodology: A search of the literature related to oncology nurse burnout, covering North America and Europe over 5 years (August 2014-January 2020), resulted in 31 articles for review. None of the studies were carried out in the UK, suggesting a need for robust investigations into oncology nurse burnout in the British health service. Summary: The prevalence of burnout among oncology nurses before the COVID-19 outbreak appeared to be high and is likely to have increased as a result of the pandemic. However, the studies investigating oncology nurse burnout are small and cross-sectional, with low-quality methods. The literature suggests the major causes of burnout arise in the workplace, particularly aspects of the environment that prevent nurses from working according to their values. Although burnout is frequently attributed to workplace factors, interventions remain focused on individuals' coping mechanisms and rarely on the workplace factors that are known to cause it.


Subject(s)
Burnout, Professional , COVID-19 , Oncology Nursing , Burnout, Professional/epidemiology , COVID-19/epidemiology , Europe/epidemiology , Humans , North America/epidemiology
11.
Sci Adv ; 7(21)2021 05.
Article in English | MEDLINE | ID: covidwho-1238477

ABSTRACT

Responses to the COVID-19 outbreak resulted in one of the largest short-term decreases in anthropogenic emissions in modern history. To date, there has been no comprehensive assessment of the impact of lockdowns on air quality and human health. Using global satellite observations and ground measurements from 36 countries in Europe, North America, and East Asia, we find that lockdowns led to reductions in NO2 concentrations globally, resulting in ~32,000 avoided premature mortalities, including ~21,000 in China. However, we do not find corresponding reductions in PM2.5 and ozone globally. Using satellite measurements, we show that the disconnect between NO2 and ozone changes stems from local chemical regimes. The COVID-related lockdowns demonstrate the need for targeted air quality policies to reduce the global burden of air pollution, especially related to secondary pollutants.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control , Environmental Monitoring , Particulate Matter/adverse effects , Air Pollution/adverse effects , COVID-19/pathology , COVID-19/virology , China/epidemiology , Environmental Exposure , Europe/epidemiology , Far East/epidemiology , Humans , North America/epidemiology , Ozone , SARS-CoV-2/pathogenicity
12.
Viruses ; 13(5)2021 05 17.
Article in English | MEDLINE | ID: covidwho-1234831

ABSTRACT

BACKGROUND: little is known about the forecasting of new variants of SARS-COV-2 in North America and the interaction of variants with vaccine-derived neutralizing antibodies. METHODS: the affinity scores of the spike receptor-binding domain (S-RBD) of B.1.1.7, B. 1.351, B.1.617, and P.1 variants in interaction with the neutralizing antibody (CV30 isolated from a patient), and human angiotensin-converting enzyme 2 (hACE2) receptor were predicted using the template-based computational modeling. From the Nextstrain global database, we identified prevalent mutations of S-RBD of SARS-CoV-2 from December 2019 to April 2021. Pre- and post-vaccination time series forecasting models were developed based on the prediction of neutralizing antibody affinity scores for S-RBD of the variants. RESULTS: the proportion of the B.1.1.7 variant in North America is growing rapidly, but the rate will reduce due to high affinity (~90%) to the neutralizing antibody once herd immunity is reached. Currently, the rates of isolation of B. 1.351, B.1.617, and P.1 variants are slowly increasing in North America. Herd immunity is able to relatively control these variants due to their low affinity (~70%) to the neutralizing antibody. The S-RBD of B.1.617 has a 110% increased affinity score to the human angiotensin-converting enzyme 2 (hACE2) in comparison to the wild-type structure, making it highly infectious. CONCLUSION: The newly emerged B.1.351, B.1.617, and P.1 variants escape from vaccine-induced neutralizing immunity and continue circulating in North America in post- herd immunity era. Our study strongly suggests that a third dose of vaccine is urgently needed to cover novel variants with affinity scores (equal or less than 70%) to eliminate developing viral mutations and reduce transmission rates.


Subject(s)
COVID-19/epidemiology , SARS-CoV-2/genetics , Adult , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , Binding Sites/genetics , COVID-19/genetics , Female , Humans , Male , Middle Aged , Models, Theoretical , North America/epidemiology , Protein Binding/genetics , Protein Domains/genetics , Receptors, Virus/metabolism , SARS-CoV-2/pathogenicity , Spike Glycoprotein, Coronavirus/genetics
13.
Sci Rep ; 11(1): 9784, 2021 05 07.
Article in English | MEDLINE | ID: covidwho-1219465

ABSTRACT

The mortality rates of COVID-19 vary across the globe. While some risk factors for poor prognosis of the disease are known, regional differences are suspected. We reviewed the risk factors for critical outcomes of COVID-19 according to the location of the infected patients, from various literature databases from January 1 through June 8, 2020. Candidate variables to predict the outcome included patient demographics, underlying medical conditions, symptoms, and laboratory findings. The risk factors in the overall population included sex, age, and all inspected underlying medical conditions. Symptoms of dyspnea, anorexia, dizziness, fatigue, and certain laboratory findings were also indicators of the critical outcome. Underlying respiratory disease was associated higher risk of the critical outcome in studies from Asia and Europe, but not North America. Underlying hepatic disease was associated with a higher risk of the critical outcome from Europe, but not from Asia and North America. Symptoms of vomiting, anorexia, dizziness, and fatigue were significantly associated with the critical outcome in studies from Asia, but not from Europe and North America. Hemoglobin and platelet count affected patients differently in Asia compared to those in Europe and North America. Such regional discrepancies should be considered when treating patients with COVID-19.


Subject(s)
COVID-19/epidemiology , Age Factors , Asia/epidemiology , Europe/epidemiology , Female , Humans , Male , North America/epidemiology , Pandemics , Risk Factors , SARS-CoV-2/isolation & purification , Sex Factors
14.
Sci Rep ; 11(1): 8435, 2021 04 19.
Article in English | MEDLINE | ID: covidwho-1193599

ABSTRACT

Expansion of COVID-19 worldwide increases interest in unraveling genomic variations of novel SARS-CoV-2 virus. Metadata of 408,493 SARS-CoV-2 genomes submitted to GISAID database were analyzed with respect to genomic clades and their geographic, age, and gender distributions. Of the currently known SARS-CoV-2 clades, clade GR was the most prevalent worldwide followed by GV then GH. Chronological analysis revealed expansion in SARS-CoV-2 clades carrying D614G mutations with the predominance of the newest clade, GV, in the last three months. D614G clades prevail in countries with more COVID-19 cases. Of them, the clades GH and GR were more frequently recovered from severe or deceased COVID-19 cases. In contrast, G and GV clades showed a significantly higher prevalence among asymptomatic patients or those with mild disease. Metadata analysis showed higher (p < 0.05) prevalence of severe/deceased cases among males than females and predominance of GR clade in female patients. Furthermore, severe disease/death was more prevalent (p < 0.05) in elderly than in adults/children. Higher prevalence of the GV clade in children compared to other age groups was also evident. These findings uniquely provide a statistical evidence on the adaptation-driven evolution of SARS-CoV-2 leading to altered infectivity, virulence, and mortality.


Subject(s)
COVID-19/pathology , SARS-CoV-2/genetics , Adult , Age Factors , Aged , COVID-19/epidemiology , COVID-19/virology , Child , Coronavirus Nucleocapsid Proteins/genetics , Coronavirus RNA-Dependent RNA Polymerase/genetics , Databases, Factual , Europe/epidemiology , Female , Humans , Male , Middle Aged , Mutation , North America/epidemiology , SARS-CoV-2/isolation & purification , Sex Factors , Spike Glycoprotein, Coronavirus/genetics , Viral Nonstructural Proteins/genetics
15.
J Epidemiol Glob Health ; 11(2): 143-145, 2021 06.
Article in English | MEDLINE | ID: covidwho-1194577

ABSTRACT

Case fatality rate (CFR) is used to calculate mortality burden of COVID-19 under different scenarios, thus informing risk-benefit balance of interventions both pharmaceutical and nonpharmaceutical. However, observed CFR is driven by testing: as more low-risk cases are identified, observed CFR will decline. This report quantifies test bias by modeling observed CFR as log-log-linear function of test density (tests per population) in 163 countries. CFR declined almost 20% (e.g. from 5% to 4%) for each doubling of test density (p < 0.0001); this association did not vary by continent (interaction p > 0.10) although at any given test density CFR was higher in Europe or North America than in Asia or Africa. This effect of test density on observed CFR is adequate to hide all but the largest true differences in case survivorship. Published estimates of CFR should specify test density, and comparisons should correct for it such as by applying the provided model.


Subject(s)
COVID-19/mortality , Africa/epidemiology , Asia/epidemiology , Bias , Europe/epidemiology , Humans , North America/epidemiology , SARS-CoV-2
16.
J Am Coll Cardiol ; 77(16): 1994-2003, 2021 04 27.
Article in English | MEDLINE | ID: covidwho-1188684

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of ST-segment elevation myocardial infarction (STEMI) care, including timely access to primary percutaneous coronary intervention (PPCI). OBJECTIVES: The goal of the NACMI (North American COVID-19 and STEMI) registry is to describe demographic characteristics, management strategies, and outcomes of COVID-19 patients with STEMI. METHODS: A prospective, ongoing observational registry was created under the guidance of 3 cardiology societies. STEMI patients with confirmed COVID+ (group 1) or suspected (person under investigation [PUI]) (group 2) COVID-19 infection were included. A group of age- and sex-matched STEMI patients (matched to COVID+ patients in a 2:1 ratio) treated in the pre-COVID era (2015 to 2019) serves as the control group for comparison of treatment strategies and outcomes (group 3). The primary outcome was a composite of in-hospital death, stroke, recurrent myocardial infarction, or repeat unplanned revascularization. RESULTS: As of December 6, 2020, 1,185 patients were included in the NACMI registry (230 COVID+ patients, 495 PUIs, and 460 control patients). COVID+ patients were more likely to have minority ethnicity (Hispanic 23%, Black 24%) and had a higher prevalence of diabetes mellitus (46%) (all p < 0.001 relative to PUIs). COVID+ patients were more likely to present with cardiogenic shock (18%) but were less likely to receive invasive angiography (78%) (all p < 0.001 relative to control patients). Among COVID+ patients who received angiography, 71% received PPCI and 20% received medical therapy (both p < 0.001 relative to control patients). The primary outcome occurred in 36% of COVID+ patients, 13% of PUIs, and 5% of control patients (p < 0.001 relative to control patients). CONCLUSIONS: COVID+ patients with STEMI represent a high-risk group of patients with unique demographic and clinical characteristics. PPCI is feasible and remains the predominant reperfusion strategy, supporting current recommendations.


Subject(s)
COVID-19/epidemiology , Percutaneous Coronary Intervention/statistics & numerical data , SARS-CoV-2 , ST Elevation Myocardial Infarction/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Canada/epidemiology , Female , Hospital Mortality , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , North America/epidemiology , Prospective Studies , Recurrence , Registries/statistics & numerical data , Reoperation/statistics & numerical data , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/mortality , ST Elevation Myocardial Infarction/therapy , Stroke/epidemiology , Stroke/etiology , United States/epidemiology , Young Adult
17.
Epidemiol Infect ; 149: e94, 2021 04 13.
Article in English | MEDLINE | ID: covidwho-1180200

ABSTRACT

The global outbreak of coronavirus disease 2019 (COVID-19) is greatly threatening the public health in the world. We reconstructed global transmissions and potential demographic expansions of severe acute respiratory syndrome coronavirus 2 based on genomic information. We found that intercontinental transmissions were rare in January and early February but drastically increased since late February. After world-wide implements of travel restrictions, the transmission frequencies decreased to a low level in April. We identified a total of 88 potential demographic expansions over the world based on the star-radiative networks and 75 of them were found in Europe and North America. The expansion numbers peaked in March and quickly dropped since April. These findings are highly concordant with epidemic reports and modelling results and highlight the significance of quarantine validity on the global spread of COVID-19. Our analyses indicate that the travel restrictions and social distancing measures are effective in containing the spread of COVID-19.


Subject(s)
COVID-19/epidemiology , Genome, Viral , Public Policy , SARS-CoV-2/genetics , Travel , Africa/epidemiology , Asia/epidemiology , Australia/epidemiology , COVID-19/transmission , COVID-19/virology , Communicable Disease Control , Europe/epidemiology , Genomics , Humans , Internationality , North America/epidemiology , Phylogeny , Physical Distancing , South America/epidemiology
18.
Sci Rep ; 11(1): 7193, 2021 03 30.
Article in English | MEDLINE | ID: covidwho-1161111

ABSTRACT

Some studies report that obesity is associated with more severe symptoms following SARS-CoV-2 infection and worse COVID-19 outcomes, however many other studies have not reproduced these findings. Therefore, it is uncertain whether obesity is in fact associated with worse COVID-19 outcomes compared to non-obese individuals. We conducted a systematic search of PubMed (including MEDLINE) and Google Scholar on May 18, 2020 to identify published studies on COVID-19 outcomes in non-obese and obese patients, covering studies published during the first 6 months of the pandemic. Meta-analyses with random effects modeling was used to determine unadjusted odds ratios (OR) and 95% confidence intervals (CI) for various COVID-19 outcomes in obese versus non-obese patients. By quantitative analyses of 22 studies from 7 countries in North America, Europe, and Asia, we found that obesity is associated with an increased likelihood of presenting with more severe COVID-19 symptoms (OR 3.03, 95% CI 1.45-6.28, P = 0.003; 4 studies, n = 974), developing acute respiratory distress syndrome (ARDS; OR 2.89, 95% CI 1.14-7.34, P = 0.025; 2 studies, n = 96), requiring hospitalization (OR 1.68, 95% CI 1.14-1.59, P < 0.001; 4 studies, n = 6611), being admitted to an intensive care unit (ICU; OR 1.35, 95% CI 1.15-1.65, P = 0.001; 9 studies, n = 5298), and undergoing invasive mechanical ventilation (IMV; OR 1.76, 95% CI 1.29-2.40, P < 0.001; 7 studies, n = 1558) compared to non-obese patients. However, obese patients had similar likelihoods of death from COVID-19 as non-obese patients (OR 0.96, 95% CI 0.74-1.25, P = 0.750; 9 studies, n = 20,597). Collectively, these data from the first 6 months of the pandemic suggested that obesity is associated with a more severe COVID-19 disease course but may not be associated with increased mortality.


Subject(s)
COVID-19/etiology , COVID-19/therapy , Obesity/epidemiology , Asia/epidemiology , COVID-19/epidemiology , COVID-19/mortality , Comorbidity , Europe/epidemiology , Hospitalization/statistics & numerical data , Humans , Intensive Care Units/statistics & numerical data , Mortality , North America/epidemiology , Odds Ratio , Respiration, Artificial , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/virology
19.
Front Public Health ; 9: 586299, 2021.
Article in English | MEDLINE | ID: covidwho-1156164

ABSTRACT

Background: The COVID 19 epidemic submerged many health systems in the Amazon. The objective of the present study was to focus on the epidemic curves of the COVID 19 epidemic in different centers, and to look at testing and mortality data. Methods: Publicly available datasets were used. The log10 of the daily cumulated number of cases starting from the day the territory reached 100 cumulated cases was plotted to compare the magnitude, shape and slope of the different curves. The maximum daily testing efforts were plotted for each territory in relation to the maximum daily number of diagnoses. The case fatality rate was computed by dividing the number of COVID 19 deaths by the number of confirmed cases. Results: In the Amazonian regions in general the speed of growth was generally lower than in Europe or the USA, or Southern Brazil. Whereas, countries like South Korea or New Zealand "broke" the curve relatively rapidly the log linear trajectory seemed much longer with signs of a decline in growth rate as of early July 2020. After a very slow start, French Guiana had the lowest slope when compared to other Amazonian territories with significant epidemics. The Amazonian states of Roraima, Amazonas, Parà, and Amapà had among the highest number of cases and deaths per million inhabitants in the world. French Guiana had significantly fewer deaths relative to its number of confirmed cases than other Amazonian territories. French Guiana had a late epidemic surge with intense testing scale-up often exceeding 4,000 persons tested daily per million inhabitants. Brazil was an outlier with low daily testing levels in relation to the number of daily diagnoses. Conclusions: There were marked heterogeneities mortality rates suggesting that socioeconomic, political factors, and perhaps ethnic vulnerability led to striking outcome differences in this Amazonian context.


Subject(s)
COVID-19/epidemiology , COVID-19/mortality , Cause of Death , Disease Outbreaks/statistics & numerical data , Epidemics/statistics & numerical data , Internationality , Brazil/epidemiology , Europe/epidemiology , French Guiana/epidemiology , Humans , North America/epidemiology , SARS-CoV-2
20.
PLoS One ; 16(3): e0237294, 2021.
Article in English | MEDLINE | ID: covidwho-1156076

ABSTRACT

The coronavirus disease 2019 (COVID-19) outbreak in North, Central, and South America has become the epicenter of the current pandemic. We have suggested previously that the infection rate of this virus might be lower in people living at high altitude (over 2,500 m) compared to that in the lowlands. Based on data from official sources, we performed a new epidemiological analysis of the development of the pandemic in 23 countries on the American continent as of May 23, 2020. Our results confirm our previous finding, further showing that the incidence of COVID-19 on the American continent decreases significantly starting at 1,000 m above sea level (masl). Moreover, epidemiological modeling indicates that the virus transmission rate is lower in the highlands (>1,000 masl) than in the lowlands (<1,000 masl). Finally, evaluating the differences in the recovery percentage of patients, the death-to-case ratio, and the theoretical fraction of undiagnosed cases, we found that the severity of COVID-19 is also decreased above 1,000 m. We conclude that the impact of the COVID-19 decreases significantly with altitude.


Subject(s)
Altitude , COVID-19/pathology , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Central America/epidemiology , Humans , Incidence , North America/epidemiology , SARS-CoV-2/isolation & purification , Severity of Illness Index , South America/epidemiology
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