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1.
Comput Educ ; 203: 104849, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: covidwho-20230841

RESUMEN

The COVID-19 pandemic has forced universities and schools around the world to adopt online learning. Teachers may wonder if their students can attain satisfactory learning performance in an online learning environment without teachers' on-the-spot attention. In order to develop students' skills in programming, promote their enjoyment of learning and intention to learn to program, the researchers integrated two innovative teaching approaches, using online peer-facilitated learning and distributed pair programming, and investigated the effects of these on students' online learning performance. This study conducted an experiment that included 128 undergraduates from four class sections of Department of Finance. Thus, the experimental design in this research was a 2 (Peer-facilitated learning vs. non-peer-facilitated learning) × 2 (Distributed pair programming vs. non-distributed pair programming) factorial pretest/post-test design. The participants in this research mainly consisted of four classes of students from a non-computer or information department who took a compulsory course on programming design.' Both quantitative and qualitative data were collected in this study. According to the results, the peer-facilitated learning group exhibited significantly better development of programming skills, enjoyment of learning, and intention to learn, than the non-peer-facilitated learning group. However, expected effects of enhancing the learning of the students in this study who received the distributed pair programming were not found. The design of online pedagogy can be a reference for online educators. The implications of applying online peer-facilitated learning and distributed pair programming to support students' learning and the design of online programming courses are discussed.

2.
Emerg Microbes Infect ; : 1-45, 2022 Nov 17.
Artículo en Inglés | MEDLINE | ID: covidwho-2242558

RESUMEN

Numerous vaccines have been developed to address the current COVID-19 pandemic, but safety, cross-neutralizing efficacy, and long-term protectivity of currently approved vaccines are still important issues. In this study, we developed a subunit vaccine, ASD254, by using a nanoparticle vaccine platform to encapsulate the SARS-CoV-2 spike receptor-binding domain (RBD) protein. As compared with the aluminum-adjuvant RBD vaccine, ASD254 induced higher titers of RBD-specific antibodies and generated 10- to 30-fold more neutralizing antibodies. Mice vaccinated with ASD254 showed protective immune responses against SARS-CoV-2 challenge, with undetectable infectious viral loads and reduced typical lesions in lung. Besides, neutralizing antibodies in vaccinated mice lasted for at least one year and were effective against various SARS-CoV-2 variants of concern, including B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), B.1.617.2 (Delta), and B.1.1.529 (Omicron). Furthermore, particle size, polydispersity index, and zeta potential of ASD254 remained stable after 8-month storage at 4°C. Thus, ASD254 is a promising nanoparticle vaccine with good immunogenicity and stability to be developed as an effective vaccine option in controlling upcoming waves of COVID-19.

3.
Spat Spatiotemporal Epidemiol ; 44: 100563, 2023 02.
Artículo en Inglés | MEDLINE | ID: covidwho-2232258

RESUMEN

BACKGROUND: Public health organizations have increasingly harnessed geospatial technologies for disease surveillance, health services allocation, and targeting place-based health promotion initiatives. METHODS: We conducted a systematic review around the theme of space-time clustering detection techniques for infectious diseases using PubMed, Web of Science, and Scopus. Two reviewers independently determined inclusion and exclusion. RESULTS: Of 2,887 articles identified, 354 studies met inclusion criteria, the majority of which were application papers. Studies of airborne diseases were dominant, followed by vector-borne diseases. Most research used aggregated data instead of point data, and a significant proportion of articles used a repetition of a spatial clustering method, instead of using a "true" space-time detection approach, potentially leading to the detection of false positives. Noticeably, most articles did not make their data available, limiting replicability. CONCLUSION: This review underlines recent trends in the application of space-time clustering methods to the field of infectious disease, with a rapid increase during the COVID-19 pandemic.


Asunto(s)
COVID-19 , Enfermedades Transmisibles , Humanos , COVID-19/epidemiología , Pandemias , Enfermedades Transmisibles/diagnóstico , Enfermedades Transmisibles/epidemiología , Análisis Espacial , Salud Pública
4.
J Affect Disord ; 325: 119-126, 2023 03 15.
Artículo en Inglés | MEDLINE | ID: covidwho-2165456

RESUMEN

BACKGROUND: This study aimed to investigate (1) the mental health impacts (i.e., insomnia and suicide ideas) of the COVID-19 pandemic and (2) the mediation effects of stay-at-home levels on those impacts. METHODS: This study investigated monthly national COVID-19 deaths, stay-at-home levels, and internet searches for words for "insomnia" and "suicide" across 45 countries during the first year of the COVID-19 pandemic (March 1, 2020, to February 28, 2021). We used the changes of internet search volumes for "insomnia" and "suicide" (from the Google Trends database) to represent the mental health impacts, and the time of cell phone activity at the residence (from Google Location History) to estimate the stay-at-home effects. We computed the proportion mediated (PM) caused by stay-at-home levels in the COVID-19 impacts on insomnia and suicide ideas, respectively. RESULTS: Throughout the first year of the COVID-19 pandemic, national COVID-19 deaths significantly correlated to increased internet searches for "insomnia" but decreased searches for "suicide". In addition, the mediation effect was significant in the first six-month of COVID-19-related increases in insomnia (PM = 42.6 %, p = 0.016), but this effect was not significant (PM = 13.1 %, p = 0.270) in the second six-month. By contrast, the mediation effect was not significant in the first six-month of COVID-19-related decrease in suicide ideation (PM = 8.1 %, p = 0.180), but this effect was significant (PM = 39.6 %, p = 0.014) in the second six-month. CONCLUSIONS: Stay-at-home levels significantly mediated both increased insomnia and decreased suicide ideas, but within different time frames.


Asunto(s)
COVID-19 , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Pandemias , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Salud Mental , Ideación Suicida , Internet
5.
Univers Access Inf Soc ; : 1-16, 2022 Dec 03.
Artículo en Inglés | MEDLINE | ID: covidwho-2158064

RESUMEN

With the development of technology and demand for online courses, there have been considerable quantities of online, blended, or flipped courses designed and provided. However, in the technology-enhanced learning environments, which are also full of social networking websites, shopping websites, and free online games, it is challenging to focus students' attention and help them achieve satisfactory learning performance. In addition, the instruction of programming courses constantly challenges both teachers and students, particularly in online learning environments. To overcome and solve these problems and to facilitate students' learning, the researchers in this study integrated two teaching approaches, using meta-cognitive learning strategy (MCLS) and team regulation (TR), to develop students' regular learning habits and further contribute to their programming skills, academic motivation, and refusal self-efficacy of Internet use, in a cloud classroom. In this research, a quasi-experiment was conducted to investigate the effects of MCLS and TR adopting the experimental design of a 2 (MCLS vs. non-MCLS) × 2 (TR vs. non-TR) factorial pre-test/post-test. In this research, the participants consisted of four classes of university students from non-information or computer departments enrolled in programming design, a required course. The experimental groups comprised three of the classes, labelled as G1, G2, and G3. G1 concurrently received both the online MCLS and TR intervention, while G2 only received the online MCLS intervention, and G3 only received the online TR intervention. Serving as the control group, the fourth class (G4) received traditional teaching. This study investigated the effects of MCLS, TR, and their combination, on improving students' programming skills, academic motivation, and refusal self-efficacy of Internet use in an online computing course. According to the results, students who received online TR significantly enhanced their programming design skills and their refusal self-efficacy of Internet use a cloud classroom. However, the expected effects of MCLS on developing students' programming skills, academic motivation, and refusal self-efficacy of Internet use were not found in this study. The teaching strategy of integrating MCLS and TR in an online programming course in this study can serve as a reference for educators when conducting online, blended, or flipped courses during the COVID-19 pandemic.

6.
Health Informatics J ; 28(4): 14604582221141835, 2022.
Artículo en Inglés | MEDLINE | ID: covidwho-2138936

RESUMEN

BACKGROUND: With the global spread of the coronavirus disease pandemic, governments have become more interested in applying telehealth technology in 2020. OBJECTIVE: This study integrates the technology acceptance model and information system success model to explore the influence of satisfaction, attitudes, and continued use of telehealth systems among middle-aged and older people in remote areas. METHODS: The study participants were patients over 40 years (inclusive) who lived in remote townships in eastern Taiwan, were diagnosed with diabetes or hypertension, and used the telehealth care system. In total, 545 questionnaires were returned, resulting in a recovery rate of 99%. RESULTS: Accepting the hypothesized structural equation model, this study found that information, system, and service quality were influenced by the mediating effect of perceived ease of use and the perceived usefulness of the technology acceptance model. The use of telehealth care systems among chronic patients increased significantly.


Asunto(s)
Telemedicina , Persona de Mediana Edad , Humanos , Anciano , Enfermedad Crónica , Tecnología , Pandemias , Manejo de la Enfermedad
7.
Lancet Microbe ; 3(11): e824-e834, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: covidwho-2031776

RESUMEN

BACKGROUND: The H3N8 avian influenza virus (AIV) has been circulating in wild birds, with occasional interspecies transmission to mammals. The first human infection of H3N8 subtype occurred in Henan Province, China, in April, 2022. We aimed to investigate clinical, epidemiological, and virological data related to a second case identified soon afterwards in Hunan Province, China. METHODS: We analysed clinical, epidemiological, and virological data for a 5-year-old boy diagnosed with H3N8 AIV infection in May, 2022, during influenza-like illness surveillance in Changsha City, Hunan Province, China. H3N8 virus strains from chicken flocks from January, 2021, to April, 2022, were retrospectively investigated in China. The genomes of the viruses were sequenced for phylogenetic analysis of all the eight gene segments. We evaluated the receptor-binding properties of the H3N8 viruses by using a solid-phase binding assay. We used sequence alignment and homology-modelling methods to study the effect of specific mutations on the human receptor-binding properties. We also conducted serological surveillance to detect the H3N8 infections among poultry workers in the two provinces with H3N8 cases. FINDINGS: The clinical symptoms of the patient were mild, including fever, sore throat, chills, and a runny nose. The patient's fever subsided on the same day of hospitalisation, and these symptoms disappeared 7 days later, presenting mild influenza symptoms, with no pneumonia. An H3N8 virus was isolated from the patient's throat swab specimen. The novel H3N8 virus causing human infection was first detected in a chicken farm in Guangdong Province in December, 2021, and subsequently emerged in several provinces. Sequence analyses revealed the novel H3N8 AIVs originated from multiple reassortment events. The haemagglutinin gene could have originated from H3Ny AIVs of duck origin. The neuraminidase gene belongs to North American lineage, and might have originated in Alaska (USA) and been transferred by migratory birds along the east Asian flyway. The six internal genes had originated from G57 genotype H9N2 AIVs that were endemic in chicken flocks. Reassortment events might have occurred in domestic ducks or chickens in the Pearl River Delta area in southern China. The novel H3N8 viruses possess the ability to bind to both avian-type and human-type sialic acid receptors, which pose a threat to human health. No poultry worker in our study was positive for antibodies against the H3N8 virus. INTERPRETATION: The novel H3N8 virus that caused human infection had originated from chickens, a typical spillover. The virus is a triple reassortment strain with the Eurasian avian H3 gene, North American avian N8 gene, and dynamic internal genes of the H9N2 viruses. The virus already possesses binding ability to human-type receptors, though the risk of the H3N8 virus infection in humans was low, and the cases are rare and sporadic at present. Considering the pandemic potential, comprehensive surveillance of the H3N8 virus in poultry flocks and the environment is imperative, and poultry-to-human transmission should be closely monitored. FUNDING: National Natural Science Foundation of China, National Key Research and Development Program of China, Strategic Priority Research Program of the Chinese Academy of Sciences, Hunan Provincial Innovative Construction Special Fund: Emergency response to COVID-19 outbreak, Scientific Research Fund of Hunan Provincial Health Department, and the Hunan Provincial Health Commission Foundation.


Asunto(s)
COVID-19 , Subtipo H3N8 del Virus de la Influenza A , Subtipo H9N2 del Virus de la Influenza A , Gripe Aviar , Gripe Humana , Humanos , Animales , Preescolar , Gripe Aviar/epidemiología , Subtipo H3N8 del Virus de la Influenza A/genética , Gripe Humana/epidemiología , Filogenia , Estudios Retrospectivos , Pollos , Aves de Corral , Patos , Mamíferos
8.
Frontiers in public health ; 10, 2022.
Artículo en Inglés | EuropePMC | ID: covidwho-1940081

RESUMEN

Real-time vaccine hesitancy surveillance is needed to better understand changes in vaccination behaviors. We aim to understand the association between coronavirus disease 2019 (COVID-19) outbreaks and population vaccine hesitancy and to monitor the dynamic changes in vaccination behaviors. We used the autoregressive integrated moving average model to examine the association between daily internet search volume for vaccines and two waves of COVID-19 local outbreaks in Taiwan from 19 March to 25 May, 2021. During the small-scale outbreak, the search volume increased significantly for 7 out of 22 days with an average increase of 17.3% ± 10.7% from the expected search volume. During the large-scale outbreak, the search volume increased significantly for 14 out of 14 days, with an average increase of 58.4% ± 14.7%. There was a high correlation between the search volume and the number of domestic cases (r = 0.71, P < 0.001). Google Trends serves as a timely indicator to monitor the extent of population vaccine willingness.

9.
J Biomed Sci ; 29(1): 49, 2022 Jul 07.
Artículo en Inglés | MEDLINE | ID: covidwho-1923546

RESUMEN

BACKGROUND: With the continuous emergence of new SARS-CoV-2 variants that feature increased transmission and immune escape, there is an urgent demand for a better vaccine design that will provide broader neutralizing efficacy. METHODS: We report an mRNA-based vaccine using an engineered "hybrid" receptor binding domain (RBD) that contains all 16 point-mutations shown in the currently prevailing Omicron and Delta variants. RESULTS: A booster dose of hybrid vaccine in mice previously immunized with wild-type RBD vaccine induced high titers of broadly neutralizing antibodies against all tested SARS-CoV-2 variants of concern (VOCs). In naïve mice, hybrid vaccine generated strong Omicron-specific neutralizing antibodies as well as low but significant titers against other VOCs. Hybrid vaccine also elicited CD8+/IFN-γ+ T cell responses against a conserved T cell epitope present in wild type and all VOCs. CONCLUSIONS: These results demonstrate that inclusion of different antigenic mutations from various SARS-CoV-2 variants is a feasible approach to develop cross-protective vaccines.


Asunto(s)
COVID-19 , SARS-CoV-2 , Animales , Anticuerpos Neutralizantes , Anticuerpos Antivirales , Anticuerpos ampliamente neutralizantes , COVID-19/prevención & control , Humanos , Ratones , SARS-CoV-2/genética , Vacunas Sintéticas , Vacunas de ARNm
10.
J Clin Invest ; 132(10)2022 05 16.
Artículo en Inglés | MEDLINE | ID: covidwho-1846632

RESUMEN

BackgroundThe Delta and Omicron variants of SARS-CoV-2 are currently responsible for breakthrough infections due to waning immunity. We report phase I/II trial results of UB-612, a multitope subunit vaccine containing S1-RBD-sFc protein and rationally designed promiscuous peptides representing sarbecovirus conserved helper T cell and cytotoxic T lymphocyte epitopes on the nucleocapsid (N), membrane (M), and spike (S2) proteins.MethodWe conducted a phase I primary 2-dose (28 days apart) trial of 10, 30, or 100 µg UB-612 in 60 healthy young adults 20 to 55 years old, and 50 of them were boosted with 100 µg of UB-612 approximately 7 to 9 months after the second dose. A separate placebo-controlled and randomized phase II study was conducted with 2 doses of 100 µg of UB-612 (n = 3,875, 18-85 years old). We evaluated interim safety and immunogenicity of phase I until 14 days after the third (booster) dose and of phase II until 28 days after the second dose.ResultsNo vaccine-related serious adverse events were recorded. The most common solicited adverse events were injection site pain and fatigue, mostly mild and transient. In both trials, UB-612 elicited respective neutralizing antibody titers similar to a panel of human convalescent sera. The most striking findings were long-lasting virus-neutralizing antibodies and broad T cell immunity against SARS-CoV-2 variants of concern (VoCs), including Delta and Omicron, and a strong booster-recalled memory immunity with high cross-reactive neutralizing titers against the Delta and Omicron VoCs.ConclusionUB-612 has presented a favorable safety profile, potent booster effect against VoCs, and long-lasting B and broad T cell immunity that warrants further development for both primary immunization and heterologous boosting of other COVID-19 vaccines.Trial RegistrationClinicalTrials.gov: NCT04545749, NCT04773067, and NCT04967742.FundingUBI Asia, Vaxxinity Inc., and Taiwan Centers for Disease Control, Ministry of Health and Welfare.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Neutralizantes , Anticuerpos Antivirales , COVID-19/prevención & control , COVID-19/terapia , Humanos , Inmunización Pasiva , Persona de Mediana Edad , SARS-CoV-2 , Linfocitos T , Adulto Joven , Sueroterapia para COVID-19
11.
Journal of Educational Technology & Society ; 24(1):64-74, 2021.
Artículo en Inglés | APA PsycInfo | ID: covidwho-1717177

RESUMEN

This paper aims at answering the "how" questions about organizing and hosting an online conference during the COVID-19 pandemic. The 3rd International Pan-Pacific Technology-Enhanced Language Learning (PPTELL) Conference and Critical Thinking Meeting (hereafter PPTELL 2020) hosted from June 29 to July 1, 2020, on Zoom is the example conference used in this paper to illustrate the challenges and approaches adopted before, during and after the conference. The mentioned conference was supposed to take place physically at the University of North Texas during the same period but was transformed into an online virtual conference due to the outbreak of COVID-19 in early 2020. It was an urgent decision, along with many unknown situations, such as the attendees' different time zones and "Zoombombing." A three-staged and target-action process guided the preparation and organization of the online conference, i.e., pre-, during, and post-conference. According to the live meeting results and the post-conference survey, PPTELL 2020 has earned a reputation from its quality and the satisfaction of the participants and attendees. Therefore, the experience shared in the current paper seems to be a good reference for the organizers and hosts of international conferences. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

12.
J Virol ; 95(22): e0117321, 2021 10 27.
Artículo en Inglés | MEDLINE | ID: covidwho-1371847

RESUMEN

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reignited global interest in animal coronaviruses and their potential for human transmission. While bats are thought to be the wildlife reservoir of SARS-CoV and SARS-CoV-2, the widespread human coronavirus OC43 is thought to have originated in rodents. Here, we sampled 297 rodents and shrews, representing eight species, from three municipalities of southern China. We report coronavirus prevalences of 23.3% and 0.7% in Guangzhou and Guilin, respectively, with samples from urban areas having significantly higher coronavirus prevalences than those from rural areas. We obtained three coronavirus genome sequences from Rattus norvegicus, including a Betacoronavirus (rat coronavirus [RCoV] GCCDC3), an Alphacoronavirus (RCoV-GCCDC5), and a novel Betacoronavirus (RCoV-GCCDC4). Recombination analysis suggests that there was a potential recombination event involving RCoV-GCCDC4, murine hepatitis virus (MHV), and Longquan Rl rat coronavirus (LRLV). Furthermore, we uncovered a polybasic cleavage site, RARR, in the spike (S) protein of RCoV-GCCDC4, which is dominant in RCoV. These findings provide further information on the potential for interspecies transmission of coronaviruses and demonstrate the value of a One Health approach to virus discovery. IMPORTANCE Surveillance of viruses among rodents in rural and urban areas of South China identified three rodent coronaviruses, RCoV-GCCDC3, RCoV-GCCDC4, and RCoV-GCCDC5, one of which was identified as a novel potentially recombinant coronavirus with a polybasic cleavage site in the spike (S) protein. Through reverse transcription-PCR (RT-PCR) screening of coronaviruses, we found that coronavirus prevalence in urban areas is much higher than that in rural areas. Subsequently, we obtained three coronavirus genome sequences by deep sequencing. After different method-based analyses, we found that RCoV-GCCDC4 was a novel potentially recombinant coronavirus with a polybasic cleavage site in the S protein, dominant in RCoV. This newly identified coronavirus RCoV-GCCDC4 with its potentially recombinant genome and polybasic cleavage site provides a new insight into the evolution of coronaviruses. Furthermore, our results provide further information on the potential for interspecies transmission of coronaviruses and demonstrate the necessity of a One Health approach for zoonotic disease surveillance.


Asunto(s)
Infecciones por Coronavirus/veterinaria , Coronavirus/genética , Recombinación Genética , Roedores/virología , Glicoproteína de la Espiga del Coronavirus/genética , Secuencia de Aminoácidos , Animales , China/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Evolución Molecular , Genoma Viral/genética , Humanos , Filogenia , Prevalencia , Musarañas/virología
13.
PLoS Pathog ; 17(8): e1009758, 2021 08.
Artículo en Inglés | MEDLINE | ID: covidwho-1352713

RESUMEN

Since the pandemic of COVID-19 has intensely struck human society, small animal model for this infectious disease is in urgent need for basic and pharmaceutical research. Although several COVID-19 animal models have been identified, many of them show either minimal or inadequate pathophysiology after SARS-CoV-2 challenge. Here, we describe a new and versatile strategy to rapidly establish a mouse model for emerging infectious diseases in one month by multi-route, multi-serotype transduction with recombinant adeno-associated virus (AAV) vectors expressing viral receptor. In this study, the proposed approach enables profound and enduring systemic expression of SARS-CoV-2-receptor hACE2 in wild-type mice and renders them vulnerable to SARS-CoV-2 infection. Upon virus challenge, generated AAV/hACE2 mice showed pathophysiology closely mimicking the patients with severe COVID-19. The efficacy of a novel therapeutic antibody cocktail RBD-chAbs for COVID-19 was tested and confirmed by using this AAV/hACE2 mouse model, further demonstrating its successful application in drug development.


Asunto(s)
COVID-19 , Enfermedades Transmisibles Emergentes , Modelos Animales de Enfermedad , Células 3T3 , Enzima Convertidora de Angiotensina 2/genética , Animales , Anticuerpos Antivirales/inmunología , Anticuerpos Antivirales/uso terapéutico , COVID-19/inmunología , COVID-19/patología , COVID-19/fisiopatología , Chlorocebus aethiops , Dependovirus/genética , Humanos , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Transducción Genética , Células Vero
14.
arxiv; 2020.
Preprint en Inglés | PREPRINT-ARXIV | ID: ppzbmed-2007.13926v1

RESUMEN

Traditional Chinese medicine (TCM) has played an important role in the prevention and control of the novel coronavirus pneumonia (COVID-19), and community prevention has become the most essential part in reducing the spread risk and protecting populations. However, most communities use a uniform TCM prevention program for all residents, which violates the "treatment based on syndrome differentiation" principle of TCM and limits the effectiveness of prevention. In this paper, we propose an intelligent optimization method to develop diversified TCM prevention programs for community residents. First, we use a fuzzy clustering method to divide the population based on both modern medicine and TCM health characteristics; we then use an interactive optimization method, in which TCM experts develop different TCM prevention programs for different clusters, and a heuristic algorithm is used to optimize the programs under the resource constraints. We demonstrate the computational efficiency of the proposed method and report its successful application to TCM-based prevention of COVID-19 in 12 communities in Zhejiang province, China, during the peak of the pandemic.


Asunto(s)
COVID-19 , Infecciones por Coronavirus
15.
Spat Spatiotemporal Epidemiol ; 34: 100354, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-623802

RESUMEN

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first discovered in late 2019 in Wuhan City, China. The virus may cause novel coronavirus disease 2019 (COVID-19) in symptomatic individuals. Since December of 2019, there have been over 7,000,000 confirmed cases and over 400,000 confirmed deaths worldwide. In the United States (U.S.), there have been over 2,000,000 confirmed cases and over 110,000 confirmed deaths. COVID-19 case data in the United States has been updated daily at the county level since the first case was reported in January of 2020. There currently lacks a study that showcases the novelty of daily COVID-19 surveillance using space-time cluster detection techniques. In this paper, we utilize a prospective Poisson space-time scan statistic to detect daily clusters of COVID-19 at the county level in the contiguous 48 U.S. and Washington D.C. As the pandemic progresses, we generally find an increase of smaller clusters of remarkably steady relative risk. Daily tracking of significant space-time clusters can facilitate decision-making and public health resource allocation by evaluating and visualizing the size, relative risk, and locations that are identified as COVID-19 hotspots.


Asunto(s)
Enfermedades Transmisibles Emergentes/epidemiología , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades/estadística & datos numéricos , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Síndrome Respiratorio Agudo Grave/epidemiología , COVID-19 , Infecciones por Coronavirus/diagnóstico , Bases de Datos Factuales , Femenino , Humanos , Masculino , Tamizaje Masivo/métodos , Modelos Estadísticos , Método de Montecarlo , Neumonía Viral/diagnóstico , Distribución de Poisson , Prevalencia , Estudios Prospectivos , Salud Pública , Síndrome Respiratorio Agudo Grave/diagnóstico , Agrupamiento Espacio-Temporal , Estados Unidos/epidemiología
16.
medrxiv; 2020.
Preprint en Inglés | medRxiv | ID: ppzbmed-10.1101.2020.05.12.20099739

RESUMEN

Objectives To determine the case fatality rates and death risk factors. Design Retrospective case series. Setting A COVID-19 ward of a secondary Hospital in Wuhan, China. Participants Consecutively hospitalized COVID-19 patients between Jan 3, 2020 and Feb 27, 2020. Outcomes were followed up to discharge or death. Results Of 121 patients included, 66 (54.6%) were males. The median age was 59 (IQR: 46 to 67) years, and hypertension (33 patients; 27.3%) the leading comorbidity. Lymphopenia (83 of 115 patients; 72.2%) frequently occurred and then normalized on day 4 (IQR: 3 to 6) after admission in the survivors, with lung lesion absorbed gradually on day 8 (IQR: 6 to10) after onset (33 of 57 patients; 57.9%). The real-time polymerase chain reaction (RT-PCR) assays for SARS-CoV-2 were positive in 78 (78/108; 72.2%) patients, and a false-negative RT-PCR occurred in 15 (13.9%) patients. Hypoxemia occurred in 94 (94/117; 80.3%) patients, and supplemental oxygen was given in 88 (72.7%) patients, and mon-invasive or invasive ventilation in 20 (16.5%) cases. Corticosteroid use might link to death. The case fatality rates were 4.4% (one of 23 patients), 29.3% (12/41), 22.8% (13/57) or 45% (9/20) for patients with moderate, severe, critical illness or on ventilator. The length of hospital stay was 14 (IQR: 10 to 20) days, and selfcare ability worsened in 21 patients (21/66; 31.8%) cases. Patients over 60 years were most likely to have poorer outcomes, and increasing in age by one-year increased risk for death by 18% (CI: 1.04-1.32). Conclusions In management of patients with SARS-CoV-2 pneumonia, especially the elderly with hypertension, close monitoring and appropriate supportive treatment should be taken earlier and aggressively to prevent from developing severe or critical illness. Corticosteroid use might link to death. Repeated RT-PCR tests or novel detection methods for SARS-CoV-2 should be adopted to improve diagnostic efficiency.


Asunto(s)
Enfermedades Pulmonares , Enfermedad Crítica , Síndrome Respiratorio Agudo Grave , Hipoxia , Hipertensión , Muerte , COVID-19 , Linfopenia
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