Local travel behaviour under continuing COVID-19 waves- A proxy for pandemic fatigue?

COVID-19 continues to threaten the world. Relaxing local travel behaviours on preventing the spread of COVID-19, may increase the infection risk in subsequent waves of SARS-CoV-2 transmission. In this study, we analysed changes in the travel behaviour of different population groups (adult, child, student, elderly) during four pandemic waves in Hong Kong before January 2021, by 4-billion second-by-second smartcard records of subway. A significant continuous relaxation in human travel behaviour was observed during the four waves of SARS-CoV-2 transmission. Residents sharply reduced their local travel by 51.9%, 50.1%, 27.6%, and 20.5% from the first to fourth pandemic waves, respectively. The population flow in residential areas, workplaces, schools, shopping areas, amusement areas and border areas, decreased on average by 30.3%, 33.5%, 41.9%, 58.1%, 85.4% and 99.6%, respectively, during the pandemic weeks. We also found that many other cities around the world experienced a similar relaxation trend in local travel behaviour, by comparing traffic congestion data during the pandemic with data from the same period in 2019. The quantitative pandemic fatigue in local travel behaviour could help governments partially predicting personal protective behaviours, and thus to suggest more accurate interventions during subsequent waves, especially for highly infectious virus variants such as Omicron.

Pandemic COVID-19 ends but soil pollution increases: Impacts and a new approach for risk assessment.

For three years, a large amount of manufactured pollutants such as plastics, antibiotics and disinfectants has been released into the environment due to COVID-19. The accumulation of these pollutants in the environment has exacerbated the damage to the soil system. However, since the epidemic outbreak, the focus of researchers and public attention has consistently been on human health. It is noteworthy that studies conducted in conjunction with soil pollution and COVID-19 represent only 4 % of all COVID-19 studies. In order to enhance researchers' and the public awareness of the seriousness on the COVID-19 derived soil pollution, we propose the viewpoint that "pandemic COVID-19 ends but soil pollution increases" and recommend a whole-cell biosensor based new method to assess the environmental risk of COVID-19 derived pollutants. This approach is expected to provide a new way for environmental risk assessment of soils affected by contaminants produced from the pandemic.

The S protein of a novel recombinant PEDV strain promotes the infectivity and pathogenicity of PEDV in mid-west China.

Porcine epidemic diarrhoea virus (PEDV) is an emerging and re-emerging swine enterovirus that causes highly contagious diarrhoea and mortality in piglets. To better understand the current prevalence of PEDV in mid-west China, and to find out the reason for the re-emergence of PEDV from the viral genomic characteristics. Herein, we firstly investigated epidemiology of PEDV in mid-west China from 2019 to 2020. A total of 62.23% (257/413) of diarrhoea samples were positive for PEDV, and the PEDV-positive cases were mainly detected in winter. Then, we selected the SXSL strain as a representative strain to study the genetic and pathogenic characterization of PEDV pandemic strains in mid-west China. The recombination analysis showed that SXSL strain was a recombinant strain, and the major and minor parent strains of the recombination are CH/SCZJ/2018 strain and GDS48 strain, respectively. Complete genome sequencing and homology analysis showed that the S protein of SXSL strain contained multiple amino acid indels and mutations compared to the PEDV representative strains. Furthermore, we evaluated the effect of S protein on the infectivity and pathogenicity of PEDV by the PEDV reverse genetics system, and results showed that SXSL S protein increased the infectivity and pathogenicity of chimeric virus. Overall, our findings provided important information for understanding the roles of S protein in the prevalence of PEDV in mid-west China and developing vaccines based on PEDV pandemic strains.

The potential of biomass-derived bio-liquid to prevent the spread of SARS-CoV-2 from waste and its production-based life cycle assessment.

COVID-19 pandemic caused a significant increase in medical and infected domestic waste, greatly increasing risk of human infected with SARS-CoV-2. Therefore, it is critical to prevent the spread of SARS-CoV-2 from solid waste to humans. Current commercial disinfectants present a high carbon footprint issue. Hence, we prepared a renewable wheat straw-based bio-liquid that can damage SARS-CoV-2 RNA and protein. The wet thermochemical extraction (WTE) bio-liquid, with total organic carbon concentration exceeding 1892 mg/L, could effectively damage the virus. However, dry thermochemical extraction (DTE) samples were not efficient due to their low content of effective compounds. The life cycle assessment showed that WTE bio-liquid production implies lower energy and environmental negative impacts than DTE. Moreover, the process by-product, char, can simultaneously reduce 3.1 million tonnes of global CO2 emissions while used as coal substitute. Yield of bio-liquid extremely exceed commercial disinfectant with just 1 % wheat straw utilisation, which meet the demand of processing solid waste. Further, their costs are significantly lower than commercial disinfectants, which are suitable for developing countries. Therefore, the antiviral bio-liquid produced from agricultural straw can be a new way to meet the needs of preventing the spread of SARS-CoV-2 and resume the sustainable development of society.

Milder symptoms and shorter course in patients with re-positive COVID-19: A cohort of 180 patients from Northeast China.

China experienced another widespread Coronavirus disease 2019 (COVID-19) outbreak recently caused by the Omicron variant, which is less severe but far more contagious than the other COVID-19 variants, leading local governments to focus efforts on eliminating the spread of the disease. Previous studies showed that after "recovering" from the virus, some patients could re-test positive for COVID-19 with nucleic acid tests, challenging the control of disease spread. In this study, we aimed to analyze the clinical and laboratory characteristics of re-positive COVID-19 patients in Northeast China. We retrospectively analyzed data from confirmed reverse transcription polymerase chain reaction (RT-PCR) re-positive COVID-19 patients who were admitted to the First Hospital of Jilin University, Jilin Province, China, from March to June 2022. Detailed clinical symptoms, medical history, anti-Corona Virus (CoV) IgG and IgM levels, and CoV nucleic acid cycle threshold (Ct) values during the re-positive period were collected and analyzed. A total of 180 patients were included in this study, including 62 asymptomatic cases and 118 mild cases. The cohort included 113 men and 67 women, with an average age of 45.73 years. The median time between recovery from the virus and re-positivity was 13 days. Our results showed that the proportion of re-positive patients with symptoms was lower, and the nucleic acid test-positive duration was shorter during the re-positive period. Furthermore, in patients with underlying disease, the proportion of patients with symptoms was higher, anti-CoV IgG levels were lower, and the total disease duration was longer. In conclusion, during the re-positive period, the symptoms were milder, and the CoV nucleic acid test-positive course was shorter. The concomitant underlying disease is an important factor associated with clinical symptoms, and the overall course of COVID-19 re-positive patients may be associated with lower anti-CoV IgG levels. Large-scale and multicenter studies are recommended to better understand the pathophysiology of recurrence in patients with COVID-19.

An epidemiological analysis of imported malaria in Shanghai during a COVID-19 outbreak.

BACKGROUND: The goal of this study was to understand the epidemiological characteristics of imported malaria in Shanghai specifically during the epidemic period of novel corona-virus pneumonia (COVID-19), to provide a reference for preventing the transmission of imported malaria after this disease had been previously eliminated. METHODS: The data of malaria cases reported in Shanghai from 2020 to 2021 were obtained from the China Information System for Disease Control and Prevention (CISDCP) and the Information System for Parasitic Disease Control and Prevention (ISPDCP). The characteristics of demographic and epidemiological distribution, travel-related information, diagnosis information, regions of infection acquisition and disposal information of epidemic situation were analysed with descriptive statistics. RESULTS: A total of 112 cases of malaria were reported in Shanghai from January 2020 to December 2021. There were 18 cases and 94 cases in 2020 and 2021, respectively, reaching the lowest and highest levels in the past 10 years. The incidence of malaria associated with seasons had an increasing trend (χ2 = 81.143, P < 0.05). These cases included Plasmodium falciparum (97, 86.61%), Plasmodium vivax (4, 3.57%), Plasmodium ovale (8, 7.14%) and Plasmodium malariae (3, 2.68%). The median age of patients with malaria was 38.0 years, the majority of these individuals were males (109, 97.32%), and most of them were labour personnel (93, 83.04%). Of the reported cases, 8 of these individuals (7.14%) reported experiencing malaria symptoms before their arrival in China after their stay overseas; 97 of these individuals (86.61%) reported experiencing symptoms within 14 days after their initial arrival from overseas; 15 of these individuals (13.39%) were diagnosed with 'severe malaria'; and 4 of these individuals (3.57%) were also diagnosed with COVID-19. All cases were imported from Africa, and there were no indigenous cases and deaths. CONCLUSION: Due to the impact of COVID-19, the number of imported malaria cases in Shanghai had greatly increased; however, prevention and control measures for imported malaria could be implemented to prevent re-transmission of this condition. Considering that the number of individuals returning from overseas labour is likely to increase in the next few years, it is necessary to strengthen the surveillance of imported malaria and to review the protocol for potential epidemic situations. Together, these measures could support the maintation of free-malaria status in Shanghai.

A smartphone-based platform for ratiometric visualization of SARS-CoV-2 via an oligonucleotide probe.

COVID-19 necessitates the development of reliable and convenient diagnostic tools. In this work, a facile 3D-printed smartphone platform was constructed that achieved reliable visual detection of SARS-CoV-2 by eliminating the effect of ambient light and fixing the camera position relative to the sample. The oligonucleotide probe is modified with orange-red-emitting TAMRA working as an internal standard and green-emitting FAM serving as a sensitive sensing agent. Under 365-nm UV excitation, the emission wavelengths of TAMRA and FAM are 580 nm and 518 nm, respectively. When the probes interact with the targets, the green fluorescence gradually restores while the orange-red fluorescence remains stable. Thus, a striking color transition from orange-red to green could be observed by the naked eye. The detection limit of SARS-CoV-2 nucleic acid is 0.23 nM, and the entire process of color change could be completed in 25 min. Furthermore, the RGB value analysis of the sample solution was conducted using a smartphone for reliable and reproducible discrimination of SARS-CoV-2. The proposed smartphone platform might establish a general method for visual detection of SARS-CoV-2 nucleic acid as well as other virus-related diseases.

Association of population migration with air quality: Role of city attributes in China during COVID-19 pandemic (2019-2021).

Atmospheric pollution studies have linked diminished human activity during the COVID-19 pandemic to improve air quality. This study was conducted during January to March (2019-2021) in 332 cities in China to examine the association between population migration and air quality, and examined the role of three city attributes (pollution level, city scale, and lockdown status) in this effect. This study assessed six air pollutants, namely CO, NO2, O3, PM10, PM2.5, and SO2, and measured meteorological data, with-in city migration (WCM) index, and inter-city migration (ICM) index. A linear mixed-effects model with an autoregressive distributed lag model was fitted to estimate the effect of the percent change in migration on air pollution, adjusting for potential confounding factors. In summary, lower migration was associated with decreased air pollution (other than O3). Pollution change in susceptibility is more likely to occur in NO2 decrease and O3 increase, but unsusceptibility is more likely to occur in CO and SO2, to city attributes from low migration. Cities that are less air polluted and population-dense may benefit more from decreasing PM10 and PM2.5. The associations between population migration and air pollution were stronger in cities with stringent traffic restrictions than in cities with no lockdowns. Based on city attributes, an insignificant difference was observed between the effects of ICM and WCM on air pollution. Findings from this study may gain knowledge about the potential interaction between migration and city attributes, which may help decision-makers adopt air-quality policies with city-specific targets and paths to pursue similar air quality improvements for public health but at a much lower economic cost than lockdowns.

Inactivated Vaccines Against SARS-CoV-2: Neutralizing Antibody Titers in Vaccine Recipients.

Background: Although effective vaccines have been developed against coronavirus disease 2019 (COVID-19), the level of neutralizing antibodies (NAbs) induced after vaccination in the real world is still unknown. The aim of this work was to evaluate the level and persistence of NAbs induced by two inactivated COVID-19 vaccines in China. Methods: Serum samples were collected from 1,335 people aged 18 years and over who were vaccinated with an inactivated COVID-19 vaccine at Peking University People's Hospital from January 19 to June 23, 2021, for the detection of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. Results: The positive rate for NAbs against SARS-CoV-2 was 79-91% from the first month to the second month after the second vaccine dose. The gradual decline in positivity rate for NAb response was observed from 78% at 3 months post-vaccination to 0% at 12 months post-vaccination. When there was a 21-day interval between the two doses of vaccine, the NAb positivity rate was 0% 6 months after the second dose. NAb levels were significantly higher when the interval between two doses were 3-8 weeks than when it was 0-3 weeks (χ2 = 14.04, p < 0.001). There was a linear correlation between NAbs and IgG antibodies in 1,335 vaccinated patients. NAb levels decreased in 31 patients (81.6%) and increased in 7 patients (18.4%) over time in the series of 38 patients after the second vaccination. The NAb positivity rate was significantly higher in 18- to 40-year-old subjects than in 41- to 60-year-old subjects (t = -1.959, p < 0.01; t = 0.839, p < 0.01). Conclusion: The NAb positivity rate was the highest at the first and second month after the second dose of vaccine, and gradually decreased over time. With a 21-day interval between two doses of vaccine, neutralizing antibody levels persisted for only 6 months after the second dose of vaccine. Therefore, a third vaccine dose is recommended. Our results suggest that in cases in which NAbs cannot be detected, IgM/IgG antibodies can be detected instead. The level of NAbs produced after vaccination was affected by age but not by sex. Our results suggest that an interval of 21 to 56 days between shots is suitable for vaccination.

Optimization of energy efficiency and COVID-19 pandemic control in different indoor environments.

The COVID-19 pandemic has led to considerable morbidity and mortality, and consumed enormous resources (e.g. energy) to control and prevent the disease. It is crucial to balance infection risk and energy consumption when reducing the spread of infection. In this study, a quantitative human, behavior-based, infection risk-energy consumption model for different indoor environments was developed. An optimal balance point for each indoor environment can be obtained using the anti-problem method. For this study we selected Wangjing Block, one of the most densely populated places in Beijing, as an example. Under the current ventilation standard (30 m3/h/person), prevention and control of the COVID-19 pandemic would be insufficient because the basic reproduction number (R0 ) for students, workers and elders are greater than 1. The optimal required fresh air ventilation rates in most indoor environments are near or below 60 m3/h/person, after considering the combined effects of multiple mitigation measures. In residences, sports buildings and restaurants, the demand for fresh air ventilation rate is relatively high. After our global optimization of infection risk control (R0  ≤ 1), energy consumption can be reduced by 13.7% and 45.1% on weekdays and weekends, respectively, in contrast to a strategy of strict control (R0  = 1 for each indoor environment).

Environmental risks of disposable face masks during the pandemic of COVID-19: Challenges and management.

Since the COVID-19 outbreak in early 2020, face mask (FM) has been recognized as an effective measure to reduce the infection, increasing its consumption across the world. However, the large amount of at-home FM usage changed traditional medical waste management practices, lack of improper management. Currently, few studies estimate FM consumption at a global scale, not to say a comprehensive investigation on the environmental risks of FM from a life cycle perspective. Therefore, global FM consumption and its associated environmental risks are clarified in the present study. Our result shows that 449.5 billion FMs were consumed from January 2020 to March 2021, with an average of 59.4 FMs per person worldwide. This review also provides a basis to understand the environmental risk of randomly disposed of FM and highlights the urgent requirement for the attention of FMs waste management to prevent pollution in the near future.

Transmission risk of SARS-CoV-2 in the watershed triggered by domestic wastewater discharge.

The outbreak of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has already become an unprecedented global pandemic. However, the transmission of SARS-CoV-2, especially the protected SARS-CoV-2 RNA (pRNA) with infectious particles in waterways, is still largely unexplored. In this study, we developed a model to estimate SARS-CoV-2 transmission from the risk source in the excretion of patients to the final exposure in surface water. The model simulated the spatial and temporal distribution of the viral pRNA concentrations in the surface water of the Elbe watershed from March 2020 to January 2021. The results show that the WWTPs with the maximum capacity of >10,000 population equivalents were responsible for 95% of the viral load discharged into the surface water. We estimated the pRNA concentrations in surface water to be 1.33 × 10-2 copies·L-1 on average in the watershed based on the model simulation on viral transmission. It had considerable variations in spatial and temporal scales, which are dominantly controlled by epidemic situations and virus transport with decay in water, respectively. A quantitative microbial risk assessment was conducted to estimate the viral infection probability from surface water ingestion with consideration of the influence of toilet usage frequency and gender/age population groups. All the infection probabilities in the study period were lower than the reference risk levels of 10-4 and 10-5. The individuals aged 15-34 years had the highest infection probability of 4.86 × 10-9 on average from surface water ingestion during swimming activities. The data provided herein suggest that the low pRNA concentrations and infection probability reflected that the waterways were unlikely to be a significant transmission route for SARS-CoV-2.

Thermal stability of diagnostic targets Plasmodium falciparum histidine rich protein II and Plasmodium lactate dehydrogenase in rapid detection

During the COVID-19 epidemic, blood samples are usually processed at 56 degrees C to attenuate the virus before pathogen detection. 71 blood samples of malaria patients reported by Shanghai Center for Disease Control and Prevention in 2017-2019 were collected, including 38 with Plasmodium falciparum infection, 8 P. malariae, 11 P. ovale and 14 P. vivax. The effect of inactivation on the thermal stability of P. falciparum histidine rich protein II (PfHRPII) and Plasmodium lactate dehydrogenase (pLDH) in blood samples was assessed before and after incubation at 56 degrees C for 30 min using the rapid diagnostic test (RDT) kit. The results showed that among the 38 P. falciparum T1-positive (PfHRPII) blood samples before heat treatment, 35 samples remained to be T1-positive (92.11%, 35/38, X 2 = 3.123, P > 0.05) after heat treatment;while 54 blood samples (26 P. falciparum, 6 P. vivax, 10 P. ovale and 12 P. vivax) that were T2-positive (pLDH) before heat treatment turned to be T2-negative (positive rate 0, 0/54, X 2 = 87.755, P < 0.01) after heat treatment. It was demonstrated that PfHRPII is stable during incubation at 56 degrees C for 30 min, while pLDH is unstable and degraded or inactivated during the heating. Therefore, the detection results of P. falciparum will not be affected by RDT, but diagnosis of the parasites other than P. falciparum in blood samples may be missed.

Increased photokeratitis during the coronavirus disease 2019 pandemic: Clinical and epidemiological features and preventive measures.

ABSTRACT: An increased incidence of photokeratitis has occurred during the coronavirus disease 2019 (COVID-19) pandemic due to improper and unprotected use of ultraviolet lamps. Here, we summarize the clinical and epidemiological features of this increased incidence of photokeratitis and share advice in using health education to prevent it.We collected data from patients diagnosed with photokeratitis from October 7, 2019 to December 1, 2019, and from February 17, 2020 to April 12, 2020, and compared the frequency of onset, site of ultraviolet radiation (UVR) exposure, reason for exposure, exposure time, and recovery time. We also implemented and evaluated multiple measures of public health education to prevent increased disease.After the COVID-19 outbreak, the frequency of onset of photokeratitis increased significantly, especially among young women. The main reason for UVR exposure changed from welding to disinfection. The incidence sites varied, and the exposure time was longer. As a result, patients needed a longer time to recover. Positive health education was an useful and convenient measure to prevent the disease.While the COVID-19 pandemic is ongoing, more attention should be paid to public health and implement positive measures to prevent photokeratitis.

Many Nationalisms, One Disaster: Categories, Attitudes and Evolution of Chinese Nationalism on Social Media during the COVID -19 Pandemic.

Previous research has shown the increase of Chinese nationalism in some international events. However, it is unclear how a specific event fosters the rise of a particular type of nationalism, and how these different categories of nationalism relate to globalism. Given that, this study collected the most popular comments on 164 international COVID-19 events on Weibo to categorize different types of nationalism and measure the popularity index. The distribution of nationalism-categories across different topics was later estimated through semantic analysis, so as to explore how nationalism implies netizens' anti-globalization and pro-globalization sentiments. Specifically, the study categorized two different expressions of nationalism during the COVID-19 pandemic in China: a counterattack posture to external threats that is reflected as the Suppression of Ambivalent Attitudes, or a comparative response to global competition that serves as a stimulate to the Feeling of National Superiority. While the first expression is aligned with anti-globalization feelings, the second nationalistic sentiment stems from a sense of national superiority, which does not pose a threat to globalization. Our research revealed that a political global crisis not only influences the rise of nationalism but also its evolution.

Continuous focus on COVID-19 epidemic: Changes in China's clinical guidance.

BACKGROUNDS: The epidemic of coronavirus disease 2019 (COVID-19) is spreading across the world. As the first country who suffered from the outbreak, China has been taking strict and effective measures to contain the epidemic and treat the disease under the instruction of updating guidance. AIMS: To compare the changes and updates in China's clinical guidance for COVID-19. METHODS: We explored China's experience in dealing with the epidemic by longitudinal comparison of China's clinical guidance for COVID-19. RESULTS: As of March 4, there are 7 editions of the guidance. With the increasing understanding of COVID-19, changes have been made in aetiology, epidemiology, pathology, clinical features, diagnostic criteria, clinical classification, and treatment. CONCLUSIONS: We have made a summary of the changes and updates in China's clinical guidance for COVID-19, which mirrors the deepening understanding of the disease over the course of fighting it, hoping to help clinicians worldwide.

A Risk Prediction Model for Evaluating the Disease Progression of COVID-19 Pneumonia.

Background and Objective: The epidemic of coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has expanded from China throughout the world. This study aims to estimate the risk of disease progression of patients who have been confirmed with COVID-19. Methods: Meta-analysis was performed in existing literatures to identify risk factors associated with COVID-19 pneumonia progression. Patients with COVID-19 pneumonia were admitted to hospitals in Wuhan or Hangzhou were retrospectively enrolled. The risk prediction model and nomogram were developed from Wuhan cohort through logistic regression algorithm, and then validated in Hangzhou and Yinchuan cohorts. Results: A total of 270 patients admitted to hospital between Dec 30, 2019, and Mar 30, 2020, were retrospectively enrolled (Table 1). The development cohort (Wuhan cohort) included 87 (43%) men and 115 (57%) women, and the median age was 53 years old. Hangzhou validation cohort included 20 (48%) men and 22 (52%) women, and the median age was 59 years old. Yinchuan validation cohort included 12 (46%) men and 14 (54%) women, and the median age was 44 years old. The meta-analysis along with univariate logistic analysis in development cohort have shown that age, fever, diabetes, hypertension, CREA, BUN, CK, LDH, and neutrophil count were significantly associated with disease progression of COVID-19 pneumonia. The model and nomogram derived from development cohort show good performance in both development and validation cohorts. Conclusion: The severe COVID-19 pneumonia is associated with various types of risk factors including age, fever, comorbidities, and some laboratory examination indexes. The model integrated with these factors can help to evaluate the disease progression of COVID-19 pneumonia.

Establishment of method for dual simultaneous detection of PEDV and TGEV by combination of magnetic micro-particles and nanoparticles.

Transmissible gastroenteritis virus (TGEV) and porcine epidemic diarrhea virus (PEDV) are the main pathogens causing viral diarrhea in pig, mixed infections of these two viruses are very common in intensive pig rearing. However, there is a lack of a method to simultaneously detect and distinguish PEDV and TGEV in preclinical levels. In this study, we aimed to establish a dual ultrasensitive nanoparticle DNA probe-based PCR assay (dual UNDP-PCR) based on functionalized magnetic bead enrichment and specific nano-technology amplification for simultaneous detection and distinguish diagnosis of PEDV and TGEV. The detection limit of dual UNDP-PCR for single or multiple infections of PEDV and TGEV is 25 copies/g, which is 400 times more sensitive than the currently known duplex RT-PCR, showing better specificity and sensitivity without cross-reaction with other viruses. For pre-clinical fecal samples, the dual UNDP-PCR showed a markedly higher positive detection rate (52.08%) than conventional duplex RT-PCR (13.21%), can rapidly and accurately identify targeted pathogens whenever simple virus infection or co-infection. In summary, this study provides a technique for detecting and distinguishing PEDV and TGEV in preclinical levels, which is high sensitivity, specificity, repeatability, low cost and broad application prospect.

Spread and Impact of COVID-19 in China: A Systematic Review and Synthesis of Predictions From Transmission-Dynamic Models.

Background: Coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China, in December 2019 and quickly spread throughout China and the rest of the world. Many mathematical models have been developed to understand and predict the infectiousness of COVID-19. We aim to summarize these models to inform efforts to manage the current outbreak. Methods: We searched PubMed, Web of science, EMBASE, bioRxiv, medRxiv, arXiv, Preprints, and National Knowledge Infrastructure (Chinese database) for relevant studies published between 1 December 2019 and 21 February 2020. References were screened for additional publications. Crucial indicators were extracted and analysed. We also built a mathematical model for the evolution of the epidemic in Wuhan that synthesised extracted indicators. Results: Fifty-two articles involving 75 mathematical or statistical models were included in our systematic review. The overall median basic reproduction number (R0) was 3.77 [interquartile range (IQR) 2.78-5.13], which dropped to a controlled reproduction number (Rc) of 1.88 (IQR 1.41-2.24) after city lockdown. The median incubation and infectious periods were 5.90 (IQR 4.78-6.25) and 9.94 (IQR 3.93-13.50) days, respectively. The median case-fatality rate (CFR) was 2.9% (IQR 2.3-5.4%). Our mathematical model showed that, in Wuhan, the peak time of infection is likely to be March 2020 with a median size of 98,333 infected cases (range 55,225-188,284). The earliest elimination of ongoing transmission is likely to be achieved around 7 May 2020. Conclusions: Our analysis found a sustained Rc and prolonged incubation/ infectious periods, suggesting COVID-19 is highly infectious. Although interventions in China have been effective in controlling secondary transmission, sustained global efforts are needed to contain an emerging pandemic. Alternative interventions can be explored using modelling studies to better inform policymaking as the outbreak continues.