Characterization of IL-10 Family of Cytokines in Acute and Convalescent COVID-19 Individuals.

Cytokines are major players in orchestrating inflammation, disease pathogenesis, and severity during COVID-19. Members of the interleukin (IL)-10 family of cytokines play important roles in regulating immune responses to various inflammatory and infectious diseases. However, the role of the IL-10 family of cytokines in COVID-19 remains elusive. Hence, we determined the plasma levels of the IL-10 family of cytokines (IL-10, IL-19, IL-20, IL-22, and IL-24) in 7 groups of COVID-19 individuals, based on days since real-time reverse transcriptase-polymerase chain reaction confirmation of SARS-CoV-2 infection. Our data show that the levels of IL-10, IL-19, IL-20, IL-22, and IL-24 cytokines decreased from days 15-30 to days 61-90 and plateaued thereafter. Severe COVID-19 patients exhibit increased plasma levels of IL-10, IL-19, IL-20, IL-22, and IL-24 compared to mild patients. Thus, our study provides evidence of alterations in the plasma levels of the IL-10 family of cytokines in convalescent COVID-19 individuals.

Emotions in the time of COVID-19: A sentiment analysis of tweets during the nationwide lockdown in India

BackgroundCOVID-19 pandemic is unprecedented in terms of burden, nature and quantum of control measures and public reactions. We report trends in public emotions and sentiments before and during the nation-wide lockdown implemented since 25th March 2020 in India. MethodsWe collected a sample of tweets containing the keywords coronavirus or COVID-19 published between 12th March and 14th April in India. After pre-processing, the tweets were subjected to sentiment analysis using natural language processing algorithms. ResultsOur analysis of 226170 tweets revealed a positive public sentiment (mean sentiment score=0.25). Tweets expressing a given sentiment showed significant (p<0.001) waning of negativity; negative tweets decreased (39.3% to 35.9%) and positive tweets increased (49.8% to 51.8%). Trust (0.85 words/tweet/day) and fear (0.66 words/tweet/day) were the dominant positive and negative emotions, respectively. ConclusionsPositive sentiments dominated during the COVID-19 lockdown in India. A surveillance system monitoring public sentiments on public health interventions for COVID-19 should be established.

Epidemiology of COVID-19 and effect of public health interventions, Chennai, India, March - October 2020

ObjectivesTo describe the public health strategies and their effect in controlling the COVID-19 pandemic from March to October 2020 in Chennai, India. SettingChennai, a densely populated metropolitan city in Southern India, was one of the five cities which contributed to more than half of the COVID-19 cases in India. ParticipantsWe collected the de-identified line list of all the 192,450 COVID-19 case-patients reported from 17 March to 31 October 2020 in Chennai and their contacts for the analysis. We defined a COVID-19 case-patient based on the RT-PCR positive test in one of the Government approved labs. Outcome measuresThe primary outcomes of interest were incidence of COVID-19 per million population, case fatality ratio, deaths per million and the effective reproduction number (Rt). We also analysed the indicators for surveillance, testing, contact tracing and isolation. ResultsOf the 192,450 RT-PCR confirmed COVID-19 case-patients reported in Chennai from 17 March-31 October 2020, 114,889 (60%) were males. The highest incidence was 41,064 per million population among the 61-80 years. The incidence peaked during June 2020 at 5239 per million and declined to 3,627 per million in October 2020. The city reported 3,543 deaths, with a case fatality ratio (CFR) of 1.8% and the crude death rate was 431 per million. When lockdown began, Rt was high (4.2) in March and fluctuated from April to June 2020. The Rt dropped below one by the first week of July and remained so until October 2020, even with the relaxation of restrictions ConclusionThe combination of public health strategies controlled the COVID-19 epidemic in a large, densely populated city in India. We recommend continuing the interventions to prevent resurgence, even as vaccination is being rolled out. StrengthsO_LIWe did a comprehensive analysis of COVID-19 strategies and outcome in a large, densely populated metropolitan city in India. C_LIO_LIWe documented that the community-centric public health strategies were feasible and effective in controlling the COVID-19 outbreak even in a large, thickly populated city C_LIO_LIThe lessons learnt are relevant to similar settings in low-and middle-income countries. Given the ongoing multiple waves of COVID-19 and the difficulty in controlling the transmission, our experience and lessons learnt will be valuable for policymakers and scientific advisors globally C_LI LimitationsO_LIWe analysed the data available from the GCC database and not from the hospitals where patients with moderate to severe illness were admitted. Hence, we could not report the severity of illness among admitted patients. C_LIO_LISecond, the COVID-19 incidence might have been underestimated while testing was low during the early phase of the epidemic C_LI

Landscaping capacity-building initiatives in epidemiology in India: bridging the demand–supply gap

India, the second most populous country in the world, has 17% of the world’spopulation but its total share of global disease burden is 21%. With epidemiologicaltransition, the challenge of the public health system is to deal with a high burden ofnoncommunicable diseases, while still continuing the battle against communicablediseases. To combat this progression, public health capacity-building initiativesfor the health workforce are necessary to develop essential skills in epidemiologyand competencies in other related fields of public health. This study is an effortto systematically explore the training programmes in epidemiology in India andto understand the demand–supply dynamics of epidemiologists in the country. Asystematic, predefined approach, with three parallel strategies, was used to collectand assemble the data regarding epidemiology training in India and assess thedemand–supply of epidemiologists in the country. The programmes offering trainingin epidemiology included degree and diploma courses offered by departments ofpreventive and social medicine/community medicine in medical colleges and 19long-term academic programmes in epidemiology, with an estimated annual outputof 1172 per year. The demand analysis for epidemiologists estimated that there isneed for at least 3289 epidemiologists to cater for the demand of various institutionsin the country. There is a wide gap in demand–supply of epidemiologists in thecountry and an urgent need for further strengthening of epidemiology training inIndia. More capacity-building and training initiatives in epidemiology are thereforeurgently required to promote research and address the public health challengesconfronting the country

Avian influenza A(H7N9) and the closure of live bird markets

On 31 March 2013, the National Health and Family Planning Commission, China notified the World Health Organization of three cases of human infection with avian influenza A(H7N9) from Shanghai and Anhui.1 By 8 May, 131 cases, including 26 deaths, had been notified from 11 provinces/municipalities.1,2 The majority (81%) of reported cases were from Shanghai municipality and Zhejiang and Jiangsu provinces. Available data indicate that more than three quarters of cases (59/77, 76%) had recent exposure to animals. Among these, 58% (34/59) had direct contact with chickens and 64% (38/59) visited a live bird market (LBM).3 Provincial and national authorities in China have collected more than 80 000 samples from LBMs, poultry slaughter houses, poultry farms, wild bird habitats, pig slaughter houses and their environments. As of 7 May, 50 samples were positive for avian influenza A(H7N9): 39 samples from poultry from LBMs in Anhui, Jiangsu, Jiangxi, Guangdong, Shanghai and Zhejiang provinces/municipalities (26 chickens, three ducks, four pigeons, six unknown) and 11 environmental samples from LBMs in Shanghai, Henan and Shandong provinces.4 None of the samples from poultry farms or pigs were positive

Human infections with avian influenza A(H7N9) virus in China: preliminary assessments of the age and sex distribution

Since 31 March 2013, the government of China has been notifying the World Health Organization (WHO) of human infections with the avian influenza A(H7N9) virus,1 as mandated by the International Health Regulations (2005).2 While human infections with other subgroups of H7 influenza viruses (e.g. H7N2, H7N3, and H7N7) have previously been reported,3 the current event in China is of historical significance as it is the first time that A(H7N9) viruses have been detected among humans and the first time that a low pathogenic avian influenza virus is being associated with human fatalities.4 In this rapidly evolving situation, detailed epidemiologic and clinical data from reported cases are limited—making assessments challenging—however, some key questions have arisen from the available data. Age and sex data, as one of the first and most readily available data, may be an important proxy for gender-specific behaviours/conditions and an entry point for response.5,6 Here, we describe the age and sex distribution of the human cases of avian influenza A(H7N9) to better inform risk assessments and potential next steps.