ArticleLiterature Review

The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak

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Abstract

Coronavirus disease (COVID-19) is caused by SARS-COV2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. Based on the large number of infected people that were exposed to the wet animal market in Wuhan City, China, it is suggested that this is likely the zoonotic origin of COVID-19. Person-to-person transmission of COVID-19 infection led to the isolation of patients that were subsequently administered a variety of treatments. Extensive measures to reduce person-to-person transmission of COVID-19 have been implemented to control the current outbreak. Special attention and efforts to protect or reduce transmission should be applied in susceptible populations including children, health care providers, and elderly people. In this review, we highlights the symptoms, epidemiology, transmission, pathogenesis, phylogenetic analysis and future directions to control the spread of this fatal disease.

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... 1,2 The coronavirus infection primarily targets the human respiratory system. 3 Patients may be asymptomatic, have atypical symptoms such as hyposmia, nasal congestion, rhinorrhea, sputum, abdominal discomfort, vomiting, and diarrhea, or have classic symptoms suc as fever, headache, dry cough, and dyspnea. 4 Based on severity, Covid-19 is classified as mild, moderate, severe and critical illness. ...
... Furthermore, our country's and Africa's underlying population demographics, behaviors, economic status, healthcare system, and endemic disease patterns differ from other parts of the world, making it challenging to forecast and generalize conclusions based on others' setup. 3 The first incidence of Covid-19 in Ethiopia was verified on March 13, 2020. The Ethiopian government has taken several public health measures to combat the Covid-19 threat, including raising awareness, closing schools, restricting large gatherings and movement of people, and preparing and equipping treatment centers to treat Covid-19 patients and isolate contacts with confirmed cases. ...
... The symptoms appear to vary from location to location, as well as from person to person, depending on sex, age, and other factors, indicating the role of patients' background characteristics in the clinical presentation, severity, and fate of the disease. 3 The duration of viral shedding could differ from individual to individual. 15 When am I going to get better? ...
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Background: The world is currently facing a pandemic of Coronavirus Disease 2019 (Covid-19). It has caused significant morbidity and mortality. So far little is known about recovery time (prolonged hospital stay) from Covid-19 and its determinants in Ethiopia as well as in the study area. Therefore, the aim of this study was to determine time to recovery from Covid-19, and identify predictors of time to recovery among patients admitted to treatment centers of Southern Nations Nationalities and Peoples Region (SNNPR). Methods and materials: A facility-based retrospective cohort study was conducted among Covid-19 patients admitted to care centers of SNNPR from May 30, 2020 to October 15, 2021. A sample of 845 patients was included in the study. Summarization of the data was done using mean (standard deviation) and median (inter quartile range). Kaplan-Meier Survival Curve was used to estimate recovery time from Covid-19 and the independent effects of covariates on recovery time was analyzed using multivariable Cox-proportional hazard model. Results: The incidence density of recovery was 8.24 per 100 person-days (95% CI: 7.67, 8.85). The overall median recovery time was 10 days (IQR: 8-16 days). Critical stage of Covid-19 (aHR = 0.19, 95% CI: 0.12, 0.29), severe stage of Covid-19 (aHR = 0.40, 95% CI: 0.29, 0.56), mechanical ventilation (aHR = 0.20, 95% CI: 0.073, 0.56) and treatment center (aHR = 0.68, 95% CI: 0.51, 0.90) were significant predictors of recovery rate among Covid-19 patients. Conclusion: The median time to recovery from Covid-19 was relatively short. The incidence density of recovery was 8.24 per 100 person-days. The hazard of recovery was lower for patients at higher levels of Covid-19 severity and for patients in need of mechanical ventilation. Early identification of severity levels of the patients is required at the time of admission. Special attention, critical follow-up and management is warranted for patients at higher levels of Covid-19 severity.
... Coronavirus is one of the pathogens that attacks the respiratory system [3]. This virus can be spread person-to-person through direct contact or droplets spread by coughing or sneezing from an infected person [3]. ...
... Coronavirus is one of the pathogens that attacks the respiratory system [3]. This virus can be spread person-to-person through direct contact or droplets spread by coughing or sneezing from an infected person [3]. Consequently, some precautions that can be taken to avoid coronavirus transmission are diligently washing hands, maintaining cleanliness, and keeping a distance from other people. ...
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In December 2021, the latest COVID-19 variant, Omicron, was confirmed in Indonesia. Unlike the Delta variant, the number of deaths in the Omicron type did not increase significantly and remained constant, even though the cases increased significantly. It is hoped that Indonesia will declare COVID-19 endemic. Jakarta is the capital of Indonesia and the first city where the new COVID-19 virus emerged. Therefore, we are trying to model COVID-19 cases in Jakarta and predict future cases to see if endemic conditions are identified. We applied Neural Network Auto-Regressive (NNAR) and Long Short-Term Memory (LSTM) methods. It is found that the NNAR forecast better for positive confirmed cases with an R-squared 0.939 and the LSTM forecast better for cases of death with an R-squared 0.9337. The forecasting results for the next 7 days reveal that positive confirmed cases of COVID-19 in Jakarta will increase slightly. In addition, the death cases experienced a very small increase, only one new case. According to the results of this study, it can be concluded that COVID-19 in Jakarta will enter an endemic phase in Jakarta, with no substantial increase in cases and a low mortality rate.
... After reading the randomly assigned framing article (technocratic, regulatory, or control), all respondents read an article excerpt from a fictional, but factually accurate, scientific journal (Nature Science) about COVID-19 and the relationship between humans and ecosystem health (Figure 4). This article included factual information from Bonilla-Aldana et al. (2020), Mackenzie and Smith, (2020), and Rothan and Byrareddy (2020) regarding the wildlife origin of COVID-19, the risk to human health and wellbeing associated with the disease, and the potential economic losses from zoonoses such as COVID-19. This article lacked ideological framing, and we sought to reduce the perception of cultural meanings by specifically focusing on descriptive wording in this article. ...
... The removal of two items ("The scientists who did the study were FIGURE 4 | Factually accurate article from a fictional 'Nature Science' academic journal highlighting the science surrounding COVID-19 without cultural framing. Generated by authors with information from Bonilla-Aldana et al. (2020), Mackenzie and Smith (2020), and Rothan and Byrareddy (2020). ...
... The new coronavirus disease 2019 (COVID-19) is an ongoing highly viral respiratory infectious disease caused by Severe Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) [1][2][3][4], which originated in China in 2019 [5,6], and has since spread to over 280 million people and led to over 5.4 million deaths across the globe [7]. The COVID-19 virus has mutated into several variants including B.1.1.7 (Alpha), P.1 (Gamma), B.1.351 ...
... To investigate the impact of intervention measures, time-dependent controls 1 ( ), 2 ( ), 3 The optimal control system is given by the following system: ...
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A new mathematical model for COVID-19 and HIV/AIDS is considered to assess the impact of COVID-19 on HIV dynamics and vice-versa. Investigating the epidemiologic synergy between COVID-19 and HIV is important. The dynamics of the full model is driven by that of its sub-models; therefore, basic analysis of the two sub-models; HIV-only and COVID-19 only is carried out. The basic reproduction number is computed and used to prove local and global asymptotic stability of the sub-models' disease-free and endemic equilibria. Using the fmincon function in the Optimization Toolbox of MATLAB, the model is fitted to real COVID-19 data set from South Africa. The impact of intervention measures, namely, COVID-19 and HIV prevention interventions and COVID-19 treatment are incorporated into the model using time-dependent controls. It is observed that HIV prevention measures can significantly reduce the burden of co-infections with COVID-19, while effective treatment of COVID-19 could reduce co-infections with opportunistic infections such as HIV/AIDS. In particular, the COVID-19 only prevention strategy averted about 10,500 new co-infection cases, with similar number also averted by the HIV-only prevention control.
... The new disease COVID-19, induced by SARS-CoV-2, causes acute respiratory infection. COVID-19 was first reported in the city of Wuhan, China, began to spread rapidly around the world and, in March 2020, the WHO declared the coronavirus global outbreak a pandemic [1][2][3]. By 13 April 2022, according to data from Johns Hopkins University, there were 500,994,183 cases and 6,186,945 deaths from COVID-19. ...
... There are many studies confirming that the level of physical activity affects mood and well-being [30][31][32][33]. In March 2020, the World Health Organization declared a pandemic [1][2][3]. At that time, people's behaviour related to professional work, lifestyle and forms of spending free time changed. ...
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The new disease COVID-19, induced by SARS-CoV-2, causes acute respiratory infection. Many countries, including Poland, began to set a variety of different restrictions to reduce the spread of the virus. Most students had problems with online lessons. The study was conducted among second year medicine students of the Medical University of Wroclaw, and after the entire process of verification 200 respondents were accepted. The research consisted of completing the same anonymous online questionnaires twice in March and October 2020. This finally allowed for a critical assessment of the impact of the pandemic and its restrictions on the students’ daily lives. During the online classes, low levels of physical activity persisted (p = 0.718), whereas time spent sitting increased (p < 0.001). Despite positive changes in declared snacking (p = 0.061), we observed significant drops in the index of healthy diet (p = 0.001) and nutritional knowledge (p < 0.001) as well as an increase in the consumption of fast-food (p < 0.001) and energy drinks (p = 0.019). Reduced nutritional knowledge can cause a decrease in attention to healthy food preparation and much more frequent consumption of fast-food
... SARS-CoV-2 as the cause of COVID-19 infection has affected global health since December, 2019. Most COVID-19 infected individuals show mild clinical symptoms whereas the small group who develop severe and complicated faces of the virus [1,2]. e infection could occur in all ages and spread easily; however, the likelihood of developing a severe clinical course of the infection may increase with different medical status like cardiovascular diseases, diabetes, chronic respiratory diseases, and hypertension [2][3][4]. ...
... Most COVID-19 infected individuals show mild clinical symptoms whereas the small group who develop severe and complicated faces of the virus [1,2]. e infection could occur in all ages and spread easily; however, the likelihood of developing a severe clinical course of the infection may increase with different medical status like cardiovascular diseases, diabetes, chronic respiratory diseases, and hypertension [2][3][4]. Several studies have investigated to picture COVID-19 clinical features and also specific antibody response to SARS-CoV-2 [5][6][7][8]. e viral transmission is supposed to happen mainly via droplet spread and close contact although the airborne transmission is specifically in the form of aerosols which is the new concern. ...
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Background: According to the contagious ability of the new virus, SARS-CoV-2, characterization of viral shedding duration in the period of infection is highly valuable in terms of providing quarantine guidelines and isolation policies. Therefore, we aimed at viral shedding determination in 58 COVID-19 confirmed Iranian subjects in different stages. Methods: 58 COVID-19 confirmed Iranian subjects including 21 outpatients and 37 inpatients were investigated. The analytical data and clinical properties were documented in the standard questionnaire. The RT-PCR tests were done two and three weeks after the symptoms initiation. Results: Viral eradication occurred in 44.8% two weeks after illness initiation whereas in 71% who achieved a negative PCR test in the third week. Moreover, prolonged viral shedding was observed in hospitalized cases in comparison to outpatients. Almost 30% of patients continued viral shedding three weeks after disease initiation. Conclusion: A longer duration of viral shedding in hospitalized cases rather than outpatients was observed in this study. The results similar to other investigations call into question if the current policies are enough to prevent the viral spread or not. This study should be done on a larger sample to provide an appropriate time in isolation policy.
... Long-term effects of CF aggravated the development of job stress and BO and then led to a low level of work engagement, posing challenges for staff retention and influencing patient safety (Craig and Sprang, 2009;Maiden et al., 2011;Thomas, 2013;Mason et al., 2014;Khamisa et al., 2015;Kim et al., 2017;Zhang et al., 2018;Wood et al., 2019;Allday et al., 2020). Coronavirus disease 2019 , an unprecedented global health crisis (Har and Snbbc, 2020), has infected over 243 million people and caused 5 million deaths as of 25 October 2021 (Johns Hopkins University, 2021). Evidence showed that service providers from different fields are highly susceptible to psychological problems under the high-pressure and highrisk situations, which was also demonstrated under COVID-19 conditions (Shih et al., 2009;Kang et al., 2015;Alharbi et al., 2020b;Louise Duncan, 2020;Ran et al., 2020;Tominaga et al., 2020;Tang et al., 2021). ...
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AimsA negative association between the lower level of psychological resilience (PR) and increased risk of compassion fatigue (CF) and higher Coronavirus disease 2019 (COVID-19) stress has been revealed. However, bibliometric studies have not been performed to comprehensively investigate this topic. This study aimed to identify the status and trends in the CF and PR field from 2008 to 2021 and during the COVID-19 pandemic.Methods We identified relevant literature from the Web of Science Core Collection® database using “resilience” and “compassion fatigue” on September 30, 2021. All search results were exported in plain text format for collaboration network analysis, reference-based co-citation analysis, analysis of journals, and keywords-based co-occurrence analysis, which were performed using Citespace® 5.8.R1.ResultsA total of 388 publications were identified finally, and there has been an increasing trend in the annual number of publications with light fluctuations. The analysis of journals and keywords indicated that nurses and social workers are the main research targets, and their mental problems are the main research topics. The turnover intention of health care providers has been a research focus, particularly during the COVID-19.Conclusion The results of the present study help us understand the status of the CF and PR field and its recent developments.
... China has suffered great economic and social harm following the outbreak of Corona Virus Disease 2019 (COVID- 19), in late December 2019 in Wuhan, China [2]. Considering that COVID-19 is highly infectious [3], its origin, transmission routes, and pathogenesis have remained unclear at the beginning of the outbreak, and the government's prevention and control strategy have been gradually and dynamically adapted to the epidemic's development. Scientific forecasting can help prevent major outbreaks by establishing a proactive and anticipatory safeguard system to prevent the continuous spread of epidemics [4]. ...
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Toward solving the slow convergence and low prediction accuracy problems associated with XGBoost in COVID-19-based transmission prediction, a novel algorithm based on guided aggregation is presented to optimize the XGBoost prediction model. In this study, we collect the early COVID-19 propagation data using web crawling techniques and use the Lasso algorithm to select the important attributes to simplify the attribute set. Moreover, to improve the global exploration and local mining capability of the grey wolf optimization (GWO) algorithm, a backward learning strategy has been introduced, and a chaotic search operator has been designed to improve GWO. In the end, the hyperparameters of XGBoost are continuously optimized using COLGWO in an iterative process, and Bagging is employed as a method of integrating the prediction effect of the COLGWO-XGBoost model optimization. The experiments, firstly, compared the search means and standard deviations of four search algorithms for eight standard test functions, and then, they compared and analyzed the prediction effects of fourteen models based on the COVID-19 web search data collected in China. Results show that the improved grey wolf algorithm has excellent performance benefits and that the combined model with integrated learning has good prediction ability. It demonstrates that the use of network search data in the early spread of COVID-19 can complement the historical information, and the combined model can be further extended to be applied to other prevention and control early warning tasks of public emergencies.
... In response, EMR hospitals have learned the significant role of community during outbreaks [22,58,59], one KI emphasized: "To win this pandemic, to win this battle, we have to win the community, the community is the key." (KI-14). HMs utilized a variety of interventions to combat stigma, regain public trust, and raise awareness including assigning official spokespersons, designating a media and communications team, mobilizing volunteers, broadcasting daily news briefings, publishing multi-lingual flyers and educational posters, using hotlines, webpages, and social media accounts, creating applications for screening and health education, and engaging religious and community leaders [44,49,[60][61][62][63]. ...
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Background During rapidly evolving outbreaks, health services and essential medical care are interrupted as facilities have become overwhelmed responding to COVID-19. In the Eastern Mediterranean Region (EMR), more than half of countries are affected by emergencies, hospitals face complex challenges as they respond to humanitarian crises, maintain essential services, and fight the pandemic. While hospitals in the EMR have adapted to combat COVID-19, evidence-based and context-specific recommendations are needed to guide policymakers and hospital managers on best practices to strengthen hospitals’ readiness, limit the impact of the pandemic, and create lasting hospital sector improvements towards recovery and resilience. Aim Guided by the WHO/EMR’s “Hospital readiness checklist for COVID-19”, this study presents the experiences of EMR hospitals in combatting COVID-19 across the 22 EMR countries, including their challenges and interventions across the checklist domains, to inform improvements to pandemic preparedness, response, policy, and practice. Methods To collect in-depth and comprehensive information on hospital experiences, qualitative and descriptive quantitative data was collected between May-October 2020. To increase breadth of responses, this comprehensive qualitative study triangulated findings from a regional literature review with the findings of an open-ended online survey (n = 139), and virtual in-depth key informant interviews with 46 policymakers and hospital managers from 18 out of 22 EMR countries. Purposeful sampling supported by snowballing was used and continued until reaching data saturation, measures were taken to increase the trustworthiness of the results. Led by the checklist domains, qualitative data was thematically analyzed using MAXQDA. Findings Hospitals faced continuously changing challenges and needed to adapt to maintain operations and provide essential services. This thematic analysis revealed major themes for the challenges and interventions utilized by hospitals for each of hospital readiness domains: Preparedness, Leadership, Operational support, logistics, supply management, Communications and Information, Human Resources, Continuity of Essential Services and Surge Capacity, Rapid Identification and Diagnosis, Isolation and Case Management, and Infection, Prevention and Control. Conclusion Hospitals are the backbone of COVID-19 response, and their resilience is essential for achieving universal health coverage. Multi-pronged (across each of the hospitals readiness domains) and multi-level policies are required to strengthen hospitals resilience and prepare health systems for future outbreaks and shocks.
... The virus, although perhaps less fatal than other emerging viruses in the Corona family, is very difficult to control and spreads rapidly, making it particularly dangerous [7]. Overall, the pandemic has resulted in filled hospital beds, an exhausted health workforce, shortages of personal protective equipment, infected hospital staff, understaffing in care centers, and anxiety in various countries of the world [8,9]. Along with vaccination, measures such as health education, increasing knowledge and information, and improving people's attitudes and perform preventive behaviors such as quarantining at home, using masks and gloves, washing hands and disinfecting surfaces play a very important role in controlling the COVID-19 pandemic [10,11]. ...
Article
Background: The COVID-19 pandemic has become a grave threat to public health. Along with vaccination, preventive behaviors are still an important part in controlling in controlling the COVID-19 pandemic. The present study aimed to investigate health beliefs and sample characteristics associated with COVID-19 preventive health behaviors among an Iranian sample. Preventive behaviors are still an important part in controlling in controlling the COVID-19 pandemic. Methods: This is a cross-sectional study, using a multi-stage randomized sampling method. Participants (N = 250 males and 236 females) were recruited from health centers in Saveh, Iran. Self-administered questionnaires included sociodemographic information, health behaviors, and constructs associated with the Health Beliefs Model (HBM). Data were analyzed using independent t-tests, analysis of variance, and multiple regression with significance level set at α ≤ 0.05. Results: Perceived disease susceptibility (β = 0.44, P< 0.001), self-efficacy to enact preventative behaviors (β = 0.24, P < 0.01), education (β = 0.20, P < 0.001), non-smoking status (β = 0.14, P < 0.01), marital status (β = 0.10, P < 0.03), and perceived barriers to disease preventative behaviors (β = -0.10, P < 0.04) were important predictors of prevention practices for COVID-19, and accounted for 61.4% (adjusted R2) of the variance associated with preventive behavior for COVID-19. Conclusion: As there is accepted therapy for COVID-19, it is especially important to control COVID-19 through behavior change. Results indicate that two behavioral constructs that have the most impact on prevention are perceived disease susceptibility and self-efficacy. Therefore, public health initiatives are needed to enhance perceived susceptibility to the disease and improve self-efficacy to perform preventative behaviors in spite of perceived barriers.
... For instance, when feeling anxious, they are likely to develop a defense mechanism, in the form of a fight or flight response, as a way of overcoming the threat [69]. A fight response is activated when a threat is deemed manageable, whereas a flight response is ignited when a threat is hard to overcome [70]. ...
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In this research, we examined how COVID-19 impacts employee decision-making and performance, knowing that this virus has negatively affected public health, crippled economies, and transformed social and business environments across the globe. To quantitatively test our specific hypotheses regarding the effects of employees’ perceived risk of COVID-19 and psychological distress on negative performance outcomes, we surveyed 443 healthcare workers who were employed by a group of private hospitals in Zimbabwe. These essential workers were delivering day-to-day frontline services with high exposure to COVID-19 during the pandemic. We find that employees’ perceived risk of COVID-19 increases their disengagement, turnover intention, burnout, and low morale at a p < 0.05 significance level. These latter relationships are mediated by employees’ psychological distress at a p < 0.05 significance level. Our findings shed light on how the COVID-19 pandemic is affecting the cognitions and behaviors of the frontline workers who are vulnerable to this contagious disease. Turnover intentions are amplified among healthcare employees, due to their perceived risk of COVID-19 and the resulting psychological distress. Similarly, burnout becomes predominant as these workers worry about contracting the coronavirus due to the poor working conditions they face. As such, our research confirms that the pandemic has intensified the precariousness of work and challenge of managing employee performance, especially for frontline healthcare workers.
... This pandemic has posed catastrophic impacts on nations' healthcare resources, especially in regions with fragile healthcare infrastructures, such as Africa [1], Afghanistan [2], and Bangladesh [3], and overloaded healthcare systems due to the coexisting contagious disease, like Zika [4] and Tuberculosis [5]. SARS-CoV-2 belongs to the beta-Coronaviruses [6] and shares a similar genome with other members of this family, particularly Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV [7,8], which were responsible for the outbreaks of CoVs in the past [9]. Similar to their clinical presentations [10], SARS-CoV-2 infection accompanies by plethoric manifestations such as fatigue, fever, dyspnea, cough, diarrhea, and in severe cases with ARDS and multi-systemic dysfunctions [11,12]. ...
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A global pandemic has erupted as a result of the new brand coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This pandemic has been consociated with widespread mortality worldwide. The antiviral immune response is an imperative factor in confronting the recent coronavirus disease 2019 (COVID-19) infections. Meantime, cytokines recognize as crucial components in guiding the appropriate immune pathways in the restraining and eradication of the virus. Moreover, SARS-CoV-2 can induce uncontrolled inflammatory responses characterized by hyper-inflammatory cytokine production, which causes cytokine storm and acute respiratory distress syndrome (ARDS). As excessive inflammatory responses are contributed to the severe stage of the COVID-19 disease, therefore, the pro-inflammatory cytokines are regarded as the Achilles heel during COVID-19 infection. Among these cytokines, interleukin (IL-) 1 family cytokines (IL-1, IL-18, IL-33, IL-36, IL-37, and IL-38) appear to have a strong inflammatory role in severe COVID-19. Hence, understanding the underlying inflammatory mechanism of these cytokines during infection is critical for reducing the symptoms and severity of the disease. Here, the possible mechanisms and pathways involved in inflammatory immune responses are discussed.
... It can also be transmitted through contact with surfaces contaminated by the virus if individuals place their hands on their mouth or nose (Singhal, 2020). It was thus named in February 2020 by the World Health Organization, which declared it a pandemic in March of the same year (Rothan & Byrareddy, 2020 The scenes described come from informal reports and semi-structured interviews carried out between September and October 2020, which are part of the pre-field of the research that was called SEXVID. 5 The study has been carried out at the national level by five public Brazilian universities, 6 and its general objective is to investigate sexual practices and risk management in times of in understanding how the pandemic changes the experiences of sexual practices of different groups and populations living in Brazil, identifying what they consider risk and what elements make up the management of this risk based on its framing caused by the pandemic effects. Thus, in SEXVID, we intend to analyze the heterogeneous assemblages the subjects produced, to establish risk hierarchies and risk management practices in the exercise of their sexuality since March 11, 2020, the date of the first declaration that public activities would be suspended in Brazil, in the Federal District, 8 and when physical distancing measures began to be promoted as the main strategies to prevent Sars-CoV-2 infection. ...
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This text presents initial questions from the SEXVID national survey on sexual practices and risk management in the Covid-19 context. The category of risk management, taken from studies about management and health in relation to HIV/AIDS and practices of assemblage, with reference to studies of materialities, articulates heterogeneous elements involved in managing offline sexual encounters in the context of the pandemic. We focus on two questions: how does this management take place, especially in a political environment lacking public policies on prevention and risk, and what are the practical materialities that constitute this articulated assemblage of elements that justify or not the risk of contamination. We use scenes constructed from semi-structured interviews in the initial phase of the study to contextualize the central question and learn about the impact of the pandemic on the sexual experiences of part of the population.
... (3) Children are characterized by mild clinical symptoms, with the main symptoms in the form of fever, cough, signs of intoxication, etc. (6) The majority of cases are asymptomatic, while about 10% require hospitalization. (7) There are some cases with a severe course (about 1% of children), especially in children with a burdened pre-morbid and comorbid background and severe comorbid disorders. (4) Overall, no particular changes were found in the structure of morbidity in children in different "waves" of COVID-19. ...
Article
The aim of our research was to assess the intensity of oxidative stress (OS) in children and adolescents with COVID-19 using the oxidative stress index (OSI). Methods and Results: The study was conducted between May 2020 and March 2021. The main group included 17 children and adolescents [8(47.1%) boys and 9(52.9%) girls; mean age of 12.35±4.01 years] with diagnosed COVID-19 infection (mild to moderate course) selected as a result of the primary diagnostic examination from among those admitted to hospitalization at the Irkutsk Regional Infectious Diseases Clinical Hospital. The control group included 17 healthy children and adolescents (average age of 12.35±4.01 years) matched by copy-pair type. The obtained data indicated statistically significant differences in a number of parameters between children and adolescents with COVID-19 and the control groups. We found statistically significant higher levels of LPO products (CDs, P
... 1 It presents as a clinical spectrum, with severe disease often manifesting as respiratory compromise leading to significant morbidity and mortality. [2][3][4] Patients on haemodialysis are particularly at risk. [5][6][7][8][9][10] Traditional public health measures do not apply due to their obligation to travel to and from enclosed units for regular treatment, often on public or shared transport. ...
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Objectives To assess the applicability of risk factors for severe COVID-19 defined in the general population for patients on haemodialysis. Setting A retrospective cross-sectional study performed across thirty four haemodialysis units in midlands of the UK. Participants All 274 patients on maintenance haemodialysis who tested positive for SARS-CoV-2 on PCR testing between March and August 2020, in participating haemodialysis centres. Exposure The utility of obesity, diabetes status, ethnicity, Charlson Comorbidity Index (CCI) and socioeconomic deprivation scores were investigated as risk factors for severe COVID-19. Main outcomes and measures Severe COVID-19, defined as requiring supplemental oxygen or respiratory support, or a C reactive protein of ≥75 mg/dL (RECOVERY trial definitions), and its association with obesity, diabetes status, ethnicity, CCI, and socioeconomic deprivation. Results 63.5% (174/274 patients) developed severe disease. Socioeconomic deprivation associated with severity, being most pronounced between the most and least deprived quartiles (OR 2.81, 95% CI 1.22 to 6.47, p=0.015), after adjusting for age, sex and ethnicity. There was no association between obesity, diabetes status, ethnicity or CCI with COVID-19 severity. We found no evidence of temporal evolution of cases (p=0.209) or clustering that would impact our findings. Conclusion The incidence of severe COVID-19 is high among patients on haemodialysis; this cohort should be considered high risk. There was strong evidence of an association between socioeconomic deprivation and COVID-19 severity. Other risk factors that apply to the general population may not apply to this cohort.
... The World Health Organization (WHO) identified corona virus (COVID-19) could infect animals and humans through direct interaction of the face, which was first discovered in China, Wuhan Province around the end of December 2019 [1][2][3][4]. The virus as a new virus which was then called CoV-2019 or better known as COVID-19 in February 2020 [5]. ...
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The rapid spread of corona virus disease 2019 (COVID-19), throughout direct of the human-to-human interaction makes the virus massively infect humans in all around the world. Until now, there has not been found the right way of healing it. This study aims to design of the intelligent automated quest control system capable for detecting COVID-19 by the body of temperature. The method approach was taken applied research, beginning with determining of the hardware using the ArduinoTM UNO microcontroller, the MLX90614 infrared thermometer, the TCRT5000 infrared reflective sensor, motor driver L293D, the output was displayed on a Liquid Crystal Display (LCD) screen, interaction control using Roller Limit Switch and instruction using the C programming language with Arduino IDE user interface. The system testing is done by comparing the temperature sensor readings infrared thermometer versus standard thermometer. Based on the results of a limited scale trial of 5 volunteers, an average error of 2.72% was obtained and the system worked well (opening or locking the door) in accordance with the temperature limits that had been set for detecting COVID-19. This research novelty that the simple and inexpensive design of the device system prevented and minimize the spread of COVID-19. The last, limitations of the system not being tested by the experts and large sample.
... However, in cases where the infection progresses, respiratory failure may occur, which can sometimes be accompanied by multi-organ failure [5]. In addition to the most common symptoms of fever, cough, fatigue, myalgia, hemoptysis, and shortness of breath, it is known that the infection is not always limited to the respiratory tract, creating problems involving many other systems of the body [6,7]. Studies have shown that this infection may also have neurological involvement [8]. ...
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The most common neurological disease in the world and one of the leading reasons for mortality is stroke. In addition to its effect on many systems of the body, COVID-19 infection also affects the central nervous system and causes neurological involvement. In our study, we examined the effects of the COVID-19 pandemic on stroke by comparing the pre-pandemic and pandemic times. Patients who presented to the emergency department with a stroke during the same time in two different years were included in the study. Patients with clinical conditions mimicking stroke in the differential diagnosis, those with a positive polymerase chain reaction test for COVID-19, and those with COVID-19 pneumonia were excluded from the sample. Patients diagnosed with stroke were examined using clinical, laboratory, and radiological imaging methods. Length of stay in hospital (service or intensive care unit) and mortality rates were recorded. There was no significant difference between the pre-pandemic and pandemic times in relation to the incidence of ischemic and hemorrhagic stroke, sex, and age. Although the number of patients presenting with an ischemic stroke increased during the pandemic time, the rate of acute ischemic stroke patients decreased. In addition, there was a decrease in the rates of patients who underwent intravenous thrombolytic and mechanical thrombectomy. Stroke cases increased during the pandemic time, but the rate of admission for acute ischemic stroke decreased. Because of this reason patients delaying their hospital visits because of pandemics lost their chance of acute treatment.
... In rehabilitation, an urgent readiness for disruptive events (Middleton et al., 2020) and the call for telehealth options have emerged (Hosseiniravandi et al., 2020). Remote activities under supervision are an option for persons with Parkinson's disease (PD) to remain physically active and healthy (Rothan & Byrareddy, 2020). On the other hand, there is no information whether some features of PD such as severity of disease, FOG, or having a caregiver might affect persons with PD's attendance in a remote physical activity program. ...
Article
Background: Telemonitoring can maintain daily exercise routine during the COVID-19 pandemic of individuals with Parkinson's disease (PD). However, there are barriers to adherence and attendance with remote physical rehabilitation. The main objective of this study was to evaluate adherence rate, barriers to attendance, and safety of a telemonitoring program for individuals with PD; and secondarily to evaluate the individual and their family members perceived overall experience when performing the telemonitoring physical exercise program. Methods: This was a phase 1 of a clinical trial, engaging 19 individuals with idiopathic PD of an in-person community rehabilitation program. For 24 weeks an asynchronous telemonitoring physical exercise program delivered two sessions per week by video including warm-up, balance, aerobic and resistance exercises, and cool-down. During the remote program were verified: adherence rate at entrance, attendance rate, barriers to attend, safety, and overall experience of the program. Results and conclusion: Only one participant did not perform any session and 18 participants completed between 2 and 34 sessions. Participants with a caregiver showed higher attendance rates. The most frequently cited barriers to attend the program were: pain; lack of motor skills; and reduced physical fitness. In relation to safety of the program, the most frequently reported was fear of falling. Although participants reported the telemonitoring program induced health benefits and they had positive experiences for themselves and for their families, most of participants prefer an in-person program. In this sense, the asynchronous telemonitoring physical exercise program was safe, showed moderate adherence, with attendance rate depending on the presence of a companion.
... Epidemiological studies suggest that the mortalities are higher in elder populations and the incidence is much lower in children [19]. Respiratory troubles along with elevated white blood cell (WBC) and cytokine levels are reported in patients suffering from COVID-19 [20]. One of the COVID-19 patients reported 5 days of fever accompanied by cough, coarse breathing sounds of both lungs with a body temperature of 39 C. The WBC differential count exhibited 70.0% neutrophils and 0.1% eosinophils along with elevations in levels of C-reactive protein (16.16 mg/L; normal range 0e10 mg/L), erythrocyte sedimentation rate (29 mm/h; normal range <20 mm/ h), and D-dimer (580 ng/mL; normal range 500 ng/mL). ...
Chapter
This chapter details the various therapeutic options available for the treatment of the novel coronavirus, SARS-CoV-2, that has brought the world to a standstill. As at 3.53 CEST, June 28, 2020, WHO reported 9,843,073 confirmed cases of COVID-19, with a death toll of 495,760. The rate of the spread of this disease is alarming posing serious threat to the world healthcare system. Clinical investigations and research are on the way for the development of vaccines or antiviral drugs. Despite this effort, no medication has been found to be very effective for its treatment. In this chapter, emphasis was laid on the need for repurposing of antiviral drugs to combat COVID-19 along with other alternatives such as convalescent plasma therapy and exploitation of drugs from medicinal plants and other natural resources.
... In late December 2019, several cases of pneumonia of unknown etiology were reported in Wuhan, the capital of Hubei province, Central China. The initial clinical presentations were greatly resembling viral pneumonia, and several cases were found to possibly be epidemiologically linked to the Huanan seafood and wet animal market in Wuhan using a surveillance mechanism designed for "pneumonia of unknown etiology" that was established in the wake of the 2003 SARS-CoV outbreak in order to allow timely identification of such novel pathogens Rothan and Byrareddy 2020). On January 3, 2020, with the use of next-generation sequencing of bronchoalveolar lavage fluid samples, a novel coronavirus was confirmed by the Chinese Center for Disease Control and Prevention (CDC) to be the cause of this disease. ...
Article
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In light of the outbreak caused by the COVID-19 and its impact on the physical and mental wellbeing, we explored the consequences of this pandemic on the mental health among pre-professional health sciences students and their awareness regarding the virus. A descriptive observational cross-sectional study was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Jeddah and Riyadh campuses. Data was collected from 770 participants using an online questionnaire, and statistical analysis was performed using SPSS. The majority of the participants (87.5%) considered governmental authorities as their main source of information, and therefore, they were up to date on the general information regarding COVID-19. For findings on mental health, it was found that 61.9% were exhibiting variant degrees of depression, as well as 50% expressing signs of extremely severe anxiety. However, 50.9% of the participants expressed no signs of stress during this pandemic. An association was found between gender and mental health showing females to have higher tendencies to express signs of extremely severe depression, anxiety, and stress. An association was also found between parents’ marital status and anxiety. Analysis revealed that participants with separated parents were the least among the participants to show no signs of anxiety, as well as reporting the highest numbers in the “extremely severe” anxiety category. With the increased awareness and higher than normal levels of the investigated mental illnesses, we advise that proper action should be considered to address this issue.
... Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), an evolving worldwide health problem, is the cause of coronavirus disease 2019 (COVID- 19), first reported in Wuhan, China, in December 2019 [1]. After an average incubation period of about five days (range: 2-14 days) [2], most cases showed mild symptoms, mainly from the respiratory tract, while some resulted in viral pneumonia, acute respiratory distress syndrome (ARDS), multiple organ failure, or death. ...
Preprint
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Objective Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), a worldwide health problem, is the cause of 2019 coronavirus disease. This study aimed to compare the trace element (selenium and iron), electrolyte (calcium and sodium), and physical activity levels of COVID-19 patients before and after COVID-19 treatment. Method This prospective study was conducted in patients diagnosed with COVID-19 (n=15). Trace element (selenium and iron), electrolyte (calcium and sodium), and physical activity levels of the patients were compared before and after the treatment. Result Most of patients had selenium deficiency (86.7%), iron deficiency (73.3%), calcium deficiency (66.7%) and sodium deficiency (46.7%) before COVID-19 treatment. The most important improvements were seen in iron deficiency (from 73.3% to 26.7%) and sodium deficiency (from 46.7% to 13.3%) after the treatment. Selenium, iron, calcium, and sodium levels of the patients were significantly higher after the treatment (p < 0.05). The patients had low physical activity before and after COVID-19 treatment. In addition, no statistically significant difference was found in the comparison of physical activity levels (p > 0.05). Conclusion This study indicated that selenium, iron, calcium, and sodium levels and deficiencies might improve after treating patients with COVID-19. However, the results of this study showed that the physical activity levels of COVID-19 patients might remain stable and low throughout the treatment process.
... Coronavirus disease 2019 (COVID-19) is a viral infectious disease caused by the coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [25]. It is a single-stranded, enveloped RNA virus named after its crown-like surface projections seen on electron microscopy [7]. ...
... As a comprehensive, multi-component intervention, Baduanjin may act through many intermediate variables along the pathway to improved anxiety outcomes. Several studies have suggested that COVID-19 is a new infectious disease with the characteristics of human-to-human transmission, long latency and high mortality [76][77][78][79]. There is still a lot of uncertainty about the origin, nature and process of the disease. ...
Article
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Abstract Background This study aimed to examine the effect of Baduanjin exercise on COVID-19-related anxiety, psychological well-being, and the lower back pain of college students during the coronavirus pandemic in China. Setting The study was carried out in a temporary experimental center of four universities in Wenzhou city in Zhejiang Province, China. Population 387 participants who were college students were allocated to two groups: the Baduanjin exercise group(BEG, n = 195); and the Control group(CG,n = 192). Methods In this randomized controlled trial,387 participants who were college students were randomly allocated in a 1:1 ratio to 12-week Baduanjin exercise group (BEG, n = 195)and 12-week Control group(CG,n = 192).CAS(Coronavirus Anxiety Scale), PWBS(Psychological Well-being Scale),NMQ( Nordic Musculoskeletal Questionnaire), was used to assess COVID-19-related anxiety, psychological well-being, and lower back pain at second times ( before and after the intervention). The paired t-test and an independent t-test (with a 95% confidence interval) was used to compare the outcome variables of the two groups. Results Within-group comparison, there was no significant difference in the control group before and after the intervention. In contrast, the Baduanjin group had a significant improvement before and after the intervention. Between-group comparison, the Baduanjin group had a significant difference from the control group. The intervention effect on the Baduanjin exercise group was remarkably better than that of the control group (p
... Bassetti et al. studied the contaminating behavior of COVID-19, and further, they investigated what obstacles we can face due to this virus [25,26]. Cao [34]. ...
Article
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For the analysis of the recent deadly pandemic Sars-Cov-2, we constructed the mathematical model containing the whole population, partitioned into five different compartments, represented by SEIQR model. This current model especially contains the quarantined class and the factor of loss of immunity. Further, we discussed the stability of the SEIQR model (constructed on the basis of system of coupled differential equations). The basic reproduction that indicates the behavior of the disease is also estimated by the use of next-generation matrix method. Numerical simulation of this model is provided, the results are analyzed by theoretically strong numerical methods, and computationally known tool MATLAB Simulink is also used for visualization of the results. Validation of results by Simulink software and numerical methods shows that our model and adopted methodology are appropriate and accurate and could be used for further predictions on COVID-19. Our results suggest that the isolation of the active cases and strong immunization of patients or individuals play a major role to fight against the deadly Sars-Cov-2.
... The coronavirus disease 2019 (COVID-19) is caused by a single-stranded RNA virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. The World Health Organization declared the COVID-19 outbreak a pandemic in March 2020. ...
Article
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Background The COVID-19 pandemic is an ongoing global healthcare crisis that negatively affects pregnant women. Although patients with an acute infection during pregnancy have been widely studied, information regarding labor and delivery while infected is sparse. The aim of the study was to ascertain maternal, obstetrical, and perinatal outcomes of women who gave birth while infected with SARS-CoV-2. Methods Patients diagnosed with COVID-19 during pregnancy at a tertiary medical center in 4/20–2/21 were identified by a retrospective database search. Those with an active intrapartum SARS-CoV-2 infection were compared with those who recovered at least 10 days before labor and delivery. Results Of the 176 women included in the study, 84 had a SARS-CoV-2 infection at the time of delivery and 92 had recovered from the infection. There was no statistically significant between-group difference in mean gestational age at delivery (39 weeks for both, p = 0.71) and overall rate of cesarean delivery (26.2% vs 17.4%, respectively, p = 0.35) or non-elective cesarean delivery (10.71% vs 4.34%, respectively, p = 0.48). In the active-infection group, the rate of severe disease was 2.4%, and of critical disease (with intensive care unit admission, mechanical ventilation, and ECMO), 3.6%, compared to zero for both in the recovered group. No differences were found between the groups in adverse perinatal outcomes. Conclusion Delivery is safe and feasible in women with active SARS-CoV-2 infection. Nevertheless, we found a non-significant trend for more severe disease and for cesarean delivery and urgent cesarean delivery (for COVID-19-related indications) in women with an intrapartum SARS-CoV-2 infection.
... To address COVID-19 pandemic, several mathematical approaches including Refs. [7][8][9][10][11][12][13] have been established. Reference [14] established a primer for COVID-19 mathematical model formulation, theoretical analysis and numerical simulations. ...
Article
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The study of COVID-19 pandemic which paralyzed global economy of countries is a crucial research area for effective future planning against other epidemics. Unfortunately, we now have variants of the disease resulting to what is now known as waves of the pandemic. Several mathematical models have been developed to study this disease. While recent models incorporated control measures, others are without optimal control measures or demographic parameters. In this study, we propose a deterministic compartmental epidemiological model to study the transmission dynamic of the spread of the third wave of the pandemic in Nigeria, and we incorporated optimal control measures as strategies to reduce the burden of the deadly disease. Specifically, we investigated the transmission dynamics of COVID-19 model without demographic features. We then conducted theoretical analysis of the model with and without optimal control strategy. In the model without optimal control, we computed the reproduction number, an epidemiological threshold useful for bringing the third wave of the pandemic under check in Nigeria, and we proofed the disease stability and conducted sensitivity analysis in order to identify parameters that can impact the reproduction number tremendously. In a similar reasoning, for the model with control strategy, we check the necessary condition for the model. To validate our theoretical analyses, we illustrated the applications of the proposed model using COVID-19 data for Nigeria for a period when the country was under the yoke of the third wave of the disease. The data were then fitted to the model, and we derived a predictive tool toward making a forecast for the cumulative number of cases of infection, cumulative number of active cases and the peak of the third wave of the pandemic. From the simulations, it was observed that the presence of optimal control parameters leads to significant impact on the reduction of the spread of the disease. However, it was discovered that the success of the control of the disease relies on the proper and effective implementation of the optimal control strategies efficiently and adequately.
... Several reports from China and America state that a majority of affected patients were males [19][20][21]. The records from Italy show that male sex and age were independent risk factors while all the cases from Germany reported on 30 th January 2020 were males with no mentionable medical history [22][23][24][25]. The percentage of past medical history in various age groups is represented in Fig. 1 while percentage of various symptoms manifested in COVID-19 patients is depicted in Fig. 2. ...
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Coronavirus disease 2019 (COVID-19) is rapidly expanding in U.S.A, Spain and Europe and to respond to it, countries are using national lockdown strategies and restrictions on international travels. While in India, strategies implemented proves to be more efficient in controlling the community spread of the disease. Our statistical analysis was based on the publicly available data of the new daily confirmed cases reported from various countries and about the ongoing trials of several diagnostic and treatment methods. Real time RT-PCR proved its inefficiency as a diagnostic tool, thus the country focused on the ELISA based humoral response assay and included Convalescent Plasma therapy as a core treatment protocol and this helped India to ensure higher recovery rate (22.5%) in a short duration. Complete lockdown till 3rd and imposition of stringent measures helped the country to limit the death toll (3%). Union Ministry of Health and Family Welfare is monitoring around 9.45 lakh suspected cases. From our statistical analysis, it is clear that India is in a better position than many other countries in case of survival rates but immediate actions have to be taken so as to avoid disease spread in the states with higher population density. Convalescent Plasma therapy should be implemented and developing effective diagnostic tools and anti-viral drugs should be of major concern.
... The coronavirus disease or the COVID-19 pandemic is considered one of the most significant and thoroughly studied health crises in the present era (Rothan & Byrareddy, 2020), affecting most world countries regardless of their location or socioeconomic status, including Egypt (Bulut & Kato, 2020;Lai et al., 2020). Healthcare professionals are considered one of the major groups exposed and affected by the pandemic, as while the general population was advised to stay at home and practice social distancing, healthcare professionals had to continue their work necessitating direct contact with suspected and confirmed cases of COVID-19, added to that the deficiency of the personal protective equipment (PPE) and the uncertainty of management protocols led to a higher possibility of infection (The, 2020). ...
Article
Abstract Objectives: The current study aimed to detect the BOS prevalence and determinants among residents working during the second wave of the COVID-19 pandemic in an Egyptian tertiary university referral hospital. Methods: A crosssectional study evaluating the working period from June to November 2020 during the COVID-19 pandemic second wave, through a five sections questionnaire evaluating: 1 − sociodemographic characteristics, 2 − job characteristics, 3 − negative thoughts related to their job, 4 − resident’s health problems, and 5 − evaluating BOS through Maslach Burnout Inventory (MBI) scale (including emotional exhaustion [EE], depersonalization [DP], and personal accomplishment [PA] as subscales). Results: We included 230 residents with a median age of 27 years. The median MBI sub-scales (IQ Range) values were 30.0 (20, 39), 21.0 (15, 30), and 29.5 (22, 36) for EE, DP, and PA, respectively. About 51.0% and 83.0% of the residents were high in EE and DP, while 8.7% were low in PA. The median EE and DP were higher in younger age (⩽27 years; p = .002 and .024), males (p = .001 and <.001), working >90 hours weekly (p = .016 and <.001), exposure to harassment (p < .001), and having COVID-19 infection (p = .002 and .001). Residents working in surgical departments reported higher DP scores than those in non-surgical departments (p = .03). There was a mild positive correlation between working hours per week and the total scores in EE and DP, r = .24 (p < .001) and r = .23 (p = .001) respectively, while it was found to have a negative correlation with the PA (r = −.133 and p = .044). Conclusions: The BOS is evident and considerably high among the residents working during the COVID-19 pandemic. Younger age, males, working in surgical departments, and those who got COVID-19 infection were most vulnerable.
... Secondly, China took a series of very strict measures to prevent the spread of the virus. Due to the risk of aerosol transmission of the new coronavirus disease [26], all possible transmission routes were cut off, including different entry and exit routes for medical staff and patients, three zones and two channels constructed for prevention of cross infection, 24 h supervision by special team for reducing the risk of self-contamination by PPE, strict three-level protection medical personnel, timely cleaning after work and so on. These measures may be regarded as exces-sive protection, but because of strict adherence, Chinese medical workers were protected well with no cross infection rather than the highly infected rate of about 16% in the United States [27]. ...
Article
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Objective: To explore the application value of mobile cabin hospitals in combating COVID-19 outbreak. Methods: The basic clinical data, the number of admission, CT scan, novel coronavirus nucleic acid testing results were collected and calculated. The operational elements of running this temporary hospital were reviewed from its construction to closing. Results: Wuhan Hanyang Mobile Cabin Hospital was transformed from Hall B1 of Wuhan International Expo Center. With a total of 930 beds in this temporary hospital, 1,028 patients were admitted, among them, 598 patients were cured, and 430 patients were transferred to designated hospitals in the special period. Totally, 1,206 mobile CT scan were conducted. 2,295 novel coronavirus nucleic acid tests were performed, among which, 1,032 tests showed two continuous negative results, 924 tests with one negative, while 302 tests with positive result (13.16%). No nosocomial infection of working staff was found due to the conduction of multiple measures. The patients' livelihoods were well safeguarded in mobile cabin hospitals. Conclusion: The mobile cabin hospital compulsory quarantine for mild patients can serve as an alternative method to combat COVID-19.
Article
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), appears to be diminishing in infectivity and hospitalizations in the United States and many parts of the world. This review will provide current information on the pathogenesis of SARS-CoV-2 and long haul COVID, emerging research on systemic complications, and antibody responses of vaccines and boosters.
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Background: Coronavirus is one of the major pathogens of the human respiratory system and a major threat to the human health. Objectives: This modeling study aimed to project the epidemics trend of coronavirus disease 2019 (COVID-19) in Qom, Iran Methods: This study projected the COVID-19 outbreak in Qom using a modified susceptible-exposed-infectious-recovered (SEIR) compartmental model by the end of December 2020. The model was calibrated based on COVID-19 epidemic trend in Qom from 1 January to 11 July. The number of infected, hospitalized, and death cases were projected by 31 December. A Monte Carlo uncertainty analysis was applied to obtain 95% uncertainty interval (UI) around the estimates. Results: According to the results, the reduced contact rate and increased isolation rate were effective in reducing the size of the epidemic in all scenarios. By reducing the contact rate from eight to six, the number of new cases on the peak day, as well as the total number of cases admitted to the hospital by the end of the period (31 December), decreased. For example, in Scenario A, compared to Scenario E, with a decrease in contact rate from eight to six, the number of new cases on peak days decreased from 15,700 to 1,100. The largest decrease in the number of new cases on peak days was related to Scenario F with 270 cases. Also, the total number of cases decreased from 948,000 to 222,000 between the scenarios, and the largest decrease in this regard was related to Scenario F, with 188,000 cases. Conclusions: The parameters of contact rate and isolation rate can reduce the number of infected cases and prevent the outbreak, or at least delay the onset of the peak. This can help health policymakers and community leaders to upgrade their health care systems.
Chapter
Various individuals, community organizations and institutions must be involved in planning and developing a cure for the COVID-19 flu pandemic. In addition to governmental organizations, those who need to be involved in the process are responsible for implementing pandemic plans. There should be a balance between centralized national control and regional and local communities through the effective implementation of the guidelines. There is a need to introduce social distancing and to study and isolate cases to contain disease spread. Due to the amendment and tightening of the law "SARS-CoV-2" in many countries, special attention should be paid to respect for citizens, especially national minorities. That is why it is necessary to protect freedom statements and providing access to critical information; make sure that quarantines, locks and travel bans comply with legal standards; persons.
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Background and Aims COVID-19 hasbeen a devastatingpandemic. There are indications that vitamin A is depleted during infections. Vitamin A is important in development and immune homeostasis. It has been used successfully in measles, RSV and AIDSinfections. In this study, we aimed to measurethe serum retinol levels in severe COVID-19 patients to assessthe importance of vitamin A in the COVID-19 pathogenesis. Methods The serum retinol level was measured in two groups of patients: the COVID-19 group, which consisted of 27 severe COVID-19 patients hospitalized in the intensive care unit with respiratory failure, and the control group, which consisted of 23 patients without COVID-19 symptoms. Results The mean serum retinol levels were 0.37 mg/L in the COVID-19 group and 0.52 mg/L in the control group. The difference between the serum retinol levels in the two groups was statistically significant.There was no significant difference in retinol levels between different ages and genders within the COVID-19 group. Comorbidity did not affect serum retinol levels. Conclusion The serum retinol level was significantly lower in patients with severe COVID-19, and this difference was independent of age or underlying comorbidity.Our data show that retinol and retinoic acid signaling might be important in immunopathogenesis of COVID-19.
Book
Coronavirus Drug Discovery SARS-CoV-2 (COVID-19) Prevention, Diagnosis, and Treatment
Chapter
The outbreak of the pandemic, COVID-19, triggered by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) throughout the world took a large number of lives till today and even counting. We have made an effort in this critical hour to compile and contemplate the literature reported till July 13, 2020 about the structure and morphology, epidemiology, transmission, replication cycle, and potential therapeutic strategies to tackle this pandemic. We have also highlighted some unexplored targets and potential gateways for the researchers in the field which may help to unravel some breakthrough therapy against this infection. Additionally, we have focused on the different approaches for vaccine development which could be used by researchers to develop a vaccine strong enough to eradicate this viral infection and to improve the current healthcare of the infected patients.
Technical Report
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This special edition provides an overview of the UKHSA Cleaner Air Programme and describes recent work to build the evidence-base, improve awareness and understanding, and influence and support stakeholders to take action to improve air quality and health.
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Background Certain clinical manifestations of coronavirus disease (COVID-19) mimic those associated with human herpesvirus (HHV) infection. In this study, we estimated the prevalence of herpesvirus in patients with COVID-19 and determined if coinfection is associated with poorer outcomes and neurological symptoms. Methods We analyzed samples of 53 patients diagnosed with COVID-19. The samples were evaluated for the presence of alphaherpesviruses, betaherpesviruses, and gammaherpesviruses, and the viral loads were quantified using quantitative polymerase chain reaction (qPCR) method. Results Among the patients, in 79.2% had detection at least one type of herpesvirus. HHV-6 (47.2%), cytomegalovirus (43.3%), and HHV-7 (39.6%) showed the highest detection rates. Patients with a high severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) load were more likely to show herpes simplex virus 1 detection ( p = 0.037). Among patients coinfected with SARS-CoV-2 and HHVs, 26.4% showed central nervous system-associated neurological symptoms and herpetic manifestations. A statistically significant association was observed between neurological changes and HHV-6 detection ( p = 0.034). Conclusions The findings showed a high prevalence of herpesvirus in patients with COVID-19. Furthermore, even though SARS-CoV-2 and HHV coinfection was not associated with poorer outcomes, the findings demonstrated the association between neurological symptoms and HHV-6 detection.
Article
In many nations affected by the COVID-19 pandemic, the situation in higher education institutions has changed. During the pandemic, these institutions have introduced numerous e-solutions to continue the process of education. Besides, research has shown many benefits in the last years of MOOCs. Yet, to date there are few studies to explore some individual characteristics, such as learners’ metacognitive skills, that might have an impact on learning outcomes in MOOCs. Furthermore, promotion of deep learning is a serious challenge for online courses including MOOCs. Therefore, the purpose of this research was to explore the role of metacognition in promoting deep learning in MOOCs during COVID-19 pandemic. The participants were students at the department of home economics who were all at the seventh academic level. Based on their scores on the metacognition awareness inventory (MAI), they were divided into two experimental groups, i.e. high metacognition students and low metacognition students. A three- aspect assessment card of deep learning namely connecting concepts, creating new concepts, and critical thinking was used to collect data. The results showed that MOOC was more effective in fostering the deep learning aspects of high metacognition skills, and deep learning as a whole. With regard to backward seeking and slow watching events, results showed significant differences in favor of high metacognition students (HMs). Nevertheless, there were no statistically significant differences between students in both groups regarding the pausing event.
Article
Objective To identify factors associated with COVID-19 positivity among staff and their family members of icddr,b, a health research institute located in Bangladesh. Setting Dhaka, Bangladesh. Participants A total of 4295 symptomatic people were tested for SARS-CoV-2 by reverse-transcription PCR between 19 March 2020 and 15 April 2021. Multivariable logistic regression was done to identify the factors associated with COVID-19 positivity by contrasting test positives with test negatives. Result Forty-three per cent of the participants were tested positive for SARS-CoV-2. The median age was high in positive cases (37 years vs 34 years). Among the positive cases, 97% were recovered, 2.1% had reinfections, 24 died and 41 were active cases as of 15 April 2021. Multivariable regression analysis showed that age more than 60 years (adjusted OR (aOR)=2.1, 95% CI 1.3 to 3.3; p<0.05), blood group AB (aOR=1.5, 95% CI 1.1 to 2; p<0.05), fever (aOR=3.1, 95% CI 2.6 to 3.7; p<0.05), cough (aOR=1.3, 95% CI 1.1 to 1.6; p<0.05) and anosmia (aOR=2.7, 95% CI 1.3 to 5.7; p<0.05) were significantly associated with higher odds of being COVID-19 positive when compared with participants who were tested negative. Conclusions The study findings suggest that older age, fever, cough and anosmia were associated with COVID-19 among the study participants.
Article
Preventive behaviors have played an essential role in coping with COVID‐19 and may continue to exerting a crucial impact on pandemic control in the future. This study aimed to evaluate the effectiveness of social‐cognitive factors on maintenance of COVID‐19 preventive behaviors based on a dual‐process model, which encompasses a reasoned path via the intention to maintain and a social reaction path via the willingness to stop. We collected a probability sample of 472 community‐dwelling adults. Social‐cognitive factors, behavioral tendencies, and preventive behaviors of COVID‐19 were measured. The results supported that the dual‐process framework could account for individual differences in preventive behaviors. Self‐efficacy and response cost significantly explained the intention to maintain preventive behaviors, while favorability of risk image and subjective norm significantly explained the willingness to stop preventive behaviors. Our findings proposed strategies for promoting individuals' maintenance of preventive behaviors during a pandemic. The development of prevention policies may focus on two paths: strengthening the intended path by enhancing self‐efficacy and decreasing response cost of preventive behaviors and monitoring and improving social influences, such as risk prototype and subjective norm, which can reduce the willingness to stop preventive behaviors.
Article
Amaç: Bu çalışmada COVID-19 sebebiyle ev izolasyonundaki kişilerin semptomlarını takip etmek ve dolayısıyla hastalık dönemini hastane dışında geçiren kişilerin klinik seyri hakkında bilgi sahibi olmak amaçlandı. Gereç ve Yöntemler: Bir sağlık kuruluşu personelinden 27 Mart 2020- 27 Şubat 2021 tarihleri arasında ev izolasyonunda olan, COVID-19 hastası toplam 501 kişi ile bir araştırmacının her gün telefonla görüştüğü çalışma, longitudinal olarak planlandı. Kişilere Sağlık Bakanlığının COVID-19 Rehberi ve literatür doğrultusunda hazırlanan anket soruları yöneltildi. Bezmialem Vakıf Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan izin alındı. Verilerin değerlendirilmesinde Ki-kare, Mann-Whitney U, Spearman’s korelasyon testleri kullanılmış, anlamlılık sınırı olarak 0,05 kabul edilmiştir. Bulgular: Çalışmadaki kişilerin (501) %65,7’si kadın, yaş ortalamaları 34,9 ± 9,1 yıldır. 501 kişiden 201’i (%40,1) temas yerini bildiğini söylemiştir. 107 kişi (%53,2) kurum içi, 94 kişi (%46,8) kurum dışı olarak bildirmiştir. İzolasyon sürecinde hastaneye yatışın sigara kullanımı veya kronik hastalık varlığı ile farklılık göstermediği (sırasıyla p=0,101 ve 0,361), ileri yaş ve erkek cinsiyet ile istatistiksel olarak arttığı bulunmuştur (sırasıyla p
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Despite the fact that COVID-19 vaccines serve as an important tool for protection against COVID-19 infection, in individuals aged above 65 years, as well as the entire community, there are significant problems associated with getting vaccinated. The aim of this study is to determine the effect of perceptions and attitudes toward the COVID-19 epidemic in individuals over the age of 65 living in Şanlıurfa, Turkey in 2021, on the situation of having COVID-19 vaccination. The study is designed as a case-control type of research. The study population was comprised of individuals aged 65 years and above located in Şanlıurfa, Turkey. The Case Group consisted of individuals, who rejected the COVID-19 vaccination and the Control Group consisted of individuals who have received the vaccine. The individuals recruited in the Case and Control Groups were selected by means of the snowball sampling method. The study included a total of 240 individuals including 120 in the Case Group and 120 in the Control Group. Rate of vaccine rejection was higher in individuals who believed that the media exaggerated the pandemic, the disease had low contagiousness, the pandemic was a conspiracy, the environmental pollution had no role in the disease, the domestic measures taken against the epidemic were inadequate, the personal hygiene could not protect from disease, and who did not believe that the disease was inevitable [p < 0.05]. Governments have a lot of responsibilities in providing accurate information about vaccination to people and increasing confidence in the health system.
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Coronavirus disease 2019 (COVID-19) is a highly infectious disease characterized by higher leukocyte numbers, acute respiratory distress, and elevated levels of plasma proinflammatory cytokines. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19, begins its pathogenesis by the binding of the virus to the host's angiotensin-converting enzyme 2 (ACE-2) receptor and then replication. The various replicated viruses then reinfect other cells and organs with ACE-2 receptor and further wreak havoc and could later result in multisystem organ failure. Presently, efforts are on the way to develop vaccines and drugs for this virus. But the current spike in COVID-19 cases linked to mutation in the virus genome and those of its enzymes is a cause of concern. Studies conducted by some authors have identified 6 major clads (basal, D614G, L84S, L3606F, D448del, and G392D), out of which D614G (a G-to-A base change at position 23403 in the Wuhan reference strain) was found to be the most reoccurring clad. This chapter examines all of these.
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Coronavirus Disease 2019 (COVID-19) has been a significant cause of global mortality and morbidity since it was first reported in December 2019 in Wuhan, China. COVID19 like previous coronaviruses primarily affects the lungs causing pneumonia, interstitial pneumonitis, and severe acute respiratory distress syndrome (ARDS). However, there is increasing evidence linking COVID-19 to cardiovascular complications such as arrhythmias, heart failure, cardiogenic shock, fulminant myocarditis, and cardiac death. Given the novelty of this virus, there is paucity of data on some cardiovascular complications of COVID-19, specifically myocarditis. Myocarditis is an inflammatory disease of the heart muscle with a heterogenous clinical presentation and progression. It is mostly caused by viral infections and is the result of interaction of the virus and the host's immune system. There have been several case reports linking COVID-19 with myocarditis, however the true mechanism of cardiac injury remains under investigation. In this paper we review the clinical presentation, proposed pathophysiology, differential diagnoses and management of myocarditis in COVID-19 patients.
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In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named "2019 novel coronavirus (2019-nCoV)" by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world's attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.
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Background: Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans. Methods: We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Jin Yin-tan Hospital of Wuhan, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed. Results: Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown β-CoV strain in all five patients, with 99.8-99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6-87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor. Conclusion: A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.
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Backgrounds: An ongoing outbreak of a novel coronavirus (2019-nCoV) pneumonia hit a major city of China, Wuhan, December 2019 and subsequently reached other provinces/regions of China and countries. We present estimates of the basic reproduction number,R0, of 2019-nCoV in the early phase of the outbreak. Methods: Accounting for the impact of the variations in disease reporting rate, we modelled the epidemic curve of 2019-nCoV cases time series, in mainland China from January 10 to January 24, 2020, through the exponential growth. With the estimated intrinsic growth rate (γ), we estimated R0 by using the serial intervals (SI) of two other well-known coronavirus diseases, MERS and SARS, as approximations for the true unknown SI. Findings: The early outbreak data largely follows the exponential growth. We estimated that the meanR0 ranges from 2.24 (95%CI: 1.96-2.55) to 3.58 (95%CI: 2.89-4.39) associated with 8-fold to 2-fold increase in the reporting rate. We demonstrated that changes in reporting rate substantially affect estimates of R0. CONCLUSION: The mean estimate ofR0 for the 2019-nCoV ranges from 2.24 to 3.58, and significantly larger than 1. Our findings indicate the potential of 2019-nCoV to cause outbreaks.
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A cluster of pneumonia cases linked to a novel coronavirus (2019‐nCoV) was reported by China in late December 2019. Reported case incidence has now reached the hundreds, but this is likely an underestimate. As of 24 January 2020, with reports of thirteen exportation events, we estimate the cumulative incidence in China at 5502 cases (95% confidence interval: 3027, 9057). The most plausible number of infections is in the order of thousands, rather than hundreds, and there is a strong indication that untraced exposures other than the one in the epidemiologically linked seafood market in Wuhan have occurred.
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In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed another clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.).
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A novel coronavirus (2019-nCoV) causing severe acute respiratory disease emerged recently in Wuhan, China. Information on reported cases strongly indicates human-to-human spread, and the most recent information is increasingly indicative of sustained human-to-human transmission. While the overall severity profile among cases may change as more mild cases are identified, we estimate a risk of fatality among hospitalised cases at 14% (95% confidence interval: 3.9-32%).
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Since December 2019, a total of 41 cases of pneumonia of unknown etiology have been confirmed in Wuhan city, Hubei Province, China. Wuhan city is a major transportation hub with a population of more than 11 million people. Most of the patients visited a local fish and wild animal market last month. At a national press conference held today, Dr. Jianguo Xu, an academician of the Chinese Academy of Engineering, who led a scientific team announced that a new‐type coronavirus, tentatively named by World Health Organization as the 2019‐new coronavirus (2019‐nCoV), had caused this outbreak (1).
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Feline coronavirus (FCoV) is a complex viral agent that causes a variety of clinical manifestations in cats, commonly known as feline infectious peritonitis (FIP). It is recognized that FCoV can occur in two different serotypes. However, differences in the S protein are much more than serological or antigenic variants, resulting in the effective presence of two distinct viruses. Here, we review the distinct differences in the S proteins of these viruses, which are likely to translate into distinct biological outcomes. We introduce a new concept related to the non-taxonomical classification and differentiation among FCoVs by analyzing and comparing the genetic, structural, and functional characteristics of FCoV and the FCoV S protein among the two serotypes and FCoV biotypes. Based on our analysis, we suggest that our understanding of FIP needs to consider whether the presence of these two distinct viruses has implications in clinical settings.
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Severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) are two highly transmissible and pathogenic viruses that emerged in humans at the beginning of the 21st century. Both viruses likely originated in bats, and genetically diverse coronaviruses that are related to SARS-CoV and MERS-CoV were discovered in bats worldwide. In this Review, we summarize the current knowledge on the origin and evolution of these two pathogenic coronaviruses and discuss their receptor usage; we also highlight the diversity and potential of spillover of bat-borne coronaviruses, as evidenced by the recent spillover of swine acute diarrhoea syndrome coronavirus (SADS-CoV) to pigs.
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There has been an outbreak of the severe acute respiratory syndrome (SARS) worldwide. We report the clinical, laboratory, and radiologic features of 138 cases of suspected SARS during a hospital outbreak in Hong Kong. From March 11 to 25, 2003, all patients with suspected SARS after exposure to an index patient or ward were admitted to the isolation wards of the Prince of Wales Hospital. Their demographic, clinical, laboratory, and radiologic characteristics were analyzed. Clinical end points included the need for intensive care and death. Univariate and multivariate analyses were performed. There were 66 male patients and 72 female patients in this cohort, 69 of whom were health care workers. The most common symptoms included fever (in 100 percent of the patients); chills, rigors, or both (73.2 percent); and myalgia (60.9 percent). Cough and headache were also reported in more than 50 percent of the patients. Other common findings were lymphopenia (in 69.6 percent), thrombocytopenia (44.8 percent), and elevated lactate dehydrogenase and creatine kinase levels (71.0 percent and 32.1 percent, respectively). Peripheral air-space consolidation was commonly observed on thoracic computed tomographic scanning. A total of 32 patients (23.2 percent) were admitted to the intensive care unit; 5 patients died, all of whom had coexisting conditions. In a multivariate analysis, the independent predictors of an adverse outcome were advanced age (odds ratio per decade of life, 1.80; 95 percent confidence interval, 1.16 to 2.81; P=0.009), a high peak lactate dehydrogenase level (odds ratio per 100 U per liter, 2.09; 95 percent confidence interval, 1.28 to 3.42; P=0.003), and an absolute neutrophil count that exceeded the upper limit of the normal range on presentation (odds ratio, 1.60; 95 percent confidence interval, 1.03 to 2.50; P=0.04). SARS is a serious respiratory illness that led to significant morbidity and mortality in our cohort.
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An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient's initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.
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Since end of December 2019, a cluster of patients with pneumonia of unknown origin was reported from Wuhan, Hubei province, China. They shared a connection with the Huanan South China Seafood Market in Wuhan, and now it has been confirmed that the disease is caused by a novel coronavirus (provisionally named 2019‐nCoV). As of today (30 January 2020), 7734 cases have been confirmed in China, and 90 cases have also been cumulatively reported from Taiwan, Thailand, Vietnam, Malaysia, Nepal, Sri Lanka, Cambodia, Japan, Singapore, Republic of Korea, United Arab Emirate, United States, The Philippines, India, Australia, Canada, Finland, France, and Germany (Finland, France and Germany are the only European countries in which cases [n= 1, n = 5, and n = 4, respectively] have been reported up to date). According to the released news, the case rate fatality is 2.2% (170/7824).
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The recent emergence of Wuhan coronavirus (2019-nCoV) puts the world on alert. 2019-nCoV is reminiscent of the SARS-CoV outbreak in 2002 to 2003. Our decade-long structural studies on the receptor recognition by SARS-CoV have identified key interactions between SARS-CoV spike protein and its host receptor angiotensin-converting enzyme 2 (ACE2), which regulate both the cross-species and human-to-human transmissions of SARS-CoV. One of the goals of SARS-CoV research was to build an atomic-level iterative framework of virus-receptor interactions to facilitate epidemic surveillance, predict species-specific receptor usage, and identify potential animal hosts and animal models of viruses. Based on the sequence of 2019-nCoV spike protein, we apply this predictive framework to provide novel insights into the receptor usage and likely host range of 2019-nCoV. This study provides a robust test of this reiterative framework, providing the basic, translational, and public health research communities with predictive insights that may help study and battle this novel 2019-nCoV.
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Background: In late December, 2019, patients presenting with viral pneumonia due to an unidentified microbial agent were reported in Wuhan, China. A novel coronavirus was subsequently identified as the causative pathogen, provisionally named 2019 novel coronavirus (2019-nCoV). As of Jan 26, 2020, more than 2000 cases of 2019-nCoV infection have been confirmed, most of which involved people living in or visiting Wuhan, and human-to-human transmission has been confirmed. Methods: We did next-generation sequencing of samples from bronchoalveolar lavage fluid and cultured isolates from nine inpatients, eight of whom had visited the Huanan seafood market in Wuhan. Complete and partial 2019-nCoV genome sequences were obtained from these individuals. Viral contigs were connected using Sanger sequencing to obtain the full-length genomes, with the terminal regions determined by rapid amplification of cDNA ends. Phylogenetic analysis of these 2019-nCoV genomes and those of other coronaviruses was used to determine the evolutionary history of the virus and help infer its likely origin. Homology modelling was done to explore the likely receptor-binding properties of the virus. Findings: The ten genome sequences of 2019-nCoV obtained from the nine patients were extremely similar, exhibiting more than 99·98% sequence identity. Notably, 2019-nCoV was closely related (with 88% identity) to two bat-derived severe acute respiratory syndrome (SARS)-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21, collected in 2018 in Zhoushan, eastern China, but were more distant from SARS-CoV (about 79%) and MERS-CoV (about 50%). Phylogenetic analysis revealed that 2019-nCoV fell within the subgenus Sarbecovirus of the genus Betacoronavirus, with a relatively long branch length to its closest relatives bat-SL-CoVZC45 and bat-SL-CoVZXC21, and was genetically distinct from SARS-CoV. Notably, homology modelling revealed that 2019-nCoV had a similar receptor-binding domain structure to that of SARS-CoV, despite amino acid variation at some key residues. Interpretation: 2019-nCoV is sufficiently divergent from SARS-CoV to be considered a new human-infecting betacoronavirus. Although our phylogenetic analysis suggests that bats might be the original host of this virus, an animal sold at the seafood market in Wuhan might represent an intermediate host facilitating the emergence of the virus in humans. Importantly, structural analysis suggests that 2019-nCoV might be able to bind to the angiotensin-converting enzyme 2 receptor in humans. The future evolution, adaptation, and spread of this virus warrant urgent investigation. Funding: National Key Research and Development Program of China, National Major Project for Control and Prevention of Infectious Disease in China, Chinese Academy of Sciences, Shandong First Medical University.
Article
Background: In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods: In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings: Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation: The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding: National Key R&D Program of China.
Article
Background: To help health workers and the public recognize and deal with the 2019 novel coronavirus (2019-nCoV) quickly, effectively and calmly with an updated understanding. Methods: A comprehensive search from Chinese and worldwide official websites and announcements was performed between 1 Dec 2019 to 9:30 am 26 Jan 2020 (Beijing time). A latest summary of 2019-nCoV and the current outbreak was drawn. Results: Up to 24 pm 25 Jan 2020, a total 1,975 cases were confirmed infection of 2019-nCoV in China mainland with a total of 56 deaths occurred. The latest mortality was approximately 2.84% with a total 2,684 cases still suspected. The China National Health Commission reported the details of the first 17 deaths up to 24 pm 22 Jan 2020. The deaths included 13 males and 4 females. The median age of the deaths was 75 (range 48-89) years. Fever (64.7%) and cough (52.9%) were the most common first symptoms in deaths. The median days from first symptom to death were 14.0 (range 6-41) days, and tended to be shorter among people of 70-year old or above (11.5 [range 6-19] days) than those with ages below 70-year old (20 [range 10-41] days, P=0.033). Conclusion: The infection of 2019-nCoV is spreading and increasing nationwide. The first occurred deaths were majorly elderly people who might have faster disease progresses. The public should still be cautious in dealing with the virus and paying more attention to protect elderly people from the virus. This article is protected by copyright. All rights reserved.
Article
As of January 22, 2020, a total of 571 cases of the 2019-new coronavirus (2019-nCoV) have been reported in 25 provinces (districts and cities) in China. At present, there is no vaccine or antiviral treatment for human and animal coronavirus, so that identifying the drug treatment options as soon as possible is critical for the response to the 2019-nCoV outbreak. Three general methods, which include existing broad-spectrum antiviral drugs using standard assays, screening of a chemical library containing many existing compounds or databases, and the redevelopment of new specific drugs based on the genome and biophysical understanding of individual coronaviruses, are used to discover the potential antiviral treatment of human pathogen coronavirus. Lopinavir /Ritonavir, Nucleoside analogues, Neuraminidase inhibitors, Remdesivir, peptide (EK1), abidol, RNA synthesis inhibitors (such as TDF, 3TC), anti-inflammatory drugs (such as hormones and other molecules), Chinese traditional medicine, such ShuFengJieDu Capsules and Lianhuaqingwen Capsule, could be the drug treatment options for 2019-nCoV. However, the efficacy and safety of these drugs for 2019- nCoV still need to be further confirmed by clinical experiments.
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The emergence of a new coronavirus in China raises global alarm.
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The current outbreak of viral pneumonia in the city of Wuhan, China, was caused by a novel coronavirus designated 2019‐nCoV by the World Health Organization, as determined by sequencing the viral RNA genome. Many initial patients were exposed to wildlife animals at the Huanan seafood wholesale market, where poultry, snake, bats, and other farm animals were also sold. To investigate possible virus reservoir, we have carried out comprehensive sequence analysis and comparison in conjunction with relative synonymous codon usage (RSCU) bias among different animal species based on the 2019‐nCoV sequence. Results obtained from our analyses suggest that the 2019‐nCoV may appear to be a recombinant virus between the bat coronavirus and an origin‐unknown coronavirus. The recombination may occurred within the viral spike glycoprotein, which recognizes a cell surface receptor. Additionally, our findings suggest that 2019‐nCoV has most similar genetic information with bat coronovirus and most similar codon usage bias with snake. Taken together, our results suggest that homologous recombination may occur and contribute to the 2019‐nCoV cross‐species transmission. Research Highlights • Taken together, our results suggest that homologous recombination may occur and contribute to the 2019‐nCoV cross‐species transmission.
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Influenza viruses constitute a major health threat and economic burden globally, frequently exacerbated by preexisting or rapidly emerging resistance to antiviral therapeutics. To address the unmet need of improved influenza therapy, we have created EIDD-2801, an isopropylester prodrug of the ribonucleoside analog N⁴ -hydroxycytidine (NHC, EIDD-1931) that has shown broad anti-influenza virus activity in cultured cells and mice. Pharmacokinetic profiling demonstrated that EIDD-2801 was orally bioavailable in ferrets and nonhuman primates. Therapeutic oral dosing of influenza virus–infected ferrets reduced group pandemic 1 and group 2 seasonal influenza A shed virus load by multiple orders of magnitude and alleviated fever, airway epithelium histopathology, and inflammation, whereas postexposure prophylactic dosing was sterilizing. Deep sequencing highlighted lethal viral mutagenesis as the underlying mechanism of activity and revealed a prohibitive barrier to the development of viral resistance. Inhibitory concentrations were low nanomolar against influenza A and B viruses in disease-relevant well-differentiated human air-liquid interface airway epithelia. Correlating antiviral efficacy and cytotoxicity thresholds with pharmacokinetic profiles in human airway epithelium models revealed a therapeutic window >1713 and established dosing parameters required for efficacious human therapy. These data recommend EIDD-2801 as a clinical candidate with high potential for monotherapy of seasonal and pandemic influenza virus infections. Our results inform EIDD-2801 clinical trial design and drug exposure targets.
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Middle East respiratory syndrome (MERS) is a new human disease caused by a novel coronavirus (CoV). Clinical data on MERS-CoV infections are scarce. We report epidemiological, demographic, clinical, and laboratory characteristics of 47 cases of MERS-CoV infections, identify knowledge gaps, and define research priorities. We abstracted and analysed epidemiological, demographic, clinical, and laboratory data from confirmed cases of sporadic, household, community, and health-care-associated MERS-CoV infections reported from Saudi Arabia between Sept 1, 2012, and June 15, 2013. Cases were confirmed as having MERS-CoV by real-time RT-PCR. 47 individuals (46 adults, one child) with laboratory-confirmed MERS-CoV disease were identified; 36 (77%) were male (male:female ratio 3·3:1). 28 patients died, a 60% case-fatality rate. The case-fatality rate rose with increasing age. Only two of the 47 cases were previously healthy; most patients (45 [96%]) had underlying comorbid medical disorders, including diabetes (32 [68%]), hypertension (16 [34%]), chronic cardiac disease (13 [28%]), and chronic renal disease (23 [49%]). Common symptoms at presentation were fever (46 [98%]), fever with chills or rigors (41 [87%]), cough (39 [83%]), shortness of breath (34 [72%]), and myalgia (15 [32%]). Gastrointestinal symptoms were also frequent, including diarrhoea (12 [26%]), vomiting (ten [21%]), and abdominal pain (eight [17%]). All patients had abnormal findings on chest radiography, ranging from subtle to extensive unilateral and bilateral abnormalities. Laboratory analyses showed raised concentrations of lactate dehydrogenase (23 [49%]) and aspartate aminotransferase (seven [15%]) and thrombocytopenia (17 [36%]) and lymphopenia (16 [34%]). Disease caused by MERS-CoV presents with a wide range of clinical manifestations and is associated with substantial mortality in admitted patients who have medical comorbidities. Major gaps in our knowledge of the epidemiology, community prevalence, and clinical spectrum of infection and disease need urgent definition. None.
The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health -the latest 2019 novel coronavirus outbreak in Wuhan, China
  • D S Hui
  • E Ia
  • T A Madani
  • F Ntoumi
  • R Kock
  • O Dar
D.S. Hui, E. IA, T.A. Madani, F. Ntoumi, R. Kock, O. Dar, et al., The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health -the latest 2019 novel coronavirus outbreak in Wuhan, China, Int. J. Infect. Dis. 91 (2020) 264-266.