# pos

id: cord-011663-3ggah1y1
pos: NNP
token:
  https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200207sitrep-18-ncov.pdf?sfvrsn=fa644293_2

lemma:
  https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200207sitrep-18-ncov.pdf?sfvrsn=fa644293_2


id: cord-287233-srkny5v4
pos: NNP
token:
  www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meetingof-the-international-health-regulations-(2005)-emergency-committeeregarding-the-outbreak

lemma:
  www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meetingof-the-international-health-regulations-(2005)-emergency-committeeregarding-the-outbreak


# ent

id: cord-253208-wknht58z
type: PROTEIN
entity:
  lactate dehydrogenase LDH 200 5 U l vs 721 0 U l P 0 01 and blood urea nitrogen BUN 4 10 mmol l vs 9 70 mmol l P 0 01


id: cord-253208-wknht58z
type: PROTEIN
entity:
  alanine aminotransferase 24 U l vs 35 U l P 0 01 creatine kinase 51 0 U l vs 107 0 U l P 0 017 and serum creatinine 61 5 μmol l vs 95 0 μmol l P 0 04


id: cord-289907-wzctqkd7
type: GGP
entity:
  Kanu N E Olawepo O A Aruna O Michael C A Dunkwu L Ipadeola O Naidoo D Umeokonkwo C D Matthias A Okunromade O Badaru S


id: cord-289907-wzctqkd7
type: ORG
entity:
  Nigeria Federal Ministry of Health 2020 Nigeria Health Facility Registry Nigeria Health Facility Registry Geographic


id: cord-297326-n0fpu8s3
type: GPE
entity:
  Hong Kong Special Administrative Region Business Dynamics Systems Thinking and Modeling for a Complex World System


id: cord-340938-mk01k235
type: ORG
entity:
  Clinical Research Center Ruijin Hospital Shanghai Jiao Tong University School of Medicine Restrictions


id: cord-263245-2qub96mz
type: WORK_OF_ART
entity:
  Standard Quantitative Disk Carrier Test Method for Determining Bactericidal Virucidal Fungicidal Mycobactericidal and Sporicidal Activities of Chemicals Guideline


id: cord-263245-2qub96mz
type: ORG
entity:
  U S Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research


id: cord-345020-ai5tib7h
type: DISEASE
entity:
  influenza A P 0 001 and metapneumovirus P 0 015 while males were more likely to test positive for picornavirus P 0 003 Table S1 There was no significant difference in sex distribution for the other viruses Patients residing in rural areas


id: cord-354272-99vw735a
type: ORG
entity:
  Centers for Disease Control and Prevention Military Health Topics Health Readiness Armed Forces Health Surveillance


id: cord-354474-hbl2ywix
type: PROTEIN
entity:
  I Aljamaan F Al Eyadhy A Jamal A Al Amri M Barry M Al Subaie S Somily A M Al Zamil F title Knowledge


id: cord-309001-erm705tg
type: DISEASE
entity:
  hypertension cardiovascular disease diabetes malignancy cerebrovascular disease chronic obstructive pulmonary disease COPD chronic kidney disease


id: cord-305264-0uhabgsr
type: LAW
entity:
  STATA 13 1 StataCorp College Station TX USA The Providence Community Health Centers Review Committee


# url

id: cord-011663-3ggah1y1
domain: www.who.int
url:
  http://www.who.int/docs/default-source/coronaviruse/situation-reports/20200207sitrep-18-ncov.pdf?sfvrsn=fa644293_2


# bib

id: cord-000724-lzhobnch
author: ZHANG, J.
date: 2011-11-18
txt: ./txt/cord-000724-lzhobnch.txt
cache: ./cache/cord-000724-lzhobnch.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405768/
doi: 10.1017/s0950268811002214
summary:
  The questionnaire collected the following data : (1) knowledge about seasonal influenza and vaccination (22 items requiring true, false or unsure responses) included five dimensions to assess general information, severity of influenza, influenza vaccination, high-risk groups and vaccination-recommended groups; (2) risk perception (12 items with a 4-point Likert scale) towards influenza and pandemic with three dimensions (i.e. personal vulnerability to illness, negative consequences of contracting influenza and severity of influenza) ; (3) health locus of control including internal, chance and powerful others dimensions assessed by the Multidimensional Health Locus of Control (MHLC) scales [28] (18 items) ; (4) vaccination behaviours (nine items) including vaccination status (whether respondents had been vaccinated in the previous season), vaccination intent (whether respondents intended to be vaccinated next season) and vaccination history (how many times respondents had been vaccinated in the last 5 years) ; (5) reasons for accepting or refusing vaccination using two open questions; and (6) demographic characteristics (10 items) including gender, age group, highest educational qualification, place of work, clinical speciality, year of qualification as a nurse and whether or not respondents had direct patient contact.

title:
  Seasonal influenza vaccination knowledge, risk perception, health beliefs and vaccination behaviours of nurses

abstract:
  The relationship between knowledge, risk perceptions, health belief towards seasonal influenza and vaccination and the vaccination behaviours of nurses was explored. Qualified nurses attending continuing professional education courses at a large London university between 18 April and 18 October 2010 were surveyed (522/672; response rate 77·7%). Of these, 82·6% worked in hospitals; 37·0% reported receiving seasonal influenza vaccination in the previous season and 44·9% reported never being vaccinated during the last 5 years. All respondents were categorized using two-step cluster analyses into never, occasionally, and continuously vaccinated groups. Nurses vaccinated the season before had higher scores of knowledge and risk perception compared to the unvaccinated (P<0·001). Nurses never vaccinated had the lowest scores of knowledge and risk perception compared to other groups (P<0·001). Nurses' seasonal influenza vaccination behaviours are complex. Knowledge and risk perception predict uptake of vaccination in nurses.


id: cord-011663-3ggah1y1
author: Haider, Najmul
date: 2020-06-10
txt: ./txt/cord-011663-3ggah1y1.txt
cache: ./cache/cord-011663-3ggah1y1.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303470/
doi: 10.1017/s0950268820001211
abstract: nan
summary:
  title: Response to ''Evaluation of modelling study shows limits of COVID-19 importing risk simulations in sub-Saharan Africa'' (Epidemiology and Infection – HYG-LE-10513-May-20) Response to ''Evaluation of modelling study shows limits of COVID-19 importing risk simulations in sub-Saharan Africa'' (Epidemiology and Infection -HYG-LE-10513-May-20) Najmul [2] . In the letter, the authors state that they obtained 2417 COVID-19 cases reported by 40 countries in sub-Saharan Africa within the 30 days of the first case confirmed in Nigeria on 27 February. The authors also point out that the model did not consider the risk of importing COVID-19 cases from other countries. At the time, virtually no instances of community transmission were being reported outside of China and thus there was no data available to reliably calculate the risk of case importation from other countries (please see WHO''s situation Report-18 on Novel Coronavirus (2019-nCoV): https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200207sitrep-18-ncov.pdf?sfvrsn=fa644293_2). Evaluation of modelling study shows limits of COVID-19 importing risk simulations in sub-Saharan Africa

title:
  Response to ‘Evaluation of modelling study shows limits of COVID-19 importing risk simulations in sub-Saharan Africa’ (Epidemiology and Infection – HYG-LE-10513-May-20)


id: cord-253208-wknht58z
author: Wang, Xue
date: 2020-09-09
txt: ./txt/cord-253208-wknht58z.txt
cache: ./cache/cord-253208-wknht58z.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32900409/
doi: 10.1017/s0950268820002071
summary:
  title: Ratios of neutrophil-to-lymphocyte and platelet-to-lymphocyte predict all-cause mortality in inpatients with coronavirus disease 2019 (COVID-19): a retrospective cohort study in a single medical centre The current study aims to explore whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with the development of death in patients with COVID-19. In view of the small number of deaths (n = 12) in the current study, NLR of 2.306 might have potential value for helping clinicians to identify patients with severe COVID-19, with a sensitivity of 100.0% and a specificity of 56.7% (AUC: 0.729, 95% CI 0.563–0.892; P = 0.063). In the current study, the investigators aimed to determine whether the PLR can serve as a valuable predictor of in-hospital mortality, and the value of NLR for predicting the all-cause mortality in patients with COVID-19. The current study suggests that the elevated NLR is associated with all-cause mortality in patients with COVID-19, while PLR was not associated with this.

title:
  Ratios of neutrophil-to-lymphocyte and platelet-to-lymphocyte predict all-cause mortality in inpatients with coronavirus disease 2019 (COVID-19): a retrospective cohort study in a single medical centre

abstract:
  The Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a public health emergency of international concern. The current study aims to explore whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with the development of death in patients with COVID-19. A total of 131 patients diagnosed with COVID-19 from 13 February 2020 to 14 March 2020 in a hospital in Wuhan designated for treating COVID-19 were enrolled in the current study. These 131 patients had a median age of 64 years old (interquartile range: 56–71 years old). Furthermore, among these patients, 111 (91.8%) patients were discharged and 12 (9.2%) patients died in the hospital. The pooled analysis revealed that the NLR at admission was significantly elevated for non-survivors, when compared to survivors (P < 0.001). The NLR of 3.338 was associated with all-cause mortality, with a sensitivity of 100.0% and a specificity of 84.0% (area under the curve (AUC): 0.963, 95% confidence interval (CI) 0.911–1.000; P < 0.001). In view of the small number of deaths (n = 12) in the current study, NLR of 2.306 might have potential value for helping clinicians to identify patients with severe COVID-19, with a sensitivity of 100.0% and a specificity of 56.7% (AUC: 0.729, 95% CI 0.563–0.892; P = 0.063). The NLR was significantly associated with the development of death in patients with COVID-19. Hence, NLR is a useful biomarker to predict the all-cause mortality of COVID-19.


id: cord-261282-r1nprlne
title: The presence of fever in adults with influenza and other viral respiratory infections
author: CHUGHTAI, A. A.
date: 2016-10-03
txt: ./txt/cord-261282-r1nprlne.txt
cache: ./cache/cord-261282-r1nprlne.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/27691995/
doi: 10.1017/s0950268816002181
summary:
  [13] examined clinical trial data of 3744 adult ILI cases (defined as body temperature 537·8°C or patients subjective feeling of feverishness) and of those 2470 (66%) had laboratory-confirmed influenza. The aim of this study was to compare the rates of fever in adult subjects with confirmed influenza and other respiratory virus infections and examine predictors of fever. Rates of fever in influenza and other viral respiratory infections in this study were lower compared to other studies which report fever in around 50-70% adult cases [1, 5, 13, 15] . Clinical signs and symptoms are less studied for other viral respiratory infections, but available evidence suggests that other respiratory viruses are associated with a lower rate of fever compared to influenza [5, [30] [31] [32] [33] . Compared to children, this study shows that adults are less likely to have fever with a respiratory viral infection, even influenza.

abstract:
  We compared the rates of fever in adult subjects with laboratory-confirmed influenza and other respiratory viruses and examined the factors that predict fever in adults. Symptom data on 158 healthcare workers (HCWs) with a laboratory-confirmed respiratory virus infection were collected using standardized data collection forms from three separate studies. Overall, the rate of fever in confirmed viral respiratory infections in adult HCWs was 23·4% (37/158). Rates varied by virus: human rhinovirus (25·3%, 19/75), influenza A virus (30%, 3/10), coronavirus (28·6%, 2/7), human metapneumovirus (28·6%, 2/7), respiratory syncytial virus (14·3%, 4/28) and parainfluenza virus (8·3%, 1/12). Smoking [relative risk (RR) 4·65, 95% confidence interval (CI) 1·33–16·25] and co-infection with two or more viruses (RR 4·19, 95% CI 1·21–14·52) were significant predictors of fever. Fever is less common in adults with confirmed viral respiratory infections, including influenza, than described in children. More than 75% of adults with a viral respiratory infection do not have fever, which is an important finding for clinical triage of adult patients with respiratory infections. The accepted definition of ‘influenza-like illness’ includes fever and may be insensitive for surveillance when high case-finding is required. A more sensitive case definition could be used to identify adult cases, particularly in event of an emerging viral infection.


id: cord-263245-2qub96mz
author: Singh, D.
date: 2020-09-29
txt: ./txt/cord-263245-2qub96mz.txt
cache: ./cache/cord-263245-2qub96mz.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268820002319
doi: 10.1017/s0950268820002319
summary:
  This review summarises the studies on alcohol-based hand sanitisers and their disinfectant activity against SARS-CoV-2 and related viruses. The literature shows that the type and concentration of alcohol, formulation and nature of product, presence of excipients, applied volume, contact time and viral contamination load are critical factors that determine the effectiveness of hand sanitisers. When soap and water are not available, the Food and Drug Administration (FDA) recommends sanitising of non-visibly soiled hands with an alcoholbased agent containing 80% v/v ethanol or 75% v/v isopropanol [4] . This review assesses available information on the composition, formulation and effectiveness of alcohol-based hand disinfection products with specific reference to their activity against SARS-CoV-2. Alcohol-based hand rubs in the form of foam, rinse and gel did not differ significantly in trials of antimicrobial activity but the application volume and drying time had a profound effect on their efficacy [54] .

title:
  Alcohol-based hand sanitisers as first line of defence against SARS-CoV-2: a review of biology, chemistry and formulations

abstract:
  The pandemic due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged as a serious global public health issue. Since the start of the outbreak, the importance of hand-hygiene and respiratory protection to prevent the spread of the virus has been the prime focus for infection control. Health regulatory organisations have produced guidelines for the formulation of hand sanitisers to the manufacturing industries. This review summarises the studies on alcohol-based hand sanitisers and their disinfectant activity against SARS-CoV-2 and related viruses. The literature shows that the type and concentration of alcohol, formulation and nature of product, presence of excipients, applied volume, contact time and viral contamination load are critical factors that determine the effectiveness of hand sanitisers.


id: cord-275002-axp2ggbf
author: Brandl, M.
date: 2020-10-13
txt: ./txt/cord-275002-axp2ggbf.txt
cache: ./cache/cord-275002-axp2ggbf.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33046173/
doi: 10.1017/s0950268820002460
summary:
  title: Mass gathering events and undetected transmission of SARS-CoV-2 in vulnerable populations leading to an outbreak with high case fatality ratio in the district of Tirschenreuth, Germany To investigate the outbreak, we analysed surveillance and other data available at the district health department, including data on cases living in care facilities and public health measures applied. In order to investigate reasons for the rapid increase of cases and the magnitude of the outbreak, we used national and local surveillance data on laboratory-confirmed, reported COVID-19 cases in TIR from 17 February to 11 May 2020. We contacted local laboratories to estimate the number of SARS-CoV-2 tests performed in the period of 7 March 2020 (first laboratory confirmation in TIR) and 13 May 2020 and compared the data with those reported for Germany [6] .

title:
  Mass gathering events and undetected transmission of SARS-CoV-2 in vulnerable populations leading to an outbreak with high case fatality ratio in the district of Tirschenreuth, Germany

abstract:
  In early March 2020, a COVID-19-outbreak occurred in the district of Tirschenreuth, Germany. The outbreak was characterised by a rapid increase in case numbers and a comparatively high crude case fatality ratio (CFR; 11%). Until the beginning of May 2020, 1122 cases were reported in the district. To investigate the outbreak, we analysed surveillance and other data available at the district health department, including data on cases living in care facilities and public health measures applied. Furthermore, we compared the number of tests performed in Tirschenreuth and in Germany as a whole. We interviewed the first 110 cases in order to investigate potential exposures at the beginning of the outbreak. We found that returning ski-travellers from Austria and Italy and early undetected community transmission likely initiated the outbreak which was then accelerated by Bavarian beer festivities. Testing of mainly acute cases in the district of Tirschenreuth resulted in a higher rate of positive tests compared to the whole of Germany. Despite adjustment for age, the CFR continued to exceed the German mean which was due to spread to vulnerable populations. Strict public health measures likely contributed to control the outbreak by mid-April 2020.


id: cord-276916-j53i5xfs
title: Reconstruction and prediction of viral disease epidemics
author: Kraemer, M. U. G.
date: 2018-11-05
txt: ./txt/cord-276916-j53i5xfs.txt
cache: ./cache/cord-276916-j53i5xfs.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/30394230/
doi: 10.1017/s0950268818002881
summary:
  Some pathogens that were previously not considered to pose a general threat to human health have emerged at regional and global scales, such as Zika and Ebola Virus Disease. During emerging infectious disease outbreaks, empirical information and mathematical modelling techniques are now commonly used to characterise and predict the spatio-temporal dynamics of the spread of pathogens. Common spatiotemporal analyses of pathogen genomes focus on mapping and predicting virus lineage exchange among locations, with the underlying aim of reconstructing the pathways of disease introduction and spread, albeit at a coarse spatial resolution, and often retrospectively [2, 8, 33, 35, 37, 38] . In the recent yellow fever outbreak in southern Brazil, linking epidemiological, spatial and genomic data and techniques could provide insights into the transmission potential and risk of urban transmission [102] .

abstract:
  A growing number of infectious pathogens are spreading among geographic regions. Some pathogens that were previously not considered to pose a general threat to human health have emerged at regional and global scales, such as Zika and Ebola Virus Disease. Other pathogens, such as yellow fever virus, were previously thought to be under control but have recently re-emerged, causing new challenges to public health organisations. A wide array of new modelling techniques, aided by increased computing capabilities, novel diagnostic tools, and the increased speed and availability of genomic sequencing allow researchers to identify new pathogens more rapidly, assess the likelihood of geographic spread, and quantify the speed of human-to-human transmission. Despite some initial successes in predicting the spread of acute viral infections, the practicalities and sustainability of such approaches will need to be evaluated in the context of public health responses.


id: cord-277159-klhmed21
author: Bassal, R.
date: 2019-02-22
txt: ./txt/cord-277159-klhmed21.txt
cache: ./cache/cord-277159-klhmed21.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268819000062
doi: 10.1017/s0950268819000062
summary:
  Human HEV infection, investigated using seroprevalence studies, was found to be more prevalent in older ages [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] , lower socio-economic status [21] , poorer residence areas [9, [14] [15] , among sheltered homeless adults [22] or uneducated people [14] , specific nationalities (for example, higher in mixed race donors and ethnic groups within China [12, 15] , or in immigrants from Afghanistan [14] ), drinking water from wells or rivers [15] , consumption of meat products [7, 15, 17, 23] especially pork [24, 25] and following blood transfusions [1] . This study aimed to assess HEV seroprevalence in camels (dromedary), in Bedouins living in the southern part of Israel in the vicinity of camels, in non-Bedouins Arabs (Muslims living in northern and central Israel) and in Israeli-born Jews and to assess the factors associated with anti-HEV seropositivity.

title:
  Seroprevalence of hepatitis E virus in dromedary camels, Bedouins, Muslim Arabs and Jews in Israel, 2009–2017

abstract:
  Hepatitis E virus (HEV) is an emerging cause of viral hepatitis worldwide. Recently, HEV-7 has been shown to infect camels and humans. We studied HEV seroprevalence in dromedary camels and among Bedouins, Arabs (Muslims, none-Bedouins) and Jews and assessed factors associated with anti-HEV seropositivity. Serum samples from dromedary camels (n = 86) were used to determine camel anti-HEV IgG and HEV RNA positivity. Human samples collected between 2009 and 2016 from >20 years old Bedouins (n = 305), non-Bedouin Arabs (n = 320) and Jews (n = 195), were randomly selected using an age-stratified sampling design. Human HEV IgG levels were determined using Wantai IgG ELISA assay. Of the samples obtained from camels, 68.6% were anti-HEV positive. Among the human populations, Bedouins and non-Bedouin Arabs had a significantly higher prevalence of HEV antibodies (21.6% and 15.0%, respectively) compared with the Jewish population (3.1%). Seropositivity increased significantly with age in all human populations, reaching 47.6% and 34.8% among ⩾40 years old, in Bedouins and non-Bedouin Arabs, respectively. The high seropositivity in camels and in ⩾40 years old Bedouins and non-Bedouin Arabs suggests that HEV is endemic in Israel. The low HEV seroprevalence in Jews could be attributed to higher socio-economic status.


id: cord-285061-7vah0pjm
author: Khosravi, A.
date: 2020-06-10
txt: ./txt/cord-285061-7vah0pjm.txt
cache: ./cache/cord-285061-7vah0pjm.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32517845/
doi: 10.1017/s0950268820001247
summary:
  title: The basic reproduction number and prediction of the epidemic size of the novel coronavirus (COVID-19) in Shahroud, Iran The aim of this study was to estimate the basic reproduction number (R(0)) of COVID-19 in the early stage of the epidemic and predict the expected number of new cases in Shahroud in Northeastern Iran. The basic reproduction number (R 0 ) is the average expected number of new cases infected by a primary case and must be estimated early during an epidemic [4, 5] . Given the high incidence rate in the region, the aim of this report is to estimate the R 0 of the COVID-19 in the early stage of the epidemic (20 February to 04 March) and predict the trajectory of the epidemic and new cases in Shahroud. During the first 42 days of the epidemic (20 February to 01 April 2020), a total of 993 suspected samples were tested for COVID-19 in Shahroud, and 424 (42.7%) of them tested positive.

title:
  The basic reproduction number and prediction of the epidemic size of the novel coronavirus (COVID-19) in Shahroud, Iran

abstract:
  The aim of this study was to estimate the basic reproduction number (R(0)) of COVID-19 in the early stage of the epidemic and predict the expected number of new cases in Shahroud in Northeastern Iran. The R(0) of COVID-19 was estimated using the serial interval distribution and the number of incidence cases. The 30-day probable incidence and cumulative incidence were predicted using the assumption that daily incidence follows a Poisson distribution determined by daily infectiousness. Data analysis was done using ‘earlyR’ and ‘projections’ packages in R software. The maximum-likelihood value of R(0) was 2.7 (95% confidence interval (CI): 2.1−3.4) for the COVID-19 epidemic in the early 14 days and decreased to 1.13 (95% CI 1.03–1.25) by the end of day 42. The expected average number of new cases in Shahroud was 9.0 ± 3.8 cases/day, which means an estimated total of 271 (95% CI: 178–383) new cases for the period between 02 April to 03 May 2020. By day 67 (27 April), the effective reproduction number (R(t)), which had a descending trend and was around 1, reduced to 0.70. Based on the R(t) for the last 21 days (days 46–67 of the epidemic), the prediction for 27 April to 26 May is a mean daily cases of 2.9 ± 2.0 with 87 (48–136) new cases. In order to maintain R below 1, we strongly recommend enforcing and continuing the current preventive measures, restricting travel and providing screening tests for a larger proportion of the population.


id: cord-287233-srkny5v4
title: Application of ‘mobile hospital’ against 2019-nCoV in China
author: Yu, Hai-ping
date: 2020-04-24
txt: ./txt/cord-287233-srkny5v4.txt
cache: ./cache/cord-287233-srkny5v4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32326989/
doi: 10.1017/s0950268820000862
abstract: nan
summary:
  In this anti-epidemic battle, our hospital adopted the mobile hospital to deal with patients in the early stage of the outbreak in Shanghai and as a supplement medical facility to assist the Wuhan KeTing Medical Shelter. As a temporary facility in the early stage of the outbreak On 23 January, we completed the layout of the mobile hospital fever clinic in just 4 h, which not only effectively deals with fever patients, but also saves precious time for our hospital to complete the formal reconstruction of its fever clinic. From 23 to 27 January, 367 fever patients were registered in the mobile hospital, including one confirmed patient, without any medical staff being infected. The following areas were set up: triage and waiting room, consultation room, laboratory, pharmacy, treatment room (equipped with six infusion chairs), two isolation wards (equipped with beds and mobile toilets) and rest and dressing rooms for medical staff (Figs 1 and 2 ).


id: cord-288102-iom6lu7o
title: Analysis of factors affecting the prognosis of COVID-19 patients and viral shedding duration
author: Han, Jing
date: 2020-06-25
txt: ./txt/cord-288102-iom6lu7o.txt
cache: ./cache/cord-288102-iom6lu7o.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268820001399
doi: 10.1017/s0950268820001399
summary:
  The clinical characteristics of patients with COVID-19 were analysed to determine the factors influencing the prognosis and virus shedding time to facilitate early detection of disease progression. The clinical characteristics of 185 patients with COVID-19 diagnosed in Tianjin were analysed retrospectively to determine the factors affecting their prognoses and the duration of viral shedding with the aim of facilitating early treatment and improving patient prognosis. We found that a lower PaO 2 /FiO 2 at the time of admission is a risk factor for a poor prognosis in patients with severe COVID-19. In our study, univariate analysis results showed that age was a risk factor for prolonged viral shedding duration, but no significant difference was found in the multivariate Cox analysis. This study showed that diabetes mellitus, age, the time from symptom onset to treatment and PaO 2 /FiO 2 can predict the prognosis of patients with COVID-19.

abstract:
  The clinical characteristics of patients with COVID-19 were analysed to determine the factors influencing the prognosis and virus shedding time to facilitate early detection of disease progression. Logistic regression analysis was used to explore the relationships among prognosis, clinical characteristics and laboratory indexes. The predictive value of this model was assessed with receiver operating characteristic curve analysis, calibration and internal validation. The viral shedding duration was calculated using the Kaplan–Meier method, and the prognostic factors were analysed by univariate log-rank analysis and the Cox proportional hazards model. A retrospective study was carried out with patients with COVID-19 in Tianjin, China. A total of 185 patients were included, 27 (14.59%) of whom were severely ill at the time of discharge and three (1.6%) of whom died. Our findings demonstrate that patients with an advanced age, diabetes, a low PaO(2)/FiO(2) value and delayed treatment should be carefully monitored for disease progression to reduce the incidence of severe disease. Hypoproteinaemia and the fever duration warrant special attention. Timely interventions in symptomatic patients and a time from symptom onset to treatment <4 days can shorten the duration of viral shedding.


id: cord-289907-wzctqkd7
title: Descriptive epidemiology of coronavirus disease 2019 in Nigeria, 27 February–6 June 2020
author: Elimian, K. O.
date: 2020-09-11
txt: ./txt/cord-289907-wzctqkd7.txt
cache: ./cache/cord-289907-wzctqkd7.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32912370/
doi: 10.1017/s095026882000206x
summary:
  A descriptive analysis of the clinical characteristics, treatment modalities and outcomes of the first 32 COVID-19 patients admitted to Mainland Hospital in Lagos State, Nigeria, found that two-thirds of patients were male, and the mean age was 38.1 years [7] . Through NCDC''s surveillance and laboratory network as well as coordination of state PHEOCs, epidemiological information on COVID-19 cases are captured into a real-time networked platform called Surveillance Outbreak Response Management and Analysis System (SORMAS). During the study period, 36 states plus FCT had reported confirmed COVID-19 cases; all states were actively monitoring for cases through the Integrated Disease Surveillance and Response system (IDSR) system [9] . Laboratory diagnosis of COVID-19 was done by Residential setting c Residential setting of each person tested for COVID-19 was based on the population size and administrative/ legal criteria for the reporting Local Government Areas (LGA) as recorded by field staff, in line with common classification of urban and rural classification in Nigeria [12] .

abstract:
  The objective of this study was to describe the epidemiology of COVID-19 in Nigeria with a view of generating evidence to enhance planning and response strategies. A national surveillance dataset between 27 February and 6 June 2020 was retrospectively analysed, with confirmatory testing for COVID-19 done by real-time polymerase chain reaction (RT-PCR). The primary outcomes were cumulative incidence (CI) and case fatality (CF). A total of 40 926 persons (67% of total 60 839) had complete records of RT-PCR test across 35 states and the Federal Capital Territory, 12 289 (30.0%) of whom were confirmed COVID-19 cases. Of those confirmed cases, 3467 (28.2%) had complete records of clinical outcome (alive or dead), 342 (9.9%) of which died. The overall CI and CF were 5.6 per 100 000 population and 2.8%, respectively. The highest proportion of COVID-19 cases and deaths were recorded in persons aged 31–40 years (25.5%) and 61–70 years (26.6%), respectively; and males accounted for a higher proportion of confirmed cases (65.8%) and deaths (79.0%). Sixty-six per cent of confirmed COVID-19 cases were asymptomatic at diagnosis. In conclusion, this paper has provided an insight into the early epidemiology of COVID-19 in Nigeria, which could be useful for contextualising public health planning.


id: cord-290591-yi6yjjne
author: Desai, Angel N.
date: 2019-04-03
txt: ./txt/cord-290591-yi6yjjne.txt
cache: ./cache/cord-290591-yi6yjjne.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s095026881900058x
doi: 10.1017/s095026881900058x
summary:
  This invited editorial introduces a special issue of Epidemiology & Infection while also discussing advances in emerging infectious diseases. Although many of these diseases have the potential to cause public health emergencies, a lack of timely surveillance and effective interventions continue to hamper preparedness efforts [2] . review the recent Nipah virus outbreaks in Bangladesh and India, shedding light on transmission patterns of this emerging pathogen while also highlighting the importance of ongoing surveillance [6] . Lessons learned from the WHO response to the recent 2017 pneumonic plague outbreak in Madagascar are presented by Heitzinger et al., who highlight specifically the challenges of implementing rapid infection prevention and control measures in epidemic settings [7] . It is also crucial to encourage research during outbreaks through rapid data sharing to facilitate rapid response efforts, as is promoted through organisations such as the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) [9] .

title:
  Bending the epidemic curve: advancements and opportunities to reduce the threat of emerging pathogens

abstract:
  This invited editorial introduces a special issue of Epidemiology & Infection while also discussing advances in emerging infectious diseases.


id: cord-291361-2vn1o7ag
author: Li, Jing
date: 2020-07-06
txt: ./txt/cord-291361-2vn1o7ag.txt
cache: ./cache/cord-291361-2vn1o7ag.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268820001491
doi: 10.1017/s0950268820001491
summary:
  title: Epidemiological and clinical characteristics of three family clusters of COVID-19 transmitted by latent patients in China The epidemiological and clinical characteristics of the family cluster patients were analysed and compared with those of 43 contemporaneous sporadic cases. In terms of epidemiological characters and clinical symptoms, no significant differences were observed between the family cluster and sporadic cases. In this study, we aimed to investigate the epidemiological and clinical characteristics of these three family clusters of COVID-19 cases by comparing them with sporadic cases, which would provide insights for epidemic control in the context of the current serious situation worldwide. This study revealed that sporadic cases had lower levels of albumin and lymphocyte counts than family cluster cases; otherwise, there were no significant differences in terms of other epidemiological characters and clinical features between the two groups. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China

title:
  Epidemiological and clinical characteristics of three family clusters of COVID-19 transmitted by latent patients in China

abstract:
  From 21 January 2020 to 9 February 2020, three family clusters involving 31 patients with coronavirus disease 2019 were identified in Wenzhou, China. The epidemiological and clinical characteristics of the family cluster patients were analysed and compared with those of 43 contemporaneous sporadic cases. The three index cases transmitted the infection to 28 family members 2–10 days before illness onset. Overall, 28 of the 41 sporadic cases and three of 31 patients in the family clusters came back from Wuhan (65.12 vs. 9.68%, P< 0.001). In terms of epidemiological characters and clinical symptoms, no significant differences were observed between the family cluster and sporadic cases. However, the lymphocyte counts of sporadic cases were significantly lower than those of family cluster cases ((1.32 ± 0.55) × 10(9)/l vs. (1.63 ± 0.70) × 10(9)/l, P = 0.037), and the proportion of hypoalbuminaemia was higher in sporadic cases (18/43, 41.86%) than in the family clusters (6/31, 19.35%) (P < 0.05). Within the family cluster, the second- and third-generation cases had milder clinical manifestations, without severe conditions, compared with the index and first-generation cases, indicating that the virulence gradually decreased following passage through generations within the family clusters. Close surveillance, timely recognition and isolation of the suspected or latent patient is crucial in preventing family cluster infection.


id: cord-292502-m76rne1l
title: The COVID-19 pandemic: the public health reality
author: Cheema, S.
date: 2020-09-22
txt: ./txt/cord-292502-m76rne1l.txt
cache: ./cache/cord-292502-m76rne1l.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268820002216
doi: 10.1017/s0950268820002216
summary:
  Undeniably, the COVID-19 pandemic has resulted in loss of human life; it has wreaked havoc on healthcare systems worldwide, highlighting inequities in healthcare availability and access; it has resulted in drastic public health measures in most countries of the world. Here, we present data that pose questions on the magnitude of attention that the COVID-19 pandemic has garnered compared to other public health issues that are in dire need of prevention and response. The loss of income is likely to result in an increase of adverse health outcomes for many of the individuals affected, and the overall economic crisis will negatively impact the ability of entire countries to provide effective healthcare to their citizens. Hence, we believe that the mortality and disease burden during and after the COVID-19 pandemic due to the social and economic consequences of the preventive measures and other factors can be substantially high.

abstract:
  The coronavirus disease (COVID-19), while mild in most cases, has nevertheless caused significant mortality. The measures adopted in most countries to contain it have led to colossal social and economic disruptions, which will impact the medium- and long-term health outcomes for many communities. In this paper, we deliberate on the reality and facts surrounding the disease. For comparison, we present data from past pandemics, some of which claimed more lives than COVID-19. Mortality data on road traffic crashes and other non-communicable diseases, which cause more deaths each year than COVID-19 has so far, is also provided. The indirect, serious health and social effects are briefly discussed. We also deliberate on how misinformation, confusion stemming from contrasting expert statements, and lack of international coordination may have influenced the public perception of the illness and increased fear and uncertainty. With pandemics and similar problems likely to re-occur, we call for evidence-based decisions, the restoration of responsible journalism and communication built on a solid scientific foundation.


id: cord-293525-c7nwygl1
title: Extension of the known distribution of a novel clade C betacoronavirus in a wildlife host
author: Saldanha, I. F.
date: 2019-04-03
txt: ./txt/cord-293525-c7nwygl1.txt
cache: ./cache/cord-293525-c7nwygl1.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/31063092/
doi: 10.1017/s0950268819000207
summary:
  An EriCoV-specific BRYT-Green(®) real-time reverse transcription PCR assay was used to test 351 samples of faeces or distal large intestinal tract contents collected from casualty or dead hedgehogs from a wide area across GB. Characterisation of these Erinaceus coronavirus (EriCoV) nucleotide sequences revealed high nucleotide identity to MERS-CoV [3] , the cause of an acute respiratory syndrome in humans with high case fatality rates [5, 6] . Many animal species seem to have the capacity for coronavirus infection in the absence of apparent disease, including bats [15] , aquatic birds [16] and rabbits when inoculated with MERS-CoV [17] . Whole genome sequencing was performed on RNA extracted from one faecal sample collected in 2014 (R618/14) which was identified as EriCoV-positive by real-time RT-PCR. The highest proportion of EriCoV-positive hedgehog samples were submitted from the South of England (34/217, 16%); however, BLR showed no significant association (P = 0.678) between EriCoV infection status and wider region when other factors including age and year were included.

abstract:
  Disease surveillance in wildlife populations presents a logistical challenge, yet is critical in gaining a deeper understanding of the presence and impact of wildlife pathogens. Erinaceus coronavirus (EriCoV), a clade C Betacoronavirus, was first described in Western European hedgehogs (Erinaceus europaeus) in Germany. Here, our objective was to determine whether EriCoV is present, and if it is associated with disease, in Great Britain (GB). An EriCoV-specific BRYT-Green(®) real-time reverse transcription PCR assay was used to test 351 samples of faeces or distal large intestinal tract contents collected from casualty or dead hedgehogs from a wide area across GB. Viral RNA was detected in 10.8% (38) samples; however, the virus was not detected in any of the 61 samples tested from Scotland. The full genome sequence of the British EriCoV strain was determined using next generation sequencing; it shared 94% identity with a German EriCoV sequence. Multivariate statistical models using hedgehog case history data, faecal specimen descriptions and post-mortem examination findings found no significant associations indicative of disease associated with EriCoV in hedgehogs. These findings indicate that the Western European hedgehog is a reservoir host of EriCoV in the absence of apparent disease.


id: cord-297326-n0fpu8s3
title: New coronavirus outbreak. Lessons learned from the severe acute respiratory syndrome epidemic
author: ÁLVAREZ, E.
date: 2015-01-16
txt: ./txt/cord-297326-n0fpu8s3.txt
cache: ./cache/cord-297326-n0fpu8s3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/25591619/
doi: 10.1017/s095026881400377x
summary:
  Here, we develop a model that explains the severe acute respiratory syndrome coronavirus (SARS-CoV) epidemic that occurred in Hong Kong in 2003. These equations involve three stocks (SUSCEPTIBLE, LATENT, INFECTED), three auxiliary variables (prevalence, contagion rate, recovery rate) and three parameters (incubation period, case fatality, disease duration). The simulation output for the variable ''sick per day'' fit the data reported by the Hong Kong authorities (Fig. 4a) , suggesting that the model was able to reproduce the epidemic curve. These results are consistent with a previous report showing the basic reproductive numbers for different SARS epidemic curves, which supports the notion that our model is able to largely replicate the disease outbreak in Hong Kong [31] . Under these conditions, the model output fits the epidemic curve observed in the Hong Kong SARS-CoV outbreak (Fig. 4) .

abstract:
  System dynamics approach offers great potential for addressing how intervention policies can affect the spread of emerging infectious diseases in complex and highly networked systems. Here, we develop a model that explains the severe acute respiratory syndrome coronavirus (SARS-CoV) epidemic that occurred in Hong Kong in 2003. The dynamic model developed with system dynamics methodology included 23 variables (five states, four flows, eight auxiliary variables, six parameters), five differential equations and 12 algebraic equations. The parameters were optimized following an iterative process of simulation to fit the real data from the epidemics. Univariate and multivariate sensitivity analyses were performed to determine the reliability of the model. In addition, we discuss how further testing using this model can inform community interventions to reduce the risk in current and future outbreaks, such as the recently Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic.


id: cord-305264-0uhabgsr
author: Weng, C-H.
date: 2020-07-09
txt: ./txt/cord-305264-0uhabgsr.txt
cache: ./cache/cord-305264-0uhabgsr.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32641191/
doi: 10.1017/s0950268820001569
summary:
  In this study, we reviewed 120 consecutive adult patients (≥18 years old) with COVID-19 at a major federally qualified health centre in Rhode Island, United States from 19 March to 29 April 2020. To determine if BCG vaccination provided protection from COVID-19, we reviewed a predominately Latino/Hispanic population receiving care at the major federally qualified health centre (FQHC) in Providence, Rhode Island, United States. COVID-19 patients with BCG vaccination were less likely to be hospitalised during the disease course (3.7% vs. A recent population-based study examining the cohort of Israeli adults aged 35−41 years found that the BCG vaccine may not reduce the likelihood of acquiring SARS-CoV-2 (difference, 1.3%; 95% CI −0.3% to 2.9%; P = 0.09) [10] . However, the lower hospitalisation rate among BCG-vaccinated patients from our prospective cohort study suggests the potential of BCG in preventing more severe COVID-19 among those who acquired SARS-CoV-2.

title:
  Bacillus Calmette–Guérin vaccination and clinical characteristics and outcomes of COVID-19 in Rhode Island, United States: a cohort study

abstract:
  Coronavirus disease 2019 (COVID-19) has resulted in a global pandemic, and there is limited data on effective therapies. Bacillus Calmette–Guérin (BCG) vaccine, a live-attenuated strain derived from an isolate of Mycobacterium bovis and originally designed to prevent tuberculosis, has shown some efficacy against infection with unrelated pathogens. In this study, we reviewed 120 consecutive adult patients (≥18 years old) with COVID-19 at a major federally qualified health centre in Rhode Island, United States from 19 March to 29 April 2020. Median age was 39.5 years (interquartile range, 27.0–50.0), 30% were male and 87.5% were Latino/Hispanics. Eighty-two (68.3%) patients had BCG vaccination. Individuals with BCG vaccination were less likely to require hospital admission during the disease course (3.7% vs. 15.8%, P = 0.019). This association remained unchanged after adjusting for demographics and comorbidities (P = 0.017) using multivariate regression analysis. The finding from our study suggests the potential of BCG in preventing more severe COVID-19.


id: cord-307834-shmpfnrj
author: Massad, Eduardo
date: 2020-06-09
txt: ./txt/cord-307834-shmpfnrj.txt
cache: ./cache/cord-307834-shmpfnrj.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268820001223
doi: 10.1017/s0950268820001223
summary:
  The second model calculates the probability that an infected traveller will generate at least one secondary autochthonous case in the visited country. Next, we calculate the values of parameters π and σ from equations (9a) and (9b) to estimate the probability that the infected traveller who imported the virus to his/her home country would generate at least one secondary case, according to equation (11) . One model addresses the case of disease exportation from the epidemic outbreak and considers a certain number of travellers leaving the epidemic region during the incubation period, thereby importing the virus into another country. We simulated the model with the same case of the province of Hubei in China and the results show that one single infective traveller would be able to generate at least one secondary autochthonous case in the visited country, along his/her infectiousness period, with a probability of 23%.

title:
  Two complementary model-based methods for calculating the risk of international spreading of a novel virus from the outbreak epicentre. The case of COVID-19

abstract:
  We present two complementary model-based methods for calculating the risk of international spread of the novel coronavirus SARS-CoV-2 from the outbreak epicentre. One model aims to calculate the number of cases that would be exported from an endemic country to disease-free regions by travellers. The second model calculates the probability that an infected traveller will generate at least one secondary autochthonous case in the visited country. Although this paper focuses on the data from China, our methods can be adapted to calculate the risk of importation and subsequent outbreaks. We found an average R(0) = 5.31 (ranging from 4.08 to 7.91) and a risk of spreading of 0.75 latent individuals per 1000 travellers. In addition, one infective traveller would be able to generate at least one secondary autochthonous case in the visited country with a probability of 23%.


id: cord-309001-erm705tg
author: Liu, Q.
date: 2020-06-30
txt: ./txt/cord-309001-erm705tg.txt
cache: ./cache/cord-309001-erm705tg.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268820001442
doi: 10.1017/s0950268820001442
summary:
  To describe the laboratory findings of cases of death with coronavirus disease 2019 (COVID-19) and to establish a scoring system for predicting death, we conducted this single-centre, retrospective, observational study including 336 adult patients (≥18 years old) with severe or critically ill COVID-19 admitted in two wards of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, who had definite outcomes (death or discharge) between 1 February 2020 and 13 March 2020. This single-centre, retrospective, observational study included adult patients (≥18 years old) with severe or critically ill COVID-19 admitted in two wards of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan. Therefore, in this research study, we analysed the laboratory examination indicators of patients who died and hoped to find out the risk factors that could predict the outcome of death.

title:
  Laboratory findings and a combined multifactorial approach to predict death in critically ill patients with COVID-19: a retrospective study

abstract:
  To describe the laboratory findings of cases of death with coronavirus disease 2019 (COVID-19) and to establish a scoring system for predicting death, we conducted this single-centre, retrospective, observational study including 336 adult patients (≥18 years old) with severe or critically ill COVID-19 admitted in two wards of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, who had definite outcomes (death or discharge) between 1 February 2020 and 13 March 2020. Single variable and multivariable logistic regression analyses were performed to identify mortality-related factors. We combined multiple factors to predict mortality, which was validated by receiver operating characteristic curves. As a result, in a total of 336 patients, 34 (10.1%) patients died during hospitalisation. Through multivariable logistic regression, we found that decreased lymphocyte ratio (Lymr, %) (odds ratio, OR 0.574, P < 0.001), elevated blood urea nitrogen (BUN) (OR 1.513, P = 0.009), and raised D-dimer (DD) (OR 1.334, P = 0.002) at admission were closely related to death. The combined prediction model was developed by these factors with a sensitivity of 100.0% and specificity of 97.2%. In conclusion, decreased Lymr, elevated BUN, and raised DD were found to be in association with death outcomes in critically ill patients with COVID-19. A scoring system was developed to predict the clinical outcome of these patients.


id: cord-313415-5qrpucr4
author: Lai, Rongtao
date: 2020-08-25
txt: ./txt/cord-313415-5qrpucr4.txt
cache: ./cache/cord-313415-5qrpucr4.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32838815/
doi: 10.1017/s0950268820001892
summary:
  During SARS period in 2003, fever clinics emerged in many cities in mainland China with the purpose to screen the suspected SARS patients and to transfer the confirmed cases to designated hospitals for professional management. During SARS period in 2003, fever clinics emerged in many cities in mainland China with the purpose to screen the suspected SARS patients and to transfer the confirmed cases to designated hospitals for professional management. It is employed for discerning patients with suspected symptoms and signs, for timely isolation, for effectively blocking disease transmission during the early outbreak period before the pathogen has been identified, and for determining effective therapeutic methods; this strategy was used during the severe acute respiratory syndrome (SARS) epidemic in 2003 [2] . In the early outbreak period, the use of the sentinel surveillance strategy in fever clinics can provide benefits in terms of identifying patients with suspected symptoms, effectively blocking disease transmission, and protecting vulnerable populations.

title:
  Sentinel surveillance strategies for early detection of coronavirus disease in fever clinics: experience from China

abstract:
  Sentinel surveillance system plays a key role in screening and monitoring emerging and acute infectious diseases in order to identify the suspected cases in time. During SARS period in 2003, fever clinics emerged in many cities in mainland China with the purpose to screen the suspected SARS patients and to transfer the confirmed cases to designated hospitals for professional management. Shanghai city has reserved the fever clinics and the designated hospitals since then. Hence, clinicians in the front line are able to respond quickly to the emerging COVID-19 outbreak with their accumulated knowledge and experiences from the past. One hundred seventeen fever clinics distributed in various district areas in Shanghai have played a vital ‘sentinel’ role to fight against the COVID-19 epidemic. Most of suspected patients were identified in fever clinics and thereafter among these suspected patients the COVID-19 cases were confirmed and were isolated quickly to avoid the spread. We would like to share the sentinel roadmap for screening and diagnosis of COVID-19 to medical healthcare workers around the world, especially countries who are facing great challenges to cope with COVID-19 and meanwhile with limited medical resources. These sentinel surveillance strategies will certainly provide insight into the early detection and timely isolation of suspected cases from the others.


id: cord-321260-oi37dfsp
author: Ahmed, Anwar E.
date: 2017-12-22
txt: ./txt/cord-321260-oi37dfsp.txt
cache: ./cache/cord-321260-oi37dfsp.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s095026881700293x
doi: 10.1017/s095026881700293x
summary:
  title: Estimating survival rates in MERS-CoV patients 14 and 45 days after experiencing symptoms and determining the differences in survival rates by demographic data, disease characteristics and regions: a worldwide study The author hypothesised that people of older age, with underlying medical conditions and from Saudi Arabia or other Middle East countries are at high risk of death related to MERS-CoV. The author obtained information on age, gender, date of notification, date of onset of MERS symptoms, date of outcome or death, whether a patient or healthcare worker, symptomatic, underlying medical conditions, source of infection and the reported country. For the MERS patients studied, the Republic of Korea or other countries (95.83% and 91.67%) had much higher 14-and 45-day survival rates than the Middle East (84.09% and 75.00%) and Saudi Arabia (82.51% and 62.92%), respectively.

title:
  Estimating survival rates in MERS-CoV patients 14 and 45 days after experiencing symptoms and determining the differences in survival rates by demographic data, disease characteristics and regions: a worldwide study

abstract:
  Although Middle East respiratory syndrome coronavirus (MERS-CoV) has a recorded 5 years of circulation in 27 countries worldwide, there is no international study to assess whether there is variation in mortality by region. Neither has there been a comprehensive study detailing how the disease characteristics of MERS-CoV influence mortality in patients presenting symptoms. This study aimed to assess how region, patient and disease characteristics influence 14- and 45-day mortality in MERS patients. The author utilised publically available data on MERS-CoV. The study included 883 MERS patients reported between 5 January 2015 and 10 March 2017. Data on patient and disease characteristics were collected. The mean age at MERS-CoV diagnosis was 54.3 years: 69.1% were male, and 86.7% of the cases were reported from Saudi Arabia. About 40% of MERS patients studied were over the age of 60. The study estimated 14- and 45-day survival rates after initial onset of symptoms: 83.67% and 65.9%, respectively. Saudi Arabian MERS patients exhibited 4.1 and 5.0 times higher 14-day (adjusted hazard risk (aHR) = 4.1; 95% confidence interval (CI) 1.012–16.921) and 45-day (aHR = 5.0; 95% CI 1.856–13.581) mortality risk compared with MERS patients in the Republic of Korea or other countries. Similarly, Middle Eastern MERS patients showed 5.3 and 4.1 times higher 14-day (aHR = 5.3; 95% CI 1.070–25.902) and 45-day (aHR = 4.1; 95% CI 1.288–113.076) mortality risk compared with MERS patients in the Republic of Korea or other countries. The results demonstrated a link between mortality and geography, disease and patient factors such as regions, symptoms, source of infections, underlying medical conditions, modes of transmission, non-healthcare workers and those of older age. Educational programmes, access to healthcare and early diagnosis could be implemented as modifiable factors to reduce the higher mortality rates in MERS patients.


id: cord-323551-22v2hn3v
title: Rates of asymptomatic respiratory virus infection across age groups
author: Galanti, M.
date: 2019-04-15
txt: ./txt/cord-323551-22v2hn3v.txt
cache: ./cache/cord-323551-22v2hn3v.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268819000505
doi: 10.1017/s0950268819000505
summary:
  We enrolled 214 individuals at multiple New York City locations and tested weekly for respiratory viral pathogens, irrespective of symptom status, from fall 2016 to spring 2018. Here, we document rates of asymptomatic respiratory virus infection through a large-scale community study across multiple age groups. For the entire duration of the study, participants provided a daily report rating nine respiratory illness-related symptoms (fever, chills, muscle pain, watery eyes, runny nose, sneezing, sore throat, cough, chest pain), which were recorded on a Likert scale (0 = none, 1 = mild, 2 = moderate, 3 = severe). Pairwise comparisons between single infections and coinfections across all eight definitions showed that testing positive for multiple viruses was not associated with more severe symptoms. Figure 3 shows that while children were most frequently infected with a respiratory virus (they presented with the highest number of viral shedding events per season), they recorded (as reported by their parents) the lowest symptom scores on average.

abstract:
  Respiratory viral infections are a leading cause of disease worldwide. A variety of respiratory viruses produce infections in humans with effects ranging from asymptomatic to life-treathening. Standard surveillance systems typically only target severe infections (ED outpatients, hospitalisations, deaths) and fail to track asymptomatic or mild infections. Here we performed a large-scale community study across multiple age groups to assess the pathogenicity of 18 respiratory viruses. We enrolled 214 individuals at multiple New York City locations and tested weekly for respiratory viral pathogens, irrespective of symptom status, from fall 2016 to spring 2018. We combined these test results with participant-provided daily records of cold and flu symptoms and used this information to characterise symptom severity by virus and age category. Asymptomatic infection rates exceeded 70% for most viruses, excepting influenza and human metapneumovirus, which produced significantly more severe outcomes. Symptoms were negatively associated with infection frequency, with children displaying the lowest score among age groups. Upper respiratory manifestations were most common for all viruses, whereas systemic effects were less typical. These findings indicate a high burden of asymptomatic respiratory virus infection exists in the general population.


id: cord-325226-8zrtjuwf
title: Underreporting COVID-19: the curious case of the Indian subcontinent
author: Biswas, Raaj Kishore
date: 2020-09-11
txt: ./txt/cord-325226-8zrtjuwf.txt
cache: ./cache/cord-325226-8zrtjuwf.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268820002095
doi: 10.1017/s0950268820002095
summary:
  In the meantime, academic studies started making inferences on the COVID-19 response effectiveness through comparing the disease prevalence and fatality rates between higher and lower income nations in order to investigate the curious case of low COVID-19 infection rates among the LMICs. Conducting research on LMICs with limited data could often lead to erroneous findings and biased interpretations, which is becoming a concern with the avalanche of studies published daily. India, Pakistan and Bangladesh are among the worst 20 countries affected by the COVID-19 pandemic in terms of total number of cases; however, they are ranked 138, 139 and 147, respectively, in tests per million population, as of 18 June 2020 [1] . This lack of testing capabilities during the early days accompanied by the limited protective gears for health personnel and low implementation capacity related to the response of such pandemics could have concealed the true rate of infection and disease spread in the LMICs of the ISC.

abstract:
  COVID-19 has spread across the globe with higher burden placed in Europe and North America. However, the rate of transmission has recently picked up in low- and middle-income countries, particularly in the Indian subcontinent. There is a severe underreporting bias in the existing data available from these countries mostly due to the limitation of resources and accessibility. Most studies comparing cross-country cases or fatalities could fail to account for this systematic bias and reach erroneous conclusions. This paper provides several recommendations on how to effectively tackle these issues regarding data quality, test coverage and case counts.


id: cord-325453-5eskj42c
author: Haider, Najmul
date: 2020-09-07
txt: ./txt/cord-325453-5eskj42c.txt
cache: ./cache/cord-325453-5eskj42c.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268820002046
doi: 10.1017/s0950268820002046
summary:
  Higher risk of importation of COVID-19 from China for a given country was negatively correlated with the time taken to detect the first case in that country (adjusted R(2) = 0.63–0.66), while the GHSI and JEE had minimal predictive value. Multiple linear regression analysis was utilised to assess the amount of variation in either the time to detection of the first case that can be explained by the GHSI and JEE score and the importation risk among countries reporting cases by 20th February 2020. Our study further confirms that the health preparedness indices used either in the GHSI or JEE had low predictive value in terms of (i) number of cases detected in the country until 20th February 2020 when most cases were imported from China and (ii) mortality outcome (deaths/million) until either 11th March or 1st July 2020.

title:
  The Global Health Security index and Joint External Evaluation score for health preparedness are not correlated with countries'' COVID-19 detection response time and mortality outcome

abstract:
  Global Health Security Index (GHSI) and Joint External Evaluation (JEE) are two well-known health security and related capability indices. We hypothesised that countries with higher GHSI or JEE scores would have detected their first COVID-19 case earlier, and would experience lower mortality outcome compared to countries with lower scores. We evaluated the effectiveness of GHSI and JEE in predicting countries' COVID-19 detection response times and mortality outcome (deaths/million). We used two different outcomes for the evaluation: (i) detection response time, the duration of time to the first confirmed case detection (from 31st December 2019 to 20th February 2020 when every country's first case was linked to travel from China) and (ii) mortality outcome (deaths/million) until 11th March and 1st July 2020, respectively. We interpreted the detection response time alongside previously published relative risk of the importation of COVID-19 cases from China. We performed multiple linear regression and negative binomial regression analysis to evaluate how these indices predicted the actual outcome. The two indices, GHSI and JEE were strongly correlated (r = 0.82), indicating a good agreement between them. However, both GHSI (r = 0.31) and JEE (r = 0.37) had a poor correlation with countries' COVID-19–related mortality outcome. Higher risk of importation of COVID-19 from China for a given country was negatively correlated with the time taken to detect the first case in that country (adjusted R(2) = 0.63–0.66), while the GHSI and JEE had minimal predictive value. In the negative binomial regression model, countries' mortality outcome was strongly predicted by the percentage of the population aged 65 and above (incidence rate ratio (IRR): 1.10 (95% confidence interval (CI): 1.01–1.21) while overall GHSI score (IRR: 1.01 (95% CI: 0.98–1.01)) and JEE (IRR: 0.99 (95% CI: 0.96–1.02)) were not significant predictors. GHSI and JEE had lower predictive value for detection response time and mortality outcome due to COVID-19. We suggest introduction of a population healthiness parameter, to address demographic and comorbidity vulnerabilities, and reappraisal of the ranking system and methods used to obtain the index based on experience gained from this pandemic.


id: cord-327701-1qgaxcqq
title: Risk factors and patterns of household clusters of respiratory viruses in rural Nepal
author: Scott, E. M.
date: 2019-10-14
txt: ./txt/cord-327701-1qgaxcqq.txt
cache: ./cache/cord-327701-1qgaxcqq.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/31607271/
doi: 10.1017/s0950268819001754
summary:
  In a prospective longitudinal study utilizing intensive weekly home-based active surveillance to evaluate the household transmission of nine respiratory viruses in rural South Asia, initial infection in young children was associated with the greatest risk of symptomatic respiratory virus household transmission with spread to infants occurring in 45% of transmission events. A higher proportion of initial infection among this group resulted in secondary cases compared to other age groups, including school-age children and mothers, a finding confirmed in our multivariable model of transmission incidence. While a model of Kenya transmission data supports immunizing school-age children to diminish transmission of the virus to infants, our study suggests that in rural South Asia, preschool-age children are more likely to transmit respiratory viruses to other household members [38] . Our study of non-influenza respiratory virus transmission within households in rural Nepal highlights the importance of targeting preschool-age children to prevent the spread of respiratory viral illness.

abstract:
  Viral pneumonia is an important cause of death and morbidity among infants worldwide. Transmission of non-influenza respiratory viruses in households can inform preventative interventions and has not been well-characterised in South Asia. From April 2011 to April 2012, household members of pregnant women enrolled in a randomised trial of influenza vaccine in rural Nepal were surveyed weekly for respiratory illness until 180 days after birth. Nasal swabs were tested by polymerase chain reaction for respiratory viruses in symptomatic individuals. A transmission event was defined as a secondary case of the same virus within 14 days of initial infection within a household. From 555 households, 825 initial viral illness episodes occurred, resulting in 79 transmission events. The overall incidence of transmission was 1.14 events per 100 person-weeks. Risk of transmission incidence was associated with an index case age 1–4 years (incidence rate ratio (IRR) 2.35; 95% confidence interval (CI) 1.40–3.96), coinfection as initial infection (IRR 1.94; 95% CI 1.05–3.61) and no electricity in household (IRR 2.70; 95% CI 1.41–5.00). Preventive interventions targeting preschool-age children in households in resource-limited settings may decrease the risk of transmission to vulnerable household members, such as young infants.


id: cord-327867-1wkbjtji
author: Da''ar, Omar B.
date: 2018-06-11
txt: ./txt/cord-327867-1wkbjtji.txt
cache: ./cache/cord-327867-1wkbjtji.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268818001541
doi: 10.1017/s0950268818001541
summary:
  title: Underlying trend, seasonality, prediction, forecasting and the contribution of risk factors: an analysis of globally reported cases of Middle East Respiratory Syndrome Coronavirus This study set out to identify and analyse trends and seasonal variations of monthly global reported cases of the Middle East respiratory syndrome coronavirus (MERS-CoV). This study set out to identify trends and seasonal variations; made a prediction based on the globally reported cases of the Middle East respiratory syndrome coronavirus (MERS-CoV), extrapolated into the future by forecasting the trend and assessed contributions of various risk factors for the MERS-CoV cases. Using linear time series models and their application to the modelling and prediction of the globally reported MERS-CoV data, the present study identified trends, analysed seasonality, predicted and forecast evolution of MERS-CoV cases and assessed the contribution of various risk factors.

title:
  Underlying trend, seasonality, prediction, forecasting and the contribution of risk factors: an analysis of globally reported cases of Middle East Respiratory Syndrome Coronavirus

abstract:
  This study set out to identify and analyse trends and seasonal variations of monthly global reported cases of the Middle East respiratory syndrome coronavirus (MERS-CoV). It also made a prediction based on the reported and extrapolated into the future by forecasting the trend. Finally, the study assessed contributions of various risk factors in the reported cases. The motivation for this study is that MERS-CoV remains among the list of blueprint priority and potential pandemic diseases globally. Yet, there is a paucity of empirical literature examining trends and seasonality as the available evidence is generally descriptive and anecdotal. The study is a time series analysis using monthly global reported cases of MERS-CoV by the World Health Organisation between January 2015 and January 2018. We decomposed the series into seasonal, irregular and trend components and identified patterns, smoothened series, generated predictions and employed forecasting techniques based on linear regression. We assessed contributions of various risk factors in MERS-CoV cases over time. Successive months of the MERS-CoV cases suggest a significant decreasing trend (P = 0.026 for monthly series and P = 0.047 for Quarterly series). The MERS-CoV cases are forecast to wane by end 2018. Seasonality component of the cases oscillated below or above the baseline (the centred moving average), but no association with the series over time was noted. The results revealed contributions of risk factors such as camel contact, male, old age and being from Saudi Arabia and Middle East regions to the overall reported cases of MERS-CoV. The trend component and several risk factors for global MERS-CoV cases, including camel contact, male, age and geography/region significantly affected the series. Our statistical models appear to suggest significant predictive capacity and the findings may well inform healthcare practitioners and policymakers about the underlying dynamics that produced the globally reported MERS-CoV cases.


id: cord-330954-ft14aa2n
title: Epidemiological characteristics of COVID-19 patients in convalescence period
author: Liu, B. M.
date: 2020-06-03
txt: ./txt/cord-330954-ft14aa2n.txt
cache: ./cache/cord-330954-ft14aa2n.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32487271/
doi: 10.1017/s0950268820001181
summary:
  The discharged patients must meet the following criteria: (1) the body temperature returns to normal for more than 3 days; (2) respiratory symptoms improve significantly; (3) pulmonary imaging shows that the acute exudative lesions were significantly absorbed and improved; (4) the SARS-CoV-2 ribonucleic acid (RNA) detection results of two consecutive respiratory specimens are negative (sampling interval should be at least 24 h). We recorded the clinical manifestations, RNA detection results of oropharyngeal swab specimens, SARS-CoV-2 IgM−IgG antibodies detection results (data were collected on the 28th day after discharge), chest computed tomography (CT) images and medication of these patients. A case report of four mild-to-moderate COVID-19 patients (all were medical staff) showed that all convalescent patients without clinical symptoms presented RP findings of RNA detection in throat swab specimens at 5−13 days after discharge [14] . Another study found that among 62 COVID-19 convalescent medical staff, two patients without clinical symptoms showed RP findings of RNA detection in throat swab specimens at 5−6 days after discharge [15] .

abstract:
  This study aimed to investigate the clinical characteristics and to analyse the epidemiological features of coronavirus disease 2019 (COVID-19) patients during convalescence. In this study, we enrolled 71 confirmed cases of COVID-19 who were discharged from hospital and transferred to isolation wards from 6 February to 26 March 2020. They were all employees of Zhongnan Hospital of Wuhan University or their family members of which three cases were <18 years of age. Clinical data were collected and analysed statistically. Forty-one cases (41/71, 57.7%) comprised medical faculty, young and middle-aged patients (aged ⩽60 years) accounted for 81.7% (58/71). The average isolation time period for all adult patients was 13.8 ± 6.1 days. During convalescence, RNA detection results of 35.2% patients (25/71) turned from negative to positive. The longest RNA reversed phase time was 7 days. In all, 52.9% of adult patients (36/68) had no obvious clinical symptoms, and the remaining ones had mild and non-specific clinical symptoms (e.g. cough, sputum, sore throat, disorders of the gastrointestinal tract etc.). Chest CT signs in 89.7% of adult patients (61/68) gradually improved, and in the others, the lesions were eventually absorbed and improved after short-term repeated progression. The main chest CT manifestations of adult patients were normal, GGO or fibre streak shadow, and six patients (8.8%) had extrapulmonary manifestations, but there was no significant correlation with RNA detection results (r = −0.008, P > 0.05). The drug treatment was mainly symptomatic support therapy, and antibiotics and antiviral drugs were ineffective. It is necessary to re-evaluate the isolation time and standard to terminate isolation for discharged COVID-19 patients.


id: cord-332097-mrsmwxvo
author: SZILAGYI, P. G.
date: 2016-03-02
txt: ./txt/cord-332097-mrsmwxvo.txt
cache: ./cache/cord-332097-mrsmwxvo.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/26931351/
doi: 10.1017/s0950268816000315
summary:
  We used a rolling cross-sectional design to sample participants, conducted telephone interviews to assess ARI symptoms (defined as a current illness with feverishness or cough within the past 7 days), collected nasal/throat swabs to identify viruses, and extracted healthcare utilization from outpatient/inpatient records. Population-level surveillance is an integral step in assessing morbidity from ARIs. Also vaccines are in development for several viral pathogens including respiratory syncytial virus (RSV) [15] , parainfluenza viruses (PIVs) [16] , and human metapneumovirus (hMPV, first identified in the early 2000s) which are significant causes of hospitalizations, ED visits and outpatient visits [2, [17] [18] [19] . Our prospective, population-wide surveillance study used a previously described rolling cross-sectional (RCS) study design [27] in two communities (Rochester, NY and Marshfield, WI) in the 2011 winter season to identify individuals with ARIs (defined as a current illness with feverishness or cough within the past 7 days) and document viruses associated with these ARIs. The RCS design was first described and used by political scientists in the early 1980s for studies of voter preferences and election results; it consists of a series of cross-sectional samples in which each sample is representative of the source population [28] .

title:
  Incidence and viral aetiologies of acute respiratory illnesses (ARIs) in the United States: a population-based study

abstract:
  We conducted prospective, community-wide surveillance for acute respiratory illnesses (ARIs) in Rochester, NY and Marshfield, WI during a 3-month period in winter 2011. We estimated the incidence of ARIs in each community, tested for viruses, and determined the proportion of ARIs associated with healthcare visits. We used a rolling cross-sectional design to sample participants, conducted telephone interviews to assess ARI symptoms (defined as a current illness with feverishness or cough within the past 7 days), collected nasal/throat swabs to identify viruses, and extracted healthcare utilization from outpatient/inpatient records. Of 6492 individuals, 321 reported an ARI within 7 days (4·9% total, 5·7% in Rochester, 4·4% in Marshfield); swabs were collected from 208 subjects. The cumulative ARI incidence for the entire 3-month period was 52% in Rochester [95% confidence interval (CI) 42–63] and 35% in Marshfield (95% CI 28–42). A specific virus was identified in 39% of specimens: human coronavirus (13% of samples), rhinovirus (12%), RSV (7%), influenza virus (4%), human metapneumovirus (4%), and adenovirus (1%). Only 39/200 (20%) had a healthcare visit (2/9 individuals with influenza). ARI incidence was ~5% per week during winter.


id: cord-332258-o3u52mhl
title: Possible indirect transmission of COVID-19 at a squash court, Slovenia, March 2020: case report
author: Brlek, A.
date: 2020-06-19
txt: ./txt/cord-332258-o3u52mhl.txt
cache: ./cache/cord-332258-o3u52mhl.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32600479/
doi: 10.1017/s0950268820001326
summary:
  title: Possible indirect transmission of COVID-19 at a squash court, Slovenia, March 2020: case report We conducted an epidemiological investigation which revealed a cluster of five COVID-19 cases, linked to playing squash at a sports venue in Maribor, Slovenia. Epidemiological investigation revealed a cluster of five COVID-19 cases linked to playing squash at a sports venue in Maribor, Slovenia. Our epidemiological investigation raises possibility that secondary cases in the cluster got the infection through indirect transmission at the sports venue. We concluded that the mode of transmission between the index patient and the secondary cases in this cluster was either through contaminated common objects or virus aerosol, since all three pairs shared the same squash hall, which is a small and confined space with poor ventilation, where strenuous physical activity is performed, during which shedding and aerosolisation of the virus could be increased [4, [10] [11] [12] .

abstract:
  Since the beginning of the COVID-19 epidemic, there is an ongoing debate and research regarding the possible ways of virus transmission. We conducted an epidemiological investigation which revealed a cluster of five COVID-19 cases, linked to playing squash at a sports venue in Maribor, Slovenia. Acquired data raises possibility that the transmission occurred indirectly through contaminated objects in changing room or squash hall or via aerosolisation in squash hall.


id: cord-337692-b89ow1mf
title: Ecologic association between influenza and COVID-19 mortality rates in European countries
author: Petti, S.
date: 2020-09-11
txt: ./txt/cord-337692-b89ow1mf.txt
cache: ./cache/cord-337692-b89ow1mf.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32912363/
doi: 10.1017/s0950268820002125
summary:
  Ecologic studies investigating COVID-19 mortality determinants, used to make predictions and design public health control measures, generally focused on population-based variable counterparts of individual-based risk factors. We considered the 3-year average influenza (2014–2016) and COVID-19 (31 May 2020) crude mortality rates in 34 countries using EUROSTAT and ECDC databases and performed correlation and regression analyses. An apparently perplexing characteristic of the reported association between the two mortality rates was that while influenza virus circulation during the seasons considered in the present analysis was uncontrolled, SARS-CoV-2 circulation was probably limited by the widespread exceptional public health measures implemented in Europe [32] . This study reported an inverse association between number of hospital beds and mortality rates (Table 2) , thus showing that high influenza and COVID-19 mortality was also due to inefficiencies of the healthcare systems, and corroborated by data from several European countries [45] .

abstract:
  Ecologic studies investigating COVID-19 mortality determinants, used to make predictions and design public health control measures, generally focused on population-based variable counterparts of individual-based risk factors. Influenza is not causally associated with COVID-19, but shares population-based determinants, such as similar incidence/mortality trends, transmission patterns, efficacy of non-pharmaceutical interventions, comorbidities and underdiagnosis. We investigated the ecologic association between influenza mortality rates and COVID-19 mortality rates in the European context. We considered the 3-year average influenza (2014–2016) and COVID-19 (31 May 2020) crude mortality rates in 34 countries using EUROSTAT and ECDC databases and performed correlation and regression analyses. The two variables – log transformed, showed significant Spearman's correlation ρ = 0.439 (P = 0.01), and regression coefficients, b = 0.743 (95% confidence interval, 0.272–1.214; R(2) = 0.244; P = 0.003), b = 0.472 (95% confidence interval, 0.067–0.878; R(2) = 0.549; P = 0.02), unadjusted and adjusted for confounders (population size and cardiovascular disease mortality), respectively. Common significant determinants of both COVID-19 and influenza mortality rates were life expectancy, influenza vaccination in the elderly (direct associations), number of hospital beds per population unit and crude cardiovascular disease mortality rate (inverse associations). This analysis suggests that influenza mortality rates were independently associated with COVID-19 mortality rates in Europe, with implications for public health preparedness, and implies preliminary undetected SARS-CoV-2 spread in Europe.


id: cord-340938-mk01k235
author: Xu, Kandi
date: 2020-07-07
txt: ./txt/cord-340938-mk01k235.txt
cache: ./cache/cord-340938-mk01k235.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268820001533
doi: 10.1017/s0950268820001533
summary:
  A retrospective cohort of COVID-19 patients from four hospitals in three provinces in China was established, and 598 patients were included from 1 January to 8 March 2020, and divided into moderate, severe and critical illness group. To our knowledge, no previous studies have been conducted to investigate the risk factors of severity of COVID-19 based on ordinal response, namely moderate, severe and critical illness. Here, we conducted a retrospective study based on COVID-19 patients from four designated hospitals in Shanghai, Hubei and Anhui provinces to describe the clinical features of COVID-19, and aimed to identify the predictors of multi-level response of severity from moderate, severe to critical illness. In this study, we identified older age, presence of hypertension, elevated ALT, cTnI and myohaemoglobin, prolonged interval between illness onset and diagnosis and admission as the independent determinants to predict the risk of developing more severe illness among COVID-19 patients.

title:
  Application of ordinal logistic regression analysis to identify the determinants of illness severity of COVID-19 in China

abstract:
  Corona Virus Disease 2019 (COVID-19) has presented an unprecedented challenge to the health-care system across the world. The current study aims to identify the determinants of illness severity of COVID-19 based on ordinal responses. A retrospective cohort of COVID-19 patients from four hospitals in three provinces in China was established, and 598 patients were included from 1 January to 8 March 2020, and divided into moderate, severe and critical illness group. Relative variables were retrieved from electronic medical records. The univariate and multivariate ordinal logistic regression models were fitted to identify the independent predictors of illness severity. The cohort included 400 (66.89%) moderate cases, 85 (14.21%) severe and 113 (18.90%) critical cases, of whom 79 died during hospitalisation as of 28 April. Patients in the age group of 70+ years (OR = 3.419, 95% CI: 1.596–7.323), age of 40–69 years (OR = 1.586, 95% CI: 0.824–3.053), hypertension (OR = 3.372, 95% CI: 2.185–5.202), ALT >50 μ/l (OR = 3.304, 95% CI: 2.107–5.180), cTnI >0.04 ng/ml (OR = 7.464, 95% CI: 4.292–12.980), myohaemoglobin>48.8 ng/ml (OR = 2.214, 95% CI: 1.42–3.453) had greater risk of developing worse severity of illness. The interval between illness onset and diagnosis (OR = 1.056, 95% CI: 1.012–1.101) and interval between illness onset and admission (OR = 1.048, 95% CI: 1.009–1.087) were independent significant predictors of illness severity. Patients of critical illness suffered from inferior survival, as compared with patients in the severe group (HR = 14.309, 95% CI: 5.585–36.659) and in the moderate group (HR = 41.021, 95% CI: 17.588–95.678). Our findings highlight that the identified determinants may help to predict the risk of developing more severe illness among COVID-19 patients and contribute to optimising arrangement of health resources.


id: cord-341795-zbqfs77n
author: Sikkema, R. S.
date: 2019-02-21
txt: ./txt/cord-341795-zbqfs77n.txt
cache: ./cache/cord-341795-zbqfs77n.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s095026881800345x
doi: 10.1017/s095026881800345x
summary:
  This systematic review aims to compile and analyse all published data on MERS-coronavirus (CoV) in the global camel population to provide an overview of current knowledge on the distribution, spread and risk factors of infections in dromedary camels. In the field surveys included in this review, MERS-CoV RNA has been described in rectal swab samples, although other field studies report negative results [3, [22] [23] [24] and when viral RNA can be detected, the positivity rate of rectal swabs is lower compared with nasal swab samples [19, [25] [26] [27] . Middle East respiratory syndrome coronavirus neutralising serum antibodies in dromedary camels: a comparative serological study Longitudinal study of Middle East respiratory syndrome coronavirus infection in dromedary camel herds in Saudi Arabia Middle East respiratory syndrome coronavirus (MERS-CoV) RNA and neutralising antibodies in milk collected according to local customs from dromedary camels

title:
  Global status of Middle East respiratory syndrome coronavirus in dromedary camels: a systematic review

abstract:
  Dromedary camels have been shown to be the main reservoir for human Middle East respiratory syndrome (MERS) infections. This systematic review aims to compile and analyse all published data on MERS-coronavirus (CoV) in the global camel population to provide an overview of current knowledge on the distribution, spread and risk factors of infections in dromedary camels. We included original research articles containing laboratory evidence of MERS-CoV infections in dromedary camels in the field from 2013 to April 2018. In general, camels only show minor clinical signs of disease after being infected with MERS-CoV. Serological evidence of MERS-CoV in camels has been found in 20 countries, with molecular evidence for virus circulation in 13 countries. The seroprevalence of MERS-CoV antibodies increases with age in camels, while the prevalence of viral shedding as determined by MERS-CoV RNA detection in nasal swabs decreases. In several studies, camels that were sampled at animal markets or quarantine facilities were seropositive more often than camels at farms as well as imported camels vs. locally bred camels. Some studies show a relatively higher seroprevalence and viral detection during the cooler winter months. Knowledge of the animal reservoir of MERS-CoV is essential to develop intervention and control measures to prevent human infections.


id: cord-345020-ai5tib7h
author: Price, O. H.
date: 2019-06-17
txt: ./txt/cord-345020-ai5tib7h.txt
cache: ./cache/cord-345020-ai5tib7h.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268819001055
doi: 10.1017/s0950268819001055
summary:
  Studies investigating viral interference since the pandemic are sparser, though two studies reported that the timing and magnitude of respiratory virus epidemics were affected by the timing of the seasonal influenza A peak [15, 16] . We used routine diagnostic testing data of specimens from both the community and hospitals at the Victorian Infectious Diseases Reference Laboratory (VIDRL) between 2002 and 2017 to describe relationships between respiratory viruses, with a focus on influenza A and RSV. Seasonality of viruses was assessed visually by time series analysis and for further investigation each virus was compared with influenza A and RSV using cross-correlations that estimated the association between peaks in epidemic curves at a lag or lead of up to 15 weeks. Results of further investigation by logistic regression adjusted for covariates that are predictors of codetection (sex, age and season) were compatible with influenza A, RSV and picornavirus conferring temporary immunity against infection by another respiratory virus.

title:
  Using routine testing data to understand circulation patterns of influenza A, respiratory syncytial virus and other respiratory viruses in Victoria, Australia

abstract:
  Several studies have reported evidence of interference between respiratory viruses: respiratory viruses rarely reach their epidemic peak concurrently and there appears to be a negative association between infection with one respiratory virus and co-infection with another. We used results spanning 16 years (2002–2017) of a routine diagnostic multiplex panel that tests for nine respiratory viruses to further investigate these interactions in Victoria, Australia. Time series analyses were used to plot the proportion positive for each virus. The seasonality of all viruses included was compared with respiratory syncytial virus (RSV) and influenza A virus using cross-correlations. Logistic regression was used to explore the likelihood of co-infection with one virus given infection with another. Seasonal peaks were observed each year for influenza A and RSV and less frequently for influenza B, coronavirus and parainfluenza virus. RSV circulated an average of 6 weeks before influenza A. Co-infection with another respiratory virus was less common with picornavirus, RSV or influenza A infection. Our findings provide further evidence of a temporal relationship in the circulation of respiratory viruses. A greater understanding of the interaction between respiratory viruses may enable better prediction of the timing and magnitude of respiratory virus epidemics.


id: cord-346673-kyc1wks5
author: NICKBAKHSH, S.
date: 2016-03-02
txt: ./txt/cord-346673-kyc1wks5.txt
cache: ./cache/cord-346673-kyc1wks5.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268816000339
doi: 10.1017/s0950268816000339
summary:
  In particular, our study shows that (i) human coronavirus infections are more common during influenza seasons and in co-infections than previously recognized, (ii) factors associated with co-infection differ from those associated with viral infection overall, (iii) virus prevalence has increased over time especially in infants aged <1 year, and (iv) viral infection risk is greater in the post-2009 pandemic era, likely reflecting a widespread change in the viral population that warrants further investigation. We analysed diagnostic data generated by NHSGGC using multiplex PCR from 2005 to 2013 with the following objectives: (i) to describe testing and virus prevalence trends, (ii) to examine temporal and patient subgroup distributions for each individual virus, and (iii) to compare factors associated with overall viral infection and co-infection using statistical modelling, in order to provide robust and timely estimates of who is most at risk of viral-associated respiratory illness, and when, within a major urban UK population.

title:
  Extensive multiplex PCR diagnostics reveal new insights into the epidemiology of viral respiratory infections

abstract:
  Viral respiratory infections continue to pose a major global healthcare burden. At the community level, the co-circulation of respiratory viruses is common and yet studies generally focus on single aetiologies. We conducted the first comprehensive epidemiological analysis to encompass all major respiratory viruses in a single population. Using extensive multiplex PCR diagnostic data generated by the largest NHS board in Scotland, we analysed 44230 patient episodes of respiratory illness that were simultaneously tested for 11 virus groups between 2005 and 2013, spanning the 2009 influenza A pandemic. We measured viral infection prevalence, described co-infections, and identified factors independently associated with viral infection using multivariable logistic regression. Our study provides baseline measures and reveals new insights that will direct future research into the epidemiological consequences of virus co-circulation. In particular, our study shows that (i) human coronavirus infections are more common during influenza seasons and in co-infections than previously recognized, (ii) factors associated with co-infection differ from those associated with viral infection overall, (iii) virus prevalence has increased over time especially in infants aged <1 year, and (iv) viral infection risk is greater in the post-2009 pandemic era, likely reflecting a widespread change in the viral population that warrants further investigation.


id: cord-347916-9suvf3ln
title: Higher level of neutrophil-to-lymphocyte is associated with severe COVID-19
author: Kong, Man
date: 2020-07-09
txt: ./txt/cord-347916-9suvf3ln.txt
cache: ./cache/cord-347916-9suvf3ln.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268820001557
doi: 10.1017/s0950268820001557
summary:
  This study aims to assess the association between the neutrophil-to-lymphocyte ratio (NLR) and the incidence of severe COVID-19 infection. A study indicated that large amounts of pro-inflammatory cytokines in serum were associated with pulmonary inflammation and extensive lung damage in COVID-19, similar to severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome coronavirus (MERS-COV) infection [6] . The current study aimed to investigate the association between different laboratory data (including lymphocyte subsets and inflammatory biomarkers) and clinical characteristics of hospitalised patients with mild and severe COVID-19 infection to reveal a potentially useful prognostic factor associated with severe morbidity. Compared with the mild group, most patients in the severe group showed higher levels of infection-related indicators, such as procalcitonin (0.07 vs. In this study, the patients in the highest NLR tertile presented a 5.9-fold increased risk of incidence of severe COVID-19 after adjustments for potential confounders were applied.

abstract:
  In December 2019, cases of severe coronavirus 2019 (COVID-19) infection rapidly progressed to acute respiratory failure. This study aims to assess the association between the neutrophil-to-lymphocyte ratio (NLR) and the incidence of severe COVID-19 infection. A retrospective cohort study was conducted on 210 patients with COVID-19 infection who were admitted to the Central Hospital of Wuhan from 27 January 2020 to 9 March 2020. Peripheral blood samples were collected and examined for lymphocyte subsets by flow cytometry. Associations between tertiles of NLR and the incidence of severe illness were analysed by logistic regression. Of the 210 patients with COVID-19, 87 were diagnosed as severe cases. The mean NLR of the severe group was higher than that of the mild group (6.6 vs. 3.3, P < 0.001). The highest tertile of NLR (5.1–19.7) exhibited a 5.9-fold (95% CI 1.3–28.5) increased incidence of severity relative to that of the lowest tertile (0.6–2.5) after adjustments for age, diabetes, hypertension and other confounders. The number of T cells significantly decreased in the severe group (0.5 vs. 0.9, P < 0.001). COVID-19 might mainly act on lymphocytes, particularly T lymphocytes. NLR was identified as an early risk factor for severe COVID-19 illness. Patients with increased NLR should be admitted to an isolation ward with respiratory monitoring and supportive care.


id: cord-348039-kl1a0au3
title: What might the future bring? COVID-19 planning considerations for faculty and universities
author: Majowicz, S. E.
date: 2020-04-29
txt: ./txt/cord-348039-kl1a0au3.txt
cache: ./cache/cord-348039-kl1a0au3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32345390/
doi: 10.1017/s0950268820000898
summary:
  This paper applies a scenario planning approach, to outline some current uncertainties related to COVID-19 and what they might mean for plausible futures for which we should prepare, and to identify factors that we as individual faculty members and university institutions should be considering now, when planning for the future under COVID-19. The PHAC report was underpinned by two planning methodologies: scenario planning [4] , which aims to describe the range of plausible futures so that decisions and plans can be robust in the face of uncertainty; and a modified Political, Economic, Social, Technological (PEST) analysis [5] , a framework for identifying macro-level factors in the wider environment that can impact organisations'' abilities to function. This paper applies a similar approach, in order to: (a) outline some current uncertainties related to COVID-19, and what they might mean for plausible futures for which we should prepare; and (b) list factors that we as individual faculty members and university institutions should be considering now, when planning for the future under COVID-19.

abstract:
  This paper applies a scenario planning approach, to outline some current uncertainties related to COVID-19 and what they might mean for plausible futures for which we should prepare, and to identify factors that we as individual faculty members and university institutions should be considering now, when planning for the future under COVID-19. Although the contextual focus of this paper is Canada, the content is likely applicable to other places where the COVID-19 epidemic curve is in its initial rising stage, and where universities are predominantly publicly funded institutions.


id: cord-349262-gnqbyc6t
author: Hemida, Maged Gomaa
date: 2020-10-14
txt: ./txt/cord-349262-gnqbyc6t.txt
cache: ./cache/cord-349262-gnqbyc6t.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268820002459
doi: 10.1017/s0950268820002459
summary:
  title: The Middle East respiratory syndrome coronavirus in the breath of some infected dromedary camels (Camelus dromedarius) Dromedary camels remain the currently identified reservoir for the Middle East respiratory syndrome coronavirus (MERS-CoV). We tested nasal swabs, breath samples from animals within this herd by the real-time PCR. However, the nasal swabs are still the sample of choice in the diagnosis of MERS-CoV among the infected dromedary camel population. Detection of the virus in the air of positive camel''s herd [5, 6] may suggest the virus is excreted in the breath of the infected animals in high concentration. The aim of our study was to test the possibility of MERS-CoV shedding in the breath of the infected dromedary camels. Longitudinal study of Middle East respiratory syndrome coronavirus infection in dromedary camel herds in Saudi Arabia Dromedary camels and the transmission of Middle East respiratory syndrome coronavirus (MERS-CoV)

title:
  The Middle East respiratory syndrome coronavirus in the breath of some infected dromedary camels (Camelus dromedarius)

abstract:
  Dromedary camels remain the currently identified reservoir for the Middle East respiratory syndrome coronavirus (MERS-CoV). The virus is released in the secretions of the infected camels, especially the nasal tract. The virus shedding curve through the nasal secretions was studied. Although human transmission of the virus through the respiratory tract of close contact people with dromedary reported previously, the exact mechanism of transmission is still largely unknown. The main goal of this study was to check the possibility of MERS-CoV shedding in the exhaled air of the infected camels. To achieve this goal, we conducted a follow-up study in one of the dromedary camel herds, December 2018–April 2019. We tested nasal swabs, breath samples from animals within this herd by the real-time PCR. Our results showed that some of the tested nasal swabs and breath were positive from 24 March 2019 until 7 April 2019. The phylogenetic analysis of the obtained S and N gene sequences revealed the detected viruses are clustering together with some human and camel samples from the eastern region, especially from Al-Hufuf city, as well as some samples from Qatar and Jordon. These results are clearly showing the possibility of shedding of the virus in the breath of the infected camels. This could explain, at least in part, the mechanism of transmission of MERS-CoV from animals to humans. This study is confirming the shedding of MERS-CoV in the exhaled air of the infected camels. Further studies are needed for a better understanding of the MERS-CoV.


id: cord-349298-8s69wprh
author: MUNYWOKI, P. K.
date: 2014-06-05
txt: ./txt/cord-349298-8s69wprh.txt
cache: ./cache/cord-349298-8s69wprh.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/24901443/
doi: 10.1017/s0950268814001393
summary:
  The shedding durations were longer than previous estimates (3·9–7·4 days) based on immunofluorescence antigen detection or viral culture, and were shown to be strongly associated with age, severity of infection, and revealed potential interaction with other respiratory viruses. Respiratory syncytial virus (RSV) is a major viral cause of lower respiratory tract infection in children worldwide [1] with the key risk group being young infants [2] . The rate of RSV recovery was lower (i.e. shedding duration increased) by 65% in episodes with co-infection compared to those without (aHR 0·35, 95% CI 0·23-0·51), with a similar result for each virus individually. A community study nested within a birth cohort in coastal Kenya targeting symptomatic RSV infections by Okiro and colleagues reported a mean duration of shedding of 4·5 days [12] .

title:
  Influence of age, severity of infection, and co-infection on the duration of respiratory syncytial virus (RSV) shedding

abstract:
  RSV is the most important viral cause of pneumonia and bronchiolitis in children worldwide and has been associated with significant disease burden. With the renewed interest in RSV vaccines, we provide realistic estimates on duration, and influencing factors on RSV shedding which are required to better understand the impact of vaccination on the virus transmission dynamics. The data arise from a prospective study of 47 households (493 individuals) in rural Kenya, followed through a 6-month period of an RSV seasonal outbreak. Deep nasopharyngeal swabs were collected twice each week from all household members, irrespective of symptoms, and tested for RSV by multiplex PCR. The RSV G gene was sequenced. A total of 205 RSV infection episodes were detected in 179 individuals from 40 different households. The infection data were interval censored and assuming a random event time between observations, the average duration of virus shedding was 11·2 (95% confidence interval 10·1–12·3) days. The shedding durations were longer than previous estimates (3·9–7·4 days) based on immunofluorescence antigen detection or viral culture, and were shown to be strongly associated with age, severity of infection, and revealed potential interaction with other respiratory viruses. These findings are key to our understanding of the spread of this important virus and are relevant in the design of control programmes.


id: cord-354272-99vw735a
author: DARLING, N. D.
date: 2017-10-24
txt: ./txt/cord-354272-99vw735a.txt
cache: ./cache/cord-354272-99vw735a.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/29061208/
doi: 10.1017/s0950268817002345
summary:
  title: Retrospective, epidemiological cluster analysis of the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic using open source data In an effort to better understand the patterns of transmission, a retrospective analysis of epidemiological clusters identified throughout the ongoing MERS-CoV epidemic was conducted using open-source data. Several key search terms were utilized to capture all cluster-related literature, including ''MERS-CoV'', ''nosocomial'', ''cluster'', ''transmission'', ''superspreader'', ''contact tracing'', and ''healthcare worker''. An exported cluster was defined as any cluster that resulted from verified travel of an index case (from an area of known MERS-CoV transmission) within one incubation period (14 days) of symptom onset. If a case was reported from the city during the estimated time in which there was ongoing nosocomial transmission, had no travel or camel exposure in the 14 days prior to illness onset, and had no known household contact with a confirmed MERS-CoV case, the case was included in the case count for that particular nosocomial cluster.

title:
  Retrospective, epidemiological cluster analysis of the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic using open source data

abstract:
  The Middle East respiratory syndrome coronavirus (MERS-CoV) is caused by a novel coronavirus discovered in 2012. Since then, 1806 cases, including 564 deaths, have been reported by the Kingdom of Saudi Arabia (KSA) and affected countries as of 1 June 2016. Previous literature attributed increases in MERS-CoV transmission to camel breeding season as camels are likely the reservoir for the virus. However, this literature review and subsequent analysis indicate a lack of seasonality. A retrospective, epidemiological cluster analysis was conducted to investigate increases in MERS-CoV transmission and reports of household and nosocomial clusters. Cases were verified and associations between cases were substantiated through an extensive literature review and the Armed Forces Health Surveillance Branch's Tiered Source Classification System. A total of 51 clusters were identified, primarily nosocomial (80·4%) and most occurred in KSA (45·1%). Clusters corresponded temporally with the majority of periods of greatest incidence, suggesting a strong correlation between nosocomial transmission and notable increases in cases.


id: cord-354474-hbl2ywix
author: Temsah, M. H.
date: 2020-08-28
txt: ./txt/cord-354474-hbl2ywix.txt
cache: ./cache/cord-354474-hbl2ywix.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1017/s0950268820001958
doi: 10.1017/s0950268820001958
summary:
  As the Middle East respiratory syndrome coronavirus (MERS-CoV) continues to occur in small outbreaks in Saudi Arabia, we aimed to assess the knowledge, attitudes and intended practices of healthcare workers (HCWs) during the early stage of the COVID-19 pandemic and compare worry levels with previous findings during the MERS-CoV outbreak in 2015. To further understand the knowledge, attitudes and intended practices of HCWs during the early stage of the COVID-19 pandemic, it is particularly beneficial to obtain their input, especially in an area of the world where other respiratory viral illnesses are either endemic, such as MERS-CoV, or seasonal, such as influenza. The perceived adequacy of knowledge, hygienic practice changes and HCW attitudes toward infection control measures were assessed using a series of Likert-based questions (Supplementary Tables S2-S4 ). The level of knowledge of HCWs toward viral infection outbreaks during the current COVID-19 pandemic are much higher compared to the previous study conducted in the same institution during MERS-CoV a few years ago [15] .

title:
  Knowledge, attitudes and practices of healthcare workers during the early COVID-19 pandemic in a main, academic tertiary care centre in Saudi Arabia

abstract:
  As the Middle East respiratory syndrome coronavirus (MERS-CoV) continues to occur in small outbreaks in Saudi Arabia, we aimed to assess the knowledge, attitudes and intended practices of healthcare workers (HCWs) during the early stage of the COVID-19 pandemic and compare worry levels with previous findings during the MERS-CoV outbreak in 2015. We sent an adapted version of our previously published MERS-CoV questionnaire to the same cohort of HCWs at a tertiary hospital in Saudi Arabia. About 40% of our sample had previous experience with confirmed or suspected MERS-CoV patients, and those had a significantly higher knowledge score (13.16 ± 2.02 vs. 12.58 ± 2.27, P = 0.002) and higher adherence to protective hygienic practices (2.95 ± 0.80 vs. 2.74 ± 0.92, P = 0.003). The knowledge scores on COVID-19 were higher in the current cohort than the previous MERS-CoV outbreak cohort (68% vs. 79.7%, P < 0.001). HCWs from the current cohort who felt greater anxiety from COVID-19 compared to MERS-CoV were less likely to have been exposed to MERS-CoV infected/suspected cases (odds ratio (OR) = 0.646, P = 0.042) and were less likely to have attended the hospital awareness campaign on COVID-19 (OR = 0.654, P = 0.035). We concluded that previous experience with MERS-CoV was associated with increased knowledge and adherence to protective hygienic practices, and reduction of anxiety towards COVID-19.


id: cord-355171-oi3ezlsl
title: Quantifying the risk of respiratory infection in healthcare workers performing high-risk procedures
author: MACINTYRE, C. R.
date: 2013-12-05
txt: ./txt/cord-355171-oi3ezlsl.txt
cache: ./cache/cord-355171-oi3ezlsl.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/24308554/
doi: 10.1017/s095026881300304x
summary:
  This study determined the risk of respiratory infection associated with high-risk procedures (HRPs) performed by healthcare workers (HCWs) in high-risk settings. In droplet transmission, pathogens or droplets which are larger than 5 μm, such as influenza virus and Bordetella pertussis are transmitted from an infected patient to HCWs through breathing, talking, coughing, sneezing, as well as through performing high-risk procedures (HRPs) [2, 7, 8] . Although various guidelines and policies for infection control measures are implemented in healthcare settings worldwide, the risk of transmission of infectious diseases while performing HRPs has not been well quantified.

abstract:
  This study determined the risk of respiratory infection associated with high-risk procedures (HRPs) performed by healthcare workers (HCWs) in high-risk settings. We prospectively studied 481 hospital HCWs in China, documented risk factors for infection, including performing HRPs, measured new infections, and analysed whether HRPs predicted infection. Infection outcomes were clinical respiratory infection (CRI), laboratory-confirmed viral or bacterial infection, and an influenza infection. About 12% (56/481) of the study participants performed at least one HRP, the most common being airway suctioning (7·7%, 37/481). HCWs who performed a HRP were at significantly higher risk of developing CRI and laboratory-confirmed infection [adjusted relative risk 2·9, 95% confidence interval (CI) 1·42–5·87 and 2·9, 95% CI 1·37–6·22, respectively]. Performing a HRP resulted in a threefold increase in the risk of respiratory infections. This is the first time the risk has been prospectively quantified in HCWs, providing data to inform occupational health and safety policies.


