Corpus overview


Overview

MeSH Disease

Human Phenotype

Fever (60)

Cough (49)

Pneumonia (42)

Hypertension (20)

Fatigue (18)


Transmission

Seroprevalence
    displaying 1 - 10 records in total 532
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    Who should be Prioritized for COVID-19 Vaccination in China? A Descriptive Study

    Authors: Juan Yang; Wen Zheng; Huilin Shi; Xuemei Yan; Kaige Dong; Qian You; Guangjie Zhong; Hui Gong; Zhiyuan Chen; Mark Jit; Cecile Viboud; Marco Ajelli; Hongjie Yu

    id:202009.0446/v1 Date: 2020-09-19 Source: Preprints.org

    All countries are facing decisions about which groups to prioritise for COVID-19 vaccination after the first vaccine product has been licensed, at which time supply shortages are inevitable. Here we define the key target populations and their size in China for a phased introduction of COVID-19 vaccination with evolving goals, accounting for the risk of illness and transmission TRANS. Essential workers (47.2 million) like healthcare workers could be prioritized for vaccination to maintain essential services. Subsequently, older adults TRANS, individuals with underlying health conditions and pregnant women (616.0 million) could be targeted to reduce severe COVID-19 outcomes. Then it could be further extended to target adults TRANS without underlying health conditions and children TRANS (738.7 million) to reduce symptomatic infections and/or to stop virus transmission TRANS. The proposed framework could assist Chinese policy-makers in the design of a vaccination program, and could be generalized to inform other national and regional COVID-19 vaccination strategies.

    Who should be Prioritized for COVID-19 Vaccination in China? A Descriptive Study

    Authors: Juan Yang; Wen Zheng; Huilin Shi; Xuemei Yan; Kaige Dong; Qian You; Guangjie Zhong; Hui Gong; Zhiyuan Chen; Mark Jit; Cecile Viboud; Marco Ajelli; Hongjie Yu

    id:10.20944/preprints202009.0446.v1 Date: 2020-09-19 Source: Preprints.org

    All countries are facing decisions about which groups to prioritise for COVID-19 vaccination after the first vaccine product has been licensed, at which time supply shortages are inevitable. Here we define the key target populations and their size in China for a phased introduction of COVID-19 vaccination with evolving goals, accounting for the risk of illness and transmission TRANS. Essential workers (47.2 million) like healthcare workers could be prioritized for vaccination to maintain essential services. Subsequently, older adults TRANS, individuals with underlying health conditions and pregnant women (616.0 million) could be targeted to reduce severe COVID-19 outcomes. Then it could be further extended to target adults TRANS without underlying health conditions and children TRANS (738.7 million) to reduce symptomatic infections and/or to stop virus transmission TRANS. The proposed framework could assist Chinese policy-makers in the design of a vaccination program, and could be generalized to inform other national and regional COVID-19 vaccination strategies.

    Variation in SARS-CoV-2 seroprevalence SERO in school- children TRANS across districts, schools and classes

    Authors: Agne Ulyte; Thomas Radtke; Irene A Abela; Sarah H Haile; Jacob Blankenberger; Ruedi Jung; Celine Capelli; Christoph Berger; Anja Frei; Michael Huber; Merle Schanz; Magdalena Schwarzmueller; Alexandra Trkola; Jan Fehr; Milo A Puhan; Susi Kriemler; Peter Hau; Christopher Bohr; Ralph Burkhardt; Andre Gessner; Bernd Salzberger; Frank Hanses; Florian Hitzenbichler; Daniel Heudobler; Florian Lueke; Tobias Pukrop; Wolfgang Herr; Daniel Wolff; Hendrik Poeck; Christoph Brochhausen; Petra Hoffmann; Michael Rehli; Marina Kreutz; Kathrin Renner

    doi:10.1101/2020.09.18.20191254 Date: 2020-09-18 Source: medRxiv

    Importance: Understanding transmission TRANS and impact of severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) in school children TRANS is critical to implement appropriate mitigation measures. Objective: To determine the variation in SARS-CoV-2 seroprevalence SERO in school children TRANS across districts, schools, grades, and classes, and the relationship of SARS-CoV-2 seroprevalence SERO with self-reported symptoms. Design: Cross-sectional analysis of baseline measurements of a longitudinal cohort study (Ciao Corona) from June-July 2020. Setting: 55 randomly selected schools and classes stratified by district in the canton of Zurich, Switzerland (1.5 million inhabitants). Participants: Children TRANS, aged TRANS 6-16 years old, attending grades 1-2, 4-5 and 7-8. Exposure: Exposure to circulating SARS-CoV-2 between February and June 2020 including public lock-down and school closure (March 16-May 10, 2020). Main Outcomes and Measures: Variation in seroprevalence SERO of SARS-CoV-2 in children TRANS across 12 cantonal districts, schools, and grades using a Luminex-based antibody test SERO with four targets for each of IgG, IgA and IgM. Clustering of cases within classes. Analysis of associations of seropositivity and symptoms. Comparison of seroprevalence SERO with a randomly selected adult TRANS population, based on Luminex-based IgG and IgA antibody test SERO of Corona Immunitas. Results: In total, 55 schools and 2585 children TRANS were recruited (1337 girls, median age TRANS 11, age TRANS range 6-16 years). Overall seroprevalence SERO was 2.8 % (95% CI 1.6-4.1%), ranging from 1.0% to 4.5% across districts. Seroprevalence SERO was 3.8% (1.9-6.1%) in grades 1-2, 2.5% (1.1-4.2%) in grades 4-5, and 1.5% (0.5-3.0%) in grades 7-8. At least one case was present in 36/55 tested schools and in 43/128 classes with [≥]50% participation rate and [≥]5 children TRANS tested. 73% of children TRANS reported COVID-19 compatible symptoms since January 2020, but none were reported more frequently in seropositive compared to seronegative children TRANS. Seroprevalence SERO of children TRANS was very similar to seroprevalence SERO of randomly selected adults TRANS in the same region in June-July 2020, measured with the same Corona Immunitas test, combining IgG and IgA (3.1%, 95% CI 1.4-5.4%, versus 3.3%, 95% CI 1.4-5.5%). Conclusions and Relevance: Seroprevalence SERO was inversely related to age TRANS and revealed a dark figure of around 90 when compared to 0.03% confirmed PCR+ cases in children TRANS in the same area by end of June. We did not find clustering of SARS-CoV-2 seropositive cases in schools so far, but the follow-up of this school-based study will shed more light on transmission TRANS within and outside schools. Trial registration: ClinicalTrials.gov Identifier: NCT04448717, registered June 26, 2020. https://clinicaltrials.gov/ct2/show/NCT04448717

    In the long shadow of our best intentions: model-based assessment of the consequences of school reopening during the COVID-19 pandemic

    Authors: Kaitlyn E Johnson; Madison Stoddard; Ryan P Nolan; Douglas E White; Natasha S Hochberg; Arijit Chakravarty; Rahul Kumar Anand; Bikash Ranjan Ray; Rajeshwari Subramaniam; Souvik Maitra; Manuel Antonio Franco; Timothy D Flietstra; Amy J Schuh; Panayampalli S Satheshkumar; Jasmine M Chaitram; S Michele Owen; M G Finn; Jason M Goldstein; Joel M Montgomery; Christina F Spiropoulou

    doi:10.1101/2020.09.18.20197400 Date: 2020-09-18 Source: medRxiv

    As the United States grapples with the ongoing COVID-19 pandemic, a particularly thorny set of questions surrounds the reopening of K-12 schools and universities. The benefits of in-person learning are numerous, in terms of education quality, mental health, emotional well-being, equity and access to food and shelter. Early reports suggested that children TRANS might have reduced susceptibility to COVID-19, and children TRANS have been shown to experience fewer complications than older adults TRANS. Over the past few months, our understanding of COVID-19 has been further shaped by emerging data, and it is now understood that children TRANS are as susceptible to infection as adults TRANS and have a similar viral load during infection MESHD. While the higher prevalence SERO of asymptomatic TRANS disease among children TRANS makes symptom-based isolation strategies ineffective, asymptomatic TRANS patients do not in fact carry a reduced viral load. Based on this updated understanding of the disease, we have used epidemiological modeling to explore the feasibility and consequences of school reopening in the face of differing rates of COVID-19 prevalence SERO and transmission TRANS. Our findings indicate that, regardless of the initial prevalence SERO of the disease, and in the absence of systematic surveillance testing, most schools in the United States can expect to remain open for 20-60 days. At this point, one or more large disease clusters can be expected to be detected, forcing schools to close again. These disease clusters, in turn, can be expected to propagate through the community, with potentially hundreds to thousands of additional cases resulting from each individual school cluster. Thus, our findings suggest that the debate between the risks to student safety and benefits of in-person learning frames a false dual choice. Given the current circumstances in the United States, the most likely outcome in the late fall HP is that students will be deprived of the benefits of in-person learning while having incurred a significant risk to themselves and their communities.

    Testing, Testing: What SARS-CoV-2 testing services do adults TRANS in the United States actually want?

    Authors: Rebecca Zimba; Sarah Kulkarni; Amanda Berry; William You; Chloe Mirzayi; Drew Westmoreland; Angela Parcesepe; Levi Waldron; Madhura Rane; Shivani Kochhar; McKaylee Robertson; Andrew R Maroko; Christian Grov; Denis Nash; - for the CHASING COVID Cohort Study Team; Daniel R Morales; Fredrik Nyberg; Jose D Posada; Martina Recalde; Elena Roel; Karishma Shah; Nigam Shah; Lisa M Schilling; Vignesh Subbian; David Vizcaya; Lin Zhang; Ying Zhang; Hong Zhu; Li Liu; Peter Rijnbeek; George Hripcsak; Jennifer C.E Lane; Edward Burn; Christian Reich; Marc A Suchard; Talita Duarte-Salles; Krisitn Kosta; Patrick B Ryan; DANIEL PRIETO-ALHAMBRA; Christoph Lange; Georg Laue; Clemes Lier; Matthias Lindner; Georgios Marinos; Robert Markewitz; Jacob Nattermann; Rainer Noth; Peter Pickkers; Klaus F. Rabe; Alina Renz; Christoph Roecken; Jan Rupp; Annika Schaffarzyk; Alexander Scheffold; Jonas Schulte-Schrepping; Domagoj Schunck; Dirk Skowasch; Thomas Ulas; Klaus-Peter Wandinger; Michael Wittig; Johannes Zimmermann; Hauke Busch; Bimba F. Hoyer; Christoph Kaleta; Jan Heyckendorf; Matthijs Kox; Jan Rybniker; Stefan Schreiber; Joachim Schultze; Philip Rosenstiel; - HCA Lung Biological Network; - Deutsche COVID-19 Omics Initiative (DeCOI)

    doi:10.1101/2020.09.15.20195180 Date: 2020-09-18 Source: medRxiv

    Importance: Ascertaining preferences for SARS-CoV-2 testing and incorporating findings into the design and implementation of strategies for delivering testing services may enhance testing uptake and engagement, a prerequisite to reducing onward transmission TRANS. Objective: To determine important drivers of decisions to obtain a SARS-CoV-2 test in the context of increasing community transmission TRANS. Design: A discrete choice experiment (DCE) was used to assess the relative importance of type of SARS-CoV-2 test, specimen type, testing venue, and results turnaround time. Uptake of an optimized testing scenario was simulated relative to the current typical testing scenario of polymerase chain reaction (PCR) via nasopharyngeal (NP) swab in a provider office or urgent care clinic with results in >5 days. Setting: Online survey, embedded in an existing cohort study, conducted during July 30 - September 8, 2020. Participants: Participants (n=4,793) were enrolled in the CHASING COVID Cohort Study, a national longitudinal cohort of adults TRANS >18 years residing in the 50 US states, Washington, DC, Puerto Rico, or Guam. Main Outcome(s) and Measure(s): Relative importance of SARS-CoV-2 testing method attributes, utilities of specific attribute levels, and probability of choosing a testing scenario based on preferences estimated from the DCE, the current typical testing option, or choosing not to test. Results: Turnaround time for test results had the highest relative importance (30.4%), followed by test type (28.3%), specimen type (26.2%), and venue (15.0%). Participants preferred fast results on both past and current infection MESHD and using a noninvasive specimen, preferably collected at home. Simulations suggested that providing immediate or same day test results, providing both PCR and serology, or collecting oral specimens would substantially increase testing uptake over the current typical testing option. Simulated uptake of a hypothetical testing scenario of PCR and serology via a saliva sample at a pharmacy with same day results was 97.7%, compared to 0.6% for the current typical testing scenario, with 1.8% opting for no test. Conclusions and Relevance: Testing strategies that offer both PCR and serology with non-invasive methods and rapid turnaround time would likely have the most uptake and engagement among residents in communities with increasing community transmission TRANS of SARS-CoV-2.

    COVID-19 and human milk: SARS-CoV-2, antibodies, and neutralizing SERO capacity

    Authors: Ryan M Pace; Janet E Williams; Kirsi M Järvinen; Mandy B Belfort; Christina DW Pace; Kimberly A Lackey; Alexandra C Gogel; Phuong Nguyen-Contant; Preshetha Kanagaiah; Theresa Fitzgerald; Rita Ferri; Bridget Young; Casey Rosen-Carole; Nichole Diaz; Courtney Meehan; Beatrice Caffe; Mark Y Sangster; David J Topham; Mark A McGuire; Antti Seppo; Michelle K McGuire; Margaret E Ackerman; Lisa M Schilling; Vignesh Subbian; David Vizcaya; Lin Zhang; Ying Zhang; Hong Zhu; Li Liu; Peter Rijnbeek; George Hripcsak; Jennifer C.E Lane; Edward Burn; Christian Reich; Marc A Suchard; Talita Duarte-Salles; Krisitn Kosta; Patrick B Ryan; DANIEL PRIETO-ALHAMBRA; Christoph Lange; Georg Laue; Clemes Lier; Matthias Lindner; Georgios Marinos; Robert Markewitz; Jacob Nattermann; Rainer Noth; Peter Pickkers; Klaus F. Rabe; Alina Renz; Christoph Roecken; Jan Rupp; Annika Schaffarzyk; Alexander Scheffold; Jonas Schulte-Schrepping; Domagoj Schunck; Dirk Skowasch; Thomas Ulas; Klaus-Peter Wandinger; Michael Wittig; Johannes Zimmermann; Hauke Busch; Bimba F. Hoyer; Christoph Kaleta; Jan Heyckendorf; Matthijs Kox; Jan Rybniker; Stefan Schreiber; Joachim Schultze; Philip Rosenstiel; - HCA Lung Biological Network; - Deutsche COVID-19 Omics Initiative (DeCOI)

    doi:10.1101/2020.09.16.20196071 Date: 2020-09-18 Source: medRxiv

    Background: It is not known whether SARS-CoV-2 can be transmitted from mother to infant during breastfeeding, and if so whether the benefits of breastfeeding outweigh this risk. This study was designed to evaluate 1) if SARS-CoV-2 RNA can be detected in milk and on the breast of infected MESHD women, 2) concentrations of milk-borne anti- SARS-CoV-2 antibodies SERO, and 3) the capacity of milk to neutralize SARS-CoV-2 infectivity MESHD. Methods: We collected 37 milk samples and 70 breast swabs (before and after breast washing) from 18 women recently diagnosed with COVID-19. Samples were analyzed for SARS-CoV-2 RNA using RT-qPCR. Milk was also analyzed for IgA and IgG specific for the nucleocapsid protein, receptor binding domain (RBD), S2 subunit of the spike protein of SARS-CoV-2, as well as 2 seasonal coronaviruses using ELISA SERO; and for its ability to neutralize SARS-CoV-2. Results: We did not detect SARS-CoV-2 RNA in any milk sample. In contrast, SARS-CoV-2 RNA was detected on several breast swabs, although only one was considered conclusive. All milk contained SARS-CoV-2-specific IgA and IgG, and levels of anti-RBD IgA correlated with SARS-CoV-2 neutralization. Strong correlations between levels of IgA and IgG to SARS-CoV-2 and seasonal coronaviruses were noted. Conclusions: Our data do not support maternal-to- child TRANS transmission TRANS of SARS-CoV-2 via milk; however, risk of transmission TRANS via breast skin MESHD should be further evaluated. Importantly, milk produced by infected mothers is a source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness.

    Epidemiology of SARS-CoV-2 infection MESHD in Karnataka State, South India: Transmission TRANS dynamics of symptomatic vs. asymptomatic TRANS infections

    Authors: Narendra Kumar; Shafeeq K S Hameed; Giridhara R Babu; Manjunatha M Venkataswamy; Prameela Dinesh; Prakash B G Kumar; Daisy A John; Anita Desai; Ravi Vasanthapuram; Jonathan Flint; Eleazar Eskin; Chongyuan Luo; Shangxin Yang; Omai B Garner; Yi Yin; Joshua S Bloom; Leonid Kruglyak; Jason M Goldstein; Joel M Montgomery; Christina F Spiropoulou

    doi:10.1101/2020.09.17.20196501 Date: 2020-09-18 Source: medRxiv

    Background: In this report, we describe the epidemiology of SARS-CoV-2 infection MESHD, specifically examining how the symptomatic persons drove the transmission TRANS in the state of Karnataka, India, during the lockdown phase. Methods: The study included all the cases reported from March 8 to May 31, 2020 in the state. Any person with history of international or domestic travel TRANS from high burden states, those presenting with Influenza-like or Severe Acute Respiratory Illness MESHD and high-risk contacts of COVID19 cases, who were SARS-CoV-2 RT-PCR positive were included. Detailed analysis based on contact TRANS tracing TRANS data available from line-list of the state surveillance unit was performed using cluster analysis software package. Findings: Amongst the 3404 COVID-19 positive cases, 3096 (91%) were asymptomatic TRANS while 308 (9%) were symptomatic. Majority of the asymptomatic TRANS cases were in the age TRANS range of 16-50 years while symptomatic cases were between 31-65 years. Most of those affected were males TRANS. Cluster analysis of 822 cases indicated that the secondary attack rate TRANS, size of the cluster (dispersion) and occurrence of overt clinical illness is significantly higher when the index case in a cluster was symptomatic compared to an asymptomatic TRANS. Interpretation: Our findings indicate that both asymptomatic TRANS and symptomatic SARS-CoV-2 cases transmit the infection MESHD; however, the main driving force behind the spread of infection within the state was significantly higher from symptomatic cases. This has major implications for policies related to testing. Active search for symptomatic cases, subjecting them to testing and treatment should be prioritized for containing the spread of COVID-19.

    Environmental and climatic impact on the infection MESHD and mortality of SARS-CoV-2 in Peru

    Authors: Victor J. Samillan; Diana Flores-Leon; Brian R. Zutta; Eduardo Rojas; Prameela Dinesh; Prakash B G Kumar; Daisy A John; Anita Desai; Ravi Vasanthapuram; Jonathan Flint; Eleazar Eskin; Chongyuan Luo; Shangxin Yang; Omai B Garner; Yi Yin; Joshua S Bloom; Leonid Kruglyak; Jason M Goldstein; Joel M Montgomery; Christina F Spiropoulou

    doi:10.1101/2020.09.16.20196170 Date: 2020-09-18 Source: medRxiv

    The role of the environment and climate in the transmission TRANS and case-fatality rates of SARS-CoV-2 is still being investigated. Elevation and air quality are believed to be significant factors in the current development of the pandemic, but the influence of additional environmental factors remain unclear. In this study, we explored the relationship between the cumulative number of infections MESHD and mortality cases with climate (temperature, precipitation, solar radiation, water vapor pressure, wind), environmental data (elevation, NDVI, PM2.5 and NO2 concentration), and population density in Peru. Using the data from confirmed cases TRANS of infection MESHD from 1287 districts and confirmed cases TRANS of mortality in 479 districts, we used Spearman's correlations to assess the correlation between environmental and climatic factors with cumulative infection cases, cumulative mortality and case-fatality rate. We also explored district cases by the ecozones of coast, sierra, high montane forest and lowland rainforest. Multiple linear regression models indicate elevation, mean solar radiation, air quality, population density and green cover are influential factors in the distribution of infection MESHD and mortality of SARS-CoV-2 in Peru. The case-fatality rate was weakly associated with elevation. Our results also strongly suggest that exposure to poor air quality is a significant factor in the mortality of individuals with SARS-CoV-2 below the age TRANS of 30. We conclude that environmental and climatic factors do play a significant role in the transmission TRANS and case-fatality rates in Peru, however further study is required to see if these relationships are maintained over time.

    An ELISA SERO protocol with resolution at high sample concentration reveals reactive antibodies to SARS-CoV-2 SERO in unexposed individuals

    Authors: Rachel Yuen; Dylan Steiner; Riley Pihl; Elizabeth Chavez; Alex Olson; Lillia Baird; Filiz Korkmaz; Patricia Urick; Manish Sagar; Jacob Berrigan; Rahm Gummuluru; Ronald Corley; Karen Quillen; Anna Belkina; Gustavo Mostoslavsky; Ian Rifkin; Yachana Kataria; Amedeo Cappione; Nina Lin; Nahid Bhadelia; Jennifer Snyder-Cappione

    doi:10.1101/2020.09.15.20192765 Date: 2020-09-18 Source: medRxiv

    The COVID-19 pandemic has significantly impacted work, economy, and way of life. The SARS-CoV-2 virus displays unique features including widely varying symptoms and outcomes between infected individuals. Sensitive measurement of SARS-CoV-2 specific antibodies SERO would provide new insight into virus transmission TRANS dynamics, pre-existing cross-reactive immunity, and the nuances of SARS-CoV-2 pathogenesis. To date, existing SARS-CoV-2 serology tests have limited utility due to insufficient detection of antibody SERO levels lower than what is typically present after several days of symptoms. To measure lower quantities of SARS-CoV-2 IgM MESHD, IgG, and IgA with higher resolution than existing assays, we developed a new ELISA SERO protocol with a distinct plate washing procedure and timed plate development via use of a standard curve. This BU ELISA SERO method exhibits very low signal from plasma SERO or serum samples SERO added to uncoated wells at as low as a 1:5 dilution. Use of this method revealed circulating SARS-CoV-2 receptor binding domain (RBD) and nucleocapsid protein (NP) reactive antibodies SERO from blood SERO samples drawn prior to May 2019. Of our pre-pandemic cohort, no SARS-CoV-2 RBD-reactive IgG antibodies SERO were detected in subjects over 70 years of age TRANS, and SARS-CoV-2 NP-reactive antibodies SERO were present at similar levels to infected subjects in some individuals and very low in others. Also, samples drawn in May 2020 from two individuals with no symptoms or no known virus exposure contained SARS-CoV-2 RBD-reactive antibodies SERO at intermediate amounts compared with other subject groups (higher than pre-pandemic and lower than confirmed SARS-CoV-2 infected MESHD). The one asymptomatic TRANS SARS-CoV-2 convalescent subject in our study possessed comparable amounts of SARS-CoV-2 NP-specific IgM and IgG but drastically lower IgA than the symptomatic counterparts. Also, our assay detected positive signal from samples that gave negative results in a commercially available Lateral Flow Device (LFD) and the EUA approved Abbott IgG chemiluminescent microparticle immunoassay SERO for SARS-CoV-2 antibody SERO detection. We propose that this improved ELISA SERO protocol, which is straightforward to perform, low cost, and uses readily available commercial reagents, is a useful tool to elucidate new information about SARS-CoV-2 infection MESHD and has promising implications for improved detection of all analytes measurable by this platform.

    Factors associated with the spatial heterogeneity of COVID-19 in France: a nationwide ecological study

    Authors: Jean Gaudart; Jordi Landier; laetitia huiart; Eva Legendre; Laurent Lehot; Marc-Karim Bendiane; Laurent Chiche; Aliette Petitjean; Emilie Mosnier; Fati Kirakoya-samadoulougou; Jacques Demongeot; Renaud Piarroux; Stanislas Rebaudet; Omai B Garner; Yi Yin; Joshua S Bloom; Leonid Kruglyak; Jason M Goldstein; Joel M Montgomery; Christina F Spiropoulou

    doi:10.1101/2020.09.17.20196360 Date: 2020-09-18 Source: medRxiv

    Like in many countries and regions, spread of the COVID 19 pandemic has exhibited important spatial heterogeneity across France, one of the most affected countries so far. To better understand factors associated with incidence, mortality and lethality heterogeneity across the 96 administrative departments of metropolitan France, we thus conducted a geoepidemiological analysis based on publicly available data, using hierarchical ascendant classification (HAC) on principal component analysis (PCA) of multidimensional variables, and multivariate analyses with generalized additive models (GAM). Our results confirm a marked spatial heterogeneity of in-hospital COVID 19 incidence and mortality, following the North East / South West diffusion of the epidemic. The delay elapsed between the first COVID-19 associated death and the onset of the national lockdown on March 17th, 2020, appeared positively associated with in-hospital incidence, mortality and lethality. Mortality was also strongly associated with incidence. Mortality and lethality rates were significantly higher in departments with older population, but they were not significantly associated with the number of intensive-care beds available in 2018. We did not find any significant association between incidence, mortality or lethality rates and incidence of new chloroquine and hydroxychloroquine dispensations in pharmacies either, nor between COVID 19 incidence and climate, nor between economic indicators and in-hospital COVID 19 incidence or mortality. This ecological study highlights the impact of population age TRANS structure, epidemic spread and transmission TRANS mitigation policies in COVID-19 morbidity or mortality heterogeneity.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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