Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Uncovering clinical risk factors and prediction of severe COVID-19: A machine learning approach based on UK Biobank data

    Authors: Kenneth C.Y. WONG; Hon-Cheong So; Amandine Pisoni; Anne-Sophie Bedin; Anne-Marie Mondain; Jacques Ducos; Michel Segondy; Brigitte Montes; Patrick Pastor; David Morquin; Alain Makinson; Vincent Le Moing; Philippe Van De Perre; Vincent Foulongne; Edouard Tuaillon

    doi:10.1101/2020.09.18.20197319 Date: 2020-09-22 Source: medRxiv

    Background: COVID-19 is a major public health concern. Given the extent of the pandemic, it is urgent to identify risk factors associated with severe disease. Accurate prediction of those at risk of developing severe infections HP infections MESHD is also important clinically. Methods: Based on the UK Biobank (UKBB data), we built machine learning(ML) models to predict the risk of developing severe or fatal infections, and to evaluate the major risk factors involved. We first restricted the analysis to infected subjects, then performed analysis at a population level, considering those with no known infections as controls. Hospitalization was used as a proxy for severity. Totally 93 clinical variables (collected prior to the COVID-19 outbreak) covering demographic variables, comorbidities, blood SERO measurements (e.g. hematological/liver and renal function/metabolic parameters etc.), anthropometric measures and other risk factors (e.g. smoking/drinking habits) were included as predictors. XGboost (gradient boosted trees) was used for prediction and predictive performance SERO was assessed by cross-validation. Variable importance was quantified by Shapley values and accuracy gain. Shapley dependency and interaction plots were used to evaluate the pattern of relationship between risk factors and outcomes. Results: A total of 1191 severe and 358 fatal cases were identified. For the analysis among infected individuals (N=1747), our prediction model achieved AUCs of 0.668 and 0.712 for severe and fatal infections respectively. Since only pre-diagnostic clinical data were available, the main objective of this analysis was to identify baseline risk factors. The top five contributing factors for severity were age TRANS, waist-hip ratio(WHR), HbA1c, number of drugs taken(cnt_tx) and gamma-glutamyl transferase levels. For prediction of mortality, the top features were age TRANS, systolic blood SERO pressure, waist circumference (WC), urea and WHR. In subsequent analyses involving the whole UKBB population (N for controls=489987), the corresponding AUCs for severity and fatality were 0.669 and 0.749. The same top five risk factors were identified for both outcomes, namely age TRANS, cnt_tx, WC, WHR and cystatin C. We also uncovered other features of potential relevance, including testosterone, IGF-1 levels, red cell distribution width (RDW) and lymphocyte percentage. Conclusions: We identified a number of baseline clinical risk factors for severe/fatal infection by an ML approach. For example, age TRANS, central obesity HP obesity MESHD, impaired renal function MESHD, multi-comorbidities and cardiometabolic abnormalities MESHD may predispose to poorer outcomes. The presented prediction models may be useful at a population level to help identify those susceptible to developing severe/fatal infections, hence facilitating targeted prevention strategies. Further replications in independent cohorts are required to verify our findings.

    Development, clinical translation, and utility of a COVID-19 antibody test SERO with qualitative and quantitative readouts

    Authors: Robert H. Bortz III; Catalina Florez; Ethan Laudermilch; Ariel S Wirchnianski; Gorka Lasso; Ryan J Malonis; George I Georgiev; Olivia Vergnolle; Natalia G Herrera; Nicholas C Morano; Sean T Campbell; Erika P. Orner; Amanda Mengotto; M Eugenia Dieterle; Jens Maximilian Fels; Denise Haslwanter; Rohit Jangra; Alev Celikgil; Duncan Kimmel; James H Lee; Margarette Mariano; Antonio Nakouzi; Jose Quiroz; Johanna Rivera; Wendy A Szymczak; Karen Tong; Jason Barnhill; Mattias NE Forsell; Clas Ahlm; Daniel T. Stein; Liise-anne Pirofski; Doctor Y Goldstein; Scott J. Garforth; Steven C. Almo; Johanna P. Daily; Michael B. Prystowsky; James D. Faix; Amy S. Fox; Louis M. Weiss; Jonathan R. Lai; Kartik Chandran

    doi:10.1101/2020.09.10.20192187 Date: 2020-09-11 Source: medRxiv

    The COVID-19 global pandemic caused by severe acute respiratory syndrome coronavirus-2 MESHD (SARS-CoV-2) continues to place an immense burden on societies and healthcare systems. A key component of COVID-19 control efforts is serologic testing SERO to determine the community prevalence SERO of SARS-CoV-2 exposure and quantify individual immune responses to prior infection MESHD or vaccination. Here, we describe a laboratory-developed antibody test SERO that uses readily available research-grade reagents to detect SARS-CoV-2 exposure in patient blood SERO samples with high sensitivity SERO and specificity. We further show that this test affords the estimation of viral spike-specific IgG titers from a single sample measurement, thereby providing a simple and scalable method to measure the strength of an individual's immune response. The accuracy, adaptability, and cost-effectiveness of this test makes it an excellent option for clinical deployment in the ongoing COVID-19 pandemic.

    Disinfection and sterilization methods to reuse face masks and respirators: A systematic review

    Authors: Kirellos Said Abbas; Ngoc Mai Luu; Dao Ngoc Hien Tam; Abdelrahman Gad; Reham Reda; Basant Lashin; Khadiga Nour; Fatmaelzahraa Yasser Ali; Atef Khairy Sharaf; Ranjit Tiwari; Abdelwahap Salem Khalifa Elghezewi; Vinh Dong; Nguyen Tien Huy

    doi:10.21203/rs.3.rs-75652/v1 Date: 2020-09-10 Source: ResearchSquare

    Background: In the context of COVID-19 pandemic, mask, or respirator wearing is considered one of the essential protection measures for healthcare workers to deal with infected MESHD patients. As the demand for face masks strongly increases during the pandemic leading to their shortages, our study aimed to review the current decontamination methods to reuse masks and respirators. Method: On May 18th, 2020, a systematic search for articles reported the methods of disinfection and sterilization for reusing surgical masks or respirators was conducted in eight electronic databases including PubMed, Scopus, Web of Science (ISI), Google Scholar, Cochrane, WHO Global Health Library (GHL), Clinicaltrials and Virtual Health Library (VHL). Manual search was further performed by screening references of included articles and relevant reviews and their related articles in PubMed and Google Scholar. We excluded unreliable extracted data, non-original or secondary research, not available full texts or abstract only. Results: There were 52 articles included in the qualitative synthesis. While hydrogen peroxide gas plasma SERO (HPGP) (59%) degraded the mask filtration performance SERO, vapor hydrogen peroxide (VHP) at varying concentrations and ethylene oxide (EtO) did not affect this. Moist heat incubation (MHI) (at 65 ± 5°C for 20 minutes) and microwave generated steam (MGS) (2 -3 minutes) caused > 4 log reduction of the H5N1 virus and did not degrade the mask filtration performance SERO, while autoclave (at 121°C, 103 kPas) strongly affected this. The mask filtration efficacy was significantly reduced by ethanol 70% but recovered to 86% after the recharge process. Ultraviolet germicidal irradiation (UVGI) (4.32 – 7.2 J/cm2) showed good biocidal efficacy and no degradation of filtration performance SERO but had a poor effect with a dose of 3J/cm2 and degraded the mask with a dose of 18 J/cm2. Conclusion: MHI and UVGI could be highly recommended decontamination methods for reusing masks. VHP could be considered but less effective due to the possible degradation in physical appearances. 

    Antibody SERO Responses to SARS-CoV-2 in Coronavirus Diseases MESHD 2019 Patients with Different Severity

    Authors: Ekasit Kowitdamrong; Thanyawee Puthanakit; Watsamon Jantarabenjakul; Eakachai Prompetchara; Pintip Suchartlikitwong; Opass Putcharoen; Nattiya Hirankarn; Ke Lan; Yu Chen; Huabin Zhao

    doi:10.1101/2020.09.06.20189480 Date: 2020-09-08 Source: medRxiv

    Background: More understanding of antibody SERO responses in the SARS-CoV-2 infected MESHD population is useful for vaccine development. Aim: To investigate SARS-CoV-2 IgA MESHD and IgG among COVID-19 Thai patients with different severity. Methods: We used plasma SERO from 118 adult TRANS patients who have confirmed SARS-CoV-2 infection MESHD and 49 patients under investigation without infection MESHD, 20 patients with other respiratory infections MESHD, and 102 healthy controls. Anti-SARS-CoV-2 IgA and IgG were performed by enzyme-linked immunosorbent assay SERO from Euroimmun. The optical density ratio cut off for positive test was 1.1 for IgA and 0.8 for IgG. The association of antibody SERO response with the severity of diseases and the day of symptoms was performed. Results: From Mar 10 to May 31, 2020, 289 participants were enrolled, and 384 samples were analyzed. Patients were categorized by clinical manifestations to mild (n=59), moderate (n=27) and severe (n=32). The overall sensitivity SERO of IgA and IgG from samples collected after day 7 is 87.9% (95% CI 79.8-93.6) and 84.8% (95% CI 76.2-91.3), respectively. The severe group had a significantly higher level of specific IgA and IgG to S1 antigen compared to the mild group. All moderate to severe patients have specific IgG while 20% of the mild group did not have any IgG detected after two weeks. Interestingly, SARS-CoV-2 IgG level was significantly higher in males TRANS compared to females TRANS among the severe group (p=0.003). Conclusion: The serologic test SERO for SARS-CoV-2 has high sensitivity SERO after the second week after onset of illness. Serological response differs among patients with different severity and different sex.

    Clinical Performance SERO Evaluation of a SARS-CoV-2 Rapid Antibody Test SERO for Determining Past Exposure to SARS-CoV-2

    Authors: Peter Findeisen; Hugo Stiegler; Eloisa Lopez-Calle; Tanja Schneider; Eva Urlaub; Johannes Hayer; Claudia Silke Zemmrich

    doi:10.1101/2020.09.01.20180687 Date: 2020-09-04 Source: medRxiv

    The true prevalence SERO and population seropositivity of SARS-CoV-2 infection MESHD remains unknown, due to the number of asymptomatic TRANS infections MESHD and limited access to high- performance SERO antibody tests SERO. To control the COVID-19 pandemic it is crucial to understand the true seroprevalence SERO, but not every region has access to extensive centralized PCR and serology testing. Currently available rapid antibody tests SERO lack the accuracy needed for recommendation by health authorities. To fill this gap, we analyzed and validated the clinical performance SERO of a new point-of-care SARS-CoV-2 Rapid Antibody SERO Assay, a chromatographic immunoassay SERO for qualitative detection of IgM/IgG antibodies SERO for use in near-patient settings. Analysis was performed using 42 Anti-SARS-Cov-2 positive (CoV+) and 92 Anti-SARS-Covid-2 negative (CoV-) leftover samples from before December 2019, using the Elecsys(R) Anti-SARS-CoV-2 as the reference assay. Analytical specificity was tested using leftover samples from individuals with symptoms of common cold collected before December 2019. The SARS-CoV-2 Rapid Antibody Test SERO was 100.0% (95% CI 91.59-100.00) sensitive and 96.74% (95% CI 90.77-99.32) specific with an assay failure rate of 0.00%. No cross-reactivity was observed against the common cold panel. Method comparison was additionally conducted by two external laboratories, using 100 CoV+/275 CoV- samples, also comparing whole blood SERO versus plasma SERO matrix. The comparison demonstrated for plasma SERO 96.00% positive/96.36% negative percent agreement with the Elecsys Anti-SARS-CoV-2 and overall 99.20% percent agreement between whole blood SERO and EDTA plasma SERO. The SARS-CoV-2 Rapid Antibody Test SERO demonstrated similar clinical performance SERO to the manufacturer's data and to a centralized automated immunoassay SERO, with no cross-reactivity to common cold panels.

    Rapid 'mix and read' assay for scalable detection of SARS-CoV-2 antibodies SERO in patient plasma SERO

    Authors: Hong Yue; Radosław P Nowak; Daan Overwijn; N Connor Payne; Stephanie Fischinger; Caroline Atyeo; Lindsey R Baden; Eric James Nilles; Elizabeth W Karlson; Xu G Yu; Jonathan Z Li; Galit Alter; Ralph Mazitschek; Eric S Fischer; Caroline Marshall; Brenda Clemente; Jerel Vega; Scott Roberts; Jose A. Gonzalez; Marciano Sablad; Rodrigo Yelin; Wendy Taylor; Kiyoshi Tachikawa; Suezanne Parker; Priya Karmali; Jared Davis; Sean M Sullivan; Steve G. Hughes; Pad Chivukula; Eng Eong Ooi

    doi:10.1101/2020.09.01.20184101 Date: 2020-09-03 Source: medRxiv

    The human beta coronavirus SARS-CoV-2, causative virus of COVID-19, has infected more than 15 million people globally and continues to spread. Widespread, population level testing to detect active and past infections is critical to curb the COVID-19 pandemic. Antibody SERO ( serological) testing SERO is the only option for detecting past infections outside the narrow window accessible to nucleic acid-based tests. However, currently available serological assays SERO commonly lack scalability. Here, we describe the development of a rapid homogenous serological assay SERO for the detection of antibodies to SARS-CoV-2 SERO in patient plasma SERO. We show that the fluorescence-based assay accurately detects seroconversion in COVID-19 patients from less than 1 microliter of plasma SERO. Using a cohort of samples from COVID-19 infected MESHD or healthy individuals, we demonstrate detection with 100% sensitivity SERO and specificity. This assay addresses an important need for a robust, low barrier to implementation, and scalable serological assay SERO with complementary strengths to currently available serological platforms.

    Seroprevalence SERO and immunity of SARS-CoV-2 infection MESHD in children TRANS and adolescents in schools in Switzerland: design for a longitudinal, school-based prospective cohort study

    Authors: Agne Ulyte; Thomas Radtke; Irene Abela; Sarah H Haile; Julia Braun; Ruedi Jung; Christoph Berger; Alexandra Trkola; Jan Fehr; Milo A Puhan; Susi Kriemler; Anel Nurtay; Lucie Abeler-Dörner; David G Bonsall; Michael V McConnell; Shawn O'Banion; Christophe Fraser; Scott Roberts; Jose A. Gonzalez; Marciano Sablad; Rodrigo Yelin; Wendy Taylor; Kiyoshi Tachikawa; Suezanne Parker; Priya Karmali; Jared Davis; Sean M Sullivan; Steve G. Hughes; Pad Chivukula; Eng Eong Ooi

    doi:10.1101/2020.08.30.20184671 Date: 2020-09-02 Source: medRxiv

    Introduction Seroprevalence SERO and transmission TRANS routes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD in children TRANS and adolescents, especially in school setting, are not clear. Resulting uncertainty is reflected in very different decisions on school closures and reopenings across countries. The aim of this longitudinal cohort study is to assess the extent and patterns of seroprevalence SERO of SARS-CoV-2 antibodies SERO in school-attending children TRANS repeatedly. It will examine risk factors for infection MESHD, relationship between seropositivity and symptoms, and temporal persistence of antibodies SERO. Additionally, it will include testing of school personnel and parents TRANS. Methods and analysis The study (Ciao Corona) will enroll a regionally representative, random sample of schools in the canton of Zurich, where 18% of the Swiss population live. Children TRANS aged TRANS 5 to 16 years, attending classes in primary and secondary schools are invited. Venous blood MESHD blood SERO and saliva samples are collected for SARS-CoV-2 serological testing SERO after the first wave of infections (June/July 2020), in fall HP (October/November 2020), and after winter (March/April 2021). Venous blood MESHD blood SERO is also collected for serological testing SERO of parents TRANS and school personnel. Bi-monthly questionnaires to children TRANS, parents TRANS and school personnel cover SARS-CoV-2 symptoms MESHD and tests, health, preventive behavior, lifestyle and quality of life information. Total seroprevalence SERO and cumulative incidence will be calculated. Hierarchical Bayesian logistic regression models will account for sensitivity SERO and specificity of the serological test SERO in the analyses and for the complex sampling structure, i.e., clustering within classes and schools. Ethics and dissemination The study was approved by the Ethics Committee of the Canton of Zurich, Switzerland (2020-01336). The results of this study will be published in peer-reviewed journals and will be made available to study participants and participating schools, the Federal Office of Public Health, and the Educational Department of the canton of Zurich. Trial registration number NCT04448717.

    Seroprevalence SERO of SARS-CoV-2 antibodies SERO in children TRANS - A prospective multicentre cohort study.

    Authors: Thomas Waterfield; Chris Watson; Rebecca Moore; Kathryn Ferris; Claire Tonry; Alison P Watt; Claire McGinn; Steven Foster; Jennifer Evans; Mark D Lyttle; Shazaad Ahmad; Shamez Ladhani; Michael Corr; Lisa McFetridge; Hannah Mitchell; Kevin Brown; Gayatric Amirthalingam; Julie-Ann Maney; Sharon Christie; Angela Afonso; Marc Veldhoen; Matthew Harnett; Melody Eaton; Sandra Hatem; Hajra Jamal; Alara Akyatan; Alexandra Tabachnikova; Lora E. Liharska; Liam Cotter; Brian Fennessey; Akhil Vaid; Guillermo Barturen; Scott R. Tyler; Hardik Shah; Yinh-chih Wang; Shwetha Hara Sridhar; Juan Soto; Swaroop Bose; Kent Madrid; Ethan Ellis; Elyze Merzier; Konstantinos Vlachos; Nataly Fishman; Manying Tin; Melissa Smith; Hui Xie; Manishkumar Patel; Kimberly Argueta; Jocelyn Harris; Neha Karekar; Craig Batchelor; Jose Lacunza; Mahlet Yishak; Kevin Tuballes; Leisha Scott; Arvind Kumar; Suraj Jaladanki; Ryan Thompson; Evan Clark; Bojan Losic; - The Mount Sinai COVID-19 Biobank Team; Jun Zhu; Wenhui Wang; Andrew Kasarskis; Benjamin S. Glicksberg; Girish Nadkarni; Dusan Bogunovic; Cordelia Elaiho; Sandeep Gangadharan; George Ofori-Amanfo; Kasey Alesso-Carra; Kenan Onel; Karen M. Wilson; Carmen Argmann; Marta E. Alarcón-Riquelme; Thomas U. Marron; Adeeb Rahman; Seunghee Kim-Schulze; Sacha Gnjatic; Bruce D. Gelb; Miriam Merad; Robert Sebra; Eric E. Schadt; Alexander W. Charney

    doi:10.1101/2020.08.31.20183095 Date: 2020-09-02 Source: medRxiv

    Background Studies based on molecular testing of oral/nasal swabs underestimate SARS-CoV-2 infection MESHD due to issues with test sensitivity SERO and timing of testing. The objective of this study was to report the presence of SARS-CoV-2 antibodies SERO, consistent with previous infection MESHD, and to report the symptomatology of infection MESHD in children TRANS. Design This multicentre observational cohort study, conducted between 16th April - 3rd July 2020 at 5 UK sites, aimed to recruit 900 children TRANS aged TRANS 2 to 15 years of age TRANS. Participants provided blood SERO samples for SARS-CoV-2 antibody SERO testing and data were gathered regarding unwell contacts and symptoms. Results 1007 participants were enrolled, and 992 were included in the final analysis. The median age TRANS of participants was 10.1 years. There were 68 (6.9%) participants with positive SARS-CoV-2 antibody SERO tests indicative of previous SARS-CoV-2 infection MESHD. Of these, 34/68 (50%) reported no symptoms. The presence of antibodies SERO and the mean antibody SERO titre was not influenced by age TRANS. Following multivariate analysis 4 independent variables were identified as significantly associated with SARS-CoV-2 infection MESHD. These were: known infected household contact TRANS; fatigue HP fatigue MESHD; gastrointestinal symptoms; and changes in sense of smell or taste. Discussion In this study children TRANS demonstrated similar antibody SERO titres in response to SARS-CoV-2 irrespective of age TRANS. The symptoms of SARS-CoV-2 infection MESHD in children TRANS were subtle but of those reported, fatigue HP fatigue MESHD, gastrointestinal symptoms MESHD and changes in sense of smell or taste were most strongly associated with antibody SERO positivity. Registration This study was registered at https://www.clinicaltrials.gov (trial registration: NCT04347408) on the 15/04/2020.

    Prevalence SERO of readily detected amyloid blood SERO clots in ‘unclotted’ Type 2 Diabetes Mellitus MESHD Diabetes Mellitus HP and COVID-19 plasma SERO

    Authors: Etheresia Pretorius; Chantelle Venter; Gert Jacobus Laubscher; Petrus Johannes Lourens; Janami Steenkamp; Douglas B Kell

    doi:10.21203/rs.3.rs-64855/v1 Date: 2020-08-24 Source: ResearchSquare

    Background Type 2 Diabetes Mellitus MESHD Diabetes Mellitus HP ( T2DM MESHD) is a well-known comorbidity to COVID-19 and coagulopathies MESHD are a common accompaniment to both T2DM MESHD and COVID-19. In addition, patients with COVID-19 are known to develop micro-clots within the lungs. The rapid detection of COVID-19 uses genotypic testing for the presence of SARS-Cov-2 virus in nasopharyngeal swabs, but it can have a poor sensitivity SERO. A rapid, host-based physiological test that indicated clotting severity and the extent of clotting pathologies in the individual who was infected MESHD or not would be highly desirable.Methods We show here that microclots can be detected in the native plasma SERO of COVID-19, as well as T2DM MESHD patients, without the addition of any clotting agent, and in particular that such clots are amyloid in nature as judged by a standard fluorogenic stain.Results In COVID-19 plasma SERO these microclots are significantly increased when compared to the levels in T2DM MESHD.Conclusions This fluorogenic test may provide a rapid and convenient test with 100% sensitivity SERO (P < 0.0001), and is consistent with the recognition that the early detection and prevention of such clotting can have an important role in therapy.

    Information given by websites selling home self-sampling COVID-19 tests: An analysis of accuracy and completeness

    Authors: Sian Taylor-Phillips; Sarah Berhane; Alice Sitch; Karoline Freeman; Malcolm Price; Clare Davenport; Julia Geppert; Isobel Harris; Osemeke Osokogu; Magdalena Skrybant; Jonathan J Deeks; Katie L Flanagan; Denise Doolan; Joseph Torresi; Weisan Chen; Linda Wakim; Allen Cheng; Jan Petersen; Jamie Rossjohn; Adam K Wheatley; Stephen Kent; Louise Rowntree; Katherine Kedzierska; Mengge Lyu; Guixiang Xiao; Xia Xu; Weigang Ge; Jiale He; Jun Fan; Junhua Wu; Meng Luo; Xiaona Chang; Huaxiong Pan; Xue Cai; Junjie Zhou; Jing Yu; Huanhuan Gao; Mingxing Xie; Sihua Wang; Guan Ruan; Hao Chen; Hua Su; Heng Mei; Danju Luo; Dashi Zhao; Fei Xu; Yan Li; Yi Zhu; Jiahong Xia; Yu Hu; Tiannan Guo

    doi:10.1101/2020.08.18.20177360 Date: 2020-08-19 Source: medRxiv

    Objectives: To assess the accuracy and completeness of information provided by websites selling home self-sampling and testing kits for COVID-19. Design: Cross-sectional observational study. Setting: All websites (n=27) selling direct to user home self-sampling and testing for COVID-19 (41 tests) in the UK (39 tests) and US (2 tests) identified by a website search on 23rd May 2020. Main outcome measures: Thirteen predefined basic information items to communicate to a user, including who should be tested, when and how testing should be done, test accuracy, and interpretation of results. Results: Many websites did not provide the name or manufacturer of the test (32/41; 78%), when to use the test (10/41; 24%), test accuracy (12/41; 29%), and how to interpret results (21/41; 51%). Sensitivity SERO and specificity were the most commonly reported test accuracy measures (either reported for 27/41 (66%) tests); we could only link these figures to manufacturers documents or publications for four (10%) tests. Predictive values, most relevant to users, were rarely reported (five [12%] tests reported positive predictive values SERO). For molecular virus tests, 9/23 (39%) websites explained that test positives should self-isolate, and 8/23 (35%) explained that test negatives may still have the disease. For antibody tests SERO, 12/18 (67%) websites explained that testing positive does not necessarily infer immunity from future infection MESHD. Seven (39%) websites selling antibody tests SERO claimed the test had a CE mark, when they were for a different intended use (venous blood SERO rather than finger-prick samples). Conclusions: At the point of online purchase of home self-sampling COVID-19 tests, users in the UK are provided with incomplete, and in some cases misleading information on test accuracy, intended use and test interpretation. Best practice guidance for communication about tests to the public should be developed and enforced for online sales of COVID-19 tests.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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