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SARS-CoV-2 proteins

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    Infectivity, susceptibility, and risk factors associated with SARS-CoV-2 transmission under intensive contact tracing in Hunan, China

    Authors: Shixiong Hu; Wei Wang; Yan Wang; Maria Litvinova; Kaiwei Luo; Lingshuang Ren; Qianlai Sun; Xinghui Chen; Ge Zeng; Jing Li; Lu Liang; Zhihong Deng; Wen Zheng; Mei Li; Hao Yang; Jinxin Guo; Kai Wang; Xinhua Chen; Ziyan Liu; Han Yan; Huilin Shi; Zhiyuan Chen; Yonghong Zhou; Kaiyuan Sun; Alessandro Vespignani; Cécile Viboud; Lidong Gao; Marco Ajelli; Hongjie Yu

    doi:10.1101/2020.07.23.20160317 Date: 2020-07-24 Source: medRxiv

    Abstract Importance Several parameters driving the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain unclear, including age-specific differences in infectivity and susceptibility, and the contribution of inapparent infections to transmission. Robust estimates of key time-to-event distributions remain scarce as well. Objective Illustrate SARS-CoV-2 transmission patterns and risk factors, and estimate key time-to-event distributions. Design, Setting, and Participants Individual-based data on 1,178 SARS-CoV-2 infected MESHD individuals and their 15,648 contacts identified by contact tracing monitoring over the period from January 13-April 02, 2020 were extracted from the notifiable infectious diseases reporting system in Hunan Province, China. Demographic characteristics, severity classification, exposure and travel history, and key clinical timelines were retrieved. Exposures Confirmed SARS-CoV-2 infection MESHD by positive polymerase chain reaction test result of respiratory samples, and exposure to SARS-CoV-2 infected MESHD individuals via household, relative, social, and other types of contacts. Main Outcomes and Measures The relative contribution of pre-symptomatic and asymptomatic transmission, key time-to-event parameters, and the effect of biological, demographic, and behavioral factors on SARS-CoV-2 infectivity MESHD and susceptibility were quantified. Results Among SARS-CoV-2 infected MESHD individuals, the estimated mean serial interval was 5.5 days (95%CI -5.0, 19.9) and the mean generation time was 5.5 days (95%CI 1.7, 11.6). Infectiousness was estimated to peak 1 HGNC.8 days before symptom onset, with 95% of transmission events occurring between -7.6 days and 7.3 days from the date of symptom onset. The proportion of pre-symptomatic transmission was estimated at 62.5%, while a lower bound for the proportion of asymptomatic transmission was 3.5%. Infectiousness of SARS-CoV-2 was not significantly different between working-age adults (15-59 years old) and other age groups (0-14 years old: p-value=0.16; 60 years and over: p-value=0.33), whilst susceptibility to SARS-CoV-2 infection MESHD was estimated to increase with age (p-value=0.03). In addition, transmission risk was higher for household contacts (p-value<0.001), but decreased in later generations of a cluster (second generation: OR=0.13, p-value<0.001; generations 3-4: OR=0.05, p-value<0.001, relative to generation 1) and for those exposed to infectors with a larger number of contacts (p-value=0.04). Conclusions and Relevance These findings support the contribution of children to transmission and the importance of pre-symptomatic transmission, in turn highlighting the importance of large-scale testing, contact tracing activities, and the use of personnel protective equipment during the COVID-19 pandemic MESHD COVID-19 pandemic MESHD.

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MeSH Disease
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SARS-CoV-2 Proteins


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