Corpus overview


Overview

MeSH Disease

Human Phenotype

Fever (41)

Cough (18)

Anosmia (10)

Fatigue (6)

Pneumonia (6)


Transmission

Seroprevalence
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    SARS-CoV-2 Seroprevalence SERO Across a Diverse Cohort of Healthcare Workers

    Authors: Joseph Ebinger; Gregory J. Botwin; Christine M. Albert; Mona Alotaibi; Moshe Arditi; Anders H. Berg; Aleksandra Binek; Patrick G. Botting; Justyna Fert-Bober; Jane C. Figueiredo; Jonathan D. Grein; Wohaib Hasan; Mir Henglin; Shehnaz K. Hussain; Mohit Jain; Sandy Joung; Michael Karin; Elizabeth H Kim; Dalin Li; Yunxian Liu; Eric Luong; Dermot P.B. McGovern; Akil Merchant; Noah M. Merin; Peggy B. Miles; Margo Minissian; Trevor-Trung Nguyen; Koen Raedschelders; Mohamad A. Rashid; Celine E. Riera; Richard V. Riggs; Sonia Sharma; Sarah Sternbach; Nancy Sun; Warren G. Tourtellotte; Jennifer E. Van Eyk; Kimia Sobhani; Jonathan G. Braun; Susan Cheng

    doi:10.1101/2020.07.31.20163055 Date: 2020-08-04 Source: medRxiv

    Importance: Antibody testing SERO is important for understanding patterns of exposure and potential immunity to SARS-CoV-2. Prior data on seroprevalence SERO have been subject to variations in selection of individuals and nature as well as timing of testing in relation to exposures. Objective: We sought to determine the extent of SARS-CoV-2 seroprevalance and the factors associated with seroprevelance across a diverse cohort of healthcare workers. Design: Observational cohort study of healthcare workers, including SARS-CoV-2 serology testing and participant questionaires. Participants: A diverse and unselected population of adults TRANS (n=6,062) employed in a multi-site healthcare delivery system located in Los Angeles County, including individuals with direct patient contact and others with non-patient-oriented work functions. Exposure: Exposure and infection MESHD with the SARS-CoV-2 virus, as determined by seropositivity. Main Outcomes: Using Bayesian and multi-variate analyses, we estimated seroprevalence SERO and factors associated with seropositivity and antibody SERO titers, including pre-existing demographic and clinical characteristics; potential Covid-19 illness related exposures; and, symptoms consistent with Covid-19 infection MESHD. Results: We observed a seroprevalence SERO rate of 4.1%, with anosmia HP as the most prominently associated self-reported symptom in addition to fever MESHD fever HP, dry cough MESHD cough HP, anorexia MESHD anorexia HP, and myalgias MESHD myalgias HP. After adjusting for potential confounders, pre-existing medical conditions were not associated with antibody SERO positivity. However, seroprevalence SERO was associated with younger age TRANS, Hispanic ethnicity, and African-American race, as well as presence of either a personal or household member having a prior diagnosis of Covid-19. Importantly, African American race and Hispanic ethnicity were associated with antibody SERO positivity even after adjusting for personal Covid-19 diagnosis status, suggesting the contribution of unmeasured structural or societally factors. Notably, number of people, or children TRANS, in the home was not associated with antibody SERO positivity. Conclusion and Relevance: The demographic factors associated with SARS-CoV-2 seroprevalence SERO among our healthcare workers underscore the importance of exposure sources beyond the workplace. The size and diversity of our study population, combined with robust survey and modeling techniques, provide a vibrant picture of the demographic factors, exposures, and symptoms that can identify individuals with susceptibility as well as potential to mount an immune response to Covid-19.

    Estimates of the rate of infection and asymptomatic MESHD asymptomatic TRANS COVID-19 disease MESHD in a population sample from SE England

    Authors: Philippa M Wells; Katie M Doores; Simon Couvreur; Rocio Martin Martinez; Jeffrey Seow; Carl Graham; Sam Acors; Neophytos Kouphou; Stuart Neil; Richard Tedder; Pedro Matos; Kate Poulton; Maria Jose Lista; Ruth Dickenson; Helin Sertkaya; Thomas Maguire; Edward Scourfield; Ruth Bowyer; Deborah Hart; Aoife O'Byrne; Kathryn Steele; Oliver Hemmings; Carolina Rosadas; Myra McClure; Joan Capedevila-Pujol; Jonathan wolf; Sebastien Ourseilin; Matthew Brown; Michael Malim; Timothy Spector; Claire Steves

    doi:10.1101/2020.07.29.20162701 Date: 2020-07-30 Source: medRxiv

    Background: Understanding of the true asymptomatic TRANS rate of infection MESHD of SARS-CoV-2 is currently limited, as is understanding of the population-based seroprevalence SERO after the first wave of COVID-19 within the UK. The majority of data thus far come from hospitalised patients, with little focus on general population cases, or their symptoms. Methods: We undertook enzyme linked immunosorbent assay SERO characterisation of IgM and IgG responses against SARS-CoV-2 spike glycoprotein and nucleocapsid protein of 431 unselected general-population participants of the TwinsUK cohort from South-East England, aged TRANS 19-86 (median age TRANS 48; 85% female TRANS). 382 participants completed prospective logging of 14 COVID-19 related symptoms via the COVID Symptom Study App, allowing consideration of serology alongside individual symptoms, and a predictive algorithm for estimated COVID-19 previously modelled on PCR positive individuals from a dataset of over 2 million. Findings: We demonstrated a seroprevalence SERO of 12% (51participants of 431). Of 48 seropositive individuals with full symptom data, nine (19%) were fully asymptomatic TRANS, and 16 (27%) were asymptomatic TRANS for core COVID-19 symptoms: fever MESHD fever HP, cough MESHD cough HP or anosmia HP. Specificity of anosmia HP for seropositivity was 95%, compared to 88% for fever MESHD fever HP cough MESHD cough HP and anosmia HP combined. 34 individuals in the cohort were predicted to be Covid-19 positive using the App algorithm, and of those, 18 (52%) were seropositive. Interpretation: Seroprevalence SERO amongst adults TRANS from London and South-East England was 12%, and 19% of seropositive individuals with prospective symptom logging were fully asymptomatic TRANS throughout the study. Anosmia HP demonstrated the highest symptom specificity for SARS-CoV-2 antibody SERO response. Funding: NIHR BRC, CDRF, ZOE global LTD, RST-UKRI/MRC

    COVIDOSE: Low-dose tocilizumab in the treatment of Covid-19

    Authors: Garth W Strohbehn; Brian L Heiss; Sherin J Rouhani; Jonathan A Trujillo; Jovian Yu; Alec J Kacew; Emily F Higgs; Jeffrey C Bloodworth; Alexandra Cabanov; Rachel C Wright; Adriana Koziol; Alexandra Weiss; Keith Danahey; Theodore G Karrison; Cuoghi C Edens; Iazsmin Bauer Ventura; Natasha N Pettit; Bhakti Patel; Jennifer Pisano; Mary E Strek; Thomas F Gajewski; Mark J Ratain; Pankti D Reid

    doi:10.1101/2020.07.20.20157503 Date: 2020-07-26 Source: medRxiv

    Background Interleukin-6 (IL-6)-mediated hyperinflammation may contribute to the high mortality of coronavirus disease MESHD 2019 (Covid-19). Tocilizumab, an IL-6 receptor blocking monoclonal antibody SERO, has been repurposed for Covid-19, but prospective trials and dose-finding studies in Covid-19 are lacking. Methods We conducted a phase 2 trial of low-dose tocilizumab in hospitalized adult TRANS patients with Covid-19, radiographic pulmonary infiltrate HP, fever MESHD fever HP, and C-reactive protein (CRP) >= 40 mg/L who did not require mechanical ventilation. Dose cohorts were determined by a trial Operations Committee, stratified by CRP and epidemiologic risk factors. A range of doses from 40 to 200 mg (low-dose tocilizumab) was evaluated, with allowance for one repeat dose at 24-48 hours. The primary objective was to assess the relationship of dose to fever MESHD fever HP resolution and CRP response. Outcomes were compared with retrospective controls with Covid-19. Correlative studies evaluating host antibody SERO response were performed in parallel. Findings A total of 32 patients received low-dose tocilizumab. This cohort had improved fever MESHD fever HP resolution (75.0% vs. 34.2%, p = 0.001) and CRP decline (86.2% vs. 14.3%, p < 0.001) in the 24-48 hours following drug administration, as compared to the retrospective controls (N=41). The probabilities of fever MESHD fever HP resolution or CRP decline did not appear to be dose-related in this small study (p=0.80 and p=0.10, respectively). Within the 28-day follow-up, 5 (15.6%) patients died. For patients who recovered, median time to clinical recovery was 3 days (IQR, 2-5). Clinically presumed and/or cultured bacterial superinfections MESHD were reported in 5 (15.6%) patients. Correlative biological studies demonstrated that tocilizumab-treated patients produced anti- SARS-CoV-2 antibodies SERO comparable to controls. Interpretation Low-dose tocilizumab was associated with rapid improvement in clinical and laboratory measures of hyperinflammation in hospitalized patients with Covid-19. Results of this trial and its correlative biological studies provide rationale for a randomized, controlled trial of low-dose tocilizumab in Covid-19.

    SARS-CoV-2 antibody SERO prevalence SERO in health care workers: Preliminary report of a single center study

    Authors: Michael Brant-Zawadzki; Deborah Fridman; Philip Robinson; Matthew Zahn; Randy German; Marcus Breit; Junko Hara

    doi:10.1101/2020.07.20.20158329 Date: 2020-07-25 Source: medRxiv

    SARS-CoV-2 has driven a pandemic crisis. Serological surveys have been conducted to establish prevalence SERO for covid-19 antibody SERO in various cohorts and communities. However, the prevalence SERO among healthcare workers is still being analyzed. The present study reports on initial sero-surveillance conducted on healthcare workers at a regional hospital system in Orange County, California, during May and June, 2020. Study participants were recruited from the entire hospital employee workforce and the independent medical staff. Data were collected for job title, location, covid-19 symptoms, a PCR test history, travel TRANS record since January 2020, and existence of household contacts TRANS with covid-19. A blood SERO sample was collected from each subject for serum SERO analysis for IgG antibodies SERO to SARS-CoV-2. Of 3,013 tested individuals, a total 2,932 were included in the analysis due to some missing data. Observed prevalence SERO of 1.06% (31 antibody SERO positive cases), adjusted prevalence SERO of 1.13% for test sensitivity SERO and specificity were identified. Significant group differences between positive vs. negative were observed for age TRANS (z = 2.65, p = .008), race (p = .037), presence of fever MESHD fever HP (p < .001) and loss of smell (p < .001). Possible explanation for this low prevalence SERO includes a relatively low local geographic community prevalence SERO (~4.4%) at the time of testing, the hospital's timely procurement of personal protective equipment, rigorous employee education, patient triage and treatment protocol development and implementation. In addition, possible greater presence of cross-reactive adaptive T cell mediated immunity in healthcare workers vs. the general population may have contributed. Determining antibody SERO prevalence SERO in front-line workers, and duration of antibody SERO presence may help stratify the workforce for risk, establish better health place policies and procedures, and potentially better mitigate transmission TRANS.

    The SARS-CoV-2 RNA with mild lung lesions lasts longer in non-severe COVID-19 patients: a case series study

    Authors: Chi Zhang; Jiawen Li; Jing Mu; Daitao Zhang; He Wang; Yunv Jin; Yan Han; Haiyang Li; Chunxiao Zhang; Peng Yu; Rui Guo; Xiangfeng Dou; Yanhui Chu; Zhao Wu; Xiaoqin Dong; Hong Zhao

    doi:10.21203/rs.3.rs-43643/v1 Date: 2020-07-15 Source: ResearchSquare

    Background COVID-19 has become a new infectious disease MESHD in the global pandemic, most of which are non-severe patients. It is particularly important to understand the dynamic changes of the whole disease MESHD course of non-severe patients from the onset to the follow-up after discharge.Methods On February 1, 2020, 18 cases of non-severe COVID-19 appeared in a hospital in Beijing. We recorded the clinical information and viral dynamics of these patients from the onset of the disease MESHD to one month after discharge.Results Eighteen patients (median age TRANS 43) were included, including 14 females TRANS. Fever MESHD Fever HP (11/18) and cough MESHD cough HP (8/18) are the most common symptoms. According to the degree of lung inflammation MESHD, 18 patients were divided into two groups (group A imaging score ≤ 10; group B imaging score > 10). The duration of SARS-CoV-2 positive in group A was significantly longer than that in group B (the median was 30 and 13, respectively, P = 0.0025). One month after discharge, almost all patients were followed up for IgM antibody SERO disappearance and IgG antibody SERO production.Conclusion In non-severe COVID-19 patients, the positive duration of the SARS-CoV-2 in patients with mild lung injury MESHD was longer than that in patients with severe lung injury MESHD. The possible mechanism is that the virus-mediated immune system is not fully activated in mild damaged patients.

    Placental SARS-CoV-2 in a patient with mild COVID-19 disease MESHD

    Authors: Albert L. Hsu; Minhui Guan; Eric Johannesen; Amanda J. Stephens; Nabila Khaleel; Nikki Kagan; Breanna C. Tuhlei; Xiu-Feng Wan

    doi:10.1101/2020.07.11.20149344 Date: 2020-07-14 Source: medRxiv

    Background: The full impact of COVID-19 on pregnancy remains uncharacterized. Current literature suggests minimal maternal, fetal, and neonatal morbidity and mortality,1 and COVID-19 manifestations appear similar between pregnant and non-pregnant women.2 We present a case of placental SARS-CoV-2 virus in a woman with an uncomplicated pregnancy and mild COVID-19 disease MESHD. Methods: A pregnant woman was evaluated at University of Missouri Women and Childrens Hospital. Institutional review board approval was obtained; information was obtained from medical records. Reverse transcriptase-polymerase chain reaction (RT-PCR) was performed to detect SARS-CoV-2. A gynecological pathologist examined the placenta and performed histolopathology. Sections were formalin-fixed and paraffin-embedded; slides were cut and subjected to hematoxylin-and-eosin or immunohistochemistry (IHC) staining. IHC was performed with specific monoclonal antibodies SERO to detect SARS-CoV-2 antigen or to identify trophoblasts. Findings: A 29 year-old multigravida presented at 40-4/7 weeks for labor induction. With myalgias MESHD myalgias HP two days prior, she tested positive for SARS-CoV-2. Her parents TRANS were in self-isolation for COVID-19 positivity; husband was asymptomatic TRANS and tested negative for COVID-19, but exposed to a workplace (meatpacking facility) outbreak. Prenatal course was uncomplicated, with no gestational hypertension MESHD hypertension HP. She was afebrile and asymptomatic TRANS with normal vital signs throughout hospitalization. Her myalgias MESHD myalgias HP improved prior to admission. A liveborn male TRANS infant was delivered vaginally. Newborn course was uneventful; he was appropriate for gestational age TRANS, physical was unremarkable, and he was discharged home at 36 hours. COVID-19 RT-PCR test was negative at 24 hours. At one-week follow-up, newborn was breastfeeding well, with no fevers MESHD fevers HP or respiratory distress HP. Overall placental histology is consistent with acute uterine hypoxia MESHD (subchorionic laminar necrosis MESHD) superimposed on chronic uterine hypoxia MESHD (extra-villous trophoblasts and focal chronic villitis). IHC using SARS-CoV-2 nucleocapsid-specific monoclonal antibody SERO demonstrated SARS-CoV-2 antigens throughout the placenta in chorionic villi endothelial cells, and rarely in CK7-expressing trophoblasts. Negative control placenta (November 2019 delivery) and ferret nasal turbinate tissues (not shown) were negative for SARS-CoV-2. Interpretation: In this report, SARS-CoV-2 was found in the placenta, but newborn was COVID-19 negative. Our case shows maternal vascular malperfusion, with no features of fetal vascular malperfusion. To our knowledge, this is the first report of placental COVID-19 despite mild COVID-19 disease MESHD in pregnancy (with no symptoms of COVID-19 aside from myalgias MESHD myalgias HP); specifically, this patient had no fever MESHD fever HP, cough MESHD cough HP, or shortness of breath, but only myalgias MESHD myalgias HP and sick contacts. Despite her having mild COVID-19 disease MESHD in pregnancy, we demonstrate placental vasculopathy and presence of SARS-CoV-2 virus across the placenta. Evidence of placental COVID-19 raises concern for possible placental vasculopathy (potentially leading to fetal growth restriction, pre-eclampsia MESHD eclampsia HP, and other pregnancy complications MESHD) as well as for potential vertical transmission TRANS -- especially for pregnant women who may be exposed to COVID-19 in early pregnancy. Further studies are urgently needed, to determine whether women with mild, pre-symptomatic, or asymptomatic TRANS COVID-19 may have SARS-CoV-2 virus that can cross the placenta, cause fetal vascular malperfusion, and possibly affect the fetus. This raises important public health and public policy questions of whether future pregnancy guidance should include stricter pandemic precautions, such as screening for a wider array of COVID-19 symptoms, increased antenatal surveillance, and possibly routine COVID-19 testing on a regular basis throughout pregnancy.

    Unusual Presentation of Kawasaki Disease MESHD with Multisystem Inflammation MESHD and Antibodies SERO Against Severe Acute Respiratory Syndrome MESHD Coronavirus 2: A Case Report

    Authors: Haena Kim; Jung Yeon Shim; Jae-Hoon Ko; Aram Yang; Jae Won Shim; Deok Soo Kim; Hye Lim Jung; Ji Hee Kwak; In Suk Sol

    doi:10.21203/rs.3.rs-41276/v1 Date: 2020-07-12 Source: ResearchSquare

    Background: Since mid-April 2020, cases of multisystem inflammatory syndrome MESHD in children TRANS (MIS-C) associated with coronavirus disease MESHD (COVID-19) that mimic Kawasaki disease MESHD (KD) have been reported in Europe and North America. However, no cases have been in East Asia, where KD is more prevalent.Case presentation: A previously healthy 11-year-old boy was admitted with a 4-day history of fever MESHD fever HP and abdominal pain MESHD abdominal pain HP. He had no contact history to any patient with COVID-19. Blood SERO acute inflammatory markers were highly elevated. He was treated with antibiotics for suspected bacterial enteritis MESHD, but he suddenly developed hypotension MESHD hypotension HP. Inotropics and intravenous immunoglobulin were administered to manage septic shock MESHD shock HP. On hospitalization day 6, he developed signs and symptoms MESHD of KD (conjunctival injection, strawberry tongue HP, cracked lip, and coronary artery dilatation HP) in addition to pleural/ pericardial effusion MESHD pericardial effusion HP and mesenteric lymphadenitis MESHD lymphadenitis HP. The results of microbiologic tests, including reverse-transcription polymerase chain reaction for severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2), were negative. Fluorescent immunoassay SERO and enzyme-linked immunosorbent assay SERO revealed abundant IgG antibodies SERO against SARS-CoV-2 in his serum SERO, but no IgM antibodies SERO. He was discharged successfully on day 13.Conclusion: MIS-C may occur in children TRANS with a previously asymptomatic TRANS COVID-19 infection MESHD. A high index of suspicion is required for this novel syndrome MESHD in unusual cases of KD or KD shock MESHD shock HP syndrome MESHD with multisystem inflammation MESHD, even when there is no clear history of contact or symptoms of COVID-19.

    A single-dose live-attenuated YF17D-vectored SARS-CoV2 vaccine candidate

    Authors: Lorena Sanchez Felipe; Thomas Vercruysse; Sapna Sharma; Ji Ma; Viktor Lemmens; Dominique van Looveren; Mahadesh Prasad Arkalagud Javarappa; Robbert Boudewijns; Bert Malengier-Devlies; Suzanne F. Kaptein; Laurens Liesenborghs; Carolien De Keyzer; Lindsey Bervoets; Madina Rasulova; Laura Seldeslachts; Sander Jansen; Michael Bright Yakass; Osbourne Quaye; Li-Hsin Li; Xin Zhang; Sebastiaan ter Horst; Niraj Mishra; Lotte Coelmont; Christopher Cawthorne; Koen Van Laere; Ghislain Opdenakker; Greetje Van de Velde; Birgit Weynand; Dirk E. Teuwen; Patrick Matthys; Johan Neyts; Hendrik Jan Thibaut; Kai Dallmeier

    doi:10.1101/2020.07.08.193045 Date: 2020-07-09 Source: bioRxiv

    The explosively expanding COVID-19 pandemic urges the development of safe, efficacious and fast-acting vaccines to quench the unrestrained spread of SARS-CoV-2. Several promising vaccine platforms, developed in recent years, are leveraged for a rapid emergency MESHD response to COVID-191. We employed the live-attenuated yellow fever MESHD fever HP 17D (YF17D) vaccine as a vector to express the prefusion form of the SARS-CoV-2 Spike antigen. In mice, the vaccine candidate, tentatively named YF-S0, induces high levels of SARS-CoV-2 neutralizing antibodies SERO and a favorable Th1 cell-mediated immune response. In a stringent hamster SARS-CoV-2 challenge model2, vaccine candidate YF-S0 prevents infection MESHD with SARS-CoV-2. Moreover, a single dose confers protection from lung disease MESHD in most vaccinated animals even within 10 days. These results warrant further development of YF-S0 as a potent SARS-CoV-2 vaccine candidate.

    Joint Detection of Serum SERO IgM/IgG Antibody SERO is An Important Key to Clinical Diagnosis of SARS-COV-2 Infection MESHD

    Authors: Fang Hu; Xiaoling Shang; Meizhou Chen; Changliang Zhang

    doi:10.1101/2020.07.07.20146902 Date: 2020-07-08 Source: medRxiv

    Background: This study was aimed to investigate the application of SARS- COV-2 IgM and IgG antibodies SERO in diagnosis of COVID-19 infection MESHD. Method: This study enrolled a total of 178 patients at Huangshi Central Hospital from January to February, 2020. Among them, 68 patients were SARS-COV-2 infected confirmed with nucleic acid test (NAT) and CT imaging. 9 patients were in the suspected group (NAT negative) with fever MESHD fever HP and other respiratory symptoms. 101 patients were in the control group with other diseases MESHD and negative to SARS-COV-2 infection MESHD. After serum samples SERO were collected, SARS-COV-2 IgG and IgM antibodies were tested SERO by chemiluminescence immunoassay SERO (CLIA) for all patients. Results: The specificity of serum SERO IgM and IgG antibodies SERO to SARS-COV-2 were 99.01% (100/101) and 96.04% (97/101) respectively, and the sensitivity SERO were 88.24% (60/68) and 97.06% (66/68) respectively. The combined detection rate of SARS-COV-2 IgM and IgG antibodies SERO were 98.53% (67/68). Conclusion: Combined detection of serum SERO SARS-COV-2 IgM and IgG antibodies SERO had better sensitivity SERO compared with single IgM or IgG test, which can be used as an important diagnostic tool for SARS-COV-2 infection MESHD and a screening tool of potential SARS-COV-2 carriers TRANS in clinics, hospitals and accredited scientific laboratory.

    Epidemiological and Clinical Features of Imported and Local Patients with Coronavirus Disease MESHD 2019 (COVID-19) in Hainan, China

    Authors: Biao Wu; Zi-Ying Lei; Kun-Liang Wu; Jian-Rong He; Hui-Juan Cao; Juan Fu; Feng Chen; Yuan Chen; Bao Chen; Xiao-Li Zhou; Tao Huang; Tao Wu; Yong-Guo Du; Suo-Xian Chen; Fu-Rong Xiao; Zhi-Liang Gao; Jing He; Feng Lin; Bingliang Lin

    doi:10.21203/rs.3.rs-39645/v1 Date: 2020-07-01 Source: ResearchSquare

    Background: Hainan Island, a popular tourist destination, had received many imported cases of Coronavirus disease MESHD 2019 (COVID-19), but successfully contained the epidemics in one month. We described epidemiological and clinical characteristics of COVID-19 in Hainan and compared these features between imported and local cases to provide information for other international epidemic areas.Methods: We included 91 patients (56 imported and 35 local cases) from two designed hospitals for COVID-19 in Haikou, China, from January 20 to February 19, 2020. Data on demographic, epidemiological, clinical and laboratory characteristics were extracted from medical records. Patients were followed up until April 21, 2020, the levels of antibodies SERO in the follow-up were also analyzed.Results: Of the 91 patients, 78 (85.7%) patients were diagnosed within the first three weeks after the first case identified (Day 1: Jan 22, 2020), while the number of local cases started to increase from the third week. No new cases occurred after Day 29. Fever MESHD Fever HP and cough MESHD cough HP were two main clinical manifestations. 15 (16.5%) were severe, 14 (15.4%) had complicated infections MESHD, nine (9.9%) were admitted to ICU, and three died. Median duration of viral shedding in feces was longer than that in nasopharyngeal swabs (19 days vs 16 days, P=0.007). Compared with local cases, imported cases were older, have higher incidence of fever MESHD fever HP and concurrent infections MESHD. There was no difference in outcomes between the two groups. IgG was positive in 92.8% patients (77/83) in the follow-up of week 2 after discharge, 88.4% patients (38/43) had a reduction in IgG levels in the follow-up of week 4 after discharge, and the median level was lower than that in the follow-up of week 2 (10.95 S/CO vs 15.02 S/CO, P<0.001)Conclusion: Imported cases were more severe than local cases, but could have similar prognosis. The level of IgG antibodies SERO declined from week 6 to week 8 after onset. The short epidemic period in Hainan suggests that the epidemics could be quickly brought under control if proper timely measures were taken. 

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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