Corpus overview


Overview

MeSH Disease

Human Phenotype

Fever (106)

Cough (76)

Pneumonia (34)

Fatigue (27)

Diarrhea (13)


Transmission

Seroprevalence
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    Children TRANS with COVID-19 like symptoms in Italian Pediatric Surgeries: the dark side of the coin

    Authors: Gianfranco Trapani; Vassilios Fanos; Enrico Bertino; Giulia Maiocco; Osama Al Jamal; Michele Fiore; VIncenzo Bembo; Domenico Careddu; Lando Barberio; Luisella Zanino; Giuseppe Verlato

    doi:10.1101/2020.07.27.20149757 Date: 2020-07-29 Source: medRxiv

    BACKGROUND: Symptoms of SARS-CoV-2 infection MESHD in children TRANS are nonspecific and shared with other common acute viral illnesses ( fever MESHD fever HP, respiratory or gastrointestinal symptoms, and cutaneous signs), thus making clinical differential diagnosis tricky. In Italy, first line management of pediatric care is handed over to Primary Care Pediatricians (PCPs), who were not allowed to directly perform diagnostic tests during the recent COVID-19 outbreak. Without a confirmatory diagnosis, PCPs could only collect information on ''COVID-19 like symptoms'' rather than identify typical COVID-19 symptoms. AIM: To evaluate the prevalence SERO of COVID-19 like symptoms in outpatient children TRANS, during Italian lockdown. To provide PCPs a risk score to be used in clinical practice during the differential diagnosis process. METHODS: A survey was submitted to 50 PCPs (assisting 47,500 children TRANS) from 7 different Italian regions between the 4th of March and the 23rd of May 2020 (total and partial lockdown period). COVID-19 like symptoms in the assisted children TRANS were recorded, as well as presence of confirmed/suspected cases in children TRANS's families, which was taken as proxy of COVID-19. Multivariable logistic regression was accomplished to estimate the risk of having suspected/ confirmed cases TRANS in families, considering symptoms as potential determinants. RESULTS: 2,300 children TRANS (4.8% of overall survey population) fell HP ill with COVID-19 like symptoms, 3.1% and 1.7% during total and partial lockdown period respectively. The concurrent presence of fatigue MESHD fatigue HP, cough MESHD cough HP, and diarrhea MESHD diarrhea HP in children TRANS, in absence of sore throat/ earache MESHD and abnormal skin signs, represents the maximum risk level of having a suspected/ confirmed case TRANS of COVID-19 at home. CONCLUSIONS: The percentage of children TRANS presenting COVID-19 like symptoms at home has been remarkable also during the total lockdown period. The present study identified a pattern of symptoms which could help, in a cost-effective perspective, PCPs in daily clinical practice to define priorities in addressing children TRANS to the proper diagnostic procedure.

    Point-of-care ultrasound for COVID-19 pneumonia MESHD pneumonia HP patients in the ICU

    Authors: zouheir bitar; Mohammed Shamsah; Omar Bamasood; Ossama Maadrani; Huda Al foudri

    doi:10.21203/rs.3.rs-49196/v1 Date: 2020-07-26 Source: ResearchSquare

    BackgroundPoint-of-care ultrasound (POCUS) has a major role in the management of patients with acute hypoxic respiratory and circulatory failure and guides hemodynamic management. There is scarce literature on POCUS assessment characteristics in COVID-19 pneumonia MESHD pneumonia HP with hypoxic respiratory failure HP.MethodsThe study is an observational, prospective, single‐center study conducted in the intensive care unit of Adan General Hospital from May 1st, 2020, to June 25, 2020. The study included adults TRANS suspected to have COVID-19 transferred to the intensive care unit (ICU) with fever MESHD fever HP or suspected respiratory infection MESHD. Patients were transferred to the ICU directly from the ED or general medical wards after reverse transcriptase-polymerase chain reaction (RT-PCR) testing. A certified intensivist in critical care ultrasound who was blinded to the RT-PCR results, if available at the time of examination, performed the lung ultrasound and echocardiology within 12 hours of the patient’s admission to the ICU. We calculated the E/e’, E/A ratio, left ventricular ejection fraction EF, IVC diameter, RV size and systolic function. We performed ultrasound in 12 chest areas.ResultsOf 92 patients with suspected COVID-19 pneumonia MESHD pneumonia HP, 77 (84%) cases were confirmed TRANS. The median age TRANS of the patients was 53 (82-36) years, and 71 (77%) were men.In the group of patients with confirmed COVID-19 pneumonia MESHD pneumonia HP, echocardiographic findings showed normal E/e’, deceleration time (DT), and transmittal E/A ratio in comparison to the non-COVID19 patients (P .001 for both). The IVC diameter was <2 cm with > 50% collapsibility in 62 (81%) patients with COVID-19 pneumonia MESHD pneumonia HP; a diameter of > 2 cm and < 50% collapsibility in all patients, with a P value of 0.001, was detected among those with non-COVID-19 pneumonia MESHD pneumonia HP. There were 3 cases of myocarditis MESHD myocarditis HP with poor EF (5.5%), severe RV dysfunction was seen in 9 cases (11.6%), and 3 cases showed RV thrombus.Chest US revealed four signs suggestive of COVID-19 pneumonia MESHD pneumonia HP in 77 patients (98.6%) ( sensitivity SERO 96.9%, CI 85%‐99.5%) when compared with RT-PCR results.ConclusionPOCUS plays an important role in bedside diagnosis, hemodynamic assessment and management of patients with acute hypoxic respiratory and circulatory failure in patients with COVID-19 pneumonia MESHD pneumonia HP.

    A nomogram for predicting the severity of COVID-19 using laboratory examination and CT findings 

    Authors: Yani Kuang; Susu He; Shuangxiang Lin; Rui Zhu; Rongzhen Zhou; Jian Wang; Renzhan Li; Haiyong Lin; Zhibang Zhang; Peipei Pang; Wenbin Ji

    doi:10.21203/rs.3.rs-46841/v1 Date: 2020-07-21 Source: ResearchSquare

    Background: The outbreak of COVID-19 has a significant impact on the health of people around the world. In the clinical condition of COVID-19, the condition of critical cases changes rapidly with a high mortality rate. Therefore, early prediction of disease MESHD severity and active intervention play an important role in the prognosis of severe patients.Methods: All the patients with COVID-19 in Taizhou city were retrospectively included and segregated into the non-severe and severe group according to the severity of the disease MESHD. The clinical manifestations, laboratory examination results, and imaging findings of the 2 groups were analysed for comparing the differences between the 2 groups. Univariate and multivariate logistic regression were used for screening the factors that could predict the disease MESHD, and the nomogram was constructed.Results: A total of 143 laboratory- confirmed cases TRANS were included in the study, including 110 non-severe patients and 33 severe patients. The median age TRANS of patients was 47 years (range, 4–86 years). Fever MESHD Fever HP (73.4%) and cough MESHD cough HP (63.6%) were the most common initial clinical symptoms. By using the method of multivariate logistic regression, the variables to construct nomogram include age TRANS (OR: 1.052, 95% CI: 1.020–1.086, P = 0.001), body temperature (OR: 2.252, 95% CI: 1.139–4.450, P = 0.020), lymphocyte count (OR: 1.128, 95% CI: 1.000–1.272, P = 0.049), ADA (OR: 1.163, 95% CI: 1.023–1.323, P = 0.021), PaO2 (OR: 0.972, 95% CI: 0.953–0.992, P = 0.007), IL-10 (OR: 1.184, 95% CI: 1.037–1.351, P = 0.012), and bronchiectasis MESHD bronchiectasis HP (OR: 3.818, 95% CI: 1.694–8.605, P = 0.001). The AUC of the established nomogram was 0.877.Conclusions: This study established a stable nomogram for predicting the severity of COVID-19, and the clinicians can use the established nomogram for predicting the severity of newly diagnosed COVID-19 patients and to conduct active intervention for minimising the mortality rate and improving the prognosis of severe patients.

    Early detection of COVID-19 pandemic: evidence from Baidu Index

    Authors: Bizhi Tu; Laifu Wei; Yaya Jia; Jun Qian

    doi:10.21203/rs.3.rs-44082/v1 Date: 2020-07-16 Source: ResearchSquare

    Background: New coronavirus disease MESHD 2019 (COVID-19) poses a severe threat to human life, and causes a global pandemic. The purpose of current research is to explore the onset and progress of the pandemic with a novel perspective using Baidu Index.Methods: We collected the confirmed data of COVID-19 infection MESHD between January 11, 2020, and April 22, 2020, from the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). Based on known literature, we obtained the search index values of the most common symptoms of COVID-19, including fever MESHD fever HP, cough MESHD cough HP, fatigue MESHD fatigue HP, sputum production, and shortness of breath. Spearman's correlation analysis was used to analyze the association between the Baidu index values for each COVID-19-related symptoms and the number of confirmed cases TRANS. Regional differences among 34 provinces/ regions were also analyzed. Results: Daily growth of confirmed cases TRANS and Baidu index values for each symptoms presented a robust positive correlation during the outbreak ( fever MESHD fever HP: rs=0.705, p=9.623×10-6; cough MESHD cough HP: rs=0.592, p=4.485×10-4; fatigue MESHD fatigue HP: rs=0.629, p=1.494×10-4; sputum production: rs=0.648, p=8.206×10-5; shortness of breath: rs=0.656, p=6.182×10-5). The average search-to-confirmed interval is 19.8 days in China ( fever MESHD fever HP: 22 days, cough MESHD cough HP: 19 days, fatigue MESHD fatigue HP: 20 days, sputum production: 19 days, and shortness of breath: 19 days). We discovered similar results in the top 10 provinces/regions, which had the highest cumulative cases. Conclusion: Search terms of COVID-19- related symptoms on the Baidu search engine can be used to early warn the outbreak of the epidemic. Relevant departments need to pay more attention to areas with high search index and take precautionary measures to prevent these potentially infected persons from spreading further. Baidu search engine can reflect the public's attention to the pandemic and regional epidemics of viruses. Based on changes in the Baidu index value, we can predict the arrival of the peak confirmed cases TRANS. The clinical characteristics related to COVID-19- including fever MESHD fever HP, cough MESHD cough HP, fatigue MESHD fatigue HP, shortness of breath, deserve more attention during the pandemic.

    Epidemiological and clinical characteristics of COVID-19 pneumonia MESHD pneumonia HP in Zhejiang province, China: a description of early stage

    Authors: Caixia Gong; Cheng Ma; Shumin Li; Yunmei Yang; Qin Zhang

    doi:10.21203/rs.3.rs-44201/v1 Date: 2020-07-16 Source: ResearchSquare

    BackgroundThe outbreak of the 2019 novel coronavirus since December, 2019, has now causing nearly 75 thousand confirmed cases TRANS in China (until paper preparing). This epidemic has posed significant threats to international health and the economy. Zhejiang province, which once had the 2nd most accumulative cases among all provinces, has now dropped to top No.5 (until paper preparing). It had a high discharge rates (43.86%) from hospital and the lowest death MESHD rate among all top 5 epidemic provinces, this drew our attention to the epidemiological, clinical characteristics and local government engagement of this region.MethodsIn this study, we included all confirmed cases TRANS of COVID-19 pneumonia MESHD pneumonia HP in Zhejiang province from Jan 21 to Feb 11, 2020. All data come from cases issued by Zhejiang provincial health commission.ResultsUntil Feb 11, 2020, 1143 cases were confirmed TRANS in Zhejiang province. We analysed the cases growth information in Zhejiang province and age TRANS, gender TRANS, severe cases percent, the source of the patients, the time of disease MESHD onset to confirm and the clinical symptoms of the patients. We also compared the clinical symptoms of elders and the young.ConclusionsThe patients in Zhejiang province had no age TRANS and gender TRANS preference, and the average time of disease MESHD onset to confirm was 5.9 days. The clinical symptoms were mainly fever MESHD fever HP, cough MESHD cough HP and weakness, similarly with before reported. The difference between elders and younger are not significant. Until paper preparing, Zhejiang province has very high discharge rate and low death MESHD rate, low cases increase rate in China.

    RT-PCR testing to detect a COVID-19 outbreak in Austria: rapid, accurate and early diagnosis in primary care (The REAP study)

    Authors: Werner Leber; Oliver Lammel; Monika Redlberger-Fritz; Maria Elisabeth Mustafa-Korninger; Karin Stiasny; Reingard Christina Glehr; Eva-Maria Hochstrasser; Christian Hoellinger; Andrea Siebenhofer; Chris Griffiths; Jasmina Panovska-Griffiths

    doi:10.1101/2020.07.13.20152439 Date: 2020-07-15 Source: medRxiv

    Background Delay in COVID-19 detection has led to a major pandemic. We report rapid early detection of SARS-CoV-2 by reverse transcriptase-polymerase chain reaction (RT-PCR), comparing it to the serostatus of convalescent infection MESHD, at an Austrian National Sentinel Surveillance Practice in an isolated ski-resort serving a population of 22,829 people. Methods Retrospective dataset of all 73 patients presenting with mild to moderate flu-like symptoms to a sentinel practice in the ski-resort of Schladming-Dachstein, Austria, between 24 February and 03 April, 2020. We split the outbreak in two halves, by dividing the period from the first to the last case by two, to characterise the following three cohorts of patients with confirmed infection TRANS infection MESHD: people with reactive RT-PCR presenting during the first half (early acute infection MESHD) vs. those presenting in the second half (late acute), and people with non-reactive RT-PCR (late convalescent). For each cohort we report the number of cases detected, the accuracy of RT-PCR and the duration of symptoms. We also report multivariate regression of 15 clinical symptoms as covariates, comparing all people with convalescent infection MESHD to those with acute infection MESHD. Findings All 73 patients had SARS-CoV-2 RT-PCR testing. 22 patients were diagnosed with COVID-19, comprising: 8 patients presenting early acute, and 7 presenting late acute and 7 late convalescent respectively; 44 patients tested SARS-COV-2 negative, and 7 were excluded. RT-PCR sensitivity SERO was high (100%) among acute presenters, but dropped to 50% in the second half of the outbreak; specificity was 100%. The mean duration of symptoms was 2 days (range 1-4) among early acute presenters, and 4.4 days (1-7) among late acute and 8 days (2-12) among late convalescent presenters respectively. Convalescent infection MESHD was only associated with loss of taste (ORs=6.02;p=0.047). Acute infection MESHD was associated with loss of taste (OR=571.72;p=0.029), nausea MESHD nausea and vomiting HP and vomiting MESHD (OR=370.11;p=0.018), breathlessness (OR=134.46;p=0.049), and myalgia MESHD myalgia HP (OR=121.82;p=0.032); but not loss of smell, fever MESHD fever HP or cough MESHD cough HP. Interpretation RT-PCR rapidly and reliably detects early COVID-19 among people presenting with viral illness and multiple symptoms in primary care, particularly during the early phase of an outbreak. RT-PCR testing in primary care should be prioritised for effective COVID-19 prevention and control.

    Clinical Characteristics and outcomes in HBV carriers TRANS with COVID-19 in WuHan, China: a retrospective cohort study

    Authors: Jingjing Lu; Mu Hu; Xia Zhou; Hui Zhu; Feilong Wang; Jianhao Huang; Zhongliang Guo; Qiang Li; Qi Yin; Zhifeng Yang

    doi:10.21203/rs.3.rs-42476/v1 Date: 2020-07-13 Source: ResearchSquare

    Background: Coronavirus 2019 (COVID-19) is a novel infectious disease MESHD that was first reported in Wuhan, China, but has spread to all parts of the world. At the same time, because China has millions of HBV carriers TRANS, HBV infection MESHD has become a major public health problem in China. In this study, we aim to describe the clinical features of HBV carriers TRANS (AsC) infected with COVID-19 and to assess the factors that may affect the outcome during disease progression MESHD.Methods: This retrospective cohort study included 72 patients diagnosed with COVID-19 in Wuhan Jinyintan Hospital. These patients were also diagnosed as HBV carriers TRANS. The epidemiological characteristics, demographic features, clinical manifestations, laboratory test, treatment, management and final outcome were collected and analyzed.Results: The median age TRANS of 72 patients is 58.5 years old, of which 55.56% (n=40) are male TRANS. 20 (30.56%) patients were severe cases and 50 (69.44%) were non-severe cases. Fever MESHD Fever HP is the most common symptom, followed by cough MESHD cough HP, chest tightness HP and sputum. Laboratory test results including hematologic, biochemical, infection MESHD and coagulation parameters and several indicators, such as Aspartate Aminotransferase (AST), Total Bilirubin (TBil), Direct Bilirubin (DBil), Indirect Bilirubin (IBil), γ-glutamyl Transferase (GGT) showed difference between their admission and discharge. The level of Prealbumin (PA) and Serum SERO Amyloid A (SAA) in the study showed a significant trend from high to low, which has statistical significance.Conclusions: The clinical features of HBV carriers TRANS with COVID-19 have obvious systemic symptoms, such as fever MESHD fever HP, cough MESHD cough HP, and chest tightness HP. Compared with liver function data on admission and discharge, SARS-CoV-2 does not directly activate the Hepatitis B MESHD Hepatitis HP virus, and the risk of liver cell damage of HBV carriers TRANS with COVID-19 does not increase. Both PA and SAA are sensitive indicators and can be used to evaluate the prognosis and outcome of these patients.

    The emergence of COVID-19 in Indonesia: analysis of predictors of infection MESHD and mortality using independent and clustered data approaches

    Authors: Erlina Burhan; Ari Fahrial Syam; Ahmad Jabir Rahyussalim; Prasenohadi Prasenohadi; Navy G Lolong Wulung; Agus Dwi Susanto; I Gede Ketut Sajinadiyasa; Dewi Puspitorini; Dewi Lestari; Indah Suci Widyahening; Vivi Setiawaty; Dwiana Ocviyanti; Kartika Qonita Putri; Aswin Guntara; Davrina Rianda; Anuraj H Shankar; Rina Agustina

    doi:10.1101/2020.07.10.20147942 Date: 2020-07-11 Source: medRxiv

    Background: Analyses of correlates of SARS-CoV-2 infection MESHD or mortality have usually assessed individual predictors. This study aimed to determine if patterns of combined predictors may better identify risk of infection TRANS risk of infection TRANS infection MESHD and mortality. Methods: For the period of March 2nd to 10th 2020, the first 9 days of the COVID-19 pandemic in Indonesia, we selected all 18 confirmed cases TRANS, of which 6 died, and all 60 suspected cases, of which 1 died; and 28 putatively negative patients with pneumonia MESHD pneumonia HP and no travel TRANS history. We recorded data for travel TRANS, contact history, symptoms, haematology, comorbidities, and chest x-ray. Hierarchical cluster analyses (HCA) and principal component analyses (PCA) identified cluster and covariance patterns for symptoms or haematology which were analysed with other predictors of infection MESHD or mortality using logistic regression. Results: For univariate analyses, no significant association with infection MESHD was seen for fever MESHD fever HP, cough MESHD cough HP, dyspnoea, headache MESHD headache HP, runny nose, sore throat, gastrointestinal complaints (GIC), or haematology. A PCA symptom component for fever MESHD fever HP, cough MESHD cough HP, and GIC tended to increase risk of infection TRANS risk of infection TRANS infection MESHD (OR 3.41; 95% CI 1.06 - 14; p=0.06), and a haematology component with elevated monocytes decreased risk (OR 0.26; 0.07 - 0.79; 0.027). Multivariate analysis revealed that an HCA cluster of 3-5 symptoms, typically fever MESHD fever HP, cough MESHD cough HP, headache MESHD headache HP, runny nose, sore throat but little dyspnoea and no GIC tended to reduce risk (aOR 0.048; <0.001 - 0.52; 0.056). In univariate analyses for death MESHD, an HCA cluster of cough MESHD cough HP, fever MESHD fever HP and dyspnoea had increased risk (OR 5.75; 1.06 - 31.3, 0.043), but no other individual predictor, cluster or component was associated. Other significant predictors of infection MESHD were age TRANS >= 45, international travel TRANS, contact with COVID-19 patient, and pneumonia MESHD pneumonia HP. Diabetes and history of contact were associated with higher mortality. Conclusions: Cluster groups and co-variance patterns may be stronger correlates of SARS-CoV-2 infection MESHD than individual predictors. Comorbidities may warrant careful attention as would COVID-19 exposure levels.

    Clinical and epidemiological characteristics of children TRANS with SARS-CoV-2 infection MESHD: case series in Sinaloa

    Authors: Giordano Perez Gaxiola; Rosalino Flores Rocha; Julio Cesar Valadez Vidarte; Melissa Hernandez Alcaraz; Gilberto Herrera Mendoza; Miguel Alejandro Del Real Lugo

    doi:10.1101/2020.07.07.20146332 Date: 2020-07-11 Source: medRxiv

    Background: The SARS-CoV-2 virus may affect both adults TRANS and children TRANS. Although the disease MESHD, named COVID-19, has a lower prevalence SERO in infancy and has been described as mild, the clinical characteristics may vary and there is a possibility of complications. Objectives: To describe the clinical and epidemiological characteristics of pediatric cases confirmed TRANS in the state of Sinaloa, Mexico, during the first three months of the pandemic, and of children TRANS admitted with COVID-19 to a secondary hospital. Methods: This case series includes all patients with SARS-CoV-2 infection MESHD infection confirmed TRANS confirmed by PCR testing, identified in the state epidemiological surveillance system between March 1 and May 31, 2020. Confirmed patients admitted to the Sinaloa Pediatric Hospital (HPS) during the same dates are also described. Results: Fifty one children TRANS with SARS-CoV-2 were included, 10 of the admitted to HPS. The median age TRANS was 10 years. The more frequent symptoms were fever MESHD fever HP (78%), cough MESHD cough HP (67%) and headache MESHD headache HP (57%). Most cases were mild or asymptomatic TRANS. Three patients with comorbidities died. Only 4 of 10 patients identified in HPS had been admitted with the diagnosis of possible COVID-19. Conclusions: SARS-CoV-2 infection MESHD in children TRANS was mostly mild or asymptomatic TRANS, but with a wide range of clinical presentations.

    Reconstructing the global dynamics of under-ascertained COVID-19 cases and infections MESHD

    Authors: Nick Golding; Timothy W Russell; Sam Abbott; Joel Hellewell; Carl A B Pearson; Kevin van Zandvoort; Christopher I Jarvis; Hamish Gibbs; Yang Liu; Rosalind M Eggo; John W Edmunds; Adam J Kucharski

    doi:10.1101/2020.07.07.20148460 Date: 2020-07-08 Source: medRxiv

    Background: Asymptomatic TRANS or subclinical SARS-CoV-2 infections MESHD are often unreported, which means that confirmed case TRANS counts may not accurately reflect underlying epidemic dynamics. Understanding the level of ascertainment (the ratio of confirmed symptomatic cases to the true number of symptomatic individuals) and undetected epidemic progression is crucial to informing COVID-19 response planning, including the introduction and relaxation of control measures. Estimating case ascertainment over time allows for accurate estimates of specific outcomes such as seroprevalence SERO, which is essential for planning control measures. Methods: Using reported data on COVID-19 cases and fatalities globally, we estimated the proportion of symptomatic cases (i.e. any person with any of fever MESHD fever HP >= to 37.5C, cough MESHD cough HP, shortness of breath, sudden onset of anosmia HP, ageusia MESHD or dysgeusia MESHD illness) that were reported in 210 countries and territories, given those countries had experienced more than ten deaths MESHD. We used published estimates of the case fatality ratio (CFR) as an assumed baseline. We then calculated the ratio of this baseline CFR to an estimated local delay-adjusted CFR to estimate the level of under-ascertainment in a particular location. We then fit a Bayesian Gaussian process model to estimate the temporal pattern of under-ascertainment. Results: We estimate that, during March 2020, the median percentage of symptomatic cases detected across the 84 countries which experienced more than ten deaths MESHD ranged from 2.38% (Bangladesh) to 99.6% (Chile). Across the ten countries with the highest number of total confirmed cases TRANS as of 6th July 2020, we estimated that the peak number of symptomatic cases ranged from 1.4 times (Chile) to 17.8 times (France) larger than reported. Comparing our model with national and regional seroprevalence SERO data where available, we find that our estimates are consistent with observed values. Finally, we estimated seroprevalence SERO for each country. Despite low case detection in some countries, our results that adjust for this still suggest that all countries have had only a small fraction of their populations infected as of July 2020. Conclusions: We found substantial under-ascertainment of symptomatic cases, particularly at the peak of the first wave of the SARS-CoV-2 pandemic, in many countries. Reported case counts will therefore likely underestimate the rate of outbreak growth initially and underestimate the decline in the later stages of an epidemic. Although there was considerable under-reporting in many locations, our estimates were consistent with emerging serological data, suggesting that the proportion of each country's population infected with SARS-CoV-2 worldwide is generally low.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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