Corpus overview


Overview

MeSH Disease

Fever (20)

Infections (14)

Disease (9)

Cough (8)

Death (4)


Human Phenotype

Fever (20)

Cough (8)

Anosmia (5)

Pneumonia (4)

Dyspnea (3)


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

    Massive cerebral venous thrombosis HP venous thrombosis MESHD related to oligosymptomatic COVID-19 infection MESHD: a case report

    Authors: Simone Beretta; Fulvio Da Re; Valentina Francioni; Paolo Remida; Benedetta Storti; Lorenzo Fumagalli; Maria Luisa Piatti; Patrizia Santoro; Diletta Cereda; Claudia Cutellè; Fiammetta Pirro; Danilo Antonio Montisano; Francesca Beretta; Francesco Pasini; Annalisa Cavallero; Ildebrando Appollonio; Carlo Ferrarese

    doi:10.21203/rs.3.rs-49755/v1 Date: 2020-07-27 Source: ResearchSquare

    Background: The development of thrombotic coagulopathy is frequent in COVID-19 patients, but the timing after infection MESHD, cerebral venous system involvement, treatment and outcome are uncertain.Case Presentation: We report a case of massive cerebral venous thrombosis HP venous thrombosis MESHD occurring in the late phase of COVID-19 infection MESHD. Mild respiratory symptoms, without fever MESHD fever HP, started three weeks before headache MESHD headache HP and acute neurological deficits. She had no dyspnea MESHD dyspnea HP, although she was hypoxic and with typical COVID-19 associated interstitial pneumonia MESHD pneumonia HP. Brain CT scan showed a left parietal hypodense lesion with associated sulcal subarachnoid haemorrhage. CT angiography showed a massive cerebral vein thrombosis MESHD. An asymptomatic TRANS concomitant right internal iliac vein thrombosis MESHD was found. Both cerebral venous thrombosis HP venous thrombosis MESHD and deep venous thrombosis HP venous thrombosis MESHD were effectively treated with unfractionated heparin started on the day of admission, then shifted to low molecular weight heparin, with a favorable clinical course. Nasopharyngel swab, repeated twice, tested negative for SARS-CoV-2. Serological tests SERO confirmed SARS-CoV-2 infection MESHD. Conclusions: Our case supports active surveillance and prevention of thrombotic complications associated with COVID-19, which may affect both peripheral and cerebral venous system. Early initiation of unfractionated heparin may lead to good neurological outcome.

    EPICOVID19: Psychometric assessment and validation of a short diagnostic scale for a rapid Covid-19 screening based on reported symptoms

    Authors: Luca Bastiani; Loredana Fortunato; Stefania Pieroni; Fabrizio Bianchi; Fulvio Adorni; Federica Prinelli; Andrea Giacomelli; Gabriele Pagani; Stefania Maggi; Caterina Trevisan; Marianna Noale; Nithiya Jesuthasan; Aleksandra Sojic; Carla Pettenati; Massimo Andreoni; Raffaele Antonelli Incalzi; Massimo Galli; Sabrina Molinaro

    doi:10.1101/2020.07.22.20159590 Date: 2020-07-25 Source: medRxiv

    Background Confirmed COVID-19 cases have been reported in 213 countries and regions and as of 12 July 2020, over 12 million cases, with 561617 deaths MESHD have been reported worldwide. The number of cases changes quickly and varies depending upon which source you use to track, so in the current epidemiological context, the early recognition is critical for the rapid identification of suspected cases (with SARS-CoV-2 infection MESHD-like symptoms and signs MESHD) to be immediately subjected to quarantine measures. Although surveys are widely used for identifying COVID-19 cases, outcomes and associated risks, no validated epidemiological tool exists for surveying SARS-CoV-2 infection MESHD in the population so far. Methods Our study is the phase II of the EPICOVID19 national survey, launched in April 2020 including a national convenience sample of 201121 adults TRANS, who voluntarily filled the EPICOVID19 questionnaire. The phase II questionnaire was mailed to all subjects who underwent tests for COVID-19 by nasopharyngeal swab (NPS) and who accepted to be involved in the second phase of the study, focused on the results reported for NPS and/or serological IgG/IgM tests. We evaluated the capability of the self-reported symptoms collected through the EPICOVID19 questionnaire to discriminate the COVID-19 among symptomatic subjects, in order to identify possible cases to undergo instrumental measurements and clinical examinations. We defined a method for the identification of a total score and validated it with reference to the serological and molecular clinical diagnosis, using four standard steps: identification of critical factors, confirmation of presence of latent variable, development of optimal scoring algorithm and validation of the scoring algorithm. Findings 2703 subjects [66% response rate] completed the Phase II questionnaire. Of 2703 individuals, 694 (25.7%) were NPS(+) and of these 84 (12.1% of the 694 NPS(+)) were asymptomatic TRANS. In the individuals who performed serological testing SERO, of the 472 who did IgG(+) and 421 who did IgM(+), 22.9% and 11.6% tested positive, respectively. Among IgG(+) 1 of 108 subjects was asymptomatic TRANS (0.9%) while 5/49 subjects among IgM(+) were asymptomatic TRANS (10.2%). Compared with NPS(-), among NPS(+) subjects there was a higher rate for Fever MESHD Fever HP (421 [60.7%] vs 391[19.5% ]; p<0.0001), Loss of Taste and/or Smell (365 [52.6%] vs 239 [11.9% ]; p<0.0001) and Cough MESHD Cough HP (352 [50.7%] vs 580 [28.9% ]; p<0.0001). Also for other symptoms the frequencies were significantly higher in NPS(+) subjects than in NPS(-) ones (p<0.001). Among groups with serological tests SERO, the symptoms with higher percentages in the subjects IgG(+) were Fever MESHD Fever HP (65 [60.2%] vs 43[11.8% ]; p<0.0001) and Pain MESHD Pain HP in muscles, bones, joints (73 [67.6%] vs 71 [19.5% ]; p<0.0001). For the COVID-19 self-reported symptoms items, exploratory (proportion variance explained [89.9%]) and confirmatory factor analysis results (SMSR 0.072; RMSEA 0.052) highlights the presence of one latent variable (factor) underlying the symptoms. We define the one-factor solution as EPICOVID19 diagnostic scale and optimal score for each items was identified: Respiratory problems (1.03), Chest pain MESHD Chest pain HP (1.07), Loss of Taste and/or Smell (0.97) and Tachycardia MESHD Tachycardia HP ( palpitations HP) (1.05) were the most important symptoms. The cut-off score was 2.56 ( Sensitivity SERO 76.56%; Specificity 68.24%) in NPS(+) and 2.59 (Se 80.37; Sp 80.17) in IgG(+) subjects.

    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.

    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.

    SEROPREVALENCE SERO AND CLINICAL SPECTRUM OF SARS-CoV-2 INFECTION MESHD IN THE FIRST VERSUS THIRD TRIMESTER OF PREGNANCY

    Authors: Francesca Crovetto; Fatima Crispi; Elisa Llurba; Francesc Figueras; Maria Dolores Gomez-Roig; Eduard Gratacos

    doi:10.1101/2020.06.17.20134098 Date: 2020-06-19 Source: medRxiv

    Introduction: Case registries of pregnant women diagnosed with coronavirus disease MESHD (COVID-19) by polymerase chain reaction (PCR) have reported that the majority experienced mild infection MESHD, but up to 9% may require critical care. Most COVID-19 cases published were in the third trimester of pregnancy, which could reflect reporting bias, higher risk of infection TRANS risk of infection TRANS infection MESHD or increased disease MESHD severity in late pregnancy. Seroprevalence SERO studies may allow reliable estimates of the susceptibility to infection MESHD and clinical spectrum since they include asymptomatic TRANS and mild infections MESHD not tested for PCR. We evaluated the seroprevalence SERO and clinical presentation of severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD in pregnant women in the first and third trimester. Methods: The study was approved by the Institutional Review Board at each institution and informed consent was obtained. We recruited 874 consecutive pregnancies attending for first trimester screening (10-16 weeks of gestation, n=372) or delivery (n=502) from April 14 to May 5. All women were interviewed with a structured questionnaire for COVID-19 symptoms two months prior to sampling. SARS-CoV-2 IgG and IgM/IgA antibodies were tested SERO (COVID-19 VIRCLIA Monotest, Vircell Microbiologist, Spain; reported sensitivity SERO 70% IgG and 89% IgM/IgA, and specificity 89% and 99% respectively). Indeterminate results were re-tested (VITROS Immunodiagnostic Products Anti-SARS-CoV2 Total Tests, Ortho Clinical Diagnostics, USA; 100% sensitivity SERO and specificity) and re-classified as positive or negative. Women with COVID-19 were diagnosed and managed according to standard protocols and guidelines3,4. Statistical differences were tested using the {chi}2 test or Student t-test as appropriate (p<0.05). Results: A total of 125 of 874 women (14.3%) were positive for either IgG or IgM/IgA SARS-CoV-2 antibodies SERO, 54/372 (14.5%) in the first and 71/502 (14.1%) in the third trimester. A total of 75/125 (60%) reported no symptoms of COVID-19 in the past 2 months, whereas 44 (35.2%) reported one or more symptoms, of which 31 (24.8%) had at least 3 symptoms or anosmia HP and 8 (6.4%) dyspnea MESHD dyspnea HP. Overall, 7 women (5.6%) were admitted for persistent fever MESHD fever HP despite paracetamol and dyspnea MESHD dyspnea HP, of which 3 had signs of pneumonia MESHD pneumonia HP on chest radiography. All 3 had criteria for severity (bilateral chest condensation, respiratory rate>30 and leukopenia MESHD leukopenia HP) and required oxygen support but not critical care or mechanical ventilation, and they were all discharged well. The rates of symptomatic infection MESHD, hospital admission or dyspnea MESHD dyspnea HP were significantly higher in third trimester women (Table and Figure). Discussion: The 14.3% seroprevalence SERO of SARS-COV-2 in pregnant women in this study was substantially larger than the contemporary rates of PCR positive cases (0.78%) reported for women 20-40y in Barcelona. The data confirm that COVID-19 is asymptomatic TRANS in the majority of pregnant women6 and illustrate the value of seroprevalence SERO studies to capture the high proportion of asymptomatic TRANS or mild infections MESHD. In this study, none of the 125 pregnant women with SARS-CoV-2 infection MESHD required critical care as compared to 9% reported in cases diagnosed with PCR. However, the proportion of infections MESHD with symptoms or dyspnea MESHD dyspnea HP was remarkably higher in the third trimester, and these results are in line with COVID-19 registries, reporting that 81% of hospitalized women were in late pregnancy or peripartum. These results provide reassuring information that, even in settings with a high prevalence SERO, SARS-CoV-2 infection MESHD in pregnancy mostly presents with asymptomatic TRANS or mild clinical forms. The susceptibility to infection MESHD seemed to be the same in the first and the third trimesters of gestation. The data further suggest that, as with other respiratory viruses, COVID-19 could be more severe and require increased surveillance in late pregnancy. These findings should be confirmed and extended with larger consecutive prevalence SERO studies in pregnancy.

    Seroprevalence SERO against COVID-19 and follow-up of suspected cases in primary TRANS health care in Spain

    Authors: Carlos Brotons; Jordi Serrano; Diana Fernandez; Carlos Garcia-Ramos; Begona Ichazo; Jeannine Lemaire; Patricia Montenegro; Irene Moral; Ricky Perez- Wienese; Marc Pitarch; Mireia Puig; Maria Teresa Vilella; Jaume Sellares

    doi:10.1101/2020.06.13.20130575 Date: 2020-06-16 Source: medRxiv

    Background During the coronavirus disease MESHD 2019 (COVID-19) pandemic little information has been available about patients with mild or moderate symptoms attended and followed in the primary care setting, most of whom had an unknown status for the severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD. Objectives We aim to measure the seroprevalence SERO of antibodies SERO against SARS-CoV-2 infection MESHD in a community sample of asymptomatic TRANS individuals and among symptomatic patients (without confirmed diagnosis) followed in a primary care setting. As a secondary objective, we estimated the proportions of symptomatic patients seeing at an emergency MESHD department (ED), hospitalized or dying, and identified the most important clinical symptoms associated with a positive infection MESHD. Methods From April 21 to April 24 2020, we selected a random sample of 600 individuals stratified by age groups TRANS, from a total population of 19,899 individuals from a community area in Barcelona (study population 1). From April 29 to May 5 2020, we also invited all the patients that had been followed by general practitioners (GPs) (study population 2). We used for both populations COVID-19 Rapid lateral flow immunoassay SERO which qualitatively assesses the presence of patient-generated IgG and IgM in approximately 10-15 minutes. The prevalence SERO (95% confidence intervals [CI]) of infection MESHD (past and current) was defined as the proportion of individuals with antibody SERO seropositivity. Odds ratios (ORs) for a positive test result were estimated using logistic regression analysis. Results Three hundred and eleven asymptomatic TRANS individuals from the randomly selected sample accepted to participate in the study. The overall mean age TRANS was 43.7 years (SD 21.79, range 1-94) and 55% were women. Seventeen individuals were seropositive for IgM and/or IgG, resulting an overall prevalence SERO of 5,47% (95% CI, 3.44-8.58). Six-hundred and thirty-four symptomatic patients were followed by GPs. The overall mean age TRANS was 46.97 years (SD 20.05, range 0-92) and 57.73% were women. Of these, 244 patients (38.49%) were seropositive for IgM and/or IgG. During the follow-up period, 27.13% of symptomatic patients attended the ED, 11.83% were hospitalized and about 2% died. Results of the multivariate logistic regression analysis showed that the OR for a positive test was significantly increased in patients who had fever MESHD fever HP (>38{degrees}C), ageusia MESHD and contact with a patient diagnosed with COVID-19. Conclusions The seroprevalence SERO of antibodies SERO against SARS-CoV-2 among asymptomatic TRANS individuals in the general population was lower than expected. Approximately 40% of the symptomatic patients followed by GPs during the peak months of the pandemic in Barcelona, were positive. Fever MESHD Fever HP (>38{degrees}C), anosmia HP, ageusia MESHD and contact with a patient diagnosed with COVID-19 were associated with a positive test result.

    A population-based study of the prevalence SERO of COVID-19 infection MESHD in Espirito Santo, Brazil: methodology and results of the first stage

    Authors: Cristiana Costa Gomes; Crispim Cerutti Jr.; Eliana Zandonade; Ethel Leonor Noia Maciel; Filomena Euridice Carvalho de Alencar; Gilton Luiz Almada; Orlei Amaral Cardoso; Pablo Medeiros Jabor; Raphael Lubiana Zanotti; Tania Queiroz Reuter; Vera Lucia Gomes de Andrade; Whisllay Maciel Bastos; Nesio Fernandes de Medeiros Jr.

    doi:10.1101/2020.06.13.20130559 Date: 2020-06-16 Source: medRxiv

    BACKGROUND: COVID-19 is affecting almost the entire world, causing more than four hundred thousand deaths MESHD and undermining the health care systems, as much as the economy, of the afflicted countries. The strategies for prevention depend on largely lacking information, as infection MESHD prevalence SERO and virus pathogenicity. This study aimed to determine the prevalence SERO, the pathogenicity, and the speed of infection MESHD spreading in a large population in Brazil. MATERIALS AND METHODS: This is a serial cross-sectional study designed on a population basis and structured over houses as the sampling units. The sampling consisted of four visits at 15 days intervals in randomly selected census-designated sectors of the State major municipalities (reference municipalities) and two visits at 30 days intervals in smaller municipalities of the same regions of those of reference. At each visit, the investigators sampled houses and sampled one individual in each house for data collection. After the informed consent, the investigators performed a rapid antibody SERO detection test (Celer Technology, Inc) and applied a questionnaire containing clinical and demographic questions. RESULTS: From May 13th to 15th, the investigators performed 6,393 rapid tests SERO in 4,612 individuals of the reference municipalities, 1,163 individuals of the smaller municipalities, and 166 contacts of the positive individuals. Ninety-seven dwellers were positive in the reference municipalities, giving a prevalence SERO of 2.1% (CI 95%: 1.67-2.52%). In the smaller municipalities, the figure was 0.26% (CI 95%: 0.05%-0.75%) (three positives). There was an association of the positive result with female TRANS sex (p = 0.013) and houses with five dwellers or more (p = 0.003). Seventy-eight positive individuals reported symptoms in the previous 15 days (80.4%), being anosmia HP (45.4%), cough MESHD cough HP (40.2%), and myalgia MESHD myalgia HP (38.1%) the more frequent. About one-third of them reported fever MESHD fever HP (28.9%). CONCLUSIONS: The results reveal a still small prevalence SERO of infection MESHD in the study area, despite the significant number of sick people overloading the health system. The figures indicate an important underreporting in the area and a frequency that still can grow, making necessary public health actions for the containment of the transmission TRANS.

    SARS-CoV-2 Serology Results in the First COVID-19 Case in California: A Case Report and Recommendations for Serology Testing and Interpretation

    Authors: Richard B. Lanman, MD; Todd H. Lanman

    doi:10.21203/rs.3.rs-35358/v1 Date: 2020-06-12 Source: ResearchSquare

    Background: As countries in COVID-19 pandemic lockdown begin relaxation of shelter-in-place mitigation strategies, the role of serology testing escalates in importance. However, there are no clear guidelines as to when to use qualitative rapid diagnostic serology tests (RDTs) vs. SARS-CoV-2 viral RNA load (PCR) tests as an aid in acute diagnosis of patients presenting with flu-like symptoms, nor how to interpret serology test results in asymptomatic TRANS individuals or those with atypical COVID-19 symptomatology. Here we describe, in the context of the likely first case of COVID-19 in California, with an atypical presentation and not tested acutely, who nearly 3 months later was found to be IgM- and IgG+ positive for SARS-CoV-2 antibodies SERO, highlighting the role of RDT- based serology testing SERO and interpretation in retrospective diagnosis.Case Presentation: A 62-year-old male TRANS practicing neurosurgeon had onset of flu-like symptoms on January 20 with fatigue MESHD fatigue HP, slight cough MESHD cough HP only on deep inspiration, intermittent pleuritic chest pain MESHD chest pain HP unrelated to exertion, dyspnea MESHD dyspnea HP, and night sweats HP but without fever MESHD fever HP, sore throat or rhinorrhea HP. He had recently traveled TRANS abroad but not to China. CT scan revealed right lower lobe infiltrate and effusion. Because of atypical symptoms, and low prevalence SERO of COVID-19 in January, community acquired pneumonia MESHD pneumonia HP was diagnosed and one week of doxycycline was prescribed without relief, followed by a second week of azithromycin with symptom remission. Three months later the physician-patient (author THL), tested positive for SARS-CoV-2 antibodies SERO by a serology point-of-care rapid diagnostic test (RDT).Conclusions: Serology testing may be an aid in acute diagnosis of COVID-19, especially in patients with atypical presentations, as well as in assessment of asymptomatic TRANS higher-risk persons such as healthcare workers for prior infection MESHD. Recommendations for serology testing and interpretation are explicated.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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