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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    COVID19: An Opinion on Animal Infections MESHD and Role of Veterinarians in One Health Perspective

    Authors: SWAGATIKA PRIYADARSINI; ROHIT SINGH; ARUN SOMAGOND; PUJA MECH

    id:10.20944/preprints202008.0069.v1 Date: 2020-08-03 Source: preprints.org

    Coronavirus disease MESHD is the current cause of global concern. The massive outbreak of COVID-19 has led the World Health Organization (WHO) to declare this as a pandemic situation. The Severe Acute Respiratory Syndrome MESHD Coronavirus-2 (SARSCoV-2) is responsible for COVID-19 leading to acute respiratory distress HP and substantial mortality in humans. However, the first laboratory confirmation of SARS-CoV-2 in a pet dog in Hong Kong has shown the possibility of human-to-animal transmission TRANS (zooanthroponotic) of the virus. Thereafter, many animals including cat, tiger, lion and mink have also been reported to acquire the virus in several countries. In this situation the role of veterinarian assumes important in treating the animals, helping in food security, disease MESHD diagnosis, surveillance and boosting the economy of livestock stakeholders at the grassroot level. In the absence of any selective vaccine or drug against SARS-CoV-2, the world is anticipated to triumph over this pandemic with collaborative, multisectoral, and transdisciplinary approach linking human, animal and environmental health. This article gives an insight into the confirmed SARS-CoV-2 outbreaks in animals, including the factors behind the shuffling of the virus among variety of species and also emphasizes on the role of veterinarian in managing and safeguarding public health so as to pave the way for adopting one health approach in order to conserve biodiversity.

    Clinical features and disease MESHD severity in an Iranian population of COVID-19 patients

    Authors: Shima Nabavi; Zahra Javidarabshahi; Abolghasem Allahyari; Mohammad Ramezani; Mohsen Seddigh-Shamsi; Sahar Ravanshad; Mina AkbariRad; Farnoosh Ebrahimzadeh; Shohre Khatami; Maryam Emadzadeh; Neda Saeedian; Ahmadreza Zarifian; Maryam Miri; Fariba Rezaeetalab; Sepide Hejazi; Reza Basiri; Mahnaz Mozdourian

    doi:10.21203/rs.3.rs-51568/v1 Date: 2020-07-31 Source: ResearchSquare

    Objectives: Coronavirus disease MESHD 2019 (COVID-19) can present with a variety of symptoms. Severity of the disease MESHD may be associated with several factors. Here, we review clinical features of COVID-19 patients with different severities.Methods: This cross-sectional study was performed in Imam Reza hospital, Mashhad, Iran, during February-April 2020. COVID-19 patients with typical computed tomography (CT) patterns and/or positive reverse-transcriptase polymerase chain reaction (RT-PCR) were included. The patients were classified into three groups of moderate, severe, and critical based on disease MESHD severity. Demographic, clinical, laboratory, and radiologic findings were collected and compared. P<0.05 was considered statistically significant.Results: Overall, 200 patients with mean age TRANS of 69.75±6.39 years, of whom 82 (41%) were female TRANS were studied. Disease MESHD was severe/critical in the majority of patients (167, 83.5%). Disease MESHD severity was significantly associated with age TRANS, malignant comorbidities, dyspnea MESHD dyspnea HP, nausea MESHD nausea/vomiting HP/ vomiting MESHD, confusion MESHD confusion HP, respiratory rate, pulse rate, O2 saturation, extent of CT involvement, serum SERO C-reactive protein (CRP), pH, pO2, and aspartate transaminase (P<0.05). Moreover, complications including shock MESHD shock HP, coagulopathy, acidosis MESHD acidosis HP, sepsis MESHD sepsis HP, acute respiratory distress HP syndrome MESHD (ARDS), intensive care unit (ICU) admission, and intubation were significantly higher in patients with higher severities. O2 saturation, nausea MESHD nausea/vomiting HP/ vomiting MESHD, and extent of lung CT involvement were independent predictors of severe/critical COVID-19 (OR=0.342, 45.93, and 25.48, respectively; P<0.05).Conclusions: Our results indicate O2 saturation, nausea MESHD nausea/vomiting HP/ vomiting MESHD, and extent of lung CT involvement as independent predictors of severe COVID-19 conditions. Serum SERO CRP levels and pO2 were also considerably higher patients with higher severity and can be used along with other factors as possible predictors of severe disease MESHD in COVID-19 patients.

    Increased number of pulmonary megakaryocytes in COVID-19 patients with diffuse alveolar damage. An autopsy study with clinical correlation and review of the literature.

    Authors: Mariel F. Valdivia-Mazeyra; Clara Salas; Jesús M. Nieves-Alonso; Luz Martín-Fragueiro; Carmen Bárcena; Patricia Muñoz-Hernández; Karen Villar-Zarra; Javier Martín-López; Fernando Ramasco-Rueda; Javier Fraga; José A. Jiménez-Heffernan

    doi:10.21203/rs.3.rs-49093/v1 Date: 2020-07-25 Source: ResearchSquare

    Megakaryocytes are normally present in the lung where they play a role in platelet homeostasis. The latter are well known to participate in the pathogenesis of lung damage, particularly in acute lung injury MESHD. Although megakaryocytes are usually not mentioned as a characteristic histopathologic finding associated to acute pulmonary injury, a few studies point out that their number is increased in the lungs of patients with diffuse alveolar damage. In this autopsy study we have observed a relevant number of pulmonary megakaryocytes in COVID-19 patients dying with acute respiratory distress HP syndrome MESHD. We have studied pulmonary tissue samples of 18 patients most of which died after prolonged disease MESHD and use of mechanical ventilation. Most samples showed fibroproliferative or fibrotic diffuse alveolar damage and an increased number of megakaryocytes. In six, thrombi of the pulmonary microcirculation were seen. We compare our findings with previous published autopsy reports, mainly focusing on the description of megakaryocytes. Our patients showed abnormal coagulation parameters with high levels of fibrinogen, D-dimers and variable thrombocytopenia MESHD thrombocytopenia HP. Since the lung is considered an active site of megakariopoiesis, a prothrombotic status leading to platelet activation, aggregation and consumption may trigger a compensatory pulmonary response. An increased number of pulmonary megakaryocytes suggests and supports a relation with the thrombotic events so often seen in COVID-19. Regardless of its etiology, future studies of patients dying with acute pulmonary injury should include pulmonary megakaryocytes as a histologic variable of interest.

    Cell type-specific immune dysregulation HP in severely ill COVID-19 patients

    Authors: Changfu Yao; Stephanie A Bora; Tanyalak Parimon; Tanzira Zaman; Oren A Friedman; Joseph A Palatinus; Nirmala S Surapaneni; Yuri P Matusov; Giuliana Cerro Chiang; Alexander G Kassar; Nayan Patel; Chelsi ER Green; Adam W Aziz; Harshpreet Suri; Jo Suda; Andres A Lopez; Gislaine A Martins; Barry R Stripp; Sina A Gharib; Helen S Goodridge; Peter Chen

    doi:10.1101/2020.07.23.20161182 Date: 2020-07-24 Source: medRxiv

    Coronavirus disease MESHD 2019 (COVID-19) has quickly become the most serious pandemic since the 1918 flu pandemic. In extreme situations, patients develop a dysregulated inflammatory lung injury MESHD called acute respiratory distress HP syndrome MESHD (ARDS) that causes progressive respiratory failure HP requiring mechanical ventilatory support. Recent studies have demonstrated immunologic dysfunction in severely ill COVID-19 patients. To further delineate the dysregulated immune response driving more severe clinical course from SARS-CoV-2 infection MESHD, we used single-cell RNA sequencing (scRNAseq) to analyze the transcriptome of peripheral blood SERO mononuclear cells (PBMC) from hospitalized COVID-19 patients having mild disease MESHD (n = 5), developing ARDS (n = 6), and recovering from ARDS (n = 6). Our data demonstrated an overwhelming inflammatory response with select immunodeficiencies HP within various immune populations in ARDS patients. Specifically, their monocytes had defects in antigen presentation and deficiencies in interferon responsiveness that contrasted the higher interferon signals in lymphocytes. Furthermore, cytotoxic activity was suppressed in both NK and CD8 lymphocytes whereas B cell activation was deficient, which is consistent with the delayed viral clearance in severely ill COVID-19 patients. Finally, we identified altered signaling pathways in the severe group that suggests immunosenescence and immunometabolic changes could be contributing to the dysfunctional immune response. Our study demonstrates that COVID-19 patients with ARDS have an immunologically distinct response when compared to those with a more innocuous disease MESHD course and show a state of immune imbalance in which deficiencies in both the innate and adaptive immune response may be contributing to a more severe disease MESHD course in COVID-19.

    Chronic Hemodialysis Patients have better outcomes with COVID-19 - a retrospective cohort study

    Authors: Ashutossh Naaraayan; Abhishek Nimkar; Amrah Hasan; Sushil Pant; Momcilo Durdevic; Henrik Elenius; Corina Nava Suarez; Prasanta Basak; Kameswari Lakshmi; Michael Mandel; Stephen Jesmajian

    doi:10.1101/2020.07.22.20159202 Date: 2020-07-24 Source: medRxiv

    Introduction Several comorbid conditions, have been identified as risk factors in patients with COVID-19. However, there is a dearth of data describing the impact of COVID-19 infection MESHD in patients with end-stage renal disease MESHD on hemodialysis (ESRD-HD). Methods This retrospective case series analyzed 362 adult TRANS patients consecutively hospitalized with confirmed COVID-19 illness between March 12, 2020 and May 13, 2020, at a teaching hospital in the New York City metropolitan area. Primary outcome was severe pneumonia MESHD pneumonia HP as defined by the World Health Organization. Secondary outcomes were: 1) the Combined Outcome of Acute respiratory distress HP syndrome MESHD or in-hospital Death MESHD (COAD), and 2) the need for High-levels of Oxygen supplementation (HiO2). Results Patients with ESRD-HD had lower odds for poor outcomes including severe pneumonia MESHD pneumonia HP [Odds Ratio (OR) 0.4, Confidence Interval (CI) (0.2-0.9) p=.04], HiO2 [OR 0.3, CI (0.1-0.8) p=.02] and COAD [OR 0.4, CI (0.2-1.05) p=.06], when compared to patients without ESRD. In contrast, higher odds for severe pneumonia MESHD pneumonia HP, COAD and HiO2 were seen with advancing age TRANS. African-Americans were over-represented in the hospitalized patient cohort, when compared to their representation in the community (35% vs 18%). Hispanics had higher odds for severe-illness and HiO2 when compared to Caucasians. Conclusions Patients with ESRD-HD had a milder course of illness with a lower likelihood of severe pneumonia MESHD pneumonia HP and a lesser need for aggressive oxygen supplementation when compared to patients not on chronic dialysis. This protective effect, might have a pathophysiologic basis and needs to be further explored.

    Early initiation of Extracorporeal Blood SERO Purification using the AN69ST (oXiris®) hemofilter as a treatment modality for COVID - 19 patients: a single-centre case series

    Authors: Petar Ugurov; Dijana Popevski; Tanja Gramosli; Dashurie Neziri; Dragica Vuckova; Emil Stoicovski; Lidija Veljanovska-Kiridjievska; Katerina Ignevska; Sanja Mehandziska; Elena Ambarkova; Rodney Alexander Rosalia; Zan Mitrev

    doi:10.21203/rs.3.rs-44717/v1 Date: 2020-07-17 Source: ResearchSquare

    Introduction: Our understanding of the COVID-19 disease MESHD has been steadily evolving since the original outbreak in December 2019. Advanced disease MESHD is characterised by a hyperinflammatory state, systemic coagulopathies and multiorgan involvement, in particular respiratory distress HP. We here describe our initial experience with treating of COVID-19 patients based on early initiation of extracorporeal blood SERO purification, systemic heparinisation and respiratory support.Methods: 15 patients were included; 2 were females TRANS. We monitored real-time several biochemical, immunological and coagulation biomarkers associated with disease MESHD severity following admission to our dedicated COVID-19 intensive care unit. To guide personalised treatment, we monitored among others levels of IL-6, IL-8, TNF-α, C-Reactive Protein (CRP), Neutrophil-to-Lymphocyte ratios, Thrombocyte counts, D-Dimers, Fibrinogen, and Activation Clotting time (ACT).Treatment consisted of individualised respiratory support supplemented with 1 - 4 cycles of 24-hour Extracorporeal Organ Support (ECOS) and Blood SERO Purification using the AN69ST (oXiris®) hemofilter. We administered heparin (300 U/kg) to counter suspected hypercoagulability HP (= elevated Fibrinogen or D-dimers) states to maintain ACT ≥ 180 seconds.Results: N = 10 presented with severe to critical disease MESHD (= dyspnoea, hypoxia MESHD, respiratory rate > 30/min, peripheral oxygen saturation < 90%, or > 50% lung involvement on X-ray imaging). A single case was admitted with a critical condition (= respiratory failure HP). One patient died after 5 days of hospitalisation after developing Acute Respiratory Syndrome MESHD. 8 Patients have been discharged - average ICU length-of-stay was 9.9 ± 2.4 days. Clinical improvement was associated with normalisation (increase) of thrombocytes, white blood SERO cells, stable levels of IL-6 (< 50 ng/mL) and a decrease of CRP and Fibrinogen. Conclusion: Means to monitor COVID-19 disease MESHD severity during hospitalisation are crucial to control disease progression MESHD and prevent hyperinflammation and irreversible multiorgan failure. We present here a real-time monitoring system accounting for biochemical, immunological, coagulation parameters and radiological imaging. The combination of systemic heparin anticoagulation regimens and blood SERO purification may prevent hyperinflammation, thromboembolism MESHD thromboembolism HP during hospitalisation and thus support clinical recovery. 

    Lung ultrasound and computed tomography to monitor COVID-19 pneumonia MESHD pneumonia HP in critically ill patients: a two-center prospective cohort study

    Authors: Micah Heldeweg; Jorge A. Lopez Matta; Mark E. Haaksma; Jasper M. Smit; Carlos V. Elzo Kraemer; Harm-Jan S. de Grooth; E. de Jonge; L.J. Meijboom; Leo M.A. Heunks; David J. van Westerloo; Pieter Roel Tuinman

    doi:10.21203/rs.3.rs-44726/v1 Date: 2020-07-17 Source: ResearchSquare

    Background: Lung ultrasound can adequately monitor disease MESHD severity in pneumonia MESHD pneumonia HP and acute respiratory distress HP syndrome MESHD. We hypothesize lung ultrasound can adequately monitor COVID-19 pneumonia MESHD pneumonia HP in critically ill patients. Methods: Adult TRANS patients with COVID-19 pneumonia MESHD pneumonia HP admitted to the intensive care unit of two academic hospitals who underwent a 12-zone lung ultrasound and a chest CT examination were included. Baseline characteristics, and outcomes including composite endpoint death MESHD or ICU stay >30 days were recorded. Lung ultrasound and CT images were quantified as a Lung Ultrasound Score Involvement index (LUSI) and CT Severity Involvement index (CTSI). Primary outcome was the correlation, agreement, and concordance between LUSI and CTSI. Secondary outcome was the association of LUSI and CTSI with the composite endpoints.Results: We included 55 ultrasound examinations in 34 patients, which were 88% were male TRANS, with a mean age TRANS of 63 years and mean P/F ratio of 151. The correlation between LUSI and CTSI was strong (r=0.795), with an overall 15% bias, and limits of agreement ranging -40 to 9.7. Concordance between changes in sequentially measured LUSI and CTSI was 81%. In the univariate model, high involvement on LUSI and CTSI were associated with a composite endpoint. In the multivariate model, LUSI was the only remaining independent predictor.Conclusions: Lung ultrasound can be used as an alternative for chest CT in monitoring COVID-19 pneumonia MESHD pneumonia HP in critically ill patients as it can quantify pulmonary involvement, register changes over the course of the disease MESHD, and predict death MESHD or ICU stay >30 days.Trial registration: NTR, NL8584. registered 01 May 2020 - retrospectively registered, https://www.trialregister.nl/trial/8584

    Increased serum SERO levels of soluble TNF-α receptor is associated with mortality of ICU COVID-19 patients

    Authors: Esmaeil Mortaz; Payam Tabarsi; Hamidreza Jamaati; Neda Dalil Roofchayee; Neda KakaDezfuli; Seyed MohammadReza Hashemian; Afshin Moniri; Majid Marjani; Majid Malekmohammd; Davood Manosuri; Mohammd Varahram; Gert Folkerts; Ian M Adcock

    doi:10.1101/2020.07.12.20152066 Date: 2020-07-15 Source: medRxiv

    Background: Severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) that causes coronavirus disease MESHD 2019 (COVID-19) has spread to almost 100 countries, infected over 10M patients and resulted in 505K deaths MESHD worldwide as of 30th June 2020. The major clinical feature of severe COVID-19 requiring ventilation is acute Respiratory Distress HP Syndrome MESHD (ARDS) with multi-functional failure as a result of a cytokine storm with increased serum SERO levels of cytokines such as TNF- and IL-6 being reported. TNF- levels are increased during the cytokine storm in very ill patients and soluble receptors for IL-6 and IL-2 are present in the blood SERO of COVID-19 patients, Objectives: To elucidate the involvement of serum SERO levels of soluble TNF-Receptor of severe and mild COVID-19 patients to determine for severity of disease MESHD. Method: We recruited 16 severe COVID-19 patients in the ICU on ventilator support and 26 milder COVID-19 patients who were hospitalised but not within the intensive care unit (ICU) between March-May 2020 at the Masih Daneshvari Hospital Tehran, Iran. After harvesting of whole blood SERO the serum SERO was isolated and soluble TNF-Receptor levels measured by ELISA SERO. Results: Serum SERO levels of the usually inhibitory soluble TNF receptor 1 (sTNFaR1) were significantly elevated in severe COVID-19 patients at admission to ICU. High serum SERO levels of sTNFaR1 were associated with mortality of severe COVID-19 patients treated within ICU. Conclusions: This pilot study demonstrates for role of STNF-aR1 receptor in severity of disease MESHD. Future studies should examine whether lower levels of systemic sTNFaR1 at admission may indicate a better disease MESHD outcome.

    Antibody SERO responses to SARS-CoV2 are distinct in children TRANS with MIS-C compared to adults TRANS with COVID-19

    Authors: Stuart P Weisberg; Thomas Connors; Yun Zhu; Matthew Baldwin; Wen-Hsuan Lin; Sandeep Wontakal; Peter A Szabo; Steven B Wells; Pranay Dogra; Joshua I Gray; Emma Idzikowski; Francesca Bovier; Julia Davis-Porada; Rei Matsumoto; Maya Meimei Li Poon; Michael P Chait; Cyrille Mathieu; Branka Horvat; Didier Decimo; Zachary C Bitan; Francesca La Carpia; Stephen A Ferrara; Emily Mace; Joshua Milner; Anne Moscona; Eldad A Hod; Matteo Porotto; Donna L Farber

    doi:10.1101/2020.07.12.20151068 Date: 2020-07-14 Source: medRxiv

    Clinical manifestations of COVID-19 caused by the novel coronavirus SARS-CoV-2 are associated with age TRANS. While children TRANS are largely spared from severe respiratory disease MESHD, they can present with a SARS-CoV-2-associated multisystem inflammatory syndrome MESHD (MIS-C) similar to Kawasaki's disease MESHD. Here, we show distinct antibody SERO (Ab) responses in children TRANS with MIS-C compared to adults TRANS with severe COVID-19 causing acute respiratory distress HP syndrome MESHD (ARDS), and those who recovered from mild disease MESHD. There was a reduced breadth and specificity of anti- SARS-CoV-2-specific antibodies SERO in MIS-C patients compared to the COVID patient groups; MIS-C predominantly generated IgG Abs specific for the Spike (S) protein but not for the nucleocapsid (N) protein, while both COVID-19 cohorts had anti-S IgG, IgM and IgA Abs, as well as anti-N IgG Abs. Moreover, MIS-C patients had reduced neutralizing activity compared to COVID-19 cohorts, indicating a reduced protective serological response. These results suggest a distinct infection MESHD course and immune response in children TRANS and adults TRANS who develop severe disease MESHD, with implications for optimizing treatments based on symptom and age TRANS.

    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.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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