Corpus overview


Overview

MeSH Disease

Human Phenotype

Cough (67)

Fever (59)

Pneumonia (18)

Fatigue (17)

Myalgia (11)


Transmission

Seroprevalence
    displaying 1 - 10 records in total 67
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    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

    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.

    COVID-19 infection MESHD among healthcare workers: a cross-sectional study in southwest Iran

    Authors: Golnar Sabetian; Mohsen Moghadami; Leila Hashemizadeh Fard Haghighi; Mohammad Javad Fallahi; Reza Shahriarirad; Naeimehossadat Asmarian; Yalda Sadat Moeini

    doi:10.21203/rs.3.rs-47641/v1 Date: 2020-07-22 Source: ResearchSquare

    Objective: With the novel coronavirus pandemic, the impact on the healthcare system and workers cannot be overlooked.  However, studies on the infection MESHD status of medical personnel are still lacking. It is imperative to ensure the safety of health-care workers (HCWs) not only to safeguard continuous patient care but also to ensure they do not transmit the virus, therefore evaluation infection MESHD rates in these groups are indicated.Methods: Demographic and clinical data regarding infected cases among HCWs of Fars, Iran with positive SARS‐CoV‐2 PCR tests were obtained from 10th March to 16th May.Results: Our data demonstrated a rate of 5.62% (273 out of 4854 cases) infection MESHD among HCW, with a mean age TRANS of 35 years and a dominance of female TRANS cases (146 cases: 53.5%). The majority of infected cases were among nurses (51.3%) while the most case infection MESHD rate (CIR) was among physicians (27 out of 842 performed test (3.2%)). Also, the highest rate of infection MESHD was in the emergency MESHD rooms (30.6%). Also, 35.5% of the patients were asymptomatic TRANS and the most frequent clinical features among symptomatic patients were myalgia MESHD myalgia HP (46%) and cough MESHD cough HP (45.5%). Although 5.5% were admitted to hospitals, there were no reports of ICU admission. Furthermore, 10.3% of the cases reported transmitting the infection MESHD to family and friends TRANS. Regarding safety precautions, 1.6% didn't wear masks and 18.7% didn't use gloves in work environments. Conclusion: HCWs are among the highest groups at risk of infection TRANS risk of infection TRANS infection MESHD during the COVID-19 pandemic; therefore, analysis of the infection MESHD status of these groups is vital to maintain enough attention from the public, provide effective suggestions for government agencies and expanding protective measures is essential to decrease infection MESHD rates.

    High Number of RNA Copies in Asymptomatic TRANS Individuals Infected with SARS-CoV-2 in an Area of the Colombian Caribbean

    Authors: Salim Mattar; Caty Martinez-Bravo; Ricardo Rivero; Hector Contreras; Alvaro Faccini-Martinez; Camilo Guzman; Ketty Galeana; Nelson Alvis; Veronica Contreras; German Arrieta; Marco Gonzalez; Jorge Miranda; Martha Ospina; Francisco Camargo-Assis; Marcela Mercado; Evelyn Garay; Alejandra Garcia-Perez; Yesica Lopez; Vaneza Tique

    doi:10.21203/rs.3.rs-44324/v1 Date: 2020-07-16 Source: ResearchSquare

    Background.  Severe acute respiratory syndrome MESHD Coronavirus 2 (SARS-CoV-2) is an emerging pandemical virus that has caused millions of reported cases and hundreds of thousands of deaths MESHD in less than six months. South America has suffered the pandemic because it lacks the hospital and economic capacities needed to contain the pandemic's advance. Public health implications of transmission TRANS, while asymptomatic TRANS is a critical concern at the current pandemic.Objective: Describe the socio-demographic, clinical, and viral kinetics features of a cohort of SARS-CoV-2 infected individuals from the Colombian Caribbean. Methods: Six hundred eighty-six clinical samples from several hospital centers in the province were received between April 9th and May 16th, 2020. RNA was extracted using lysis buffers and spin columns. The samples were tested for SARS-CoV-2 by RT-qPCR (Reverse transcription real-time polymerase chain reaction) using commercially available multiplex real-time PCR assay for simultaneous detection of 3 target genes of SARS-CoV-2 (AllplexTM, 2019-nCoV assay, Korea). Viral copies quantification was done using a standard curve constructed from seriated dilutions of a SARS-CoV-2 positive control. Statics descriptive methods were used. Results: Thirty-five nasopharyngeal samples were positive for SARS-CoV-2 infection MESHD; the average age TRANS was 43 (range, 1-95 years). Seventeen of 35 (49%) of the patients showed symptoms. Most of them had cough MESHD cough HP, fever MESHD fever HP, and odynophagia HP, 3 of the patients reported having arthralgia MESHD arthralgia HP. Only two patients required hospitalization. None of the patients had known co-morbidities. RT-qPCR results show that two of the symptomatic patients had significantly higher RNA copies than the rest of the patients. Eighteen of 35 (51%) individuals were asymptomatic TRANS, the average age TRANS was 30 (range, 6-61 years. Four individuals showed a higher copy than some symptomatic patients. Nonetheless, the average of RNA copies 8.26 x10+10 was lower than the symptomatic.Conclusions: the population studied was young with an average of 43 years in symptomatic and 30 years of asymptomatic TRANS; this is important because of the high impact in the economy, and probably it is the cause of the reduced lethality observed in the department. Because a large proportion of infections MESHD probably result from transmission TRANS from asymptomatic TRANS or pre-symptomatic persons, the usefulness of public health interventions in Colombian provinces should be based in the molecular screening in a vast conglomerate's population and to quantify the viral load. 

    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.

    Maternal and perinatal characteristics and outcomes of pregnancies complicated with COVID-19 in Kuwait

    Authors: Amal Ayed; Alia Embaireeg; Asmaa Benawadth; Wadha Al-Fouzan; Majeda Hammoud; Monif Alhathal; Abeer Alzaydai; Mariam Ayed

    doi:10.1101/2020.07.10.20150623 Date: 2020-07-14 Source: medRxiv

    Background: In late December of 2019, a novel coronavirus (SARS-CoV-2) was identified in the Chinese city Wuhan among a cluster of pneumonia MESHD pneumonia HP patients. While it is known that pregnant women have reduced immunity and they are at risk for COVID-19 infection MESHD during the current pandemic, it is not clear if the disease MESHD manifestation would be different in pregnant women from non-pregnant women. Objectives: To describe the maternal and neonatal clinical features as well as outcome of pregnancies complicated with SARS-CoV-2 infection MESHD. Methods: In this retrospective national-based study, we analyzed the medical records of all SARS-CoV-2 positive pregnant patients and their neonates who were admitted to New-Jahra Hospital, Kuwait, between March 15th 2020 and May 31st 2020. The outcomes of pregnancies were assessed until the end date of follow-up (June 15th 2020). Results: A total of 185 pregnant women were enrolled with a median age TRANS of 31 years (interquartile range, IQR: 27.5-34), and median gestational age TRANS at diagnosis was 29 weeks (IQR: 18-34). The majority (88%) of the patients had mild symptoms, with fever MESHD fever HP (58%) being the most common presenting symptom followed by cough MESHD cough HP (50.6%). During the study period, 141 (76.2%) patients continued their pregnancy, 3 (1.6%) had a miscarriage, 1 (0.5%) had intrauterine fetal death MESHD and only 2 (1.1%) patients developed severe pneumonia MESHD pneumonia HP and required intensive care. Most of the neonates were asymptomatic TRANS, and only 2 (5%) of them tested positive on day 5 by nasopharyngeal swab testing. Conclusion: Pregnant women do not appear to be at higher risk to the COVID-19 than the general population. The clinical features of pregnant women with SARS-CoV-2 infection MESHD were similar to those of the general population having SARS-CoV-2 infection MESHD. Favorable maternal and neonatal outcomes reinforce the existing evidence and may guide healthcare professionals in the management of pregnancies complicated with SARS-CoV-2 infection MESHD.

    Staff testing for COVID-19 via an online pre-registration form

    Authors: Muhammad Saadiq Moolla; Arifa Parker; Mohammed Aslam Parker; Sthembiso Sithole; Leila Amien; Rubeena Chiecktey; Tasneem Bawa; Abdurasiet Mowlana

    doi:10.1101/2020.07.13.20152876 Date: 2020-07-14 Source: medRxiv

    Background: Healthcare workers are at increased risk of contracting SARS-CoV-2 and potentially causing institutional outbreaks. Staff testing is critical in identifying and isolating infected individuals while also reducing unnecessary workforce depletion. Tygerberg Hospital implemented an online pre-registration system to expedite staff and cluster testing. Objectives: We aimed to identify (1) specific presentations associated with a positive or negative result for SARS-CoV-2 and (2) staff sectors where enhanced strategies for testing might be required. Methods: Retrospective descriptive study involving all clients making use of the hospital's pre-registration system during May 2020. Results: Of 799 clients, most were young and female TRANS with few comorbidities. The most common occupation was nurses followed by administrative staff, doctors and general assistants. Doctors tested earlier compared to other staff (median: 1.5 vs 4 days). The most frequent presenting symptoms were headache MESHD headache HP, sore throat, cough MESHD cough HP and myalgia MESHD myalgia HP. Amongst those testing positive (n=105), fever MESHD fever HP, altered smell, altered taste sensation, chills MESHD chills HP and history of fever MESHD fever HP were the most common symptoms. Three or more symptoms was more predictive of a positive test, but 12/145 asymptomatic TRANS clients also tested positive. Conclusion: Staff coronavirus testing using an online pre-registration form is a viable and acceptable strategy. While some presentations are less likely to be associated with SARS-CoV-2 infection MESHD, no symptom can completely exclude it. Staff testing should form part of a bundle of strategies to protect staff including wearing masks, regular hand washing, buddy screening, physical distancing, availability of PPE and special dispensation for COVID-19-related leave.

    Clinical and Epidemiological Characteristics and Outcome of Patients With Covid-19 in Sri Lanka; An Observational Study

    Authors: Meththananda Herath; Jayasekera Madduma Mudiyanselage Priyamali thusharika; Pathirage Loku pathirage Manoji Muditha Kumari; Thushan Amila Wijesinghe Wedikkula Acharige; karthick Gunananthan; Bernard Pingamagae Don June; Nirosha Madhuwanthi Hettiarachchi; Thushari Dilrukshi Kaluthantrige Dona; Piyarathne Lasantha Roshan Samarakoon Pathirana Mudiyanselage; Nuwan Bhathiya Senevirathne; Sivajini Bhishman; Asanka Gunaseela Jayawardana Kankanamage Aruna Jayawardhana; Harsha Priya Sanjeewa Weerasinghe arachchige; Priyantha Balasooriya; Prasath Thushanthy; Ganaka Senarathna; Krishantha Jayasekera; Sutharshan Ponnuthurai; Suranga Ravinda Manilgama; Inoka Kumudini Jayasinghe; Thilak Widana Arachchilage Ananda Jayalath; Pirasath Selladurai

    doi:10.21203/rs.3.rs-42505/v1 Date: 2020-07-13 Source: ResearchSquare

    Background Clinical manifestations of coronavirus disease MESHD 2019 (COVID19) can vary from asymptomatic TRANS to profusely symptomatic due to many factors. Having data on the clinical characteristics of the affected patients is important for the screening and diagnosis of COVID-19. Main objective of this study is to evaluate the clinical and epidemiological characteristics and outcomes of patients with COVID-19 admitted to six treatment centres in Sri Lanka.Methods For the specific epidemic situation of COVID-19, we chose to conduct a descriptive retrospective study from six treatment centres in the country between March 10, 2020 and May 30, 2020.Results The study included 431 laboratory confirmed patients with COVID-19. Of them, 335 (78.2%) were males TRANS and their mean age TRANS was 37 years. Most patients (373: 86.5%) had had close contact TRANS with COVID-19 positive patients. The majority were asymptomatic TRANS (243: 56.3%) and of the symptomatic patients, the most common symptom was sore throat (81, 19%), followed by cough MESHD cough HP (72, 17%), headache MESHD headache HP (72, 17%), fever MESHD fever HP (50, 12%), and nasal discharge (36, 8%). Eight patients required either high dependency care or intensive unit care two of them succumbed to the illness (0.5%). Hydroxychloroquine (HCQ) was used as a treatment in 248 patients and they had a significantly longer (17.6 days) duration of hospital stays compared those who were not treated (13.6 days) with HCQ. When the HCQ was not used as a treatment, asymptomatic TRANS individuals had significantly shorter durations of hospital (11.1 days) stays compared to symptomatic individuals (14.3 days).Conclusions The majority of patients remained asymptomatic TRANS during the course of illness. The most common symptom was sore throat, seen in one fifth of patients, followed by cough MESHD cough HP, and headache MESHD headache HP. Our study also indicated the possibility of reduced viral clearance and hence longer duration of hospital stays with HCQ.

    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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