Corpus overview


Overview

MeSH Disease

Cough (53)

Fever (49)

Infections (33)

Disease (23)

Fatigue (19)


Human Phenotype

Cough (53)

Fever (49)

Fatigue (19)

Dyspnea (13)

Anosmia (11)


Transmission

Seroprevalence
    displaying 1 - 10 records in total 53
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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

    Determinants of SARS-CoV-2 infection MESHD in Italian healthcare workers: a multicenter study

    Authors: Paolo Boffetta; Francesco Violante; Paolo Durando; Giuseppe De Palma; Enrico Pira; Luigi Vimercati; Alfonso Cristaudo; Giancarlo Icardi; Emma Sala; Maurizio Coggiola; Silvio Tafuri; Vittorio Gattini; Pietro Apostoli; Giovanna Spatari; - Working Group on SARS-CoV-2 infection in Italian healthcare workers

    doi:10.1101/2020.07.29.20158717 Date: 2020-07-30 Source: medRxiv

    Background. Healthcare workers (HCW) are at increased risk of being infected with SARS-CoV-2, yet limited information is available on risk factors of infection MESHD. Methods. We pooled data on occupational surveillance of 10,654 HCW who were tested for SARS-CoV-2 infection MESHD in six Italian centers. Information was available on demographics, job title, department of employment, source of exposure, use of personal protective equipment (PPE), and COVID-19-related symptoms. We fitted multivariable logistic regression models to calculate odds ratios (OR) and 95% confidence intervals (CI). Findings. The prevalence SERO of infection MESHD varied across centers and ranged from 3.0% to 22.0%, being strongly correlated with that of the respective areas. Women were at lower risk of infection TRANS risk of infection TRANS infection MESHD compared to men. Fever MESHD Fever HP, cough MESHD cough HP, dyspnea MESHD dyspnea HP and malaise were the symptoms most strongly associated with infection MESHD, together with anosmia HP and ageusia MESHD. No differences in the risk of infection TRANS risk of infection TRANS infection MESHD were detected between job titles, or working in a COVID-19 designated department. Reported contact with a patient inside or outside the workplace was a risk factor. Use of a mask was strongly protective against risk of infection TRANS risk of infection TRANS infection MESHD as was use of gloves. The use of a mask by the source of exposure (patient or colleague) had an independent effect in reducing infection MESHD infection risk TRANS infection risk TRANS risk.

    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.

    Association of olfactory dysfunction with hospitalization for COVID-19: a multicenter study in Kurdistan

    Authors: Hosna Zobairy; Erfan Shamsoddin; Mohammad Aziz Rasouli; Nasrollah Veisi Khodlan; Ghobad Moradi; Bushra Zareie; Sara Teymori; Jalal Asadi; Ahmad Sofi-Mahmudi; Ahmad R. Sedaghat

    doi:10.1101/2020.07.26.20158550 Date: 2020-07-28 Source: medRxiv

    Objective: To evaluate the association of olfactory dysfunction (OD) with hospitalization for COVID-19. Study Design: Multi-center cohort study. Setting: Emergency MESHD departments of thirteen COVID-19-designed hospitals in Kurdistan province, Iran. Subjects and Methods: Patients presenting with flu-like symptoms who tested positive by RT-PCR for COVID-19 between May 1st and 31st, 2020. At the time of presentation and enrollment, patients were asked about the presence of OD, fever MESHD fever HP, cough MESHD cough HP, shortness of breath, headache MESHD headache HP, rhinorrhea HP and sore throat. The severity of OD was assessed on an 11-point scale from 0 (none) to 10 ( anosmia HP). Patients were either hospitalized or sent home for outpatient care based on standardized criteria. Results: Of 203 patients, who presented at a mean of 6 days into the COVID-19 disease MESHD course, 25 patients (12.3%) had new OD and 138 patients (68.0%) were admitted for their COVID-19. Patients admitted for COVID-19 had a higher prevalence SERO of all symptoms assessed, including OD (p<0.05 in all cases), and OD identified admitted patients with 84.0% sensitivity SERO and 34.3% specificity. On univariate logistic regression, hospitalization was associated with OD (odds ratio [OR] = 2.47, 95%CI: 1.085-6.911, p=0.049). However, hospitalization for COVID-19 was not associated with OD (OR=3.22, 95% CI: 0.57-18.31, p=0.188) after controlling for confounding demographics and comorbidities. Conclusion: OD may be associated with hospitalization for (and therefore more severe) COVID-19. However, this association between OD and COVID-19 severity is more likely driven by patient characteristics linked to OD, such as greater numbers of COVID-19 symptoms experienced or high-risk comorbidities.

    Older adults TRANS hospitalized with Covid-19: Clinical characteristics and early outcomes from a single center in Istanbul, Turkey 

    Authors: Alpay Medetalibeyoğlu; Naci Senkal; Murat Kose; Yunus Catma; Emine Bilge Caparali; Mustafa Erelel; Mustafa Oral Oncul; Gulistan Bahat; Tufan Tukek

    doi:10.21203/rs.3.rs-47728/v1 Date: 2020-07-22 Source: ResearchSquare

    Objective: Older adults TRANS have been continuously reported to be at higher risk for adverse outcomes of Covid-19. We aimed to describe clinical characteristics and early outcomes of the older Covid-19 patients hospitalized in our center comparatively with the younger patients, and also to analyze the triage factors that were related to the in-hospital mortality of older adults TRANS.Design: Retrospective; observational studySetting: Istanbul Faculty of Medicine hospital, TurkeyParticipants: 362 hospitalized patients with laboratory-confirmed Covid-19 from March 11 to May 11, 2020.Measurements: The demographic information; associated comorbidities; presenting clinical, laboratory, radiological characteristics on admission and outcomes from the electronic medical records were analyzed comparatively between the younger (<65 years) and older (≥65 years) adults TRANS. Factors associated with in-hospital mortality of the older adults TRANS were analyzed by multivariate regression analyses.Results: The median age TRANS was 56 years (interquartile range [IQR], 46-67), and 224 (61.9%) were male TRANS. There were 104 (28.7%) patients ≥65 years of age TRANS. More than half of the patients (58%) had one or more chronic comorbidity. The three most common presenting symptoms in the older patients were fatigue MESHD fatigue HP/ myalgia MESHD myalgia HP (89.4%), dry cough MESHD cough HP (72.1%), and fever MESHD fever HP (63.5%). Cough MESHD Cough HP and fever MESHD fever HP were significantly less prevalent in older adults TRANS compared to younger patients (p=0.001 and 0.008, respectively). Clinically severe pneumonia MESHD pneumonia HP was present in 31.5% of the study population being more common in older adults TRANS (49% vs. 24.4%) (p<0.001). The laboratory parameters that were significantly different between the older and younger adults TRANS were as follows: the older patients had significantly higher CRP, D-dimer, TnT, pro-BNP, procalcitonin levels, higher prevalence SERO of lymphopenia MESHD lymphopenia HP, neutrophilia HP, increased creatinine, and lower hemoglobin, ALT, albumin level (p<0.05). In the radiological evaluation, more than half of the patients (54.6%) had moderate-severe pneumonia MESHD pneumonia HP, which was more prevalent in older patients (66% vs. 50%) (p=0.006). The adverse outcomes were significantly more prevalent in older adults TRANS compared to the younger patients (ICU admission, 28.8% vs. 8.9%; mortality, 23.1% vs. 4.3%, p<0.001).  Among the triage evaluation parameters, the only factor associated with higher mortality was the presence of clinically severe pneumonia MESHD pneumonia HP on admission (Odds Ratio=12.3, 95% confidence interval=2.7-55.5, p=0.001).Conclusion: Older patients presented with more prevalent chronic comorbidities, less prevalent symptomatology but more severe respiratory signs and laboratory abnormalities than the younger patients. Among the triage assessment factors, the clinical evaluation of pulmonary involvement came in front to help clinicians to stratify the patients for mortality risk.

    Longitudinal symptom dynamics of COVID-19 infection MESHD in primary care

    Authors: Barak Mizrahi; Smadar Shilo; Hagai Rossman; Nir Kalkstein; Karni Marcus; Yael Barer; Ayya Keshet; Na'ama Shamir-Stein; Varda Shalev; Anat Ekka Zohar; Gabriel Chodick; Eran Segal

    doi:10.1101/2020.07.13.20151795 Date: 2020-07-14 Source: medRxiv

    Objective : Data regarding the clinical characteristics of COVID-19 infection MESHD is rapidly accumulating. However, most studies thus far are based on hospitalized patients and lack longitudinal follow up. As the majority of COVID-19 cases are not hospitalized, prospective studies of symptoms in the population presenting to primary care are needed. Here, we assess the longitudinal dynamic of clinical symptoms in non-hospitalized individuals prior to and throughout the diagnosis of SARS-CoV-2 infection MESHD. Design Data on symptoms were extracted from electronic health records (EHR) consisting of both results of PCR tests and symptoms recorded by primary care physicians, and linked longitudinal self reported symptoms. Setting The second largest Health Maintenance Organization in Israel , Maccabi Health Services Participants From 1/3/2020 to 07/06/2020, information on symptoms from either surveys or primary care visits was available for 206,377 individuals, including 2,471 who tested positive for COVID-19. Main Outcomes Longitudinal prevalence SERO of clinical symptoms in COVID-19 infection MESHD diagnosed by PCR testing for SARS-CoV-2 from nasopharyngeal swabs. Results: In adults TRANS, the most prevalent symptoms recorded in EHR were cough MESHD cough HP (11.6%), fever MESHD fever HP (10.3%), and myalgia MESHD myalgia HP (7.7%) and the most prevalent self-reported symptoms were cough MESHD cough HP (21%), fatigue MESHD fatigue HP (19%) and rhinorrhea HP and/or nasal congestion (17%). In children TRANS, the most prevalent symptoms recorded in the EHR were fever MESHD fever HP (7%), cough MESHD cough HP (5.5%) and abdominal pain MESHD abdominal pain HP (2.4%) . Emotional disturbances were documented in 15.9% of the positive adults TRANS and 4.2% of the children TRANS. Loss of taste and smell, either self-reported or documented by a physician, 3 weeks prior to testing, were the most discriminative symptoms in adults TRANS (OR =11.18 and OR=5.47 respectively). Additional symptoms included self reported headache MESHD headache HP (OR = 2.03) and fatigue MESHD fatigue HP (OR = 1.73) and a documentation of syncope MESHD syncope HP, rhinorrhea HP (OR = 2.09 for both ) and fever MESHD fever HP (OR= 1.62 ) by a physician. Mean time to recovery TRANS was 23.5 +- 9.9 days. Children TRANS had a significantly shorter disease MESHD duration (21.7 +- 8.8 days, p-value=0.01). Several symptoms, including fatigue MESHD fatigue HP, myalgia MESHD myalgia HP, runny nose and shortness of breath were reported weeks after recovery. Conclusions As the COVID-19 pandemic progresses rapidly worldwide, obtaining accurate information on symptoms and their progression is of essence. Our study shed light on the full clinical spectrum of symptoms experienced by infected individuals in primary care, and may alert physicians for the possibility of COVID-19 infection MESHD.

    Diagnostic value of skin manifestation MESHD of SARS-CoV-2 infection MESHD

    Authors: Veronique Bataille; Alessia Visconti; Niccolo' Rossi; Benjamin Murray; Abigail Bournot; Jonathan Wolf; Sebastien Ourselin; Claire Steves; Timothy Spector; Mario Falchi

    doi:10.1101/2020.07.10.20150656 Date: 2020-07-11 Source: medRxiv

    SARS-CoV-2 causes multiple immune-related reactions at various stages of the disease MESHD. The wide variety of skin presentations has delayed linking these to the virus. Previous studies had attempted to look at the prevalence SERO and timing of SARS-COV-2 rashes but were based on mostly hospitalized severe cases and had little follow up. Using data collected on a subset of 336,847 eligible UK users of the COVID Symptom Study app, we observed that 8.8% of the swab positive cases (total: 2,021 subjects) reported either a body rash or an acral rash, compared to 5.4% of those with a negative swab test (total: 25,136). Together, these two skin presentations showed an odds ratio (OR) of 1.67 (95% confidence interval [CI]: 1.41-1.96) for being swab positive. Skin rashes HP were also predictive in the larger untested group of symptomatic app users (N=54,652), as 8.2% of those who had reported at least one classical COVID-19 symptom, i.e., fever MESHD fever HP, persistent cough MESHD cough HP, and/or anosmia HP, also reported a rash. Data from an independent online survey of 11,546 respondents with a rash showed that in 17% of swab positive cases, the rash was the initial presentation. Furthermore, in 21%, the rash was the only clinical sign. Skin rashes HP cluster with other COVID-19 symptoms, are predictive of a positive swab test and occur in a significant number of cases, either alone or before other classical symptoms. Recognising rashes is important in identifying new and earlier COVID-19 cases.

    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.

    Health-care workers with COVID-19 living in Mexico City: clinical characterization and related outcomes

    Authors: Neftali Eduardo Antonio-Villa; Omar Yaxmehen Bello-Chavolla; Arsenio Vargas-Vazquez; Carlos A. Fermin-Martinez; Alejandro Marquez-Salinas; Jessica Paola Bahena-Lopez

    doi:10.1101/2020.07.02.20145169 Date: 2020-07-04 Source: medRxiv

    BACKGROUND: Health-care workers (HCWs) have increased risk for SARS-CoV-2 infection MESHD. Information about the prevalence SERO and risk factors for adverse outcomes in HCWs is scarce in Mexico. Here, we aimed to explore prevalence SERO of SARS-CoV-2, symptoms, and risk factors associated with adverse outcomes in HCWs in Mexico City. METHODS: We explored data collected by the National Epidemiological Surveillance System in Mexico City. All cases underwent real-time RT-PCR test. We explored outcomes related to severe COVID-19 in HCWs and the diagnostic performance SERO of symptoms to detect SARS-CoV-2 infection MESHD in HCWs. RESULTS: As of July 2nd, 2020, 34,263 HCWs were tested for SARS-CoV-2, and 10,925 were confirmed (31.9%). Overall, 4,200 were nurses (38.4%), 3,244 physicians (29.7%), 126 dentists (1.15%) and 3,355 laboratory personnel and other HCWs (30.7%). After follow-up, 992 HCWs required hospitalization (9.08%), 206 developed severe outcomes (1.89%), and 90 required mechanical-ventilatory support (0.82%). Lethality was recorded in 224 (2.05%) cases. Symptoms associated with SARS-CoV-2 positivity were fever MESHD fever HP, cough MESHD cough HP, malaise, shivering HP, myalgias MESHD myalgias HP at evaluation but neither had significant predictive value. We also identified 333 asymptomatic TRANS SARS-CoV-2 infections MESHD (3.05%). Older HCWs with chronic non- communicable diseases MESHD, pregnancy, and severe respiratory symptoms were associated with higher risk for adverse outcomes. Physicians had higher risk for hospitalization and for severe outcomes compared with nurses and other HCWs. CONCLUSIONS: We report a high prevalence SERO of SARS-CoV-2 in HCWs in Mexico City. No symptomatology can accurately discern HCWs with SARS-CoV-2 infection MESHD. Particular attention should focus on HCWs with risk factors to prevent adverse outcomes and reduce infection MESHD infection risk TRANS infection risk TRANS risk.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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