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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Predicting clinical outcome with phenotypic clusters in COVID-19 pneumonia HP pneumonia MESHD: 2 an analysis of 12,066 hospitalized patients from the Spanish registry SEMI-3 COVID-19.

    Authors: Manuel Rubio-Rivas; Xavier Corbella; Jose Maria Mora-Lujan; Jose Loureiro Amigo; Almudena Lopez Sampalo; Carmen Yera Bergua; Pedro Jesus Esteve Atienzar; Luis Felipe Diez Garcia; Ruth Gonzalez Ferrer; Susana Plaza Canteli; Antia Perez Pineiro; Begona Cortes Rodriguez; Leyre Jorquer Vidal; Ignacio Perez Catalan; Marta Leon Tellez; Jose Angel Martin Oterino; Maria Candelaria Martin Gonzalez; Jose Luis Serrano Carrillo de Albornoz; Eva Garcia Sardon; Jose Nicolas Alcala Pedrajas; Anabel Martin Urda Diez Canseco; Maria Jose Esteban Giner; Pablo Telleria Gomez; Ricardo Gomez Huelgas; Jose Manuel Ramos Rincon; Nina la Cour Freiesleben; Henriette Svarre Nielsen

    doi:10.1101/2020.09.14.20193995 Date: 2020-09-15 Source: medRxiv

    (1) Background: This study aims to identify different clinical phenotypes in COVID-19 88 pneumonia HP pneumonia MESHD using cluster analysis and to assess the prognostic impact among identified clusters in 89 such patients. (2) Methods: Cluster analysis including 11 phenotypic variables was performed in a 90 large cohort of 12,066 COVID-19 patients, collected and followed-up from March 1, to July 31, 2020, 91 from the nationwide Spanish SEMI-COVID-19 Registry. (3) Results: Of the total of 12,066 patients 92 included in the study, most were males TRANS (7,052, 58.5%) and Caucasian (10,635, 89.5%), with a mean 93 age TRANS at diagnosis of 67 years (SD 16). The main pre-admission comorbidities were arterial 94 hypertension HP hypertension MESHD (6,030, 50%), hyperlipidemia HP hyperlipidemia MESHD (4,741, 39.4%) and diabetes mellitus HP diabetes mellitus MESHD (2,309, 19.2%). The 95 average number of days from COVID-19 symptom onset TRANS to hospital admission was 6.7 days (SD 7). 96 The triad of fever HP fever MESHD, cough HP cough MESHD, and dyspnea HP dyspnea MESHD was present almost uniformly in all 4 clinical phenotypes 97 identified by clustering. Cluster C1 (8,737 patients, 72.4%) was the largest, and comprised patients 98 with the triad alone. Cluster C2 (1,196 patients, 9.9%) also presented with ageusia and anosmia MESHD anosmia HP; 99 cluster C3 (880 patients, 7.3%) also had arthromyalgia, headache HP headache MESHD, and sore throat; and cluster C4 100 (1,253 patients, 10.4%) also manifested with diarrhea HP diarrhea MESHD, vomiting HP vomiting MESHD, and abdominal pain HP abdominal pain MESHD. Compared to 101 each other, cluster C1 presented the highest in-hospital mortality (24.1% vs. 4.3% vs. 14.7% vs. 102 18.6%; p<0.001). The multivariate study identified phenotypic clusters as an independent factor for 103 in-hospital death. (4) Conclusion: The present study identified 4 phenotypic clusters in patients with 104 COVID-19 pneumonia HP pneumonia MESHD, which predicted the in-hospital prognosis of clinical outcomes.

    Clinical Characteristics, Risk Factors and Predictive Value of COVID-19 Pneumonia HP: A Retrospective Study of 173 Patients in Wuhan, China

    Authors: Yang Zhang; Jun Xue; Mi Yan; Jing Chen; Hai Liu; Shao-Bo Wang; Jian-Xing Luo; Fang Yang; Jian-Yuan Tang; Xiao-Yu Hu

    doi:10.21203/rs.3.rs-76134/v1 Date: 2020-09-11 Source: ResearchSquare

    Background: COVID-19 is a globally emerging infectious disease MESHD. As the global epidemic continues to spread, the risk of COVID-19 transmission TRANS and diffusion in the world will also remain. Currently, several studies describing its clinical characteristics have focused on the initial outbreak, but rarely to the later stage. Here we described clinical characteristics, risk factors for disease severity and in-hospital outcome in patients with COVID-19 pneumonia HP pneumonia MESHD from Wuhan. Methods: Patients with COVID-19 pneumonia HP pneumonia MESHD admitted to Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 13 to March 8, 2020, were retrospectively enrolled. Multivariable logistic regression analysis was used to identify risk factors for disease severity and in-hospital outcome and establish predictive models. Receiver operating characteristic (ROC) curve was used to assess the predictive value of above models.Results: 106 (61.3%) of the patients were female TRANS. The mean age TRANS of study populations was 62.0 years, of whom 73 (42.2%) had underlying comorbidities mainly including hypertension HP hypertension MESHD (24.9%). The most common symptoms on admission were fever HP fever MESHD (67.6%) and cough HP (60.1%), digestive symptoms (22.0%) was also very common. Older age TRANS (OR: 3.420; 95%Cl: 1.415-8.266; P=0.006), diarrhea HP diarrhea MESHD (OR: 0.143; 95%Cl: 0.033-0.611; P=0.009) and lymphopenia HP lymphopenia MESHD (OR: 4.769; 95%Cl: 2.019-11.266; P=0.000) were associated with severe illness on admission; the area under the ROC curve (AUC) of predictive model were 0.860 (95%CI: 0.802-0.918; P=0.000). Older age TRANS (OR: 0.309; 95%Cl: 0.142-0.674; P=0.003), leucopenia (OR: 0.165; 95%Cl: 0.034-0.793; P=0.025), increased lactic dehydrogenase (OR: 0.257; 95%Cl: 0.100-0.659; P=0.005) and interleukins-6 levels (OR: 0.294; 95%Cl: 0.099-0.872; P=0.027) were associated with poor in-hospital outcome; AUC of predictive model were 0.752 (95%CI: 0.681-0.824; P=0.000).Conclusion: Older patients with diarrhea HP diarrhea MESHD and lymphopenia HP lymphopenia MESHD need early identification and timely intervention to prevent the progression to severe COVID-19 pneumonia HP pneumonia MESHD. However, older patients with leucopenia, increased lactic dehydrogenase and interleukins-6 levels are at a high risk for poor in-hospital outcome.Trial registration: ChiCTR2000029549

    Characteristics and Prognosis of COVID-19 in Patients with COPD MESHD

    Authors: Desirée Graziani; Joan B Soriano; Carlos Del Rio-Bermudez; Diego Morena; Teresa Díaz; María Castillo; Miguel Alonso; Julio Ancochea; José Luis Izquierdo

    id:10.20944/preprints202009.0242.v1 Date: 2020-09-11 Source: Preprints.org

    Patients with COPD MESHD have a higher prevalence SERO of coronary ischemia MESHD and other factors that put them at risk for COVID-19-related complications. We aimed to explore the impact of COVID-19 in a large population-based sample of patients with COPD MESHD in Castilla-La Mancha MESHD, Spain. We analyzed clinical data in electronic health records from January 1st to May 10th, 2020 by using Natural Language Processing through the SAVANA Manager® clinical platform. Out of 31,633 COPD MESHD patients, 793 had a diagnosis of COVID-19. The proportion of patients with COVID-19 in the COPD population (2,51%; CI95% 2,33 – 2,68) was significantly higher than in the general population aged TRANS > 40 years (1,16%; 95%CI 1,14 – 1,18); P < .001. Compared with COPD-free individuals, COPD MESHD patients with COVID-19 showed significantly poorer disease prognosis, as evaluated by hospitalizations (31,1 % vs 39,8%: OR 1,57; 95%CI 1,14 – 1,18) and mortality (3,4% vs 9,3%: OR 2,93; 95%CI 2,27 – 3,79). Patients with COPD MESHD and COVID-19 were significantly older (75 vs. 66 years), predominantly male TRANS (83% vs 17%), smoked more frequently, and had more comorbidities than their non-COPD counterparts. Pneumonia HP was the most common diagnosis among COPD MESHD patients hospitalized due to COVID-19 (59%); 19% of patients showed pulmonary infiltrates HP suggestive of pneumonia HP pneumonia MESHD and heart failure MESHD. Mortality in COPD MESHD patients with COVID-19 was associated with older age TRANS and prevalence SERO of heart failure MESHD (P<0.05). COPD MESHD patients with COVID-19 showed higher rates of hospitalization and mortality, mainly associated with pneumonia HP pneumonia MESHD. This clinical profile is different from exacerbations caused by other respiratory viruses in the winter season.

    Low-dose Whole-lung Irradiation for COVID-19 Pneumonia HP: What is the Optimal Dose? Final Results of a Pilot Study

    Authors: Ahmad Ameri; Pooya Ameri; Nazanin Rahnama; Majid Mokhtari; Meghdad Sedaghat; Fahimeh Hadavand; Rama Bozorgmehr; Mehrdad Haghighi; Farzad Taghizadeh-Hesary

    id:10.20944/preprints202009.0229.v1 Date: 2020-09-10 Source: Preprints.org

    Purpose: Novel coronavirus disease MESHD (COVID-19) is the current global concern. Radiotherapy (RT), commonly employed in cancer MESHD management, has been considered one of the potential treatments for COVID-19 pneumonia HP pneumonia MESHD. Here, we present the final report of the pilot trial evaluating the efficacy and safety of low-dose whole-lung irradiation (LD-WLI) in patients with COVID-19 pneumonia HP pneumonia MESHD. Methods and Materials: We enrolled patients with moderate COVID-19 pneumonia HP pneumonia MESHD who were older than 60 years. Participants were treated with LD-WLI in a single fraction of 0.5 or 1.0Gy along with the national protocol of COVID-19. The primary endpoints were improvement of SpO2, the number of hospital/ICU stay days, and the number of intubations after RT and the secondary endpoints were alterations of the c-reactive peptide, interleukin-6, ferritin, procalcitonin, and D-dimer. The response rate (RR) was defined as a rise in SpO2 upon RT with rising or constant trend in the next two days, and clinical recovery (CR) included patients who were discharged from the hospital or acquired SpO2 ≥93% on room air. Results: Between 21 May 2020 and 2 July 2020, ten patients were enrolled. The median age TRANS was 75 years, 80% were male TRANS, and 80% had comorbidities. The first five patients received a single 0.5Gy-WLI, and others received 1.0Gy. Patients were followed for 2-14 days (median 5.5 days). Following one day, nine patients experienced an improvement in SpO2. Five patients were discharged (median 6th day, range 2nd-14th day), and four patients died (median 7th day, range 3rd-10th day). Overall, the RR and CR were 60.0% and 55.5%, respectively. The RR and CR rates of 0.5- and 1.0Gy group were 80% vs 40% and 75% vs 40%, respectively. No acute radiation-induced toxicity MESHD was recorded. Conclusions: LD-WLI with a single 0.5Gy fraction seems to be a more appropriate dose to warrant further evaluation in a large-scale, randomized trial.

    Is there a correlation between pulmonary inflammation MESHD index with COVID-19 disease severity and outcome?

    Authors: Aliae Mohamed-Hussein; Islam Galal; Mohammed Mustafa Abdel Rasik Mohamed; Howaida Abd Elaal; Karim ME Aly; Shaikha Sami Abushaikha; Mujeeb Chettiyam Kandy; John Gibb; Sue VandeWoude; Robyn Esterbauer; Samantha K Davis; Helen E Kent; Francesca L Mordant; Timothy E Schlub; David L Gordon; David S Khoury; Kanta Subbarao; Deborah Cromer; Tom P Gordon; Amy W Chung; Miles P Davenport; Stephen J Kent

    doi:10.1101/2020.09.09.20182592 Date: 2020-09-10 Source: medRxiv

    Rational: the radiologic pulmonary inflammatory index (PII) may be used as early predictor of inflammation MESHD as laboratory assessments in COVID-19. The purpose of this study was to compare the clinical and radiological features between the cases of COVID-19 necessitating ICU and those who did not, and to correlate the PII with other inflammatory markers and outcome. Patients and methods: This study included 72 patients with confirmed COVID-19. Their electronic records of were retrospectively revised and the demographic, clinical, laboratory, HRCT data, PII and the outcomes of the patients were analyzed. Results: They were 50/50% males TRANS/ females TRANS, mean age TRANS was 47.1 (16.8). During their stay, 15.3% necessitated ICU admittance, 68% cured, 9 cases referred and five cases (6.9%) died. The baseline lesions identified were ground glass opacification in (93%), higher PII and >3 lobes affection were considerably recorded in those who required ICU (P= 0.041 and 0.013). There were correlations between PII with age TRANS (r=0.264, P=0.031), ferritin (r=0.225, P=0.048) and D Dimer (r=0.271, P=0.043). Conclusions: The use of PII together with clinical and laboratory data may be valuable in defining the inflammatory state of COVID-19. It was correlated with other inflammatory indices as D dimer, ferritin even before clinical deterioration.

    Convalescent plasma SERO as potential therapy for severe COVID-19 pneumonia HP pneumonia MESHD.

    Authors: Ricardo Valentini; Juan Dupont; Jose Fernandez; Jorge Solimano; Fernando Palizas; Dardo Riveros; Pablo Saul; Laura Dupont; Juan Medina; Viviana Falasco; Florencia Fornillo; Julia Laviano; Daniela Maymo; Daniel Gotta; Alfredo Martinez; Pablo Bonvehi

    doi:10.1101/2020.09.01.20184390 Date: 2020-09-07 Source: medRxiv

    At the beginning of the COVID-19 pandemic, there was high mortality and a lack of effective treatment for critically ill MESHD patients. Build on the experience in argentine hemorrhagic fever MESHD fever HP with convalescent plasma SERO, we incorporated 90 patients into a multicenter study, and 87 were evaluable. We collected 397 donations from 278 convalescent donors. Patients received plasma SERO with an IgG concentration of 0.7-0.8 (measured by Abbott chemiluminescence) for every 10 kg of body weight. Survival during the first 28 days was the primary objective. 77% were male TRANS, age TRANS 54 (+/-15.6 y/o (range 27-85); body mass index 29.7 +/-; 4,4; hypertension HP 39% and diabetes 20%; 19.5% had an immunosuppression condition; 23% were healthcare workers. Plasma SERO was administered to 55 patients (63%) on spontaneous breathing with oxygen supplementation (mainly oxygen mask with reservoir bag in 80%), and 32 patients (37%) were infused on mechanical ventilation. The 28-day survival rate was 80%, with 91% in patients infused on spontaneous breathing and 63% in those infused on mechanical ventilation (p = 0.0002). There was a significant improvement in the WHO pneumonia HP clinical scale at 7 and 14 days, and in PaO2 / FiO2, ferritin and LDH, in the week post-infusion. We observed an episode of circulatory volume overload and a febrile reaction, both mild. Convalescent plasma SERO infusions are feasible, safe, and potentially effective, especially before requiring mechanical ventilation, and are an attractive clinical option for treating severe forms of COVID-19 until other effective therapies become available.

    G6PD deficiency MESHD and severity of COVID19 pneumonia HP pneumonia MESHD and acute respiratory distress syndrome MESHD respiratory distress HP syndrome: tip of the iceberg?

    Authors: Jihad G. Youssef; Faisal Zahiruddin; George Youssef; Sriram Padmanabhan; Joe Ensor; Sai Ravi Pingali; Youli Zu; Sandeep Sahay; Swaminathan P. Iyer

    doi:10.21203/rs.3.rs-72639/v1 Date: 2020-09-05 Source: ResearchSquare

    The severe pneumonia HP pneumonia MESHD caused by human coronavirus (hCoV)-SARS-CoV-2 has inflicted heavy causalities, especially among the elderly TRANS and those with comorbid illnesses irrespective of age TRANS. The high mortality in African Americans and males TRANS, in general, raises concern for a possible X-linked mediated process that could affect viral pathogenesis and the immune system. We hypothesized that G6PD, the most common X-linked enzyme deficiency MESHD associated with redox status, may have a role in the severity of pneumonia HP pneumonia MESHD. A retrospective chart review was performed in hospitalized patients with COVID19 pneumonia HP pneumonia MESHD needing supplemental oxygen. A total of 17 patients were evaluated: six with G6PD deficiency MESHD and 11 with normal levels. The two groups (normal and G6PD def) were comparable in terms of age TRANS, sex and comorbidities and laboratory parameters LDH, IL-6, CRP, and ferritin. Thirteen patients needed ventilatory support, with 6 in the G6PD group (83% vs. 72%). The main differences indicating increasing severity in the G6PD def group included G6PD levels (12.2 vs. 5.6, P=0.0002), PaO2/FiO2 ratio (159 vs. 108, P=0.05), days before intubation (2.5 vs. 4.8 P= 0.03), days on mechanical ventilation (10.25 vs. 21 days P=0.04), hemoglobin level (10 vs. 8.1 P=0.03) and hematocrit (32 vs. 26 P=0.015). Only one patient with G6PD deficiency MESHD died; 16 were discharged home. Our clinical series ascribes a possible biological role for G6PD deficiency MESHD in SARS-CoV2 viral proliferation. It is imperative that further studies be performed to understand the interplay between the viral and host factors in G6PD deficiency MESHD that may lead to disparity in outcomes. 

    Risk Factors For COVID-19 Positivity in Hospitalized Patients in A Low Prevalence SERO Setting

    Authors: Iris Zohar; Orna Schwartz; Debby Ben David; Margarita Mashavi; Mohamad Aboulil; Orit Yossepowitch; Shirley Shapiro Ben David; ‪Yasmin Maor‬‏

    doi:10.21203/rs.3.rs-72761/v1 Date: 2020-09-05 Source: ResearchSquare

    Background: Identifying hospitalized patients with Coronavirus disease MESHD 2019 (COVID-19) in a low prevalence SERO setting is challenging.  We aimed to identify differences between COVID-19 positive and negative patients. Methods: Hospitalized patients with respiratory illness MESHD, or fever HP fever MESHD, were isolated in the emergency room and tested for COVID-19. Patients with a negative PCR and low probability for COVID-19 were taken out of isolation. Patients with a higher probability for COVID-19 remained in isolation during hospitalization and were retested after 48 hours. Risk factors for COVID-19 were assessed using logistic regression. Results: 254 patients were included, 37 COVID-19-positive (14.6%) and 217 COVID-19-negative (85.4%). Median age TRANS was 76 years, 52% were males TRANS. In a multivariate regression model, variables significantly associated with COVID-19 positivity were exposure to a confirmed COVID-19 case, length of symptoms before testing, bilateral and peripheral infiltrates in chest X-ray, neutrophil count within the normal range, and elevated LDH. In an analysis including only patients with pneumonia HP pneumonia MESHD (N=78, 18 positive for COVID-19), only bilateral and peripheral infiltrates, normal neutrophil count and elevated LDH were associated with COVID-19 positivity. Conclusions: The clinical presentation of COVID-19 positive and negative patients is similar, but radiographic and laboratory features may help to identify COVID-19 positive patients and to initiate quick decisions regarding isolation.

    Combined lymphocyte/monocyte count, D-dimer and iron status predict COVID-19 course and outcome in a long-term care facility

    Authors: Flavia Biamonte; Cirino Botta; Maria Mazzitelli; Salvatore Rotundo; Enrico Maria Trecarichi; Daniela Foti; Carlo Torti; Giuseppe Viglietto; Daniele Torella; Francesco Costanzo

    doi:10.21203/rs.3.rs-72047/v1 Date: 2020-09-04 Source: ResearchSquare

    Background: The Sars-CoV-2 can cause severe pneumonia HP pneumonia MESHD with multiorgan disease, which created an urgent need for the identification of clinical and laboratory predictors of the progression towards severe and fatal forms of this illness. In the present study, we retrospectively evaluated and integrated laboratory parameters/variables of 45 elderly TRANS subjects from a long-term care facility with Sars-CoV-2 outbreak and spread, to identify potential common patterns of systemic response able to better stratify patients’ clinical course and outcome.Methods: Baseline white blood SERO cells, granulocytes’, lymphocytes’, and platelets’ counts, hemoglobin, total iron, ferritin, D-dimer, and interleukin 6 (IL-6) concentration were used to generate a principal component analysis (PCA). Statistical analysis was performed by using R statistical package version 4.0.Results: Of the 45 patients, 19 were male TRANS and 26 were female TRANS, with a median age TRANS of 81 years. The overall mortality rate was 26.67%. By PCA and clustering approach we identified 3 laboratory patterns of response, renamed as low-risk, intermediate-risk, and high-risk, strongly associated with patients’ survival (p<0.01). D-dimer, iron status, lymphocyte/monocyte count represented the main markers discriminating high- and low-risk groups. Furthermore, patients belonging to the high-risk group presented a significantly longer time to ferritin decrease (p:0.047). Iron-to-ferritin-ratio (IFR) significantly segregated recovered and dead patients in the intermediate-risk group (p:0.012).Conclusions: Our data generate the hypothesis that a combination of few laboratory parameters, and in particular iron status, D-dimer and lymphocyte/monocyte count at admission and during the hospital stay, can predict clinical progression in COVID-19.

    Positive association of Angiotensin II Receptor Blockers, not Angiotensin-Converting Enzyme Inhibitors, with an increased vulnerability to SARS-CoV-2 infection MESHD in patients hospitalized for suspected COVID-19 pneumonia HP pneumonia MESHD

    Authors: Jean-Louis GEORGES; Floriane Floriane Gilles; Helene Cochet; Alisson Bertrand; Marie De Tournemire; Victorien Monguillon; Maeva Pasqualini; Alix Prevot; Guillaume Roger; Joseph Saba; Josephine Soltani; Mehrsa Koukabi-Fradelizi; Jean Paul Beressi; Cecile Laureana; Jean Fran&ccedilois Prost; Livarek Bernard; Elisabet Leiva; Albert Ariza-Sole; Paolo D Dallaglio; Maria Quero; Antonio Soriano; Alberto Pasqualetto; Maylin Koo; Virginia Esteve; Arnau Antoli; Rafael Moreno; Sergi Yun; Pau Cerda; Mariona Llaberia; Francesc Formiga; Marta Fanlo; Abelardo Montero; David Chivite; Olga Capdevila; Ferran Bolao; Xavier Pinto; Josep Llop; Antoni Sabate; Jordi Guardiola; Josep M Cruzado; Josep Comin-Colet; Salud Santos; Ramon Jodar; Xavier Corbella

    doi:10.1101/2020.08.30.20182451 Date: 2020-09-01 Source: medRxiv

    Background. Angiotensin converting enzyme (ACE) type 2 is the receptor of SARSCoV-2 for entry into lungs cells. Because ACE-2 may be modulated by ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), there is concern that patients treated with ACEIs and ARBs are at higher risk for COVID-19 infection MESHD. Aim. This study sought to analyze the association of COVID-19 with previous treatment with ACEI and ARB. Methods. We retrospectively reviewed 684 consecutive patients hospitalized for suspected COVID-19 pneumonia HP pneumonia MESHD and tested by PCR. Patients were split into 2 groups, whether (group 1, n=484) or not (group 2, n=250) COVID-19 was confirmed. Multivariate adjusted comparisons included a propensity score analysis. Results Age TRANS was 63.6 {+/-} 18.7 years, and 302(44%) were female TRANS. Hypertension HP Hypertension MESHD was present in 42.6% and 38.4% patients of group 1 and 2, respectively (P=0.28). A treatment with ARBs (20.7% versus 12.0%, respectively, OR 1.92, 95% confidence interval [1.23-2.98], p=0.004) was more frequent in patients of group 1 than in group 2. No difference was found for treatment with ACEIs (12.7% vs 15.7%, respectively, OR 0.81 [0.52-1.26], p=0.35). Propensity score matched multivariate logistic regression confirmed a significant association between COVID-19 and a previous treatment with ARBs (adjusted OR 2.18 [1.29-3.67], p=0.004). Significant interaction between ARBs and ACEIs for the risk of COVID-19 was observed in patients aged TRANS>60, women, and hypertensive MESHD patients. Conclusion . This study suggests that ACEIs and ARBs are not similarly associated with the COVID-19. In this retrospective series, patients with COVID-19 pneumonia HP pneumonia MESHD received more frequently a previous treatment with ARBs, than patients without COVID-19.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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