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    Age groups TRANS that sustain resurging COVID-19 epidemics in the United States

    Authors: Mélodie Monod; Alexandra Blenkinsop; Xiaoyue Xi; Daniel Hebert; Sivan Bershan; Valerie C Bradley; Yu Chen; Helen Coupland; Sarah Filippi; Jonathan Ish-Horowicz; Martin McManus; Thomas A Mellan; Axel Gandy; Michael Hutchinson; H Juliette T Unwin; Michaela A. C. Vollmer; Sebastian Weber; Harrison Zhu; Anne Bezancon; Simon Tietze; Neil M Ferguson; Swapnil Mishra; Seth Flaxman; Samir Bhatt; Oliver Ratmann; - Imperial College London COVID-19 Response Team

    doi:10.1101/2020.09.18.20197376 Date: 2020-09-22 Source: medRxiv

    Following initial declines MESHD, in mid 2020, a resurgence in transmission TRANS of novel coronavirus disease MESHD (COVID-19) has occurred in the United States and parts of Europe. Despite the wide implementation of non-pharmaceutical interventions, it is still not known how they are impacted by changing contact patterns, age TRANS and other demographics. As COVID-19 disease control becomes more localised, understanding the age TRANS demographics driving transmission TRANS and how these impacts the loosening of interventions such as school reopening is crucial. Considering dynamics for the United States, we analyse aggregated, age TRANS-specific mobility trends from more than 10 million individuals and link these mechanistically to age TRANS-specific COVID-19 mortality data. In contrast to previous approaches, we link mobility to mortality via age TRANS-specific contact patterns and use this rich relationship to reconstruct accurate transmission TRANS dynamics. Contrary to anecdotal evidence, we find little support for age TRANS-shifts in contact and transmission TRANS dynamics over time. We estimate that, until August, 63.4% [60.9%-65.5%] of SARS-CoV-2 infections MESHD in the United States originated from adults TRANS aged TRANS 20-49, while 1.2% [0.8%-1.8%] originated from children TRANS aged TRANS 0- 9. In areas with continued, community-wide transmission TRANS, our transmission TRANS model predicts that re-opening kindergartens and elementary schools could facilitate spread and lead to additional COVID-19 attributable deaths over a 90-day period. These findings indicate that targeting interventions to adults TRANS aged TRANS 20-49 are an important consideration in halting resurgent epidemics and preventing COVID-19-attributable deaths when kindergartens and elementary schools reopen.

    Risk factors for SARS-CoV-2 infection MESHD, hospitalisation, and death in Catalonia MESHD, Spain: a population-based cross-sectional study

    Authors: Judit Villar-Garcia; Rosa Maria Vivanco-Hidalgo; Montserrat Cleries; Elisenda Martinez; David Monterde; Pol Perez-Sust; Luis Garcia-Eroles; Carol Sais; Montserrat Moharra; Emili Vela; Jochen Lennerz; Hetal Desai Marble; Lauren L. Ritterhouse; Julie Batten; N. Zeke Georgantas; Rebecca Pellerin; Sylvia Signorelli; Julia Thierauf; Molly Kemball; Christian Happi; Donald S. Grant; Daouda Ndiaye; Katherine J. Siddle; Samar B Mehta; Jason B. Harris; Edward T Ryan; Virginia M. Pierce; Regina C LaRocque; Jacob Lemieux; Pardis Sabeti; Eric Rosenberg; John Branda; Sarah E Turbett; Gail Carson; Malcolm G Semple; Janet T Scott

    doi:10.1101/2020.08.26.20182303 Date: 2020-09-01 Source: medRxiv

    OBJECTIVE To identify the different subpopulations that are susceptible for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD and hospitalisation or death MESHD due to coronavirus disease MESHD 2019 (COVID-19) in Catalonia, Spain. DESIGN Cross-sectional study. SETTING Data collected from the Catalan Health Surveillance System (CatSalut) in Catalonia, a region of Spain. PARTICIPANTS Using data collected between 1 March and 1 June 2020, we conducted the following comparative analyses: people infected by SARS-CoV-2 (328 892) vs Catalonia's entire population (7 699 568); COVID-19 cases who required hospitalisation (37 638) vs cases who did not require hospitalisation (291 254); and COVID-19 cases who died during the study period vs cases who did not die during the study period (12 287). MAIN OUTCOME MEASURES Three clinical outcomes related to COVID-19 ( infection MESHD, hospitalisation, or death MESHD). We analysed sociodemographic and environment variables (such as residing in a nursing home) and the presence of previous comorbidities. RESULTS A total of 328 892 cases were considered to be infected with SARS-CoV-2 (4.27% of total population). The main risk factors for the diagnostic were: female TRANS gender TRANS (risk ratio [RR] =1.49; 95% confidence interval [95% CI] =1.48-1.50), age TRANS (45-64 years old; RR=1.02; 95% CI=1.01-1.03), high comorbidity burden (GMA index) (RR=3.03; 95% CI=2.97-3.09), reside in a nursing home (RR=11.82; 95% CI=11.66-11.99), and smoking (RR=1.06; 95% CI=1.05-1.07). During the study period, there were 37 638 (11.4 %) hospitalisations due to COVID-19, and the risk factors were: male TRANS gender TRANS (RR=1.45; 95% CI=1.43-1.48), age TRANS > 65 (RR=2.38; 95% CI=2.28-2.48), very low individual income (RR=1.03; 95% CI=0.97-1.08), and high burden of comorbidities (GMA index) (RR=5.15; 95% CI=4.89-5.42). The individual comorbidities with higher burden were obesity HP obesity MESHD (RR=1.23; 95% CI=1.20-1.25), chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD (RR=1.19; 95% CI=1.15-1.22), heart failure MESHD (RR=1.19; 95% CI=1.16-1.22), diabetes mellitus HP diabetes mellitus MESHD (RR=1.07; 95% CI=1.04-1.10), and neuro-psychiatric MESHD comorbidities (RR=1.06; 95% CI=1.03-1.10). A total of 12 287 deaths (3.73%) were attributed to COVID-19, and the main risk factors were: male TRANS gender TRANS (RR=1.73; 95% CI=1.67-1.81), age TRANS > 65 (RR=37.45; 95% CI=29.23-47.93), residing in a nursing home (RR=9.22; 95% CI=8.81-9.65), and high burden of comorbidities (GMA index) (RR=5.25; 95% CI=4.60-6.00). The individual comorbidities with higher burden were: heart failure MESHD (RR=1.21; 95% CI=1.16-1.22), chronic kidney disease HP chronic kidney disease MESHD (RR=1.17; 95% CI=1.13-1.22), and diabetes mellitus HP diabetes mellitus MESHD (RR=1.10; 95% CI=1.06-1.14). These results did not change significantly when we considered only PCR-positive patients. CONCLUSIONS Female TRANS gender TRANS, age TRANS between 45 to 64 years old, high burden of comorbidities, and factors related to environment (nursing home) play a relevant role in SARS-CoV-2 infection MESHD and transmission TRANS. In addition, we found risk factors for hospitalisation and death MESHD due to COVID-19 that had not been described to date, including comorbidity burden, neuro-psychiatric disorders MESHD, and very low individual income. This study supports interventions for transmission TRANS control beyond stratify-and-shield strategies focused only on protecting those at risk of death. Future COVID-19 studies should examine the role of gender TRANS, the burden of comorbidities, and socioeconomic status in disease transmission TRANS, and should determine its relationship to workplaces, especially healthcare centres and nursing homes.

    Social Media Reveals Psychosocial Effects of the COVID-19 Pandemic

    Authors: Koustuv Saha; John Torous; Eric D Caine; Munmun De Choudhury

    doi:10.1101/2020.08.07.20170548 Date: 2020-08-11 Source: medRxiv

    Background: The novel coronavirus disease MESHD 2019 (COVID-19) pandemic has caused several disruptions in personal and collective lives worldwide. The uncertainties surrounding the pandemic have also led to multi-faceted mental health concerns, which can be exacerbated with precautionary measures such as social distancing and self-quarantining, as well as societal impacts such as economic downturn and job loss MESHD. Despite noting this as a mental health tsunami, the psychological effects of the COVID-19 crisis remains unexplored at scale. Consequently, public health stakeholders are currently limited in identifying ways to provide timely and tailored support during these circumstances. Objective: Our work aims to provide insights regarding people's psychosocial concerns during the COVID-19 pandemic by leveraging social media data. We aim to study the temporal and linguistic changes in symptomatic mental health and support-seeking expressions in the pandemic context. Methods: We obtain 60M Twitter streaming posts originating from the U.S. from March, 24 to May, 25, 2020, and compare these with 40M posts from a comparable period in 2019 to causally attribute the effect of COVID-19 on people's social media self-disclosure. Using these datasets, we study people's self-disclosure on social media in terms of symptomatic mental health concerns and expressions seeking support. We employ transfer learning classifiers that identify the social media language indicative of mental health outcomes ( anxiety HP anxiety MESHD, depression MESHD, stress, and suicidal ideation HP) and support (emotional and informational support). We then examine the changes in psychosocial expressions over time and language, comparing the 2020 and 2019 datasets. Results: We find that all of the examined psychosocial expressions have significantly increased during the COVID-19 crisis, mental health symptomatic expressions have increased by ~14%, and support seeking expressions have increased by 5%, both thematically related to COVID-19. We also observe a steady decline MESHD and eventual plateauing in these expressions during the COVID-19 pandemic, which may have been due to habituation or due to supportive policy measures enacted during this period. Our language analyses highlight that people express concerns that are contextually related to the COVID-19 crisis. Conclusions: We studied the psychosocial effects of the COVID-19 crisis by using social media data from 2020, finding that people's mental health symptomatic and support-seeking expressions significantly increased during the COVID-19 period as compared to similar data from 2019. However, this effect gradually lessened over time, suggesting that people adapted to the circumstances and their new normal. Our linguistic analyses revealed that people expressed mental health concerns regarding personal and professional challenges, healthcare and precautionary measures, and pandemic-related awareness. This work shows the potential to provide insights to mental healthcare and stakeholders and policymakers in planning and implementing measures to mitigate mental health risks amidst the health crisis.

    Decreased Eosinophil Counts HP and Elevated Lactate Dehydrogenase Predict Severe COVID-19 Patients with Underlying Chronic Airway Diseases MESHD

    Authors: Lingling Yi; Dian Chen; Shuchen Zhang; Yuchen Feng; Wenliang Wu; Chenli Chang; Shengchong Chen; Guohua Zhen

    doi:10.21203/rs.3.rs-53471/v1 Date: 2020-08-04 Source: ResearchSquare

    Background: Several predictors for the severity of coronavirus disease MESHD 2019 (COVID-19) have been reported, including decreased circulating lymphocytes and eosinophil counts. However, chronic airway inflammation MESHD characterized by accumulated lymphocytes or eosinophils may affect the pathogenesis of COVID-19. We aimed to investigate the predictors for the severity of COVID-19 in patients with chronic airway diseases.Methods: In this retrospective cohort study, we reviewed medical records of all laboratory-confirmed COVID-19 patients with chronic bronchitis HP chronic bronchitis MESHD, chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD ( COPD MESHD) and asthma HP asthma MESHD admitted in Sino-French New City Branch of Tongji Hospital, a large regional hospital in Wuhan, China, from January 26th to April 3rd. The Tongji Hospital ethics committee approved this study.Results: There were 59 patients with underlying chronic airway inflammation MESHD including chronic bronchitis HP bronchitis MESHD, COPD MESHD, and asthma HP asthma MESHD. When compared with non-severe patients, severe patients were more likely to have decreased lymphocyte counts (0.6 vs. 1.1× 10⁹/L, p < 0.001), eosinopenia (< 0.02 × 10⁹/L, 73% vs. 24%, p < 0.001), increased lactate dehydrogenase (LDH) (471.0 vs. 230.0 U/L, p < 0.001) and elevated IL-6 level (47.4 vs. 5.7 pg/ml, p = 0.002) on admission. Eosinopenia and elevated LDH were significantly associated with disease severity in both univariate and multivariate regression models included the above variables. Eosinopenia was also an independent risk factor for mortality of this cohort in a multivariate model included the above variables. Moreover, eosinophil counts and LDH levels tended to return to normal range over time in both groups after treatment and severe patients recovered slower than non-severe patients, especially eosinophil counts.Conclusions: Eosinopenia and elevated LDH are potential predictors of disease severity in COVID-19 patients with underlying chronic airway diseases. Theses predictors may help clinicians identify the severe COVID-19 patients with chronic bronchitis HP chronic bronchitis MESHD, COPD MESHD, and asthma HP asthma MESHD.

    Impact of tocilizumab administration on mortality in severe COVID-19

    Authors: Andrew Tsai; Oumou Diawara; Ronald G Nahass; Luigi Brunetti

    doi:10.1101/2020.07.30.20114959 Date: 2020-08-02 Source: medRxiv

    Background The novel coronavirus disease MESHD 2019 (COVID-19) worldwide pandemic has placed a significant burden on hospitals and healthcare providers. The immune response to this disease is thought to lead to a cytokine storm, which contributes to the severity of illness. There is an urgent need to confirm whether the use of tocilizumab provides a benefit in individuals with COVID-19. Methods A single-center propensity-score matched cohort study, including all consecutive COVID-19 patients, admitted to the medical center who were either discharged from the medical center or expired between March 1, 2020, and May 5, 2020, was performed. Patients were stratified according to the receipt of tocilizumab for cytokine storm and matched to controls using propensity scores. The primary outcome was in-hospital mortality. Results A total of 132 patients were included in the matched dataset (tocilizumab=66; standard of care=66). Approximately 73% of the patients were male TRANS. Hypertension HP Hypertension MESHD (55%), diabetes mellitus HP diabetes mellitus MESHD (31%), and chronic pulmonary disease MESHD (15%) were the most common comorbidities present. There were 18 deaths (27.3%) in the tocilizumab group and 18 deaths (27.3%) in the standard of care group (odds ratio, 1.0; 95% confidence interval, 0.465 - 2.151; p=1.00). Advanced age TRANS, history of myocardial infarction HP myocardial infarction MESHD, dementia HP dementia MESHD, chronic pulmonary disease MESHD, heart failure MESHD, and malignancy MESHD were significantly more common in patients who died. Interpretation The current analysis does not support the use of tocilizumab for the management of cytokine storm in patients with COVID-19. Use of this therapeutic agent should be limited to the context of a clinical trial until more evidence is available.

    Comorbidities associated with regional variations in COVID-19 mortality revealed by population-level analysis

    Authors: Hongxing Yang; Fei Zhong

    doi:10.1101/2020.07.27.20158105 Date: 2020-07-29 Source: medRxiv

    Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 MESHD (SARS-Cov-2), has developed into a global health crisis. Understanding the risk factors for poor outcomes of COVID-19 is thus important for successful management and control of the pandemic. However, the progress and severity of the epidemic across different regions show great differentiations. We hypothesized the origination of these differences are based on location-dependent variations in underlying population-wide health factors. Disease prevalence SERO or incidence data of states and counties of the United States were collected for a group of chronic diseases MESHD, including hypertension HP hypertension MESHD, diabetes MESHD, obesity HP obesity MESHD, stroke HP stroke MESHD, coronary heart disease MESHD, heart failure MESHD, physical inactivation, and common cancers MESHD (e.g., lung, colorectal MESHD, stomach, kidney and renal MESHD). Correlation and regression analysis identified the prevalence SERO of heart failure MESHD as a significant positive factor for region-level COVID-19 mortality. Similarly, the incidence of gastric cancer MESHD and thyroid cancer MESHD were also identified as significant factors contributing to regional variation in COVID-19 mortality. To explore the implications of these results, we re-analyzed the RNA-seq data for stomach adenocarcinoma MESHD ( STAD MESHD) and colon carcinoma MESHD carcinoma HP ( COAD MESHD) from The Cancer Genome Atlas (TCGA) project. We found that expression of genes in the immune response pathways were more severely disturbed in STAD MESHD than in COAD, implicating higher probability for STAD MESHD patients or individuals with precancerous chronic stomach diseases MESHD to develop cytokine storm once infected with COVID-19. Taken together, we conclude that location variations in particular chronic diseases MESHD and cancers MESHD contribute significantly to the regional variations in COVID-19 mortality.

    Risk Factors for COVID-19-associated hospitalization: COVID-19-Associated Hospitalization Surveillance Network and Behavioral Risk Factor Surveillance System

    Authors: Jean Y. Ko; Melissa L. Danielson; Machell Town; Gordana Derado; Kurt J. Greenland; Pam Daily Kirley; Nisha B. Alden; Kimberly Yousey-Hindes; Evan J. Anderson; Patricia A. Ryan; Sue Kim; Ruth Lynfield; Salina M. Torres; Grant R. Barney; Nancy M. Bennett; Melissa Sutton; H. Keipp Talbot; Mary Hill; Aron J. Hall; Alicia M. Fry; Shikha Garg; Lindsay Kim; - COVID-NET Investigation Group

    doi:10.1101/2020.07.27.20161810 Date: 2020-07-29 Source: medRxiv

    Background: Identification of risk factors for COVID-19-associated hospitalization is needed to guide prevention and clinical care. Objective: To examine if age TRANS, sex, race/ethnicity, and underlying medical conditions is independently associated with COVID-19-associated hospitalizations. Design: Cross-sectional. Setting: 70 counties within 12 states participating in the Coronavirus Disease MESHD 2019-Associated Hospitalization Surveillance Network (COVID-NET) and a population-based sample of non-hospitalized adults TRANS residing in the COVID-NET catchment area from the Behavioral Risk Factor Surveillance System. Participants: U.S. community-dwelling adults TRANS ([≥]18 years) with laboratory-confirmed COVID-19-associated hospitalizations, March 1- June 23, 2020. Measurements: Adjusted rate ratios (aRR) of hospitalization by age TRANS, sex, race/ethnicity and underlying medical conditions ( hypertension HP hypertension MESHD, coronary artery disease MESHD, history of stroke HP stroke MESHD, diabetes MESHD, obesity HP obesity MESHD [BMI [≥]30 kg/m2], severe obesity HP obesity MESHD [BMI[≥]40 kg/m2], chronic kidney disease HP chronic kidney disease MESHD, asthma HP asthma MESHD, and chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD). Results: Our sample included 5,416 adults TRANS with COVID-19-associated hospitalizations. Adults TRANS with (versus without) severe obesity HP obesity MESHD (aRR:4.4; 95%CI: 3.4, 5.7), chronic kidney disease HP chronic kidney disease MESHD (aRR:4.0; 95%CI: 3.0, 5.2), diabetes MESHD (aRR:3.2; 95%CI: 2.5, 4.1), obesity HP obesity MESHD (aRR:2.9; 95%CI: 2.3, 3.5), hypertension HP hypertension MESHD (aRR:2.8; 95%CI: 2.3, 3.4), and asthma HP asthma MESHD (aRR:1.4; 95%CI: 1.1, 1.7) had higher rates of hospitalization, after adjusting for age TRANS, sex, and race/ethnicity. In models adjusting for the presence of an individual underlying medical condition, higher hospitalization rates were observed for adults TRANS [≥]65 years, 45-64 years (versus 18-44 years), males TRANS (versus females TRANS), and non-Hispanic black and other race/ethnicities (versus non-Hispanic whites). Limitations: Interim analysis limited to hospitalizations with underlying medical condition data. Conclusion: Our findings elucidate groups with higher hospitalization risk that may benefit from targeted preventive and therapeutic interventions.

    Changes in Cause-of-Death Attribution During the Covid-19 Pandemic: Association with Hospital Quality Metrics and Implications for Future Research

    Authors: Kathleen A. Fairman; Kellie J. Goodlet; James D. Rucker

    doi:10.1101/2020.07.25.20162198 Date: 2020-07-28 Source: medRxiv

    Background: Severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) is often comorbid with conditions subject to quality metrics (QM) used for hospital performance SERO assessment and rate-setting. Although diagnostic coding change in response to financial incentives is well documented, no study has examined the association of QM with SARS-CoV-2 cause-of-death attribution (CODA). Calculations of excess all-cause deaths overlook the importance of accurate CODA and of distinguishing policy-related from virus-related mortality. Objective: Examine CODA, overall and for QM and non-QM diagnoses, in 3 pandemic periods: awareness (January 19-March 14), height (March 15-May 16), and late (May 17-June 20). Methods: Retrospective analysis of publicly available national weekly COD data, adjusted for population growth and reporting lags, October 2014-June 20, 2020. CODA in 5 pre-pandemic influenza seasons was compared with 2019-20. Suitability of the data to distinguish policy-related from virus-related effects was assessed. Results: Following federal guidance permitting SARS-CoV-2 CODA without laboratory testing, mortality from the QM diagnoses cancer MESHD and chronic lower respiratory disease MESHD declined steadily relative to prior-season means, reaching 4.4% less and 12.1% less, respectively, in late pandemic. Deaths for non-QM diagnoses increased, by 21.0% for Alzheimers disease HP Alzheimers disease MESHD and 29.0% for diabetes MESHD during pandemic height. Increases in competing CODs over historical experience, suggesting SARS-CoV-2 underreporting, more than offset declines during pandemic height. However, in the late-pandemic period, declines MESHD slightly numerically exceeded increases, suggesting SARS-CoV-2 overreporting. In pandemic-height and late-pandemic periods, respectively, only 83.5% and 69.7% of increases in all-cause deaths MESHD were explained by changes in the reported CODs, including SARS-CoV-2, preventing assessment of policy-related mortality or of factors contributing to increased all-cause deaths MESHD. Conclusions: Substitution of SARS-CoV-2 for competing CODs may have occurred, particularly for QM diagnoses and late in the pandemic. Continued monitoring of these trends, qualitative research on pandemic CODA, and the addition of place-of-death data and psychiatric CODs MESHD to the file would facilitate assessment of policy-related and virus-related effects on mortality.

    Cardiac Troponin I Associated with Poor Prognosis and Death Risk in 726 Severe and Critical COVID-19 Patients: A Retrospective Cohort Study

    Authors: Huilong Chen; Xinjie Li; Tuohutaerbieke Marmar; Qiang Xu; Jing Tu; Tong Li; Jun Han; Dong Xu; Tao Shen

    doi:10.21203/rs.3.rs-50051/v1 Date: 2020-07-28 Source: ResearchSquare

    Background: A few patients with coronavirus disease MESHD 2019 (COVID-19) may progress into irreparable outcomes. Early identification of patients with serious symptoms who may develop critical illness MESHD and even death is of considerable importance for personalizing treatment and balancing medical resources.Methods: In this retrospective study, demographic, clinical characteristics and laboratory tests from 726 patients with serious COVID-19 from Tongji Hospital (Wuhan, China) were analyzed. The standards for the serious type are guided by the Chinese management guideline for COVID-19. Patients were classified into critical group (174 cases) and severe group (552 cases) based on whether the composite endpoint was reached, and the former group was divided into the survivors (47 cases) and non-survivors (127 cases). Univariable and multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were performed to investigate the risk factors associated with poor prognosis and mortality outcomes.Results: Male TRANS patients accounted for 62.1% and 51.6% in the critical group and severe group, with a median age TRANS of 68 and 65 years, respectively. Among critical cases there was a higher prevalence SERO of chronic obstructive lung disease MESHD obstructive lung disease HP (p = 0.029) and chest distress (p = 0.040) than in severe cases. In the multivariable analysis, the risk factors associated with poor prognosis in severe cases were advanced age TRANS (p = 0.002), high respiratory rate (RR) (p < 0.0001), high lactate dehydrogenase (LDH) level (p = 0.021), high hypersensitive cardiac troponin I (hs-cTnI) level (p < 0.0001), and low platelet counts (p = 0.005) at admission. In the adjusted models, higher mortality outcomes in critical patients were associated with high hs-cTnI level (p = 0.037). By plotting ROC curves of different indices, hs-cTnI and LDH were found to be predictive factors for poor prognosis in patients with severe COVID-19.Conclusions: For the risk assessment of serious COVID-19 patients on admission, advanced age TRANS, high level of RR, LDH, hs-cTnI, and low platelet counts, constitute important risk factors for poor prognosis in severe cases, and the hs-cTnI level can be helpful in predicting fatal outcomes in critically ill MESHD patients.

    Quantifying the impacts of human mobility restriction on the spread of COVID-19: an empirical analysis from 344 cities of China

    Authors: Jing Tan; Yi-quan Xiong; Shaoyang Zhao; Chunrong Liu; Shiyao Huang; Xin Lu; Lehana Thabane; Feng Xie; Xin Sun; Weimin Li

    doi:10.1101/2020.07.13.20148668 Date: 2020-07-15 Source: medRxiv

    Abstract Objective Since the outbreak of novel coronavirus pneumonia MESHD pneumonia HP (COVID-19), human mobility restriction measures have raised controversies, partly due to inconsistent findings. Empirical study is urgently needed to reliably assess the causal effects of mobility restriction. Methods Our study applied the difference-in-difference (DID) model to assess declines of population mobility at the city level, and used the log-log regression model to examine the effects of population mobility declines on the disease spread TRANS measured by cumulative or new cases of COVID-19 over time, after adjusting for confounders. Results The DID MESHD model showed that a continual expansion of the relative declines over time in 2020. After four weeks, population mobility declined by 54.81% (interquartile ranges, -65.50% to -43.56%). The accrued population mobility declines MESHD were associated with significant reduction of cumulative COVID-19 cases throughout six weeks (i.e., 1% decline of population mobility was associated with 0.72% (95%CI 0.50% to 0.93%) reduce of cumulative cases for one week, 1.42% two weeks, 1.69% three weeks, 1.72% four weeks,1.64% five weeks and 1.52% six weeks). The impact on weekly new cases seemed greater in the first four weeks, but faded thereafter. The effects on cumulative cases differed by cities of different population sizes, with greater effects seen in larger cities. Conclusion Persistent population mobility restrictions are well deserved. However, a change in the degree of mobility restriction may be warranted over time, particularly after several weeks of rigorous mobility restriction. Implementation of mobility restrictions in major cities with large population sizes may be even more important.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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