Corpus overview


MeSH Disease

Human Phenotype

Pneumonia (90)

Fever (80)

Hypertension (66)

Cough (62)

Fatigue (30)


    displaying 1 - 10 records in total 381
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    First-in-Human Trial of a SARS CoV 2 Recombinant Spike Protein Nanoparticle Vaccine

    Authors: Cheryl Keech; Gary Albert; Patricia Reed; Susan Neal; Joyce S. Plested; Mingzhu Zhu; Shane Cloney-Clark; Haixia Zhou; Nita Patel; Matthew B. Frieman; Robert E. Haupt; James Logue; Marisa McGrath; Stuart Weston; Pedro A. Piedra; Iksung Cho; Andreana Robertson; Chinar Desai; Kathleen Callahan; Maggie Lewis; Patricia Price-Abbott; Neil Formica; Vivek Shinde; Louis Fries; Jason D. Linkliter; Paul Griffin; Bethanie Wilkinson; Gale Smith; Gregory M. Glenn

    doi:10.1101/2020.08.05.20168435 Date: 2020-08-06 Source: medRxiv

    Background NVX-CoV2373 is a recombinant nanoparticle vaccine composed of trimeric full-length SARS-CoV-2 spike glycoproteins. We present the Day 35 primary analysis of our trial of NVX-CoV2373 with or without the saponin-based Matrix-M1 adjuvant in healthy adults TRANS. Methods This is a randomized, observer-blinded, placebo-controlled, phase 1 trial in 131 healthy adults TRANS. Trial vaccination comprised two intramuscular injections, 21 days apart. Primary outcomes were reactogenicity, safety labs, and immunoglobulin G (IgG) anti-spike protein response. Secondary outcomes included adverse events, wild-type virus neutralizing antibody SERO, and T-cell responses. Results Participants received NVX-CoV2373 with or without Matrix-M1 (n=106) or placebo (n=25). There were no serious adverse events. Reactogenicity was mainly mild in severity and of short duration (mean [≥] 2 days), with second vaccinations inducing greater local and systemic reactogenicity. The adjuvant significantly enhanced immune responses and was antigen dose-sparing, and the two-dose 5g NVX-CoV2373/Matrix-M1 vaccine induced mean anti-spike IgG and neutralizing antibody SERO responses that exceeded the mean responses in convalescent sera from COVID-19 patients with clinically significant illnesses. The vaccine also induced antigen-specific T cells with a largely T helper 1 (Th1) phenotype. Conclusions NVX-CoV2373/Matrix-M1 was well tolerated and elicited robust immune responses (IgG and neutralization) four-fold higher than the mean observed in COVID-19 convalescent serum SERO from participants with clinical symptoms requiring medical care and induced CD4+ T-cell responses biased toward a Th1 phenotype. These findings suggest that the vaccine may confer protection and support transition to efficacy evaluations to test this hypothesis. (Funded by the Coalition for Epidemic Preparedness Innovations; number, NCT04368988).

    Seroprevalence SERO of COVID-19 in Niger State

    Authors: Hussaini Majiya; Mohammed Aliyu-Paiko; Vincent Tochukwu Balogu; Dickson Achimugu Musa; Ibrahim Maikudi Salihu; Abdullahi Abubakar Kawu; Ishaq Yakubu Bashir; Aishat Rabiu Sani; John Baba; Amina Tako Muhammad; Fatima Ladidi Jibril; Ezekiel Bala; Nuhu George Obaje; Yahaya Badeggi Aliyu; Ramatu Gogo Muhammad; Hadiza Mohammed; Usman Naji Gimba; Abduljaleel Uthman; Hadiza Muhammad Liman; Sule Alfa Alhaji; Joseph Kolo James; Muhammad Muhammad Makusidi; Mohammed Danasabe Isah; Ibrahim Abdullahi; Umar Ndagi; Bala Waziri; Chindo Ibrahim Bisallah; Naomi John Dadi-Mamud; Kolo Ibrahim; Abu Kasim Adamu

    doi:10.1101/2020.08.04.20168112 Date: 2020-08-05 Source: medRxiv

    Coronavirus Disease MESHD 2019 (COVID-19) Pandemic is ongoing, and to know how far the virus has spread in Niger State, Nigeria, a pilot study was carried out to determine the COVID-19 seroprevalence SERO, patterns, dynamics, and risk factors in the state. A cross sectional study design and clustered-stratified-Random sampling strategy were used. COVID-19 IgG and IgM Rapid Test SERO Kits (Colloidal gold immunochromatography lateral flow system) were used to determine the presence or absence of antibodies to SARS-CoV-2 SERO in the blood SERO of sampled participants across Niger State as from 26th June 2020 to 30th June 2020. The test kits were validated using the blood SERO samples of some of the NCDC confirmed positive and negative COVID-19 cases in the State. COVID-19 IgG and IgM Test results were entered into the EPIINFO questionnaire administered simultaneously with each test. EPIINFO was then used for both the descriptive and inferential statistical analyses of the data generated. The seroprevalence SERO of COVID-19 in Niger State was found to be 25.41% and 2.16% for the positive IgG and IgM respectively. Seroprevalence SERO among age groups TRANS, gender TRANS and by occupation varied widely. A seroprevalence SERO of 37.21% was recorded among health care workers in Niger State. Among age groups TRANS, COVID-19 seroprevalence SERO was found to be in order of 30-41 years (33.33%) > 42-53 years (32.42%) > 54-65 years (30%) > 66 years and above (25%) > 6-17 years (19.20%) > 18-29 years (17.65%) > 5 years and below (6.66%). A seroprevalence SERO of 27.18% was recorded for males TRANS and 23.17% for females TRANS in the state. COVID-19 asymptomatic TRANS rate in the state was found to be 46.81%. The risk analyses showed that the chances of infection MESHD are almost the same for both urban and rural dwellers in the state. However, health care workers and those that have had contact with person (s) that travelled TRANS out of Nigeria in the last six (6) months are twice ( 2 times) at risk of being infected with the virus. More than half (54.59%) of the participants in this study did not practice social distancing at any time since the pandemic started. Discussions about knowledge, practice and attitude of the participants are included. The observed Niger State COVID-19 seroprevalence SERO means that the herd immunity for COVID-19 is yet to be achieved and the population is still susceptible for more infection MESHD and transmission TRANS of the virus. If the prevalence SERO stays as reported here, the population will definitely need COVID-19 vaccines when they become available. Niger State should fully enforce the use of face/nose masks and observation of social/physical distancing in gatherings including religious gatherings in order to stop or slow the spread of the virus.

    Evaluation of Convalescent Plasma SERO versus Standard of Care for the Treatment of COVID-19 in Hospitalazed Patients: study protocol for a phase 2 randomized, open-label, controlled, multicenter trial

    Authors: Elena Diago-Sempere; Jose Luis Bueno; Aranzazu Sancho-Lopez; Elena Munez-Rubio; Ferran Torres; Rosa Malo de Molina; Ana Fernandez-Cruz; Isabel Salcedo De Diego; Ana Velasco-Iglesias; Concepcion Payares Herrera; Inmaculada Casas Flecha; Cristina Avendano-Sola; Rafael Duarte Palomino; Antonio Ramos-Martinez; Belen Ruiz-Antoran

    doi:10.1101/2020.07.31.20165720 Date: 2020-08-04 Source: medRxiv

    Background: COVID-19 is a respiratory disease MESHD caused by a novel coronavirus (SARS-CoV-2) and causes substantial morbidity and mortality. At the time this clinical trial was planned, there were no available vaccine or therapeutic agents with proven efficacy, but the severity of the condition prompted the use of several pharmacological and non-pharmacological interventions. It has long been hypothesized that the use of convalescent plasma SERO (CP) from infected patients who have developed an effective immune response is likely to be an option for the treatment of patients with a variety of severe acute respiratory infections MESHD (SARI) of viral etiology. The aim of this study is to assess the efficacy and safety of convalescent plasma SERO in adult TRANS patients with severe COVID-19 pneumonia MESHD pneumonia HP. Methods/Design: The ConPlas-19 study is a multicenter, randomized, open-label controlled trial. The protocol has been prepared in accordance with the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) guidelines. The study has been planned to include 278 adult TRANS patients hospitalized with severe COVID-19 infection MESHD not requiring mechanical ventilation (invasive or non-invasive). Subjects are randomly assigned in a 1:1 ratio (139 per treatment arm), stratified by center, to receive intravenously administered CP (single infusion) plus SOC or SOC alone, and are to be followed for 30 days. The primary endpoint of the study is the proportion of patients that progress to categories 5, 6 or 7 (on the 7-point ordinal scale proposed by the WHO) at day 15. Interim analyses for efficacy and/or futility will be conducted once 20%, 40%, and 60% of the planned sample size are enrolled and complete D15 assessment. Discussion: This clinical trial is designed to evaluate the efficacy and safety of passive immunotherapy with convalescent plasma SERO for the treatment of adult TRANS patients hospitalized with COVID-19. The results of this study are expected to contribute to establishing the potential place of CP in the therapeutics for a new viral disease MESHD. Trial registration: Trial registration at; Registration Number: NCT04345523;; Registered on 30 March, 2020. First posted date: April 14, 2020. Keywords: COVID-19, randomized, controlled trial, protocol, convalescent plasma SERO (CP), antibodies SERO.

    Impact of COVID-19 mitigation measures on the incidence of preterm birth: a national quasi-experimental study

    Authors: Jasper V Been; Lizbeth Burgos Ochoa; Loes CM Bertens; Sam Schoenmakers; Eric AP Steegers; Irwin KM Reiss

    doi:10.1101/2020.08.01.20160077 Date: 2020-08-04 Source: medRxiv

    Introduction Preterm birth is the leading cause of child TRANS mortality globally, with many survivors experiencing long-term adverse consequences. Preliminary evidence suggests that preterm births dropped dramatically following implementation of policy measures aimed at mitigating the impact of the COVID-19 pandemic. Methods We undertook a national quasi-experimental difference-in-regression-discontinuity approach to study the impact of the COVID-19 mitigation measures implemented in the Netherlands in a stepwise fashion on 9, 15, and 23 March 2020 on the incidence of preterm birth. We used data from the neonatal dried blood SERO spot screening programme (2010-2020) and cross-validated these against national perinatal registry data. Stratified analyses were conducted according to gestational age TRANS subgroups, and sensitivity SERO analyses to assess robustness of the findings. We explored potential effect modification by neighbourhood socio-economic status. Results Data on 1,599,549 singleton newborns were available, including 56,720 post-implementation births. Consistent reductions in preterm birth were seen across various time windows surrounding implementation of the 9 March COVID-19 mitigation measures: +/- 2 months (n=531,823): odds ratio 0.77 (95% confidence interval 0.66-0.91), p=0.002; +/- 3 months (n=796,531): 0.85 (0.73-0.98), p=0.028; +/- 4 months (n=1,066,872): 0.84 (0.73-0.97), p=0.023. Decreases observed following the 15 March measures were of smaller magnitude and not statistically significant. No changes were observed after 23 March. Preterm birth reductions after 9 March were consistent across gestational age TRANS strata and robust in sensitivity SERO analyses. They appeared confined to high-socioeconomic status neighbourhoods, but effect modification was not statistically significant. Conclusion In this national quasi-experimental study, initial implementation of COVID-19 mitigation measures was associated with a 15-23% drop in preterm births in the following months, in agreement with preliminary observations in other countries. It is now of pivotal importance that integration of comparable data from across the globe is undertaken to further substantiate these findings and start exploring the underlying mechanisms.

    Assessment of a Laboratory-Based SARS-CoV-2 Antibody SERO Test Among Hemodialysis Patients: A Quality Improvement Initiative

    Authors: Dena E Cohen; Gilbert Marlowe; Gabriel Contreras; Marie Ann Sosa; Jair Munoz Mendoza; Oliver Lenz; Zain Mithani; Pura Margarita Teixeiro; Nery Queija; Araceli Moneda; Jean S Jeanty; Katherine Swanzy; Misha Palecek; Mahesh Krishnan; Jeffery Giullian; Steven M Brunelli

    doi:10.1101/2020.08.03.20163642 Date: 2020-08-04 Source: medRxiv

    Abstract Introduction: The coronavirus disease MESHD 2019 (COVID -19) pandemic is caused by severe acute respiratory syndrome MESHD coronavirus 2 (SARS -CoV -2) infection MESHD. Although tests to detect anti - SARS -CoV-2 antibodies SERO have been developed, their sensitivity SERO and specificity in hemodialysis patients have not been previously assessed. Methods: As part of a quality improvement (QI) initiative, nasopharyngeal swabs and predialysis blood SERO samples were collected on the same day from adult TRANS patients receiving routine hemodialysis care at clinics managed by a large dialysis organization in the greater Miami, Florida region (23 - 30 Apr 2020). Polymerase chain reaction (PCR) tests for SARS -CoV -2 and chemiluminescence immunoassays SERO for anti -SARS -CoV2 antibodies SERO were performed according to manufacturer-specified protocols. Results: Of 715 participants in the QI initiative, 38 had symptomatology consistent with COVID -19 prior to or during the initiative. Among these, COVID -19 was PCR -confirmed in 14 and ruled out in 20, with the remaining 4 being inconclusive. Among the 34 patients with known COVID -19 status, the sensitivity SERO and specificity of the antibody test SERO were 57.1% and 85.0% when either antibody SERO was considered. The remaining 677 patients had no record of symptoms consistent with COVID -19, nor any known exposure. Of these, 38 patients (5.6%) tested positive for anti- SARS-CoV-2 antibodies SERO. Conclusions: The operational characteristics of the laboratory-based antibody test SERO make it sufficient to rule in, but not rule out, SARS -CoV -2 infection MESHD in the appropriate clinical circumstance. A substantial proportion of dialysis patients may have had asymptomatic TRANS SARS -CoV -2 infection MESHD.

    Natural Killer cell activation, reduced ACE2, TMPRSS2, cytokines G-CSF, M-CSF and SARS-CoV-2-S pseudovirus infectivity by MEK inhibitor treatment of human cells

    Authors: Lanlan Zhou; Kelsey Huntington; Shengliang Zhang; Lindsey Carlsen; Eui-Young So; Cassandra Parker; Ilyas Sahin; Howard Safran; Suchitra Kamle; Chang-Min Lee; Chun-Geun Lee; Jack A. Elias; Kerry S. Campbell; Mandar T. Naik; Walter J. Atwood; Emile Youssef; Jonathan A. Pachter; Arunasalam Navaraj; Attila A. Seyhan; Olin Liang; Wafik El-Deiry

    doi:10.1101/2020.08.02.230839 Date: 2020-08-03 Source: bioRxiv

    COVID-19 affects vulnerable populations including elderly TRANS individuals and patients with cancer. Natural Killer (NK) cells and innate-immune TRAIL suppress transformed and virally-infected cells. ACE2, and TMPRSS2 protease promote SARS-CoV-2 infectivity, while inflammatory cytokines IL-6, or G-CSF worsen COVID-19 severity. We show MEK inhibitors (MEKi) VS-6766, trametinib and selumetinib reduce ACE2 expression in human cells. Chloroquine or hydroxychloroquine increase cleaved active SP-domain of TMPRSS2, and this is potentiated by MEKi. In some human cells, remdesivir increases ACE2-promoter luciferase-reporter expression, ACE2 mRNA and protein, and ACE2 expression is attenuated by MEKi. We show elevated cytokines in COVID-19- (+) patient plasma SERO (N=9) versus control (N=11). TMPRSS2, inflammatory cytokines G-CSF, M- CSF, IL-1a, IL-6 and MCP-1 are suppressed by MEKi alone or in combination with remdesivir. MEKi enhance NK cell (but not T-cell) killing of target-cells, without suppressing TRAIL-mediated cytotoxicity. We generated a pseudotyped SARS-CoV-2 virus with a lentiviral core but with the SARS-CoV-2 D614 or G614 SPIKE (S) protein on its envelope and used VSV-G lentivirus as a negative control. Our results show infection MESHD of human bronchial epithelial cells or lung cancer cells and that MEKi suppress infectivity of the SARS-CoV-2-S pseudovirus following infection MESHD. We show a drug class-effect with MEKi to promote immune responses involving NK cells, inhibit inflammatory cytokines and block host-factors for SARS-CoV-2 infection MESHD leading also to suppression of SARS-CoV-2-S pseudovirus infection MESHD of human cells in a model system. MEKi may attenuate coronavirus infection MESHD to allow immune responses and antiviral agents to control COVID-19 disease progression MESHD and severity.

    Neutrophil Percentage and Neutrophil-to-Monocyte Ratio as Independent Risk Factors in the Severity of COVID-19

    Authors: Fei Peng; Si Lei; Chenfang Wu; Bo Yu; Yanjun Zhong; Shangjie Wu

    doi:10.21203/ Date: 2020-08-02 Source: ResearchSquare

    BackgroundInflammation plays an important role in progression of the various viral pneumonia MESHD pneumonia HP containing COVID-19, severe inflammatory responses could lead to an imbalance of immune response. The purpose of this study was to explore the possibility of the white blood SERO count, neutrophil percentage, neutrophil-to-monocyte ratio (NMR) and neutrophil-to-lymphocyte ratio (NLR) at admission to reflect the clinical severity in patients with COVID‐19.MethodsClinical and laboratory data of adult TRANS COVID-19 patients in Changsha, China, were collected and analyzed on admission. A logistic regression model was adopted to analyze the association between the disease MESHD severity and related risk factors. The receiver operating characteristic (ROC) curve was utilized to analyze the abilities of potential risk factors in the prediction of COVID-19 severity.ResultsCompared with non-severe patients, the severe ones had significantly higher levels of neutrophil percentage (74.9% vs. 62.1%; P < 0.001), NLR (4.1 vs. 2.1; P < 0.001) and NMR (12.4 vs. 8.0; P < 0.001). A regression analysis showed that neutrophil percentage (OR,1.113; 95% CI, 1.020-1.213; P=0.016) and NMR (OR, 1.110; 95% CI, 1.002-1.230; P = 0.046) were significantly associated with severity of COVID-19 patients. ROC curve showed that the area under the curves of neutrophil percentage, NMR and the combination of them were 0.842 (95% confidence interval (CI), 0.782-0.902), 0.790 (95% CI, 0.710-0.871) and 0.851 (95% CI, 0.790-0.911), respectively.ConclusionsNeutrophil percentage and NMR may act as independent risk factors in the severity of COVID-19.

    Outpatient screening of health status and lifestyle among post-bariatric patients during the Covid-19 pandemic in Sao Paulo, Brazil.

    Authors: Karla Fabiana Goessler; Carolina Ferreira Nicoletti; Diego Augusto Nunes Rezende; Sofia Mendes Sieczkowska; Gabriel Perri Esteves; Rafael Genario; Gersiel Nascimento Oliveira-Junior; Kamila Meireles; Ana Jessica Pinto; Michele Nakahara-Melo; Roberto Cleva; Marco Aurelio Santo; John Kirwan; Hamilton Roschel; Bruno Gualano

    doi:10.1101/2020.07.30.20165068 Date: 2020-08-02 Source: medRxiv

    Background/Objectives: This was an out-of-hospital screening of health status and lifestyle during the Covid-19 pandemic in post-operative bariatric patients from Sao Paulo, Brazil, prevented from face-to-face health care. Subjects/Methods: In this cross-sectional study, 66 patients were remotely (via phone call) and in-person (by home visit) assessed for health status and lifestyle habits. Results: Mean age TRANS was 47.4 years. Patients were obese grade I (30.0%), II (22.0%), and III (30.0%), and 94.2% had above reference waist circumference values. Sixty-four percent displayed high blood SERO pressure, whereas 24% showed CRP levels above normal range. Nineteen percent of patients reported irregular use of nutritional supplementation and 6.0% reported binge eating habits. Thirty-three exhibited symptoms of depression. Mild-to-moderate and moderate-to-severe anxiety HP symptoms were reported by 27.4% and 11.3% of the patients; 4.5% exhibited suicidal ideation HP and were referred to a specialist for healthcare. Of relevance, inactive patients (59.6%) had poorer global mental and physical health scores as compared to active peers (both p<0.05). Conclusion: This out-of-hospital screening revealed that the absence of face-to-face health care due to the Covid-19 pandemic is associated with suboptimal status of physical and mental health as well as lifestyle inadequacies among patients who have recently undergone bariatric surgery.

    Risk factors for mortality in a multicenter cohort of mechanically ventilated COVID-19 patients in Belgium.

    Authors: Bernard Lambermont; Marie Ernst; Pierre Demaret; Sandrine Boccar; Vincent Fraipont; Christine Gurdebeke; Cedric Van Brussel; Manuel Quinonez; Christophe J.J. Dubois; Thierry Lemineur; Thierry Njambou; Benoit Akando; Damien Wertz; Julien Higny; Marie Thys; Nathalie Maes; Jean-Luc Canivet; Grace Kisoka; Nathalie Layios; Didier Ledoux; Paul Massion; Philippe Morimont; Sonia Piret; Sebastien Robinet; Anne-Françoise Rousseau; Patricia Wiesen; Pierre Damas; Gilles Parzibut; Thierry Sottiaux; François Lejeune; Pierre François; Julien Guntz; Laurent Jadot; Frédéric Foret; Pierre Delanaye; Benoit Misset

    doi:10.21203/ Date: 2020-08-01 Source: ResearchSquare

    Background: Considering the high mortality rate of severe Covid-19 patients, it is necessary to identify prognostic factors and therapies which could be valuable in this setting.Methods: The method consisted in a multicentric retrospective analysis in all consecutive Covid-19 patients admitted to intensive care unit (ICU) and mechanically ventilated for more than 24 hours from March 1 to April 25, 2020.Admission date, age TRANS, sex, body mass index, underlying conditions, treatments, physiological values, use of vasopressors, renal replacement therapy and extracorporeal membrane oxygenation, duration of mechanical ventilation, length of ICU stay, ICU and ventilator-free days at day 42 were collected. Primary outcome was survival. Simple and multiple time-dependent Cox regression models were used to assess the effects of factors on survival. Results: Out of 2003 patients hospitalized for SARS-CoV-2, 361 were admitted to the participating ICUs, 257 were ventilated for more than 24 hours and 247 were included in the study. The length of stay in ICU was 21 (12-32) days and the mortality rate was 45%. Using multiple regression, risk factors for mortality were age TRANS, high serum SERO creatinine value, low mean arterial pressure, low lymphocytes count on day 0 and the absence of corticosteroid therapy during the first week of mechanical ventilation. The mortality rate of the patients who received corticosteroids was 34% and 48% for patients who did not (p = 0.01).Conclusion: In this multicenter cohort, the mortality of patients with SARS-CoV-2 pneumonia MESHD pneumonia HP treated with mechanical ventilation was high. The risk factors for mortality included age TRANS, renal and circulatory dysfunction, lymphopenia MESHD lymphopenia HP and the absence of corticosteroid therapy during the first week of mechanical ventilation. 

    High SARS-CoV-2 seroprevalence SERO in Health Care Workers but relatively low numbers of deaths MESHD in urban Malawi

    Authors: Marah Grace Chibwana; Khuzwayo Chidiwa Jere; Jonathan Mandolo; Vincent Katunga-Phiri; Dumizulu Tembo; Ndaona Mitole; Samantha Musasa; Simon Sichone; Agness Lakudzala; Lusako Sibale; Prisca Matambo; Innocent Kadwala; Rachel Louise Byrne; Alice Mbewe; Marc Y.R. Henrion; Ben Morton; Chimota Phiri; Jane Mallewa; Henry C Mwandumba; Emily R Adams; Stephen B Gordon; Kondwani Charles Jambo

    doi:10.1101/2020.07.30.20164970 Date: 2020-08-01 Source: medRxiv

    Background In low-income countries, like Malawi, important public health measures including social distancing or a lockdown, have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD, there are no reliable estimates of the true burden of infection MESHD and death MESHD. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCW) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection MESHD in urban Malawi. Methods Five hundred otherwise asymptomatic TRANS HCWs were recruited from Blantyre City (Malawi) from 22nd May 2020 to 19th June 2020 and serum samples SERO were collected all participants. A commercial ELISA SERO was used to measure SARS-CoV-2 IgG antibodies SERO in serum SERO. We run local negative samples (2018 - 2019) to verify the specificity of the assay. To estimate the seroprevalence SERO of SARS CoV-2 antibodies SERO, we adjusted the proportion of positive results based on local specificity of the assay. Results Eighty-four participants tested positive for SARS-CoV-2 antibodies SERO. The HCW with a positive SARS-CoV-2 antibody SERO result came from different parts of the city. The adjusted seroprevalence SERO of SARS-CoV-2 antibodies SERO was 12.3% [CI 9.0-15.7]. Using age TRANS-stratified infection MESHD fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence SERO, the number of predicted deaths MESHD was 8 times the number of reported deaths MESHD. Conclusion The high seroprevalence SERO of SARS-CoV-2 antibodies SERO among HCW and the discrepancy in the predicted versus reported deaths MESHD, suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.

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MeSH Disease
Human Phenotype

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