Corpus overview


Overview

MeSH Disease

Human Phenotype

Pneumonia (78)

Fever (60)

Cough (43)

Anxiety (29)

Respiratory distress (17)


Transmission

Seroprevalence
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    Hospital length of stay for severe COVID-19: implications for Remdesivir's value

    Authors: Michaela Anderson; Peter Bach; Matthew R Baldwin

    doi:10.1101/2020.08.10.20171637 Date: 2020-08-12 Source: medRxiv

    Remdesivir has been granted emergency MESHD use authorization for treatment of severe COVID-19. Remdesivir's pricing is based on a presumed reduction of hospital length of stay (LOS) by four days. But the Adaptive COVID-19 Treatment Trial (ACTT-1) that suggested this treatment benefit excluded patients who were expected to be discharged within 72 hours. Perhaps as a result, median time to recovery TRANS was unusually long in both arms of the study (15 days vs 11 days). Remdesivir requires a 5-day inpatient stay, so patients who would otherwise be discharged in fewer than 5 days may remain hospitalized to complete treatment while patients who would be discharged between 5 and 8 days, would only have potential reductions in their hospital LOS of 0-3 days. In a retrospective analysis of 1643 adults TRANS with severe COVID-19 admitted to Columbia University Medical Center and the Allen community hospital between March 9, 2020 and April 23, 2020, median hospital LOS was 7 (3-14) days. Five-hundred and eighty-six patients (36%) had a LOS of 1-4 days, 384 (23%) had a LOS of 5-8 days, and 673 (41%) were hospitalized for greater than or equal to 9 days. Remdesivir treatment may not provide the LOS reductions that the company relied on when pricing the therapy: 36% of the cohort would need to have LOS prolonged to receive a 5-day course, and only 41% of patients in our cohort had LOS of 9 days or more, meaning they could have their LOS shortened by 4 days and still receive a full Remdesivir course. Further investigation of shorter treatment courses and programs to facilitate outpatient intravenous Remdesivir administration are needed.

    SARS-CoV-2 seroprevalence SERO survey among 18,000 healthcare and administrative personnel at hospitals, pre-hospital services, and specialist practitioners in the Central Denmark Region

    Authors: Sanne Jespersen; Susan Mikkelsen; Thomas Greve; Kathrine Agergaard Kaspersen; Martin Tolstrup; Jens Kjaergaard Boldsen; Jacob Dvinge Redder; Kent Nielsen; Anders Moensted Abildgaard; Henrik Albert Kolstad; Lars Oestergaard; Marianne Kragh Thomsen; Holger Jon Moeller; Christian Erikstrup

    doi:10.1101/2020.08.10.20171850 Date: 2020-08-12 Source: medRxiv

    Objectives: The objective of this study was to perform a large seroprevalence SERO survey on severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) among Danish healthcare workers to identify high risk groups. Design: Cross-sectional survey. Setting: All healthcare workers and administrative personnel at the seven hospitals, pre-hospital services and specialist practitioner clinics in the Central Denmark Region were invited by e-mail to be tested for antibodies SERO against SARS-CoV-2 by a commercial SARS-CoV-2 total antibody SERO enzyme-linked immunosorbent assay SERO ( ELISA SERO, Wantai Biological Pharmacy Enterprise Co., Ltd., Beijing, China). Participants: A total of 25,950 participants were invited. Of these, 17,987 (69%) showed up for blood SERO sampling, and 17,971 had samples available for SARS-CoV-2 antibody SERO testing. Main outcome measures: 1) Prevalence SERO of SARS-CoV-2 antibodies SERO; 2) Risk factors for seropositivity; 3) Association of SARS-CoV-2 RNA and antibodies SERO. Results: After adjustment for assay sensitivity SERO and specificity, the overall seroprevalence SERO was 3.4% (CI: 2.5%-3.8%). The seroprevalence SERO was higher in the western part of the region than in the eastern part (11.9% vs 1.2%, difference: 10.7 percentage points, CI: 9.5-12.2). In the high prevalence SERO area, the emergency MESHD departments had the highest seroprevalence SERO (29.7%) while departments without patients or with limited patient contact had the lowest seroprevalence SERO (2.2%). Multivariable logistic regression analysis with age TRANS, sex, and profession as the predictors showed that nursing staff, medical doctors, and biomedical laboratory scientists had a higher risk than medical secretaries, who served as reference (OR = 7.3, CI: 3.5-14.9; OR = 4., CI: 1.8-8.9; and OR = 5.0, CI: 2.1-11.6, respectively). Among the total 668 seropositive participants, 433 (64.8%) had previously been tested for SARS-CoV-2 RNA, and 50.0% had a positive RT-PCR result. A total of 98% of individuals who had a previous positive viral RNA test were also found to be seropositive. Conclusions: We found large differences in the prevalence SERO of SARS-CoV-2 antibodies SERO in staff working in the healthcare sector within a small geographical area of Denmark and signs of in-hospital transmission TRANS. Half of all seropositive staff had been tested positive by PCR prior to this survey. This study raises awareness of precautions which should be taken to avoid in-hospital transmission TRANS. Additionally, regular testing of healthcare workers for SARS-CoV-2 should be considered to identify areas with increased transmission TRANS. Trial registration: The study is approved by the Danish Data Protection Agency (1-16-02-207-20).

    Love during lockdown: findings from an online survey examining the impact of COVID-19 on the sexual practices of people living in Australia

    Authors: Jacqueline Coombe; Fabian Kong; Helen Bittleston; Hennie Williams; Jane Tomnay; Alaina Vaisey; Sue Malta; Jane Goller; Meredith Temple-Smith; Louise Bourchier; Andrew Lau; Eric Chow; Jane S Hocking

    doi:10.1101/2020.08.10.20171348 Date: 2020-08-12 Source: medRxiv

    Introduction: Australia recorded its first case of COVID-19 in late January 2020. On 22 March 2020, amid increasing daily case numbers, the Australian Government implemented lockdown restrictions to help flatten the curve. Our study aimed to understand the impact of lockdown restrictions on sexual and reproductive health. Here we focus on sexual practices. Methods: An online survey was open from the 23 April 2020 to the 11 May 2020. Participants were recruited online via social media and other networks and were asked to report on their sexual practices in 2019 and during lockdown. Logistic regression was used to calculate the difference (including 95% confidence intervals) in the proportion of sex practices between time periods. Results: Of the 1187 who commenced the survey, 965 (81.3%) completed it. Overall 70% were female TRANS and 66.3% were aged TRANS 18 to 29 years. Most (53.5%) reported less sex during lockdown than in 2019. Compared with 2019, participants were more likely to report sex with a spouse (35.3% vs 41.7%; difference=6.4%; 95%CI: 3.6, 9.2) and less likely to report sex with a girl/boyfriend (45.1% vs 41.8%; diff=-3.3%; 95%CI: -7.0, -0.4) or with casual hook-up (31.4% vs 7.8%; 95%CI:-26.9, -19.8). Solo sex activities increased, 14.6% (123/840) reported using sex toys more often and 26.0% (218/838) reported masturbating more often. Dating app use decreased during lockdown compared with 2019 (42.1% vs 27.3%; difference= -14.8%; 95%CI: -17.6, -11.9). Using dating apps for chatting/texting (89.8% vs 94.5%; diff=4.7%; 95%CI:1.0, 8.5) and for setting up virtual dates (2.6% vs 17.2%; diff=14.6%; 95%CI:10.1, 19.2) increased during lockdown. Conclusion: Although significant declines in sexual activity during lockdown were reported, people did not completely stop engaging in sexual activities during the pandemic, highlighting the importance of ensuring availability of normal sexual and reproductive health services during global emergencies MESHD.

    Turbulence dictates the fate of virus-containing liquid droplets in violent expiratory events

    Authors: Marco E. Rosti; Mattia Cavaiola; Stefano Olivieri; Agnese Seminara; Andrea Mazzino

    id:2008.05119v1 Date: 2020-08-12 Source: arXiv

    Violent expiratory events, such as coughing MESHD coughing HP and sneezing MESHD sneezing HP, are highly nontrivial examples of two-phase mixture of liquid droplets dispersed into an unsteady humid turbulent fluid phase. Understanding the physical mechanisms determining the fate of droplets is becoming a priority given the global COVID-19 emergency MESHD caused by the SARS-CoV-2 infection MESHD. By means of state-of-the-art fully resolved direct numerical simulations we contribute to solve this issue by identifying the key role of turbulence on the fate of exhaled droplets. Our results impact the current notion of social distance.

    Characterisation of 22446 patients attending UK emergency MESHD departments with suspected COVID-19 infection MESHD: Observational cohort study

    Authors: Steve Goodacre; Ben Thomas; Ellen Lee; Laura Sutton; Amanda Loban; Simon Waterhouse; Richard Simmonds; Katie Biggs; Carl Marincowitz; Jose Schutter; Sarah Connelly; Elena Sheldon; Jamie Hall; Emma Young; Andrew Bentley; Kirsty Challen; Chris Fitzsimmons; Tim Harris; Fiona Lecky; Andrew Lee; Ian Maconochie; Darren Walter

    doi:10.1101/2020.08.10.20171496 Date: 2020-08-11 Source: medRxiv

    Background Hospital emergency MESHD departments play a crucial role in the initial management of suspected COVID-19 infection MESHD. We aimed to characterise patients attending emergency MESHD departments with suspected COVID-19, including subgroups based on sex, ethnicity and COVID-19 test results. Methods We undertook a mixed prospective and retrospective observational cohort study in 70 emergency MESHD departments across the United Kingdom (UK). We collected presenting data from 22446 people attending with suspected COVID-19 between 26 March 2020 and 28 May 2020. Outcomes were admission to hospital, COVID-19 result, organ support (respiratory, cardiovascular or renal), and death MESHD, by record review at 30 days. Results Adults TRANS were acutely unwell (median NEWS2 score 4) and had high rates of admission (67.1%), COVID-19 positivity (31.2%), organ support (9.8%) and death MESHD (15.9%). Children TRANS had much lower rates of admission (27.4%), COVID-19 positivity (1.2%), organ support (1.4%) and death MESHD (0.3%). Adult TRANS men and women presented in similar numbers (10210 versus 10506), but men were more likely to be admitted (72.9% v 61.4%), require organ support (12.2% v 7.7%) and die (18.7% v 13.3%). Black or Asian adults TRANS tended to be younger than White adults TRANS (median age TRANS 54, 50 and 67 years), were less likely to be admitted (60.8%, 57.3%, 69.6%) or die (11.9%, 11.2%, 16.8%), but were more likely to require organ support (15.9%, 14.3%, 8.9%) or have a positive COVID-19 test (40.8%, 42.1%, 30.0%). Adults TRANS admitted with confirmed COVID-19 had similar age TRANS and comorbidities (except chronic lung disease HP lung disease MESHD) to those who did not have COVID-19 confirmed, but were much more likely to need organ support (22.2% v 8.9%) or die (32.7% v 15.9%). Conclusions Important differences exist between patient groups presenting to the emergency MESHD department with suspected COVID-19. People with confirmed COVID-19 have a poor prognosis, compared with similar emergency MESHD admissions without confirmed COVID-19.

    Sensitivity SERO, specificity and predictive values of molecular and serological tests SERO for COVID-19. A longitudinal study in emergency MESHD room.

    Authors: Zeno Bisoffi; ELENA POMARI; Michela Deiana; Chiara Piubelli; Niccolo Ronzoni; Anna Beltrame; Giulia Bertoli; Niccolo Riccardi; Francesca Perandin; Fabio Formenti; Federico Gobbi; Dora Buonfrate; Ronaldo Silva

    doi:10.1101/2020.08.09.20171355 Date: 2020-08-11 Source: medRxiv

    Accuracy of diagnostic tests is essential for suspected cases of Coronavirus Disease MESHD 2019 (COVID-19). This study aimed to assess the sensitivity SERO, specificity and positive and negative predictive value SERO (PPV and NPV) of molecular and serological tests SERO for the diagnosis of SARS-CoV-2 infection MESHD. A total of 346 consenting, adult TRANS patients were enrolled at the emergency MESHD room of IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy. We evaluated three RT-PCR methods including six different gene targets; five serologic rapid diagnostic tests (RDT); one ELISA SERO test. The final classification of infected/not infected patients was performed using Latent Class Analysis in combination with clinical re-assessment of incongruous cases and was the basis for the main analysis of accuracy. Of 346 patients consecutively enrolled, 85 (24.6%) were classified as infected. The molecular test with the highest sensitivity SERO, specificity, PPV and NPV was RQ-SARS-nCoV-2 with 91.8% (C.I. 83.8-96.6), 100% (C.I. 98.6-100.0), 100.0% (C.I. 95.4-100.0) and 97.4% (C.I. 94.7-98.9) respectively, followed by CDC 2019-nCoV with 76.2% (C.I. 65.7-84.8), 99.6% (C.I. 97.9-100.0), 98.5% (C.I. 91.7-100.0) and 92.9% (C.I. 89.2-95.6) and by in-house test targeting E-RdRp with 61.2% (C.I. 50.0-71.6), 99.6% (C.I. 97.9-100.0), 98.1% (C.I. 89.9-100.0) and 88.7% (C.I. 84.6-92.1). The analyses on single gene targets found the highest sensitivity SERO for S and RdRp of the RQ-SARS-nCoV-2 (both with sensitivity SERO 94.1%, C.I. 86.8-98.1). The in-house RdRp had the lowest sensitivity SERO (62.4%, C.I. 51.2-72.6). The specificity ranged from 99.2% (C.I. 97.3-99.9) for in-house RdRp and N2 to 95.0% (C.I. 91.6-97.3) for E. The PPV ranged from 97.1% (C.I. 89.8-99.6) of N2 to 85.4% (C.I. 76.3-92.00) of E, and the NPV from 98.1% (C.I. 95.5-99.4) of gene S to 89.0% (C.I. 84.8-92.4) of in-house RdRp. All serological tests SERO had <50% sensitivity SERO and low PPV and NPV. One RDT (VivaDiag IgM) had high specificity (98.5%, with PPV 84.0%), but poor sensitivity SERO (24.7%). Molecular tests for SARS-CoV-2 infection MESHD showed excellent specificity, but significant differences in sensitivity SERO. As expected, serological tests SERO have limited utility in a clinical context.

    Coordinated support for local action: A modeling study of strategies to facilitate behavior adoption in urban poor communities of Liberia for sustained COVID-19 suppression

    Authors: Laura Skrip; Mosoka P Fallah; Jamie Bedson; Laurent H├ębert-Dufresne; Benjamin Muir Althouse

    doi:10.1101/2020.08.11.20172031 Date: 2020-08-11 Source: medRxiv

    Background: Long-term suppression of SARS-CoV-2 transmission TRANS will require context-specific strategies that recognize the heterogeneous capacity of communities to undertake public health recommendations, particularly due to limited access to food, sanitation facilities, and physical space required for self-quarantine or isolation. We highlight the epidemiological impact of barriers to adoption of public health recommendations by urban slum populations in low- and middle-income countries (LMICs) and the potential role of community-based initiatives to coordinate efforts that support cases and high-risk contacts. Methods: Daily case updates published by the National Public Health Institute of Liberia were used to inform a stratified stochastic compartmental model representing transmission TRANS of SARS-CoV-2 in two subpopulations (urban poor versus less socioeconomically vulnerable) of Montserrado County, Liberia. Differential transmission TRANS was considered at levels of the subpopulation, household versus community, and events (i.e., funerals). Adoption of home-isolation behavior was assumed to be related to the proportion of each subpopulation residing in housing units with multiple rooms, access to sanitation facilities, and access to basic goods like water and food. Percentage reductions in cumulative infection MESHD counts, cumulative counts of severe cases, and maximum daily infection MESHD counts for each subpopulation were evaluated across intervention scenarios that included symptom-triggered, community-driven efforts to support high-risk contacts and confirmed cases TRANS in self-isolation following the scheduled lifting of the state of emergency MESHD. Results: Modeled outbreaks for the status quo scenario differed between the two subpopulations, with increased overall infection MESHD burden but decreased numbers of severe cases in the urban poor subpopulation relative to the less socioeconomically vulnerable population after 180 days post-introduction into Liberia. With more proactive self-isolation by mildly symptomatic individuals after lifting of the public health emergency MESHD, median reductions in cumulative infections MESHD infections, severe HP, severe cases, and maximum daily incidence were 7.6% (IQR: 2.2%-20.9%), 7.0% (2.0%-18.5%), and 9.9% (2.5%-31.4%) for cumulative infections MESHD infections, severe HP, severe cases, and maximum daily incidence, respectively, across epidemiological curve simulations in the urban poor subpopulation and 16.8% (5.5%-29.3%), 15.0% (5.0%-26.4%), and 28.1% (IQR: 9.3%-47.8%) in the less socioeconomically vulnerable population. An increase in the maximum attainable percentage of behavior adoption by the urban slum subpopulation, with the provision of support to facilitate self-isolation or quarantine, was associated with median reductions in cumulative infections MESHD infections, severe HP, severe cases, and maximum daily incidence were 19.2% (IQR: 10.1%-34.0%), 21.1% (IQR: 13.3%-34.2%), and 26.0% (IQR: 11.5%-48.9%), respectively, relative to the status quo scenario. Conclusions: Broadly supported post-lockdown recommendations that prioritize proactively monitoring symptoms, seeking testing and isolating at home by confirmed cases TRANS are limited by resource constraints in urban poor communities. Investing in community-based initiatives that determine needs and coordinate needs-based support for self-identified cases and their contacts could provide a more effective, longer-term strategy for suppressing transmission TRANS of COVID-19 in settings with prevalent distrust and socioeconomic vulnerabilities.

    Impact of COVID-19 on Urology Practice in Saudi Arabia

    Authors: Meshari Alzahrani; Mohammad Alkhamees; Sulaiman Almutairi; Ahmed Aljuhayman; Sultan Alkhateeb

    id:10.20944/preprints202008.0261.v1 Date: 2020-08-11 Source: Preprints.org

    From the moment the World Health Organization (WHO) declared COVID-19 to be a pandemic disease MESHD, COVID-19 began to affect the lives of many healthcare providers worldwide. In response to this pandemic, urology departments and training residency programs implemented urgent measures to reduce outpatient clinics, adopted the use of telemedicine, regulated emergency MESHD and outpatient urological procedures, promoted the use of operating theatres, and developed the use of sustainable e-learning alternatives to traditional urology resident/staff educational activities. Here, we review the response of urologists in Saudi Arabia to the COVID-19 pandemic and how they applied both for the patients and for the healthcare of urologist personnel.

    The impact of COVID-19 on the reproductive health of people living in Australia: findings from an online survey

    Authors: Jacqueline Coombe; Fabian Kong; Helen Bittleston; Hennie Williams; Jane Tomnay; Alaina Vaisey; Sue Malta; Jane Goller; Meredith Temple-Smith; Louise Bourchier; Andrew Lau; Jane S Hocking

    doi:10.1101/2020.08.10.20172163 Date: 2020-08-11 Source: medRxiv

    Introduction: Australia introduced lockdown measures to control COVID-19 on 22 March 2020. For two months, Australians were asked to remain at home and only leave for essential activities. We investigate the impact this had on sexual and reproductive health (SRH). Methods: Australians aged TRANS 18+ were eligible to participate in an online survey from 23 April-11 May 2020. Questions included contraceptive use, pregnancy intentions and access to SRH services. We report on the experiences of 518 female TRANS participants aged TRANS <50 years. Pregnancy intentions and contraceptive use were analysed using descriptive statistics. Odds ratios and 95% confidence intervals were calculated to investigate difficulty accessing SRH products and services. Qualitative data were analysed using descriptive thematic analysis. Results: Most participants (55.4%, 287/518) were aged TRANS 18-24 years. Most (76.1%, 379/498) indicated they were trying to avoid pregnancy. The oral contraceptive pill was the most common single method used (20.8%; 107/514). Nearly 20% (101/514) reported they were not using contraception. Older women (OR=0.4; 95%CI: 0.1, 0.9 for 25-34 vs 18-24 years) and those employed (OR=0.4; 95%CI: 0.2, 0.7) had less trouble accessing contraception during lockdown. Women aged TRANS 25-34 (OR=0.4; 95%CI: 0.3, 0.7) or 35-49 years (OR=0.3; 95%CI: 0.1, 0.6) were less likely to experience difficulty accessing feminine hygiene products. Qualitative analysis suggested that COVID-19 affected pregnancy plans, with participants delaying childbearing, or deciding to remain childfree. Conclusion: COVID-19 lockdown impacted the SRH of Australian women. Findings highlight the importance of continued access to SRH services and products during global emergencies MESHD.

    The COVID-19 Early Detection in Doctors and Healthcare Workers (CEDiD) Study: study protocol for a prospective observational trial

    Authors: Alexander Zargaran; Dina Radenkovic; Chelsea Trengrove; Gill Arbane; Kariem El-Boghdadly; Rocio Teresa Martinez-Nunez; Anne Greenough

    doi:10.1101/2020.08.11.20172502 Date: 2020-08-11 Source: medRxiv

    Background: The global COVID-19 pandemic has caused worldwide disruption with its exponential spread mandating national and international lockdown measures. Hospital-associated transmission TRANS has been identified as a major factor in the perpetuation of COVID-19, with healthcare workers at high-risk of becoming infected with SARS-CoV-2 and representing important vectors for spread, but not routinely having their clinical observations monitored or being tested for COVID-19. Methods: A single-center, prospective observational study of 60 healthcare workers will explore how many healthcare workers in high-risk areas develop COVID-19 infection MESHD over a thirty day period. High-risk areas are defined as COVID positive wards, the intensive care unit or the accident and emergency MESHD department. Healthcare workers (HCWs) will be recruited and have daily self-administered nasopharyngeal SARS-CoV-2 PCR tests. They will also be provided with a wearable medical device to measure their clinical observations during non-working hours, and be asked to complete a daily self-reported symptom questionnaire over the study period. Statistical analysis will assess the proportion of healthcare workers who develop COVID-19 infection MESHD as a primary objective, with secondary objectives exploring what symptoms are developed, time-to-event, and deviations in clinical observations. Discussion: At present clinical observations, symptoms and COVID-19 PCR swabs are not routinely undertaken for healthcare workers. If the CEDiD (COVID-19 Early Detection in Doctors and Healthcare Workers) study is successful, it will provide useful information for workforce decisions in reducing hospital-associated transmission TRANS of COVID-19. The data will help in determining whether there are early warning signs for development of COVID-19 infections MESHD amongst healthcare workers and may contribute to the evidence base advocating for more regular testing of healthcare workers observations, symptoms and COVID-19 status. Trial registration ClinicalTrials.gov, NCT04363489. Registered on 27th July 2020

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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