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MeSH Disease


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    Asymptomatic TRANS Employee Screening for SARS-CoV-2: Implementation of and Reactions to an Employer-Based Testing Program.

    Authors: Laura Goetz; Tyler L DeLaughder; Kathleen L Kennedy; Nicholas Schork; Timothy McDaniel; Jeffrey Trent; David Engelthaler; Bishesh Khanal; Martin Smid; Milan Zajicek; Tomas Diviak; Roman Neruda; Petra Vidnerova; Brian Pickering; Andrew D Badley; Rahul Kashyap; AJ Venkatakrishnan; Venky Soundararajan; Jennifer E. Wu; Cécile Alanio; Kurt D'Andrea; Oliva Kuthuru; Jeanette Dougherty; Ajinkya Pattekar; Justin Kim; Nicholas Han; Sokratis A. Apostolidis; Alex C. Huang; Laura Vella; - The UPenn COVID Processing Unit; E. John Wherry; Nuala J. Meyer; Sara Cherry; Paul Bates; Daniel J. Rader; Scott E. Hensley

    doi:10.1101/2020.11.06.20227314 Date: 2020-11-10 Source: medRxiv

    Introduction. Asymptomatic TRANS testing for SARS-CoV-2 among healthcare workers or other essential personnel could remove infected carriers TRANS from the workforce, decreasing chances for transmission TRANS and workplace outbreaks. Results from one-time testing programs have been reported but data regarding longitudinal testing, including information about employees reactions to such programs, is not readily available. Methods. To identify asymptomatic TRANS carriers TRANS of SARS-CoV-2, we implemented a longitudinal screening program for critical on-site employees within our research institute in early April 2020. We conducted a survey of both on-site employees and those working from home in order to measure their reactions to the testing program. Statistical analysis of the survey was conducted with general linear regression and Pearsons Chi-Square tests. Results. Despite an ongoing high community prevalence SERO rate of COVID-19 MESHD, to date only two asymptomatic TRANS employees tested positive out of 1050 tests run during 7 months of the program. However, 12 symptomatic employees not participating in the program have tested positive. The employee survey was completed by 132/306 (43%) employees, with 93% agreeing that asymptomatic TRANS employee screening led to a better and safer working environment and 75% agreeing with on-site public health measures to help contain the virus, but only 58% feeling COVID-19 MESHD was a serious threat to their health. Conclusion. Our results suggest that a longitudinal asymptomatic TRANS employee screening program for SARS-CoV-2 can be accepted by employees and can be used to maintain the health of the workforce, potentially keeping positivity rates below community levels in the face of the ongoing COVID-19 MESHD pandemic.

    Symptomatic SARS-CoV-2 re-infection of a health care worker in a Belgian nosocomial outbreak despite primary neutralizing antibody SERO response.

    Authors: Philippe Selhorst; Sabrina van Ierssel; Jo Michiels; Joachim Mariën; Koen Bartholomeeusen; Eveline Dirinck; Sarah Vandamme; Hilde Jansens; Kevin K. Ariën

    doi:10.1101/2020.11.05.20225052 Date: 2020-11-09 Source: medRxiv

    Background. It is currently unclear whether SARS-CoV-2 re-infection will remain a rare event, only occurring in individuals who fail to mount an effective immune response, or whether it will occur more frequently when humoral immunity wanes following primary infection. Methods. A case of re-infection was observed in a Belgian nosocomial outbreak involving 3 patients and 2 health care workers. To distinguish re-infection from persistent infection and detect potential transmission TRANS clusters, whole genome sequencing was performed on nasopharyngeal swabs of all individuals including the re-infection case's first episode. IgA, IgM, and IgG and neutralizing antibody SERO responses were quantified in serum SERO of all individuals, and viral infectiousness was measured in the swabs of the reinfection case. Results. Re-infection MESHD infection was confirmed TRANS in a young, immunocompetent health care worker as viral genomes derived from the first and second episode belonged to different SARS-CoV-2 clades. The symptomatic re-infection occurred after an interval of 185 days, despite the development of an effective humoral immune response following symptomatic primary infection. The second episode, however, was milder and characterized by a fast rise in serum SERO IgG and neutralizing antibodies SERO. Although contact tracing TRANS and virus culture remained inconclusive, the health care worker formed a transmission TRANS cluster with 3 patients and showed evidence of virus replication but not of neutralizing antibodies SERO in her nasopharyngeal swabs. Conclusion. If this case is representative of most Covid-19 MESHD patients, long-lived protective immunity against SARS-CoV-2 might not be likely.

    Nafamostat Mesylate in lipid carrier TRANS for nasal SARS-CoV2 titer reduction MESHD in a hamster model

    Authors: Lisette Cornelissen; Esmee Hoefsmit; Disha Rao; Judith Lijnsvelt; Lucien ven Keulen; Marieke van Es; Volker Grimm; Rene H Medema; Christian U Blank; Marcella Chiari; Alessandro Gori; Marina Cretich

    doi:10.1101/2020.11.09.372375 Date: 2020-11-09 Source: bioRxiv

    Severe acute respiratory syndrome MESHD corona virus 2 (SARS-CoV-2) has been responsible for the largest pandemic in recent decades. After seemingly being in control due to consequent lock-downs and social distancing, the majority of countries faces currently a second wave of exponentially increasing infections, hospital referrals and deaths due to SARS-CoV-2-mediated disease MESHD ( COVID-19 MESHD). To date, no effective vaccination has been found, and wearing masks and social distancing are the only effective approaches to reduce further spreading. However, unwillingness in the societies to distance again and consequently wear masks might be reasons for the second SARS-CoV-2 infection MESHD wave. User-friendly chemicals interfering at the host site with viral entry might be an approach to contain the pandemic. In addition, such an approach would work synergistic with vaccinations that miss new virus mutants. Nafamostat (NM) has been shown in vitro to interfere with cellular virus entry by inhibition of the host transmembrane protease serine 2 (TMPRSS2), an enzyme required for SARS-CoV-2 spike protein cleavage, a prerequisite for cell entry. We hypothesized that nasal application of NM in a liposomal layer (as additional mechanical barrier) could lower the nasal viral load and subsequently reduce the severity of COVID-19 MESHD. We found, indeed, that nasal viral load one day post single NM application, was lowered in a hamster SARS-CoV-2 infection MESHD model. However, severity of subsequent local tissue destruction and weight loss HP weight loss MESHD due to pneumonitis MESHD was not favorably altered. In conclusion, a single NM application reduced nasal viral load, but did not favorably improve the outcome of COVID-19 MESHD, likely due to the short half-time of NM. Improvement of NM stability or repetitive application (which was not permitted in this animal model according to Dutch law) might circumvent these challenges.

    Epidemiological characteristics of deaths from COVID-19 MESHD: an analysis at almost three months of the first confirmed case TRANS in Peru

    Authors: Willy Ramos; Juan Arrasco; Jhony A. De La Cruz-Vargas; Luis Ordonez; Maria Vargas; Yovanna Seclen; Miguel Luna; Nadia Guerrero; Jose Medina; Isabel Sandoval; Edith Solis; Manuel Loayza; Benjamin S Glicksberg; Matthew Levin; David Reich; Dennis Charney; Erwin P Bottinger; Laurie Keefer; Mayte Suarez-Farinas; Girish N Nadkarni; Zahi A Fayad; Claudia De La Cruz; Paola Di Meglio; Paolo Gisondi; Kimme Hyrich; Denis Jullien; Jo Lambert; Hoseah Waweru; Helena Marzo-Ortega; Iain McInnes; Luigi Naldi; Sam Norton; Lluis Puig; Phyllis Spuls; Raj Sengupta; Tiago Torres; RIchard B Warren; John Weinman; Christopher EM Griffiths; Jonathan N Barker; Matthew A Brown; James B Galloway; Catherine H Smith

    doi:10.1101/2020.11.05.20226639 Date: 2020-11-07 Source: medRxiv

    OBJECTIVE: To determine the epidemiological characteristics of deaths from COVID-19 MESHD in Peru from March 28 to May 21, 2020, 85 days after the report of the first confirmed case TRANS. MATERIAL AND METHODS: Case series type study. Deaths from various sources were investigated, including the COVID-19 MESHD Epidemiological Surveillance and the National System of Deaths. Deaths that met the definition of a confirmed case TRANS and had a positive (reactive) result of RT-PCR or rapid test SERO were considered for the analysis. From these sources, epidemiological variables were obtained and a time analysis was performed, defining as the pre-hospital time the time from the onset of symptoms TRANS to the date of hospitalization and hospital time from the date of hospitalization to the date of death MESHD. RESULTS: 3,244 confirmed deaths were included in the study. Deaths were more frequent in males TRANS (71.8%), elders (68.3%), residents of the department of Lima (41.8%), and others from the coast (37.7%). In 81.3% of cases, the death MESHD occurred in a public hospital, 16.0% died at home, shelter, penitentiary institution, public highway, or in transit to a hospital, and 31.1% had some comorbidity. Statistical difference was observed in pre-hospital time according to age group TRANS (p <0.001) and gender TRANS (p = 0.037), being significantly higher in adults TRANS, elders, and women. There was a statistically significant difference in hospital time according to geographic area, showing a significantly shorter time in the departments of the coast (p <0.001) and Andean region (p = 0.014) compared to Lima. The cases that were seen in private clinics (p = 0.001) survived longer than those seen in public hospitals. CONCLUSION: Deaths from COVID-19 MESHD occur mainly in male TRANS, elders, on the coast, with considerable deaths at home, in shelters, penitentiaries, public roads, or in transit to a hospital. Pre-hospital time is affected by age group TRANS and gender TRANS; while, hospital time is also influenced by the region of origin and the health care provider. KEYWORDS: Coronavirus, COVID-19 MESHD, deaths, epidemiology, Peru.

    COVID-19 MESHD Wastewater Epidemiology: A Model to Estimate Infected Populations

    Authors: Christopher Steven McMahan; Stella Self; Lior Rennert; Corey Kalbaugh; David Kriebel; Duane Graves; Jessica A Deaver; Sudeep Popat; Tanju Karanfil; David L Freedman; Ismail Nabeel; Alexander Charney; Benjamin S Glicksberg; Matthew Levin; David Reich; Dennis Charney; Erwin P Bottinger; Laurie Keefer; Mayte Suarez-Farinas; Girish N Nadkarni; Zahi A Fayad; Claudia De La Cruz; Paola Di Meglio; Paolo Gisondi; Kimme Hyrich; Denis Jullien; Jo Lambert; Hoseah Waweru; Helena Marzo-Ortega; Iain McInnes; Luigi Naldi; Sam Norton; Lluis Puig; Phyllis Spuls; Raj Sengupta; Tiago Torres; RIchard B Warren; John Weinman; Christopher EM Griffiths; Jonathan N Barker; Matthew A Brown; James B Galloway; Catherine H Smith

    doi:10.1101/2020.11.05.20226738 Date: 2020-11-07 Source: medRxiv

    BACKGROUND: Wastewater-based epidemiology (WBE) provides an opportunity for near real-time, cost-effective monitoring of community level transmission TRANS of SARS-CoV-2, the virus that causes COVID-19 MESHD. Detection of SARS-CoV-2 RNA in wastewater can identify the presence of COVID-19 MESHD in the community, but methods are lacking for estimating the numbers of infected individuals based on wastewater RNA concentrations. METHODS: Composite wastewater samples were collected from three sewersheds and tested for SARS-CoV-2 RNA. A Susceptible-Exposed-Infectious-Removed (SEIR) model based on mass rate of SARS-CoV-2 RNA in the wastewater was developed to predict the number of infected individuals. Predictions were compared to confirmed cases TRANS identified by the South Carolina Department of Health and Environmental Control for the same time period and geographic area. RESULTS: Model predictions for the relationship between mass rate of virus release to the sewersheds and numbers of infected individuals were validated based on estimated prevalence SERO from individual testing. A simplified equation to estimate the number of infected individuals fell HP within the 95% confidence limits of the model. The unreported rate for COVID-19 MESHD estimated by the model was approximately 12 times that of confirmed cases TRANS. This aligned well with an independent estimate for the state of South Carolina. CONCLUSIONS: The SEIR model provides a robust method to estimate the total number of infected individuals in a sewershed based on the mass rate of RNA copies released per day. This overcomes some of the limitations associated with individual testing campaigns and thereby provides an additional tool that can be used to better inform policy decisions.

    COVID-19 MESHD isolation and containment strategies for ships: Lessons from the USS Theodore Roosevelt outbreak

    Authors: Madison Stoddard; Kaitlyn Johnson; Douglas White; Ryan Nolan; Natasha Hochberg; Arijit Chakravarty; Kayleigh J Mason; Helen McAteer; Freya Meynall; Bolaji Coker; Alexandra Vincent; Dominic Urmston; Amber Vesty; Jade Kelly; Camille Lancelot; Lucy Moorhead; Herve Bachelez; Ian N Bruce; Francesca Capon; Claudia Romina Contreras; Andrew P Cope; Claudia De La Cruz; Paola Di Meglio; Paolo Gisondi; Kimme Hyrich; Denis Jullien; Jo Lambert; Hoseah Waweru; Helena Marzo-Ortega; Iain McInnes; Luigi Naldi; Sam Norton; Lluis Puig; Phyllis Spuls; Raj Sengupta; Tiago Torres; RIchard B Warren; John Weinman; Christopher EM Griffiths; Jonathan N Barker; Matthew A Brown; James B Galloway; Catherine H Smith

    doi:10.1101/2020.11.05.20226712 Date: 2020-11-07 Source: medRxiv

    The control of shipborne disease MESHD outbreaks represents a vexing but entirely predictable challenge at the start of any pandemic. Passenger ships, with large numbers of people confined in close quarters, can serve as incubators of disease, seeding the pandemic across the globe as infected passengers return home. Short-term steps taken by local authorities can exacerbate this problem, creating humanitarian crises and worsening the scale of the outbreak. In this work, we have undertaken a model-based examination of the USS Theodore Roosevelt outbreak to understand the dynamics of COVID-19 MESHD spread aboard the aircraft carrier TRANS. We have used a series of counterfactual "what-if" analyses to better understand the options available to public health authorities in such situations. The models suggest that rapid mass evacuation and widespread surveillance testing can be effective in these settings. Our results lead to a set of generalizable recommendations for disease control that are broadly applicable to the current COVID-19 MESHD crisis as well as to future pandemics.

    Modelling and Forecasting The Number of Confirmed Cases TRANS and Deaths from COVID-19 MESHD Pandemic in USA from April 12th to May 21st, 2020

    Authors: Babak Jamshidi; Shahriar Jamshidi Zargaran; Amir Talaei-Khoei; Mohsen Kakavandi; Lian Chen; Sara K Huston; Rajesh Srinivasan; Carrie A Redlich; Albert I Ko; Jeremy S Faust; Howard P Forman; Harlan M Krumholz

    doi:10.1101/2020.10.30.20223412 Date: 2020-11-04 Source: medRxiv

    In the present paper, our objective is to forecast the spread of the pandemic of COVID-19 MESHD in terms of the number of confirmed cases TRANS and deaths MESHD. The paper is based on a two-part to model the time series of the daily relative increments whose second part solely models the pattern of the death rate. All the simulations and calculations have been done in MatLab R2015b, and the average curves and confidence intervals are calculated based on 100 simulations of the fitted models. Our results establish that the cumulative number of confirmed cases TRANS reach 1464729 cases on 21 May 2020, with 80% confidence interval of [1375362 1540424], and the number of new confirmed cases TRANS decreases to the interval [12801 22578] with the probability of 80% (the point prediction is equal to 17551) on 21 May 2020. Finally, we forecast that the cumulative number of deaths from 18747 cases on 11 April increases to around 47000 cases on 21 May.

    Forecasting new daily confirmed cases TRANS infected by COVID-19 MESHD in Italy from April 9th to May 18th 2020

    Authors: Babak Jamshidi; Amir Talaei-Khoei; Shahriar Jamshidi Zargaran; Mansour Rezaei; Lian Chen; Sara K Huston; Rajesh Srinivasan; Carrie A Redlich; Albert I Ko; Jeremy S Faust; Howard P Forman; Harlan M Krumholz

    doi:10.1101/2020.10.30.20223222 Date: 2020-11-04 Source: medRxiv

    We aim at forecasting the outbreak of COVID-19 MESHD in Italy by using a two-part time series to model the daily relative increments. Our model is based on the data observed from 22 February to 8 April 2020 and its objective is forecasting 40 days from 9 April to 18 May 2020. All the calculations, simulations, and results in the present paper have been done in MatLab R2015b. The average curve and 80% upper and lower bounds are calculated based on 100 simulations of the fitted models. According to our model, it is expected that by May 18th, 2020, the relative increment (RI) falls HP to the interval of 0.31% to 1.24% (average equal to 0.78%). During the last three days of the studied period, the RI belonged to the interval 2.5% to 3%. Accordingly, It is expected that the new daily confirmed cases TRANS face a decreasing to around 1900 on average. Finally, our prediction establishes that the cumulative number of confirmed cases TRANS reaches 237635 (with 80% confidence interval equal to [226340 248417] by May 18th, 2020.

    SARS-CoV-2 Infection MESHD Hospitalization Rate and Infection Fatality Rate among the Non-Congregant Population in Connecticut

    Authors: Shiwani Mahajan; Cesar Caraballo; Shu-Xia Li; Claire Dong; Lian Chen; Sara K Huston; Rajesh Srinivasan; Carrie A Redlich; Albert I Ko; Jeremy S Faust; Howard P Forman; Harlan M Krumholz

    doi:10.1101/2020.10.30.20223461 Date: 2020-11-04 Source: medRxiv

    Importance: COVID-19 MESHD case fatality and hospitalization rates, calculated using the number of confirmed cases TRANS of COVID-19 MESHD, have been described widely in the literature. However, the number of infections confirmed TRANS by testing underestimates the total infections as it is biased based on the availability of testing and because asymptomatic TRANS individuals may remain untested. The infection fatality rate (IFR) and infection hospitalization rate (IHR), calculated using the estimated total infections based on a representative sample of a population, is a better metric to assess the actual toll of the disease. Objective: To determine the IHR and IFR for COVID-19 MESHD using the statewide SARS-CoV-2 seroprevalence SERO estimates for the non-congregate population in Connecticut. Design: Cross-sectional. Setting: Adults TRANS residing in a non-congregate setting in Connecticut between March 1 and June 1, 2020. Participants: Individuals aged TRANS 18 years or above. Exposure: Estimated number of adults TRANS with SARS-CoV-2 antibodies SERO. Main Outcome and Measures: COVID-19 MESHD-related hospitalizations and deaths among adults TRANS residing in a non-congregate setting in Connecticut between March 1 and June 1, 2020. Results: Of the 2.8 million individuals residing in the non-congregate settings in Connecticut through June 2020, 113,515 (90% CI 56,758-170,273) individuals had SARS-CoV-2 antibodies SERO. There were a total of 9425 COVID-19 MESHD-related hospitalizations and 4071 COVID-19 MESHD-related deaths in Connecticut between March 1 and June 1, 2020, of which 7792 hospitalizations and 1079 deaths occurred among the non-congregate population. The overall COVID-19 MESHD IHR and IFR was 6.86% (90% CI, 4.58%-13.72%) and 0.95% (90% CI, 0.63%-1.90%) among the non-congregate population. Older individuals, men, non-Hispanic Black individuals and those belonging to New Haven and Litchfield counties had a higher burden of hospitalization and deaths, compared with younger individuals, women, non-Hispanic White or Hispanic individuals, and those belonging to New London county, respectively. Conclusion and Relevance: Using representative seroprevalence SERO estimates, the overall COVID-19 MESHD IHR and IFR were estimated to be 6.86% and 0.95% among the non-congregate population in Connecticut. Accurate estimation of IHR and IFR among community residents is important to guide public health strategies during an infectious disease outbreak.

    Prevalence SERO Of COVID-19 MESHD In Rural Versus Urban Areas in a Low-Income Country: Findings from a State-Wide Study in Karnataka, India

    Authors: Manoj Mohanan; Anup Malani; Kaushik Krishnan; Anu Acharya; Brian Hart; Matthew Cross; Keith Stokes; Yung-Chun Chuang; Yu-Wei Cheng; Hung-Yu Sun; Markita P Landry; Sandra Ciesek; Gail Naughton; Martin Latterich; Philip A Mudd; Alfred Spada; Nicole Rindone; Denise Loizou; Lishomwa Ndhlovu; Raavi Gupta; Valerie Tulier-Laiwa; Maya Petersen; Diane V Havlir; - The CLIAHUB Consortium; Joseph DeRisi

    doi:10.1101/2020.11.02.20224782 Date: 2020-11-04 Source: medRxiv

    Although the vast majority of confirmed cases TRANS of COVID-19 MESHD are in low- and middle-income countries, there are relatively few published studies on the epidemiology of SARS-CoV-2 in these countries. The few there are focus on disease prevalence SERO in urban areas. We conducted state-wide surveillance for COVID-19 MESHD, in both rural and urban areas of Karnataka between June 15-August 29, 2020. We tested for both viral RNA and antibodies SERO targeting the receptor binding domain (RBD). Adjusted seroprevalence SERO across Karnataka was 46.7% (95% CI: 43.3-50.0), including 44.1% (95% CI: 40.0-48.2) in rural and 53.8% (95% CI: 48.4-59.2) in urban areas. The proportion of those testing positive on RT-PCR, ranged from 1.5 to 7.7% in rural areas and 4.0 to 10.5% in urban areas, suggesting a rapidly growing epidemic. The relatively high prevalence SERO in rural areas is consistent with the higher level of mobility measured in rural areas, perhaps because of agricultural activity. Overall seroprevalence SERO in the state implies that by August at least 31.5 million residents had been infected by August, nearly an order of magnitude larger than confirmed cases TRANS.

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