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1.
Eur Rev Med Pharmacol Sci ; 25(2): 1135-1145, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33577070

RESUMEN

OBJECTIVE: To explore the different clinical and CT features distinguishing COVID-19 from H1N1 influenza pneumonia. PATIENTS AND METHODS: We compared two independent cohorts of COVID-19 pneumonia (n=405) and H1N1 influenza pneumonia (n=78), retrospectively. All patients were confirmed by RT-PCR. Four hundred and five cases of COVID-19 pneumonia were confirmed in nine hospitals of Zhejiang province, China from January 21 to February 20, 2020. Seventy-eight cases of H1N1 influenza pneumonia were confirmed in our hospital from January 1, 2017 to February 29, 2020. Their clinical manifestations, laboratory test results, and CT imaging characteristics were compared. RESULTS: COVID-19 pneumonia patients showed less proportions of underlying diseases, fever and respiratory symptoms than those of H1N1 pneumonia patients (p<0.01). White blood cell count, neutrophilic granulocyte percentage, C-reactive protein, procalcitonin, D-Dimer, and lactate dehydrogenase in H1N1 pneumonia patients were higher than those of COVID-19 pneumonia patients (p<0.05). H1N1 pneumonia was often symmetrically located in the dorsal part of inferior lung lobes, while COVID-19 pneumonia was unusually showed as a peripheral but non-specific lobe distribution. Ground glass opacity was more common in COVID-19 pneumonia and consolidation lesions were more common in H1N1 pneumonia (p<0.01). COVID-19 pneumonia lesions showed a relatively clear margin compared with H1N1 pneumonia. Crazy-paving pattern, thickening vessels, reversed halo sign and early fibrotic lesions were more common in COVID-19 pneumonia than H1N1 pneumonia (p<0.05). Pleural effusion in COVID-19 pneumonia was significantly less common than H1N1 pneumonia (p<0.01). CONCLUSIONS: Compared with H1N1 pneumonia in Zhejiang, China, the clinical manifestations of COVID-19 pneumonia were more concealed with less underlying diseases and slighter respiratory symptoms. The more common CT manifestations of COVID-19 pneumonia included ground-glass opacity with a relatively clear margin, crazy-paving pattern, thickening vessels, reversed halo sign, and early fibrotic lesions, while the less common CT manifestations of COVID-19 pneumonia included consolidation and pleural effusion.


Asunto(s)
/diagnóstico por imagen , Subtipo H1N1 del Virus de la Influenza A/aislamiento & purificación , Gripe Humana/diagnóstico por imagen , Gripe Humana/epidemiología , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Estudios de Casos y Controles , China/epidemiología , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
3.
BMC Med ; 19(1): 45, 2021 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-33563270

RESUMEN

BACKGROUND: All countries are facing decisions about which population groups to prioritize for access to COVID-19 vaccination after the first vaccine products have been licensed, at which time supply shortages are inevitable. Our objective is to define the key target populations, their size, and priority for a COVID-19 vaccination program in the context of China. METHODS: On the basis of utilitarian and egalitarian principles, we define and estimate the size of tiered target population groups for a phased introduction of COVID-19 vaccination, considering evolving goals as vaccine supplies increase, detailed information on the risk of illness and transmission, and past experience with vaccination during the 2009 influenza pandemic. Using publicly available data, we estimated the size of target population groups, and the number of days needed to vaccinate 70% of the target population. Sensitivity analyses considered higher vaccine coverages and scaled up vaccine delivery relative to the 2009 pandemic. RESULTS: Essential workers, including staff in the healthcare, law enforcement, security, nursing homes, social welfare institutes, community services, energy, food and transportation sectors, and overseas workers/students (49.7 million) could be prioritized for vaccination to maintain essential services in the early phase of a vaccination program. Subsequently, older adults, individuals with underlying health conditions and pregnant women (563.6 million) could be targeted for vaccination to reduce the number of individuals with severe COVID-19 outcomes, including hospitalizations, critical care admissions, and deaths. In later stages, the vaccination program could be further extended to target adults without underlying health conditions and children (784.8 million), in order to reduce symptomatic infections and/or to stop virus transmission. Given 10 million doses administered per day, and a two-dose vaccination schedule, it would take 1 week to vaccinate essential workers but likely up to 7 months to vaccinate 70% of the overall population. CONCLUSIONS: The proposed framework is general but could assist Chinese policy-makers in the design of a vaccination program. Additionally, this exercise could be generalized to inform other national and regional strategies for use of COVID-19 vaccines, especially in low- and middle-income countries.


Asunto(s)
/uso terapéutico , Personal de Salud , Programas de Inmunización/métodos , Selección de Paciente , Policia , Adolescente , Anciano , /mortalidad , Niño , China/epidemiología , Comorbilidad , Teoría Ética , Femenino , Industria de Alimentos , Prioridades en Salud , Hospitalización , Humanos , Programas de Inmunización/organización & administración , Lactante , Vacunas contra la Influenza/uso terapéutico , Gripe Humana/prevención & control , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Mortalidad , Casas de Salud , Pandemias/prevención & control , Formulación de Políticas , Embarazo , Transportes , Vacunación , Adulto Joven
4.
JAMA Netw Open ; 4(2): e2037053, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33566109

RESUMEN

Importance: Alpha 1-adrenergic receptor blocking agents (α1-blockers) have been reported to have protective benefits against hyperinflammation and cytokine storm syndrome, conditions that are associated with mortality in patients with coronavirus disease 2019 and other severe respiratory tract infections. However, studies of the association of α1-blockers with outcomes among human participants with respiratory tract infections are scarce. Objective: To examine the association between the receipt of α1-blockers and outcomes among adult patients hospitalized with influenza or pneumonia. Design, Setting, and Participants: This population-based cohort study used data from Danish national registries to identify individuals 40 years and older who were hospitalized with influenza or pneumonia between January 1, 2005, and November 30, 2018, with follow-up through December 31, 2018. In the main analyses, patients currently receiving α1-blockers were compared with those not receiving α1-blockers (defined as patients with no prescription for an α1-blocker filled within 365 days before the index date) and those currently receiving 5α-reductase inhibitors. Propensity scores were used to address confounding factors and to compute weighted risks, absolute risk differences, and risk ratios. Data were analyzed from April 21 to December 21, 2020. Exposures: Current receipt of α1-blockers compared with nonreceipt of α1-blockers and with current receipt of 5α-reductase inhibitors. Main Outcomes and Measures: Death within 30 days of hospital admission and risk of intensive care unit (ICU) admission. Results: A total of 528 467 adult patients (median age, 75.0 years; interquartile range, 64.4-83.6 years; 273 005 men [51.7%]) were hospitalized with influenza or pneumonia in Denmark between 2005 and 2018. Of those, 21 772 patients (4.1%) were currently receiving α1-blockers compared with a population of 22 117 patients not receiving α1-blockers who were weighted to the propensity score distribution of those receiving α1-blockers. In the propensity score-weighted analyses, patients receiving α1-blockers had lower 30-day mortality (15.9%) compared with patients not receiving α1-blockers (18.5%), with a corresponding risk difference of -2.7% (95% CI, -3.2% to -2.2%) and a risk ratio (RR) of 0.85 (95% CI, 0.83-0.88). The risk of ICU admission was 7.3% among patients receiving α1-blockers and 7.7% among those not receiving α1-blockers (risk difference, -0.4% [95% CI, -0.8% to 0%]; RR, 0.95 [95% CI, 0.90-1.00]). A comparison between 18 280 male patients currently receiving α1-blockers and 18 228 propensity score-weighted male patients currently receiving 5α-reductase inhibitors indicated that those receiving α1-blockers had lower 30-day mortality (risk difference, -2.0% [95% CI, -3.4% to -0.6%]; RR, 0.89 [95% CI, 0.82-0.96]) and a similar risk of ICU admission (risk difference, -0.3% [95% CI, -1.4% to 0.7%]; RR, 0.96 [95% CI, 0.83-1.10]). Conclusions and Relevance: This cohort study's findings suggest that the receipt of α1-blockers is associated with protective benefits among adult patients hospitalized with influenza or pneumonia.


Asunto(s)
Antagonistas de Receptores Adrenérgicos alfa 1/uso terapéutico , Mortalidad Hospitalaria , Hospitalización , Inflamación/tratamiento farmacológico , Gripe Humana/tratamiento farmacológico , Unidades de Cuidados Intensivos , Neumonía/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , /patología , Estudios de Cohortes , Dinamarca , Femenino , Humanos , Inflamación/etiología , Gripe Humana/mortalidad , Gripe Humana/patología , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Pandemias , Neumonía/mortalidad , Neumonía/patología , Puntaje de Propensión , Índice de Severidad de la Enfermedad
5.
J Am Osteopath Assoc ; 121(2): 211-220, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33567082

RESUMEN

Context: While the data generated by medical students at schools that require electronic patient encounter logs is primarily used to monitor their training progress, it can also be a great source of public health data. Specifically, it can be used for syndromic surveillance, a method used to analyze instantaneous health data for early detection of disease outbreaks. Objective: To analyze how the International Classification of Diseases, 10th Revision (ICD-10) codes input by medical students at the Edward Via College of Osteopathic Medicine into the Clinical Rotation Evaluation and Documentation Organizer (CREDO) patient encounter logging system could act as a new syndromic surveillance tool. Methods: A CREDO database query was conducted for ICD-10 codes entered between November 1, 2019 and March 13, 2020 using the World Health Organization's 2011 revised case definitions for Influenza Like Illness (ILI). During that period, medical students had an approximated mean of 3,000 patient encounters per day from over 1,500 clinical sites. A cumulative sum technique was applied to the data to generate alert thresholds. Breast cancer, a disease with a stable incidence during the specified timeframe, was used as a control. Results: Total ILI daily ICD-10 counts that exceeded alert thresholds represented unusual levels of disease occurred 11 times from November 20, 2020 through February 28, 2020. This analysis is consistent with the COVID-19 pandemic timeline. The first statistically significant ILI increase occurred nine days prior to the first laboratory confirmed case in the country. Conclusion: Syndromic surveillance can be timelier than traditional surveillance methods, which require laboratory testing to confirm disease. As a result of this study, we are installing a real-time alert for ILI into CREDO, so rates can be monitored continuously as an indicator of possible future new infectious disease outbreaks.


Asunto(s)
/epidemiología , Prácticas Clínicas , Vigilancia de Guardia , Estudiantes de Medicina , Brotes de Enfermedades , Femenino , Humanos , Gripe Humana/epidemiología , Clasificación Internacional de Enfermedades , Masculino , Vigilancia de la Población/métodos , Infecciones del Sistema Respiratorio/epidemiología , Estudios Retrospectivos , Estados Unidos/epidemiología
6.
Artículo en Inglés | MEDLINE | ID: mdl-33573537

RESUMEN

Background: The current COVID-19 pandemic is not the first time New South Wales prisons have faced contagion. This paper examines the current responses in New South Wales prisons to the threat of COVID-19 to prisoner health, by contrasting contemporary activities with actions and policy developed during two historical epidemics: the influenza epidemic of 1860 and pandemic of 1919. Method: Epidemiological information relating to cases of disease in NSW prisons during the 1860 and 1919 influenza epidemics was obtained from the Comptroller-General's reports for the specific outbreak years and for the preceding and succeeding five-year periods. Additional archival sources such as digitised newspaper reports and articles available through the National Library of Australia were analysed for closer detail. The management of these outbreaks was compared to current strategies to mitigate against risk from the COVID-19 pandemic in the NSW prison system. Results: Interesting similarities were discovered in relation to the management of the historic influenza outbreaks in NSW prisons and in the management of the current COVID-19 pandemic. An outbreak of influenza in mid-1860 impacted seven penal institutions in Sydney and Parramatta. Infection rates at these institutions were between 3.1% and 100%; the mean rate was 41.8%. The public health measures employed at the time included allowing 'air circulation freely night and day', and treatments that were 'tonical and stimulatory'. Discussion: While the past 100 or more years have brought huge progress in scientific knowledge, public health approaches remain the mainstay of outbreak management in prisons; and, as in 1919, the opportunity for Australia to observe the rest of the world and plan for action has not been wasted. Prisons pose a potential risk for pandemic spread but they also present a unique opportunity for reducing disease risk by ironic virtue of the 'separate system' that was recognised even 100 years ago as characteristic of these institutions.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/métodos , Gripe Humana/historia , Prisiones/historia , Salud Pública , Control de Enfermedades Transmisibles/historia , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Gripe Humana/epidemiología , Nueva Gales del Sur/epidemiología , Prisiones/organización & administración , Prisiones/normas
7.
BMC Med Res Methodol ; 21(1): 34, 2021 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-33583405

RESUMEN

BACKGROUND: Ensemble modeling aims to boost the forecasting performance by systematically integrating the predictive accuracy across individual models. Here we introduce a simple-yet-powerful ensemble methodology for forecasting the trajectory of dynamic growth processes that are defined by a system of non-linear differential equations with applications to infectious disease spread. METHODS: We propose and assess the performance of two ensemble modeling schemes with different parametric bootstrapping procedures for trajectory forecasting and uncertainty quantification. Specifically, we conduct sequential probabilistic forecasts to evaluate their forecasting performance using simple dynamical growth models with good track records including the Richards model, the generalized-logistic growth model, and the Gompertz model. We first test and verify the functionality of the method using simulated data from phenomenological models and a mechanistic transmission model. Next, the performance of the method is demonstrated using a diversity of epidemic datasets including scenario outbreak data of the Ebola Forecasting Challenge and real-world epidemic data outbreaks of including influenza, plague, Zika, and COVID-19. RESULTS: We found that the ensemble method that randomly selects a model from the set of individual models for each time point of the trajectory of the epidemic frequently outcompeted the individual models as well as an alternative ensemble method based on the weighted combination of the individual models and yields broader and more realistic uncertainty bounds for the trajectory envelope, achieving not only better coverage rate of the 95% prediction interval but also improved mean interval scores across a diversity of epidemic datasets. CONCLUSION: Our new methodology for ensemble forecasting outcompete component models and an alternative ensemble model that differ in how the variance is evaluated for the generation of the prediction intervals of the forecasts.


Asunto(s)
Brotes de Enfermedades , Predicción/métodos , Modelos Estadísticos , /epidemiología , Fiebre Hemorrágica Ebola/epidemiología , Humanos , Gripe Humana/epidemiología , Infección por el Virus Zika/epidemiología
8.
Eur Respir Rev ; 30(159)2021 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-33568526

RESUMEN

PURPOSE: Corticosteroids have been considered in medicine for a long time, and they are broadly prescribed. In infectious diseases, corticosteroids have been regarded as a thread due to their immunosuppressive effects and therefore their anti-inflammatory properties. MAIN: In recent years, there have been several studies published that aimed to determine the role of corticosteroids in patients with community-acquired pneumonia (CAP), because, despite significant advances in new antibiotics and supportive care, deaths of patients with CAP remain unacceptably high. While the 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) CAP guidelines did not mention the use of corticosteroids in the management of CAP, the recently published 2019 IDSA/ATS guidelines recommended their use in patients with septic shock refractory to vasopressors and fluid resuscitation. Regarding viral infection, the use of corticosteroids in patients with influenza has shown to be associated with significantly higher mortality and higher incidence of nosocomial infection, while in patients with coronavirus disease 2019 (COVID-19) there is a good body of evidence of the benefit of corticosteroids in terms of mortality. CONCLUSIONS: The use of corticosteroids has been considered as a potential alternative co-adjuvant treatment in patients with pneumonia. In patients with COVID-19, the evidence is quite strong and there is a clear benefit of the use of corticosteroids in those patients presenting severe forms of disease.


Asunto(s)
Corticoesteroides/uso terapéutico , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Gripe Humana/tratamiento farmacológico , Corticoesteroides/efectos adversos , Toma de Decisiones Clínicas , Humanos , Seguridad del Paciente , Medición de Riesgo , Factores de Riesgo , Resultado del Tratamiento
9.
Nat Commun ; 12(1): 726, 2021 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-33563980

RESUMEN

Human mobility is a primary driver of infectious disease spread. However, existing data is limited in availability, coverage, granularity, and timeliness. Data-driven forecasts of disease dynamics are crucial for decision-making by health officials and private citizens alike. In this work, we focus on a machine-learned anonymized mobility map (hereon referred to as AMM) aggregated over hundreds of millions of smartphones and evaluate its utility in forecasting epidemics. We factor AMM into a metapopulation model to retrospectively forecast influenza in the USA and Australia. We show that the AMM model performs on-par with those based on commuter surveys, which are sparsely available and expensive. We also compare it with gravity and radiation based models of mobility, and find that the radiation model's performance is quite similar to AMM and commuter flows. Additionally, we demonstrate our model's ability to predict disease spread even across state boundaries. Our work contributes towards developing timely infectious disease forecasting at a global scale using human mobility datasets expanding their applications in the area of infectious disease epidemiology.


Asunto(s)
Predicción/métodos , Gripe Humana/epidemiología , Aprendizaje Automático , Australia/epidemiología , Humanos , Gripe Humana/prevención & control , Gripe Humana/transmisión , Modelos Teóricos , Ciudad de Nueva York/epidemiología , Dinámica Poblacional , Reproducibilidad de los Resultados , Teléfono Inteligente
10.
Am J Public Health ; 111(3): 405-406, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33566662
11.
BMJ Open ; 11(2): e041354, 2021 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-33563620

RESUMEN

OBJECTIVES: We studied time trends in seasonal influenza vaccination and associations with socioeconomic and health-related determinants in Switzerland, overall and in people aged ≥65 years. DESIGN: Three cross-sectional surveys. PARTICIPANTS: Individuals who participated in the Swiss Health Surveys 2007, 2012 and 2017. We calculated the proportion reporting influenza vaccination in the last 12 months, and performed multivariable logistic regression analyses. RESULTS: We included 51 582 individuals in this analysis. The median age was 49 years (IQR 25-64), and 27 518 were women (53.3%). The proportion of reporting a history of influenza vaccination overall was 31.9% (95% CI 31.4 to 32.4); and dropped from 34.5% in 2007 to 28.8% in 2017. The uptake of vaccination within the past 12 months was 16% in 2007 and similar in 2012 and 2017 (around 14%). In people with chronic disease, uptake dropped from 43.8% in 2007 to 37.1% in 2012 and to 31.6% in 2017 (p<0.001). In people aged ≥65 years, uptake dropped from 47.8% in 2007 to 38.5% in 2012 to 36.2% in 2017 (p<0.001). In logistic regression, self-reported vaccination coverage decreased in the 65-75 years old (adjusted OR (aOR) 0.56, 95% CI 0.48 to 0.66 between 2007 and 2012; aOR 0.89, 95% CI 0.77 to 1.03 between 2012 and 2017). Uptake was positively associated with the ≥65 age group, living in French-speaking and urban areas, history of smoking, bad self-reported health status, private/semiprivate health insurance, having a medical profession and having any underlying chronic disease. CONCLUSION: Influenza vaccination coverage was low in older and chronically ill persons. Significant efforts are required in preparing for the influenza season 2020/2021 to reduce the double burden of COVID-19 and seasonal influenza. These efforts should include campaigns but also novel approaches using social media.


Asunto(s)
Vacunas contra la Influenza/administración & dosificación , Gripe Humana , Autoinforme , Vacunación/tendencias , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Gripe Humana/prevención & control , Masculino , Persona de Mediana Edad , Embarazo , Suiza , Adulto Joven
12.
Nat Commun ; 12(1): 1001, 2021 02 12.
Artículo en Inglés | MEDLINE | ID: mdl-33579926

RESUMEN

Stringent nonpharmaceutical interventions (NPIs) such as lockdowns and border closures are not currently recommended for pandemic influenza control. New Zealand used these NPIs to eliminate coronavirus disease 2019 during its first wave. Using multiple surveillance systems, we observed a parallel and unprecedented reduction of influenza and other respiratory viral infections in 2020. This finding supports the use of these NPIs for controlling pandemic influenza and other severe respiratory viral threats.


Asunto(s)
/epidemiología , Gripe Humana/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , /prevención & control , Control de Enfermedades Transmisibles , Monitoreo Epidemiológico , Hospitalización/estadística & datos numéricos , Humanos , Gripe Humana/prevención & control , Gripe Humana/virología , Nueva Zelanda/epidemiología , Pandemias , Salud Pública , Infecciones del Sistema Respiratorio/prevención & control , Infecciones del Sistema Respiratorio/virología , /aislamiento & purificación
13.
Nature ; 590(7845): 185, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33564188
14.
Curr Med Sci ; 41(1): 51-57, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33582905

RESUMEN

Coronavirus disease 2019 (COVID-19) occurs in the influenza season and has become a global pandemic. The present study aimed to examine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infection with influenza A virus (IAV) in an attempt to provide clues for the antiviral interventions of co-infected patients. We described two patients who were co-infected with SARS-CoV-2 and IAV treated at Wuhan Union Hospital, China. In addition, we performed a review in PubMed, Web of Science and CNKI (from January 1 up to November 1, 2020) with combinations of the following key words: "COVID-19, SARS-COV-2, influenza A and co-infection". A total of 28 co-infected patients were enrolled in the analysis. Of the 28 patients, the median age was 54.5 years (IQR, 34.25-67.5) and 14 cases (50.0%) were classified as severe types. The most common symptoms were fever (85.71%), cough (82.14%) and dyspnea (60.71%). Sixteen patients had lymphocytopenia on admission and 23 patients exhibited abnormal radiological changes. The median time from symptom onset to hospital admission was 4 days (IQR, 3-6), and the median time of hospital stay was 14 days (IQR, 8.5-16.75). In conclusion, patients with SARS-COV-2 and IAV co-infection were similar to those infected with SARS-COV-2 alone in symptoms and radiological images. SARS-COV-2 co-infection with IAV could lead to more severe clinical condition but did not experience longer hospital stay compared with patients infected with SARS-COV-2 alone.


Asunto(s)
/epidemiología , Coinfección/epidemiología , Virus de la Influenza A/aislamiento & purificación , Gripe Humana/epidemiología , /aislamiento & purificación , Adulto , Anciano , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Índice de Severidad de la Enfermedad
17.
Adv Clin Exp Med ; 30(1): 109-114, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33529514

RESUMEN

BACKGROUND: This review focuses on the frequency of symptoms in COVID-19 in comparison to SARS, influenza and common cold. OBJECTIVES: To evaluate and compare the knowledge about the clinical features, symptoms and differences between patients with COVID-19, SARS, influenza, and common cold. The research can help ear, nose and throat specialists and other health practitioners manage patients during the COVID-19 pandemic. MATERIAL AND METHODS: The biomedical databases used in the study included PubMed and MEDLINE. Statistical analysis using the Z-score test assessed which symptoms were more characteristic of COVID-19 than other viral diseases. RESULTS: Among individuals with COVID-19, the most frequently reported symptoms were cough (70%), fever (45%), muscular pain (29%), and headache (21%), whereas sore throat (12%), and rhinorrhea (4%) were observed at lower rates. Fever was identified as most frequent in COVID-19 (74%), appearing at a higher rate in those cases than in influenza (68%) or the common cold (40%) (p < 0.05). In comparison to other viral diseases, sore throat was rarely reported in COVID-19 and SARS (12% and 18%, respectively) (p < 0.05). In influenza and common cold, a cough was identified in 93% and 80% of cases (p < 0.05). Headache, rhinorrhea, muscular pain, and sore throat were more common in influenza (91%, 91%, 94%, and 84%, respectively) and common cold (89%, 81%, 94%, and 84%, respectively) than in COVID-19 (21%, 4%, 29%, and 12%, respectively) and SARS (45%, 12%, 55%, and 18%, respectively) (p < 0.05). CONCLUSION: The results of the analysis show that a greater number of general symptoms should lead to a diagnosis of influenza or common cold rather than COVID-19.


Asunto(s)
Resfriado Común , Gripe Humana , Resfriado Común/diagnóstico , Resfriado Común/epidemiología , Humanos , Gripe Humana/diagnóstico , Gripe Humana/epidemiología , Pandemias
19.
Sci Adv ; 7(1)2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33523846

RESUMEN

Here, we report the topology-matched design of heteromultivalent nanostructures as potent and broad-spectrum virus entry inhibitors based on the host cell membrane. Initially, we investigate the virus binding dynamics to validate the better binding performance of the heteromultivalent moieties as compared to homomultivalent ones. The heteromultivalent binding moieties are transferred to nanostructures with a bowl-like shape matching the viral spherical surface. Unlike the conventional homomultivalent inhibitors, the heteromultivalent ones exhibit a half maximal inhibitory concentration of 32.4 ± 13.7 µg/ml due to the synergistic multivalent effects and the topology-matched shape. At a dose without causing cellular toxicity, >99.99% reduction of virus propagation has been achieved. Since multiple binding sites have also been identified on the S protein of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), we envision that the use of heteromultivalent nanostructures may also be applied to develop a potent inhibitor to prevent coronavirus infection.


Asunto(s)
Glicoproteínas Hemaglutininas del Virus de la Influenza/química , Virus de la Influenza A/efectos de los fármacos , Gripe Humana/virología , Nanopartículas/química , Neuraminidasa/química , Animales , Antivirales/farmacología , Sitios de Unión , Membrana Celular/metabolismo , Perros , Membrana Eritrocítica/virología , Humanos , Virus de la Influenza A/fisiología , Células de Riñón Canino Madin Darby , Unión Proteica , Glicoproteína de la Espiga del Coronavirus , Virión , Acoplamiento Viral/efectos de los fármacos , Internalización del Virus/efectos de los fármacos
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