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1.
Cancer Cytopathol ; 128(9): 597-598, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32885911
2.
Ann Glob Health ; 86(1): 95, 2020 08 06.
Artículo en Inglés | MEDLINE | ID: mdl-32832388

RESUMEN

Currently, Nigeria is still at the ascending phase of the COVID-19 curve with no sign of deceleration. Thus, the recent decision by governors of states in northern Nigeria to deport Almajirai (itinerant Islamic school pupils) from their states as part of efforts to contain COVID-19 transmission is likely to have a serious backlash. With hundreds of Almajirai testing positive to COVID-19, and millions of others untested, they constitute ubiquitous nodes of transmission. Their deportation has created multiple emigration channels that constitute prospective feeders to covert community transmission. This viewpoint examines this trend within the context of Nigeria's current [in]capacity to manage the spread of COVID-19 and concludes that greater risks seem to lie ahead unless the government takes stringent containment measures.


Asunto(s)
Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa , Evaluación de Necesidades , Pandemias , Neumonía Viral , Salud Pública , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/normas , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa/prevención & control , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Regulación Gubernamental , Humanos , Islamismo , Nigeria/epidemiología , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Política , Pobreza , Salud Pública/métodos , Salud Pública/normas
4.
Lancet Public Health ; 5(9): e475-e483, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32745512

RESUMEN

BACKGROUND: Data for front-line health-care workers and risk of COVID-19 are limited. We sought to assess risk of COVID-19 among front-line health-care workers compared with the general community and the effect of personal protective equipment (PPE) on risk. METHODS: We did a prospective, observational cohort study in the UK and the USA of the general community, including front-line health-care workers, using self-reported data from the COVID Symptom Study smartphone application (app) from March 24 (UK) and March 29 (USA) to April 23, 2020. Participants were voluntary users of the app and at first use provided information on demographic factors (including age, sex, race or ethnic background, height and weight, and occupation) and medical history, and subsequently reported any COVID-19 symptoms. We used Cox proportional hazards modelling to estimate multivariate-adjusted hazard ratios (HRs) of our primary outcome, which was a positive COVID-19 test. The COVID Symptom Study app is registered with ClinicalTrials.gov, NCT04331509. FINDINGS: Among 2 035 395 community individuals and 99 795 front-line health-care workers, we recorded 5545 incident reports of a positive COVID-19 test over 34 435 272 person-days. Compared with the general community, front-line health-care workers were at increased risk for reporting a positive COVID-19 test (adjusted HR 11·61, 95% CI 10·93-12·33). To account for differences in testing frequency between front-line health-care workers and the general community and possible selection bias, an inverse probability-weighted model was used to adjust for the likelihood of receiving a COVID-19 test (adjusted HR 3·40, 95% CI 3·37-3·43). Secondary and post-hoc analyses suggested adequacy of PPE, clinical setting, and ethnic background were also important factors. INTERPRETATION: In the UK and the USA, risk of reporting a positive test for COVID-19 was increased among front-line health-care workers. Health-care systems should ensure adequate availability of PPE and develop additional strategies to protect health-care workers from COVID-19, particularly those from Black, Asian, and minority ethnic backgrounds. Additional follow-up of these observational findings is needed. FUNDING: Zoe Global, Wellcome Trust, Engineering and Physical Sciences Research Council, National Institutes of Health Research, UK Research and Innovation, Alzheimer's Society, National Institutes of Health, National Institute for Occupational Safety and Health, and Massachusetts Consortium on Pathogen Readiness.


Asunto(s)
Infecciones por Coronavirus/transmisión , Personal de Salud/estadística & datos numéricos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Equipo de Protección Personal/estadística & datos numéricos , Neumonía Viral/transmisión , Adulto , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Aplicaciones Móviles , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Estudios Prospectivos , Medición de Riesgo , Autoinforme , Reino Unido/epidemiología , Estados Unidos/epidemiología , Adulto Joven
5.
J Healthc Eng ; 2020: 8843664, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32832047

RESUMEN

Coronavirus Disease (COVID19) is a fast-spreading infectious disease that is currently causing a healthcare crisis around the world. Due to the current limitations of the reverse transcription-polymerase chain reaction (RT-PCR) based tests for detecting COVID19, recently radiology imaging based ideas have been proposed by various works. In this work, various Deep CNN based approaches are explored for detecting the presence of COVID19 from chest CT images. A decision fusion based approach is also proposed, which combines predictions from multiple individual models, to produce a final prediction. Experimental results show that the proposed decision fusion based approach is able to achieve above 86% results across all the performance metrics under consideration, with average AUROC and F1-Score being 0.883 and 0.867, respectively. The experimental observations suggest the potential applicability of such Deep CNN based approach in real diagnostic scenarios, which could be of very high utility in terms of achieving fast testing for COVID19.


Asunto(s)
Betacoronavirus , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico por imagen , Aprendizaje Profundo , Redes Neurales de la Computación , Neumonía Viral/diagnóstico por imagen , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Ingeniería Biomédica , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Bases de Datos Factuales , Humanos , Pandemias , Neumonía Viral/epidemiología , Tórax/diagnóstico por imagen
6.
N Z Med J ; 133(1519): 81-88, 2020 07 31.
Artículo en Inglés | MEDLINE | ID: mdl-32777798

RESUMEN

AIM: The diagnostic sensitivity of the SARS-CoV-2 real time reverse transcription polymerase chain reaction (RT-PCR) test has not been determined. This has led to a degree of uncertainty in the interpretation of results, particularly in patients tested repeatedly. The aim of this study was to explore the characteristics of patients who initially tested negative, and subsequently tested positive for SARS-CoV-2. METHODS: This retrospective observational study utilised data from the LabPlus Virology laboratory, Auckland City Hospital, to identify cases (hospital and community) with initial negative and subsequent positive SARS-CoV-2 RT-PCR results. Their clinical and laboratory characteristics were summarised. RESULTS: From 1 February to 13 April a total of 20,089 samples were received for SARS-CoV-2 testing. Of 2,011 samples from patients with multiple tests, 25 samples were positive. Nine samples were from patients who initially tested negative then tested positive. Reasons for the initial negative test results, which were all from upper respiratory tract samples, included pre-symptomatic presentation or late presentation. All patients had significant risk factors and ongoing or evolving symptoms, which warranted repeat testing. CONCLUSION: Few patients had discordant test results for SARS-CoV-2 RT-PCR. For patients who have a significant risk factor and a negative test result, repeat testing should be performed.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Enfermedades Asintomáticas/epidemiología , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/normas , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Diagnóstico Diferencial , Reacciones Falso Negativas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Reproducibilidad de los Resultados , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo
7.
N Z Med J ; 133(1519): 89-94, 2020 07 31.
Artículo en Inglés | MEDLINE | ID: mdl-32777799

RESUMEN

AIM: There is concern the low incidence of coronavirus disease 2019 (COVID-19) in children reflects under-testing in this population. This study sought to describe the age-distribution of SARS-CoV-2 testing in the Northern Region of New Zealand. METHODS: A retrospective single-centre review of all SARS-CoV-2 tests performed at LabPLUS, Auckland City Hospital, between 12 February and 18 April 2020. RESULTS: A total of 22,333 tests were performed, with 313 (1.40%) positive results. The age-adjusted SARS-CoV-2 testing rate was three times higher in adults than in children. The overall proportion of positive tests was lower in children (0.86%) than adults (1.45%). However, within the paediatric population the proportion of tests positive differed significantly between those <10 years old (0.08%) and those 10-14 years old (2.6%). CONCLUSION: The lower proportion of tests positive in children <10 years of age suggests they are appropriately tested relative to their rates of disease. A large high school-associated cluster makes the higher proportion of tests positive in children 10-14 years old difficult to interpret. Older children may have a higher risk of infection and increasing testing in intermediate and high school aged children may be indicated.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Adolescente , Adulto , Distribución por Edad , Niño , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Análisis por Conglomerados , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Femenino , Humanos , Masculino , Nueva Zelanda/epidemiología , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Estudios Retrospectivos
8.
MMWR Morb Mortal Wkly Rep ; 69(33): 1139-1143, 2020 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-32817597

RESUMEN

Preventing coronavirus disease 2019 (COVID-19) in correctional and detention facilities* can be challenging because of population-dense housing, varied access to hygiene facilities and supplies, and limited space for isolation and quarantine (1). Incarcerated and detained populations have a high prevalence of chronic diseases, increasing their risk for severe COVID-19-associated illness and making early detection critical (2,3). Correctional and detention facilities are not closed systems; SARS-CoV-2, the virus that causes COVID-19, can be transmitted to and from the surrounding community through staff member and visitor movements as well as entry, transfer, and release of incarcerated and detained persons (1). To better understand SARS-CoV-2 prevalence in these settings, CDC requested data from 15 jurisdictions describing results of mass testing events among incarcerated and detained persons and cases identified through earlier symptom-based testing. Six jurisdictions reported SARS-CoV-2 prevalence of 0%-86.8% (median = 29.3%) from mass testing events in 16 adult facilities. Before mass testing, 15 of the 16 facilities had identified at least one COVID-19 case among incarcerated or detained persons using symptom-based testing, and mass testing increased the total number of known cases from 642 to 8,239. Case surveillance from symptom-based testing has likely underestimated SARS-CoV-2 prevalence in correctional and detention facilities. Broad-based testing can provide a more accurate assessment of prevalence and generate data to help control transmission (4).


Asunto(s)
Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades/prevención & control , Tamizaje Masivo , Neumonía Viral/epidemiología , Prisiones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Vivienda/estadística & datos numéricos , Humanos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Prevalencia , Estados Unidos/epidemiología
9.
Respir Med ; 170: 106062, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32843180

RESUMEN

BACKGROUND: Given the high incidence of confirmed infection by SARS-CoV-2 and mortality by COVID-19 in the Spanish population, its impact was analysed among persons with Cystic Fibrosis (CF) as a group at risk of a worse evolution. The possible causes of the incidence observed in them are explained and how CF Units have faced this health challenge is detailed. METHODS: Retrospective descriptive observational study, for which a Spanish CF Patients with Confirmed COVID-19 Registry is created, requesting information on number of people affected between 8 March-16 May 2020 and their clinical-demographic characteristics from the CF Units participating in the European Cystic Fibrosis Society Patient Registry (ECFSPR). The accumulated incidence is calculated, compared with that of the general population. Additionally, a survey (CF-COVID19-Spain) is carried out on prevention of SARS-CoV-2 infection, workings of CF Units and possible reasons for the incidence observed. RESULTS: COVID-19 was diagnosed in eight CF patients, one of whom had received a lung transplant. The accumulated incidence was 32/10000 in CF patients and 49/10000 in the general population. General death rate was 5.85/10000 while no CF patients included in the ECFSPR died. The characteristics of those affected and the results of the survey are described. CONCLUSIONS: Despite being considered a disease at high risk of severe COVID-19, the low incidence and mortality in CF patients in Spain contrasts with the figures for the general population. The possible factors that would explain such findings are discussed, with the help of the results of the CF-COVID19-Spain survey.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus , Fibrosis Quística/epidemiología , Pandemias , Neumonía Viral , Adulto , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/terapia , Femenino , Humanos , Incidencia , Masculino , Mortalidad , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/terapia , Sistema de Registros/estadística & datos numéricos , Estudios Retrospectivos , Medición de Riesgo , España/epidemiología
10.
Epidemiol Infect ; 148: e183, 2020 08 06.
Artículo en Inglés | MEDLINE | ID: mdl-32758313

RESUMEN

Diagnostic testing for the novel coronavirus is an important tool to fight the coronavirus disease (Covid-19) pandemic. However, testing capacities are limited. A modified testing protocol, whereby a number of probes are 'pooled' (i.e. grouped), is known to increase the capacity for testing. Here, we model pooled testing with a double-average model, which we think to be close to reality for Covid-19 testing. The optimal pool size and the effect of test errors are considered. The results show that the best pool size is three to five, under reasonable assumptions. Pool testing even reduces the number of false positives in the absence of dilution effects.


Asunto(s)
Técnicas de Laboratorio Clínico , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Betacoronavirus , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/normas , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Humanos , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Prevalencia , Sensibilidad y Especificidad
11.
Biosens Bioelectron ; 166: 112436, 2020 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-32750677

RESUMEN

Our recent experience of the COVID-19 pandemic has highlighted the importance of easy-to-use, quick, cheap, sensitive and selective detection of virus pathogens for the efficient monitoring and treatment of virus diseases. Early detection of viruses provides essential information about possible efficient and targeted treatments, prolongs the therapeutic window and hence reduces morbidity. Graphene is a lightweight, chemically stable and conductive material that can be successfully utilized for the detection of various virus strains. The sensitivity and selectivity of graphene can be enhanced by its functionalization or combination with other materials. Introducing suitable functional groups and/or counterparts in the hybrid structure enables tuning of the optical and electrical properties, which is particularly attractive for rapid and easy-to-use virus detection. In this review, we cover all the different types of graphene-based sensors available for virus detection, including, e.g., photoluminescence and colorimetric sensors, and surface plasmon resonance biosensors. Various strategies of electrochemical detection of viruses based on, e.g., DNA hybridization or antigen-antibody interactions, are also discussed. We summarize the current state-of-the-art applications of graphene-based systems for sensing a variety of viruses, e.g., SARS-CoV-2, influenza, dengue fever, hepatitis C virus, HIV, rotavirus and Zika virus. General principles, mechanisms of action, advantages and drawbacks are presented to provide useful information for the further development and construction of advanced virus biosensors. We highlight that the unique and tunable physicochemical properties of graphene-based nanomaterials make them ideal candidates for engineering and miniaturization of biosensors.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Técnicas Biosensibles , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Grafito , Neumonía Viral/diagnóstico , Virus/aislamiento & purificación , Reacciones Antígeno-Anticuerpo , Betacoronavirus/genética , Betacoronavirus/patogenicidad , Técnicas Biosensibles/instrumentación , Técnicas Biosensibles/métodos , Técnicas Biosensibles/tendencias , Técnicas de Laboratorio Clínico/instrumentación , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Colorimetría , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , ADN Viral/análisis , ADN Viral/genética , Técnicas Electroquímicas , Diseño de Equipo , Grafito/química , Humanos , Luminiscencia , Nanoestructuras/química , Hibridación de Ácido Nucleico , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Puntos Cuánticos/química , Espectrometría Raman , Resonancia por Plasmón de Superficie , Virología/métodos , Virus/genética , Virus/patogenicidad
12.
J Infect Dev Ctries ; 14(7): 713-720, 2020 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-32794459

RESUMEN

INTRODUCTION: There are significant differences in the active cases and fatality rates of Covid-19 for different European countries. METHODOLOGY: The present study employs Monte Carlo based transmission growth simulations for Italy, Germany and Turkey. The probabilities of transmission at home, work and social networks and the number of initial cases have been calibrated to match the basic reproduction number and the reported fatality curves. Parametric studies were conducted to observe the effect of social distancing, work closure, testing and quarantine of the family and colleagues of positively tested individuals. RESULTS: It is observed that estimates of the number of initial cases in Italy compared to Turkey and Germany are higher. Turkey will probably experience about 30% less number of fatalities than Germany due its smaller elderly population. If social distancing and work contacts are limited to 25% of daily routines, Germany and Turkey may limit the number of fatalities to a few thousands as the reproduction number decreases to about 1.3 from 2.8. Random testing may reduce the number of fatalities by 10% upon testing least 5/1000 of the population. Quarantining of family and workmates of positively tested individuals may reduce the total number of fatalities by about 50%. CONCLUSIONS: The fatality rate of Covid-19 is estimated to be about 1.5% based on the simulation results. This may further be reduced by limiting the number of non-family contacts to two, conducting tests more than 0.5% of the population and immediate quarantine of the contacts for positively tested individuals.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Cuarentena , Adolescente , Adulto , Distribución por Edad , Anciano , Número Básico de Reproducción , Niño , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Composición Familiar , Alemania/epidemiología , Humanos , Italia/epidemiología , Persona de Mediana Edad , Método de Montecarlo , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Aislamiento Social , Red Social , Turquia/epidemiología , Adulto Joven
13.
Biosens Bioelectron ; 167: 112479, 2020 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-32763826

RESUMEN

COVID-19 pandemic outbreak is the most astounding scene ever experienced in the 21st century. It has been determined to be caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). With the global pandemic, the lack of efficient rapid and accurate molecular diagnostic testing tools has hindered the public opportunely response to the emerging viral threat. Herein, a DNA nanoscaffold hybrid chain reaction (DNHCR)-based nucleic acid assay strategy is reported for rapid detection of SARS-CoV-2 RNA. In this method, the DNA nanoscaffolds have been first constructed by the self-assembly of long DNA strands and self-quenching probes (H1). Then, the SARS-CoV-2 RNA will initiate the hybridization of H1 and free H2 DNA probes along the nanoscaffold, and an illuminated DNA nanostring is instantly obtained. By taking advantages of the localization design of the H1 probes and the temperature tolerance of the isothermal amplification, the proposed DNHCR method can detect target at short responding time (within 10 min) and mild condition (15 °C-35 °C). Moreover, the reliability of DNHCR method in serum and saliva samples have also been validated. Therefore, DNHCR-based method is expected to provide a simple and faster alternative to the traditional SARS-CoV-2 qRT-PCR assay.


Asunto(s)
Betacoronavirus , Técnicas Biosensibles/métodos , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/virología , Neumonía Viral/diagnóstico , Neumonía Viral/virología , Betacoronavirus/genética , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , ADN/síntesis química , ADN/química , ADN/genética , Estudios de Factibilidad , Humanos , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Diagnóstico Molecular/estadística & datos numéricos , Nanoestructuras/química , Nanotecnología , Técnicas de Amplificación de Ácido Nucleico/métodos , Pandemias , Neumonía Viral/epidemiología , ARN Viral/análisis , ARN Viral/genética , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
14.
Epidemiol Infect ; 148: e178, 2020 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-32807244

RESUMEN

Different countries have adopted strategies for the early detection of SARS-CoV-2 since the declaration of community transmission by the World Health Organization (WHO) and timely diagnosis has been considered one of the major obstacles for surveillance and healthcare. Here, we report the increase of the number of laboratories to COVID-19 diagnosis in Brazil. Our results demonstrate an increase and decentralisation of certified laboratories, which does not match the much higher increase in the number of COVID-19 cases. Also, it becomes clear that laboratories are irregularly distributed over the country, with a concentration in the most developed state, São Paulo.


Asunto(s)
Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Laboratorios/provisión & distribución , Neumonía Viral/diagnóstico , Betacoronavirus , Brasil/epidemiología , Infecciones por Coronavirus/epidemiología , Humanos , Incidencia , Técnicas de Diagnóstico Molecular , Pandemias , Neumonía Viral/epidemiología
15.
Spat Spatiotemporal Epidemiol ; 34: 100355, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32807400

RESUMEN

Identifying areas with low access to testing and high case burden is necessary to understand risk and allocate resources in the COVID-19 pandemic. Using zip code level data for New York City, we analyzed testing rates, positivity rates, and proportion positive. A spatial scan statistic identified clusters of high and low testing rates, high positivity rates, and high proportion positive. Boxplots and Pearson correlations determined associations between outcomes, clusters, and contextual factors. Clusters with less testing and low proportion positive tests had higher income, education, and white population, whereas clusters with high testing rates and high proportion positive tests were disproportionately black and without health insurance. Correlations showed inverse associations of white race, education, and income with proportion positive tests, and positive associations with black race, Hispanic ethnicity, and poverty. We recommend testing and health care resources be directed to eastern Brooklyn, which has low testing and high proportion positives.


Asunto(s)
Enfermedades Transmisibles Emergentes/epidemiología , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades/estadística & datos numéricos , Disparidades en Atención de Salud/etnología , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Salud Urbana/etnología , Adulto , Anciano , Anciano de 80 o más Años , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Análisis por Conglomerados , Infecciones por Coronavirus/diagnóstico , Femenino , Disparidades en el Estado de Salud , Disparidades en Atención de Salud/economía , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Neumonía Viral/diagnóstico , Medición de Riesgo , Análisis Espacial , Salud Urbana/economía , Población Urbana
16.
Nat Hum Behav ; 4(8): 856-865, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32737472

RESUMEN

The first case of COVID-19 was detected in Brazil on 25 February 2020. We report and contextualize epidemiological, demographic and clinical findings for COVID-19 cases during the first 3 months of the epidemic. By 31 May 2020, 514,200 COVID-19 cases, including 29,314 deaths, had been reported in 75.3% (4,196 of 5,570) of municipalities across all five administrative regions of Brazil. The R0 value for Brazil was estimated at 3.1 (95% Bayesian credible interval = 2.4-5.5), with a higher median but overlapping credible intervals compared with some other seriously affected countries. A positive association between higher per-capita income and COVID-19 diagnosis was identified. Furthermore, the severe acute respiratory infection cases with unknown aetiology were associated with lower per-capita income. Co-circulation of six respiratory viruses was detected but at very low levels. These findings provide a comprehensive description of the ongoing COVID-19 epidemic in Brazil and may help to guide subsequent measures to control virus transmission.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus , Transmisión de Enfermedad Infecciosa , Gripe Humana , Pandemias , Neumonía Viral , Adulto , Anciano , Brasil/epidemiología , Niño , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Coinfección/epidemiología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa/prevención & control , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Gripe Humana/diagnóstico , Gripe Humana/epidemiología , Gripe Humana/virología , Masculino , Mortalidad , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Neumonía Viral/terapia , Neumonía Viral/transmisión , Factores Socioeconómicos
17.
Dan Med J ; 67(8)2020 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-32741438

RESUMEN

INTRODUCTION: Chemosensory loss is a common symptom of coronavirus disease 2019 (COVID-19) and has been associated with a milder clinical course in younger patients. Whereas several studies have confirmed this association, knowledge about the improvement and recovery of olfactory and gustatory loss is lacking. The aim of this study was to investigate the temporal dynamics of improvement and recovery from sudden olfactory and gustatory loss in patients with confirmed and suspected COVID-19. METHODS: Subjective chemosensory function, symptoms of COVID-19, COVID-19 tests results, demographics and medical history were collected through a questionnaire. RESULTS: Among the 109 study participants, 95 had a combined olfactory and gustatory loss, five participants had isolated olfactory loss and nine participants has isolated taste loss. The mean age of participants was 39.4 years and 25% of participants were under the age of 30 years. Young age was not associated with a higher recovery rate. After a mean time of > 30 days since the chemosensory loss, participants reported relatively low recovery and improvement rates. For participants with olfactory loss, only 44% had fully recovered, whereas 28% had not yet experienced any improvement of symptoms. After gustatory loss, 50% had fully recovered, whereas 20% had not yet experienced any improvement. Olfactory and gustatory deficits were predominantly quantitative and mainly included complete loss of both olfactory and gustatory function. CONCLUSIONS: Chemosensory loss was frequent in young individuals and persisted beyond a month after symptom onset, often without any improvement during this time. FUNDING: The author wishes to acknowledge research salary funding from Arla Foods (Viby, Denmark) and the Central Region Denmark. The sponsors had no say, roles or responsibilities in relation to the study, including (but not limited to) the study design, data collection, management and analysis. TRIAL REGISTRATION: not relevant.


Asunto(s)
Ageusia , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus , Trastornos del Olfato , Pandemias , Neumonía Viral , Adulto , Ageusia/diagnóstico , Ageusia/etiología , Ageusia/rehabilitación , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/fisiopatología , Dinamarca/epidemiología , Autoevaluación Diagnóstica , Femenino , Humanos , Masculino , Trastornos del Olfato/diagnóstico , Trastornos del Olfato/etiología , Trastornos del Olfato/rehabilitación , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/fisiopatología , Recuperación de la Función , Encuestas y Cuestionarios , Evaluación de Síntomas/métodos , Evaluación de Síntomas/estadística & datos numéricos
18.
Ann Biol Clin (Paris) ; 78(4): 363-382, 2020 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-32753365

RESUMEN

The point-of-care tests (POCT) are subject to accreditation. A national inventory survey provides a synthesis of knowledge. The survey distributed 31 questions in 2019. 147 responses were received (75% biologists, 49% CHU, 42% CHG). Only 20.41% are accredited ISO22870, the majority for <50% of the medical departments; 70% say they are going there at the end of 2019 or in 2020. The maps are unknown for 32% (EBMD) and 82% (TROD). Visibility is poor with: medical establishment committee (40%), IT department (31%). Connection is necessary for 87-95% depending on the criterion (QC, authorizations, etc.) and 66% of answers highlight that less than 50% of connexion is effective. The major advantage is the delay of the result (62.5%), then the relationship with the health teams (33.3%). The disadvantages: difficulty of the quality approach (45%), cost of tests (34.3%). Human resource requirements are identified for technicians (82%) and biologists (76%). The multiplicity of sites, devices and operators means that it is difficult to set up and maintain. Biology outside the laboratories, under biological responsibility, must meet a rigorous imperative quality approach.


Asunto(s)
Técnicas de Laboratorio Clínico , Salud Global , Laboratorios/estadística & datos numéricos , Laboratorios/normas , Pruebas en el Punto de Atención , Acreditación , Servicios de Laboratorio Clínico/normas , Servicios de Laboratorio Clínico/estadística & datos numéricos , Técnicas de Laboratorio Clínico/normas , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Francia/epidemiología , Salud Global/normas , Salud Global/estadística & datos numéricos , Historia del Siglo XXI , Humanos , Internacionalidad , Ensayos de Aptitud de Laboratorios/normas , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Sistemas de Atención de Punto/normas , Sistemas de Atención de Punto/estadística & datos numéricos , Pruebas en el Punto de Atención/organización & administración , Pruebas en el Punto de Atención/normas , Pruebas en el Punto de Atención/estadística & datos numéricos , Garantía de la Calidad de Atención de Salud/organización & administración , Encuestas y Cuestionarios
19.
BMC Pulm Med ; 20(1): 203, 2020 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-32727446

RESUMEN

BACKGROUND: COVID-19 is an infectious disease caused by a novel coronavirus (SARS-CoV-2). The immunopathogenesis of the infection is currently unknown. Healthcare workers (HCWs) are at highest risk of infection and disease. Aim of the study was to assess the sero-prevalence of SARS-CoV-2 in an Italian cohort of HCWs exposed to COVID-19 patients. METHODS: A point-of-care lateral flow immunoassay (BioMedomics IgM-IgG Combined Antibody Rapid Test) was adopted to assess the prevalence of IgG and IgM against SARS-CoV-2. It was ethically approved ("Milano Area 1" Ethical Committee prot. n. 2020/ST/057). RESULTS: A total of 202 individuals (median age 45 years; 34.7% males) were retrospectively recruited in an Italian hospital (Milan, Italy). The percentage (95% CI) of recruited individuals with IgM and IgG were 14.4% (9.6-19.2%) and 7.4% (3.8-11.0%), respectively. IgM were more frequently found in males (24.3%), and in individuals aged 20-29 (25.9%) and 60-69 (30.4%) years. No relationship was found between exposure to COVID-19 patients and IgM and IgG positivity. CONCLUSIONS: The present study did show a low prevalence of SARS-CoV-2 IgM in Italian HCWs. New studies are needed to assess the prevalence of SARS-CoV-2 antibodies in HCWs exposed to COVID-19 patients, as well the role of neutralizing antibodies.


Asunto(s)
Anticuerpos Antivirales , Betacoronavirus/inmunología , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus , Personal de Salud/estadística & datos numéricos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Pandemias , Neumonía Viral , Adulto , Factores de Edad , Anciano , Anticuerpos Antivirales/análisis , Anticuerpos Antivirales/clasificación , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/inmunología , Femenino , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/estadística & datos numéricos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Exposición Profesional/estadística & datos numéricos , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/inmunología , Estudios Seroepidemiológicos , Factores Sexuales
20.
J Orthop Surg Res ; 15(1): 279, 2020 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-32703305

RESUMEN

BACKGROUND: According to the required reorganization of all hospital activities, the recent COVID-19 pandemic had dramatic consequences on the orthopedic world. We think that informing the orthopedic community about the strategy that we adopted both in our hospital and in our Department of Orthopedics could be useful, particularly for those who are facing the pandemic later than Italy. METHODS: Changes were done in our hospital by medical direction to reallocate resources to COVID-19 patients. In the Orthopedic Department, a decrease in the number of beds and surgical activity was stabilized. Since March 13, it has been avoided to perform elective surgery, and since March 16, non-urgent outpatient consultations were abolished. This activity reduction was associated with careful evaluation of staff and patients: extensive periodical swab testing of all healthcare staff and swab testing of all surgical patients were applied. RESULTS: These restrictions determined an overall reduction of all our surgical activities of 30% compared to 2019. We also had a reduction in outpatient clinic activities and admissions to the orthopedic emergency unit. Extensive swab testing has proven successful: of more than 160 people tested in our building, only three COVID-19 positives were found, and of over more than 200 surgical procedures, only two positive patients were found. CONCLUSIONS: Extensive swab test of all people (even if asymptomatic) and proactive tracing and quarantining of potential COVID-19 positive patients may diminish the virus spread.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Ortopedia/organización & administración , Neumonía Viral/epidemiología , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Urgencias Médicas , Reforma de la Atención de Salud/organización & administración , Hospitalización , Humanos , Control de Infecciones/organización & administración , Italia/epidemiología , Procedimientos Ortopédicos/estadística & datos numéricos , Servicio Ambulatorio en Hospital/organización & administración , Servicio Ambulatorio en Hospital/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Servicio de Cirugía en Hospital/organización & administración
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