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1.
Artigo em Inglês | MEDLINE | ID: mdl-34429342

RESUMO

BACKGROUND AND OBJECTIVE: To describe the impact of coronavirus disease 2019 (COVID-19) on people with neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD). METHODS: The COVID-19 Infections in Multiple Sclerosis (MS) and Related Diseases (COViMS) Registry collected data on North American patients with MS and related diseases with laboratory-positive or highly suspected SARS-CoV-2 infection. Deidentified data were entered into a web-based registry by health care providers. Data were analyzed using t-tests, Pearson χ2 tests, or Fisher exact tests for categorical variables. Univariate logistic regression models examined effects of risk factors and COVID-19 clinical severity. RESULTS: As of June 7, 2021, 77 patients with NMOSD and 20 patients with MOGAD were reported in the COViMS Registry. Most patients with NMOSD were laboratory positive for SARS-CoV-2 and taking rituximab at the time of COVID-19 diagnosis. Most patients with NMOSD were not hospitalized (64.9% [95% CI: 53.2%-75.5%]), whereas 15.6% (95% CI: 8.3%-25.6%) were hospitalized only, 9.1% (95% CI: 3.7%-17.8%) were admitted to the ICU and/or ventilated, and 10.4% (95% CI: 4.6%-19.5%) died. In patients with NMOSD, having a comorbidity was the sole factor identified for poorer COVID-19 outcome (OR = 6.0, 95% CI: 1.79-19.98). Most patients with MOGAD were laboratory positive for SARS-CoV-2, and almost half were taking rituximab. Among patients with MOGAD, 75.0% were not hospitalized, and no deaths were recorded; no factors were different between those not hospitalized and those hospitalized, admitted to the ICU, or ventilated. DISCUSSION: Among the reported patients with NMOSD, a high mortality rate was observed, and the presence of comorbid conditions was associated with worse COVID-19 outcome. There were no deaths reported in the patients with MOGAD, although these observations are limited due to small sample size.


Assuntos
Doenças Autoimunes do Sistema Nervoso/mortalidade , COVID-19/mortalidade , COVID-19/terapia , Glicoproteína Mielina-Oligodendrócito/imunologia , Neuromielite Óptica/mortalidade , Sistema de Registros , Adulto , Idoso , Doenças Autoimunes do Sistema Nervoso/imunologia , COVID-19/diagnóstico , Comorbidade , Feminino , Hospitalização , Humanos , Fatores Imunológicos/administração & dosagem , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Neuromielite Óptica/tratamento farmacológico , América do Norte/epidemiologia , Avaliação de Resultados em Cuidados de Saúde , Respiração Artificial , Rituximab/administração & dosagem
2.
Eur J Epidemiol ; 36(6): 629-640, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34114189

RESUMO

We estimated the impact of a comprehensive set of non-pharmeceutical interventions on the COVID-19 epidemic growth rate across the 37 member states of the Organisation for Economic Co-operation and Development during the early phase of the COVID-19 pandemic and between October and December 2020. For this task, we conducted a data-driven, longitudinal analysis using a multilevel modelling approach with both maximum likelihood and Bayesian estimation. We found that during the early phase of the epidemic: implementing restrictions on gatherings of more than 100 people, between 11 and 100 people, and 10 people or less was associated with a respective average reduction of 2.58%, 2.78% and 2.81% in the daily growth rate in weekly confirmed cases; requiring closing for some sectors or for all but essential workplaces with an average reduction of 1.51% and 1.78%; requiring closing of some school levels or all school levels with an average reduction of 1.12% or 1.65%; recommending mask wearing with an average reduction of 0.45%, requiring mask wearing country-wide in specific public spaces or in specific geographical areas within the country with an average reduction of 0.44%, requiring mask-wearing country-wide in all public places or all public places where social distancing is not possible with an average reduction of 0.96%; and number of tests per thousand population with an average reduction of 0.02% per unit increase. Between October and December 2020 work closing requirements and testing policy were significant predictors of the epidemic growth rate. These findings provide evidence to support policy decision-making regarding which NPIs to implement to control the spread of the COVID-19 pandemic.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Máscaras/estatística & dados numéricos , Organização para a Cooperação e Desenvolvimento Econômico , Distanciamento Físico , Quarentena/estatística & dados numéricos , Ásia/epidemiologia , Australásia/epidemiologia , Europa (Continente)/epidemiologia , Humanos , Estudos Longitudinais , América do Norte/epidemiologia , Pandemias , Quarentena/métodos , SARS-CoV-2
3.
Viruses ; 13(5)2021 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-34067890

RESUMO

BACKGROUND: little is known about the forecasting of new variants of SARS-COV-2 in North America and the interaction of variants with vaccine-derived neutralizing antibodies. METHODS: the affinity scores of the spike receptor-binding domain (S-RBD) of B.1.1.7, B. 1.351, B.1.617, and P.1 variants in interaction with the neutralizing antibody (CV30 isolated from a patient), and human angiotensin-converting enzyme 2 (hACE2) receptor were predicted using the template-based computational modeling. From the Nextstrain global database, we identified prevalent mutations of S-RBD of SARS-CoV-2 from December 2019 to April 2021. Pre- and post-vaccination time series forecasting models were developed based on the prediction of neutralizing antibody affinity scores for S-RBD of the variants. RESULTS: the proportion of the B.1.1.7 variant in North America is growing rapidly, but the rate will reduce due to high affinity (~90%) to the neutralizing antibody once herd immunity is reached. Currently, the rates of isolation of B. 1.351, B.1.617, and P.1 variants are slowly increasing in North America. Herd immunity is able to relatively control these variants due to their low affinity (~70%) to the neutralizing antibody. The S-RBD of B.1.617 has a 110% increased affinity score to the human angiotensin-converting enzyme 2 (hACE2) in comparison to the wild-type structure, making it highly infectious. CONCLUSION: The newly emerged B.1.351, B.1.617, and P.1 variants escape from vaccine-induced neutralizing immunity and continue circulating in North America in post- herd immunity era. Our study strongly suggests that a third dose of vaccine is urgently needed to cover novel variants with affinity scores (equal or less than 70%) to eliminate developing viral mutations and reduce transmission rates.


Assuntos
COVID-19/epidemiologia , SARS-CoV-2/genética , Adulto , Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/imunologia , Sítios de Ligação/genética , COVID-19/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , América do Norte/epidemiologia , Ligação Proteica/genética , Domínios Proteicos/genética , Receptores Virais/metabolismo , SARS-CoV-2/patogenicidade , Glicoproteína da Espícula de Coronavírus/genética
4.
Proc Biol Sci ; 288(1952): 20210719, 2021 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-34074117

RESUMO

Predicting the emergence and spread of infectious diseases is critical for the effective conservation of biodiversity. White-nose syndrome (WNS), an emerging infectious disease of bats, has resulted in high mortality in eastern North America. Because the fungal causative agent Pseudogymnoascus destructans is constrained by temperature and humidity, spread dynamics may vary by geography. Environmental conditions in the southern part of the continent are different than the northeast, where disease dynamics are typically studied, making it difficult to predict how the disease will manifest. Herein, we modelled WNS pathogen spread in Texas based on cave densities and average dispersal distances of hosts, projecting these results out to 10 years. We parameterized a predictive model of WNS epidemiology and its effects on bat populations with observed cave environmental data. Our model suggests that bat populations in northern Texas will be more affected by WNS mortality than southern Texas. As such, we recommend prioritizing the preservation of large overwintering colonies of bats in north Texas through management actions. Our model illustrates that infectious disease spread and infectious disease severity can become uncoupled over a gradient of environmental variation and highlight the importance of understanding host, pathogen and environmental conditions across a breadth of environments.


Assuntos
Ascomicetos , Quirópteros , Doenças Transmissíveis Emergentes , Hibernação , Animais , América do Norte/epidemiologia
6.
Sci Rep ; 11(1): 9784, 2021 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-33963250

RESUMO

The mortality rates of COVID-19 vary across the globe. While some risk factors for poor prognosis of the disease are known, regional differences are suspected. We reviewed the risk factors for critical outcomes of COVID-19 according to the location of the infected patients, from various literature databases from January 1 through June 8, 2020. Candidate variables to predict the outcome included patient demographics, underlying medical conditions, symptoms, and laboratory findings. The risk factors in the overall population included sex, age, and all inspected underlying medical conditions. Symptoms of dyspnea, anorexia, dizziness, fatigue, and certain laboratory findings were also indicators of the critical outcome. Underlying respiratory disease was associated higher risk of the critical outcome in studies from Asia and Europe, but not North America. Underlying hepatic disease was associated with a higher risk of the critical outcome from Europe, but not from Asia and North America. Symptoms of vomiting, anorexia, dizziness, and fatigue were significantly associated with the critical outcome in studies from Asia, but not from Europe and North America. Hemoglobin and platelet count affected patients differently in Asia compared to those in Europe and North America. Such regional discrepancies should be considered when treating patients with COVID-19.


Assuntos
COVID-19/epidemiologia , Fatores Etários , Ásia/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , América do Norte/epidemiologia , Pandemias , Fatores de Risco , SARS-CoV-2/isolamento & purificação , Fatores Sexuais
8.
Vet Res ; 52(1): 68, 2021 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-33980312

RESUMO

Glaesserella parasuis strains were characterized by serotyping PCR, vtaA virulence marker Leader Sequence (LS)-PCR, clinical significance, and geographic region. Overall, the serovars 4, 5/12, 7, 1, and 13 were the most commonly detected. Serovars of greatest clinical relevance were systemic isolates that had a higher probability of being serovar 5/12, 13, or 7. In comparison, pulmonary isolates had a higher likelihood of being serovars 2, 4, 7, or 14. Serovars 5/12 and 13 have previously been considered disease-associated, but this study agrees with other recent studies showing that serovar 7 is indeed associated with systemic G. parasuis disease. Serovar 4 strains illustrated how isolates can have varying degrees of virulence and be obtained from pulmonary, systemic, or nasal sites. Serovars 8, 9, 15, and 10 were predominantly obtained from nasal samples, which indicates a limited clinical significance of these serovars. Additionally, most internal G. parasuis isolates were classified as virulent by LS-PCR and were disease-associated isolates, including serovars 1, 2, 4, 5/12, 7, 13, and 14. Isolates from the nasal cavity, including serovars 6, 9, 10, 11, and 15, were classified as non-virulent by LS-PCR. In conclusion, the distribution of G. parasuis serovars remains constant, with few serovars representing most of the strains isolated from affected pigs. Moreover, it was confirmed that the LS-PCR can be used for G. parasuis virulence prediction of field strains worldwide.


Assuntos
Infecções por Haemophilus/veterinária , Haemophilus parasuis/genética , Doenças dos Suínos/epidemiologia , Animais , Ásia/epidemiologia , Europa (Continente)/epidemiologia , Infecções por Haemophilus/epidemiologia , Infecções por Haemophilus/microbiologia , América do Norte/epidemiologia , Reação em Cadeia da Polimerase/veterinária , Prevalência , Estudos Soroepidemiológicos , Sorotipagem/veterinária , Sus scrofa , Suínos , Doenças dos Suínos/microbiologia
9.
Antimicrob Agents Chemother ; 65(7): e0200020, 2021 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-33972241

RESUMO

To estimate the incidence of carbapenem-resistant Enterobacterales (CRE), a global collection of 81,781 surveillance isolates of Enterobacterales collected from patients in 39 countries in five geographic regions from 2012 to 2017 was studied. Overall, 3.3% of isolates were meropenem-nonsusceptible (MIC ≥2 µg/ml), ranging from 1.4% (North America) to 5.3% (Latin America) of isolates by region. Klebsiella pneumoniae accounted for the largest number of meropenem-nonsusceptible isolates (76.7%). The majority of meropenem-nonsusceptible Enterobacterales carried KPC-type carbapenemases (47.4%), metallo-ß-lactamases (MBLs; 20.6%) or OXA-48-like ß-lactamases (19.0%). Forty-three carbapenemase sequence variants (8 KPC-type, 4 GES-type, 7 OXA-48-like, 5 NDM-type, 7 IMP-type, and 12 VIM-type) were detected, with KPC-2, KPC-3, OXA-48, NDM-1, IMP-4, and VIM-1 identified as the most common variants of each carbapenemase type. The resistance mechanisms responsible for meropenem-nonsusceptibility varied by region. A total of 67.3% of all carbapenemase-positive isolates identified carried at least one additional plasmid-mediated or intrinsic chromosomally encoded extended-spectrum ß-lactamase, AmpC ß-lactamase, or carbapenemase. The overall percentage of meropenem-nonsusceptible Enterobacterales increased from 2.7% in 2012 to 2014 to 3.8% in 2015 to 2017. This increase could be attributed to the increasing proportion of carbapenemase-positive isolates that was observed, most notably among isolates carrying NDM-type MBLs in Asia/South Pacific, Europe, and Latin America; OXA-48-like carbapenemases in Europe, Middle East/Africa, and Asia/South Pacific; VIM-type MBLs in Europe; and KPC-type carbapenemases in Latin America. Ongoing CRE surveillance combined with a global antimicrobial stewardship strategy, sensitive clinical laboratory detection methods, and adherence to infection control practices will be needed to interrupt the spread of CRE.


Assuntos
Antibacterianos , beta-Lactamases , África , Antibacterianos/farmacologia , Ásia , Proteínas de Bactérias/genética , Carbapenêmicos/farmacologia , Europa (Continente) , Humanos , Meropeném/farmacologia , Testes de Sensibilidade Microbiana , Oriente Médio , América do Norte/epidemiologia , beta-Lactamases/genética
10.
Vet Parasitol ; 294: 109392, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33971481

RESUMO

A diverse array of ixodid and argasid ticks infest dogs and cats in North America, resulting in skin lesions, blood loss, and disease. The ticks most commonly found on pets in this region are hard ticks of the genera Amblyomma, Dermacentor, Ixodes, and Rhipicephalus, as well as the more recently established Haemaphysalis longicornis. Soft tick genera, especially Otobius and Ornithodoros, are also reported from pets in some regions. In this review, we provide a summary of the complex and diverse life histories, distinct morphologies, and questing and feeding behaviors of the more common ticks of dogs and cats in North America with a focus on recent changes in geographic distribution. We also review pathogens of dogs and cats associated with the different tick species, some of which can cause serious, potentially fatal disease, and describe the zoonotic risk posed by ticks of pets. Understanding the natural history of ticks and the maintenance cycles responsible for providing an ongoing source of tick-borne infections is critical to effectively combatting the challenges ticks pose to the health of pets and people.


Assuntos
Doenças do Gato/parasitologia , Doenças do Cão/parasitologia , Ixodidae/fisiologia , Infestações por Carrapato/veterinária , Doenças Transmitidas por Carrapatos/veterinária , Animais , Doenças do Gato/epidemiologia , Doenças do Gato/transmissão , Gatos , Doenças do Cão/epidemiologia , Doenças do Cão/transmissão , Cães , Comportamento Alimentar , Feminino , Humanos , Ixodidae/classificação , Ixodidae/microbiologia , Masculino , América do Norte/epidemiologia , Infestações por Carrapato/epidemiologia , Infestações por Carrapato/parasitologia , Doenças Transmitidas por Carrapatos/microbiologia , Doenças Transmitidas por Carrapatos/transmissão , Zoonoses
12.
BMC Infect Dis ; 21(1): 468, 2021 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-34022823

RESUMO

BACKGROUND: Vector control plays a critical role in the prevention, control and elimination of vector-borne diseases, and interventions of vector control continue to depend largely on the action of chemical insecticides. A global survey was conducted on the management practices of vector control insecticides at country level to identify gaps to inform future strategies on pesticide management, seeking to improve efficacy of interventions and reduce the side-effects of chemicals used on health and the environment. METHODS: A survey by questionnaire on the management practices of vector control insecticides was disseminated among all WHO Member States. Data were analysed using descriptive statistics in MS Excel. RESULTS: Responses were received from 94 countries, or a 48% response rate. Capacity for insecticide resistance monitoring was established in 68-80% of the countries in most regions, often with external support; however, this capacity was largely lacking from the European & Others Region (i.e. Western & Eastern Europe, North America, Australia and New Zealand). Procurement of vector control insecticides was in 50-75% of countries taking place by agencies other than the central-level procuring agency, over which the central authorities lacked control, for example, to select the product or assure its quality, highlighting the importance of post-market monitoring. Moreover, some countries experienced problems with estimating the correct amounts for procurement, especially for emergency purposes. Large fractions (29-78%) of countries across regions showed shortcomings in worker safety, pesticide storage practices and pesticide waste disposal. Shortcomings were most pronounced in countries of the European & Others Region, which has long been relatively free from mosquito-borne diseases but has recently faced challenges of re-emerging vector-borne diseases. CONCLUSIONS: Critical shortcomings in the management of vector control insecticides are common in countries across regions, with risks of adverse pesticide effects on health and the environment. Advocacy and resource mobilization are needed at regional and country levels to address these challenges.


Assuntos
Vetores de Doenças , Saúde Global , Resistência a Inseticidas/efeitos dos fármacos , Inseticidas/farmacologia , Controle de Mosquitos/métodos , Doenças Transmitidas por Vetores/epidemiologia , Doenças Transmitidas por Vetores/prevenção & controle , Animais , Ásia/epidemiologia , Monitoramento Epidemiológico , Europa (Continente)/epidemiologia , Humanos , América do Norte/epidemiologia , América do Sul/epidemiologia , Inquéritos e Questionários
13.
Br J Nurs ; 30(10): S8-S14, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34037439

RESUMO

The challenges presented by the global COVID-19 pandemic have intensified the stressors placed on nurses, leading to burnout. Oncology nurse burnout is likely to be an increasingly significant issue for cancer services as the true cost of the pandemic is revealed. Delays in diagnosis and treatment of cancers are reported widely, inevitably leading to poor prognosis and more aggressive treatments for patients. Gaining a better understanding of oncology nurse burnout, its prevalence and causes as well as strategies to reduce or prevent it will help to improve patient care and support staff wellbeing during and after the pandemic. Methodology: A search of the literature related to oncology nurse burnout, covering North America and Europe over 5 years (August 2014-January 2020), resulted in 31 articles for review. None of the studies were carried out in the UK, suggesting a need for robust investigations into oncology nurse burnout in the British health service. Summary: The prevalence of burnout among oncology nurses before the COVID-19 outbreak appeared to be high and is likely to have increased as a result of the pandemic. However, the studies investigating oncology nurse burnout are small and cross-sectional, with low-quality methods. The literature suggests the major causes of burnout arise in the workplace, particularly aspects of the environment that prevent nurses from working according to their values. Although burnout is frequently attributed to workplace factors, interventions remain focused on individuals' coping mechanisms and rarely on the workplace factors that are known to cause it.


Assuntos
Esgotamento Profissional , COVID-19 , Enfermagem Oncológica , Esgotamento Profissional/epidemiologia , COVID-19/epidemiologia , Europa (Continente)/epidemiologia , Humanos , América do Norte/epidemiologia
14.
Parasitol Res ; 120(6): 1993-2001, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34021801

RESUMO

A new genus, Megancestus n. gen., is proposed to accommodate the caryophyllidean tapeworm Biacetabulum carpiodi Mackiewicz, 1969 from carpsuckers and quillback (Carpiodes spp.) in North America. This species is not closely related to other species of Biacetabulum Hunter, 1927 and is transferred to a newly erected genus. This new genus is typified by the possession of a small body (total length of 3.1-7.5 mm) with a scolex that bears a pair of large acetabulum-like loculi, two pairs of shallow lateral loculi, and a slightly convex apical disc, testes arranged in one or two layers, oval, thick-walled cirrus-sac, well-developed external seminal vesicle, separate gonopores, H-shaped ovary, few median vitelline follicles, and the uterus extending by a single loop anterior to the cirrus-sac. Megancestus differs from all Nearctic caryophyllidean genera (family Capingentidae), including Biacetabulum, by vitelline follicles dorsal to the ovary that connect the preovarian and postovarian vitelline fields. The most closely related Hunterella Mackiewicz et McCrae, 1962 differs by shape of the scolex (tholate, i.e., devoid of any loculi), dumbbell-shaped ovary and the uterus not extending anterior to the cirrus-sac. Megancestus carpiodi (Mackiewicz, 1969) n. comb. is the only species of the genus and it is a stenoxenous parasite, which has been found only in the river carpsucker (Carpiodes carpio-type host), quillback (Carpiodes cyprinus) and highfin carpsucker (Carpiodes velifer) (Catostomidae: Ictiobinae) in the lower and middle Mississippi basin.


Assuntos
Cestoides/classificação , Infecções por Cestoides/veterinária , Cipriniformes/parasitologia , Doenças dos Peixes/parasitologia , Animais , Cestoides/anatomia & histologia , Infecções por Cestoides/parasitologia , Feminino , Doenças dos Peixes/epidemiologia , América do Norte/epidemiologia , Filogenia , Especificidade da Espécie
15.
Sci Adv ; 7(21)2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34020946

RESUMO

Responses to the COVID-19 outbreak resulted in one of the largest short-term decreases in anthropogenic emissions in modern history. To date, there has been no comprehensive assessment of the impact of lockdowns on air quality and human health. Using global satellite observations and ground measurements from 36 countries in Europe, North America, and East Asia, we find that lockdowns led to reductions in NO2 concentrations globally, resulting in ~32,000 avoided premature mortalities, including ~21,000 in China. However, we do not find corresponding reductions in PM2.5 and ozone globally. Using satellite measurements, we show that the disconnect between NO2 and ozone changes stems from local chemical regimes. The COVID-related lockdowns demonstrate the need for targeted air quality policies to reduce the global burden of air pollution, especially related to secondary pollutants.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Monitoramento Ambiental , Material Particulado/efeitos adversos , Poluição do Ar/efeitos adversos , COVID-19/patologia , COVID-19/virologia , China/epidemiologia , Exposição Ambiental , Europa (Continente)/epidemiologia , Extremo Oriente/epidemiologia , Humanos , América do Norte/epidemiologia , Ozônio , SARS-CoV-2/patogenicidade
16.
J Epidemiol Glob Health ; 11(2): 143-145, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33876593

RESUMO

Case fatality rate (CFR) is used to calculate mortality burden of COVID-19 under different scenarios, thus informing risk-benefit balance of interventions both pharmaceutical and nonpharmaceutical. However, observed CFR is driven by testing: as more low-risk cases are identified, observed CFR will decline. This report quantifies test bias by modeling observed CFR as log-log-linear function of test density (tests per population) in 163 countries. CFR declined almost 20% (e.g. from 5% to 4%) for each doubling of test density (p < 0.0001); this association did not vary by continent (interaction p > 0.10) although at any given test density CFR was higher in Europe or North America than in Asia or Africa. This effect of test density on observed CFR is adequate to hide all but the largest true differences in case survivorship. Published estimates of CFR should specify test density, and comparisons should correct for it such as by applying the provided model.


Assuntos
COVID-19/mortalidade , África/epidemiologia , Ásia/epidemiologia , Viés , Europa (Continente)/epidemiologia , Humanos , América do Norte/epidemiologia , SARS-CoV-2
17.
Epidemiol Infect ; 149: e94, 2021 04 13.
Artigo em Inglês | MEDLINE | ID: mdl-33845928

RESUMO

The global outbreak of coronavirus disease 2019 (COVID-19) is greatly threatening the public health in the world. We reconstructed global transmissions and potential demographic expansions of severe acute respiratory syndrome coronavirus 2 based on genomic information. We found that intercontinental transmissions were rare in January and early February but drastically increased since late February. After world-wide implements of travel restrictions, the transmission frequencies decreased to a low level in April. We identified a total of 88 potential demographic expansions over the world based on the star-radiative networks and 75 of them were found in Europe and North America. The expansion numbers peaked in March and quickly dropped since April. These findings are highly concordant with epidemic reports and modelling results and highlight the significance of quarantine validity on the global spread of COVID-19. Our analyses indicate that the travel restrictions and social distancing measures are effective in containing the spread of COVID-19.


Assuntos
COVID-19/epidemiologia , Genoma Viral , Política Pública , SARS-CoV-2/genética , Viagem , África/epidemiologia , Ásia/epidemiologia , Austrália/epidemiologia , COVID-19/transmissão , COVID-19/virologia , Controle de Doenças Transmissíveis , Europa (Continente)/epidemiologia , Genômica , Humanos , Internacionalidade , América do Norte/epidemiologia , Filogenia , Distanciamento Físico , América do Sul/epidemiologia
18.
J Am Coll Cardiol ; 77(16): 1994-2003, 2021 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-33888249

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of ST-segment elevation myocardial infarction (STEMI) care, including timely access to primary percutaneous coronary intervention (PPCI). OBJECTIVES: The goal of the NACMI (North American COVID-19 and STEMI) registry is to describe demographic characteristics, management strategies, and outcomes of COVID-19 patients with STEMI. METHODS: A prospective, ongoing observational registry was created under the guidance of 3 cardiology societies. STEMI patients with confirmed COVID+ (group 1) or suspected (person under investigation [PUI]) (group 2) COVID-19 infection were included. A group of age- and sex-matched STEMI patients (matched to COVID+ patients in a 2:1 ratio) treated in the pre-COVID era (2015 to 2019) serves as the control group for comparison of treatment strategies and outcomes (group 3). The primary outcome was a composite of in-hospital death, stroke, recurrent myocardial infarction, or repeat unplanned revascularization. RESULTS: As of December 6, 2020, 1,185 patients were included in the NACMI registry (230 COVID+ patients, 495 PUIs, and 460 control patients). COVID+ patients were more likely to have minority ethnicity (Hispanic 23%, Black 24%) and had a higher prevalence of diabetes mellitus (46%) (all p < 0.001 relative to PUIs). COVID+ patients were more likely to present with cardiogenic shock (18%) but were less likely to receive invasive angiography (78%) (all p < 0.001 relative to control patients). Among COVID+ patients who received angiography, 71% received PPCI and 20% received medical therapy (both p < 0.001 relative to control patients). The primary outcome occurred in 36% of COVID+ patients, 13% of PUIs, and 5% of control patients (p < 0.001 relative to control patients). CONCLUSIONS: COVID+ patients with STEMI represent a high-risk group of patients with unique demographic and clinical characteristics. PPCI is feasible and remains the predominant reperfusion strategy, supporting current recommendations.


Assuntos
COVID-19/epidemiologia , Intervenção Coronária Percutânea/estatística & dados numéricos , SARS-CoV-2 , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Canadá/epidemiologia , Feminino , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , América do Norte/epidemiologia , Estudos Prospectivos , Recidiva , Sistema de Registros/estatística & dados numéricos , Reoperação/estatística & dados numéricos , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Estados Unidos/epidemiologia , Adulto Jovem
19.
Sci Rep ; 11(1): 8435, 2021 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-33875719

RESUMO

Expansion of COVID-19 worldwide increases interest in unraveling genomic variations of novel SARS-CoV-2 virus. Metadata of 408,493 SARS-CoV-2 genomes submitted to GISAID database were analyzed with respect to genomic clades and their geographic, age, and gender distributions. Of the currently known SARS-CoV-2 clades, clade GR was the most prevalent worldwide followed by GV then GH. Chronological analysis revealed expansion in SARS-CoV-2 clades carrying D614G mutations with the predominance of the newest clade, GV, in the last three months. D614G clades prevail in countries with more COVID-19 cases. Of them, the clades GH and GR were more frequently recovered from severe or deceased COVID-19 cases. In contrast, G and GV clades showed a significantly higher prevalence among asymptomatic patients or those with mild disease. Metadata analysis showed higher (p < 0.05) prevalence of severe/deceased cases among males than females and predominance of GR clade in female patients. Furthermore, severe disease/death was more prevalent (p < 0.05) in elderly than in adults/children. Higher prevalence of the GV clade in children compared to other age groups was also evident. These findings uniquely provide a statistical evidence on the adaptation-driven evolution of SARS-CoV-2 leading to altered infectivity, virulence, and mortality.


Assuntos
COVID-19/patologia , SARS-CoV-2/genética , Adulto , Fatores Etários , Idoso , COVID-19/epidemiologia , COVID-19/virologia , Criança , Proteínas do Nucleocapsídeo de Coronavírus/genética , RNA-Polimerase RNA-Dependente de Coronavírus/genética , Bases de Dados Factuais , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , América do Norte/epidemiologia , SARS-CoV-2/isolamento & purificação , Fatores Sexuais , Glicoproteína da Espícula de Coronavírus/genética , Proteínas não Estruturais Virais/genética
20.
J Zoo Wildl Med ; 52(1): 157-165, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33827172

RESUMO

Takin (Budorcus taxicolor) are classified as "Vulnerable" on the International Union for the Conservation of Nature Red List. Thus, ex situ conservation efforts provide assurance populations for future survival of this species. The objective of this study was to identify common causes of morbidity and mortality in takin populations in human care. Twenty North American institutions that housed takin from 1997 to 2017 completed a survey requesting medical and husbandry data. Data were examined broadly, by sex and age groups. There were 206 morbidity events (male = 133; female = 73) submitted across 102 takin (male = 62; female = 40). The most common causes of morbidity were infectious or inflammatory diseases (50%; 104/206), degenerative diseases (22%; 46/206), and traumatic events (17%; 34/206). Necropsy reports were provided for 42 takin that died during the study period. The most common causes of mortality were infectious or inflammatory diseases (26%; 11/42), traumatic events (24%; 10/42), and degenerative disease (12%; 5/42). Sixty-two percent of infectious or inflammatory diseases causing morbidity were associated with endoparasites (64/104). Degenerative joint diseases more commonly affected males (78%; 36/46) as well as forelimbs (48%; 22/46) when compared to hindlimbs (30%; 14/46) and unspecified limbs (22%; 10/46). The prevalence of trauma as a cause of morbidity and mortality was higher in neonate and juvenile takin groups combined (morbidity = 19%; mortality = 50%) as compared to adult and senior takin groups combined (morbidity = 15%; mortality = 11%). Older takin were euthanatized more often (57%; 16/28) than younger takin (29%; 4/14). Correlations between husbandry and health were difficult as a result of the inherent limitations of the survey. These data will inform takin-holding zoologic institutions and contribute to the successful management of takin in human care.


Assuntos
Doenças dos Animais/patologia , Criação de Animais Domésticos , Animais de Zoológico , Ruminantes , Envelhecimento , Doenças dos Animais/mortalidade , Animais , Bovinos , Feminino , Masculino , América do Norte/epidemiologia , Fatores Sexuais
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