Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 45.331
Filtrar
1.
Environ Health Prev Med ; 25(1): 57, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008319

RESUMO

BACKGROUND: At the end of 2019, the outbreak of coronavirus disease 2019 (COVID-19) severely damaged and endangered people's lives. The public health emergency management system in China has played an essential role in handling the response to the outbreak, which has been appreciated by the World Health Organization and some countries. Hence, it is necessary to conduct an overall analysis of the development of the health emergency management system in China. This can provide a reference for scholars to aid in understanding the current situation and to reveal new research topics. METHODS: We collected 2247 international articles from the Web of Science database and 959 Chinese articles from the China National Knowledge Infrastructure database. Bibliometric and mapping knowledge domain analysis methods were used in this study for temporal distribution analysis, cooperation network analysis, and co-word network analysis. RESULTS: The first international article in this field was published in 1991, while the first Chinese article was published in 2005. The research institutions producing these studies mainly existed in universities and health organizations. Developed countries and European countries published the most articles overall, while eastern China published the most articles within China. There were 52 burst words for international articles published from 1999-2018 and 18 burst words for Chinese articles published from 2003-2018. International top-ranked articles according to the number of citations appeared in 2005, 2007, 2009, 2014, 2015, and 2016, while the corresponding Chinese articles appeared in 2003, 2004, 2009, and 2011. CONCLUSIONS: There are differences in the regional and economic distribution of international and Chinese cooperation networks. International research is often related to timely issues mainly by focusing on emergency preparedness and monitoring of public health events, while China has focused on public health emergencies and their disposition. International research began on terrorism and bioterrorism, followed by disaster planning and emergency preparedness, epidemics, and infectious diseases. China considered severe acute respiratory syndrome as the starting research background and the legal system construction as the research starting point, which was followed by the mechanism, structure, system, and training abroad for public health emergency management.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Betacoronavirus , China/epidemiologia , Surtos de Doenças/prevenção & controle , Humanos , Internacionalidade
2.
Biomed Res Int ; 2020: 2854186, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33015160

RESUMO

Objectives: To evaluate the role of short-term low-dose glucocorticoids in mild COVID-19 patients. Methods: We conducted a retrospective, cross-sectional, single-center study in Kunming, China. A total of 33 mild COVID-19 cases were divided into two treatment groups (with and without glucocorticoids, methylprednisolone, were used in this setting), and the absolute value of peripheral blood lymphocyte count; CD3+, CD4+, and CD8+ T cell counts; and the time to achieve negative transformation of a nucleic acid pharyngeal swab were recorded. Peripheral blood lymphocyte and T cell counts were compared between the treatment group and 25 healthy individuals. At the point of time when there was a 50% accumulation conversion rate (positive to negative nucleic acid on pharyngeal swab), and the nucleic acid turned negative in half of the patients in two groups, the peripheral blood lymphocyte and T cell counts were compared between treatment groups. Results: The mean cumulative time for the 50% negative conversion rate of the nucleic acid in the pharyngeal swab was 17.7 ± 5.1 days and 13.9 ± 5.4 days in the glucocorticoid group and the nonglucocorticoid group, respectively. The absolute peripheral blood lymphocyte count and the T cell subset count in the glucocorticoid group were lower than those in the nonglucocorticoid group. When the nucleic acid turned negative in half of the patients, the absolute value of peripheral blood lymphocyte count and CD4+ T cells of the glucocorticoid group and the nonglucocorticoid group was not significantly different; the CD3+ and CD8+ T cells in the glucocorticoid group were lower than those in the nonglucocorticoid group. The absolute peripheral blood lymphocyte count, CD3+ T cells, and CD4+ T cells in the glucocorticoid group were lower than those of the healthy group during the whole disease period, and CD8+ T cells returned to normal at 19-21 days of the disease period. There was no significant difference between the nonglucocorticoid group and the healthy group for absolute peripheral blood lymphocyte and CD8+ T cells; moreover, CD3+ T cells and CD4+ T cells were lower in the nonglucocorticoid group than those in the healthy group from the day of admission to the 18th day and returned to normal at the period of 19-21 days. The absolute peripheral lymphocyte count (P = 0.048, effect size d = 0.727) and T cell subset count (CD3: P = 0.042, effect size d = 0.655; CD4: P < 0.01, effect size d = 0.599; and CD8: P = 0.034, effect size d = 0.550) in the nonglucocorticoid group were higher than those in the glucocorticoid group, and the difference between the groups was statistically significant. Conclusions: This study found that the use of short-term, low-dose glucocorticoids does not negatively influence the clinical outcome, without affecting the final clearance of viral nucleic acid in mild COVID-19 patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Glucocorticoides/administração & dosagem , Pneumonia Viral/tratamento farmacológico , Adolescente , Adulto , Betacoronavirus/isolamento & purificação , Criança , China/epidemiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Estudos Transversais , Feminino , Humanos , Contagem de Linfócitos , Masculino , Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/imunologia , Pneumonia Viral/virologia , Estudos Retrospectivos , Subpopulações de Linfócitos T/imunologia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
3.
J Orthop Surg Res ; 15(1): 452, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008440

RESUMO

BACKGROUND: A large number of cases of pneumonia caused by novel ß-coronavirus emerged in Hubei Province, China, at the end of 2019 and demonstrated great potential for transmission. At present, known independent risk factors include age, diabetes, and other chronic diseases, which may be similar to the patients with chronic wound; thus, we try to explore the clinical characteristics, prognostic factors, and management recommendation of patients with chronic infective wounds during the COVID-19 epidemic period. METHODS: In this single-center, retrospective observational study, we included all cases with chronic infective wounds that came to our hospital between the full outbreak of the COVID-19 in China (January 23, 2020) and the latest date prior to posting (20 April 2020). Demographic data, comorbidities, laboratory and imaging findings, consultation history, and clinical outcomes (lesion cured, uncontrolled, amputated, etc. as of May 10, 2020) were collected for all individuals. Patients were subdivided into gangrene, traumatic infection, and other types of soft tissue infection wound (including bedsores, gout ruptures, stab wounds, and so on) according to the causes of wound, and their disease-related information were compared group by group. RESULTS: Among the total 81 patients with chronic infective wounds, 60% were male, with a mean age of 60.8 years (SD 18.6), including 38 (47%) patients with traumatic infection, 29 (36%) gangrene cases, and 14 (17%) other soft tissue infection wounds. Common comorbidities are hypertension (32%), diabetes (32%), cardiovascular disease (24%), and kidney injury (12%), and the patients with gangrenes have the most comorbidities. As of May 10, 2020, there were 78 patients discharged, and their average stay time is 15.8 days (SD 14.2), while people still at the hospital is 39.7 days (SD 8.7) much longer than the discharged and also has more comorbidities. But there is no significant difference in the hospitalization time of three types of wounds. And fortunately, none of all the patients were infected by coronavirus. CONCLUSION: The majority of patients with chronic wounds are severely ill with high risk of infection and poor prognosis; therefore, management of patients with chronic wounds should be improved.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Infecção dos Ferimentos/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , China/epidemiologia , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos
4.
Artigo em Inglês | MEDLINE | ID: mdl-33023103

RESUMO

Health rumors often mislead people and cause adverse health behaviors. Especially during a public health emergency, health rumors may result in severe consequences for people's health and risk governance. Insight into how these rumors form and harm people's health behavior is critical for assisting people in establishing scientific health cognition and to enhance public health emergency responses. Using the case study with interview data of a salient purchase craze led by a health rumor during the COVID-19 outbreak in China, this article aimed to illustrate the process of how a piece of information becomes a health rumor. Furthermore, we identify factors that cause people to believe rumors and conduct behavior that leads to a purchase craze. Results show that a public misunderstanding of the unique psychology of uncertainty, cultural and social cognition, and conformity behavior jointly informs people's beliefs in rumors and further causes purchase craze behavior. We developed a simplified model to demonstrate how an ordinary news report can lead to a rumor. Based on this model, some implications of effective health communication are suggested for managing rumors.


Assuntos
Infecções por Coronavirus/epidemiologia , Decepção , Surtos de Doenças , Conhecimentos, Atitudes e Prática em Saúde , Pneumonia Viral/epidemiologia , China/epidemiologia , Comportamento do Consumidor/estatística & dados numéricos , Humanos , Pandemias , Saúde Pública
5.
Comput Math Methods Med ; 2020: 9017157, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029196

RESUMO

This paper deals with the mathematical modeling and numerical simulations related to the coronavirus dynamics. A description is developed based on the framework of the susceptible-exposed-infectious-removed model. Initially, a model verification is carried out calibrating system parameters with data from China, Italy, Iran, and Brazil. Results show the model capability to predict infectious evolution. Afterward, numerical simulations are performed in order to analyze different scenarios of COVID-19 in Brazil. Results show the importance of the governmental and individual actions to control the number and the period of the critical situations related to the pandemic.


Assuntos
Simulação por Computador , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Algoritmos , Betacoronavirus , Brasil/epidemiologia , China/epidemiologia , Doenças Transmissíveis/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Itália/epidemiologia , Modelos Teóricos , Pandemias , Informática em Saúde Pública , Reprodutibilidade dos Testes
6.
BMC Public Health ; 20(1): 1525, 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33032575

RESUMO

BACKGROUND: This study was intended to investigate the epidemiological characteristics of COVID-19 clusters and the severity distribution of clinical symptoms of involved cases in Sichuan Province, so as to provide information support for the development and adjustment of strategies for the prevention and control of local clusters. METHODS: The epidemiological characteristics of 67 local clusters of COVID-19 cases in Sichuan Province reported as of March 17, 2020 were described and analyzed. Information about all COVID-19 clusters and involved cases was acquired from the China Information System for Disease Control and Prevention and analyzed with the epidemiological investigation results taken into account. RESULTS: The clusters were temporally and regionally concentrated. Clusters caused by imported cases from other provinces accounted for 73.13%; familial clusters accounted for 68.66%; the average attack rate was 8.54%, and the average secondary attack rate was 6.11%; the median incubation period was 8.5 d; a total of 28 cases met the criteria for incubation period determination, and in the 28 cases, the incubation period was > 14 d in 21.43% (6/28). a total of 226 confirmed cases were reported in the 67 clusters. Ten cases were exposed before the confirmed cases they contacted with developed clinical symptoms, and the possibility of exposure to other infection sources was ruled out; two clusters were caused by asymptomatic carriers; confirmed cases mainly presented with fever, respiratory and systemic symptoms; a gradual decline in the severity of clinical symptoms was noted with the increase of the case generation. CONCLUSIONS: Population movement and gathering restrictions and strict close contact management measures will significantly contribute to the identification and control of cases. Transmission during the incubation period and asymptomatic infections have been noted. Studies on the pathogenicity and transmissibility in these populations and on COVID-19 antibody levels and protective effects in healthy people and cases are required.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Análise por Conglomerados , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pandemias , Adulto Jovem
7.
Artigo em Chinês | MEDLINE | ID: mdl-33040505

RESUMO

Objective:The STOP-Bang(S-B) questionnaire is widely used for screening patients with OSA. However, BMI and NC cutoff value in the original S-B questionnaire is 35 kg/m²and 40cm, the BMI and NC value in the young and middle-aged female patients in China is lower than that. We aimed to establish a more appropriate modified STOP-Bang(MS-B) questionnaire. Method:A total of 523 cases with suspected OSA in the young and middle-aged female were included in this study. All patients were asked to completed the S-B, MS-B questionnaire and undergo overnight polysomnography(PSG). The BMI and NC value of the MS-B were determined by the optimal operating points of the ROC. The ability of S-B and MS-B were assessed by ROC and McNemar's test. Result:BMI=28 kg/m²and NC=36 cm as alternative cutoff is to refine S-B questionnaire. When taking apnea hypopnea index(AHI) ≥5 times/h, ≥15 times/h and ≥30 times/h as cut-offs, MS-B had higher sensitivity(88.7% vs 86.7%, 92.8% vs 87.7%, 95.0% vs 90.1%, respectively) and the area under the curve(0.74 vs 0.706, 0.734 vs 0.703, 0.739 vs 0.699, respectively) than S-B. There were significant differences in McNemar test(P<0.05). Conclusion:This study examined the clinical utility of MS-B. MS-B may improve predictive performance of S-B questionnaire in the young and middle-aged female with OSA.


Assuntos
Apneia Obstrutiva do Sono , China/epidemiologia , Feminino , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Polissonografia , Apneia Obstrutiva do Sono/diagnóstico , Inquéritos e Questionários
8.
Can Respir J ; 2020: 2045341, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33005276

RESUMO

Objective: Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus SARS-CoV-2, was first identified in December 2019 in Wuhan, China, and has since spread globally, resulting in an ongoing pandemic. However, the study of asymptomatic patients is still rare, and the understanding of its potential transmission risk is still insufficient. In this study, epidemiological investigations were conducted in the Zhejiang province to understand the epidemiology and clinical characteristics of asymptomatic patients with COVID-19. Methods: This retrospective study was carried out on 22 asymptomatic patients and 234 symptomatic patients with COVID-19 who were hospitalized in Zhejiang Duodi Hospital from January 21 to March 16, 2020. The characteristics of epidemiology, demography, clinical manifestations, and laboratory data of mild patients were compared and analyzed. Results: The median age was 28 years in asymptomatic patients and 48 years in symptomatic patients. The proportion who were female was 77.3% in asymptomatic patients and 36.3% in symptomatic patients (p < 0.001). The proportion of patients with coexisting diseases was 4.5% in asymptomatic patients and 38.0% in symptomatic patients (p=0.002). The proportion of patients with increased CRP was 13.6% in the asymptomatic group and 61.1% in the symptomatic group (p < 0.001). The proportion of patients received antiviral therapy was 45.5% in the asymptomatic group and 97.9% in the symptomatic group (p < 0.001). The proportion of patients received oxygen therapy was 22.7% in the asymptomatic group and 99.1% in symptomatic patients (p < 0.001). By March 16, 2020, all patients were discharged from the hospital, and no symptoms had appeared in the asymptomatic patients during hospitalization. The median course of infection to discharge was 21.5 days in asymptomatic patients and 22 days in symptomatic patients. Conclusions: Asymptomatic patients are also infectious; relying only on clinical symptoms, blood cell tests, and radiology examination will lead to misdiagnosis of most patients, leading to the spread of the virus. Investigation of medical history is the best strategy for screening asymptomatic patients, especially young people, women, and people without coexisting disease, who are more likely to be asymptomatic when infected. Although the prognosis is good, isolation is critical for asymptomatic patients, and it is important not to end isolation early before a nucleic acid test turns negative.


Assuntos
Doenças Assintomáticas , Infecções por Coronavirus , Transmissão de Doença Infecciosa/prevenção & controle , Pandemias , Pneumonia Viral , Medição de Risco/métodos , Adulto , Fatores Etários , Doenças Assintomáticas/epidemiologia , Doenças Assintomáticas/terapia , Betacoronavirus/isolamento & purificação , China/epidemiologia , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Erros de Diagnóstico/prevenção & controle , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Oxigenoterapia/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Prognóstico , Fatores Sexuais
9.
Transl Psychiatry ; 10(1): 337, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33009366

RESUMO

Data are scarce regarding the comorbid mental disorders and their management among COVID-19 patients. This study described the clinical characteristics and management of COVID-19 patients treated in psychiatric inpatient settings due to comorbid first-onset mental disorders in Wuhan, China. This electronic medical records-based study included 25 COVID-19 patients with first-onset mental disorders and 55 patients with first-onset mental disorders without COVID-19 (control group). Data collected included ICD-10 diagnoses of mental disorders, psychiatric and respiratory symptoms, treatments, and outcomes. Adjustment disorder (n = 11, 44.0%) and acute and transient psychotic disorders, with associated acute stress (n = 6, 24.0%) were main clinical diagnoses in the COVID-19 group while serious mental illnesses (i.e., schizophrenia, 24.5%) and alcohol use disorders (10.9%) were overrepresented in the control group. On admission, the most common psychiatric symptom in COVID-19 patients was insomnia symptoms (n = 18, 72.0%), followed by aggressive behaviors (n = 16, 64.0%), delusion (n = 10, 40.0%), and severe anxiety (n = 9, 36.0%). In addition to respiratory treatments, 76.0% COVID-19 patients received antipsychotics, 40.0% sedative-hypnotics, and 24.0% mood stabilizers. At the end of inpatient treatment, 4 (16.0%) COVID-19 patients were transferred to other hospitals to continue respiratory treatment after their psychiatric symptoms were controlled while the remaining 21 (84.0%) all recovered. Compared to the control group, COVID-19 group had significantly shorter length of hospital stay (21.2 vs. 37.4 days, P < 0.001). Adjustment disorder and acute and transient psychotic disorders are the main clinical diagnoses of COVID-19 patients managed in psychiatric inpatient settings. The short-term prognosis of these patients is good after conventional psychotropic treatment.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Hospitalização/estatística & dados numéricos , Transtornos Mentais , Pandemias , Pneumonia Viral , Psicotrópicos , China/epidemiologia , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/fisiopatologia , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Administração dos Cuidados ao Paciente/métodos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Prognóstico , Escalas de Graduação Psiquiátrica , Psicotrópicos/classificação , Psicotrópicos/uso terapêutico , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos
10.
PLoS One ; 15(10): e0240081, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33007008

RESUMO

Given the global spread of coronavirus disease (COVID-19), strict discharge standard is of great significance for the prevention and control of the epidemic, thus, the purpose of this study is to formulate more strict and scientific discharge standards. A total of 845 patients with mild and general COVID-19 who were considered to be discharged from hospital were included in this study. The median time from the onset of COVID-19 to the occurrence of two consecutive negative nucleic acid tests of these patients was 21 days. 223 of the 845 patients were tested again after two consecutive negative nucleic acid tests and 17.49% of the patients were positive. Moreover, 82.51% (184 of 223) of these patients experienced negative results from three consecutive nucleic acid tests, the median time from the onset of COVID-19 to the occurrence of three consecutive negative nucleic acid tests was 23 days (range: 3-56 days), and 38 of which were further tested after three consecutive negative nucleic acid tests, while about 5.26% (2 of 38) patients showed positive nucleic acid test results. Thus, we suggested that the patient should be negative for at least 3 consecutive nucleic acid tests before discharge, and the test time should be no earlier than the 23rd day since the onset of the disease.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Alta do Paciente , Pneumonia Viral/diagnóstico , RNA Viral/análise , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , China/epidemiologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Adulto Jovem
11.
Rev Sci Tech ; 39(2): 591-598, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33046917

RESUMO

The first recorded outbreak of African swine fever (ASF) was confirmed in the People's Republic of China in early August 2018. By the end of July 2019, there had been 150 outbreaks of ASF in 31 provinces, including 146 in domestic pigs and four in wild boar. The Chinese Government attaches great importance to the prevention and control of ASF. The Chinese animal health authority promptly launched the highest-priority emergency response against this key animal disease; initiated an extensive surveillance network covering all provinces; formulated and promulgated supporting policies, such as compensation for culled animals and financial credit for affected producers; and established a joint coordination body for ASF prevention and control, led by the Ministry of Agriculture and Rural Affairs and involving a further 20 Ministries, including the Departments of Transportation, Customs and Market Supervision. All levels of local government undertook territorial management responsibilities and developed support policies to encourage all stakeholders to take part in ASF prevention and control. Furthermore, the Chinese Government developed a strategy that integrated both the legal and scientific aspects of ASF control, formulating and releasing a comprehensive policy for the whole pork production chain 'from farm to fork'. The plan included daily disease reports from the disease monitoring network, and adopted effective measures, such as blockades and culling, restricting live pig movements and implementing controls on swill feeding, to cut off viral transmission routes to the greatest extent possible.


Assuntos
Vírus da Febre Suína Africana , Febre Suína Africana , Defesa Civil , Doenças dos Suínos , Febre Suína Africana/epidemiologia , Febre Suína Africana/prevenção & controle , Animais , China/epidemiologia , Sus scrofa , Suínos
12.
Nat Commun ; 11(1): 5012, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33024096

RESUMO

Understanding changes in human mobility in the early stages of the COVID-19 pandemic is crucial for assessing the impacts of travel restrictions designed to reduce disease spread. Here, relying on data from mainland China, we investigate the spatio-temporal characteristics of human mobility between 1st January and 1st March 2020, and discuss their public health implications. An outbound travel surge from Wuhan before travel restrictions were implemented was also observed across China due to the Lunar New Year, indicating that holiday travel may have played a larger role in mobility changes compared to impending travel restrictions. Holiday travel also shifted healthcare pressure related to COVID-19 towards locations with lower healthcare capacity. Network analyses showed no sign of major changes in the transportation network after Lunar New Year. Changes observed were temporary and did not lead to structural reorganisation of the transportation network during the study period.


Assuntos
Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Viagem/tendências , Betacoronavirus , China/epidemiologia , Assistência à Saúde , Férias e Feriados , Humanos , Densidade Demográfica , Saúde Pública , Fatores de Tempo , Transportes
13.
Euro Surveill ; 25(40)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33034281

RESUMO

BackgroundThe natural history of disease in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remained obscure during the early pandemic.AimOur objective was to estimate epidemiological parameters of coronavirus disease (COVID-19) and assess the relative infectivity of the incubation period.MethodsWe estimated the distributions of four epidemiological parameters of SARS-CoV-2 transmission using a large database of COVID-19 cases and potential transmission pairs of cases, and assessed their heterogeneity by demographics, epidemic phase and geographical region. We further calculated the time of peak infectivity and quantified the proportion of secondary infections during the incubation period.ResultsThe median incubation period was 7.2 (95% confidence interval (CI): 6.9‒7.5) days. The median serial and generation intervals were similar, 4.7 (95% CI: 4.2‒5.3) and 4.6 (95% CI: 4.2‒5.1) days, respectively. Paediatric cases < 18 years had a longer incubation period than adult age groups (p = 0.007). The median incubation period increased from 4.4 days before 25 January to 11.5 days after 31 January (p < 0.001), whereas the median serial (generation) interval contracted from 5.9 (4.8) days before 25 January to 3.4 (3.7) days after. The median time from symptom onset to discharge was also shortened from 18.3 before 22 January to 14.1 days after. Peak infectivity occurred 1 day before symptom onset on average, and the incubation period accounted for 70% of transmission.ConclusionThe high infectivity during the incubation period led to short generation and serial intervals, necessitating aggressive control measures such as early case finding and quarantine of close contacts.


Assuntos
Infecções por Coronavirus/transmissão , Coronavirus/patogenicidade , Período de Incubação de Doenças Infecciosas , Pneumonia Viral/transmissão , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Criança , Pré-Escolar , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Adulto Jovem
14.
Infect Dis Poverty ; 9(1): 141, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33046120

RESUMO

In the past five months, success in control the national epidemic of coronavirus disease 2019 (COVID-19) has been witnessed in China. The implementation of public health measures accounts for the success which include different interventions in the early or later stages of the outbreak. It is clear that although not all measures were universally effective worldwide, their achievements have been significant. More solidarity is needed to deal with this global pandemic with more learning and understanding. Understanding which of the public health interventions implemented in China were effective may provide ideas for international epidemic control.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública/métodos , Betacoronavirus/isolamento & purificação , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Diagnóstico Precoce , Humanos , Controle de Infecções/normas , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Saúde Pública/normas
15.
BMC Infect Dis ; 20(1): 749, 2020 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-33050892

RESUMO

BACKGROUND: Two months after the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, tens of thousands of hospitalized patients had recovered, and little is known about the follow-up of the recovered patients. METHODS: The clinical characteristics, reverse transcriptase-polymerase chain reaction (RT-PCR) results from throat swab specimens and the results of serological COVID-19 rapid diagnostic test (RDT) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were retrospectively reviewed for a total of 758 recovered patients who were previously hospitalized in 17 hospitals and quarantined at 32 rehabilitation stations in Wuhan, China. RESULTS: In total, 59 patients (7.78%) had recurrent positive findings for COVID-19 on RT-PCR from throat swabs. With regard to antibody detection, 50/59 (84.75%) and 4/59 (6.78%) patients had positive IgG or dual positive IgG/IgM RDT results, respectively. CONCLUSIONS: Some patients who had been quarantined and had subsequently recovered from COVID-19 had recurrent positive RT-PCR results for SARS-CoV-2, and the possibility of transmission of the virus by recovered patients needs further investigation. TRIAL REGISTRATION: Current Controlled Trials ChiCTR2000033580 , Jun 6th 2020. Retrospectively registered.


Assuntos
Betacoronavirus/genética , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Síndrome Respiratória Aguda Grave/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/sangue , Criança , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Seguimentos , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/fisiopatologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Estudos Retrospectivos , Fatores de Risco , Síndrome Respiratória Aguda Grave/fisiopatologia , Síndrome Respiratória Aguda Grave/virologia , Adulto Jovem
16.
BMC Public Health ; 20(1): 1557, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33066742

RESUMO

BACKGROUND: Tuberculosis (TB) is one of the major infectious diseases that seriously endanger people's health. In Shandong province, the relationship between the level of economic development and TB incidence has not been studied. This study aims to provide more research basis for the government to prevent and control TB by exploring the impact of different economic factors on TB incidence. METHODS: By constructing threshold regression model (TRM), we described the extent to which different economic factors contribute to TB registered incidence and differences in TB registered incidence among seventeen cities with different levels of economic development in Shandong province, China, during 2006-2017. Data were retrieved from the China Information System for Disease Control and Prevention. RESULTS: Per capita medical expenditure (regression coefficient, -0.0314462; SD, 0.0079305; P > |t|, 0.000) and per capita savings (regression coefficient, 0.0001924; SD, 0.0000566; P > |t|, 0.001) passed the significance test at the level of 1%.They are the two economic indicators that have the greatest impact on TB registered incidence. Through the threshold test, we selected the per capita savings as the threshold variable. In the three stages of per capita savings (<9772.8086 China Yuan(CNY); 9772.8086-33,835.5391 CNY; >33,835.5391 CNY), rural per capita income always has a significant negative impact on the TB registered incidence (The regression coefficients are - 0.0015682, - 0.0028132 and - 0.0022253 respectively. P is 0.007,0.000 and 0.000 respectively.).In cities with good economies, TB registered incidence was 38.30% in 2006 and dropped to 25.10% by 2017. In cities with moderate economies, TB registered incidence peaked in 2008 at 43.10% and dropped to 27.1% by 2017.In poorer cities, TB registered incidence peaked in 2008 at 56.30% and dropped to 28.9% in 2017. CONCLUSION: We found that per capita savings and per capita medical expenditure are most closely related to the TB incidence. Therefore, relevant departments should formulate a more complete medical system and medical insurance policy to effectively solve the problem of "difficult and expensive medical treatment". In order to further reduce the TB incidence, in addition to timely and accurate diagnosis and treatment, it is more important for governments to increase investment in medicine and health care.


Assuntos
Desenvolvimento Econômico/estatística & dados numéricos , Tuberculose/epidemiologia , China/epidemiologia , Cidades/epidemiologia , Humanos , Incidência , Sistema de Registros
17.
BMC Public Health ; 20(1): 1558, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33066755

RESUMO

The individual infectiousness of coronavirus disease 2019 (COVID-19), quantified by the number of secondary cases of a typical index case, is conventionally modelled by a negative-binomial (NB) distribution. Based on patient data of 9120 confirmed cases in China, we calculated the variation of the individual infectiousness, i.e., the dispersion parameter k of the NB distribution, at 0.70 (95% confidence interval: 0.59, 0.98). This suggests that the dispersion in the individual infectiousness is probably low, thus COVID-19 infection is relatively easy to sustain in the population and more challenging to control. Instead of focusing on the much fewer super spreading events, we also need to focus on almost every case to effectively reduce transmission.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Distribuição Binomial , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
18.
BMC Public Health ; 20(1): 1560, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33066764

RESUMO

BACKGROUND: To examine the relationship between social capital and depression among community-dwelling older adults in Anhui Province, China. METHODS: A cross-sectional study was conducted among older people selected from three cities of Anhui Province, China using a multi-stage stratified cluster random sampling method. Data were collected through questionnaire interviews and information on demographic characteristics, social capital, and depression was collected. The generalized linear model and classification and regression tree model were employed to assess the association between social capital and depression. RESULTS: Totally, 1810 older people aged ≥60 years were included in the final analysis. Overall, all of the social capital dimensions were positively associated with depression: social participation (coefficient: 0.35, 95% CI: 0.22-0.48), social support (coefficient:0.18, 95% CI:0.07-0.28), social connection (coefficient: 0.76, 95% CI:0.53-1.00), trust (coefficient:0.62, 95% CI:0.33-0.92), cohesion (coefficient:0.31, 95% CI:0.17-0.44) and reciprocity (coefficient:0.30, 95% CI:0.11-0.48), which suggested that older people with higher social capital had a smaller chance to develop depression. A complex joint effect of certain social capital dimensions on depression was also observed. The association with depression and the combinative effect of social capital varied among older adults across the cities. CONCLUSIONS: Our study suggests that improving social capital could aid in the prevention of depression among older adults.


Assuntos
Depressão/epidemiologia , Capital Social , Idoso , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
19.
PLoS One ; 15(10): e0240421, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33031477

RESUMO

OBJECTIVE: To evaluate the microbial loading in aerosols produced after air-puff by non-contact tonometer (NCT) as well as the effect of alcohol disinfection on the inhibition of microbes and thus to provide suggestions for the prevention and control of COVID-19 in ophthalmic departments of hospitals or clinics during the great pandemics. METHODS: A cross-sectional study was carried out in this study. A NIDEK NCT was used for intraocular pressure (IOP) measurement for patients who visited Department of Ophthalmology in Qilu Hospital of Shandong University during March 18-25 2020. After ultra-violate (UV) light disinfection, the room air was sampled for 5 minutes. Before and after alcohol disinfection, the air samples and nozzle surface samples were respectively collected by plate exposure method and sterile moist cotton swab technique after predetermined times of NCT air-puff. Microbial colony counts were calculated after incubation for 48 hours. Finally, mass spectrometry was performed for the accurate identification of microbial species. RESULTS: Increased microbial colonies were detected from air samples close to NCT nozzle after air-puff compared with air samples at a distance of 1 meter from the nozzle (p = 0.001). Interestingly, none microbes were detected on the surface of NCT nozzle. Importantly, after 75% alcohol disinfection less microbes were detected in the air beside the nozzle (p = 0.003). Microbial species identification showed more than ten strains of microbes, all of which were non-pathogenic. CONCLUSION: Aerosols containing microbes were produced by NCT air-puff in the ophthalmic consultation room, which may be a possible virus transmission route in the department of ophthalmology during the COVID-19 pandemic. Alcohol disinfection for the nozzle and the surrounding air was efficient at decreasing the microbes contained in the aerosols and theoretically this prevention measure could also inhibit the virus. This will give guidance for the prevention of virus transmission and protection of hospital staff and patients.


Assuntos
Microbiologia do Ar , Álcoois/química , Infecções por Coronavirus/prevenção & controle , Desinfetantes/química , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Tonometria Ocular/métodos , Aerossóis/química , Betacoronavirus/fisiologia , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Hospitais , Humanos , Oftalmologia/métodos , Pneumonia Viral/epidemiologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-33050574

RESUMO

SARS-CoV-2 is a new coronavirus that has caused a worldwide pandemic. It produces severe acute respiratory disease (COVID-19), which is fatal in many cases, characterised by the cytokine release syndrome (CRS). According to the World Health Organization, those who smoke are likely to be more vulnerable to infection. Here, in order to clarify the epidemiologic relationship between smoking and COVID-19, we present a systematic literature review until 28th April 2020 and a meta-analysis. We included 18 recent COVID-19 clinical and epidemiological studies based on smoking patient status from 720 initial studies in China, the USA, and Italy. The percentage of hospitalised current smokers was 7.7% (95% CI: 6.9-8.4) in China, 2.3% (95% CI: 1.7-2.9) in the USA and 7.6% (95% CI: 4.2-11.0) in Italy. These percentages were compared to the smoking prevalence of each country and statistically significant differences were found in them all (p < 0.0001). By means of the meta-analysis, we offer epidemiological evidence showing that smokers were statistically less likely to be hospitalised (OR = 0.18, 95% CI: 0.14-0.23, p < 0.01). In conclusion, the analysis of data from 18 studies shows a much lower percentage of hospitalised current smokers than expected. As more studies become available, this trend should be checked to obtain conclusive results and to explore, where appropriate, the underlying mechanism of the severe progression and adverse outcomes of COVID-19.


Assuntos
Infecções por Coronavirus/terapia , Hospitalização/estatística & dados numéricos , Pneumonia Viral/terapia , Fumantes/estatística & dados numéricos , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Itália/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Estados Unidos/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA