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1.
J Epidemiol Community Health ; 75(1): 84-87, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32855261

RESUMO

BACKGROUND: The presymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been documented in limited clusters, and it is predicted through modelling. However, there is a lack of evidence from observations with a large sample size. METHODS: We used data from meticulous contact tracing of people exposed to cases of SARS-CoV-2 to estimate the proportion of cases that result from the presymptomatic transmission of the virus in Beijing during January 2020 and February 2020. RESULTS: The results showed that presymptomatic transmission occurred in at least 15% of 100 secondary COVID-19 cases. The earliest presymptomatic contact event occurred 5 days prior to the index case's onset of symptoms, and this occurred in two clusters. CONCLUSIONS: The finding suggested that the contact tracing period should be earlier and highlighted the importance of preventing transmission opportunities well before the onset of symptoms.


Assuntos
Infecções Assintomáticas/epidemiologia , Portador Sadio/virologia , Surtos de Doenças , /isolamento & purificação , Adulto , Doenças Assintomáticas , /epidemiologia , Portador Sadio/epidemiologia , China/epidemiologia , Busca de Comunicante , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , /genética
2.
Am J Infect Control ; 49(1): 115-119, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33157181

RESUMO

A Veterans Affairs long term care facility on Long Island New York was confronted with a COVID-19 outbreak in late March to Mid-April 2020. Faced with a dwindling supply of PPE, the Infection Control team distributed supplies saved for a possible Ebola outbreak. A COVID unit was created within the nursing home facilitating the geographic isolation of cases; universal testing of residents and employees allowed for the implementation of proper quarantine measures. It was a multidisciplinary team approach led by the Infection Control team that successfully contained this outbreak.


Assuntos
Infecções Assintomáticas/epidemiologia , Portador Sadio/epidemiologia , Controle de Infecções/organização & administração , Casas de Saúde/organização & administração , Equipamento de Proteção Individual/provisão & distribução , Idoso , Idoso de 80 Anos ou mais , /prevenção & controle , Portador Sadio/diagnóstico , Portador Sadio/transmissão , Surtos de Doenças , Feminino , Pessoal de Saúde , Humanos , Controle de Infecções/métodos , Profissionais Controladores de Infecções , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Isolamento de Pacientes , Estados Unidos/epidemiologia , United States Department of Veterans Affairs
4.
J Infect Chemother ; 27(1): 70-75, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32950393

RESUMO

OBJECTIVES: The symptoms of Coronavirus disease 2019 (COVID-19) vary among patients. The aim of this study was to investigate the clinical manifestation and disease duration in young versus elderly patients. METHODS: We retrospectively analyzed 187 patients (87 elderly and 100 young patients) with confirmed COVID-19. The clinical characteristics and chest computed tomography (CT) extent as defined by a score were compared between the two groups. RESULTS: The numbers of asymptomatic cases and severe cases were significantly higher in the elderly group (elderly group vs. young group; asymptomatic cases, 31 [35.6%] vs. 10 [10%], p < 0.0001; severe cases, 25 [28.7%] vs. 8 [8.0%], p = 0.0002). The proportion of asymptomatic patients and severe patients increased across the 10-year age groups. There was no significant difference in the total CT score and number of abnormal cases. A significant positive correlation between the disease duration and patient age was observed in asymptomatic patients (ρ = 0.4570, 95% CI 0.1198-0.6491, p = 0.0034). CONCLUSIONS: Although the extent of lung involvement did not have a significant difference between the young and elderly patients, elderly patients were more likely to have severe clinical manifestations. Elderly patients were also more likely to be asymptomatic and a source of COVID-19 viral shedding.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Eliminação de Partículas Virais , Adulto , Fatores Etários , Idoso , Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/patologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
5.
Bull Math Biol ; 83(1): 1, 2020 12 08.
Artigo em Inglês | MEDLINE | ID: mdl-33289877

RESUMO

Newly emerging pandemics like COVID-19 call for predictive models to implement precisely tuned responses to limit their deep impact on society. Standard epidemic models provide a theoretically well-founded dynamical description of disease incidence. For COVID-19 with infectiousness peaking before and at symptom onset, the SEIR model explains the hidden build-up of exposed individuals which creates challenges for containment strategies. However, spatial heterogeneity raises questions about the adequacy of modeling epidemic outbreaks on the level of a whole country. Here, we show that by applying sequential data assimilation to the stochastic SEIR epidemic model, we can capture the dynamic behavior of outbreaks on a regional level. Regional modeling, with relatively low numbers of infected and demographic noise, accounts for both spatial heterogeneity and stochasticity. Based on adapted models, short-term predictions can be achieved. Thus, with the help of these sequential data assimilation methods, more realistic epidemic models are within reach.


Assuntos
/epidemiologia , Pandemias , Infecções Assintomáticas/epidemiologia , Número Básico de Reprodução/estatística & dados numéricos , Simulação por Computador , Interpretação Estatística de Dados , Alemanha/epidemiologia , Humanos , Funções Verossimilhança , Conceitos Matemáticos , Modelos Biológicos , Modelos Estatísticos , Pandemias/estatística & dados numéricos , Processos Estocásticos , Fatores de Tempo
6.
J R Soc Interface ; 17(173): 20200775, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33292095

RESUMO

Controlling the regional re-emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after its initial spread in ever-changing personal contact networks and disease landscapes is a challenging task. In a landscape context, contact opportunities within and between populations are changing rapidly as lockdown measures are relaxed and a number of social activities re-activated. Using an individual-based metapopulation model, we explored the efficacy of different control strategies across an urban-rural gradient in Wales, UK. Our model shows that isolation of symptomatic cases or regional lockdowns in response to local outbreaks have limited efficacy unless the overall transmission rate is kept persistently low. Additional isolation of non-symptomatic infected individuals, who may be detected by effective test-and-trace strategies, is pivotal to reducing the overall epidemic size over a wider range of transmission scenarios. We define an 'urban-rural gradient in epidemic size' as a correlation between regional epidemic size and connectivity within the region, with more highly connected urban populations experiencing relatively larger outbreaks. For interventions focused on regional lockdowns, the strength of such gradients in epidemic size increased with higher travel frequencies, indicating a reduced efficacy of the control measure in the urban regions under these conditions. When both non-symptomatic and symptomatic individuals are isolated or regional lockdown strategies are enforced, we further found the strongest urban-rural epidemic gradients at high transmission rates. This effect was reversed for strategies targeted at symptomatic individuals only. Our results emphasize the importance of test-and-trace strategies and maintaining low transmission rates for efficiently controlling SARS-CoV-2 spread, both at landscape scale and in urban areas.


Assuntos
/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Pandemias/prevenção & controle , Infecções Assintomáticas/epidemiologia , /transmissão , Simulação por Computador , Busca de Comunicante , Humanos , Modelos Biológicos , População Rural , População Urbana , País de Gales/epidemiologia
7.
PLoS One ; 15(12): e0242132, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326421

RESUMO

A quantitative COVID-19 model that incorporates hidden asymptomatic patients is developed, and an analytic solution in parametric form is given. The model incorporates the impact of lock-down and resulting spatial migration of population due to announcement of lock-down. A method is presented for estimating the model parameters from real-world data, and it is shown that the various phases in the observed epidemiological data are captured well. It is shown that increase of infections slows down and herd immunity is achieved when active symptomatic patients are 10-25% of the population for the four countries we studied. Finally, a method for estimating the number of asymptomatic patients, who have been the key hidden link in the spread of the infections, is presented.


Assuntos
/patologia , Imunidade Coletiva , Modelos Teóricos , Infecções Assintomáticas/epidemiologia , /imunologia , França/epidemiologia , Humanos , Itália/epidemiologia , Japão/epidemiologia , Quarentena , Suíça/epidemiologia
8.
Medicine (Baltimore) ; 99(51): e23547, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371079

RESUMO

ABSTRACT: This study aims to investigate the clinical characteristics and viral shedding kinetics of asymptomatic patients with coronavirus disease 2019 (COVID-19).The data of 38 asymptomatic patients positive for SARS-CoV-2 nucleic acid were collected from February to March 2020 in Tuanfeng County, Huanggang, Hubei, China. The epidemiology, laboratory examination, chest imaging, viral nucleic acid test results, clinical characteristics, and viral shedding time were summarized in this retrospective study.The study included 20 family members of patients with COVID-19, 10 medical personnel participating in COVID-19 treatment or working in a fever clinic, 6 personnel from quarantine places, 1 individual with a close contact history with confirmed patients, and 1 local epidemic prevention personnel. All were positive for SARS-CoV-2 nucleic acid. The white blood cell (WBC) count, the absolute value of lymphocytes, C-reactive protein (CRP), and D-dimer were normal. Pneumonia manifestations were not found in the chest computed tomography (CT) scan of 36 patients; the remaining 2 cases included a 1-year-old child and a pregnant woman, and they did not undergo chest CT. The viral shedding time was 6 days.All asymptomatic patients with COVID-19 had a history of close contact or exposure. Laboratory tests were normal. Chest imaging did not show any pneumonia manifestation. The viral shedding time was <10 days, which is shorter than that of patients with COVID-19. A timely discovery of such asymptomatic infections is crucial for blocking the spread of the virus and strengthening the prevention and control measures.


Assuntos
Infecções Assintomáticas/epidemiologia , Eliminação de Partículas Virais , Adolescente , Adulto , Infecções Assintomáticas/terapia , /diagnóstico por imagem , Criança , China/epidemiologia , Feminino , Humanos , Indóis/uso terapêutico , Lactente , Masculino , Medicina Tradicional Chinesa , Pessoa de Meia-Idade , Radiografia Torácica , Estudos Retrospectivos , Adulto Jovem
11.
J Korean Med Sci ; 35(48): e424, 2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33316860

RESUMO

BACKGROUND: On February 21, 2020, 2 coronavirus disease 2019 (COVID-19) cases in pilgrim travelers from Korea to Israel were identified. We investigated the source of infection, clinical features of COVID-19, and transmission potential of presymptomatic and asymptomatic cases. METHODS: All 39 pilgrim travelers were aggressively tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Their clinical features and possible source of infection were investigated by interview and review of their medical records. Ten confirmed cases without symptoms at the first sampling dates were selected for follow-up reverse transcription polymerase chain reaction tests. RESULTS: Of 39 pilgrim travelers, 30 (77%) were positive for SARS-CoV-2. Among the 30 positive COVID-19 cases, 4 (13%) were asymptomatic. Available follow-up cycle threshold values from 10 cases gradually increased over time and were lower during the presymptomatic period than during the postsymptomatic period. Out of 328 contacts related to the COVID-19 cases in the pilgrim travelers, 22 additional cases (7%) were confirmed with SARS-CoV-2 infections. Three tertiary cases were identified to be transmitted by presymptomatic secondary cases. CONCLUSION: To prevent transmission of COVID-19, we need to focus on presymptomatic and asymptomatic cases, and massive testing for SARS-CoV-2 is required. More research about the possibility of presymptomatic transmission over 2 days before symptom onset is required.


Assuntos
/epidemiologia , Viagem , Idoso , Infecções Assintomáticas/epidemiologia , Controle de Doenças Transmissíveis , Surtos de Doenças , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Reação em Cadeia da Polimerase em Tempo Real , República da Coreia
12.
BMC Infect Dis ; 20(1): 930, 2020 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-33287717

RESUMO

BACKGROUND: COVID-19 is a newly emerging disease caused by a novel coronavirus (SARS-CoV-2), which spread globally in early 2020. Asymptomatic carriers of the virus contribute to the propagation of this disease, and the existence of asymptomatic infection has caused widespread fear and concern in the control of this pandemic. METHODS: In this study, we investigated the origin and transmission route of SARS-CoV-2 in Anhui's two clusters, analyzed the role and infectiousness of asymptomatic patients in disease transmission, and characterized the complete spike gene sequences in the Anhui strains. RESULTS: We conducted an epidemiological investigation of two clusters caused by asymptomatic infections sequenced the spike gene of viruses isolated from 12 patients. All cases of the two clusters we investigated had clear contact histories, both from Wuhan, Hubei province. The viruses isolated from two outbreaks in Anhui were found to show a genetically close link to the virus from Wuhan. In addition, new single nucleotide variations were discovered in the spike gene. CONCLUSIONS: Both clusters may have resulted from close contact and droplet-spreading and asymptomatic infections were identified as the initial cause. We also analyzed the infectiousness of asymptomatic cases and the challenges to the current epidemic to provided information for the development of control strategies.


Assuntos
Infecções Assintomáticas/epidemiologia , /virologia , Glicoproteína da Espícula de Coronavírus/genética , /transmissão , China/epidemiologia , Busca de Comunicante , Surtos de Doenças , Feminino , Humanos , Masculino , Epidemiologia Molecular , Pandemias , Filogenia , RNA Viral/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Análise de Sequência de RNA
13.
Artigo em Inglês | MEDLINE | ID: mdl-33276678

RESUMO

In this article, we investigate the impact of COVID-19 through screening and surveillance methods adopted in India, as well as the potential health system, social, political, and economic consequences. The research was done in a chronological manner, and data was collected between 30 January 2020 till 12 June 2020. Initial containment measures, including point of entry screenings and testing protocols, appeared insufficient. However, testing capacity was gradually expanded after the commencement of a nation-wide lockdown. Modeling predictions have shown varying results on the emergence of cases depending on the infectiousness of asymptomatic individuals, with a peak predicted in mid-July having over two million cases. The country also faces risks of the economic plunge by losing approximately 4% of its gross domestic product, due to containment measures and reduction in goods importation. The low public health expenditure combined with a lack of infrastructure and low fiscal response implies several challenges to scale up the COVID-19 response and management. Therefore, an emergency preparedness and response plan is essential to integrate into the health system of India.


Assuntos
/epidemiologia , Pandemias , Infecções Assintomáticas/epidemiologia , Previsões , Humanos , Índia/epidemiologia , Programas de Rastreamento
14.
BMC Public Health ; 20(1): 1809, 2020 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-33246432

RESUMO

BACKGROUND: Mathematical modelling of infectious diseases is a powerful tool for the design of management policies and a fundamental part of the arsenal currently deployed to deal with the COVID-19 pandemic. METHODS: We present a compartmental model for the disease where symptomatic and asymptomatic individuals move separately. We introduced healthcare burden parameters allowing to infer possible containment and suppression strategies. In addition, the model was scaled up to describe different interconnected areas, giving the possibility to trigger regionalized measures. It was specially adjusted to Mendoza-Argentina's parameters, but is easily adaptable for elsewhere. RESULTS: Overall, the simulations we carried out were notably more effective when mitigation measures were not relaxed in between the suppressive actions. Since asymptomatics or very mildly affected patients are the vast majority, we studied the impact of detecting and isolating them. The removal of asymptomatics from the infectious pool remarkably lowered the effective reproduction number, healthcare burden and overall fatality. Furthermore, different suppression triggers regarding ICU occupancy were attempted. The best scenario was found to be the combination of ICU occupancy triggers (on: 50%, off: 30%) with the detection and isolation of asymptomatic individuals. In the ideal assumption that 45% of the asymptomatics could be detected and isolated, there would be no need for complete lockdown, and Mendoza's healthcare system would not collapse. CONCLUSIONS: Our model and its analysis inform that the detection and isolation of all infected individuals, without leaving aside the asymptomatic group is the key to surpass this pandemic.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Epidemias/prevenção & controle , Pandemias/prevenção & controle , Isolamento de Pacientes , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Argentina/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Modelos Teóricos , Pneumonia Viral/epidemiologia
15.
PLoS One ; 15(11): e0241572, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33147295

RESUMO

INTRODUCTION: Neurosyphilis can occur at any stage of syphilis. After treatment, 30%-40% of syphilis patients remained serofast. But the prevalence of asymptomatic neurosyphilis (ANS) among serofast syphilis patients remains unclear. Untimely treatment or improper management for ANS may result in neurological complications. So we perform the meta-analysis to evaluate the prevalence of ANS cases among HIV-negative serofast syphilis patients for exploring their relationship and addressing their clinical management. METHODS: We searched CNKI, Wan Fang, VIP, CBMdisc, PubMed, Embase and Medline from January 1st 1990 to September 22nd 2020 for both English and Chinese records. We strictly restrict the eligibility criteria. STROBE was used for reporting quality assessment. We examined forest plots and conducted both fix-effects and random-effects to estimate prevalence by R version 3.6.2/R studio 1.2.1335 statistical software packages META version 4.9-9. If appropriate, between-study heterogeneity was examined using the I2 statistic and subgroup analysis. RESULTS: Of 77 screened records, 5 were included. The pooled prevalence of ANS among HIV-negative serofast syphilis patients was 13% (95% CI 3%-23%; I2 = 93% P<0.01, 417 people). The prevalence of ANS for the verified ANS classification definition was 3% (95% CI 0%-7%; I2 = 67% P = 0.08, two studies, 189 people), and 21% (95% CI 6%-36%; I2 = 86% P<0.01, three studies, 228 people) for the likely ANS classification. The prevalence of ANS among the serofast syphilis patients who were followed up for one year was 29% (95% CI 22%-36%; I2 = 0% P = 0.5, two studies, 167 people) and 5% (95% CI 0%-13%; I2 = 79% P = 0.03, two studies, 144 people) for two years. The prevalence in the studies from different geographical subgroups was as follows: 9% (95% CI 0%-19%; I2 = 82% P<0.01, three studies, 169 people) in South-central China, 6% (95% CI 1%-10%; one study, 106 people) in East China, and 30% (95% CI 23%-38%; one study, 142 people) in North China. CONCLUSION: This meta-analysis showed a high estimated prevalence of ANS in HIV-negative serofast syphilis patients, the prevalence of ANS among patients diagnosed with the verified ANS case definition is much lower than that for the likely ANS classification. It may be necessary to carry out nontreponemal test, protein test and leukocyte count for cerebrospinal fluid (CSF) in treated serofast patients for better clinical management to avoid neurological complications. The case classification definition of ANS is a key factor to evaluate the prevalence. Geographical heterogeneity needs more studies to detect. In future we need better-design studies to explore relationship between ANS and serofast status.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por HIV/diagnóstico , Neurossífilis/epidemiologia , Sorodiagnóstico da AIDS/estatística & dados numéricos , China/epidemiologia , Infecções por HIV/sangue , Humanos , Neurossífilis/sangue , Neurossífilis/diagnóstico , Prevalência , Fatores de Risco , Sorodiagnóstico da Sífilis/estatística & dados numéricos
17.
Pan Afr Med J ; 35(Suppl 2): 145, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33193960

RESUMO

Introduction: available evidence suggests that children infected with COVID-19 tend to have a less severe form of the disease. However, most of the studies that have established this largely emanate from outside sub-Saharan Africa. The pandemic nature of the infection makes it instructive to evaluate its pattern among children across different climes, including ours. This study was set out to describe the clinical characteristics of children with COVID-19 in Bauchi State, North-East Nigeria. Methods: this was a cross sectional study that involved 53 children between the ages of 0 and 18 years, who had RT-PCR confirmed COVID-19 infection between March and June 2020 in Bauchi State, Nigeria. Data on epidemiological and clinical characteristics was analysed using IBM SPSS Statistics V 21.® Relationship between categorical variables was established using the chi square test. The level of statistical significance was set at < 0.05, at a confidence interval (CI) of 95%. Results: the mean age was 12.63 ± 4.31 years with a slight preponderance of males (1.1: 1). Majority were asymptomatic (60.4%), while 32.1% and 7.5% had mild and moderate diseases respectively. The most common symptoms were cough (20.8%), fever (17%), and sneezing (15.1%). Five children (9.4%) complained of loss of taste while anosmia was documented in one child (1.9%). We observed a significant relationship between age category and the presence of symptoms. In fact, children younger than 10 years (pre-adolescents) were five times more likely to be symptomatic when compared to those above this age (p = 0.029, C I 1.08-21.56). Conclusion: our findings have shown a mild pattern of disease and good outcome among infected children. However, we must be mindful of the higher vulnerability among younger children, especially those below 10 years.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Adolescente , Distribuição por Idade , Infecções Assintomáticas/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Nigéria/epidemiologia , Distribuição por Sexo , Avaliação de Sintomas , Resultado do Tratamento
18.
PLoS One ; 15(11): e0242768, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33216801

RESUMO

This is a retrospective single-center study of 417 consecutive patients with coronavirus disease 2019 (COVID-19) admitted to Jaber Al-Ahmad Hospital in Kuwait between February 24, 2020 and May 24, 2020. In total, 39.3% of patients were asymptomatic, 41% were symptomatic with mild/moderate symptoms, 19.7% were admitted to the intensive care unit (ICU). Most common symptoms in cohort patients were fever (34.3%) and dry cough (32.6%) while shortness in breath was reported in (75.6%) of ICU admissions. Reported complications requiring ICU admission included Sepsis (68.3%), acute respiratory distress syndrome (95.1%) and heart failure (63.4%). ICU patients were more likely to have comorbidities, in comparison to non-ICU patients, including diabetes (35.4% vs 20.3%) and hypertension (40.2% vs 26.9%). Mortality rate of cohort was 14.4% and mean age of death was 54.20 years (± 11.09) and 90% of death cases were males. Chest high-resolution computed tomography for ICU cases reveled multifocal large patchy areas of ground glass opacification mixed with dense consolidation. Cases admitted to ICU showed abnormal levels of markers associated with infection, inflammation, abnormal blood clotting, heart problems and kidney problems. Mean hospital stay for asymptomatic cases was 20.69 days ±8.57 and for mild/moderate cases was 21.4 days ±8.28. Mean stay in ICU to outcome for survivors was 11.95 days ±8.96 and for death cases 13.15 days ±10.02. In this single-center case series of 417 hospitalized COVID-19 patients in Kuwait 39.3% were asymptomatic cases, 41% showed mild/moderate symptoms and 18.7% were admitted to ICU with a mortality rate of 14.4%.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Assintomáticas/epidemiologia , Betacoronavirus , Criança , Pré-Escolar , Comorbidade , Feminino , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Adulto Jovem
19.
Public Health ; 189: 54-59, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33160088

RESUMO

OBJECTIVES: Contact tracing and quarantine are common measures used in the management of infectious disease outbreaks. However, few studies have measured their impact on the control of the COVID-19 pandemic. This study aimed to assess the effectiveness of those measures on reducing transmission of severe acute respiratory syndrome coronavirus 2 in a community setting. STUDY DESIGN: The study design is a retrospective cohort study. METHODS: A retrospective cohort study of COVID-19 cases notified in Eastern Porto from March 1st to April 30th, 2020 was performed. Intervention and control cohorts were defined based on whether cases were subjected to contact tracing and quarantine measures before the laboratory confirmation of disease. The number of secondary cases per index case and the proportion of cases with subsequent secondary cases were the primary outcomes. Secondary outcomes included the time from symptom onset to specimen collection and the number of close contacts. The analysis was stratified according to whether national lockdown measures had already been implemented. RESULTS: The intervention and control cohorts comprised 98 and 453 cases, respectively. No differences were observed concerning primary outcomes. The intervention group had a shorter time between symptom onset and specimen collection (median: 3 days, interquartile range [IQR]: 1-6, vs. median: 5 days, IQR: 2-7, P-value = 0.004) and fewer close contacts (median: 0, IQR: 0-2, vs. median: 2, IQR: 1-4, P-value<0.001). The stratified analysis returned similar results. CONCLUSION: Local public health measures were effective in reducing the time between symptom onset and laboratory diagnosis and the number of close contacts per case. No effect was apparent on secondary case figures, suggesting that further measures may be required.


Assuntos
Infecções Assintomáticas/epidemiologia , Busca de Comunicante/métodos , Transmissão de Doença Infecciosa/prevenção & controle , Quarentena , Adulto , Idoso , Técnicas de Laboratório Clínico , Controle de Doenças Transmissíveis/métodos , Surtos de Doenças/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Isolamento de Pacientes , Portugal/epidemiologia , Saúde Pública , Estudos Retrospectivos
20.
Ann Acad Med Singap ; 49(8): 530-537, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33164022

RESUMO

INTRODUCTION: In this study, a comparison of clinical, epidemiological and laboratory parameters between symptomatic and asymptomatic children with SARS-CoV-2 infection was performed. MATERIALS AND METHODS: Data from all children with laboratory confirmed SARS-CoV-2 infection admitted to KK Women's and Children's Hospital (KKH), Singapore, from January to May 2020 were analysed. RESULTS: Of the 39 COVID-19 children included, 38.5% were asymptomatic. Household transmission accounted for 95% of cases. The presenting symptoms of symptomatic children were low-grade fever (54.2%), rhinorrhoea (45.8%), sore throat (25%), diarrhoea (12.5%) and acute olfactory dysfunction (5.4%). Children of Chinese ethnicity (37.5% vs 6.7%), complete blood count (45.8% vs 6.7%) and liver enzyme abnormalities (25% vs 7.7%) were more common in symptomatic versus asymptomatic children. All children had a mild disease course and none required oxygen supplementation or intensive care. CONCLUSIONS: The high proportion of asymptomatic infected children coupled with household transmission as the main source of paediatric COVID-19 infection underscores the importance of early screening and isolation of children upon detection of an index case of COVID-19 in a household. Symptomatic children were more likely to have abnormal laboratory parameters but they did not have a poorer outcome compared to asymptomatic cases.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Adolescente , Fatores Etários , Betacoronavirus , Criança , Pré-Escolar , Estudos de Coortes , Infecções por Coronavirus/complicações , Hospitalização , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Pandemias , Pneumonia Viral/complicações , Singapura , Avaliação de Sintomas
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