scholarly journals Features Associated With Contagiousness Among COVID-19 Cases in Shanghai, China

2021 ◽  
Author(s):  
Dechuan Kong ◽  
Qiwen Fang ◽  
Huanyu Wu ◽  
Linjie Hu ◽  
Abram L. Wagner ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Disease Onset ◽  
Upper Respiratory Tract ◽  
Medical Visits ◽  
Upper Respiratory ◽  
Successive Generations ◽  
Delays In Diagnosis ◽  
Binomial Models ◽  
Age And Sex ◽  
Increase In Risk

Abstract Background: Little is known about the characteristics of those who transmit SARS-CoV-2 infection vs those who do not, but this information could inform disease control policies. This study described the features of clusters in the first wave of COVID-19 in Shanghai and compared contagiousness by clinical and health care risk factors.Methods: In this retrospective cohort study of cases in Shanghai in January and February 2020, cases with successive generations were considered to be “contagious.” Characteristics of contagious and non-contagious cases were compared in log-binomial models that also adjusted for age and sex. Results: Between January 21 and February 17, 2020, 333 cases of COVID-19 were reported in Shanghai across 28 known infection chains. Contagiousness was higher among cases with a sore throat (risk ratio [RR]: 3.41, 95% CI: 1.59, 7.35, P=0.0051), and those with heart disease (RR: 2.06, 95% CI: 0.72, 5.90). Delays in diagnosis were also associated with higher risk of contagiousness. Having ≥2 medical visits before diagnosis was associated with 4.46 times higher risk of contagiousness (95% CI: 2.03, 9.83, P=0.0002), and there was a non-significant increase in risk with increasing numbers of days between disease onset and isolation (for each day, RR: 1.08, 95% CI: 1.01, 1.16, P=0.1734).Conclusions: Individuals with mild COVID-19 symptoms in the upper respiratory tract may still be contagious, and such individuals should be prioritized for early diagnosis and isolation to limit further chains of transmission.

NEW CORONAVIRUS INFECTION COVID-19: FEATURES OF THE COURSE IN CHILDREN IN THE RUSSIAN FEDERATION

2020 ◽  
Vol 99 (6) ◽  
pp. 57-62
Author(s):  
A.V. Gorelov ◽  
◽  
S.V. Nikolaeva ◽  
V.G. Akimkin ◽  
◽  
...  
Keyword(s):  
Russian Federation ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Final Diagnosis ◽  
Upper Respiratory Tract ◽  
Number Of Children ◽  
Coronavirus Infection ◽  
The Russian Federation ◽  
Upper Respiratory ◽  
Tract Infections

Objective of the research: to determine clinical and epidemiological features of the course of the new coronavirus infection (COVID-19) caused by SARS-CoV-2 in children in the Russian Federation (RF). Materials and methods: a retrospective analysis of all confirmed COVID-19 cases in children in the first half of 2020 in the Russian Federation was performed. Information about patients (age, sex, examination date, place of residence, disease severity final diagnosis, etc.) was taken from the database containing the Rospotrebnadzor report form № 970 «Information on cases of infectious diseases in persons with suspected new coronavirus infection» January – June 2020 across the Russian Federation. Research results were processed using the IBM SPSS Statistics 26 program. To assess the differences in nominal indicators (proportions), the Pearson χ2 test was used. The results were considered statistically significant at p<0,05. Results: in the RF, the total number of children infected with COVID-19 in the first half of 2020 amounted to 8,4% among all patients with this infection. Children of all ages get sick with COVID-19, and boys are slightly more likely than girls (52,2% versus 47,8%, p>0,05). In children, the maximum number of cases is registered in family foci – 75%. Upper respiratory tract infections were diagnosed in 72,1% of patients. The proportion of pneumonia was 1,8%, and 2/3 of children were over 3 years old (p<0,001). In almost 1/3 of patients, the infection course had no clinical manifestations. 18,2% of children at the disease onset had increased body temperature, while only 3,5% of children had hyperthermia above 390 C. Cough was registered in 50,8% of cases. Rhinitis/rhinopharyngitis developed only in every 4th child. Symptoms pathognomonic for COVID-19, such as loss of smell (anosmia) and taste (ageusia), were recorded only in 17% of cases. 41,3% of patients received treatment in a hospital, and among them children under 3 years of age predominated. Conclusion: in children in the RF, the new coronavirus infection COVID-19 is generally favorable.

scholarly journals The value of lymphocyte-to-monocyte ratio and neutrophil-to-lymphocyte ratio in differentiating pneumonia from upper respiratory tract infection (URTI) in children: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghua Wu ◽  
Xu Wang ◽  
Mingqi Zhou ◽  
Guo-Bo Chen ◽  
Jing Du ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Retrospective Cohort ◽  
Bacterial Pneumonia ◽  
Clinical Symptoms ◽  
Upper Respiratory Tract ◽  
Blood Biomarkers ◽  
Screening Model ◽  
Upper Respiratory

Abstract Backgrounds Early and accurate diagnosis of pediatric pneumonia in primary health care can reduce the chance of long-term respiratory diseases, related hospitalizations and mortality while lowering medical costs. The aim of this study was to assess the value of blood biomarkers, clinical symptoms and their combination in assisting discrimination of pneumonia from upper respiratory tract infection (URTI) in children. Methods Both univariate and multivariate logistic regressions were used to build the pneumonia screening model based on a retrospective cohort, comprised of 5211 children (age ≤ 18 years). The electronic health records of the patients, who had inpatient admission or outpatient visits between February 15, 2012 to September 30, 2018, were extracted from the hospital information system of Zhejiang Provincial People’s Hospital, Hangzhou, Zhejiang Province, China. The children who were diagnosed with pneumonia and URTI were enrolled and their clinical features and levels of blood biomarkers were compared. Using the area under the ROC curve, both two screening models were evaluated under 80% (training) versus 20% (test) cross-validation data split for their accuracy. Results In the retrospective cohort, 2548 of 5211 children were diagnosed with the defined pneumonia. The univariate screening model reached predicted AUCs of 0.76 for lymphocyte/monocyte ratio (LMR) and 0.71 for neutrophil/lymphocyte ratio (NLR) when identified overall pneumonia from URTI, attaining the best performance among the biomarker candidates. In subgroup analysis, LMR and NLR attained AUCs of 0.80 and 0.86 to differentiate viral pneumonia from URTI, and AUCs of 0.77 and 0.71 to discriminate bacterial pneumonia from URTI respectively. After integrating LMR and NLR with three clinical symptoms of fever, cough and rhinorrhea, the multivariate screening model obtained increased predictive values, reaching validated AUCs of 0.84, 0.95 and 0.86 for distinguishing pneumonia, viral pneumonia and bacterial pneumonia from URTI respectively. Conclusions Our study demonstrated that combining LMR and NLR with critical clinical characteristics reached promising accuracy in differentiating pneumonia from URTI, thus could be considered as a useful screening tool to assist the diagnosis of pneumonia, in particular, in community healthcare centers. Further researches could be conducted to evaluate the model’s clinical utility and cost-effectiveness in primary care scenarios to facilitate pneumonia diagnosis, especially in rural settings.

scholarly journals To the question regarding accuracy of COVID-2019 laboratory diagnostics

2021 ◽  
Vol 11 (1) ◽  
pp. 9-16
Author(s):  
A. N. Kulichenko ◽  
N. S. Sarkisyan
Keyword(s):  
Respiratory Tract ◽  
Sensitivity And Specificity ◽  
False Positive ◽  
False Negative ◽  
Disease Onset ◽  
Diagnostic Sensitivity ◽  
Pcr Analysis ◽  
Laboratory Diagnostics ◽  
Upper Respiratory Tract ◽  
Upper Respiratory

Issues of accuracy (sensitivity and specificity) of PCR-analysis depending on features of performing preanalytical and analytical stages of laboratory diagnostics of COVID-19, as well as comparing PCR and lung computed tomography (CT) results have been analyzed in the study. Currently, a molecular genetic test based on polymerase chain reaction (PCR) is used for diagnostics of a new coronavirus infection (COVID-19). As of November 1, 2020, more than 750 million PCR tests have been conducted globally. Evidence accumulated by now allows to estimate diagnostic sensitivity and specificity of the SARS-CoV-2-specific PCR as high as 82—91% and 99—100%, respectively. In addition, increased PCR sensitivity may be noted upon performing repeated testing of the upper respiratory tract samples comprising 82.2% during the primary analysis that was further elevated up to 90.6% after two consecutive tests. A whole set of factors affect the PCR accuracy. In particular, false negative data might result from insufficient amount of virus-coupled genetic material in the sample, timeframe and mistakes made upon selecting biological samples. It was found that SARS-CoV-2 virus RNA was detected at the maximum diagnostic sensitivity in the upper respiratory tract 1—3 days before the onset of symptoms and sustained within the 5—6 days after disease onset. Such period of time is associated with the peak risk of SARS-CoV-2 transmission. On week 2 after disease onset, there have been noted elevated rate of detecting viral RNA in bronchopulmonary samples. The duration of detecting virus-related markers (including those found in the absence of viable virus forms) correlates with disease severity and may last for as long as 1—2 months. Another real-world issue related to PCR analysis is posed by an opportunity of obtaining false positive data, which solution requires high level organized laboratory research, especially in case large-scale studies. Upon that, it is worth noting that positive PCR results may account for detecting solely certain RNA-related fragments present in any sample, rather than a viable virus. It was noted that PCR in comparison to CT analysis demonstrates higher specificity, but does not allow to distinguish pneumonia caused by SARS-CoV-2 from pneumonia caused by other etiological agents (up to 25% false positive results). However, the diagnostic CT sensitivity was 97.2% that exceeds such parameter for PCR by 10—15%. It was concluded that the approach combining use of both PCR and CT by taking into account their own features as well as factors affecting the accuracy of the data obtained, allows us to correctly interpret the diagnostical results.

scholarly journals Epidemiological and clinical features in patients with coronavirus disease 2019 outside of Wuhan, China: Special focus in asymptomatic patients

2021 ◽  
Vol 15 (3) ◽  
pp. e0009248
Author(s):  
Ping Liu ◽  
Ruichao Niu ◽  
Jie Chen ◽  
Yuling Tang ◽  
Wenfang Tang ◽  
...  
Keyword(s):  
Disease Onset ◽  
Clinical Findings ◽  
Special Focus ◽  
Upper Respiratory Tract ◽  
Wuhan City ◽  
Family Cluster ◽  
Asymptomatic Patients ◽  
Initial Symptoms ◽  
The World ◽  
Upper Respiratory

Objectives In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan City and rapidly spread across the world. The clinical characteristics of affected patients in different regions and populations may differ. Thus, this study aimed to identify the characteristics of the disease to provide an insight about the prevention and treatment of COVID-19. Methods Data on the demographic characteristics and clinical findings of the patients admitted at the First Hospital of Changsha from January 1, 2020 to February 10, 2020 were assessed. Results In this study, there were 8 (3.8%) asymptomatic, 21 (10.0%) mild upper respiratory tract infection (URTI), and 180 (86.1%) pneumonia cases. In total, 47 (22.5%) patients resided in Wuhan, and 45 (21.5%) had recently traveled to Wuhan before disease onset. Moreover, 19 (9.1%) had contact with people from Wuhan, and 69 (33.0%) were family cluster cases. The median incubation period was approximately 6.3 (range: 1.0–20.0) days. Fever and cough were the most common initial symptoms: 99 (49.3%) patients presented with fever, without cough; 59 (29.4%) with cough, without fever; and 33 (16.4%) with both fever and cough. Conclusion The symptoms of patients with COVID-19 were relatively mild outside Wuhan, and family cluster was a remarkable epidemic characteristic. Special attention should be paid to asymptomatic patients.

Allergy of the Upper Respiratory Tract

1970 ◽  
Vol 3 (2) ◽  
pp. 265-276 ◽  
Author(s):  
Jack D. Clemis ◽  
Eugene L. Derlacki
Keyword(s):  
Respiratory Tract ◽  
Upper Respiratory Tract ◽  
Upper Respiratory
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