Clinical Characteristics Of Coronavirus Disease 2019 Research Articles

COVID-19 Pandemic as Risk Factors for Excessive Weight Gain in Pediatrics: The Role of Changes in Nutrition Behavior. A Narrative Review.

During the coronavirus disease 2019 (COVID-19) pandemic, social isolation, semi-lockdown, and “stay at home” orders were imposed upon the population in the interest of infection control. This dramatically changes the daily routine of children and adolescents, with a large impact on lifestyle and wellbeing. Children with obesity have been shown to be at a higher risk of negative lifestyle changes and weight gain during lockdown. Obesity and COVID-19 negatively affect children and adolescents’ wellbeing, with adverse effects on psychophysical health, due in large part to food choices, snacking between meals, and comfort eating. Moreover, a markable decrease in physical activity levels and an increase in sedentary behavior is associated with weight gain, especially in children with excessive weight. In addition, obesity is the most common comorbidity in severe cases of COVID-19, suggesting that immune dysregulation, metabolic unbalance, inadequate nutritional status, and dysbiosis are key factors in the complex mechanistic and clinical interplay between obesity and COVID-19. This narrative review aims to describe the most up-to-date evidence on the clinical characteristics of COVID-19 in children and adolescents, focusing on the role of excessive weight and weight gain in pediatrics. The COVID-19 pandemic has taught us that nutrition education interventions, access to healthy food, as well as family nutrition counselling should be covered by pediatric services to prevent obesity, which worsens disease outcomes related to COVID-19 infection.

Golden Syrian Hamsters as a Model for Revisiting the Role of Biological Sex Differences in SARS-CoV-2 Infection

ABSTRACTThere is growing evidence that coronavirus disease 2019 (COVID-19) affects males more severely than females, including compelling evidence indicating that biological sex is an important clinical factor influencing disease pathology and outcomes. In their recent article in mBio, S. Dhakal, C. A. Ruiz-Bedoya, R. Zhou, P. S. Creisher, et al. (mBio 12:e00974-21, 2021, https://doi.org/10.1128/mBio.00974-21) find further evidence to support this hypothesis as they interrogate biological sex differences in the pathogenesis and clinical features of COVID-19 in the golden Syrian hamster model. Their study probes SARS-CoV-2 infection in terms of loss of body mass, recovery, lung compromise, viral replication, inflammatory response, immune response, and, most importantly, the role of estrogen. They also demonstrate the value of a novel unbiased, quantitative chest computed tomography (CT) imaging approach. The golden Syrian hamster model holds a promising opportunity to further investigate how biological sex acts as a primary determinant in SARS-CoV-2 pathogenesis, as also demonstrated in this study.

What you need to know about children's COVID-19: a systematic review.

The aim of the systematic review is to describe clinical features of coronavirus disease 2019 (COVID-19) in children with a focus on the possible reasons why children are less susceptible to COVID-19 and whether their immune response works better than adults. The three research questions below were determined. (1) Why do pediatric COVID-19 cases have milder clinical symptoms than adults? (2) What are clinical manifestations, diagnosis, and treatment of COVID-19 in children? (3) How long lasts viral shedding after recovery? We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Abstracts of Reviews of Effects, as well as foreign literature with English translations. Extra information and data have been collected from Google Scholar and the American Society for Microbiology. Information on patients' age, comorbidities, methods of treatment, and effects on mortality and morbidity were extracted. It is concluded that children are less susceptible to COVID-19 than adults and that the symptoms in children are less severe than in adults. A low incidence of COVID-19 in children and milder disease than in adults might be attributed to many theories and reasons; however, the mechanisms involved are not fully understood.

A Possible Type IV Hypersensitivity Reaction to Older Antiepileptic Drugs During and After Recovery from COVID-19 Infection.

Nearly two years after the onset of the coronavirus disease 2019 (COVID-19) pandemic, healthcare workers face new and unexpected complications. Although accelerating the vaccination process in recent months has reduced the incidence and mortality of the COVID-19 infection, the general population (particularly vulnerable groups) remains at risk of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Over the last two months, Iran has encountered the fifth wave of the COVID-19 pandemic, i. e., the B.1.617.2 (Delta) variant of the SARS-CoV-2, with faster infectiousness and higher severity and mortality among hospitalized patients 1. Although fever, cough, and expectoration are the most common clinical features of COVID-19, recent studies have indicated an increasing number of skin manifestation reports in the disease. Besides, there is growing evidence that underlying SARS-CoV-2 infection may increase the risk of adverse drug reactions 2. However, the enduring concern in our medical centers in recent days is a raised incidence of Stevens-Johnson syndrome (SJS) in recovered COVID-19 patients following monotherapy with older antiepileptic drugs (0.004 vs. 0.0008% - i. e., 5 times higher than the pre-COVID-19 period) 3. It is worth noting that these patients did not have any history of SJS/toxic epidermal necrolysis (TEN) or additional etiopathogenic factors, including infections, genetic factors (particularly HLA-B*1502 allele), and malignancy. Furthermore, for many years before developing the COVID-19 and recovering from it, they had been treated with the above drugs without showing any cutaneous hypersensitivity reactions. These observational findings raise two important questions: (i) Could a history of the COVID-19 infection be a potential risk factor for type IV hypersensitivity reactions to older antiepileptic drugs? (ii) If so, what are its mechanisms of action?

COVID-19 in Children with Down Syndrome: Data from the Trisomy 21 Research Society Survey.

Adults with Down Syndrome (DS) are at higher risk for severe outcomes of coronavirus disease 2019 (COVID-19) than the general population, but evidence is required to understand the risks for children with DS, which is necessary to inform COVID-19 shielding advice and vaccination priorities. We aimed to determine the epidemiological and clinical characteristics of COVID-19 in children with DS. Using data from an international survey obtained from a range of countries and control data from the United States, we compared the prevalence of symptoms and medical complications and risk factors for severe outcomes between DS and non-DS paediatric populations with COVID-19. Hospitalised COVID-19 patients <18 years with DS had a higher incidence of respiratory symptoms, fever, and several medical complications from COVID-19 than control patients without DS <18 years. Older age, obesity, and epilepsy were significant risk factors for hospitalisation among paediatric COVID-19 patients with DS, and age and thyroid disorder were significant risk factors for acute respiratory distress syndrome. Mortality rates were low in all paediatric COVID-19 patients (with and without DS), contrasting with previous findings in adults with DS (who exhibit higher mortality than those without DS). Children with DS are at increased risk for more severe presentations of COVID-19. Efforts should be made to ensure the comprehensive and early detection of COVID-19 in this population and to identify children with DS who present comorbidities that pose a risk for a severe course of COVID-19. Our results emphasize the importance of vaccinating children with DS as soon as they become eligible.

Clinical Characteristics of COVID-19 among Children in Sarajevo, Bosnia and Herzegovina

Objective − To present the characteristics of children with coronavirus disease 2019 (COVID-19) treated at the Pediatrics Department, Ilidža Primary Health Care, The Public Institution Health Centre of Sarajevo Canton, Bosnia and Herzegovina. Methods − This is a descriptive cross-sectional study of 56 children with confirmed SARS-CoV-2 infection between March 2020 − May 2021. The parameters included were: aged 0-6 years, gender, clinical signs and symptoms, type of transmission, the presence of comorbidities, vaccination with Bacillus Calmette – Guérin (BCG) vaccine, laboratory and radiology results, and treatment. Results – Out of a total of children 57.1% were aged 3-6 years. There were 58.9% boys and 41.1% girls, 36 children had symptoms and 20 were asymptomatic. The most common symptoms were fever (57.1%) and cough (35.7%). 44 children had a mild form of the disease and they were treated at home with counseling by a pediatrician over the phone, 10 children required outpatient treatment by a pediatrician, 2 were hospitalized. After treatment, all of them recovered. Most of the children (83.9%) were infected by transmission from a household member. Conclusions − COVID-19 in children is generally a mild disease. Children with SARS-CoV-2 were mostly infected by contact with an adult, and transmission from children is minimal. Most children were treated symptomatically at home, only a small number were hospitalized.

Prevalence and Presentation of Paediatric Coronavirus Disease 2019 in Lagos, Nigeria.

Background The objective of this study was to describe the prevalence and clinical features of coronavirus disease 2019 (COVID-19) among children (≤18 years) evaluated for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection at a testing centre in Lagos, Nigeria. Methodology. This was a retrospective study. Data on the sociodemographic, clinical characteristics and SARS-CoV-2 results of participants at a modified drive-through centre for COVID-19 test sample collection over four months were retrieved from the electronic medical records (EMR). Data obtained were analyzed using SPSS version 22.0. Results A total of 307 children (≤18 years) were evaluated in this review. The prevalence of SARS-CoV-2 infection among the paediatric population was 16.3%. The median age (interquartile range (IQR)) was 9 (4–14) years. Common symptoms reported by the positive cases were fever (40.0%), cough (32.9%), sore throat (17.1%), and runny nose (15.7%). The majority of the positive cases had mild symptoms. Fever and sore throat were associated with the positive cases. Conclusion Fever and sore throat were associated with SARS-CoV-2 infection among our cohort which buttresses the need for a high level of suspicion and clinical acumen in the management of common febrile diseases in paediatric settings.

Clinical Features of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorders.

Background and ObjectivesTo describe the clinical features and disease outcomes of coronavirus disease 2019 (COVID-19) in patients with neuromyelitis optica spectrum disorder (NMOSD).MethodsThe Neuroimmunology Brazilian Study Group has set up the report of severe acute respiratory syndrome (SARS-CoV2) cases in patients with NMOSD (pwNMOSD) using a designed web-based case report form. All neuroimmunology outpatient centers and individual neurologists were invited to register their patients across the country. Data collected between March 19 and July 25, 2020, were uploaded at the REDONE.br platform. Inclusion criteria were as follows: (1) NMOSD diagnosis according to the 2015 International Panel Criteria and (2) confirmed SARS-CoV2 infection (reverse transcription-polymerase chain reaction or serology) or clinical suspicion of COVID-19, diagnosed according to Center for Disease Control / Council of State and Territorial Epidemiologists (CDC/CSTE) case definition. Demographic and NMOSD-related clinical data, comorbidities, disease-modifying therapy (DMT), COVID-19 clinical features, and severity were described.ResultsAmong the 2,061 pwNMOSD followed up by Brazilian neurologists involved on the registry of COVID-19 in pwNMOSD at the REDONE.br platform, 34 patients (29 women) aged 37 years (range 8–77), with disease onset at 31 years (range 4–69) and disease duration of 6 years (range 0.2–20.5), developed COVID-19 (18 confirmed and 16 probable cases). Most patients exhibited mild disease, being treated at home (77%); 4 patients required admission at intensive care units (severe cases); and 1 patient died. Five of 34 (15%) presented neurologic manifestations (relapse or pseudoexacerbation) during or after SARS-CoV2 infection.DiscussionMost NMOSD patients with COVID-19 presented mild disease forms. However, pwNMOSD had much higher odds of hospitalization and intensive care unit admission comparing with the general Brazilian population. The frequency of death was not clearly different. NMOSD disability, DMT type, and comorbidities were not associated with COVID-19 outcome. SARS-CoV2 infection was demonstrated as a risk factor for NMOSD relapses. Collaborative studies using shared NMOSD data are needed to suitably define factors related to COVID-19 severity and neurologic manifestations.

Treatment of psoriasis with biologics in the early COVID-19 pandemic: A study examining patient attitudes toward the treatment and disease course.

BackgroundSince March 2020, the coronavirus disease 2019 (COVID‐19) pandemic has been ongoing all around the world with a wide range of clinical course including asymptomatic cases to severe and fatal respiratory tract disease. Patients on immunosuppressive treatments were predicted to be more susceptible to COVID‐19.AimsIt was aimed to assess treatment continuity, the course of psoriasis and the course and clinical features of COVID‐19 in patients treated with biological agents for psoriasis at the early initial period of COVID‐19 pandemic.Patients/MethodsPatients treated with biological agents for psoriasis at our institute were contacted by phone between 1 and 10 July 2020 and fulfilled a questionnaire about their continuity to psoriasis treatments, clinical course of psoriasis, and any suspicion/diagnosis of COVID‐19.ResultsA total of 106 patients, 41 females and 65 males, were enrolled. Mean age of the patients was 46.1 ± 12.1 years (range: 19–77). Median duration of psoriasis was 18 years (min–max: 1 month–51 years). Twenty‐four patients (22.6%) were using tumor necrosis alpha inhibitors (ETA:1, IFX:19, ADA:4), whereas 82 patients (77.4%) were using interleukin (IL) 12/23 or IL‐17 inhibitors (UST:48, SECU:30, IXE:4). Seventy‐six patients (71.7%) continued the treatment, whereas 30 patients (28.3%) interrupted the treatment voluntarily. Twenty out of 30 patients (66.6%) who interrupted the treatment had an exacerbation of psoriasis. None of the patients were diagnosed with COVID‐19 in the study period.ConclusionPatients with psoriasis who received biological therapy continued their treatment at a high rate during the early period of the COVID‐19 pandemic. No COVID‐19 diagnosis was made among patients whether they continued or discontinued treatment. Recurrence and exacerbation of psoriasis in a significant proportion of patients who interrupted treatment and absence of COVID‐19 diagnosis in each group support the importance and safety of continuity of biological treatments for psoriasis in COVID‐19 era.

Age-Related Differences in the Expression of Most Relevant Mediators of SARS-CoV-2 Infection in Human Respiratory and Gastrointestinal Tract.

Background: Clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection seem to differ in children compared to that in adults. It has been hypothesized that the lower clinical severity in children could be influenced by differential expression of the main host functional receptor to SARS-CoV-2, the angiotensin-converting enzyme 2 (ACE2), but data are still conflicting. To explore the origin of age-dependent clinical features of coronavirus disease 2019 (COVID-19), we comparatively evaluated the expression in children and adult subjects of the most relevant mediators of the SARS-CoV-2 infection: ACE2, angiotensin-converting enzyme 1 (ACE1), transmembrane serine protease-2 (TMPRSS2), and neuropilin-1 (NRP1), at upper respiratory tract and small intestine level.Methods: The expression of ACE2, ACE1, TMPRSS2, and NRP1 in nasal epithelium and in small intestine epithelium was investigated by quantitative real-time PCR analysis.Results: We found no differences in ACE2, ACE1, and TMPRSS2 expression in the nasal epithelium comparing children and adult subjects. In contrast, nasal epithelium NRP1 expression was lower in children compared to that in adults. Intestinal ACE2 expression was higher in children compared to that in adults, whereas intestinal ACE1 expression was higher in adults. Intestinal TMPRSS2 and NRP1 expression was similar comparing children and adult subjects.Conclusions: The lower severity of SARS-CoV-2 infection observed in children may be due to a different expression of nasal NRP1, that promotes the virus interaction with ACE2. However, the common findings of intestinal symptoms in children could be due to a higher expression of ACE2 at this level. The insights from these data will be useful in determining the treatment policies and preventive measures for COVID-19.

Clinical characteristics of COVID-19 in family clusters: a systematic review.

BackgroundCoronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread around the world and reports of children during early epidemic period showed features of family clusters. The aim of this study is to assess clinical profiles of COVID-19 in family clusters with children.MethodsWe performed a systematic literature review of English database (PubMed, Web of Science) and Chinese database (“www.cnki.net”, “www.cqvip.com” and “www.Wanfangdata.com.cn”) to identify papers on family clusters of COVID-19 with children and their family members.ResultsEighteen studies involving 34 children and 98 adults from 28 families were included. Fever, cough and ground-grass opacity change of chest computed tomography (CT) were the dominant features, whereas proportion of asymptomatic infections for children was higher than adults with statistical significance (32.4% and 13.3%, respectively, P < 0.05). Median time of longer incubation period (10 days) and shorter duration of pharyngeal swab nucleic acid test positive period (11 days) were seen in children than adults (7 and 17 days, respectively) with statistical significance (P < 0.05). There were statistically significant differences in lymphopenia, increased C-reactive protein and abnormal chest CT between children and adult patients (P < 0.05). Twenty-seven families reported adults as first case of COVID-19 in family clusters.ConclusionsThe same virus strain can cause milder disease in children compared with their caregivers. Children of COVID-19 were infected by adults in family during the early epidemic period. Asymptomatic patients can transmit the virus.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12519-021-00434-z.

A Brief Review of Clinical Features of Coronavirus Disease 2019 (COVID-19) in Algeria

Purposes: The objective of the current work is to highlight the most common clinical and biological characteristics and potential risk factors of COVID-19 in Algeria. Methods: This study was conducted using data of four published studies about clinical, biological characteristics and risk factors for severity and mortality of COVID-19 realized in three hospitals (Beni Messous, Bologhine and Rouiba) in the department of Algiers (Algeria). Results: Results showed that cough, fever and asthenia were the most common clinical signs in COVID-19 positive patients. The median age of the presented cases was 54.4 years and 61% of them were older than 50 years. Also, 68% of them have at least one related comorbidity where diabetes and hypertension were the most common. Elevated sedimentation rate, elevated LDH, elevated CRP, elevated ALT/AST and lymphopenia were the most common biological abnormalities observed. Conclusion: This work despite some limitations could contribute to the clinical characterization of COVID-19 in Algeria.

Clinical Considerations in Otorhinolaryngology Practice in COVID-19 Pandemic Era

The coronavirus disease 2019 (COVID-19) epidemic originated in Wuhan, China and spread rapidly worldwide, leading the World Health Organization to declare an official global COVID- 19 pandemic in March 2020. The upper aero-digestive tract is known to be the highest viral load reside. The infection spreads via droplets or direct contact with contaminated surfaces via aeorsol. The otolaryngologists deal with diseases of the upper-aerodigestive tract and routinely are engaged in respiratory droplet and aerosol-generating procedures (AGP). In particular, because airborne transmission occurs during examination and AGP, otolaryngologists are considered to be at a high risk of contracting COVID-19 during this pandemic. Therefore otolaryngologists need to do precautions to protect staff and patients and minimize transmission of the disease. We also need to wear adequate personal protective equipment according to the examination and procedure. This article discusses the disease transmission and clinical characteristics of COVID-19 as well as precaution guidelines in outpatient clinics of otorhinolaryngology.

Clinical Characteristics of COVID-19 in a Tertiary Health Facility in Northeast Nigeria

Aim: The coronavirus disease 2019 (COVID-19), caused by a newly identified β-coronavirus (severe acute respiratory syndrome coronavirus-2), has a varied clinical manifestation. We evaluated the clinical features of COVID-19 in symptomatic patients that presented for care at a Federal Medical Centre Nguru, Northeast Nigeria. Methodology: In this retrospective cohort study, we reviewed and analyzed relevant information abstracted from the medical records of symptomatic COVID-19 patients that were managed from March 14 to October 14, 2020, in the facility. Results: Clinical records of 55 symptomatic COVID-19 patients were evaluated in this study. Their mean age was 49.1 ± 16.3 (females 51.4 ± 15.6, males 48.5 ± 17.2, P = 0.601) with females constituting 47.2% of the studied patients. Fever (87.3%), cough (67.3%), sore throat (49.1%) and rhinorrhea (41.8%) were the most common clinical feature. Other features included difficulty in breathing (25.5%) and ageusia (14.6%). Gastrointestinal symptoms such as diarrhea, vomiting and abdominal pain were seen in 10.9%, 18.2%, and 9.1%, respectively. Twenty-one (38.2%) patients had a preexisting health condition. Chronic kidney disease was the most common; it was seen in 34% of patients, other common conditions included hypertensive heart disease (24%), and diabetes mellitus (16%). Conclusion: Respiratory symptoms are the most common presentation of COVID-19 in our setting. However, some patients also presented with additional extrapulmonary symptoms. A significant proportion, 38.2% of symptomatic COVID-19 patients, had preexisting health conditions.

Comparison and clinical characteristics of COVID-19 between January and February 2020 in Wuhan, China

Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) continues to make a deadly impact on human life all over the world. Therefore, we aimed to analyze the changes in clinical characteristics of coronavirus disease 2019 (COVID-19) patients over time. We recruited 896 patients who were admitted to the Renmin Hospital of Wuhan University between 30th January 2020 and 16st March 2020. We conducted a retrospective study collecting clinical characteristics, radiologic and laboratory findings, treatments administered, and clinical outcomes in the patients. The data collected were compared between patients with onset of illness in January 2020 and patients with onset of illness in February 2020, in Wuhan, China. Categorical data and non-normally distributed continuous data were examined by the χ2 test and the Mann-Whitney-Wilcoxon test respectively, and the Kaplan-Meier plot was used to analyze survival data. Univariate and multivariate logistic regression methods were used to explore the risk factors associated with in-hospital death. A total of 896 patients were enrolled; the median age was 60 (range, 47-69) years, 685 (76.5%) were categorized into group A (patients with onset of illness in January 2020), and 211 (23.5%) were categorized into group B (patients with onset of illness in February 2020). Compared with group B, group A had a higher incidence of fever (P<0.001), and a lower rate of asymptomatic individuals (P<0.001). Group A patients had a higher incidence of neutrophilia (P=0.043), an elevated D-dimer (P<0.001), and an increased lactate dehydrogenase (LDH) (P=0.002), but a lower incidence of a normal computed tomography (CT) scan (P=0.001). CD3 cell counts (P=0.015) and CD4 cell counts (P=0.04) were significantly reduced in group A patients. Critically ill patients were less frequent (P=0.005) and patients with milder disease were more common (P=0.001) in group B. The fatality rate was significantly less in group B patients (P=0.028). Multivariate regression indicated that older age (odds ratio 1.086, 95% CI: 1.061-1.111, per year increase; P<0.001) increased the risk of in-hospital death. Female sex (odds ratio 0.523, 95% CI: 0.316-0.865; P=0.012) and being in group B (odds ratio 0.423, 95% CI: 0.212-0.844; P=0.015) significantly decreased the risk of in-hospital death. The condition of patients with onset of illness in January was more serious than that of patients with onset of illness in February 2020. The time of onset of illness was an independent risk factor for in-hospital death comparing January and February 2020. Changing pathogenicity of SARS-CoV-2 and improved healthcare may have contributed to the results, however, more basic research is required to support this hypothesis.

Screening of COVID-19 in outpatient children with cancer or solid organ transplantation: preliminary report.

Clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pediatric immunosuppressed patients is unknown. Emerging data describe a milder or asymptomatic course in children compared with adults in this scenario. We present the seroprevalence and clinical features of coronavirus disease 2019 in a prospective cohort of 114 immunosuppressed children and adolescents from three groups: kidney transplantation, liver transplantation, and cancer patients. Among the thirty-five (30.7%) patients who had a positive serological test for SARS-CoV-2, 77% did not report previous symptoms and none of them developed any complications of coronavirus disease 2019 (COVID-19) after 30 or more days of follow-up. Among those who were symptomatic, diarrhea, fever, and cough were the most common findings.Conclusion: Seroprevalence of SARS-CoV-2 infection is high among immunosuppressed children and adolescents. COVID-19 has a mild or asymptomatic course in most of these patients. What is Known:• The number of immunosuppressed patients with coronavirus disease 2019 is increasing.• Viral infections have the potential for greater severity in immunocompromised children.What is New:• Seroprevalence for severe acute respiratory syndrome coronavirus 2 in immunocompromised pediatric patients was 31%.• A quarter of the serology-positive patients reported mild symptoms and none of them developed multisystem inflammatory syndrome in children associated with coronavirus disease 2019.

Analysis of Epidemiological and Clinical Characteristics of COVID-19 in Northwest Mexico and the Relationship Between the Influenza Vaccine and the Survival of Infected Patients.

The first cases of unexplained pneumonia were reported in Wuhan, China, in December of 2019. Later, a novel coronavirus (SARS-CoV-2) was identified as the causal agent of pneumonia. This virus has since spread to more than 180 countries and has been declared a pandemic by the World Health Organization. Herein, we aimed to determine the epidemiological and clinical characteristics of symptomatic patients with coronavirus disease 2019 (COVID-19) and the relationship between the influenza vaccine with a lower risk of severe COVID-19 infection in the state of Sinaloa. We collected demographic and clinical data of 4,040 patients with acute respiratory infections across Sinaloa state hospitals from February 28 to May 15, 2020. The prevalence of COVID-19 among hospitalized patients with respiratory symptoms in Sinaloa showed 45.2% of men were more affected than women (p < 0.001), and people aged 40–49 years were the most affected. The main symptoms of COVID-19 infection were cough and fever (p < 0.001), while hypertension, obesity, and type 2 diabetes were the chronic diseases associated with COVID-19 than non-COVID-19 (p < 0.003). Healthcare workers were most likely to be infected compared to other occupations (p < 0.001). The general lethality rate was 14.1%, and males >62 years were the ones who had a higher lethality rate (p < 0.001); the aforementioned chronic diseases were related to higher lethality of COVID-19 (p < 0.001). Likewise, higher lethality was seen in housewives and patient retirees/pensioners compared with other occupations (p < 0.001). Finally, we found there was a relationship between influenza vaccination and a lower risk of severe COVID-19 infection and mortality (p < 0.001). These findings showed that healthcare workers, men >62 years with chronic diseases, and retired people were most affected. Furthermore, the influenza vaccine could decrease the severeness of COVID-19 cases.

Digestive system symptoms and function in children with COVID-19: A meta-analysis.

The prevalence of children exhibiting coronavirus disease 2019 (COVID-19) with digestive system involvement remains unknown. Therefore, we aimed to quantify the impact of COVID-19 on the digestive system of children.In this meta-analysis, we searched PubMed, Embase, and Web of Science from January 1, 2020, to June 31, 2020. We also searched for COVID-19 publications in specific journals for more comprehensive results. We included studies that reported the epidemiological and clinical characteristics of COVID-19, and we excluded duplicate publications, reviews, animal studies, case reports, publications without the full text, studies with incomplete information, and studies from which data extraction was impossible.We conducted a meta-analysis of the incidence of gastrointestinal symptoms and changes in liver function involving 19 studies. The pooled prevalence of diarrhea was 10% (95% CI: 7–14; I2 = 84%), that of nausea or vomiting was 7% (95% CI: 5–11; I2 = 77%), and that of abdominal pain was 4% (95% CI: 2–9; I2 = 79%). In addition, the pooled incidence of increased alanine aminotransferase was 8% (95% CI: 5–15; I2 = 46%), and the pooled incidence of increased AST was 15% (95% CI: 9–26; I2 = 66%). The pooled rate of recovery was 97% (95% CI: 94–100; I2 = 86%), and the pooled rate of death, which was 1% (95% CI: 1–4; I2 = 48%), was much smaller than the recovery rate.Our research shows that digestive system symptoms and function in children with COVID-19 are not uncommon. More attention should be paid to this unique group of patients.

A snapshot of public knowledge of novel coronavirus disease 2019: a web-based national survey

BackgroundAlthough the number of existing cases of coronavirus disease 2019 (COVID-19) in China has been decreasing since late February 2020, the number of confirmed cases abroad is surging. Improving public knowledge of COVID-19 is critical to controlling the pandemic. This study aimed to determine China’s public knowledge of COVID-19 and the attitudes towards control measures.MethodsA cross-sectional study was conducted over 48 h from 22:30 29 February 2020 to 22:30 2 March 2020 based on a self-administered web-based questionnaire. The survey was conducted on the WeChat network. Exponential non-discriminative snowball sampling was applied. The questionnaire was voluntarily completed by WeChat users. The questionnaire covered basic demographic information, public knowledge of the epidemiological and clinical characteristics of COVID-19, psychological state, and attitudes towards the overall control measures. The primary outcome was the China’s public knowledge of COVID-19 and the attitudes towards control measures and secondary outcome was the psychological state of the public during this pandemic.ResultsThe study included 10,905 participants and 10,399 valid questionnaires were included for analysis. Participants with tertiary education, younger participants and healthcare workers had better overall knowledge than other participants (all P < 0.05). Approximately 91.9% of the participants believed in person-to-person transmission and 39.1% believed in animal-to-person transmission. No significant correlation between anxiety and the number of regional existing confirmed cases was found, while participants in Hubei were more anxious than those in other regions. In general, 74.1% of the participants acknowledged the effectiveness of the overall control measures, and the percentage of participants with agreement with the overall control measures was negatively correlated with the number of regional existing confirmed cases (r = − 0.492, P = 0.007).ConclusionsIn conclusion, the survey revealed that the Chinese public had overall good knowledge of COVID-19 except for those indeterminate knowledges. With dynamic changes in the global pandemic situation and more research, further studies should be conducted to explore changes in public knowledge and attitudes towards COVID-19 in the future. The media could be used in a strict and regular manner to publicize knowledge of such pandemics to halt their spread.

Lethal zoonotic coronavirus infections of humans - comparative phylogenetics, epidemiology, transmission, and clinical features of coronavirus disease 2019, The Middle East respiratory syndrome and severe acute respiratory syndrome.

Severe acute respiratory syndrome-coronaviruses-2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), emerged as a new zoonotic pathogen of humans at the end of 2019 and rapidly developed into a global pandemic. Over 106 million COVID-19 cases including 2.3 million deaths have been reported to the WHO as of February 9, 2021. This review examines the epidemiology, transmission, clinical features, and phylogenetics of three lethal zoonotic coronavirus infections of humans: SARS-CoV-1, SARS-CoV-2, and The Middle East respiratory syndrome coronavirus (MERS-COV). Bats appear to be the common natural source of SARS-like CoV including SARS-CoV-1 but their role in SARS-CoV-2 and MERS-CoV remains unclear. Civet cats and dromedary camels are the intermediary animal sources for SARS-CoV-1 and MERS-CoV infection, respectively whereas that of SARS-CoV-2 remains unclear. SARS-CoV-2 viral loads peak early on days 2-4 of symptom onset and thus high transmission occurs in the community, and asymptomatic and presymptomatic transmission occurs commonly. Nosocomial outbreaks are hallmarks of SARS-CoV-1 and MERS-CoV infections whereas these are less common in COVID-19. Several COVID-19 vaccines are now available. Of the three lethal zoonotic coronavirus infections of humans, SARS-CoV-2 has caused a devastating global pandemic with over a million deaths. The emergence of genetic variants, such as D614G, N501Y (variants 1 and 2), has led to an increase in transmissibility and raises concern about the possibility of re-infection and impaired vaccine response. Continued global surveillance is essential for both SARS-CoV-2 and MERS-CoV, to monitor changing epidemiology due to viral variants.