History Of Epidemiological Exposure Research Articles

Caso autóctono de rickettsiosis por Rickettsia parkeri en la Selva Paranaense, Misiones, Argentina

We report an autochthonous case of Rickettsia parkeri rickettsiosis occurred in June 2018 in a forested area of the Urugua-í Provincial Park, Misiones, Argentina. No previous records of this disease in humans have been previously reported in this region. The epidemiological, ecological, clinical, and laboratory features required for a proper diagnosis and adequate treatment are described here. The fact of considering rickettsiosis as a differential diagnosis in a patient with exanthematic acute febrile syndrome is highlighted, being the epidemiological history of exposure to the vector (ticks of the genus Amblyomma) an essential element.

Characteristics of SARS-CoV-2 Omicron infection in children imported from Hong Kong

Objective: To understand the clinical characteristics of children with SARS-CoV-2 Omicron infection imported from Hong Kong Special Administrative Region. Methods: This retrospective study was conducted to collect the data including clinical manifestations, outcomes and vaccination of 107 children with SARS-CoV-2 Omicron infection imported from Hong Kong Special Administrative Region to be admitted to the designated referral hospital in Shanghai from February to March 2022. According to the occurrence of clinical symptoms, the cases were divided into asymptomatic group and symptomatic group. According to the age of diagnosis, the cases were divided into <3 years group, 3-<6 years group and 6-<18 years group, and the clinical manifestations in different age group were analyzed with t-test and Mann-Whitney rank-sum test. Besides, to analyze the effectiveness of vaccination against SARS-CoV-2 Omicron infection in different age group, the cases aged 3-<18 years were also subdivided into unvaccinated group, 1-dose group and 2-dose group, and the relative risk (RR) was used to demonstrate the effectiveness. Results: Among the 107 cases, 66 were male and 41 were female, with infection age of 10 (5, 14) years. There were 29 cases in the asymptomatic group, and 78 cases in the symptomatic group, and no significant difference in the age of infection was observed between the 2 groups (11 (6, 14) vs. 10 (5, 14) years, Z=0.49, P>0.05). And there were no severe cases in symptomatic group. The length of hospitalization was (18±6) days, and was longer in symptomatic group than that in asymptomatic group ((19±6) vs. (16±7) d, t=0.17, P=0.030). Eight-two cases (76.6%) had a history of epidemiological exposure and, among whom, 81 cases (75.7%) were associated with household transmission. Among symptomatic group, 57 cases (73.1%) had fever and 20 cases (25.6%) had cough. Of the 74 cases undergoing chest CT examination, 17 cases (23.0%) showed mild abnormalities. Of the 83 cases who received the lab tests, 23 cases (27.7%) had white blood cell counts<4×109/L, 3 cases (3.6%) had C-reaction protein >8.0 mg/L, and 6 cases (7.2%) had slightly elevated aspartate transaminase and alanine aminotransferase. Among the 92 children aged 3-<18 years, 31 cases were unvaccinated, 34 cases received 1 dose, and 27 cases received 2 doses. The interval between the last vaccination and infection was 2.2 (0.6, 6.0) months; the interval between the last vaccination and infection in the 2-dose group was longer than that in 1-dose group (6.0 (4.5, 7.3) vs. 0.7 (0.3,2.0) months, Z=3.59, P<0.001).The risk of symptomatic infection was reduced by 45% (RR=0.55, 95% CI 0.35-0.87) with two-dose vaccination compared to non-vaccination in cases aged 3-<18 years. All these cases recovered completely. Conclusions: Children infected with SARS-CoV-2 Omicron are usually mild or asymptomatic. Household transmission is the main pattern of infection with SARS-CoV-2 Omicron in children. Two-dose SARS-CoV-2 vaccination in children aged 3-<18 years can provide partial protection against disease caused by SARS-CoV-2 Omicron.

Clinical characteristics and outcome analysis of COVID-19 patients with pulmonary tuberculosis

Coronavirus disease (COVID-19) and tuberculosis (TB) are two respiratory infectious diseases with a high incidence of transmission, mainly via respiratory droplets and both can weaken the immune system and lower the number of CD4+T cells in patients. COVID-19 can occur before, at the same time or after the diagnosis of TB. Patients with pulmonary TB are more likely to have co-infection when they have a history of epidemiological exposure to COVID-19. At present, many cases of nosocomial infection of COVID-19 caused by ineffective prevention and control measures in tuberculosis hospitals have been reported successively at domestic and overseas. Therefore, it is urgent to strengthen the prevention and control of nosocomial infections in tuberculosis hospitals. The superposition of the two diseases can lead to a worsening prognosis, aggravating the patient's condition and making treatment more difficult. In addition, in the context of the new coronavirus epidemic, early recognition of co-infection with new coronavirus should be made when TB patients in chest hospitals present with symptoms such as aggregated fever or progressive disease. At the same time, we should focus on identifying the clinical and imaging manifestations of TB and COVID-19 co-infection. At present, research on COVID-19 complicated with pulmonary TB is scarce, and there are disputes on many aspects. As a country with a high prevalence of tuberculosis, it is of great practical significance to identify the clinical characteristics, outcomes, and treatment of the two infectious diseases in China.

1026. Following the Hoof Prints: Detecting Coxiella and Brucella infections with A Plasma-based Microbial Cell-Free DNA Next-generation Sequencing Test

Background Coxiella burnetii and Brucella spp. are zoonotic bacterial pathogens responsible for Q fever and Brucellosis, respectively. Both pathogens have a global distribution and Brucellosis is the most common zoonosis in the world. However, the CDC reports only 80-120 cases of human brucellosis and ~150 cases of acute Q fever annually. The diagnosis of these infections can be limited by: (1) their difficulty to culture; (2) the insensitivity and nonspecificity of serology; (3) the clinical overlap with other infections; and (4) the unreliability of epidemiological exposure history for these zoonoses. Unbiased microbial cell free DNA (mcfDNA) next-generation sequencing (NGS) offers a potential solution to overcome these limitations.MethodsThe Karius TestTM (KT) developed and validated in Karius’s CLIA certified/CAP accredited lab in Redwood City, CA detects mcfDNA in plasma. After mcfDNA is extracted and NGS performed, human reads are removed, and remaining sequences are aligned to a curated database of > 1500 organisms. McfDNA from organisms present above a statistical threshold are reported and quantified in molecules/µL (MPM). KT detections of Coxiella and Brucella were reviewed from August 2017 - present; clinical information was obtained with test requisition or consultation upon result reporting.ResultsKT detected 8 cases of Coxiella burnetii (1735 MPM +/- 3000) and 5 cases of Brucella melitensis (avg 296 MPM +/- 223) (Table 1), representing approximately 1-2% of all detections in the US during this period. All of the Coxiella detections were in adults (100% male) with 5 cases of fever of unknown origin, 2 cases of culture-negative endocarditis and one case of endovascular graft infection. Brucella detections occurred in 3 adults and 2 children (60% male), 3 with exposure to unpasteurized dairy and included 3 cases of spine infection (2 vertebral osteomyelitis, 1 epidural abscess). ConclusionOpen-ended, plasma-based mcfDNA NGS provides a rapid, non-invasive test to diagnose diverse clinical manifestations of zoonotic infections such as Q fever and Brucellosis against competing broad differential diagnoses. Furthermore, these cases highlight the potential of the KT to diagnose infections caused by fastidious/unculturable pathogens with cryptic clinical presentations.Disclosures Nicholas R. Degner, MD, MPH, MS, Karius Inc. (Employee, Shareholder) Ricardo Castillo-Galvan, MD MPH, Karius Inc. (Consultant) Jose Alexander, MD, D(ABMM), FCCM, CIC, SM, MB(ASCP), BCMAS, Karius (Employee) Aparna Arun, MD, Karius (Employee) Ann Macintyre, DO, Karius, Inc. (Employee) Bradley Perkins, MD, Karius, Inc. (Employee) Asim A. Ahmed, MD, Karius, Inc. (Employee) Matthew Smollin, PharmD, Karius, Inc. (Employee)

A novel artificial intelligence-assisted triage tool to aid in the diagnosis of suspected COVID-19 pneumonia cases in fever clinics.

BackgroundCurrently, the need to prevent and control the spread of the 2019 novel coronavirus disease (COVID-19) outside of Hubei province in China and internationally has become increasingly critical. We developed and validated a diagnostic model that does not rely on computed tomography (CT) images to aid in the early identification of suspected COVID-19 pneumonia (S-COVID-19-P) patients admitted to adult fever clinics and made the validated model available via an online triage calculator.MethodsPatients admitted from January 14 to February 26, 2020 with an epidemiological history of exposure to COVID-19 were included in the study [model development group (n=132) and validation group (n=32)]. Candidate features included clinical symptoms, routine laboratory tests, and other clinical information on admission. The features selection and model development were based on the least absolute shrinkage and selection operator (LASSO) regression. The primary outcome was the development and validation of a diagnostic aid model for the early identification of S-COVID-19-P on admission.ResultsThe development cohort contained 26 cases of S-COVID-19-P and seven cases of confirmed COVID-19 pneumonia (C-COVID-19-P). The final selected features included one demographic variable, four vital signs, five routine blood values, seven clinical signs and symptoms, and one infection-related biomarker. The model’s performance in the testing set and the validation group resulted in area under the receiver operating characteristic (ROC) curves (AUCs) of 0.841 and 0.938, F1 scores of 0.571 and 0.667, recall of 1.000 and 1.000, specificity of 0.727 and 0.778, and precision of 0.400 and 0.500, respectively. The top five most important features were age, interleukin-6 (IL-6), systolic blood pressure (SYS_BP), monocyte ratio (MONO%), and fever classification (FC). Based on this model, an optimized strategy for the early identification of S-COVID-19-P in fever clinics has also been designed.ConclusionsA machine-learning model based solely on clinical information and not on CT images was able to perform the early identification of S-COVID-19-P on admission in fever clinics with a 100% recall score. This high-performing and validated model has been deployed as an online triage tool, which is available at https://intensivecare.shinyapps.io/COVID19/.

Telemonitoring of Children with COVID-19: Experience Report of the First 100 Cases.

Introduction:The first case of coronavirus disease 2019 (COVID-19) in Brazil was diagnosed in February 2020. On March 20, the Ministry of Health issued Ordinance no. 467, regulating the use of telemedicine during the pandemic period. One of the various modalities of telemedicine is telemonitoring.Objective:To report our experience with telemonitoring and evaluate its applicability in the follow-up of the first 100 children who received the diagnosis of COVID-19 after visiting the emergency department of Sabará Hospital Infantil (“Hospital Sabará”) and who had no indications for hospitalization.Methods:The care records of the children were retrospectively analyzed, and telephone contact with the families of patients who did not complete the proposed telemonitoring protocol was initiated.Results:The average age of the children was 5.5 years, and a slight male predominance (54/100) was observed. Comorbidities were present in 24/100. The source of infection was family members living in the same household in 88/100 and other sources in 12/100. In the first telemonitoring, 44% of the evaluated patients were asymptomatic. In the second telemonitoring, 81% of the patients were asymptomatic. Telemonitoring was completed by 70% of the children. A total of 14 children returned to the emergency department, 11 of whom spontaneously (2/11 were admitted) and 3 under the indication of telemedicine (3/3 were admitted).Conclusions:Telemonitoring proved to be a clinically valuable resource in the follow-up of children with COVID-19, as it allowed continuity of care and identified patients with indications to return to the emergency department of Hospital Sabará and for hospitalization, thus avoiding unnecessary emergency department visits.

Clinical characteristics and risk factors of mild-to-moderate COVID-19 patients with false-negative SARS-CoV-2 nucleic acid.

This study investigates the clinical and imaging characteristics of coronavirus disease 2019 (COVID‐19) patients with false‐negative nucleic acids. Mild‐to‐moderate COVID‐19 patients, including 19 cases of nucleic acid false‐negative patients and 31 cases of nucleic acid positive patients, were enrolled. Their epidemiological, clinical, and laboratory examination data and imaging characteristics were analyzed. Risk factors for false negatives were discussed. Compared with the nucleic acid positive group, the false‐negative group had less epidemiological exposure (52.6% vs 83.9%; P = .025), less chest discomfort (5.3% vs 32.3%; P = .035), and faster recovery (10 [8, 13] vs 15 [11, 18.5] days; P = .005). The number of involved lung lobes was (2 [1, 2.5] vs 3 [2, 4] days; P = .004), and the lung damage severity score was (3 [2.5, 4.5] vs 5 [4, 9] days; P = .007), which was lighter in the nucleic acid false‐negative group. Thus, the absence of epidemiological exposure may be a potential risk factor for false‐negative nucleic acids. The false‐negative cases of COVID‐19 are worth noting because they have a risk of viral transmission without positive test results, lighter clinical manifestations, and less history of epidemiological exposure.

Manifestaciones clínicas y resultados materno-perinatales del COVID-19 asociado al embarazo: Una revisión sistemática

Objetivo: Evaluar las manifestaciones clínicas y resultados materno-perinatales de la infección por COVID-19 asociada al embarazo. Material y métodos: Se revisaron ocho bases de datos electrónicas (Science Direct, Pubmed, Lilacs, Scielo, Redalyc, LitCovid, EBSCO y Scopus). Se consideraron estudios primarios a texto completo en idioma español e inglés; publicados entre el 01 de enero y 15 de mayo de 2020; y realizados en gestantes con diagnóstico confirmado de COVID-19 (reacción en cadena polimerasa con transcripción inversa [RT-PCR]. Resultados: Se incluyeron 15 estudios que informaron 224 casos de infección por COVID-19 asociada al embarazo, principalmente en gestantes del tercer trimestre (13/15). La tos y fiebre fueron las principales manifestaciones clínicas reportadas en todas las investigaciones. Menos de la tercera parte de estudios muestran al dolor abdominal como manifestación obstétrica que motiva la búsqueda de atención. El antecedente epidemiológico de exposición y las alteraciones en exámenes auxiliares de laboratorio (linfopenia y PCR elevado, principalmente) son reportadas con regular frecuencia. La enfermedad por COVID-19 asociado al embarazo se presenta principalmente de forma leve; asimismo, la mortalidad e ingreso a UCI son resultados maternos exclusivamente asociados a las pocas presentaciones severas. La cesárea es la vía de culminación mayormente empleada, siendo en pocos casos la neumonía por COVID-19 la indicación citada. El bajo peso al nacer y el ingreso a UCIN son resultados perinatales descritos en 9 de 15 estudios, existiendo poca mortalidad perinatal. Solo en tres estudios se reporta que existe transmisión vertical. Conclusión: La enfermedad por COVID-19 asociado al embarazo se reporta principalmente en gestantes de tercer trimestre, con fiebre y tos presentes a la admisión, siendo mayormente casos leves. Asimismo, genera pocas complicaciones materno-perinatales; sin embargo, en casos severos la morbimortalidad es más frecuente.

Potential transmission of SARS-CoV-2 on a flight from Singapore to Hangzhou, China: An epidemiological investigation

BackgroundBetween January 24, 2020 and February 15, 2020, an outbreak of COVID-19 occurred among 335 passengers on a flight from Singapore to Hangzhou in China. This study aimed to investigate the source of the outbreak and assess the risk of transmission of COVID-19 during the flight. MethodUsing a standardized questionnaire, we collected information on the travelers’ demographic characteristics and illness before, during, and after the flight. We also collected data on factors potentially associated with COVID-19 transmission during the flight. ResultsA total of 16 COVID-19 patients were diagnosed among all passengers; the overall attack rate was 4.8%. The attack rate among passengers who had departed from Wuhan was significantly higher than that among those who had departed from other places. One passenger without an epidemiological history of exposure before boarding developed COVID-19. During the flight, he was seated near four infected passengers from Wuhan for approximately an hour and did not wear his facemask correctly during the flight. ConclusionsCOVID-19 transmission may have occurred during the flight. However, the majority of the cases in the flight-associated outbreak could not be attributed to transmission on the flight but were associated with exposure to the virus in Wuhan or to infected members in a single tour group.

Clinical analysis of 150 cases of 2019 novel coronavirus infection in Nanyang City, Henan Province

Objective: To analyze the epidemiological characteristics and clinical features of the patients with 2019-nCoV infection in Nanyang City, so as to provide evidence for clinical diagnosis and treatment. Methods: The epidemiology, clinical symptoms, atory and radiologic data of 150 patients with 2019-nCoV infection admitted to the designated hospitals in Nanyang City from January 24,2020 to February 16, 2020 were retrospectively analyzed. Results: The 150 patients with 2019 nCov infection consisted of 67 men and 83 women, and the median age was (45±16) years; 69 of them were the first generation case,60 of them were the second generation case, 6 of them were the third generation case,the median incubation period of the first generation case was (5.4±2.2) days, and the second generation case was (6.7±3.1) days, and the first-generation cases are the majority in severe patients (69%) . The most common basic disease was hypertension (13 cases, 9%), diabetes (9 cases, 6%), and the most common symptom is fever(142 cases, 95%, 63% showed moderate fever) , cough and sputum(108 cases,72%), fatigue(23 cases,15%), anorexia(20 cases, 13%), headache, diarrhea, muscle soreness, sore throat as the first symptoms. The average time from onset of symptoms to consultation was (4.2±2.2) days for all patients. The changes in peripheral blood cells were mainly lymphonpenia (83 cases, 55%) and eosinophilia (95 cases, 63%), The lymphocyte count of the severe and critically ill patients was more significantly reduced, and some patients had increased myocardial enzymes, mainly LDH (47 cases, 31%), and a few patients had liver function damage, mainly manifested in ALT and AST. High, very few patients have renal impairment. Among the inflammation-related indicators, the main manifestations are increased CRP (66 cases, 43%) and ESR (86 cases, 57%), elevated D-Dimer in 29% of patients. 144 cases have different degrees of infective lesions in chest CT examination, with 30 cases (21%) on one side and 144 cases (79%) on both sides. Morphologically, most of the lesions were patchy ground glass lesions, which could be accompanied by air bronchus signs and some consolidation and paving stone signs. Of the cases showing "white lung", 87% were sever ill or critically ill. After active treatment, 45% of patients were discharged according to discharge standards. 33% of sever and critically ill patients were discharged, 49% of them were degraded hospitalization.The average length of hospitalization was (12±4) days. Conclusion: A history of epidemiological exposure, fever, chest CT with signs of pneumonia, normal or decreased WBC, and lymphocytopenia, eosinophilia are the clinical basis for the diagnosis of this disease, and most of the sever patients were the first generation cases. The degree of lymphocytopenia is related to the severity of the disease.

Vital role of chest CT in diagnosis of coronavirus disease 2019 (COVID-19).

In December 2019, a new virus called coronavirus disease 2019 (COVID-19) causing severe acute respiratory syndrome emerged in Wuhan, China, and rapidly spread to other areas of China and other regions of the world. Since it was a discovery, COVID-19 has spread to several countries and to this date, affecting about 2,329,651 people and caused about 160,721 deaths. Since most COVID-19 infected cases were diagnosed with pneumonia and characteristic chest computed tomography (CT) scan patterns, radiological examinations have become an important tool in early diagnosis. Nowadays, CT findings combined with normal blood cells (WBCs), lymphopenia and a history of epidemiological exposure have been used as criteria for clinical diagnosis of COVID-19. It is noteworthy that reverse transcription polymerase chain reaction (RT-PCR) test is still gold standard for the diagnosis. This review focuses on role of chest CT in the clinical evaluation of disease progression and more accurate diagnosis.

Internet Hospitals Help Prevent and Control the Epidemic of COVID-19 in China: Multicenter User Profiling Study.

BackgroundDuring the spread of the novel coronavirus disease (COVID-19), internet hospitals in China were engaged with epidemic prevention and control, offering epidemic-related online services and medical support to the public.ObjectiveThe aim of this study is to explore the role of internet hospitals during the prevention and control of the COVID-19 outbreak in China.MethodsOnline epidemic-related consultations from multicenter internet hospitals in China during the COVID-19 epidemic were collected. The counselees were described and classified into seven type groups. Symptoms were recorded and compared with reported patients with COVID-19. Hypochondriacal suspicion and offline visit motivation were detected within each counselees’ group to evaluate the social panic of the epidemic along with the consequent medical-seeking behaviors. The counselees’ motivation and the doctors’ recommendation for an offline visit were compared. Risk factors affecting the counselees’ tendency of hypochondriacal suspicion and offline visit motivation were explored by logistic regression models. The epidemic prevention and control measures based on internet hospitals were listed, and the corresponding effects were discussed.ResultsA total of 4913 consultations were enrolled for analysis with the median age of the counselees at 28 years (IQR 22-33 years). There were 104 (2.12%) healthy counselees, 147 (2.99%) hypochondriacal counselees, 34 (0.69%) exposed counselees, 853 (17.36%) mildly suspicious counselees, 42 (0.85%) moderately suspicious counselees, 3550 (72.26%) highly suspicious counselees, and 183 (3.72%) severely suspicious counselees. A total of 94.20% (n=4628) of counselees had epidemic-related symptoms with a distribution similar to those of COVID-19. The hypochondriacal suspicion (n=2167, 44.11%) was common. The counselees’ motivation and the doctors’ recommendation for offline visits were inconsistent (P<.001) with a Cohen kappa score of 0.039, indicating improper medical-seeking behaviors. Adult counselees (odds ratio [OR]=1.816, P<.001) with epidemiological exposure (OR 7.568, P<.001), shortness of breath (OR 1.440, P=.001), diarrhea (OR 1.272, P=.04), and unrelated symptoms (OR 1.509, P<.001) were more likely to have hypochondriacal suspicion. Counselees with severe illnesses (OR 2.303, P<.001), fever (OR 1.660, P<.001), epidemiological exposure history (OR 1.440, P=.01), and hypochondriacal suspicion (OR 4.826, P<.001) were more likely to attempt an offline visit. Reattending counselees (OR 0.545, P=.002) were less motivated to go to the offline clinic.ConclusionsInternet hospitals can serve different types of epidemic counselees, offer essential medical supports to the public during the COVID-19 outbreak, reduce the social panic, promote social distancing, enhance the public’s ability of self-protection, correct improper medical-seeking behaviors, reduce the chance of nosocomial cross-infection, and facilitate epidemiological screening, thus, playing an important role on preventing and controlling COVID-19.

Preliminary recommendations for lung surgery during COVID-19 epidemic period.

Preliminary recommendations for lung surgery during COVID-19 epidemic period.

Clinical characteristics of severe acute respiratory syndrome coronavirus 2 reactivation

Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were based on information from the general population. However, limited data was available for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reactivation. This study aimed to evaluate the clinical characteristics of the SARS-CoV-2 reactivation. Clinical records, laboratory results, and chest CT scans were retrospectively reviewed for 55 patients with laboratory-confirmed COVID-19 pneumonia (i.e., with throat swab samples that were positive for SARS-CoV-2) who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from Jan. 8 to Feb. 10, 2020. All 55 patients had a history of epidemiological exposure to COVID-19, and 5 (9%) patients who discharged from hospital presented with SARS-CoV-2 reactivation. Among the 5 reactivated patients, other symptoms were also observed, including fever, cough, sore throat, and fatigue. One of the 5 patients had progressive lymphopenia (from 1.3 to 0.56 × 109 cells per L) and progressive neutrophilia (from 4.5 to 18.28 × 109 cells per L). All 5 reactivated patients presented normal aminotransferase levels. Throat swab samples from the 5 reactivated patients were tested for SARS-CoV-2, indicating all positive for the virus. Findings from this small group of cases suggested that there was currently evidence for reactivation of SARS-CoV-2 and there might be no specific clinical characteristics to distinguish them.

A Novel Triage Tool of Artificial Intelligence Assisted Diagnosis Aid System for Suspected COVID-19 Pneumonia in Fever Clinics

Abstract Currently, the prevention and control of COVID-19 outside Hubei province in China, and other countries has become more and more critically serious. We developed and validated a diagnosis aid model without CT images for early identification of suspected COVID-19 pneumonia (S-COVID-19-P) on admission in adult fever patients and made the validated model available via an online triage calculator. Patients admitted from Jan 14 to Feb 26, 2020 with the epidemiological history of exposure to COVID-19 were included [Model development (n = 132) and validation (n = 32)]. Candidate features included clinical symptoms, routine laboratory tests and other clinical information on admission. Features selection and model development were based on Lasso regression. The primary outcome is the development and validation of a diagnosis aid model for S-COVID-19-P early identification on admission. The development cohort contains 26 S-COVID-19-P and 7 confirmed COVID-19 pneumonia cases. The model performance in held-out testing set and validation cohort resulted in AUCs of 0.841 and 0.938, F-1 score of 0.571 and 0.667, recall of 1.000 and 1.000, specificity of 0.727 and 0.778, and the precision of 0.400 and 0.500. Based on this model, an optimized strategy for S-COVID-19-P early identification in fever clinics has also been designed. S-COVID-19-P could be identified early by a machine-learning model only used collected clinical information without CT images on admission in fever clinics with 100% recall score. The well performed and validated model has been deployed as an online triage tool, which is available at: https://intensivecare.shinyapps.io/COVID19/.

Severe Acute Respiratory Syndrome: What Have We Learned Two Years Later?

Severe Acute Respiratory Syndrome: What Have We Learned Two Years Later?