Prevalence Of Coronavirus Disease 2019 Research Articles

VCA in the Era of the COVID-19 Pandemic.

VCA in the Era of the COVID-19 Pandemic.

Prevalence of COVID-19 in West Gondar zone, Northwest Ethiopia: a population-based retrospective study.

Coronavirus disease-19 (COVID-19) has spread rapidly around the world, affecting every community directly or indirectly. Therefore, this study aims to investigate the prevalence of COVID-19 infection in the population of the West Gondar zone. A retrospective cross-sectional study was conducted from November 2020 to January 2021, in the West Gondar zone, Northwest Ethiopia. Records of study participants with required information like of age, gender, travel history, type of specimen taken, and site of specimen taken were included. Statistical package for social sciences (SPSS) version 20 software was used for analysis. Descriptive statistics were summarized as percentages and means ±SD. The Chi-square test is used to compare categorical data. A total of 1,166 participants were enrolled in this study. Of them, 16 individuals had positive results, giving a prevalence of 1.37% (95% CI: 0.66-2.08). Living in an urban area (P-value=0.035) and being female (P-value=0.045) was statistically associated with the positive rate for COVID-19. This study revealed a low prevalence of COVID-19 infection in the study area despite the increasing and rapid dissemination of the disease. State-wide population prevalence study should be done to estimate the general prevalence of COVID-19 in Ethiopia.

Short Communication: Ongoing Impact of the Social Determinants of Health During the Second and Third Waves of the COVID-19 Pandemic in People Living with HIV Receiving Care in a Montreal-Based Tertiary Care Center.

We performed retrospective chart reviews and described the clinical characteristics, exposure risks, and disease severity of people living with HIV (PLWH) attending the Chronic Viral Illness Service (CVIS) in Montreal, Canada, who developed coronavirus disease 2019 (COVID-19) during September 2020-August 2021, coinciding with the second and third waves of the pandemic. A total of 61 PLWH with a positive COVID-19 polymerase chain reaction were identified, giving a COVID-19 prevalence of 5%. The most common exposure risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during waves two and three was having a family member/close contact with COVID-19 (36%). Similar to what we observed during the first wave, PLWH who acquired COVID-19 during waves two and three of the pandemic often worked or lived in long-term care residences or health care settings, putting them at risk. Five people (8%) were asymptomatic. Nearly all persons had mild disease on initial presentation and most had a full recovery. Two individuals were admitted to hospital with COVID-19, whereas three individuals acquired COVID-19 nosocomially. No individuals died due to COVID-19. Two individuals developed symptoms associated with long COVID-19 syndrome. Findings highlight the ongoing impact of the social determinants of health during the second and third waves of the pandemic in PLWH.

Incidence and Prevalence of Coronavirus Disease 2019 Within a Healthcare Worker Cohort During the First Year of the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic.

BackgroundPreventing SARS-CoV2 infections in healthcare workers (HCWs) is critical for healthcare delivery. We aimed to estimate and characterize the prevalence and incidence of COVID-19 in a US HCW cohort and to identify risk factors associated with infection.MethodsWe conducted a longitudinal cohort study of HCWs at 3 Bay Area medical centers using serial surveys and SARS-CoV-2 viral and orthogonal serological testing, including measurement of neutralizing antibodies. We estimated baseline prevalence and cumulative incidence of COVID-19. We performed multivariable Cox proportional hazards models to estimate associations of baseline factors with incident infections and evaluated the impact of time-varying exposures on time to COVID-19 using marginal structural models.Results2435 HCWs contributed 768 person years of follow-up time. We identified 21/2435 individuals with prevalent infection, resulting in a baseline prevalence of 0.86% (95% CI, 0.53% to 1.32%). We identified 70/2414 (2.9%) incident infections yielding a cumulative incidence rate of 9.11 cases per 100 person years (95% CI 7.11 to 11.52). Community contact with a known COVID-19 case most strongly correlated with increased hazard for infection (HR 8.1, 95% CI, 3.8, 17.5). High-risk work-related exposures (i.e., breach in protective measures) drove an association between work exposure and infection (HR 2.5, 95% CI, 1.3-4.8). More cases were identified in HCW when community case rates were high.ConclusionWe observed modest COVID-19 incidence despite consistent exposure at work. Community contact was strongly associated with infections but contact at work was not unless accompanied by high-risk exposure.

Investigating the Extent of Coronaphobia and some Related Psycho-Social Variables in Iran

Investigating the Extent of Coronaphobia and some Related Psycho-Social Variables in Iran

Remote management of osteoporosis in the first wave of the COVID-19 pandemic

SummaryWe conducted a survey during the first pandemic wave of coronavirus disease 2019 (COVID-19) on a large group of osteoporotic patients to evaluate the general conditions of osteoporotic patients and the impact of the pandemic on the management of osteoporosis, finding high compliance to treatments and low COVID-19 lethality.IntroductionDuring the first pandemic wave of coronavirus disease 2019 (COVID-19), 209,254 cases were diagnosed in Italy; fatalities were 26,892 and were overwhelmingly older patients. The high prevalence of osteoporosis in this age group suggests a potential relationship between SARS-CoV-2 infection and bone metabolism.MethodsIn a telephone survey conducted from April to May 2020, patients from the Osteoporosis Center, Clinic of Endocrinology and Metabolic Diseases of Umberto I Hospital (Ancona, Italy), were interviewed to evaluate the general clinical conditions of osteoporotic patients, compliance with osteoporosis medications, COVID-19 prevalence, hospitalization rate, COVID-19 mortality, and lethality.ResultsAmong the 892 patients interviewed, 77.9% were taking osteoporosis treatment and 94.6% vitamin D supplementation as prescribed at the last visit. COVID-19-like symptoms were reported by 5.1%, whereas confirmed cases were 1.2%. A total number of 33 patients had been in hospital and the hospitalization rate of those who had not discontinued vitamin D supplementation was less than 4%. There were eight deaths, two with a concomitant COVID-19 diagnosis. The prevalence of severe osteoporosis was 50% in total COVID-19 patients and 87.5% in deceased COVID-19 patients. The overall COVID-19 mortality was 0.2%; lethality was 20%, lower than the national rate of the same age group.ConclusionsThis large group of osteoporotic patients showed high compliance and lower COVID-19 lethality compared to patients of the same age. Novel approaches such as telemedicine can provide critical support for the remote follow-up of patients with chronic diseases also in the setting of routine care.

Seroprevalence of SARS-Cov-2 IgG antibodies in patients at a single center in Saudi Arabia.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had a massive impact on public health as well as the economy. Understanding the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among undiagnosed individuals is important for developing an informed pandemic response.OBJECTIVE: Investigate the prevalence of undiagnosed COVID-19 disease.DESIGN: Cross-sectional.SETTING: Tertiary care center in Madinah, Saudi Arabia.SUBJECTS AND METHODS: All participants were on follow-up visits to various clinics and had not been previously diagnosed with COVID-19. Enzyme-linked immunosorbent assay was used to specifically assess the anti-spike IgG antibody seropositivity in serum samples. We associated the seropositivity rates of the participants with age, body mass index (BMI), nationality, blood groups, and sex with uni- and multivariate analyses.MAIN OUTCOME MEASURES: Seropositivity for IgG anti-spike antibodies against SARS-CoV-2.SAMPLE SIZE AND CHARACTERISTICS: 527 subjects, with a median (interquartile percentiles) age of the 527 subjects was 34 (24–41).RESULTS: Of the 527 samples, about one-fourth (n=124, 23.5%) were positive for anti-spike IgG antibody against SARS CoV-2. Age was associated with anti-spike IgG antibody positivity (P<.002). Participants >30 years were more likely to be seropositive (28-29%) than younger participants (15.4%). Additionally, seropositivity was associated with female gender (P<.001) and a higher BMI (P<.006). In the multivariate logistic regression, age >30, female gender and BMI >40 were associated with seropositivity.CONCLUSION: The percentage of seropositive individuals reflects the high level of undiagnosed COVID-19 patients among the population. Our results will help in a better evaluation of the public health measures applied during the COVID-19 pandemic and any future public health crises.LIMITATIONS: Sample size was small, single-center study and no rural areas were included.CONFLICT OF INTEREST: None.

The study protocol: COVID-19 awareness and perception among dentists in the Russian Federation.

Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide since it has been first identified in November 2018. It is transmissible via air droplets from infected individuals. Close contact between dentists and patients has aggravated the pandemic situation in Russia. It is necessary to reduce the risk of spreading COVID-19 during dental appointments by adhering to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) recommendations. Questionnaires were developed to assess levels of COVID-19 infection and preventive measures in private and state-funded dental practices in Moscow and other cities in Russia. Two questionnaires were developed to assess the COVID-19 situation among dental professionals and their patients. The first, for dentists, included four domains: demographic data, signs, and symptoms of COVID-19 experienced by dentists, personal protective measures taken by dentists, and presence or absence of dental practice during the pandemic. For dentists' patients, the second included domains regarding their health status after their dental appointment. 1,500 questionnaires were sent to different cities and regions of Russia; 1,011 questionnaires (67.4%) were returned. We used statistical observation (monitoring) and clustering to analyze the data. The x2 was used to check the significance level. We found a direct relationship between those patients who contracted COVID-19 after dental treatment by those dentists who did not follow recommended measures in the dental clinic. However, patients were less likely to become infected after dental treatment by those dentists who followed the measures, such as the disinfection of surfaces and dental equipment several times a day, the wearing of medical masks by all patients, and the airing of the dental office after each patient for 10 minutes. Dentists wearing an FFP2 or FFP3 respirator, as well as a sterile disposable microfiber medical gown, prevented their patients from becoming infected with COVID-19 at dental appointments and, as a result, the spread of the virus. A key aspect of this study is its knowledge regarding preventive measures against COVID-19. The findings of this study can potentially help in formulating strategies to reduce the prevalence of COVID-19.

Applicability of CO-RADS in an Anonymized Cohort Including Earlyand Advanced Stages of COVID-19 in Comparison to the Recommendations of the German Radiological Society and Radiological Society of North America.

Classifications were created to facilitate radiological evaluation of the novel coronavirus disease 2019 (COVID-19) on computed tomography (CT) images. The categorical CT assessment scheme (CO-RADS) categorizes lung parenchymal changes according to their likelihood of being caused by SARS-CoV-2 infection. This study investigates the diagnostic accuracy of diagnosing COVID-19 with CO-RADS compared to the Thoracic Imaging Section of the German Radiological Society (DRG) classification and Radiological Society of North America (RSNA) classification in an anonymized patient cohort. To mimic advanced disease stages, follow-up examinations were included as well. This study includes all patients undergoing chest CT in the case of a suspected SARS-CoV-2 infection or an already confirmed infection between March 13 and November 30, 2020. During the study period, two regional lockdowns occurred due to high incidence values, increasing the pre-test probability of COVID-19. Anonymized CT images were reviewed retrospectively and in consensus by two radiologists applying CO-RADS, DRG, and RSNA classification. Afterwards, CT findings were compared to results of sequential real-time reverse transcriptase polymerase chain reaction (qPCR) test performed during hospitalization to determine statistical analysis for diagnosing COVID-19. 536 CT examinations were included. CO-RADS, DRG and RSNA achieved an NPV of 96 %/94 %/95 % (CO-RADS/DRG/RSNA), PPV of 83 %/80 %/88 %, sensitivity of 86 %/76 %/80 %, and specificity of 96 %/95 %/97 %. The disease prevalence was 20 %. All applied classifications can reliably exclude a SARS-CoV-2 infection even in an anonymous setting. Nevertheless, pre-test probability was high in our study setting and has a great influence on the classifications. Therefore, the applicability of the individual classifications will become apparent in the future with lower prevalence and incidence of COVID-19. · CO-RADS, DRG, and RSNA classifications help to reliably detect infected patients in an anonymized setting. · Pre-test probability has a great influence on the individual classifications. · Difficulties in an anonymized study setting are severe pulmonary changes and residuals.. · Valentin B, Steuwe A, Wienemann T et al. Applicability of CO-RADS in an Anonymized Cohort Including Early and Advanced Stages of COVID-19 in Comparison to the Recommendations of the German Radiological Society andRadiological Society of North America. Fortschr Röntgenstr 2022; 194: 862 - 872.

Epidemiological Features of COVID-19 in Makkah City: A Retrospective Data Analysis.

Background Coronavirus disease 2019 (COVID-19) is continuing to circulate and change, affecting billions of people worldwide and leading to increased mortality rates, especially in the Holy City of Makkah, Kingdom of Saudi Arabia (KSA). This study was aimed at investigating the epidemiological features of COVID-19 in Makkah City, KSA. Methods A retrospective analysis was conducted to investigate the prevalence of COVID-19 and the association between the severity and mortality of COVID-19 with demographic factors and comorbidities. Results Among 4,742 COVID-19 patients, the incidence rate observed in males was 66.7%, and 69.7% were from Al-Noor Specialized Hospital. The highest incidence rate (25.2%) was found in the age group > 60 years old, followed by the age group 51-60 years (21.8%). Furthermore, the highest frequency was observed in patients from Saudi Arabia (36.8%), followed by patients from Myanmar (14.7%) and Bangladesh (9.4%). The overall frequency of COVID-19 severity and death was 20.3% and 11.6%, respectively. Body mass index analysis showed that 1% of the patients were underweight, while 9.2% were overweight and 4.4% were obese. In addition, 9.6% had diabetes, 6.9% had hypertension, 1.1% had heart disease, and 2.2% had other chronic diseases. Conclusion The study concluded that the overall percentages of severe COVID-19 (intensive care unit) cases and deaths in Makkah City, KSA, were 20.3% and 11.6%, respectively, and there was a higher incidence in male patients. The severity of infection was shown to have a strong significant correlation with different chronic diseases, nationality, body mass index, death rate (mortality), heart disease, and length of hospital stay (P < 0.05). Despite these findings, more studies are needed to explain the underlying mechanisms that influence the overall health status of patients with specific characteristics and comorbidities.

Prevalence of Coronavirus Disease 2019 (COVID-19) in Different Clinical Stages before the National COVID-19 Vaccination Programme in Malaysia: A Systematic Review and Meta-Analysis.

More than 1.75 million COVID-19 infections and 16 thousand associated deaths have been reported in Malaysia. A meta-analysis on the prevalence of COVID-19 in different clinical stages before the National COVID-19 Vaccination Program in Malaysia is still lacking. To address this, the disease severity of a total of 215 admitted COVID-19 patients was initially recorded in the early phase of this study, and the data were later pooled into a meta-analysis with the aim of providing insight into the prevalence of COVID-19 in 5 different clinical stages during the outset of the COVID-19 pandemic in Malaysia. We have conducted a systematic literature search using PubMed, Web of Science, Scopus, ScienceDirect, and two preprint databases (bioRxiv and medRxiv) for relevant studies with specified inclusion and exclusion criteria. The quality assessment for the included studies was performed using the Newcastle–Ottawa Scale. The heterogeneity was examined with an I2 index and a Q-test. Funnel plots and Egger’s tests were performed to determine publication bias in this meta-analysis. Overall, 5 studies with 6375 patients were included, and the pooled prevalence rates in this meta-analysis were calculated using a random-effect model. The highest prevalence of COVID-19 in Malaysia was observed in Stage 2 cases (32.0%), followed by Stage 1 (27.8%), Stage 3 (17.1%), Stage 4 (7.6%), and Stage 5 (3.4%). About two-thirds of the number of cases have at least one morbidity, with the highest percentage of hypertension (66.7%), obesity (55.5%), or diabetes mellitus (33.3%) in Stage 5 patients. In conclusion, this meta-analysis suggested a high prevalence of COVID-19 occurred in Stage 2. The prevalence rate in Stage 5 appeared to be the lowest among COVID-19 patients before implementing the vaccination program in Malaysia. These meta-analysis data are critically useful for designing screening and vaccination programs and improving disease management in the country.

Impact of Social Distancing and Personal Hygiene on the Prevalence of Epidemic Keratoconjunctivitis during the COVID-19 Pandemic

Purpose: To analyze the change in the weekly incidence of epidemic keratoconjunctivitis (EKC) per 1,000 outpatients during the coronavirus disease 2019 (COVID-19) pandemic by comparing the mean weekly proportion of EKC of 2020 with that from 2016 to 2019.Methods: Using data from the Korea Disease Control and Prevention Agency for 2016-2020, we analyzed the weekly proportion of EKC per 1,000 outpatients. The data were also analyzed according to age, semester and vacation periods, region, and social distancing stages. For the Daegu data, we also analyzed the effects of social distancing in an area.Results: The mean weekly proportion of EKC per 1,000 outpatients in 2020 was lower than in previous years for all ages (2016-2019 19.77 ± 7.17‰, 2020 7.28 ± 2.97‰; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). During the semester, the mean difference between 2016-2019 and 2020 was significant, particularly for preschool children. In Daegu, the weekly proportion of EKC per 1,000 outpatients during the extra 12-18 weeks of social distancing was significantly lower (2016-2019, 18.78 ± 6.61‰; 2020, 8.94 ± 2.92‰; &lt;i&gt;p&lt;/i&gt; &lt; 0.001).Conclusions: The public health interventions implemented during the COVID-19 outbreak not only reduced the prevalence of COVID-19 but also reduced the prevalence of EKC. Therefore, maintaining hygiene principles and standard precautions may help prevent EKC.

Correlation of the variations in prevalence of coronavirus disease 2019 and vitamin D receptor gene polymorphisms in cohorts from 26 countries

Aim: This study aimed to investigate the correlation between the rates of coronavirus disease 2019 (COVID-19) prevalence and mortality and the frequency of vitamin D receptor (VDR) gene polymorphisms at the loci rs7975232 (ApaI), rs1544410 (BsmI), rs2228570 (FokI), and rs731236 (TaqI) in cohorts from 26 countries.Methods: The study included the use of 26 countries where VDR gene polymorphisms at the loci rs731236 (TaqI), rs7975232 (ApaI), rs2228570 (FokI), and rs1544410 (BsmI) were determined and where the relevant frequencies of alleles in healthy populations were reported: Italy, China, Turkey, Japan, Mexico, Russia, India, Poland, Egypt, Czechia, Ethiopia, Saudi Arabia, Greece, the Netherlands, Korea, Spain, the United States, Pakistan, Nigeria, Lebanon, the Central African Republic, Finland, Iran, Tunisia, Brazil, and Croatia. The COVID-19 prevalence and mortality rates (per million population) reported for each country on 6 December 2020 were recorded.Results: A significant positive correlation was found between the frequency of AA genotype of rs7975232 and the COVID-19 prevalence (r=0.45, r2=0.20, p=0.02) and mortality (r=0.42, r2=0.17, p=0.03) rates. Twenty percent of the variability in prevalence and 17% of the variability in mortality could be explained by the frequency of AA genotype. Similarly, a significant positive correlation was found between the frequency of TT genotype of rs731236 and the COVID-19 prevalence (r=0.42, r2=0.17, p=0.03) rates. Seventeen percent of the variability in prevalence could be explained by the frequency of TT genotype. The correlations between the frequency of rs1544410 and rs2228570 and the COVID-19 prevalence and mortality were not significant.Conclusion: The variation in COVID-19 prevalence in the 26 populations included can be explained by the polymorphisms at the rs7975232 (ApaI) and rs731236 (TaqI) loci.

COVID-19 and varicocele: The possible overlap factors and the common therapeutic approaches.

Varicocele is recognized as one of the main attributable causes of male infertility which can affect spermatogenesis by various pathophysiological mechanisms. Recent studies have identified oxidative stress and reduction in antioxidant, hyperthermia, hypoxia, hormonal dysfunction, and inflammatory conditions as major factors in the pathophysiology of varicocele, all of which have known direct associations with the coronavirus disease 2019 (COVID-19) and can significantly increase the risk of detrimental COVID-19-related outcomes. Emerging data have shown an association between COVID-19 and inflammation, overproduction of cytokine, and other pathophysiological processes. The present review, summarizes the current understanding of the pathophysiology of varicocele and investigates the potential correlation between the severity of COVID-19 and the varicocele disease. In addition, various possible treatments which can be effective in both diseases were examined. Despite numerous challenges associated with the prevalence of COVID-19 in healthcare systems in infected countries, special attention should be given to maintaining a high level of care for complex patients with a pre-existing disease such as varicocele and providing appropriate practical advice for optimal control of the COVID-19 disease.

Prevalence and clinical characteristics of COVID-19 in inpatients with schizophrenia in Wuhan, China

BACKGROUNDIn contrast to many Western countries, China has maintained its large psychiatric hospitals. The prevalence and clinical characteristics of coronavirus disease 2019 (COVID-19) in inpatients with schizophrenia (SCZ) are unclear.AIMTo assess the prevalence of COVID-19 among inpatients with SCZ and compare the infected to uninfected SCZ patients in a Wuhan psychiatric hospital.METHODSWe retrospectively collected demographic characteristics and clinical profiles of all SCZ patients with COVID-19 at Wuhan’s Youfu Hospital.RESULTSAmong the 504 SCZ patients, 84 had COVID-19, and we randomly sampled 174 who were uninfected as a comparison group. The overall prevalence of COVID-19 in SCZ patients was 16.7%. Among the 84 SCZ patients with confirmed COVID-19, the median age was 54 years and 76.2% were male. The most common symptom was fever (82%), and less common symptoms were cough (31%), poor appetite (20%), and fatigue (16%). Compared with SCZ patients without COVID-19, those with COVID-19 were older (P = 0.006) and significantly lighter (P = 0.002), and had more comorbid physical diseases (P = 0.001). Surprisingly, those infected were less likely to be smokers (< 0.001) or to be treated with clozapine (P = 0.03). Further logistic regression showed that smoking [odds ratio (OR) = 5.61], clozapine treated (OR = 2.95), and male (OR = 3.48) patients with relatively fewer comorbid physical diseases (OR = 0.098) were at a lower risk for COVID-19. SCZ patients with COVID-19 presented primarily with fever, but only one-third had a cough, which might otherwise be the most common mode of transmission between individuals.CONCLUSIONTwo unexpected protective factors for COVID-19 among SCZ inpatients are smoking and clozapine treatment.

Wastewater surveillance of SARS-CoV-2 in Austria: development, implementation, and operation of the Tyrolean wastewater monitoring program.

Wastewater-based epidemiology (WBE) is an effective approach for tracking information on spatial distribution and temporal trends of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the community level. Herein, the development, implementation, and operation of the wastewater monitoring program serving Tyrol - a federal province of Austria - are described. The development of this program was initiated by Tyrolean health authorities at the end of the first phase of the Coronavirus disease 2019 (COVID-19) pandemic (May 2020). In close co-operation with the water sector and academic institutions, efficient and effective workflows and processes for wastewater surveillance were established. The monitoring program went into operation in November 2020. By the end of July 2021, a total of 5,270 wastewater influent samples collected at 43 sites were analyzed. The monitoring program provided valuable insights into the development of the pandemic situation in Tyrol and fulfilled several tasks that are of importance in different phases of the pandemic. It represented an early-warning system, provided independent confirmation of temporal trends in COVID-19 prevalence, enabled the assessment of the effectiveness of measures, alerted about bursts of disease activity, and provided evidence for the absence of COVID-19. These findings underline the importance of establishing national wastewater monitoring programs as a complementary source of information for efficient and effective pandemic management.

Impact of COVID-19 on pregnant women in South Korea: Focusing on prevalence, severity, and clinical outcomes

BackgroundIn the era of coronavirus disease 2019 (COVID-19) pandemic, there is a paucity of information regarding actual prevalence of COVID-19 in pregnant women compared to non-pregnant women. The purpose of this study was to investigate the prevalence of COVID-19 infection and clinical outcome in pregnant women and non-pregnant women. MethodsThis is a nationwide cross-sectional study in South Korea between January 2020 and February 2021 using the claim database. The primary outcome was the prevalence of COVID-19 in pregnant women, and the secondary outcome was the occurrence of severe COVID-19 illness among infected patients. Severity of COVID-19 was classified into four categories according to WHO ordinal scale. ResultsThe prevalence of COVID-19 infection was lower in pregnant women than non-pregnant women aged 20–44 (0·02% vs. 0.14%, p < 0.0001). However, among COVID-19 positive women at age 20–44, pregnant women was at higher risk of oxygen therapy after hospitalization (score 4 in WHO ordinal scale: 6.4% vs. 1.6%, p < 0.05). There were no deaths or hospitalized severe disease in pregnant women with COVID-19, although the majority of them (96·2%) were admitted to hospital. On the other hand, 42·3% of non-pregnant women at 20–44 age were admitted to hospital and 0.04% of them died and 0.1% had hospitalized severe disease. ConclusionsThe prevalence of COVID-19 infection in pregnant women was lower than non-pregnant women in Korea, resulting in relatively small cases of fatality. It has implications that public health policy, such as an effective response to COVID-19 and a powerful preemptive strategy for pregnant women, can lower risk of COVID-19 infection and better clinical outcomes in pregnant women with COVID-19.

A Sensitive and Rapid Wastewater Test for SARS-COV-2 and Its Use for the Early Detection of a Cluster of Cases in a Remote Community.

ABSTRACTThroughout the coronavirus disease 2019 (COVID-19) pandemic, wastewater surveillance has been used to monitor trends in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence in the community. A major challenge in establishing wastewater surveillance programs, especially in remote areas, is the need for a well-equipped laboratory for sample analysis. Currently, no options exist for rapid, sensitive, mobile, and easy-to-use wastewater tests for SARS-CoV-2. The performance of the GeneXpert system, which offers cartridge-based, rapid molecular clinical testing for SARS-CoV-2 in a portable platform, was evaluated using wastewater as the input. The GeneXpert demonstrated a SARS-CoV-2 limit of detection in wastewater below 32 copies/mL with a sample processing time of less than an hour. Using wastewater samples collected from multiple sites across Canada during February and March 2021, a high overall agreement (97.8%) was observed between the GeneXpert assay and laboratory-developed tests regarding the presence or absence of SARS-CoV-2. Additionally, with the use of centrifugal filters, the detection threshold of the GeneXpert system was improved to <10 copies/mL in wastewater. Finally, to support on-site wastewater surveillance, GeneXpert testing was implemented in Yellowknife, a remote community in Northern Canada, where its use successfully alerted public health authorities to undetected transmission of COVID-19. The identification of SARS-CoV-2 in wastewater triggered clinical testing of recent travelers and identification of new COVID-19 cases/clusters. Taken together, these results suggest that GeneXpert is a viable option for surveillance of SARS-CoV-2 in wastewater in locations that do not have access to established testing laboratories.IMPORTANCE Wastewater-based surveillance is a powerful tool that provides an unbiased measure of COVID-19 prevalence in a community. This work describes a sensitive wastewater rapid test for SARS-CoV-2 based on a widely distributed technology, the GeneXpert. The advantages of an easy-to-use wastewater test for SARS-CoV-2 are clear: it supports surveillance in remote communities, improves access to testing, and provides faster results allowing for an immediate public health response. The application of wastewater rapid testing in a remote community facilitated the detection of a COVID-19 cluster and triggered public health action, clearly demonstrating the utility of this technology. Wastewater surveillance will become increasingly important in the postvaccination pandemic landscape as individuals with asymptomatic/mild infections continue transmitting SARS-CoV-2 but are unlikely to be tested.

Estimating the prevalence of COVID-19 disease and its effect among trainees in the endodontic postgraduate programs in the kingdom of Saudi Arabia: A web-based survey study

Introduction: The coronavirus disease 2019 (COVID-19) pandemic had a profound impact on dental care and academic education. This survey investigated the prevalence of the COVID-19 pandemic, symptoms, and its impact among endodontic trainees in the Kingdom of Saudi Arabia.Materials and Methods: This cross-sectional web-based survey targeted all endodontic residents in Saudi Arabia. A 22-item questionnaire was distributed to a total of 197 participants. The questionnaire included questions related to demographic information, COVID-19 impact on endodontic postgraduate training, the incidence of testing positive, symptoms experienced, and infection control measures. Descriptive and analytic statistics (Chi-square or Fisher's exact test) were used for the analysis. The significance level was set at P ≤ 0.05.Results: A total of 125 residents completed the survey. During June and July of 2020, most residents (45% and 50%) were required to perform only urgent endodontic care. Among the 125 residents, 52.8% reported being tested for severe acute respiratory syndrome coronavirus 2. Of these 66 who were tested, 13.6% had positive results. Eight of the nine residents who tested positive were male. Muscle pain, loss of smell and taste, fever, and headache were the most reported symptoms. A nonsurgical root canal treatment was the most common endodontic procedure performed among those surveyed (100%, n = 125), followed by endodontic emergency (84.8%, n = 106), with surgical endodontic treatment being far less frequent (27.2%, n = 34). Enhanced infection prevention and control measures were common practices during the pandemic; almost half of the residents reported using an N95 respirator or equivalent face mask. Residents continued to provide urgent care during the pandemic, and the majority returning gradually to practice as they had before the COVID-19 pandemic by December 2020.Conclusion: This survey showed a relatively low prevalence of COVID-19 among endodontic residents compared with other frontline healthcare workers. More male residents tested positive COVID-19. A more effective protection measurement should be made available and accessible to endodontic residents to ensure their safety and prevent interruptions to their clinical training.

Performance Comparison of Five SARS-CoV-2 Antibody Assays for Seroprevalence Studies.

BackgroundSeroprevalence studies of coronavirus disease 2019 (COVID-19) cases, including asymptomatic and past infections, are important to estimate the scale of the disease outbreak and to establish quarantine measures. We evaluated the clinical performance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody assays available in Korea for use in seroprevalence studies.MethodsThe sensitivity, specificity, cross-reactivity, and interference of five SARS-CoV-2 antibody assays were evaluated using the following 398 serum samples from confirmed COVID-19 patients, 510 negative control samples from before 2018 (pre-pandemic), 163 serum samples from patients with SARS, Middle East respiratory syndrome (MERS), and other viral infections, and five samples for the interference study.ResultsThe sensitivities of the five assays ranged from 92.2% to 98%, and their specificities, including cross-reactivity and interference, ranged from 97.5% to 100%. The agreement rates were excellent (kappa >0.9). Adjustment of the cutoff values could be considered through ROC curve analysis. The positive predictive values of the individual assays varied from 3.5% to 100% at a 0.1% prevalence but were as high as ≥95% when two assays were combined.ConclusionsThe prevalence of COVID-19 in Korea is considered to be exceptionally low at present; thus, we recommend using a combination of two or more SARS-CoV-2 antibody assays rather than a single assay. These results could help select SARS-CoV-2 antibody assays for COVID-19 seroprevalence studies in Korea.