A Novel Scoring System for Prediction of Disease Severity in COVID-19
Logistic regression, retrospective cohort, COVID-19, severity pneumonia, prediction scoring system
Background: A novel enveloped RNA beta coronavirus, Corona Virus Disease 2019 (COVID-19) caused severe and even fetal pneumonia in China and other countries from December 2019. Early detection of severe patients with COVID-19 is of great significance to shorten the disease course and reduce mortality.Methods: We assembled a retrospective cohort of 80 patients (including 56 mild and 24 severe) with COVID-19 infection treated at Beijing You'an Hospital. We used univariable and multivariable logistic regression analyses to select the risk factors of severe and even fetal pneumonia and build scoring system for prediction, which was validated later on in a group of 22 COVID-19 patients.Results: Age, white blood cell count, neutrophil, glomerular filtration rate, and myoglobin were selected by multivariate analysis as candidates of scoring system for prediction of disease severity in COVID-19. The scoring system was applied to calculate the predictive value and found that the percentage of ICU admission (20%, 6/30) and ventilation (16.7%, 5/30) in patients with high risk was much higher than those (2%, 1/50; 2%, 1/50) in patients with low risk (p = 0.009; p = 0.026). The AUC of scoring system was 0.906, sensitivity of prediction is 70.8%, and the specificity is 89.3%. According to scoring system, the probability of patients in high risk group developing severe disease was 20.24 times than that in low risk group.Conclusions: The possibility of severity in COVID-19 infection predicted by scoring system could help patients to receiving different therapy strategies at a very early stage.Topic: COVID-19, severe and fetal pneumonia, logistic regression, scoring system, prediction.
Yan Zhao, Chi Zhang, Qi Wang, Xuemei Li, Ling Qin, Bin Xu, Yonghong Zhang, Ying-Mei Feng, Kang Li, Ronghua Jin, Jian-Ping Sun, Yanchao Dai, Tao Dong, Lian-Chun Liang, Zhongjie Hu, Haiping Xiang
Frontiers in Cellular and Infection Microbiology
A novel sub-epidemic modeling framework for short-term forecasting epidemic waves
Mathematical framework, epidemic wave, sub-epidemic, unobserved heterogeneity, SARS, Plague
Abstract Background Simple phenomenological growth models can be useful for estimating transmission parameters and forecasting epidemic trajectories. However, most existing phenomenological growth models only support single-peak outbreak dynamics whereas real epidemics often display more complex transmission trajectories. Methods We develop and apply a novel sub-epidemic modeling framework that supports a diversity of epidemic trajectories including stable incidence patterns with sustained or damped oscillations to better understand and forecast epidemic outbreaks. We describe how to forecast an epidemic based on the premise that the observed coarse-scale incidence can be decomposed into overlapping sub-epidemics at finer scales. We evaluate our modeling framework using three outbreak datasets: Severe Acute Respiratory Syndrome (SARS) in Singapore, plague in Madagascar, and the ongoing Ebola outbreak in the Democratic Republic of Congo (DRC) and four performance metrics. Results The sub-epidemic wave model outperforms simpler growth models in short-term forecasts based on performance metrics that account for the uncertainty of the predictions namely the mean interval score (MIS) and the coverage of the 95% prediction interval. For example, we demonstrate how the sub-epidemic wave model successfully captures the 2-peak pattern of the SARS outbreak in Singapore. Moreover, in short-term sequential forecasts, the sub-epidemic model was able to forecast the second surge in case incidence for this outbreak, which was not possible using the simple growth models. Furthermore, our findings support the view that the national incidence curve of the Ebola epidemic in DRC follows a stable incidence pattern with periodic behavior that can be decomposed into overlapping sub-epidemics. Conclusions Our findings highlight how overlapping sub-epidemics can capture complex epidemic dynamics, including oscillatory behavior in the trajectory of the epidemic wave. This observation has significant implications for interpreting apparent noise in incidence data where the oscillations could be dismissed as a result of overdispersion, rather than an intrinsic part of the epidemic dynamics. Unless the oscillations are appropriately modeled, they could also give a false positive, or negative, impression of the impact from public health interventions. These preliminary results using sub-epidemic models can help guide future efforts to better understand the heterogenous spatial and social factors shaping sub-epidemic patterns for other infectious diseases.
Gerardo Chowell, Amna Tariq, James M. Hyman
A Novel Synonymous Mutation of Sars-Cov-2: Is This Possible to Affect Their Antigenicity and Immunogenicity?
spike protein, antigenicity, SARS-CoV-2, COVID-19
The S glycoprotein of coronaviruses is important for viral entry and pathogenesis with most variable sequences. Therefore, we analyzed the S gene sequences of SARS-CoV-2 to better understand the antigenicity and immunogenicity of this virus in this study. In phylogenetic analysis, two subtypes (SARS-CoV-2a and -b) were confirmed within SARS-CoV-2 strains. These two subtypes were divided by a novel synonymous mutation of D614G. This may play a crucial role in the evolution of SARS-CoV-2 to evade the host immune system. The region containing this mutation point was confirmed as a B-cell epitope located in the S1 domain, and SARS-CoV-2b strains exhibited severe reduced antigenic indexes compared to SARS-CoV-2a in this area. This may allow these two subtypes to have different antigenicity. If the two subtypes have different serological characteristics, a vaccine for both subtypes will be more effective to prevent COVID-19. Thus, further study is urgently required to confirm the antigenicity of these two subtypes.
Yong-Ho Park, Sung Jae Kim, Van Giap Nguyen, Bongkyun Park, Hee-Chun Chung
A novel treatment approach to the novel coronavirus: an argument for the use of therapeutic plasma exchange for fulminant COVID-19
Philip Keith, Matthew Day, Linda Perkins, Lou Moyer, Kristi Hewitt, Adam Wells
Medical emergencies. Critical care. Intensive care. First aid
A numerical assessment of social distancing of preventing airborne transmission of COVID-19 during different breathing and coughing processes
Abstract The spread of the novel coronavirus disease (COVID-19) continues to show that geographic barriers alone cannot contain the virus. Asymptomatic carriers play a critical role in the nature of this virus, which is rapidly escalating into a global pandemic. Asymptomatic carriers can inadvertently transmit the virus through the air stream. Many diseases can infect human bodies with tiny droplets or particles that carry various viruses and bacteria that are generated by the respiratory system of infected patients. This article presents the numerical results of the spread of droplets or particles in a room. The proposed numerical model in this work takes into account the sedimentation of particles or droplets under the action of gravitational sedimentation and transport in the room during the process of breathing and sneezing or coughing. Three different cases are numerically investigated taking into account normal breathing and coughing or sneezing, respectively, and three different rates of particle ejection from the mouth are considered. Navier–Stokes equations for incompressible flows were used to describe three-dimensional air flow inside ventilated rooms. The influence of ventilation rate on social distancing is also computationally investigated. It was found that particles can move up to 5 m with a decrease in concentration in the direction of the air flow. The conclusions made in this work show that, given the environmental conditions, the two meter social distance recommended by WHO is insufficient.
Alibek Issakhov, Yeldos Zhandaulet, Perizat Omarova, Aidana Alimbek, Aliya Borsikbayeva, Ardak Mustafayeva
A nutraceutical strategy for downregulating TGFβ signalling: prospects for prevention of fibrotic disorders, including post-COVID-19 pulmonary fibrosis
James J DiNicolantonio, Mark F McCarty, Jorge Barroso-Aranda, Simon Assanga, Lidianys Maria Lewis Lujan, James H O'Keefe
Diseases of the circulatory (Cardiovascular) system
A one-year hospital-based prospective COVID-19 open-cohort in the Eastern Mediterranean region: The Khorshid COVID Cohort (KCC) study.
The COVID-19 is rapidly scattering worldwide, and the number of cases in the Eastern Mediterranean Region is rising. Thus, there is a need for immediate targeted actions. We designed a longitudinal study in a hot outbreak zone to analyze the serial findings between infected patients for detecting temporal changes from February 2020. In a hospital-based open-cohort study, patients are followed from admission until one year from their discharge (the 1st, 4th, 12th weeks, and the first year). The patient recruitment phase finished at the end of August 2020, and the follow-up continues by the end of August 2021. The measurements included demographic, socio-economics, symptoms, health service diagnosis and treatment, contact history, and psychological variables. The signs improvement, death, length of stay in hospital were considered primary, and impaired pulmonary function and psychotic disorders were considered main secondary outcomes. Moreover, clinical symptoms and respiratory functions are being determined in such follow-ups. Among the first 600 COVID-19 cases, 490 patients with complete information (39% female; the average age of 57±15 years) were analyzed. Seven percent of these patients died. The three main leading causes of admission were: fever (77%), dry cough (73%), and fatigue (69%). The most prevalent comorbidities between COVID-19 patients were hypertension (35%), diabetes (28%), and ischemic heart disease (14%). The percentage of primary composite endpoints (PCEP), defined as death, the use of mechanical ventilation, or admission to an intensive care unit was 18%. The Cox Proportional-Hazards Model for PCEP indicated the following significant risk factors: Oxygen saturation < 80% (HR = 6.3; [CI 95%: 2.5,15.5]), lymphopenia (HR = 3.5; [CI 95%: 2.2,5.5]), Oxygen saturation 80%-90% (HR = 2.5; [CI 95%: 1.1,5.8]), and thrombocytopenia (HR = 1.6; [CI 95%: 1.1,2.5]). This long-term prospective Cohort may support healthcare professionals in the management of resources following this pandemic.
Ramin Sami, Forogh Soltaninejad, Babak Amra, Zohre Naderi, Shaghayegh Haghjooy Javanmard, Bijan Iraj, Somayeh Haji Ahmadi, Azin Shayganfar, Mehrnegar Dehghan, Nilufar Khademi, Nastaran Sadat Hosseini, Mojgan Mortazavi, Marjan Mansourian, Miquel Angel Mañanas, Hamid Reza Marateb, Peyman Adibi
A organização das mulheres extrativistas na região Sudoeste mato-grossense, Brasil
Agricultura Familiar, Biodiversidade, Gênero, Renda
http://dx.doi.org/10.1590/S0104-026X2014000100005 Culturalmente a região Sudoeste mato-grossense é diversa, podendo ser atribuída à existência de populações migrantes e às comunidades tradicionais. Objetivou-se discutir a organização das mulheres do campo na região Sudoeste mato-grossense, que obtêm sua remuneração e contribuem para o aumento da renda familiar através do extrativismo sustentável de frutos nativos do Cerrado (Savana). O delineamento utilizado foi o estudo de caso. Os recursos financeiros obtidos pelas mulheres são expressivos e têm contribuído de maneira significativa para a sobrevivência do grupo familiar, como também para o reconhecimento de sua força de trabalho e na conquista de cidadania. Entretanto, as políticas públicas precisam ser ajustadas de modo a valorizar o trabalho das mulheres para a produção e reprodução familiar no campo e sua contribuição social no desenvolvimento regional.
Ronaldo José Neves, Sandra Mara Alves da Silva Neves, Maurício Ferreira Mendes, Tânia Paula da Silva
https://periodicos.ufsc.br/index.php/ref/article/view/33714
A organização dos agricultores familiares do município de Carlos Barbosa/RS
RESUMO: A partir do presente estudo, busca-se compreender como estão organizados os agricultores familiares do município de Carlos Barbosa/RS, no que se refere as principais atividades agropecuárias, tomando como referência dados disponibilizados pela Emater e pela Secretaria de Desenvolvimento Rural. Para isso, buscou-se identificar as diversas atividades, que, no momento, viabilizam a reprodução e permanência da agricultura familiar. Os referenciais teóricos utilizados na investigação que resultaram neste artigo buscam elementos que propiciem a compreensão do fenômeno analisado. A pesquisa é qualitativa e exploratória, com utilização de entrevista semiestruturada. Como resultado verificou-se que a agricultura familiar exerce importante papel na produção de alimentos e no fornecimento de matéria prima, como o leite, para indústrias de laticínios. As unidades pesquisadas são diversificadas, havendo unidades cuja produção se caracteriza pelas lavouras temporárias e outras pelas permanentes, associadas à criação de animais. PALAVRAS-CHAVE: Agricultura familiar; Diversificação; Carlos Barbosa/RS.
Ligian Cristiano Gomes, Janete Webler Cancelier
https://diversitasjournal.com.br/diversitas_journal/article/view/1361
A paisagem na análise geográfica: considerações sobre uma paisagem rural em Guarapuava-PR
Agricultura orgânica, Categorias Geográficas, Paisagem, paisagem rural
O presente artigo aborda a paisagem como uma categoria de análise importante para a Geografia, apresentando o conceito a partir da ótica Humana da disciplina. Assim, por meio da percepção dos moradores da área próxima ao rio Guabiroba, em Guarapuava – PR, procurou-se interpretar a relação dos proprietários com a paisagem do seu entorno. Nessa direção, a relação destes com a paisagem rural envolve questões das esferas econômica, social, cultural e ambiental – entre as quais se destaca a prática da agricultura orgânica como tendência e elemento fundamental para a leitura da paisagem rural em questão.
https://periodicos.uff.br/geographia/article/view/13718