中国258个城市新型冠状病毒肺炎时空分布特征研究

目的分析中国新型冠状病毒肺炎(COVID-19)的时空分布特征及相关因素,为COVID-19防控提供依据。方法基于2020年1月21日至3月23日中国258个城市的COVID-19发病率、人口流动(湖北省武汉市迁入)、社会人口学、地理信息数据,进行空间自相关和热点分析,揭示COVID-19流行的空间异质性,识别热点区域。利用地理加权回归模型结合线性回归模型,探讨空间异质性的相关因素。结果 2020年1月21日至3月23日,258个城市累计报告29 789例COVID-19病例,COVID-19流行总体呈空间聚集性(Moran’s I=0.436,Z=25.363,P<0.001)。各地的百度迁徙指数(武汉市迁入)与COVID-19发病关联有统计学意义(t=14.550,P<0.001),百度迁徙指数表现出正向效应(β:0.564~0.565)。结论中国COVID-19流行存在空间异质性,武汉市人口迁入多的地区报告发病水平更高。对新发传染病的时空特征理解有助于疾病流行的早期预警和控制。     

Development and Validation of a Multivariable Risk Prediction Model for COVID-19 Mortality in the Southern United States

ObjectiveTo evaluate clinical characteristics of patients admitted to the hospital with coronavirus disease 2019 (COVID-19) in Southern United States and development as well as validation of a mortality risk prediction model.Patients and MethodsSouthern Louisiana was an early hotspot during the pandemic, which provided a large collection of clinical data on inpatients with COVID-19. We designed a risk stratification model to assess the mortality risk for patients admitted to the hospital with COVID-19. Data from 1673 consecutive patients diagnosed with COVID-19 infection and hospitalized between March 1, 2020, and April 30, 2020, was used to create an 11-factor mortality risk model based on baseline comorbidity, organ injury, and laboratory results. The risk model was validated using a subsequent cohort of 2067 consecutive hospitalized patients admitted between June 1, 2020, and December 31, 2020.ResultsThe resultant model has an area under the curve of 0.783 (95% CI, 0.76 to 0.81), with an optimal sensitivity of 0.74 and specificity of 0.69 for predicting mortality. Validation of this model in a subsequent cohort of 2067 consecutively hospitalized patients yielded comparable prognostic performance.ConclusionWe have developed an easy-to-use, robust model for systematically evaluating patients presenting to acute care settings with COVID-19 infection.     

2020年12月全球新型冠状病毒肺炎疫情风险评估

  目的  评估2020年12月新型冠状病毒肺炎（COVID-19）疫情全球流行情况及对我国的输入风险。  方法  根据美国约翰斯·霍普金斯大学公开发布的每日COVID-19疫情数据,结合牛津大学发布的政策严格性指数,采用流行病学描述方法,通过总体概述、WHO各区及重点国家疫情趋势综合评估和周边十四国疫情与防控政策综合分析,对全球COVID-19疫情风险进行综合、全面与及时的评估。 对于各国评估结果,用“全球重点关注国家”“各WHO分区一般关注国家”和“周边特别关注国家”予以表示。  结果  与2020年11月相比,12月全球新增确诊病例增长了13.33%,全球新增死亡病例增长了25.14%,欧洲区新增确诊和死亡病例均最多,非洲区新增确诊病例和死亡病例较上个月增长最快,均为130.10%,是需要重点关注的地区。 全球每新增1000万确诊病例用时整体呈现快速缩短趋势,每新增50万死亡病例用时呈缩短趋势,对2020年12月全球整体疫情高位波动贡献最大的为欧洲区与美洲（北）区。 俄罗斯和阿富汗12月呈高位波动态势,是我国陆地接壤十四国中特别关注国家。  结论  全球COVID-19疫情发展态势严峻,对于全球重点关注国家要进行持续监测,实时调整入境管控政策,并与相关机构建立沟通机制,及时预警。     

COVID-19 mortality and its risk factors: A single-center observational study

Objectives: To determine COVID-19 mortality and its risk factors in hospitalized patients at of a tertiary care center in north India. Methods: A retrospective observational study was conducted of patients who were hospitalized from May 2020 to January 2021. The in-hospital mortality was assessed, and demographic variables and comorbidities between COVID-19 deaths and survivors were compared. Results: A total of 24000 patients were admitted during the study period, among which 17000 had shown positive results of the RT-PCR test for COVID-19. The total mortality was 329 patients (1.37％), among which 232 (70.52％) succumbed due to COVID-19, and 97 (29.48％) died due to other illnesses. The mean age of the patients was (64.09±16.99) years. The mean age was significantly higher in COVID-19 related deaths [(67.63±13.78) years] as compared to that of the survivors [(60.52±19.5) years] (P<0.001). Compared to COVID-19 survivors, there were more males (72.41％ v.s. 61.5％) and less females (27.59％ v.s. 38.5％) in COVID-19 related deaths (P=0.001). Comorbidities such as hypertension, diabetes mellitus, and chronic kidney disease showed a significant correlation with COVID-19 mortality with an adjusted odds ratio of 2.389 (95％ CI: 1.465-2.982), 3.891 (95％ CI: 2.059-5.392), and 6.358 (95％ CI: 5.675-10.564), respectively. Conclusions: Elderly males with comorbidities have higher risk for mortality related to COVID-19. Ongoing vaccination drive is rightfully prioritised to serve the high-risk category first.     

An epidemiological evaluation of COVID-19 in La paz,Bolivia

IntroductionThe Plurinational State of Bolivia (Bolivia) has experienced four major waves of coronavirus disease 2019 (COVID-19) so far. Although the ministry of health has been tracking morbidity and mortality through each wave, epidemiology of COVID-19 in Bolivia is not well defined, despite a need for more accurate measurement of the number of cases and deaths to allow for forecasting of the pandemic. This study examined prevalence of COVID-19 at community level, determinants of its occurrence and vaccine effectiveness.MethodsWe conducted a cross-sectional study in La Paz city on 2,775 individuals between March 2020 and February 2022. A structured questionnaire was used to collect data on COVID-19 morbidity, mortality and vaccination status.ResultsOf the 2,775 participants, 1,586 (57.1%) were infected with COVID-19, and 187 (6.7%) were suspected cases. The mortality rate was 2.9%. Sinopharm, Johnson & Johnson, Gamaleya, Pfizer-BioNtech, Moderna and AstraZeneka vaccines are in use, and all vaccines have demonstrated effectiveness in reducing the risk of onset. Risk for mortality was significantly lower in the vaccinated group with an odds ratio of 0.037 (95％ confidential interval: 0.01–0.10, p-value: <0.001).ConclusionsActual prevalence of COVID-19 in La Paz (the prevalence rate: 63.8%, including suspected case) was higher than that reported by the Ministry of Health and Sports in Bolivia (7.5%). In addition, vaccination has contributed significantly to the control of the COVID-19 epidemic in Bolivia. We believe that our report will be useful for COVID-19 prevention strategies in Bolivia for the future.     

2020年早期我国新型冠状病毒肺炎疫情轨迹分析

  目的   分析2020年早期全国31个省级行政区（不含香港、澳门特别行政区和台湾地区,下同）新型冠状病毒肺炎（COVID-19）发病数随时间的变化轨迹,探索早期疫情的发展规律和可能的影响因素。   方法  从中国疾病预防控制信息系统传染病信息系统中获取截至2020年4月8日的COVID-19发病数据,应用SAS 9.4软件从不同区域层面拟合COVID-19发病数随时间变化的轨迹模型,依据其轨迹特征进行分组,并对不同亚组进行异质性分析,发掘其潜在差异。  结果  在全国31个省级行政区层面上,COVID-19发病数随时间变化的轨迹可分为2个组,第1组和第2组为三次项曲线,呈“升–降–升”的趋势,湖北省属于第2组,其他地区属于第1组,其轨迹曲线的峰值远远低于第2组。在除湖北省以外的30个省级行政区层面上,分为2个组,均为三次项曲线,毗邻湖北省的几个省份、东北部分地区和东部几个沿海省份属于第2组,该组发病峰值较高,其余属于第1组。 在湖北省各地级市层面上,分为2个组,分别为二次和四次项曲线,武汉市为第2组,其余各市为第1组。 在武汉市各区层面上,分为2个组,分别为二次和四次项曲线。  结论  我国不同地区COVID-19发病数随时间变化的轨迹存在异质性,疫情早发生地病例基数大,传播范围广、速度快。另外,COVID-19传播与相对地理位置、初始输入病例数等因素紧密相关。 利用轨迹模型研究疫情发展规律,有助于针对性地制定COVID-19防控策略,为新发呼吸道传染病提供一定防控经验。     

甘肃省新型冠状病毒肺炎疫情时间风险的空间特征分析

目的描述并探讨甘肃省新型冠状病毒肺炎(COVID-19)疫情的时间风险特征。方法收集截至2020年2月16日甘肃省各县(区)报告的COVID-19的发病数、相应县(区)人口数等数据,运用空间统计学的方法计算各县(区)的时间风险指数频率指数(α)、持续时间频率(β)和强度指数(γ)。结果全局自相关分析发现,α的Moran’s I系数为0.115,提示未来COVID-19发病频率增加概率较小。γ的Moran’s I系数为0.070,说明COVID-19确诊病例不会集中出现,疫情的发病强度较低。甘肃省COVID-19疫情的α、β存在全局空间自相关性(P<0.05),γ不存在全局空间自相关性(P>0.05)。α局部空间自相关分析发现区域(主要分布于兰州市城关区、七里河区、安宁区、红古区、皋兰县和榆中县)内存在高-高聚集性(P<0.05)。β局部空间自相关分析发现区域(主要分布于兰州市城关区、七里河区、西固区、安宁区、皋兰县和榆中县)内存在高-高聚集性(P<0.05)。结论结果提示兰州市大部分县(区)呈现高风险聚集性,但发病强度较低;全省在疫情期间采取的各项防控措施及时、有效。     

Geographic Variation of Pediatric Burn Injuries in a Metropolitan Area

OBJECTIVES: To use a geographic information system (GIS) and spatial statistics to describe the geographic variation of burn injuries in children 0-14 years of age in a major metropolitan area. METHODS: The authors reviewed patient records for burn injuries treated during 1995 at the two children's hospitals in St. Louis. Patient addresses were matched to block groups using a GIS, and block group burn injury rates were calculated. Mapping software and Bayesian analysis were used to create maps of burn injury rates and risks in the city of St. Louis. RESULTS: Three hundred eleven children from the city of St. Louis were treated for burn injuries in 1995. The authors identified an area of high incidence for burn injuries in North St. Louis. The filtered rate contour was 6 per 1,000 children at risk, with block group rates within the area of 0 to 58.8 per 1,000 children at risk. Hierarchical Bayesian analysis of North St. Louis burn data revealed a relative risk range of 0.8771 to 1.182 for census tracts within North St. Louis, suggesting that there may be pockets of high risk within an already identified high-risk area. CONCLUSIONS: This study shows the utility of geographic mapping in providing information about injury patterns within a defined area. The combination of mapping injury rates and spatial statistical analysis provides a detailed level of injury surveillance, allowing for identification of small geographic areas with elevated rates of specific injuries.     

Impact of regional heterogeneity on the severity of COVID-19

The main objective of the study is to assess the impact of regional heterogeneity on the severity of COVID-19 in Japan. We included 27,865 cases registered between January 2020 and February 2021 in the COVID-19 Registry of Japan, to examine the relationship between the National Early Warning Score (NEWS) of COVID-19 patients on the day of admission and the prefecture where the patients live. A hierarchical Bayesian model was used to examine the random effect of each prefecture in addition to the patients’ backgrounds. Additionally, we compared the results of two models; one model included the number of beds secured for COVID-19 patients in each prefecture as one of the fixed effects, and the other model did not. The results indicated that the prefecture had a substantial impact on the severity of COVID-19 on admission, even when considering the effect of the number of beds separately. Our analysis revealed a possible association between regional heterogeneity and increased/decreased risk of severe COVID-19 infection on admission. This heterogeneity was derived not only from the number of beds secured in each prefecture but also from other factors.     

2020年湖北省荆州市新型冠状病毒肺炎疫情流行特征分析

目的 探讨湖北省荆州市新型冠状病毒肺炎(COVID-19)确诊病例流行病学特征,为今后类似疫情防控提供科学依据.方法 通过中国疾病预防控制信息系统收集2020年荆州市COVID-19病例资料,描述病例的流行病学特征.结果 2020年荆州市累计报告COVID-19病例1 550例,重症病例占22.71％(352/1 55...     

Incidence of adverse reactions to COVID-19 vaccination:A meta-analysis of randomized controlled trials

Objective:To systematically evaluate the incidence of adverse reactions to coronavirus disease 2019(COVID-19)vaccination.Methods:We systematically searched PubMed,Embase,The Cochrane Library,Web of Science,CNKI,WanFang Data,and VIP Database from the inception of each database to August 31,2021.Randomized controlled clinical trials(RCTs)on the safety of different types of COVID-19 vaccines were retrieved and analyzed.A random or fixed-effects model was used with an odds ratio as the effect size.The quality of each reference was evaluated.The incidence of the adverse reactions of the placebo group and the vaccination group was compared.Heterogeneity and publication bias were taken care of by meta-regression and sub-group analyses.Results:A total of 13 articles were included,with 81287 subjects.Compared with the placebo group,the vaccination group showed a higher combined risk ratio(RR)of total adverse reactions(RR=1.67,95%CI:1.46-1.91,P<0.01),local adverse reactions(RR=2.86,95%CI:2.11-3.87,P<0.01),systemic adverse reactions(RR=1.25,95%CI:0.92-1.72,P=0.16),pain(RR=2.55,95%CI:1.75-3.70,P<0.01),swelling(RR=4.16,95%CI:1.71-10.17,P=0.002),fever(RR=2.34,95%CI:1.84-2.97,P<0.01),fatigue(RR=1.36,95%CI:1.32-1.41,P<0.01)and headache(RR=1.22,95%CI:1.18-1.26,P<0.01).The subgroup analysis showed the incidence of adverse reactions of the vaccination group after injection of the three COVID-19 vaccines(inactivated viral vaccines,mRNA vaccines and adenovirus vector vaccines)was higher than that of the placebo group,and the difference between the placebo group and the vaccination group in the mRNA vaccine subgroup and the adenovirus vector vaccine subgroup was statistically significant(P<0.01).The incidence of adverse reactions after injection of COVID-19 vaccine in subgroups of different ages was significantly higher than that in the placebo group(P<0.01).Conclusions:COVID-19 vaccines have a good safety,among which adenovirus vector vaccine has the highest incidence of adverse reactions.Both adolescents and adults vaccinated with novel coronavirus vaccine have a certain proportion of adverse reactions,but the symptoms are mild and can be relieved by themselves.Our meta-analysis can help boost global awareness of vaccine safety,promote mass vaccination,help build regional and global immune barriers and effectively curb the recurrency of COVID-19.     

我国西北及东北边境地区新型冠状病毒肺炎疫情流行特征分析

目的应用公开数据,对我国西北及东北边境地区的新型冠状病毒肺炎（COVID-19）疫情（截至2020年4月20日）进行分析,为COVID-19疫情防控提供科学依据。方法采用国家卫生健康委员会和各地政府发布的西北[以新疆维吾尔自治区（新疆）为例]及东北（以黑龙江省为例）地区各城市2020年1月23日至4月20日的COVID-19疫情数据,分析各地COVID-19感染率,并采用Joinpoint软件,按日均变化百分比（day percentage change, DPC）进行趋势分析。结果截至2020年4月20日,新疆及黑龙江省共累计报告确诊病例989例,其中新疆76例,黑龙江省913例（包含境外输入病例383例）。 新疆疫情仅1个高峰,先缓慢上升（DPC=7.0%, P<0.05）,后迅速下降（DPC=?12.0%,?64.2%,均P<0.05）。黑龙江省疫情发展较为复杂,有2个高峰。 第1个高峰期,疫情迅速上升（DPC=20.1%,P<0.05）,后缓慢下降（DPC=?11.4%,?56.6%,均P<0.05）;第2个高峰期,疫情又迅速上升（DPC=129.4%,P<0.05）,且趋势更快,后再次缓慢下降（DPC=?10.1%,P<0.05）。结论两地COVID-19疫情均由输入病例引发,输入病例多,防控压力大。防控措施如能有效规范落实,则可在较短的时间内控制疫情。     

Knowledge,attitude, and practice regarding COVID-19 among COVID-19 patients and their correlation with the outcomes: A cross-sectional study

Objective: To assess the knowledge, attitude, and practice (KAP) regarding COVID-19 among COVID-19 patients and their relation with the outcomes.Methods: This cross-sectional study was carried out among COVID-19 patients (18-year-old or older) consecutively admitted to a dedicated COVID-19 hospital located in northwest Rajasthan, India. Data regarding socio-demographic parameters, KAP, and primary composite outcome (admission to intensive care unit, mechanical ventilation, or in-hospital death) were collected. KAP scores were compared between different demographic variables and primary composite outcomes. Association between different demographic variables, primary composite outcomes, and KAP scores were determined through multivariate linear regression. Besides, the correlation among KAP scores was analyzed. Results: Out of the total 222 patients, most of them (65.76％) had average KAP scores towards COVID-19. The mean scores for knowledge were 7.88, with an overall correct rate of 71.63％; the mean attitude scores were 2.42, with an overall correct rate of 60.50％; the mean practice scores were 5.12, with an overall correct rate of 64.00％. Patients who met the primary composite outcomes had higher knowledge scores, but lower attitude and practice scores. The result showed a significant positive correlation between the level of education, socioeconomic class, and knowledge, attitude, and practice towards COVID-19. Knowledge towards COVID-19 was significantly associated with a positive attitude and good practice. Conclusions: Our findings show that adult COVID-19 patients have average KAP towards COVID-19 among COVID-19 patients. Poor attitude and practice towards COVID-19 are associated with adverse outcomes, so it is suggested to strengthen attitude and practice towards COVID-19 to improve the outcomes.     

Temporal trends in microbial detection during the COVID-19 pandemic: Analysis of the Japan surveillance for Infection Prevention and Healthcare Epidemiology (J-SIPHE) database

The impact of the COVID-19 pandemic on the incidence of microbial infections and other metrics related to antimicrobial resistance (AMR) has not yet been fully described. Using data from Japan Surveillance for Infection Prevention and Healthcare Epidemiology (J-SIPHE), a national surveillance database system that routinely collects clinical and epidemiological data on microbial infections, infection control practices, antimicrobial use, and AMR emergence from participating institutions in Japan, we assessed the temporal changes in AMR-related metrics before and after the start of the COVID-19 pandemic. We found that an apparent decrease in the incidence of microbial infections in 2020 compared with 2019 may have been driven primarily by a reduction in bed occupancy, although the incidence showed a constant or even slightly increasing trend after adjusting for bed occupancy. Meanwhile, we found that the incidence of Streptococcus pneumoniae dramatically decreased from April 2020 onward, probably due to stringent non-pharmaceutical interventions against COVID-19. Antimicrobial use showed a weak increasing trend, while the use of hand sanitiser at the included medical institutions increased by about 50% in 2020 compared with 2019.     

新型冠状病毒肺炎疫情防控措施对上海市嘉定区法定传染病发病率的影响

目的 了解新型冠状病毒肺炎（新冠肺炎）疫情防控措施对上海市嘉定区法定传染病流行的影响。方法 收集嘉定区2017—2021年法定传染病报告数据,分析比较新冠肺炎防控措施前后法定传染病发病率的变化。结果 在实施新冠肺炎防控措施下,2020年嘉定区法定传染病发病率为167.59/10万,较前3年平均发病率（421.04/10万）降低了60.20%（χ2=2 424.369,P<0.001）;2021年法定传染病发病率为213.82/10万,较2017—2019年平均发病率降低了49.22%（χ2=1 578.996,P<0.001）。2020年和2021年乙类、丙类传染病发病率均低于2017—2019年平均发病率,其中乙类分别降低了38.79%和30.70%;丙类分别降低了71.23%和58.76%。2020年和2021年嘉定区肠道传染病、呼吸道传染病、经血液和性传播传染病发病率均低于2017—2019年平均发病率,其中2020年分别降低了59.27%、68.02%和36.52%,2021年分别降低了37.96%,56.37%和30.51%。2020年和2021年发病率最高的仍为...     

2020年10月中国大陆需关注的突发公共卫生事件风险评估

目的评估2020年10月在我国大陆地区发生或者可能由境外输入的突发公共卫生事件风险。方法2020年9月29日中国疾病预防控制中心根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息，采用专家会商法，并通过视频会议形式邀请省（自治区、直辖市）疾病预防控制中心专家参与评估。结果随着学校和托幼机构开学、经济活动恢复，预计2020年10月我国的突发公共卫生事件的报告数将较9月有上升，可能会接近往年同期平均水平。 全球新型冠状病毒肺炎疫情此起彼伏、持续蔓延，我国境内自2020年8月29日以来全部恢复低风险水平。 我国发生新型冠状病毒肺炎输入及其续发本地传播风险持续存在，目前采取积极的外防输入、内防反弹的策略，一旦发现本地疫情则采取常态化精准防控和局部疫情应急处置相结合的措施；在做好合法入境人员管理、加强输入冷冻品监测和非法入境人员管理的情况下，我国能够继续做到有效发现和及时控制再次发生的本地疫情。 10月还需要注意预防诺如病毒感染性腹泻和食物中毒。结论需要对新型冠状病毒肺炎予以特别关注，对诺如病毒感染性腹泻和食物中毒予以一般关注。     

2020年贵州省新型冠状病毒肺炎疫情特征分析

  目的  分析2020年贵州省新型冠状病毒肺炎（COVID-19）病例流行病学特征,为制定防控措施和策略提供依据。  方法  收集2020年贵州省报告的COVID-19病例信息,采用描述性流行病学方法,对病例的三间分布、感染来源及疫情特征等进行分析。  结果  2020年1月22日至12月31日,全省累计报告COVID-19病例173例,死亡2例,病死率为1.16%。 其中确诊病例147例（84.97%）,无症状感染者26例（15.03%）;重症病例31例（21.09%）;本地病例84例（48.55%）、境内输入病例87例（50.29%）、境外输入病例2例（1.16%）。 疫情曲线呈双峰型,两个高峰间隔7 d,第1个发病高峰以境内输入病例为主,第2个发病高峰以本地病例为主。 全省9个（100%）市/州44个（50%）县（区）均有病例报告,主要分布在贵阳市、毕节市及遵义市（占全省总病例的70.70%）。 男、女性别比为1.06∶1;各年龄组均有病例报告,年龄中位数为37岁。 82例（47.40%）病例是通过密切接触者主动筛查发现,55例（31.79%）是通过主动就诊发现,36例（20.81%）是通过对湖北省武汉市来黔等重点人员主动筛查发现。 暴露因素以密切接触者（42.77%）和武汉市旅居史人员（38.73%）为主。 29起聚集性疫情均为家庭聚集病例。  结论  贵州省COVID-19病例以境内输入及密切接触感染为主。 对疫情重点地区人员及密切接触者等重点人员的早期排查、集中隔离管理及对发热病例的监测是早发现和防止疫情传播的关键。     

Thromboembolic Risk in Hospitalized and Nonhospitalized COVID-19 Patients: A Self-Controlled Case Series Analysis of a Nationwide Cohort

ObjectiveTo assess the associations between coronavirus disease 2019 (COVID-19) infection and thromboembolism including myocardial infarction (MI), ischemic stroke, deep vein thrombosis (DVT), and pulmonary embolism (PE).Patients and MethodsA self-controlled case-series study was conducted covering the whole of Scotland’s general population. The study population comprised individuals with confirmed (positive test) COVID-19 and at least one thromboembolic event between March 2018 and October 2020. Their incidence rates during the risk interval (5 days before to 56 days after the positive test) and the control interval (the remaining periods) were compared intrapersonally.ResultsAcross Scotland, 1449 individuals tested positive for COVID-19 and experienced a thromboembolic event. The risk of thromboembolism was significantly elevated over the whole risk period but highest in the 7 days following the positive test (incidence rate ratio, 12.01; 95% CI, 9.91 to 14.56) in all included individuals. The association was also present in individuals not originally hospitalized for COVID-19 (incidence rate ratio, 4.07; 95% CI, 2.83 to 5.85). Risk of MI, stroke, PE, and DVT were all significantly higher in the week following a positive test. The risk of PE and DVT was particularly high and remained significantly elevated even 56 days following the test.ConclusionConfirmed COVID-19 infection was associated with early elevations in risk with MI, ischemic stroke, and substantially stronger and prolonged elevations with DVT and PE both in hospital and community settings. Clinicians should consider thromboembolism, especially PE, among people with COVID-19 in the community.