广州市新型冠状病毒肺炎病例密切接触者核酸检测灵敏度和特异度分析

目的:分析广州市新型冠状病毒肺炎（COVID-19）疫情防控不同阶段中,密切接触者新型冠状病毒（新冠病毒）核酸检测的灵敏度和特异度,为优化疫情防控策略提供科学依据。方法:2020年2月21日至9月22日广州市COVID-19病例的密切接触者20 348例,均已接受新冠病毒核酸检测。针对疫情防控的不同阶段,比较核酸检测的...     

宁波市新型冠状病毒肺炎疫情动态清零精准防控策略和措施效果评价

目的:对宁波市新型冠状病毒肺炎（COVID-19）疫情动态清零精准防控策略和措施效果进行评价。方法:根据2021年12月宁波市报告的COVID-19确诊病例和个案流行病学调查报告绘制流行曲线,建立传播动力学模型,预测不同干预措施下的累计确诊病例数,计算基本再生数（ R0）和实时再生数（ R ...     

广州市番禺区成年居民新型冠状病毒肺炎宣传教育效果调查

目的 了解广州市番禺区成年居民新型冠状病毒肺炎（COVID-19）防控相关知识、态度和行为现状,以此验证健康教育成效。 方法 通过问卷星,于2020年2月23日至3月13日邀请广州市番禺区成年居民在线填写COVID-19防控知信行调查问卷,采用描述流行病学分析方法对结果进行分析。 结果 共调查35 797名成年居民,调查对象COVID-19防控知识得分高认知率83.9%,知晓率最高的前3项分别是传播途径（99.3%）、外出回家后要洗手（99.2%）和感染后症状（98.9%）。调查对象COVID-19防控积极态度持有率87.0%,99.9%调查对象认可勤洗手,99.9%相信国家能战胜疫情;调查对象COVID-19防控良好行为形成率86.6%,行为形成率最高的前2项是减少外出（98.3%）和勤洗手（98.0%）。多因素logistic回归分析结果显示：女性、文化程度高、职业为医务人员、广州户籍、常住城市、高认知水平、态度积极者,其COVID-19防控健康行为执行水平越高。 结论 COVID-19防控宣传取得了良好效果,居民对疾病认知度高,并采取积极防护措施。男性、文化程度较低者,防控认知度较低,态度较消极,健康行为执行较差,建议针对薄弱人群开展重点健康教育。     

做好学校肺结核防控 提升COVID-19疫情防控效果

如今新型冠状病毒肺炎（COVID-19）疫情仍在全球扩散蔓延,我国COVID-19疫情防控已经进入常态下精准防控阶段。肺结核是经呼吸道传播的慢性传染病,目前仍是严重危害人民健康的重大传染病。学校是人员相对密集且接触频繁的场所,出现COVID-19或肺结核病例后极易发生聚集性疫情。肺结核和COVID-19在呼吸道临床表现方面具有许多相似之处,因此学校出现肺结核病例会增加COVID-19疫情防控的复杂性。此外,做好学校结核病防控,有助于提高呼吸道传染病防控意识。及时处理从健康监测中发现的可疑肺结核症状者,既有助于精准防控肺结核疫情,又能提升COVID-19疫情防控效果。     

浙江省首例新型冠状病毒肺炎报告病例流行病学调查

  目的  对上海市2020年1月20日 — 3月24日报告的所有新型冠状病毒肺炎（COVID-19）确诊病例进行疫情特征和防控情况分析,掌握本市疫情时空扩散特征、传播和变动的空间差异及与落实的防控措施之间的内在联系。  方法  通过整理上海市卫生健康委员会官方网站疫情通告和COVID-19确诊病例流行病学调查资料,收集汇总病例的年龄、性别、确诊日期、感染来源等,运用描述性流行病学方法分析本市COVID-19确诊病例的疫情扩散特征和采取的各项防控措施。  结果  上海市COVID-19确诊病例中,18～40岁青年人感染的比重较大,占39.03 %（169/433）;疫情共分为5个阶段,分别为第一次缓慢上升阶段、高速增长阶段、升速放缓阶段、维持“0”报告阶段和再次缓慢上升阶段;各阶段各类COVID-19确诊病例的报告和上海市采取的各项防控措施密不可分;本市疫情扩散比最高为0.5022,各区在不同疫情发展阶段,疫情扩散比均表现为不同形态;总体而言,上海市COVID-19疫情防控措施是卓有成效的。  结论   上海市疫情已进入新的防控阶段,应根据国外COVID-19疫情形势,采取针对性的防控措施,及时发现境外输入性病例。     

新型冠状病毒感染流行期间大型综合性医院感染防控策略

目的探讨医院新型冠状病毒感染(COVID-19)疫情防控与诊疗救治并行时,如何制定COVID-19医院感染防控策略,为大型综合性医院制定疫情防控策略提供科学依据。方法医院以"管理传染源,切断传播途径,保护易感人群"为原则,分别从"管人"、"管物"、"管流程"方面提出建立应急防控组织体系、发挥疾病预防控制科的专业作用、加强门急诊的管理、加强住院患者的防控管理、管理各级各类人员、制订诊疗防控流程、环境的清洁消毒、人员培训教育、加强后勤物资保障等防控策略与具体措施。结果所有来院患者均得到科学合理接诊,医务人员身体和心理状态稳定,医护人员和住院患者均未出现COVID-19。结论研究医院的COVID-19防控策略可为疫情流行期间综合性医院院内感染防控提供参考。     

传染病预测模型在新型冠状病毒肺炎疫情中的应用研究进展

新型冠状病毒肺炎（COVID-19）在全球范围内迅速传播,快速预测COVID-19规模具有重大公共卫生意义,目前主要利用动力学模型、时间序列模型以及时空交互模型来拟合传染病资料,预测COVID-19的流行特征及发展趋势。本研究对常见传染病预测模型的应用进行综述,总结传染病预测模型在COVID-19发病趋势预测中的应用进展,为传染病预测模型在传染病疫情防控中的应用提供参考。     

辽宁省境外输入新型冠状病毒肺炎病例流行特征分析及防治措施效果评价

目的 分析辽宁省境外输入新型冠状病毒肺炎(COVID-19)病例流行特征及防治措施,为防控COVID-19境外输入疫情提供依据.方法 通过中国疾病预防控制信息系统收集2020年1月29日-7月12日辽宁省境外输人COVID-19病例资料,结合现场流行病学调查报告,对境外输入COVID-19病例的时间、地区、人群分布、输...     

孕妇新型冠状病毒肺炎及疫苗的流行病学研究进展

新型冠状病毒肺炎（COVID-19）是一种由新型冠状病毒（新冠病毒）引起的急性呼吸道传染性疾病。由于妊娠期间的生理变化,孕妇易感COVID-19,尤其是新冠病毒变异株流行期间,孕妇不良妊娠结局的发生风险可能更高。目前尚缺乏孕妇接种新冠病毒疫苗（新冠疫苗）的随机临床试验证据,各国关于孕妇接种新冠疫苗的推荐存在差异,这给孕妇COVID-19的防控带来了一定挑战。本文回顾了国内外妊娠期感染新冠病毒的重要研究进展,论述了妊娠期患COVID-19对孕妇、胎儿及婴儿的危害,以及真实世界研究中妊娠期接种新冠疫苗的有效性和安全性等,以期为今后开展孕妇相关研究,制定防控措施提供参考。     

新型冠状病毒肺炎两种不同流行模式及其防控效果比较：基于广州和温州市的分析

目的 比较广州、温州市两个城市新型冠状病毒肺炎（COVID-19）的流行模式,并评估两个城市疫情的防控效果。方法 获取截至2020年2月29日广州和温州市COVID-19确诊病例的个案数据,绘制两个城市疫情的流行曲线,收集不同时间的防控措施,计算在两个城市的实时再生数。结果 广州和温州市分别纳入确诊病例346例和465例,两个城市病例均集中在30～59岁（广州市：54.9%;温州市：70.3%）。流行曲线显示广州和温州市的每日发病数分别在1月27日与1月26日到达峰值,随后出现下降趋势。两个城市的发病高峰均出现在湖北省输入病例的抵达高峰后,且温州市的湖北省输入病例的抵达高峰早于广州市。广州市一直以输入病例为主,温州市从前期的以输入病例为主转变为后期以本地病例为主。虽然两个城市流行模式存在差异,在采取了有力的防控措施后,两个城市均取得了较好的防控效果。结论 COVID-19输入疫情可导致两种不同的流行模式,但采取强有力的防控措施,均能有效控制疫情蔓延。     

Impact of COVID-19 on Structure and Function of Program of All-Inclusive Care for the Elderly (PACE) Sites in North Carolina

ObjectivesThe novel coronavirus disease 2019 (COVID-19) deeply affected all forms of long-term care for older adults, highlighting infection control issues, provider and staff shortages, and other challenges. As a comparatively new, community-based long-term care option, the Program of All-Inclusive Care for the Elderly (PACE) faced unique challenges. This project investigated the impact of COVID-19 on operations in all PACE programs in one US state.DesignQualitative study.Setting and ParticipantsStructured interviews with administrators of all 12 PACE programs in North Carolina.MethodsInterviews were conducted December 2020 to January 2021 by trained interviewers over Zoom; they were transcribed, coded, and qualitatively analyzed using thematic analysis.ResultsReported COVID-19 infection rates among PACE participants for 2020 averaged 12.3 cases, 4.6 hospitalizations, and 1.9 deaths per 100 enrollees. Six themes emerged from analyses: new, unprecedented administrative challenges; insufficient access to and integration with other health care providers; reevaluation of the core PACE model, resulting in a transition to home-based care; reorientation to be more family-focused in care provision; implementation of new, creative strategies to address participant and family psychological and social well-being in the home; and major reconfiguration of staffing, including transitions to new and different roles and a concomitant effort to provide support and relief to staff.Conclusions and ImplicationsWhile facing many challenges that required major changes in care provision, PACE was successful in mounting a COVID-19 response that upheld safety, promoted the physical and mental well-being of participants, and responded to the needs of family caregivers. Administrators felt that, after the pandemic, the PACE service model is likely to remain more home-based and less reliant on the day center than in the past. As a result, PACE may have changed for the better and be well-positioned to play an expanded role in our evolving long-term care system.     

U.S. public support for COVID-19 vaccine donation to low- and middle-income countries during the COVID-19 pandemic

As COVID-19 vaccines become available to the public, there will be a massive worldwide distribution effort. Vaccine distribution has historically been unequal primarily due to the inability of nations with developing economies to purchase enough vaccine to fully vaccinate their populations. Inequitable access to COVID-19 vaccines will not just cause humanitarian suffering, it will likely also be associated with increased economic suffering worldwide. This study focuses on the U.S. population and its beliefs about future COVID-19 vaccine donation by the U.S. to low- and middle-income countries.This study carried out a survey among 788 U.S. adults. Variables include demographics, COVID-19 vaccine priority status, COVID-19 vaccine donation beliefs, and Social Dominance Orientation.Analyses showed that older respondents were both less likely to endorse higher levels of COVID-19 vaccine donations and were more likely to want to wait until all in the U.S. who want the vaccine have received it; those who identified as Democrats were more likely to endorse higher levels of future COVID-19 vaccine donation than Republicans; and those scoring higher on SDO were both less likely to endorse higher levels of COVID-19 vaccine donations as well as more likely to want to wait until all in the U.S. who want the vaccine have received it. Policymakers, as well as healthcare providers and public health communication professionals, should give consideration to those messages most likely to engender support for global prevention efforts with each audience segment.     

COVID‑19 vaccine hesitancy among pregnant women and their reported reasons for vaccine refusal – A prospective study in Tehran,Iran

ObjectiveEvaluation of covid?19 vaccine hesitancy among pregnant women and their reported reasons for vaccine refusal.MethodsThis prospective study was performed in Arash women’s Hospital, Tehran, Iran, between December 1, 2021 and January 1, 2022. All pregnant women who were attended to prenatal care unit were considered eligible for inclusion. A validated questionnaire was used for data gathering. Written informed consent was obtained from all participants.ResultsFinally, 477 pregnant women were recruited and were divided into two groups according the status of vaccine acceptance (237 accepted and 240 women refused vaccination). The mean age of accepted participants was higher (31.65 ± 5.69 vs 30.39 ± 5.5; P = 0.01). There was a significant statistical difference between the groups regarding education level. Access to internet and social media were also significantly different between the two groups (94.8% in accepted vs 86.6% in refused group; P = 0.002). There was more rate of severe COVID-19 infection in friends or relatives of accepted group (50% vs 38%). we did not find any statistically significant differences in obstetric characteristics and the rate of obstetric complications between the two groups. The most common reasons reported by participants for vaccine refusal, was fear of vaccination side effects on the fetus (86.5%), and the less common reported reasons were husband's disagreement (9.7%), use of traditional medicine (5.6%), religious beliefs (3.7%), and information obtained from social media (2.8%). After advices from medical staff, most of these mothers (86.5%) still refused vaccination.ConclusionBased on the results of the present study, rate of COVID-19 vaccine hesitancy was about 50% and its most common reported reason was fear of probable side effects of vaccine on the fetus.     

Determinants of humoral immune response to SARS-CoV-2 vaccines in solid cancer patients: A systematic review and meta-analysis

ImportanceSolid cancer patients following SARS-CoV-2 vaccination are likely to have a lower seroconversion rate than healthy adults. Seroconversion between those with and without cancer is likely to vary moderately or to be restricted to specific subgroups. Therefore, we sought to conduct a systematic review and meta-analysis to identify risk factors for diminished humoral immune responses in solid cancer patients.MethodsMEDLINE, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov were used to search literature through May 1, 2022. Prospective or retrospective studies comparing responders with non-responders against SARS-CoV-2 spike (S) protein receptor-binding domain (RBD) following COVID-19 vaccination were included. Pooled Odds Ratios (pORs) with 95% CIs for binary variables and differences in means (with SDs) for continuous variables were calculated to determine the pooled effect estimates of risk factors for poor antibody response.ResultsFifteen studies enrolling 3593 patients were included in the analysis. Seroconversion was seen in 84% of the pooled study population. Male gender, age >65 years, and recent chemotherapy were all factors in a poor immune response. Patients under follow-up, those who received immunotherapy or targeted therapy, were more likely to be seropositive. Cancer subtypes, vaccine types, and timing of antibody testing from the 2nd dose of vaccine did not correlate with seroconversion.ConclusionCytotoxic therapy for solid cancer may portend poor immune response following 2 doses of COVID-19 vaccines suggesting a need for booster doses in these patients. Immunotherapy and targeted therapy are likely to be associated with seropositive status, and thus can be considered as an alternative to cytotoxic agents in cases where both therapies are equally efficacious.     

Reactogenicity within 2 weeks after mRNA COVID-19 vaccines: Findings from the CDC v-safe surveillance system

BackgroundPost-authorization monitoring of mRNA-based COVID-19 vaccines is needed to better characterize their reactogenicity. We assessed reactions reported during the 2 weeks after receipt of BNT162b2 (Pfizer–BioNTech) and mRNA-1273 (Moderna) vaccines.MethodsWe monitored persons who enrolled in v-safe after vaccination health checker^SM, a U.S. smartphone-based vaccine monitoring system, after receiving BNT162b2 or mRNA-1273. V-safe participants received text message prompts to complete web-based surveys. We analyzed responses from persons who received BNT162b2 or mRNA-1273 from December 14, 2020 through March 14, 2021 and completed at least one survey by March 28, 2021. We measured the proportion of participants reporting local and systemic reactions solicited in surveys completed days 0 through 7 post-vaccination. For day 14 surveys, participants described new or worsening symptoms in a free-text response. We assessed the proportion of participants reporting new or worsening local and systemic reactions.ResultsOne-third of participants were aged <45 years, two-thirds were female, and approximately half received BNT162b2 vaccine. A total of 4,717,908 participants reported during the 7 days after dose 1 and 2,906,377 reported during the 7 days after dose 2. Most reported at least one injection-site reaction (68.5% after dose 1; 72.9% after dose 2) or at least one systemic reaction (50.6% after dose 1; 69.5% after dose 2). Reactogenicity was greater after dose 2 and among mRNA-1273 recipients, persons aged <45 years, and females. New or worsening local and systemic reactions were uncommon during week 2 after either dose; the most frequent were local reactions for dose 1 mRNA-1273 recipients (2.6%). These reactions were reported more often among females after dose 1 mRNA-1273 (3.6%).ConclusionsDuring post-authorization monitoring among >4 million vaccinees, local and systemic reactions were commonly reported following mRNA-based vaccines. Reactions were most common during the first week following dose 2 and among persons aged <45 years, females, and mRNA-1273 recipients.     

Evaluation of potential adverse events following COVID-19 mRNA vaccination among adults aged 65 years and older: Two self-controlled studies in the U.S.

BackgroundOur near-real-time safety monitoring of 16 adverse events (AEs) following COVID-19 mRNA vaccination identified potential elevation in risk for six AEs following primary series and monovalent booster dose administration. The crude association with AEs does not imply causality. Accordingly, we conducted robust evaluation of potential associations.MethodsWe conducted two self-controlled case series studies of COVID-19 mRNA vaccines (BNT162b2 and mRNA-1273) in U.S. Medicare beneficiaries aged ≥ 65 years. Adjusted incidence rate ratio (IRRs) and 95 % confidence intervals (CIs) were estimated following primary series doses for acute myocardial infarction (AMI), pulmonary embolism (PE), immune thrombocytopenia (ITP), disseminated intravascular coagulation (DIC); and following monovalent booster doses for AMI, PE, ITP, Bell’s Palsy (BP) and Myocarditis/Pericarditis (Myo/Peri).ResultsThe primary series study included 3,360,981 individuals who received 6,388,542 primary series doses; the booster study included 6,156,100 individuals with one monovalent booster dose. The AMI IRR following BNT162b2 primary series and booster was 1.04 (95 % CI: 0.91 to 1.18) and 1.06 (95 % CI: 1.003 to 1.12), respectively; for mRNA-1273 primary series and booster, 1.01 (95 % CI: 0.82 to 1.26) and 1.05 (95 % CI: 0.998 to 1.11), respectively. The hospital inpatient PE IRR following BNT162b2 primary series and booster was 1.19 (95 % CI: 1.03 to 1.38) and 0.86 (95 % CI: 0.78 to 0.95), respectively; for mRNA-1273 primary series and booster, 1.15 (95 % CI: 0.94 to 1.41) and 0.87 (95 % CI: 0.79 to 0.96), respectively. The studies’ results do not support that exposure to COVID-19 mRNA vaccines elevate the risk of ITP, DIC, Myo/Peri, and BP.ConclusionWe did not find an increased risk for AMI, ITP, DIC, BP, and Myo/Peri and there was not consistent evidence for PE after exposure to COVID-19 mRNA primary series or monovalent booster vaccines. These results support the favorable safety profile of COVID-19 mRNA vaccines administered in the U.S. elderly population.     

COVID-19: Role of Nutrition and Supplementation

At the end of 2019, a new coronavirus (COVID-19) appeared on the world scene, which mainly affects the respiratory system, causing pneumonia and multi-organ failure, and, although it starts with common symptoms such as shortness of breath and fever, in about 2–3% of cases it leads to death. Unfortunately, to date, no specific treatments have been found for the cure of this virus and, therefore, it is advisable to implement all possible strategies in order to prevent infection. In this context, it is important to better define the role of all behaviors, in particular nutrition, in order to establish whether these can both prevent infection and improve the outcome of the disease in patients with COVID-19. In the literature, it is widely shown that states of malnutrition, overweight, and obesity negatively affect the immune system, leading to viral infections, and several studies have shown that nutritional interventions can act as immunostimulators, helping to prevent viral infections. Even if several measures, such as the assumption of a specific diet regimen, the use of dietary supplements, and other similar interventions, are promising for the prevention, management, and recovery of COVID-19 patients, it is important to highlight that strong data from randomized clinical trials are needed to support any such assumption. Considering this particular scenario, we present a literature review addressing several important aspects related to diet and SARS-CoV-2 infection, in order to highlight the importance of diet and supplementation in prevention and management of, as well as recovery from COVID-19.     

Preferences for COVID-19 vaccination information and location: Associations with vaccine hesitancy,race and ethnicity

This study examined the association between preferences for being informed about the COVID-19 vaccine and where to receive it with vaccination intent and race/ethnicity. We conducted an online survey, oversampling Black and Latino panel members. The 1668 participants were 53.2% female, 34.8% White, 33.3% Black, and 31.8% Latino. Participants who were vaccine hesitant (answered “not sure” or “no” to vaccination intent) were more likely to prefer a conversation with their doctor compared to those who answered “yes” (25.0% and 23.4% vs 7.8%, P < .001, respectively). Among participants who responded “not sure”, 61.8% prefer to be vaccinated at a doctor’s office, compared with 35.2% of those who responded “yes” (P < .001). Preferred location differed by race/ethnicity (P < .001) with 67.6% of Black “not sure” participants preferring a doctor’s office compared to 60.2% of Latino and 54.9% of White “not sure” participants. These findings underscore the need to integrate healthcare providers into COVID-19 vaccination programs.     

Relationship between pre-existing allergies and anaphylactic reactions post mRNA COVID-19 vaccine administration

Two mRNA vaccines for COVID-19, Pfizer-BioNTech and Moderna, are approved for emergency use in the United States. After their approval and dosing in millions of recipients, reports of anaphylaxis began to appear in the Vaccine Adverse Reporting System (VAERS). Here we provide an analysis of the relationship between prior history of allergy and/or anaphylaxis and anaphylaxis rates following the administration of mRNA COVID-19 vaccines. Overall reported incidence of anaphylaxis was estimated to be rare at 4.2 cases per million doses. It appeared that the relative incidence of anaphylaxis following administration of these COVID-19 vaccines was two and seven times higher for recipients with a prior history of allergies and/or anaphylaxis, respectively. This report provides valuable metrics to make evidence-based decisions for subjects with pre-existing allergic conditions receiving a COVID-19 mRNA vaccine.     

COVID-19 in clinical practice: A narrative synthesis

The coronavirus disease 2019 (COVID-19) was first reported in the city of Wuhan, China. The disease rapidly spread to the rest of China, to Southern-East Asia, then to Europe, America, and on to the rest of the world. COVID-19 is associated with a betacoronavirus named SARS-CoV-2. The virus penetrates the organism through the respiratory tract, conveyed by contaminated droplets. The main cell receptor targeted is the surface-bound ACE-2. As of the 26th July 2020, 15,200,000 COVID-19 cases and 650,000 deaths were reported worldwide. The mortality rate is estimated between 1.3 and 18.3%. The reproductive rate without any public health intervention is estimated around 4-5.1 in France. Most hospitalized patients for COVID-19 present respiratory symptoms, which in some cases is associated with fever. Up to 86% of admissions to ICU are related to acute respiratory failure. To date, no anti-viral therapy has proven its efficacy considering randomized trials. Only immunomodulatory treatments such as corticosteroids have shown to cause significant improvement in patient outcome.