Dataset Information

Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study.

ABSTRACT:

Objective

To evaluate viral loads at different stages of disease progression in patients infected with the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the first four months of the epidemic in Zhejiang province, China.

Design

Retrospective cohort study.

Setting

A designated hospital for patients with covid-19 in Zhejiang province, China.

Participants

96 consecutively admitted patients with laboratory confirmed SARS-CoV-2 infection: 22 with mild disease and 74 with severe disease. Data were collected from 19 January 2020 to 20 March 2020.

Main outcome measures

Ribonucleic acid (RNA) viral load measured in respiratory, stool, serum, and urine samples. Cycle threshold values, a measure of nucleic acid concentration, were plotted onto the standard curve constructed on the basis of the standard product. Epidemiological, clinical, and laboratory characteristics and treatment and outcomes data were obtained through data collection forms from electronic medical records, and the relation between clinical data and disease severity was analysed.

Results

3497 respiratory, stool, serum, and urine samples were collected from patients after admission and evaluated for SARS-CoV-2 RNA viral load. Infection was confirmed in all patients by testing sputum and saliva samples. RNA was detected in the stool of 55 (59%) patients and in the serum of 39 (41%) patients. The urine sample from one patient was positive for SARS-CoV-2. The median duration of virus in stool (22 days, interquartile range 17-31 days) was significantly longer than in respiratory (18 days, 13-29 days; P=0.02) and serum samples (16 days, 11-21 days; P<0.001). The median duration of virus in the respiratory samples of patients with severe disease (21 days, 14-30 days) was significantly longer than in patients with mild disease (14 days, 10-21 days; P=0.04). In the mild group, the viral loads peaked in respiratory samples in the second week from disease onset, whereas viral load continued to be high during the third week in the severe group. Virus duration was longer in patients older than 60 years and in male patients.

Conclusion

The duration of SARS-CoV-2 is significantly longer in stool samples than in respiratory and serum samples, highlighting the need to strengthen the management of stool samples in the prevention and control of the epidemic, and the virus persists longer with higher load and peaks later in the respiratory tissue of patients with severe disease.

SUBMITTER: Zheng S

PROVIDER: S-EPMC7190077 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Publications

Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study.

Zheng Shufa S Fan Jian J Yu Fei F Feng Baihuan B Lou Bin B Zou Qianda Q Xie Guoliang G Lin Sha S Wang Ruonan R Yang Xianzhi X Chen Weizhen W Wang Qi Q Zhang Dan D Liu Yanchao Y Gong Renjie R Ma Zhaohui Z Lu Siming S Xiao Yanyan Y Gu Yaxi Y Zhang Jinming J Yao Hangping H Xu Kaijin K Lu Xiaoyang X Wei Guoqing G Zhou Jianying J Fang Qiang Q Cai Hongliu H Qiu Yunqing Y Sheng Jifang J Chen Yu Y Liang Tingbo T

BMJ (Clinical research ed.) 20200421

<h4>Objective</h4>To evaluate viral loads at different stages of disease progression in patients infected with the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the first four months of the epidemic in Zhejiang province, China.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>A designated hospital for patients with covid-19 in Zhejiang province, China.<h4>Participants</h4>96 consecutively admitted patients with laboratory confirmed SARS-CoV-2 infection: 22 with ...[more]

PMID: 32317267

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Project description:BackgroundFoodborne diseases are a major cause of morbidity and mortality and a major public health problem worldwide. We aim to explore characteristics of foodborne disease outbreaks (FBDOs) in Zhejiang Province and to provide data support for foodborne disease prevention and control. To our knowledge, few such analyses have been published at the provincial level.MethodsDescriptive statistical methods were used to analyze the data reported by centers for disease control (CDC) at all levels in Zhejiang Province through Foodborne Disease Outbreaks Surveillance System (FDOSS) during 2015-2020.ResultsA total of 962 FBDOs were reported during this period, resulting in 8324 illnesses, 1028 hospitalizations, and 20 deaths. The number of outbreaks (410 outbreaks, 42.62%) and cases (4991 cases, 59.96%) caused by bacteria were the largest, followed by poisonous mushrooms (157 outbreaks, 587 cases), which was the main cause of death (15 deaths, 75%). The highest number of FBDOs occurred in households (381 outbreaks, 39.60%), followed by restaurants (219 outbreaks, 22.77%) and canteens (174 outbreaks, 18.08%). Animal-based foods were the most common single food reported (232 outbreaks, 24.12%), followed by poisonous mushrooms (162 outbreaks, 16.84%), and plant-based foods (133 outbreaks, 13.83%). Poisonous mushrooms took the first place in outbreaks in households (38.32%, 146/381), while bacteria took the first place in outbreaks outside households. Vibrio parahaemolyticus was responsible for the largest number of outbreaks (232 outbreaks, 24.12%), which mainly occurred in catering service units (93.10%, 216/232). Different types of bacteria tended to be found in different food categories, such as Vibrio parahaemolyticus, which was mainly found in aquatic products.ConclusionsAnalysis of FBDOs can provide insight into the most important pathogens and sources of foodborne disease, helping authorities identify high-risk etiologies, high-risk foods, and high-risk settings to guide policies that would reduce FBDOs.

Project description:IntroductionThe emergence of novel SARS-CoV-2 has caused a pandemic of Coronavirus Disease 19 (COVID-19) which has spread exponentially worldwide. A robust surveillance system is essential for correct estimation of the disease burden and containment of the pandemic. We evaluated the performance of COVID-19 case-based surveillance system in FCT, Nigeria and assessed its key attributes.MethodsWe used a cross-sectional study design, comprising a survey, key informant interview, record review and secondary data analysis. A self-administered, semi-structured questionnaire was administered to key stakeholders to assess the attributes and process of operation of the surveillance system using CDC's Updated Guidelines for Evaluation of Public Health Surveillance System 2001. Data collected alongside surveillance data from March 2020 to January 2021 were analyzed and summarized using descriptive statistics.ResultsOut of 69,338 suspected cases, 12,595 tested positive with RT-PCR with a positive predictive value (PPV) of 18%. Healthcare workers were identified as high-risk group with a prevalence of 23.5%. About 82% respondents perceived the system to be simple, 85.5% posited that the system was flexible and easily accommodates changes, 71.4% reported that the system was acceptable and expressed willingness to continue participation. Representativeness of the system was 93%, stability 40%, data quality 56.2% and timeliness 45.5%, estimated result turnaround time (TAT) was suboptimal.ConclusionThe system was found to be useful, simple, flexible, sensitive, acceptable, with good representativeness but the stability, data quality and timeliness was poor. The system meets initial surveillance objectives but rapid expansion of sample collection and testing sites, improvement of TAT, sustainable funding, improvement of electronic database, continuous provision of logistics, supplies and additional trainings are needed to address identified weaknesses, optimize the system performance and meet increasing need of case detection in the wake of rapidly spreading pandemic. More risk-group persons should be tested to improve surveillance effectiveness.

Dataset Information

Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study.

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusion

Publications

Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study.

Similar Datasets

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