Project description:The pandemic of COVID-19 is seriously challenging the medical organization in many parts of the world. This novel corona virus SARS-CoV-2 has a specific tropism for the low respiratory airways, but causes severe pneumonia in a low percentage of patients. However, the rapid spread of the infection during this pandemic is causing the need to hospitalize a high number of patients. Pneumonia in COVID-19 has peculiar features and can be studied by lung ultrasound in the early approach to suspected patients. The sonographic signs are non-specific when considered alone, but observation of some aspects of vertical artifacts can enhance the diagnostic power of the ultrasound examination. Also, the combination of sonographic signs in patterns and their correlation with blood exams in different phenotypes of the disease may allow for a reliable characterization and be of help in triaging and admitting patients.
Project description:Effective public health response to novel pandemics relies on accurate and timely surveillance of pandemic spread, as well as characterization of the clinical course of the disease in affected individuals. We sought to determine whether Internet search patterns can be useful for tracking COVID-19 spread, and whether these data could also be useful in understanding the clinical progression of the disease in 32 countries across six continents. Temporal correlation analyses were conducted to characterize the relationships between a range of COVID-19 symptom-specific search terms and reported COVID-19 cases and deaths for each country from January 1 through April 20, 2020. Increases in COVID-19 symptom-related searches preceded increases in reported COVID-19 cases and deaths by an average of 18.53 days (95% CI 15.98-21.08) and 22.16 days (20.33-23.99), respectively. Cross-country ensemble averaging was used to derive average temporal profiles for each search term, which were combined to create a search-data-based view of the clinical course of disease progression. Internet search patterns revealed a clear temporal pattern of disease progression for COVID-19: Initial symptoms of fever, dry cough, sore throat and chills were followed by shortness of breath an average of 5.22 days (3.30-7.14) after initial symptom onset, matching the clinical course reported in the medical literature. This study shows that Internet search data can be useful for characterizing the detailed clinical course of a disease. These data are available in real-time at population scale, providing important benefits as a complementary resource for tracking pandemics, especially before widespread laboratory testing is available.
Project description:As the COVID-19 ravaging through the globe, accurate forecasts of the disease spread are crucial for situational awareness, resource allocation, and public health decision-making. Alternative to the traditional disease surveillance data collected by the United States (US) Centers for Disease Control and Prevention (CDC), big data from Internet such as online search volumes also contain valuable information for tracking infectious disease dynamics such as influenza epidemic. In this study, we develop a statistical model using Internet search volume of relevant queries to track and predict COVID-19 pandemic in the United States. Inspired by the strong association between COVID-19 death trend and symptom-related search queries such as "loss of taste", we combine search volume information with COVID-19 time series information for US national level forecasts, while leveraging the cross-state cross-resolution spatial temporal framework, pooling information from search volume and COVID-19 reports across regions for state level predictions. Lastly, we aggregate the state-level frameworks in an ensemble fashion to produce the final state-level 4-week forecasts. Our method outperforms the baseline time-series model, while performing reasonably against other publicly available benchmark models for both national and state level forecast.
Project description:BackgroundReal-time surveillance of search behavior on the internet has achieved accessibility in measuring disease activity. In this study, we systematically assessed the associations between internet search trends of gastrointestinal (GI) symptom terms and daily newly confirmed COVID-19 cases at both global and regional levels.MethodsRelative search volumes (RSVs) of GI symptom terms were derived from internet search engines. Time-series analyses with autoregressive integrated moving average models were conducted to fit and forecast the RSV trends of each GI symptom term before and after the COVID-19 outbreak. Generalized additive models were used to quantify the effects of RSVs of GI symptom terms on the incidence of COVID-19. In addition, dose-response analyses were applied to estimate the shape of the associations.ResultsThe RSVs of GI symptom terms could be characterized by seasonal variation and a high correlation with symptoms of "fever" and "cough" at both global and regional levels; in particular, "diarrhea" and "loss of taste" were abnormally increased during the outbreak period of COVID-19, with elevated point changes of 1.31 and 8 times, respectively. In addition, these symptom terms could effectively predict a COVID-19 outbreak in advance, underlying the lag correlation at 12 and 5 days, respectively, and with mutual independence. The dose-response curves showed a consistent increase in daily COVID-19 risk with increasing search volumes of "diarrhea" and "loss of taste".ConclusionThis is the first and largest epidemiologic study that comprehensively revealed the advanced prediction of COVID-19 outbreaks at both global and regional levels via GI symptom indicators.
Project description:Firearm-related violence is a leading cause of morbidity and mortality and is at the center of a major public health and policy debate in the United States. Despite the critical role of data in informing this debate, accurate and comprehensive data on firearm sales and ownership is not readily available. In this study, we evaluate the potential of using firearm-related internet search queries as a complementary, freely available, and near-real-time data source for tracking firearm sales and ownership that enables analysis at finer geographic and temporal scales. (Here, we examine data by state and by month to compare with other data sources, but search engine volume can be analyzed by city and by the week or by day). We validate search query volume against available data on background checks in all 50 US states, and find that they are highly correlated over time (Pearson's r = 0.96, Spearman's ρ = 0.94) and space (Pearson's r = 0.78, Spearman's ρ = 0.76). We find that stratifying this analysis by gun type (long-gun vs. handgun) increases this correlation dramatically, across both time and space. We also find a positive association between firearm-related search query volume and firearm-related mortality (Pearson's r = 0.87, Spearman's ρ = 0.90), and a negative association with the strength of state-level firearm control policies (Pearson's r = -0.82, Spearman's ρ = -0.83). Based on these findings, we propose a framework for prospective surveillance that incorporates firearm-related internet search volume as a useful complementary data source to inform the public health policy debate on this issue.
Project description:OBJECTIVE:The spread of misinformation has accompanied the coronavirus pandemic, including topics such as immune boosting to prevent COVID-19. This study explores how immune boosting is portrayed on the internet during the COVID-19 pandemic. DESIGN:Content analysis. METHODS:We compiled a dataset of 227 webpages from Google searches in Canada and the USA using the phrase 'boost immunity' AND 'coronavirus' on 1 April 2020. We coded webpages for typology and portrayal of immune boosting and supplements. We recorded mentions of microbiome, whether the webpage was selling or advertising an immune boosting product or service, and suggested strategies for boosting immunity. RESULTS:No significant differences were found between webpages that appeared in the searches in Canada and the USA. The most common types of webpages were from news (40.5%) and commercial (24.7%) websites. The concept of immune boosting was portrayed as beneficial for avoiding COVID-19 in 85.5% of webpages and supplements were portrayed as beneficial in 40% of the webpages, but commercial sites were more likely to have these portrayals. The top immune boosting strategies were vitamin C (34.8%), diet (34.4%), sleep (34.4%), exercise (30.8%) and zinc (26.9%). Less than 10% of the webpages provide any critique of the concept of immune boosting. CONCLUSIONS:Pairing evidence-based advice for maintaining one's health (eg, healthy diet, exercise, sleep) with the phrase immune boosting and strategies lacking in evidence may inadvertently help to legitimise the concept, making it a powerful marketing tool. Results demonstrate how the spread of misinformation is complex and often more subtle than blatant fraudulent claims.
Project description:Google Trends is an online tool that allows measurement of search term popularity on Google, spatially and temporally. While not an epidemiological tool for determining incidence, it can estimate the popularity of a certain disease by search volume over time.1,2 It has previously correlated well with infectious disease incidence and has demonstrated utility in disease forecasting, especially with influenza data.3 We utilized Google Trends to investigate whether search interest in common gastrointestinal (GI) symptoms would correlate with coronavirus disease 2019 (COVID-19) incidence data.
Project description:The COVID-19 outbreak is a global pandemic with community circulation in many countries, including the United States, with confirmed cases in all states. The course of this pandemic will be shaped by how governments enact timely policies and disseminate information and by how the public reacts to policies and information. Here, we examine information-seeking responses to the first COVID-19 case public announcement in a state. Using an event study framework for all US states, we show that such news increases collective attention to the crisis right away. However, the elevated level of attention is short-lived, even though the initial announcements are followed by increasingly strong policy measures. Specifically, searches for "coronavirus" increased by about 36% (95% CI: 27 to 44%) on the day immediately after the first case announcement but decreased back to the baseline level in less than a week or two. We find that people respond to the first report of COVID-19 in their state by immediately seeking information about COVID-19, as measured by searches for coronavirus, coronavirus symptoms, and hand sanitizer. On the other hand, searches for information regarding community-level policies (e.g., quarantine, school closures, testing) or personal health strategies (e.g., masks, grocery delivery, over-the-counter medications) do not appear to be immediately triggered by first reports. These results are representative of the study period being relatively early in the epidemic, and more-elaborate policy responses were not yet part of the public discourse. Further analysis should track evolving patterns of responses to subsequent flows of public information.
Project description:BACKGROUND:Timely allocation of medical resources for coronavirus disease (COVID-19) requires early detection of regional outbreaks. Internet browsing data may predict case outbreaks in local populations that are yet to be confirmed. OBJECTIVE:We investigated whether search-engine query patterns can help to predict COVID-19 case rates at the state and metropolitan area levels in the United States. METHODS:We used regional confirmed case data from the New York Times and Google Trends results from 50 states and 166 county-based designated market areas (DMA). We identified search terms whose activity precedes and correlates with confirmed case rates at the national level. We used univariate regression to construct a composite explanatory variable based on best-fitting search queries offset by temporal lags. We measured the raw and z-transformed Pearson correlation and root-mean-square error (RMSE) of the explanatory variable with out-of-sample case rate data at the state and DMA levels. RESULTS:Predictions were highly correlated with confirmed case rates at the state (mean r=0.69, 95% CI 0.51-0.81; median RMSE 1.27, IQR 1.48) and DMA levels (mean r=0.51, 95% CI 0.39-0.61; median RMSE 4.38, IQR 1.80), using search data available up to 10 days prior to confirmed case rates. They fit case-rate activity in 49 of 50 states and in 103 of 166 DMA at a significance level of .05. CONCLUSIONS:Identifiable patterns in search query activity may help to predict emerging regional outbreaks of COVID-19, although they remain vulnerable to stochastic changes in search intensity.
Project description:DNA methylation is an epigenetic modification, influenced by both genetic and environmental variation, that plays a key role in transcriptional regulation and many organismal phenotypes. Although patterns of DNA methylation have been shown to differ between human populations, it remains to be determined how epigenetic diversity relates to the patterns of genetic and gene expression variation at a global scale. Here we measured DNA methylation at 485,000 CpG sites in five diverse human populations, and analyzed these data together with genome-wide genotype and gene expression data. We found that population-specific DNA methylation mirrors genetic variation, and has greater local genetic control than mRNA levels. We estimated the rate of epigenetic divergence between populations, which indicates far greater evolutionary stability of DNA methylation in humans than has been observed in plants. This study provides a deeper understanding of worldwide patterns of human epigenetic diversity, as well as initial estimates of the rate of epigenetic divergence in recent human evolution.