- 作者列表："Radon K","Saathoff E","Pritsch M","Guggenbühl Noller JM","Kroidl I","Olbrich L","Thiel V","Diefenbach M","Riess F","Forster F","Theis F","Wieser A","Hoelscher M","KoCo19 collaboration group.
BACKGROUND:Due to the SARS-CoV-2 pandemic, public health interventions have been introduced globally in order to prevent the spread of the virus and avoid the overload of health care systems, especially for the most severely affected patients. Scientific studies to date have focused primarily on describing the clinical course of patients, identifying treatment options and developing vaccines. In Germany, as in many other regions, current tests for SARS-CoV2 are not conducted on a representative basis and in a longitudinal design. Furthermore, knowledge about the immune status of the population is lacking. Nonetheless, these data are needed to understand the dynamics of the pandemic and hence to appropriately design and evaluate interventions. For this purpose, we recently started a prospective population-based cohort in Munich, Germany, with the aim to develop a better understanding of the state and dynamics of the pandemic. METHODS:In 100 out of 755 randomly selected constituencies, 3000 Munich households are identified via random route and offered enrollment into the study. All household members are asked to complete a baseline questionnaire and subjects ≥14 years of age are asked to provide a venous blood sample of ≤3 ml for the determination of SARS-CoV-2 IgG/IgA status. The residual plasma and the blood pellet are preserved for later genetic and molecular biological investigations. For twelve months, each household member is asked to keep a diary of daily symptoms, whereabouts and contacts via WebApp. If symptoms suggestive for COVID-19 are reported, family members, including children < 14 years, are offered a pharyngeal swab taken at the Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, for molecular testing for SARS-CoV-2. In case of severe symptoms, participants will be transferred to a Munich hospital. For one year, the study teams re-visits the households for blood sampling every six weeks. DISCUSSION:With the planned study we will establish a reliable epidemiological tool to improve the understanding of the spread of SARS-CoV-2 and to better assess the effectiveness of public health measures as well as their socio-economic effects. This will support policy makers in managing the epidemic based on scientific evidence.
背景: 由于SARS-CoV-2 大流行，为了防止病毒的传播和避免卫生保健系统负担过重，全球范围内已经开始采取公共卫生干预措施。特别是对于受影响最严重的患者。迄今为止的科学研究主要集中在描述患者的临床过程，确定治疗方案和开发疫苗。在德国，与许多其他地区一样，目前的SARS-CoV2 测试没有在代表性基础上和纵向设计中进行。此外，缺乏关于人群免疫状况的知识。尽管如此，需要这些数据来了解大流行的动态，从而适当设计和评估干预措施。为此，我们最近在德国慕尼黑启动了一个基于人群的前瞻性队列，目的是更好地了解大流行的状态和动态。 方法: 在随机选择的 100 个选区中的 755 个选区中，通过随机途径确定了 3000 个慕尼黑家庭，并提供入组研究。要求所有家庭成员完成基线问卷，并要求 ≥ 14 岁的受试者提供 ≤ 3 ml的静脉血样本，以确定SARS-CoV-2 IgG/IgA状态。残留的血浆和血球被保存下来，用于以后的遗传和分子生物学研究。十二个月来，每个家庭成员都被要求通过WebApp记录每日症状、下落和联系人。如果有提示新型冠状病毒肺炎的症状报告，家庭成员，包括 <14 岁的儿童，可以在慕尼黑LMU大学医院传染病和热带医学部采集咽拭子，用于SARS-CoV-2 的分子检测。如果症状严重，参与者将被转移到慕尼黑医院。在一年的时间里，研究小组每六周重新访问一次家庭进行血液采样。 讨论: 通过计划中的研究，我们将建立一个可靠的流行病学工具，以提高对SARS-CoV-2 传播的认识，并更好地评估公共卫生措施的有效性及其社会经济影响。这将支持决策者根据科学证据管理疫情。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.