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Epidemiology of the 2020 Pandemic of COVID-19 in the State of Texas: The First Month of Community Spread.
德克萨斯州 2020 大流行新型冠状病毒肺炎流行病学社区传播的第一个月。
- 影响因子:1.78
- DOI:10.1007/s10900-020-00854-4
- 作者列表:"Khose S","Moore JX","Wang HE
- 发表时间:2020-08-01
Abstract
:The pandemic of novel Coronavirus (SARS-CoV-2) is currently spreading rapidly across the United States. We provide a comprehensive overview of COVID-19 epidemiology across the state of Texas, which includes vast rural & vulnerable communities that may be disproportionately impacted by the spread of this new disease. All 254 Texas counties were included in this study. We examined the geographic variation of COVID-19 from March 1 through April 8, 2020 by extracting data on incidence and case fatality from various national and state datasets. We contrasted incidence and case fatality rates by county-level demographic and healthcare resource factors. Counties which are part of metropolitan regions, such as Harris and Dallas, experienced the highest total number of confirmed cases. However, the highest incidence rates per 100,000 population were in found in counties of Donley (353.5), Castro (136.4), Matagorda (114.4) and Galveston (93.4). Among counties with greater than 10 cases, the highest CFR were observed in counties of Comal (10.3%), Hockley (10%), Hood (10%), and Castro (9.1%). Counties with the highest CFR (> 10%) had a higher proportion of non-Hispanic Black residents, adults aged 65 and older, and adults smoking, but lower number of ICU beds per 100,000 population, and number of primary care physicians per 1000 population. Although the urban areas of Texas account for the majority of COVID-19 cases, the higher case-fatality rates and low health care capacity in rural areas need attention.
摘要
: 新型冠状病毒 (SARS-CoV-2) 大流行目前正在美国各地迅速蔓延。我们提供了一个全面的概述新型冠状病毒肺炎流行病学在德克萨斯州,包括广大农村 & 脆弱社区可能不成比例地受到传播这一新的疾病.所有 254 个德克萨斯州县都被纳入本研究。我们通过从各种国家和州数据集中提取发病率和病死率数据,检查了COVID-1 9 从 2020 年 3 月 1 日至 4 月 8 日的地理变异。我们通过县级人口和医疗资源因素对比了发病率和病死率。作为大都市地区一部分的县,如哈里斯和达拉斯,经历了最高的确诊病例总数。然而,每 100,000 人口中发病率最高的是Donley (353.5) 、Castro (136.4) 、Matagorda (114.4) 和Galveston (93.4)。在病例大于 10 的县中,CFR最高的是Comal (10.3%) 、Hockley (10%) 、Hood (10%) 和Castro (9.1%)。CFR最高 (> 10%) 的县非西班牙裔黑人居民、 65 岁及以上的成年人以及吸烟的成年人的比例较高,但每 100,000 人口的ICU床位数量和每 1000 人口的初级保健医生数量较低。虽然德克萨斯州的城市地区占新型冠状病毒肺炎病例的大多数,但农村地区较高的病死率和较低的卫生保健能力需要关注。
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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.
呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。