Analysis of the Transmissibility Change of 2019-Novel Coronavirus Pneumonia and Its Potential Factors in China from 2019 to 2020.
- 作者列表："Zhao Y","Wang R","Li J","Zhang Y","Yang H","Zhao Y
Background:Recently, a large-scale novel coronavirus pneumonia (NCP) outbreak swept China. As of Feb. 9, 2020, a total of 40,260 patients have been diagnosed with NCP, and 23,589 patients were suspected to have infected by the 2019 novel coronavirus (COVID-19), which puts forward a great challenge for public health and clinical treatment in China. Until now, we are in the high-incidence season of NCP. Thus, the analysis of the transmissibility change of NCP and its potential factors may provide a reliable reference for establishing effective prevention and control strategies. Method:By means of the method of calculating the instantaneous basic reproduction number R0t proposed by Cori et al. (2013), we use R0t to describe the transmissibility change of COVID-19 in China, 2019-2020. In addition, the Baidu Index (BDI) and Baidu Migration Scale (BMS) were selected to measure the public awareness and the effect of Wuhan lockdown (restricted persons in Wuhan outflow from the epidemic area) strategy, respectively. The Granger causality test (GCT) was carried out to explore the association between public awareness, the effect of the Wuhan lockdown strategy, and the transmissibility of COVID-19. Results:The estimated averaged basic reproduction number of NCP in China was 3.44 with 95% CI (2.87, 4.0) during Dec. 8, 2019, to Feb. 9, 2020. The instantaneous basic reproduction numbers (R0t ) have two waves and reaching peaks on Jan. 8 and Jan. 27, respectively. After reaching a peak on Jan. 27, R0t showed a continuous decline trend. On Feb. 9, R0t has fallen to 1.68 (95% CI: 1.66, 1.7), but it is still larger than 1. We find a significantly negative association between public awareness and the transmissibility change of COVID-19, with one unit increase in cumulative BDI leading to a decrease of 0.0295% (95% CI: 0.0077, 0.051) R0t . We also find a significantly negative association between the effect of the Wuhan lockdown strategy and the transmissibility change of COVID-19, and a one unit decrease in BMS may lead to a drop of 2.7% (95% CI: 0.382, 4.97) R0t . Conclusion:The current prevention and control measures have effectively reduced the transmissibility of COVID-19; however, R0t is still larger than the threshold 1. The results show that the government adopting the Wuhan lockdown strategy plays an important role in restricting the potential infected persons in Wuhan outflow from the epidemic area and avoiding a nationwide spread by quickly controlling the potential infection in Wuhan. Meanwhile, since Jan. 18, 2020, the people successively accessed COVID-19-related information via the Internet, which may help to effectively implement the government's prevention and control strategy and contribute to reducing the transmissibility of NCP. Therefore, ongoing travel restriction and public health awareness remain essential to provide a foundation for controlling the outbreak of COVID-19.
背景: 最近，一场大规模的新型冠状病毒肺炎(NCP) 爆发席卷中国。截至 2020 年 2 月 9 日，共有 40,260 名患者被诊断为NCP，23,589 至新型冠状病毒 (新型冠状病毒肺炎) 疑似感染 2019 名患者，这对我国的公共卫生和临床治疗提出了巨大的挑战。到目前为止，我们正处于NCP的高发季节。因此，分析NCP的传染性变化及其潜在影响因素，可为制定有效的防控策略提供可靠的参考依据。 方法: 采用Cori等 (2013) 提出的计算瞬时基本再生数R0t的方法，用R0t描述中国传染性的新型冠状病毒肺炎变化，2019-2020。此外，百度指数 (BDI) 和百度 (Baidu) 迁移量表 (BMS) 分别选取的公众意识和对武汉锁定状态 (受限人员武汉流出疫区) 策略，分别。采用Granger因果关系检验 (GCT) 探讨了公众意识、武汉封锁战略效果与传染性新型冠状病毒肺炎之间的关系。 结果: 在 2019 年 12 月 8 日至 20 20 年 2 月 9 日期间，中国NCP的估计平均基本再现数为 3.44，95% CI (2.87，4.0)。瞬时基本再生数 (R0t) 有两个波，分别在 1 月 8 日和 1 月 27 日达到峰值。在 1 月 27 日达到峰值后，R0t呈持续下降趋势。2 月 9 日，R0t已降至 1.68 (95% CI: 1.66，1.7)，但仍大于 1。我们发现公众意识与传染性变化新型冠状病毒肺炎显著负相关，累积BDI增加一个单位导致下降 0.0295% (95% CI: 0.0077，0.051) R0t。我们还发现武汉封锁策略的效果与传染性变化新型冠状病毒肺炎显著负相关，BMS减少一个单位可能导致 2.7% 的下降 (95% CI: 0.382，4.97) R0t。 结论: 现行的防控措施有效地降低了传染性的新型冠状病毒肺炎，R0t仍然大于阈值 1。结果表明，政府采取武汉封锁战略，通过快速控制武汉地区的潜在感染，对限制武汉地区潜在感染者从疫区流出，避免在全国范围内传播具有重要作用。武汉。同时，自 2020 年 1 月 18 日起，人民群众通过互联网陆续访问COVID-19-related信息，这可能有助于有效实施政府的防控策略，并有助于降低NCP的传染性。因此，持续的旅行限制和公众健康意识仍然是控制新型冠状病毒肺炎疫情的基础。
METHODS::The antimicrobial functions of neutrophils are facilitated by a defensive armamentarium of proteins stored in granules, and by the formation of neutrophil extracellular traps (NETs). However, the toxic nature of these structures poses a threat to highly vascularized tissues, such as the lungs. Here, we identified a cell-intrinsic program that modified the neutrophil proteome in the circulation and caused the progressive loss of granule content and reduction of the NET-forming capacity. This program was driven by the receptor CXCR2 and by regulators of circadian cycles. As a consequence, lungs were protected from inflammatory injury at times of day or in mouse mutants in which granule content was low. Changes in the proteome, granule content and NET formation also occurred in human neutrophils, and correlated with the incidence and severity of respiratory distress in pneumonia patients. Our findings unveil a 'disarming' strategy of neutrophils that depletes protein stores to reduce the magnitude of inflammation.
METHODS::Pneumonia is a common respiratory infectious disease that involves the inflammation of the pulmonary parenchyma. Periodontal disease is widespread and correlated with pneumonia. However, the relationship between periodontal treatment and clinical infectious outcomes in patients with pneumonia has remained undetermined. The aim of this study was to investigate the association between periodontal treatment and the risk of pneumonia events in the Taiwanese population. A nationwide population-based cohort study was conducted using data from the Taiwanese National Health Insurance Research Database (NHIRD). A total of 49,400 chronic periodontitis patients who received periodontal treatment from 2001 to 2012 were selected. In addition, 49,400 healthy individuals without periodontal diseases were picked randomly from the general population after propensity score matching according to age, gender, monthly income, urbanization, and comorbidities. The Cox proportional hazard regression analysis was adopted to assess the hazard ratio (HR) of pneumonia between the periodontal treatment cohort and the comparison cohort. The average ages of the periodontal treatment and comparison groups were 44.25 ± 14.82 years and 44.15 ± 14.5 years, respectively. The follow up durations were 7.66 and 7.41 years for the periodontal treatment and comparison groups, respectively. We found 2504 and 1922 patients with newly diagnosed pneumonia in the comparison cohort and the periodontal treatment cohort, respectively. The Kaplan-Meier plot revealed that the cumulative incidence of pneumonia was significantly lower over the 12 year follow-up period in the periodontal treatment group (using the log-rank test, p < 0.001). In conclusion, this nationwide population-based study indicated that the patients with periodontal treatment exhibited a significantly lower risk of pneumonia than the general population.
METHODS:OBJECTIVE:To describe the treatment of community-acquired pneumonia (CAP) in children under five years in Tanzania. METHODS:Between January and December 2017, children aged 2-59 months with chest radiography-confirmed CAP were enrolled. The parents were interviewed to collect information on the patients and home-based medication. Clinical information was derived from the patient files. Nasopharyngeal swab and blood samples were collected for isolation of the causative pathogens. Swab samples were analysed by quantitative PCR whereas blood samples were tested using BacT/Alert 3D. RESULTS:Overall, 109 children with CAP were included in this analysis. Provision of care to most children was delayed (median = 4.6 days). A quarter (26.6%) were given unprescribed/leftover antibiotics at home. Only one child had positive bacterial culture. Referrals were associated with nasopharyngeal carriage of Streptococcus pneumoniae (p = 0.003) and Haemophilus influenzae (p = 0.004). Of all admitted children, more than a quarter (n = 29) did not need to be hospitalised and inappropriately received injectable instead of oral antibiotics. CONCLUSION:We found high rates of home treatment, particularly with antibiotics. Appropriate health care was delayed for most children because of home treatment. Efforts are needed at the community level to improve awareness of antimicrobial resistance.