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Chung MH, Chua GT, Leung D, Chan KW, Nicholls J, Lau YL. Fatal SARS in X-Linked Lymphoproliferative Disease Type 1: A Case Report. Front Pediatr 2022; 10:794110. [PMID: 35498795 PMCID: PMC9047755 DOI: 10.3389/fped.2022.794110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/14/2022] [Indexed: 12/31/2022] Open
Abstract
X-linked lymphoproliferative disease (XLP1) is an inborn error of immunity (IEI) with severe immune dysregulation caused by a mutation in the SH2D1A gene resulting in the absence or dysfunction of signaling lymphocytic activation molecule (SLAM)-associated protein (SAP). The severe acute respiratory syndrome (SARS) caused by SARS-coronavirus (CoV), a highly pathogenic CoV, has been shown to only cause mild diseases in Asian children. We report on a 5-year-old Nepalese boy with agammaglobulinemia and probable SARS who died of diffuse alveolar damage 22 days after admission amid the SARS outbreak. The index patient and his younger brother were genetically confirmed to have XLP1. In the current coronavirus disease 2019 (COVID-19) pandemic, most children also had mild disease only. Children with severe COVID-19 would warrant investigations for underlying IEI, particularly along the pathways leading to immune dysregulation.
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Affiliation(s)
- Ming Hin Chung
- Department of Pediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Gilbert T Chua
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Daniel Leung
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Koon Wing Chan
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - John Nicholls
- Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yu Lung Lau
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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2
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Curreli F, Ahmed S, Victor SMB, Drelich A, Panda SS, Altieri A, Kurkin AV, Tseng CK, Hillyer CD, Debnath AK. Discovery of Highly Potent Fusion Inhibitors with Potential Pan-Coronavirus Activity That Effectively Inhibit Major COVID-19 Variants of Concern (VOCs) in Pseudovirus-Based Assays. Viruses 2021; 14:69. [PMID: 35062273 DOI: 10.3390/v14010069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/26/2021] [Accepted: 12/29/2021] [Indexed: 12/30/2022] Open
Abstract
We report the discovery of several highly potent small molecules with low-nM potency against severe acute respiratory syndrome coronavirus (SARS-CoV; lowest half-maximal inhibitory concentration (IC50: 13 nM), SARS-CoV-2 (IC50: 23 nM), and Middle East respiratory syndrome coronavirus (MERS-CoV; IC50: 76 nM) in pseudovirus-based assays with excellent selectivity index (SI) values (>5000), demonstrating potential pan-coronavirus inhibitory activities. Some compounds showed 100% inhibition against the cytopathic effects (CPE; IC100) of an authentic SARS-CoV-2 (US_WA-1/2020) variant at 1.25 µM. The most active inhibitors also potently inhibited variants of concern (VOCs), including the UK (B.1.1.7) and South African (B.1.351) variants and the Delta variant (B.1.617.2) originally identified in India in pseudovirus-based assay. Surface plasmon resonance (SPR) analysis with one potent inhibitor confirmed that it binds to the prefusion SARS-CoV-2 spike protein trimer. These small-molecule inhibitors prevented virus-mediated cell-cell fusion. The absorption, distribution, metabolism, and excretion (ADME) data for one of the most active inhibitors, NBCoV1, demonstrated drug-like properties. An in vivo pharmacokinetics (PK) study of NBCoV1 in rats demonstrated an excellent half-life (t1/2) of 11.3 h, a mean resident time (MRT) of 14.2 h, and oral bioavailability. We expect these lead inhibitors to facilitate the further development of preclinical and clinical candidates.
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Abstract
BACKGROUND The outbreak of coronavirus disease 2019 (COVID-19), like severe acute respiratory syndrome (SARS), provokes fear, anxiety and depression in the public, which further affects mental health issues. Taiwan has used their experience of the SARS epidemic for the management of foreseeable problems in COVID-19 endemic. AIM/OBJECTIVE This review summarizes issues concerning mental health problems related to infectious diseases from current literatures. RESULTS In suspected cases under quarantine, confirmed cases in isolation and their families, health care professionals, and the general population and related effective strategies to reduce these mental health issues, such as helping to identify stressors and normalizing their impact at all levels of response as well as public information and communication messages by electronic devices. The importance of community resilience was also addressed. Psychological first aid, psychological debriefing, mental health intervention and psychoeducation were also discussed. Issues concerning cultures and religions are also emphasized in the management plans. CONCLUSION Biological disaster like SARS and COVID-19 not only has strong impact on mental health in those being infected and their family, friends, and coworkers, but also affect wellbeing in general public. There are evidenced that clear and timely psychoeducation, psychological first aid and psychological debriefing could amileorate negative impact of disaster, thus might also be helpful amid COVID-19 pandemic.
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Affiliation(s)
- Kuan-Ying Hsieh
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City
| | - Wei-Tsung Kao
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City.,Department of Sports, Health and Leisure and Graduate Institute of Sports, Health and Leisure, Cheng Shiu University, Kaohsiung City
| | - Dian-Jeng Li
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City
| | - Wan-Chun Lu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City
| | - Kuan-Yi Tsai
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City
| | - Wei-Jen Chen
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City.,Graduate Institute of Counseling Psychology and Rehabilitation Counseling, National Kaohsiung Normal University, Kaohsiung City
| | - Li-Shiu Chou
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City
| | - Joh-Jong Huang
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung City
| | - Su-Ting Hsu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City.,Graduate Institute of Counseling Psychology and Rehabilitation Counseling, National Kaohsiung Normal University, Kaohsiung City
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von Overbeck J. Insurance and Epidemics: SARS, West Nile Virus and Nipah Virus. J Insur Med 2021; 49:37-45. [PMID: 33971002 DOI: 10.17849/insm-49-1-37-45.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Severe acute respiratory syndrome (SARS) reminds us that sudden disease emergence is a permanent part of our world-and should be anticipated in our planning. Historically the emergence of new diseases has had little or no impact beyond a small, localized cluster of infections. However, given just the right conditions, a highly virulent pathogen can suddenly spread across time and space with massive consequences, as has occurred on several occasions in human history. In the wake of the SARS outbreak, we are now forced to confront the unpleasant fact that human activities are increasing the frequency and severity of these kinds of emergences. The idea of more frequent biological ''invasions'' with economic and societal impacts comparable to SARS, presents stakeholders in the global economy with unprecedented new risks, challenges and even opportunities. As a major contributor to economic stability, the insurance industry must follow these trends very closely and develop scenarios to anticipate these events.
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5
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Abstract
Coronaviruses, seven of which are known to infect humans, can cause a spectrum of clinical presentations ranging from asymptomatic infection to severe illness and death. Four human coronaviruses (hCoVs)-229E, HKU1, NL63 and OC43-circulate globally, commonly infect children and typically cause mild upper respiratory tract infections. Three novel coronaviruses of zoonotic origin have emerged during the past two decades: severe acute respiratory syndrome coronavirus (SARS-CoV-1), Middle East respiratory syndrome coronavirus (MERS-CoV) and the recently discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which is the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic. These novel coronaviruses are known to cause severe illness and death predominantly in older adults and those with underlying comorbidities. Consistent with what has been observed during the outbreaks of SARS and MERS, children with COVID-19 are more likely to be asymptomatic or to have mild-to-moderate illness, with few deaths reported in children globally thus far. Clinical symptoms and laboratory and radiological abnormalities in children have been similar to those reported in adults but are generally less severe. A rare multisystem inflammatory syndrome in children (MIS-C) which has resulted in critical illness and some deaths has recently been described. Clinical trials for therapeutics and vaccine development should include paediatric considerations. Children may play an important role in the transmission of infection and outbreak dynamics and could be a key target population for effective measures to control outbreaks. The unintended consequences of the unprecedented scale and duration of pandemic control measures for children and families around the world should be carefully examined.Abbreviations: 2019-nCoV, 2019 novel coronavirus; ADEM, acute demyelinating encephalomyelitis; AAP, American Academy of Pediatrics; ACE-2, angiotensin-converting enzyme 2; ARDS, acute respiratory distress syndrome; BCG, bacillus Calmette-Guérin; BNP, brain natriuretic peptide; CDC, Centers for Disease Control and Prevention; CRP, C-reactive protein; CSF, cerebrospinal fluid; COVID-19, coronavirus disease 2019; CT, computed tomography; CXR, chest X-ray; DOL, day of life; hCoV, human coronavirus; ICU, intensive care unit; IL, interleukin; IVIG, intravenous immunoglobulin; KD, Kawasaki disease; LDH, lactate dehydrogenase; MERS, Middle East respiratory syndrome; MERS-CoV, Middle East respiratory syndrome coronavirus; MEURI, monitored emergency use of unregistered and experimental interventions; MIS-C, multi-system inflammatory syndrome in children; PCR, polymerase chain reaction; PICU, paediatric intensive care unit; RNA, ribonucleic acid; RCT, randomised-controlled trial; RSV, respiratory syncytial virus; SARS, severe acute respiratory syndrome; SARS-CoV-1, severe acute respiratory syndrome coronavirus 1; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TNF-alpha, tumour necrosis factor alpha; UK United Kingdom; UNICEF, United Nations Children's Fund; USA, United States of America; WHO, World Health Organization.
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Affiliation(s)
- Nipunie Rajapakse
- Division of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Devika Dixit
- Division of Infectious Diseases, Department of Pediatrics and Internal Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Abstract
Lithium salts have been in the therapeutic toolbox for better or worse since the 19th century, with purported benefit in gout, hangover, insomnia, and early suggestions that lithium improved psychiatric disorders. However, the remarkable effects of lithium reported by John Cade and subsequently by Mogens Schou revolutionized the treatment of bipolar disorder. The known molecular targets of lithium are surprisingly few and include the signaling kinase glycogen synthase kinase-3 (GSK-3), a group of structurally related phosphomonoesterases that includes inositol monophosphatases, and phosphoglucomutase. Here we present a brief history of the therapeutic uses of lithium and then focus on GSK-3 as a therapeutic target in diverse diseases, including bipolar disorder, cancer, and coronavirus infections.
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Affiliation(s)
| | | | - Peter S. Klein
- Department of Medicine, Perelman School of Medicine,
University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, USA; (M.E.S.); (R.S.B.)
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Joseph S, Nair B, Nath LR. The Ineluctable Role of ACE-2 Receptors in SARS COV-2 Infection and Drug Repurposing as a Plausible SARS COV-2 Therapy: A Concise Treatise. Curr Mol Med 2021; 21:888-913. [PMID: 33563197 DOI: 10.2174/1573405617666210204212024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 02/08/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent for the COVID-19 infectious disease that spreads via the respiratory route and has reached a drastic level of a global pandemic. Symptoms of COVID-19 may vary from mild (fever, dry cough, shortness of breath) to severe pneumonia-like respiratory symptoms as exacerbation of disease occurs. Unlike SARS-CoV, the SARSCoV- 2 has a higher binding affinity to ACE-2 receptors, which signifies its higher transmission rate from person to person. Even though ACE-2 is significant in the reninangiotensin- aldosterone system (RAAS) regulation that exhibits protection to various organs, it plays a significant role in COVID-19 disease pathogenesis. Viral interferences with the ACE-2 peptidase activity are found in SARS-CoV-2 infected patients leading to pro-inflammatory responses, hypertension and multi-organ damage. Angiotensinconverting enzyme-2 is constrained to a variety of organ systems, but surface ACE-2 receptors on lung epithelia are largely affected, which lead to pathological alterations in lung histology which may progress to respiratory failure. The viral tropism mainly occurs by the attachment to the angiotensin-converting enzymes-2 receptors in the host cell; thus drugs targeting ACE-2 expressions may arise as the future therapeutic strategy to combat COVID-19 infections. The innovative approach of repurposing drugs has shown temporary effectiveness to curb the rising pandemic. This article mainly focuses on the prominence of ACE-2 receptors which are expressed during the COVID infections and the repurposing strategy of available drug therapies.
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Affiliation(s)
- Sherin Joseph
- Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Ponekkara P.O., Kochi, Kerala 682041, India
| | - Bhagyalakshmi Nair
- Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Ponekkara P.O., Kochi, Kerala 682041, India
| | - Lekshmi R Nath
- Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Ponekkara P.O., Kochi, Kerala 682041, India
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Pang XC, Zhang HX, Zhang Z, Rinkiko S, Cui YM, Zhu YZ. The Two-Way Switch Role of ACE2 in the Treatment of Novel Coronavirus Pneumonia and Underlying Comorbidities. Molecules 2020; 26:E142. [PMID: 33396184 DOI: 10.3390/molecules26010142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 01/11/2023] Open
Abstract
December 2019 saw the emergence of the coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which has spread across the globe. The high infectivity and ongoing mortality of SARS-CoV-2 emphasize the demand of drug discovery. Angiotensin-converting enzyme II (ACE2) is the functional receptor for SARS-CoV-2 entry into host cells. ACE2 exists as a membrane-bound protein on major viral target pulmonary epithelial cells, and its peptidase domain (PD) interacts SARS-CoV-2 spike protein with higher affinity. Therefore, targeting ACE2 is an important pharmacological intervention for a SARS-CoV-2 infection. In this review, we described the two-way switch role of ACE2 in the treatment of novel coronavirus pneumonia and underlying comorbidities, and discussed the potential effect of the ACE inhibitor and angiotensin receptor blocker on a hypertension patient with the SARS-CoV-2 infection. In addition, we analyzed the S-protein-binding site on ACE2 and suggested that blocking hot spot-31 and hot spot-353 on ACE2 could be a therapeutic strategy for preventing the spread of SARS-CoV-2. Besides, the recombinant ACE2 protein could be another potential treatment option for SARS-CoV-2 induced acute severe lung failure. This review could provide beneficial information for the development of anti-SARS-CoV-2 agents via targeting ACE2 and the clinical usage of renin-angiotensin system (RAS) drugs for novel coronavirus pneumonia treatment.
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Chang PC, Yang CC, Kao KC, Wen MS. Clinical outcomes of patients hospitalized for COVID-19 versus SARS: a meta-analysis. Aging (Albany NY) 2020; 12:24552-24569. [PMID: 33229624 PMCID: PMC7803544 DOI: 10.18632/aging.104139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/18/2020] [Indexed: 12/15/2022]
Abstract
Estimating the case-fatality rate and clinical outcomes for patients with coronavirus disease 2019 (COVID-19) is crucial because health care systems must adequately prepare for outbreaks and design appropriate policies. A systematic search of PubMed, Embase, and Medline+Journal (via OVID) were conducted for relevant journal publications from database inception to May 4, 2020. Articles that reported the fatality rates and clinical outcomes of patients hospitalized for COVID-19 or severe acute respiratory syndrome (SARS) infection were included. Nine clinical reports (four SARS reports and five COVID-19 reports) with a total of 851 patients (367 and 484 patients with SARS and COVID-19, respectively) were analyzed. A greater proportion of hospitalized patients with COVID-19 had bilateral pneumonia (90.0% [76.3%-96.2%] vs. 35.9% [21.4%-53.6%], p < 0.001) and required ventilators (23.8% [18.8%-29.6%] vs. 15.3% [11.9%-19.4%], p = 0.010) compared with hospitalized patients with SARS. The case-fatality rate was 9.5% (6.5%-13.7%) and 6.1% (3.5%-10.3%) among patients with COVID-19 and SARS, respectively (p = 0.186). The case-fatality rate among hospitalized patients with COVID-19 was comparable to that during the 2003 SARS outbreak. A higher incidence of bilateral pneumonia and increased ventilator usage were noted among patients with COVID-19 compared with patients with SARS.
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Affiliation(s)
- Po-Cheng Chang
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Medical School, Taoyuan, Taiwan
| | - Chien-Chang Yang
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Medical School, Taoyuan, Taiwan
| | - Kuo-Chin Kao
- Division of Thoracic Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Medical School, Taoyuan, Taiwan
| | - Ming-Shien Wen
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Medical School, Taoyuan, Taiwan
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Zhang ZL, Zhong H, Liu YX, Le KJ, Cui M, Yu YT, Gu ZC, Gao Y, Lin HW. Current therapeutic options for coronavirus disease 2019 (COVID-19)-lessons learned from severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) therapy: a systematic review protocol. Ann Transl Med 2020; 8:1527. [PMID: 33313272 PMCID: PMC7729372 DOI: 10.21037/atm-20-2340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Coronavirus disease 2019 (COVID-19), also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, first manifested in December 2019, and spread rapidly worldwide. Facing this lethal disease, there is an urgent need to develop potent therapies against SARS-CoV-2 infection. SARS-CoV-2 phylogenetically and symptomatically resembles SARS-CoV and Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Numerous agents have been utilised during the severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) epidemics, which may show some benefit against SARS-CoV-2. Methods MEDLINE, EMBASE, Cochrane Library, CBM Disc, China National Knowledge Infrastructure, Wanfang Data, and the China Science and Technology Journal Database will be searched. Manual searches will be conducted by searching pre-printing websites, clinical trial registers, and screening the reference lists of inclusive studies. The screening of all citations and the selection of inclusive articles will be conducted by two reviewers. Randomised controlled trials (RCTs) and controlled cohort studies reporting antiviral therapies, including ribavirin, remdesivir, lopinavir/ritonavir, arbidol, chloroquine, hydroxychloroquine, and interferon, for SARS, MERS, and COVID-19 will be included. The primary outcomes will be mortality, incidence of acute respiratory distress syndrome, and utilisation of mechanical ventilation and intensive care unit admission. The secondary outcomes will be improvement in symptoms and chest radiography results, virus clearance, changes in blood test results, and serum tests. The quality of the retrieved RCTs and observational studies will be appraised according to the Cochrane risk of bias tool and the Newcastle-Ottawa Scale, respectively. If feasible, we will perform a fixed- or random-effects meta-analysis. Discussion This systematic review and meta-analysis will summarise all the available evidence for the efficacy and safety of current therapeutic options in SARS-CoV, MERS-CoV, or SARS-CoV-2-infected patients. The findings of this study may inform subsequent antiviral interventions for patients with COVID-19. Study registration The protocol of this study has been submitted to the PROSPERO platform (https://www.crd.york.ac.uk/PROSPERO/), and the registration number is CRD42020168639.
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Affiliation(s)
- Zai-Li Zhang
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Han Zhong
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yang-Xi Liu
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ke-Jia Le
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Min Cui
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yue-Tian Yu
- Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhi-Chun Gu
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuan Gao
- Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hou-Wen Lin
- Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Lee KH, Yoon S, Jeong GH, Kim JY, Han YJ, Hong SH, Ryu S, Kim JS, Lee JY, Yang JW, Lee J, Solmi M, Koyanagi A, Dragioti E, Jacob L, Radua J, Smith L, Oh H, Tizaoui K, Cargnin S, Terrazzino S, Ghayda RA, Kronbichler A, Shin JI. Efficacy of Corticosteroids in Patients with SARS, MERS and COVID-19: A Systematic Review and Meta-Analysis. J Clin Med 2020; 9:jcm9082392. [PMID: 32726951 PMCID: PMC7465945 DOI: 10.3390/jcm9082392] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/27/2020] [Accepted: 06/29/2020] [Indexed: 12/27/2022] Open
Abstract
(1) Background: The use of corticosteroids in critical coronavirus infections, including severe acute respiratory syndrome (SARS), Middle East Respiratory Syndrome (MERS), or Coronavirus disease 2019 (COVID-19), has been controversial. However, a meta-analysis on the efficacy of steroids in treating these coronavirus infections is lacking. (2) Purpose: We assessed a methodological criticism on the quality of previous published meta-analyses and the risk of misleading conclusions with important therapeutic consequences. We also examined the evidence of the efficacy of corticosteroids in reducing mortality in SARS, MERS and COVID-19. (3) Methods: PubMed, MEDLINE, Embase, and Web of Science were used to identify studies published until 25 April 2020, that reported associations between steroid use and mortality in treating SARS/MERS/COVID-19. Two investigators screened and extracted data independently. Searches were restricted to studies on humans, and articles that did not report the exact number of patients in each group or data on mortality were excluded. We calculated odds ratios (ORs) or hazard ratios (HRs) under the fixed- and random-effect model. (4) Results: Eight articles (4051 patients) were eligible for inclusion. Among these selected studies, 3416 patients were diagnosed with SARS, 360 patients with MERS, and 275 with COVID-19; 60.3% patients were administered steroids. The meta-analyses including all studies showed no differences overall in terms of mortality (OR 1.152, 95% CI 0.631–2.101 in the random effects model, p = 0.645). However, this conclusion might be biased, because, in some studies, the patients in the steroid group had more severe symptoms than those in the control group. In contrast, when the meta-analysis was performed restricting only to studies that used appropriate adjustment (e.g., time, disease severity), there was a significant difference between the two groups (HR 0.378, 95% CI 0.221–0.646 in the random effects model, p < 0.0001). Although there was no difference in mortality when steroids were used in severe cases, there was a difference among the group with more underlying diseases (OR 3.133, 95% CI 1.670–5.877, p < 0.001). (5) Conclusions: To our knowledge, this study is the first comprehensive systematic review and meta-analysis providing the most accurate evidence on the effect of steroids in coronavirus infections. If not contraindicated, and in the absence of side effects, the use of steroids should be considered in coronavirus infection including COVID-19.
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Affiliation(s)
- Keum Hwa Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Sojung Yoon
- Yonsei University College of Medicine, Seoul 03722, Korea; (S.Y.); (J.Y.K.); (S.R.)
| | - Gwang Hun Jeong
- College of Medicine, Gyeongsang National University, Jinju 52727, Korea;
| | - Jong Yeob Kim
- Yonsei University College of Medicine, Seoul 03722, Korea; (S.Y.); (J.Y.K.); (S.R.)
| | - Young Joo Han
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Korea;
| | - Sung Hwi Hong
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; (S.H.H.); (R.A.G.)
| | - Seohyun Ryu
- Yonsei University College of Medicine, Seoul 03722, Korea; (S.Y.); (J.Y.K.); (S.R.)
| | - Jae Seok Kim
- Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju 26426, Korea; (J.S.K.); (J.Y.L.); (J.W.Y.)
| | - Jun Young Lee
- Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju 26426, Korea; (J.S.K.); (J.Y.L.); (J.W.Y.)
| | - Jae Won Yang
- Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju 26426, Korea; (J.S.K.); (J.Y.L.); (J.W.Y.)
| | - Jinhee Lee
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
| | - Marco Solmi
- Department of Neuroscience, University of Padova, 35121 Padova, Italy;
| | - Ai Koyanagi
- Research and development unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain; (A.K.); (L.J.)
- ICREA, Pg. Lluis Companys 23, 08010 Barcelona, Spain
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linkoping University, SE-581 85 Linkoping, Sweden;
| | - Louis Jacob
- Research and development unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain; (A.K.); (L.J.)
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180 Montigny-le-Bretonneux, France
| | - Joaquim Radua
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain;
- Mental Health Research Networking Center (CIBERSAM), 08036 Barcelona, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
- Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, 11330 Stockholm, Sweden
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK;
| | - Hans Oh
- School of Social Work, University of Southern California, Los Angeles, CA 90015, USA;
| | - Kalthoum Tizaoui
- Department of Basic Sciences, Division of Histology and Immunology, Faculty of Medicine Tunis, Tunis El Manar University, Tunis 1068, Tunisia;
| | - Sarah Cargnin
- Department of Pharmaceutical Sciences and Interdepartmental Research Center of Pharmacogenetics and Pharmacogenomics (CRIFF), University of Piemonte Orientale, 28100 Novara, Italy; (S.C.); (S.T.)
| | - Salvatore Terrazzino
- Department of Pharmaceutical Sciences and Interdepartmental Research Center of Pharmacogenetics and Pharmacogenomics (CRIFF), University of Piemonte Orientale, 28100 Novara, Italy; (S.C.); (S.T.)
| | - Ramy Abou Ghayda
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; (S.H.H.); (R.A.G.)
- Division of Urology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Andreas Kronbichler
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, 6020 Innsbruck, Austria;
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea;
- Correspondence: ; Tel.: +82-2-2228-2050
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12
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Giovane RA, Rezai S, Cleland E, Henderson CE. Current pharmacological modalities for management of novel coronavirus disease 2019 (COVID-19) and the rationale for their utilization: A review. Rev Med Virol 2020; 30:e2136. [PMID: 32644275 PMCID: PMC7361252 DOI: 10.1002/rmv.2136] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 12/22/2022]
Abstract
SARS‐CoV‐2 has caused a pandemic which is putting strain on the health‐care system and global economy. There is much pressure to develop both preventative and curative therapies for SARS‐CoV‐2 as there is no evidence to support therapies to improve outcomes in patients with SARS‐CoV‐2. Medications that inhibit certain steps of virus life cycle that are currently used to treat other illnesses such as Malaria, Ebola, HIV and Hepatitis C are being studied for use against SARS‐CoV‐2. To date, data is limited for medications that facilitate clinical improvement of COVID‐19 infections.
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Affiliation(s)
- Richard A Giovane
- Department of Family Medicine, Regional Medical Center of Central Alabama, Greenville, Alabama, USA
| | - Shadi Rezai
- Department of OB/GYN, Valley Community Healthcare, North Hollywood, California, USA
| | - Ellen Cleland
- Department of Family Medicine, University of Alabama, Tuscaloosa, Alabama, USA
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13
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Huang ST, Lai HC, Lin YC, Huang WT, Hung HH, Ou SC, Lin HJ, Hung MC. Principles and treatment strategies for the use of Chinese herbal medicine in patients at different stages of coronavirus infection. Am J Cancer Res 2020; 10:2010-2031. [PMID: 32774998 PMCID: PMC7407358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a novel, human-infecting β-coronavirus enveloped, positive-sense single-stranded RNA viruses, similar to the severe acute respiratory syndrome (SARS) infection that emerged in November 2002. In traditional Chinese medicine (TCM), the epidemic disease concepts of "febrile epidemics" (wenyi) or "warm diseases" (wenbing) are based on geographic and cultural aspects, and Chinese herbal medicine (CHM) played an important role in the treatment of epidemic diseases. CHM was widely used to treat patients suffered with SARS almost two decades ago during outbreak of SARS, with proven safety and potential benefits. TCM has also been widely used to treat cancer patients for a long history and much of them associate with immunomodulatory activity and are used to treat coronavirus-related diseases. We propose the use of CHM treatment principles for clinical practice, based on four main stages of COVID-19 infection: early, intermediate, severe, and convalescence. We suggest corresponding decoctions that exhibit antiviral activity and anti-inflammatory effects in the early stage of infection; preventing the disease from progressing from an intermediate to severe stage of infection; restoring normal lung function and improving consciousness in the severe stage; and ameliorating pulmonary and vascular injury in the convalescent stage. We summarize the pharmaceutical mechanisms of CHM for treating coronavirus via antiviral, anti-inflammatory and immunomodulatory effects.
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Affiliation(s)
- Sheng-Teng Huang
- School of Chinese Medicine, China Medical UniversityTaichung, Taiwan
- Department of Chinese Medicine, China Medical University HospitalTaichung, Taiwan
- Research Cancer Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University HospitalTaichung, Taiwan
- An-Nan Hospital, China Medical UniversityTainan, Taiwan
| | - Hsiang-Chun Lai
- Department of Chinese Medicine, China Medical University HospitalTaichung, Taiwan
| | - Yu-Chun Lin
- Department of Chinese Medicine, China Medical University HospitalTaichung, Taiwan
| | - Wei-Te Huang
- Department of Chinese Medicine, China Medical University HospitalTaichung, Taiwan
| | - Hao-Hsiu Hung
- Department of Chinese Medicine, China Medical University HospitalTaichung, Taiwan
| | - Shi-Chen Ou
- Department of Chinese Medicine, China Medical University HospitalTaichung, Taiwan
| | - Hung-Jen Lin
- School of Chinese Medicine, China Medical UniversityTaichung, Taiwan
- Department of Chinese Medicine, China Medical University HospitalTaichung, Taiwan
| | - Mien-Chie Hung
- Graduate Institute of Biomedical Sciences, Research Center for Cancer Biology and Center for Molecular Medicine, China Medical UniversityTaichung, Taiwan
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14
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Priyadarshini I, Mohanty P, Kumar R, Son LH, Chau HTM, Nhu VH, Thi Ngo PT, Tien Bui D. Analysis of Outbreak and Global Impacts of the COVID-19. Healthcare (Basel) 2020; 8:E148. [PMID: 32485875 PMCID: PMC7349011 DOI: 10.3390/healthcare8020148] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 12/15/2022] Open
Abstract
Corona viruses are a large family of viruses that are not only restricted to causing illness in humans but also affect animals such as camels, cattle, cats, and bats, thus affecting a large group of living species. The outbreak of Corona virus in late December 2019 (also known as COVID-19) raised major concerns when the outbreak started getting tremendous. While the first case was discovered in Wuhan, China, it did not take long for the disease to travel across the globe and infect every continent (except Antarctica), killing thousands of people. Since it has become a global concern, different countries have been working toward the treatment and generation of vaccine, leading to different speculations. While some argue that the vaccine may only be a few weeks away, others believe that it may take some time to create the vaccine. Given the increasing number of deaths, the COVID-19 has caused havoc worldwide and is a matter of serious concern. Thus, there is a need to study how the disease has been propagating across continents by numbers as well as by regions. This study incorporates a detailed description of how the COVID-19 outbreak started in China and managed to spread across the globe rapidly. We take into account the COVID-19 outbreak cases (confirmed, recovered, death) in order to make some observations regarding the pandemic. Given the detailed description of the outbreak, this study would be beneficial to certain industries that may be affected by the outbreak in order to take timely precautionary measures in the future. Further, the study lists some industries that have witnessed the impact of the COVID-19 outbreak on a global scale.
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Affiliation(s)
- Ishaani Priyadarshini
- Department of Electrical and Computer Science, University of Delaware, Newark, DE 19716, USA;
| | - Pinaki Mohanty
- Department of Computer Science, Purdue University, 610 Purdue Mall, West Lafayette, IN 47907, USA;
| | - Raghvendra Kumar
- Computer Science and Engineering Department, GIET University, Gunupur, Odisha 765022, India;
| | - Le Hoang Son
- VNU Information Technology Institute, Vietnam National University, Hanoi 010000, Vietnam;
| | - Hoang Thi Minh Chau
- Faculty of Information Technology, University of Economic and Technical Industries, Hanoi 010000, Vietnam;
| | - Viet-Ha Nhu
- Geographic Information Science Research Group, Ton Duc Thang University, Ho Chi Minh City 700000, Vietnam
- Faculty of Environment and Labour Safety, Ton Duc Thang University, Ho Chi Minh City 700000, Vietnam
| | - Phuong Thao Thi Ngo
- Institute of Research and Development, Duy Tan University, Da Nang 550000, Vietnam;
| | - Dieu Tien Bui
- Department of Business and IT, University of South-Eastern Norway, Gullbringvegen 36, N-3800 BøiTelemark, Norway;
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15
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Luo X, Lv M, Wang X, Long X, Ren M, Zhang X, Liu Y, Li W, Zhou Q, Ma Y, Fukuoka T, Ahn HS, Lee MS, Luo Z, Liu E, Wang X, Chen Y. Supportive care for patient with respiratory diseases: an umbrella review. Ann Transl Med 2020; 8:621. [PMID: 32566558 PMCID: PMC7290632 DOI: 10.21037/atm-20-3298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background Supportive treatment is an important and effective part of the management for patients with life-threatening diseases. This study aims to identify and evaluate the forms of supportive care for patients with respiratory diseases. Methods An umbrella review of supportive care for patient with respiratory diseases was undertaken. We comprehensively searched the following databases: Medline, EMBASE, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang Data and CBM (SinoMed) from their inception to 31 March 2020, and other sources to identify systematic reviews and meta-analyses related to supportive treatments for patient with respiratory diseases including Coronavirus Disease 2019 (COVID-19), severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and influenza. We assessed the methodological quality using the AMSTAR score and the quality of the evidence for the primary outcomes of each included systematic review and meta-analysis. Results We included 18 systematic reviews and meta-analyses in this study. Most studies focused on the respiratory and circulatory support. Ten studies were of high methodological quality, five studies of medium quality, and three studies of low quality. According to four studies extracorporeal membrane oxygenation did not reduce mortality in adults [odds ratio/relative risk (OR/RR) ranging from 0.71 to 1.28], but two studies reported significantly lower mortality in patients receiving venovenous extracorporeal membrane oxygenation than in the control group (OR/RR ranging from 0.38 to 0.73). Besides, monitoring of vital signs and increasing the number of medical staff may also reduce the mortality in patients with respiratory diseases. Conclusions Our overview suggests that supportive care may reduce the mortality of patients with respiratory diseases to some extent. However, the quality of evidence for the primary outcomes in the included studies was low to moderate. Further systematic reviews and meta-analyses are needed to address the evidence gap regarding the supportive care for SARS, MERS and COVID-19.
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Affiliation(s)
- Xufei Luo
- School of Public Health, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.,Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Meng Lv
- School of Public Health, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.,Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Xiaoqing Wang
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Xin Long
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Mengjuan Ren
- School of Public Health, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Xianzhuo Zhang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China
| | - Yunlan Liu
- School of Public Health, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Weiguo Li
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Qi Zhou
- The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China
| | - Yanfang Ma
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Toshio Fukuoka
- Emergency and Critical Care Center, the Department of General Medicine, Department of Research and Medical Education at Kurashiki Central Hospital, Kurashiki, Japan.,Advisory Committee in Cochrane Japan, Tokyo, Japan
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.,Korea Cochrane Centre, Seoul, Korea
| | - Myeong Soo Lee
- Korea Institute of Oriental Medicine, Daejeon, Korea.,University of Science and Technology, Daejeon, Korea
| | - Zhengxiu Luo
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Enmei Liu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Xiaohui Wang
- School of Public Health, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Yaolong Chen
- School of Public Health, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.,Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.,Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou 730000, China.,Chinese GRADE Center, Lanzhou 730000, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China
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16
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Abstract
Given the rapidly progressing coronavirus disease 2019 (COVID-19) pandemic, this report on a US cohort of 54 COVID-19 patients from Stanford Hospital and data regarding risk factors for severe disease obtained at initial clinical presentation is highly important and immediately clinically relevant. We identified low presenting oxygen saturation as predictive of severe disease outcomes, such as diagnosis of pneumonia, acute respiratory distress syndrome, and admission to the intensive care unit, and also replicated data from China suggesting an association between hypertension and disease severity. Clinicians will benefit by tools to rapidly risk stratify patients at presentation by likelihood of progression to severe disease.
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17
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Lee KM, Jung K. Factors Influencing the Response to Infectious Diseases: Focusing on the Case of SARS and MERS in South Korea. Int J Environ Res Public Health 2019; 16:E1432. [PMID: 31013648 DOI: 10.3390/ijerph16081432] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/28/2019] [Accepted: 04/09/2019] [Indexed: 11/24/2022]
Abstract
Following the 2003 the severe acute respiratory syndrome (SARS) and the 2015 Middle East Respiratory Syndrome (MERS) outbreak in South Korea, this research aims to explore and examine the factors influencing the response to infectious diseases, which encompasses both communicable and non-communicable diseases. Through a qualitative research method, this research categorizes the factors as inputs, processes and outputs and applies them into the 2003 SARS and MERS outbreak in South Korea. As the results conducted meta-analyses to comprehensively analyze the correlations of factors influencing disaster response from a Korean context, the findings show that the legislative factor had direct and indirect influence on the overall process of infectious disease response and that Leadership of the central government, establishment of an intergovernmental response system, the need for communication, information sharing and disclosure and onsite response were identified as key factors influencing effective infectious disease response.
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18
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Offeddu V, Yung CF, Low MSF, Tam CC. Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis. Clin Infect Dis 2018; 65:1934-1942. [PMID: 29140516 PMCID: PMC7108111 DOI: 10.1093/cid/cix681] [Citation(s) in RCA: 205] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/29/2017] [Indexed: 01/01/2023] Open
Abstract
This systematic review and meta-analysis quantified the protective effect of facemasks and respirators against respiratory infections among healthcare workers. Relevant articles were retrieved from Pubmed, EMBASE, and Web of Science. Meta-analyses were conducted to calculate pooled estimates. Meta-analysis of randomized controlled trials (RCTs) indicated a protective effect of masks and respirators against clinical respiratory illness (CRI) (risk ratio [RR] = 0.59; 95% confidence interval [CI]:0.46-0.77) and influenza-like illness (ILI) (RR = 0.34; 95% CI:0.14-0.82). Compared to masks, N95 respirators conferred superior protection against CRI (RR = 0.47; 95% CI: 0.36-0.62) and laboratory-confirmed bacterial (RR = 0.46; 95% CI: 0.34-0.62), but not viral infections or ILI. Meta-analysis of observational studies provided evidence of a protective effect of masks (OR = 0.13; 95% CI: 0.03-0.62) and respirators (OR = 0.12; 95% CI: 0.06-0.26) against severe acute respiratory syndrome (SARS). This systematic review and meta-analysis supports the use of respiratory protection. However, the existing evidence is sparse and findings are inconsistent within and across studies. Multicentre RCTs with standardized protocols conducted outside epidemic periods would help to clarify the circumstances under which the use of masks or respirators is most warranted.
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Affiliation(s)
- Vittoria Offeddu
- Saw Swee Hock School of Public Health, National University of Singapore
| | - Chee Fu Yung
- Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | | | - Clarence C Tam
- Saw Swee Hock School of Public Health, National University of Singapore.,London School of Hygiene & Tropical Medicine, London, United Kingdom
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19
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Demurtas OC, Massa S, Illiano E, De Martinis D, Chan PKS, Di Bonito P, Franconi R. Antigen Production in Plant to Tackle Infectious Diseases Flare Up: The Case of SARS. Front Plant Sci 2016; 7:54. [PMID: 26904039 PMCID: PMC4742786 DOI: 10.3389/fpls.2016.00054] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 01/13/2016] [Indexed: 05/09/2023]
Abstract
Severe acute respiratory syndrome (SARS) is a dangerous infection with pandemic potential. It emerged in 2002 and its aetiological agent, the SARS Coronavirus (SARS-CoV), crossed the species barrier to infect humans, showing high morbidity and mortality rates. No vaccines are currently licensed for SARS-CoV and important efforts have been performed during the first outbreak to develop diagnostic tools. Here we demonstrate the transient expression in Nicotiana benthamiana of two important antigenic determinants of the SARS-CoV, the nucleocapsid protein (N) and the membrane protein (M) using a virus-derived vector or agro-infiltration, respectively. For the M protein, this is the first description of production in plants, while for plant-derived N protein we demonstrate that it is recognized by sera of patients from the SARS outbreak in Hong Kong in 2003. The availability of recombinant N and M proteins from plants opens the way to further evaluation of their potential utility for the development of diagnostic and protection/therapy tools to be quickly manufactured, at low cost and with minimal risk, to face potential new highly infectious SARS-CoV outbreaks.
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Affiliation(s)
- Olivia C. Demurtas
- Department of Sustainability, Biotechnology Laboratory, Italian National Agency for New Technologies, Energy and Sustainable Economic DevelopmentRome, Italy
| | - Silvia Massa
- Department of Sustainability, Biotechnology Laboratory, Italian National Agency for New Technologies, Energy and Sustainable Economic DevelopmentRome, Italy
| | - Elena Illiano
- Department of Sustainability, Biomedical Technology Laboratory, Italian National Agency for New Technologies, Energy and Sustainable Economic DevelopmentRome, Italy
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di MilanoMilan, Italy
| | - Domenico De Martinis
- International Relations Office, Italian National Agency for New Technologies, Energy and Sustainable Economic DevelopmentRome, Italy
| | - Paul K. S. Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales HospitalHong Kong, China
- Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales HospitalHong Kong, China
| | - Paola Di Bonito
- Istituto Superiore di Sanità, Department of Infectious, Parasitic and Immune-Mediated DiseasesRome, Italy
- *Correspondence: Rosella Franconi, ; Paola Di Bonito,
| | - Rosella Franconi
- Department of Sustainability, Biomedical Technology Laboratory, Italian National Agency for New Technologies, Energy and Sustainable Economic DevelopmentRome, Italy
- *Correspondence: Rosella Franconi, ; Paola Di Bonito,
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20
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Abstract
OBJECTIVE Severe acute respiratory syndrome (SARS) was a highly virulent atypical pneumonia caused by a novel coronavirus that resulted in a pandemic in 2003. Singapore was one of the most severely affected countries, and SARS took a heavy toll on our health care system. The lessons learned during the pandemic have shaped our national contagion response plan and have proved valuable in subsequent epidemics. We describe the lessons learned for the radiology department. CONCLUSION Our experience with SARS has shaped and changed our daily practice of radiology.
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21
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Cao Z, Zeng D, Zheng X, Wang Q, Wang F, Wang J, Wang X. Spatio-temporal evolution of Beijing 2003 SARS epidemic. Sci China Earth Sci 2010; 53:1017-1028. [PMID: 32288761 PMCID: PMC7104599 DOI: 10.1007/s11430-010-0043-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Accepted: 10/28/2009] [Indexed: 05/19/2023]
Abstract
Studying spatio-temporal evolution of epidemics can uncover important aspects of interaction among people, infectious diseases, and the environment, providing useful insights and modeling support to facilitate public health response and possibly prevention measures. This paper presents an empirical spatio-temporal analysis of epidemiological data concerning 2321 SARS-infected patients in Beijing in 2003. We mapped the SARS morbidity data with the spatial data resolution at the level of street and township. Two smoothing methods, Bayesian adjustment and spatial smoothing, were applied to identify the spatial risks and spatial transmission trends. Furthermore, we explored various spatial patterns and spatio-temporal evolution of Beijing 2003 SARS epidemic using spatial statistics such as Moran's I and LISA. Part of this study is targeted at evaluating the effectiveness of public health control measures implemented during the SARS epidemic. The main findings are as follows. (1) The diffusion speed of SARS in the northwest-southeast direction is weaker than that in northeast-southwest direction. (2) SARS's spread risk is positively spatially associated and the strength of this spatial association has experienced changes from weak to strong and then back to weak during the lifetime of the Beijing SARS epidemic. (3) Two spatial clusters of disease cases are identified: one in the city center and the other in the eastern suburban area. These two clusters followed different evolutionary paths but interacted with each other as well. (4) Although the government missed the opportunity to contain the early outbreak of SARS in March 2003, the response strategies implemented after the mid of April were effective. These response measures not only controlled the growth of the disease cases, but also mitigated the spatial diffusion.
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Affiliation(s)
- ZhiDong Cao
- Key Laboratory of Complex Systems and Intelligence Science, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
| | - DaJun Zeng
- Key Laboratory of Complex Systems and Intelligence Science, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
| | - XiaoLong Zheng
- Key Laboratory of Complex Systems and Intelligence Science, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
| | - QuanYi Wang
- Beijing Center for Disease Control and Prevention, Beijing, 100013 China
| | - FeiYue Wang
- Key Laboratory of Complex Systems and Intelligence Science, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190 China
| | - JinFeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101 China
| | - XiaoLi Wang
- Beijing Center for Disease Control and Prevention, Beijing, 100013 China
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22
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Abstract
In fewer than four months in 2003, severe acute respiratory syndrome (SARS) spread from China to 25 countries and Taiwan, becoming the first new, easily transmissible infectious disease of the twenty-first century. The role of air transport in the diffusion of the disease became obvious early in the crisis; to assess that role more carefully, this study relates the spatial-temporal pattern of the SARS outbreak to a measure of airline network accessibility. Specifically, the accessibility from those countries that were infected by SARS, beginning with China, to other countries was measured using airline schedules. The country-pair accessibility measure, along with other country-level factors relevant to the disease, were tested as determinants of the speed with which SARS arrived in infected countries as well as its failure to arrive in most countries. The analyses indicate that airline network accessibility was an especially influential variable but also that the importance of this variable diminished in the latter weeks of the outbreak. The latter finding is partly attributable to public health measures, particularly health screening in airports. The timing and geography of those measures are reviewed using data from media reports and interim World Health Organization (WHO) documents during the outbreak. The uneven effort to curtail the international diffusion of SARS suggests further planning is needed to develop a concerted response to contain future epidemics.
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Affiliation(s)
- John T Bowen
- Department of Geography & Urban Planning, University of Wisconsin-Oshkosh, Oshkosh, WI 54901, USA E-mail:
| | - Christian Laroe
- Department of Geography & Urban Planning, University of Wisconsin-Oshkosh, Oshkosh, WI 54901, USA E-mail:
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23
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Vabret A, Mourez T, Dina J, Freymuth F. [Human coronaroviruses]. Virologie (Montrouge) 2005; 9:273-87. [PMID: 34679294 DOI: 10.1684/vir.2011.2118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Coronaviruses are a large group of viruses and infect a lot of species of mammals and birds. Five coronaviruses currently infect humans: HCoVs 229E and OC43, identified in 1960's, SARS-CoV identified in March 2003 during the SARS epidemic, and the HCoVs NL63 and HKU1, identified in 2004 and 2005. The genome of the coronaviruses is a linear, nonsegmented, positive-sense single-stranded RNA molecule of approximately 30 kb. The evolution of these viruses occurs through some features: the flexibility of the genome including a high number of potentially non-essential genes, the demonstrated ability of the coronaviruses to establish persistent infections, the quasi-species structure of the viral population, the ability to undergo RNA mutations, deletions and recombinations at a high frequency. Two epidemiologic pictures of human coronavirus infections have to be distinguished: as suggested by a few epidemiologic studies, the classical coronaviruses, including HCoVs 229E, OC43, and NL63 are distributed worldwide and would circulate during seasonal outbreaks. In contrast, the SARS-CoV is responsible of the first new emerging infectious disease of this millennium, infecting more than 8,000 people and killing nearly 800 during a period of six months beginning at the end of 2002. Human coronaviruses may be also involved in enteric and neurologic diseases. The detection of coronaviruses is difficult and mainly based on molecular assays (RT-PCR). Despite research activities on the development of vaccines and antiviral agents, there is no established specific therapy to date.
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Lee-Baggley D, DeLongis A, Voorhoeave P, Greenglass E. Coping with the threat of severe acute respiratory syndrome: Role of threat appraisals and coping responses in health behaviors. Asian J Soc Psychol 2004; 7:9-23. [PMID: 32313437 PMCID: PMC7159516 DOI: 10.1111/j.1467-839x.2004.00131.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The present study examines the psychological impact of severe acute respiratory syndrome (SARS) by exploring the coping strategies and health behaviors enacted in response to the SARS epidemic. Hierarchical linear regression indicated that the use of wishful thinking in response to the threat of SARS was related to both avoiding public places and avoiding people perceived to be possible carriers of the SARS virus, but was not associated with the use of more adaptive health behaviors, such as using disinfectants and hand washing. Conversely, those who reported engaging in empathic responding in response to the threat of SARS were both less likely to report avoiding people perceived as being at a high risk for SARS and more likely to report engaging in effective health behaviors. Support seeking was not a significant predictor of the health behaviors examined in the present study. Results are discussed in terms of coping with health threats and health promotion.
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Affiliation(s)
| | - Anita DeLongis
- University of British Columbia, Vancouver, British Columbia
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Abstract
Severe acute respiratory syndrome (SARS) was first reported in China, and spread to 29 regions, affecting over 8000 people worldwide. For the general public, the psychological impact of SARS may have been greater than the physical health danger of the disease. The present paper proposes the influence of psychological factors on people's cognitive, affective, and behavioral responses during the SARS outbreak. The various papers in this special issue of the Journal reveal how people have reacted during the SARS outbreak: People's general coping styles may be related to their health behavior during the outbreak. Cultural differences were evident in the perception of SARS, and individuals’ perceptual styles may have influenced their ability to cope with the outbreak. The way in which individuals coped with SARS‐related stressful events was different from their usual practices of managing daily stress. Individual differences in the adoption of preventive measures were related to the distinct susceptibility to several social‐cognitive biases.
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Affiliation(s)
- Cecilia Cheng
- Hong Kong University of Science and Technology, Kowloon, Hong Kong
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Tam KP, Lau IYM, Chiu CY. Biases in the perceived prevalence and motives of severe acute respiratory syndrome prevention behaviors among Chinese high school students in Hong Kong. Asian J Soc Psychol 2004; 7:67-81. [PMID: 32313438 PMCID: PMC7159753 DOI: 10.1111/j.1467-839x.2004.00135.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In two studies conducted in Hong Kong during and immediately after the outbreak of severe acute respiratory syndrome (SARS), participants displayed several social cognitive biases when they estimated the prevalence of and inferred the motives underlying SARS preventive behaviors. First, participants who practiced preventive behaviors (practicers) consistently estimated that more people practiced such behaviors than did non‐practicers (false consensus bias). Second, for some preventive behaviors, participants believed that their own behaviors were more motivated by prosocial concerns (relative to self‐interest) than were other practicers (pluralistic ignorance). Finally, non‐practicers underestimated the importance of prosocial concerns underlying some preventive behaviors (actor‐observer bias). We discussed the relevance of these social cognitive biases to health education and to Hong Kong people's psychological reactions to SARS.
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Jin W, Hu L, Du Z, Gao Q, Gao H, Ning Y, Feng J, Zhang J, Yin W, Li N. Genome sequence variation analysis of two SARS coronavirus isolates after passage in Vero cell culture. Chin Sci Bull 2004; 49:1824-1827. [PMID: 32214713 PMCID: PMC7089035 DOI: 10.1007/bf03183408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2004] [Accepted: 07/24/2004] [Indexed: 11/06/2022]
Abstract
SARS coronavirus is an RNA virus whose replication is error-prone, which provides possibility for escape of host defenses, and even leads to evolution of new viral strains during the passage or the transmission. Lots of variations have been detected among different SARS-CoV strains. And a study on these variations is helpful for development of efficient vaccine. Moreover, the test of nucleic acid characterization and genetic stability of SARS-CoV is important in the research of inactivated vaccine. The whole genome sequences of two SARS coronavirus strains after passage in Vero cell culture were determined and were compared with those of early passages, respectively. Results showed that both SARS coronavirus strains have high genetic stability, although nearly 10 generations were passed. Four nucleotide variations were observed between the second passage and the 11th passage of Sino1 strain for identification of SARS inactivated vaccine. Moreover, only one nucleotide was different between the third passage and the 10th passage of Sino3 strain for SARS inactivated vaccine. Therefore, this study suggested it was possible to develop inactivated vaccine against SARS-CoV in the future.
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Affiliation(s)
- Weiwu Jin
- State Key Laboratory for Agrobiotechnology, China Agricultural University, 100094 Beijing, China
| | - Liangxiang Hu
- Sino Biotech Co., Ltd., No. 39 Shangdi Xi Rd. Haidian District, 100085 Beijing, China
| | - Zhenglin Du
- State Key Laboratory for Agrobiotechnology, China Agricultural University, 100094 Beijing, China
| | - Qiang Gao
- Sino Biotech Co., Ltd., No. 39 Shangdi Xi Rd. Haidian District, 100085 Beijing, China
| | - Hong Gao
- Sino Biotech Co., Ltd., No. 39 Shangdi Xi Rd. Haidian District, 100085 Beijing, China
| | - Ye Ning
- Sino Biotech Co., Ltd., No. 39 Shangdi Xi Rd. Haidian District, 100085 Beijing, China
| | - Jidong Feng
- State Key Laboratory for Agrobiotechnology, China Agricultural University, 100094 Beijing, China
| | - Jiansan Zhang
- Sino Biotech Co., Ltd., No. 39 Shangdi Xi Rd. Haidian District, 100085 Beijing, China
| | - Weidong Yin
- Sino Biotech Co., Ltd., No. 39 Shangdi Xi Rd. Haidian District, 100085 Beijing, China
| | - Ning Li
- State Key Laboratory for Agrobiotechnology, China Agricultural University, 100094 Beijing, China
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Abstract
The severe acute respiratory syndrome (SARS) caused tremendous damage to many Asia countries, especially China. The transmission process and outbreak pattern of SARS is still not well understood. This study aims to find a simple model to describe the outbreak pattern of SARS cases by using SARS case data commonly released by governments. The outbreak pattern of cumulative SARS cases is expected to be a logistic type because the infection will be slowed down due to the increasing control effort by people and/or due to depletion of susceptible individuals. The increase rate of SARS cases is expected to decrease with the cumulative SARS cases, as described by the traditional logistical model, which is widely used in population dynamic studies. The instantaneous rate of increases were significantly and negatively correlated with the cumulative SARS cases in mainland of China (including Beijing, Hebei, Tianjin, Shanxi, the Autonomous Region of Inner Mongolia) and Singapore. The basic reproduction numberR 0 in Asia ranged from 2.0 to 5.6 (except for Taiwan, China). TheR 0 of Hebei and Tianjin were much higher than that of Singapore, Hongkong, Beijing, Shanxi, Inner Mongolia, indicating SARS virus might have originated differently or new mutations occurred during transmission. We demonstrated that the outbreaks of SARS in many regions of Asia were well described by the logistic model, and the control measures implemented by governments are effective. The maximum instantaneous rate of increase, basic reproductive number, and maximum cumulative SARS cases were also calculated by using the logistic model.
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Abstract
Phylogenetic tree of coronaviruses (CoVs) including the human SARS-associated virus is reconstructed from complete genomes by using our newly developed K-string composition approach. The relation of the human SARS-CoV to other coronaviruses, i.e. the rooting of the tree is suggested by choosing an appropriate outgroup. SARS-CoV makes a separate group closer but still distant from G2 (CoVs in mammalian host). The relation between different isolates of the human SARS virus is inferred by first constructing an ultrametric distance matrix from counting sequence variations in the genomes. The resulting tree is consistent with clinic relations between the SARS-CoV isolates. In addition to a larger variety of coronavirus genomes these results provide phylogenetic knowledge based on independent novel methodology as compared to recent phylogenetic studies on SARS-CoV.
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Affiliation(s)
- Lei Gao
- 1Institute of Theoretical Physics, Chinese Academy of Sciences, 100080 Beijing, China
- 2T-Life Research Center, Fudan University, 200433 Shanghai, China
| | - Ji Qi
- 1Institute of Theoretical Physics, Chinese Academy of Sciences, 100080 Beijing, China
- 2T-Life Research Center, Fudan University, 200433 Shanghai, China
| | - Haibin Wei
- 3Graduate School, Zhejiang University, 310027 Hangzhou, China
- 4Hangzhou Branch, Beijing Genomics Institute, Chinese Academy of Sciences, 310008 Hangzhou, China
| | - Yigang Sun
- 3Graduate School, Zhejiang University, 310027 Hangzhou, China
- 4Hangzhou Branch, Beijing Genomics Institute, Chinese Academy of Sciences, 310008 Hangzhou, China
| | - Bailin Hao
- 2T-Life Research Center, Fudan University, 200433 Shanghai, China
- 4Hangzhou Branch, Beijing Genomics Institute, Chinese Academy of Sciences, 310008 Hangzhou, China
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