#Clinical Characteristics of Moderate #COVID19 #Patients #Aggravation in #Wuhan Stadium Cabin Hospital: A 571 Cases of Retrospective Cohort Study (J Med Virol., abstract)

[Source: Journal of Medical Virology, full page: (LINK). Abstract, edited.]

Clinical Characteristics of Moderate COVID‐19 Patients Aggravation in Wuhan Stadium Cabin Hospital: A 571 Cases of Retrospective Cohort Study

Lei Shu,  Xiaoyan Wang,  Mingquan Li,  Xiaolin Chen,  Ningfei Ji,  Lei Shi,  Mingjing Wu, Kaili Deng,  Jing Wei,  Xueli Wang,  Yang Cao,  Jiaxin Yan,  Ganzhu Feng

First published: 11 August 2020 | DOI: https://doi.org/10.1002/jmv.26414

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/jmv.26414

 

Abstract

In order to report the clinical characteristics and potential risk factors of COVID‐19 Patients in Wuhan Stadium Cabin Hospital in Hubei Province. A total of 571 patients of COVID‐19 treated in the Wuhan Stadium Cabin Hospital were selected for analysis, univariable and multivariable logistic regression methods were used to explore the risk factors associated with disease aggravation. The main clinical symptoms of moderate COVID‐19 were fever, cough and dyspnea, hypertension, diabetes and coronary heart diseases were the main comorbidities both in transferred and stable patients. 26 patients (4.55%) of mild and moderate patients had disease aggravation, and most of which occurred between 36 hours to 48 hours after admission. Multiple regression analysis showed increasing odds of disease aggravation associated with former smoker history, diabetes, dyspnea, consolidation and interstitial abnormalities of CT scanning, lymphopenia and elevated of CRP, the time points of transferred patients mainly between 36 hours to 48 hours (65.38%), and the average hospital stay for stable patients was 15 days.It could help clinicians to identify patients with poor prognosis at an early stage, and provide early warning role for timely intervention.

This article is protected by copyright. All rights reserved.

Keywords: SARS-CoV-2; COVID-19; Hubei; China.

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#Clinical and #epidemiological #features of 46 #children under 1 year old with #coronavirus disease 2019 (#COVID19) in #Wuhan, #China: a descriptive study (J Infect Dis., abstract)

[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

Clinical and epidemiological features of 46 children under 1 year old with coronavirus disease 2019 (COVID-19) in Wuhan, China: a descriptive study

Xinghua Liu, Rong Xie, Wei Li, Yan Guo, Bo Zhang, Yue Zhang, Juanjuan Wang, Cao Peng, Xiao Lei, Qunying Luo, Qiong Zhang, Jianqiao Tang, Yunqiao Li, Jianying Chen

The Journal of Infectious Diseases, jiaa472, https://doi.org/10.1093/infdis/jiaa472

Published: 06 August 2020

 

Abstract

The number of COVID-19 cases has exceeded 10 million. However, little is known about the epidemiology and clinical characteristics of COVID-19 infants. We collected medical information of 46 confirmed patients (0-1 year old) and retrospectively analyzed epidemiological history, clinical symptoms, and laboratory test results. The median age is 5 (IQR, 2-7) months. Sixteen cases had fever and 27 cases had cough. Moderate disease was present in 40 cases and cardiac injury occurred in 38 cases, following by liver dysfunction in 20 cases and lymphocytosis in no cases. Of all infant patients, two received invasive mechanical ventilation and one died with MODS.

children, clinical features, SARS-CoV-2, outcome

Topic:  heart injuries – epidemiology – cough – fever – child – china – infant – lymphocytosis – signs and symptoms – mechanical ventilation – liver dysfunction – laboratory test  finding – sars-cov-2 – covid-19

Issue Section: Brief Report

This content is only available as a PDF.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: SARS-CoV-2; COVID-19; Pediatrics; China.

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#SARS-CoV-2 #infection in #China — Before the pandemic (PLOS Negl Trop Dis., abstract)

[Source: PLOS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]

OPEN ACCESS | REVIEW

SARS-CoV-2 infection in China—Before the pandemic

Huiying Liang , Lingling Zheng , Huimin Xia , Jinling Tang

Published: August 6, 2020 | DOI: https://doi.org/10.1371/journal.pntd.0008472

 

Abstract

In order to rapidly inform polices in the international response to the ongoing pandemic of coronavirus disease 19 (COVID-19), we summarize in this review current evidence on epidemiological and clinical features of the infection, transmission routes, problems of nucleic-acid testing, the epidemiological trend in China and impact of interventional measures, and some lessons learned. We concluded that the epidemic is containable with traditional nonpharmacological interventions, mainly through social distancing and finding and isolating suspected patients and close contacts. Nonpharmacological interventions are the only effective measures currently accessible and have suppressed some 90% of the infections in China. Close contacts are the major mechanism of transmission, which makes it possible to control this epidemic through nonpharmacological methods. Nucleic-acid testing alone may miss some 50% of infected patients, and other methods such as chest computerized tomography (CT) or serology should be considered to supplement molecular testing. The development of vaccines and drugs is important, but hesitation to make use of nonpharmacological interventions may mean missing golden opportunities for effective actions.

 

Author summary

In particular, we summarize the origin of the pathogen, epidemiological and clinical features of the infection, transmission routes and transmissibility, problems of nucleic-acid testing and diagnostic criteria, the epidemiological trend in China and its relation to interventional measures, and special issues including infection in doctors and children and the role of vaccines versus traditional nonpharmacological interventions in control of the epidemic. Importantly, evidence clearly suggests the following:

  • The epidemic is containable with traditional nonpharmacological interventions, largely by social distancing and testing and isolation of suspected patients and close contacts.
  • Nonpharmacological interventions are the most immediately accessible effective measures and have helped suppress some 90% of infections in China.
  • Close contacts through droplets and fomites are the major mechanism of transmission, and asymptomatic infections and aerosols are unlikely important in spreading the virus. This is a major feature of the virus and explains why it is containable through nonpharmacological methods.
  • Nucleic-acid testing alone may miss many truly infected patients, and chest CT should always be used if available to supplement molecular testing.
  • Development of vaccines and drugs are important, but any hesitation to use nonpharmacological interventions may mean missing golden opportunities for useful actions against the epidemic.

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Citation: Liang H, Zheng L, Xia H, Tang J (2020) SARS-CoV-2 infection in China—Before the pandemic. PLoS Negl Trop Dis 14(8): e0008472. https://doi.org/10.1371/journal.pntd.0008472

Editor: Laith Yakob, London School of Hygiene & Tropical Medicine, UNITED KINGDOM

Published: August 6, 2020

Copyright: © 2020 Liang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: This work was funded by the National Key Research and Development Program of China (2019YFB1404803).

Competing interests: The authors have declared that no competing interests exist.

Keywords: SARS-CoV-2; COVID-19; China.

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Repeat #Chest #Ct #Scans In Moderate-to-Severe Patients’ Management During the #Covid19 Pandemic: Observations From a Single Centre in #Wuhan, #China (Rad Prot Dosim., abstract)

[Source: Radiation Protection Dosimetry, full page: (LINK). Abstract, edited.]

Repeat Chest Ct Scans In Moderate-to-Severe Patients’ Management During the Covid-19 Pandemic: Observations From a Single Centre in Wuhan, China

Lang Chen, Qiuxia Wang, Hongyu Wu, Junwu Hu, Jing Zhang

Radiation Protection Dosimetry, ncaa106, https://doi.org/10.1093/rpd/ncaa106

Published: 31 July 2020

 

Abstract

Objective

To observe the rates of repeated computed tomographic scans (CTs) in a cohort of patients with coronavirus disease-2019 (COVID-19) and to assess the validity of repeat CTs.

Methods

Each CT was recorded, and the validity of the repeated CTs was assessed.

Results

The 394 patients underwent a total of 1493 CTs. Of the 394 patients, 260 received at least one non-value-added CT. Both the total number of CTs (median, 4; interquartile range (IQR), 3–5) and non-value-added CTs (median, 1; IQR, 0–1) per patient were strongly related to the disease duration (R2 = 0.566 for total CTs, R2 = 0.432 for non-value-added CTs, p < 0.001). The proportion of non-value-added CTs was potentially higher after 3 weeks from symptom onset (>35%).

Conclusions

There was a high rate of repeat CTs for the COVID-19 patients, and the proportion of non-value-added CTs increased with disease duration. Follow-up CT should be avoided without clinical decline.

Advances in Knowledge

As COVID-19 is impacting healthcare systems across the globe, we believe in our findings that serial chest CT imaging has limited clinical utility in basically stable COVID-19 patients, will help relieve some of this burden.

Issue Section: Paper

Keywords: SARS-CoV-2; COVID-19; Radiology; China.

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Comparison of #Face – #Touching #Behaviors Before and During the #Coronavirus Disease 2019 Pandemic (JAMA Netw Open, abstract)

[Source: JAMA Network Open, full page: (LINK). Abstract, edited.]

Comparison of Face-Touching Behaviors Before and During the Coronavirus Disease 2019 Pandemic

Yong-Jian Chen, MD1; Gang Qin, MD1,2; Jie Chen, MD1; Jian-Liang Xu, MD3; Ding-Yun Feng, MD4; Xiang-Yuan Wu, MD1; Xing Li, MD1

Author Affiliations: 1 Guangdong Key Laboratory of Liver Disease Research, Department of Medical Oncology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; 2 Grade 2015, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; 3 Department of Hepatobiliary Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; 4 Department of Pulmonary and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

JAMA Netw Open. 2020;3(7):e2016924. doi:10.1001/jamanetworkopen.2020.16924

 

Key Points

  • Question  – Is wearing face masks associated with reduced face-touching behaviors?
  • Findings  – In this cross-sectional study, including 4699 individuals before the coronavirus disease 2019 (COVID-19) pandemic and 2887 individuals during the COVID-19 pandemic, mandatory mask-wearing policies were associated with increased mask wearing among the general population during the COVID-19 pandemic. Wearing masks, either medical or fabric, was associated with reduced face-touching behavior, especially touching of the eyes, nose, and mouth.
  • Meaning  – These findings suggest that mandatory mask-wearing policies were associated with reducing face-touching behavior among the general population in public areas, which may help to prevent contact transmission of COVID-19.

 

Abstract

Importance  

There is insufficient evidence on the efficacy of masks in the general population for the prevention of coronavirus disease 2019 (COVID-19) in public areas. Therefore, it is imperative to investigate the association of mandatory mask-wearing policies with behaviors associated with the transmission of COVID-19.

Objective  

To assess the association of mask wearing with face-touching behavior among the general population in public areas.

Design, Setting, and Participants  

This cross-sectional study used videos recorded in public transportation stations, streets, and parks among the general population in China, Japan, South Korea, Western Europe (ie, England, France, Germany, Spain, and Italy), and the US to analyze mask-wearing and face-touching behavior in public areas. Videos before the COVID-19 pandemic were defined as those recorded from January 2018 to October 2019, and those during the COVID-19 pandemic were defined as those recorded during February 2020 to March 2020 in China, Japan, and South Korea and during March 2020 in Western Europe and the US. Individuals who clearly displayed their face and face-touching behavior were included, and those whose behaviors were influenced by filming or public events were excluded.

Exposures  

Mandatory mask-wearing policies enacted at various time points in China, Japan, South Korea, Western Europe, and the US.

Main Outcomes and Measures  

Proportion of individuals wearing masks and incidence of face touching.

Results  

This study included 4699 individuals before the COVID-19 pandemic and 2887 individuals during the pandemic. During the periods studied, mask wearing increased in all regions except the US, from 20 of 1745 individuals (1.1%) to 1090 of 1097 individuals (99.4%) in mainland China (P < .001), 44 of 1422 individuals (3.1%) to 346 of 893 individuals (38.7%) in Japan (P < .001), 6 of 717 individuals (0.8%) to 277 of 324 individuals (85.5% ) in South Korea (P < .001), 1 of 546 individuals (0.2%) to 6 of 379 individuals (1.6%) in Western Europe (P = .02), and 1 of 269 individuals (0.4%) to 4 of 194 individuals (2.1%) in the US (P = .17). Surgical masks were predominant in China (989 masks [89.1%]), and fabric masks were predominant in the other regions (Japan: 371 masks [95.1%]; South Korea: 240 masks [84.8%]; Western Europe: 6 masks [85.7%]; US: 5 masks [100%]). Face-touching behaviors decreased from before COVID-19 to during COVID-19 among individuals in China (72 incidences of 1745 observations [4.1%] to 12 incidences of 1097 observations [1.1%]; P < .001), South Korea (80 incidences of 717 observations [11.2%] to 7 incidences of 324 observations [2.2%]; P < .001), and Europe (62 incidences of 546 observations [11.4%] to 23 incidences of 379 observations [6.1%]; P = .01). Logistic regression found that mask wearing was associated with a reduction in face touching in China (odds ratio [OR], 3.91; 95% CI, 2.11-7.24) and South Korea (OR, 6.69; 95% CI, 2.69-16.69) and of touching the nose, mouth, and eyes (China: OR, 8.60; 95% CI, 2.65-27.86; South Korea: OR, 29.27; 95% CI, 1.79-478.22).

Conclusions and Relevance  

The findings of this cross-sectional study suggest that mandatory mask-wearing policies were associated with increased mask wearing during the COVID-19 pandemic. Mask wearing was associated with reduced face-touching behavior, especially touching of the eyes, nose, and mouth, which may prevent contact transmission of COVID-19 among the general population in public areas.

Keywords: SARS-CoV-2; COVID-19; Facemasks; Society; China.

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#Relationship Between #serum #SARS-CoV-2 nucleic acid (#RNAemia) and #Organ #Damage in #COVID19 Patients: A Cohort Study (Clin Infect Dis., abstract)

[Source: Clinical Infectious Diseases, full page: (LINK). Abstract, edited.]

Relationship Between serum SARS-CoV-2 nucleic acid(RNAemia) and Organ Damage in COVID-19 Patients: A Cohort Study

Dan Xu, MD, Fuling Zhou, MD, Wenbo Sun, MS, Liangjun Chen, MD, Lan Lan, MD, Huan Li, MD, Feng Xiao, PhD, Ying Li, MD, Vijaya B Kolachalama, PhD, Yirong Li, MD, Xinghuan Wang, MD, Haibo Xu, MD

Clinical Infectious Diseases, ciaa1085, https://doi.org/10.1093/cid/ciaa1085

Published: 28 July 2020

 

Abstract

Background

SARS-CoV-2 has spread worldwide and has the ability to damage multiple organs. However, information on serum SARS-CoV-2 nucleic acid(RNAemia) in patients affected by COVID-19 is limited.

Methods

Patients who admitted to Zhongnan Hospital of Wuhan University with laboratory-confirmed COVID-19, were tested SARS-COV-2 RNA in serum from January 28, 2020, to February 9, 2020. Demographic data, laboratory findings, radiological, comorbidities and outcomes data were collected and analyzed.

Results

85 patients were included in the analysis. The viral load of throat swabs was significantly higher than serum samples. The highest detection of SARS-CoV-2 RNA in serum samples was between 11 to 15 days after the symptom onset. Analysis to compare with and without RNAemia provided evidence that CT and some laboratory biomarkers(total protein, BUN, LDH, hypersensitive troponin I and D-dimer) were abnormal, and that the extent of these abnormalities was generally higher in RNAemia than in non-RNAemia. Organ damages(respiratory failure, cardiac damage, renal damage and coagulopathy) were more common in RNAemia than non-RNAemia. Patients with vs without RNAemia had shorter durations from serum testing SARS-CoV-2 RNA. The mortality rate was higher among patients with vs without RNAemia.

Conclusions

This study provides evidence to support that SARS-CoV-2 may have an important role in multiple organ damage, such as respiratory failure, cardiac damage, renal damage and coagulopathy. We did not find strong evidence that SARS-CoV-2 plays a role in damage of liver and the central nervous system. And our evidence suggests that RNAemia has a significant association with a higher risk of in-hospital mortality.

RNAemia, SARS-CoV-2, COVID-19, organ damage

Issue Section: Major Article

This content is only available as a PDF.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: SARS-CoV-2; COVID-19; China.

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#Antibody #responses to #SARS‐CoV‐2 in healthy individuals returning to #Shenzhen (J Med Virol., abstract)

[Source: Journal of Medical Virology, full page: (LINK). Abstract, edited.]

Antibody responses to SARS‐CoV‐2 in healthy individuals returning to Shenzhen

Cantong Zhang,  Liancheng Lin,  Donge Tang,  Fuju Liu,  Meng Li, Qiongying Li, Zhaoxiang Deng,  Guohai Chu,  Dayong Gu,  Yong Dai

First published: 25 July 2020 | DOI:  https://doi.org/10.1002/jmv.26355

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/jmv.26355

 

Abstract

Objective

To verify reliability of antibody detection and investigate population immunity to SARS‐CoV‐2 in the local Chinese population.

Design, Setting, and Participants

This was a cross‐sectional study that was conducted in Shenzhen to detect anti‐coronavirus antibodies including, IgG, IgM, and IgA. In the COVID‐19 group, 9 patients were enrolled after diagnosis. In the control group, 1589 individuals without clinical symptoms (cough, fever, and fatigue) and returning from outside Shenzhen were enrolled. The first study enrollment occurred at the end of February 2020; the final study visit was March 18, 2020.

Results

In the COVID‐19 group, the 7 of 9 patients were positive for IgM, IgG, and IgA. Meanwhile, 6 of the 1589 healthy individuals were found to be weakly positive for IgG. According to SARS‐CoV‐2 nucleic acid tests, the 6 individuals were all negative.

Conclusion

Strong supplemental support for clinical information can be provided by antibody detection, especially for IgA. According to comparison with overseas reports, the infection rate of the Chinese population outside Shenzhen, China, is significantly low, so most of the population in China is still susceptible. Hence, social distancing measures are still inevitable until a vaccine is developed successfully.

This article is protected by copyright. All rights reserved.

Keywords: SARS-CoV-2; COVID-19; Serology; Seroprevalence; China.

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Post-pandemic #testing of #SARS-CoV-2 in #Huanan #Seafood #Market area in #Wuhan, #China (Clin Infect Dis., abstract)

[Source: Clinical Infectious Diseases, full page: (LINK). Abstract, edited.]

Post-pandemic testing of SARS-CoV-2 in Huanan Seafood Market area in Wuhan, China

Jingwen Li, Chengbi Wu, Xing Zhang, Lan Chen, Xinyi Wang, Xiuli Guan, Jinghong Li, Zhicheng Lin, Nian Xiong

Clinical Infectious Diseases, ciaa1043, https://doi.org/10.1093/cid/ciaa1043

Published: 25 July 2020

 

Abstract

76 days after the COVID-19 epidemic was contained in Wuhan, the Chinese government carried out a citywide SARS-CoV-2 nucleic acid testing for all the residents from May 14th to June 1st, 2020. Our hospital tested 107,662 residents around Huanan Seafood Market, uncovering a positivity rate of 0.006%.

asymptomatic, infectious, COVID-19, Huanan Seafood Market

Issue Section: Brief Report

This content is only available as a PDF.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: SARS-CoV-2; COVID-19; Diagnostic tests; Hubei; China.

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#COVID19 and #China: #lessons and the way forward (Lancet, summary)

[Source: Lancet, full page: (LINK). Summary, edited.]

COVID-19 and China: lessons and the way forward

The Lancet

Published: July 25, 2020 | DOI: https://doi.org/10.1016/S0140-6736(20)31637-8

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China has largely controlled COVID-19. A country of 1·4 billion people and a size similar to Europe or the USA now reports only clusters of cases rather than widespread community transmission. China has been widely criticised for its role and responsibilities during the pandemic because of censorship, transparency, and human rights concerns. But the rest of the world can still learn from China’s successes in bringing its outbreak under control.

(…)

Keywords: SARS-CoV-2; COVID-19; China.

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#Transmission #route and #introduction of Pandemic #SARS‐CoV‐2 between #China, #Italy and #Spain (J Med Virol., abstract)

[Source: Journal of Medical Virology, full page: (LINK). Abstract, edited.]

Transmission route and introduction of Pandemic SARS‐CoV‐2 between China, Italy and Spain

Benazi Nabil,  Bounab Sabrina,  Bounab Abdelhakim

First published: 22 July 2020 | DOI:  https://doi.org/10.1002/jmv.26333

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/jmv.26333

 

Abstract

We present a phylodynamic and phylogeographic analysis of this new SARS‐CoV‐2 virus in this report. A tree of maximum credibility was constructed using the 72 entire genome sequences of this virus, from the three countries (China, Italy and Spain) available as of 03/26/2020 on the GISAID reference frame. To schematize the current SARS‐CoV‐2 migration scenario between and within the three countries chosen, using the multitype bearth‐death model implemented in BEAST2. Bayesian phylogeographic reconstruction shows that SARS‐COV‐2 has a rate of evolution of 2.11×10 ‐3 / sites / year (95% HPD:1.56×10‐3−3.89×10‐3), and a geographic origin in Shanghai, where tMRCA emerged, according to the analysis of the molecular clock, around November 13, 2019. While for Italy and Spain, there are two tMRCA for each country, which agree with the assumption of several introductions for these countries. That explains also this very short period of subepidermal circulation before the recent events. A total of 8 (median) migration events occurred during this short period, the largest proportion of which (6 events (75 %) occurred from Shanghai(China) to Spain and from Italy to Spain. Such events are marked by speeds of migration that are comparatively lower as compared to that from Shanghai to Italy. Shanghai’s R0 and Italy’s are closer to each other, though Spain’s is slightly higher. All these results allow us to conclude the need for an automatic system of mixed, molecular and classical epidemiological surveillance, which could play a role in this global surveillance of public health and decision‐making.

This article is protected by copyright. All rights reserved.

Keywords: SARS-CoV-2; COVID-19; China; Italy; Spain.

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