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Coronavirus disease (COVID-19)
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Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19)
More LessInformation on severity of coronavirus disease (COVID-19) (transmissibility, disease seriousness, impact) is crucial for preparation of healthcare sectors. We present a simple approach to assess disease seriousness, creating a reference cohort of pneumonia patients from sentinel hospitals. First comparisons exposed a higher rate of COVID-19 patients requiring ventilation. There were more case fatalities among COVID-19 patients without comorbidities than in the reference cohort. Hospitals should prepare for high utilisation of ventilation and intensive care resources.
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Rapidly increasing cumulative incidence of coronavirus disease (COVID-19) in the European Union/European Economic Area and the United Kingdom, 1 January to 15 March 2020
The cumulative incidence of coronavirus disease (COVID-19) cases is showing similar trends in European Union/European Economic Area countries and the United Kingdom confirming that, while at a different stage depending on the country, the COVID-19 pandemic is progressing rapidly in all countries. Based on the experience from Italy, countries, hospitals and intensive care units should increase their preparedness for a surge of patients with COVID-19 who will require healthcare, and in particular intensive care.
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Serological and molecular findings during SARS-CoV-2 infection: the first case study in Finland, January to February 2020
Anu Haveri , Teemu Smura , Suvi Kuivanen , Pamela Österlund , Jussi Hepojoki , Niina Ikonen , Marjaana Pitkäpaasi , Soile Blomqvist , Esa Rönkkö , Anu Kantele , Tomas Strandin , Hannimari Kallio-Kokko , Laura Mannonen , Maija Lappalainen , Markku Broas , Miao Jiang , Lotta Siira , Mika Salminen , Taneli Puumalainen , Jussi Sane , Merit Melin , Olli Vapalahti and Carita Savolainen-KopraThe first case of coronavirus disease (COVID-19) in Finland was confirmed on 29 January 2020. No secondary cases were detected. We describe the clinical picture and laboratory findings 3–23 days since the first symptoms. The SARS-CoV-2/Finland/1/2020 virus strain was isolated, the genome showing a single nucleotide substitution to the reference strain from Wuhan. Neutralising antibody response appeared within 9 days along with specific IgM and IgG response, targeting particularly nucleocapsid and spike proteins.
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Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020
More LessOn 5 February 2020, in Yokohama, Japan, a cruise ship hosting 3,711 people underwent a 2-week quarantine after a former passenger was found with COVID-19 post-disembarking. As at 20 February, 634 persons on board tested positive for the causative virus. We conducted statistical modelling to derive the delay-adjusted asymptomatic proportion of infections, along with the infections’ timeline. The estimated asymptomatic proportion was 17.9% (95% credible interval (CrI): 15.5–20.2%). Most infections occurred before the quarantine start.
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Post-discharge surveillance and positive virus detection in two medical staff recovered from coronavirus disease 2019 (COVID-19), China, January to February 2020
Yuanyuan Xing , Pingzheng Mo , Yu Xiao , Oiu Zhao , Yongxi Zhang and Fan WangSince December 2019, 62 medical staff of Zhongnan Hospital in Wuhan, China have been hospitalised with coronavirus disease 2019. During the post-discharge surveillance after clinical recovery, swabs were positive in two asymptomatic cases (3.23%). Case 1 had presented typical clinical and radiological manifestations on admission, while manifestation in Case 2 was very mild. In conclusion, a small proportion of recovered patients may test positive after discharge, and post-discharge surveillance and isolation need to be strengthened.
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Retrospective analysis of the possibility of predicting the COVID-19 outbreak from Internet searches and social media data, China, 2020
Cuilian Li , Li Jia Chen , Xueyu Chen , Mingzhi Zhang , Chi Pui Pang and Haoyu ChenThe peak of Internet searches and social media data about the coronavirus disease 2019 (COVID-19) outbreak occurred 10–14 days earlier than the peak of daily incidences in China. Internet searches and social media data had high correlation with daily incidences, with the maximum r > 0.89 in all correlations. The lag correlations also showed a maximum correlation at 8–12 days for laboratory-confirmed cases and 6–8 days for suspected cases.
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Evaluation of a quantitative RT-PCR assay for the detection of the emerging coronavirus SARS-CoV-2 using a high throughput system
More LessFacing the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), high-volume respiratory testing is demanded in laboratories worldwide. We evaluated the performance of a molecular assay for the detection of SARS-CoV-2 on a high-throughput platform, the cobas 6800, using the ‘open channel’ for integration of a laboratory-developed assay. We observed good analytical performance in clinical specimens. The fully automated workflow enables high-throughput testing with minimal hands-on time, while offering fast and reliable results.
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First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020
Gianfranco Spiteri , James Fielding , Michaela Diercke , Christine Campese , Vincent Enouf , Alexandre Gaymard , Antonino Bella , Paola Sognamiglio , Maria José Sierra Moros , Antonio Nicolau Riutort , Yulia V. Demina , Romain Mahieu , Markku Broas , Malin Bengnér , Silke Buda , Julia Schilling , Laurent Filleul , Agnès Lepoutre , Christine Saura , Alexandra Mailles , Daniel Levy-Bruhl , Bruno Coignard , Sibylle Bernard-Stoecklin , Sylvie Behillil , Sylvie van der Werf , Martine Valette , Bruno Lina , Flavia Riccardo , Emanuele Nicastri , Inmaculada Casas , Amparo Larrauri , Magdalena Salom Castell , Francisco Pozo , Rinat A. Maksyutov , Charlotte Martin , Marc Van Ranst , Nathalie Bossuyt , Lotta Siira , Jussi Sane , Karin Tegmark-Wisell , Maria Palmérus , Eeva K. Broberg , Julien Beauté , Pernille Jorgensen , Nick Bundle , Dmitriy Pereyaslov , Cornelia Adlhoch , Jukka Pukkila , Richard Pebody , Sonja Olsen and Bruno Christian CiancioIn the WHO European Region, COVID-19 surveillance was implemented 27 January 2020. We detail the first European cases. As at 21 February, nine European countries reported 47 cases. Among 38 cases studied, 21 were linked to two clusters in Germany and France, 14 were infected in China. Median case age was 42 years; 25 were male. Late detection of the clusters’ index cases delayed isolation of further local cases. As at 5 March, there were 4,250 cases.
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Potential scenarios for the progression of a COVID-19 epidemic in the European Union and the European Economic Area, March 2020
Two months after the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the possibility of established and widespread community transmission in the European Union and European Economic Area (EU/EEA) is becoming more likely. We provide scenarios for use in preparedness for a possible widespread epidemic. The EU/EEA is moving towards the ‘limited sustained transmission’ phase. We propose actions to prepare for potential mitigation phases and coordinate efforts to protect the health of citizens.
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Rapid establishment of laboratory diagnostics for the novel coronavirus SARS-CoV-2 in Bavaria, Germany, February 2020
The need for timely establishment of diagnostic assays arose when Germany was confronted with the first travel-associated outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Europe. We describe our laboratory experiences during a large contact tracing investigation, comparing previously published real-time RT-PCR assays in different PCR systems and a commercial kit. We found that assay performance using the same primers and probes with different PCR systems varied and the commercial kit performed well.
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Differential diagnosis of illness in patients under investigation for the novel coronavirus (SARS-CoV-2), Italy, February 2020
A novel coronavirus (SARS-CoV-2) has been identified as the causative pathogen of an ongoing outbreak of respiratory disease, now named COVID-19. Most cases and sustained transmission occurred in China, but travel-associated cases have been reported in other countries, including Europe and Italy. Since the symptoms are similar to other respiratory infections, differential diagnosis in travellers arriving from countries with wide-spread COVID-19 must include other more common infections such as influenza and other respiratory tract diseases.
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Early transmission patterns of coronavirus disease 2019 (COVID-19) in travellers from Wuhan to Thailand, January 2020
Pilailuk Okada , Rome Buathong , Siripaporn Phuygun , Thanutsapa Thanadachakul , Sittiporn Parnmen , Warawan Wongboot , Sunthareeya Waicharoen , Supaporn Wacharapluesadee , Sumonmal Uttayamakul , Apichart Vachiraphan , Malinee Chittaganpitch , Nanthawan Mekha , Noppavan Janejai , Sopon Iamsirithaworn , Raphael TC Lee and Sebastian Maurer-StrohWe report two cases of coronavirus disease 2019 (COVID-19) in travellers from Wuhan, China to Thailand. Both were independent introductions on separate flights, discovered with thermoscanners and confirmed with RT-PCR and genome sequencing. Both cases do not seem directly linked to the Huanan Seafood Market in Hubei but the viral genomes are identical to four other sequences from Wuhan, suggesting early spread within the city already in the first week of January.
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First cases of coronavirus disease 2019 (COVID-19) in France: surveillance, investigations and control measures, January 2020
Sibylle Bernard Stoecklin , Patrick Rolland , Yassoungo Silue , Alexandra Mailles , Christine Campese , Anne Simondon , Matthieu Mechain , Laure Meurice , Mathieu Nguyen , Clément Bassi , Estelle Yamani , Sylvie Behillil , Sophie Ismael , Duc Nguyen , Denis Malvy , François Xavier Lescure , Scarlett Georges , Clément Lazarus , Anouk Tabaï , Morgane Stempfelet , Vincent Enouf , Bruno Coignard , Daniel Levy-Bruhl and Investigation teamA novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) causing a cluster of respiratory infections (coronavirus disease 2019, COVID-19) in Wuhan, China, was identified on 7 January 2020. The epidemic quickly disseminated from Wuhan and as at 12 February 2020, 45,179 cases have been confirmed in 25 countries, including 1,116 deaths. Strengthened surveillance was implemented in France on 10 January 2020 in order to identify imported cases early and prevent secondary transmission. Three categories of risk exposure and follow-up procedure were defined for contacts. Three cases of COVID-19 were confirmed on 24 January, the first cases in Europe. Contact tracing was immediately initiated. Five contacts were evaluated as at low risk of exposure and 18 at moderate/high risk. As at 12 February 2020, two cases have been discharged and the third one remains symptomatic with a persistent cough, and no secondary transmission has been identified. Effective collaboration between all parties involved in the surveillance and response to emerging threats is required to detect imported cases early and to implement adequate control measures.
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Laboratory readiness and response for novel coronavirus (2019-nCoV) in expert laboratories in 30 EU/EEA countries, January 2020
Timely detection of novel coronavirus (2019-nCoV) infection cases is crucial to interrupt the spread of this virus. We assessed the required expertise and capacity for molecular detection of 2019-nCoV in specialised laboratories in 30 European Union/European Economic Area (EU/EEA) countries. Thirty-eight laboratories in 24 EU/EEA countries had diagnostic tests available by 29 January 2020. A coverage of all EU/EEA countries was expected by mid-February. Availability of primers/probes, positive controls and personnel were main implementation barriers.
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Effectiveness of airport screening at detecting travellers infected with novel coronavirus (2019-nCoV)
More LessWe evaluated effectiveness of thermal passenger screening for 2019-nCoV infection at airport exit and entry to inform public health decision-making. In our baseline scenario, we estimated that 46% (95% confidence interval: 36 to 58) of infected travellers would not be detected, depending on incubation period, sensitivity of exit and entry screening, and proportion of asymptomatic cases. Airport screening is unlikely to detect a sufficient proportion of 2019-nCoV infected travellers to avoid entry of infected travellers.
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Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20–28 January 2020
More LessA novel coronavirus (2019-nCoV) is causing an outbreak of viral pneumonia that started in Wuhan, China. Using the travel history and symptom onset of 88 confirmed cases that were detected outside Wuhan in the early outbreak phase, we estimate the mean incubation period to be 6.4 days (95% credible interval: 5.6–7.7), ranging from 2.1 to 11.1 days (2.5th to 97.5th percentile). These values should help inform 2019-nCoV case definitions and appropriate quarantine durations.
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Novel coronavirus (2019-nCoV) early-stage importation risk to Europe, January 2020
As at 27 January 2020, 42 novel coronavirus (2019-nCoV) cases were confirmed outside China. We estimate the risk of case importation to Europe from affected areas in China via air travel. We consider travel restrictions in place, three reported cases in France, one in Germany. Estimated risk in Europe remains high. The United Kingdom, Germany and France are at highest risk. Importation from Beijing and Shanghai would lead to higher and widespread risk for Europe.
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Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020
More LessSince December 2019, China has been experiencing a large outbreak of a novel coronavirus (2019-nCoV) which can cause respiratory disease and severe pneumonia. We estimated the basic reproduction number R0 of 2019-nCoV to be around 2.2 (90% high density interval: 1.4–3.8), indicating the potential for sustained human-to-human transmission. Transmission characteristics appear to be of similar magnitude to severe acute respiratory syndrome-related coronavirus (SARS-CoV) and pandemic influenza, indicating a risk of global spread.
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Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR
Victor M Corman , Olfert Landt , Marco Kaiser , Richard Molenkamp , Adam Meijer , Daniel KW Chu , Tobias Bleicker , Sebastian Brünink , Julia Schneider , Marie Luisa Schmidt , Daphne GJC Mulders , Bart L Haagmans , Bas van der Veer , Sharon van den Brink , Lisa Wijsman , Gabriel Goderski , Jean-Louis Romette , Joanna Ellis , Maria Zambon , Malik Peiris , Herman Goossens , Chantal Reusken , Marion PG Koopmans and Christian DrostenBackgroundThe ongoing outbreak of the recently emerged novel coronavirus (2019-nCoV) poses a challenge for public health laboratories as virus isolates are unavailable while there is growing evidence that the outbreak is more widespread than initially thought, and international spread through travellers does already occur.
AimWe aimed to develop and deploy robust diagnostic methodology for use in public health laboratory settings without having virus material available.
MethodsHere we present a validated diagnostic workflow for 2019-nCoV, its design relying on close genetic relatedness of 2019-nCoV with SARS coronavirus, making use of synthetic nucleic acid technology.
ResultsThe workflow reliably detects 2019-nCoV, and further discriminates 2019-nCoV from SARS-CoV. Through coordination between academic and public laboratories, we confirmed assay exclusivity based on 297 original clinical specimens containing a full spectrum of human respiratory viruses. Control material is made available through European Virus Archive – Global (EVAg), a European Union infrastructure project.
ConclusionThe present study demonstrates the enormous response capacity achieved through coordination of academic and public laboratories in national and European research networks.
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Real-time tentative assessment of the epidemiological characteristics of novel coronavirus infections in Wuhan, China, as at 22 January 2020
A novel coronavirus (2019-nCoV) causing severe acute respiratory disease emerged recently in Wuhan, China. Information on reported cases strongly indicates human-to-human spread, and the most recent information is increasingly indicative of sustained human-to-human transmission. While the overall severity profile among cases may change as more mild cases are identified, we estimate a risk of fatality among hospitalised cases at 14% (95% confidence interval: 3.9–32%).
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