Treatment for COVID-19 patients in Vietnam: Analysis of time-to-recovery

Objective:To describe the recovery time and related factors among COVID-19 patients in Vietnam.Methods:We used the secondary data obtained from the official database of the Ministry of Health of Vietnam and other public data sources that were available by April 9 th,2020.Cox proportional hazards model was carried out to identify factors related to recovery time among COVID-19 patients.Results:By April 9 th,2020,the cumulative number of COVID-19 cases detected in Vietnam was 255,of which 129(50.6%)patients had fully recovered.The median recovery time of patients was 17(95%CI=16-19)days.Older patients had a lower likelihood of recovery(HR=0.98,95%CI=0.97-0.99,P<0.001),whereas patients with a history of international incoming travel had a higher likelihood of recovery(HR=1.57,95%CI=1.03-2.40,P=0.036).There was no statistically significant difference in the recovery time of patients treated in different hospital settings.Conclusions:More attention is needed for older patients and who did not have international travel history.Patients confirmed with COVID-19 could be treated at local health facilities to avoid unnecessary referrals and burdens to specialized hospitals at the central level.

The Impact of COVID-19 Pandemic on Mother-Infant Bond: A Systematic Review

Background: The healthy bond that develops prenatally between the mother and her infant is important for the neuropsychological development and development of the child. In stressful situations and mental disorders, the development of this bond is inhibited. With this study, an attempt is made to investigate whether the COVID-19 pandemic affected the development of the mother-infant bond. Methods: We have searched in the databases, PubMed, Google Scholar, PsycINFO, from July to October 2023 and we have found 18 related articles. Results: Most studies supported a lower mother-infant attachment during the pandemic period. We also found increased rates of depressive symptoms, anxiety and post-traumatic stress during the pandemic. Conclusions: The period of the pandemic and the psychological factors were the right conditions for the reduced development of the mother-infant bond. In epidemiological outbreaks, the mental health of the mother and her relationship with the infant should be a priority for perinatal care professionals.

COVID-19 patient with an incubation period of 27 d:A case report

BACKGROUND As a highly contagious disease,coronavirus disease 2019(COVID-19)is wreaking havoc around the world due to continuous spread among close contacts mainly via droplets,aerosols,contaminated hands or surfaces.Therefore,centralized isolation of close contacts and suspected patients is an important measure to prevent the transmission of COVID-19.At present,the quarantine duration in most countries is 14 d due to the fact that the incubation period of severe acute respiratory syndrome coronavirus type 2(SARS-CoV-2)is usually identified as 1-14 d with median estimate of 4-7.5 d.Since COVID-19 patients in the incubation period are also contagious,cases with an incubation period of more than 14 d need to be evaluated.CASE SUMMARY A 70-year-old male patient was admitted to the Department of Respiratory Medicine of The First Affiliated Hospital of Harbin Medical University on April 5 due to a cough with sputum and shortness of breath.On April 10,the patient was transferred to the Fever Clinic for further treatment due to close contact to one confirmed COVID-19 patient in the same room.During the period from April 10 to May 6,nucleic acid and antibodies to SARS-CoV-2 were tested 7 and 4 times,respectively,all of which were negative.On May 7,the patient developed fever with a maximum temperature of 39℃,and his respiratory difficulties had deteriorated.The results of nucleic acid and antibody detection of SARS-CoV-2 were positive.On May 8,the nucleic acid and antibody detection of SARS-CoV-2 by Heilongjiang Provincial Center for Disease Control were also positive,and the patient was diagnosed with COVID-19 and reported to the Chinese Center for Disease Control and Prevention.CONCLUSION This case highlights the importance of the SARS-CoV-2 incubation period.Further epidemiological investigations and clinical observations are urgently needed to identify the optimal incubation period of SARS-CoV-2 and formulate rational and evidence-based quarantine policies for COVID-19 accordingly.

A Study on the Global Scenario of COVID-19 Related Case Fatality Rate, Recovery Rate and Prevalence Rate and Its Implications for India—A Record Based Retrospective Cohort Study

Importance: Corona virus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pandemic claiming millions of lives since the first outbreak was reported in Wuhan, China during December 2019. It is thus important to make cross-country comparison of the relevant rates and understand the socio-demographic risk factors. Methods: This is a record based retrospective cohort study. Table 1 was extracted from https://www.worldometers.info/coronavirus/ and from the Corona virus resource center (Table 2, Figures 1-3), Johns Hopkins University. Data for Table 1 includes all countries which reported >1000 cases and Table 2 includes 20 countries reporting the largest number of deaths. The estimation of CFR, RR and PR of the infection, and disease pattern across geographical clusters in the world is presented. Results: From Table 1, we could infer that as on 4th May 2020, COVID-19 has rapidly spread world-wide with total infections of 3,566,423 and mortality of 248,291. The maximum morbidity is in USA with 1,188,122 cases and 68,598 deaths (CFR 5.77%, RR 15% and PR 16.51%), while Spain is at the second position with 247,122 cases and 25,264 deaths (CFR 13.71%, RR 38.75%, PR 9.78%). Table 2 depicts the scenario as on 8th October 2020, where-in the highest number of confirmed cases occurred in US followed by India and Brazil (cases per million population: 23,080, 5007 & 23,872 respectively). For deaths per million population: US recorded 647, while India and Brazil recorded 77 and 708 respectively. Conclusion: Studying the distribution of relevant rates across different geographical clusters plays a major role for measuring the disease burden, which in-turn enables implementation of appropriate public healthcare measures.

Investigation and Research on the Psychological Status of Children and Adolescents During the Epidemic Period of COVID-19

Objective:The paper was to analyze the investigation and study of the psychological status of children and adolescents during the epidemic period of COVID-19.Methods:From March 5th to 11th,2020,1766 students from 8 to 18 years old in Yan'an area were taken as the research objects,and the psychological characteristics of this group of people during the epidemic period of COVID-19 were analyzed by the online questionnaires.Results:In the questionnaire,all children and adolescents were in good psychological conditions,and they had not shown serious negative psychological emotions,and they attached great importance to COVID-19.Conclusion:The psychological changes of children and adolescents during the epidemic period of COVID-19 are diverse.Most children and adolescents have a good mental state,and a few have negative psychological emotions.It can strengthen the psychological management of children and adolescents during the epidemic,and promote the healthy growth of children and adolescents clinically.

中医药对新型冠状病毒肺炎(COVID-19)恢复期患者肺功能影响的Meta分析

目的系统评价中医药对新型冠状病毒肺炎(COVID-19,简称:新冠肺炎)恢复期患者的肺功能影响,以期为临床决策及后续临床研究的开展提供参考。方法计算机检索中国知网(CNKI)、万方数据库(WanFang)、中国生物医学文献数据库(SinoMed)、维普期刊数据库(VIP)、PubMed、The Cochrane Library、EMbase数据库,检索时间为建库至2022年7月。由2名研究者按照纳入与排除标准独立筛选文献、提取数据且评估纳入研究的偏倚风险及方法学质量,采用Review Manager 5.4软件进行Meta分析。结果共纳入9项研究,其中5项随机对照试验、2项非随机对照试验、2项队列研究,纳入研究共包含1101例新冠肺炎恢复期患者。Meta分析结果显示:(1)针刺、中西医结合康复训练,可有效提升患者第一秒用力呼气容积(forced expiratory volume in one second,FEV1)水平(SMD=1.43,95%CI[1.10,1.75],P<0.00001)。(2)中西医结合康复训练可提升患者第一秒用力呼气容积占用力肺活量的百分比(forced expiratory volume in one second/forced vital capacity,FEV1/FVC)(MD=12.12,95%CI[9.46,14.79],P<0.00001)。(3)中药联合常规康复训练可有效降低患者改良医学研究学会呼吸困难量表(modified Medical Research Council,mMRC)评分(MD=-0.16,95%CI[-0.17,-0.15],P<0.00001)。(4)针刺、中药可提升肺部CT好转率(RR=1.14,95%CI[1.06,1.23],P=0.0003)。结论中医药可提升新冠肺炎恢复期患者FEV1及FEV1/FVC水平、降低mMRC评分及促进肺部CT好转率,促进新冠肺炎恢复期患者康复。受纳入研究数量限制,结论尚需更多高质量研究予以验证。

Positive reverse transcription-polymerase chain reaction assay results in patients recovered from COVID-19: Report of two cases

BACKGROUND Coronavirus disease 2019(COVID-19)has spread around the globe.On February 28,2020,the World Health Organization adjusted the risk of spread and impact of COVID-19 to“very high”at the global level.Studies have mainly focused on the etiology,epidemiology,and treatment of COVID-19 to limit further spread and the negative impact of the disease,while less attention has been devoted to the follow-up and reexamination of patients who recovered from COVID-19 or were released from quarantine.CASE SUMMARY This study reports two cases where patients who had negative reverse transcription-polymerase chain reaction(RT-PCR)test results and met the criteria for discharge subsequently had positive RT-PCR test results.The clinical manifestations and computed tomography(CT)findings of these patients were examined.The conversion of RT-PCR test results in these two patients may be related to false-negative and false-positive outcomes of the test.CT images helped track improvement of pulmonary lesions.CONCLUSION The timing of discharge of COVID-19 patients should be determined by comprehensive analysis of CT images and RT-PCR test results.

Efficacy and Safety of Viusid and Asbrip in Hospitalized Patients with Mild and Moderate COVID-19: A Randomized Controlled Trial

Background: The aim of this study was to test Viusid and Asbrip as adjuvants to the standard treatment of patients with COVID-19 disease which could favor the recovery of the patients and reduce the hospitalization days. Design: This is a randomized, open-label, controlled trial to determine the efficacy and safety of Viusid and Asbrip in hospitalized patients with mild to moderate symptoms of COVID-19. Material and Methods: A total of 60 patients with proven COVID-19 disease by PCR test were randomized in a 2:1 ratio. In the active group 40 patients received oral doses of Viusid (30 ml TID) and Asbrip (10 ml TID) plus standard treatment. The control group consisted of 20 patients receiving only standard treatment. The trial began with hospitalization, followed by home treatment for a total of 21 days. Four symptoms were followed: fever, dyspnea, cough and fatigue, assessed by score 0 - 3: 0 = well, 1 = mild, 2 = moderate, 3 = severe, with total sum, Composite Symptom Score (CSS) from 0 to 12. Results: The 21 days diagram of CSS shows statistically better results of Viusid-Asbrip group vs. Control group from day 4 to day 21. Time to semi-recovery in days, assessed by 50% of CSS, is better in Viusid-Asbrip group vs. Control group (6.07 ± 2.77 vs. 8.35 ± 2.94, p = 0.02). Time to recovery in days respectively is (14.05 ± 4.15 vs. 19.25 ± 2.12, p = 0.0001). And Hospitalization days are (9.05 ± 2.58 vs. 12.75 ± 4.44, p = 0.0003). Conclusion: This trial shows that adding of Viusid & Asbrip to the treatment of COVID-19 can contribute to faster recovery of the patients, decreasing of the hospital stay and milder course of the disease.

Transport in the Aftermath of COVID-19: Lessons Learned and Future Directions

This paper is a review of the impact on transport in the Asian region where enforced lockdowns and transport reductions have come with real human costs in the areas of economic development and access to jobs, society and services from various perspectives including urban planning and transport, economy, GHG and air pollutant emissions and gender as some of the areas of focus in the Sustainable Development Goals. Transportation systems with a high level of planning, flexible modes of transport and good communication with the public have proved more resilient than others. Furthermore, digital infrastructure has proven to be a key transport solution through this crisis. Data collection and real-time analysis have proven that their time has come to be effective in urban planning and transport management. Digital infrastructure is also driving online shopping and urban delivery services that allow people seeking to be socially distant to access daily necessities in a fast and relatively inexpensive manner. Making use of new global data sets and computing techniques can help cities and countries to plan better. Developing countries will need to improve their ability to gather relevant data from public and private sources and furthermore use the data to achieve more resilient, sustainable transportation. Achieving Sustainable Development Goals will require a reprioritization of funding and efforts to ensure that countries are building optimized infrastructure that provide transport and mobility services with minimal financial burdens including new leapfrog transit systems.

The Effect of Dexamethasone versus Methylprednisolone in the Treatment of COVID-19 Patients in Jordan

Background: Previous studies focused on the treatment effect of steroids versus no steroids in treating severe COVID-19 patients, a few studies evaluated outcomes for treating those patients with either dexamethasone or methylprednisolone. Currently, we evaluate the difference in mortality associated with treating COVID-19 patients with dexamethasone versus methylprednisolone. Methods: With a retrospective multicenter study, records were reviewed for the admitted patients with severe COVID-19 during the peak of the severe COVID-19 pandemic. All admitted patients on dexamethasone or methylprednisolone were included. Patients were analyzed as all populations and propensity scores matched patients. Propensity scores were calculated for several confounders by the generalized linear model, and a “greedy” near-neighbor matching algorithm was used. Continuous variables with nonnormal distribution were analyzed by Wilcoxon signed rank test. Chi-squared and Fischer exact test analyzed categorical variables. P-values were adjusted by the Bonferroni method for both data cohorts. Body mass index was in categories. Radiological findings were divided into five categories. The outcomes: mortality, the need for home oxygen therapy, recovery, and residual symptoms on discharge were analyzed by an independent two-sample test for equality of proportions (with Yates correction), and logistic regression analysis. Results: Among the 1128 reviewed records, patients on dexamethasone or methylprednisolone were 1071, and the propensity score-matched patients were 784: dexamethasone 393 and methylprednisolone 391. There was no significant difference in the characteristics of patients between the two steroids (p-value and adjusted p-value > 0.05) for most variables. PSM adjusted a few discrepant variables before analysis. The outcome of the unmatched patients demonstrated dexamethasone benefit in the need for home oxygen therapy ( 0.05). However, matched patients demonstrated significantly lower mortality associated with dexamethasone treatment (difference -2.68%, 95%CI, -1.0, -0.004, p = 0.03, and OR 1.7, p = 0.017), and no difference for the other outcomes, including the need for home oxygen therapy (p-value > 0.05). Conclusion: Dexamethasone treatment caused significantly less mortality than methylprednisolone in treating our COVID-19 patients, but no significant difference in recovery, the need for home oxygen therapy, and residual symptoms on discharge.

Recovery rates and long-term olfactory dysfunction following COVID-19 infection

Objectives:Olfactory dysfunction is one of the most recognized symptoms of COVID-19,significantly impacting quality of life,particularly in cases where recovery is prolonged.This review aims to explore patterns of olfactory recovery post-COVID-19 infection,with particular focus on delayed recovery.Data Sources:Published literature in the English language,including senior author's own work,online and social media platforms,and patients'anecdotal reports.Method:A comprehensive review of the literature was undertaken by the authors with guidance from the senior author with expertise in the field of olfaction.Results:Based on self-report,an estimated 95%of patients recover their olfactory function within 6 months post-COVID-19 infection.However,psychophysical testing detects higher rates of persistent olfactory dysfunction.Recovery has been found to continue for at least 2 years postinfection;negative prognostic indicators include severe olfactory loss in the acute phase,female sex,and older age.Variability in quantitative and qualitative disturbance in prolonged cases likely reflects both peripheral and central pathophysiological mechanisms.Limitations of many of the reviewed studies reflect lack of psychophysical testing and baseline olfactory assessment.Conclusions:Post-COVID-19 olfactory dysfunction remains a significant health and psychosocial burden.Emerging evidence is improving awareness and knowledge among clinicians to better support patients through their olfactory rehabilitation,with hope of recovery after several months or years.Further research is needed to better understand the underlying pathogenesis of delayed recovery,identify at risk individuals earlier in the disease course,and develop therapeutic targets.

Relationship between infection,physical and mental health and exercise habits of some Chinese residents after recovery from COVID-19

This study aimed to determine the infection status,exercise habits,anxiety levels,and sleep quality in Chinese residents who recovered from infection during the period of coronavirus disease 2019(COVID-19)period.It also aimed to investigate the influencing factors of recovery status and aid in improving intervention measures for COVID-19 recovery.This study is a sub-study nested within a cross-sectional investigation of infection and physical and mental health among partially recovered residents in all 34 provincial areas of China during the COVID-19 pandemic.A total of 1013 participants(374 males and 639 females)completed the study.Cardiopulmonary endurance was significantly lower after infection than before infection(p<0.001).Women(3.924.97)exhibited higher levels of anxiety than men(3.334.54,p?0.015).The sleep score was significantly higher after infection(8.277.05)than before infection(4.174.97,p<0.001).The active and regular exercise groups exhibited significantly shorter durations of fever than the sedentary and irregular groups(p?0.033;p?0.021).Additionally,the active group demonstrated significantly fewer recovery days([7.323.24]days)than the sedentary group([7.663.06]days,p?0.035).We found a correlation between age and the recovery time of symptoms after COVID-19.We noted that a greater number of symptoms corresponded to poorer cardiopulmonary fitness and sleep quality.Individuals who engage in sedentary lifestyles and irregular exercise regimens generally require prolonged recovery periods.Therefore,incorporating moderate exercise,psychological support,sleep hygiene and other health interventions into post-COVID-19 recovery measures is imperative.

The importance of managing emotions and mental health in this lockdown period

With hundreds of millions of people grappling with isolation and heightened anxiety,the Novel Coronavirus pandemic is likely to have a serious universal impact on mental health worldwide,especially the elderly.Before the spread of coronavirus pneumonia all over the world,Chinese data have shown that the elderly is the most vulnerable faced with such diseases.We should pay more attention to those older people and help them manage their emotions to reduce the negative effects of social and emotional distance.

中医药基于抗炎及改善神经递质途径治疗新冠后失眠的研究进展

新型冠状病毒肺炎(COVID-19)传染性强,伴随症状多,失眠已经成为新冠肺炎患者康复后最常见的症状之一,目前仍缺少对其发病机制的研究以及有效的治疗方法。中医药疗法主要通过降低体内细胞因子,减轻炎性反应、提高神经递质水平等机制,改善新冠后患者失眠症状。该文收集了中医药通过上述途径治疗新冠后失眠的不同方法以及临床研究,在针灸治疗方面,主要以足三里、百会、神庭、神门、印堂、三阴交居多,传统方剂有交泰丸、沙参麦冬汤,中成药有舒眠胶囊,中药中百合、莲子、夜交藤、合欢皮、柏子仁、酸枣仁也能不同程度地缓解失眠症状。耳穴压豆及传统运动疗法八段锦也能明显缓解失眠、焦虑、抑郁症状。

Increased number of symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged time to return to full sports performance—AWAREⅧ

Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods Prospective cohort study with cross sectional analysis.A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age,sex,type/level of sport,co-morbidities,pre-infection training hours,and 26 acute SARS-CoV-2 symptoms from 3 categories(“nose and throat”,“chest and neck”,and“whole body”/systemic).Data on days to RTFP were obtained by structured interviews.Factors associated with RTFP were demographics,sport participation,history of co-morbidities,pre-infection training history,and acute symptoms(type,number).Outcomes were:(a)days to RTFP(median,interquartile range(IQR))in asymptomatic(n=7)and symptomatic athletes(n=77),and(b)hazard ratios(HRs;95%confidence interval)for symptomatic athletes with vs.without a factor(univariate,multiple models).HR<1 was predictive of higher percentage chance of prolonged RTFP.Significance was p<0.05.Results Days to RTFP were 30 days(IQR:23–40)for asymptomatic and 64 days(IQR:42–91)for symptomatic participants(p>0.05).Factors associated with prolonged RTFP(univariate models)were:females(HR=0.57;p=0.014),endurance athletes(HR=0.41;p<0.0001),co-morbidity number(HR=0.75;p=0.001),and respiratory disease history(HR=0.54;p=0.026).In symptomatic athletes,prolonged RTFP(multiple models)was significantly associated with increased“chest and neck”(HR=0.85;p=0.017)and“nose and throat”(HR=0.84;p=0.013)symptoms,but the association was more profound between prolonged RFTP and increased total number of“all symptoms”(HR=0.91;p=0.001)and“whole body”/systemic(HR=0.82;p=0.007)symptoms.Conclusion A larger number of total symptoms and specifically“whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.

Alterations in Phenotypes and Responses of T Cells Within 6 Months of Recovery from COVID-19: A Cohort Study

The COVID-19 pandemic,caused by the SARS-CoV-2 infection,is a global health crisis.While many patients have clinically recovered,little is known about long-term alterations in T cell responses of COVID-19 convalescents.In this study,T cell responses in peripheral blood mononuclear cells of a long-time COVID-19 clinically recovered(20–26 weeks)cohort(LCR)were measured via flow cytometry and ELISpot.The T cell responses of LCR were comparatively analyzed against an age and sex matched short-time clinically recovered(4–9 weeks)cohort(SCR)and a healthy donor cohort(HD).All volunteers were recruited from Wuhan Jinyintan Hospital,China.Phenotypic analysis showed that activation marker PD-1 expressing on CD4^(+)T cells of LCR was still significantly lower than that of HD.Functional analysis indicated that frequencies of Tc2,Th2 and Th17 in LCR were comparable to those of HD,but Tc17 was higher than that of HD.In LCR,compared to the HD,there were fewer IFN-c producing T cells but more IL-2 secreting T cells.In addition,the circulating Tfh cells in LCR were still slightly lower compared to HD,though the subsets composition had recovered.Remarkably,SARS-CoV-2 specific T cell responses in LCR were comparable to that of SCR.Collectively,T cell responses experienced long-term alterations in phenotype and functional potential of LCR cohort.However,after clinical recovery,SARS-CoV-2 specific T cell responses could be sustained at least for six months,which may be helpful in resisting re-infection。

The incubation period of COVID-19: a global meta-analysis of 53 studies and a Chinese observation study of 11 545 patients

Background:The incubation period is a crucial index of epidemiology in understanding the spread of the emerging Coronavirus disease 2019(COVID-19).In this study,we aimed to describe the incubation period of COVID-19 globally and in the mainland of China.Methods:The searched studies were published from December 1,2019 to May 26,2021 in CNKI,Wanfang,PubMed,and Embase databases.A random-efect model was used to pool the mean incubation period.Meta-regression was used to explore the sources of heterogeneity.Meanwhile,we collected 11545 patients in the mainland of China outside Hubei from January 19,2020 to September 21,2020.The incubation period ftted with the Log-normal model by the coarseDataTools package.Results:A total of 3235 articles were searched,53 of which were included in the meta-analysis.The pooled mean incubation period of COVID-19 was 6.0 days(95%confdence interval[CI]5.6–6.5)globally,6.5 days(95%CI 6.1–6.9)in the mainland of China,and 4.6 days(95%CI 4.1–5.1)outside the mainland of China(P=0.006).The incubation period varied with age(P=0.005).Meanwhile,in 11545 patients,the mean incubation period was 7.1 days(95%CI 7.0–7.2),which was similar to the fnding in our meta-analysis.Conclusions:For COVID-19,the mean incubation period was 6.0 days globally but near 7.0 days in the mainland of China,which will help identify the time of infection and make disease control decisions.Furthermore,attention should also be paid to the region-or age-specifc incubation period.

Demand for longer quarantine period among common and uncommon COVID-19 infections: a scoping review

Background:As one of the non-pharmacological interventions to control the transmission of COVID-19,determining the quarantine duration is mainly based on the accurate estimates of the incubation period.However,patients with coarse information of the exposure date,as well as infections other than the symptomatic,were not taken into account in previously published studies.Thus,by using the statistical method dealing with the interval-censored data,we assessed the quarantine duration for both common and uncommon infections.The latter type includes the presymptomatic,the asymptomatic and the recurrent test positive patients.Methods:As of 10 December 2020,information on cases have been collected from the English and Chinese databases,including Pubmed,Google scholar,CNKI(China National Knowledge Infrastructure)and Wanfang.Official websites and medias were also searched as data sources.All data were transformed into doubly interval-censored and the accelerated failure time model was applied.By estimating the incubation period and the time-to-event distribution of worldwide COVID-19 patients,we obtain the large percentiles for determining and suggesting the quarantine policies.For symptomatic and presymptomatic COVID-19 patients,the incubation time is the duration from exposure to symptom onset.For the asymptomatic,we substitute the date of first positive result of nucleic acid testing for that of symptom onset.Furthermore,the time from hospital discharge or getting negative test result to the positive recurrence has been calculated for recurrent positive patients.Results:A total of 1920 laboratory confirmed COVID-19 cases were included.Among all uncommon infections,34.1%(n=55)of them developed symptoms or were identified beyond fourteen days.Based on all collected cases,the 95th and 99th percentiles were estimated to be 16.2 days(95%Cl 15.5-17.0)and 22.9 days(21.7-24.3)respectively.Besides,we got similar estimates based on merely symptomatic and presymptomatic infections as 15.1 days(14.4-15.7)and 21.1 days(20.0-22.2).Conclusions:There are a certain number of infected people who require longer quarantine duration.Our findings well support the current practice of the extended active monitoring.To further prevent possible transmissions induced and facilitated by such infectious outliers after the 14-days quarantine,properly prolonging the quarantine duration could be prudent for high-risk scenarios and in regions with insufficient test resources.

Multistate Models for the Recovery Process in the Covid-19 Context:An Empirical Study of Chinese Enterprises

The Covid-19 pandemic has severely affected enterprises worldwide.It is thus of practical significance to study the process of enterprise recovery from Covid-19.However,the research on the effects of relevant determinants of business recovery is limited.This article presents a multistate modeling framework that considers the determinants,recovery time,and transition likelihood of Chinese enterprises by the state of those enterprises as a result of the pandemic(recovery state),with the help of an accelerated failure time model.Empirical data from 750 enterprises were used to evaluate the recovery process.The results indicate that the main problems facing non-manufacturing industries are supply shortages and order cancellations.With the increase of supplies and orders,the probability of transition between different recovery states gradually increases,and the recovery time of enterprises becomes shorter.For manufacturing industries,the factors that hinder recovery are more complex.The main problems are employee panic and order cancellations in the initial stage,employee shortages in the middle stage,and raw material shortages in the full recovery stage.This study can provide a reference for enterprise recovery in the current pandemic context and help policymakers and business managers take necessary measures to accelerate recovery.

Cellular and Molecular Atlas of Peripheral Blood Mononuclear Cells from a Pregnant Woman After Recovery from COVID-19

Objective:This study aimed to investigate the immune response of a pregnant woman who recovered from the coronavirus disease 2019(COVID_(R)S)by using single-cell transcriptomic profiling of peripheral blood mononuclear cells(PBMCs)and to analyze the properties of different immune cell subsets.Methods:PBMCs were collected from the COVID_(R)S patient at 28 weeks of gestation,before a cesarean section.The PBMCs were then analyzed using single-cell RNA sequencing.The transcriptional profiles of myeloid,T,and natural killer(NK)cell subsets were systematically analyzed and compared with those of healthy pregnant controls from a published single-cell RNA sequencing data set.Results:We identified major cell types such as T cells,B cells,NK cells,and myeloid cells in the PBMCs of our COVID_(R)S patient.The increase of myeloid and B cells and decrease of T cells and NK cells in the PBMCs in this patient were quite distinct compared with that in the control subjects.After reclustering and Augur analysis,we found that CD16 monocytes and mucosal-associated invariant T(MAIT)cells were mostly affected within different myeloid,T,and NK cell subtypes in our COVID_(R)S patient.The proportion of CD16 monocytes in the total myeloid population was increased,and the frequency of MAIT cells in the total T and NK cells was significantly decreased in the COVID-RS patient.We also observed significant enrichment of gene sets related to antigen processing and presentation,T-cell activation,T-cell differentiation,and tumor necrosis factor superfamily cytokine production in CD16 monocytes,and enrichment of gene sets related to antigen processing and presentation,response to type II interferon,and response to virus in MAIT cells.Conclusion:Our study provides a single-cell resolution atlas of the immune gene expression patterns in PBMCs from a COVID_(R)S patient.Our findings suggest that CD16-positive monocytes and MAIT cells likely play crucial roles in the maternal immune response against severe acute respiratory syndrome coronavirus 2 infection.These results contribute to a better understanding of the maternal immune response to severe acute respiratory syndrome coronavirus 2 infection and may have implications for the development of effective treatments and preventive strategies for the coronavirus disease 2019 in pregnant women.