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Introduction: The COVID‐19 pandemic has taken many forms and continues to evolve, now around the Omicron wave, raising concerns over the globe. With COVID‐19 being declared no longer a "public health emergency of international concern (PHEIC)," the COVID pandemic is still far from over, as new Omicron subvariants of interest and concern have risen since January of 2023. Mainly with the XBB.1.5 and XBB.1.16 subvariants, the pandemic is still very much "alive" and "breathing." Methods: This review consists of five highly concerning questions about the current state of the COVID Omicron peak. We searched four main online databases to answer the first four questions. For the last one, we performed a systematic review of the literature, with keywords "Omicron," "Guidelines," and "Recommendations." Results: A total of 31 articles were included. The main symptoms of the current Omicron wave include a characteristically high fever, coughing, conjunctivitis (with itching eyes), sore throat, runny nose, congestion, fatigue, body ache, and headache. The median incubation period of the symptoms is shorter than the previous peaks. Vaccination against COVID can still be considered effective for the new subvariants. Conclusion: Guidelines recommend continuation of personal protective measures, third and fourth dose boosters, along with administration of bivalent messenger RNA vaccine boosters. The consensus antiviral treatment is combination therapy using Nirmatrelvir and Ritonavir, and the consensus for pre‐exposure prophylaxis is Tixagevimab and Cilgavimab combination. We hope the present paper raises awareness for the continuing presence of COVID and ways to lower the risks, especially for at‐risk groups. Key points: The COVID pandemic is far from over, with new variants of interest and concern rising since January of 2023 (mainly XBB.1.5 and XBB.1.16 subvariants).The main symptoms of the current Omicron wave include a high fever, coughing, conjunctivitis (with itching of the eyes), sore throat, runny nose and congestion, fatigue, body ache, and headache.The median incubation period for the current peak was calculated to be 3.8 days which is shorter than the incubation period calculated for most of the previous peaks; and the median duration of the symptoms was calculated to be 5 days for the current peak which is shorter than the duration calculated for the previous peaks by 3–5 days.A cumulative 64.42% of the population worldwide are fully vaccinated against COVID‐19 as of June 16, 2023. Vaccination against COVID can still be considered mostly effective against new symptoms, severe disease, long COVID, and death for the new subvariants.Guidelines recommend continuation of personal protective measures, third and fourth dose boosters, particularly in individuals above 60, immunocompromised patients, and healthcare personnel, along with administration of bivalent messenger RNA vaccine boosters.The consensus option for antiviral treatment is combination therapy using Nirmatrelvir and Ritonavir, and the consensus for pre‐exposure prophylaxis is Tixagevimab and Cilgavimab combination. [ABSTRACT FROM AUTHOR]

In recent years, advanced regularization techniques have emerged as a powerful tool aimed at stable estimation of infectious disease parameters that are crucial for future projections, prevention, and control. Unlike other system parameters, i.e., incubation and recovery rates, the case reporting rate, J, and the time-dependent effective reproduction number, Re(t), are directly influenced by a large number of factors making it impossible to pre-estimate these parameters in any meaningful way. In this study, we propose a novel iteratively-regularized trust-region optimization algorithm, combined with SuSvIuIvRD compartmental model, for stable reconstruction of J and Re(t) from reported epidemic data on vaccination percentages, incidence cases, and daily deaths. The innovative regularization procedure exploits (and takes full advantage of) a unique structure of the Jacobian and Hessian approximation for the nonlinear observation operator. The proposed inversion method is thoroughly tested with synthetic and real SARS-CoV-2 Delta variant data for different regions in the United States of America from July 9, 2021, to November 25, 2021. Our study shows that case reporting rate during the Delta wave of COVID-19 pandemic in the US is between 12% and 37%, with most states being in the range from 15% to 25%. This confirms earlier accounts on considerable under-reporting of COVID-19 cases due to the impact of "silent spreaders" and the limitations of testing. [ABSTRACT FROM AUTHOR]

Stability analysis of nonlinear age-of-infection and -immunity structured SVLIAR-type model of susceptible, vaccinated, latent, COVID-19 infected, asymptomatic and recovered sub-classes of population dynamics is carried out in this paper. The SVLIAR model uses five age variables - age of vaccine immunity of vaccinated individuals, age of virus infection in organism during incubation period of latent individuals, "age" of infectious disease treatment of infected individuals, age of asymptomatic infectious dis-ease of asymptomatic individuals, "age" of immunity of organism after recovering of recovered individuals. Individuals can move from one subclass to another when these age variables take some fixed values, that is the processes in sub-classes are adjusted and synchronized by age variables. The conditions for the existence of disease-free and unique endemic equilibria and their local asymptotic stability were obtained. The local asymptotic stability/instability of endemic equilibrium of SVLIAR model is defined by criterion, which relates the demographic characteristics of population, infection disease characteristics (disease-induced death rate, death rate induced by the complications after disease), characteristics of vaccination (fraction of fully vaccinated susceptibles per unit of time, vaccination efficacy) and characteristics of age variables (their maximum values) of sub-classes. These theoretical results help understand better the conditions of transmission dynamics of the COVID-19 induced disease. [ABSTRACT FROM AUTHOR]

Background: During the XXVI Antarctic Campaign of the RV (Research Vessel) "Hespérides", a SARS-CoV-2 COVID-19 outbreak was detected on board, which led to the ship returning to harbor and stopped the mission. Objectives: Describing the management of the COVID-19 outbreak on board the "Hespérides", the epidemiological characteristics and prevention and control measures carried out. Patients and methods: Retrospective, observational study over 55 crew members and 35 scientists while on board. Obtained data was analyzed from epidemiologic surveys and the swab samples by RAT (Rapid Antigen Test) and PCR (Polymerase Chain Reaction). Results: The outbreak reached 34 of the 55 persons of the crew (Attack Rate 62%) and 16 of the 34 persons among the passengers (Attack Rate AR 46%), being symptomatic 75% and 100% of them, respectively. The average number of days to detect a positive from the last close contact, obtained a mean of 2,73 days CI 95% (1,88; 3,58), compatible with incubation period of the Omicron variant. Every symptomatic patient tested positive in RAT. Meanwhile, no asymptomatic patient tested positive in RAT and needed PCR testing for identification. The infected people stayed a mean of 10 days of quarantine. For the gross rate ratio without considering other variables, among the crew the risk of becoming positive was higher for men and sailors, no significant differences were found (p>0,05). Conclusions: The estimated incidence rate was quite high because of the close environment (62% of the crew). The implementation of outbreak preventive, control and management measures, minimized the impact on health and allowed the successful achievement of the mission; specially, vaccination, the application of the onboard developed decision support tools, reversal of isolation, confining the healthy ones, disembarking contacts with risk of infection and the procedure of finishing isolation for the infected cases. [ABSTRACT FROM AUTHOR]

China is experiencing the same situation that we observed in Europe at the beginning of 2022, where all cases are due the Omicron-related variants and recombinations. Transmission dynamics of SARS-CoV-2 Omicron variant infections in Hangzhou, Zhejiang, China, January-February 2022. Figure 1 summarizes the distribution of the observed lineages in the last few weeks in Europe, USA, Italy, and China. Is a new COVID-19 wave coming from China due to an unknown variant of concern?. [Extracted from the article]

Pre-symptomatic transmission potentially reduces the effectiveness of symptom-onset-based containment and control strategies for the coronavirus disease (COVID-19). Despite evidence from multiple settings, the proportion of pre-symptomatic transmission varies among countries. To estimate the extent of pre-symptomatic transmission in South Korea, we used individual-level COVID-19 case records from the Korea Disease Control and Prevention Agency and Central Disease Control Headquarters. We inferred the probability of symptom onset per day since infection based on the density distribution of the incubation period to stratify the serial interval distribution in Period 1 (20 January–10 February 2020) and Period 2 (25 July–4 December 2021), without and with expanded testing or implementation of social distancing strategies, respectively. Assuming both no correlation as well as positive and negative correlations between the incubation period and the serial interval, we estimated the proportion of pre-symptomatic transmission in South Korea as 43.5% (accounting for correlation, range: 9.9–45.4%) and 60.0% (56.2–64.1%) without and with expanded testing, respectively, during the Delta variant's predominance. This study highlights the importance of considering pre-symptomatic transmission for COVID-19 containment and mitigation strategies because pre-symptomatic transmission may play a key role in the epidemiology of COVID-19. [ABSTRACT FROM AUTHOR]

A novel coronavirus, COVID-19 is responsible for the current outbreak of pneumonia. As of 16 September 2021, a total of 2,049,750 COVID-19 cases were recorded in Malaysia. In this study, we aimed to describe a cluster of COVID-19 cases among nonclinical staff in a teaching hospital in Kuala Lumpur Malaysia. We obtained epidemiological and clinical data from patients with confirmed COVID-19, via phone interviews and patient medical records. We performed chronological mapping of the cases to identify the possible period, mode of transmission, and cluster pattern. Three laboratory-confirmed COVID-19 cases were identified from the teaching hospital cluster. These three cases were linked epidemiologically to the religious gathering cluster in Malaysia. Seventy-four close contacts consisting of teaching hospital staff were quarantined. The median incubation period was four days (IQR 1-7). The need for intensified surveillance and a high level of alertness is vital to minimise the risk of widespread transmission in Malaysia. [ABSTRACT FROM AUTHOR]

Since March 11th, 2020, COVID-19 has been a global pandemic for more than one years due to a long and infectious incubation period. This paper establishes a heterogeneous epidemic model that divides the incubation period into infectious and non-infectious and employs the Bayesian framework to model the 'Diamond Princess' enclosed space incident. The heterogeneity includes two different identities, two transmission methods, two different-size rooms, and six transmission stages. This model is also applicable to similar mixed structures, including closed schools, hospitals, and communities. As the COVID-19 pandemic continues, our mathematical modeling can provide management insights to the governments and policymakers on how the COVID-19 disease has spread and what prevention strategies still need to be taken. [ABSTRACT FROM AUTHOR]

Background: Sixty-eight laboratory-confirmed cases of the coronavirus disease 2019 (COVID-19) (12 in Alberta [AB], 56 in Saskatchewan [SK]) were linked to a gathering at a hospital in Alberta on June 1-4, 2020, and a wake/funeral in a First Nations community in northern Saskatchewan on June 9-11, 2020.Objective: The objectives were to provide a comprehensive description of the epidemiology of the outbreak and describe the chains of transmission to inform the hypothesis that there were multiple introductions of COVID-19 at the wake/funeral.Methods: Case investigation and contact tracing was conducted by local public health in AB and SK. The Public Health Agency of Canada conducted a centralized case analysis. An epidemic curve and a Gantt chart for period of communicability were created to support or refute whether there had been multiple introductions of COVID-19 at the wake/funeral.Results: Illness onset dates ranged from May 31 to July 1, 2020. Ages ranged from 2 to 80 years (median age=43 years). Five cases were hospitalized; there were no deaths. The available case exposure information supports the hypothesis that there had been multiple introductions of COVID-19 at the wake/funeral. Public health authorities in AB and SK declared the outbreak over on July 20, 2020; based on two incubation periods (i.e. 28 days) following the illness onset of the last primary case.Conclusion: During multijurisdictional outbreaks, data sharing, coordination across health authorities and centralized analysis is essential to understanding the events that lead to the outbreak and possible hypotheses around chains of transmission. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 is a new type of coronavirus that has never been previously identified in humans. COVID-19 can cause respiratory system disorders, ranging from mild symptoms such as flu, to lung infections, such as pneumonia. The average incubation period is 5-6 days with the longest incubation period being 14 days. This virus spread rapidly around the world, including to Indonesia. From March 2, 2020 to July 9, 2020, Indonesia reported 70,736 confirmed COVID-19 cases and 3,417 deaths (CFR 4.8%). Based on data obtained from the Indonesian Pediatrician Association, 416 out of 72,314 cases confirmed positive for COVID-19 (0.9%) were children aged less than 10 years, 549/72,314 or 1% were children aged 10-19 years, and 450 of them had died by March 21, 2020. This study aimed to examine the relationship between age and gender with the incidence of COVID-19 in children at Pasar Rebo Hospital, Jakarta. Data collection used secondary data, the sample included 150 respondents, and the research instrument used was observation sheets at Pasar Rebo Hospital, Jakarta. The design of this study was quantitative cross-sectional. This research used the Chi-square test and t-test for data analysis. A total of 57.3% of respondents were male, and 42% had symptoms. According to the findings, there was a relationship between age and gender with the incidence of COVID-19 in children (p < 0.001). Male children were more at risk of being infected with COVID-19 than females, likely due to differences in the immunological system related to gender as women have a lower susceptibility to viral infections than men. Based on the results, there was also a relationship between age and the incidence of COVID-19 in children at the hospital. These results have implications for differences in the nursing care that is needed for boys vs. girls with COVID-19. [ABSTRACT FROM AUTHOR]

Predicting the number of COVID-19 cases in a geographical area is important for the management of health resources and decision making. Several methods have been proposed for COVID-19 case predictions but they have important limitations in terms of model interpretability, related to COVID-19's incubation period and major trends of disease transmission. To be able to explain prediction results in terms of incubation period and transmission trends, this paper presents the Multivariate Shapelet Learning (MSL) model to learn shapelets from historical observations in multiple areas. An experimental evaluation was done to compare the prediction performance of eleven algorithms, using the data collected from 50 US provinces/states. Results show that the proposed method is effective and efficient. The learned shapelets explain increasing and decreasing trends of new confirmed cases, and reveal that the COVID-19 incubation period in the USA is around 28 days. [ABSTRACT FROM AUTHOR]

Various types of Coronaviruses are envelopedRNAviruses from the Coronaviridae family and part of the Coronavirinae subfamily. This family of viruses affects neurological, gastrointestinal, hepatic, and respiratory systems. Recently, a new member of this family, named Covid-19, is moving around the world. The expansion of Covid-19 carries many risks, and its control requires strict planning and special policies. Iran is one of the countries in the world where the outbreak of the disease has been serious and the daily number of confirmed cases is increasing in some places. Prediction of future confirmed cases of the COVID-19 is planning with a certain policy to provide the clinical and medical supplementary. Time series models based on the statistical methodology are useful to model and forecast time-indexed data. In many situations in the real world, the ordinary classical time series models based on the symmetrical and light-tailed distributions cannot lead to a satisfactory result (or predicion). Thus, in our methodology, we consider the analysis of symmetrical/asymmetrical and light/heavy-tailed time series data based on the two-piece scale mixture of the normal (TP-SMN) distribution. The proposed model is useful for symmetrical and light-tailed time series data, and it can work well relative to the ordinary Gaussian and symmetry models (especially for COVID-19 datasets). In this study, we fit the proposed model to the historical COVID-19 datasets in Iran. We show that the proposed time series model is the best fitted model to each dataset. Finally, we predict the number of confirmed COVID-19 cases in Iran. [ABSTRACT FROM AUTHOR]

The incubation period and generation time are key characteristics in the analysis of infectious diseases. The commonly used contact‐tracing–based estimation of incubation distribution is highly influenced by the individuals' judgment on the possible date of exposure, and might lead to significant errors. On the other hand, interval censoring–based methods are able to utilize a much larger set of traveling data but may encounter biased sampling problems. The distribution of generation time is usually approximated by observed serial intervals. However, it may result in a biased estimation of generation time, especially when the disease is infectious during incubation. In this paper, the theory from renewal process is partially adopted by considering the incubation period as the interarrival time, and the duration between departure from Wuhan and onset of symptoms as the mixture of forward time and interarrival time with censored intervals. In addition, a consistent estimator for the distribution of generation time based on incubation period and serial interval is proposed for incubation‐infectious diseases. A real case application to the current outbreak of COVID‐19 is implemented. We find that the incubation period has a median of 8.50 days (95% confidence interval [CI] [7.22; 9.15]). The basic reproduction number in the early phase of COVID‐19 outbreak based on the proposed generation time estimation is estimated to be 2.96 (95% CI [2.15; 3.86]). [ABSTRACT FROM AUTHOR]

The article presents the growth rate of COVID-19 were subject to significant uncertainty, as expected with limited data and difficulties in case ascertainment, but as cases were recorded in multiple countries and robust inferences could bemade. Topics include the impact of physical distancing interventions was typically not seen after implementation, and the temporal patterns are more critical than precise estimates of the time-insensitive basic reproduction number for initiating interventions.

Background: It has been indicated that pregnant women and neonates are susceptible to COVID‐19 infection. Nevertheless, the unresolved question is about the possibility of COVID‐19 infection in neonates born to COVID‐19 mothers. The present study aimed to assess the routes through which neonates may be infected with the virus: vertically or nosocomially. Case report: This study reports the case of a neonate with COVID-19 infection who became symptomatic 30 h after birth. His pharyngeal swab specimen was reported as positive by real-time reverse transcription-polymerase chain reaction (RT-PCR). It happened while the newborn’s mother was tested for the COVID-19 twice, and she received negative results both times. Conclusion: According to the incubation period of COVID‐19 which is at least 1 day, the possibility of nosocomial transmission is less than other cases reported so far. Moreover, the mother had no COVID-19 symptoms during the last month of delivery. Further clinical research is necessary to determine the routes of maternal transmission of COVID-19 to neonates. [ABSTRACT FROM AUTHOR]

In this study, a nonlinear robust control policy is designed together with a state observer in order to manage the novel coronavirus disease (COVID-19) outbreak having an uncertain epidemiological model with unmeasurable variables. This nonlinear model for the COVID-19 epidemic includes eight state variables (susceptible, exposed, infected, quarantined, hospitalized, recovered, deceased, and insusceptible populations). Two plausible scenarios are put forward in this article to control this epidemic before and after its vaccine invention. In the first scenario, the social distancing and hospitalization rates are employed as two applicable control inputs to diminish the exposed and infected groups. However, in the second scenario after the vaccine development, the vaccination rate is taken into account as the third control input to reduce the susceptible populations, in addition to the two objectives of the first scenario. The proposed feedback control measures are defined in terms of the hospitalized and deceased populations due to the available statistical data, while other unmeasurable compartmental variables are estimated by an extended Kalman filter (EKF). In other words, the susceptible, exposed, infected, quarantined, recovered, and insusceptible individuals cannot be identified precisely because of the asymptomatic infection of COVID-19 in some cases, its incubation period, and the lack of an adequate community screening. Utilizing the Lyapunov theorem, the stability and bounded tracking convergence of the closed-loop epidemiological system are investigated in the presence of modeling uncertainties. Finally, a comprehensive simulation study is conducted based on Canada's reported cases for two defined timing plans (with different treatment rates). Obtained results demonstrate that the developed EKF-based control scheme can achieve desired epidemic goals (exponential decrease of infected, exposed, and susceptible people). • A hypothetical robust control policy to manage the COVID-19 outbreak. • Two scenarios for the epidemic control before and after the vaccine development. • Hospitalized and deceased populations are the only available feedback data. • EKF is used to estimate other unmeasurable compartments' populations. • Lyapunov theorem is employed to ensure the controlled epidemic's stability. [ABSTRACT FROM AUTHOR]

This article provides an overview through philately on the history of the quarantine ap-plications which dominate the whole world nowadays because of the COVID-19 pandemic. In this review article, the History of Quarantine is enriched with philatelic examples and tried to explain. Quarantine is defined as the isolation of animals, people, or land to prevent the spread of diseases or pests. It is different from medical isolation, which is for people who have been infected with the disease. The word "quarantine" comes from quarantine, Italian language meaning "40 days". This is because of the 40-day isolation of ships and people practiced as a measure of disease prevention related to the plague. This practice was named "Quaranta" in the Republic of Venice, whose economy is based on trade, by keeping the ships coming to the city in the sea for 40 days off the city, so that the capital Venice will not be infected with epidemics. People's efforts to take precautions against a possible pandemic risk are a practice that has been going on for ages. Quarantine, which is among the measures to prevent the spread of infectious diseases, includes measures taken by avoiding contact with humans and animals in suspected cases exposed to infectious diseases for a period equal to the longest incubation period of the disease. [ABSTRACT FROM AUTHOR]

Today, coronavirus appears as a serious challenge to the whole world. Epidemiological data of coronavirus is collected through media and web sources for the purpose of analysis. New data on COVID-19 are available daily, yet information about the biological aspects of SARS-CoV-2 and epidemiological characteristics of COVID-19 remains limited, and uncertainty remains around nearly all its parameters' values. This research provides the scientific and public health communities better resources, knowledge, and tools to improve their ability to control the infectious diseases. Using the publicly available data on the ongoing pandemic, the present study investigates the incubation period and other time intervals that govern the epidemiological dynamics of the COVID-19 infections. Formulation of the testing hypotheses for different countries with a 95% level of confidence, and descriptive statistics have been calculated to analyze in which region will COVID-19 fall according to the tested hypothesized mean of different countries. The results will be helpful in decision making as well as in further mathematical analysis and control strategy. Statistical tools are used to investigate this pandemic, which will be useful for further research. The testing of the hypothesis is done for the differences in various effects including standard errors. Changes in states' variables are observed over time. The rapid outbreak of coronavirus can be stopped by reducing its transmission. Susceptible should maintain safe distance and follow precautionary measures regarding COVID-19 transmission. [ABSTRACT FROM AUTHOR]

Background: The outbreak of COVID-19 has been defined by the World Health Organization as a pandemic, and containment depends on traditional public health measures. However, the explosive growth of the number of infected cases in a short period of time has caused tremendous pressure on medical systems. Adequate isolation facilities are essential to control outbreaks, so this study aims to quickly estimate the demand and number of isolation beds. Methods: We established a discrete simulation model for epidemiology. By adjusting or fitting necessary epidemic parameters, the effects of the following indicators on the development of the epidemic and the occupation of medical resources were explained: (1) incubation period, (2) response speed and detection capacity of the hospital, (3) disease healing time, and (4) population mobility. Finally, a method for predicting the number of isolation beds was summarized through multiple linear regression. This is a city level model that simulates the epidemic situation from the perspective of population mobility. Results: Through simulation, we show that the incubation period, response speed and detection capacity of the hospital, disease healing time, degree of population mobility, and infectivity of cured patients have different effects on the infectivity, scale, and duration of the epidemic. Among them, (1) incubation period, (2) response speed and detection capacity of the hospital, (3) disease healing time, and (4) population mobility have a significant impact on the demand and number of isolation beds (P <0.05), which agrees with the following regression equation: N = P × (-0.273 + 0.009I + 0.234M + 0.012T1 + 0.015T2) × (1 + V). [ABSTRACT FROM AUTHOR]

The ongoing Coronavirus Disease 2019 (COVID‐19) has posed a serious threat to human public health and global economy. Population mobility is an important factor that drives the spread of COVID‐19. This study aimed to quantitatively evaluate the impact of population flow on the spread of COVID‐19 from a spatiotemporal perspective. To this end, a case study was carried out in Hubei Province, which was once the most affected area of COVID‐19 outbreak in Mainland China. The geographically and temporally weighted regression (GTWR) model was applied to model the spatiotemporal association between COVID‐19 epidemic and population mobility. Two patterns of population flows, including the population inflow from Wuhan and intra‐city population movement, were considered to construct explanatory variables. Results indicate that the GTWR model can reveal the spatial–temporal‐varying relationships between COVID‐19 and population mobility. Moreover, the association between COVID‐19 case counts and population movements presented three stages of temporal variation characteristics due to the virus incubation period and implementation of strict lockdown measures. In the spatial dimension, evident geographical disparities were observed across Hubei Province. These findings can provide policymakers useful knowledge about the impact of population movement on the spatio‐temporal transmission of COVID‐19. Thus, targeted interventions, if necessary in certain time periods, can be implemented to restrict population flow in cities with high transmission risk. Key Points: To quantitatively evaluate how the effect of population flows on COVID‐19 spread varies over time and space in Hubei Province, ChinaThe association showed three stages of temporal variation characteristics and strong geographical disparities across Hubei ProvinceThe implementation of control measures by restricting population movements can play a key role in mitigating the spread of this epidemic [ABSTRACT FROM AUTHOR]

The first case of coronavirus disease (COVID-19) infection was on 17 November 2019 according to Chinese government sources. COVID-19 symptoms among children seem to be milder compared with adults. Moreover, whether certain groups of children, for instance, those with comorbidities, may be at higher risk of more severe illness is unknown. Emerging data on the spread of COVID-19 in children have not been presented in detail. Due to its long incubation period (2-14 days) and because children can be asymptomatic or present mild, nonspecific symptoms, everyone should be considered potential COVID-19 carriers unless proven otherwise. This article is aimed at highlighting vertical transmission, clinical presentation, pediatric inflammatory multisystem syndrome and common COVID-19 features among children/adolescents and its impact on them. Pediatric patients with COVID-19 may not have fever or cough. However, social distancing and everyday preventive measures are necessary as those with less serious illness and others without symptoms are likely to play a major role in disease transmission. [ABSTRACT FROM AUTHOR]

Background: The aim of our study was to determine through a systematic review and meta-analysis the incubation period of COVID-19. It was conducted based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Criteria for eligibility were all published population-based primary literature in PubMed interface and the Science Direct, dealing with incubation period of COVID-19, written in English, since December 2019 to December 2020. We estimated the mean of the incubation period using meta-analysis, taking into account between-study heterogeneity, and the analysis with moderator variables. Results: This review included 42 studies done predominantly in China. The mean and median incubation period were of maximum 8 days and 12 days respectively. In various parametric models, the 95th percentiles were in the range 10.3–16 days. The highest 99th percentile would be as long as 20.4 days. Out of the 10 included studies in the meta-analysis, 8 were conducted in China, 1 in Singapore, and 1 in Argentina. The pooled mean incubation period was 6.2 (95% CI 5.4, 7.0) days. The heterogeneity (I2 77.1%; p < 0.001) was decreased when we included the study quality and the method of calculation used as moderator variables (I2 0%). The mean incubation period ranged from 5.2 (95% CI 4.4 to 5.9) to 6.65 days (95% CI 6.0 to 7.2). Conclusions: This work provides additional evidence of incubation period for COVID-19 and showed that it is prudent not to dismiss the possibility of incubation periods up to 14 days at this stage of the epidemic. [ABSTRACT FROM AUTHOR]

Introduction: Ayurveda being one of the oldest surviving Medical Tradition, has a key role to play in this crucial situation.Covid-19 it is not a simple infectious disease it is a pandemic disease caused by Coronavirus which reflects in human but stay as a host in animals. These viruses contain seven different strains; of which SARS-COV-2 is responsible for Covid-19. Its spread through droplets via air due to sneezing, cough, talking and direct or indirect contact with an infected patient such as handshake, touch surfaces contact by an infected person. This virus causes the severe acute respiratory syndrome. Its incubation period varies between 2 to 14 days, the disease can transmit from symptoms less person to person. Material & Methods: Covid-19research information was collected from the world health organization, books, research papers, journals. Ayurveda literature from reference books, internet, and opinions of experts utilize as a review. Observations and Results: COVID-19 can be provisionally understood from the Ayurvedic perspective as vātakapha dominant sannipātajvara of āgantu origin with pittānubandha. The asymptomatic, presymptomatic, mild, moderate, severe and critical stages of COVID-19 with varying clinical presentations have been analysed on the basis of nidāna, doṣa, dūṣya, nidānapañcaka and ṣaṭkriyākāla. Conclusion: It will be good to take preventive measures which boost our immunity in these times. Ayurveda extensive knowledge base on preventive care by which each individual can achieve by uplifting and maintain his or her immunity. In Ayurveda, Immunity comes under the heading of Vyadhiksamatwa. In Ayurveda, many single drugs or compound formulation were mentioned as Rasayana to boost up Immunity (Bala or Vyadhiksamatwa). [ABSTRACT FROM AUTHOR]

To increase situational awareness and support evidence-based policymaking, we formulated a mathematical model for coronavirus disease transmission within a regional population. This compartmental model accounts for quarantine, self-isolation, social distancing, a nonexponentially distributed incubation period, asymptomatic persons, and mild and severe forms of symptomatic disease. We used Bayesian inference to calibrate region-specific models for consistency with daily reports of confirmed cases in the 15 most populous metropolitan statistical areas in the United States. We also quantified uncertainty in parameter estimates and forecasts. This online learning approach enables early identification of new trends despite considerable variability in case reporting. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) viral course and behavior remain unpredictable. This study describes incubation time and viral clearance of COVID-19 hospitalized cases in Northern Jordan. Methods: All COVID-19 confirmed cases hospitalized from March 15 to June 09, 2020, were included. Nasopharyngeal swabs were collected, and COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) was performed every two days in all cases. The viral cure was defined when two negative RT-PCR tests were obtained ≥ 24 hours apart. Viral clearance time (VCT) reflects the time from the first positive nasopharyngeal swab to the first of two consecutive negative tests. Results: In this cohort, a total of 157 patients were included. Most cases resulted from two major outbreaks. The median incubation period was 6 days (IQR, 3– 10) and ranged from 1 to 17 days. The median VCT was 13 days (IQR, 7– 2) and ranged from 1 to 40 days. Symptomatic presentation and abnormal chest radiograph were predictors for a prolonged VCT (p=0.015 and p=0.014, respectively). The median time of resolution of symptoms was 7 days (IQR, 3– 10 days). Most symptomatic cases (91.7%) remained RT-PCR positive for up to 20 days after symptoms resolution, with a median of 13.5 days. VCT significantly correlated with the incubation period (p=0.013). Conclusion: Viral cure lagged for as long as 20 days after resolution of symptoms. Continuing with social-distancing, frequent hand hygiene, and wearing facial mask remains essential and is recommended even after clinical resolution of symptoms. [ABSTRACT FROM AUTHOR]

The article presents the discussion on subset of the children progressing to liver failure. Topics include HAdVs being double-stranded non-enveloped DNA viruses well known to be associated with pediatric illnesses; and transmission of HAdV similar to that of other respiratory viruses, by drops or aerosols, or through direct inoculation in the conjunctiva or oral-nasal mucosa.

Immunosuppressed patients like patients with leukemia or lymphoma, but also patients after autologous or allogeneic stem cell transplantation are at particular risk for an infection with COVID‐19. We describe a COVID‐19 outbreak on our leukemia and stem cell transplantation unit (LSCT‐Unit) originating from a patient with newly diagnosed acute myeloid leukemia. The patient was treated with intensive induction chemotherapy and we characterize the subsequent outbreak of COVID‐19 on a LSCT‐Unit. We describe the characteristics of the 36 contacts among the medical team, the results of their PCR and antibody tests and clinical aspects and features of infected employees. Of these 36 close contacts, 9 employees of the LSCT‐Unit were infected and were tested positive by PCR and/or antibody‐testing. 8/9 of them were symptomatic, 3/9 with severe, 5/9 with mild symptoms, and one person without symptoms. Due to stringent hygiene measures, the outbreak did not lead to infections of other patients despite ongoing clinical work. Moreover, we demonstrate that incubation period and clinical course of a COVID‐19 infection in an immunosuppressed patient could be unusual compared to that of immunocompetent patients. Consistent PCR and antibody testing are helpful to understand, control, and prevent outbreaks. For the safety of health‐care workers and patients alike, all employees wore FFP2 masks and were trained to adhere to several further safety guidelines. The implementation of rigorous hygiene measures is the key to controlling an outbreak and preventing infections of other patients. [ABSTRACT FROM AUTHOR]

Background: During the coronavirus disease 2019 (COVID-19) pandemic, temporary foreign workers (TFWs) provided a critical role to maintaining the food supply in Canada, yet workers faced a number of challenges that made them particularly vulnerable to COVID-19. The objective of this study was to describe the epidemiological investigation and public health response to a COVID-19 outbreak among TFWs in an agricultural setting in British Columbia from March to May 2020.Methods: An outbreak was declared on March 28, 2020 following detection of two cases of COVID-19 among a group of 63 TFWs employed by a nursery and garden centre. Outbreak control measures included immediate isolation of cases, case finding via outreach screening and testing, cohorting of asymptomatic workers and enhanced cleaning and disinfection. The outbreak was declared over on May 10, 2020.Results: A total of 26 COVID-19 cases were identified among the group of TFWs; no cases were identified among local workers. Cases were primarily male (77%) with a median age of 41 years. Symptom onsets ranged from March 8 to April 9, 2020. One case required overnight hospitalization for pneumonia.Conclusion: This was the first COVID-19 community outbreak identified in British Columbia and the first COVID-19 outbreak identified among TFWs in Canada. This outbreak began prior to implementation of provincial and federal quarantine orders for international travellers. A provincial policy was later developed that requires TFWs to quarantine in government-funded accommodation prior to deployment to agricultural settings. [ABSTRACT FROM AUTHOR]

• Nosocomial infection is an ongoing concern in the COVID-19 outbreak. • Assessing the cost and health outcomes of an extended screening strategy using a branching process infection model. • In the base case analysis, an R 0 of 2.5 and incubation period of 4 days, an estimated 239 cases could be averted over 150 days. • The expanded screening criteria can help to identify and promptly isolate positive COVID cases in a cost-saving manner. • The proposed screening criteria should be considered to mitigate nosocomial transmission risk within healthcare facilities. Nosocomial infection is an ongoing concern in the COVID-19 outbreak. The effective screening of suspected cases in the healthcare setting is therefore necessary, enabling the early identification and prompt isolation of cases for epidemic containment. We aimed to assess the cost and health outcomes of an extended screening strategy, implemented in Singapore on 07 February 2020, which maximizes case identification in the public healthcare system. We explored the effects of the expanded screening criteria which allow clinicians to isolate and investigate patients presenting with undifferentiated fever or respiratory symptoms or chest x-ray abnormalities. We formulated a cost appraisal framework which evaluated the treatment costs averted from the prevention of secondary transmission in the hospital setting, as determined by a branching process infection model, and compared these to the costs of the additional testing required to meet the criteria. In the base case analysis, an R 0 of 2.5 and incubation period of 4 days, an estimated 239 (95% CI: 201–287) cases could be averted over 150 days within the hospital setting through ESC. A corresponding $2.36 (2–2.85) million USD in costs could be averted with net cost savings of $124,000 (95% CI: −334,000 to 516,000). In the sensitivity analyses, when positive identification rates (PIR) were above 7%, regardless of R 0 and incubation period, all scenarios were cost-saving. The expanded screening criteria can help to identify and promptly isolate positive COVID cases in a cost-saving manner or within acceptable cost margins where the costs incurred from the testing of negative patients could be negated by the averted costs. Outbreak control must be sustainable and effective; the proposed screening criteria should be considered to mitigate nosocomial transmission risk within healthcare facilities. [ABSTRACT FROM AUTHOR]

Background: This study was intended to investigate the epidemiological characteristics of COVID-19 clusters and the severity distribution of clinical symptoms of involved cases in Sichuan Province, so as to provide information support for the development and adjustment of strategies for the prevention and control of local clusters.Methods: The epidemiological characteristics of 67 local clusters of COVID-19 cases in Sichuan Province reported as of March 17, 2020 were described and analyzed. Information about all COVID-19 clusters and involved cases was acquired from the China Information System for Disease Control and Prevention and analyzed with the epidemiological investigation results taken into account.Results: The clusters were temporally and regionally concentrated. Clusters caused by imported cases from other provinces accounted for 73.13%; familial clusters accounted for 68.66%; the average attack rate was 8.54%, and the average secondary attack rate was 6.11%; the median incubation period was 8.5 d; a total of 28 cases met the criteria for incubation period determination, and in the 28 cases, the incubation period was > 14 d in 21.43% (6/28). a total of 226 confirmed cases were reported in the 67 clusters. Ten cases were exposed before the confirmed cases they contacted with developed clinical symptoms, and the possibility of exposure to other infection sources was ruled out; two clusters were caused by asymptomatic carriers; confirmed cases mainly presented with fever, respiratory and systemic symptoms; a gradual decline in the severity of clinical symptoms was noted with the increase of the case generation.Conclusions: Population movement and gathering restrictions and strict close contact management measures will significantly contribute to the identification and control of cases. Transmission during the incubation period and asymptomatic infections have been noted. Studies on the pathogenicity and transmissibility in these populations and on COVID-19 antibody levels and protective effects in healthy people and cases are required. [ABSTRACT FROM AUTHOR]

Coronaviruses have long been studied in both human and veterinary fields. Whereas the initial detection of endemic human respiratory coronaviruses was problematic, detection of these and newly discovered human coronaviruses has been greatly facilitated with major advances in the laboratory. Nevertheless, technological factors can affect the accuracy and timeliness of virus detection. Many human coronaviruses can be variably found in stool samples. All human coronaviruses have been variably associated with symptoms of gastroenteritis. Coronaviruses can occasionally be cultured from enteric specimens, but most detection is accomplished with genetic amplification technologies. Excretion of viral RNA in stool can extend for a prolonged period. Culture‐positive stool samples have been found to exceed a fourteen day period after onset of infection for some coronaviruses. Virus can also sometimes be cultured from patients' respiratory samples during the late incubation period. Relatively asymptomatic patients may excrete virus. Both viable and nonviable virus can be found in the immediate environment of the patient, the health care worker, and less often the public. These lessons from the past study of animal and human coronaviruses can be extended to presumptions for severe acute respiratory syndrome coronavirus 2. Already, the early reports from the coronavirus disease‐2019 pandemic are confirming some concerns. These data have the cumulative potential to cause us to rethink some current and common public health and infection control strategies. Highlights: coronaviruses are variably found in human enteric samples during the course of infection.abdominal and intestinal illnesses are associated with coronavirus infections.enteric excretion of live virus and viral RNA have been confirmed.occasionally, live virus can be found in stool samples to exceed a fourteen day period after disease onset, and virus can also be cultured from these samples during the late incubation period or from asymptomatic individuals. [ABSTRACT FROM AUTHOR]

Cases of coronavirus disease 2019 (COVID‐19) emigrating from Wuhan escalated the risk of spreading the disease in other cities. This report focused on outside‐Wuhan patients to assess the transmission and clinical characteristics of this illness. Contact investigation was conducted on each patient who was admitted to the assigned hospitals in Hunan Province (geographically adjacent to Wuhan) from 22 January to 23 February 2020. Cases were confirmed by the polymerase chain reaction test. Demographic, clinical, and outcomes were collected and analyzed. Of the 104 patients, 48 (46.15%) were cases who immigrated from Wuhan; 93 (89.42%) had a definite contact history with infection. Family clusters were the major body of patients. Transmission along the chain of three "generations" was observed. Five asymptomatic infected cases were found and two of them infected their relatives. Mean age was 43 (range, 8‐84) years, and 49 (47.12%) were male. The median incubation period was 6 (range, 1‐32) days, which of 8 patients ranged from 18 to 32 days, 96 (92.31%) were discharged, and 1 (0.96%) died. The average hospital stay was 10 (range, 8‐14) days. Family but not community transmission became the main body of infections in the two centers, suggesting the timely control measures after the Wuhan shutdown worked well. Asymptomatic transmission demonstrated here warned us that it may lead to the widespread of COVID‐19. A 14‐day quarantine may need to be prolonged. Highlights: The smoothly increase in the cumulative number of confirmations of the two centers indicates that the timely control measures work well, family clusters represent as the major body of infections, transmission along the chain of 3 "generations" was observed. No gender difference of patients was found, indicating male and female may have the same susceptibility of this illness. But the asymptomatic transmission demonstrated here warned us it may bring more risk to the spread of COVID‐19. The differences in demographics and clinical characteristics between emigrated patients and indigenous cases were not significant. [ABSTRACT FROM AUTHOR]

Background: The long incubation period and asymptomatic spread of COVID-19 present considerable challenges for health-care institutions. The identification of infected individuals is vital to prevent the spread of illness to staff and other patients as well as to identify those who may be at risk for disease-related complications. This is particularly relevant with the resumption of elective orthopaedic surgery around the world. We report the results of a universal testing protocol for COVID-19 in patients undergoing orthopaedic surgery during the coronavirus pandemic and to describe the postoperative course of asymptomatic patients who were positive for COVID-19.Methods: A retrospective review of adult operative cases between March 25, 2020, and April 24, 2020, at an orthopaedic specialty hospital in New York City was performed. Initially, a screening questionnaire consisting of relevant signs and symptoms (e.g., fever, cough, shortness of breath) or exposure dictated the need for nasopharyngeal swab real-time quantitative polymerase chain reaction (RT-PCR) testing for all admitted patients. An institutional policy change occurred on April 5, 2020, that indicated nasopharyngeal swab RT-PCR testing for all orthopaedic admissions. Screening and testing data for COVID-19 as well as relevant imaging, laboratory values, and postoperative complications were reviewed for all patients.Results: From April 5, 2020, to April 24, 2020, 99 patients underwent routine nasopharyngeal swab testing for COVID-19 prior to their planned orthopaedic surgical procedure. Of the 12.1% of patients who tested positive for COVID-19, 58.3% were asymptomatic. Three asymptomatic patients developed postoperative hypoxia, with 2 requiring intubation. The negative predictive value of using the signs and symptoms of disease to predict a negative test result was 91.4% (95% confidence interval [CI], 81.0% to 97.1%). Including a positive chest radiographic finding as a screening criterion did not improve the negative predictive value of screening (92.5% [95% CI, 81.8% to 97.9%]).Conclusions: A protocol for universal testing of all orthopaedic surgery admissions at 1 hospital in New York City during a 3-week period revealed a high rate of COVID-19 infections. Importantly, the majority of these patients were asymptomatic. Using chest radiography did not significantly improve the negative predictive value of screening. These results have important implications as hospitals anticipate the resumption of elective surgical procedures.Level Of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Background: In December, 2019, the newly identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, causing COVID-19, a respiratory disease presenting with fever, cough, and often pneumonia. WHO has set the strategic objective to interrupt spread of SARS-CoV-2 worldwide. An outbreak in Bavaria, Germany, starting at the end of January, 2020, provided the opportunity to study transmission events, incubation period, and secondary attack rates.Methods: A case was defined as a person with SARS-CoV-2 infection confirmed by RT-PCR. Case interviews were done to describe timing of onset and nature of symptoms and to identify and classify contacts as high risk (had cumulative face-to-face contact with a confirmed case for ≥15 min, direct contact with secretions or body fluids of a patient with confirmed COVID-19, or, in the case of health-care workers, had worked within 2 m of a patient with confirmed COVID-19 without personal protective equipment) or low risk (all other contacts). High-risk contacts were ordered to stay at home in quarantine for 14 days and were actively followed up and monitored for symptoms, and low-risk contacts were tested upon self-reporting of symptoms. We defined fever and cough as specific symptoms, and defined a prodromal phase as the presence of non-specific symptoms for at least 1 day before the onset of specific symptoms. Whole genome sequencing was used to confirm epidemiological links and clarify transmission events where contact histories were ambiguous; integration with epidemiological data enabled precise reconstruction of exposure events and incubation periods. Secondary attack rates were calculated as the number of cases divided by the number of contacts, using Fisher's exact test for the 95% CIs.Findings: Patient 0 was a Chinese resident who visited Germany for professional reasons. 16 subsequent cases, often with mild and non-specific symptoms, emerged in four transmission generations. Signature mutations in the viral genome occurred upon foundation of generation 2, as well as in one case pertaining to generation 4. The median incubation period was 4·0 days (IQR 2·3-4·3) and the median serial interval was 4·0 days (3·0-5·0). Transmission events were likely to have occurred presymptomatically for one case (possibly five more), at the day of symptom onset for four cases (possibly five more), and the remainder after the day of symptom onset or unknown. One or two cases resulted from contact with a case during the prodromal phase. Secondary attack rates were 75·0% (95% CI 19·0-99·0; three of four people) among members of a household cluster in common isolation, 10·0% (1·2-32·0; two of 20) among household contacts only together until isolation of the patient, and 5·1% (2·6-8·9; 11 of 217) among non-household, high-risk contacts.Interpretation: Although patients in our study presented with predominately mild, non-specific symptoms, infectiousness before or on the day of symptom onset was substantial. Additionally, the incubation period was often very short and false-negative tests occurred. These results suggest that although the outbreak was controlled, successful long-term and global containment of COVID-19 could be difficult to achieve.Funding: All authors are employed and all expenses covered by governmental, federal state, or other publicly funded institutions. [ABSTRACT FROM AUTHOR]

Dear Sir, Since the first cases reported in China in December 2019 [[1]], coronavirus disease 2019 (COVID-19) caused by a novel coronavirus, now referred to as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), became a pandemic raising a lot of concern to control [[2]]. Protection of nuclear medicine staff Although biological COVID-19 protection is currently evaluated and bears specificities, it shares a common approach with radiological protection that is well mastered by nuclear medicine teams. Nuclear medicine staffs are occasionally using FFP 2 respirators (or N95 respirators) when taking care of patients with bacterial, fungal, or viral (e.g., influenza) respiratory infections. [Extracted from the article]

Objective: To assess the awareness level of medical doctors regarding COVID-19 Material and Methods: This cross-sectional study was conducted by Department of Medicine, Khyber Teaching Hospital Peshawar. A total of 283 medical doctors including dental/medical undergraduates of final year professionals, postgraduate residents and fellows participated in the study and filled an online validated questionnaire. The questionnaire comprised of questions about characteristics of study participants, origin and nature of COVID-19, clinical features and complications of COVID-19, diagnosis and management of COVID-19 and lastly about preventive measures against COVID-19. The results were stratified into tables on the basis of qualification of the study participants. Data was analyzed by SPSS 23 and presented in tables. Results: Results of the survey indicate that doctors are generally aware about the different aspects of COVID-19. About 96.1% doctors were aware of bat origin of COVID-19; 49.5% were aware about animal to person and person to person mode of spread of corona virus; 83.4% were aware about droplet borne mode of transmission of coronavirus infection; 91.9% doctors knew about up to 2 weeks incubation period of COVID-19 and 97.2% of the participants were informed that COVID had been declared a pandemic by World Health Organization (WHO). Seventy-seven percent (77%) doctors were aware that dry cough is a common presentation of COVID-19 among the options of runny nose, body aches and pains and dry cough; 82% were aware that acute respiratory distress syndrome (ARDS) is the most lethal complication of COVID-19; 55.8% study participants were aware that COVID-19 was causing most of the daily mortalities in current COVID pandemic while 75.3% doctors were aware about 2% global fatality rate of COVID-19. Most of the study respondents (97.2%) were informed about viral RNA PCR from nasopharyngeal swab as diagnostic modality for COVID-19; 87.6% doctors were aware about most common computed tomography (CT) chest findings of bilateral lung infiltrates and 89% respondents knew about supportive care as ultimate care for patients with COVID-19. Majority of doctors (66.1%) were aware that social distancing was most important preventive measure against COVID-19, with frequent hand washing and use of face mask to follow respectively. Almost, 75.6% participants were aware that N95 mask was meant for use by staff taking nasopharyngeal swab from suspected COVID-19 patient and 94% of the doctors were aware about 20 seconds recommended duration of hand washing by World Health Organization. Conclusion: Doctor's community is aware of different aspects of COVID-19 including epidemiology, clinical manifestations, diagnostics, complications and preventive measures effective against COVID-19. [ABSTRACT FROM AUTHOR]

This review presents a synopsis on the current COVID-19 pandemic, with focus on preventive measures. COVID-19 is a new viral infection, and is in form of a positive-sense, single-stranded RNA Coronavirus which belongs to an expanded group of viruses which were identified six decades ago. Importantly, the new COVID-19 belongs to the group of SARS-CoV, and it originated in bats but infected humans through smuggled pangolins. At first, the mode of transmission of infection was animal-to-person, but person-to-person and community transmission of the virus has been confirmed in many parts of the world. With an incubation period of between two-fourteen days, signs and symptoms of infection are mild to high respiratory illness; characterized with cough, breathing problems (shortness of breath), high temperature (Fever), tiredness (Fatigue) and nausea. Presently, no vaccines or specific treatment is available for COVID-19, in light of the aforementioned; prevention is the only substantial and less expensive option. With the envisaged explosive community transmission of COVID-19 in the coming weeks in places with limited daily testing, especially in African countries, it is recommended among many that social distancing which includes avoiding any form of contact with people; either through greetings, hugging or shaking of hands and large gatherings, avoid contact with animal items, dead or alive animals, sick and dead people from areas experiencing COVID-19 epidemic, and basic hygienic practices like thorough washing of hands with clean water and antiseptic soap for the duration of at least twenty seconds should be practiced always. However, in the absence of the aforementioned, an alcohol-based hand gel should be used on the hands frequently. Furthermore, health care workers should adhere strictly to the standard preventive measures in areas of heightened COVID-19 epidemic. [ABSTRACT FROM AUTHOR]

The pandemic of coronavirus disease-19 started in Wuhan City of China in December 2019 and quickly spread all over the world, infecting almost two million people. The clinical presentation of the disease is mild/moderate in 80% of cases; however, it leads to a critical clinical presentation by 20%, which is severe or very severe disease requires intensive care. The mortality is high, especially in cases with advanced age, comorbidities, and pneumonia-related acute respiratory distress syndrome and respiratory failure, while children are often with subclinical manifestations. The most common clinical findings are fever, cough, fatigue, and shortness of breath. The incubation period ranges from 2 to 14 days. The most common laboratory findings are lymphocytopenia and thrombocytopenia. Elevated D-dimer, ferritin, troponin I, lactate dehydrogenase and interleukin-6, and hypoxia (O2 saturation =90%) were identified as "poor prognostic factors" associated with severe disease and mortality. The monitoring of such parameters was reported to be beneficial for determining patients with risk and potentially high mortality. [ABSTRACT FROM AUTHOR]