Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported at the end of 2019 as a worldwide health concern causing a pandemic of unusual viral pneumonia and many other organ damages, which was defined by the World Health Organization as coronavirus disease 2019 (COVID-19). The pandemic is considered a significant threat to global public health till now. In this review, we have summarized the lessons learnt during the emergence and spread of SARS-CoV-2, including its prototype and variants. The overall clinical features of variants of concern (VOC), heterogeneity in the clinical manifestations, radiology and pathology of COVID-19 patients are also discussed, along with advances in therapeutic agents.
Humans ; COVID-19 ; SARS-CoV-2 ; Pneumonia, Viral/prevention & control* ; Global Health ; China/epidemiology*

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a new zoonotic agent that emerged in December 2019, causes coronavirus disease 2019 (COVID-19). This infection can be spread by asymptomatic, presymptomatic, and symptomatic carriers. SARS-CoV-2 spreads primarily via respiratory droplets during close person-to-person contact in a closed space, especially a building. This article summarizes the environmental factors involved in SARS-CoV-2 transmission, including a strategy to prevent SARS-CoV-2 transmission in a building environment. SARS-CoV-2 can persist on surfaces of fomites for at least 3 days depending on the conditions. If SARS-CoV-2 is aerosolized intentionally, it is stable for at least several hours. SARS-CoV-2 is inactivated rapidly on surfaces with sunlight. Close-contact aerosol transmission through smaller aerosolized particles is likely to be combined with respiratory droplets and contact transmission in a confined, crowded, and poorly ventilated indoor environment, as suggested by some cluster cases. Although evidence of the effect of aerosol transmission is limited and uncertainty remains, adequate preventive measures to control indoor environmental quality are required, based on a precautionary approach, because COVID-19 has caused serious global damages to public health, community, and the social economy. The expert panel for COVID-19 in Japan has focused on the "3 Cs," namely, "closed spaces with poor ventilation," "crowded spaces with many people," and "close contact." In addition, the Ministry of Health, Labour and Welfare of Japan has been recommending adequate ventilation in all closed spaces in accordance with the existing standards of the Law for Maintenance of Sanitation in Buildings as one of the initial political actions to prevent the spread of COVID-19. However, specific standards for indoor environmental quality control have not been recommended and many scientific uncertainties remain regarding the infection dynamics and mode of SARS-CoV-2 transmission in closed indoor spaces. Further research and evaluation are required regarding the effect and role of indoor environmental quality control, especially ventilation.
Aerosols ; Air Pollution, Indoor/prevention & control* ; Betacoronavirus/physiology* ; COVID-19 ; Coronavirus Infections/transmission* ; Crowding ; Environment, Controlled ; Humans ; Pandemics/prevention & control* ; Pneumonia, Viral/transmission* ; SARS-CoV-2 ; Ventilation

OBJECTIVE: To explore the preventing infection measures of new coronavirus disease 2019(COVID-19) patients during mechanical ventilation, and to provide reference for the safe application of mechanical ventilation. METHODS: Retrieved from PubMed, Ovid and other databases, and combined with the application experience of mechanical ventilation were collected to explore the preventing infection measures of COVID-19 patients during mechanical ventilation. RESULTS: This paper put forward the preventing infection measures of external circuit, internal circuit, outer surface, filter and special parts in ventilator. The preventing infection measures of sputum suction and nebulization were summarized. CONCLUSIONS The preventing infection measures of COVID-19 patients during mechanical ventilation are successfully completed, which can provide suggestions for the application and maintenance of mechanical ventilation.
Betacoronavirus ; COVID-19 ; Coronavirus Infections/therapy* ; Humans ; Infection Control/methods* ; Pandemics/prevention & control* ; Pneumonia, Viral/therapy* ; Respiration, Artificial ; SARS-CoV-2 ; Ventilators, Mechanical

OBJECTIVE: To explore the infection prevention and control strategy of bedside blood purification treatment in corona virus disease 2019 (COVID-19) isolation ward, and to evaluate the effect of infection prevention and control management measures. METHODS: We summarized and analyzed the clinical features, infection status, outcome and infection prevention and control measures of bedside blood purification treatment patients in COVID-19 isolation ward from February 8, 2020 to March 31, 2020, analyzed the COVID-19 cross-infection between the patients and medical staffs, and the blood-borne pathogens cross-infection situation between the patients, and analyzed the effect of bundle prevention and control measures in controlling the occurrence and spread of cross-infection. RESULTS: A total of 101 COVID-19 patients were hospitalized in this COVID-19 isolation ward, of whom 10 patients (9.90%) received bedside blood purification treatment and the blood purification treatment method was continuous hemodialysis filtration (CVVHDF), and the 10 patients received 79 times of blood purification treatment in total. The prevention and control management measures adopted included divisional isolation, patient behavior isolation and patient placement, operator personal protection and hand hygiene, dialysis waste fluid disposal, isolation room air purification, object surfaces, medical devices and medical fabrics dis-infection management. There were no occurrence and spread of COVID-19 in the medical healthcare workers and blood-borne pathogens cross-infection in the patients. And all the twice throat swabs (two sampling interval > 1 day) of the medical staffs in COVID-19 virus nucleic acid test were negative. The 2 suspected COVID-19 patients' throat swab virus nucleic acid test and the COVID-19 IgG, IgM were always both negative, the chest CT showed no viral pneumonia. CONCLUSION Bedside blood purification treatment in the COVID-19 isolation ward, the occurrence and spread of healthcare associated infection can be effectively controlled through effective infection prevention and control management, including divisional isolation, patient behavior isolation and patient placement, operator personal protection and hand hygiene, dialysis waste fluid disposal, isolation room's air purification, object surfaces, medical devices and medical fabrics disinfection, which can provide experience for diagnosis, treatment and prevention and control of patients in the respiratory infectious disease ward.
Betacoronavirus ; COVID-19 ; Coronavirus Infections/therapy* ; Humans ; Infection Control/statistics & numerical data* ; Pandemics/prevention & control* ; Pneumonia, Viral/therapy* ; SARS-CoV-2

OBJECTIVE: To investigate the current situation of virus exposure risk incidents of nurses against corona virus disease 2019 (COVID-19) in Wuhan, and to provide reference evidence for nursing managers to protect nursing staff who were working in the isolation ward. METHODS: In the study, 308 nursing staff against COVID-19 working in the isolation ward in Wuhan were conveniently selected to participate in the investigation. The designed questionnaires including 7 kinds of protective exposure risk events were made by the team of researchers on the basis of literature review and interview with the nurses in Wuhan. All the participants recalled their working experience in the status of dressing in personal protective equipment and filled in the questionnaires online by WeChat according to the same instruction. RESULTS: The questionnaires were filled in validly by a total of 304 nursing staff, of whom 88.8% received emergency training on the prevention and dealing measurement of exposure risk events. The incidence of shoe cover contamination, falling off or torn was relatively high, about 53.6%. Due to the protection of gloves, the incidence of hand or skin contamination was relatively low, about 14.1%. The most nervousness of protective exposure risk event for nurses was N95 mask contamination, falling off or shifting, with a score of 8.2±2.3, showing a higher psychiatric burden. Single factor analysis found that the number of days in Wuhan was different, the number of the types of protective risk events occurred was different (χ²=14.562, P=0.024), orderly multivariate Logistic regression found that men were the independent protective factor for the number of the types of protective exposure risk events that occurred (P=0.019). CONCLUSION Protective exposure risk events may occur in the work of nursing staff working in the isolation ward in Wuhan. It is necessary to guide nurses to prevent the occurrence of protective exposure risk events and effectively deal with them, so as to prevent virus exposure and reduce psycholo-gical burden.
Betacoronavirus ; COVID-19 ; China ; Coronavirus Infections/transmission* ; Ear Protective Devices ; Humans ; Male ; Occupational Exposure/prevention & control* ; Pandemics/prevention & control* ; Pneumonia, Viral/transmission* ; Risk Factors ; SARS-CoV-2

OBJECTIVE: To determine the environmental contamination degree of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in corona virus disease 2019 (COVID-19) wards, to offer gui-dance for the infection control and to improve safety practices for medical staff, by sampling and detecting SARS-CoV-2 nucleic acid from the air of hospital wards, the high-frequency contact surfaces in the contaminated area and the surfaces of medical staff's protective equipment in a COVID-19 designated hospital in Wuhan, China. METHODS: From March 11 to March 19, 2020, we collected air samples from the clean area, the buffer room and the contaminated area respectively in the COVID-19 wards using a portable bioaerosol concentrator WA-15. And sterile premoistened swabs were used to sample the high-frequency contacted surfaces in the contaminated area and the surfaces of medical staff's protective equipment including outermost gloves, tracheotomy operator's positive pressure respiratory protective hood and isolation clothing. The SARS-CoV-2 nucleic acid of the samples were detected by real-time fluorescence quantitative PCR. During the isolation medical observation period, those medical staff who worked in the COVID-19 wards were detected for SARS-CoV-2 nucleic acid with oropharyngeal swabs, IgM and IgG antibody in the sera, and chest CT scans to confirm the infection status of COVID-19. RESULTS: No SARS-CoV-2 nucleic acid was detected in the tested samples, including the 90 air samples from the COVID-19 wards including clean area, buffer room and contaminated area, the 38 high-frequency contact surfaces samples of the contaminated area and 16 surface samples of medical staff's protective equipment including outermost gloves and isolation clothing. Moreover, detection of SARS-CoV-2 nucleic acid by oropharyngeal swabs and IgM, IgG antibodies in the sera of all the health-care workers who participated in the treatment for COVID-19 were all negative. Besides, no chest CT scan images of medical staff exhibited COVID-19 lung presentations. CONCLUSION Good ventilation conditions, strict disinfection of environmental facilities in hospital wards, guidance for correct habits in patients, and strict hand hygiene during medical staff are important to reduce the formation of viral aerosols, cut down the aerosol load, and avoid cross-infection in isolation wards. In the face of infectious diseases that were not fully mastered but ma-naged as class A, it is safe for medical personnel to be equipped at a high level.
Betacoronavirus ; COVID-19 ; China ; Coronavirus Infections ; Humans ; Medical Staff ; Pandemics ; Pneumonia, Viral ; Protective Devices ; SARS-CoV-2 ; Severe Acute Respiratory Syndrome/prevention & control*

Betacoronavirus ; Communication ; Coronavirus Infections ; epidemiology ; prevention & control ; therapy ; Disease Outbreaks ; Humans ; Medical Staff ; Pandemics ; prevention & control ; Patient Care Team ; Personal Protective Equipment ; Pneumonia, Viral ; epidemiology ; prevention & control ; therapy

Severe cases infected with the coronavirus disease 2019 (COVID-19), named by the World Health Organization (WHO) on Feb. 11, 2020, tend to present a hypercatabolic state because of severe systemic consumption, and are susceptible to stress ulcers and even life-threatening gastrointestinal bleeding. Endoscopic diagnosis and treatment constitute an irreplaceable part in the handling of severe COVID-19 cases. Endoscopes, as reusable precision instruments with complicated structures, require more techniques than other medical devices in cleaning, disinfection, sterilization, and other reprocessing procedures. From 2016 to 2019, health care-acquired infection caused by improper endoscope reprocessing has always been among the top 5 on the list of top 10 health technology hazards issued by the Emergency Care Research Institute. Considering the highly infective nature of COVID-19 and the potential aerosol contamination therefrom, it is of pivotal significance to ensure that endoscopes are strictly reprocessed between uses. In accordance with the national standard "Regulation for Cleaning and Disinfection Technique of Flexible Endoscope (WS507-2016)," we improved the workflow of endoscope reprocessing including the selection of chemicals in an effort to ensure quality control throughout the clinical management towards COVID-19 patients. Based on the experience we attained from the 12 severe COVID-19 cases in our hospital who underwent endoscopy 23 times in total, the article provides an improved version of endoscopic reprocessing guidelines for bedside endoscopic diagnosis and treatment on COVID-19 patients for reference.
Adult ; Aged ; Aged, 80 and over ; Betacoronavirus ; China ; Coronavirus Infections ; diagnosis ; therapy ; Cross Infection ; prevention & control ; Disinfection ; methods ; Endoscopes ; virology ; Equipment Contamination ; prevention & control ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Peracetic Acid ; Personal Protective Equipment ; Pneumonia, Viral ; diagnosis ; therapy ; Sterilization ; methods ; Workflow

Since its emergence in December 2019, corona virus disease 2019 (COVID-19) has impacted several countries, affecting more than 90 thousand patients and making it a global public threat. The routes of transmission are direct contact, and droplet and possible aerosol transmissions. Due to the unique nature of dentistry, most dental procedures generate significant amounts of droplets and aerosols, posing potential risks of infection transmission. Understanding the significance of aerosol transmission and its implications in dentistry can facilitate the identification and correction of negligence in daily dental practice. In addition to the standard precautions, some special precautions that should be implemented during an outbreak have been raised in this review.
Aerosols ; Betacoronavirus ; Coronavirus Infections ; prevention & control ; transmission ; Cross Infection ; prevention & control ; Dentistry ; Hand Hygiene ; Humans ; Infection Control ; methods ; Pandemics ; prevention & control ; Personal Protective Equipment ; Pneumonia, Viral ; prevention & control ; transmission

Pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection emerged in Wuhan City, Hubei Province, China in December 2019. By Feb. 11, 2020, the World Health Organization (WHO) officially named the disease resulting from infection with SARS-CoV-2 as coronavirus disease 2019 (COVID-19). COVID-19 represents a spectrum of clinical manifestations that typically include fever, dry cough, and fatigue, often with pulmonary involvement. SARS-CoV-2 is highly contagious and most individuals within the population at large are susceptible to infection. Wild animal hosts and infected patients are currently the main sources of disease which is transmitted via respiratory droplets and direct contact. Since the outbreak, the Chinese government and scientific community have acted rapidly to identify the causative agent and promptly shared the viral gene sequence, and have carried out measures to contain the epidemic. Meanwhile, recent research has revealed critical aspects of SARS-CoV-2 biology and disease pathogenesis; other studies have focused on epidemiology, clinical features, diagnosis, management, as well as drug and vaccine development. This review aims to summarize the latest research findings and to provide expert consensus. We will also share ongoing efforts and experience in China, which may provide insight on how to contain the epidemic and improve our understanding of this emerging infectious disease, together with updated guidance for prevention, control, and critical management of this pandemic.
Amino Acid Motifs ; Animals ; Antiviral Agents ; Betacoronavirus ; genetics ; China ; epidemiology ; Communicable Disease Control ; methods ; Coronavirus Infections ; diagnosis ; epidemiology ; physiopathology ; prevention & control ; therapy ; Humans ; Immunization, Passive ; Medicine, Chinese Traditional ; Pandemics ; Pneumonia, Viral ; diagnosis ; epidemiology ; physiopathology ; therapy ; Protein Domains ; Spike Glycoprotein, Coronavirus ; chemistry ; Viral Vaccines