Corona peer reviewed artikelen +datavisualisatie & statistieken topic

Gezien alle fake news en onzin die wordt geplaatst over het Coronavirus, plaats hier alle relevante peer reviewed wetenschappelijke artikelen over Corona (of ook andere artikelen/interviews zolang het door een dokter/wetenschapper is gemaakt). Gelukkig is er veel onderzoek gedaan naar het Coronavirus.

Plaats ook verschillende data analyses/visualisaties en statistieken over het Corona virus.

quote:

SARS-CoV-2, voorheen bekend als 2019-nCoV, is een virus dat de besmettelijke luchtwegaandoening COVID-19 bij mensen veroorzaakt.SARS-CoV-2 is een virus-stam uit het geslacht betacoronavirussen uit de onderfamilie van coronavirussen.

Algemene linkjes
Actuele informatie en data van het RIVM, dagelijkse update om 14:00
WHO Corona website
Elsevier corona information centre
Coronavirus laatste nieuws van BNO



Aantal bekende grafieken:

SPOILER

Om spoilers te kunnen lezen moet je zijn ingelogd. Je moet je daarvoor eerst gratis Registreren. Ook kun je spoilers niet lezen als je een ban hebt.

Data visualisaties:
https://twitter.com/Datagraver
Voorbeelden:

SPOILER

Om spoilers te kunnen lezen moet je zijn ingelogd. Je moet je daarvoor eerst gratis Registreren. Ook kun je spoilers niet lezen als je een ban hebt.

Worldometer coronavirus site
Mapping the Outbreak timelapse
Preppers kaart verspreiding in NL Nog een kaartje van NL
Nog een kaartje van NL
Wuhan Corona Virus Map

Livetrackers:

(link 1) (link 2) (link 3)

Wetenschappelijke artikelen:

A pneumonia outbreak associated with a new coronavirus of probable bat origin
Coronavirus latest: First vaccine clinical trials begin in United States
China’s response to a novel coronavirus stands in stark contrast to the 2002 SARS outbreak response
Arguments in favor of remdesivir for treating SARS-CoV-2 infections
Chloroquine and hydroxychloroquine as available weapons to fight COVID-19
Coronavirus Disease 2019 (COVID-19): Protecting Hospitals From the Invisible
Clinical features of deaths in the novel coronavirus epidemic in China
COVID‐19 and Rationally Layered Social Distancing
Mental health groups providing support, education in wake of COVID‐19
The potential chemical structure of anti‐SARS‐CoV‐2 RNA‐dependent RNA polymerase
A report of clinical diagnosis and treatment of nine cases of coronavirus disease 2019
2019 novel coronavirus patients’ clinical characteristics, discharge rate and fatality rate of meta‐analysis
Novel Coronavirus (COVID‐19) Epidemic: What Are the Risks for Older Patients?

Plaats gerust artikelen en data en andere verhalen over de mortality rates, comorbidity, comortality, besmettelijkheid, medicijnen, vaccinaties, behandelingen,aanpak van overheden, mentale gezondheid etc. En data visualisaties/analyse en andere statistieken over het Coronavirus. Bij interessante bronnen en nieuws probeer ik de OP te updaten. Deel vooral hier, en zet er altijd even een bron bij. Geen fake news of sensatie nieuws van kranten hier aub



[ Bericht 0% gewijzigd door Momo op 17-03-2020 17:28:48 ]

quote:

Op dinsdag 17 maart 2020 17:03 schreef Kyran het volgende:
Goed idee. Alleen denk ik dat er te weinig peer reviewed artikelen zullen zijn de komende tijd. Misschien uitbreiden naar ook niet peer reviewed artikelen?

Gewoon een idee

Ja zolang het wetenschappelijke inhoud heeft, kan ook een interview gewoon zijn met een expert. Of bericht van een krant over een wetenschappelijk artikel, zodat het ook begrijpbaar is of nieuws over het maken van vaccins/behandelingen (zo lang het met bron is).

quote:

Fosun Pharma and BioNTech form COVID-19 vaccine strategic alliance in China

(15 March 2020, Shanghai, Hong Kong) – Today, Fosun Pharma industrial, a subsidiary company of Shanghai Fosun Pharmaceutical (Group) Co., Ltd (“Fosun Pharma” or “the Group”; Stock Code: 600196.SH, 02196.HK) and BioNTech SE (NASDAQ: BNTX, “BioNTech” or “the Company”) announced a strategic development and commercialization collaboration to advance BioNTech’s mRNA vaccine in China for the prevention of COVID-19 infections.

Under the terms of the agreement, the two Companies will work jointly on the development of COVID-19 vaccines based on BioNTech’s mRNA technology platform in China. The Companies will collaborate to conduct clinical trials in China leveraging Fosun Pharma’s extensive clinical development, regulatory, and commercial capabilities in the country. BioNTech will supply the mRNA vaccine for clinical trials from GMP manufacturing facilities in Europe.

mRNA is a nucleic acid molecule that carries genetic information. The mRNA vaccine introduces the genetic information into the body, so that the cells in the body produce the corresponding antigen, which induces the body to produce neutralizing antibodies and stimulates the response of T cells, and fights against the virus through the dual mechanisms of humoral immunity and cellular immunity. In the face of a sudden epidemic, compared with traditional vaccines, synthesis and production process of mRNA vaccine is more convenient, and has strong immunogenicity, which does not need additional adjuvant as needed by the traditional vaccine, and with good safety.

BioNTech is a leading mRNA technology company that has diversified mRNA platform technologies, integrated R&D system and strong manufacturing capability. “The mRNA technology introduces genetic information into human body, then the body's own cells produce the corresponding proteins that cure or prevent disease. Fosun Pharma R&D has been tracking the development of this technology. The two companies expect further cooperation in this field,” says Dr. Aimin Hui, President of Fosun Pharma Global R&D.

“We see this collaboration as an important step in our global effort to expedite the development of mRNA vaccines to prevent COVID-19 infection. Fosun Pharma shares our commitment to move rapidly to address the COVID-19 outbreak and brings deep development experience and an extensive network in the pharmaceutical market in China,” says Founder and CEO of BioNTech, Ugur Sahin, M.D.

Wu Yifang, President and CEO of Fosun Pharma states, “A potential pandemic requires a collective effort and both companies are passionate about contributing to the fight against the current coronavirus outbreak. We are excited to collaborate with BioNTech, one of the leading companies worldwide in the mRNA field. Our shared objective is to develop a vaccine against the coronavirus and to be able to rapidly manufacture a vaccine to turn the tide of COVID-19 infection.”

Under the terms of the agreement, Fosun Pharma will pay BioNTech up to $85 million in licensing fees (including a down payment, clinical development registration and sales milestone payments) as agreed, and a sales commission equal to 35% of the product's annual gross profit during the agreed sales commission period. Meanwhile, Fosun Pharma has agreed to make an equity investment of USD 50 million (EUR 44 million) for 1,580,777 ordinary shares in BioNTech.

Design of an Epitope-Based Synthetic Long Peptide Vaccine to Counteract the Novel China Coronavirus (2019-nCoV)

In this report, we demonstrate that it is possible to design epitope-based peptide vaccine candidates to counteract the novel China coronavirus (2019-nCoV) by using an approach similar to the one used in cancer neoantigen vaccination therapy. We identified multiepitope peptide vaccine candidates against 2019-nCov that can potentially trigger both CD4+ and CD8+ T cell immune response with increased efficiency due to the presence of CD4+ and CD8+ T cell epitopes and a cathepsin-sensitive linker. Furthermore, we suggest that the peptide design strategy should incorporate population-specific HLA alleles in order to optimize binding specificity of the peptides. We refer to this as populationalized vaccinomics.

Ook even hier een linkje naar het topic van @_I over de verschillende mutaties van Corona virus die nu in de wereld rond gaan. Zo kun je bijvoorbeeld zien dat het Corona virus dat nu vooral actief in de VS vooral uit Azië komt en niet uit Europa. De varianten die je vooral in Nederland vind zijn afkomstig uit Noord-Italië.

Nextstrain

En de website waar dat op staat:
https://nextstrain.org/ncov?c=country&f_country=Japan,USA,China&l=radial

quote:

Op dinsdag 17 maart 2020 19:42 schreef merdobach het volgende:
Is al bekend welke onderzoeken het rivm gebruikt?

Zie voorlopig behandeladvies RIVM, en voor behandelopties RIVM

[ Bericht 0% gewijzigd door Momo op 17-03-2020 19:53:30 ]

How will country-based mitigation measures influence the course of the COVID-19 epidemic?

Hier ander onderzoek van RIVM onderzoekers in samenwerking met 2 Britse onderzoekers die daar ook in een vergelijkbare rol werken. Ook een beetje in lijn met wat Rutte zei over het verspreiden van besmettingen.

quote:

Op dinsdag 17 maart 2020 20:33 schreef Breekfast het volgende:

[..]

Ik heb geen verstand van het verloop van mutaties bij virussen. Maar is er ook al iets te zeggen of de verschillende aftakkingen zich anders (bijvoorbeeld agressiever of milder) gedragen? Of is het daar nog te vroeg voor? Of zijn de mutaties die in zo'n korte periode optreden überhaupt niet significant genoeg?

Als je naar de sterftecijfers in Italië kijkt dan zou je bijna denken dat daar een meer agressieve variant heerst. Maar dat kan ook hele andere oorzaken hebben (gemiddelde leeftijd van de geïnfecteerden, worden alle besmettingen vastgesteld/geregistreerd, enzovoort).

https://www.globaltimes.cn/content/1181612.shtml

Dat vermoeden is er wel. Waarschijnlijk wordt daar nu meer onderzoek naar gedaan.

Wat betreft de invloed van temperatuur en vochtigheid op de verspreiding van het virus:


High Temperature and High Humidity Reduce the Transmission of COVID-19

This paper investigates how air temperature and humidity influence the transmission of COVID-19. After estimating the serial interval of COVID-19 from 105 pairs of the virus carrier and the infected, we calculate the daily effective reproductive number, R, for each of all 100 Chinese cities with more than 40 cases. Using the daily R values from January 21 to 23, 2020 as proxies of non-intervened transmission intensity, we find, under a linear regression framework for 100 Chinese cities, high temperature and high relative humidity significantly reduce the transmission of COVID-19, respectively, even after controlling for population density and GDP per capita of cities. One degree Celsius increase in temperature and one percent increase in relative humidity lower R by 0.0383 and 0.0224, respectively. This result is consistent with the fact that the high temperature and high humidity significantly reduce the transmission of influenza. It indicates that the arrival of summer and rainy season in the northern hemisphere can effectively reduce the transmission of the COVID-19.

[ Bericht 5% gewijzigd door Momo op 18-03-2020 10:08:53 ]

Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1

A novel human coronavirus that is now named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (formerly called HCoV-19) emerged in Wuhan, China, in late 2019 and is now causing a pandemic.1 We analyzed the aerosol and surface stability of SARS-CoV-2 and compared it with SARS-CoV-1, the most closely related human coronavirus.2

We evaluated the stability of SARS-CoV-2 and SARS-CoV-1 in aerosols and on various surfaces and estimated their decay rates using a Bayesian regression model (see the Methods section in the Supplementary Appendix, available with the full text of this letter at NEJM.org). SARS-CoV-2 nCoV-WA1-2020 (MN985325.1) and SARS-CoV-1 Tor2 (AY274119.3) were the strains used. Aerosols (<5 μm) containing SARS-CoV-2 (105.25 50% tissue-culture infectious dose [TCID50] per milliliter) or SARS-CoV-1 (106.75-7.00 TCID50 per milliliter) were generated with the use of a three-jet Collison nebulizer and fed into a Goldberg drum to create an aerosolized environment. The inoculum resulted in cycle-threshold values between 20 and 22, similar to those observed in samples obtained from the upper and lower respiratory tract in humans.

Our data consisted of 10 experimental conditions involving two viruses (SARS-CoV-2 and SARS-CoV-1) in five environmental conditions (aerosols, plastic, stainless steel, copper, and cardboard). All experimental measurements are reported as means across three replicates.

SARS-CoV-2 remained viable in aerosols throughout the duration of our experiment (3 hours), with a reduction in infectious titer from 103.5 to 102.7 TCID50 per liter of air. This reduction was similar to that observed with SARS-CoV-1, from 104.3 to 103.5 TCID50 per milliliter (Figure 1A).

SARS-CoV-2 was more stable on plastic and stainless steel than on copper and cardboard, and viable virus was detected up to 72 hours after application to these surfaces (Figure 1A), although the virus titer was greatly reduced (from 103.7 to 100.6 TCID50 per milliliter of medium after 72 hours on plastic and from 103.7 to 100.6 TCID50 per milliliter after 48 hours on stainless steel). The stability kinetics of SARS-CoV-1 were similar (from 103.4 to 100.7 TCID50 per milliliter after 72 hours on plastic and from 103.6 to 100.6 TCID50 per milliliter after 48 hours on stainless steel). On copper, no viable SARS-CoV-2 was measured after 4 hours and no viable SARS-CoV-1 was measured after 8 hours. On cardboard, no viable SARS-CoV-2 was measured after 24 hours and no viable SARS-CoV-1 was measured after 8 hours (Figure 1A).

Both viruses had an exponential decay in virus titer across all experimental conditions, as indicated by a linear decrease in the log10TCID50 per liter of air or milliliter of medium over time (Figure 1B). The half-lives of SARS-CoV-2 and SARS-CoV-1 were similar in aerosols, with median estimates of approximately 1.1 to 1.2 hours and 95% credible intervals of 0.64 to 2.64 for SARS-CoV-2 and 0.78 to 2.43 for SARS-CoV-1 (Figure 1C, and Table S1 in the Supplementary Appendix). The half-lives of the two viruses were also similar on copper. On cardboard, the half-life of SARS-CoV-2 was longer than that of SARS-CoV-1. The longest viability of both viruses was on stainless steel and plastic; the estimated median half-life of SARS-CoV-2 was approximately 5.6 hours on stainless steel and 6.8 hours on plastic (Figure 1C). Estimated differences in the half-lives of the two viruses were small except for those on cardboard (Figure 1C). Individual replicate data were noticeably “noisier” (i.e., there was more variation in the experiment, resulting in a larger standard error) for cardboard than for other surfaces (Fig. S1 through S5), so we advise caution in interpreting this result.

We found that the stability of SARS-CoV-2 was similar to that of SARS-CoV-1 under the experimental circumstances tested. This indicates that differences in the epidemiologic characteristics of these viruses probably arise from other factors, including high viral loads in the upper respiratory tract and the potential for persons infected with SARS-CoV-2 to shed and transmit the virus while asymptomatic.3,4 Our results indicate that aerosol and fomite transmission of SARS-CoV-2 is plausible, since the virus can remain viable and infectious in aerosols for hours and on surfaces up to days (depending on the inoculum shed). These findings echo those with SARS-CoV-1, in which these forms of transmission were associated with nosocomial spread and super-spreading events,5 and they provide information for pandemic mitigation efforts.

Data van GGD en RIVM

Mutations can reveal how the coronavirus moves—but they’re easy to overinterpret

mmediately after Christian Drosten published a genetic sequence of the novel coronavirus online on 28 February, he took to Twitter to issue a warning. As the virus has raced around the world, more than 350 genome sequences have been shared on the online platform GISAID. They hold clues to how the new virus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading and evolving. But because the sequences represent a tiny fraction of cases and show few telltale differences, they are easy to overinterpret, as Drosten realized.

A virologist at the Charité University Hospital in Berlin, he had sequenced the virus from a German patient infected with COVID-19 in Italy. The genome looked similar to that of a virus found in a patient in Munich, the capital of Bavaria, more than 1 month earlier; both shared three mutations not seen in early sequences from China. Drosten realized this could give rise to the idea that the Italian outbreak was “seeded” by the one in Bavaria, which state public health officials said had been quashed by tracing and quarantining all contacts of the 14 confirmed cases. But he thought it was just as likely that a Chinese variant carrying the three mutations had taken independent routes to both countries. The newly sequenced genome “is not sufficient to claim a link between Munich and Italy,” Drosten tweeted.

His warning went unheeded. A few days later, Trevor Bedford of the Fred Hutchinson Cancer Research Center, who analyzes the stream of viral genomes and discusses them in Twitter threads, wrote that the pattern suggested the outbreak in Bavaria had not been contained after all, and appeared to have led to the Italian outbreak. The analysis spread widely. Technology Review asserted that “the Munich event could be linked to a decent part of the overall European outbreak” and Twitter users called on Germany to apologize. (This Science correspondent retweeted Bedford’s thread as well.)

irologist Eeva Broberg of the European Centre for Disease Prevention and Control agrees with Drosten that there are more plausible scenarios for how the disease reached northern Italy than an undetected spread from Bavaria. Other scientists say Bedford jumped the gun as well. “I have to kick his butt a bit for this,” says Richard Neher, a computational biologist at the University of Basel who works with Bedford. “It’s a cautionary tale,” says Andrew Rambaut, a molecular evolutionary biologist at the University of Edinburgh. “There is no way you can make that claim just from the phylogeny alone.” Bedford later clarified he believed it was equally plausible there had been two separate introductions from China. “I think I should have been more careful with that Twitter thread,” he says.

It was a case study in the power and pitfalls of real-time analysis of viral genomes. “This is an incredibly important disease. We need to understand how it is moving,” says Bette Korber, a biologist at Los Alamos National Laboratory who is also studying the genome of SARS-CoV-2. “With very limited evolution during the outbreak, [these researchers] are doing what they can and they are making suggestions, which I think at this point should be taken as suggestions.”

The sequence data were most informative early on, says Kristian Andersen, a computational biologist at Scripps Research. The very first sequence, in early January, answered the most basic question: What pathogen is causing the disease? The ones that followed were almost identical, strongly suggesting there was a single introduction from an animal into the human population. If the virus had jumped the species barrier multiple times, scientists would see more variety among the first human cases.

Now, more diversity is emerging. Like all viruses, SARS-CoV-2 evolves over time through random mutations, only some of which are caught and corrected by the virus’s error correction machinery. Over the length of its 30,000-base-pair genome, SARS-CoV-2 accumulates an average of about one to two mutations per month, Rambaut says. “It’s about two to four times slower than the flu,” he says. Using these little changes, researchers can draw up phylogenetic trees, much like family trees. They can also make connections between different cases of COVID-19 and gauge whether there might be undetected spread of the virus.

For instance, when researchers sequenced the second virus genome in Washington—from a teenager diagnosed with COVID-19 on 27 February—it looked like a direct descendant of the first genome, a case found 6 weeks earlier, that had acquired three further mutations. Bedford tweeted that he considered it “highly unlikely” that the two genomes came from separate introductions. “I believe we are facing an already substantial outbreak in Washington State that was not detected until now,” he wrote. That analysis turned out to be correct: Washington has now reported more than 100 cases and 15 deaths and additional genomes from other patients have bolstered the link. In this case, Bedford’s hypothesis was much stronger because the two patients both came from Snohomish County, Rambaut says: “It’s very unlikely that this highly related virus would travel to exactly the same town in Washington,” he says.

Few other firm conclusions about the virus’s spread have emerged, in part because the wealth of genomes is still a tiny sample of the more than 100,000 cases worldwide. Although China accounts for 80% of all COVID-19 cases, only one-third of the published genomes are from China—and very few of them are from later cases. And because it’s early in the outbreak, most genomes are still very similar, which makes it hard to draw conclusions. “We just have this handful of mutations, which makes these groupings so ambiguous,” Neher says. “As the outbreak unfolds, we expect to see more and more diversity and more clearly distinct lineages,” he says. “And then it will become easier and easier to actually put things together.”

Scientists will also be scouring the genomic diversity for mutations that might change how dangerous the pathogen is or how fast it spreads. There, too, caution is warranted. A paper published by Lu Jian of Peking University and colleagues on 3 March in the journal National Science Review analyzed 103 virus genomes and argued that they fell into one of two distinct types, named S and L, distinguished by two mutations. Because 70% of sequenced SARS-CoV-2 genomes belong to L, the newer type, the authors concluded that virus has evolved to become more aggressive and to spread faster.

But they lack evidence, Rambaut says. “What they’ve done is basically seen these two branches and said, ‘That one is bigger, [so that virus] must be more virulent or more transmissible,’” he says. However, just because a virus is exported and leads to a large outbreak elsewhere does not mean it is behaving differently: “One of these lineages is going to be bigger than the other just by chance.” Some researchers have called for the paper to be retracted. “The claims made in it are clearly unfounded and risk spreading dangerous misinformation at a crucial time in the outbreak,” four scientists at the University of Glasgow wrote in a response published on www.virological.org. (In a response, Lu wrote the four had misunderstood his study.)

Most genomic changes don’t alter the virus’s behavior, Drosten says. The only way to confirm that a mutation has an effect is to study it in cell cultures or animal models and show, for instance, that it has become better at entering cells or transmitting, he says. And if the virus does change in an important way, it could go either way, making it more or less dangerous. In 2018, Drosten’s group published a paper showing that early in the SARS outbreak of 2002–03, that virus lost a small chunk of its genome, 29 base pairs in one gene. Adding those base pairs back in the lab made the virus much better at replicating in several cell culture models.

It might seem strange that a mutation that weakens the virus would become established, but that can happen when it has just entered the human population and isn’t competing with strains lacking the mutation, Drosten says. “Sadly, this new virus doesn’t have that deletion,” he adds

Een heel stuk over besmetten zonder dat je symptomen hebt:

Presumed Asymptomatic Carrier Transmission of COVID-19

A novel coronavirus has resulted in an ongoing outbreak of viral pneumonia in China.1-3 Person-to-person transmission has been demonstrated,1 but, to our knowledge, transmission of the novel coronavirus that causes coronavirus disease 2019 (COVID-19) from an asymptomatic carrier with normal chest computed tomography (CT) findings has not been reported.

Over het ontwikkelen van PTSS na het beleven van Covid-19 infectie zelf of in je omgeving:

Prevalence and predictors of PTSS during COVID-19 Outbreak in China Hardest-hit Areas: Gender differences matter

Highlights

•The prevalence of posttraumatic stress symptoms (PTSS) in China hardest-hit areas a month after the COVID-19 outbreak was 7%.

•Hierarchical regression analysis and non-parametric test suggested that women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal.

•Participants with better sleep quality or less frequency of early awakenings reported lower PTSS.

Geupdate versie van klinische beschrijving van 69 patienten in China

Clinical Features of 69 Cases with Coronavirus Disease 2019 in Wuhan, China


From December 2019 to February 2020, 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a serious outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China. Related clinical features are needed.

We reviewed 69 patients who were hospitalized in Union hospital in Wuhan between January 16 to January 29, 2020. All patients were confirmed to be infected with SARS-CoV-2 and the final date of follow-up was February 4, 2020.


The median age of 69 enrolled patients was 42.0 years (IQR 35.0-62.0), and 32 patients (46%) were men. The most common symptoms were fever (60[87%]), cough (38[55%]), and fatigue (29[42%]). Most patients received antiviral therapy (66 [98.5%] of 67 patients) and antibiotic therapy (66 [98.5%] of 67 patients). As of February 4, 2020, 18 (26.9%) of 67 patients had been discharged, and five patients had died, with a mortality rate of 7.5%. According to the lowest SpO2 during admission, cases were divided into the SpO2≥90% group (n=55) and the SpO2<90% group (n=14). All 5 deaths occurred in the SpO2<90% group. Compared with SpO2≥90% group, patients of the SpO2<90% group were older, and showed more comorbidities and higher plasma levels of IL6, IL10, lactate dehydrogenase, and c reactive protein. Arbidol treatment showed tendency to improve the discharging rate and decrease the mortality rate.

COVID-19 appears to show frequent fever, dry cough, and increase of inflammatory cytokines, and induced a mortality rate of 7.5%. Older patients or those with underlying comorbidities are at higher risk of death.

Datagraver

Nieuw artikel:
Viral Invasion and Type I Interferon Response Characterize the Immunophenotypes during COVID-19 Infection

The new coronavirus COVID-19 has spread globally and caused a pneumonia outbreak. Although the whole genome sequences of COVID-19 have been rapidly obtained, pathogenesis of COVID-19 caused severe disease remains elusive. Understanding the immune responses in patients with severe disease may significantly advance the development of effective therapies. Here, using scRNA-seq technology, we profiled the immunophenotypes of four patients’ PBMCs before, during, and after their ICU cares. Our data identified gene expression signatures of viral invasion and type I interferon (IFN-I) responses as the key manifestations characterized the life-threatening stage of COVID-19 infection in human. The association between viral load/IFN-α levels and disease severity in COVID-19 infection marked the key difference in the pathogenesis of this new coronavirus from previous coronavirus such as SARS-CoV infections.

Ook een nieuw artikel:

Potentialdual therapeutic approach against SARS-CoV-2/COVID-19 with Nitazoxanide and Hydroxychloroquine

Coronaviruses are ubiquitous in nature and infectsdiverse species with frequent cross-species transmission. There have been multipleevents of animal to human transmission throughout historyincludingSARS,MERS and most recently SARS-CoV-2(COVID-19)that is responsible for the current pandemic. The rapid spread of SARS-CoV-2/COVID-19 has overwhelmed the capabilities of major nations due to the sheer number of patients with severe disease and critically ill patients requiring intensive care. The high molecular and clinical similarity between SARS and SARS-CoV-2 enable us to draw some parallels between them and utilize nearly two decades of existing researchfrom SARS. Herein I describe a Novel synergistictherapeutic approach against SARS-CoV-2/COVID-19 by repurposing Nitazoxanide and Hydroxychloroquineto target viral and host factors for controlling this disease. Both these drugs are readily available, expected to be highly potent andcan be administered at the population level to ensure infected patients do not advance to the point of needing prolonged hospitalization and critical care thereby changing the course of this disease. The proposed treatment regimen would be expected to diminish the severity of illness by reducing viral titersandrescuing the innate-immune system dysregulation brought about by the viral infection that underlies the high mortality in the older/vulnerable populations there by allowing our health-care system a more controlled disease response.

Toch even hier (Informatie van Artsen voor Longziekten en Tuberculose (NVALT) ), ondanks het een AD.nl artikel is. Voor al die mensen lopen te roepen dat allerlei middelen gebruikt moeten worden.

quote:

Longartsen met handen in haar: ‘Aanbevolen medicijnen hebben niet veel effect, maar wel bijwerkingen’

Longartsen zitten met hun handen in het haar omdat er geen effectieve behandeling is voor het coronavirus. In een nieuwe Nederlandse richtlijn die specialisten gisteren met elkaar bespraken, staat dat er nog onvoldoende bewijs is voor de werking van de in de richtlijn genoemde medicijnen. Sommigen richten wellicht zelfs meer schade aan dan dat ze goed doen. ,,In de praktijk zien we in Brabant tot nu toe niet veel effect van die medicijnen, maar hebben patiënten wel last van bijwerkingen.’’

De eerste behandelresultaten stemmen de voorzitter van de Nederlandse Vereniging van Artsen voor Longziekten en Tuberculose (NVALT) Leon van den Toorn treurig. ,,Wat we tot nu toe in de praktijk zien in de regio Brabant is dat de aanbevolen medicijnen niet veel effect lijken te hebben’’, verklaart Van den Toorn. ,,Maar patiënten hebben in ieder geval wel last van bijwerkingen, zoals depressieve klachten, misselijkheid en braken.’’

Hartritmestoornissen

In de databank voor bijwerkingen Lareb staat dat chloroquine naast maagdarmklachten en hoofdpijn bijvoorbeeld ook ernstige hartklachten en hartritmestoornissen kan veroorzaken. ,,Gebruik dit medicijn NIET als u deze hartritmestoornis heeft’’, klinkt het dringende advies.

Volgens de longarts, die zelf werkzaam is in het Rotterdamse Erasmus MC is het middel dat ‘in Nederland verreweg het meest geprobeerd wordt ‘chloroquine’, een medicijn dat ook gebruikt wordt om malaria te voorkomen. ,,Niet alle ziekenhuizen zijn er enthousiast over, maar de in meeste ziekenhuizen wordt het wel gegeven bij de ziekere patiënten.’’ Of er in Nederland mensen gered zijn met dat middel? ,,Zo kun je dat niet zeggen, heel veel weten we er nog niet over’’, erkent de voorman. Bovendien benadrukt hij: ,,Je weet natuurlijk ook niet wat er met die mensen was gebeurd als je het middel níet had toegepast.’’

Reageerbuisjes

Longartsen staan mede door het gebrek aan bewijs voor grote dilemma’s bij de behandeling van coronapatiënten. ,,In lekentaal komt het er simpel gezegd op neer dat de medicijnen in reageerbuisjes zijn onderzocht’’, legt Van den Toorn uit. ,,In het laboratorium zijn er aanwijzingen dat die medicijnen mogelijk iets tegen het virus doen, maar we weten nog niet of dat daadwerkelijk het geval is als je er mensen mee behandelt.’’

De voorzitter van de longartsen pleit voor gedegen onderzoek naar de medicijnen die tot nu toe geprobeerd zijn tegen het nieuwe coronavirus. Hij krijgt bijval van arts-microbioloog Marc Bonten uit het UMC Utrecht: ,,De middelen die er nu zijn moeten getest worden op twee dingen: één, of ze mensen beter maken, en twee, of ze veilig gebruikt kunnen worden. Die middelen moeten op grote schaal bij mensen gebruikt gaan worden, om te zien of ze effect hebben.’’

Testen op mensen

De Rotterdamse longarts Hans in ‘t Veen uit het Franciscus Gasthuis en Vlietland herkent de moeilijkheden. ,,Er zijn drie problemen: De medicatie is niet beschikbaar, de medicatie is vaak toxisch en we weten zelfs niet eens of het helpt.’’ Volgens hem gaat er over die richtlijn ‘zeker veel discussie’ komen. ,,Als het niet bewezen is en heel schadelijk is: moet je de vraag stellen of je de behandelingsadviezen zo nadrukkelijk kan opschrijven?’’ zo nuanceert hij de aanbeveling hardop.

Om te achterhalen of de middelen werken moeten mensen min of meer gaan functioneren als proefkonijn. Bonten: ,,Het zijn helaas echte mensen die je daarvoor nodig hebt, maar je moet die medicijnen onderzoeken. Anders weten we over een half jaar nog steeds niet wat de beste behandeling is.’’
In levensgevaar

De richtlijn beveelt specialisten aan om de omstreden middelen alleen te gebruiken bij patiënten met ‘ernstige klachten’ en als mensen in levensgevaar zijn. Gisteren spraken artsen via een videoconferentie over de richtlijn: ,,De bewijslast voor de middelen die in de richtlijn genoemd worden is helaas flinterdun’’, erkent Van den Toorn. ,,Daarom is er continue overleg, wordt van vele patiënten bijgehouden wat de behandeling is geweest en proberen we daar uiteindelijk wijzer van te worden. Ondertussen wachten we ook op de uitkomsten van studies die nog lopen. Alleen het duurt nog wel even voordat daar de resultaten van binnenkomen: dat gaat niet in een week.’’

Naast chloroquine, is er ook nog een een ander malariamedicijn ‘hydroxychloroquine’, ,,Dat lijkt op chloroquine en wordt in sommige ziekenhuizen ook toegepast’’, weet Van den Toorn. En verder is er de virusremmer ‘remdesivir’. Dit middel werd oorspronkelijk gebruikt tegen de extreem dodelijke ziekte ebola, maar viel af omdat andere middelen beter bleken te werken. In Nederland wordt het volgens Van den Toorn nog bijna niet voorgeschreven, omdat dat middel heel slecht beschikbaar is’.

Strijd zonder wapens

Zo lijken de doktoren een oneerlijke strijd te voeren tegen het nieuwe coronavirus dat in steeds meer landen om zich heen slaat. Of je dat een strijd zonder wapens kunt noemen? Van den Toorn geeft toe: ,,Tot nu toe voeren we oorlog zonder goede wapens, maar we gaan er desondanks vanuit dat we de strijd uiteindelijk gaan winnen. Bovendien knapt het overgrote deel van de patiënten op, óók zonder die medicijnen, dus dat geeft hoop.’’

Datagraver

Hier een NRC artikel over hoe het RIVM de maatregelen zoals bijvoorbeeld sluiten van de scholen ook zeer wetenschappelijk benaderd. Een wiskundige benadering met modellen.

Waarom bierviltjesberekeningen over het virus niet werken

Wiskundige modellen Afstand houden, scholen sluiten, ‘lockdown’: bij het RIVM rekenen hypercomplexe wiskundige modellen alle maatregelen na. NRC sprak er vijf wetenschappers over. „Zonder wiskundige modellen is niet te begrijpen wat je ziet.”

Epidemiologische situatie COVID-19 in Nederland 25 maart 2020
Samenvatting

Tot en met 25 maart 2020 zijn er in Nederland in totaal 6412 COVID-19 patiënten gemeld aan het RIVM Rijksinstituut voor Volksgezondheid en Milieu . De meeste gemelde patiënten vallen in de leeftijdscategorie 55-59 jaar. Tot nu toe zijn van deze gemelde patiënten 1836 opgenomen in het ziekenhuis en 356 overleden.
De meeste overleden patiënten zaten in de leeftijdscategorie 80-84 jaar.

https://www.rivm.nl/documenten/epidemiologische-situatie-covid-19-in-nederland-25-maart-2020

Treatment of COVID-19 with Individualized Immune Boosting Interventions

There are major concerns regarding the current global pandemic of coronavirus disease 2019 (COVID-19) caused by the coronavirus SARS-CoV-2. Whereas most of the infected individuals have no symptoms or only mild symptoms, in a small minority, the infection can lead to pneumonia and death. One major concern regarding the pandemic is the 2.3% average case fatality rate of the COVID-19 patients, with the fatality rate increasing to 8% for patients aged 70 to 79 and 14.8% for those aged 80 and over. Another major concern is the person-to-person transmission of the coronavirus by asymptomatic individuals during the incubation period, making it difficult to limit the spread of the disease. Many steps are underway worldwide to limit the spread of the disease, e.g. cancellation of conferences and large gatherings, closure of schools, curtailment of travel, etc. Considering the magnitude of the adverse impact on the social, cultural, commercial, educational, scientific, health, and other aspects of the society from such steps and the large anticipated casualties with the expected spread of the disease worldwide, it is important to explore methods of reducing the fatality rates of COVID-19 patients. Since the weakness of the immune system is one of the major contributing factors for the occurrence of pneumonia, and inflammation contributes to increased mortality rates of pneumonia patients, interventions that improve the immune response and/or reduce inflammation may reduce the pneumonia incidence and mortality in COVID-19 patients. There are indeed a large number of interventions that improve the immune response and/or reduce inflammation. However, all the interventions would not be applicable or acceptable to everyone and so the interventions would need to be individualized based on individual circumstances and preferences. This approach, known as “Individualized Interventions to Improve the Immune Response”, or the I4R approach needs to be tested in pilot clinical trials for the treatment of COVID-19 patients. If the pilot clinical trials demonstrate that it is effective in reducing the incidence and mortality due to pneumonia, widespread adoption of the I4R approach for treating COVID-19 patients may reduce their morbidity and mortality, reducing the concerns regarding the coronavirus. This may be helpful in reducing the need for the drastic steps that have been taken worldwide, and help in the return of life to normalcy. Therefore, clinical trials of the I4R approach should be conducted on an urgent basis.

Covid-19 fatality is likely overestimated

The final case fatality rate (CFR) from SARS-CoV-2, the virus that causes covid-19, will likely be lower than those initially reported.1 Previous reviews of H1N1 and SARS show the systematic inflation of early mortality estimates.23 Early estimates of H1N1’s mortality were susceptible to uncertainty about asymptomatic and subclinical infections, heterogeneity in approaches to diagnostic testing, and biases in confounding, selection, detection, reporting, and so on.23 These biases are difficult to overcome early in a pandemic.3

We read Xu and colleagues’ report of 62 cases of covid-19 outside of Wuhan, China, with interest, as no patients died in the study period.5 Compared with a report of the 72 314 cases throughout China, the marked differences in outcomes from Hubei (the province of which Wuhan is the capital) compared with all other provinces are worth a brief discussion.4

The CFR in China (through 11 February) is reported as 2.3%.15 The CFR among the initial Wuhan cohort was reported as 4.3%, with a rate of 2.9% in Hubei province.15 But outside Hubei the CFR has been 0.4%. Deaths occurred only in cases deemed “critical.” Importantly, the CFR from these reports is from infected, syndromic people presenting to healthcare facilities, with higher CFRs among older patients in hospital (8%-14.8% in the Wuhan cohort).

As accessibility and availability of testing for the novel coronavirus increases, the measured CFR will continue to drop, especially as subclinical and mild cases are identified.678 Alternatively, the CFR might not fall as much as in previous epidemics and pandemics, given the prolonged disease course of covid-19 or if mitigation measures or hospital resources prove inadequate.9101112

As with other pandemics, the final CFR for covid-19 will be determined after the pandemic and should not distract from the importance of aggressive, early mitigation to minimise spread of infection.

Presentatie Jaap van Dissel 25 maart technische briefing tweede kamer

Vanuit de SC @George_of_the_Jungle

[ Bericht 19% gewijzigd door Momo op 26-03-2020 12:01:04 ]

Data initiatieven omtrent COVID-19 via overheid.nl

Datagraver

De maatregelen in alle landen per 26 maart

Could chloroquine /hydroxychloroquine be harmful in Coronavirus Disease 2019 (COVID-19) treatment?

The Impact of Cross-Cultural Differences in Handwashing Patterns on the COVID-19 Outbreak Magnitude

Frequent handwashing with soap for at least 20 seconds at a time is widely advised as one of the preventive measures against COVID-19. Yet, while it is possible to quickly influence individual hygiene behaviorin the short term, in the long run, changing handwashing culture in a particular country as well as globally is a much more difficult task. Considering the relative stability of cross-cultural differencesover time, we explorewhether and to what extent handwashing culture can be used to explain and predict the relative penetration of COVID-19 pandemicinternationally. We find that even though many different factors could have influenced the rapid expansion of the virus, handwashing culture is a very good predictor of the COVID-19 spread magnitude.

Covid-19: Data analysis of the Lombardy region and the provinces of Bergamo and Brescia

The data analysis on deaths in the Lombardy Region and of both the provinces of Bergamo and Brescia shows a twofold aspect on the trend of the epidemic: - all the data show a bias linked to the event of March 10th (day for which the Lombardy region data is partial) and the subsequent change in the way in which positive cases and deaths are calculated; - following the containment measures of the Prime Minister's Decree of March 11th, the spread of the epidemic, although still exponential in nature, has a reduced multiplication coefficient. Our analysis concludes that the situation is not yet compatible with a plateau trend and allows us to predict the trend in the number of deaths in the Lombardy region. We therefore conclude that the containment measures put in place by the government on March 11th will allow a reduction in deaths from around 8000 to just over 6500 for March 27th.

A simplified model for expected development of the SARS-CoV-2 (Corona) spread in Germany and US after social distancing

Widespread opinions and discussion exist regarding the efficiency of social distancing after crucial spread of the SARS-CoV-2 virus during the actual Covid-19 pandemic. While Germany has released a federal law that prohibits any type of direct contact for more than 2 people other countries including the US released curfews.
People are now wondering whether these measures are helpful to stop or hamper the Covid-19 pandemic and to limit the spread of the new corona virus.
A quantitative statement on this question depends on many parameters that are difficult to grasp mathematically and cannot therefore be made conclusively (they include consistent adherence to the measures decided, the estimated number of unreported cases, the possible limitation by test capacities, possible mutations of the virus, etc ...). However, it turns out that a reduction in the actual daily new infection rate (actual daily growth rate of reported cases, in short: infection rate) from the current value of 30-35% in the US to 10% would be extremely effective in stopping the spread of the virus. The severe restrictions in Germany which closed any public events, schools and universities a week ago might already have contributed to a reduction of the growth rate of reported cases below 30%.

Clinical Characteristics of Fatal and Recovered Cases of Coronavirus Disease 2019 (COVID-19) in Wuhan, China: A Retrospective Study

The 2019 novel coronavirus (2019-nCoV) has caused the outbreak of the acute respiratory disease in Wuhan, Hubei Province of China since December 2019. This study is performed to analyze the clinical characteristics of patients who succumbed to and who recovered from 2019 novel coronavirus disease (COVID-19).Clinical data were collected from two tertiary hospitals in Wuhan. A retrospective investigation was conducted to analyze the clinical characteristics of fatal cases of COVID-19 (death group) and compare them with recovered patients (recovered group). Continuous variables were analyzed using the Mann-Whitney U test. Categorical variables were analyzed by χ test or Fisher's exact tests as appropriate.

Totaal aantal meldingen per gemeente. De laatste paar dagen worden iets langer getoond.


Totaal aanntal meldingen per 100.000 inwoners. Vooral de gemeente Boekel en aanliggende worden hard getroffen.


De meeste nieuwe meldingen zijn in Amsterdam en Rotterdam de laatste dagen.


@George_of_the_Jungle

Estimating the number of infections and the impact of non-pharmaceutical interventions on COVID-19 in 11 European countries



Deze is wel interessant qua geschatte deel van de bevolking dat besmet is.

Warm weer lijkt niet de besmettingskans te reduceren

Association between ambient temperature and COVID-19 infection in 122 cities from China

The exposure-response curves suggested that the relationship between mean temperature and COVID-19 confirmed cases was approximately linear in the range of less than 3 °C and became flat above 3 °C.
•

When mean temperature (lag0-14) was below 3 °C, each 1 °C rise was associated with a 4.861% (95% CI: 3.209-6.513) increase in the daily number of COVID-19 confirmed cases.
•

There is no evidence supporting that case counts of COVID-19 could decline when the weather becomes warmer when the temperature is above 3 °C.

Cross-Country Comparison of Case Fatality Rates of COVID-19/SARS-COV-2

Objectives
Case fatality rates (CFR) and recovery rates are important readouts during epidemics and pandemics. In this article, an international analysis was performed on the ongoing coronavirus disease 2019 (COVID-19) pandemic.
Methods
Data were retrieved from accurate databases according to the user’s guide of data sources for patient registries, CFR and recovery rates were calculated for each country. A comparison of CFR between countries with total cases ≥ 1,000 was observed for 12th and 23rd March.
Results
Italy’s CFR was the highest of all countries studied for both time points (12th March, 6.22% versus 23rd March, 9.26%). The data showed that even though Italy was the only European country reported on 12rd March, Spain and France had the highest CFR of 6.16 and 4.21%, respectively, on 23rd March, which was strikingly higher than the overall CFR of 3.61%.
Conclusion
Obtaining detailed and accurate medical history from COVID-19 patients, and analyzing CFR alongside the recovery rate, may enable the identification of the highest risk areas so that efficient medical care may be provided. This may lead to the development of point-of-care tools to help clinicians in stratifying patients based on possible requirements in the level of care, to increase the probabilities of survival from COVID-19 disease.

A Coadunation of Biological and Mathematical Perspectives on the Pandemic COVID-19: A Review

Coronaviruse disease (COVID-19) outbreak has created an emergency globally, and social distancing and isolation is the only solution to prevent its spread. Several countries have announced fully locked on to tackle this pandemic. The recent COVID-2019 has shaken the globe with incidence cases of more than half-million cases, and a mortality toll of more than twenty thousand to date. The coronavirus family is inclusive of pathogen of both – animal species and humans, encapsulating the isolated severe acute respiratory syndrome coronavirus (SARS-CoV). Researchers round the globe have been dexterously working to decode this lethal virus. Many mathematical frameworks have also been depicted which have helped to understand the dynamics of the COVID-19. Research on coronaviruses continues to explore various aspects of viral replication and pathogenesis to understanding the predilection of these viruses to switch between species, to develop an infection in a new host, and to identify significant reservoirs of coronaviruses will dramatically aid in our potential to prophesize when and where potential epidemics may occur. Many of the non-structural and accessory proteins encoded by the viruses remain unclear and unknown. This systematic review highlights the current situation of the pandemic, virus genomic composition, pathogenesis, symptomatology, diagnosis, and prognosis along with mathematical models of disease transmission and dynamics.

Dashboard: Covid-19 in Nederland, informatie: landelijk en regionaal.

[ Bericht 2% gewijzigd door Momo op 07-04-2020 18:18:35 ]

Waarom Europeanen misschien harder getroffen worden door het virus, nog niet peer reviewed maar wel geschikt voor hier.

ACE2 variants underlie interindividual variability and susceptibility to COVID-19 in Italian population