SUMMARY In recent decades, several new diseases have emerged in different geographical areas, with pathogens including Ebola virus, Zika virus, Nipah virus, and coronaviruses (CoVs). Recently, a new type of viral infection emerged in Wuhan City, China, and initial genomic sequencing data of this virus do not match with previously sequenced CoVs, suggesting a novel CoV strain (2019-nCoV), which has now been termed severe acute respiratory syndrome CoV-2 (SARS-CoV-2). Although coronavirus disease 2019 (COVID-19) is suspected to originate from an animal host (zoonotic origin) followed by human-to-human transmission, the possibility of other routes should not be ruled out. Compared to diseases caused by previously known human CoVs, COVID-19 shows less severe pathogenesis but higher transmission competence, as is evident from the continuously increasing number of confirmed cases globally. Compared to other emerging viruses, such as Ebola virus, avian H7N9, SARS-CoV, and Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV-2 has shown relatively low pathogenicity and moderate transmissibility. Codon usage studies suggest that this novel virus has been transferred from an animal source, such as bats. Early diagnosis by real-time PCR and next-generation sequencing has facilitated the identification of the pathogen at an early stage. Since no antiviral drug or vaccine exists to treat or prevent SARS-CoV-2, potential therapeutic strategies that are currently being evaluated predominantly stem from previous experience with treating SARS-CoV, MERS-CoV, and other emerging viral diseases. In this review, we address epidemiological, diagnostic, clinical, and therapeutic aspects, including perspectives of vaccines and preventive measures that have already been globally recommended to counter this pandemic virus.

Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) begun in December 2019 in China, causing a Public Health Emergency of International Concern. Among raised questions, clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews have been published on this matter. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases. Observational studies, and also case reports, were included and analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). Results: 660 articles were retrieved (1/1/2020-2/23/2020). After screening by abstract/title, 27 articles were selected for full-text assessment. Of them, 19 were finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 40.8-74.4%) and dyspnea (45.6%, 10.9-80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), with 32.8% presenting acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock and 13.9% (95%CI 6.2-21.5%) of hospitalized patients with fatal outcomes (case fatality rate, CFR).Conclusion: COVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected patients and this group was associated with a CFR of over 13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure, and facilities to treat severe COVID-19.

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Background Determinants of vaccine acceptance are multifactorial, complex, and in most cases, context-dependent. We determined the prevalence of COVID-19 vaccination intention (VI) and fear of its adverse effects (FAE) as well as their associated factors in Latin America and the Caribbean (LAC). Methods We conducted a secondary cross-sectional analysis of a database collected by the University of Maryland and Facebook. We included participants aged 18 and over from LAC surveyed, January 15 to February 1, 2021. We evaluated VI, FAE, sociodemographic characteristics, COVID-19 symptomatology, compliance with community mitigation strategies, food and economic insecurity, mental health evaluation and the influence in VI when recommended by different stakeholders. We calculated crude and adjusted prevalence ratios with their 95%CIs. Results We analyzed 472,521 responses by Latin American adults, finding a VI and FAE prevalence of 80.0% and 81.2%, respectively. We found that female and non-binary genders were associated with a lower probability of VI and a higher probability of FAE. Besides, living in a town, village or rural area and economic insecurity was associated with a higher FAE probability. The fears of becoming seriously ill, a family member becoming seriously ill from COVID-19 and having depressive symptoms were associated with a higher probability of VI and FAE. Conclusion Eight out of 10 adults in LAC have VI and FAE. The factors identified are useful for the development of communication strategies to reduce FAE frequency. It is necessary to guarantee mass vaccination and support the return of economic activities.

SUMMARY Parasitic infections previously seen only in developing tropical settings can be currently diagnosed worldwide due to travel and population migration. Some parasites may directly or indirectly affect various anatomical structures of the heart, with infections manifested as myocarditis, pericarditis, pancarditis, or pulmonary hypertension. Thus, it has become quite relevant for clinicians in developed settings to consider parasitic infections in the differential diagnosis of myocardial and pericardial disease anywhere around the globe. Chagas' disease is by far the most important parasitic infection of the heart and one that it is currently considered a global parasitic infection due to the growing migration of populations from areas where these infections are highly endemic to settings where they are not endemic. Current advances in the treatment of African trypanosomiasis offer hope to prevent not only the neurological complications but also the frequently identified cardiac manifestations of this life-threatening parasitic infection. The lack of effective vaccines, optimal chemoprophylaxis, or evidence-based pharmacological therapies to control many of the parasitic diseases of the heart, in particular Chagas' disease, makes this disease one of the most important public health challenges of our time.

Background The coronavirus disease (COVID-19) pandemic has affected more than 200 countries and has infected more than 2,800,000 people as of April 24, 2020. It was first identified in Wuhan City in China in December 2019. Objective The aim of this study is to identify the top 15 countries with spatial mapping of the confirmed cases. A comparison was done between the identified top 15 countries for confirmed cases, deaths, and recoveries, and an advanced autoregressive integrated moving average (ARIMA) model was used for predicting the COVID-19 disease spread trajectories for the next 2 months. Methods The comparison of recent cumulative and predicted cases was done for the top 15 countries with confirmed cases, deaths, and recoveries from COVID-19. The spatial map is useful to identify the intensity of COVID-19 infections in the top 15 countries and the continents. The recent reported data for confirmed cases, deaths, and recoveries for the last 3 months was represented and compared between the top 15 infected countries. The advanced ARIMA model was used for predicting future data based on time series data. The ARIMA model provides a weight to past values and error values to correct the model prediction, so it is better than other basic regression and exponential methods. The comparison of recent cumulative and predicted cases was done for the top 15 countries with confirmed cases, deaths, and recoveries from COVID-19. Results The top 15 countries with a high number of confirmed cases were stratified to include the data in a mathematical model. The identified top 15 countries with cumulative cases, deaths, and recoveries from COVID-19 were compared. The United States, the United Kingdom, Turkey, China, and Russia saw a relatively fast spread of the disease. There was a fast recovery ratio in China, Switzerland, Germany, Iran, and Brazil, and a slow recovery ratio in the United States, the United Kingdom, the Netherlands, Russia, and Italy. There was a high death rate ratio in Italy and the United Kingdom and a lower death rate ratio in Russia, Turkey, China, and the United States. The ARIMA model was used to predict estimated confirmed cases, deaths, and recoveries for the top 15 countries from April 24 to July 7, 2020. Its value is represented with 95%, 80%, and 70% confidence interval values. The validation of the ARIMA model was done using the Akaike information criterion value; its values were about 20, 14, and 16 for cumulative confirmed cases, deaths, and recoveries of COVID-19, respectively, which represents acceptable results. Conclusions The observed predicted values showed that the confirmed cases, deaths, and recoveries will double in all the observed countries except China, Switzerland, and Germany. It was also observed that the death and recovery rates were rose faster when compared to confirmed cases over the next 2 months. The associated mortality rate will be much higher in the United States, Spain, and Italy followed by France, Germany, and the United Kingdom. The forecast analysis of the COVID-19 dynamics showed a different angle for the whole world, and it looks scarier than imagined, but recovery numbers start looking promising by July 7, 2020.

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A complete genome sequence was obtained for a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain isolated from an oropharyngeal swab specimen of a Nepalese patient with coronavirus disease 2019 (COVID-19), who had returned to Nepal after traveling to Wuhan, China.