Objective To investigate the clinical characteristics, epidemiological characteristics, and transmissibility of coronavirus disease 2019 (COVID-19) in a family cluster outbreak transmitted by a 3-month-old confirmed positive infant. Methods Field-based epidemiological methods were used to investigate cases and their close contacts. Real-time fluorescent reverse transcription polymerase chain reaction (RT-PCR) was used to detect Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) for all collected specimens. Serum SARS-CoV-2 IgM and IgG antibodies were detected by Chemiluminescence and Gold immnnochromatography (GICA). Results The outbreak was a family cluster with an attack rate of 80% (4/5). The first case in this family was a 3-month-old infant. The transmission chain was confirmed from infant to adults (her father, mother and grandmother). Fecal tests for SARS-CoV-2 RNA remained positive for 37 days after the infant was discharged. The infant’s grandmother was confirmed to be positive 2 days after the infant was discharged from hospital. Patients A (3-month-old female), B (patient A’s father), C (patient A’s grandmother), and D (patient A’s mother) had positive serum IgG and negative IgM, but patients A’s grandfather serum IgG and IgM were negative. Conclusion SARS-CoV-2 has strong transmissibility within family settings and presence of viral RNA in stool raises concern for possible fecal–oral transmission. Hospital follow-up and close contact tracing are necessary for those diagnosed with COVID-19.
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by a wide spectrum of clinical manifestations and degrees of severity. Few genomic biomarkers for SLE have been validated and employed to inform clinical classifications and decisions. To discover and assess the gene-expression based SLE predictors in published studies, we performed a meta-analysis using our established signature database and a data similarity-driven strategy. From 13 training data sets on SLE gene-expression studies, we identified a SLE meta-signature (SLEmetaSig100) containing 100 concordant genes that are involved in DNA sensors and the IFN signaling pathway. We rigorously examined SLEmetaSig100 with both retrospective and prospective validation in two independent data sets. Using unsupervised clustering, we retrospectively elucidated that SLEmetaSig100 could classify clinical samples into two groups that correlated with SLE disease status and disease activities. More importantly, SLEmetaSig100 enabled personalized stratification demonstrating its ability to prospectively predict SLE disease at the individual patient level. To evaluate the performance of SLEmetaSig100 in predicting SLE, we predicted 1,171 testing samples to be either non-SLE or SLE with positive predictive value (97–99%), specificity (85%-84%), and sensitivity (60–84%). Our study suggests that SLEmetaSig100 has enhanced predictive value to facilitate current SLE clinical classification and provides personalized disease activity monitoring.
Background: There are limited data regarding the prevalence and risk factors relating to vitamin D deficiency (VDD) in children of Hainan, a tropical city with abundant sunlight in China. To gather and analyze the serum VD levels of healthy children in Hainan, so as to understand their VD nutritional status and improve the representative data of VD nutritional status in South China. Methods: Children who presented to the outpatient clinic for physical examination at 4 hospitals in the Hainan Province from 2012 to 2020 were enrolled in this study. The serum 25-hydroxyvitamin D (25-OHD) levels was analyzed. 25-OHD levels <50 nmol/L is considered VDD, 50-75 nmol/L is vitamin D insufficiency (VDI), and ≥75 nmol/L is VD sufficient (VDS). Results: The average serum 25-OHD level was 94.63±49.99 nmol/L [95% confidence interval (CI):93.67-95.60]. VDD was detected in 13.98% of participants (1,435 cases), VDI was detected in 30.60% of participants (3,140 cases), and 55.42% presented with VDS (5,687 cases). The average 25-OHD level of boys was significantly higher than that of girls (t=3.67, P<0.001). The average serum 25-OHD levels in the following age groups 0-1, 1-3, 3-7, 7-14, and 14-18 years were 105. 92±57.39, 100.55±53.22, 86.35±39.19, 73.61±34.21, and 54.97±19.19 nmol/L, respectively. These results suggested that with an increase in age, the 25-OHD levels decreased. The average 25-OHD levels of children with a body mass index (BMI) <85 th percentile were significantly higher than that of children in the overweight and obese group (F=7.393, P=0.001).Conclusions: A certain proportion of all age groups showed vitamin D deficiency and insufficiency in Hainan. A formal recommendation for vitamin D supplementation should be considered, especially in autumn and winter seasons for children over 7 years old, and in those with BMI ≥85th percentile or BMI ≥95 th percentile.
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