The novel coronavirus (2019-nCoV) is spreading very fast in Hubei Province of China. As of February 14, 2020, 51,986 confirmed cases (including laboratory-confirmed cases and clinically-confirmed cases) were reported in Hubei Province, and 1,318 of them died. Respiratory droplets and contact transmission are considered to be the most important routes of transmission of 2019-nCoV, but do not fully account for the occurrence of all coronavirus disease 2019 (COVID-19) cases, previously known as novel coronavirus pneumonia (NCP), and the reasons for the rapid spread of this virus (1).In Biosafety Level 3 (BSL-3) Laboratory of the National Institute for Viral Disease Control and Prevention, Vero cells were used for viral isolation from stool samples of COVID-19 patients sent by Heilongjiang CDC. A 2019-nCoV strain was isolated from a stool specimen of a laboratory-confirmed COVID-19 severe pneumonia case, who experienced onset on January 16, 2020 and was sampled on February 1, 2020. The interval between sampling and onset was 15 days. The full-length genome sequence indicated that the virus had high-nucleotide similarity (99.98%) to that of the first isolated novel coronavirus isolated from Wuhan, China (Figure 1). In the Vero cells, viral particles with typical morphology of a

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Background:The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has progressed to a pandemic associated with substantial morbidity and mortality. The WHO and the United States Center for Disease Control and Prevention (CDC) have issued interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19), but there is limited data on the virologic and clinical characteristics for prognosis of severe COVID-19. Methods:A total of 50 patients with severe COVID-19 were divided into good and poor recovery groups. The dynamic viral shedding and serological characteristics of SARS-CoV-2 were explored. The risk factors associated with poor recovery and lung lesion resolutions were identified. In addition, the potential relationships among the viral shedding, the pro-inflammatory response, and lung lesion evolutions were characterized. Results:A total of 58% of the patients had poor recovery and were more likely to have a prolonged interval of viral shedding. The longest viral shedding was 57 days after symptom onset. Older age, hyperlipemia, hypoproteinemia, corticosteroid therapy, consolidation on chest computed-tomography (CT), and prolonged SARS-CoV-2 IgM positive were all associated with poor recovery. Additionally, the odds of impaired lung lesion resolutions were higher in patients with hypoproteinemia, hyperlipemia, and elevated levels of IL-4 and ferritin. Finally, viral shedding and proinflammatory responses were closely correlated with lung lesion evolutions on chest CT. : medRxiv preprint ConclusionsPatients with severe COVID-19 have prolonged SARS-CoV-2 infection and delayed intermittent viral shedding. Older age, hyperlipemia, hypoproteinemia, corticosteroid usage, and prolonged SARS-CoV-2 IgM positive might be utilized as predicative factors for the patients with poor recovery.

Currently, there is no specific treatment for COVID-19 proven by clinical trials. WHO and CDC guidelines therefore endorse supportive care only. However, frontline clinicians have been applying several virus-based and host-based therapeutics in order to combat SARS-CoV-2. Medications from COVID-19 case reports, observational studies and the COVID-19 Treatment Guideline issued by the China's National Health Commission (7th edition published March 3rd, 2020. Edited translation attached) are evaluated in this review. Key evidence from relevant in vitro researches, animal models and clinical studies in SARS-CoV-2, SARS-CoV and MERS-CoV are examined. Antiviral therapies remdesivir, lopinavir/ritonavir and umifenovir, if considered, could be initiated before the peak of viral replication for optimal outcomes. Ribavirin may be beneficial as an add-on therapy and is ineffective as a monotherapy. Corticosteroids use should be limited without indicating comorbidities. IVIG is not recommended due to lack of data in COVID-19. Xuebijing may benefit patients with complications of bacterial pneumonia or sepsis. The efficacy of interferon is unclear due to conflicting outcomes in SARS and MERS studies. Chloroquine and hydroxychloroquine have shown in vitro inhibition of SARS-CoV-2 and may be beneficial as both prophylactic and treatment therapy. For patients who developed cytokine release syndrome, interleukin-6 inhibitors may be beneficial. Given the rapid disease spread and increasing mortality, active treatment with readily available medications may be considered timely prior to disease progression.

What is known about this topic? Few major outbreaks of coronavirus disease 2019 have occurred in China after major nonpharmaceutical interventions and vaccines have been deployed and implemented. However, sporadic outbreaks that had high possibility to be linked to cold chain products were reported in several cities of China.. What is added by this report?In July 2020, a COVID-19 outbreak occurred in Dalian, China. The investigations of this outbreak strongly suggested that the infection source was from COVID-19 virus-contaminated packaging of frozen seafood during inbound unloading personnel contact. What are the implications for public health practice? Virus contaminated paper surfaces could maintain infectivity for at least 17-24 days at -25 ℃. Exposure to COVID-19 virus-contaminated surfaces is a potential route for introducing the virus to a susceptible population. Countries with no domestic transmission of COVID-19 should consider introducing prevention strategies for both inbound travellers and imported goods. Several measures to prevent the introduction of the virus via cold-chain goods can be implemented. INVESTIGATION AND RESULTSCOVID-19 cases were diagnosed by a local hospital in Dalian according to the Protocol for Prevention and Control of COVID-19 (Edition 6) issued by China CDC (1). In this study, a confirmed case was defined as having a throat swab that tested positive for COVID-19 virus RNA by RT-qPCR; an undiscovered infected case was defined as having a sera sample that tested positive for COVID-19 antibodies but negative for COVID-19 virus RNA. Detailed epidemiological investigation for early cases were conducted through in-person interviews for their travel history, activity, work history, and contact history starting 14 days (incubation period) before the onset of illness. Environmental samples and cold-chain product samples collected from Company K were further tested with RT-qPCR. Individuals who had contact with the China CDC Weekly Chinese Center for Disease Control and Prevention CCDC Weekly / Vol. 3 / No.

Purpose As a standard source of capital for entrepreneurs, crowdfunding has recently gained wide attention in business and academia. With scientific endorsement, some research is conducted to explore the antecedents of online crowdfunding success. The factors that can influence the backers’ investment which is the key to success are information from prior backers’ and creators’ behaviors. Based on the signaling theory, the purpose of this paper is to systematically investigate the dynamic influences and interaction effects of signals with different forms (action-based or opinion-based signals) and sources (creator-sourced or backer-sourced signals) on backers’ investment behaviors over a project-funding cycle. Design/methodology/approach A panel data set of 3,010 projects with 640,625 transaction records from April 28, 2013 to September 31, 2017 is collected from a famous online crowdfunding platform – Zhongchou.cn in China and the negative binomial panel data model with fixed effect is used to obtain our empirical results. Findings The findings demonstrate that the work of different signals is significantly effective at the early stage of a project and decreases with time. Furthermore, our results show that there are both synergistic effect and substitution effect among different signals. Specifically, the direction of interaction effect depends on the forms of signals and the backers’ sensitivity toward that signal, and the interaction effects are also dynamic. Originality/value This paper has shed light on the roles of different signal types and their interactions in influencing funding behavior over a project-funding cycle, enriched the literature on crowdfunding and provided both theoretical and practical implications.

Of this series of epidemics, the epidemic in Nanjing City affected the largest geographical area and had the most significant cumulative number of cases. The investigation revealed that the index case, which was China CDC Weekly Chinese Center for Disease Control and Prevention CCDC Weekly / Vol. 3 / No. 41

Objectives: To explore the efficacy of corticosteroid treatment in patients with severe COVID-19 pneumonia and the association between corticosteroid use and patient mortality. Methods: A retrospective investigation was made on the medical records of the patients with severe and critical patients with COVID-19 pneumonia from January to February 2020. First, the patients who received corticosteroid treatment were compared with patients without given corticosteroid treatment. Then a propensity score matching method was used to control confounding factors. Cox survival regression analysis was used to evaluate the effect of corticosteroid therapy on the mortality of severe and critical patients with COVID-19. Results: A total of 371 severe and critical patients were included in our analyses. 209 patients were treated with corticosteroid therapy. Most of them were treated with methylprednisolone (197[94.3%]). The median corticosteroid therapy was applied 3(IQR 2-6) days after admission, 13(IQR 10-17) days after symptoms appeared. Temperature on admission(OR=1.255,[95%CI 1.021-1.547],p=0.032), ventilation(OR=1.926,[95%CI 1.148-3.269],p=0.014) and ICU admission(OR=3.713, [95%CI 1.776-8.277],p<0.001) were significantly associated with corticosteroids use. After PS matching, the cox regression survival analysis showed that corticosteroid use was significantly associated with a lower mortality rate (HR=0.592, [95%CI 0.406-0.862], p=0.006). Conclusion: Corticosteroid therapy use in severe and critical patients with COVID-19 pneumonia leads to lower mortality but may cause other side effects. Corticosteroid therapy should be used carefully.