Background: Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel batorigin CoV causing severe and fatal pneumonia in humans. Methods: We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Jin Yin-tan Hospital of Wuhan, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed. Results: Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown b-CoV strain in all five patients, with 99.8% to 99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically 1 closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6% to 87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor. Conclusion: A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.
Background: Many healthcare workers were infected by coronavirus disease 2019 (COVID-19) early in the epidemic posing a big challenge for epidemic control. Hence, this study aims to explore perceived infection routes, influencing factors, psychosocial changes, and management procedures for COVID-19 infected healthcare workers. Methods: This is a cross-sectional, single hospital-based study. We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29, 2020. All participants completed a validated questionnaire. Electronic consent was obtained from all participants. Perceived causes of infection, infection prevention, control knowledge and behaviour, psychological changes, symptoms and treatment were measured.(Continued on next page) Results: Finally, 103 professional staff with COVID-19 finished the questionnaire and was included (response rate: 98.1%). Of them, 87 cases (84.5%) thought they were infected in working environment in hospital, one (1.0%) thought their infection was due to the laboratory environment, and 5 (4.9%) thought they were infected in daily life or community environment. Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively. Forty-three (41.8%) thought their infection was related to protective equipment, utilization of common equipment (masks and gloves). The top three first symptoms displayed before diagnosis were fever (41.8%), lethargy (33.0%) and muscle aches (30.1%). After diagnosis, 88.3% staff experienced psychological stress or emotional changes during their isolation period, only 11.7% had almost no emotional changes. Arbidol (Umifenovir; an anti-influza drug; 69.2%) was the drug most commonly used to target infection in mild and moderate symptoms. Conclusion: The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases. Positive psychological intervention is necessary.
Abstract. Open biomass burning is an important source of air pollution in China and globally. Joint observations of air pollution were conducted in five cities (Shanghai, Hangzhou, Ningbo, Suzhou and Nanjing) of the Yangtze River delta, and a heavy haze episode with visibility 2.9–9.8 km was observed from 28 May to 6 June 2011. The contribution of biomass burning was quantified using both ambient monitoring data and the WRF/CMAQ (Weather Research and Forecasting (WRF) and Community Multiscale Air Quality (CMAQ)) model simulation. It was found that the average and maximum daily PM2.5 concentrations during the episode were 82 and 144 μgm−3, respectively. Weather pattern analysis indicated that stagnation enhanced the accumulation of air pollutants, while the following precipitation event scavenged the pollution. Mixing depth during the stagnant period was 240–399 m. Estimation based on observation data and CMAQ model simulation indicated that biomass open burning contributed 37% of PM2.5, 70% of organic carbon and 61% of elemental carbon. Satellite-detected fire spots, back-trajectory analysis and air quality model simulation were integrated to identify the locations where the biomass was burned and the pollutants transport. The results suggested that the impact of biomass open burning is regional, due to the substantial inter-province transport of air pollutants. PM2.5 exposure level could be reduced 47% for the YRD region if complete biomass burning is forbidden and significant health benefit is expected. These findings could improve the understanding of heavy haze pollution, and suggest the need to ban open biomass burning during post-harvest seasons.
Abstract. Open biomass burning is an important source of air pollution in China and globally. Joint observations of air pollution were conducted in five cities (Shanghai, Hangzhou, Ningbo, Suzhou and Nanjing) of the Yangtze River Delta, and a heavy haze episode with visibility 2.9–9.8 km was observed from 28 May to 6 June 2011. The contribution of biomass burning was quantified using both ambient monitoring data and the WRF/CMAQ model simulation. It was found that the average and maximum daily PM2.5 concentrations during the episode were 82 μg m−3 and 144 μg m−3, respectively. Weather pattern analysis indicated that a stagnant process enhanced the accumulation of air pollutants, while the following precipitation process scavenged the pollution. Daily minimum mixing depth during the stagnant period was below 50 m. Both observation data and CMAQ model simulation indicated that biomass open burning contributed 37% of PM2.5, 70% of organic carbon and 61% of elemental carbon. Satellite-detected fire spots, back-trajectory analysis and air model simulation can be integrated to identify the locations where the biomasses are burned. The results also suggest that the impact of biomass open burning is regional, due to the substantial inter-province transport of air pollutants. These findings would improve the understanding of not only heavy haze and air pollution episodes, but also the emissions of such open fires.
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