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      Citizen science initiative points at childhood BCG vaccination as a risk factor for COVID‐19

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          Abstract

          Current results do not provide conclusive evidence on the effect of BCG vaccination on COVID‐19 alone or in combination with other factors. To address this limitation, in this study we used a citizen science initiative on the COVID‐19 pandemic to collect data worldwide during 2 October 2020–30 October 2020 (1,233 individuals) in a structured way for analysing factors and characteristics of affected individuals in relation to BCG vaccination. For the first time, the results of our study suggested that vaccination with BCG may increase the risk for COVID‐19 at certain age, particularly in individuals vaccinated at childhood. Childhood BCG vaccination increased the likelihood of being diagnosed with COVID‐19 fivefold in COVID‐19 low‐incidence countries and threefold in high‐incidence countries. A reasonable explanation for this effect is the activation of certain innate immunity mechanisms associated with inflammatory reactions. These factors should be considered when analysing the risks associated with this global pandemic.

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Children and Adolescents: A Systematic Review

            The current rapid worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection justifies the global effort to identify effective preventive strategies and optimal medical management. While data are available for adult patients with coronavirus disease 2019 (COVID-19), limited reports have analyzed pediatric patients infected with SARS-CoV-2.
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              Is Open Access

              BCG vaccine protection from severe coronavirus disease 2019 (COVID-19)

              Significance The COVID-19 pandemic is one of the most devastating in recent history. The bacillus Calmette−Guérin (BCG) vaccine against tuberculosis also confers broad protection against other infectious diseases, and it has been proposed that it could reduce the severity of COVID-19. This epidemiological study assessed the global linkage between BCG vaccination and COVID-19 mortality. Signals of BCG vaccination effect on COVID-19 mortality are influenced by social, economic, and demographic differences between countries. After mitigating multiple confounding factors, several significant associations between BCG vaccination and reduced COVID-19 deaths were observed. This study highlights the need for mechanistic studies behind the effect of BCG vaccination on COVID-19, and for clinical evaluation of the effectiveness of BCG vaccination to protect from severe COVID-19.
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                Author and article information

                Contributors
                jose_delafuente@yahoo.com , josedejesus.fuente@uclm.es
                Journal
                Transbound Emerg Dis
                Transbound Emerg Dis
                10.1111/(ISSN)1865-1682
                TBED
                Transboundary and Emerging Diseases
                John Wiley and Sons Inc. (Hoboken )
                1865-1674
                1865-1682
                20 April 2021
                : 10.1111/tbed.14097
                Affiliations
                [ 1 ] SaBio Instituto de Investigación en Recursos Cinegéticos IREC‐CSIC‐UCLM‐JCCM Ciudad Real Spain
                [ 2 ] Department of Veterinary Pathobiology Center for Veterinary Health Sciences Oklahoma State University Stillwater OK USA
                [ 3 ] Escuela de Ingeniería Industrial y Aeroespacial University of Castilla La Mancha Toledo Spain
                [ 4 ] Martsinovsky Institute of Medical Parasitology, Tropical and Vector Borne Diseases Sechenov First Moscow State Medical University Moscow Russia
                Author notes
                [*] [* ] Correspondence

                José de la Fuente, SaBio, IREC, CSIC‐UCLM‐JCCM, Ronda de Toledo sn, Ciudad Real 13005, Spain.

                Emails: jose_delafuente@ 123456yahoo.com ; josedejesus.fuente@ 123456uclm.es

                Author information
                https://orcid.org/0000-0001-7383-9649
                https://orcid.org/0000-0003-0012-4006
                Article
                TBED14097
                10.1111/tbed.14097
                8251061
                33825348
                2777c1ff-dcd0-4803-89af-d7840de8cc12
                © 2021 Wiley‐VCH GmbH

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 01 March 2021
                : 30 December 2020
                : 01 April 2021
                Page count
                Figures: 1, Tables: 2, Pages: 6, Words: 12719
                Categories
                Rapid Communication
                Rapid Communications
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.4 mode:remove_FC converted:02.07.2021

                Infectious disease & Microbiology
                bcg vaccine,citizen science,covid‐19,humans,innate immunity,pandemics,risk factors,severe acute respiratory syndrome coronavirus 2,vaccination

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