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      Clinical Characteristics and Results of Semen Tests Among Men With Coronavirus Disease 2019

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      , PhD 1 , 2 , , MD 2 , 3 , , PhD 4 , , MD 4 , , , MD 5 ,
      JAMA Network Open
      American Medical Association

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          Abstract

          This cohort study examines the clinical characteristics of men with coronavirus disease 2019 whose semen tested positive for severe acute respiratory syndrome coronavirus 2.

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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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            Clinical Characteristics of Coronavirus Disease 2019 in China

            Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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              Virus in Semen and the Risk of Sexual Transmission

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                Author and article information

                Journal
                JAMA Netw Open
                JAMA Netw Open
                JAMA Netw Open
                JAMA Network Open
                American Medical Association
                2574-3805
                7 May 2020
                May 2020
                7 May 2020
                : 3
                : 5
                : e208292
                Affiliations
                [1 ]Nanlou Respiratory Diseases Department, Chinese People’s Liberation Army General Hospital, Beijing, China
                [2 ]Department of Nephrology, Chinese People’s Liberation Army General Hospital, Chinese People’s Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Chinese People’s Liberation Army Postgraduate Medical School, Beijing, China
                [3 ]Department of Nephrology, Beijing-Chaoyang Hospital, Beijing, China
                [4 ]Department of Respiratory Medicine, The Eighth Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, China
                [5 ]Shangqiu Municipal Hospital, Shangqiu, China
                Author notes
                Article Information
                Accepted for Publication: April 13, 2020.
                Published: May 7, 2020. doi:10.1001/jamanetworkopen.2020.8292
                Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Li D et al. JAMA Network Open.
                Corresponding Authors: Weiguo Zhao, MD, Department of Respiratory Medicine, The Eighth Medical Center of Chinese People’s Liberation Army General Hospital, 17th Heishanhu Road, Beijing, 100093, China ( zhaowg309@ 123456163.com ); Shixi Zhang, MD, Shangqiu Municipal Hospital, Shangqiu, No. 1 Yingbin Road, Shangqiu City, Henan Province, China, 476100, China ( Shixizhang1977@ 123456163.com ).
                Author Contributions: Drs Zhao and Zhang had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Li, Jin, and Bao contributed equally to this work.
                Concept and design: Li, Jin, Zhao, Zhang.
                Acquisition, analysis, or interpretation of data: Li, Jin, Bao.
                Drafting of the manuscript: Li, Jin.
                Critical revision of the manuscript for important intellectual content: All authors.
                Statistical analysis: Li, Jin, Bao.
                Obtained funding: Li, Jin.
                Administrative, technical, or material support: Li, Zhao, Zhang.
                Conflict of Interest Disclosures: None reported.
                Funding/Support: This study was partially supported by grant KF2018-06 from the Open Project Program of the State Key Laboratory of Kidney Diseases in People’s Liberation Army General Hospital.
                Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
                Article
                zld200055
                10.1001/jamanetworkopen.2020.8292
                7206502
                32379329
                9e67015d-55da-4a90-84ed-478a99d12007
                Copyright 2020 Li D et al. JAMA Network Open.

                This is an open access article distributed under the terms of the CC-BY License.

                History
                : 28 February 2020
                : 13 April 2020
                Categories
                Research
                Research Letter
                Online Only
                Infectious Diseases

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