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      SARS-CoV-2/COVID-19 – Epidemiologie und Prävention Translated title: SARS-CoV-2/COVID-19—epidemiology and prevention

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          Abstract

          SARS-CoV‑2 („severe acute respiratory syndrome coronavirus 2“) hat sich seit Dezember 2019 rasch weltweit ausgebreitet. Eine erste Welle ist bis Ende Juni 2020 in vielen Regionen sichtbar. Wir stellen hier das aktuelle Wissen zur Epidemiologie und Prävention dar. SARS-CoV‑2 wird v. a. durch Tröpfchen und Aerosole übertragen und repliziert überwiegend im oberen und unteren Respirationstrakt. Die Basisreproduktionszahl R 0 liegt zwischen 2 und 3, die Inkubationszeit beträgt im Median 6 (2–14) Tage. Wie bei den verwandten Coronaviren SARS-CoV und MERS(„Middle East respiratory syndrome“)-CoV spielen Superspreading-Ereignisse bei der Ausbreitung eine wichtige Rolle. Eine hohe Rate von Infektionen verläuft unkompliziert, moderate bis schwere Verläufe treten bei 5–10 % der Infizierten auf. Pneumonien, kardiale Beteiligung und Thromboembolien sind die häufigsten zur Hospitalisierung führenden Manifestationen. Risikofaktoren für einen komplizierten Verlauf sind höheres Alter, Hypertonie, Diabetes mellitus und chronische Herz- und Lungenerkrankungen sowie Immundefekte. Derzeit liegt die Schätzung für die IFR („infection fatality rate“) über alle Altersgruppen zwischen 0,5 und 1 %. Mit Bündeln verschiedener Maßnahmen zur Reduktion sozialer Kontakte wurden Ausbrüche in vielen Regionen begrenzt. Für Deutschland wird für die erste Welle eine Befallsrate von 0,4–1,8 % geschätzt, eine Übersterblichkeit konnte dabei nicht beobachtet werden.

          Translated abstract

          Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread globally since December 2019. A first wave is visible up to the end of June 2020 in many regions. This article presents a review of the current knowledge on the epidemiology and prevention. The SARS-CoV‑2 predominantly replicates in the upper and lower respiratory tracts and is particularly transmitted by droplets and aerosols. The estimate for the basic reproduction number (R 0) is between 2 and 3 and the median incubation period is 6 days (range 2–14 days). As with the related SARS-CoV and Middle East respiratory syndrome (MERS-CoV), superspreading events play an important role in the dissemination. A high proportion of infections are uncomplicated but moderate or severe courses develop in 5–10% of infected persons. Pneumonia, cardiac involvement and thromboembolisms are the most frequent manifestations leading to hospitalization. Risk factors for a complicated course are high age, hypertension, diabetes mellitus and chronic cardiovascular and pulmonary diseases as well as immunodeficiency. Currently, the estimation for the infection fatality rate (IFR) is between 0.5% and 1% across all age groups. Outbreaks were limited in many regions with bundles of various measures for reduction of social contacts. The incidence for the first wave in Germany can be estimated as 0.4–1.8% and excess mortality could not be observed.

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          Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

          Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.
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            Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

            Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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              Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

              There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).
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                Author and article information

                Contributors
                bernd.salzberger@ukr.de
                Journal
                Nephrologe
                Nephrologe
                Der Nephrologe
                Springer Medizin (Heidelberg )
                1862-040X
                1862-0418
                15 December 2020
                : 1-7
                Affiliations
                [1 ]GRID grid.411941.8, ISNI 0000 0000 9194 7179, Abt. Krankenhaushygiene und Infektiologie, , Universitätsklinikum Regensburg, ; Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Deutschland
                [2 ]Sachgebiet Infektionsschutz und Hygiene, Gesundheitsamt Regensburg, Regensburg, Deutschland
                [3 ]Klinik für Rheumatologie und klinische Immunologie, Fachklinikum Bad Abbach, Bad Abbach, Deutschland
                [4 ]GRID grid.411941.8, ISNI 0000 0000 9194 7179, Institut für Medizinische Mikrobiologie und Hygiene, , Universitätsklinikum Regensburg, ; Regensburg, Deutschland
                Author notes
                [Redaktion]

                C. Erley, Berlin

                J. Floege, Aachen

                W. Kleophas, Hamburg

                Article
                472
                10.1007/s11560-020-00472-0
                7736674
                33343742
                d512b23c-f79d-40b0-8305-b3e0670588f9
                © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 20 November 2020
                Categories
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                coronavirus,pandemie,basisreproduktionszahl,mortalität,infektionssterblichkeitsrate,pandemic,basic reproduction number,mortality,infection fatality rate

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