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Article: Incidence and Mortality of COVID-19-Associated Invasive Fungal Infections Among Critically Ill Intubated Patients: A Multicenter Retrospective Cohort Analysis.

Zuniga-Moya, Julio C / Papadopoulos, Benjamin / Mansoor, Armaghan-E-Rehman / Mazi, Patrick B / Rauseo, Adriana M / Spec, Andrej

Open forum infectious diseases

2024 Volume 11, Issue 4, Page(s) ofae108

Abstract: Background: An association between coronavirus disease 2019 (COVID-19)-associated invasive fungal infections (CAIFIs) and high mortality among intubated patients has been suggested in previous research. However, some of the current evidence was derived ... ...

Abstract	Background: An association between coronavirus disease 2019 (COVID-19)-associated invasive fungal infections (CAIFIs) and high mortality among intubated patients has been suggested in previous research. However, some of the current evidence was derived from small case series and multicenter studies conducted during different waves of the COVID-19 pandemic. We examined the incidence of CAIFIs and their associated mortality using a large, multicenter COVID-19 database built throughout the pandemic. Methods: We conducted a retrospective analysis of the National COVID Cohort Collaborative (N3C) database collected from 76 medical centers in the United States between January 2020 and August 2022. Patients were 18 years or older and intubated after severe acute respiratory syndrome coronavirus 2 infection. The primary outcomes were incidence and all-cause mortality at 90 days. To assess all-cause mortality, we fitted Cox proportional hazard models after adjusting for confounders via inverse probability weighting. Results: Out of the 4 916 229 patients with COVID-19 diagnosed during the study period, 68 383 (1.4%) met our cohort definition. The overall incidence of CAIFI was 2.80% (n = 1934/68 383). Conclusions: The incidence of CAIFI was modest but associated with higher 90-day all-cause mortality among intubated patients. Systemic antifungals modified mortality.
Language	English
Publishing date	2024-04-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofae108
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Article ; Online: International Nosocomial Infection Control Consortium (INICC) report of health care-associated infections, data summary of 25 countries for 2014 to 2023, Surgical Site Infections Module.

Rosenthal, Victor Daniel / Yin, Ruijie / Jin, Zhilin / Alkhawaja, Safaa Abdulaziz / Zuñiga-Chavarria, Maria Adelia / Salgado, Estuardo / El-Kholy, Amani / Zuniga Moya, Julio C / Patil, Priyanka / Nadimpalli, Gita / Pattabhiramarao, Rao Nadimpalli / Zala, Dolatsinh / Villegas-Mota, Isabel / Ider, Bat-Erdene / Tumu, Nellie / Duszynska, Wieslawa / Nguyet, Le Thi Thu / Nair, Pravin K / Memish, Ziad A

American journal of infection control

2024

Abstract: Background: Surgical site infection (SSI) rates are higher in low-resource countries (LRC) than in high-income counterparts.: Methods: Prospective cohort study using the INICC Surveillance Online System, from 116 hospitals in 75 cities across 25 ... ...

Abstract	Background: Surgical site infection (SSI) rates are higher in low-resource countries (LRC) than in high-income counterparts. Methods: Prospective cohort study using the INICC Surveillance Online System, from 116 hospitals in 75 cities across 25 Latin-American, Asian, Eastern-European, and Middle-Eastern countries: Argentina, Bahrain, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Egypt, Honduras, India, Kosovo, Kuwait, Lebanon, Mexico, Mongolia, Pakistan, Papua New Guinea, Philippines, Poland, Romania, Saudi Arabia, Thailand, Turkey, Venezuela, Vietnam. CDC/NHSN definitions were applied. Surgical procedures (SPs) were categorized according to the International Classification of Diseases criteria. Results: From 2014 to 2023, we collected data on 1,251 SSIs associated with 56,617 SPs. SSI rates were significantly higher in SPs of INICC compared to CDC/NHSN data: hip prosthesis (3.68% vs 0.67%, relative risk [RR]=5.46, 95% confidence interval [CI]=3.71-8.03, P<.001), knee prosthesis (2.02% vs 0.58%, RR=3.49, 95% CI=1.87-6.49, P<.001), coronary artery bypass (4.16% vs 1.37%, RR=3.03, 95% CI=2.35-3.91, P<.001), peripheral vascular bypass (15.69% vs 2.93%, RR=5.35, 95% CI=2.30-12.48, P<.001), abdominal aortic aneurysm repair (8.51% vs 2.12%, RR=4.02, 95% CI=2.11-7.65, P<.001), spinal fusion (6.47% vs 0.70%, RR=9.27, 95% CI=6.21-13.84, P<.001), laminectomy (2.68% vs 0.72%, RR=3.75, 95% CI=2.36-5.95, P<.001), among others. Conclusions: Elevated SSI rates in LRCs emphasize the need for effective interventions.
Language	English
Publishing date	2024-04-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	392362-9
ISSN	1527-3296 ; 0196-6553
ISSN (online)	1527-3296
ISSN	0196-6553
DOI	10.1016/j.ajic.2024.04.007
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Article ; Online: The Geographic Distribution of Dimorphic Mycoses in the United States for the Modern Era.

Mazi, Patrick B / Sahrmann, John M / Olsen, Margaret A / Coler-Reilly, Ariella / Rauseo, Adriana M / Pullen, Matthew / Zuniga-Moya, Julio C / Powderly, William G / Spec, Andrej

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2022 Volume 76, Issue 7, Page(s) 1295–1301

Abstract: Background: The dimorphic mycoses (DMs) of the United States-Histoplasma, Coccidioides, and Blastomyces-commonly known as endemic mycoses of North America (in addition to Paracoccidioides) are increasingly being diagnosed outside their historical areas ... ...

Abstract	Background: The dimorphic mycoses (DMs) of the United States-Histoplasma, Coccidioides, and Blastomyces-commonly known as endemic mycoses of North America (in addition to Paracoccidioides) are increasingly being diagnosed outside their historical areas of endemicity. Despite this trend, the maps outlining their geographic distributions have not been updated in more than half a century using a large, nationwide database containing individual-patient-level data. Methods: This was a retrospective analysis of >45 million Medicare fee-for-service beneficiaries from 1 January 2007 through 31 December 2016. Diagnoses of histoplasmosis, coccidioidomycosis, and blastomycosis were defined by International Classification of Diseases, Ninth/10th Revision, codes. The primary outcome was the incidence of histoplasmosis, coccidioidomycosis, and blastomycosis for each US county. Clinically meaningful thresholds for incidence were defined as 100 cases/100 000 person-years for histoplasmosis and coccidioidomycosis and 50 cases/100 000 person-years for blastomycosis. Results: There were 79 749 histoplasmosis, 37 726 coccidioidomycosis, and 6109 blastomycosis diagnoses in unique persons from 2007-2016 across 3143 US counties. Considering all US states plus Washington, DC, 94% (48/51) had ≥1 county above the clinically relevant threshold for histoplasmosis, 69% (35/51) for coccidioidomycosis, and 78% (40/51) for blastomycosis. Conclusions: Persons with histoplasmosis, coccidioidomycosis, and blastomycosis are diagnosed in significant numbers outside their historical geographic distributions established >50 years ago. Clinicians should consider DM diagnoses based on compatible clinical syndromes with less emphasis placed on patients' geographic exposure. Increased clinical suspicion leading to a subsequent increase in DM diagnostic testing would likely result in fewer missed diagnoses, fewer diagnostic delays, and improved patient outcomes.
MeSH term(s)	Aged ; Humans ; United States/epidemiology ; Blastomycosis/epidemiology ; Coccidioidomycosis/epidemiology ; Coccidioidomycosis/diagnosis ; Histoplasmosis/diagnosis ; Histoplasmosis/epidemiology ; Retrospective Studies ; Medicare ; Mycoses
Language	English
Publishing date	2022-11-07
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciac882
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Article ; Online: A dengue outbreak in a rural community in Northern Coastal Ecuador: An analysis using unmanned aerial vehicle mapping.

Lee, Gwenyth O / Vasco, Luis / Márquez, Sully / Zuniga-Moya, Julio C / Van Engen, Amanda / Uruchima, Jessica / Ponce, Patricio / Cevallos, William / Trueba, Gabriel / Trostle, James / Berrocal, Veronica J / Morrison, Amy C / Cevallos, Varsovia / Mena, Carlos / Coloma, Josefina / Eisenberg, Joseph N S

PLoS neglected tropical diseases

2021 Volume 15, Issue 9, Page(s) e0009679

Abstract: Dengue is recognized as a major health issue in large urban tropical cities but is also observed in rural areas. In these environments, physical characteristics of the landscape and sociodemographic factors may influence vector populations at small ... ...

Abstract	Dengue is recognized as a major health issue in large urban tropical cities but is also observed in rural areas. In these environments, physical characteristics of the landscape and sociodemographic factors may influence vector populations at small geographic scales, while prior immunity to the four dengue virus serotypes affects incidence. In 2019, a rural northwestern Ecuadorian community, only accessible by river, experienced a dengue outbreak. The village is 2-3 hours by boat away from the nearest population center and comprises both Afro-Ecuadorian and Indigenous Chachi households. We used multiple data streams to examine spatial risk factors associated with this outbreak, combining maps collected with an unmanned aerial vehicle (UAV), an entomological survey, a community census, and active surveillance of febrile cases. We mapped visible water containers seen in UAV images and calculated both the green-red vegetation index (GRVI) and household proximity to public spaces like schools and meeting areas. To identify risk factors for symptomatic dengue infection, we used mixed-effect logistic regression models to account for the clustering of symptomatic cases within households. We identified 55 dengue cases (9.5% of the population) from 37 households. Cases peaked in June and continued through October. Rural spatial organization helped to explain disease risk. Afro-Ecuadorian (versus Indigenous) households experience more symptomatic dengue (OR = 3.0, 95%CI: 1.3, 6.9). This association was explained by differences in vegetation (measured by GRVI) near the household (OR: 11.3 95% 0.38, 38.0) and proximity to the football field (OR: 13.9, 95% 4.0, 48.4). The integration of UAV mapping with other data streams adds to our understanding of these dynamics.
MeSH term(s)	Adolescent ; Adult ; Aircraft ; Animals ; Child ; Culicidae ; Dengue/epidemiology ; Disease Outbreaks ; Ecuador/epidemiology ; Family Characteristics ; Geographic Mapping ; Humans ; Mosquito Control ; Mosquito Vectors ; Risk Factors ; Rural Population ; Time Factors
Language	English
Publishing date	2021-09-27
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2735
ISSN (online)	1935-2735
ISSN	1935-2735
DOI	10.1371/journal.pntd.0009679
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Article ; Online: Clinical Spectrum of Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Protection From Symptomatic Reinfection.

Maier, Hannah E / Kuan, Guillermina / Saborio, Saira / Carrillo, Fausto Andres Bustos / Plazaola, Miguel / Barilla, Carlos / Sanchez, Nery / Lopez, Roger / Smith, Matt / Kubale, John / Ojeda, Sergio / Zuniga-Moya, Julio C / Carlson, Bradley / Lopez, Brenda / Gajewski, Anna M / Chowdhury, Mahboob / Harris, Eva / Balmaseda, Angel / Gordon, Aubree

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2021 Volume 75, Issue 1, Page(s) e257–e266

Abstract: Background: There are few data on the full spectrum of disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across the lifespan from community-based or nonclinical settings.: Methods: We followed 2338 people in ... ...

Abstract	Background: There are few data on the full spectrum of disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across the lifespan from community-based or nonclinical settings. Methods: We followed 2338 people in Managua, Nicaragua, aged <94 years from March 2020 through March 2021. SARS-CoV-2 infection was identified through real-time reverse transcription polymerase chain reaction (RT-PCR) or through enzyme-linked immunosorbent assay. Disease presentation was assessed at the time of infection or retrospectively by survey at the time of blood collection. Results: There was a large epidemic that peaked between March and August 2020. In total, 129 RT-PCR-positive infections were detected, for an overall incidence rate of 5.3 infections per 100 person-years (95% confidence interval [CI], 4.4-6.3). Seroprevalence was 56.7% (95% CI, 53.5%-60.1%) and was consistent from age 11 through adulthood but was lower in children aged ≤10 years. Overall, 31.0% of the infections were symptomatic, with 54.7% mild, 41.6% moderate, and 3.7% severe. There were 2 deaths that were likely due to SARS-CoV-2 infection, yielding an infection fatality rate of 0.2%. Antibody titers exhibited a J-shaped curve with respect to age, with the lowest titers observed among older children and young adults and the highest among older adults. When compared to SARS-CoV-2-seronegative individuals, SARS-CoV-2 seropositivity at the midyear sample was associated with 93.6% protection from symptomatic reinfection (95% CI, 51.1%-99.2%). Conclusions: This population exhibited a very high SARS-CoV-2 seropositivity with lower-than-expected severity, and immunity from natural infection was protective against symptomatic reinfection.
MeSH term(s)	Adolescent ; Adult ; Aged ; COVID-19/epidemiology ; Child ; Humans ; Reinfection/epidemiology ; Retrospective Studies ; SARS-CoV-2 ; Seroepidemiologic Studies ; Young Adult
Language	English
Publishing date	2021-07-27
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciab717
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Article: Prevalence of Cryptococcal Antigen and Outcomes in People With Human Immunodeficiency Virus in Honduras: A Cohort Study.

Zuniga-Moya, Julio C / Romero-Reyes, Luis Enrique / Saavedra, Emilio Barrueto / Montoya, Sandra / Varela, Diana / Borjas, Mitchel / Cerna, Alicia / Bejarano, Suyapa / Martinez, Paola / Lujan, Karen / Erazo, Karen / Lainez, Isis / Pineda, Luisamaria / Yanes, David / O'Halloran, Jane A / Spec, Andrej

Open forum infectious diseases

2020 Volume 8, Issue 1, Page(s) ofaa557

Abstract: Background: Cryptococcal meningitis is a major cause of death among people with human immunodeficiency virus (PWH). Cryptococcal antigen (CrAg) testing of asymptomatic patients is an important public health measure to reduce mortality in high-incidence ... ...

Abstract	Background: Cryptococcal meningitis is a major cause of death among people with human immunodeficiency virus (PWH). Cryptococcal antigen (CrAg) testing of asymptomatic patients is an important public health measure to reduce mortality in high-incidence areas. However, limited data exist on CrAg prevalence in Central America. Methods: We conducted a prospective cohort study at the 2 largest human immunodeficiency virus (HIV) clinics and hospitals in Honduras. Cryptococcal antigen in serum and cerebrospinal fluid was performed in individuals with HIV who had CD4 ≤100 cells/mm Results: A total of 220 PWH were tested for CrAg, 12.7% (n = 28) of which tested positive. Cryptococcal antigen prevalence was higher among hospitalized individuals in 40% (n = 10 of 25) of the cases. The proportion (35.8%) of individuals taking Conclusions: Cryptococcal antigen prevalence in Honduras was high among PWH. Moreover, individuals who tested positive for CrAg testing were at a higher risk of death. Systemic CrAg of PWH with a CD4 ≤100 cells/mm
Language	English
Publishing date	2020-11-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofaa557
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Article ; Online: Epidemiology, Outcomes, and Associated Factors of Coronavirus Disease 2019 (COVID-19) Reverse Transcriptase Polymerase Chain Reaction-Confirmed Cases in the San Pedro Sula Metropolitan Area, Honduras.

Zuniga-Moya, Julio C / Norwood, Dalton Argean / Romero Reyes, Luis Enrique / Barrueto Saavedra, Emilio / Diaz, Roxana / Fajardo, Wendy Carolina / Pineda, Allan / Torres, Diana / Barahona, Rodolfo / Leiva, Said Omar / Hernandez, Pastora X / Silva, Hector / Leiva, Carlos Raul / Estrada, Lourdes / Barahona-Campos, Alma / Gordon, Aubree

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2020 Volume 72, Issue 10, Page(s) e476–e483

Abstract: Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused substantial morbidity and mortality worldwide. Few reports exist in Latin America, a current epicenter of transmission. Here, we aim to describe the ... ...

Abstract	Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused substantial morbidity and mortality worldwide. Few reports exist in Latin America, a current epicenter of transmission. Here, we aim to describe the epidemiology and outcomes associated with coronavirus disease 2019 (COVID-19) in Honduras. Methods: Baseline clinical and epidemiological information of SARS-CoV-2 reverse transcriptase polymerase chain reaction-confirmed cases detected between 17 March-4 May in the San Pedro Sula Metropolitan area was collected; for hospitalized cases, clinical data were abstracted. Logistic regression models were fit to determine the factors associated with hospitalization. Results: We identified 877 COVID-19 cases, of which 25% (n = 220) were hospitalized. The 19-44-year age group (57.8%) and males (61.3%) were predominant in overall COVID-19 cases. Of the cases, 34% (n = 299) had at least 1 preexisting medical condition. Individuals aged 45-69 years (adjusted odds ratio [aOR] = 4.05; 95% confidence interval [CI], 2.85-5.76) or ≥70 years (aOR = 9.12; 95% CI, 5.24-15.86), of male sex (aOR = 1.72; 95% CI, 1.21-2.44), and those with a preexisting condition (aOR = 2.12; 95% CI, 1.43-3.14) had higher odds of hospitalization. Of inpatients, 50% were hospitalized more than 7 days. The median length of hospitalization was 13 days (interquartile range [IQR], 8-29) among individuals aged 19-44 years, and 17 days (IQR, 11-24.6) among those aged 45-69. Of the fatal cases, 42% occurred among adults under 60 years old. Conclusions: Our findings show that a high proportion of COVID-19 cases in Honduras occurred among younger adults, who also constituted a significant proportion of severe and fatal cases. Preexisting conditions were associated with severe outcomes independently from age and were highly prevalent in Honduran COVID-19 cases.
MeSH term(s)	Adult ; Aged ; COVID-19 ; Honduras/epidemiology ; Hospitalization ; Humans ; Male ; Middle Aged ; Pandemics ; Reverse Transcriptase Polymerase Chain Reaction ; SARS-CoV-2 ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-08-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciaa1188
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Article: Epidemiology, outcomes and associated factors of COVID-19 RT-PCR confirmed cases in the San Pedro Sula Metropolitan Area, Honduras

Clin. infect. dis

Abstract: BACKGROUND: The SARS-CoV-2 pandemic has caused substantial morbidity and mortality worldwide. Few reports exist in Latin America, a current epicenter of transmission. Here, we aim to describe the epidemiology and outcomes associated with COVID-19 in ... ...

Abstract	BACKGROUND: The SARS-CoV-2 pandemic has caused substantial morbidity and mortality worldwide. Few reports exist in Latin America, a current epicenter of transmission. Here, we aim to describe the epidemiology and outcomes associated with COVID-19 in Honduras. METHODS: Baseline clinical and epidemiological information of SARS-CoV-2 RT-PCR confirmed cases detected between March 17th-May 4th in the San Pedro Sula Metropolitan area was collected, and, for hospitalized cases, clinical data was abstracted. Logistic regression models were fit to determine factors associated with hospitalization. RESULTS: 877 COVID-19 cases were identified of which 25% (n=220) were hospitalized. The 19-44-year age group (57.8%) and males (61.3%) were predominant in overall COVID-19 cases. 34% of the cases (n=299) had at least one pre-existing medical condition. Individuals aged 45-69 years [aOR= 4.05, 95% CI: 2.85-5.76], ≥70 years [aOR= 9.12, 95% CI:5.24-15.86], of male sex [aOR =1.72, CI 95%: 1.21-2.44] and those with a pre-existing condition [aOR= 2.12, 95% CI: 1.43-3.14] had a higher odd of hospitalization. Fifty percent of inpatients were hospitalized more than 7 days. Median length of hospitalization was 13 days [IQR: 8-29] among individuals aged 19-44 years, and 17 days [IQR: 11-24.6] among those aged 45-69. Forty-two percent of the fatal cases occurred among adults under 60 years old. CONCLUSIONS: Our findings show that a high proportion of COVID-19 cases in Honduras occurred among younger adults, who also constituted a significant proportion of severe and fatal cases. Pre-existing conditions were associated with severe outcomes independently from age and were highly prevalent in Honduran COVID-19 cases.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #719222
Database	COVID19

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Article ; Online: Epidemiology, Outcomes, and Associated Factors of Coronavirus Disease 2019 (COVID-19) Reverse Transcriptase Polymerase Chain Reaction–Confirmed Cases in the San Pedro Sula Metropolitan Area, Honduras

Clinical Infectious Diseases ; ISSN 1058-4838 1537-6591

2020

Abstract: Abstract Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused substantial morbidity and mortality worldwide. Few reports exist in Latin America, a current epicenter of transmission. Here, we aim to describe the ... ...

Abstract	Abstract Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused substantial morbidity and mortality worldwide. Few reports exist in Latin America, a current epicenter of transmission. Here, we aim to describe the epidemiology and outcomes associated with coronavirus disease 2019 (COVID-19) in Honduras. Methods Baseline clinical and epidemiological information of SARS-CoV-2 reverse transcriptase polymerase chain reaction–confirmed cases detected between 17 March–4 May in the San Pedro Sula Metropolitan area was collected; for hospitalized cases, clinical data were abstracted. Logistic regression models were fit to determine the factors associated with hospitalization. Results We identified 877 COVID-19 cases, of which 25% (n = 220) were hospitalized. The 19–44-year age group (57.8%) and males (61.3%) were predominant in overall COVID-19 cases. Of the cases, 34% (n = 299) had at least 1 preexisting medical condition. Individuals aged 45–69 years (adjusted odds ratio [aOR] = 4.05; 95% confidence interval [CI], 2.85–5.76) or ≥70 years (aOR = 9.12; 95% CI, 5.24–15.86), of male sex (aOR = 1.72; 95% CI, 1.21–2.44), and those with a preexisting condition (aOR = 2.12; 95% CI, 1.43–3.14) had higher odds of hospitalization. Of inpatients, 50% were hospitalized more than 7 days. The median length of hospitalization was 13 days (interquartile range [IQR], 8–29) among individuals aged 19–44 years, and 17 days (IQR, 11–24.6) among those aged 45–69. Of the fatal cases, 42% occurred among adults under 60 years old. Conclusions Our findings show that a high proportion of COVID-19 cases in Honduras occurred among younger adults, who also constituted a significant proportion of severe and fatal cases. Preexisting conditions were associated with severe outcomes independently from age and were highly prevalent in Honduran COVID-19 cases.
Keywords	Microbiology (medical) ; Infectious Diseases ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
DOI	10.1093/cid/ciaa1188
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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