Startseite Analysis of COVID-19 outbreak origin in China in 2019 using differentiation method for unusual epidemiological events
Artikel Open Access

Analysis of COVID-19 outbreak origin in China in 2019 using differentiation method for unusual epidemiological events

  • Vladan Radosavljevic EMAIL logo
Veröffentlicht/Copyright: 28. Juni 2021
Artikel downloaden (PDF)
Open Medicine
Aus der Zeitschrift Open Medicine Band 16 Heft 1

Abstract

Objectives

Origin of outbreaks could be natural, accidental, deliberate, and caused by a new or re-emerging bioagent. The aim of this study was the retrospective analysis of whether the COVID-19 outbreak was natural, accidental, deliberate one, or caused by a new or re-emerging bioagent.

Methods

Analysis was performed according to the Radosavljevic–Belojevic method for outbreak scoring and differentiation. Data for the application of this method were obtained by literature review in the Medline database for the period from 2000 to 2020.

Results

The analysis of the unusual COVID-19 outbreak shows that the present official assumption of its natural origin is questionable and pointed out to a probability that the pathogen could have also been accidentally introduced in the human population.

Conclusion

There are no conclusive pieces of evidence about the reservoir of the pathogen or the source of infection. These parameters are essential for the final clarification of the outbreak origin. This study suggests that the COVID-19 outbreak is a consequence of an accidental release of a new COVID-19 virus, probably during the technical accident and/or negligent violation of hygienic norms in the laboratory facility. Further epidemiological, microbiological, and forensic analyses are needed to clarify the COVID-19 outbreak.

Keywords: Outbreak; pandemic; COVID-19; outbreak origin; outbreak differentiating; SARS-CoV-2

1 Introduction

The origin of the COVID-19 pandemic is of crucial importance because of the following reasons: over three million people have died worldwide, hundreds of millions of people got infected and diseased, psychological consequences on people, and enormous economic losses. The first postulate of the outbreak investigation is to find out the source/reservoir of the outbreak and eliminate it to stop epidemic expansion, and hence the explicit and detailed description of the origin of COVID-19 pandemic is needed. For a year and a half, along with common China and WHO investigation, and hundreds of published scientific articles, we do not yet have any conclusive answer about the origin of the COVID-19 pandemic. So, the reliable and appropriate method for detection of the pandemic origin has to be applied.

The origin of outbreaks could be natural, accidental, deliberate, and caused by a new or re-emerging bioagent [1]. There are very important issues/questions about COVID-19 outbreak origin:

  1. What is the source of the outbreak?

  2. Is it possible to prove an animal(s) to be the source/reservoir of the outbreak?

  3. Is there proof of infection/disease in humans with the COVID-19 virus directly transmitted from animals?

  4. Were there dead animals infected with the COVID-19 virus?

  5. Was there a reverse spread with the COVID-19 virus (from humans to animals)?

  6. Epidemiologists first look for the source of the outbreak to eliminate or mitigate it. In the COVID-19 outbreak, there is no scientific information about such or similar attempts in China (country of origin). Instead, there were stories about N.N. person(s) who visited Huanan Seafood Wholesale Market and made pandemic, and “TV introduction” with the fauna of Southeastern Asia (bats, pangolins, snakes, and turtles). Should we believe it?

  7. Does this outbreak originate as a onetime infection or as a repeated infection?

  8. How did the infectious dose start the outbreak? Was the infectious dose from a couple of heat-treated bats enough?

  9. What happened with the bat hunters and people who prepared and transported the “infected bats” to the market? [2]

  10. It takes weeks, months, and in some cases years for establishing the complete genome. Chinese authorities officially informed WHO on December 31, 2019 about the COVID-19 outbreak and as of January 12, 2020 sent the complete genome sequence worldwide. It looks strange that Chinese scientists detect a complete genome sequence within a couple of weeks without any previous contact with the COVID-19 virus.

  11. Luc Montagnier publicly announced that the genome sequence was artificially changed. There is no serious scientific denial of it.

  12. Chinese official data of less than 5000 deaths seem unbelievable? Such data should be compared [3] with data from other countries.

  13. If Chinese anti-epidemic measures are so effective, why did not the other countries incorporate them?

  14. What experiments did scientists in Wuhan Institute of Virology perform on bats? [4]

  15. Were preventive measures regarding staff behavior and use of equipment in Wuhan Institute of Virology satisfactory?

  16. Although Chinese experts were introduced very well with a set of 19 questions that were prepared for early and distant outbreak differentiation, those questions have not been mentioned until now [5].

  17. Chinese officials took too much time to publicly report the unusual/atypical manifestation (heavily moribund patients with fulminant illness course) of a known disease (pneumonia) [6].

  18. Chinese authorities did not report the existence of several unusual/unexplained syndromes (loss of smell and taste) coexisting in the COVID-19 patients.

  19. Strangely, Chinese public health authorities did not report for 1 month (December 2019) a sudden unexplainable increase in the morbidity and/or mortality rates in human population (higher than expected) for pneumonia [6].

  20. Chinese medical authorities did not report for 1 month (December 2019) clustering of patients with fever only or fever and other symptoms [6].

  21. Was there one or more explosive outbreaks from the Huanan Seafood Wholesale Market in Wuhan with indicators of a point source origin?

  22. Was there a high concentration of the COVID-19 virus in the environment (incriminated Huanan Seafood Wholesale Market)?

  23. Were there the existence of biological risk and a biological threat in the Hubei province for the COVID-19 outbreak?

2 Methods

A literature review was performed in the database MEDLINE for the period from January 1, 2000 to October 31, 2020, to obtain the necessary data for a retrospective analysis of the COVID-19 outbreak. The period from January 1, 2000 to October 31, 2020 was reviewed because of the possibility to find the appropriate scientific method for investigating the pandemic origin and very similar epidemiological event. The guiding question of the literature review was the origin of the COVID-19 pandemic.

The types of reviewed literature were original research articles and review articles published in the English language in peer-reviewed journals.

Criteria for inclusion in the review were the following keywords: outbreak, pandemic, COVID-19, outbreak origin, outbreak differentiating, case fatality rate, mortality, contact tracing, SARS-CoV-2, and China.

The time period in which the research was carried out was from July 1 to December 31, 2020.

Two search strategies were used for the article selection and accordingly a number of articles were studied. The first search strategy for the article selection was focused on the type and the origin of the COVID-19 outbreak. Query box “All fields” was used, because of its comprehensiveness. Other query boxes gave an unsatisfied number of references.

Step one: COVID-19 AND outbreak origin = 1101 references; terms to the query box: All fields.

Step two: COVID-19 AND outbreak origin AND outbreak differentiating = 38 references; terms to the query box: All fields.

Step three: COVID-19 AND outbreak origin AND outbreak differentiating AND China = 14 references; terms to the query box: All fields.

The second search strategy for the article selection was focused on the key outbreak parameters and the original name of the virus from the COVID-19 outbreak. Query box “TEXT WORD” was used, because it gave a satisfied number of references.

Step one: COVID-19 AND case fatality rate AND mortality = 291 references; terms to the query box: TEXT WORD.

Step two: COVID-19 AND contact tracing = 1300 references; terms to the query box: TEXT WORD.

Step three: SARS-CoV-2 AND outbreak origin = 0 references; terms to the query box: TEXT WORD.

First, large groups of the articles were rejected for further consideration after reading the articles’ titles. After reading the abstracts of the articles, the second most numerous group of articles were rejected for further consideration. The third group of articles was rejected after reading the articles’ methods and results. The fourth group of articles was rejected after reading the entire article. Finally, the fifth group of articles was rejected after reading and mutually comparing with other articles (criteria were article scientific informativeness and scientific reliability).

There are three methods for outbreak differentiating. The Radosavljevic–Belojevic method has two parts. The first part for early orientation and differentiation of unusual epidemiological events (UEEs) was applied and is shown in Table 1. Characteristics of this part of the method are described in refs [7,8]. After this first orientation about the type of COVID-19 outbreak, the second part of the method is subtle and detailed differentiation of the four possible UEE scenarios: natural outbreak of a known disease, natural outbreak of a new or re-emerging disease, outbreak by an accidental release of a pathogen, and outbreak by a deliberate delivery of a biological agent (described in refs [1,9]) is shown in Table 2. In both the parts of the method, indicators were scored with 1 if they were present in the outbreak, and scored with 0 if indicators were not present in the outbreak. Also, the Radosavljevic–Belojevic method was the most suitable to answer questions from Section 1.

Table 1

Scoring of the COVID-19 outbreak according to the model of Radosavljevic and Belojevic [7,9] for differentiation between natural, accidental, and deliberate outbreak caused by new or re-emerging pathogen

No. Epidemiological/infectiological indicators Score
1 Unusual/atypical disease/manifestation (symptoms/signs) or unexpected fulminant course of disease in humans and/or animals 1
2 Failure of patient to respond to usual therapy or illness in a population (human and animal) despite immunizations 1
3 Several unusual/unexplained syndromes coexisting in the same case without any other explanation 1
4 Sudden unexplainable increase in the number of cases or deaths in human and/or animal population 1
5 Morbidity and/or mortality higher than expected 1
6 Clustering of patients with fever and/or fever and respiratory symptoms and/or lymphadenopathy 1
7 Disease identified in the region for the first time ever or again after a long period of time 1
8 Disease with an unusual/atypical seasonal distribution 1
9 Simultaneous occurrence of epidemics and/or epizootics 1
10 Explosive epidemics and/or epizootics with indicators on a point-source origin 1
11 Disease with an unusual geographic distribution 1
12 Occurrence of a non-endemic (imported) or previously eradicated disease 0
13 Epidemiological data suggesting a common exposure 1
14 Simultaneous epidemics and/or epizootics occur at different locations 1
15 Total score 13

1 = high probability of a deliberate or accidental outbreak, 0 = low probability of a deliberate or accidental outbreak, assessment of scores: 1–4 probably natural outbreak, 5–9 possibly deliberate or accidental outbreak, 10–14 probably deliberate or accidental outbreak.

Table 2

Assessment of the COVID-19 pandemic origin in 2019–2020 by differentiation scoring for a natural outbreak of a disease (NE), a natural outbreak of a new or re-emerging disease (NR), an outbreak by an accidental release of a pathogen (AR), and a deliberate outbreak (DO)

Parameter NE NR AR DO
Perpetrator/source of infection/reservoir of pathogen
Sophistication N/A 1
Motivation N/A 0
Intention N/A 0
Intelligence N/A 0
Secrecy N/A 0
Number of perpetrators N/A 0
Number of sources of infection/reservoirs 1 1
Accessibility to sources of agent/pathogen 1 1
Accessibility to targets/population at risk 1 1
Biological agent/pathogen
A category* 0 0
B category* 0 0
C category* 0 0
Emerging pathogen 1 1
Amount of the available agent/pathogen 1 1
Means/media of delivery/factors of transmission
Air 1 1
Food 1 1
Water 0 0
Fomites 1 1
Vectors 0 0
Biological ammunition 0 0
Delivery systems 0 0
Dispersion systems/mechanism of release 0 0
Target/susceptible population at risk
Intelligence 0 1
Secrecy 1 1
Personal control 1 1
Control of means/media of delivery/factors of transmission 1 1
Physical protection 1 1
Protection by chemoprophylaxis 0 0
Protection by immunoprophylaxis 0 0
Importance of target/population at risk 0 0
Location of target/population at risk 0 1
Number of people in a target/population at risk 0 1
Distribution of people in a target/population at risk 0 1
Total — 12 17 —

*CDC classification, 0 = low probability, 1 = high probability, N/A = not applicable/no data, – = eliminated from further consideration, total scores: 0–8 = lowly probable type of outbreak (TO), 9–16 = possible TO, 17–24 = highly probable TO, 25–33 = certain TO.

Two other methods for outbreak differentiating are not appropriate for the COVID-19 outbreak, because they are focused on differentiating between natural and deliberate outbreaks. They do not have scenarios for accidental outbreaks and outbreaks caused by a new or re-emerging pathogen and that was the reason for not including them in this analysis [10,11].

3 Results

In Table 1, the total score indicates that the COVID-19 outbreak was UEE with the features of probably accidental or deliberate epidemics.

Indicator 1. The clinical picture of the COVID-19 deviated from the expected one in pneumonia [12,13,14,15]. In a significant number of convalescents, senses of taste and smell were lost (scored with 1).

Indicator 2. Patients with the COVID-19 disease did not respond to the usual antibiotic and/or antiviral therapy (scored with 1).

Indicator 3. The outbreak was characterized by bilateral pneumonia, frequent requirement of artificial ventilation, and heart damage [13]. Significant number of patients lost senses of taste and smell and had extreme fatigue. The unexplainable rapid increase in the number of such patients was alarming for the wider scientific medical community and for the China government (scored with 1).

Indicator 4. Mortality and case fatality rate of pneumonia were higher than expected [16,17]. There are no data about animals sick or dead due to the COVID-19 virus (scored with 1).

Indicator 5. See indicator 4. There were no data about China, and because of the very high percentage of “undocumented” pneumonia patients it was not possible to calculate morbidity rate even approximately, but surely it was higher than expected (scored with 1) [18].

Indicator 6. See indicator 4. There were especially family clustering cases of pneumonia (scored with 1) [19].

Indicator 7. The outbreak was caused by a new pathotype of the coronaviruses, the COVID-19 virus. Chinese authorities informed WHO about new pathogen and new disease on December 31, 2019, and sent a worldwide sequence of the viral genome on January 12, 2020 (scored with 1) of pneumonia cases [4].

Indicator 8. After 1 year of the outbreak start and spread worldwide, obviously there was no seasonal distribution of the COVID-19 (scored with 1).

Indicator 9. There were no data about epizootics. Outbreak expanded to pandemic, so there were a lot of simultaneous epidemics worldwide (scored with 1).

Indicator 10. The epidemic was explosive and with indicators of a point-source origin because in a few weeks from the local outbreak it became pandemic comprising all continents and nearly all states and territories (scored with 1).

Indicator 11. Each pandemic (except flu) has an unusual geographical distribution.

Indicator 12. COVID-19 was a new disease, not non-endemic (imported) or previously eradicated disease, so this indicator was scored with 0.

Indicator 13. Common exposure to potential sources of pathogens was strictly forbidden, logically it was common exposure at the start of the outbreak and numerous times after that (scored with 1).

Indicator 14. See indicator 9.

The total score was 13 out of 14 points, which meant it was probably the artificial (deliberate or accidental) epidemic. Because of that, a method for subtle and detailed differentiation of the four possible UEE scenarios, namely natural outbreak of a known disease, natural outbreak of a new or re-emerging disease, outbreak by an accidental release of a pathogen, and outbreak by a deliberate delivery of a biological agent, was used.

3.1 Deliberate outbreak scenario

COVID-19 outbreak may not be a biological attack (BA) because of several issues:

  1. There is no BA which became pandemic in a short time;

  2. SARS-CoV-2 is not a bioweapon because of low lethality;

  3. If any BSL-4 laboratory tries to produce bioweapon, it must have already or simultaneously produce “antidote” (vaccine, serum, or drugs);

  4. There is no information about any country with BSL-4 laboratory, which has experimented with coronaviruses as a bioweapon.

3.2 Natural outbreak scenario

COVID-19 outbreak may not be a naturally originated outbreak because of several issues:

  1. There is no scientific evidence that the COVID-19 virus exists in any animal;

  2. There is no scientific evidence that the COVID-19 virus transfers from any animal to a human;

  3. In natural epidemics, sources/reservoirs of infection may be discovered by usual epidemiological and microbiological routine investigations, and there are no tendencies to keep themselves unknown. For over 1 year from the start of the COVID-19 outbreak, nobody reported scientifically detailed initial phases (source; reservoir of the outbreak; way of transmission of the first case; who, when, and how exactly the people were infected; etc.) of the course of the COVID-19 outbreak, and why?

  4. In natural outbreaks, the number and distribution of sources of infection are related to the incubation period and period of disease communicability of pneumonia [5]. There is no detailed and logical order of such data from the beginning of the COVID-19 outbreak.

Consequently, two types of outbreaks, BA and naturally originated outbreak, are eliminated from further consideration.

3.3 Natural outbreak of a new or re-emerging disease

3.3.1 Sources/reservoirs of the infection

Animals as a source/reservoir of the outbreak of pneumonia have no next indicators: sophistication, motivation, intention, intelligence, secrecy, and number of perpetrators (Table 2) [1,9]. But parameters such as number of sources/reservoirs of virus, accessibility to sources of the virus, and accessibility to targets surely exist in the case of animals as a source/reservoir of the outbreak and scored 1 for each parameter.

3.3.2 Biological agent vs pathogen

COVID-19 virus is an emerging agent like SARS virus, Ebola virus, MERS virus, Swine flu virus, and Avian flu virus. The epidemic was explosive (many people were infected in a brief period), which meant that the pathogens were released in large amounts during a short time. It was not possible that a couple of bats or even a whole flock of them heat-treated might infect so many people in urban Wuhan population with pneumonia [20,21,22]. It was much more possible that bat hunters and traders became first diseased and clearly traced the source of the outbreak. Because of the abovementioned reasons these two parameters scored 1 each.

3.3.3 Means/media of delivery vs factors of transmission

Air, food, and fomites are proved ways of transmission of pneumonia and each of them scored 1 [23,24,25].

3.4 Target vs susceptible population at risk

3.4.1 Intelligence

The first cases and even more clusters were not recognized and the infection spread throughout China and worldwide (scored with 0).

3.4.2 Secrecy

Chinese authorities did not provide relevant information about this UEE and reported pneumonia to WHO on December 31, 2019 [26]. There was no international scientific cooperation about the origin of the outbreak (source/reservoir of the infection, trace of possible infected human contacts, or infected animals) [27]. During the SARS pandemic, Chinese authorities hid information about epidemics for 6 weeks and during that time epidemic “advanced” to pandemic [1]. So, 1 point for secrecy.

3.4.3 Personal control

Personal control was very rigorous (wearing face masks, physical distancing among people, isolation of areas even with several million inhabitants, advice for hand hygiene, intensified other hygienic measures and their control, and intensified recognition of potential infected or diseased people (measuring temperature). This parameter scored 1.

3.4.4 Control of means/media of delivery/factors of transmission

According to the available data, the control of means/media of delivery/factors of transmission was carried out rigorously and was very successful (isolation – “quarantine,” and disinfection of commonly used and frequently used surfaces). Therefore, this parameter is scored with 1.

3.4.5 Physical protection measures

Physical protection measures for the population at risk were not in place during the initial phase of the outbreak. Later, such measures were strictly applied (see Sections 3.4.3 and 3.4.4) [27]. Consequently, this parameter was scored with 1.

3.4.6 Protection by chemoprophylaxis and/or by immunoprophylaxis

There was protection neither by chemoprophylaxis nor by immunoprophylaxis, so both parameters were scored with 0.

3.4.7 Importance of target/population at risk

There was no evidence that the so-called “hard targets” or “soft targets” were aimed, and this parameter is scored with 0.

3.4.8 Number of people in target/at risk

Densely populated metropolitan areas like Wuhan were in favor of a deliberate outbreak, but not of a natural outbreak of a new or re-emerging disease or an accidental outbreak. So, this parameter is scored with 0.

3.4.9 Location and distribution of people in target/at risk

No special targets (e.g., military, political, economic, or cultural) could be identified. Rural areas (caves) as natural habitats for bats, or jungles for pangolins, but not metropolitan areas like Wuhan with 11 million densely populated inhabitants, are preferred locations for the outbreak focus in the case of a natural outbreak or a new or re-emerging disease. So, these two parameters are scored each with 0.

3.5 Accidental release outbreak scenario

3.5.1 Sources/reservoirs of the infection

In the case of the accidental outbreak scenario parameter, sophistication must be scored with 1. Parameters such as motivation, intention, intelligence, secrecy, and number of perpetrators are scored each with 0. But parameters such as number of sources/reservoirs of the virus, accessibility to sources of virus, and accessibility to targets surely existed in the accidental outbreak scenario and scored each with 1.

3.5.2 Biological agent vs pathogen

COVID-19 virus is an emerging agent (see Section 3.3). In the case of the accidental release outbreak scenario, the staffs were not probably conscious of the repeated release of the COVID-19 virus from the laboratories. How long it was unknown, but surely the virus was released in a large amount during a short time. Because of the abovementioned reason, this parameter is scored with 1.

3.5.3 Means/media of delivery vs factors of transmission

Air, food, and fomites are proved ways of transmission and each of them scored with 1 [23,24,25].

3.6 Target vs susceptible population at risk

3.6.1 Intelligence

Some Chinese doctors were “pressed” to withdraw their reports about new and unusual pneumonia. Even more, in the case of accidental pathogen release, authorities were very quickly informed about the accident and this parameter is scored with 1.

3.6.2 Secrecy

See Section 3.4.2.

3.6.3 Personal control

See Section 3.4.3.

3.6.4 Control of means/media of delivery/factors of transmission

See Section 3.4.4.

3.6.5 Physical protection measures

See Section 3.4.5 [28].

3.6.6 Protection by chemoprophylaxis and/or by immunoprophylaxis

See Section 3.4.6.

3.6.7 Importance of target/population at risk

See Section 3.4.7.

3.6.8 Number of people in target/at risk and location and distribution of people in target/of people at risk

Laboratories with BSL-4 are usually located near the big cities and university centers because of the highly qualified manpower who lived there, such as a densely populated metropolitan area like Wuhan that was in favor of an accidental outbreak.

Also, such laboratories are usually located in large scientific and/or medical centers with many people employed, frequenting hundreds in the same building.

So, these three parameters were scored each with 1.

3.6.9 Score interpretation

Final scores of the differentiation method suggest that the high probable cause of COVID-19 outbreak was by an accidental release of a new COVID-19 virus from the Wuhan Institute of Virology. This was probably attributable to a technical accident and/or negligent violation of hygienic norms in the laboratory facility.

4 Discussion

From the very start of the COVID-19 outbreak, there was a lack of scientific data about the pathogen source and the mode of its transmission [29]. Bats, probably heat-treated, as the source of the outbreak were questionable.

Analysis of the unusual COVID-19 epidemic in 2019/2020 by the two-part method (Radosavljevic–Belojevic method) for differentiation between natural outbreak, accidental outbreak, deliberate outbreak, and outbreak caused by a new or re-emerging pathogen showed that this epidemic was an accidental outbreak caused by the new pathogen, probably attributable to a technical accident and/or negligent violation of hygienic norms in the laboratory facility.

The method used is strictly focused on specific outbreak characteristics important for outbreaks differentiating and in total has 47 indicators – outbreak features. There is a general agreement between the results of the two parts of the method. The first part almost completely (with 13 out of 14 indicators) indicates a deliberate or accidental outbreak. Indicators 1, 2, 3, 7, 8, and 11 are of essential importance for determining an artificial (accidental or deliberate) outbreak nature. Their scoring with each one as contributing key clues presents additional evidence for the artificial nature of the outbreak. So, the question arises concerning the COVID-19 epidemic: “What was it, actually?”

The second part for subtle and detailed outbreak differentiation, clearly at the start declines natural outbreak scenario and deliberate outbreak scenario. The final results show 12 points for the outbreak scenario caused by the new or re-emerging pathogen and 17 points for the accidental outbreak scenario.

This method clarified the German Escherichia coli outbreak in 2011, indicating an accidental outbreak scenario. Also, the method is retrospectively used and published in reputable publications, in other “famous” epidemics (Ameritrax in 2001, Sverdlovsk outbreak in 1979, Kosovo tularemia outbreak in 1999/2000, and Swine flu in 2009/2010). Additionally, the method was first tested on several dozen outbreaks before publishing (data not shown).

The new hybrid and chimeric COVID-19 virus combines features of known viruses and differs in its genetic and pathogenic features from known coronaviruses. There are over 1400 species of bats, at least 3200 distinct coronaviruses that infect bats, and numerous articles about bats as possible/probable culprit sources of the COVID-19 virus [2]. But, there is no scientific proof of bats infected with the COVID-19 virus. Even more, incriminated kinds of bats live in other continents and there are no data about the COVID-19 virus in those bats [2,15]. Actually, except being suspicious, we do not know the source/reservoir of the COVID-19 epidemic.

A long-lasting exposure to the pathogen for several weeks, until authorities’ interventions became effective, indicating that an accidental release was very possible in the COVID-19 epidemic [15]. With very obscure data about outbreak origin (source/reservoir of the outbreak, course of the outbreak in the first week(s)), suspicion about intentional hiding of data increases.

If the bats from the fish market were reservoirs for the COVID-19 virus (fish market was closed on January 1, 2020), authorities should know who brought and sold them on the market [29,30]. Authorities could find natural habitat and reservoirs for the COVID-19 disease tracing those people [29,30]. Furthermore, without solving the source/reservoir of the COVID-19 outbreak, it is not possible to prevent similar outbreak again worldwide.

In conclusion, this study suggests that the COVID-19 outbreak was a consequence of an accidental release of a new COVID-19 virus, probably during the technical accident and/or negligent violation of hygienic norms in the laboratory facility. Accordingly, permanent laboratory personnel education, maximal hygienic norms in the laboratory facilities, and urgent international scientific cooperation are necessary to effectively prevent and resolve similar possible outbreaks. Further epidemiological, microbiological, and forensic analyses are needed to clarify the COVID-19 outbreak origin. Detection of people with SARS-CoV-2 antibodies in Northern Italy probably would show that because of very intensive business relationships (production of modern clothes, shoes, and handbags) between Wuhan and Milano, the pandemic began much earlier and had a very clandestine start [31].

tel: +38164-2371-485, fax: +381113005144

  1. Funding information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

  2. Author contributions: There is only one author, namely Vladan Radosavljevic.

  3. Conflict of interest: There is no conflict of interest related to this manuscript. The paper and the data have not previously been published, either in whole or in part, and no similar paper is in press or under review elsewhere.

  4. Data availability statement: All data mentioned in the article are originated from the publications on the article reference list.

  5. Footnote: The views, opinions, assertions and findings contained herein are those of the author and should not be construed as official positions, policies or decisions of the Serbian Ministry of Defense or Serbian Armed Forces, unless so designated by other documentation.

References

[1] Radosavljevic V. A new method of differentiation between a biological attack and other epidemics. In: Hunger I, Radosavljevic V, Belojevic G, Rotz LD, editors. Biopreparedness and public health. Heidelberg: Springer; 2013. p. 17–32.10.1007/978-94-007-5273-3_3Suche in Google Scholar

[2] Sun K, Viboud C. Impact of contact tracing on SARS-CoV-2 transmission. Lancet Infect Dis. 2020;20(8):876–7. 10.1016/S1473-3099(20)30357-1.Suche in Google Scholar

[3] Worldmeter. Available from: https://www.worldmeters.info/coronavirus/countries/; 2000 (Accessed 29 December 2020).Suche in Google Scholar

[4] Burki T. Outbreak of coronavirus disease 2019. Lancet Infect Dis. 2020;20(3):1018–9. 10.1016/S1473-3099(20)30076-1.Suche in Google Scholar

[5] Radosavljevic V, Banjari I, Belojevic G, editors. Defence against bioterrorism: methods for prevention and control. 1st ed. Heidelberg: Springer; 2018.10.1007/978-94-024-1263-5Suche in Google Scholar

[6] World Health Organization. Origin of SARS-CoV-2; 2020 March 26. Available from: https://apps.who.int/iris/handle/10665/332197Suche in Google Scholar

[7] Radosavljevic V, Belojevic G. Unusual epidemilogical event – new model for early orientation and differentation between natural and deliberate outbreak. Public Health. 2012;126(1):77–81. 10.1016/j.puhe.2011.11.006.Suche in Google Scholar

[8] Radosavljevic V, Finke E-J, Belojevic G. Escherichia coli O104:H4 outbreak in Germany – clarification of the origin of the epidemic. Eur J Public Health. 2015;25(1):125–9. 10.1093/eurpub/cku048.Suche in Google Scholar

[9] Radosavljevic V, Finke E-J, Belojevic G. Analysis of the Escherichia coli O104:H4 outbreak in Germany in 2011 by a differentiation method for unusual epidemiological events. Cent Eur J Public Health. 2016;24(1):9–15. 10.21101/cejph.a4255.Suche in Google Scholar

[10] Grunow R, Finke E-J. A procedure for differentiating between the intentional release of biological warfare agents and natural outbreaks of disease: its use in analyzing the tularemia outbreak in Kosovo in 1999 and 2000. Clin Microbiol Infect. 2002;8(8):510–21. 10.1046/j.1469-0691.2002.00524.x.Suche in Google Scholar

[11] Dembek ZF, Kortepeter MG, Pavlin JA. Discernment between deliberate and natural infectious disease outbreaks. Epidemiol Infect. 2007;135(3):353–71. 10.1017/S0950268806007011.Suche in Google Scholar

[12] Bagcchi S. Mysterious pneumonia in China. Lancet Infect Dis. 2020;20(2):173. 10.1016/S1473-3099(20)30011-6.Suche in Google Scholar

[13] Topol EJ. COVID-19 can affect the heart. Science. 2020;370(6515):408–9. 10.1126/science.abe2813.Suche in Google Scholar

[14] Wu JT, Leung K, Bushman M, Kishore N, Niehus R, de Salazar PM, et al. Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nat Med. 2020;26(4):506–10. 10.1038/s41591-020-0822-7.Suche in Google Scholar

[15] Wu Y-C, Chen C-S, Chan Y-J. The outbreak of COVID-19: An overview. J Chin Med Assoc. 2020;83(3):217–20. 10.1097/JCMA.0000000000000270.Suche in Google Scholar

[16] Joy M, Hobbs FDR, McGagh D, Akinyemi O, de Lusignan S. Excess mortality from COVID-19 in an English sentinel network population. Lancet Infect Dis. 2020;21(4):e74. 10.1016/S1473-3099(20)30632-0.Suche in Google Scholar

[17] Rajgor DD, Lee MH, Archuleta S, Bagdasarian N, Chye Quek S. The many estimates of the COVID-19 case fatality rate. Lancet Infect Dis. 2020;20(7):776–7. 10.1016/S1473-3099(20)30244-9.Suche in Google Scholar

[18] Li R, Pei S, Chen B, Song Y, Zhang T, Yang W, et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science. 2020;368(6490):489–93. 10.1126/science.abb3221.Suche in Google Scholar

[19] Jing Q-L, Liu M-J, Zhang Z-B, Fang L-Q, Yuan J, Zhang A-R, et al. Household secondary attack rate of COVID-19 and associated determinants in Guangzhou, China: a retrospective cohort study. Lancet Infect Dis. 2020;20(10):1141–50. 10.1016/S1473-3099(20)30471-0.Suche in Google Scholar

[20] Malaiyan J, Arumugam S, Mohan K, Radhakrishnan GG. An update on the origin of SARS‐CoV‐2: Despite closest identity, bat (RaTG13) and pangolin derived coronaviruses varied in the critical binding site and O‐linked glycan residues. J Med Virol. 2021;93(1):499–505. 10.1002/jmv.26261.Suche in Google Scholar PubMed PubMed Central

[21] Morens DM, Breman JG, Calisher CH, Doherty PC, Hahn BH, Keusch GT, et al. The origin of COVID-19 and why it matters. Am J Trop Med Hyg. 2020;103(3):955–9. 10.4269/ajtmh.20-0849.Suche in Google Scholar PubMed PubMed Central

[22] Latinne A, Hu B, Olival KJ, Zhu G, Zhang L, Li H, et al. Origin and cross-species transmission of bat coronaviruses in China. Nat Commun. 2020;11(1):4235. 10.1038/s41467-020-17687-3.Suche in Google Scholar PubMed PubMed Central

[23] Karia R, Gupta I, Khandait H, Yadav A, Yadav A. COVID-19 and its modes of transmission. SN Compr Clin Med. 2020;2:1798–801, Epub 2020 Sep 1.10.1007/s42399-020-00498-4Suche in Google Scholar

[24] van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564–7. 10.1056/NEJMc2004973.Suche in Google Scholar

[25] Zhang Y, Chen C, Zhu S, Shu C, Wang D, Song J, et al. Isolation of 2019-nCoV from a stool specimen of a laboratory-confirmed case of the coronavirus disease 2019 (COVID-19). China CDC Weekly. 2020;2(8):123–4. 10.46234/ccdcw2020.033.Suche in Google Scholar

[26] Thorp HH. The costs of secrecy. Science. 2020;367(6481):959. 10.1126/science.abb4420.Suche in Google Scholar

[27] Thanh HN, Van TN, Thu HNT, Van BN, Thanh BD, Thu HPT, et al. Outbreak investigation for COVID-19 in northern Vietnam. Lancet Infect Dis. 2020;20(5):535–6. 10.1016/S1473-3099(20)30159-6.Suche in Google Scholar

[28] Lau H, Khosrawipour V, Kocbach P, Mikolajczyk A, Schubert J, Bania J, et al. The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China. J Travel Med. 2020;27(3):taaa037. 10.1093/jtm/taaa037.Suche in Google Scholar PubMed PubMed Central

[29] Zhang X, Chen X, Zhang Z, Roy A, Shen Y. Strategies to trace back the origin of COVID-19. J Infect. 2020;80(6):e39–40. 10.1016/j.jinf.2020.03.032.Suche in Google Scholar PubMed PubMed Central

[30] Yu WB, Tang G-D, Zhang L, Corlett RT. Decoding evolution and transmissions of novel pneumonia coronavirus (SARS-CoV-2) using the whole genomic data. Zool Res. 2020;41(3):247–57. 10.24272/j.issn.2095-8137.2020.022.Suche in Google Scholar PubMed PubMed Central

[31] Apolone G, Montomoli E, Manenti A, Boeri M, Sabia F, Hyseni I, et al. Unexpected detection of SARS-CoV-2 antibodies in the prepandemic period in Italy. Tumori J. 2020. First published online: November 11. 10.1177/0300891620974755.Suche in Google Scholar PubMed PubMed Central

Received: 2021-01-18
Revised: 2021-05-20
Accepted: 2021-05-21
Published Online: 2021-06-28

© 2021 Vladan Radosavljevic, published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

Artikel in diesem Heft

  1. Research Articles
  2. Identification of ZG16B as a prognostic biomarker in breast cancer
  3. Behçet’s disease with latent Mycobacterium tuberculosis infection
  4. Erratum
  5. Erratum to “Suffering from Cerebral Small Vessel Disease with and without Metabolic Syndrome”
  6. Research Articles
  7. GPR37 promotes the malignancy of lung adenocarcinoma via TGF-β/Smad pathway
  8. Expression and role of ABIN1 in sepsis: In vitro and in vivo studies
  9. Additional baricitinib loading dose improves clinical outcome in COVID-19
  10. The co-treatment of rosuvastatin with dapagliflozin synergistically inhibited apoptosis via activating the PI3K/AKt/mTOR signaling pathway in myocardial ischemia/reperfusion injury rats
  11. SLC12A8 plays a key role in bladder cancer progression and EMT
  12. LncRNA ATXN8OS enhances tamoxifen resistance in breast cancer
  13. Case Report
  14. Serratia marcescens as a cause of unfavorable outcome in the twin pregnancy
  15. Spleno-adrenal fusion mimicking an adrenal metastasis of a renal cell carcinoma: A case report and embryological background
  16. Research Articles
  17. TRIM25 contributes to the malignancy of acute myeloid leukemia and is negatively regulated by microRNA-137
  18. CircRNA circ_0004370 promotes cell proliferation, migration, and invasion and inhibits cell apoptosis of esophageal cancer via miR-1301-3p/COL1A1 axis
  19. LncRNA XIST regulates atherosclerosis progression in ox-LDL-induced HUVECs
  20. Potential role of IFN-γ and IL-5 in sepsis prediction of preterm neonates
  21. Rapid Communication
  22. COVID-19 vaccine: Call for employees in international transportation industries and international travelers as the first priority in global distribution
  23. Case Report
  24. Rare squamous cell carcinoma of the kidney with concurrent xanthogranulomatous pyelonephritis: A case report and review of the literature
  25. An infertile female delivered a baby after removal of primary renal carcinoid tumor
  26. Research Articles
  27. Hypertension, BMI, and cardiovascular and cerebrovascular diseases
  28. Case Report
  29. Coexistence of bilateral macular edema and pale optic disc in the patient with Cohen syndrome
  30. Research Articles
  31. Correlation between kinematic sagittal parameters of the cervical lordosis or head posture and disc degeneration in patients with posterior neck pain
  32. Review Articles
  33. Hepatoid adenocarcinoma of the lung: An analysis of the Surveillance, Epidemiology, and End Results (SEER) database
  34. Research Articles
  35. Thermography in the diagnosis of carpal tunnel syndrome
  36. Pemetrexed-based first-line chemotherapy had particularly prominent objective response rate for advanced NSCLC: A network meta-analysis
  37. Comparison of single and double autologous stem cell transplantation in multiple myeloma patients
  38. The influence of smoking in minimally invasive spinal fusion surgery
  39. Impact of body mass index on left atrial dimension in HOCM patients
  40. Expression and clinical significance of CMTM1 in hepatocellular carcinoma
  41. miR-142-5p promotes cervical cancer progression by targeting LMX1A through Wnt/β-catenin pathway
  42. Comparison of multiple flatfoot indicators in 5–8-year-old children
  43. Early MRI imaging and follow-up study in cerebral amyloid angiopathy
  44. Intestinal fatty acid-binding protein as a biomarker for the diagnosis of strangulated intestinal obstruction: A meta-analysis
  45. miR-128-3p inhibits apoptosis and inflammation in LPS-induced sepsis by targeting TGFBR2
  46. Dynamic perfusion CT – A promising tool to diagnose pancreatic ductal adenocarcinoma
  47. Biomechanical evaluation of self-cinching stitch techniques in rotator cuff repair: The single-loop and double-loop knot stitches
  48. Review Articles
  49. The ambiguous role of mannose-binding lectin (MBL) in human immunity
  50. Case Report
  51. Membranous nephropathy with pulmonary cryptococcosis with improved 1-year follow-up results: A case report
  52. Fertility problems in males carrying an inversion of chromosome 10
  53. Acute myeloid leukemia with leukemic pleural effusion and high levels of pleural adenosine deaminase: A case report and review of literature
  54. Metastatic renal Ewing’s sarcoma in adult woman: Case report and review of the literature
  55. Burkitt-like lymphoma with 11q aberration in a patient with AIDS and a patient without AIDS: Two cases reports and literature review
  56. Skull hemophilia pseudotumor: A case report
  57. Judicious use of low-dosage corticosteroids for non-severe COVID-19: A case report
  58. Adult-onset citrullinaemia type II with liver cirrhosis: A rare cause of hyperammonaemia
  59. Clinicopathologic features of Good’s syndrome: Two cases and literature review
  60. Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review
  61. Research Articles
  62. Effects of hydroxyethyl starch and gelatin on the risk of acute kidney injury following orthotopic liver transplantation: A multicenter retrospective comparative clinical study
  63. Significance of nucleic acid positive anal swab in COVID-19 patients
  64. circAPLP2 promotes colorectal cancer progression by upregulating HELLS by targeting miR-335-5p
  65. Ratios between circulating myeloid cells and lymphocytes are associated with mortality in severe COVID-19 patients
  66. Risk factors of left atrial appendage thrombus in patients with non-valvular atrial fibrillation
  67. Clinical features of hypertensive patients with COVID-19 compared with a normotensive group: Single-center experience in China
  68. Surgical myocardial revascularization outcomes in Kawasaki disease: systematic review and meta-analysis
  69. Decreased chromobox homologue 7 expression is associated with epithelial–mesenchymal transition and poor prognosis in cervical cancer
  70. FGF16 regulated by miR-520b enhances the cell proliferation of lung cancer
  71. Platelet-rich fibrin: Basics of biological actions and protocol modifications
  72. Accurate diagnosis of prostate cancer using logistic regression
  73. miR-377 inhibition enhances the survival of trophoblast cells via upregulation of FNDC5 in gestational diabetes mellitus
  74. Prognostic significance of TRIM28 expression in patients with breast carcinoma
  75. Integrative bioinformatics analysis of KPNA2 in six major human cancers
  76. Exosomal-mediated transfer of OIP5-AS1 enhanced cell chemoresistance to trastuzumab in breast cancer via up-regulating HMGB3 by sponging miR-381-3p
  77. A four-lncRNA signature for predicting prognosis of recurrence patients with gastric cancer
  78. Knockdown of circ_0003204 alleviates oxidative low-density lipoprotein-induced human umbilical vein endothelial cells injury: Circulating RNAs could explain atherosclerosis disease progression
  79. Propofol postpones colorectal cancer development through circ_0026344/miR-645/Akt/mTOR signal pathway
  80. Knockdown of lncRNA TapSAKI alleviates LPS-induced injury in HK-2 cells through the miR-205/IRF3 pathway
  81. COVID-19 severity in relation to sociodemographics and vitamin D use
  82. Clinical analysis of 11 cases of nocardiosis
  83. Cis-regulatory elements in conserved non-coding sequences of nuclear receptor genes indicate for crosstalk between endocrine systems
  84. Four long noncoding RNAs act as biomarkers in lung adenocarcinoma
  85. Real-world evidence of cytomegalovirus reactivation in non-Hodgkin lymphomas treated with bendamustine-containing regimens
  86. Relation between IL-8 level and obstructive sleep apnea syndrome
  87. circAGFG1 sponges miR-28-5p to promote non-small-cell lung cancer progression through modulating HIF-1α level
  88. Nomogram prediction model for renal anaemia in IgA nephropathy patients
  89. Effect of antibiotic use on the efficacy of nivolumab in the treatment of advanced/metastatic non-small cell lung cancer: A meta-analysis
  90. NDRG2 inhibition facilitates angiogenesis of hepatocellular carcinoma
  91. A nomogram for predicting metabolic steatohepatitis: The combination of NAMPT, RALGDS, GADD45B, FOSL2, RTP3, and RASD1
  92. Clinical and prognostic features of MMP-2 and VEGF in AEG patients
  93. The value of miR-510 in the prognosis and development of colon cancer
  94. Functional implications of PABPC1 in the development of ovarian cancer
  95. Prognostic value of preoperative inflammation-based predictors in patients with bladder carcinoma after radical cystectomy
  96. Sublingual immunotherapy increases Treg/Th17 ratio in allergic rhinitis
  97. Prediction of improvement after anterior cruciate ligament reconstruction
  98. Effluent Osteopontin levels reflect the peritoneal solute transport rate
  99. circ_0038467 promotes PM2.5-induced bronchial epithelial cell dysfunction
  100. Significance of miR-141 and miR-340 in cervical squamous cell carcinoma
  101. Association between hair cortisol concentration and metabolic syndrome
  102. Microvessel density as a prognostic indicator of prostate cancer: A systematic review and meta-analysis
  103. Characteristics of BCR–ABL gene variants in patients of chronic myeloid leukemia
  104. Knee alterations in rheumatoid arthritis: Comparison of US and MRI
  105. Long non-coding RNA TUG1 aggravates cerebral ischemia and reperfusion injury by sponging miR-493-3p/miR-410-3p
  106. lncRNA MALAT1 regulated ATAD2 to facilitate retinoblastoma progression via miR-655-3p
  107. Development and validation of a nomogram for predicting severity in patients with hemorrhagic fever with renal syndrome: A retrospective study
  108. Analysis of COVID-19 outbreak origin in China in 2019 using differentiation method for unusual epidemiological events
  109. Laparoscopic versus open major liver resection for hepatocellular carcinoma: A case-matched analysis of short- and long-term outcomes
  110. Travelers’ vaccines and their adverse events in Nara, Japan
  111. Association between Tfh and PGA in children with Henoch–Schönlein purpura
  112. Can exchange transfusion be replaced by double-LED phototherapy?
  113. circ_0005962 functions as an oncogene to aggravate NSCLC progression
  114. Circular RNA VANGL1 knockdown suppressed viability, promoted apoptosis, and increased doxorubicin sensitivity through targeting miR-145-5p to regulate SOX4 in bladder cancer cells
  115. Serum intact fibroblast growth factor 23 in healthy paediatric population
  116. Algorithm of rational approach to reconstruction in Fournier’s disease
  117. A meta-analysis of exosome in the treatment of spinal cord injury
  118. Src-1 and SP2 promote the proliferation and epithelial–mesenchymal transition of nasopharyngeal carcinoma
  119. Dexmedetomidine may decrease the bupivacaine toxicity to heart
  120. Hypoxia stimulates the migration and invasion of osteosarcoma via up-regulating the NUSAP1 expression
  121. Long noncoding RNA XIST knockdown relieves the injury of microglia cells after spinal cord injury by sponging miR-219-5p
  122. External fixation via the anterior inferior iliac spine for proximal femoral fractures in young patients
  123. miR-128-3p reduced acute lung injury induced by sepsis via targeting PEL12
  124. HAGLR promotes neuron differentiation through the miR-130a-3p-MeCP2 axis
  125. Phosphoglycerate mutase 2 is elevated in serum of patients with heart failure and correlates with the disease severity and patient’s prognosis
  126. Cell population data in identifying active tuberculosis and community-acquired pneumonia
  127. Prognostic value of microRNA-4521 in non-small cell lung cancer and its regulatory effect on tumor progression
  128. Mean platelet volume and red blood cell distribution width is associated with prognosis in premature neonates with sepsis
  129. 3D-printed porous scaffold promotes osteogenic differentiation of hADMSCs
  130. Association of gene polymorphisms with women urinary incontinence
  131. Influence of COVID-19 pandemic on stress levels of urologic patients
  132. miR-496 inhibits proliferation via LYN and AKT pathway in gastric cancer
  133. miR-519d downregulates LEP expression to inhibit preeclampsia development
  134. Comparison of single- and triple-port VATS for lung cancer: A meta-analysis
  135. Fluorescent light energy modulates healing in skin grafted mouse model
  136. Silencing CDK6-AS1 inhibits LPS-induced inflammatory damage in HK-2 cells
  137. Predictive effect of DCE-MRI and DWI in brain metastases from NSCLC
  138. Severe postoperative hyperbilirubinemia in congenital heart disease
  139. Baicalin improves podocyte injury in rats with diabetic nephropathy by inhibiting PI3K/Akt/mTOR signaling pathway
  140. Clinical factors predicting ureteral stent failure in patients with external ureteral compression
  141. Novel H2S donor proglumide-ADT-OH protects HUVECs from ox-LDL-induced injury through NF-κB and JAK/SATA pathway
  142. Triple-Endobutton and clavicular hook: A propensity score matching analysis
  143. Long noncoding RNA MIAT inhibits the progression of diabetic nephropathy and the activation of NF-κB pathway in high glucose-treated renal tubular epithelial cells by the miR-182-5p/GPRC5A axis
  144. Serum exosomal miR-122-5p, GAS, and PGR in the non-invasive diagnosis of CAG
  145. miR-513b-5p inhibits the proliferation and promotes apoptosis of retinoblastoma cells by targeting TRIB1
  146. Fer exacerbates renal fibrosis and can be targeted by miR-29c-3p
  147. The diagnostic and prognostic value of miR-92a in gastric cancer: A systematic review and meta-analysis
  148. Prognostic value of α2δ1 in hypopharyngeal carcinoma: A retrospective study
  149. No significant benefit of moderate-dose vitamin C on severe COVID-19 cases
  150. circ_0000467 promotes the proliferation, metastasis, and angiogenesis in colorectal cancer cells through regulating KLF12 expression by sponging miR-4766-5p
  151. Downregulation of RAB7 and Caveolin-1 increases MMP-2 activity in renal tubular epithelial cells under hypoxic conditions
  152. Educational program for orthopedic surgeons’ influences for osteoporosis
  153. Expression and function analysis of CRABP2 and FABP5, and their ratio in esophageal squamous cell carcinoma
  154. GJA1 promotes hepatocellular carcinoma progression by mediating TGF-β-induced activation and the epithelial–mesenchymal transition of hepatic stellate cells
  155. lncRNA-ZFAS1 promotes the progression of endometrial carcinoma by targeting miR-34b to regulate VEGFA expression
  156. Anticoagulation is the answer in treating noncritical COVID-19 patients
  157. Effect of late-onset hemorrhagic cystitis on PFS after haplo-PBSCT
  158. Comparison of Dako HercepTest and Ventana PATHWAY anti-HER2 (4B5) tests and their correlation with silver in situ hybridization in lung adenocarcinoma
  159. VSTM1 regulates monocyte/macrophage function via the NF-κB signaling pathway
  160. Comparison of vaginal birth outcomes in midwifery-led versus physician-led setting: A propensity score-matched analysis
  161. Treatment of osteoporosis with teriparatide: The Slovenian experience
  162. New targets of morphine postconditioning protection of the myocardium in ischemia/reperfusion injury: Involvement of HSP90/Akt and C5a/NF-κB
  163. Superenhancer–transcription factor regulatory network in malignant tumors
  164. β-Cell function is associated with osteosarcopenia in middle-aged and older nonobese patients with type 2 diabetes: A cross-sectional study
  165. Clinical features of atypical tuberculosis mimicking bacterial pneumonia
  166. Proteoglycan-depleted regions of annular injury promote nerve ingrowth in a rabbit disc degeneration model
  167. Effect of electromagnetic field on abortion: A systematic review and meta-analysis
  168. miR-150-5p affects AS plaque with ASMC proliferation and migration by STAT1
  169. MALAT1 promotes malignant pleural mesothelioma by sponging miR-141-3p
  170. Effects of remifentanil and propofol on distant organ lung injury in an ischemia–reperfusion model
  171. miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway
  172. Identification of LIG1 and LIG3 as prognostic biomarkers in breast cancer
  173. MitoQ inhibits hepatic stellate cell activation and liver fibrosis by enhancing PINK1/parkin-mediated mitophagy
  174. Dissecting role of founder mutation p.V727M in GNE in Indian HIBM cohort
  175. circATP2A2 promotes osteosarcoma progression by upregulating MYH9
  176. Prognostic role of oxytocin receptor in colon adenocarcinoma
  177. Review Articles
  178. The function of non-coding RNAs in idiopathic pulmonary fibrosis
  179. Efficacy and safety of therapeutic plasma exchange in stiff person syndrome
  180. Role of cesarean section in the development of neonatal gut microbiota: A systematic review
  181. Small cell lung cancer transformation during antitumor therapies: A systematic review
  182. Research progress of gut microbiota and frailty syndrome
  183. Recommendations for outpatient activity in COVID-19 pandemic
  184. Rapid Communication
  185. Disparity in clinical characteristics between 2019 novel coronavirus pneumonia and leptospirosis
  186. Use of microspheres in embolization for unruptured renal angiomyolipomas
  187. COVID-19 cases with delayed absorption of lung lesion
  188. A triple combination of treatments on moderate COVID-19
  189. Social networks and eating disorders during the Covid-19 pandemic
  190. Letter
  191. COVID-19, WHO guidelines, pedagogy, and respite
  192. Inflammatory factors in alveolar lavage fluid from severe COVID-19 pneumonia: PCT and IL-6 in epithelial lining fluid
  193. COVID-19: Lessons from Norway tragedy must be considered in vaccine rollout planning in least developed/developing countries
  194. What is the role of plasma cell in the lamina propria of terminal ileum in Good’s syndrome patient?
  195. Case Report
  196. Rivaroxaban triggered multifocal intratumoral hemorrhage of the cabozantinib-treated diffuse brain metastases: A case report and review of literature
  197. CTU findings of duplex kidney in kidney: A rare duplicated renal malformation
  198. Synchronous primary malignancy of colon cancer and mantle cell lymphoma: A case report
  199. Sonazoid-enhanced ultrasonography and pathologic characters of CD68 positive cell in primary hepatic perivascular epithelioid cell tumors: A case report and literature review
  200. Persistent SARS-CoV-2-positive over 4 months in a COVID-19 patient with CHB
  201. Pulmonary parenchymal involvement caused by Tropheryma whipplei
  202. Mediastinal mixed germ cell tumor: A case report and literature review
  203. Ovarian female adnexal tumor of probable Wolffian origin – Case report
  204. Rare paratesticular aggressive angiomyxoma mimicking an epididymal tumor in an 82-year-old man: Case report
  205. Perimenopausal giant hydatidiform mole complicated with preeclampsia and hyperthyroidism: A case report and literature review
  206. Primary orbital ganglioneuroblastoma: A case report
  207. Primary aortic intimal sarcoma masquerading as intramural hematoma
  208. Sustained false-positive results for hepatitis A virus immunoglobulin M: A case report and literature review
  209. Peritoneal loose body presenting as a hepatic mass: A case report and review of the literature
  210. Chondroblastoma of mandibular condyle: Case report and literature review
  211. Trauma-induced complete pacemaker lead fracture 8 months prior to hospitalization: A case report
  212. Primary intradural extramedullary extraosseous Ewing’s sarcoma/peripheral primitive neuroectodermal tumor (PIEES/PNET) of the thoracolumbar spine: A case report and literature review
  213. Computer-assisted preoperative planning of reduction of and osteosynthesis of scapular fracture: A case report
  214. High quality of 58-month life in lung cancer patient with brain metastases sequentially treated with gefitinib and osimertinib
  215. Rapid response of locally advanced oral squamous cell carcinoma to apatinib: A case report
  216. Retrieval of intrarenal coiled and ruptured guidewire by retrograde intrarenal surgery: A case report and literature review
  217. Usage of intermingled skin allografts and autografts in a senior patient with major burn injury
  218. Retraction
  219. Retraction on “Dihydromyricetin attenuates inflammation through TLR4/NF-kappa B pathway”
  220. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part I
  221. An artificial immune system with bootstrap sampling for the diagnosis of recurrent endometrial cancers
  222. Breast cancer recurrence prediction with ensemble methods and cost-sensitive learning
https://doi.org/10.1515/med-2021-0305
Schlagwörter für diesen Artikel
Outbreak; pandemic; COVID-19; outbreak origin; outbreak differentiating; SARS-CoV-2
Creative Commons
BY 4.0

Artikel in diesem Heft

  1. Research Articles
  2. Identification of ZG16B as a prognostic biomarker in breast cancer
  3. Behçet’s disease with latent Mycobacterium tuberculosis infection
  4. Erratum
  5. Erratum to “Suffering from Cerebral Small Vessel Disease with and without Metabolic Syndrome”
  6. Research Articles
  7. GPR37 promotes the malignancy of lung adenocarcinoma via TGF-β/Smad pathway
  8. Expression and role of ABIN1 in sepsis: In vitro and in vivo studies
  9. Additional baricitinib loading dose improves clinical outcome in COVID-19
  10. The co-treatment of rosuvastatin with dapagliflozin synergistically inhibited apoptosis via activating the PI3K/AKt/mTOR signaling pathway in myocardial ischemia/reperfusion injury rats
  11. SLC12A8 plays a key role in bladder cancer progression and EMT
  12. LncRNA ATXN8OS enhances tamoxifen resistance in breast cancer
  13. Case Report
  14. Serratia marcescens as a cause of unfavorable outcome in the twin pregnancy
  15. Spleno-adrenal fusion mimicking an adrenal metastasis of a renal cell carcinoma: A case report and embryological background
  16. Research Articles
  17. TRIM25 contributes to the malignancy of acute myeloid leukemia and is negatively regulated by microRNA-137
  18. CircRNA circ_0004370 promotes cell proliferation, migration, and invasion and inhibits cell apoptosis of esophageal cancer via miR-1301-3p/COL1A1 axis
  19. LncRNA XIST regulates atherosclerosis progression in ox-LDL-induced HUVECs
  20. Potential role of IFN-γ and IL-5 in sepsis prediction of preterm neonates
  21. Rapid Communication
  22. COVID-19 vaccine: Call for employees in international transportation industries and international travelers as the first priority in global distribution
  23. Case Report
  24. Rare squamous cell carcinoma of the kidney with concurrent xanthogranulomatous pyelonephritis: A case report and review of the literature
  25. An infertile female delivered a baby after removal of primary renal carcinoid tumor
  26. Research Articles
  27. Hypertension, BMI, and cardiovascular and cerebrovascular diseases
  28. Case Report
  29. Coexistence of bilateral macular edema and pale optic disc in the patient with Cohen syndrome
  30. Research Articles
  31. Correlation between kinematic sagittal parameters of the cervical lordosis or head posture and disc degeneration in patients with posterior neck pain
  32. Review Articles
  33. Hepatoid adenocarcinoma of the lung: An analysis of the Surveillance, Epidemiology, and End Results (SEER) database
  34. Research Articles
  35. Thermography in the diagnosis of carpal tunnel syndrome
  36. Pemetrexed-based first-line chemotherapy had particularly prominent objective response rate for advanced NSCLC: A network meta-analysis
  37. Comparison of single and double autologous stem cell transplantation in multiple myeloma patients
  38. The influence of smoking in minimally invasive spinal fusion surgery
  39. Impact of body mass index on left atrial dimension in HOCM patients
  40. Expression and clinical significance of CMTM1 in hepatocellular carcinoma
  41. miR-142-5p promotes cervical cancer progression by targeting LMX1A through Wnt/β-catenin pathway
  42. Comparison of multiple flatfoot indicators in 5–8-year-old children
  43. Early MRI imaging and follow-up study in cerebral amyloid angiopathy
  44. Intestinal fatty acid-binding protein as a biomarker for the diagnosis of strangulated intestinal obstruction: A meta-analysis
  45. miR-128-3p inhibits apoptosis and inflammation in LPS-induced sepsis by targeting TGFBR2
  46. Dynamic perfusion CT – A promising tool to diagnose pancreatic ductal adenocarcinoma
  47. Biomechanical evaluation of self-cinching stitch techniques in rotator cuff repair: The single-loop and double-loop knot stitches
  48. Review Articles
  49. The ambiguous role of mannose-binding lectin (MBL) in human immunity
  50. Case Report
  51. Membranous nephropathy with pulmonary cryptococcosis with improved 1-year follow-up results: A case report
  52. Fertility problems in males carrying an inversion of chromosome 10
  53. Acute myeloid leukemia with leukemic pleural effusion and high levels of pleural adenosine deaminase: A case report and review of literature
  54. Metastatic renal Ewing’s sarcoma in adult woman: Case report and review of the literature
  55. Burkitt-like lymphoma with 11q aberration in a patient with AIDS and a patient without AIDS: Two cases reports and literature review
  56. Skull hemophilia pseudotumor: A case report
  57. Judicious use of low-dosage corticosteroids for non-severe COVID-19: A case report
  58. Adult-onset citrullinaemia type II with liver cirrhosis: A rare cause of hyperammonaemia
  59. Clinicopathologic features of Good’s syndrome: Two cases and literature review
  60. Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review
  61. Research Articles
  62. Effects of hydroxyethyl starch and gelatin on the risk of acute kidney injury following orthotopic liver transplantation: A multicenter retrospective comparative clinical study
  63. Significance of nucleic acid positive anal swab in COVID-19 patients
  64. circAPLP2 promotes colorectal cancer progression by upregulating HELLS by targeting miR-335-5p
  65. Ratios between circulating myeloid cells and lymphocytes are associated with mortality in severe COVID-19 patients
  66. Risk factors of left atrial appendage thrombus in patients with non-valvular atrial fibrillation
  67. Clinical features of hypertensive patients with COVID-19 compared with a normotensive group: Single-center experience in China
  68. Surgical myocardial revascularization outcomes in Kawasaki disease: systematic review and meta-analysis
  69. Decreased chromobox homologue 7 expression is associated with epithelial–mesenchymal transition and poor prognosis in cervical cancer
  70. FGF16 regulated by miR-520b enhances the cell proliferation of lung cancer
  71. Platelet-rich fibrin: Basics of biological actions and protocol modifications
  72. Accurate diagnosis of prostate cancer using logistic regression
  73. miR-377 inhibition enhances the survival of trophoblast cells via upregulation of FNDC5 in gestational diabetes mellitus
  74. Prognostic significance of TRIM28 expression in patients with breast carcinoma
  75. Integrative bioinformatics analysis of KPNA2 in six major human cancers
  76. Exosomal-mediated transfer of OIP5-AS1 enhanced cell chemoresistance to trastuzumab in breast cancer via up-regulating HMGB3 by sponging miR-381-3p
  77. A four-lncRNA signature for predicting prognosis of recurrence patients with gastric cancer
  78. Knockdown of circ_0003204 alleviates oxidative low-density lipoprotein-induced human umbilical vein endothelial cells injury: Circulating RNAs could explain atherosclerosis disease progression
  79. Propofol postpones colorectal cancer development through circ_0026344/miR-645/Akt/mTOR signal pathway
  80. Knockdown of lncRNA TapSAKI alleviates LPS-induced injury in HK-2 cells through the miR-205/IRF3 pathway
  81. COVID-19 severity in relation to sociodemographics and vitamin D use
  82. Clinical analysis of 11 cases of nocardiosis
  83. Cis-regulatory elements in conserved non-coding sequences of nuclear receptor genes indicate for crosstalk between endocrine systems
  84. Four long noncoding RNAs act as biomarkers in lung adenocarcinoma
  85. Real-world evidence of cytomegalovirus reactivation in non-Hodgkin lymphomas treated with bendamustine-containing regimens
  86. Relation between IL-8 level and obstructive sleep apnea syndrome
  87. circAGFG1 sponges miR-28-5p to promote non-small-cell lung cancer progression through modulating HIF-1α level
  88. Nomogram prediction model for renal anaemia in IgA nephropathy patients
  89. Effect of antibiotic use on the efficacy of nivolumab in the treatment of advanced/metastatic non-small cell lung cancer: A meta-analysis
  90. NDRG2 inhibition facilitates angiogenesis of hepatocellular carcinoma
  91. A nomogram for predicting metabolic steatohepatitis: The combination of NAMPT, RALGDS, GADD45B, FOSL2, RTP3, and RASD1
  92. Clinical and prognostic features of MMP-2 and VEGF in AEG patients
  93. The value of miR-510 in the prognosis and development of colon cancer
  94. Functional implications of PABPC1 in the development of ovarian cancer
  95. Prognostic value of preoperative inflammation-based predictors in patients with bladder carcinoma after radical cystectomy
  96. Sublingual immunotherapy increases Treg/Th17 ratio in allergic rhinitis
  97. Prediction of improvement after anterior cruciate ligament reconstruction
  98. Effluent Osteopontin levels reflect the peritoneal solute transport rate
  99. circ_0038467 promotes PM2.5-induced bronchial epithelial cell dysfunction
  100. Significance of miR-141 and miR-340 in cervical squamous cell carcinoma
  101. Association between hair cortisol concentration and metabolic syndrome
  102. Microvessel density as a prognostic indicator of prostate cancer: A systematic review and meta-analysis
  103. Characteristics of BCR–ABL gene variants in patients of chronic myeloid leukemia
  104. Knee alterations in rheumatoid arthritis: Comparison of US and MRI
  105. Long non-coding RNA TUG1 aggravates cerebral ischemia and reperfusion injury by sponging miR-493-3p/miR-410-3p
  106. lncRNA MALAT1 regulated ATAD2 to facilitate retinoblastoma progression via miR-655-3p
  107. Development and validation of a nomogram for predicting severity in patients with hemorrhagic fever with renal syndrome: A retrospective study
  108. Analysis of COVID-19 outbreak origin in China in 2019 using differentiation method for unusual epidemiological events
  109. Laparoscopic versus open major liver resection for hepatocellular carcinoma: A case-matched analysis of short- and long-term outcomes
  110. Travelers’ vaccines and their adverse events in Nara, Japan
  111. Association between Tfh and PGA in children with Henoch–Schönlein purpura
  112. Can exchange transfusion be replaced by double-LED phototherapy?
  113. circ_0005962 functions as an oncogene to aggravate NSCLC progression
  114. Circular RNA VANGL1 knockdown suppressed viability, promoted apoptosis, and increased doxorubicin sensitivity through targeting miR-145-5p to regulate SOX4 in bladder cancer cells
  115. Serum intact fibroblast growth factor 23 in healthy paediatric population
  116. Algorithm of rational approach to reconstruction in Fournier’s disease
  117. A meta-analysis of exosome in the treatment of spinal cord injury
  118. Src-1 and SP2 promote the proliferation and epithelial–mesenchymal transition of nasopharyngeal carcinoma
  119. Dexmedetomidine may decrease the bupivacaine toxicity to heart
  120. Hypoxia stimulates the migration and invasion of osteosarcoma via up-regulating the NUSAP1 expression
  121. Long noncoding RNA XIST knockdown relieves the injury of microglia cells after spinal cord injury by sponging miR-219-5p
  122. External fixation via the anterior inferior iliac spine for proximal femoral fractures in young patients
  123. miR-128-3p reduced acute lung injury induced by sepsis via targeting PEL12
  124. HAGLR promotes neuron differentiation through the miR-130a-3p-MeCP2 axis
  125. Phosphoglycerate mutase 2 is elevated in serum of patients with heart failure and correlates with the disease severity and patient’s prognosis
  126. Cell population data in identifying active tuberculosis and community-acquired pneumonia
  127. Prognostic value of microRNA-4521 in non-small cell lung cancer and its regulatory effect on tumor progression
  128. Mean platelet volume and red blood cell distribution width is associated with prognosis in premature neonates with sepsis
  129. 3D-printed porous scaffold promotes osteogenic differentiation of hADMSCs
  130. Association of gene polymorphisms with women urinary incontinence
  131. Influence of COVID-19 pandemic on stress levels of urologic patients
  132. miR-496 inhibits proliferation via LYN and AKT pathway in gastric cancer
  133. miR-519d downregulates LEP expression to inhibit preeclampsia development
  134. Comparison of single- and triple-port VATS for lung cancer: A meta-analysis
  135. Fluorescent light energy modulates healing in skin grafted mouse model
  136. Silencing CDK6-AS1 inhibits LPS-induced inflammatory damage in HK-2 cells
  137. Predictive effect of DCE-MRI and DWI in brain metastases from NSCLC
  138. Severe postoperative hyperbilirubinemia in congenital heart disease
  139. Baicalin improves podocyte injury in rats with diabetic nephropathy by inhibiting PI3K/Akt/mTOR signaling pathway
  140. Clinical factors predicting ureteral stent failure in patients with external ureteral compression
  141. Novel H2S donor proglumide-ADT-OH protects HUVECs from ox-LDL-induced injury through NF-κB and JAK/SATA pathway
  142. Triple-Endobutton and clavicular hook: A propensity score matching analysis
  143. Long noncoding RNA MIAT inhibits the progression of diabetic nephropathy and the activation of NF-κB pathway in high glucose-treated renal tubular epithelial cells by the miR-182-5p/GPRC5A axis
  144. Serum exosomal miR-122-5p, GAS, and PGR in the non-invasive diagnosis of CAG
  145. miR-513b-5p inhibits the proliferation and promotes apoptosis of retinoblastoma cells by targeting TRIB1
  146. Fer exacerbates renal fibrosis and can be targeted by miR-29c-3p
  147. The diagnostic and prognostic value of miR-92a in gastric cancer: A systematic review and meta-analysis
  148. Prognostic value of α2δ1 in hypopharyngeal carcinoma: A retrospective study
  149. No significant benefit of moderate-dose vitamin C on severe COVID-19 cases
  150. circ_0000467 promotes the proliferation, metastasis, and angiogenesis in colorectal cancer cells through regulating KLF12 expression by sponging miR-4766-5p
  151. Downregulation of RAB7 and Caveolin-1 increases MMP-2 activity in renal tubular epithelial cells under hypoxic conditions
  152. Educational program for orthopedic surgeons’ influences for osteoporosis
  153. Expression and function analysis of CRABP2 and FABP5, and their ratio in esophageal squamous cell carcinoma
  154. GJA1 promotes hepatocellular carcinoma progression by mediating TGF-β-induced activation and the epithelial–mesenchymal transition of hepatic stellate cells
  155. lncRNA-ZFAS1 promotes the progression of endometrial carcinoma by targeting miR-34b to regulate VEGFA expression
  156. Anticoagulation is the answer in treating noncritical COVID-19 patients
  157. Effect of late-onset hemorrhagic cystitis on PFS after haplo-PBSCT
  158. Comparison of Dako HercepTest and Ventana PATHWAY anti-HER2 (4B5) tests and their correlation with silver in situ hybridization in lung adenocarcinoma
  159. VSTM1 regulates monocyte/macrophage function via the NF-κB signaling pathway
  160. Comparison of vaginal birth outcomes in midwifery-led versus physician-led setting: A propensity score-matched analysis
  161. Treatment of osteoporosis with teriparatide: The Slovenian experience
  162. New targets of morphine postconditioning protection of the myocardium in ischemia/reperfusion injury: Involvement of HSP90/Akt and C5a/NF-κB
  163. Superenhancer–transcription factor regulatory network in malignant tumors
  164. β-Cell function is associated with osteosarcopenia in middle-aged and older nonobese patients with type 2 diabetes: A cross-sectional study
  165. Clinical features of atypical tuberculosis mimicking bacterial pneumonia
  166. Proteoglycan-depleted regions of annular injury promote nerve ingrowth in a rabbit disc degeneration model
  167. Effect of electromagnetic field on abortion: A systematic review and meta-analysis
  168. miR-150-5p affects AS plaque with ASMC proliferation and migration by STAT1
  169. MALAT1 promotes malignant pleural mesothelioma by sponging miR-141-3p
  170. Effects of remifentanil and propofol on distant organ lung injury in an ischemia–reperfusion model
  171. miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway
  172. Identification of LIG1 and LIG3 as prognostic biomarkers in breast cancer
  173. MitoQ inhibits hepatic stellate cell activation and liver fibrosis by enhancing PINK1/parkin-mediated mitophagy
  174. Dissecting role of founder mutation p.V727M in GNE in Indian HIBM cohort
  175. circATP2A2 promotes osteosarcoma progression by upregulating MYH9
  176. Prognostic role of oxytocin receptor in colon adenocarcinoma
  177. Review Articles
  178. The function of non-coding RNAs in idiopathic pulmonary fibrosis
  179. Efficacy and safety of therapeutic plasma exchange in stiff person syndrome
  180. Role of cesarean section in the development of neonatal gut microbiota: A systematic review
  181. Small cell lung cancer transformation during antitumor therapies: A systematic review
  182. Research progress of gut microbiota and frailty syndrome
  183. Recommendations for outpatient activity in COVID-19 pandemic
  184. Rapid Communication
  185. Disparity in clinical characteristics between 2019 novel coronavirus pneumonia and leptospirosis
  186. Use of microspheres in embolization for unruptured renal angiomyolipomas
  187. COVID-19 cases with delayed absorption of lung lesion
  188. A triple combination of treatments on moderate COVID-19
  189. Social networks and eating disorders during the Covid-19 pandemic
  190. Letter
  191. COVID-19, WHO guidelines, pedagogy, and respite
  192. Inflammatory factors in alveolar lavage fluid from severe COVID-19 pneumonia: PCT and IL-6 in epithelial lining fluid
  193. COVID-19: Lessons from Norway tragedy must be considered in vaccine rollout planning in least developed/developing countries
  194. What is the role of plasma cell in the lamina propria of terminal ileum in Good’s syndrome patient?
  195. Case Report
  196. Rivaroxaban triggered multifocal intratumoral hemorrhage of the cabozantinib-treated diffuse brain metastases: A case report and review of literature
  197. CTU findings of duplex kidney in kidney: A rare duplicated renal malformation
  198. Synchronous primary malignancy of colon cancer and mantle cell lymphoma: A case report
  199. Sonazoid-enhanced ultrasonography and pathologic characters of CD68 positive cell in primary hepatic perivascular epithelioid cell tumors: A case report and literature review
  200. Persistent SARS-CoV-2-positive over 4 months in a COVID-19 patient with CHB
  201. Pulmonary parenchymal involvement caused by Tropheryma whipplei
  202. Mediastinal mixed germ cell tumor: A case report and literature review
  203. Ovarian female adnexal tumor of probable Wolffian origin – Case report
  204. Rare paratesticular aggressive angiomyxoma mimicking an epididymal tumor in an 82-year-old man: Case report
  205. Perimenopausal giant hydatidiform mole complicated with preeclampsia and hyperthyroidism: A case report and literature review
  206. Primary orbital ganglioneuroblastoma: A case report
  207. Primary aortic intimal sarcoma masquerading as intramural hematoma
  208. Sustained false-positive results for hepatitis A virus immunoglobulin M: A case report and literature review
  209. Peritoneal loose body presenting as a hepatic mass: A case report and review of the literature
  210. Chondroblastoma of mandibular condyle: Case report and literature review
  211. Trauma-induced complete pacemaker lead fracture 8 months prior to hospitalization: A case report
  212. Primary intradural extramedullary extraosseous Ewing’s sarcoma/peripheral primitive neuroectodermal tumor (PIEES/PNET) of the thoracolumbar spine: A case report and literature review
  213. Computer-assisted preoperative planning of reduction of and osteosynthesis of scapular fracture: A case report
  214. High quality of 58-month life in lung cancer patient with brain metastases sequentially treated with gefitinib and osimertinib
  215. Rapid response of locally advanced oral squamous cell carcinoma to apatinib: A case report
  216. Retrieval of intrarenal coiled and ruptured guidewire by retrograde intrarenal surgery: A case report and literature review
  217. Usage of intermingled skin allografts and autografts in a senior patient with major burn injury
  218. Retraction
  219. Retraction on “Dihydromyricetin attenuates inflammation through TLR4/NF-kappa B pathway”
  220. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part I
  221. An artificial immune system with bootstrap sampling for the diagnosis of recurrent endometrial cancers
  222. Breast cancer recurrence prediction with ensemble methods and cost-sensitive learning
Jetzt anmelden und 20% sparen
Institutioneller Zugang
Wie funktioniert Authentifizierung?
Haben Sie eine Idee, wie wir unsere Website verbessern können?
Bitte schreiben Sie uns.
© 2025 De Gruyter Brill
Heruntergeladen am 9.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/med-2021-0305/html
Button zum nach oben scrollen