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      The marked body – a qualitative study on survivors embodied experiences of a COVID‐19 illness trajectory

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          Abstract

          Background

          Research on COVID‐19 has reported data on epidemiology and pathophysiology but less about what it means to be a person living through this illness. Research involving the patients’ perspectives may help to improve healthcare professionals' understanding of ways to support patients.

          Aims

          To gain in‐depth understanding of the meaning of a COVID‐19 illness trajectory from the patients’ perspective.

          Methods

          Fifteen participants who had undergone an illness trajectory due to confirmed COVID‐19 infection participated in individual qualitative interviews. Data collection, analysis and interpretation were inspired by Ricoeur’s philosophy and Merleau‐Ponty’s phenomenology of perception and embodiment has been applied as a theoretical frame.

          Findings

          Being infected with coronavirus is expressed as an experience in which the participants oscillate between relief, security, imprisonment and raw fear. A predominant focus on the physical dimensions of the diseased body was found in the encounters between patient and healthcare system, and distance may furthermore be a consequence of use of protective equipment. Stigma and fear of infection were also expressed. After COVID‐19, an overwhelming feeling of a door opening to freedom is perceived. However, the body is marked, and bears witness to decay from this insidious and frightening virus. The responsibility for assessing their bodily symptoms is placed with the individual patients themselves, who feel lonely and fearful and this keeps them indoors.

          Conclusions

          During a COVID‐19 illness, trajectory concerns about the unknown course of this disease are highlighted. Isolation is confrontational; however, a companionship between patients might emerge. The study shed light on an unavoidable gap between the patients and healthcare professionals due to the use protective equipment. After COVID‐19, the body is labelled as something others fear and become a symbol of awe and alienation for others.

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          Most cited references45

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          Clinical Characteristics of Coronavirus Disease 2019 in China

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

            Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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              Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges

              Highlights • Emergence of 2019 novel coronavirus (2019-nCoV) in China has caused a large global outbreak and major public health issue. • At 9 February 2020, data from the WHO has shown >37 000 confirmed cases in 28 countries (>99% of cases detected in China). • 2019-nCoV is spread by human-to-human transmission via droplets or direct contact. • Infection estimated to have an incubation period of 2–14 days and a basic reproduction number of 2.24–3.58. • Controlling infection to prevent spread of the 2019-nCoV is the primary intervention being used.
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                Author and article information

                Contributors
                Role: Clinical Nurse Specialistmalene.missel@regionh.dk
                Role: Chief Clinical Educator
                Role: Research Assistant
                Role: Clinical Nurse Specialist
                Role: Senior Researcher, Professor
                Journal
                Scand J Caring Sci
                Scand J Caring Sci
                10.1111/(ISSN)1471-6712
                SCS
                Scandinavian Journal of Caring Sciences
                John Wiley and Sons Inc. (Hoboken )
                0283-9318
                1471-6712
                18 March 2021
                : 10.1111/scs.12975
                Affiliations
                [ 1 ] Department of Cardiothoracic Surgery Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
                [ 2 ] 2Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
                [ 3 ] Department of Infectious Diseases Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
                [ 4 ] National Institute of Public Health University of Southern Denmark Odense Denmark
                [ 5 ] Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
                Author notes
                [*] [* ] Correspondence

                Malene Missel, Clinical Nurse Specialist, Department of Cardiothoracic Surgery, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 København, DK‐Denmark.

                Email: malene.missel@ 123456regionh.dk

                Author information
                https://orcid.org/0000-0003-3267-8038
                https://orcid.org/0000-0002-0466-9567
                https://orcid.org/0000-0003-0594-875X
                https://orcid.org/0000-0003-1099-3619
                https://orcid.org/0000-0002-9493-954X
                Article
                SCS12975
                10.1111/scs.12975
                8251171
                33734468
                cb7d6613-66e6-404b-b130-45f6f3bd64c9
                © 2021 Nordic College of Caring Science

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

                History
                : 02 October 2020
                : 15 July 2020
                : 31 January 2021
                Page count
                Figures: 0, Tables: 0, Pages: 9, Words: 14103
                Funding
                Funded by: Novo Nordisk Fonden , open-funder-registry 10.13039/501100009708;
                Award ID: NNF20SA0062831
                Funded by: Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Denmark
                Categories
                Empirical Studies
                Empirical Studies
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.4 mode:remove_FC converted:02.07.2021

                sars‐cov‐2,covid‐19,coronavirus,qualitative study,patient perspective,ricoeur,merleau‐ponty

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