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Sania A, Mahmud AS, Alschuler DM, Urmi T, Chowdhury S, Lee S, Mostari S, Shaikh FZ, Sojib KH, Khan T, Khan Y, Chowdhury A, Arifeen SE. Risk factors for COVID-19 mortality among telehealth patients in Bangladesh: A prospective cohort study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001971. [PMID: 37315095 DOI: 10.1371/journal.pgph.0001971] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 05/03/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Estimating the contribution of risk factors of mortality due to COVID-19 is particularly important in settings with low vaccination coverage and limited public health and clinical resources. Very few studies of risk factors of COVID-19 mortality used high-quality data at an individual level from low- and middle-income countries (LMICs). We examined the contribution of demographic, socioeconomic and clinical risk factors of COVID-19 mortality in Bangladesh, a lower middle-income country in South Asia. METHODS We used data from 290,488 lab-confirmed COVID-19 patients who participated in a telehealth service in Bangladesh between May 2020 and June 2021, linked with COVID-19 death data from a national database to study the risk factors associated with mortality. Multivariable logistic regression models were used to estimate the association between risk factors and mortality. We used classification and regression trees to identify the risk factors that are the most important for clinical decision-making. FINDINGS This study is one of the largest prospective cohort studies of COVID-19 mortality in a LMIC, covering 36% of all lab-confirmed COVID-19 cases in the country during the study period. We found that being male, being very young or elderly, having low socioeconomic status, chronic kidney and liver disease, and being infected during the latter pandemic period were significantly associated with a higher risk of mortality from COVID-19. Males had 1.15 times higher odds (95% Confidence Interval, CI: 1.09, 1.22) of death compared to females. Compared to the reference age group (20-24 years olds), the odds ratio of mortality increased monotonically with age, ranging from an odds ratio of 1.35 (95% CI: 1.05, 1.73) for ages 30-34 to an odds ratio of 21.6 (95% CI: 17.08, 27.38) for ages 75-79 year group. For children 0-4 years old the odds of mortality were 3.93 (95% CI: 2.74, 5.64) times higher than 20-24 years olds. Other significant predictors were severe symptoms of COVID-19 such as breathing difficulty, fever, and diarrhea. Patients who were assessed by a physician as having a severe episode of COVID-19 based on the telehealth interview had 12.43 (95% CI: 11.04, 13.99) times higher odds of mortality compared to those assessed to have a mild episode. The finding that the telehealth doctors' assessment of disease severity was highly predictive of subsequent COVID-19 mortality, underscores the feasibility and value of the telehealth services. CONCLUSIONS Our findings confirm the universality of certain COVID-19 risk factors-such as gender and age-while highlighting other risk factors that appear to be more (or less) relevant in the context of Bangladesh. These findings on the demographic, socioeconomic, and clinical risk factors for COVID-19 mortality can help guide public health and clinical decision-making. Harnessing the benefits of the telehealth system and optimizing care for those most at risk of mortality, particularly in the context of a LMIC, are the key takeaways from this study.
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Affiliation(s)
- Ayesha Sania
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Ayesha S Mahmud
- Department of Demography, University of California, Berkeley, Berkeley, California, United States of America
| | - Daniel M Alschuler
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Tamanna Urmi
- Network Science Institute, Northeastern University, Boston, Massachusetts, United States of America
| | - Shayan Chowdhury
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
- Aspire to Innovate (a2i) ICT Division, Dhaka, Bangladesh
| | - Seonjoo Lee
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
| | | | | | - Kawsar Hosain Sojib
- Aspire to Innovate (a2i) ICT Division, Dhaka, Bangladesh
- Department of Economics, Jahangirnagar University, Dhaka, Bangladesh
| | - Tahmid Khan
- Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Yiafee Khan
- Aspire to Innovate (a2i) ICT Division, Dhaka, Bangladesh
| | - Anir Chowdhury
- Aspire to Innovate (a2i) ICT Division, Dhaka, Bangladesh
| | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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Moyers SA, Hartwell M, Chiaf A, Greiner B, Oliver JA, Croff JM. Associations of Combustible Cigarette, Electronic Cigarette, and Dual Use With COVID Infection and Severity in the U.S.: A Cross-sectional Analysis of the 2021 National Health Information Survey. Tob Use Insights 2023; 16:1179173X231179675. [PMID: 37324057 PMCID: PMC10262671 DOI: 10.1177/1179173x231179675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Given the potential respiratory health risks, the association of COVID infection and the use of combustible cigarettes, electronic nicotine delivery systems (ENDS), and concurrent dual use is a priority for public health. Many published reports have not accounted for known covarying factors. This study sought to calculate adjusted odds ratios for self-reported COVID infection and disease severity as a function of smoking and ENDS use, while accounting for factors known to influence COVID infection and disease severity (i.e., age, sex, race and ethnicity, socioeconomic status and educational attainment, rural or urban environment, self-reported diabetes, COPD, coronary heart disease, and obesity status). Data from the 2021 U.S. National Health Interview Survey, a cross-sectional questionnaire design, were used to calculate both unadjusted and adjusted odds ratios for self-reported COVID infection and severity of symptoms. Results indicate that combustible cigarette use is associated with a lower likelihood of self-reported COVID infection relative to non-use of tobacco products (AOR = .64; 95% CI [.55, .74]), whereas ENDS use is associated with a higher likelihood of self-reported COVID infection (AOR = 1.30; 95% CI [1.04, 1.63]). There was no significant difference in COVID infection among dual users (ENDS and combustible use) when compared with non-users. Adjusting for covarying factors did not substantially change the results. There were no significant differences in COVID disease severity between those of varying smoking status. Future research should examine the relationship between smoking status and COVID infection and disease severity utilizing longitudinal study designs and non-self-report measures of smoking status (e.g., the biomarker cotinine), COVID infection (e.g., positive tests), and disease severity (e.g., hospitalizations, ventilator assistance, mortality, and ongoing symptoms of long COVID).
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Affiliation(s)
- Susette A Moyers
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Micah Hartwell
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, USA
| | - Ashleigh Chiaf
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Benjamin Greiner
- Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Jason A Oliver
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Julie M Croff
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Akita T, Oda K, Narukawa S, Morita Y, Tange K, Nakai Y, Yamashita C. Intracellular Drug Delivery Process of Am80-Encapsulated Lipid Nanoparticles Aiming for Alveolar Regeneration. Pharmaceuticals (Basel) 2023; 16:838. [PMID: 37375785 DOI: 10.3390/ph16060838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) results in obstructive ventilatory impairment caused by emphysema, and current treatment is limited to symptomatic therapy or lung transplantation. Therefore, the development of new treatments to repair alveolar destruction is especially urgent. Our previous study revealed that 1.0 mg/kg of synthetic retinoid Am80 had a repair effect on collapsed alveoli in a mouse model of elastase-induced emphysema. From these results, however, the clinical dose calculated in accordance with FDA guidance is estimated to be 5.0 mg/60 kg, and it is desirable to further reduce the dose to allow the formulation of a powder inhaler for clinical application. To efficiently deliver Am80 to the retinoic acid receptor in the cell nucleus, which is the site of action, we focused on SS-cleavable proton-activated lipid-like material O-Phentyl-P4C2COATSOME®SS-OP, hereinafter referred to as "SS-OP"). In this study, we investigated the cellular uptake and intracellular drug delivery process of Am80-encapsulated SS-OP nanoparticles to elucidate the mechanism of Am80 by nanoparticulation. Am80-encapsulated SS-OP nanoparticles were taken up into the cells via ApoE, and then Am80 was efficiently delivered into the nucleus via RARα. These results indicated the usefulness of SS-OP nanoparticles as drug delivery system carriers of Am80 for COPD treatment.
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Affiliation(s)
- Tomomi Akita
- Department of Pharmaceutics and Drug Delivery, Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda 278-8510, Japan
| | - Kazuaki Oda
- Department of Pharmaceutics and Drug Delivery, Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda 278-8510, Japan
| | - Satoru Narukawa
- Department of Pharmaceutics and Drug Delivery, Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda 278-8510, Japan
| | - Yuki Morita
- Department of Pharmaceutics and Drug Delivery, Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda 278-8510, Japan
| | - Kota Tange
- Life Science Research Laboratory, NOF CORPORATION, 3-3 Chidori-cho, Kawasaki-ku, Kawasaki City 210-0865, Japan
| | - Yuta Nakai
- Life Science Research Laboratory, NOF CORPORATION, 3-3 Chidori-cho, Kawasaki-ku, Kawasaki City 210-0865, Japan
| | - Chikamasa Yamashita
- Department of Pharmaceutics and Drug Delivery, Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda 278-8510, Japan
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Ballouz T, Menges D, Anagnostopoulos A, Domenghino A, Aschmann HE, Frei A, Fehr JS, Puhan MA. Recovery and symptom trajectories up to two years after SARS-CoV-2 infection: population based, longitudinal cohort study. BMJ 2023; 381:e074425. [PMID: 37257891 DOI: 10.1136/bmj-2022-074425] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To evaluate longer term symptoms and health outcomes associated with post-covid-19 condition within a cohort of individuals with a SARS-CoV-2 infection. DESIGN Population based, longitudinal cohort. SETTING General population of canton of Zurich, Switzerland. PARTICIPANTS 1106 adults with a confirmed SARS-CoV-2 infection who were not vaccinated before infection and 628 adults who did not have an infection. MAIN OUTCOME MEASURES Trajectories of self-reported health status and covid-19 related symptoms between months six, 12, 18, and 24 after infection and excess risk of symptoms at six months after infection compared with individuals who had no infection. RESULTS 22.9% (95% confidence interval 20.4% to 25.6%) of individuals infected with SARS-CoV-2 did not fully recover by six months. The proportion of individuals who had an infection who reported not having recovered decreased to 18.5% (16.2% to 21.1%) at 12 months and 17.2% (14.0% to 20.8%) at 24 months after infection. When assessing changes in self-reported health status, most participants had continued recovery (68.4% (63.8% to 72.6%)) or had an overall improvement (13.5% (10.6% to 17.2%)) over time. Yet, 5.2% (3.5% to 7.7%) had a worsening in health status and 4.4% (2.9% to 6.7%) had alternating periods of recovery and health impairment. The point prevalence and severity of covid-19 related symptoms also decreased over time, with 18.1% (14.8% to 21.9%) reporting symptoms at 24 months. 8.9% (6.5% to 11.2%) of participants reported symptoms at all four follow-up time points, while in 12.5% (9.8% to 15.9%) symptoms were alternatingly absent and present. Symptom prevalence was higher among individuals who were infected compared with those who were not at six months (adjusted risk difference 17.0% (11.5% to 22.4%)). Excess risk (adjusted risk difference) for individual symptoms among those infected ranged from 2% to 10%, with the highest excess risks observed for altered taste or smell (9.8% (7.7% to 11.8%)), post-exertional malaise (9.4% (6.1% to 12.7%)), fatigue (5.4% (1.2% to 9.5%)), dyspnoea (7.8% (5.2% to 10.4%)), and reduced concentration (8.3% (6.0% to 10.7%)) and memory (5.7% (3.5% to 7.9%)). CONCLUSIONS Up to 18% of individuals who were not vaccinated before infection had post-covid-19 condition up to two years after infection, with evidence of excess symptom risk compared with controls. Effective interventions are needed to reduce the burden of post-covid-19 condition. Use of multiple outcome measures and consideration of the expected rates of recovery and heterogeneity in symptom trajectories are important in the design and interpretation of clinical trials. REGISTRATIONS ISRCTN18181860, .
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Affiliation(s)
- Tala Ballouz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Dominik Menges
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Alexia Anagnostopoulos
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Anja Domenghino
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Department of Visceral and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Hélène E Aschmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Jan S Fehr
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Martin CA, Nazareth J, Jarkhi A, Pan D, Das M, Logan N, Scott S, Bryant L, Abeywickrama N, Adeoye O, Ahmed A, Asif A, Bandi S, George N, Gohar M, Gray LJ, Kaszuba R, Mangwani J, Martin M, Moorthy A, Renals V, Teece L, Vail D, Khunti K, Moss P, Tattersall A, Hallis B, Otter AD, Rowe C, Willett BJ, Haldar P, Cooper A, Pareek M. Ethnic differences in cellular and humoral immune responses to SARS-CoV-2 vaccination in UK healthcare workers: a cross-sectional analysis. EClinicalMedicine 2023; 58:101926. [PMID: 37034357 PMCID: PMC10071048 DOI: 10.1016/j.eclinm.2023.101926] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 04/07/2023] Open
Abstract
Background Few studies have compared SARS-CoV-2 vaccine immunogenicity by ethnic group. We sought to establish whether cellular and humoral immune responses to SARS-CoV-2 vaccination differ according to ethnicity in UK Healthcare workers (HCWs). Methods In this cross-sectional analysis, we used baseline data from two immunological cohort studies conducted in HCWs in Leicester, UK. Blood samples were collected between March 3, and September 16, 2021. We excluded HCW who had not received two doses of SARS-CoV-2 vaccine at the time of sampling and those who had serological evidence of previous SARS-CoV-2 infection. Outcome measures were SARS-CoV-2 spike-specific total antibody titre, neutralising antibody titre and ELISpot count. We compared our outcome measures by ethnic group using univariable (t tests and rank-sum tests depending on distribution) and multivariable (linear regression for antibody titres and negative binomial regression for ELISpot counts) tests. Multivariable analyses were adjusted for age, sex, vaccine type, length of interval between vaccine doses and time between vaccine administration and sample collection and expressed as adjusted geometric mean ratios (aGMRs) or adjusted incidence rate ratios (aIRRs). To assess differences in the early immune response to vaccination we also conducted analyses in a subcohort who provided samples between 14 and 50 days after their second dose of vaccine. Findings The total number of HCWs in each analysis were 401 for anti-spike antibody titres, 345 for neutralising antibody titres and 191 for ELISpot. Overall, 25.4% (19.7% South Asian and 5.7% Black/Mixed/Other) were from ethnic minority groups. In analyses including the whole cohort, neutralising antibody titres were higher in South Asian HCWs than White HCWs (aGMR 1.47, 95% CI [1.06-2.06], P = 0.02) as were T cell responses to SARS-CoV-2 S1 peptides (aIRR 1.75, 95% CI [1.05-2.89], P = 0.03). In a subcohort sampled between 14 and 50 days after second vaccine dose, SARS-CoV-2 spike-specific antibody and neutralising antibody geometric mean titre (GMT) was higher in South Asian HCWs compared to White HCWs (9616 binding antibody units (BAU)/ml, 95% CI [7178-12,852] vs 5888 BAU/ml [5023-6902], P = 0.008 and 2851 95% CI [1811-4487] vs 1199 [984-1462], P < 0.001 respectively), increments which persisted after adjustment (aGMR 1.26, 95% CI [1.01-1.58], P = 0.04 and aGMR 2.01, 95% CI [1.34-3.01], P = 0.001). SARS-CoV-2 ELISpot responses to S1 and whole spike peptides (S1 + S2 response) were higher in HCWs from South Asian ethnic groups than those from White groups (S1: aIRR 2.33, 95% CI [1.09-4.94], P = 0.03; spike: aIRR, 2.04, 95% CI [1.02-4.08]). Interpretation This study provides evidence that, in an infection naïve cohort, humoral and cellular immune responses to SARS-CoV-2 vaccination are stronger in South Asian HCWs than White HCWs. These differences are most clearly seen in the early period following vaccination. Further research is required to understand the underlying mechanisms, whether differences persist with further exposure to vaccine or virus, and the potential impact on vaccine effectiveness. Funding DIRECT and BELIEVE have received funding from UK Research and Innovation (UKRI) through the COVID-19 National Core Studies Immunity (NCSi) programme (MC_PC_20060).
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Affiliation(s)
- Christopher A. Martin
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
| | - Joshua Nazareth
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
| | - Amar Jarkhi
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Daniel Pan
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
- Li Ka Shing Centre for Health Information and Discovery, Oxford Big Data Institute, University of Oxford, UK
| | - Mrinal Das
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Nicola Logan
- University of Glasgow Centre for Virus Research, University of Glasgow, Bearsden Road, Glasgow, UK
| | - Sam Scott
- University of Glasgow Centre for Virus Research, University of Glasgow, Bearsden Road, Glasgow, UK
| | - Luke Bryant
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
| | | | - Oluwatobi Adeoye
- Leicester Medical School, University of Leicester, Leicester, UK
| | - Aleem Ahmed
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Aqua Asif
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Srini Bandi
- Department of Paediatrics, Leicester Royal Infirmary, Leicester, UK
| | - Nisha George
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Marjan Gohar
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Laura J. Gray
- Biostatistics Research Group, Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Ross Kaszuba
- Leicester Medical School, University of Leicester, Leicester, UK
| | - Jitendra Mangwani
- Academic Team of Musculoskeletal Surgery, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
| | - Marianne Martin
- Children's Intensive Care Unit, Leicester Children's Hospital, Leicester, UK
| | - Arumugam Moorthy
- Department of Rheumatology, University Hospitals of Leicester NHS Trust, Leicester, UK
- College of Life Sciences, University of Leicester, Leicester, UK
| | - Valerie Renals
- Research Space, University Hospitals of Leicester NHS Trust, UK
| | - Lucy Teece
- Biostatistics Research Group, Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Denny Vail
- Research Space, University Hospitals of Leicester NHS Trust, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | | | - Bassam Hallis
- UK Health Security Agency, Porton Down, Salisbury, UK
| | | | - Cathy Rowe
- UK Health Security Agency, Porton Down, Salisbury, UK
| | - Brian J. Willett
- University of Glasgow Centre for Virus Research, University of Glasgow, Bearsden Road, Glasgow, UK
| | - Pranab Haldar
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK
| | - Andrea Cooper
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
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Datta S, Montoya R, Franco J, Haro M, Tapia P, Pozo C, Quispe J, Lozano A, Quevedo Cruz L, Evans C. A prospective cohort study of economic and nutritional changes during the COVID-19 pandemic in urban Callao, Lima, Peru. Wellcome Open Res 2023. [DOI: 10.12688/wellcomeopenres.18536.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Background: Peru followed strict quarantine measures to control COVID-19 but reported excess mortality rates during the pandemic that were the highest globally. High obesity prevalence in Peru may have contributed to COVID-19 mortality, although economic hardship during the pandemic could have reduced obesity. To investigate these potential associations, we updated surveys of economic status, nutritional status, and risk factors for severe COVID-19 in residents of Callao, in the Lima metropolitan area of Peru. Methods: We attempted in December 2021 to invite members of households selected randomly from a map that had provided data in previous surveys 2016-2018 and 2019-2020 to participate in another survey. Households were contacted by telephone and, if uncontactable, were visited. Demographic, economic, and health-related data were collected using the Kobo toolbox platform. Results. We interviewed 83% (305/369) of censused household members for 65% (90/138) of previously participating households. Dissaving activities were reported by all households during the pandemic, more than 2016-2018 (51%, 95% confidence interval, CI=41-62%) and 2019-2020 (44%, 95%CI=33-53%, both p<0.0001). Moreover, 90% (81/90, 95%CI=82-95%) of households reported inability to afford sufficient food and hunger rates increased 1.4 times compared with 2016-2018 (95%CI=1.02, 2.0, p=0.04). Despite financial and food insecurity during the pandemic, the mean adult body mass index was maintained unchanged from the 2019-2020 survey at 27 kg/m2 (standard deviation, SD=4.5 kg/m2), having increased (p=0.0001) from 26 kg/m2 (SD=4.1 kg/m2) in 2016-2018. Overweight/obesity was the most common risk factor for severe COVID-19, and adults were 3.1 times (95%CI=2.3-4.2, p<0.0001) more likely to be overweight/obese than they were to have a co-morbid illness. There was considerable dietary diversity and only 23% of participants had taken micronutrient supplements and 11% probiotics in the past year. Conclusion: Obesity was the most prevalent risk factor for severe COVID-19 despite economic pressure, food insecurity, and hunger during the pandemic.
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57
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Hansen BT, Labberton AS, Kour P, Kraft KB. Coverage of primary and booster vaccination against COVID-19 by socioeconomic level: A nationwide cross-sectional registry study. Hum Vaccin Immunother 2023; 19:2188857. [PMID: 36941785 PMCID: PMC10072069 DOI: 10.1080/21645515.2023.2188857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
High and equitable COVID-19 vaccination coverage is important for pandemic control and prevention of health inequity. However, little is known about socioeconomic correlates of booster vaccination coverage. In this cross-sectional study of all Norwegian adults in the national vaccination program (N = 4,190,655), we use individual-level registry data to examine coverage by levels of household income and education of primary (≥2 doses) and booster (≥3 doses) vaccination against COVID-19. We stratify the analyses by age groups with different booster recommendations and report relative risk ratios (RR) for vaccination by 25 August 2022. In the 18-44 y group, individuals with highest vs. lowest education had 94% vs. 79% primary coverage (adjusted RR (adjRR) 1.15, 95%CI 1.14-1.15) and 67% vs. 38% booster coverage (adjRR 1.55, 95% CI 1.55-1.56), while individuals with highest vs. lowest income had 94% vs. 81% primary coverage (adjRR 1.10, 95%CI 1.10-1.10) and 60% vs. 43% booster coverage (adjRR 1.23, 95%CI 1.22-1.24). In the ≥45 y group, individuals with highest vs. lowest education had 96% vs. 92% primary coverage (adjRR 1.02, 95%CI 1.02-1.02) and 88% vs. 80% booster coverage (adjRR 1.09, 95%CI 1.09-1.09), while individuals with highest vs. lowest income had 98% vs. 82% primary coverage (adjRR 1.16, 95%CI 1.16-1.16) and 92% vs. 64% booster coverage (adjRR 1.33, 95%CI 1.33-1.34). In conclusion, we document large socioeconomic inequalities in COVID-19 vaccination coverage, especially for booster vaccination, even though all vaccination was free-of-charge. The results highlight the need to tailor information and to target underserved groups for booster vaccination.
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Affiliation(s)
- Bo T Hansen
- Department of Infection Control and Vaccine, Norwegian Institute of Public Health, Oslo, Norway
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Angela S Labberton
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Prabhjot Kour
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway
| | - Kristian B Kraft
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
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Kjøllesdal M, Magnusson K. Occupational risk of COVID-19 by country of birth. A register-based study. J Public Health (Oxf) 2023; 45:6-12. [PMID: 34617101 PMCID: PMC8522378 DOI: 10.1093/pubmed/fdab362] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Occupational exposure has been suggested to contribute to a disproportionate burden of COVID-19 among immigrants. We aim to assess this hypothesis in Norway. METHODS In 2729 627 adults born in Norway, Somalia, Pakistan, Iraq, Afghanistan and Turkey, we examined whether persons employed as taxi drivers, bus and tram drivers, child care workers, nurses, personal care workers in health, food service counter attendants, waiters/bartenders, cleaners and shop sale persons had a higher risk of COVID-19, from 1 April 2020 to 2 December 2020, compared with (i) Norwegian-born in the same occupational group and (ii) all others with the same birth country and aged 20-70 years, using logistic regressions. RESULTS Within each occupational group, immigrants had a greatly increased odds of COVID-19 when compared with Norwegian-born (odds ratio [OR] ~ 1.66-12.72). However, immigrants working in the selected occupations had the same odds of COVID-19 as person with same birth country not having the same occupation (OR ~ 1). Exceptions were Somalian, Afghani and Iraqi personal care workers in health services who had an increased odds of COVID-19 compared with others from the same country. CONCLUSION Occupation is not an important driver of the high rates of COVID-19 among immigrants from Somalia, Pakistan, Iraq, Afghanistan and Turkey.
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Affiliation(s)
- Marte Kjøllesdal
- Norwegian Institute of Public Health, Health Services Research, 0213 Oslo, Norway.,Norwegian University of Lifesciences, Institute of Public Health Science, 1433 Ås, Norway
| | - Karin Magnusson
- Norwegian Institute of Public Health, Health Services Research, 0213 Oslo, Norway
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Kuhlmeier E, Chan T, Meli ML, Willi B, Wolfensberger A, Reitt K, Hüttl J, Jones S, Tyson G, Hosie MJ, Zablotski Y, Hofmann-Lehmann R. A Risk Factor Analysis of SARS-CoV-2 Infection in Animals in COVID-19-Affected Households. Viruses 2023; 15:731. [PMID: 36992440 PMCID: PMC10051903 DOI: 10.3390/v15030731] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 03/18/2023] Open
Abstract
A higher prevalence of SARS-CoV-2 infections in animals that have close contact with SARS-CoV-2-positive humans ("COVID-19 households") has been demonstrated in several countries. This prospective study aimed to determine the SARS-CoV-2 prevalence in animals from Swiss COVID-19 households and to assess the potential risk factors for infection. The study included 226 companion animals (172 cats, 76.1%; 49 dogs, 21.7%; and 5 other animals, 2.2%) from 122 COVID-19 households with 336 human household members (including 230 SARS-CoV-2-positive people). The animals were tested for viral RNA using an RT-qPCR and/or serologically for antibodies and neutralizing activity. Additionally, surface samples from animal fur and beds underwent an RT-qPCR. A questionnaire about hygiene, animal hygiene, and contact intensity was completed by the household members. A total of 49 of the 226 animals (21.7%) from 31 of the 122 households (25.4%) tested positive/questionably positive for SARS-CoV-2, including 37 of the 172 cats (21.5%) and 12 of the 49 dogs (24.5%). The surface samples tested positive significantly more often in households with SARS-CoV-2-positive animals than in households with SARS-CoV-2-negative animals (p = 0.011). Significantly more animals tested positive in the multivariable analysis for households with minors. For cats, a shorter length of outdoor access and a higher frequency of removing droppings from litterboxes were factors that were significantly associated with higher infection rates. The study emphasizes that the behavior of owners and the living conditions of animals can influence the likelihood of a SARS-CoV-2 infection in companion animals. Therefore, it is crucial to monitor the infection transmission and dynamics in animals, as well as to identify the possible risk factors for animals in infected households.
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Affiliation(s)
- Evelyn Kuhlmeier
- Clinical Laboratory, Vetsuisse Faculty, Department of Clinical Diagnostics and Services, and Center for Clinical Studies, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland; (T.C.); (M.L.M.); (R.H.-L.)
| | - Tatjana Chan
- Clinical Laboratory, Vetsuisse Faculty, Department of Clinical Diagnostics and Services, and Center for Clinical Studies, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland; (T.C.); (M.L.M.); (R.H.-L.)
| | - Marina L. Meli
- Clinical Laboratory, Vetsuisse Faculty, Department of Clinical Diagnostics and Services, and Center for Clinical Studies, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland; (T.C.); (M.L.M.); (R.H.-L.)
| | - Barbara Willi
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland;
| | - Aline Wolfensberger
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland;
| | - Katja Reitt
- Center for Laboratory Medicine, Veterinary Diagnostic Services, Frohbergstrasse 3, 9001 St. Gallen, Switzerland; (K.R.); (J.H.)
| | - Julia Hüttl
- Center for Laboratory Medicine, Veterinary Diagnostic Services, Frohbergstrasse 3, 9001 St. Gallen, Switzerland; (K.R.); (J.H.)
| | - Sarah Jones
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Bearsden Road, Glasgow G61 1QH, UK; (S.J.); (G.T.)
- MRC-University of Glasgow Centre for Virus, College of Medical, Veterinary and Life Sciences, University of Glasgow, Bearsden Road, Glasgow G61 1QH, UK
| | - Grace Tyson
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Bearsden Road, Glasgow G61 1QH, UK; (S.J.); (G.T.)
| | - Margaret J. Hosie
- MRC-University of Glasgow Centre for Virus, College of Medical, Veterinary and Life Sciences, University of Glasgow, Bearsden Road, Glasgow G61 1QH, UK
| | - Yury Zablotski
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, LMU Munich, 80539 Munich, Germany;
| | - Regina Hofmann-Lehmann
- Clinical Laboratory, Vetsuisse Faculty, Department of Clinical Diagnostics and Services, and Center for Clinical Studies, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland; (T.C.); (M.L.M.); (R.H.-L.)
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Javid FA, Waheed FA, Zainab N, Khan H, Amin I, Bham A, Ghoghawala M, Sheraz A, Haloub R. COVID-19 and diabetes in 2020: a systematic review. J Pharm Policy Pract 2023; 16:42. [PMID: 36895058 PMCID: PMC9998019 DOI: 10.1186/s40545-023-00546-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
Attempts were made to review the literature on diabetic patients who experience complications when they contract COVID-19, and to determine whether ethnicity and other risk factors play an important role in the development of symptoms and their severity, as well as responding to medications. A literature search was performed using five keywords, namely COVID-19, diabetes, ethnicity, medications, and risk factors between January 2019 and December 2020 using electronic databases such as PubMed, Science Direct, Google Scholar, Springer Link, and Scopus. Forty studies were included. The review indicated that diabetes was a significant risk factor for poorer outcomes and increased mortality associated with COVID-19. There were several risk factors for diabetic patients that increased their likelihood of poorer outcomes associated with COVID-19. These included black and Asian ethnicity, male sex with high BMI. In conclusion, patients with diabetes of black or Asian origin with high BMI, male sex, and older age had an increased risk of poorer outcomes associated with COVID-19. This highlights the importance of considering the history of the patient in prioritising care and treatment.
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Affiliation(s)
- Farideh A Javid
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK.
| | - Fadi Abdul Waheed
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Nisa Zainab
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Hamza Khan
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Ibrahim Amin
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Ammar Bham
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Mohammed Ghoghawala
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Aneem Sheraz
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Radi Haloub
- Biotech and Pharmaceutical Management, Global Business School for Health (GBSH), University College London (UCL), London, UK
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Ata B, Vermeulen N, Mocanu E, Gianaroli L, Lundin K, Rautakallio-Hokkanen S, Tapanainen JS, Veiga A. SARS-CoV-2, fertility and assisted reproduction. Hum Reprod Update 2023; 29:177-196. [PMID: 36374645 PMCID: PMC9976972 DOI: 10.1093/humupd/dmac037] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain. OBJECTIVE AND RATIONALE This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals. SEARCH METHODS PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on 'SARS-CoV-2' and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible. OUTCOMES From the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients' performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients. WIDER IMPLICATIONS This review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil.
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Affiliation(s)
- Baris Ata
- Obstetrics and Gynecology Department, Koc University, Istanbul, Turkey
- ART Fertility Clinics, Dubai, United Arab Emirates
| | | | - Edgar Mocanu
- Department of Reproductive Medicine, Rotunda Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Luca Gianaroli
- Società Italiana Studi di Medicina della Riproduzione, S.I.S.Me.R. Reproductive Medicine Institute, Bologna, Emilia-Romagna, Italy
| | - Kersti Lundin
- Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Juha S Tapanainen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics and Gynaecology, Oulu University Hospital and Medical Research Centre PEDEGO Research Unit, Oulu, Finland
| | - Anna Veiga
- Barcelona Stem Cell Bank, IDIBELL Programme for Regenerative Medicine, Barcelona, Spain
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Larsen T, Bosworth ML, Ayoubkhani D, Schofield R, Ali R, Khunti K, Walker AS, Glickman M, Harrison C, Nafilyan V. Inequalities in SARS-CoV-2 case rates by ethnicity, religion, measures of socioeconomic position, English proficiency, and self-reported disability: cohort study of 39 million people in England during the alpha and delta waves. BMJ MEDICINE 2023; 2:e000187. [PMID: 37063237 PMCID: PMC10568121 DOI: 10.1136/bmjmed-2022-000187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 01/18/2023] [Indexed: 04/05/2023]
Abstract
Objective To examine sociodemographic inequalities in people with SARS-CoV-2 during the second (alpha) and third (delta) waves of the covid-19 pandemic. Design Retrospective, population based cohort study. Setting Resident population of England. Participants 39 006 194 people aged 10 years and older who were enumerated in the 2011 census, registered with the NHS, and alive on 1 September 2020. Main outcome measures Age standardised SARS-CoV-2 case rates (ie, the number of people who received a positive test result per 100 000 person weeks at risk) during the second wave (1 September 2020 to 22 May 2021) or third wave (23 May to 10 December 2021) of the pandemic. Age standardised rates were calculated by sociodemographic characteristics and adjusted rate ratios were estimated using generalised linear regression models with a Poisson distribution (models were adjusted for covariates including sex, age, geographical variables, and sociodemographic characteristics). Results During the study period, 5 767 584 people (14.8% of the study population) tested positive for SARS-CoV-2. In the second wave, the fully adjusted relative risks of having a positive test were highest for the Bangladeshi and Pakistani ethnic groups compared with the white British group, with rate ratios of 1.75 (95% confidence interval 1.73 to 1.77) and 1.69 (1.68 to 1.70), respectively. Muslim and Sikh religious groups had fully adjusted rate ratios of 1.51 (1.50 to 1.51) and 1.64 (1.63 to 1.66), respectively, compared with the Christian group. Greater area deprivation, disadvantaged socioeconomic position, living in a care home, and low English language proficiency were also associated with higher relative risk of having a positive test. However, the inequalities among groups varied over time. Being Christian, white British, without a disability, and from a more advantaged socioeconomic position were associated with increased relative risk of testing positive during the third wave. Conclusion Research is urgently needed to understand the large sociodemographic inequalities in SARS-CoV-2 case rates in order to inform policy interventions in future waves or pandemics.
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Affiliation(s)
- Tim Larsen
- Office for National Statistics, Newport, UK
| | | | | | | | | | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Ann Sarah Walker
- Nuffield Department of Medicine, Univerity of Oxford, Oxford, UK
| | | | | | - Vahé Nafilyan
- Office for National Statistics, Newport, UK
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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Hall RN, Jones A, Crean E, Marriott V, Pingault N, Marmor A, Sloan-Gardner T, Kennedy K, Coleman K, Johnston V, Schwessinger B. Public health interventions successfully mitigated multiple incursions of SARS-CoV-2 Delta variant in the Australian Capital Territory. Epidemiol Infect 2023; 151:e30. [PMID: 36786292 PMCID: PMC10024954 DOI: 10.1017/s0950268823000201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/04/2023] [Accepted: 02/03/2023] [Indexed: 02/15/2023] Open
Abstract
The COVID-19 pandemic has presented a unique opportunity to understand how real-time pathogen genomics can be used for large-scale outbreak investigations. On 12 August 2021, the Australian Capital Territory (ACT) detected an incursion of the SARS-CoV-2 Delta (B.1.617.2) variant. Prior to this date, SARS-CoV-2 had been eliminated locally since 7 July 2020. Several public health interventions were rapidly implemented in response to the incursion, including a territory-wide lockdown and comprehensive contact tracing. The ACT has not previously used pathogen genomics at a population level in an outbreak response; therefore, this incursion also presented an opportunity to investigate the utility of genomic sequencing to support contact tracing efforts in the ACT. Sequencing of >75% of the 1793 laboratory-confirmed cases during the 3 months following the initial notification identified at least 13 independent incursions with onwards spread in the community. Stratification of cases by genomic cluster revealed that distinct cohorts were affected by the different incursions. Two incursions resulted in most of the community transmission during the study period, with persistent transmission in vulnerable sections of the community. Ultimately, both major incursions were successfully mitigated through public health interventions, including COVID-19 vaccines. The high rates of SARS-CoV-2 sequencing in the ACT and the relatively small population size facilitated detailed investigations of the patterns of virus transmission, revealing insights beyond those gathered from traditional contact tracing alone. Genomic sequencing was critical to disentangling complex transmission chains to target interventions appropriately.
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Affiliation(s)
- Robyn N Hall
- Research School of Biology, The Australian National University, Acton, Canberra, Australian Capital Territory, Australia
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
- CSIRO Health & Biosecurity, Acton, Canberra, Australian Capital Territory, Australia
| | - Ashley Jones
- Research School of Biology, The Australian National University, Acton, Canberra, Australian Capital Territory, Australia
| | - Emma Crean
- Research School of Biology, The Australian National University, Acton, Canberra, Australian Capital Territory, Australia
| | - Victoria Marriott
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
| | - Nevada Pingault
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
| | - Alexandra Marmor
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
| | - Timothy Sloan-Gardner
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
| | - Karina Kennedy
- Department of Clinical Microbiology and Infectious Diseases, Canberra Health Services, Australian National University Medical School, Canberra, Australian Capital Territory, Australia
| | - Kerryn Coleman
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
| | - Vanessa Johnston
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
| | - Benjamin Schwessinger
- Research School of Biology, The Australian National University, Acton, Canberra, Australian Capital Territory, Australia
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Sanchez T, Mavragani A, Gilcrease W, Macciotta A, Saugo C, Manfredi L, Gnavi R, Strippoli E, Zengarini N, Caramello V, Costa G, Sacerdote C, Ricceri F. Multimorbidity and SARS-CoV-2-Related Outcomes: Analysis of a Cohort of Italian Patients. JMIR Public Health Surveill 2023; 9:e41404. [PMID: 36626821 PMCID: PMC9951075 DOI: 10.2196/41404] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/24/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Since the outbreak of the COVID-19 pandemic, identifying the main risk factors has been imperative to properly manage the public health challenges that the pandemic exposes, such as organizing effective vaccination campaigns. In addition to gender and age, multimorbidity seems to be 1 of the predisposing factors coming out of many studies investigating the possible causes of increased susceptibility to SARS-CoV-2 infection and adverse outcomes. However, only a few studies conducted have used large samples. OBJECTIVE The objective is to evaluate the association between multimorbidity, the probability to be tested, susceptibility, and the severity of SARS-CoV-2 infection in the Piedmont population (Northern Italy, about 4 million inhabitants). For this purpose, we considered 5 main outcomes: access to the swab, positivity to SARS-CoV-2, hospitalization, intensive care unit (ICU) admission, and death within 30 days from the first positive swab. METHODS Data were obtained from different Piedmont health administrative databases. Subjects aged from 45 to 74 years and infections diagnosed from February to May 2020 were considered. Multimorbidity was defined both with the Charlson Comorbidity Index (CCI) and by identifying patients with previous comorbidities, such as diabetes and oncological, cardiovascular, and respiratory diseases. Multivariable logistic regression models (adjusted for age and month of infection and stratified by gender) were performed for each outcome. Analyses were also conducted by separating 2 age groups (45-59 and 60-74 years). RESULTS Of 1,918,549 subjects, 85,348 (4.4%) performed at least 1 swab, of whom 12,793 (14.9%) tested positive for SARS-CoV-2. Of these 12,793 subjects, 4644 (36.3%) were hospitalized, 1508 (11.8%) were admitted to the ICU, and 749 (5.9%) died within 30 days from the first positive swab. Individuals with a higher CCI had a higher probability of being swabbed but a lower probability of testing positive. We observed the same results when analyzing subjects with previous oncological and cardiovascular diseases. Moreover, especially in the youngest group, we identified a greater risk of being hospitalized and dying. Among comorbidities considered in the study, respiratory diseases seemed to be the most likely to increase the risk of having a positive swab and worse disease outcomes. CONCLUSIONS Our study shows that patients with multimorbidity, although swabbed more frequently, are less likely to get infected with SARS-CoV-2, probably due to greater attention on protective methods. Moreover, a history of respiratory diseases is a risk factor for a worse prognosis of COVID-19. Nonetheless, whatever comorbidities affect the patients, a strong dose-response effect was observed between an increased CCI score and COVID-19 hospitalization, ICU admission, and death. These results are important in terms of public health because they help in identifying a group of subjects who are more prone to worse SARS-CoV-2 outcomes. This information is important for promoting targeted prevention and developing policies for the prioritization of public health interventions.
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Affiliation(s)
| | | | - Winston Gilcrease
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy.,UNESCO Chair in Sustainable Development and Territory Management, University of Turin, Turin, Italy
| | - Alessandra Macciotta
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy
| | - Carlo Saugo
- Klinik für Innere Medizin - Gastroenterologie, Hepatologie & Infektiologie, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Luca Manfredi
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy
| | - Roberto Gnavi
- Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| | - Elena Strippoli
- Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| | - Nicolás Zengarini
- Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| | - Valeria Caramello
- Emergency Department and High Dependency Unit, San Luigi Gonzaga University Hospital, Orbassano (TO), Italy
| | - Giuseppe Costa
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy.,Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Fulvio Ricceri
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy.,Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco (TO), Italy
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Sandie AB, Tejiokem MC, Faye CM, Hamadou A, Abah AA, Mbah SS, Tagnouokam-Ngoupo PA, Njouom R, Eyangoh S, Abanda NK, Diarra M, Ben Miled S, Tchuente M, Tchatchueng-Mbougua JB, Tchatchueng-Mbougua JB. Observed versus estimated actual trend of COVID-19 case numbers in Cameroon: A data-driven modelling. Infect Dis Model 2023; 8:228-239. [PMID: 36776734 PMCID: PMC9905042 DOI: 10.1016/j.idm.2023.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/02/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
Controlling the COVID-19 outbreak remains a challenge for Cameroon, as it is for many other countries worldwide. The number of confirmed cases reported by health authorities in Cameroon is based on observational data, which is not nationally representative. The actual extent of the outbreak from the time when the first case was reported in the country to now remains unclear. This study aimed to estimate and model the actual trend in the number of COVID -19 new infections in Cameroon from March 05, 2020 to May 31, 2021 based on an observed disaggregated dataset. We used a large disaggregated dataset, and multilevel regression and poststratification model was applied prospectively for COVID-19 cases trend estimation in Cameroon from March 05, 2020 to May 31, 2021. Subsequently, seasonal autoregressive integrated moving average (SARIMA) modeling was used for forecasting purposes. Based on the prospective MRP modeling findings, a total of about 7450935 (30%) of COVID-19 cases was estimated from March 05, 2020 to May 31, 2021 in Cameroon. Generally, the reported number of COVID-19 infection cases in Cameroon during this period underestimated the estimated actual number by about 94 times. The forecasting indicated a succession of two waves of the outbreak in the next two years following May 31, 2021. If no action is taken, there could be many waves of the outbreak in the future. To avoid such situations which could be a threat to global health, public health authorities should effectively monitor compliance with preventive measures in the population and implement strategies to increase vaccination coverage in the population.
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Key Words
- ACF, Autocorrelation Function
- AIC, Akaike information criterion
- COVID-19
- COVID-19, Coronavirus Disease 2019
- Cameroon
- Forecasting
- MAE, Mean Absolute Error
- MAPE, Mean Absolute Percentage Error
- MASE, Mean Absolute Scaled Error
- ME, Mean Error
- MPE, Mean Percentage Error
- MRP, Multilevel Regression and Post-stratification
- Observed
- PACF, Partial Autocorrelation Function
- PLACARD, Platform for Collecting, Analyzing and Reporting Data
- Post-stratification
- SARIMA, Seasonal Autoregressive integrated moving average
- SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2
- Underestimated
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Affiliation(s)
- Arsène Brunelle Sandie
- African Population and Health Research Center, West Africa Regional Office, Dakar, Senegal,Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon,Corresponding author. African Population and Health Research Center, West Africa Regional Office, Dakar, Senegal.
| | | | - Cheikh Mbacké Faye
- African Population and Health Research Center, West Africa Regional Office, Dakar, Senegal
| | - Achta Hamadou
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon
| | - Aristide Abah Abah
- Direction de la lutte contre les Maladies épidémiques et les pandémies, Ministère de la santé publique, Cameroon
| | - Serge Sadeuh Mbah
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon
| | | | - Richard Njouom
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon
| | - Sara Eyangoh
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon
| | - Ngu Karl Abanda
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon
| | | | | | - Maurice Tchuente
- Fondation pour la recherche l'ingénierie et l'innovation, Cameroon,IRD UMI 209 UMMISCO, University of Yaounde I, P.O. Box 337, Yaounde, Cameroon
| | - Jules Brice Tchatchueng-Mbougua
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon,IRD UMI 209 UMMISCO, University of Yaounde I, P.O. Box 337, Yaounde, Cameroon
| | - Jules Brice Tchatchueng-Mbougua
- Centre Pasteur du Cameroon, membre du Réseau International des Instituts Pasteur, Cameroon,IRD UMI 209 UMMISCO, University of Yaounde I, P.O. Box 337, Yaounde, Cameroon
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Han J, Yin J, Wu X, Wang D, Li C. Environment and COVID-19 incidence: A critical review. J Environ Sci (China) 2023; 124:933-951. [PMID: 36182196 PMCID: PMC8858699 DOI: 10.1016/j.jes.2022.02.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/27/2022] [Accepted: 02/10/2022] [Indexed: 05/19/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented worldwide health crisis. Many previous research studies have found and investigated its links with one or some natural or human environmental factors. However, a review on the relationship between COVID-19 incidence and both the natural and human environment is still lacking. This review summarizes the inter-correlation between COVID-19 incidence and environmental factors. Based on keyword searching, we reviewed 100 relevant peer-reviewed articles and other research literature published since January 2020. This review is focused on three main findings. One, we found that individual environmental factors have impacts on COVID-19 incidence, but with spatial heterogeneity and uncertainty. Two, environmental factors exert interactive effects on COVID-19 incidence. In particular, the interactions of natural factors can affect COVID-19 transmission in micro- and macro- ways by impacting SARS-CoV-2 survival, as well as human mobility and behaviors. Three, the impact of COVID-19 incidence on the environment lies in the fact that COVID-19-induced lockdowns caused air quality improvement, wildlife shifts and socio-economic depression. The additional value of this review is that we recommend future research perspectives and adaptation strategies regarding the interactions of the environment and COVID-19. Future research should be extended to cover both the effects of the environment on the COVID-19 pandemic and COVID-19-induced impacts on the environment. Future adaptation strategies should focus on sustainable environmental and public policy responses.
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Affiliation(s)
- Jiatong Han
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing 100875, China
| | - Jie Yin
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing 100875, China
| | - Xiaoxu Wu
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing 100875, China.
| | - Danyang Wang
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing 100875, China
| | - Chenlu Li
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing 100875, China
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Africa RE, Westenhaver ZK, Zimmerer RE, McKinnon BJ. Evaluation of Disturbances in Hearing, Tinnitus, and Dizziness as Signs of COVID-19 Infection. Otol Neurotol 2023; 44:126-133. [PMID: 36537235 PMCID: PMC9835241 DOI: 10.1097/mao.0000000000003787] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND There have been reports and studies indicating audiovestibular disturbances in COVID-19 patients with variations in the percentage of sensorineural hearing loss (SNHL). The purpose of this study is to compare the incidence of newly diagnosed SNHL, sudden idiopathic hearing loss (SIHL), tinnitus, and vestibular disturbances between infected and uninfected patients, as well as to identify population groups at risk. METHODS This study used TriNetX to obtain statistics on COVID-19 (+) and COVID-19 (-) patients from 61 healthcare organizations. Propensity score with 1:1 matching was used to control confounding variables. This study evaluated the relative risk of developing audiovestibular disturbances up to 1 month after a COVID-19 test and further investigated the incidence in COVID-19 (+) subset groups. RESULTS Between COVID-19 (+) and COVID-19 (-) patients who had an audiogram, there was no statistically significant difference in SNHL or SIHL (SNHL: relative risk [RR] = 0.69, 95% confidence interval [CI] = 0.46-1.04; SIHL: RR = 1.00, 95% CI = 0.42-2.40). Race/ethnicity or specified comorbidity did not affect the incidence of SNHL or SIHL. There was a statistically significant difference in tinnitus and vestibular disturbances between the COVID-19 (+) and the COVID-19 (-) groups (RR = 1.29, 95% CI = 1.01-1.66; RR = 2.33, 95% CI = 2.19-2.48). CONCLUSION New onset hearing loss is not more common in patients with a positive COVID-19 test than those with a negative COVID-19 test. Audiologic evaluation is needed to verify reported hearing disturbances. Although statistically significant in specific population groups, tinnitus and vestibular disturbances may not be clinically significant due to the low incidence.
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Affiliation(s)
- Robert E. Africa
- School of Medicine
- Department of Otolaryngology–Head and Neck Surgery, University of Texas Medical Branch, Galveston, TX
| | | | | | - Brian J. McKinnon
- Department of Otolaryngology–Head and Neck Surgery, University of Texas Medical Branch, Galveston, TX
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Duarte I, Ribeiro MC, Pereira MJ, Leite PP, Peralta-Santos A, Azevedo L. Spatiotemporal evolution of COVID-19 in Portugal's Mainland with self-organizing maps. Int J Health Geogr 2023; 22:4. [PMID: 36710328 PMCID: PMC9884330 DOI: 10.1186/s12942-022-00322-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/23/2022] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Self-Organizing Maps (SOM) are an unsupervised learning clustering and dimensionality reduction algorithm capable of mapping an initial complex high-dimensional data set into a low-dimensional domain, such as a two-dimensional grid of neurons. In the reduced space, the original complex patterns and their interactions can be better visualized, interpreted and understood. METHODS We use SOM to simultaneously couple the spatial and temporal domains of the COVID-19 evolution in the 278 municipalities of mainland Portugal during the first year of the pandemic. Temporal 14-days cumulative incidence time series along with socio-economic and demographic indicators per municipality were analyzed with SOM to identify regions of the country with similar behavior and infer the possible common origins of the incidence evolution. RESULTS The results show how neighbor municipalities tend to share a similar behavior of the disease, revealing the strong spatiotemporal relationship of the COVID-19 spreading beyond the administrative borders of each municipality. Additionally, we demonstrate how local socio-economic and demographic characteristics evolved as determinants of COVID-19 transmission, during the 1st wave school density per municipality was more relevant, where during 2nd wave jobs in the secondary sector and the deprivation score were more relevant. CONCLUSIONS The results show that SOM can be an effective tool to analysing the spatiotemporal behavior of COVID-19 and synthetize the history of the disease in mainland Portugal during the period in analysis. While SOM have been applied to diverse scientific fields, the application of SOM to study the spatiotemporal evolution of COVID-19 is still limited. This work illustrates how SOM can be used to describe the spatiotemporal behavior of epidemic events. While the example shown herein uses 14-days cumulative incidence curves, the same analysis can be performed using other relevant data such as mortality data, vaccination rates or even infection rates of other disease of infectious nature.
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Affiliation(s)
- Igor Duarte
- Formely: Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisbon, Portugal
| | - Manuel C. Ribeiro
- CERENA/DER, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisbon, Portugal
| | - Maria João Pereira
- CERENA/DER, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisbon, Portugal
| | - Pedro Pinto Leite
- Direção de Serviços de Informação e Análise, Direção-Geral da Saúde, Lisbon, Portugal
| | - André Peralta-Santos
- Direção de Serviços de Informação e Análise, Direção-Geral da Saúde, Lisbon, Portugal
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Leonardo Azevedo
- CERENA/DER, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisbon, Portugal
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Galanti MR, Andersson F, Caspersen IH, Peña S, Karvonen S, Magnus P, Raffetti E, Orsini N, Magnusson C, Shaaban AN, Hergens MP, Skott P. Current tobacco use and COVID-19 diagnoses in a cohort of adult clients of public dental clinics in Sweden. Sci Rep 2023; 13:1204. [PMID: 36681700 PMCID: PMC9862224 DOI: 10.1038/s41598-023-28091-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/12/2023] [Indexed: 01/22/2023] Open
Abstract
Smoking has been linked with both increased and decreased risk of COVID-19, prompting the hypothesis of a protective role of nicotine in the pathogenesis of the disease. Studies of the association between use of smokeless tobacco and COVID-19 would help refining this hypothesis. We analysed data from 424,386 residents in the Stockholm Region, Sweden, with information on smoking and smokeless tobacco (snus) use prior to the pandemic obtained from dental records. Diagnoses of COVID-19 between February and October 2020 were obtained from health-care registers. We estimated the risk of receiving a diagnosis of COVID-19 for current smokers and for current snus users relative to non-users of tobacco, adjusting for potential confounders (aRR). The aRR of COVID -19 was elevated for current snus users (1.09 ;95%CI = 0.99-1.21 among men and 1.15; 95%CI = 1.00-1.33 among women). The risk for women consuming more than 1 can/day was twice as high as among non-users of tobacco. Current smoking was negatively associated with risk of COVID-19 (aRR = 0.68; 95% CI = 0.61-0.75); including hospital admission (aRR = 0.60; 95% CI = 0.47-0.76) and intensive care (aRR = 0.43; 95% CI = 0.21-0.89). The hypothesis of a protective effect of tobacco nicotine on COVID-19 was not supported by the findings. The negative association between smoking and COVID-19 remains unexplained.
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Affiliation(s)
- M R Galanti
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden.
- Centre for Epidemiology and Community Medicine, Stockholm Region, (CES), Solnavägen 1E (Torsplan), 113 65, Stockholm, Sweden.
| | - F Andersson
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Region, (CES), Solnavägen 1E (Torsplan), 113 65, Stockholm, Sweden
| | - I H Caspersen
- Centre for Fertility and Health, Norwegian Institute of Public Health, Skøyen, Postbox 222, 0213, Oslo, Norway
| | - S Peña
- Finnish Institute for Health and Welfare, Postbox 30, 00271, Helsinki, Finland
| | - S Karvonen
- Finnish Institute for Health and Welfare, Postbox 30, 00271, Helsinki, Finland
| | - P Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Skøyen, Postbox 222, 0213, Oslo, Norway
| | - E Raffetti
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - N Orsini
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Region, (CES), Solnavägen 1E (Torsplan), 113 65, Stockholm, Sweden
| | - C Magnusson
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Region, (CES), Solnavägen 1E (Torsplan), 113 65, Stockholm, Sweden
| | - A N Shaaban
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - M P Hergens
- Unit for Communicable Disease Control, Postbox 6909, 102 39, Stockholm Region, Sweden
| | - P Skott
- Department of Orofacial Medicine, Folktandvården Stockholm, Postbox 6420, 113 82, Stockholm, Sweden
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Massó M, Granés L, Cayuelas L, Gené-Badia J, Sequeira E, Catalán M. Predictive factors for hospitalization in a cohort of primary healthcare patients with suspected COVID-19. ATENCIÓN PRIMARIA PRÁCTICA 2023. [PMCID: PMC9841078 DOI: 10.1016/j.appr.2023.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Kunz JS, Propper C. JUE Insight: Is hospital quality predictive of pandemic deaths? Evidence from US counties. JOURNAL OF URBAN ECONOMICS 2023; 133:103472. [PMID: 35765665 PMCID: PMC9221951 DOI: 10.1016/j.jue.2022.103472] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 05/30/2022] [Indexed: 06/15/2023]
Abstract
In the large literature on the spatial-level correlates of COVID-19, the association between quality of hospital care and outcomes has received little attention to date. To examine whether county-level mortality is correlated with measures of hospital performance, we assess daily cumulative deaths and pre-crisis measures of hospital quality, accounting for state fixed-effects and potential confounders. As a measure of quality, we use the pre-pandemic adjusted five-year penalty rates for excess 30-day readmissions following pneumonia admissions for the hospitals accessible to county residents based on ambulance travel patterns. Our adjustment corrects for socio-economic status and down-weighs observations based on small samples. We find that a one-standard-deviation increase in the quality of local hospitals is associated with a 2% lower death rate (relative to the mean of 20 deaths per 10,000 people) one and a half years after the first recorded death.
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Affiliation(s)
- Johannes S Kunz
- Monash University, Monash Business School, 900 Dandenong Road, 3145 Caulfield East, Vic, Australia
| | - Carol Propper
- Imperial College London, Department of Economics and Public Policy, South Kensington Campus, SW1A 2AZ United Kingdom
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Morisod K, Grazioli VS, Schlüter V, Bochud M, Gonseth Nusslé S, D'Acremont V, Bühler N, Bodenmann P. Prevalence of SARS-CoV-2 infection and associated risk factors among asylum seekers living in asylum centres: A cross-sectional serologic study in Canton of Vaud, Switzerland. J Migr Health 2023; 7:100175. [PMID: 36938329 PMCID: PMC10005972 DOI: 10.1016/j.jmh.2023.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 02/05/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023] Open
Abstract
Background Understanding the factors influencing SARS-CoV-2 transmission in asylum seekers and refugees living in centres is crucial to determine targeted public health policies protecting these populations fairly and efficiently. In response, this study was designed to explore the pandemic's spread into asylum centres during the first wave of the pandemic in Switzerland. Specifically, it aimed to identify the risk factors associated with a positive anti-SARS-CoV-2 seroprevalence test after the first semi-confinement period (16 March to 27 April 2020) amongst asylum seekers and refugees living in centres. Methods This research is part of SérocoVID, a seroepidemiologic study of SARS-CoV-2 infection conducted in the canton of Vaud, Switzerland. Migrants living in two asylum centres, one known to have had an epidemic outbreak, were invited to participate in this study. Anti-SARS-CoV-2 IgG and IgA antibodies targeting the spike viral protein were measured in all participants using a Luminex immunoassay. Each participant also completed a questionnaire measuring socio-demographic characteristics, medical history (comorbidities, smoking status, BMI, flu-like symptoms), health literacy, public health recommendations (wearing a masque in a public area, social distancing and hands cleaning), behaviours and exposures (daily life activities, number of contacts weekly). The association of these independent variables with the serologic test result were estimated using a multivariable logistic regression model. Findings A total of 124 participants from the two asylum centres took part in the study (Centre 1, n = 82; Centre 2, n = 42). The mean participation rate was 36.7%. The seroprevalence in Centres 1 and 2 were 13% [95% CI 0.03, 0.14] and 50% [0.34, 0.65], respectively. Next, 40.63% of SARS-CoV-2 positive people never developed symptoms (asymptomatic cases), and no one had severe forms of the Covid-19 disease requiring hospitalisation. Participants report high compliance with public health measures, especially hygiene rules (96.3% of positive answers) and social distancing (88.7%). However, only 11.3% said they always wore a masque in public. After adjusting for individual characteristics, infection risk was lower amongst people with high health literacy (aOR 0.16, p = 0.007 [0.04, 0.60]) and smokers (aOR 0.20, p = 0.013 [0.06, 0.69]). Conclusion Despite the lack of severe complications of Covid-19 disease in this study, findings suggest that developing targeted public health measures, especially for the low health literacy population, would be necessary to limit the risk of outbreaks in asylum centres and improve this population's safety. Further investigations and qualitative approach are required to understand more finely how living conditions, risks and behaviours such as tobacco consumption, and the adoption of protective measures impact SARS-CoV-2 infection.
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Affiliation(s)
- Kevin Morisod
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Rue du Bugnon 44, Lausanne, Vaud 1011, Switzerland
- Chair of Medicine for Vulnerable Populations, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
- Corresponding author at: Chemin de Chantemerle 10, 1010 Lausanne, Vaud, Switzerland.
| | - Véronique S. Grazioli
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Rue du Bugnon 44, Lausanne, Vaud 1011, Switzerland
- Chair of Medicine for Vulnerable Populations, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
| | - Virginie Schlüter
- Department of Training, Research and Innovation, Center for Primary Care and Public Health (Unisanté), Route de Berne 113, Lausanne, Vaud 1010 Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
| | - Murielle Bochud
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
- Department of Epidemiology and Health systems, Center for Primary Care and Public Health (Unisanté), Route de la Corniche 10, Lausanne, Vaud 1010, Switzerland
| | - Semira Gonseth Nusslé
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
- Department of Epidemiology and Health systems, Center for Primary Care and Public Health (Unisanté), Route de la Corniche 10, Lausanne, Vaud 1010, Switzerland
| | - Valérie D'Acremont
- Department of Training, Research and Innovation, Center for Primary Care and Public Health (Unisanté), Route de Berne 113, Lausanne, Vaud 1010 Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
| | - Nolwenn Bühler
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Rue du Bugnon 44, Lausanne, Vaud 1011, Switzerland
| | - Patrick Bodenmann
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Rue du Bugnon 44, Lausanne, Vaud 1011, Switzerland
- Chair of Medicine for Vulnerable Populations, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
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COVID-19: Reducing the risk via diet and lifestyle. JOURNAL OF INTEGRATIVE MEDICINE 2023; 21:1-16. [PMID: 36333177 PMCID: PMC9550279 DOI: 10.1016/j.joim.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/15/2022] [Indexed: 01/17/2023]
Abstract
This review shows that relatively simple changes to diet and lifestyle can significantly, and rapidly, reduce the risks associated with coronavirus disease 2019 (COVID-19) in terms of infection risk, severity of disease, and even disease-related mortality. A wide range of interventions including regular exercise, adequate sleep, plant-based diets, maintenance of healthy weight, dietary supplementation, and time in nature have each been shown to have beneficial effects for supporting more positive health outcomes with COVID-19, in addition to promoting better overall health. This paper brings together literature from these areas and presents the argument that non-pharmaceutical approaches should not be overlooked in our response to COVID-19. It is noted that, in several cases, interventions discussed result in risk reductions equivalent to, or even greater than, those associated with currently available vaccines. Where the balance of evidence suggests benefits, and the risk is minimal to none, it is suggested that communicating the power of individual actions to the public becomes morally imperative. Further, many lives could be saved, and many harms from the vaccine mandates avoided, if we were willing to embrace this lifestyle-centred approach in our efforts to deal with COVID-19.
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Karim A, Muhammad T, Iqbal MS, Qaisar R. Elevated plasma CAF22 are incompletely restored six months after COVID-19 infection in older men. Exp Gerontol 2023; 171:112034. [PMID: 36423404 PMCID: PMC9677556 DOI: 10.1016/j.exger.2022.112034] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The long-term complications of COVID-19 appear as significant health problems. However, the long-term muscle decline in these patients is poorly characterized. METHODS We investigated the age-related muscle decline, termed sarcopenia, before and following the COVID-19 infection in older male patients (n = 87). We evaluated handgrip strength (HGS) and functional capacity (short physical performance battery; SPPB) in COVID-19 patients 7-42 days before and one week and 6-month after COVID-19 infection. We used ELISA tests to measure plasma c-terminal agrin fragment-22 (CAF22), c-reactive protein (CRP), and 8-isoprostanes as markers of degraded neuromuscular junctions, inflammation, and oxidative stress, respectively. RESULTS Before the COVID-19 infection, 54 patients were non-sarcopenic, and 25 patients were sarcopenic, while eight patients subsequently developed sarcopenia. All patients exhibited reduced HGS and SPPB, while elevated CAF22, CRP, and 8-isoprostane levels one week post-COVID-19 infection (all p < 0.05). At six months post-COVID-19 infection, the HGS, SPPB, CAF22, CRP, and 8-isoprostanes were partly restored to baseline levels (all p < 0.05). Correlation analysis revealed that the plasma CAF22 had a significant correlation with HGS, SPPB, and COVID-19 disease severity. CAF22 also demonstrated significant areas under the curves in diagnosing sarcopenia at all three time-points. CONCLUSION Altogether, the muscle detriment due to COVID-19 persists six months post-infection, and plasma CAF22 may be helpful to detect muscle and functional decline in these patients. Timely evaluation and intervention of sarcopenia may be critical in COVID-19 treatment.
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Affiliation(s)
- Asima Karim
- Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Tahir Muhammad
- Department of Biochemistry, Gomal Medical College, Gomal University, Dera Ismail Khan 30130, Pakistan
| | - M Shahid Iqbal
- Department of Neurology and Stroke Medicine, Rehman Medical Institute, Peshawar 25124, Pakistan
| | - Rizwan Qaisar
- Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
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Xie D, Choi HK, Dalbeth N, Wallace ZS, Sparks JA, Lu N, Zeng C, Li X, Wei J, Lei G, Zhang Y. Gout and Excess Risk of Severe SARS-CoV-2 Infection Among Vaccinated Individuals: A General Population Study. Arthritis Rheumatol 2023; 75:122-132. [PMID: 36082457 PMCID: PMC9537980 DOI: 10.1002/art.42339] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/19/2022] [Accepted: 08/30/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Gout patients often have multiple comorbidities, making them susceptible to SARS-CoV-2 infection and poor outcomes. This study was undertaken to examine the association between gout and the risk of SARS-CoV-2 infection and severe outcomes, especially in patients who have received a SARS-CoV-2 vaccine. METHODS We conducted 2 cohort studies using The Health Improvement Network in the UK. Individuals with gout and those without gout from the general population were followed up from December 8, 2020 to October 31, 2021. We estimated the rate difference (RD) and hazard ratio (HR) of SARS-CoV-2 infection and severe outcomes (i.e., hospitalization and death within 30 days after SARS-CoV-2 infection) for individuals with gout versus those without gout using a Cox proportional hazards model according to SARS-CoV-2 vaccination status. We adjusted for potential confounders by using overlap weighting of exposure scores. RESULTS Among the vaccinated cohort, 1,955 cases of breakthrough COVID-19 infection occurred in 54,576 individuals with gout (4.68 cases per 1,000 person-months), and 52,468 cases occurred in 1,336,377 individuals without gout (3.76 cases per 1,000 person-months). The partially adjusted RD of breakthrough infection was 0.91 cases per 1,000 person-months (95% confidence interval [95% CI] 0.62-1.20 cases per 1,000 person-months), and the partially adjusted HR was 1.24 (95% CI 1.19-1.30). Gout was also associated with an increased risk of hospitalization (adjusted HR 1.30 [95% CI 1.10-1.53]) and death (adjusted HR 1.36 [95% CI 0.87-2.13]). Women with gout had an increased risk of hospitalization (adjusted HR 1.55 [95% CI 1.15-2.10]) and death (adjusted HR 2.46 [95% CI 1.12-5.41]). Similar associations with gout were observed in the unvaccinated cohort. CONCLUSION These general population data suggest that individuals with gout, especially women, have higher risks of SARS-CoV-2 infection and severe outcomes, even when vaccinated.
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Affiliation(s)
- Dongxing Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Hyon K. Choi
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA
- The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, USA
- Harvard Medical School, Boston, USA
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Zachary S. Wallace
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA
- The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, USA
- Harvard Medical School, Boston, USA
| | - Jeffrey A. Sparks
- Harvard Medical School, Boston, USA
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, USA
| | - Na Lu
- Arthritis Research Canada, Richmond, Canada
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoxiao Li
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
| | - Jie Wei
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Guanghua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yuqing Zhang
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA
- The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, USA
- Harvard Medical School, Boston, USA
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Body Mass Index and Clinical Outcomes in Adult COVID-19 Patients of Diverse Ethnicities. Healthcare (Basel) 2022; 10:healthcare10122575. [PMID: 36554099 PMCID: PMC9778867 DOI: 10.3390/healthcare10122575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/04/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
(1) Background: Body mass index (BMI) was observed to affect COVID-19 outcomes; however, the complete spectrum of clinical outcomes concerning BMI remains unexplored. The current study aimed to investigate the correlation between BMI and the severity and mortality of COVID-19, as well as ICU admission, radiological findings, clinical presentation, and time to viral clearance. (2) Methods: This retrospective study included 1796 multiethnic patients with COVID-19 treated at NMC Royal Hospital, Abu Dhabi, UAE. (3) Results: COVID-19’s adjusted odds of severity increased by 3.7- and 21.5-fold in classes I and III, respectively (p = 0.001). The odds of mortality were not significantly different after adjustment for age, sex, and race. The adjusted odds of ICU admission increased significantly by 3-fold and non-significantly by 4-fold in obesity classes I and II, respectively. Pneumonia was significantly higher in patients who were overweight and class I, II, and III obese. Furthermore, class III obese patients had a greater risk of presenting with combined respiratory and gastrointestinal manifestations (p < 0.001). The median time to viral clearance with a BMI > 40 kg/m2 was moderately higher than that with a BMI < 40 kg/m2. (4) Conclusions: High BMI was associated with pneumonia, ICU admission, severity, and mortality due to COVID-19.
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Morisod K, Durand MA, Selby K, Le Pogam MA, Grazioli VS, Sanchis Zozaya J, Bodenmann P, von Plessen C. Asylum Seekers' Responses to Government COVID-19 Recommendations: A Cross-sectional Survey in a Swiss Canton. J Immigr Minor Health 2022; 25:570-579. [PMID: 36508030 PMCID: PMC9743178 DOI: 10.1007/s10903-022-01436-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 12/14/2022]
Abstract
Asylum seekers face multiple language, cultural and administrative barriers that could result in the inappropriate implementation of COVID-19 measures. This study aimed to explore their knowledge and attitudes to recommendations about COVID-19. We conducted a cross-sectional survey among asylum seekers living in the canton of Vaud, Switzerland. We used logistic regressions to analyze associations between knowledge about health recommendations, the experience of the pandemic and belief to rumors, and participant sociodemographic characteristics. In total, 242 people participated in the survey, with 63% of men (n = 150) and a median age of 30 years old (IQR 23-40). Low knowledge was associated with linguistic barriers (aOR 0.36, 95% CI 0.14-0.94, p = 0.028) and living in a community center (aOR 0.43, 95% CI 0.22-0.85, p = 0.014). Rejected asylum seekers were more likely to believe COVID-19 rumors (aOR 2.81, 95% CI 1.24-6.36, p = 0.013). This survey underlines the importance of tailoring health recommendations and interventions to reach asylum seekers, particularly those living in community centers or facing language barriers.
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Affiliation(s)
- Kevin Morisod
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Marie-Anne Durand
- grid.15781.3a0000 0001 0723 035XCERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France ,Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Kevin Selby
- Department Training, Research and Innovation, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Marie-Annick Le Pogam
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Véronique S. Grazioli
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Javier Sanchis Zozaya
- grid.8515.90000 0001 0423 4662Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Patrick Bodenmann
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Christian von Plessen
- Department of Ambulatory Care, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland ,Direction Générale de La Santé (DGS), Lausanne, Switzerland ,grid.10825.3e0000 0001 0728 0170Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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78
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Abu Fanne R, Lidawi G, Maraga E, Moed M, Roguin A, Meisel SR. Correlation between Baseline 25(OH) Vitamin D Levels and Both Humoral Immunity and Breakthrough Infection Post-COVID-19 Vaccination. Vaccines (Basel) 2022; 10:vaccines10122116. [PMID: 36560526 PMCID: PMC9784151 DOI: 10.3390/vaccines10122116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Objective: Vaccines against COVID-19 induce specific antibodies whose titer is perceived as a reliable correlate of protection. Vitamin D confers complex regulatory effects on the innate and adaptive immunity. In this study, we explored a plausible impact of baseline vitamin D content on achieved immunity following COVID-19 vaccination. Methods: A retrospective observational study comprising 73,254 naïve subjects insured by the Leumit Health Service HMO, who were vaccinated between 1 February 2020 and 30 January 2022, with one available vitamin D level prior to vaccination, was performed. The association between 25(OH) vitamin D levels, SARS-CoV-2 antibody titer, and post-vaccination PCR results were evaluated. Results: Of the study population, 5026 (6.9%) tested positive for COVID-19. The proportion of low 25(OH)D levels (<30 ng/mL) was significantly higher in the PCR-positive group (81.5% vs. 79%, p < 0.001). Multivariate analysis showed a higher incidence of breakthrough infection among non-smokers [1.37 (95% CI 1.22−1.54, p < 0.001)] and lower incidences among subjects with sufficient 25(OH)D levels (>30 ng/mL) [0.87 (95% CI 0.79−0.95, p—0.004)], hyperlipidemia [0.84 (95% CI 0.76−0.93, p < 0.001], depression [OR-0.87 (95% CI: 0.79−0.96, p < 0.005], socio-economic status >10 [0.67 (95% CI 0.61−0.73, p < 0.001)], and age >44 years. SARS-CoV-2 antibody titers were available in 3659 vaccinated individuals. The prevalence of antibody titers (<50 AU) among PCR-positive subjects was 42% compared to 28% among PCR-negative subjects (p < 0.001). Baseline 25(OH)D levels showed an inverse relation to total antibody titers. However, no association was found with an antibody titer <50 AU/mL fraction. Conclusion Baseline 25(OH)D levels correlated with the vaccination-associated protective COVID-19 immunity. Antibody titers <50 AU/mL were significantly linked to breakthrough infection but did not correlate with 25(OH)D levels.
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Affiliation(s)
- Rami Abu Fanne
- Leumit Health Services, Tel Aviv 6473817, Israel
- Heart Institute, Hillel Yaffe Medical Center, Hadera 3810101, Israel
- Correspondence:
| | - Ghalib Lidawi
- Urology Department, Hillel Yaffe Medical Center, Hadera 3810101, Israel
| | - Emad Maraga
- Clinical Biochemistry Department, Hadassah Medical Center, Jerusalem 9103102, Israel
| | - Mahmud Moed
- Leumit Health Services, Tel Aviv 6473817, Israel
| | - Ariel Roguin
- Heart Institute, Hillel Yaffe Medical Center, Hadera 3810101, Israel
| | - Simcha-Ron Meisel
- Heart Institute, Hillel Yaffe Medical Center, Hadera 3810101, Israel
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Rosenwasser Y, Berger I, Loewy ZG. Therapeutic Approaches for Chronic Obstructive Pulmonary Disease (COPD) Exacerbations. Pathogens 2022; 11:1513. [PMID: 36558847 PMCID: PMC9784349 DOI: 10.3390/pathogens11121513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/08/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a progressive pulmonary disorder underpinned by poorly reversible airflow resulting from chronic bronchitis or emphysema. The prevalence and mortality of COPD continue to increase. Pharmacotherapy for patients with COPD has included antibiotics, bronchodilators, and anti-inflammatory corticosteroids (but with little success). Oral diseases have long been established as clinical risk factors for developing respiratory diseases. The establishment of a very similar microbiome in the mouth and the lung confirms the oral-lung connection. The aspiration of pathogenic microbes from the oral cavity has been implicated in several respiratory diseases, including pneumonia and chronic obstructive pulmonary disease (COPD). This review focuses on current and future pharmacotherapeutic approaches for COPD exacerbation including antimicrobials, mucoregulators, the use of bronchodilators and anti-inflammatory drugs, modifying epigenetic marks, and modulating dysbiosis of the microbiome.
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Affiliation(s)
- Yehudis Rosenwasser
- College of Pharmacy, Touro University, 230 West 125th Street, New York, NY 10027, USA
| | - Irene Berger
- College of Pharmacy, Touro University, 230 West 125th Street, New York, NY 10027, USA
| | - Zvi G. Loewy
- College of Pharmacy, Touro University, 230 West 125th Street, New York, NY 10027, USA
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA
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80
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Shan S, Zhao F, Sun M, Li Y, Yang Y. Suit the Remedy to the Case-The Effectiveness of COVID-19 Nonpharmaceutical Prevention and Control Policies Based on Individual Going-Out Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16222. [PMID: 36498294 PMCID: PMC9739683 DOI: 10.3390/ijerph192316222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Nonpharmaceutical policies for epidemic prevention and control have been extensively used since the outbreak of COVID-19. Policies ultimately work by limiting individual behavior. The aim of this paper is to evaluate the effectiveness of policies by combining macro nonpharmaceutical policies with micro-individual going-out behavior. For different going out scenarios triggered by individual physiological safety needs, friendship needs, and family needs, this paper categorizes policies with significant differences in intensity, parameterizes the key contents of the policies, and simulates and analyzes the effectiveness of the policies in different going-out scenarios with simulation methods. The empirical results show that enhancing policy intensity can effectively improve policy effectiveness. Among different types of policies, restricting the times of going out is more effective. Further, the effect of controlling going out based on physiological safety needs is better than other needs. We also evaluate the policy effectiveness of 26 global countries or regions. The results show that the policy effectiveness varies among 26 countries or regions. The quantifiable reference provided by this study facilitates decision makers to establish policy and practices for epidemic prevention and control.
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Affiliation(s)
- Siqing Shan
- School of Economics and Management, Beihang University, Beijing 100191, China
- Beijing Key Laboratory of Emergency Support Simulation Technologies for City Operation, Beijing 100191, China
| | - Feng Zhao
- School of Economics and Management, Beihang University, Beijing 100191, China
- Beijing Key Laboratory of Emergency Support Simulation Technologies for City Operation, Beijing 100191, China
| | - Menghan Sun
- School of Economics and Management, Beihang University, Beijing 100191, China
- Beijing Key Laboratory of Emergency Support Simulation Technologies for City Operation, Beijing 100191, China
| | - Yinong Li
- School of Economics and Management, Beihang University, Beijing 100191, China
- Beijing Key Laboratory of Emergency Support Simulation Technologies for City Operation, Beijing 100191, China
| | - Yangzi Yang
- School of Economics and Management, Beihang University, Beijing 100191, China
- Beijing Key Laboratory of Emergency Support Simulation Technologies for City Operation, Beijing 100191, China
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Luu MN, Alhady STM, Nguyen Tran MD, Truong LV, Qarawi A, Venkatesh U, Tiwari R, Rocha ICN, Minh LHN, Ravikulan R, Dumre SP, Giang HTN, Pavlenko D, Ali FY, Le BTD, Karimzadeh S, Bhandari P, Shah J, Abdul Aziz JM, Huy NT. Evaluation of risk factors associated with SARS-CoV-2 transmission. Curr Med Res Opin 2022; 38:2021-2028. [PMID: 36106710 DOI: 10.1080/03007995.2022.2125258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) has caused high morbidity and mortality worldwide. Since there is not enough evidence of risk factors of SARS-CoV-2 transmission, this study aimed to evaluate them. METHODS This survey-based study was conducted across 66 countries from May to November 2020 among suspected and confirmed individuals with COVID-19. The stepwise AIC method was utilized to determine the optimal multivariable logistic regression to explore predictive factors of SARS-CoV-2 transmission. RESULTS Among 2372 respondents who participated in the study, there were 1172 valid responses. The profession of non-healthcare-worker (OR: 1.77, 95%CI: 1.04-3.00, p = .032), history of SARS-CoV or MERS-CoV infection (OR: 4.78, 95%CI: 2.34-9.63, p < .001), higher frequency of contact with colleagues (OR: 1.17, 95%CI: 1.01-1.37, p = .041), and habit of hugging when greeting (OR: 1.25, 95%CI: 1.00-1.56, p = .049) were associated with an increased risk of contracting COVID-19. Current smokers had a lower likelihood of having COVID-19 compared to former smokers (OR: 5.41, 95%CI: 1.93-17.49, p = .002) or non-smokers (OR: 3.69, 95%CI: 1.48-11.11, p = .01). CONCLUSIONS Our study suggests several risk factors for SARS-CoV-2 transmission including the profession of non-healthcare workers, history of other coronavirus infections, frequent close contact with colleagues, the habit of hugging when greeting, and smoking status.
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Affiliation(s)
- Mai Ngoc Luu
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Minh Duc Nguyen Tran
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Le Van Truong
- Ministry of the Public Security, Traditional Medicine Hospital, Hanoi, Vietnam
| | | | - U Venkatesh
- Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Ranjit Tiwari
- B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | | | - Le Huu Nhat Minh
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
- Global Clinical Scholars Research Training Program, Harvard Medical School, Boston, MA, USA
| | | | | | | | - Dmytro Pavlenko
- Department of Ophthalmology, Bogomolets National Medical University, Kyiv, Ukraine
| | | | - Bao-Tran Do Le
- Faculty of Chemistry and Biochemistry, University of California, Los Angeles, CA, USA
| | - Sedighe Karimzadeh
- Department of Neurology, University Hospital Cologne, Cologne, Germany
- Online Research Club, Nagasaki University, Nagasaki, Japan
| | - Parshal Bhandari
- Department of Anesthesia and Intensive Care, PGMI/Lahore General Hospital, Lahore, Pakistan
| | - Jaffer Shah
- New York State Department of Health, New York, NY, USA
| | - Jeza Muhamad Abdul Aziz
- Baxshin research center, Baxshin Hospital, Sulaymaniyah, Kurdistan Region, Iraq
- Medical Laboratory Science, College of Health Sciences, University of Human Development, Sulaymaniyah, Kurdistan Region, Iraq
| | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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Hollinghurst J, North L, Szakmany T, Pugh R, Davies GA, Sivakumaran S, Jarvis R, Rolles M, Pickrell WO, Akbari A, Davies G, Griffiths R, Lyons J, Torabi F, Fry R, Gravenor MB, Lyons RA. SARS-CoV-2 infection risk among 77,587 healthcare workers: a national observational longitudinal cohort study in Wales, United Kingdom, April to November 2020. J R Soc Med 2022; 115:467-478. [PMID: 35796183 PMCID: PMC9747896 DOI: 10.1177/01410768221107119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/29/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To better understand the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among healthcare workers, leading to recommendations for the prioritisation of personal protective equipment, testing, training and vaccination. DESIGN Observational, longitudinal, national cohort study. SETTING Our cohort were secondary care (hospital-based) healthcare workers employed by NHS Wales (United Kingdom) organisations from 1 April 2020 to 30 November 2020. PARTICIPANTS We included 577,756 monthly observations among 77,587 healthcare workers. Using linked anonymised datasets, participants were grouped into 20 staff roles. Additionally, each role was deemed either patient-facing, non-patient-facing or undetermined. This was linked to individual demographic details and dates of positive SARS-CoV-2 PCR tests. MAIN OUTCOME MEASURES We used univariable and multivariable logistic regression models to determine odds ratios (ORs) for the risk of a positive SARS-CoV-2 PCR test. RESULTS Patient-facing healthcare workers were at the highest risk of SARS-CoV-2 infection with an adjusted OR (95% confidence interval [CI]) of 2.28 (95% CI 2.10-2.47). We found that after adjustment, foundation year doctors (OR 1.83 [95% CI 1.47-2.27]), healthcare support workers [OR 1.36 [95% CI 1.20-1.54]) and hospital nurses (OR 1.27 [95% CI 1.12-1.44]) were at the highest risk of infection among all staff groups. Younger healthcare workers and those living in more deprived areas were at a higher risk of infection. We also observed that infection rates varied over time and by organisation. CONCLUSIONS These findings have important policy implications for the prioritisation of vaccination, testing, training and personal protective equipment provision for patient-facing roles and the higher risk staff groups.
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Affiliation(s)
- Joe Hollinghurst
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Laura North
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Tamas Szakmany
- Critical Care Directorate, Grange University Hospital, Aneurin Bevan University Health Board, Llanyravon, Cwmbran, NP44 2XJ
| | - Richard Pugh
- Department of Anaesthesia, Intensive Care and Pain Medicine, Division of Population Medicine, Cardiff University, Heath Park Campus, Cardiff, CF14 4XN
| | - Gwyneth A Davies
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Shanya Sivakumaran
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Rebecca Jarvis
- Department of Anaesthetics, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board
| | - Martin Rolles
- Digital Workforce, NHS Wales Shared Services Partnership
| | - W Owen Pickrell
- South West Wales Cancer Centre, Singleton Hospital, Swansea SA2 8QA
| | - Ashley Akbari
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Gareth Davies
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Rowena Griffiths
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Jane Lyons
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Fatemeh Torabi
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Richard Fry
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
| | - Mike B Gravenor
- Swansea University Medical School and Neurology Department, Morriston Hospital, Swansea Bay University Health Board
| | - Ronan A Lyons
- Population Data Science and Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, Wales, United Kingdom, SA2 8PP
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83
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Mertens E, Serrien B, Vandromme M, Peñalvo JL. Predicting COVID-19 progression in hospitalized patients in Belgium from a multi-state model. Front Med (Lausanne) 2022; 9:1027674. [PMID: 36507535 PMCID: PMC9727386 DOI: 10.3389/fmed.2022.1027674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/03/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives To adopt a multi-state risk prediction model for critical disease/mortality outcomes among hospitalised COVID-19 patients using nationwide COVID-19 hospital surveillance data in Belgium. Materials and methods Information on 44,659 COVID-19 patients hospitalised between March 2020 and June 2021 with complete data on disease outcomes and candidate predictors was used to adopt a multi-state, multivariate Cox model to predict patients' probability of recovery, critical [transfer to intensive care units (ICU)] or fatal outcomes during hospital stay. Results Median length of hospital stay was 9 days (interquartile range: 5-14). After admission, approximately 82% of the COVID-19 patients were discharged alive, 15% of patients were admitted to ICU, and 15% died in the hospital. The main predictors of an increased probability for recovery were younger age, and to a lesser extent, a lower number of prevalent comorbidities. A patient's transition to ICU or in-hospital death had in common the following predictors: high levels of c-reactive protein (CRP) and lactate dehydrogenase (LDH), reporting lower respiratory complaints and male sex. Additionally predictors for a transfer to ICU included middle-age, obesity and reporting loss of appetite and staying at a university hospital, while advanced age and a higher number of prevalent comorbidities for in-hospital death. After ICU, younger age and low levels of CRP and LDH were the main predictors for recovery, while in-hospital death was predicted by advanced age and concurrent comorbidities. Conclusion As one of the very few, a multi-state model was adopted to identify key factors predicting COVID-19 progression to critical disease, and recovery or death.
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Affiliation(s)
- Elly Mertens
- Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Ben Serrien
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Mathil Vandromme
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - José L. Peñalvo
- Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
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COVID-19 Vaccine Effectiveness Against the Omicron Variant in a Veterans Affairs Cohort of Patients With Inflammatory Bowel Disease. Am J Gastroenterol 2022; 118:664-673. [PMID: 36730187 PMCID: PMC10045968 DOI: 10.14309/ajg.0000000000002071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/09/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION With the advent of the Omicron variant, there are concerns about the efficacy of current vaccinations, especially among immunocompromised/immunosuppressed patients. Our aim was to determine the efficacy of the first booster dose against Omicron. METHODS This was a retrospective cohort study using a well-established inflammatory bowel disease (IBD) cohort in the Veterans Health Administration. We followed patients on baseline IBD medications through the month of January 2022 during the Omicron COVID-19 wave and created adjusted models for vaccination and boosting effectiveness in reducing SARS-CoV-2 infection, hospitalization, and all-cause mortality. RESULTS A total of 22,756 patients with IBD were included, of whom 34.9% had received a booster dose. During follow-up, 622 patients (2.7%) were diagnosed with SARS-CoV-2 infection. In adjusted models, booster status was associated with a 30% reduced hazard of SARS-CoV-2 infection (hazard ratio 0.70 vs unvaccinated status, 95% confidence interval 0.56-0.88, P = 0.002), translating to 25.05% effectiveness. Boosted status was also significantly associated with reduced COVID-19 hospitalization (hazard ratio 0.35, 95% confidence interval 0.16-0.74, P = 0.006), demonstrating a 65.06% effectiveness in adjusted models. There was no significant association between vaccination status and all-cause mortality in adjusted models. DISCUSSION The boosted state was associated with a lower risk of SARS-CoV-2 infections and COVID-19-related hospitalization. Efficacy was lower than what has been seen against previous variants and decreased with prolonged duration from the booster. These findings suggest that patients with IBD, especially those who are immunosuppressed, should consider getting a second booster as per Centers for Disease Control and Prevention recommendations.
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85
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Ando W, Horii T, Jimbo M, Uematsu T, Atsuda K, Hanaki H, Otori K. Smoking cessation in the elderly as a sign of susceptibility to symptomatic COVID-19 reinfection in the United States. Front Public Health 2022; 10:985494. [PMID: 36504971 PMCID: PMC9733529 DOI: 10.3389/fpubh.2022.985494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background We aimed to clarify the relationship between coronavirus disease 2019 (COVID-19) reinfection and basic disease and smoking status. Methods The electronic health records of 165,320 patients with COVID-19 from January 1, 2020, to August 27, 2021, were analyzed. Data on age, race, sex, smoking status (never, current, former), and basic disease were analyzed using Cox proportional hazard models. Results In total, 6,133 patients (3.7%) were reinfected. The overall reinfection rate for never, current, and former smokers was 4.2, 3.5, and 5.7%, respectively. Although the risk of reinfection was highest among former smokers aged ≥65 years (7.7% [422/5,460]), the reinfection rate among current smokers aged ≥65 years was 6.2% (341/5,543). Among reinfected patients, the number of basic diseases was higher in former smokers (2.41 ± 1.16) than in current (2.28 ± 1.07, P = 0.07) and never smokers (2.07 ± 1.05, P < 0.001). Former smokers who are older may have been exposed to factors that increase their risk of symptomatic COVID-19 reinfection.
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Affiliation(s)
- Wataru Ando
- Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, Kitasato University School of Pharmacy, Shirokane, Japan,Department of Pharmacy, Kitasato University Medical Center, Kitamoto, Japan,*Correspondence: Wataru Ando
| | - Takeshi Horii
- Laboratory of Pharmacy Practice and Science 1, Division of Clinical Pharmacy, Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, Sagamihara, Japan
| | - Mitsuki Jimbo
- Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, Kitasato University School of Pharmacy, Shirokane, Japan
| | - Takayuki Uematsu
- Biomedical Laboratory, Division of Biomedical Research, Kitasato University Medical Center, Kitamoto, Japan
| | - Koichiro Atsuda
- Laboratory of Pharmacy Practice and Science 1, Division of Clinical Pharmacy, Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, Sagamihara, Japan
| | - Hideaki Hanaki
- Infection Control Research Center, Omura Satoshi Memorial Institute, Kitasato University, Shirokane, Japan
| | - Katsuya Otori
- Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, Kitasato University School of Pharmacy, Shirokane, Japan,Department of Pharmacy, Kitasato University Medical Center, Kitamoto, Japan
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Kolla E, Weill A, Desplas D, Semenzato L, Zureik M, Grimaldi L. Does Measles, Mumps, and Rubella (MMR) Vaccination Protect against COVID-19 Outcomes: A Nationwide Cohort Study. Vaccines (Basel) 2022; 10:1938. [PMID: 36423033 PMCID: PMC9694832 DOI: 10.3390/vaccines10111938] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 10/10/2023] Open
Abstract
Cross-protection from previous live attenuated vaccines is proposed to explain the low impact of COVID-19 on children. This study aimed to evaluate the effect of live attenuated MMR vaccines on the risk of being hospitalized for COVID-19 in children. An exposed (MMR vaccine)-non-exposed cohort study was conducted using the nationwide French National Health Data System (SNDS). We included children born between 1 January 2009 and 31 December 2019. Exposure was defined as a claim of at least one dose of MMR vaccine since birth. Hospitalization for COVID-19 was defined using main diagnostic ICD10 codes. Non-conditional logistic regression was used to calculate the adjusted odds ratios (aORs) of the association between MMR exposure and hospitalization for COVID-19, controlling for socio-demographic and socio-economic factors, co-morbidities, and general health. In total, 6,800,542 (median age 6 IQR [3-8] years) children exposed to a MMR vaccine and 384,162 (6 [3-9] years) not exposed were followed up with for 18 months. Among them, 873 exposed to the MMR vaccine and 38 who were not exposed were hospitalized for COVID-19. In a multi-variate analysis, the exposure of children to MMR vaccination was not associated with a decreased risk of COVID-19 hospitalization versus non-exposure (aOR (95%CI) = 1.09 [0.81-1.48]). A stratified analysis by age showed an aOR = 1.03 [0.64-1.66] for children aged 1-4, an aOR = 1.38 [0.82-2.31] for those aged 5-9, and an aOR = 1.11 [0.54-2.29] for those aged 10-12. Our study suggests that the live attenuated MMR vaccine does not protect children against COVID-19 hospitalization.
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Affiliation(s)
- Epiphane Kolla
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
- INSERM (National Institute of Health and Medical Research), University of Paris-Saclay, University Versailles Saint Quentin, Anti-Infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-Le-Bretonneux, France
| | - Alain Weill
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
| | - David Desplas
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
| | - Laura Semenzato
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
| | - Mahmoud Zureik
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
- INSERM (National Institute of Health and Medical Research), University of Paris-Saclay, University Versailles Saint Quentin, Anti-Infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-Le-Bretonneux, France
| | - Lamiae Grimaldi
- Clinical Research Unit AP-HP, Paris-Saclay, Hôpital Raymond Poincare, School of Medicine Simone Veil, University Versailles Saint Quentin—University Paris Saclay, INSERM (National Institute of Health and Medical Research), CESP, Anti-Infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-Le-Bretonneux, France
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87
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Rahimi Z, Mohammadi MJ, Araban M, Shirali GA, Cheraghian B. Socioeconomic correlates of face mask use among pedestrians during the COVID-19 pandemic: An ecological study. Front Public Health 2022; 10:921494. [PMID: 36466470 PMCID: PMC9709397 DOI: 10.3389/fpubh.2022.921494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022] Open
Abstract
Background Many countries have recommended using face masks for the general population in public places to reduce the risk of COVID-19 transmission. This study aimed to assess the effects of socioeconomic status on face mask use among pedestrians during the COVID-19 pandemic. Methods This cross-sectional study was conducted in Ahvaz, southwest Iran in August 2020. A total of 10,440 pedestrians have been studied from 92 neighborhoods of the city. Three socioeconomic indicators including Land price, Literacy rate, and the Employment rate for each neighborhood were used in this study. Analysis of Covariance and partial correlation coefficients were applied to assess the relationship between prevalence rates of mask usage and SES indicators. Results The mean ± SD age of the pedestrians was 32.2 ± 15.1 years. Of 10,440 observed participants, 67.9% were male. The overall prevalence of face mask usage was 45.6%. The prevalence of mask usage in older people and women was significantly higher than the others. The three assessed socioeconomic indicators were directly correlated to the prevalence of mask usage at individual and neighborhood levels. Conclusion We found that literacy had the strongest correlation with the prevalence of mask usage compared to the land price and employment rate among the three assessed SES indicators. Hence, it can be concluded that the social component of socioeconomic status has a greater effect on mask usage by people than the economic component of socioeconomic status.
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Affiliation(s)
- Zahra Rahimi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Javad Mohammadi
- Department of Environmental Health Engineering, Air Pollution, and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzieh Araban
- Department of Health Education and Promotion, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholam Abbas Shirali
- Department of Occupational Safety and Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,*Correspondence: Bahman Cheraghian
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Vivaldi G, Jolliffe DA, Holt H, Tydeman F, Talaei M, Davies GA, Lyons RA, Griffiths CJ, Kee F, Sheikh A, Shaheen SO, Martineau AR. Risk factors for SARS-CoV-2 infection after primary vaccination with ChAdOx1 nCoV-19 or BNT162b2 and after booster vaccination with BNT162b2 or mRNA-1273: A population-based cohort study (COVIDENCE UK). Lancet Reg Health Eur 2022; 22:100501. [PMID: 36168404 PMCID: PMC9499825 DOI: 10.1016/j.lanepe.2022.100501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Little is known about how demographic, behavioural, and vaccine-related factors affect risk of post-vaccination SARS-CoV-2 infection. We aimed to identify risk factors for SARS-CoV-2 infection after primary and booster vaccinations. Methods This prospective, population-based, UK study in adults (≥16 years) vaccinated against SARS-CoV-2 assessed risk of breakthrough SARS-CoV-2 infection up to February, 2022, for participants who completed a primary vaccination course (ChAdOx1 nCoV-19 or BNT162b2) and those who received a booster dose (BNT162b2 or mRNA-1273). Cox regression models explored associations between sociodemographic, behavioural, clinical, pharmacological, and nutritional factors and test-positive breakthrough infection, adjusted for local weekly SARS-CoV-2 incidence. Findings 1051 (7·1%) of 14 713 post-primary participants and 1009 (9·5%) of 10 665 post-booster participants reported breakthrough infection, over a median follow-up of 203 days (IQR 195–216) and 85 days (66–103), respectively. Primary vaccination with ChAdOx1 (vs BNT162b2) was associated with higher risk of infection in both post-primary analysis (adjusted hazard ratio 1·63, 95% CI 1·41–1·88) and after an mRNA-1273 booster (1·26 [1·00–1·57] vs BNT162b2 primary and booster). Lower risk of infection was associated with older age (post-primary: 0·97 [0·96–0·97] per year; post-booster: 0·97 [0·97–0·98]), whereas higher risk of infection was associated with lower educational attainment (post-primary: 1·78 [1·44–2·20] for primary/secondary vs postgraduate; post-booster: 1·46 [1·16–1·83]) and at least three weekly visits to indoor public places (post-primary: 1·36 [1·13–1·63] vs none; post-booster: 1·29 [1·07–1·56]). Interpretation Vaccine type, socioeconomic status, age, and behaviours affect risk of breakthrough infection after primary and booster vaccinations. Funding Barts Charity, UK Research and Innovation Industrial Strategy Challenge Fund.
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Identifying pre-existing conditions and multimorbidity patterns associated with in-hospital mortality in patients with COVID-19. Sci Rep 2022; 12:17313. [PMID: 36243878 PMCID: PMC9568958 DOI: 10.1038/s41598-022-20176-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 09/09/2022] [Indexed: 01/10/2023] Open
Abstract
We investigated the association between a wide range of comorbidities and COVID-19 in-hospital mortality and assessed the influence of multi morbidity on the risk of COVID-19-related death using a large, regional cohort of 6036 hospitalized patients. This retrospective cohort study was conducted using Patient Administration System Admissions and Discharges data. The International Classification of Diseases 10th edition (ICD-10) diagnosis codes were used to identify common comorbidities and the outcome measure. Individuals with lymphoma (odds ratio [OR], 2.78;95% CI,1.64-4.74), metastatic cancer (OR, 2.17; 95% CI,1.25-3.77), solid tumour without metastasis (OR, 1.67; 95% CI,1.16-2.41), liver disease (OR: 2.50, 95% CI,1.53-4.07), congestive heart failure (OR, 1.69; 95% CI,1.32-2.15), chronic obstructive pulmonary disease (OR, 1.43; 95% CI,1.18-1.72), obesity (OR, 5.28; 95% CI,2.92-9.52), renal disease (OR, 1.81; 95% CI,1.51-2.19), and dementia (OR, 1.44; 95% CI,1.17-1.76) were at increased risk of COVID-19 mortality. Asthma was associated with a lower risk of death compared to non-asthma controls (OR, 0.60; 95% CI,0.42-0.86). Individuals with two (OR, 1.79; 95% CI, 1.47-2.20; P < 0.001), and three or more comorbidities (OR, 1.80; 95% CI, 1.43-2.27; P < 0.001) were at increasingly higher risk of death when compared to those with no underlying conditions. Furthermore, multi morbidity patterns were analysed by identifying clusters of conditions in hospitalised COVID-19 patients using k-mode clustering, an unsupervised machine learning technique. Six patient clusters were identified, with recognisable co-occurrences of COVID-19 with different combinations of diseases, namely, cardiovascular (100%) and renal (15.6%) diseases in patient Cluster 1; mental and neurological disorders (100%) with metabolic and endocrine diseases (19.3%) in patient Cluster 2; respiratory (100%) and cardiovascular (15.0%) diseases in patient Cluster 3, cancer (5.9%) with genitourinary (9.0%) as well as metabolic and endocrine diseases (9.6%) in patient Cluster 4; metabolic and endocrine diseases (100%) and cardiovascular diseases (69.1%) in patient Cluster 5; mental and neurological disorders (100%) with cardiovascular diseases (100%) in patient Cluster 6. The highest mortality of 29.4% was reported in Cluster 6.
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90
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Espinosa-Gonzalez A, Prociuk D, Fiorentino F, Ramtale C, Mi E, Mi E, Glampson B, Neves AL, Okusi C, Husain L, Macartney J, Brown M, Browne B, Warren C, Chowla R, Heaversedge J, Greenhalgh T, de Lusignan S, Mayer E, Delaney BC. Remote COVID-19 Assessment in Primary Care (RECAP) risk prediction tool: derivation and real-world validation studies. Lancet Digit Health 2022; 4:e646-e656. [PMID: 35909058 PMCID: PMC9333950 DOI: 10.1016/s2589-7500(22)00123-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/11/2022] [Accepted: 06/15/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Accurate assessment of COVID-19 severity in the community is essential for patient care and requires COVID-19-specific risk prediction scores adequately validated in a community setting. Following a qualitative phase to identify signs, symptoms, and risk factors, we aimed to develop and validate two COVID-19-specific risk prediction scores. Remote COVID-19 Assessment in Primary Care-General Practice score (RECAP-GP; without peripheral oxygen saturation [SpO2]) and RECAP-oxygen saturation score (RECAP-O2; with SpO2). METHODS RECAP was a prospective cohort study that used multivariable logistic regression. Data on signs and symptoms (predictors) of disease were collected from community-based patients with suspected COVID-19 via primary care electronic health records and linked with secondary data on hospital admission (outcome) within 28 days of symptom onset. Data sources for RECAP-GP were Oxford-Royal College of General Practitioners Research and Surveillance Centre (RCGP-RSC) primary care practices (development set), northwest London primary care practices (validation set), and the NHS COVID-19 Clinical Assessment Service (CCAS; validation set). The data source for RECAP-O2 was the Doctaly Assist platform (development set and validation set in subsequent sample). The two probabilistic risk prediction models were built by backwards elimination using the development sets and validated by application to the validation datasets. Estimated sample size per model, including the development and validation sets was 2880 people. FINDINGS Data were available from 8311 individuals. Observations, such as SpO2, were mostly missing in the northwest London, RCGP-RSC, and CCAS data; however, SpO2 was available for 1364 (70·0%) of 1948 patients who used Doctaly. In the final predictive models, RECAP-GP (n=1863) included sex (male and female), age (years), degree of breathlessness (three point scale), temperature symptoms (two point scale), and presence of hypertension (yes or no); the area under the curve was 0·80 (95% CI 0·76-0·85) and on validation the negative predictive value of a low risk designation was 99% (95% CI 98·1-99·2; 1435 of 1453). RECAP-O2 included age (years), degree of breathlessness (two point scale), fatigue (two point scale), and SpO2 at rest (as a percentage); the area under the curve was 0·84 (0·78-0·90) and on validation the negative predictive value of low risk designation was 99% (95% CI 98·9-99·7; 1176 of 1183). INTERPRETATION Both RECAP models are valid tools to assess COVID-19 patients in the community. RECAP-GP can be used initially, without need for observations, to identify patients who require monitoring. If the patient is monitored and SpO2 is available, RECAP-O2 is useful to assess the need for treatment escalation. FUNDING Community Jameel and the Imperial College President's Excellence Fund, the Economic and Social Research Council, UK Research and Innovation, and Health Data Research UK.
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Affiliation(s)
- Ana Espinosa-Gonzalez
- Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Denys Prociuk
- Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Francesca Fiorentino
- Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK; Nightingale-Saunders Clinical Trials & Epidemiology Unit, King's Clinical Trials Unit, King's College London, London, UK
| | - Christian Ramtale
- Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Ella Mi
- Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Emma Mi
- Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Ben Glampson
- Department of Surgery and Cancer, Imperial College Healthcare NHS Trust, London, UK
| | - Ana Luisa Neves
- Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Cecilia Okusi
- Nuffield Department of Primary Care, University of Oxford, Oxford, UK
| | - Laiba Husain
- Nuffield Department of Primary Care, University of Oxford, Oxford, UK
| | - Jack Macartney
- Nuffield Department of Primary Care, University of Oxford, Oxford, UK
| | - Martina Brown
- South Central Ambulance Service NHS Trust, Otterboure, UK
| | - Ben Browne
- South Central Ambulance Service NHS Trust, Otterboure, UK
| | | | | | | | - Trisha Greenhalgh
- Nuffield Department of Primary Care, University of Oxford, Oxford, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care, University of Oxford, Oxford, UK
| | - Erik Mayer
- Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Brendan C Delaney
- Institute of Global Health Innovation, Department of Surgery and Cancer, Imperial College London, London, UK.
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Holt H, Talaei M, Greenig M, Zenner D, Symons J, Relton C, Young KS, Davies MR, Thompson KN, Ashman J, Rajpoot SS, Kayyale AA, El Rifai S, Lloyd PJ, Jolliffe D, Timmis O, Finer S, Iliodromiti S, Miners A, Hopkinson NS, Alam B, Lloyd-Jones G, Dietrich T, Chapple I, Pfeffer PE, McCoy D, Davies G, Lyons RA, Griffiths C, Kee F, Sheikh A, Breen G, Shaheen SO, Martineau AR. Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK). Thorax 2022; 77:900-912. [PMID: 34848555 PMCID: PMC8646971 DOI: 10.1136/thoraxjnl-2021-217487] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/09/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Risk factors for severe COVID-19 include older age, male sex, obesity, black or Asian ethnicity and underlying medical conditions. Whether these factors also influence susceptibility to developing COVID-19 is uncertain. METHODS We undertook a prospective, population-based cohort study (COVIDENCE UK) from 1 May 2020 to 5 February 2021. Baseline information on potential risk factors was captured by an online questionnaire. Monthly follow-up questionnaires captured incident COVID-19. We used logistic regression models to estimate multivariable-adjusted ORs (aORs) for associations between potential risk factors and odds of COVID-19. RESULTS We recorded 446 incident cases of COVID-19 in 15 227 participants (2.9%). Increased odds of developing COVID-19 were independently associated with Asian/Asian British versus white ethnicity (aOR 2.28, 95% CI 1.33 to 3.91), household overcrowding (aOR per additional 0.5 people/bedroom 1.26, 1.11 to 1.43), any versus no visits to/from other households in previous week (aOR 1.31, 1.06 to 1.62), number of visits to indoor public places (aOR per extra visit per week 1.05, 1.02 to 1.09), frontline occupation excluding health/social care versus no frontline occupation (aOR 1.49, 1.12 to 1.98) and raised body mass index (BMI) (aOR 1.50 (1.19 to 1.89) for BMI 25.0-30.0 kg/m2 and 1.39 (1.06 to 1.84) for BMI >30.0 kg/m2 versus BMI <25.0 kg/m2). Atopic disease was independently associated with decreased odds (aOR 0.75, 0.59 to 0.97). No independent associations were seen for age, sex, other medical conditions, diet or micronutrient supplement use. CONCLUSIONS After rigorous adjustment for factors influencing exposure to SARS-CoV-2, Asian/Asian British ethnicity and raised BMI were associated with increased odds of developing COVID-19, while atopic disease was associated with decreased odds. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT04330599).
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Affiliation(s)
- Hayley Holt
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Mohammad Talaei
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Matthew Greenig
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Dominik Zenner
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Clare Relton
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Katherine S Young
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Molly R Davies
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Katherine N Thompson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jed Ashman
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sultan Saeed Rajpoot
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Ahmed Ali Kayyale
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sarah El Rifai
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Philippa J Lloyd
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - David Jolliffe
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Olivia Timmis
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sarah Finer
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Stamatina Iliodromiti
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Alec Miners
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | - Thomas Dietrich
- School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Iain Chapple
- School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Paul E Pfeffer
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - David McCoy
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Gwyneth Davies
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Christopher Griffiths
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Frank Kee
- Centre for Public Health Research (NI), Queen's University Belfast, Belfast, UK
| | - Aziz Sheikh
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Gerome Breen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Seif O Shaheen
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Adrian R Martineau
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Inghels M, Kane R, Lall P, Nelson D, Nanyonjo A, Asghar Z, Ward D, McCranor T, Kavanagh T, Hogue T, Phull J, Tanser F. Ethnicity and risk for SARS-CoV-2 infection among the healthcare workforce: Results of a retrospective cohort study in rural United Kingdom. Int J Infect Dis 2022; 122:115-122. [PMID: 35569751 PMCID: PMC9098657 DOI: 10.1016/j.ijid.2022.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The reason why Black and South Asian healthcare workers are at a higher risk for SARS-CoV-2 infection remain unclear. We aimed to quantify the risk for SARS-CoV-2 infection among healthcare staff who belong to the ethnic minority and elucidate pathways of infection. METHODS A one-year follow-up retrospective cohort study has been conducted among National Health Service employees who were working at 123 facilities in Lincolnshire, UK. RESULTS Overall, 13,366 professionals were included. SARS-CoV-2 incidence per person-year was 5.2% (95% CI: 3.6-7.6%) during the first COVID-19 wave (January-August 2020) and 17.2% (13.5-22.0%) during the second wave (September 2020-February 2021). Compared with White staff, Black and South Asian employees were at higher risk for SARS-CoV-2 infection during both the first wave (hazard ratio, HR 1.58 [0.91-2.75] and 1.69 [1.07-2.66], respectively) and the second wave (HR 2.09 [1.57-2.76] and 1.46 [1.24-1.71]). Higher risk for SARS-CoV-2 infection persisted even after controlling for age, sex, pay grade, residence environment, type of work, and time exposure at work. Higher adjusted risk for SARS-CoV-2 infection were also found among lower-paid health professionals. CONCLUSION Black and South Asian health workers continue to be at higher risk for SARS-CoV-2 infection than their White counterparts. Urgent interventions are required to reduce SARS-CoV-2 infection in these ethnic groups.
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Affiliation(s)
- Maxime Inghels
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK; Centre Population et Développement (UMR 196 Paris Descartes - IRD), SageSud (ERL INSERM 1244), Institut de Recherche pour le Développement, Paris, France.
| | - Ros Kane
- School of Health and Social Care, University of Lincoln, UK
| | - Priya Lall
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK; London Interdisciplinary School, London, UK
| | - David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
| | - Agnes Nanyonjo
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
| | - Zahid Asghar
- School of Health and Social Care, University of Lincoln, UK
| | | | - Tracy McCranor
- Lincolnshire Partnership NHS Foundation Trust, Lincolnshire, UK
| | - Tony Kavanagh
- Lincolnshire Partnership NHS Foundation Trust, Lincolnshire, UK
| | - Todd Hogue
- School of Psychology, University of Lincoln, UK
| | - Jaspreet Phull
- Lincolnshire Partnership NHS Foundation Trust, Lincolnshire, UK
| | - Frank Tanser
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK; School of Nursing and Public Health, University of KwaZulu-Natal, Durban South Africa
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93
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Li J, Martinez MC, Frosch DL, Matt GE. Effects of Smoking on SARS-CoV-2 Positivity: A Study of a Large Health System in Northern and Central California. Tob Use Insights 2022; 15:1179173X221114799. [PMID: 35966408 PMCID: PMC9373122 DOI: 10.1177/1179173x221114799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/03/2022] [Accepted: 07/03/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction COVID-19 continues to impact vulnerable populations disproportionally. Identifying
modifiable risk factors could lead to targeted interventions to reduce infections. The
purpose of this study is to identify risk factors for testing positive for
SARS-CoV-2. Methods Using electronic health records collected from a large ambulatory care system in
northern and central California, the study identified patients who had a test for
SARS-CoV-2 between 2/20/2020 and 3/31/2021. The adjusted effect of active and passive
smoking and other risk factors on the probability of testing positive for SARS-CoV-2
were estimated using multivariable logistic regression. Analyses were conducted in
2021. Results Of 556 690 eligible patients in our sample, 70 564 (12.7%) patients tested positive for
SARS-CoV-2. Younger age, being male, racial/ethnic minorities, and having mild major
comorbidities were significantly associated with a positive SARS-CoV-2 test. Current
smokers (adjusted OR: 0.69, 95% CI: 0.66-0.73) and former smokers (adjusted OR: 0.92,
95% CI: 0.89-0.95) were less likely than nonsmokers to be lab-confirmed positive, but no
statistically significant differences were found when comparing passive smokers with
non-smokers. The patients with missing smoking status (25.7%) were more likely to be
members of vulnerable populations with major comorbidities (adjusted OR ranges from
severe: 2.52, 95% CI = 2.36-2.69 to mild: 3.28, 95% CI = 3.09-3.48), lower income
(adjusted OR: 0.85, 95% CI: 0.85-0.86), aged 80 years or older (adjusted OR: 1.11, 95%
CI: 1.07-1.16), have less access to primary care (adjusted OR: 0.07, 95% CI: 0.07-0.07),
and identify as racial ethnic minorities (adjusted OR ranges from Hispanic: 1.61, 95% CI
= 1.56-1.65 to Non-Hispanic Black: 2.60, 95% CI = 2.5-2.69). Conclusions Our findings suggest that the odds of testing positive for SARS-CoV-2 were
significantly lower in smokers compared to nonsmokers. Other risk factors include
missing data on smoking status, being under 18, being male, being a racial/ethnic
minority, and having mild major comorbidities. Since those with missing data on smoking
status were more likely to be members of vulnerable populations with higher smoking
rates, the risk of testing positive for SARS-CoV-2 among smokers may have been
underestimated due to missing data on smoking status. Future studies should investigate
the risk of severe outcomes among active and passive smokers, the role that exposure to
tobacco smoke constitutes among nonsmokers, the role of comorbidities in COVID-19
disease course, and health disparities experienced by disadvantaged groups.
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Affiliation(s)
- Jiang Li
- Palo Alto Medical Foundation Research Institute, Center for Health Systems Research, Sutter Health, Palo Alto, CA, USA
| | - Meghan C Martinez
- Palo Alto Medical Foundation Research Institute, Center for Health Systems Research, Sutter Health, Palo Alto, CA, USA
| | - Dominick L Frosch
- Palo Alto Medical Foundation Research Institute, Center for Health Systems Research, Sutter Health, Palo Alto, CA, USA
| | - Georg E Matt
- College of Sciences, San Diego State University, San Diego, CA, USA
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Meza-Torres B, Delanerolle G, Okusi C, Mayor N, Anand S, Macartney J, Gatenby P, Glampson B, Chapman M, Curcin V, Mayer E, Joy M, Greenhalgh T, Delaney B, de Lusignan S. Differences in Clinical Presentation With Long COVID After Community and Hospital Infection and Associations With All-Cause Mortality: English Sentinel Network Database Study. JMIR Public Health Surveill 2022; 8:e37668. [PMID: 35605170 PMCID: PMC9384859 DOI: 10.2196/37668] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/06/2022] [Accepted: 05/17/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Most studies of long COVID (symptoms of COVID-19 infection beyond 4 weeks) have focused on people hospitalized in their initial illness. Long COVID is thought to be underrecorded in UK primary care electronic records. OBJECTIVE We sought to determine which symptoms people present to primary care after COVID-19 infection and whether presentation differs in people who were not hospitalized, as well as post-long COVID mortality rates. METHODS We used routine data from the nationally representative primary care sentinel cohort of the Oxford-Royal College of General Practitioners Research and Surveillance Centre (N=7,396,702), applying a predefined long COVID phenotype and grouped by whether the index infection occurred in hospital or in the community. We included COVID-19 infection cases from March 1, 2020, to April 1, 2021. We conducted a before-and-after analysis of long COVID symptoms prespecified by the Office of National Statistics, comparing symptoms presented between 1 and 6 months after the index infection matched with the same months 1 year previously. We conducted logistic regression analysis, quoting odds ratios (ORs) with 95% CIs. RESULTS In total, 5.63% (416,505/7,396,702) and 1.83% (7623/416,505) of the patients had received a coded diagnosis of COVID-19 infection and diagnosis of, or referral for, long COVID, respectively. People with diagnosis or referral of long COVID had higher odds of presenting the prespecified symptoms after versus before COVID-19 infection (OR 2.66, 95% CI 2.46-2.88, for those with index community infection and OR 2.42, 95% CI 2.03-2.89, for those hospitalized). After an index community infection, patients were more likely to present with nonspecific symptoms (OR 3.44, 95% CI 3.00-3.95; P<.001) compared with after a hospital admission (OR 2.09, 95% CI 1.56-2.80; P<.001). Mental health sequelae were more strongly associated with index hospital infections (OR 2.21, 95% CI 1.64-2.96) than with index community infections (OR 1.36, 95% CI 1.21-1.53; P<.001). People presenting to primary care after hospital infection were more likely to be men (OR 1.43, 95% CI 1.25-1.64; P<.001), more socioeconomically deprived (OR 1.42, 95% CI 1.24-1.63; P<.001), and with higher multimorbidity scores (OR 1.41, 95% CI 1.26-1.57; P<.001) than those presenting after an index community infection. All-cause mortality in people with long COVID was associated with increasing age, male sex (OR 3.32, 95% CI 1.34-9.24; P=.01), and higher multimorbidity score (OR 2.11, 95% CI 1.34-3.29; P<.001). Vaccination was associated with reduced odds of mortality (OR 0.10, 95% CI 0.03-0.35; P<.001). CONCLUSIONS The low percentage of people recorded as having long COVID after COVID-19 infection reflects either low prevalence or underrecording. The characteristics and comorbidities of those presenting with long COVID after a community infection are different from those hospitalized. This study provides insights into the presentation of long COVID in primary care and implications for workload.
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Affiliation(s)
- Bernardo Meza-Torres
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Gayathri Delanerolle
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Cecilia Okusi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Nikhil Mayor
- Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
| | - Sneha Anand
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jack Macartney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Piers Gatenby
- Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
| | - Ben Glampson
- Imperial College Healthcare NHS Trust, Imperial Clinical Analytics, Research & Evaluation (iCARE), London, United Kingdom
| | - Martin Chapman
- King's College London, Population Health Sciences, London, United Kingdom
| | - Vasa Curcin
- King's College London, Population Health Sciences, London, United Kingdom
| | - Erik Mayer
- Imperial College Healthcare NHS Trust, Imperial Clinical Analytics, Research & Evaluation (iCARE), London, United Kingdom
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Brendan Delaney
- Department of Surgery & Cancer, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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95
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Mayor N, Meza-Torres B, Okusi C, Delanerolle G, Chapman M, Wang W, Anand S, Feher M, Macartney J, Byford R, Joy M, Gatenby P, Curcin V, Greenhalgh T, Delaney B, de Lusignan S. Developing a Long COVID Phenotype for Postacute COVID-19 in a National Primary Care Sentinel Cohort: Observational Retrospective Database Analysis. JMIR Public Health Surveill 2022; 8:e36989. [PMID: 35861678 PMCID: PMC9374163 DOI: 10.2196/36989] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/16/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Following COVID-19, up to 40% of people have ongoing health problems, referred to as postacute COVID-19 or long COVID (LC). LC varies from a single persisting symptom to a complex multisystem disease. Research has flagged that this condition is underrecorded in primary care records, and seeks to better define its clinical characteristics and management. Phenotypes provide a standard method for case definition and identification from routine data and are usually machine-processable. An LC phenotype can underpin research into this condition. OBJECTIVE This study aims to develop a phenotype for LC to inform the epidemiology and future research into this condition. We compared clinical symptoms in people with LC before and after their index infection, recorded from March 1, 2020, to April 1, 2021. We also compared people recorded as having acute infection with those with LC who were hospitalized and those who were not. METHODS We used data from the Primary Care Sentinel Cohort (PCSC) of the Oxford Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) database. This network was recruited to be nationally representative of the English population. We developed an LC phenotype using our established 3-step ontological method: (1) ontological step (defining the reasoning process underpinning the phenotype, (2) coding step (exploring what clinical terms are available, and (3) logical extract model (testing performance). We created a version of this phenotype using Protégé in the ontology web language for BioPortal and using PhenoFlow. Next, we used the phenotype to compare people with LC (1) with regard to their symptoms in the year prior to acquiring COVID-19 and (2) with people with acute COVID-19. We also compared hospitalized people with LC with those not hospitalized. We compared sociodemographic details, comorbidities, and Office of National Statistics-defined LC symptoms between groups. We used descriptive statistics and logistic regression. RESULTS The long-COVID phenotype differentiated people hospitalized with LC from people who were not and where no index infection was identified. The PCSC (N=7.4 million) includes 428,479 patients with acute COVID-19 diagnosis confirmed by a laboratory test and 10,772 patients with clinically diagnosed COVID-19. A total of 7471 (1.74%, 95% CI 1.70-1.78) people were coded as having LC, 1009 (13.5%, 95% CI 12.7-14.3) had a hospital admission related to acute COVID-19, and 6462 (86.5%, 95% CI 85.7-87.3) were not hospitalized, of whom 2728 (42.2%) had no COVID-19 index date recorded. In addition, 1009 (13.5%, 95% CI 12.73-14.28) people with LC were hospitalized compared to 17,993 (4.5%, 95% CI 4.48-4.61; P<.001) with uncomplicated COVID-19. CONCLUSIONS Our LC phenotype enables the identification of individuals with the condition in routine data sets, facilitating their comparison with unaffected people through retrospective research. This phenotype and study protocol to explore its face validity contributes to a better understanding of LC.
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Affiliation(s)
- Nikhil Mayor
- Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
| | - Bernardo Meza-Torres
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, United Kingdom
| | - Cecilia Okusi
- Department of Surgery & Cancer, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Gayathri Delanerolle
- Department of Surgery & Cancer, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Martin Chapman
- Population Health Sciences, Kings College London, London, United Kingdom
| | - Wenjuan Wang
- Population Health Sciences, Kings College London, London, United Kingdom
| | - Sneha Anand
- Department of Surgery & Cancer, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Michael Feher
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jack Macartney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Rachel Byford
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Piers Gatenby
- Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
| | - Vasa Curcin
- Population Health Sciences, Kings College London, London, United Kingdom
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Brendan Delaney
- Department of Surgery & Cancer, Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
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96
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Dimka J, van Doren TP, Battles HT. Pandemics, past and present: The role of biological anthropology in interdisciplinary pandemic studies. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2022. [PMCID: PMC9082061 DOI: 10.1002/ajpa.24517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Biological anthropologists are ideally suited for the study of pandemics given their strengths in human biology, health, culture, and behavior, yet pandemics have historically not been a major focus of research. The COVID‐19 pandemic has reinforced the need to understand pandemic causes and unequal consequences at multiple levels. Insights from past pandemics can strengthen the knowledge base and inform the study of current and future pandemics through an anthropological lens. In this paper, we discuss the distinctive social and epidemiological features of pandemics, as well as the ways in which biological anthropologists have previously studied infectious diseases, epidemics, and pandemics. We then review interdisciplinary research on three pandemics–1918 influenza, 2009 influenza, and COVID‐19–focusing on persistent social inequalities in morbidity and mortality related to sex and gender; race, ethnicity, and Indigeneity; and pre‐existing health and disability. Following this review of the current state of pandemic research on these topics, we conclude with a discussion of ways biological anthropologists can contribute to this field moving forward. Biological anthropologists can add rich historical and cross‐cultural depth to the study of pandemics, provide insights into the biosocial complexities of pandemics using the theory of syndemics, investigate the social and health impacts of stress and stigma, and address important methodological and ethical issues. As COVID‐19 is unlikely to be the last global pandemic, stronger involvement of biological anthropology in pandemic studies and public health policy and research is vital.
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Affiliation(s)
- Jessica Dimka
- Centre for Research on Pandemics and Society Oslo Metropolitan University Oslo Norway
| | | | - Heather T. Battles
- Anthropology, School of Social Sciences The University of Auckland Auckland New Zealand
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97
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Zhang Y, Chang HH, Iuliano AD, Reed C. Application of Bayesian spatial-temporal models for estimating unrecognized COVID-19 deaths in the United States. SPATIAL STATISTICS 2022; 50:100584. [PMID: 35013705 PMCID: PMC8730676 DOI: 10.1016/j.spasta.2021.100584] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 05/10/2023]
Abstract
In the United States, COVID-19 has become a leading cause of death since 2020. However, the number of COVID-19 deaths reported from death certificates is likely to represent an underestimate of the total deaths related to SARS-CoV-2 infections. Estimating those deaths not captured through death certificates is important to understanding the full burden of COVID-19 on mortality. In this work, we explored enhancements to an existing approach by employing Bayesian hierarchical models to estimate unrecognized deaths attributed to COVID-19 using weekly state-level COVID-19 viral surveillance and mortality data in the United States from March 2020 to April 2021. We demonstrated our model using those aged ≥ 85 years who died. First, we used a spatial-temporal binomial regression model to estimate the percent of positive SARS-CoV-2 test results. A spatial-temporal negative-binomial model was then used to estimate unrecognized COVID-19 deaths by exploiting the spatial-temporal association between SARS-CoV-2 percent positive and all-cause mortality counts using an excess mortality approach. Computationally efficient Bayesian inference was accomplished via the Polya-Gamma representation of the binomial and negative-binomial models. Among those aged ≥ 85 years, we estimated 58,200 (95% CI: 51,300, 64,900) unrecognized COVID-19 deaths, which accounts for 26% (95% CI: 24%, 29%) of total COVID-19 deaths in this age group. Our modeling results suggest that COVID-19 mortality and the proportion of unrecognized deaths among deaths attributed to COVID-19 vary by time and across states.
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Affiliation(s)
- Yuzi Zhang
- Department of Biostatistics and Bioinformatics, The Rollins School of Public Health of Emory University, 1518 Clifton Rd. N.E., Atlanta, GA 30322, USA
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, The Rollins School of Public Health of Emory University, 1518 Clifton Rd. N.E., Atlanta, GA 30322, USA
| | - A Danielle Iuliano
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carrie Reed
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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98
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Torrecillas M, Gumucio VD, Padullés A, Tubau F, Marco D, Shaw E, Fernández-Huerta M, Maisterra K, Grau I, Petito MM, Berbel D, Puig-Asensio M, Pérez XL, Domínguez MÁ, Sabater J, Ardanuy C, Càmara J. Antimicrobial use and aetiology of bloodstream infections in critically ill patients during early stages of SARS-CoV-2 pandemic. Infect Prev Pract 2022; 4:100241. [PMID: 36061570 PMCID: PMC9420204 DOI: 10.1016/j.infpip.2022.100241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/19/2022] [Indexed: 01/16/2023] Open
Abstract
Background Aim Methods Findings Conclusions
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99
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Smoking is associated with increased risk of cardiovascular events, disease severity, and mortality among patients hospitalized for SARS-CoV-2 infections. PLoS One 2022; 17:e0270763. [PMID: 35839264 PMCID: PMC9286231 DOI: 10.1371/journal.pone.0270763] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 06/16/2022] [Indexed: 01/11/2023] Open
Abstract
The clinical sequalae of SARS-CoV-2 infection are in part dependent upon age and pre-existing health conditions. Although the use of tobacco products decreases cardiorespiratory fitness while increasing susceptibility to microbial infections, limited information is available on how smoking affects COVID-19 severity. Therefore, we examined whether smokers hospitalized for COVID-19 are at a greater risk for developing severe complications than non-smokers. Data were from all hospitalized adults with SARS-CoV-2 infection from the American Heart Association's Get-With-The-Guidelines COVID-19 Registry, from January 2020 to March 2021, which is a hospital-based voluntary national registry initiated in 2019 with 122 participating hospitals across the United States. Patients who reported smoking at the time of admission were classified as smokers. Severe outcome was defined as either death or the use of mechanical ventilation. Of the 31,545 patients in the cohort, 6,717 patients were 1:2 propensity matched (for age, sex, race, medical history, medications, and time-frame of hospital admission) and classified as current smokers or non-smokers according to admission data. In multivariable analyses, after adjusting for sociodemographic characteristics, medical history, medication use, and the time of hospital admission, patients self-identified as current smokers had higher adjusted odds of death (adjusted odds ratio [aOR], 1.41; 95% CI, 1.21-1.64), the use of mechanical ventilation (aOR 1.15; 95% CI 1.01-1.32), and increased risk of major adverse cardiovascular events (aOR, 1.27; 95% CI 1.05-1.52). Independent of sociodemographic characteristics and medical history, smoking was associated with a higher risk of severe COVID-19, including death.
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100
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Kiani P, Mulder KEW, Balikji J, Kraneveld AD, Garssen J, Verster JC. Pandemic Preparedness: Maintaining Adequate Immune Fitness by Attaining a Normal, Healthy Body Weight. J Clin Med 2022; 11:jcm11143933. [PMID: 35887697 PMCID: PMC9318319 DOI: 10.3390/jcm11143933] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 01/27/2023] Open
Abstract
In addition to developing effective medicines and vaccines, pandemic preparedness also comprises general health-related, behavioral, and psychological aspects related to being more resistant in the case of future pandemics. In the context of the 2019 coronavirus (COVID-19) pandemic, recent research revealed that reduced perceived immune fitness was the best predictor of reporting more frequent and more severe COVID-19 symptoms. Up until now (June 2022), during the COVID-19 pandemic, the majority of patients who have been hospitalized were characterized as being overweight. It is therefore essential to further evaluate the relationship between body mass index (BMI) and immune fitness. This was performed by analyzing pooled data from previously published studies, conducted among N = 8586 Dutch adults. It was hypothesized that attaining a normal, healthy body weight is associated with optimal perceived immune fitness. The analysis revealed that a deviation from normal weight (i.e., having a BMI outside the range of 18.5 to 24.9 kg/m2) was associated with significantly reduced perceived immune fitness, as assessed with the immune status questionnaire and a single item perceived immune fitness scale. The effects were significant for both underweight and overweight groups and most pronounced for the obese groups. The results suggest that attaining a normal, healthy body weight might significantly contribute to maintaining adequate perceived immune fitness. Therefore, attaining a normal body weight might be an essential component of pandemic preparedness and should be supported by creating awareness and promoting the importance of regular exercise and the consumption of healthy food.
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Affiliation(s)
- Pantea Kiani
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands; (P.K.); (K.E.W.M.); (J.B.); (A.D.K.); (J.G.)
| | - Kiki E. W. Mulder
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands; (P.K.); (K.E.W.M.); (J.B.); (A.D.K.); (J.G.)
| | - Jessica Balikji
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands; (P.K.); (K.E.W.M.); (J.B.); (A.D.K.); (J.G.)
| | - Aletta D. Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands; (P.K.); (K.E.W.M.); (J.B.); (A.D.K.); (J.G.)
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands; (P.K.); (K.E.W.M.); (J.B.); (A.D.K.); (J.G.)
- Global Centre of Excellence Immunology, Nutricia Danone Research, 3584 CT Utrecht, The Netherlands
| | - Joris C. Verster
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands; (P.K.); (K.E.W.M.); (J.B.); (A.D.K.); (J.G.)
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia
- Correspondence: ; Tel.: +31-302-536-909
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