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Shivshankar P, Karmouty-Quintana H, Mills T, Doursout MF, Wang Y, Czopik AK, Evans SE, Eltzschig HK, Yuan X. SARS-CoV-2 Infection: Host Response, Immunity, and Therapeutic Targets. Inflammation 2022; 45:1430-1449. [PMID: 35320469 PMCID: PMC8940980 DOI: 10.1007/s10753-022-01656-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/27/2022] [Accepted: 02/25/2022] [Indexed: 02/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has resulted in a global pandemic with severe socioeconomic effects. Immunopathogenesis of COVID-19 leads to acute respiratory distress syndrome (ARDS) and organ failure. Binding of SARS-CoV-2 spike protein to human angiotensin-converting enzyme 2 (hACE2) on bronchiolar and alveolar epithelial cells triggers host inflammatory pathways that lead to pathophysiological changes. Proinflammatory cytokines and type I interferon (IFN) signaling in alveolar epithelial cells counter barrier disruption, modulate host innate immune response to induce chemotaxis, and initiate the resolution of inflammation. Here, we discuss experimental models to study SARS-CoV-2 infection, molecular pathways involved in SARS-CoV-2-induced inflammation, and viral hijacking of anti-inflammatory pathways, such as delayed type-I IFN response. Mechanisms of alveolar adaptation to hypoxia, adenosinergic signaling, and regulatory microRNAs are discussed as potential therapeutic targets for COVID-19.
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Affiliation(s)
- Pooja Shivshankar
- Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, 77030, USA
- Department of Biochemistry and Molecular Biology, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Harry Karmouty-Quintana
- Department of Biochemistry and Molecular Biology, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
- Department of Internal Medicine, Divisions of Critical Care, Pulmonary and Sleep Medicine, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Tingting Mills
- Department of Biochemistry and Molecular Biology, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Marie-Francoise Doursout
- Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, 77030, USA
| | - Yanyu Wang
- Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, 77030, USA
| | - Agnieszka K Czopik
- Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, 77030, USA
| | - Scott E Evans
- Department of Pulmonary Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Holger K Eltzschig
- Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, 77030, USA
| | - Xiaoyi Yuan
- Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, 77030, USA.
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Matysek A, Studnicka A, Smith WM, Hutny M, Gajewski P, Filipiak KJ, Goh J, Yang G. Influence of Co-morbidities During SARS-CoV-2 Infection in an Indian Population. Front Med (Lausanne) 2022; 9:962101. [PMID: 35979209 PMCID: PMC9377050 DOI: 10.3389/fmed.2022.962101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Since the outbreak of COVID-19 pandemic the interindividual variability in the course of the disease has been reported, indicating a wide range of factors influencing it. Factors which were the most often associated with increased COVID-19 severity include higher age, obesity and diabetes. The influence of cytokine storm is complex, reflecting the complexity of the immunological processes triggered by SARS-CoV-2 infection. A modern challenge such as a worldwide pandemic requires modern solutions, which in this case is harnessing the machine learning for the purpose of analysing the differences in the clinical properties of the populations affected by the disease, followed by grading its significance, consequently leading to creation of tool applicable for assessing the individual risk of SARS-CoV-2 infection. Methods Biochemical and morphological parameters values of 5,000 patients (Curisin Healthcare (India) were gathered and used for calculation of eGFR, SII index and N/L ratio. Spearman's rank correlation coefficient formula was used for assessment of correlations between each of the features in the population and the presence of the SARS-CoV-2 infection. Feature importance was evaluated by fitting a Random Forest machine learning model to the data and examining their predictive value. Its accuracy was measured as the F1 Score. Results The parameters which showed the highest correlation coefficient were age, random serum glucose, serum urea, gender and serum cholesterol, whereas the highest inverse correlation coefficient was assessed for alanine transaminase, red blood cells count and serum creatinine. The accuracy of created model for differentiating positive from negative SARS-CoV-2 cases was 97%. Features of highest importance were age, alanine transaminase, random serum glucose and red blood cells count. Conclusion The current analysis indicates a number of parameters available for a routine screening in clinical setting. It also presents a tool created on the basis of these parameters, useful for assessing the individual risk of developing COVID-19 in patients. The limitation of the study is the demographic specificity of the studied population, which might restrict its general applicability.
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Affiliation(s)
- Adrian Matysek
- Immunidex Ltd., London, United Kingdom
- Cognescence Ltd., London, United Kingdom
| | - Aneta Studnicka
- Clinical Analysis Laboratory, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Wade Menpes Smith
- Immunidex Ltd., London, United Kingdom
- Cognescence Ltd., London, United Kingdom
| | - Michał Hutny
- Faculty of Medical Sciences in Katowice, Students’ Scientific Society, Medical University of Silesia, Katowice, Poland
| | - Paweł Gajewski
- AGH University of Science and Technology, Krakow, Poland
| | | | - Jorming Goh
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National University Health System (NUHS), Centre for Healthy Longevity, Singapore, Singapore
| | - Guang Yang
- Cardiovascular Research Centre, Royal Brompton Hospital, London, United Kingdom
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
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103
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Adams C, Wortley P, Chamberlain A, Lopman BA. Declining COVID-19 case-fatality in Georgia, USA, March 2020 to March 2021: a sign of real improvement or a broadening epidemic? Ann Epidemiol 2022; 72:57-64. [PMID: 35649472 PMCID: PMC9148435 DOI: 10.1016/j.annepidem.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 05/18/2022] [Accepted: 05/23/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To examine whether declines in the crude U.S. COVID-19 case fatality ratio is due to improved clinical care and/or other factors. METHODS We used multivariable logistic regression, adjusted for age and other individual-level characteristics, to examine associations between report month and mortality among confirmed and probable COVID-19 cases and hospitalized cases in Georgia reported March 2, 2020 to March 31, 2021. RESULTS Compared to August 2020, mortality risk among cases was lowest in November 2020 (OR = 0.84; 95% CI: 0.78-0.91) and remained lower until March 2021 (OR = 0.86; 95% CI: 0.77-0.95). Among hospitalized cases, mortality risk increased in December 2020 (OR = 1.16, 95% CI: 1.07-1.27) and January 2021 (OR = 1.25; 95% CI: 1.14-1.36), before declining until March 2021 (OR = 0.90, 95% CI: 0.78-1.04). CONCLUSIONS After adjusting for other factors, including the shift to a younger age distribution of cases, we observed lower mortality risk from November 2020 to March 2021 compared to August 2020 among cases. This suggests that improved clinical management may have contributed to lower mortality risk. Among hospitalized cases, mortality risk increased again in December 2020 and January 2021, but then decreased to a risk similar to that among all cases by March 2021.
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Affiliation(s)
- Carly Adams
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
| | - Pascale Wortley
- HIV Epidemiology Section, Georgia Department of Public Health, State of Georgia Building, Atlanta, GA
| | - Allison Chamberlain
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Benjamin A Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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Rahimi E, Shahisavandi M, Royo AC, Azizi M, el Bouhaddani S, Sigari N, Sturkenboom M, Ahmadizar F. The risk profile of patients with COVID-19 as predictors of lung lesions severity and mortality—Development and validation of a prediction model. Front Microbiol 2022; 13:893750. [PMID: 35958125 PMCID: PMC9361066 DOI: 10.3389/fmicb.2022.893750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
Objective We developed and validated a prediction model based on individuals' risk profiles to predict the severity of lung involvement and death in patients hospitalized with coronavirus disease 2019 (COVID-19) infection. Methods In this retrospective study, we studied hospitalized COVID-19 patients with data on chest CT scans performed during hospital stay (February 2020-April 2021) in a training dataset (TD) (n = 2,251) and an external validation dataset (eVD) (n = 993). We used the most relevant demographical, clinical, and laboratory variables (n = 25) as potential predictors of COVID-19-related outcomes. The primary and secondary endpoints were the severity of lung involvement quantified as mild (≤25%), moderate (26–50%), severe (>50%), and in-hospital death, respectively. We applied random forest (RF) classifier, a machine learning technique, and multivariable logistic regression analysis to study our objectives. Results In the TD and the eVD, respectively, the mean [standard deviation (SD)] age was 57.9 (18.0) and 52.4 (17.6) years; patients with severe lung involvement [n (%):185 (8.2) and 116 (11.7)] were significantly older [mean (SD) age: 64.2 (16.9), and 56.2 (18.9)] than the other two groups (mild and moderate). The mortality rate was higher in patients with severe (64.9 and 38.8%) compared to moderate (5.5 and 12.4%) and mild (2.3 and 7.1%) lung involvement. The RF analysis showed age, C reactive protein (CRP) levels, and duration of hospitalizations as the three most important predictors of lung involvement severity at the time of the first CT examination. Multivariable logistic regression analysis showed a significant strong association between the extent of the severity of lung involvement (continuous variable) and death; adjusted odds ratio (OR): 9.3; 95% CI: 7.1–12.1 in the TD and 2.6 (1.8–3.5) in the eVD. Conclusion In hospitalized patients with COVID-19, the severity of lung involvement is a strong predictor of death. Age, CRP levels, and duration of hospitalizations are the most important predictors of severe lung involvement. A simple prediction model based on available clinical and imaging data provides a validated tool that predicts the severity of lung involvement and death probability among hospitalized patients with COVID-19.
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Affiliation(s)
- Ezat Rahimi
- Clinical Research Unit, Department of Internal Medicine, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mina Shahisavandi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Albert Cid Royo
- Department of Datascience and Biostatistics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Mohammad Azizi
- School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Said el Bouhaddani
- Department of Datascience and Biostatistics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Naseh Sigari
- Lung Diseases and Allergy Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Miriam Sturkenboom
- Department of Datascience and Biostatistics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Fariba Ahmadizar
- Department of Datascience and Biostatistics, University Medical Center Utrecht, Utrecht, Netherlands
- *Correspondence: Fariba Ahmadizar
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105
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COVID-19 Survivor Patients Carrying the Rs35705950 Risk Allele in MUC5B Have Higher Plasma Levels of Mucin 5B. Curr Issues Mol Biol 2022; 44:3283-3290. [PMID: 35892712 PMCID: PMC9329856 DOI: 10.3390/cimb44080226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Genetic susceptibility to infectious diseases is partly due to the variation in the human genome, and COVID-19 is not the exception. This study aimed to identify whether risk alleles of known genes linked with emphysema (SERPINA1) and pulmonary fibrosis (MUC5B) are associated with severe COVID-19, and whether plasma mucin 5B differs according to patients' outcomes. MATERIALS AND METHODS We included 1258 Mexican subjects diagnosed with COVID-19. We genotyped rs2892474 and rs17580 of the SERPINA1 gene and rs35705950 of MUC5B. Based on the rs35705950 genotypes, mucin 5B plasma protein levels were quantified. RESULTS Homozygous for the risk alleles of the three polymorphisms were found in less than 5% of the study population, but no statistically significant difference in the genotype or allele association analysis. At the protein level, non-survivors carrying one or two copies of the risk allele rs35705950 in MUC5B (GT + TT) had lower levels of mucin 5B compared to the survivors (0.0 vs. 0.17 ng/mL, p = 0.0013). CONCLUSION The polymorphisms rs28929474 and rs17580 of SERPINA1 and rs35705950 of MUC5B are not associated with the risk of severe COVID-19 in the Mexican population. COVID-19 survivor patients bearing one or two copies of the rs35705950 risk allele have higher plasma levels of mucin 5B.
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106
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Bruno F, Malvaso A, Chiesi F, Laganà V, Servidio R, Isella V, Ferrarese C, Gottardi F, Stella E, Agosta F, Filippi M, Lorenzo RD, Martin LR, Bruni AC, Maletta R. COVID-19 vaccine uptake among family caregivers of people with dementia: The role of attitudes toward vaccination, perceived social support and personality traits. Front Psychol 2022; 13:923316. [PMID: 35911007 PMCID: PMC9335157 DOI: 10.3389/fpsyg.2022.923316] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
People with dementia have an increased risk of contracting severe forms of COVID-19. Although in worldwide vaccination programs priority has been given to older people, having taken the vaccine does not totally eliminate the risk of contracting COVID-19 when one is in close contact with unvaccinated people. Thus, family caregivers’ choices to remain unvaccinated against COVID-19 could have potentially lethal consequences for their relatives. To our knowledge, this study represents the first attempt within the international literature to analyze COVID-19 vaccine uptake among family caregivers of people with dementia and to identify some of the psychological factors, related to COVID-19 and vaccination behavior, that could facilitate or hinder vaccine uptake. Contact information for family caregivers was obtained from five different centers and associations throughout the Italian territory. Data were collected from 179 respondents during July-September 2021 using a cross-sectional web-based survey design. More than 75% of the respondents indicated that had been vaccinated against COVID-19 and reported receiving vaccine information mainly from print or electronic newspapers (86%), followed by TV (81%) and families (64.2%). In multivariable logistic regression analyses, worries about unforeseen future effects was significantly related to COVID-19 vaccine uptake, indicating that family caregivers concerned about potential side effects of vaccines were less likely to have been vaccinated against COVID-19 (OR = 0.60, CI = 0.40-0.89). Openness to experience was also related to COVID-19 vaccine uptake, with family caregivers higher on this trait being less likely to have been vaccinated against COVID-19 (OR = 0.83, CI = 0.71-0.98). Implications for targeting of vaccine-related messages are discussed.
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Affiliation(s)
- Francesco Bruno
- Regional Neurogenetic Centre, Department of Primary Care, ASP Catanzaro, Lamezia Terme, Italy
- Association for Neurogenetic Research, Lamezia Terme, Italy
- *Correspondence: Francesco Bruno,
| | - Antonio Malvaso
- Neurology Unit and Neurorehabilitation Unit and Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Francesca Chiesi
- Section of Psychology, Department of Neuroscience, Psychology, Drug, and Child’s Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Valentina Laganà
- Association for Neurogenetic Research, Lamezia Terme, Italy
- Valentina Laganà,
| | - Rocco Servidio
- Department of Cultures, Education and Society, University of Calabria, Arcavacata di Rende, Cosenza, Italy
| | - Valeria Isella
- Department of Medicine and Surgery and Milan Center for Neuroscience (NeuroMi), University of Milano – Bicocca, Monza, Italy
| | - Carlo Ferrarese
- Department of Medicine and Surgery and Milan Center for Neuroscience (NeuroMi), University of Milano – Bicocca, Monza, Italy
| | | | | | - Federica Agosta
- Neurology Unit and Neurorehabilitation Unit and Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neurology Unit and Neurorehabilitation Unit and Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | | | - Leslie R. Martin
- Department of Psychology, La Sierra University, Riverside, CA, United States
| | | | - Raffaele Maletta
- Regional Neurogenetic Centre, Department of Primary Care, ASP Catanzaro, Lamezia Terme, Italy
- Association for Neurogenetic Research, Lamezia Terme, Italy
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107
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Muñoz-Corona C, Gutiérrez-Canales LG, Ortiz-Ledesma C, Martínez-Navarro LJ, Macías AE, Scavo-Montes DA, Guaní-Guerra E. Quality of life and persistence of COVID-19 symptoms 90 days after hospital discharge. J Int Med Res 2022; 50:3000605221110492. [PMID: 35822272 PMCID: PMC9284218 DOI: 10.1177/03000605221110492] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective We aimed to describe the persistence of symptoms in coronavirus disease 2019
(COVID-19) and quality of life (QoL) among patients 90 days after their
discharge from the hospital for infection with severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) and to determine differences in QoL
domains concerning the absence or presence of persistent symptoms. Methods To measure QoL, we used a validated Spanish version of the 36-item Short Form
Health Survey (SF-36). Results We included 141 patients. Ninety days after discharge, COVID-19 symptoms
persisted in 107 patients (75.9%), with fatigue (55.3%) and joint pain
(46.8%) being the most frequent. According to the SF-36, the role-physical
score was the dimension with the lowest values (median score, 25;
interquartile range, 0–75). Patients with joint pain, fatigue, and dyspnea
had lower scores than patients without those symptoms, with 10 of the 13
evaluated SF-36 scales showing lower levels. Conclusion Ninety days after hospital discharge from COVID-19 reference centers, most
patients had persistent symptoms and had lower SF-36 scores than patients
without symptoms. It is important to follow-up patients discharged from the
hospital after SARS-CoV-2 infection, ideally through a post-COVID-19 health
care clinic and rehabilitation program, to improve QoL in these
patients.
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Affiliation(s)
- Carolina Muñoz-Corona
- Fellow of the General Directorate of Quality and Health Education, Ministry of Health, Mexico
| | | | - Claudia Ortiz-Ledesma
- Department of Internal Medicine, Hospital Regional de Alta Especialidad del Bajío, León Guanajuato, Mexico
| | | | - Alejandro E Macías
- Department of Medicine and Nutrition, University of Guanajuato, León, Mexico
| | | | - Eduardo Guaní-Guerra
- Department of Medicine, University of Guanajuato, Guanajuato, Mexico.,Department of Research, Hospital Regional de Alta Especialidad del Bajío, León Guanajuato, Mexico
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Machine Learning Models to Predict In-Hospital Mortality among Inpatients with COVID-19: Underestimation and Overestimation Bias Analysis in Subgroup Populations. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:1644910. [PMID: 35756093 PMCID: PMC9226971 DOI: 10.1155/2022/1644910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/17/2022] [Accepted: 05/22/2022] [Indexed: 12/13/2022]
Abstract
Prediction of the death among COVID-19 patients can help healthcare providers manage the patients better. We aimed to develop machine learning models to predict in-hospital death among these patients. We developed different models using different feature sets and datasets developed using the data balancing method. We used demographic and clinical data from a multicenter COVID-19 registry. We extracted 10,657 records for confirmed patients with PCR or CT scans, who were hospitalized at least for 24 hours at the end of March 2021. The death rate was 16.06%. Generally, models with 60 and 40 features performed better. Among the 240 models, the C5 models with 60 and 40 features performed well. The C5 model with 60 features outperformed the rest based on all evaluation metrics; however, in external validation, C5 with 32 features performed better. This model had high accuracy (91.18%), F-score (0.916), Area under the Curve (0.96), sensitivity (94.2%), and specificity (88%). The model suggested in this study uses simple and available data and can be applied to predict death among COVID-19 patients. Furthermore, we concluded that machine learning models may perform differently in different subpopulations in terms of gender and age groups.
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109
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Abdulah DM, Mirza AMS. Receiving COVID-19 vaccine, hospitalization, and outcomes of patients with COVID-19: A prospective study. Monaldi Arch Chest Dis 2022; 93. [PMID: 35754392 DOI: 10.4081/monaldi.2022.2194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/04/2022] [Indexed: 11/23/2022] Open
Abstract
Despite Iraq having started the COVID-19 vaccine in January 2020, there is no official data on vaccination and hospitalization across the country. We aimed to explore the role of the COVID-19 vaccine on the hospitalization and outcomes of patients with COVID-19 in Iraqi Kurdistan. In this prospective study, patients who were admitted to two COVID-19 hospitals in Iraqi Kurdistan in 2021 were followed-up by the discharge time between August and November 2021. The mean age of the patients was 57.6 (27-98 years) of both genders. Most of the patients were illiterate (69.3%) or had a lower level of education (20.5%). A small percentage of patients had previous thrombotic disorders (4.7%) and close to half of the patients had chronic diseases (44.9%). The patients had mild to moderate (44.9%), moderate-severe (36.2%), and critical (18.9%) status. The median hospitalization day was 9 days (1-45 days). The study found that 91.3% of the COVID-19 hospitalized patients did not receive the vaccine and 26.8% of patients died. We did not find a significant association between receiving vaccination and patients' outcomes or disease severity. No patients with previous thrombotic disorders received the COVID-19 vaccine. The male patients were more likely to receive the COVID-19 vaccine compared to female patients; 14.55% vs. 4.17%, p=0.0394. This study showed that most patients with COVID-19 who were admitted to the hospitals have not received the COVID-19 vaccine. A high percentage of the COVID-19 hospitalized patients died of the disease in this region.
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Affiliation(s)
- Deldar Morad Abdulah
- Community Health Unit, College of Nursing, University of Duhok, Iraqi Kurdistan, Duhok.
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Li J, Long X, Zhang Q, Fang X, Luo H, Fang F, Lv X, Zhang D, Sun Y, Li N, Hu S, Li J, Xiong N, Lin Z. Pearson's patterns correlational of clinical risks at admissions with hospitalization outcomes during initial COVID-19 outbreak. iScience 2022; 25:104415. [PMID: 35600840 PMCID: PMC9113760 DOI: 10.1016/j.isci.2022.104415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 04/13/2022] [Accepted: 05/12/2022] [Indexed: 11/24/2022] Open
Abstract
COVID-19 outbreaks have crushed our healthcare systems, which requires clinical guidance for the healthcare following the outbreaks. We conducted retrospective cohort studies with Pearson's pattern-based analysis of clinical parameters of 248 hospitalized patients with COVID-19. We found that dysregulated neutrophil densities were correlated with hospitalization duration before death (p = 0.000066, r = -0.45 for % neutrophil; p = 0.0001, r = -0.47 for neutrophil count). As such, high neutrophil densities were associated with mortality (p = 4.23 × 10-31 for % neutrophil; p = 4.14 × 10-27 for neutrophil count). These findings were further illustrated by a representative "second week crash" pattern and validated by an independent cohort (p = 5.98 × 10-11 for % neutrophil; p = 1.65 × 10-7 for neutrophil count). By contrast, low aspartate aminotransferase (AST) or lactate dehydrogenase (LDH) levels were correlated with quick recovery (p ≤ 0.00005). Collectively, these correlational at-admission findings may provide healthcare guidance for patients with COVID-19 in the absence of targeted therapy.
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Affiliation(s)
- Jingwen Li
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xi Long
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qing Zhang
- Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Xi Fang
- Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Huiling Luo
- Department of Anesthesiology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Fang Fang
- Department of Radiology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Xuefei Lv
- Department of Radiology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Dandan Zhang
- Department of Radiology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Yu Sun
- Department of Radiology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Na Li
- Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Shaoping Hu
- Department of Radiology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Jinghong Li
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Nian Xiong
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Zhicheng Lin
- McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA
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Nguyen HB, Nguyen THM, Vo THN, Vo TCN, Nguyen DNQ, Nguyen HT, Tang TN, Nguyen TH, Do VT, Truong QB. Post-traumatic stress disorder, anxiety, depression and related factors among COVID-19 patients during the fourth wave of the pandemic in Vietnam. Int Health 2022:6607701. [PMID: 35696091 PMCID: PMC9214186 DOI: 10.1093/inthealth/ihac040] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/16/2022] [Accepted: 05/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background This study investigated post-traumatic stress disorder (PTSD), anxiety, depression and their related factors among coronavirus disease 2019 (COVID-19) patients during the fourth wave of the pandemic in Vietnam. Methods Vietnamese-fluent confirmed COVID-19 patients for at least 3 d were recruited in this online cross-sectional study to answer a three-part questionnaire including participants’ sociodemographic characteristics, PTSD (Impact of Event Scale-Revised) and anxiety and depression (Hospital Anxiety and Depression Scale). Associated factors were determined using multivariable binary logistic regression models. Results Of 1544 responses, the majority were female (53.0%), ages 18–39 y (74.8%) and were isolated and treated at field hospitals (72.2%). Family or friends were the greatest sources of mental support (68.2%), followed by healthcare providers (51.1%). The overall prevalence rates of PTSD, anxiety and depression among COVID-19 patients were 22.9%, 11.2% and 17.4%, respectively. Risk factors included older age, higher education, getting infected from the public, knowing someone who died from COVID-19 and high perception of life threat. Meanwhile, mental assistance from family or friends, a greater number of supporters, living with someone not vulnerable and higher salaries were significantly protective factors. Conclusions The psychological responses associated with some sociodemographic details. Family or friends should be the first line of mental interventions for COVID-19 patients.
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Affiliation(s)
- Hoang Bac Nguyen
- University Medical Center Ho Chi Minh City, 215, Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, 700000, Vietnam.,University of Medicine and Pharmacy at Ho Chi Minh City, 215, Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, 700000, Vietnam
| | - Thi Hong Minh Nguyen
- University Medical Center Ho Chi Minh City, 215, Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, 700000, Vietnam
| | - Thi Hong Nhan Vo
- University Medical Center Ho Chi Minh City, 215, Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, 700000, Vietnam
| | - Thi Cam Nhung Vo
- University Medical Center Ho Chi Minh City, 215, Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, 700000, Vietnam
| | - Duc Nguyet Quynh Nguyen
- University Medical Center Ho Chi Minh City, 215, Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, 700000, Vietnam
| | - Huu-Thinh Nguyen
- University Medical Center Ho Chi Minh City, 215, Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, 700000, Vietnam.,University of Medicine and Pharmacy at Ho Chi Minh City, 215, Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, 700000, Vietnam
| | - Tuan-Ngan Tang
- Department of Tissue Engineering and Regenerative Medicine, School of Biomedical Engineering, International University, Quarter 6, Linh Trung Ward, Thu Duc District, Ho Chi Minh City, 700000, Vietnam.,Vietnam National University, Quarter 6, Linh Trung Ward, Thu Duc District, Ho Chi Minh City, 700000, Vietnam
| | - Thi-Hiep Nguyen
- Department of Tissue Engineering and Regenerative Medicine, School of Biomedical Engineering, International University, Quarter 6, Linh Trung Ward, Thu Duc District, Ho Chi Minh City, 700000, Vietnam.,Vietnam National University, Quarter 6, Linh Trung Ward, Thu Duc District, Ho Chi Minh City, 700000, Vietnam
| | - Van Trang Do
- Binh Duong Medical College, Le Hong Phong Street, Phu Hoa Ward, Thu Dau Mot City, Binh Duong Province, 820000, Vietnam
| | - Quang Binh Truong
- University Medical Center Ho Chi Minh City, 215, Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, 700000, Vietnam.,University of Medicine and Pharmacy at Ho Chi Minh City, 215, Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, 700000, Vietnam
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112
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Guidotti R, Pruijm M, Ambühl PM. COVID-19 Pandemic in Dialysis Patients: The Swiss Experience. Front Public Health 2022; 10:795701. [PMID: 35655466 PMCID: PMC9152253 DOI: 10.3389/fpubh.2022.795701] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Chronic dialysis patients are classified as patients with increased risk for COVID-19. Knowledge about the incidence and survival of chronic dialysis patients infected with SARS-CoV-2 in Switzerland - a high-income country with high density of relatively small dialysis centers - is scarce. We present the findings regarding incidence, survival and regional differences, compared to those of the general population in Switzerland. Methods Information on chronic dialysis patients who tested positive for SARS-CoV-2 between February 24, 2020 and February 28, 2022 were reported to the Swiss dialysis registry by all 94 Swiss dialysis centers. Hereafter, these results were linked with clinical characteristics from the Swiss dialysis registry. Results Throughout the study period 1,120 out of ~4,700 dialysis patients tested positive for SARS-CoV-2 in Switzerland: 96 cases occurred in the first wave, 472 in the second wave and 5 in between. During the first wave, Italian-speaking Ticino was most severely affected, with a 7-fold higher incidence of dialysis patients compared to the general Swiss population. In the second wave, the majority of cases were found in the French-speaking part of Switzerland, with a 2.5 times higher incidence vs. non-dialysis patients. A total of 123 deaths were recorded in the first two waves, of which COVID-19 was the main cause of death in 100 patients. This corresponds to a highly increased overall mortality rate of 17.5% compared to 1.7% in the general population. Age was identified as the only risk factor for mortality in dialysis patients. During the third, fourth and fifth wave, 61, 43 and 443 cases, respectively, were recorded, resulting in 6 (mortality rate 9.8%), 1 (mortality rate 2.3%) and 13 deaths (mortality rate 2.9%). Conclusion Chronic dialysis patients in Switzerland were more likely to be infected by SARS-CoV-2 during the first and second wave than the rest of the population, but an inverse trend was observed during the third, fourth and fifth wave, probably thanks to vaccination. In addition, mortality is significantly increased compared to non-dialysis patients. In Swiss dialysis patients, age is the strongest risk factor for death.
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Affiliation(s)
- Rebecca Guidotti
- Institute of Nephrology, Stadtspital Zürich, Zurich, Switzerland
| | - Menno Pruijm
- Service of Nephrology and Hypertension, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Patrice M Ambühl
- Institute of Nephrology, Stadtspital Zürich, Zurich, Switzerland
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Kubale J, Balmaseda A, Frutos AM, Sanchez N, Plazaola M, Ojeda S, Saborio S, Lopez R, Barilla C, Vasquez G, Moreira H, Gajewski A, Campredon L, Maier HE, Chowdhury M, Cerpas C, Harris E, Kuan G, Gordon A. Association of SARS-CoV-2 Seropositivity and Symptomatic Reinfection in Children in Nicaragua. JAMA Netw Open 2022; 5:e2218794. [PMID: 35759261 PMCID: PMC9237791 DOI: 10.1001/jamanetworkopen.2022.18794] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/21/2022] [Indexed: 01/20/2023] Open
Abstract
Importance The impact of the SARS-CoV-2 pandemic on children remains unclear. Better understanding of the burden of COVID-19 among children and their risk of reinfection is crucial, as they will be among the last groups vaccinated. Objective To characterize the burden of COVID-19 and assess how risk of symptomatic reinfection may vary by age among children. Design, Setting, and Participants In this prospective, community-based pediatric cohort study conducted from March 1, 2020, to October 15, 2021, 1964 nonimmunocompromised children aged 0 to 14 years were enrolled by random selection from the Nicaraguan Pediatric Influenza Cohort, a community-based cohort in District 2 of Managua, Nicaragua. Additional newborn infants aged 4 weeks or younger were randomly selected and enrolled monthly via home visits. Exposures Prior COVID-19 infection as confirmed by positive anti-SARS-CoV-2 antibodies (receptor binding domain and spike protein) or real-time reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 infection at least 60 days before current COVID-19 infection. Main Outcomes and Measures Symptomatic COVID-19 cases confirmed by real-time RT-PCR and hospitalization within 28 days of symptom onset of a confirmed COVID-19 case. Results This cohort study assessed 1964 children (mean [SD] age, 6.9 [4.4] years; 985 [50.2%] male). Of 1824 children who were tested, 908 (49.8%; 95% CI, 47.5%-52.1%) were seropositive during the study. There were also 207 PCR-confirmed COVID-19 cases, 12 (5.8%) of which were severe enough to require hospitalization. Incidence of COVID-19 was highest among children younger than 2 years (16.1 cases per 100 person-years; 95% CI, 12.5-20.5 cases per 100 person-years), which was approximately 3 times the incidence rate in any other child age group assessed. In addition, 41 symptomatic SARS-CoV-2 episodes (19.8%; 95% CI, 14.4%-25.2%) were reinfections. Conclusions and Relevance In this prospective, community-based pediatric cohort study, rates of symptomatic and severe COVID-19 were highest among the youngest participants, with rates stabilizing at approximately 5 years of age. In addition, symptomatic reinfections represented a large proportion of symptomatic COVID-19 cases.
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Affiliation(s)
- John Kubale
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Angel Balmaseda
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Aaron M. Frutos
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | | | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Saira Saborio
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Roger Lopez
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Carlos Barilla
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Gerald Vasquez
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Hanny Moreira
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | | | - Lora Campredon
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Hannah E. Maier
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Mahboob Chowdhury
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Cristhiam Cerpas
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
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114
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Fieselmann J, Wahidie D, Yilmaz-Aslan Y, Brzoska P. Additional burdens of family caregivers during the COVID-19 pandemic: A qualitative analysis of social media in Germany. Nurs Health Sci 2022; 24:414-422. [PMID: 35289050 PMCID: PMC9115354 DOI: 10.1111/nhs.12937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/21/2022] [Accepted: 03/02/2022] [Indexed: 01/06/2023]
Abstract
Caregiving is associated with various burdens for family caregivers. The COVID‐19 pandemic and the protective measures implemented to restrict public life, such as social distancing and the closure of services and educational institutions, add further challenges. Little is known about how they are perceived by family caregivers. Based on an analysis of German social media posts, the aim of this study was to explore the additional strains family caregivers experience during the pandemic. The websites of three social media services were searched using the respective search engines provided by the websites. Data from a 10‐month period (March to December 2020) were identified and examined. A total of 237 publicly available posts were included in the analysis. Seven main categories were identified using a thematic approach: care and support, deterioration of the condition of the person being cared for, psychological challenges, financial challenges, infection control, access to protective equipment, and acknowledgement of family caregivers. Family caregivers are affected by additional burdens during the pandemic, which makes the development of support and relief services tailored to this population group necessary.
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Affiliation(s)
- Jana Fieselmann
- Faculty of Health, School of Medicine, Health Services Research, Witten/Herdecke University, Witten, Germany
| | - Diana Wahidie
- Faculty of Health, School of Medicine, Health Services Research, Witten/Herdecke University, Witten, Germany
| | - Yüce Yilmaz-Aslan
- Faculty of Health, School of Medicine, Health Services Research, Witten/Herdecke University, Witten, Germany.,Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.,Department of Nursing and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Patrick Brzoska
- Faculty of Health, School of Medicine, Health Services Research, Witten/Herdecke University, Witten, Germany
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115
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Comparative Clinical Characteristics, Laboratory Findings, and Outcomes of Hypoxemic and Non-Hypoxemic Patients Treated at a Makeshift COVID-19 Unit in Bangladesh: A Retrospective Chart Analysis. J Clin Med 2022; 11:jcm11112968. [PMID: 35683357 PMCID: PMC9181205 DOI: 10.3390/jcm11112968] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/13/2022] [Accepted: 05/20/2022] [Indexed: 01/08/2023] Open
Abstract
Background: Starting on 31 December 2019, from Wuhan City, China, Coronavirus disease 2019 (COVID-19) caused a global pandemic by 11 March 2020. Bangladesh detected its first case on 8 March 2020, only 66 days later the detection of the first case in China. We aimed to describe the epidemiology, clinical features, laboratory characteristics, and outcomes of Bangladeshi COVID-19 patients. Methods: This retrospective chart analysis compared Bangladeshi COVID-19 patients with hypoxemia compared to those without hypoxemia treated in a makeshift COVID-19 unit of icddr,b. Results: By March 2021, 207 remained in-patient. Nineteen patients (9.2%) died, whereas 10 (4.8%) were referred to different facilities for definitive care. Out of 207 in-patients, 88 patients required oxygen therapy. Multivariable logistic regression identified age (1.07 (1.02−1.13)), dyspnea (3.56 (1.06−11.96)), high CRP (1.13 (1.03−1.25)), and lymphopenia (6.18 (1.81−21.10)) as the independent predictors for hypoxemia in patients hospitalized for COVID 19 (for all, p < 0.05). Conclusion: Older age, dyspnea, high CRP, and lymphopenia are simple, but important, clinical and laboratory parameters. These may help clinicians to identify COVID-19 patients early who are at risk of fatal hypoxemia. Close monitoring, and prompt and aggressive treatment of these patients would curb their morbidity and mortality, especially in resource-limited settings.
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116
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Shupp B, Mehta SV, Chirayath S, Patel N, Aiad M, Sapin J, Stoltzfus J, Schneider Y. Proton pump inhibitor therapy usage and associated hospitalization rates and critical care outcomes of COVID-19 patients. Sci Rep 2022; 12:7596. [PMID: 35534666 PMCID: PMC9084256 DOI: 10.1038/s41598-022-11680-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/12/2022] [Indexed: 11/17/2022] Open
Abstract
Proton Pump Inhibitors (PPI) are one of the most prescribed medications in the United States. However, PPIs have been shown to increase the risk of enteric infections. Our study aims to evaluate the correlation between PPI and COVID-19 severity. We performed a retrospective cohort study on patients who tested positive for SARS-CoV-2 from March to August 2020. Patients were categorized based on PPI user status. Primary outcomes included need for hospital or ICU admission and 30-day mortality. Secondary outcomes looked to determine the severity of COVID-19 infection and effect of comorbid conditions. 2,594 patients were reviewed. The primary outcomes of our study found that neither active nor past PPI use was associated with increased hospital admission or 30-day mortality following completion of multivariate analysis. Additionally, there was no association between COVID-19 infection and the strength of PPI dosing (low, standard, high). However, the following covariates were independently and significantly associated with increased admission: age, male gender, diabetes, COPD, composite cardiovascular disease, kidney disease, and obesity. The following covariates were associated with increased mortality: age, male gender, COPD, and kidney disease. In conclusion, the high risk features and comorbidities of PPI users were found to have a stronger correlation to severe COVID-19 infection and poor outcomes as opposed to the use of PPI therapy.
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Affiliation(s)
- Brittney Shupp
- Internal Medicine Resident, St. Luke's University Health Network, Bethlehem, PA, USA. .,Division of Internal Medicine, St. Luke's University Health Network, 801 Ostrum St., Suite 201, Bethlehem, 18015, PA, USA.
| | - Sagar V Mehta
- Department of Gastroenterology, St. Luke's University Health Network, Bethlehem, PA, USA
| | - Subin Chirayath
- Internal Medicine Resident, St. Luke's University Health Network, Bethlehem, PA, USA
| | - Nishit Patel
- Internal Medicine Resident, St. Luke's University Health Network, Easton, PA, USA
| | - Mina Aiad
- Internal Medicine Resident, St. Luke's University Health Network, Bethlehem, PA, USA
| | - Jared Sapin
- Lewis Katz School of Medicine at Temple University - St. Luke's Campus, Bethlehem, PA, USA
| | - Jill Stoltzfus
- St. Luke's University Health Network, Bethlehem, PA, USA
| | - Yecheskel Schneider
- Department of Gastroenterology, St. Luke's University Health Network, Bethlehem, PA, USA
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117
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Rangsrisaeneepitak V, Porntharukchareon T, Dechates B, Sirisreetreerux S, Tawinprai K. Antibody levels in people with diabetes after one dose of the ChAdOx1 nCoV-19 (AZD1222) vaccine. Diabetol Int 2022; 13:637-643. [PMID: 35528950 PMCID: PMC9068501 DOI: 10.1007/s13340-022-00582-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022]
Abstract
Patients with diabetes and coexistent coronavirus disease 2019 (COVID-19) have a higher risk of COVID-19 complications. Therefore, it is critical that sustained and effective immunogenicity against COVID-19 is achieved in such patients. This study evaluates the antibody response for 56 days after the first dose of the AZD1222 vaccine in subjects with and without diabetes to assess the potential risk of delaying the second dose. This study included 282 people who received one dose of AZD1222. The geometric mean concentration of antibodies specific for severe acute respiratory syndrome coronavirus 2 IgG at 56 days was significantly (P < 0.001) lower in people with type 2 diabetes mellitus (T2D; 15.13 BAU/mL, 95% confidence interval [CI] = 10.7–21.4) than in those without diabetes (40.20 BAU/mL, 95% CI = 33.43–48.36), as confirmed by a geometric mean ratio of 0.37 (95% CI = 0.25–0.54). Weaker immune responses were also observed in diabetic patients ≥ 65 years old (10.09 BAU/mL, 95% CI = 6.09–16.71) compared with their younger counterparts (22.31 BAU/mL, 95% CI = 13.98–35.59, P = 0.034). People with T2D had weaker antibody responses than those without diabetes after the first dose of AZD1222. Older age was associated with weaker antibody responses in elderly patients with diabetes.
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Affiliation(s)
- Vimonsri Rangsrisaeneepitak
- Endocrinology and Metabolism Unit, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Thachanun Porntharukchareon
- Endocrinology and Metabolism Unit, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Bothamai Dechates
- Endocrinology and Metabolism Unit, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Supamas Sirisreetreerux
- Endocrinology and Metabolism Unit, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Kriangkrai Tawinprai
- Infectious Disease Unit, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
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118
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Awang H, Yaacob EL, Ahmad Daud A, Ahmad N, Ishak MS, Alias NA, Ghazali NH, Ismail NF, Abd Khalim MA, Mohamed Yusof SA, Samsury SF, Abd Rahman MA, Embong K. Risk Factors for Mortality among COVID-19 Patients in Besut Region, Terengganu, Malaysia. EUROPEAN JOURNAL OF MEDICAL AND HEALTH SCIENCES 2022; 4:1-6. [DOI: 10.24018/ejmed.2022.4.3.1307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Background: COVID-19 mortality is a public health issue in Malaysia and its contributing factors need to be addressed thoroughly. This study aimed to determine the risk factors for COVID-19 mortality in Besut region of Malaysia.
Materials and Methods: A 1:5 case-control study between deceased and survived groups among COVID-19 patients was conducted in Besut district, Terengganu state from 1st October 2020 until 16th September 2021 based on retrospective record review. The inclusion criteria for cases were individuals with laboratory RT-PCR confirmed positive test for COVID-19 and died during COVID-19 care period. Descriptive statistics, simple and multiple logistic regression analyses were employed for statistical analysis.
Result: There were 6464 COVID-19 cases in Besut district during the studied period. The proportion of COVID-19 mortality was 0.84%. Among the deceased group, majority of them were male (51.9%), symptomatic (87.0%), unvaccinated (94.4%); had COVID-19 of category 5 (31.5%) and comorbidity (81.5%). Multiple logistic regression revealed older age, stage 4 COVID-19, stage 5 COVID-19, symptomatic, cases with comorbidity and unvaccinated cases as the significant associated factors for COVID-19 mortality with adjusted odds ratio (AOR) of 1.07 (95%CI: 1.01, 1.10), p<0.001; AOR 92.61 (95%CI: 7.07, 1212.02), p=0.001; AOR 274.97 (95%CI: 25.27, 2991.74), p<0.001; AOR 8.83 (95%CI: 3.21, 24.28), p<0.001; AOR 46.72 (95%CI: 15.29, 142.70), p<0.001; and AOR 16.94 (95%CI: 6.34, 121.22), p=0.001, respectively.
Conclusion: Advanced age, severe stages of COVID-19, symptomatic cases, cases with comorbidity and unvaccinated cases were the risk factors for COVID-19 mortality. Emphasis should be given to these factors to ensure timely control and treatment strategies.
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119
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Jiang J, Zhong W, Huang W, Gao Y, He Y, Li X, Liu Z, Zhou H, Fu Y, Liu R, Zhang W. Development and Validation of a Predictive Nomogram with Age and Laboratory Findings for Severe COVID-19 in Hunan Province, China. Ther Clin Risk Manag 2022; 18:579-591. [PMID: 35607424 PMCID: PMC9123913 DOI: 10.2147/tcrm.s361936] [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: 02/18/2022] [Accepted: 05/03/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose To identify more objectively predictive factors of severe outcome among patients hospitalized for coronavirus disease 2019 (COVID-19). Patients and Methods A retrospective cohort of 479 hospitalized patients diagnosed with COVID-19 in Hunan Province was selected. The prognostic effects of factors such as age and laboratory indicators were analyzed using the Kaplan–Meier method and Cox proportional hazards model. A prognostic nomogram model was established to predict the progression of patients with COVID-19. Results A total of 524 patients in Hunan province with COVID-19 from December 2019 to October 2020 were retrospectively recruited. Among them, 479 eligible patients were randomly assigned into the training cohort (n = 383) and validation cohort (n = 96), at a ratio of 8:2. Sixty-eight (17.8%) and 15 (15.6%) patients developed severe COVID-19 after admission in the training cohort and validation cohort, respectively. The differences in baseline characteristics were not statistically significant between the two cohorts with regard to age, sex, and comorbidities (P > 0.05). Multivariable analyses included age, C-reactive protein, fibrinogen, lactic dehydrogenase, neutrophil-to-lymphocyte ratio, urea, albumin-to-globulin ratio, and eosinophil count as predictive factors for patients with progression to severe COVID-19. A nomogram was constructed with sufficient discriminatory power (C index = 0.81), and proper consistency between the prediction and observation, with an area under the ROC curve of 0.81 and 0.86 in the training and validation cohort, respectively. Conclusion We proposed a simple nomogram for early detection of patients with non-severe COVID-19 but at high risk of progression to severe COVID-19, which could help optimize clinical care and personalized decision-making therapies.
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Affiliation(s)
- Junyi Jiang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
- Aier Eye Institute, Changsha, Hunan, People’s Republic of China
| | - WeiJun Zhong
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - WeiHua Huang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Yongchao Gao
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Yijing He
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Xi Li
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Zhaoqian Liu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Honghao Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Yacheng Fu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Cofoe Medical Technology Co., Ltd, Changsha, People’s Republic of China
| | - Rong Liu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Wei Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
- Correspondence: Wei Zhang; Rong Liu, Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of China, Tel +86 731 84805380, Fax +86 731 82354476, Email ;
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Sajjad W, Thankappannair V, Shah S, Ahmed A, Saeb-Parsy K, Kastner C, Lamb B, Gnanapragasam VJ. Diagnostic value of the abnormal digital rectal examination in the modern MRI-based prostate cancer diagnostic pathway. JOURNAL OF CLINICAL UROLOGY 2022:10.1177/20514158221091402. [PMID: 38591853 PMCID: PMC10775687 DOI: 10.1177/20514158221091402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Objective Currently the National Institute for Health and Care Excellence (NICE) recommends an abnormal digital rectal examination (DRE) as a standalone referral criterion for suspected prostate cancer. Unlike referrals for a raised prostate-specific antigen (PSA) which are triaged directly to magnetic resonance imaging (MRI), an abnormal DRE requires re-examination in a secondary clinic first. Here, we investigated the ongoing value of the abnormal DRE as a referral criterion. Methods This study is a retrospective review of patients referred to secondary care for suspected prostate cancer based on an abnormal DRE over a 15-month period at a single UK hospital (n = 158). Age, PSA, primary and repeat DRE findings and eventual diagnosis were collated. Results A concurrent raised PSA was present in 65/158 (41%). Concordance between primary and secondary care DRE was only 72/158 (46%). The overall and significant cancer detection rate was 26/158 (16%) and 22/158 (14%), respectively. Among men with a concurrent raised PSA, 19/65 (29%) had significant cancer found, whereas with an abnormal primary care DRE and normal PSA (n = 93), only 3/93 (3%) had a significant cancer. Mandating a PSA before referral for an abnormal DRE would have redirected 65/158 (41%) of men to MRI first, negating the need for a repeat DRE (p < 0.0001). This finding was recapitulated in a second prospective validation cohort (n = 30) with 9/30 (30%) redirected to MRI first. Conclusions This is one of the first studies to investigate the value of the DRE in contemporary practice. We propose that PSA is used to triage men with an abnormal DRE to MRI without needing a repeat DRE. If the PSA is normal, the diagnostic yield is low but may still warrant a repeat DRE to assess the need for further investigations. Additional multicentre studies are required to further validate our findings. Level of evidence 4.
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Affiliation(s)
- Wasiq Sajjad
- School of Clinical Medicine, University of Cambridge, UK
| | | | - Syed Shah
- Department of Urology, Cambridge University Hospitals Trust, UK
| | - Adham Ahmed
- Department of Urology, Cambridge University Hospitals Trust, UK
| | | | | | - Benjamin Lamb
- Department of Urology, Cambridge University Hospitals Trust, UK
| | - Vincent J Gnanapragasam
- School of Clinical Medicine, University of Cambridge, UK
- Department of Urology, Cambridge University Hospitals Trust, UK
- Division of Urology, Department of Surgery, University of Cambridge, UK
- Cambridge Urology Translational Research and Clinical Trials Office, Cambridge Biomedical Campus, University of Cambridge & Cambride University Hospital, Cambridge, UK
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121
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Guerrero-Romero F, Mercado M, Rodríguez-Morán M, Ramírez-Renteria C, Martínez-Aguilar G, Marrero-Rodríguez D, Ferreira-Hermosillo A, Simental-Mendía LE, Remba-Shapiro I, Gamboa-Gómez CI, Albarrán-Sánchez A, Sanchez-García ML. Magnesium-to-Calcium Ratio and Mortality from COVID-19. Nutrients 2022; 14:nu14091686. [PMID: 35565654 PMCID: PMC9101802 DOI: 10.3390/nu14091686] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 02/05/2023] Open
Abstract
Obesity, type 2 diabetes, arterial hypertension, decrease in immune response, cytokine storm, endothelial dysfunction, and arrhythmias, which are frequent in COVID-19 patients, are associated with hypomagnesemia. Given that cellular influx and efflux of magnesium and calcium involve the same transporters, we aimed to evaluate the association of serum magnesium-to-calcium ratio with mortality from severe COVID-19. The clinical and laboratory data of 1064 patients, aged 60.3 ± 15.7 years, and hospitalized by COVID-19 from March 2020 to July 2021 were analyzed. The data of 554 (52%) patients discharged per death were compared with the data of 510 (48%) patients discharged per recovery. The ROC curve showed that the best cut-off point of the magnesium-to-calcium ratio for identifying individuals at high risk of mortality from COVID-19 was 0.20. The sensitivity and specificity were 83% and 24%. The adjusted multivariate regression model showed that the odds ratio between the magnesium-to-calcium ratio ≤0.20 and discharge per death from COVID-19 was 6.93 (95%CI 1.6-29.1) in the whole population, 4.93 (95%CI 1.4-19.1, p = 0.003) in men, and 3.93 (95%CI 1.6-9.3) in women. In conclusion, our results show that a magnesium-to-calcium ratio ≤0.20 is strongly associated with mortality in patients with severe COVID-19.
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Affiliation(s)
- Fernando Guerrero-Romero
- Biomedical Research Unit, Instituto Mexicano del Seguro Social, Durango 34067, Mexico; (M.R.-M.); (G.M.-A.); (L.E.S.-M.); (C.I.G.-G.)
- Correspondence: ; Tel.: +52-1-618-1450481
| | - Moises Mercado
- Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (M.M.); (C.R.-R.); (D.M.-R.); (A.F.-H.); (I.R.-S.); (M.L.S.-G.)
| | - Martha Rodríguez-Morán
- Biomedical Research Unit, Instituto Mexicano del Seguro Social, Durango 34067, Mexico; (M.R.-M.); (G.M.-A.); (L.E.S.-M.); (C.I.G.-G.)
| | - Claudia Ramírez-Renteria
- Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (M.M.); (C.R.-R.); (D.M.-R.); (A.F.-H.); (I.R.-S.); (M.L.S.-G.)
| | - Gerardo Martínez-Aguilar
- Biomedical Research Unit, Instituto Mexicano del Seguro Social, Durango 34067, Mexico; (M.R.-M.); (G.M.-A.); (L.E.S.-M.); (C.I.G.-G.)
| | - Daniel Marrero-Rodríguez
- Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (M.M.); (C.R.-R.); (D.M.-R.); (A.F.-H.); (I.R.-S.); (M.L.S.-G.)
| | - Aldo Ferreira-Hermosillo
- Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (M.M.); (C.R.-R.); (D.M.-R.); (A.F.-H.); (I.R.-S.); (M.L.S.-G.)
| | - Luis E. Simental-Mendía
- Biomedical Research Unit, Instituto Mexicano del Seguro Social, Durango 34067, Mexico; (M.R.-M.); (G.M.-A.); (L.E.S.-M.); (C.I.G.-G.)
| | - Ilan Remba-Shapiro
- Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (M.M.); (C.R.-R.); (D.M.-R.); (A.F.-H.); (I.R.-S.); (M.L.S.-G.)
| | - Claudia I. Gamboa-Gómez
- Biomedical Research Unit, Instituto Mexicano del Seguro Social, Durango 34067, Mexico; (M.R.-M.); (G.M.-A.); (L.E.S.-M.); (C.I.G.-G.)
| | - Alejandra Albarrán-Sánchez
- Department of Internal Medicine, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico;
| | - Miriam L. Sanchez-García
- Research Unit in Endocrine Diseases, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico; (M.M.); (C.R.-R.); (D.M.-R.); (A.F.-H.); (I.R.-S.); (M.L.S.-G.)
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Socio-Economic, Demographic and Health Determinants of the COVID-19 Outbreak. Healthcare (Basel) 2022; 10:healthcare10040748. [PMID: 35455925 PMCID: PMC9031016 DOI: 10.3390/healthcare10040748] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE In this study, the effects of social and health indicators affecting the number of cases and deaths of the COVID-19 pandemic were examined. For the determinants of the number of cases and deaths, four models consisting of social and health indicators were created. METHODS In this quantitative research, 93 countries in the model were used to obtain determinants of the confirmed cases and determinants of the COVID-19 fatalities. RESULTS The results obtained from Model I, in which the number of cases was examined with social indicators, showed that the number of tourists, the population between the ages of 15 and 64, and institutionalization had a positive effect on the number of cases. The results obtained from the health indicators of the number of cases show that cigarette consumption affects the number of cases positively in the 50th quantile, the death rate under the age of five affects the number of cases negatively in all quantiles, and vaccination positively affects the number of cases in 25th and 75th quantile values. Findings from social indicators of the number of COVID-19 deaths show that life expectancy negatively affects the number of deaths in the 25th and 50th quantiles. The population over the age of 65 and CO2 positively affect the number of deaths at the 25th, 50th, and 75th quantiles. There is a non-linear relationship between the number of cases and the number of deaths at the 50th and 75th quantile values. An increase in the number of cases increases the number of deaths to the turning point; after the turning point, an increase in the number of cases decreases the death rate. Herd immunity has an important role in obtaining this finding. As a health indicator, it was seen that the number of cases positively affected the number of deaths in the 50th and 75th quantile values and the vaccination rate in the 25th and 75th quantile values. Diabetes affects the number of deaths positively in the 75th quantile. CONCLUSION The population aged 15-64 has a strong impact on COVID-19 cases, but in COVID-19 deaths, life expectancy is a strong variable. On the other hand, it has been found that vaccination and the number of cases interaction term has an effect on the mortality rate. The number of cases has a non-linear effect on the number of deaths.
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Association of epicardial adipose tissue with the severity and adverse clinical outcomes of COVID-19: A meta-analysis. Int J Infect Dis 2022; 120:33-40. [PMID: 35421580 PMCID: PMC8996473 DOI: 10.1016/j.ijid.2022.04.013] [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: 01/22/2022] [Revised: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Epicardial adipose tissue (EAT) has been proposed to be an independent predictor of visceral adiposity. EAT measures are associated with coronary artery disease, diabetes, and chronic obstructive pulmonary disease, which are risk factors for COVID-19 poor prognosis. Whether EAT measures are related to COVID-19 severity and prognosis is controversial. Methods We searched 6 databases for studies until January 7, 2022. The pooled effects are presented as the standard mean difference (SMD) or weighted mean difference with 95% confidence intervals (CIs). The primary end point was COVID-19 severity. Adverse clinical outcomes were also assessed. Results A total of 13 studies with 2482 patients with COVID-19 were identified. All patients had positive reverse transcriptase-polymerase chain reaction results. All quantitative EAT measures were based on computed tomography. Patients in the severe group had higher EAT measures compared with the nonsevere group (SMD = 0.74, 95% CI: 0.29–1.18, P = 0.001). Patients with hospitalization requirement, requiring invasive mechanical ventilation, admitted to intensive care unit, or with combined adverse outcomes had higher EAT measures compared to their controls (all P < 0.001). Conclusions EAT measures were associated with the severity and adverse clinical outcomes of COVID-19. EAT measures might help in prognostic risk stratification of patients with COVID-19.
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Brdar I, Jerković I, Bašić Ž, Kunac N, Anđelinović D, Bezić J, Kružić I, Vuko A, Anđelinović Š. ABO and Rh blood groups, demographics, and comorbidities in COVID-19 related deaths: A retrospective study in Split-Dalmatia County, Croatia. Transfus Apher Sci 2022; 61:103440. [PMID: 35422344 PMCID: PMC8999737 DOI: 10.1016/j.transci.2022.103440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/23/2022]
Abstract
Background Blood group phenotypes have been associated with COVID-19 susceptibility and severity. This study aimed to examine ABO/Rh blood group distribution in COVID-19-related deaths considering demographics and pathological conditions. Methods We conducted a retrospective study at the University Hospital Center Split, Croatia, that included 245 COVID-19 positive individuals that died from April 8, 2020, to January 25, 2021. We extracted data on their blood groups, demographics, and pre-existing comorbidities and compared findings with general population data from blood group donations (n = 101,357) and non-COVID-19 deaths from 2019 (n = 4968). Results The proportion of dead males was significantly higher than in non-COVID-19 cases (63.7% vs. 48.9%, P < 0.001), while the proportion of older individuals did not differ. The prevailing pre-existing diseases were hypertension (59.6%), diabetes (37.1%), heart failure (28.8%), digestive disorder (26.5%), and solid tumor (21.6%). The ABO distribution in the deceased and donors' group showed significant differences, with the higher prevalence of A/AB group and lower prevalence of 0, but with individual differences significant only for AB and non-AB groups. There was a reduced proportion of females within the deceased with group 0 (P = 0.014) and a higher proportion of AB individuals with coronary heart disease (P = 0.024). Conclusion The study confirmed a higher risk of death in males. The lower proportion of type 0 in deceased individuals was greater in females, implying that group 0 is not necessarily an independent protective factor. Coronary heart disease was identified as a potential risk factor for AB individuals.
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Sansone NMS, Boschiero MN, Ortega MM, Ribeiro IA, Peixoto AO, Mendes RT, Marson FAL. Severe Acute Respiratory Syndrome by SARS-CoV-2 Infection or Other Etiologic Agents Among Brazilian Indigenous Population: An Observational Study from the First Year of Coronavirus Disease (COVID)-19 Pandemic. LANCET REGIONAL HEALTH. AMERICAS 2022; 8:100177. [PMID: 35018359 PMCID: PMC8739500 DOI: 10.1016/j.lana.2021.100177] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Indigenous peoples are vulnerable to pandemics, including to the coronavirus disease (COVID)-19, since it causes high mortality and specially, the loss of elderly Indigenous individuals. Methods The epidemiological data of severe acute respiratory syndrome (SARS) by SARS-CoV-2 infection or other etiologic agents (OEA) among Brazilian Indigenous peoples during the first year of COVID-19 pandemic was obtained from a Brazilian Ministry of Health open-access database to perform an observational study. Considering only Indigenous individuals diagnosed with SARS by COVID-19, the epidemiology data were also evaluated as risk of death. The type of sample collection for virus screening, demographic profile, clinical symptoms, comorbidities, and clinical evolution were evaluated. The primary outcome was considered the death in the Brazilian Indigenous individuals and the secondary outcome, the characteristics of Brazilian Indigenous infected by SARS-CoV-2 or OEA, as the need for intensive care unit admission or the need for mechanical ventilation support. The statistical analysis was done using Logistic Regression Model. Alpha of 0.05. Findings A total of 3,122 cases of Indigenous individuals with SARS in Brazil were reported during the first year of the COVID-19 pandemic. Of these, 1,994 were diagnosed with COVID-19 and 730/1,816 (40.2%) of them died. The death rate among individuals with SARS-CoV-2 was three-fold increased when compared to the group of individuals with OEA. Several symptoms (myalgia, loss of smell, and sore throat) and comorbidities (cardiopathy, systemic arterial hypertension, and diabetes mellitus) were more prevalent in the COVID-19 group when compared to Indigenous individuals with OEA. Similar profile was observed considering the risk of death among the Indigenous individuals with COVID-19 who presented several symptoms (oxygen saturation <95%, dyspnea, and respiratory distress) and comorbidities (renal disorders, cardiopathy, and diabetes mellitus). The multivariate analysis was significant in differentiating between the COVID-19-positive and non-COVID-19 patients [X2(7)=65.187; P-value<0.001]. Among the patients’ features, the following contributed in relation to the diagnosis of COVID-19: age [≥43 years-old [y.o.]; OR=1.984 (95%CI=1.480-2.658)]; loss of smell [OR=2.373 (95%CI=1.461-3.854)]; presence of previous respiratory disorders [OR=0.487; 95%CI=0.287-0.824)]; and fever [OR=1.445 (95%CI=1.082-1.929)]. Also, the multivariate analysis was able to predict the risk of death [X2(9)=293.694; P-value<0.001]. Among the patients’ features, the following contributed in relation to the risk of death: male gender [OR=1.507 (95%CI=1.010-2.250)]; age [≥60 y.o.; OR=3.377 (95%CI=2.292-4.974)]; the need for ventilatory support [invasive mechanical ventilation; OR=24.050 (95%CI=12.584-45.962) and non-invasive mechanical ventilation; OR=2.249 (95%CI=1.378-3.671)]; dyspnea [OR=2.053 (95%CI=1.196-3.522)]; oxygen saturation <95% [OR=1.691 (95%CI=1.050-2.723)]; myalgia [OR=0.423 (95%CI=0.191-0.937)]; and the presence of kidney disorders [OR=3.135 (95%CI=1.144-8.539)]. Interpretation The Brazilian Indigenous peoples are in a vulnerable situation during the COVID-19 pandemic and presented an increased risk of death due to COVID-19. Several factors were associated with enhanced risk of death, as male sex, older age (≥60 y.o.), and need for ventilatory support; also, other factors might help to differentiate SARS by COVID-19 or by OEA, as older age (≥43 y.o.), loss of smell, and fever. Funding Fundação de Amparo à Pesquisa do Estado de São Paulo (Foundation for Research Support of the State of São Paulo; #2021/05810-7).
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Key Words
- %, Percentage
- 95%CI, 95% Confidence Interval
- COVID-19
- COVID-19, Coronavirus Disease (2019)
- Ethnicity
- H1N1, H1N1 Strain of the Flu (Influenzae) virus
- HRCT, High-Resolution Computed Tomography
- ICU, Intensive Care Unit
- Indigenous
- Intensive Care Unit
- MV, Mechanical Ventilation
- NA, Not Applicable
- OEA, Other Etiologic Agents
- OR, Odds Ratio
- Pandemic
- RT-PCR, Real Time-Polymerase Chain Reaction
- Race
- Respiratory Disease
- SAH, Systemic Arterial Hypertension
- SARS, Severe Acute Respiratory Syndrome
- SARS-CoV, Severe Acute Respiratory Syndrome Coronavirus
- SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2
- SIVEP-Gripe, Information System for Epidemiological Surveillance of Influenza (Sistema de Informação de Vigilância Epidemiológica da Gripe)
- SUS, Sistema Único de Saúde (Brazilian Public Health System)
- Severe Acute Respiratory Syndrome
- Virus
- y.o., Years Old
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Affiliation(s)
- Nathália M S Sansone
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, SP, Brazil
| | - Matheus N Boschiero
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil
| | - Manoela M Ortega
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, SP, Brazil
| | - Isadora A Ribeiro
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, SP, Brazil
| | - Andressa O Peixoto
- Laboratory of Translational Medicine, Center for Investigation in Pediatrics, School of Medical Sciences, University of Campinas. Campinas, SP, Brazil
| | - Roberto T Mendes
- Laboratory of Translational Medicine, Center for Investigation in Pediatrics, School of Medical Sciences, University of Campinas. Campinas, SP, Brazil
| | - Fernando A L Marson
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, SP, Brazil
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Butkiewicz S, Zaczyński A, Hampel M, Pańkowski I, Gałązkowski R, Rzońca P. Analysis of Risk Factors for In-Hospital Death Due to COVID-19 in Patients Hospitalised at the Temporary Hospital Located at the National Stadium in Warsaw: A Retrospective Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073932. [PMID: 35409617 PMCID: PMC8998082 DOI: 10.3390/ijerph19073932] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 02/04/2023]
Abstract
The outbreak of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic has affected all aspects of social life and brought massive changes to the healthcare sector. The aim of this study was to identify the factors affecting the mortality of COVID-19 patients at a temporary hospital in Warsaw (Poland). The present study was conducted based on a retrospective analysis of the medical records of patients hospitalised at the temporary hospital located at the National Stadium in Warsaw between 1 March 2020 and 30 April 2021. The study included all cases of patients who were brought directly or transferred to the National Hospital from other hospitals for further treatment. With regard to comorbidities, the analysis found that five comorbidities—namely, diabetes (OR = 1.750, 95% CI: 1.009−2.444, p < 0.05), stroke history (OR = 2.408, 95% CI: 1.208−4.801, p < 0.05), renal failure (OR = 2.141, 95% CI: 1.052−4.356, p < 0.05), chronic obstructive pulmonary disease (OR = 2.044, 95% CI: 1.133−3.690, p < 0.05) and heart failure (OR = 1.930, 95% CI: 1.154−3.227, p < 0.05)—had a significant impact on the survival of COVID-19 patients. The analysis identified 14 factors that had a significant impact on the prognosis and mortality of the COVID-19 patients studied.
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Affiliation(s)
- Sławomir Butkiewicz
- Emergency Department, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 137 Wołoska St., 02-004 Warsaw, Poland; (S.B.); (I.P.)
| | - Artur Zaczyński
- Clinical Department of Neurosurgery, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 137 Wołoska St., 02-004 Warsaw, Poland;
| | - Michał Hampel
- Department of Gastroenterological and Transplant Surgery, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 137 Wołoska St., 02-004 Warsaw, Poland;
| | - Igor Pańkowski
- Emergency Department, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, 137 Wołoska St., 02-004 Warsaw, Poland; (S.B.); (I.P.)
| | - Robert Gałązkowski
- Department of Emergency Medical Services, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska St., 00-575 Warsaw, Poland;
| | - Patryk Rzońca
- Department of Human Anatomy, Faculty of Health Sciences, Medical University of Warsaw, 5 Chałubińskiego St., 02-004 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-629-98-92
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Huntley KS, Wahood W, Mintz J, Raine S, Hardigan P, Haffizulla F. Associations of Stay-at-Home Order Enforcement With COVID-19 Population Outcomes: An Interstate Statistical Analysis. Am J Epidemiol 2022; 191:561-569. [PMID: 34729584 PMCID: PMC8780467 DOI: 10.1093/aje/kwab267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 08/29/2021] [Accepted: 10/29/2021] [Indexed: 12/16/2022] Open
Abstract
In the United States, state governors initially enacted coronavirus diseases 2019 (COVID-19)-mitigation policies with limited epidemiologic data. One prevailing legislative approach, from March to May 2020, was the implementation of "stay-at-home" (SAH) executive orders. Although social distancing was encouraged, SAH orders varied between states, and the associations between potential legal prosecution and COVID-19 outcomes are currently unknown. Here, we provide empirical evidence on how executive enforcement of movement restrictions may influence population health during an infectious disease outbreak. A generalized linear model with negative binomial regression family compared COVID-19 outcomes in states with law-enforceable stay-at-home (eSAH) orders versus those with unenforceable or no SAH orders (uSAH), controlling for demographic factors, socioeconomic influences, health comorbidities, and social distancing. COVID-19 incidence was less by 1.22 cases per day per capita in eSAH states compared with uSAH states (coefficient = -1.22, 95% confidence interval (CI): -1.83, -0.61; P < 0.001), and each subsequent day without an eSAH order was associated with a 0.03 incidence increase (coefficient = 0.03, 95% CI: 0.03, 0.04; P < 0.001). Daily mortality was 1.96 less for eSAH states per capita (coefficient = -1.96, 95% CI: -3.25, -0.68; P = 0.004). Our findings suggest allowing the enforcement of public health violations, compared with community education alone, is predictive of improved COVID-19 outcomes.
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Affiliation(s)
- Kyle S Huntley
- Correspondence to Kyle S. Huntley, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, 3200 S. University Drive Fort Lauderdale, FL, 33328 (e-mail: )
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Ruiz-Frutos C, Arias-Ulloa CA, Ortega-Moreno M, Romero-Martín M, Escobar-Segovia KF, Adanaque-Bravo I, Gómez-Salgado J. Factors Associated to Psychological Distress During the COVID-19 Pandemic Among Healthcare Workers in Ecuador. Int J Public Health 2022; 67:1604626. [PMID: 35392539 PMCID: PMC8980224 DOI: 10.3389/ijph.2022.1604626] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/02/2022] [Indexed: 12/23/2022] Open
Abstract
Objective: The global COVID-19 pandemic has challenged health systems. Healthcare professionals had to face harsh conditions that have caused psycho-emotional consequences. Ecuador has been one of the countries hit hardest by the pandemic in Latin America. The objective of this study was to analyse the levels of psychological distress among healthcare workers in Ecuador during the COVID-19 pandemic. Methods: A cross-sectional descriptive study was conducted with a convenience sample of 1,056 healthcare professionals, assessing their psychological distress, physical symptoms of COVID-19, state of health, the preventive measures adopted, and the history of contact with people infected with the SARS-CoV2 virus. Results: showed that 66.0% of the participants manifested psychological distress, with significantly higher levels in women with symptoms of COVID-19 and previous contact with infected people or objects (p < 0.001). However, adherence to preventive measures and perception of health were associated with less psychological distress (p < 0.001). Conclusions: The importance of monitoring the mental health of healthcare workers during the COVID-19 pandemic was confirmed, having identified factors associated with the development of psychological distress among professionals in Ecuador.
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Affiliation(s)
- Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | | | - Mónica Ortega-Moreno
- Department of Economy, University of Huelva, Huelva, Spain
- *Correspondence: Macarena Romero-Martín, ; Juan Gómez-Salgado,
| | - Macarena Romero-Martín
- Department of Nursing, University of Huelva, Huelva, Spain
- *Correspondence: Macarena Romero-Martín, ; Juan Gómez-Salgado,
| | - Kenny F. Escobar-Segovia
- Facultad de Ingeniería en Ciencias de la Tierra, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Ingrid Adanaque-Bravo
- Facultad de Ingeniería en Mecánica y Ciencias de la Producción, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
- *Correspondence: Macarena Romero-Martín, ; Juan Gómez-Salgado,
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ÇEKMEN B. Comparison of demographic and laboratory data of young and elderly patients who deceased due to COVID-19. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1047413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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130
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Vu THT, Van Horn L, Achenbach CJ, Rydland KJ, Cornelis MC. Diet and Respiratory Infections: Specific or Generalized Associations? Nutrients 2022; 14:1195. [PMID: 35334852 PMCID: PMC8954090 DOI: 10.3390/nu14061195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Based on our recently reported associations between specific dietary behaviors and the risk of COVID-19 infection in the UK Biobank (UKB) cohort, we further investigate whether these associations are specific to COVID-19 or extend to other respiratory infections. Methods: Pneumonia and influenza diagnoses were retrieved from hospital and death record data linked to the UKB. Baseline, self-reported (2006−2010) dietary behaviors included being breastfed as a baby and intakes of coffee, tea, oily fish, processed meat, red meat (unprocessed), fruit, and vegetables. Logistic regression estimated the odds of pneumonia/influenza from baseline to 31 December 2019 with each dietary component, adjusting for baseline socio-demographic factors, medical history, and other lifestyle behaviors. We considered effect modification by sex and genetic factors related to pneumonia, COVID-19, and caffeine metabolism. Results: Of 470,853 UKB participants, 4.0% had pneumonia and 0.2% had influenza during follow up. Increased consumption of coffee, tea, oily fish, and fruit at baseline were significantly and independently associated with a lower risk of future pneumonia events. Increased consumption of red meat was associated with a significantly higher risk. After multivariable adjustment, the odds of pneumonia (p ≤ 0.001 for all) were lower by 6−9% when consuming 1−3 cups of coffee/day (vs. <1 cup/day), 8−11% when consuming 1+ cups of tea/day (vs. <1 cup/day), 10−12% when consuming oily fish in higher quartiles (vs. the lowest quartile—Q1), and 9−14% when consuming fruit in higher quartiles (vs. Q1); it was 9% higher when consuming red meat in the fourth quartile (vs. Q1). Similar patterns of associations were observed for influenza but only associations with tea and oily fish met statistical significance. The association between fruit and pneumonia risk was stronger in women than in men (p = 0.001 for interaction). Conclusions: In the UKB, consumption of coffee, tea, oily fish, and fruit were favorably associated with incident pneumonia/influenza and red meat was adversely associated. Findings for coffee parallel those we reported previously for COVID-19 infection, while other findings are specific to these more common respiratory infections.
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Affiliation(s)
- Thanh-Huyen T. Vu
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA; (T.-H.T.V.); (L.V.H.); (C.J.A.)
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA; (T.-H.T.V.); (L.V.H.); (C.J.A.)
| | - Chad J. Achenbach
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA; (T.-H.T.V.); (L.V.H.); (C.J.A.)
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Kelsey J. Rydland
- Research and Information Services, Northwestern University, Evanston, IL 60208, USA;
| | - Marilyn C. Cornelis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA; (T.-H.T.V.); (L.V.H.); (C.J.A.)
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131
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Klein S, Fegert JM, Geprägs A, Brähler E, Clemens V. The Impact of the COVID-19 Pandemic on Health, Quality of Life and Intrafamilial Relations – A Population-Based Survey in Germany. Front Psychol 2022; 13:844057. [PMID: 35360600 PMCID: PMC8963202 DOI: 10.3389/fpsyg.2022.844057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/16/2022] [Indexed: 12/28/2022] Open
Abstract
The occurrence of the novel severe acute respiratory syndrome coronavirus-2 (COVID-19) at the end of 2019 comes along with many challenges. Besides worry for one’s own health and the well-being of the family, all measures applied to limit the spread of the coronavirus affected daily life. School closures, economic shutdown and contact restrictions have led to high levels of stress. The impact on health and families has been widely discussed. However, population-based data are scarce. Here, we have assessed health, quality of life and intrafamilial relations depending on the COVID-19 pandemic. Using a three-step random-route approach, a population-based sample of 2,515 persons (52.6% female, average age of 50.3 years) was recruited during the second COVID-19 wave in Germany in winter 2020/21. While the majority of participants reported no change in their health status and the relationship with their partner and children, more than half of participants reported a decreased quality of life since the beginning of the pandemic. Female gender, age above 60 years, a low household income, not living with a partner and the experience of childhood adversity were associated with a higher risk for a worsening of health, quality of life and intrafamilial relations. These had already been well-established risk factors ahead of the pandemic. In order to avoid further increase of inequality in our society and more devastating impact of the pandemic on health and intrafamilial relations, low-level support and intervention programs are urgently needed.
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Affiliation(s)
- Stephanie Klein
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Jörg M. Fegert
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Alina Geprägs
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Elmar Brähler
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Vera Clemens
- Hospital of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
- *Correspondence: Vera Clemens,
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132
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Eckford RD, Gaisser A, Arndt V, Baumann M, Kludt E, Mehlis K, Ubels J, Winkler EC, Weg-Remers S, Schlander M. The COVID-19 Pandemic and Cancer Patients in Germany: Impact on Treatment, Follow-Up Care and Psychological Burden. Front Public Health 2022; 9:788598. [PMID: 35223757 PMCID: PMC8865576 DOI: 10.3389/fpubh.2021.788598] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 12/23/2021] [Indexed: 12/15/2022] Open
Abstract
In response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, governments imposed various measures to decrease the rate of disease spread, and health care policy makers prioritized resource allocation to accommodate COVID-19 patients. We conducted a cross-sectional online survey in Germany (July 2020-June 2021) to assess the frequency of changes to cancer care among cancer patients and to explore the psychological impact of the pandemic writ large. Cancer patients who contacted the Cancer Information Service (Krebsinformationsdienst, KID) of the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) via email were invited to complete an online questionnaire, capturing demographics, cancer specifics (e.g., type, disease phase, primary place of treatment, etc.), and any changes to their medical, follow-up, psycho-oncological or nursing care. General level of psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS) along with face-validated items regarding worries and social isolation specific to the pandemic. In total, 13% of 621 patients reported a change to their treatment or care plan. Of those patients with changes, the majority of changes were made to follow-up care after treatment (56%), to monitoring during treatment (29%) and to psychological counseling (20%). Of the overall sample, more than half of patients (55%) reported symptoms of anxiety and 39% reported symptoms of depression. Patients with a change in cancer care were more likely to report symptoms of depression than those with no change (AOR: 2.18; 95% CI: 1.26-3.76). Concern about the pandemic affecting the quality of health care was a predictor of both anxiety (AOR: 2.76; 95% CI: 1.75-4.35) and depression (AOR: 2.15; 95% CI: 1.43-3.23). Results showed that the majority of cancer patients in our study did not experience a change in their cancer care. However, the level of anxiety and psycho-social burden of cancer patients during the pandemic was high throughout the study period. Our findings underscore the need for health care services and policy makers to assess and to attend cancer patients' medical needs, with added emphasis on patients' psychological and social well-being. This applies particularly in situations where the healthcare system is strained and prioritization is necessary.
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Affiliation(s)
- Rachel D Eckford
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andrea Gaisser
- German Cancer Information Service, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Epidemiological Cancer Registry Baden-Württemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Evelyn Kludt
- German Cancer Information Service, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Katja Mehlis
- Department of Medical Oncology, Section of Translational Medical Ethics, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Jasper Ubels
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Eva C Winkler
- Department of Medical Oncology, Section of Translational Medical Ethics, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Susanne Weg-Remers
- German Cancer Information Service, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Schlander
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Alfred Weber Institute, Faculty of Economics and Social Sciences, University of Heidelberg, Heidelberg, Germany
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133
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Abstract
PURPOSE OF REVIEW The COVID-19 pandemic has led to devastating health outcomes across the world. Initially thought to primarily affect the respiratory system, there is now clear and abundant evidence that COVID-19 can impact upon the male genitourinary system and overall men's health. In this review article, we explore the potential mechanisms by which COVID-19 specifically affects men and we review the literature examining the adverse effects of the disease on men's health. RECENT FINDINGS Studies suggest that men are at higher risk for severe COVID-19 infection and death. COVID-19 infection has a negative impact on men's health including worsening semen parameters, potentially lower testosterone levels, and an increased risk of erectile dysfunction. SUMMARY COVID-19 is a highly pathogenic virus that exerts adverse effects upon the male genitourinary system in myriad ways. The COVID-19 infection can impact serum testosterone, fertility, sexual function, and mental health. Fortunately, the COVID-19 vaccine is safe and effective in preventing COVID-19 infection and many of these sequelae.
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Affiliation(s)
- Justin M Dubin
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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134
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Adrizain R, Jubaedah S, Fitriany EN, Wicaksana R, Hartantri Y, Prihatini D, Turbawati DK, Andriyoko B, Ramdan A, Rachman IA, Sudiro M, Lasminingrum L. Impact of social activity restriction and routine patient screening as a preventive measurement for tertiary referral hospital staff in a country with high COVID-19 incidence. IJID REGIONS 2022; 2:45-50. [PMID: 35721424 PMCID: PMC8616690 DOI: 10.1016/j.ijregi.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 12/15/2022]
Abstract
Health care workers are a high risk population for COVID-19 reinfection Vaccination breakthrough cases found after the mass vaccination program Social activity restriction is effective in lowering COVID-19 case numbers Routine screening for all patients recommended for a safe working environment
Background Measuring COVID-19 incidence among hospital staff and the influencing factors and preventative measures affecting outcomes is important given their high risk of exposure and potential impacts on health service provision. Method Study participants included all hospital staff with COVID-19 confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR) from March 2020 to July 2021. Data were collected on age, gender, occupation, working area, symptoms and vaccination status. We also collected data on pediatric oncology patients and their caregivers to review the hospital screening policy. Results Approximately 59% of positive cases among hospital staff occurred in the green zone; 75% were fully vaccinated. Whole-genome sequencing indicated that staff infections in June 2021 were Delta variant. A decrease in cases coincided with government implementation of social activity restriction. When RT-PCR was performed in suspected cases, 3 of 36 pediatric oncology patients and 10 staff tested positive. After routine screening, 8 of 121 patients, 3 patient caregivers, and 5 staff tested positive, all were asymptomatic, and all were infected in the community Conclusions Routine testing for staff, patients and caregivers, vaccination booster programs, continuing education of health care workers, and government policy, such as social activity restriction, are needed to protect frontline workers.
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135
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Families' Worries during the First and Second COVID-19 Wave in Germany: Longitudinal Study in Two Population-Based Cohorts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052820. [PMID: 35270515 PMCID: PMC8910069 DOI: 10.3390/ijerph19052820] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/16/2022] [Accepted: 02/22/2022] [Indexed: 02/07/2023]
Abstract
This study aimed to compare worries related to the Coronavirus disease 2019 (COVID-19) in families with young children in two regions in Germany differently affected by the pandemic (Regensburg in Southeast Germany, Leipzig in Eastern Germany) during the first and the second waves of the COVID-19 pandemic. 720 parents participating in the KUNO Kids health study in Regensburg (n = 507) or the LIFE Child study in Leipzig (n = 213) answered questions regarding COVID-19-related worries and trust in anti-pandemic policy measures during the first wave (spring 2020) and during the second wave (winter 2020/2021) of the pandemic. Ordinal mixed-effects models were performed to assess differences depending on region and time, adjusting for education and migration background. Participants worried most about the general economic situation and their family and least about their own health or financial situation. Worries about oneself, family, friends, hometown, and country were stronger during the second than during the first wave. In regional comparisons, worries about family, friends, and hometown increased more pronouncedly from wave 1 to wave 2 in Leipzig (OR ranging from 2.67 (95% CI 1.71−4.19) to 3.01 (95% CI 1.93−4.71), all p < 0.001) than in Regensburg (OR ranging from to 1.38 (95% CI 1.08−1.78) to 1.72 (95% CI 1.33−2.21), all p < 0.05), running parallel with the increase in SARS-CoV-2 infections. Trust in anti-pandemic policy measures, in contrast, decreased significantly between wave 1 and wave 2, with a stronger decrease in Regensburg (OR = 0.30 (95% CI 0.22−0.39), p < 0.001) than in Leipzig (OR = 0.91 (95% CI 0.59−1.41), n.s.). The degree of families’ COVID-19-related worries differs by region and time, which might be related to differences in infection rates and public interest. Regional differences should be taken into account when developing communication strategies and policy measures during the COVID-19 pandemic.
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136
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Ugarte-Gil MF, Alarcón GS, Izadi Z, Duarte-García A, Reátegui-Sokolova C, Clarke AE, Wise L, Pons-Estel GJ, Santos MJ, Bernatsky S, Ribeiro SLE, Al Emadi S, Sparks JA, Hsu TYT, Patel NJ, Gilbert EL, Valenzuela-Almada MO, Jönsen A, Landolfi G, Fredi M, Goulenok T, Devaux M, Mariette X, Queyrel V, Romão VC, Sequeira G, Hasseli R, Hoyer B, Voll RE, Specker C, Baez R, Castro-Coello V, Maldonado Ficco H, Reis Neto ET, Ferreira GAA, Monticielo OAA, Sirotich E, Liew J, Hausmann J, Sufka P, Grainger R, Bhana S, Costello W, Wallace ZS, Jacobsohn L, Taylor T, Ja C, Strangfeld A, Mateus EF, Hyrich KL, Carmona L, Lawson-Tovey S, Kearsley-Fleet L, Schäfer M, Machado PM, Robinson PC, Gianfrancesco M, Yazdany J. Characteristics associated with poor COVID-19 outcomes in individuals with systemic lupus erythematosus: data from the COVID-19 Global Rheumatology Alliance. Ann Rheum Dis 2022; 81:970-978. [PMID: 35172961 PMCID: PMC8882632 DOI: 10.1136/annrheumdis-2021-221636] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/14/2022] [Indexed: 12/15/2022]
Abstract
Aim To determine characteristics associated with more severe outcomes in a global registry of people with systemic lupus erythematosus (SLE) and COVID-19. Methods People with SLE and COVID-19 reported in the COVID-19 Global Rheumatology Alliance registry from March 2020 to June 2021 were included. The ordinal outcome was defined as: (1) not hospitalised, (2) hospitalised with no oxygenation, (3) hospitalised with any ventilation or oxygenation and (4) death. A multivariable ordinal logistic regression model was constructed to assess the relationship between COVID-19 severity and demographic characteristics, comorbidities, medications and disease activity. Results A total of 1606 people with SLE were included. In the multivariable model, older age (OR 1.03, 95% CI 1.02 to 1.04), male sex (1.50, 1.01 to 2.23), prednisone dose (1–5 mg/day 1.86, 1.20 to 2.66, 6–9 mg/day 2.47, 1.24 to 4.86 and ≥10 mg/day 1.95, 1.27 to 2.99), no current treatment (1.80, 1.17 to 2.75), comorbidities (eg, kidney disease 3.51, 2.42 to 5.09, cardiovascular disease/hypertension 1.69, 1.25 to 2.29) and moderate or high SLE disease activity (vs remission; 1.61, 1.02 to 2.54 and 3.94, 2.11 to 7.34, respectively) were associated with more severe outcomes. In age-adjusted and sex-adjusted models, mycophenolate, rituximab and cyclophosphamide were associated with worse outcomes compared with hydroxychloroquine; outcomes were more favourable with methotrexate and belimumab. Conclusions More severe COVID-19 outcomes in individuals with SLE are largely driven by demographic factors, comorbidities and untreated or active SLE. Patients using glucocorticoids also experienced more severe outcomes.
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Affiliation(s)
- Manuel Francisco Ugarte-Gil
- Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas, Universidad Cientifica del Sur, Lima, Peru .,Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - Graciela S Alarcón
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.,School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Zara Izadi
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.,Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Ali Duarte-García
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Cristina Reátegui-Sokolova
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru.,Unidad de Investigación Para La Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, LimaPeru
| | - Ann Elaine Clarke
- Division of Rheumatology Department of Medicine. Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Leanna Wise
- Department of Internal Medicine, Division of Rheumatology, University of Southern California, Los Angeles, California, USA
| | - Guillermo J Pons-Estel
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina.,Research Unit, Argentine Society of Rheumatology, Buenos Aires, Argentina
| | - Maria Jose Santos
- Rheumatology, Hospital Garcia de Orta, Almada, Portugal.,Rheumatology Research Unit. Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Sasha Bernatsky
- Divisions of Rheumatology and Clinical Epidemiology, McGill University Health Centre, Montreal, Québec, Canada
| | | | - Samar Al Emadi
- Rheumatology Department, Hamad Medical Corp, Doha, Qatar
| | - Jeffrey A Sparks
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Tiffany Y-T Hsu
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Naomi J Patel
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital. Harvard Medical School, Boston, Massachusetts, USA
| | - Emily L Gilbert
- Division of Rheumatology, Mayo Clinic, Jacksonville, Florida, USA
| | | | | | - Gianpiero Landolfi
- Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy
| | - Micaela Fredi
- Rheumatology and Clinical Immunology, ASST Spedali Civili, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Tiphaine Goulenok
- Internal Medicine Department, Bichat Claude Bernard Hospital, APHP, Paris, France.,Université de Paris, Paris, France
| | - Mathilde Devaux
- Internal Medicine Department, Poissy Saint-Germain-en-Laye Hospital, Poissy, France
| | - Xavier Mariette
- Department of Rheumatology, Université Paris-Saclay, Assistance Publique - Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - Viviane Queyrel
- Department of Rheumatology, Pasteur 2 Hospital, University of Nice -Sophia- Antipolis, Nice, France
| | - Vasco C Romão
- Rheumatology Research Unit, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Graca Sequeira
- Centro Hospitalar Universitário do Algarve, Unidade de Faro, Faro, Portugal
| | - Rebecca Hasseli
- Department of Rheumatology and Clinical Immunology. Campus Kerckhoff, Justus Liebig University Giessen, Bad Nauheim, Germany
| | - Bimba Hoyer
- Department of Rheumatology and Clinical Immunology, Clinic for Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Reinhard E Voll
- Department of Rheumatology and Clinical Immunology, University Medical Center Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Christof Specker
- Department of Rheumatology and Clinical Immunology, Kliniken Essen-Mitte, Essen, Germany
| | - Roberto Baez
- Hospital Francisco Lopez Lima, General Roca, Argentina
| | | | | | | | | | - Odirlei Andre André Monticielo
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Emily Sirotich
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Jean Liew
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jonathan Hausmann
- Rheumatology, Boston Children's Hospital, Boston, Massachusetts, USA.,Division of Rheumatology and Clinical Immunology, Beth Israel Deaconess Medical Center. Harvard Medical School, Boston, Massachusetts, USA
| | | | - Rebecca Grainger
- Department of Medicine, University of Otago, Wellington, New Zealand
| | | | - Wendy Costello
- Irish Children's Arthritis Network (iCAN), Tipperary, Ireland
| | - Zachary S Wallace
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital. Harvard Medical School, Boston, Massachusetts, USA
| | - Lindsay Jacobsohn
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Tiffany Taylor
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Clairissa Ja
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Anja Strangfeld
- Epidemiology and Health Services, German Rheumatism Research Center (DRFZ Berlin), Berlin, Germany
| | - Elsa F Mateus
- Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon, Portugal.,European League Against Rheumatism (EULAR) Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Kilchberg, Switzerland
| | - Kimme L Hyrich
- Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UK.,National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Saskia Lawson-Tovey
- National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK
| | - Lianne Kearsley-Fleet
- Centre for Epidemiology Versus Arthritis, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Martin Schäfer
- Epidemiology and Health Care Research, German Rheumatism Research Center (DRFZ Berlin), Berlin, Germany
| | - Pedro M Machado
- Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, UK.,National Institute for Health Research (NIHR), University College London Hospitals, London, UK.,Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.,Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - Philip C Robinson
- School of Clinical Medicine, The University of Queensland, Herston, Queensland, Australia.,Department of Rheumatology. Metro North Hospital & Health Service, Royal Brisbane and Woman's Hospital, Herston, Queensland, Australia
| | - Milena Gianfrancesco
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Jinoos Yazdany
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
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137
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Development and Validation of the Acute PNeumonia Early Assessment Score for Safely Discharging Low-Risk SARS-CoV-2-Infected Patients from the Emergency Department. J Clin Med 2022; 11:jcm11030881. [PMID: 35160331 PMCID: PMC8837152 DOI: 10.3390/jcm11030881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/29/2022] [Accepted: 02/05/2022] [Indexed: 12/10/2022] Open
Abstract
A continuous demand for assistance and an overcrowded emergency department (ED) require early and safe discharge of low-risk severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients. We developed (n = 128) and validated (n = 330) the acute PNeumonia early assessment (aPNea) score in a tertiary hospital and preliminarily tested the score on an external secondary hospital (n = 97). The score's performance was compared to that of the National Early Warning Score 2 (NEWS2). The composite outcome of either death or oral intubation within 30 days from admission occurred in 101 and 28 patients in the two hospitals, respectively. The area under the receiver operating characteristic (AUROC) curve of the aPNea model was 0.86 (95% confidence interval (CI), 0.78-0.93) and 0.79 (95% CI, 0.73-0.89) for the development and validation cohorts, respectively. The aPNea score discriminated low-risk patients better than NEWS2 at a 10% outcome probability, corresponding to five cut-off points and one cut-off point, respectively. aPNea's cut-off reduced the number of unnecessary hospitalizations without missing outcomes by 27% (95% CI, 9-41) in the validation cohort. NEWS2 was not significant. In the external cohort, aPNea's cut-off had 93% sensitivity (95% CI, 83-102) and a 94% negative predictive value (95% CI, 87-102). In conclusion, the aPNea score appears to be appropriate for discharging low-risk SARS-CoV-2-infected patients from the ED.
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138
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Fluid Resuscitation and Progression to Renal Replacement Therapy in Patients With COVID-19. J Emerg Med 2022; 62:145-153. [PMID: 35045940 PMCID: PMC8552546 DOI: 10.1016/j.jemermed.2021.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/03/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is associated with respiratory symptoms and renal effects. Data regarding fluid resuscitation and kidney injury in COVID-19 are lacking, and understanding this relationship is critical. OBJECTIVES To determine if there is an association between fluid volume administered in 24 h and development of renal failure in COVID-19 patients. METHODS Retrospective chart review; 14 hospitals in Indiana. Included patients were adults admitted between March 11, 2020 and April 13, 2020 with a positive test for severe acute respiratory syndrome coronavirus 2 within 3 days of admission. Patients requiring renal replacement therapy prior to admission were excluded. Volumes and types of resuscitative intravenous fluids in the first 24 h were obtained with demographics, medical history, and other objective data. The primary outcome was initiation of renal replacement therapy. Logistic regression modeling was utilized in creating multivariate models for determining factors associated with the primary outcome. RESULTS The fluid volume received in the first 24 h after hospital admission was associated with initiation of renal replacement therapy in two different multivariate logistic regression models. An odds ratio of 1.42 (95% confidence interval 1.01-1.99) was observed when adjusting for age, heart failure, obesity, creatinine, bicarbonate, and total fluid volume. An odds ratio of 1.45 (95% confidence interval 1.02-2.05) was observed when variables significant in univariate analysis were adjusted for. CONCLUSIONS Each liter of intravenous fluid administered to patients with COVID-19 in the first 24 h of presentation was independently associated with an increased risk for initiation of renal replacement therapy, supporting judicious fluid administration in patients with this disease.
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139
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Hoogenboom WS, Lu JQ, Musheyev B, Borg L, Janowicz R, Pamlayne S, Hou W, Duong TQ. Prophylactic versus therapeutic dose anticoagulation effects on survival among critically ill patients with COVID-19. PLoS One 2022; 17:e0262811. [PMID: 35045130 PMCID: PMC8769345 DOI: 10.1371/journal.pone.0262811] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/05/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Although patients with severe COVID-19 are known to be at high risk of developing thrombotic events, the effects of anticoagulation (AC) dose and duration on in-hospital mortality in critically ill patients remain poorly understood and controversial. The goal of this study was to investigate survival of critically ill COVID-19 patients who received prophylactic or therapeutic dose AC and analyze the mortality rate with respect to detailed demographic and clinical characteristics. MATERIALS AND METHODS We conducted a retrospective, observational study of critically ill COVID-19 patients admitted to the ICU at Stony Brook University Hospital in New York who received either prophylactic (n = 158) or therapeutic dose AC (n = 153). Primary outcome was in-hospital death assessed by survival analysis and covariate-adjusted Cox proportional hazard model. RESULTS For the first 3 weeks of ICU stay, we observed similar survival curves for prophylactic and therapeutic AC groups. However, after 3 or more weeks of ICU stay, the therapeutic AC group, characterized by high incidence of acute kidney injury (AKI), had markedly higher death incidence rates with 8.6 deaths (95% CI = 6.2-11.9 deaths) per 1,000 person-days and about 5 times higher risk of death (adj. HR = 4.89, 95% CI = 1.71-14.0, p = 0.003) than the prophylactic group (2.4 deaths [95% CI = 0.9-6.3 deaths] per 1,000 person-days). Among therapeutic AC users with prolonged ICU admission, non-survivors were characterized by older males with depressed lymphocyte counts and cardiovascular disease. CONCLUSIONS Our findings raise the possibility that prolonged use of high dose AC, independent of thrombotic events or clinical background, might be associated with higher risk of in-hospital mortality. Moreover, AKI, age, lymphocyte count, and cardiovascular disease may represent important risk factors that could help identify at-risk patients who require long-term hospitalization with therapeutic dose AC treatment.
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Affiliation(s)
- Wouter S. Hoogenboom
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, United States of America
- * E-mail: (WSH); (TQD)
| | - Joyce Q. Lu
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, United States of America
| | - Benjamin Musheyev
- Stony Brook University, Renaissance School of Medicine, Stony Brook, New York, United States of America
| | - Lara Borg
- Stony Brook University, Renaissance School of Medicine, Stony Brook, New York, United States of America
| | - Rebeca Janowicz
- Stony Brook University, Renaissance School of Medicine, Stony Brook, New York, United States of America
| | - Stacey Pamlayne
- Stony Brook University, Renaissance School of Medicine, Stony Brook, New York, United States of America
| | - Wei Hou
- Stony Brook University, Renaissance School of Medicine, Stony Brook, New York, United States of America
| | - Tim Q. Duong
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, United States of America
- * E-mail: (WSH); (TQD)
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140
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COVID-19 in Latin America and the Caribbean Region: Symptoms and Morbidities in the Epidemiology of Infection. Curr Opin Pharmacol 2022; 63:102203. [PMID: 35255454 PMCID: PMC8896761 DOI: 10.1016/j.coph.2022.102203] [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: 08/15/2021] [Revised: 01/21/2022] [Accepted: 02/01/2022] [Indexed: 01/06/2023]
Abstract
The COVID-19 pandemic has widespread economic and social effects on Latin America (LA) and the Caribbean (CA). This region, which has a high prevalence of chronic diseases, has been one of the most affected during the pandemic. Multiple symptoms and comorbidities are related to distinct COVID-19 outcomes. However, there has been no explanation as to why different patients present with different arrays of clinical presentations. Studies report that similar to comorbidities, each country in LA and the CA has its own particular health issues. Moreover, economic and social features have yet to be studied in detail to obtain a complete perspective of the disease in the region. Herein, the impact of demographic and economic characteristics in LA and the CA on COVID-19 are presented in combination with symptoms and comorbidities related to the disease as important aspects that can influence management and treatment.
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141
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Sano T, Matsumoto S, Ikeda T, Kuroda S, Kitai T, Yonetsu T, Kohsaka S, Torii S, Node K, Matsue Y. New-Onset Atrial Fibrillation in Patients With Coronavirus Disease 2019 (COVID-19) and Cardiovascular Disease - Insights From the CLAVIS-COVID Registry. Circ J 2022; 86:1237-1244. [PMID: 35082216 DOI: 10.1253/circj.cj-21-0911] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Both pre-existing atrial fibrillation (AF) and new-onset AF (NOAF) are observed in patients with coronavirus disease 2019 (COVID-19); however, the effect of AF on clinical outcomes is unclear. This study aimed to investigate the effect of AF, especially NOAF, on the outcomes of hospitalized patients with COVID-19.Methods and Results:This study analyzed 673 COVID-19 patients with cardiovascular diseases and risk factors (CVDRF). Patients were divided into 3 groups; pre-existing AF (n=55), NOAF (n=28), and sinus rhythm (SR) (n=590). The baseline characteristics and in-hospital outcomes were evaluated. The mean age of the patients was 68 years, 65.4% were male, and the in-hospital mortality rate was 15.6%. The NOAF group demonstrated a higher in-hospital mortality rate (42.9%) than the pre-existing AF (30.9%) and SR (11.2%) groups (P<0.001). Patients with NOAF had a higher incidence of acute respiratory syndrome, multiple organ disease, hemorrhage, and stroke than those with pre-existing AF and NOAF. NOAF was independently associated with in-hospital mortality after adjusting for pre-existing AF and 4C mortality score (odds ratio [95% confidence interval]: 4.71 [1.63-13.6], P<0.001). CONCLUSIONS Patients with NOAF had significantly worse outcomes as compared to patients with pre-existing AF and SR. The incidence of NOAF would be a useful predictor of clinical outcomes during hospitalization.
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Affiliation(s)
- Takahide Sano
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine
| | - Shingo Matsumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine
| | | | - Takeshi Kitai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Taishi Yonetsu
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Sho Torii
- Department of Cardiology, Tokai University School of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine
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142
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COmpliance with pandemic COmmands Scale (COCOS): The relationship between compliance with COVID-19 measures and sociodemographic and attitudinal variables. PLoS One 2022; 17:e0262698. [PMID: 35045104 PMCID: PMC8769316 DOI: 10.1371/journal.pone.0262698] [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: 07/20/2021] [Accepted: 01/04/2022] [Indexed: 11/19/2022] Open
Abstract
Several studies in different countries have reported that part of the population does not fully comply with the measures recommended to prevent COVID-19, and therefore poses a risk to public health. For this reason, several measures have been developed to assess the level of compliance, although many of them have methodological limitations or do not include a comprehensive set of items. The main goal of the current study was to develop a new instrument with suitable psychometric properties, which includes a more complete set of items and controls the impact of acquiescence bias. The participants were 1410 individuals (59.2% women) from Spain, who answered the new questionnaire and several items on sociodemographic and attitudinal issues. Exploratory and confirmatory factor analyses were carried out, and the results suggested that only one content factor was underlying the data. This solution was replicated in a different subsample, which shows the stability of the solution. Furthermore, the relationships between the scores of the new questionnaire and the sociodemographic and attitudinal variables are similar to those obtained in previous studies, which can be regarded as evidence of the validity of the new questionnaire.
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143
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Arutyunov GP, Tarlovskaya EI, Arutyunov AG, Belenkov YN, Konradi AO, Lopatin YM, Rebrov AP, Tereshchenko SN, Chesnikova AI, Hayrapetyan HG, Babin AP, Bakulin IG, Bakulina NV, Balykova LA, Blagonravova AS, Boldina MV, Vaisberg AR, Galyavich AS, Gomonova VV, Grigorieva NY, Gubareva IV, Demko IV, Evzerikhina AV, Zharkov AV, Kamilova UK, Kim ZF, Kuznetsova TY, Lareva NV, Makarova EV, Malchikova SV, Nedogoda SV, Petrova MM, Pochinka IG, Protasov KV, Protsenko DN, Ruzanau DY, Sayganov SA, Sarybaev AS, Selezneva NM, Sugraliev AB, Fomin IV, Khlynova OV, Chizhova OY, Shaposhnik II, Sh'ukarev DA, Abdrahmanova АK, Avetisian SA, Avoyan HG, Azarian KK, Aimakhanova GT, Ayipova DA, Akunov AC, Alieva MK, Aparkina AV, Aruslanova OR, Ashina EY, Badina OY, Barisheva OY, Batchayeva AS, Bitieva AM, Bikhteyev IU, Borodulina NA, Bragin MV, Budu AM, Bykova GM, Vagapova KR, Varlamova DD, Vezikova NN, Verbitskaya EA, Vilkova OE, Vinnikova EA, Vustina VV, Galova EA, Genkel VV, Gorshenina EI, Gostishev RV, Grigorieva EV, Gubareva EY, Dabylova GM, Demchenko AI, Dolgikh OY, Duyshobayev MY, Evdokimov DS, Egorova KE, Ermilova AN, Zheldybayeva AE, Zarechnova NV, Zimina YD, Ivanova SY, Ivanchenko EY, Ilina MV, Kazakovtseva MV, Kazymova EV, Kalinina YS, Kamardina NA, Karachenova AM, Karetnikov IA, Karoli NA, Karsiev MK, Кaskaeva DS, Kasymova KF, Kerimbekova ZB, Kerimova AS, Kim ES, Kiseleva NV, Klimenko DA, Klimova AV, Kovalishena OV, Kolmakova EV, Kolchinskaya TP, Kolyadich MI, Kondriakova OV, Konoval MP, Konstantinov DY, Konstantinova EA, Kordukova VA, Koroleva EV, Kraposhina AY, Kriukova TV, Kuznetsova AS, Kuzmina TY, Kuzmichev KV, Kulchoroevna CK, Kuprina TV, Kouranova IM, Kurenkova LV, Kurchugina NY, Kushubakova NA, Levankova VI, Lyubavina NA, Magdeyeva NA, Mazalov KV, Majseenko VI, Makarova AS, Maripov AM, Marusina AA, Melnikov ES, Moiseenko NB, Muradova FN, Muradyan RG, Musaelian SN, Myshak AO, Nekaeva ES, Nikitina NM, Ogurlieva BB, Odegova AA, Omarova YV, Omurzakova NA, Ospanova SO, Pahomova EV, Petrov LD, Plastinina SS, Pogrebetskaya VA, Polyakov DS, Ponomarenko EV, Popova LL, Prokofeva NA, Pudova IA, Rakov NA, Rahimov AN, Rozanova NA, Serikbolkyzy S, Simonov AA, Skachkova VV, Soloveva DV, Soloveva IA, Subbotin AK, Sukhomlinova IM, Sushilova AG, Tagayeva DR, Titojkina YV, Tikhonova EP, Tokmin DS, Tolmacheva AA, Torgunakova MS, Trenogina KV, Trostianetckaia NA, Trofimov DA, Tulichev AA, Tursunova AT, Ulanova ND, Fatenkov OV, Fedorishina OV, Fil TS, Fomina IY, Fominova IS, Frolova IA, Tsvinger SM, Tsoma VV, Cholponbaeva MB, Chudinovskikh TI, Shevchenko OA, Sheshina TV, Shishkina EA, Shishkov KY, Sherbakov SY, Yausheva EA. ACTIV SARS-CoV-2 registry (Analysis of Chronic Non-infectious Diseases Dynamics After COVID-19 Infection in Adult Patients). Assessment of impact of combined original comorbid diseases in patients with COVID-19 on the prognosis. TERAPEVT ARKH 2022; 94:32-47. [DOI: 10.26442/00403660.2022.01.201320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Indexed: 12/23/2022]
Abstract
Aim. Study the impact of various combinations of comorbid original diseases in patients infected with COVID-19 later on the disease progression and outcomes of the new coronavirus infection.
Materials and methods. The ACTIV registry was created on the Eurasian Association of Therapists initiative. 5,808 patients have been included in the registry: men and women with COVID-19 treated at hospital or at home. ClinicalTrials.gov ID NCT04492384.
Results. Most patients with COVID-19 have original comorbid diseases (oCDs). Polymorbidity assessed by way of simple counting of oCDs is an independent factor in negative outcomes of COVID-19. Search for most frequent combinations of 2, 3 and 4 oCDs has revealed absolute domination of cardiovascular diseases (all possible variants). The most unfavorable combination of 2 oCDs includes atrial hypertension (AH) and chronic heart failure (CHF). The most unfavorable combination of 3 oCDs includes AH, coronary heart disease (CHD) and CHF; the worst combination of 4 oCDs includes AH, CHD, CHF and diabetes mellitus. Such combinations increased the risk of lethal outcomes 3.963, 4.082 and 4.215 times respectively.
Conclusion. Polymorbidity determined by way of simple counting of diseases may be estimated as a factor in the lethal outcome risk in the acute phase of COVID-19 in real practice. Most frequent combinations of 2, 3 and 4 diseases in patients with COVID-19 primarily include cardiovascular diseases (AH, CHD and CHF), diabetes mellitus and obesity. Combinations of such diseases increase the COVID-19 lethal outcome risk.
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144
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Albadr Y, Crowe A, Caccetta R. Teucrium polium: Potential Drug Source for Type 2 Diabetes Mellitus. BIOLOGY 2022; 11:biology11010128. [PMID: 35053127 PMCID: PMC8772689 DOI: 10.3390/biology11010128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/06/2022] [Accepted: 01/10/2022] [Indexed: 12/02/2022]
Abstract
Simple Summary Teucrium polium (also known as Golden Germander) is a herb brewed and drunk as a tea by the locals of the Mediterranean region, used mostly to treat a number of illnesses including diabetes. When consumed regularly, the tea can be problematic since some of its ingredients can be toxic or interfere with other medications taken by the patient. Current anti-diabetic medications are not always suitable nor optimal for all patients living with diabetes and therefore new drugs are constantly being sought after which may be more useful and/or present less side effects. Therefore, identifying the specific constituents that give the desired anti-diabetic effect, isolating them and developing them further may provide new useful anti-diabetic drugs. This paper discusses some key compounds found in Golden Germander that might be valuable for developing a new medication for type 2 diabetics whilst outlining some issues with the research conducted thus far. Abstract The prevalence of type 2 diabetes mellitus is rising globally and this disease is proposed to be the next pandemic after COVID-19. Although the cause of type 2 diabetes mellitus is unknown, it is believed to involve a complex array of genetic defects that affect metabolic pathways which eventually lead to hyperglycaemia. This hyperglycaemia arises from an inability of the insulin-sensitive cells to sufficiently respond to the secreted insulin, which eventually results in the inadequate secretion of insulin from pancreatic β-cells. Several treatments, utilising a variety of mechanisms, are available for type 2 diabetes mellitus. However, more medications are needed to assist with the optimal management of the different stages of the disease in patients of varying ages with the diverse combinations of other medications co-administered. Throughout modern history, some lead constituents from ancient medicinal plants have been investigated extensively and helped in developing synthetic antidiabetic drugs, such as metformin. Teucrium polium L. (Tp) is a herb that has a folk reputation for its antidiabetic potential. Previous studies indicate that Tp extracts significantly decrease blood glucose levels r and induce insulin secretion from pancreatic β-cells in vitro. Nonetheless, the constituent/s responsible for this action have not yet been elucidated. The effects appear to be, at least in part, attributable to the presence of selected flavonoids (apigenin, quercetin, and rutin). This review aims to examine the reported glucose-lowering effect of the herb, with a keen focus on insulin secretion, specifically related to type 2 diabetes mellitus. An analysis of the contribution of the key constituent flavonoids of Tp extracts will also be discussed.
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145
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Boorgula SY, Yelamanchili S, Kottapalli P, Naga MD. An Update on Secondary Bacterial and Fungal Infections and Their Antimicrobial Resistance Pattern (AMR) in COVID-19 Confirmed Patients at a Tertiary Care Hospital. J Lab Physicians 2022; 14:260-264. [PMID: 36119429 PMCID: PMC9473943 DOI: 10.1055/s-0041-1741438] [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: 12/03/2022] Open
Abstract
Introduction
Since coronavirus disease 2019 (COVID-19) has limited treatment options, concern has been raised over secondary infections and antimicrobial resistance (AMR) patterns. It has been observed that patients who were infected with COVID-19 were predisposed to develop secondary infections. The purpose of the study is to ascertain the prevalence of the bacterial and fungal coinfections in COVID-19 patients, and also to assess the AMR patterns in the obtained isolates.
Methods
We have studied 200 clinical samples obtained from 122 COVID-19 positive patients. Pathogens were identified using Vitek 2 system. The demographic and clinical patterns were also observed.
Results
A total of 122 patients developed secondary infections. Patients aged more than 40 years were majorly affected (
p
-value < 0.0001). Respiratory samples (
n
= 96) were predominant.
Klebsiella pneumoniae
(
n
= 68) was the most common pathogen isolated followed by
Acinetobacter baumannii
(
n
= 54) and an overall 6% rise in the Carbapenem resistance was observed in the isolates.
Conclusion
To contain the secondary infections in COVID-19 patients, it is imperative to adhere to antimicrobial stewardship program and timely revise the empirical antibiotic policy.
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Affiliation(s)
| | | | | | - Mohini D. Naga
- Department of Microbiology, AIG Hospitals, Hyderabad, Telangana, India
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146
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Beridze G, Triolo F, Grande G, Fratiglioni L, Calderón-Larrañaga A. COVID-19 collateral damage-psychological burden and behavioural changes among older adults during the first outbreak in Stockholm, Sweden: a cross-sectional study. BMJ Open 2022; 12:e058422. [PMID: 34996805 PMCID: PMC8743841 DOI: 10.1136/bmjopen-2021-058422] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To explore the indirect negative effects of COVID-19 restrictions (collateral damage) on the lives and health of older adults living in central Stockholm, and to characterise the sociodemographic profile of those with the highest susceptibility to this damage. DESIGN Cross-sectional study. SETTING District of Kungsholmen in Stockholm, Sweden. PARTICIPANTS Older adults aged 68 years and above (n=1231) who participated in the ad hoc COVID-19-related phone questionnaire administered by trained staff between May and June 2020 and who had previously attended the regular follow-up assessment of the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) during 2016-2019. PRIMARY AND SECONDARY OUTCOME MEASURES Three dimensions of collateral damage: psychological burden (feelings of worry, stress and loneliness), reductions in social and physical activities, and reductions in medical and social care use since the beginning of the pandemic. Logistic regression models were used to test the association between age, sex, education and living arrangement, and the risk of collateral damage. RESULTS Vast majority of participants adhered to the national public health recommendations, with over three-quarters practising self-isolation (n=928). Half of the sample reported psychological burden, 55.3% reported reductions in social or physical activity, and 11.3% reported decreased medical or social care use. Over three quarters of participants (77.8%) were affected by at least one of the three collateral damage dimensions. Female sex was the strongest sociodemographic predictor of both individual and co-occurring dimensions of collateral damage. CONCLUSIONS COVID-19 and its restrictions during the first half of 2020 had a negative effect on the health and lives of a majority of the elderly living in central Stockholm. Women were at a higher risk of these negative consequences. We emphasise the need for predefined, evidence-based interventions to support those who are most susceptible to these consequences, both during the pandemic and once the outbreak is overcome.
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Affiliation(s)
- Giorgi Beridze
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Federico Triolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
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147
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Kubale J, Balmaseda A, Frutos AM, Sanchez N, Plazaola M, Ojeda S, Saborio S, Lopez R, Barilla C, Vasquez G, Moreira H, Gajewski A, Campredon L, Maier H, Chowdhury M, Cerpas C, Harris E, Kuan G, Gordon A. Burden of SARS-CoV-2 and protection from symptomatic second infection in children. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.01.03.22268684. [PMID: 35018380 PMCID: PMC8750653 DOI: 10.1101/2022.01.03.22268684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
IMPORTANCE The impact of the SARS-CoV-2 pandemic on children remains unclear. Better understanding of the burden of COVID-19 among children and their protection against re-infection is crucial as they will be among the last groups vaccinated. OBJECTIVE To characterize the burden of COVID-19 and assess how protection from symptomatic re-infection among children may vary by age. DESIGN A prospective, community-based pediatric cohort study conducted from March 1, 2020 through October 15, 2021. SETTING The Nicaraguan Pediatric Influenza Cohort is a community-based cohort in District 2 of Managua, Nicaragua. PARTICIPANTS A total of 1964 children aged 0-14 years participated in the cohort. Non-immunocompromised children were enrolled by random selection from a previous pediatric influenza cohort. Additional newborn infants aged ≤4 weeks were randomly selected and enrolled monthly, via home visits. EXPOSURES Prior COVID-19 infection as confirmed by positive anti SARS-CoV-2 antibodies (receptor binding domain [RBD] and spike protein) or real time RT-PCR confirmed COVID-19 infection ≥60 days prior to current COVID-19. MAIN OUTCOMES AND MEASURES Symptomatic COVID-19 cases confirmed by real time RT-PCR and hospitalization within 28 days of symptom onset of confirmed COVID-19 case. RESULTS Overall, 49.8% of children tested were seropositive over the course of the study. There were also 207 PCR-confirmed COVID-19 cases, 12 (6.4%) of which were severe enough to require hospitalization. Incidence of COVID-19 was highest among children aged <2 years-16.1 per 100 person-years (95% Confidence Interval [CI]: 12.5, 20.5)-approximately three times that of children in any other age group assessed. Additionally, 41 (19.8%) symptomatic SARS-CoV-2 episodes were re-infections, with younger children slightly more protected against symptomatic reinfection. Among children aged 6-59 months, protection was 61% (Rate Ratio [RR]:0.39, 95% CI:0.2,0.8), while protection among children aged 5-9 and 10-14 years was 64% (RR:0.36,0.2,0.7), and 49% (RR:0.51,0.3-0.9), respectively. CONCLUSIONS AND RELEVANCE In this prospective community-based pediatric cohort rates of symptomatic and severe COVID-19 were highest among the youngest participants, with rates stabilizing around age 5. Reinfections represent a large proportion of PCR-positive cases, with children <10 years displaying greater protection from symptomatic reinfection. A vaccine for children <5 years is urgently needed. KEY POINTS Question: What is the burden of COVID-19 among young children and how does protection from re-infection vary with age?Findings: In this study of 1964 children aged 0-14 years children <5 years had the highest rates of symptomatic and severe COVID-19 while also displaying greater protection against re-infection compared to children ≥10 years.Meaning: Given their greater risk of infection and severe disease compared to older children, effective vaccines against COVID-19 are urgently needed for children under 5.
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Affiliation(s)
- John Kubale
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Angel Balmaseda
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Aaron M Frutos
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | | | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Saira Saborio
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Roger Lopez
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Carlos Barilla
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Gerald Vasquez
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Hanny Moreira
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | | | - Lora Campredon
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Hannah Maier
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Mahboob Chowdhury
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Cristhiam Cerpas
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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George R, Mehta AA, Paul T, Sathyapalan DT, Haridas N, Kunoor A, Ravindran GC. Validation of MuLBSTA score to derive modified MuLB score as mortality risk prediction in COVID-19 infection. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000511. [PMID: 36962449 PMCID: PMC10021136 DOI: 10.1371/journal.pgph.0000511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022]
Abstract
COVID-19pandemic was started in December 2019. It has variable presentation from mild sore throat to severe respiratory distress. It is important to identify individuals who are likely to worsen. The Research question is how to identify patients with COVID-19 who are at high risk and to predict patient outcome based on a risk stratification model? We evaluated 251 patients with COVID-19 in this prospective inception study. We used a multi-variable Cox proportional hazards model to identify the independent prognostic risk factors and created a risk score model on the basis of available MuLBSTA score. The model was validated in an independent group of patients from October2020 to December 2021. We developed a combined risk score, the MuLBA score that included the following values and scores: Multi lobar infiltrates (negative0.254, 2), lymphopenia (lymphocytes of <0.8x109 /L, negative0.18,2), bacterial co- infection (negative, 0.306,3). In our MuLB scoring system, score of >8 was associated with high risk of mortality and <5 was at mild risk of mortality (P < 0.001). The interpretation was that The MuLB risk score model could help to predict survival in patients with severe COVID-19 infection and to guide further clinical research on risk-based treatment.
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Affiliation(s)
- Richie George
- Department of Respiratory Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Asmita A Mehta
- Department of Respiratory Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Tisa Paul
- Department of Respiratory Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Dipu T Sathyapalan
- Division of infectious Diseases, Department of Internal Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Nithya Haridas
- Department of Respiratory Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Akhilesh Kunoor
- Department of Respiratory Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Greeshma C Ravindran
- Department of Biostatistics, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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149
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National health care quality and COVID-19 case fatality rate: International comparisons of top 50 countries. Arch Gerontol Geriatr 2022; 98:104587. [PMID: 34839063 PMCID: PMC8608659 DOI: 10.1016/j.archger.2021.104587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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150
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Alvaro‐Lozano M, Sandoval‐Ruballos M, Giovannini M, Jensen‐Jarolim E, Sahiner U, Tomic Spiric V, Quecchia C, Chaker A, Heffler E, Klimek L, Brough H, Sturm G, Untersmayr E, Bonini M, Pfaar O. Allergic patients during the COVID-19 pandemic-Clinical practical considerations: An European Academy of Allergy and Clinical Immunology survey. Clin Transl Allergy 2022; 12:e12097. [PMID: 35070270 PMCID: PMC8762981 DOI: 10.1002/clt2.12097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 12/18/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected health care systems unexpectedly. However, data focusing on practical considerations experienced by health care professionals (HCPs) providing care to allergic patients is scarce. METHODS Under the framework of the European Academy of Allergy and Clinical Immunology (EAACI), a panel of experts in the field of immunotherapy developed a 42-question online survey, to evaluate real-life consequences of the COVID-19 pandemic in allergy practice. RESULTS The respondents in the survey were 618. About 80% of HCPs indicated being significantly affected in their allergy practice. A face-to-face visit reduction was reported by 93% of HCPs and about a quarter completely interrupted diagnostic challenges. Patients with severe uncontrolled asthma (59%) and anaphylaxis (47%) were prioritized for in-person care. About 81% maintained an unaltered prescription of inhaled corticosteroids (ICS) in asthmatics. About 90% did not modify intranasal corticosteroids (INCS) in patients with allergic rhinitis. Nearly half of respondents kept biological prescriptions unmodified for asthma. About 50% of respondents kept their allergen immunotherapy (AIT) prescription patterns unchanged for respiratory allergies; 60% for insect venom allergies. Oral immunotherapy (OIT) for food allergies was initiated by 27%. About 20% kept carrying out up-dosing without modifications and 14% changed to more prolonged intervals. Telemedicine practice was increased. CONCLUSIONS HCPs providing care to allergic patients were affected during the pandemic in diagnostic, management, and therapeutic approaches, including AIT for respiratory, insect-venom, and food allergies. Most HCPs maintained controller treatments for both asthma, and allergic rhinitis consistent with international recommendations, as well as biological agents in asthma. Remote tools are valuable in delivering allergy care.
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Affiliation(s)
- Montserrat Alvaro‐Lozano
- Pediatric Allergology and Clinical ImmunologyHospital Sant Joan de DéuBarcelonaSpain
- Childhood and Adolescence Allergic Illness GroupInstitut de Recerca Sant Joan de DéuBarcelonaSpain
- Facultat de Medicina i Ciències de la SalutUniversitat de BarcelonaBarcelonaSpain
| | - Mónica Sandoval‐Ruballos
- Pediatric Allergology and Clinical ImmunologyHospital Sant Joan de DéuBarcelonaSpain
- Childhood and Adolescence Allergic Illness GroupInstitut de Recerca Sant Joan de DéuBarcelonaSpain
| | - Mattia Giovannini
- Allergy UnitDepartment of PediatricsMeyer Children's University HospitalFlorenceItaly
| | - Erika Jensen‐Jarolim
- Institute of Pathophysiology and Allergy ResearchCenter for Pathophysiology, Infectiology and ImmunologyMedical University ViennaViennaAustria
- The Interuniversity Messerli Research Institute, Medical University Vienna, Veterinary University Vienna, and University ViennaViennaAustria
| | - Umit Sahiner
- Department of Pediatric Allergy and AsthmaHacettepe University School of MedicineAnkaraTurkey
| | - Vesna Tomic Spiric
- Faculty of MedicineUniversity of BelgradeBelgradeSerbia
- Clinic of Allergology and ImmunologyClinical Centre of SerbiaBelgradeSerbia
| | - Cristina Quecchia
- “Io e l’Asma” CenterChildren's HospitalASST Spedali CiviliBresciaItaly
| | - Adam Chaker
- Department of Otolaryngology and Center of Allergy and EnvironmentTUM School of MedicineTechnical University of MunichMunichGermany
| | - Enrico Heffler
- Personalized Medicine, Asthma and AllergyHumanitas Clinical and Research Hospital IRCCSRozzanoItaly
- Department of Biomedical SciencesHumanitas UniversityMilanItaly
| | - Ludger Klimek
- Center for Rhinology and AllergologyWiesbadenGermany
| | - Helen Brough
- Children's Allergy ServiceEvelina Children's HospitalGuy's and St. Thomas' HospitalLondonUK
- Paediatric Allergy GroupDepartment of Women and Children's HealthSchool of Life Course SciencesKing's College LondonLondonUK
| | - Gunter Sturm
- Department of Dermatology and VenerologyMedical University of GrazGrazAustria
- Allergy Outpatient Clinic ReummanplatzViennaAustria
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy ResearchCenter for Pathophysiology, Infectiology and ImmunologyMedical University ViennaViennaAustria
| | - Mateo Bonini
- Department of Cardiovascular and Thoracic SciencesFondazione Policlinico Universitario A. Gemelli – IRCCSUniversità Cattolica del Sacro CuoreRomeItaly
- National Heart and Lung Institute (NHLI)Imperial College LondonLondonUK
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital MarburgPhilipps‐Universität MarburgMarburgGermany
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