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Clift AK, von Ende A, Tan PS, Sallis HM, Lindson N, Coupland CAC, Munafò MR, Aveyard P, Hippisley-Cox J, Hopewell JC. Smoking and COVID-19 outcomes: an observational and Mendelian randomisation study using the UK Biobank cohort. Thorax 2022; 77:65-73. [PMID: 34580193 PMCID: PMC8483921 DOI: 10.1136/thoraxjnl-2021-217080] [Citation(s) in RCA: 95] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/14/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Conflicting evidence has emerged regarding the relevance of smoking on risk of COVID-19 and its severity. METHODS We undertook large-scale observational and Mendelian randomisation (MR) analyses using UK Biobank. Most recent smoking status was determined from primary care records (70.8%) and UK Biobank questionnaire data (29.2%). COVID-19 outcomes were derived from Public Health England SARS-CoV-2 testing data, hospital admissions data, and death certificates (until 18 August 2020). Logistic regression was used to estimate associations between smoking status and confirmed SARS-CoV-2 infection, COVID-19-related hospitalisation, and COVID-19-related death. Inverse variance-weighted MR analyses using established genetic instruments for smoking initiation and smoking heaviness were undertaken (reported per SD increase). RESULTS There were 421 469 eligible participants, 1649 confirmed infections, 968 COVID-19-related hospitalisations and 444 COVID-19-related deaths. Compared with never-smokers, current smokers had higher risks of hospitalisation (OR 1.80, 95% CI 1.26 to 2.29) and mortality (smoking 1-9/day: OR 2.14, 95% CI 0.87 to 5.24; 10-19/day: OR 5.91, 95% CI 3.66 to 9.54; 20+/day: OR 6.11, 95% CI 3.59 to 10.42). In MR analyses of 281 105 White British participants, genetically predicted propensity to initiate smoking was associated with higher risks of infection (OR 1.45, 95% CI 1.10 to 1.91) and hospitalisation (OR 1.60, 95% CI 1.13 to 2.27). Genetically predicted higher number of cigarettes smoked per day was associated with higher risks of all outcomes (infection OR 2.51, 95% CI 1.20 to 5.24; hospitalisation OR 5.08, 95% CI 2.04 to 12.66; and death OR 10.02, 95% CI 2.53 to 39.72). INTERPRETATION Congruent results from two analytical approaches support a causal effect of smoking on risk of severe COVID-19.
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Affiliation(s)
- Ashley K Clift
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Cancer Research UK Oxford Centre, Department of Oncology, University of Oxford, Oxford, UK
| | - Adam von Ende
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Pui San Tan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Hannah M Sallis
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Nicola Lindson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Carol A C Coupland
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Julia Hippisley-Cox
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jemma C Hopewell
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Sun K, Xiao X, You L, Hong X, Lin D, Liu Y, Huang C, Wang G, Li F, Sun C, Chen C, Lu J, Qi Y, Wang C, Li Y, Xu M, Ren M, Yang C, Wang G, Yan L. Development and validation of a nomogram for assessing risk of isolated high 2-hour plasma glucose. Front Endocrinol (Lausanne) 2022; 13:943750. [PMID: 36157464 PMCID: PMC9492843 DOI: 10.3389/fendo.2022.943750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/19/2022] [Indexed: 11/29/2022] Open
Abstract
A tool was constructed to assess need of an oral glucose tolerance test (OGTT) in patients whose fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are normal. Data was collected from the longitudinal REACTION study conducted from June to November 2011 (14,686 subjects, aged ≥ 40 y). In people without a prior history of diabetes, isolated high 2-hour plasma glucose was defined as 2-hour plasma glucose ≥ 11.1 mmol/L, FPG < 7.0 mmol/L, and HbA1c < 6.5%. A predictive nomogram for high 2-hour plasma glucose was developed via stepwise logistic regression. Discrimination and calibration of the nomogram were evaluated by the area under the receiver operating characteristic curve (AUC) and Hosmer-Lemeshow test; performance was externally validated in Northeast China. Parameters in the model included gender, age, drinking status, marriage status, history of hypertension and hyperlipidemia, waist-to-hip ratio, FPG, and HbA1c. All variables were noninvasive, except FPG and HbA1c. The AUC of the nomogram for isolated high 2-hour plasma glucose was 0.759 (0.727-0.791) in the development dataset. The AUCs of the internal and externally validation datasets were 0.781 (0.712-0.833) and 0.803 (0.778-0.829), respectively. Application of the nomogram during the validation study showed good calibration, and the decision curve analysis indicated that the nomogram was clinically useful. This practical nomogram model may be a reliable screening tool to detect isolated high 2-hour plasma glucose for individualized assessment in patients with normal FPG and HbA1c. It should simplify clinical practice, and help clinicians in decision-making.
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Affiliation(s)
- Kan Sun
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xianchao Xiao
- Department of Endocrinology, The First Hospital of Jilin University, Changchun, China
| | - Lili You
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaosi Hong
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Diaozhu Lin
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yujia Liu
- Department of Endocrinology, The First Hospital of Jilin University, Changchun, China
| | - Chulin Huang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Gang Wang
- Department of Endocrinology, The First Hospital of Jilin University, Changchun, China
| | - Feng Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chenglin Sun
- Department of Endocrinology, The First Hospital of Jilin University, Changchun, China
| | - Chaogang Chen
- Department of Clinical Nutrition, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiahui Lu
- Department of Clinical Nutrition, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yiqin Qi
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chuan Wang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mingtong Xu
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Meng Ren
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chuan Yang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guixia Wang
- Department of Endocrinology, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Li Yan, ; Guixia Wang,
| | - Li Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Li Yan, ; Guixia Wang,
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153
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COVID-19 pandemic evolution in the Brazilian Indigenous population. J Racial Ethn Health Disparities 2022; 9:921-937. [PMID: 33782907 PMCID: PMC8006870 DOI: 10.1007/s40615-021-01031-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has affected several neglected populations such as the Indigenous peoples, which have suffered a high impact from the pandemic. OBJECTIVES To analyze the impact on the health and disease process according to the COVID-19 evolution in the Brazilian Indigenous population. METHODS Data was collected from press releases by the Health Ministry and a descriptive analysis of the numbers of Indigenous individuals infected with the SARS-CoV-2 in Brazil was carried out. RESULTS In February 2021, there were 41,855 confirmed cases of Indigenous individuals infected by the SARS-CoV-2, including 4,387 active cases, 36,809 recovered cases, and 549 deaths. The Brazilian Indigenous population is distributed in over 300 ethnic groups and, due to the high number of deaths by the COVID-19, many of these groups are endangered. The elderly are the most affected age group, and they play a fundamental role among the Indigenous population for transmitting their customs mainly orally. Indigenous populations do not have proper access to transport to specialized health centers, since many areas are inaccessible and other cases require air or river transportation, which many times results in late assistance. When managing the COVID-19, it is important to emphasize the need for social isolation to prevent the virus from spreading among the Indigenous groups, mainly due to their contact with other ethnic groups represented by missionaries, hunters, and wood explorers, among others. CONCLUSION The adoption of practices that can reduce the virus transmission among the Indigenous population and provide them with better access to treatment, mainly for the elderly, must be prioritized in Brazil.
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Gedeborg R, Lindhagen L, Loeb S, Styrke J, Garmo H, Stattin P. Androgen deprivation therapy, comorbidity, cancer stage and mortality from COVID-19 in men with prostate cancer. Scand J Urol 2021; 56:104-111. [PMID: 34939533 DOI: 10.1080/21681805.2021.2019304] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Androgens facilitate entrance of the severe acute respiratory syndrome coronavirus 2 into respiratory epithelial cells, and male sex is associated with a higher risk of death from corona virus disease (COVID-19). Androgen deprivation therapy (ADT) could possibly improve COVID-19 outcomes. METHODS In a case-control study nested in the Prostate Cancer data Base Sweden (PCBaSe) RAPID 2019, we evaluated the association between ADT and COVID-19 as registered cause of death in men with prostate cancer. Each case was matched to 50 controls by region. We used conditional logistic regression to adjust for confounders and also evaluated potential impact of residual confounding. RESULTS We identified 474 men who died from COVID-19 in March-December 2020. In crude analyses, ADT exposure was associated with an increased risk of COVID-19 death (odds ratio [OR] 5.05, 95% CI: 4.18-6.10); however, the OR was substantially attenuated after adjustment for age, comorbidity, prostate cancer characteristics at diagnosis, recent healthcare use, and indicators of advanced cancer (adjusted OR 1.25, 95% CI: 0.95-1.65). If adjustment has accounted for at least 85% of confounding, then the true effect could be no more than a 5% reduction of the odds for COVID-19 death. CONCLUSIONS The increased mortality from COVID-19 in men with prostate cancer treated with ADT was mainly related to high age, comorbidity, and more advanced prostate cancer. There was no evidence to support the hypothesis that ADT is associated with improved COVID-19 outcomes.
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Affiliation(s)
- Rolf Gedeborg
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs Medical Center, New York, NY, USA
| | - Johan Styrke
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - Hans Garmo
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.,Translational Oncology and Urology Research (TOUR), King's College London, Guy's Hospital, London, UK
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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155
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Diabetes mellitus, maternal adiposity, and insulin-dependent gestational diabetes are associated with COVID-19 in pregnancy: the INTERCOVID study. Am J Obstet Gynecol 2021; 227:74.e1-74.e16. [PMID: 34942154 PMCID: PMC8686449 DOI: 10.1016/j.ajog.2021.12.032] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/02/2021] [Accepted: 12/13/2021] [Indexed: 12/15/2022]
Abstract
Background Among nonpregnant individuals, diabetes mellitus and high body mass index increase the risk of COVID-19 and its severity. Objective This study aimed to determine whether diabetes mellitus and high body mass index are risk factors for COVID-19 in pregnancy and whether gestational diabetes mellitus is associated with COVID-19 diagnosis. Study Design INTERCOVID was a multinational study conducted between March 2020 and February 2021 in 43 institutions from 18 countries, enrolling 2184 pregnant women aged ≥18 years; a total of 2071 women were included in the analyses. For each woman diagnosed with COVID-19, 2 nondiagnosed women delivering or initiating antenatal care at the same institution were also enrolled. The main exposures were preexisting diabetes mellitus, high body mass index (overweight or obesity was defined as a body mass index ≥25 kg/m2), and gestational diabetes mellitus in pregnancy. The main outcome was a confirmed diagnosis of COVID-19 based on a real-time polymerase chain reaction test, antigen test, antibody test, radiological pulmonary findings, or ≥2 predefined COVID-19 symptoms at any time during pregnancy or delivery. Relationships of exposures and COVID-19 diagnosis were assessed using generalized linear models with a Poisson distribution and log link function, with robust standard errors to account for model misspecification. Furthermore, we conducted sensitivity analyses: (1) restricted to those with a real-time polymerase chain reaction test or an antigen test in the last week of pregnancy, (2) restricted to those with a real-time polymerase chain reaction test or an antigen test during the entire pregnancy, (3) generating values for missing data using multiple imputation, and (4) analyses controlling for month of enrollment. In addition, among women who were diagnosed with COVID-19, we examined whether having gestational diabetes mellitus, diabetes mellitus, or high body mass index increased the risk of having symptomatic vs asymptomatic COVID-19. Results COVID-19 was associated with preexisting diabetes mellitus (risk ratio, 1.94; 95% confidence interval, 1.55–2.42), overweight or obesity (risk ratio, 1.20; 95% confidence interval, 1.06–1.37), and gestational diabetes mellitus (risk ratio, 1.21; 95% confidence interval, 0.99–1.46). The gestational diabetes mellitus association was specifically among women requiring insulin, whether they were of normal weight (risk ratio, 1.79; 95% confidence interval, 1.06–3.01) or overweight or obese (risk ratio, 1.77; 95% confidence interval, 1.28–2.45). A somewhat stronger association with COVID-19 diagnosis was observed among women with preexisting diabetes mellitus, whether they were of normal weight (risk ratio, 1.93; 95% confidence interval, 1.18–3.17) or overweight or obese (risk ratio, 2.32; 95% confidence interval, 1.82–2.97). When the sample was restricted to those with a real-time polymerase chain reaction test or an antigen test in the week before delivery or during the entire pregnancy, including missing variables using imputation or controlling for month of enrollment, the observed associations were comparable. Conclusion Diabetes mellitus and overweight or obesity were risk factors for COVID-19 diagnosis in pregnancy, and insulin-dependent gestational diabetes mellitus was associated with the disease. Therefore, it is essential that women with these comorbidities are vaccinated.
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156
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Verburgh ML, Boyd A, Wit FWNM, Schim van der Loeff MF, van der Valk M, Bakker M, Kootstra NA, van der Hoek L, Reiss P. Similar risk of SARS-CoV-2 infection and similar nucleocapsid antibody levels in people with well-controlled HIV and a comparable cohort of people without HIV. J Infect Dis 2021; 225:1937-1947. [PMID: 34929034 PMCID: PMC8755357 DOI: 10.1093/infdis/jiab616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/16/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Within the ongoing AGEhIV Cohort Study in Amsterdam, we prospectively compared the incidence of and risk factors for SARS-CoV-2 infection between HIV-positive and -negative participants. Moreover, we compared SARS-CoV-2 nucleocapsid antibody levels between participants with incident infection from both groups. METHODS Starting in September 2020, consenting HIV-positive and HIV-negative participants were assessed 6-monthly for incident SARS-CoV-2 infection, using combined IgA/IgM/IgG SARS-CoV-2 nucleocapsid antibody assay. Cumulative incidence of SARS-CoV-2 infection and associated risk factors were assessed from February 27, 2020 through April 30, 2021 using complementary log-log regression. In those with incident SARS-CoV-2 infection, N-antibody levels were compared between groups using linear regression. RESULTS 241 HIV-positive (99.2% virally suppressed) and 326 HIV-negative AGEhIV participants were included in this study. Cumulative SARS-CoV-2 incidence by April 2021 was 13.4% and 11.6% in HIV-positive and HIV-negative participants, respectively (p=0.61). Younger age and African origin were independently associated with incident infection. In those with incident infection, only self-reported fever, but not HIV status, was associated with higher N-antibody levels. CONCLUSIONS HIV-positive individuals with suppressed viremia and adequate CD4 cell counts were had similar risk of SARS-CoV-2 acquisition, and had similar SARS-CoV-2 N-antibody levels following infection compared to a comparable cohort of HIV-negative people.
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Affiliation(s)
- Myrthe L Verburgh
- Amsterdam University Medical Centers, Department of Infectious Diseases, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands.,Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Anders Boyd
- HIV Monitoring Foundation, Amsterdam, The Netherlands.,Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Ferdinand W N M Wit
- Amsterdam University Medical Centers, Department of Infectious Diseases, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands.,HIV Monitoring Foundation, Amsterdam, The Netherlands
| | - Maarten F Schim van der Loeff
- Amsterdam University Medical Centers, Department of Infectious Diseases, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands.,Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Marc van der Valk
- Amsterdam University Medical Centers, Department of Infectious Diseases, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands.,HIV Monitoring Foundation, Amsterdam, The Netherlands
| | - Margreet Bakker
- Amsterdam University Medical Centers, Department of Medical Microbiology and Infection Prevention, Laboratory of Experimental Virology, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - Neeltje A Kootstra
- Amsterdam University Medical Centers, Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - Lia van der Hoek
- Amsterdam University Medical Centers, Department of Medical Microbiology and Infection Prevention, Laboratory of Experimental Virology, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - Peter Reiss
- Amsterdam University Medical Centers, Department of Infectious Diseases, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands.,Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
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157
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Gadeyne S, Rodriguez-Loureiro L, Surkyn J, Van Hemelrijck W, Nusselder W, Lusyne P, Vanthomme K. Are we really all in this together? The social patterning of mortality during the first wave of the COVID-19 pandemic in Belgium. Int J Equity Health 2021; 20:258. [PMID: 34922557 PMCID: PMC8684273 DOI: 10.1186/s12939-021-01594-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Belgium was one of the countries that was struck hard by COVID-19. Initially, the belief was that we were 'all in it together'. Emerging evidence showed however that deprived socioeconomic groups suffered disproportionally. Yet, few studies are available for Belgium. The main question addressed in this paper is whether excess mortality during the first COVID-19 wave followed a social gradient and whether the classic mortality gradient was reproduced. METHODS We used nationwide individually linked data from the Belgian National Register and the Census 2011. Age-standardized all-cause mortality rates were calculated during the first COVID-19 wave in weeks 11-20 in 2020 and compared with the rates during weeks 11-20 in 2015-2019 to calculate absolute and relative excess mortality by socioeconomic and -demographic characteristics. For both periods, relative inequalities in total mortality between socioeconomic and -demographic groups were calculated using Poisson regression. Analyses were stratified by age, gender and care home residence. RESULTS Excess mortality during the first COVID-19 wave was high in collective households, with care homes hit extremely hard by the pandemic. The social patterning of excess mortality was rather inconsistent and deviated from the usual gradient, mainly through higher mortality excesses among higher socioeconomic groups classes in specific age-sex groups. Overall, the first COVID-19 wave did not change the social patterning of mortality, however. Differences in relative inequalities between both periods were generally small and insignificant, except by household living arrangement. CONCLUSION The social patterning during the first COVID-19 wave was exceptional as excess mortality did not follow the classic lines of higher mortality in lower classes and patterns were not always consistent. Relative mortality inequalities did not change substantially during the first COVID-19 wave compared to the reference period.
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Affiliation(s)
- Sylvie Gadeyne
- Sociology Department, Interface Demography, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.
| | - Lucia Rodriguez-Loureiro
- Sociology Department, Interface Demography, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Johan Surkyn
- Sociology Department, Interface Demography, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Wanda Van Hemelrijck
- Sociology Department, Interface Demography, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
- Netherlands Interdisciplinary Demographic Institute-KNAW/University of Groningen, Lange Houtstraat 19, The Hague, CV, NL-2511, The Netherlands
| | - Wilma Nusselder
- Department of Public Health, Erasmus MC, Dr. Molewaterplein 40, Rotterdam, GD, 3015, The Netherlands
| | - Patrick Lusyne
- Statbel, Directorate General Statistics - Statistics Belgium, North Gate - Boulevard du Roi Albert II, 16 - 1000, Brussels, Belgium
| | - Katrien Vanthomme
- Sociology Department, Interface Demography, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
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158
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Wohl DA, Barzin AH, Napravnik S, Davy-Mendez T, Smedberg JR, Thompson CM, Ruegsegger L, Gilleskie M, Weber DJ, Whinna HC, Miller MB. COVID-19 symptoms at time of testing and association with positivity among outpatients tested for SARS-CoV-2. PLoS One 2021; 16:e0260879. [PMID: 34890441 PMCID: PMC8664207 DOI: 10.1371/journal.pone.0260879] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/18/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction Symptoms associated with SARS-CoV-2 infection remain incompletely understood, especially among ambulatory, non-hospitalized individuals. With host factors, symptoms predictive of SARS-CoV-2 could be used to guide testing and intervention strategies. Methods Between March 16 and September 3, 2020, we examined the characteristics and symptoms reported by individuals presenting to a large outpatient testing program in the Southeastern US for nasopharyngeal SARS-CoV-2 RNA RT-PCR testing. Using self-reported symptoms, demographic characteristics, and exposure and travel histories, we identified the variables associated with testing positive using modified Poisson regression. Results Among 20,177 tested individuals, the proportion positive was 9.4% (95% CI, 9.0–9.8) and was higher for men, younger individuals, and racial/ethnic minorities (all P<0.05); the positivity proportion was higher for Hispanics (26.9%; 95% CI. 24.9–29.0) compared to Blacks (8.6%; 95% CI, 7.6–9.7) or Whites (5.8%; 95% CI, 5.4–6.3). Individuals reporting contact with a COVID-19 case had the highest positivity proportion (22.8%; 95% CI, 21.5–24.1). Among the subset of 8,522 symptomatic adults who presented for testing after May 1, when complete symptom assessments were performed, SARS-CoV-2 RNA PCR was detected in 1,116 (13.1%). Of the reported symptoms, loss of taste or smell was most strongly associated with SARS-CoV-2 RNA detection with an adjusted risk ratio of 3.88 (95% CI, 3.46–4.35). The presence of chills, fever, cough, aches, headache, fatigue and nasal congestion also significantly increased the risk of detecting SARS-CoV-2 RNA, while diarrhea or nausea/vomiting, although not uncommon, were significantly more common in those with a negative test result. Symptom combinations were frequent with 67.9% experiencing ≥4 symptoms, including 19.8% with ≥8 symptoms; report of greater than three symptoms increased the risk of SARS-CoV-2 RNA detection. Conclusions In a large outpatient population in the Southeastern US, several symptoms, most notably loss of taste or smell, and greater symptom burden were associated with detection of SARS-CoV-2 RNA. Persons of color and those with who were a contact of a COVID-19 case were also more likely to test positive. These findings suggest that, given limited SARS-CoV-2 testing capacity, symptom presentation and host characteristics can be used to guide testing and intervention prioritization.
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Affiliation(s)
- David A. Wohl
- Institute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- * E-mail:
| | - Amir H. Barzin
- Department of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Sonia Napravnik
- Institute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Thibaut Davy-Mendez
- Institute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, United States of America
| | - Jason R. Smedberg
- Clinical Microbiology Laboratory, McLendon Clinical Laboratories, The University of North Carolina Medical Center, Chapel Hill, NC, United States of America
| | - Cecilia M. Thompson
- Clinical Microbiology Laboratory, McLendon Clinical Laboratories, The University of North Carolina Medical Center, Chapel Hill, NC, United States of America
| | - Laura Ruegsegger
- Institute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Matt Gilleskie
- Institute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - David J. Weber
- Institute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Herbert C. Whinna
- Department of Pathology and Laboratory Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Melissa B. Miller
- Clinical Microbiology Laboratory, McLendon Clinical Laboratories, The University of North Carolina Medical Center, Chapel Hill, NC, United States of America
- Department of Pathology and Laboratory Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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159
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Amirthalingam G, Bernal JL, Andrews NJ, Whitaker H, Gower C, Stowe J, Tessier E, Subbarao S, Ireland G, Baawuah F, Linley E, Warrener L, O'Brien M, Whillock C, Moss P, Ladhani SN, Brown KE, Ramsay ME. Serological responses and vaccine effectiveness for extended COVID-19 vaccine schedules in England. Nat Commun 2021; 12:7217. [PMID: 34893611 PMCID: PMC8664823 DOI: 10.1038/s41467-021-27410-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/09/2021] [Indexed: 11/09/2022] Open
Abstract
The UK prioritised delivery of the first dose of BNT162b2 (Pfizer/BioNTech) and AZD1222 (AstraZeneca) vaccines by extending the interval between doses up to 12 weeks. In 750 participants aged 50-89 years, we here compare serological responses after BNT162b2 and AZD1222 vaccination with varying dose intervals, and evaluate these against real-world national vaccine effectiveness (VE) estimates against COVID-19 in England. We show that antibody levels 14-35 days after dose two are higher in BNT162b2 recipients with an extended vaccine interval (65-84 days) compared with those vaccinated with a standard (19-29 days) interval. Following the extended schedule, antibody levels were 6-fold higher at 14-35 days post dose 2 for BNT162b2 than AZD1222. For both vaccines, VE was higher across all age-groups from 14 days after dose two compared to one dose, but the magnitude varied with dose interval. Higher dose two VE was observed with >6 week interval between BNT162b2 doses compared to the standard schedule. Our findings suggest higher effectiveness against infection using an extended vaccine schedule. Given global vaccine constraints these results are relevant to policymakers.
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Affiliation(s)
- Gayatri Amirthalingam
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom.
| | - Jamie Lopez Bernal
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom
| | - Nick J Andrews
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom
| | - Heather Whitaker
- Statistics, Modelling and Economics Department, UK Health Security Agency, London, United Kingdom
| | - Charlotte Gower
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom
| | - Julia Stowe
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom
| | - Elise Tessier
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom
| | - Sathyavani Subbarao
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom
| | - Georgina Ireland
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom
| | - Frances Baawuah
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom
- Brondesbury Medical Centre, Kilburn, London, United Kingdom
| | - Ezra Linley
- Sero-Epidemiolgy Unit, UK Health Security Agency, Manchester, United Kingdom
| | - Lenesha Warrener
- Virus Reference Department, UK Health Security Agency, London, United Kingdom
| | | | - Corinne Whillock
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Edgbaston, United Kingdom
| | - Shamez N Ladhani
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom
- Paediatric Infectious Diseases Research Group, St. George's University of London, London, United Kingdom
| | - Kevin E Brown
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom
| | - Mary E Ramsay
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, United Kingdom
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160
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Leidi A, Berner A, Dumont R, Dubos R, Koegler F, Piumatti G, Vuilleumier N, Kaiser L, Balavoine JF, Trono D, Pittet D, Chappuis F, Kherad O, Courvoisier DS, Azman AS, Zaballa ME, Guessous I, Stringhini S. Occupational risk of SARS-CoV-2 infection and reinfection during the second pandemic surge: a cohort study. Occup Environ Med 2021; 79:116-119. [PMID: 34880045 DOI: 10.1136/oemed-2021-107924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/18/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This cohort study including essential workers, assessed the risk and incidence of SARS-CoV-2 infection during the second surge of COVID-19 according to baseline serostatus and occupational sector. METHODS Essential workers were selected from a seroprevalence survey cohort in Geneva, Switzerland and were linked to a state centralised registry compiling SARS-CoV-2 infections. Primary outcome was the incidence of virologically confirmed infections from serological assessment (between May and September 2020) to 25 January 2021, according to baseline antibody status and stratified by three predefined occupational groups (occupations requiring sustained physical proximity, involving brief regular contact or others). RESULTS 10 457 essential workers were included (occupations requiring sustained physical proximity accounted for 3057 individuals, those involving regular brief contact, 3645 and 3755 workers were classified under 'Other essential occupations'). After a follow-up period of over 27 weeks, 5 (0.6%) seropositive and 830 (8.5%) seronegative individuals had a positive SARS-CoV-2 test, with an incidence rate of 0.2 (95% CI 0.1 to 0.6) and 3.2 (95% CI 2.9 to 3.4) cases per person-week, respectively. Incidences were similar across occupational groups. Seropositive essential workers had a 93% reduction in the hazard (HR of 0.07, 95% CI 0.03 to 0.17) of having a positive test during the follow-up with no significant between-occupational group difference. CONCLUSIONS A 10-fold reduction in the hazard of being virologically tested positive was observed among anti-SARS-CoV-2 seropositive essential workers regardless of their sector of occupation, confirming the seroprotective effect of a previous SARS-CoV2 exposure at least 6 months after infection.
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Affiliation(s)
- Antonio Leidi
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Amandine Berner
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Roxane Dumont
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Richard Dubos
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Flora Koegler
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Giovanni Piumatti
- Faculty of BioMedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Nicolas Vuilleumier
- Division of Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Laurent Kaiser
- Geneva Center for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
| | | | - Didier Trono
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Didier Pittet
- Infection Control Program and World Health Organization Collaborating Center on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - François Chappuis
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Omar Kherad
- Division of Internal Medicine, La Tour Hopital, Geneva, Switzerland
| | | | - Andrew S Azman
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Maria Eugenia Zaballa
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Idris Guessous
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Silvia Stringhini
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
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161
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Pérès K, Ouvrard C, Koleck M, Rascle N, Dartigues J, Bergua V, Amieva H. Living in rural area: A protective factor for a negative experience of the lockdown and the COVID-19 crisis in the oldest old population? Int J Geriatr Psychiatry 2021; 36:1950-1958. [PMID: 34378244 PMCID: PMC8420248 DOI: 10.1002/gps.5609] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/05/2021] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Some factors influence the experience of the COVID-19 pandemic (health, loneliness, digital access...), but what about the living area? The objective was to compare between rural and urban areas, the psychological and social experiences of the older individuals with regard to the COVID-19 crisis during the first French lockdown. METHODS The sample included participants of three existing population-based cohorts on aging. Telephone interviews conducted by psychologists focused on the lockdown period. Data collected included living environment, professional assistance, social support, contacts with relatives, difficulties encountered, health, and knowledge and representations of the epidemic. The negative experience was defined by the presence of at least two of the following items: high anxiety symptomatology, depressive symptoms, worries or difficulties during the lockdown and insufficient social support. RESULTS The sample included 467 participants, aged on average 87.5 years (5.2), 58.9% were female and 47.1% lived in rural areas. Persons living in rural area had better social support, greater family presence, a less frequent feeling of imprisonment (OR = 0.60, 95 CI% = 0.36-0.99), 95% had a garden (vs. 56%), fewer depressive symptoms and lower anxiety scores, but also tended to lower comply with the health measures. Finally, they had an almost twofold lower risk of having a negative experience of the lockdown compared to their urban counterparts (OR = 0.55, 95% CI = 0.33-0.92, p = 0.0223). CONCLUSIONS The oldest old living in rural area experienced the first lockdown better than the urbans. Living conditions, with access to nature, a greater social support and family presence, could have contributed to these findings.
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Affiliation(s)
- Karine Pérès
- INSERM, U 1219 Bordeaux Population HealthUniversity of BordeauxBordeauxFrance
| | - Camille Ouvrard
- INSERM, U 1219 Bordeaux Population HealthUniversity of BordeauxBordeauxFrance
| | - Michèle Koleck
- INSERM, U 1219 Bordeaux Population HealthUniversity of BordeauxBordeauxFrance
| | - Nicole Rascle
- INSERM, U 1219 Bordeaux Population HealthUniversity of BordeauxBordeauxFrance
| | | | - Valérie Bergua
- INSERM, U 1219 Bordeaux Population HealthUniversity of BordeauxBordeauxFrance
| | - Hélène Amieva
- INSERM, U 1219 Bordeaux Population HealthUniversity of BordeauxBordeauxFrance
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162
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Foo O, Hiu S, Teare D, Syed AA, Razvi S. A global country-level analysis of the relationship between obesity and COVID-19 cases and mortality. Diabetes Obes Metab 2021; 23:2697-2706. [PMID: 34402152 PMCID: PMC8444639 DOI: 10.1111/dom.14523] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/28/2021] [Accepted: 08/10/2021] [Indexed: 12/20/2022]
Abstract
AIM To assess the association of country-level obesity prevalence with COVID-19 case and mortality rates, to evaluate the impact of obesity prevalence on worldwide variation. METHODS Data on COVID-19 prevalence and mortality, country-specific governmental actions, socioeconomic, demographic, and healthcare capacity factors were extracted from publicly available sources. Multivariable negative binomial regression was used to assess the independent association of obesity with COVID-19 case and mortality rates. RESULTS Across 168 countries for which data were available, higher obesity prevalence was associated with increased COVID-19 mortality and prevalence rates. For every 1% increase in obesity prevalence, the mortality rate was increased by 8.3% (incidence rate ratio [IRR] 1.083, 95% confidence interval [CI] 1.048-1.119; P < 0.001) and the case rate was higher by 6.6% (IRR 1.066, 95% CI 1.035-1.099; P < 0.001). Additionally, higher median population age, greater female ratio, higher Human Development Index (HDI), lower population density, and lower hospital bed availability were all significantly associated with higher COVID-19 mortality rate. In addition, stricter governmental actions, higher HDI and lower mean annual temperature were significantly associated with higher COVID-19 case rate. CONCLUSION These findings demonstrate that obesity prevalence is a significant and potentially modifiable risk factor of increased COVID-19 national caseload and mortality. Future research to study whether weight loss improves COVID-19 outcomes is urgently required.
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Affiliation(s)
- Oliver Foo
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Shaun Hiu
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Dawn Teare
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | | | - Salman Razvi
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
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163
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Maloney SF, Combs M, Scholtes RL, Underwood M, Kilgalen B, Soule EK, Breland AB. Impacts of COVID-19 on cigarette use, smoking behaviors, and tobacco purchasing behaviors. Drug Alcohol Depend 2021; 229:109144. [PMID: 34768140 PMCID: PMC8577861 DOI: 10.1016/j.drugalcdep.2021.109144] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/07/2021] [Accepted: 10/07/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The COVID-19 pandemic has had a significant global impact. As a respiratory illness, COVID-19 may pose unique risks to cigarette smokers. This study used concept mapping, a mixed-method participatory approach, to identify impacts of COVID-19 on cigarette smokers. METHODS Cigarette smokers across the United States (U.S.) were recruited to complete this online, multi-step study. Of the 126 participants who were invited to participate in this study, 91 participants (mean age = 40.9; SD = 11.3) completed at least one of the three study tasks (i.e., brainstorming, sorting, and rating). Participants completed a brief demographic survey and brainstormed statements that completed a focus prompt: "A specific way that Coronavirus/COVID-19 has impacted/affected my cigarette use, smoking behaviors, tobacco purchasing behaviors, and/or other tobacco-related behaviors is." After duplicate statements were removed, participants sorted the final list of 87 statements by similarity of content and rated how true statements were from them (1-Definitely NOT true to 7-Definitely true). RESULTS Nine thematic clusters were identified: Smoking More, Smoking to Cope/Reduce Stress, Change in Smoking Behaviors Due to COVID-19, Concerns about Smoking and COVID-19 Risk, Social Impacts, Maintaining and Rationing Cigarette Supply, Impacts on Obtaining Cigarettes, Use of Other Tobacco Products/Drugs, and Minimal/No Impacts/Concerns of COVID-19. The highest rated cluster (i.e., most true) was the Smoking More cluster followed by the Concerns about Smoking and COVID-19 Risk cluster. The highest rated statement in the study was the statement "Smoking keeps me calm". CONCLUSIONS Cigarette smokers may endure additional impacts of COVID-19, such as increased COVID-19 health burdens, stressors related to risk of exposure, social stigma and isolation, financial burdens, and increased toxicant exposure from increased smoking frequency.
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Affiliation(s)
- Sarah F Maloney
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, 100W. Franklin St. Suite 200, Richmond, VA 23220, USA
| | - Madison Combs
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, 100W. Franklin St. Suite 200, Richmond, VA 23220, USA
| | - Rebecca Lester Scholtes
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, 100W. Franklin St. Suite 200, Richmond, VA 23220, USA
| | - Megan Underwood
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, 100W. Franklin St. Suite 200, Richmond, VA 23220, USA
| | - Barbara Kilgalen
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, 100W. Franklin St. Suite 200, Richmond, VA 23220, USA
| | - Eric K Soule
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 1000 East 1st Street, Greenville, NC 27858, USA
| | - Alison B Breland
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, 100W. Franklin St. Suite 200, Richmond, VA 23220, USA.
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164
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Khanijahani A, Iezadi S, Gholipour K, Azami-Aghdash S, Naghibi D. A systematic review of racial/ethnic and socioeconomic disparities in COVID-19. Int J Equity Health 2021; 20:248. [PMID: 34819081 PMCID: PMC8611382 DOI: 10.1186/s12939-021-01582-4] [Citation(s) in RCA: 225] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/30/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Preliminary evidence from the COVID-19 pandemic shows the presence of health disparities, especially in terms of morbidity and mortality. This study aimed to systematically review the evidence on the association of racial/ethnic and socioeconomic status (SES) with health outcomes and access to healthcare services during the COVID-19 pandemic. METHODS We retrieved published evidence from late December 2019 through March 1, 2021. The target population was the population of the countries during the COVID-19 pandemic. The exposures were defined as belonging to racial/ethnic minority groups and/or low SES. The primary outcomes of interest include (1) death from COVID-19, (2) COVID-19 incidence/infection, (3) COVID-19 hospitalization, (4) ICU admission, (5) need for mechanical ventilation, (6) confirmed diagnosis, and (7) access to testing. We systematically synthesized the findings from different studies and provided a narrative explanation of the results. RESULTS After removing the duplicate results and screening for relevant titles and abstracts, 77 studies were selected for full-text review. Finally, 52 studies were included in the review. The majority of the studies were from the United States (37 studies). Despite the significant incongruity among the studies, most of them showed that racial/ethnic minority groups had higher risks of COVID-19 infection and hospitalization, confirmed diagnosis, and death. Additionally, most of the studies cited factors such as low level of education, poverty, poor housing conditions, low household income, speaking in a language other than the national language in a country, and living in overcrowded households as risk factors of COVID-19 incidence/infection, death, and confirmed diagnosis. However, findings in terms of the association of lack of health insurance coverage and unemployment with the outcome measures as well as the association of requiring mechanical ventilation, ICU admission, and access to testing for COVID-19 with race/ethnicity were limited and inconsistent. CONCLUSION It is evident that racial/ethnic minority groups and those from low SES are more vulnerable to COVID-19; therefore, public health policymakers, practitioners, and clinicians should be aware of these inequalities and strive to narrow the gap by focusing on vulnerable populations. This systematic review also revealed a major incongruity in the definition of the racial/ethnic minority groups and SES among the studies. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020190105.
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Affiliation(s)
- Ahmad Khanijahani
- Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | - Shabnam Iezadi
- Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Kamal Gholipour
- Social Determinants of Health Research Center, Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Deniz Naghibi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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165
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Vallarta-Robledo JR, Sandoval JL, Baggio S, Salamun J, Jacquérioz F, Spechbach H, Guessous I. Negative Association Between Smoking and Positive SARS-CoV-2 Testing: Results From a Swiss Outpatient Sample Population. Front Public Health 2021; 9:731981. [PMID: 34805064 PMCID: PMC8602063 DOI: 10.3389/fpubh.2021.731981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/12/2021] [Indexed: 11/28/2022] Open
Abstract
To date, most of the evidence suggests that smoking is negatively associated with testing positive for SARS-CoV-2. However, evidence has several methodological limitations. Using an outpatient sample population, we analyzed the association of testing positive for SARS-CoV-2 and smoking considering comorbidities, socioeconomic and demographic factors. Baseline data were obtained from a cohort during the first wave of the pandemic in Geneva, Switzerland (March-April 2020). RT-PCR tests were carried out on individuals suspected of having SARS-CoV-2 according to the testing strategy at that time. Logistic regressions were performed to test the association of smoking and testing positive for SARS-CoV-2 and further adjusted for comorbidities, socioeconomic and demographic factors. The sample included 5,169 participants; 60% were women and the mean age was 41 years. The unadjusted OR for testing positive for SARS-CoV-2 was 0.46 (CI: 0.38–0.54). After adjustment for comorbidities, socioeconomic and demographic factors, smoking was still negatively associated with testing positive for SARS-CoV-2 (OR: 0.44; CI: 0.35–0.77). Women (OR: 0.79; CI: 0.69–0.91), higher postal income (OR: 0.97; CI: 0.95–0.99), having respiratory (OR: 0.68; CI: 0.55–0.84) and immunosuppressive disorders (OR: 0.63; CI: 0.44–0.88) also showed independent negative associations with a positive test for SARS-CoV-2. Smoking was negatively associated with a positive test for SARS-CoV-2 independently of comorbidities, socioeconomic and demographic factors. Since having respiratory or immunosuppressive conditions and being females and healthcare workers were similarly negatively associated with SARS-CoV-2 positive testing, we hypothesize that risk factor-related protective or testing behaviors could have induced a negative association with SARS-CoV-2.
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Affiliation(s)
- Juan R Vallarta-Robledo
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - José Luis Sandoval
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.,Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - Stéphanie Baggio
- Division of Prison Health, Geneva University Hospitals, Geneva, Switzerland.,Department of Justice and Home Affairs of the Canton of Zurich, Office of Corrections, Zurich, Switzerland
| | - Julien Salamun
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Frédérique Jacquérioz
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Hervé Spechbach
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Idris Guessous
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
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Al-Tammemi AB, Barakat M, Al Tamimi D, Alhallaq SA, Al Hasan DM, Khasawneh GM, Naqera KA, Jaradat RM, Farah FW, Al-Maqableh HO, Abuawad A, Othman B, Tarhini Z, Odeh H, Khatatbeh M, Akour A, Aljaberi MA, Kolozsvári LR. Beliefs Toward Smoking and COVID-19, and the Pandemic Impact on Smoking Behavior and Quit Intention: Findings from a Community-Based Cross-Sectional Study in Jordan. Tob Use Insights 2021; 14:1179173X211053022. [PMID: 34866951 PMCID: PMC8637701 DOI: 10.1177/1179173x211053022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The relationship between smoking and coronavirus disease-2019 (COVID-19) is still topical with mixed epidemiological evidence. However, the pandemic may affect people's beliefs toward smoking as well as their smoking behavior and quit intentions. Considering high smoking rates in Jordan, our current study aimed to assess the following domains in a community-based sample from Jordan: (i) the beliefs that surround smoking/vaping and COVID-19 and (ii) the pandemic impact on smoking behavior and quit intention. METHODS A cross-sectional study was conducted in Jordan from March 9 to March 16, 2021, utilizing a web-based structured questionnaire. The questionnaire comprised 13 items on sociodemographic, health, and smoking profiles, 14 items to assess beliefs surrounding COVID-19 and the use of combustible cigarettes (CCs), waterpipe (WP), and electronic cigarettes (ECs), and 12 items to assess the pandemic impact on smoking behavior and quit intention. RESULTS Of 2424 survey respondents who participated in our study, there were 1163 never-smokers, 1044 current smokers, and 217 ex-smokers. The mean age of participants was 35.2 years (SD: 11.06). Most participants have reported anti-smoking beliefs with around 72.9% believed that WP smoking is related to the risk of contracting COVID-19. Also, 71.7% believed that smoking CC may worsen the COVID-19 clinical course, while 74.1% of respondents believed that smoking has no protective effect against COVID-19. During the pandemic, about 28.1% and 19.3% of current smokers reported increased or reduced smoking, respectively. Besides, 459 current smokers have expressed their plans/intention to quit smoking during the pandemic, of whom 27.5% (n = 126) confirmed that the driving force for their decision is a COVID-19-related reason, such as self-protection (n = 123) and protection of family members (n = 121) which were the most cited reasons. Also, around 63 participants have successfully ceased smoking during the pandemic. However, only 22 of them reported that the main driving motivation of their successful quit attempt was the COVID-19 pandemic. CONCLUSION Most participants' beliefs and attitudes were against smoking during the pandemic. Nevertheless, the double-edged effect of the pandemic on smoking habits should be carefully considered, and reliable anti-smoking measures should be strengthened and sustained in the country.
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Affiliation(s)
- Ala'a B Al-Tammemi
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Dua'a Al Tamimi
- Department of Community Health Nursing, Princess Muna College of Nursing, Mutah University, Amman, Jordan
| | - Sami A Alhallaq
- Department of Internal Medicine, Division of Pulmonology, King Hussein Medical City, Jordanian Royal Medical Services, Amman, Jordan
| | - Dima M Al Hasan
- Department of Dental Technology, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Ghena M Khasawneh
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalil Abu Naqera
- Department of Health, The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Jordan Field Office, Amman, Jordan
| | - Raghad M Jaradat
- Department of Internal Medicine, King Hussein Medical City, Jordanian Royal Medical Services, Amman, Jordan
| | - Fadi W Farah
- Department of Internal Medicine, Al-Basheer Hospital, Jordanian Ministry of Health, Amman, Jordan
| | - Hindya O Al-Maqableh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Alaa Abuawad
- Department of Pharmaceutical Sciences and Pharmaceutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Bayan Othman
- Department of Pharmaceutical Sciences and Pharmaceutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Zeinab Tarhini
- CAPTuR Laboratory, Control of Cell Activation in Tumor Progression and Therapeutic Resistance, Limoges, France
- Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Hamza Odeh
- International Medical Corps (IMC), Amman, Jordan
| | - Moawiah Khatatbeh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Amal Akour
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Musheer A Aljaberi
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - László Róbert Kolozsvári
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
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167
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Fenofibrate as a COVID-19 modifying drug: Laboratory success versus real-world reality. Atherosclerosis 2021; 339:55-56. [PMID: 34802683 PMCID: PMC8590506 DOI: 10.1016/j.atherosclerosis.2021.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/09/2021] [Indexed: 02/04/2023]
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168
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Nilles EJ, Siddiqui SM, Fischinger S, Bartsch YC, de St. Aubin M, Zhou G, Gluck MJ, Berger S, Rhee J, Petersen E, Mormann B, Loesche M, Hu Y, Chen Z, Yu J, Gebre M, Atyeo C, Gorman MJ, Zhu AL, Burke J, Slein M, Hasdianda MA, Jambaulikar G, Boyer EW, Sabeti PC, Barouch DH, Julg B, Kucharski AJ, Musk ER, Lauffenburger DA, Alter G, Menon AS. Epidemiological and Immunological Features of Obesity and SARS-CoV-2. Viruses 2021; 13:2235. [PMID: 34835041 PMCID: PMC8624148 DOI: 10.3390/v13112235] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 12/15/2022] Open
Abstract
Obesity is a key correlate of severe SARS-CoV-2 outcomes while the role of obesity on risk of SARS-CoV-2 infection, symptom phenotype, and immune response remain poorly defined. We examined data from a prospective SARS-CoV-2 cohort study to address these questions. Serostatus, body mass index, demographics, comorbidities, and prior COVID-19 compatible symptoms were assessed at baseline and serostatus and symptoms monthly thereafter. SARS-CoV-2 immunoassays included an IgG ELISA targeting the spike RBD, multiarray Luminex targeting 20 viral antigens, pseudovirus neutralization, and T cell ELISPOT assays. Our results from a large prospective SARS-CoV-2 cohort study indicate symptom phenotype is strongly influenced by obesity among younger but not older age groups; we did not identify evidence to suggest obese individuals are at higher risk of SARS-CoV-2 infection; and remarkably homogenous immune activity across BMI categories suggests immune protection across these groups may be similar.
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Affiliation(s)
- Eric J. Nilles
- Brigham and Women’s Hospital, Boston, MA 02115, USA; (G.Z.); (B.M.); (M.L.); (M.A.H.); (G.J.); (E.W.B.)
- Harvard Medical School, Boston, MA 02115, USA
- Harvard Humanitarian Initiative, Boston, MA 02114, USA;
- Massachusetts Consortium on Pathogen Readiness, Boston, MA 02115, USA; (P.C.S.); (G.A.)
| | - Sameed M. Siddiqui
- Computational and Systems Biology Program, Massachusetts Institute of Technology, Cambridge, MA 02139, USA;
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; (D.H.B.); (B.J.)
| | - Stephanie Fischinger
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA; (S.F.); (Y.C.B.); (Z.C.); (J.Y.); (M.G.); (C.A.); (M.J.G.); (A.L.Z.); (J.B.); (M.S.)
| | - Yannic C. Bartsch
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA; (S.F.); (Y.C.B.); (Z.C.); (J.Y.); (M.G.); (C.A.); (M.J.G.); (A.L.Z.); (J.B.); (M.S.)
| | | | - Guohai Zhou
- Brigham and Women’s Hospital, Boston, MA 02115, USA; (G.Z.); (B.M.); (M.L.); (M.A.H.); (G.J.); (E.W.B.)
- Harvard Medical School, Boston, MA 02115, USA
| | - Matthew J. Gluck
- Space Exploration Technologies Corp., Hawthorne, CA 90250, USA; (M.J.G.); (S.B.); (J.R.); (E.P.); (Y.H.); (E.R.M.); (A.S.M.)
| | - Samuel Berger
- Space Exploration Technologies Corp., Hawthorne, CA 90250, USA; (M.J.G.); (S.B.); (J.R.); (E.P.); (Y.H.); (E.R.M.); (A.S.M.)
| | - Justin Rhee
- Space Exploration Technologies Corp., Hawthorne, CA 90250, USA; (M.J.G.); (S.B.); (J.R.); (E.P.); (Y.H.); (E.R.M.); (A.S.M.)
| | - Eric Petersen
- Space Exploration Technologies Corp., Hawthorne, CA 90250, USA; (M.J.G.); (S.B.); (J.R.); (E.P.); (Y.H.); (E.R.M.); (A.S.M.)
| | - Benjamin Mormann
- Brigham and Women’s Hospital, Boston, MA 02115, USA; (G.Z.); (B.M.); (M.L.); (M.A.H.); (G.J.); (E.W.B.)
- Space Exploration Technologies Corp., Hawthorne, CA 90250, USA; (M.J.G.); (S.B.); (J.R.); (E.P.); (Y.H.); (E.R.M.); (A.S.M.)
| | - Michael Loesche
- Brigham and Women’s Hospital, Boston, MA 02115, USA; (G.Z.); (B.M.); (M.L.); (M.A.H.); (G.J.); (E.W.B.)
- Space Exploration Technologies Corp., Hawthorne, CA 90250, USA; (M.J.G.); (S.B.); (J.R.); (E.P.); (Y.H.); (E.R.M.); (A.S.M.)
| | - Yiyuan Hu
- Space Exploration Technologies Corp., Hawthorne, CA 90250, USA; (M.J.G.); (S.B.); (J.R.); (E.P.); (Y.H.); (E.R.M.); (A.S.M.)
| | - Zhilin Chen
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA; (S.F.); (Y.C.B.); (Z.C.); (J.Y.); (M.G.); (C.A.); (M.J.G.); (A.L.Z.); (J.B.); (M.S.)
| | - Jingyou Yu
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA; (S.F.); (Y.C.B.); (Z.C.); (J.Y.); (M.G.); (C.A.); (M.J.G.); (A.L.Z.); (J.B.); (M.S.)
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Makda Gebre
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA; (S.F.); (Y.C.B.); (Z.C.); (J.Y.); (M.G.); (C.A.); (M.J.G.); (A.L.Z.); (J.B.); (M.S.)
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Caroline Atyeo
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA; (S.F.); (Y.C.B.); (Z.C.); (J.Y.); (M.G.); (C.A.); (M.J.G.); (A.L.Z.); (J.B.); (M.S.)
| | - Matthew J. Gorman
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA; (S.F.); (Y.C.B.); (Z.C.); (J.Y.); (M.G.); (C.A.); (M.J.G.); (A.L.Z.); (J.B.); (M.S.)
| | - Alex Lee Zhu
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA; (S.F.); (Y.C.B.); (Z.C.); (J.Y.); (M.G.); (C.A.); (M.J.G.); (A.L.Z.); (J.B.); (M.S.)
| | - John Burke
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA; (S.F.); (Y.C.B.); (Z.C.); (J.Y.); (M.G.); (C.A.); (M.J.G.); (A.L.Z.); (J.B.); (M.S.)
| | - Matthew Slein
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA; (S.F.); (Y.C.B.); (Z.C.); (J.Y.); (M.G.); (C.A.); (M.J.G.); (A.L.Z.); (J.B.); (M.S.)
| | - Mohammad A. Hasdianda
- Brigham and Women’s Hospital, Boston, MA 02115, USA; (G.Z.); (B.M.); (M.L.); (M.A.H.); (G.J.); (E.W.B.)
- Harvard Medical School, Boston, MA 02115, USA
| | - Guruprasad Jambaulikar
- Brigham and Women’s Hospital, Boston, MA 02115, USA; (G.Z.); (B.M.); (M.L.); (M.A.H.); (G.J.); (E.W.B.)
- Harvard Medical School, Boston, MA 02115, USA
| | - Edward W. Boyer
- Brigham and Women’s Hospital, Boston, MA 02115, USA; (G.Z.); (B.M.); (M.L.); (M.A.H.); (G.J.); (E.W.B.)
- Harvard Medical School, Boston, MA 02115, USA
| | - Pardis C. Sabeti
- Massachusetts Consortium on Pathogen Readiness, Boston, MA 02115, USA; (P.C.S.); (G.A.)
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; (D.H.B.); (B.J.)
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA
| | - Dan H. Barouch
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; (D.H.B.); (B.J.)
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Boris Julg
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; (D.H.B.); (B.J.)
| | - Adam J. Kucharski
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Elon R. Musk
- Space Exploration Technologies Corp., Hawthorne, CA 90250, USA; (M.J.G.); (S.B.); (J.R.); (E.P.); (Y.H.); (E.R.M.); (A.S.M.)
| | - Douglas A. Lauffenburger
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA;
| | - Galit Alter
- Massachusetts Consortium on Pathogen Readiness, Boston, MA 02115, USA; (P.C.S.); (G.A.)
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; (D.H.B.); (B.J.)
| | - Anil S. Menon
- Space Exploration Technologies Corp., Hawthorne, CA 90250, USA; (M.J.G.); (S.B.); (J.R.); (E.P.); (Y.H.); (E.R.M.); (A.S.M.)
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169
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Karachaliou M, Moncunill G, Espinosa A, Castaño-Vinyals G, Jiménez A, Vidal M, Santano R, Barrios D, Puyol L, Carreras A, Mayer L, Rubio R, Cortés B, Pleguezuelos V, O'Callaghan-Gordo C, Fossati S, Rivas I, Casabonne D, Vrijheid M, Izquierdo L, Aguilar R, Basagaña X, Garcia-Aymerich J, de Cid R, Dobaño C, Kogevinas M. Infection induced SARS-CoV-2 seroprevalence and heterogeneity of antibody responses in a general population cohort study in Catalonia Spain. Sci Rep 2021; 11:21571. [PMID: 34732749 PMCID: PMC8566562 DOI: 10.1038/s41598-021-00807-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022] Open
Abstract
Sparse data exist on the complex natural immunity to SARS-CoV-2 at the population level. We applied a well-validated multiplex serology test in 5000 participants of a general population study in Catalonia in blood samples collected from end June to mid November 2020. Based on responses to fifteen isotype-antigen combinations, we detected a seroprevalence of 18.1% in adults (n = 4740), and modeled extrapolation to the general population of Catalonia indicated a 15.3% seroprevalence. Antibodies persisted up to 9 months after infection. Immune profiling of infected individuals revealed that with increasing severity of infection (asymptomatic, 1-3 symptoms, ≥ 4 symptoms, admitted to hospital/ICU), seroresponses were more robust and rich with a shift towards IgG over IgA and anti-spike over anti-nucleocapsid responses. Among seropositive participants, lower antibody levels were observed for those ≥ 60 years vs < 60 years old and smokers vs non-smokers. Overweight/obese participants vs normal weight had higher antibody levels. Adolescents (13-15 years old) (n = 260) showed a seroprevalence of 11.5%, were less likely to be tested seropositive compared to their parents and had dominant anti-spike rather than anti-nucleocapsid IgG responses. Our study provides an unbiased estimate of SARS-CoV-2 seroprevalence in Catalonia and new evidence on the durability and heterogeneity of post-infection immunity.
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Affiliation(s)
| | - Gemma Moncunill
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Ana Espinosa
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | | | - Alfons Jiménez
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 08036, Madrid, Spain
| | - Marta Vidal
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Rebeca Santano
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Diana Barrios
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Laura Puyol
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Anna Carreras
- Genomes for Life-GCAT Lab, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Leonie Mayer
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Rocío Rubio
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Beatriz Cortés
- Genomes for Life-GCAT Lab, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | | | - Cristina O'Callaghan-Gordo
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 08036, Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Serena Fossati
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Ioar Rivas
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Delphine Casabonne
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 08036, Madrid, Spain
- Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Hospitalet De Llobregat, Spain
| | - Martine Vrijheid
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 08036, Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Luis Izquierdo
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Ruth Aguilar
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Xavier Basagaña
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - Judith Garcia-Aymerich
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 08036, Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Rafael de Cid
- Genomes for Life-GCAT Lab, Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Carlota Dobaño
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Manolis Kogevinas
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 08036, Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain
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Fan VS, Dominitz JA, Eastment MC, Locke E, Green P, Berry K, O’Hare AM, Shah JA, Crothers K, Ioannou GN. Risk Factors for Testing Positive for Severe Acute Respiratory Syndrome Coronavirus 2 in a National United States Healthcare System. Clin Infect Dis 2021; 73:e3085-e3094. [PMID: 33105485 PMCID: PMC7665412 DOI: 10.1093/cid/ciaa1624] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Identifying risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection could help health systems improve testing and screening strategies. The aim of this study was to identify demographic factors, comorbid conditions, and symptoms independently associated with testing positive for SARS-CoV-2. METHODS This was an observational cross-sectional study at the Veterans Health Administration, including persons tested for SARS-CoV-2 nucleic acid by polymerase chain reaction (PCR) between 28 February and 14 May 2020. Associations between demographic characteristics, diagnosed comorbid conditions, and documented symptoms with testing positive for SARS-CoV-2 were measured. RESULTS Of 88 747 persons tested, 10 131 (11.4%) were SARS-CoV-2 PCR positive. Positivity was associated with older age (≥80 vs <50 years: adjusted odds ratio [aOR], 2.16 [95% confidence interval {CI}, 1.97-2.37]), male sex (aOR, 1.45 [95% CI, 1.34-1.57]), regional SARS-CoV-2 burden (≥2000 vs <400 cases/million: aOR, 5.43 [95% CI, 4.97-5.93]), urban residence (aOR, 1.78 [95% CI, 1.70-1.87]), black (aOR, 2.15 [95% CI, 2.05-2.26]) or American Indian/Alaska Native Hawaiian/Pacific Islander (aOR, 1.26 [95% CI, 1.05-1.52]) vs white race, and Hispanic ethnicity (aOR, 1.52 [95% CI, 1.40-1.65]). Obesity and diabetes were the only 2 medical conditions associated with testing positive. Documented fevers, chills, cough, and diarrhea were also associated with testing positive. The population attributable fraction of positive tests was highest for geographic location (35.3%), followed by demographic variables (27.1%), symptoms (12.0%), obesity (10.5%), and diabetes (0.4%). CONCLUSIONS The majority of positive SARS-CoV-2 tests were attributed to geographic location, demographic characteristics, and obesity, with a minor contribution of chronic comorbid conditions.
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Affiliation(s)
- Vincent S Fan
- Division of Pulmonary and Critical Care, University of Washington, Seattle, WA, USA
| | - Jason A Dominitz
- Division of Gastroenterology, University of Washington, Seattle, WA, USA
| | - McKenna C Eastment
- Division of Allergy and Infectious Disease, University of Washington, Seattle, WA, USA
| | - Emily Locke
- Division of Research and Development, University of Washington, Seattle, WA, USA
| | - Pamela Green
- Division of Research and Development, University of Washington, Seattle, WA, USA
| | - Kristin Berry
- Division of Research and Development, University of Washington, Seattle, WA, USA
| | - Ann M O’Hare
- Division of Nephrology at the Veterans Affairs Puget Sound Healthcare System and University of Washington, Seattle, WA, USA
| | - Javeed A Shah
- Division of Allergy and Infectious Disease, University of Washington, Seattle, WA, USA
| | - Kristina Crothers
- Division of Pulmonary and Critical Care, University of Washington, Seattle, WA, USA
| | - George N Ioannou
- Division of Gastroenterology, University of Washington, Seattle, WA, USA
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171
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Rao CY, Robinson T, Huster K, Laws RL, Keating R, Tobolowsky FA, McMichael TM, Gonzales E, Mosites E. Occupational exposures and mitigation strategies among homeless shelter workers at risk of COVID-19. PLoS One 2021; 16:e0253108. [PMID: 34723986 PMCID: PMC8559982 DOI: 10.1371/journal.pone.0253108] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/29/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To describe the work environment and COVID-19 mitigation measures for homeless shelter workers and assess occupational risk factors for COVID-19. Methods Between June 9-August 10, 2020, we conducted a self-administered survey among homeless shelter workers in Washington, Massachusetts, Utah, Maryland, and Georgia. We calculated frequencies for work environment, personal protective equipment use, and SARS-CoV-2 testing history. We used generalized linear models to produce unadjusted prevalence ratios (PR) to assess risk factors for SARS-CoV-2 infection. Results Of the 106 respondents, 43.4% reported frequent close contact with clients; 75% were worried about work-related SARS-CoV-2 infections; 15% reported testing positive. Close contact with clients was associated with testing positive for SARS-CoV-2 (PR 3.97, 95%CI 1.06, 14.93). Conclusions Homeless shelter workers may be at risk of being exposed to individuals with COVID-19 during the course of their work. Frequent close contact with clients was associated with SARS-CoV-2 infection. Protecting these critical essential workers by implementing mitigation measures and prioritizing for COVID-19 vaccination is imperative during the pandemic.
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Affiliation(s)
- Carol Y. Rao
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Tashina Robinson
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Karin Huster
- Public Health-Seattle & King County, Seattle, Washington, United States of America
| | - Rebecca L. Laws
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ryan Keating
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Farrell A. Tobolowsky
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Temet M. McMichael
- Public Health-Seattle & King County, Seattle, Washington, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Elysia Gonzales
- Public Health-Seattle & King County, Seattle, Washington, United States of America
| | - Emily Mosites
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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172
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Heilbronner U, Streit F, Vogl T, Senner F, Schaupp SK, Reich-Erkelenz D, Papiol S, Oraki Kohshour M, Klöhn-Saghatolislam F, Kalman JL, Heilbronner M, Gade K, Comes AL, Budde M, Andlauer TFM, Anderson-Schmidt H, Adorjan K, Stürmer T, Loerbroks A, Amelang M, Poisel E, Foo J, Heilmann-Heimbach S, Forstner AJ, Degenhardt F, Zimmermann J, Wiltfang J, von Hagen M, Spitzer C, Schmauss M, Reininghaus E, Reimer J, Konrad C, Juckel G, Lang FU, Jäger M, Figge C, Fallgatter AJ, Dietrich DE, Dannlowski U, Baune BT, Arolt V, Anghelescu IG, Nöthen MM, Witt SH, Andreassen OA, Chen CH, Falkai P, Rietschel M, Schulze TG, Schulte EC. Interplay between the genetics of personality traits, severe psychiatric disorders and COVID-19 host genetics in the susceptibility to SARS-CoV-2 infection. BJPsych Open 2021; 7:e188. [PMID: 34659794 PMCID: PMC8503053 DOI: 10.1192/bjo.2021.1030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 09/12/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, with its impact on our way of life, is affecting our experiences and mental health. Notably, individuals with mental disorders have been reported to have a higher risk of contracting SARS-CoV-2. Personality traits could represent an important determinant of preventative health behaviour and, therefore, the risk of contracting the virus. AIMS We examined overlapping genetic underpinnings between major psychiatric disorders, personality traits and susceptibility to SARS-CoV-2 infection. METHOD Linkage disequilibrium score regression was used to explore the genetic correlations of coronavirus disease 2019 (COVID-19) susceptibility with psychiatric disorders and personality traits based on data from the largest available respective genome-wide association studies (GWAS). In two cohorts (the PsyCourse (n = 1346) and the HeiDE (n = 3266) study), polygenic risk scores were used to analyse if a genetic association between, psychiatric disorders, personality traits and COVID-19 susceptibility exists in individual-level data. RESULTS We observed no significant genetic correlations of COVID-19 susceptibility with psychiatric disorders. For personality traits, there was a significant genetic correlation for COVID-19 susceptibility with extraversion (P = 1.47 × 10-5; genetic correlation 0.284). Yet, this was not reflected in individual-level data from the PsyCourse and HeiDE studies. CONCLUSIONS We identified no significant correlation between genetic risk factors for severe psychiatric disorders and genetic risk for COVID-19 susceptibility. Among the personality traits, extraversion showed evidence for a positive genetic association with COVID-19 susceptibility, in one but not in another setting. Overall, these findings highlight a complex contribution of genetic and non-genetic components in the interaction between COVID-19 susceptibility and personality traits or mental disorders.
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Affiliation(s)
- Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Thomas Vogl
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany
| | - Sabrina K Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany
| | - Mojtaba Oraki Kohshour
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; and Department of Immunology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Iran
| | - Farahnaz Klöhn-Saghatolislam
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany
| | - Janos L Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Katrin Gade
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | - Ashley L Comes
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany
| | - Till F M Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Germany
| | - Heike Anderson-Schmidt
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany
| | - Til Stürmer
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Germany
| | | | - Eric Poisel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Jerome Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | | | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Germany; and Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Germany; and Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Germany
| | - Jörg Zimmermann
- Psychiatrieverbund Oldenburger Land gGmbH, Karl-Jaspers-Klinik, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | - Martin von Hagen
- Clinic for Psychiatry and Psychotherapy, Clinical Center Werra-Meißner, Germany
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Germany
| | - Max Schmauss
- Department of Psychiatry, Psychotherapy and Psychosomatics, Augsburg University, Medical Faculty, Germany
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Austria
| | - Jens Reimer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Germany
| | - Fabian U Lang
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Germany
| | - Markus Jäger
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Germany
| | - Christian Figge
- Karl-Jaspers Clinic, European Medical School Oldenburg-Groningen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Tübingen, Germany
| | - Detlef E Dietrich
- AMEOS Clinical Center Hildesheim, Germany; and Center for Systems Neuroscience Hannover, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Bernhardt T Baune
- Department of Psychiatry, University of Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Australia; and The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Australia
| | - Volker Arolt
- Institute for Translational Psychiatry, University of Münster, Germany
| | | | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Ole A Andreassen
- NORMENT Centre and KG Jebsen Centre for Neurodevelopmental disorders, Institute of Clinical Medicine, University of Oslo, Norway; and Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Chi-Hua Chen
- Department of Radiology, University of California, USA
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA; and Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, University of Munich, Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital, University of Munich, Munich, Germany; and Institute of Virology, Technical University Munich/Helmholtz Zentrum München, Germany
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173
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Kavanagh FG, James DL, Brinkman D, Cornyn S, Murphy C, O'Neill S, O'Shea R, Affendi A, Lang B, O'Connor A, Keogh I, Lang E, Russell J, O'Brien D, Sheahan P. Safety of elective paediatric surgery during the coronavirus disease 2019 pandemic. Int J Pediatr Otorhinolaryngol 2021; 150:110861. [PMID: 34583300 PMCID: PMC8349430 DOI: 10.1016/j.ijporl.2021.110861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/12/2021] [Accepted: 07/27/2021] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Corona-virus Disease 2019 (COVID-19) has had a huge impact on the delivery of healthcare worldwide, particularly elective surgery. There is a lack of data regarding risk of postoperative COVID-19 infection in children undergoing elective surgery, and regarding the utility of pre-operative COVID-19 testing, and preoperative "cocooning" or restriction of movements. The purpose of this present study was to examine the safety of elective paediatric Otolaryngology surgery during the COVID-19 pandemic with respect to incidence of postoperative symptomatic COVID-19 infection or major respiratory complications. MATERIALS AND METHODS Prospective cohort study of paediatric patients undergoing elective Otolaryngology surgery between September and December 2020. Primary outcome measure was incidence of symptomatic COVID-19 or major respiratory complications within the 14 days after surgery. Parents of prospectively enrolled patients were contacted 14 days after surgery and enquiry made regarding development of postoperative symptoms, COVID-19 testing, or diagnosis of COVID-19. RESULTS 302 patients were recruited. 125 (41.4%) underwent preoperative COVID-19 RT-PCR testing. 66 (21.8%) restricted movements prior to surgery. The peak 14-day COVID-19 incidence during the study was 302.9 cases per 100,000 population. No COVID-19 infections or major respiratory complications were reported in the 14 day follow-up period. CONCLUSION The results of our study support the safety of elective paediatric Otolaryngology surgery during the pandemic, in the setting of community incidence not exceeding that observed during the study period.
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Affiliation(s)
- F G Kavanagh
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland; Institute of Research, Royal College of Surgeons in Ireland, 121 St. Stephens Green, Dublin, Ireland.
| | - D L James
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland
| | - D Brinkman
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Waterford, Waterford, Ireland
| | - S Cornyn
- Department of Otolaryngology, Children's Health Ireland @ Temple Street, Temple Street, Dublin 1, Ireland
| | - C Murphy
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Galway, Ireland
| | - S O'Neill
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Galway, Ireland
| | - R O'Shea
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland
| | - A Affendi
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland
| | - B Lang
- Department of Otolaryngology, Children's Health Ireland @ Crumlin, Cooley Road, Dublin 12, Ireland
| | - A O'Connor
- Department of Otolaryngology, Children's Health Ireland @ Temple Street, Temple Street, Dublin 1, Ireland
| | - I Keogh
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Galway, Ireland
| | - E Lang
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Waterford, Waterford, Ireland
| | - J Russell
- Department of Otolaryngology, Children's Health Ireland @ Crumlin, Cooley Road, Dublin 12, Ireland
| | - D O'Brien
- Department of Microbiology, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland
| | - P Sheahan
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland; ENTO Research Unit, College of Medicine and Health, University College Cork, College Road, Cork, Ireland; Department of Surgery, University College Cork, College Road, Cork, Ireland
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174
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Xu B, Li G, Guo J, Ikezoe T, Kasirajan K, Zhao S, Dalman RL. Angiotensin-converting enzyme 2, coronavirus disease 2019, and abdominal aortic aneurysms. J Vasc Surg 2021; 74:1740-1751. [PMID: 33600934 PMCID: PMC7944865 DOI: 10.1016/j.jvs.2021.01.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/08/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the etiologic agent of the current, world-wide coronavirus disease 2019 (COVID-19) pandemic. Angiotensin-converting enzyme 2 (ACE2) is the SARS-CoV-2 host entry receptor for cellular inoculation and target organ injury. We reviewed ACE2 expression and the role of ACE2-angiotensin 1-7-Mas receptor axis activity in abdominal aortic aneurysm (AAA) pathogenesis to identify potential COVID-19 influences on AAA disease pathogenesis. METHODS A comprehensive literature search was performed on PubMed, National Library of Medicine. Key words included COVID-19, SARS-CoV-2, AAA, ACE2, ACE or angiotensin II type 1 (AT1) receptor inhibitor, angiotensin 1-7, Mas receptor, age, gender, respiratory diseases, diabetes, and autoimmune diseases. Key publications on the epidemiology and pathogenesis of COVID-19 and AAAs were identified and reviewed. RESULTS All vascular structural cells, including endothelial and smooth muscle cells, fibroblasts, and pericytes express ACE2. Cigarette smoking, diabetes, chronic obstructive pulmonary disease, lupus, certain types of malignancies, and viral infection promote ACE2 expression and activity, with the magnitude of response varying by sex and age. Genetic deficiency of AT1 receptor, or pharmacologic ACE or AT1 inhibition also increases ACE2 and its catalytic product angiotensin 1-7. Genetic ablation or pharmacologic inhibition of ACE2 or Mas receptor augments, whereas ACE2 activation or angiotensin 1-7 treatment attenuates, progression of experimental AAAs. The potential influences of SARS-CoV-2 on AAA pathogenesis include augmented ACE-angiotensin II-AT1 receptor activity resulting from decreased reciprocal ACE2-angiotensin 1-7-Mas activation; increased production of proaneurysmal mediators stimulated by viral spike proteins in ACE2-negative myeloid cells or by ACE2-expressing vascular structural cells; augmented local or systemic cross-talk between viral targeted nonvascular, nonleukocytic ACE2-expressing cells via ligand recognition of their cognate leukocyte receptors; and hypoxemia and increased systemic inflammatory tone experienced during severe COVID-19 illness. CONCLUSIONS COVID-19 may theoretically influence AAA disease through multiple SARS-CoV-2-induced mechanisms. Further investigation and clinical follow-up will be necessary to determine whether and to what extent the COVID-19 pandemic will influence the prevalence, progression, and lethality of AAA disease in the coming decade.
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Affiliation(s)
- Baohui Xu
- Department of Surgery, Stanford University School of Medicine, Stanford, Calif.
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175
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Martin CA, Marshall C, Patel P, Goss C, Jenkins DR, Ellwood C, Barton L, Price A, Brunskill NJ, Khunti K, Pareek M. SARS-CoV-2 vaccine uptake in a multi-ethnic UK healthcare workforce: A cross-sectional study. PLoS Med 2021; 18:e1003823. [PMID: 34739480 PMCID: PMC8570522 DOI: 10.1371/journal.pmed.1003823] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 09/23/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Healthcare workers (HCWs) and ethnic minority groups are at increased risk of COVID-19 infection and adverse outcomes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is now available for frontline UK HCWs; however, demographic/occupational associations with vaccine uptake in this cohort are unknown. We sought to establish these associations in a large UK hospital workforce. METHODS AND FINDINGS We conducted cross-sectional surveillance examining vaccine uptake amongst all staff at University Hospitals of Leicester NHS Trust. We examined proportions of vaccinated staff stratified by demographic factors, occupation, and previous COVID-19 test results (serology/PCR) and used logistic regression to identify predictors of vaccination status after adjustment for confounders. We included 19,044 HCWs; 12,278 (64.5%) had received SARS-CoV-2 vaccination. Compared to White HCWs (70.9% vaccinated), a significantly smaller proportion of ethnic minority HCWs were vaccinated (South Asian, 58.5%; Black, 36.8%; p < 0.001 for both). After adjustment for age, sex, ethnicity, deprivation, occupation, SARS-CoV-2 serology/PCR results, and COVID-19-related work absences, factors found to be negatively associated with vaccine uptake were younger age, female sex, increased deprivation, pregnancy, and belonging to any non-White ethnic group (Black: adjusted odds ratio [aOR] 0.30, 95% CI 0.26-0.34, p < 0.001; South Asian: aOR 0.67, 95% CI 0.62-0.72, p < 0.001). Those who had previously had confirmed COVID-19 (by PCR) were less likely to be vaccinated than those who had tested negative. Limitations include data being from a single centre, lack of data on staff vaccinated outside the hospital system, and that staff may have taken up vaccination following data extraction. CONCLUSIONS Ethnic minority HCWs and those from more deprived areas as well as younger staff and female staff are less likely to take up SARS-CoV-2 vaccination. These findings have major implications for the delivery of SARS-CoV-2 vaccination programmes, in HCWs and the wider population, and should inform the national vaccination programme to prevent the disparities of the pandemic from widening.
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Affiliation(s)
- Christopher A Martin
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom.,Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Colette Marshall
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Prashanth Patel
- Department of Chemical Pathology and Metabolic Diseases, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.,Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Charles Goss
- Department of Occupational Health, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - David R Jenkins
- Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Claire Ellwood
- Department of Pharmacy, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Linda Barton
- Department of Haematology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Arthur Price
- Department of Immunology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Nigel J Brunskill
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.,Department of Nephrology, Leicester General Hospital, Leicester, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom.,Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom.,NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom.,NIHR Applied Research Collaboration East Midlands, Leicester, United Kingdom
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom.,Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.,NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom.,NIHR Applied Research Collaboration East Midlands, Leicester, United Kingdom
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176
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Del Brutto OH, Costa AF, Recalde BY, Mera RM. Factors Associated With a Persistent Seronegative Status 1 Year After a SARS-CoV-2 Massive Infection Outbreak in Community Dwellers Living in Rural Ecuador: A Prospective Population-based Study. J Prim Care Community Health 2021; 12:21501327211054989. [PMID: 34715744 PMCID: PMC8558583 DOI: 10.1177/21501327211054989] [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] [Indexed: 12/05/2022] Open
Abstract
Background The SARS-CoV-2 pandemic is affecting millions of people living in rural areas of Low- and Middle-Income Countries and is causing an already anticipated devastating effect on the health and economics of these populations. More information is needed to modify behaviors that may counterbalance the consequences of mass spread of the virus in these underserved communities. This study aimed to identify factors associated with a persistent SARS-CoV-2 seronegative status 1 year after a massive infection outbreak in middle-aged and older adults living in rural Ecuador. Methods Individuals enrolled in the Atahualpa Project Cohort as of March 2020 received 5 rounds of tests for determination of SARS-CoV-2 antibodies in blood. Individuals who remained seronegative up to April 2021 were considered “persistently seronegative.” An adjusted Poisson regression model was fitted to estimate the incidence risk ratio of factors directly or inversely associated with a persistent seronegative status. Results A total of 673 individuals received baseline tests. Thirty-one declined consent or died and 429 seroconverted, leaving 213 seronegative subjects. Average SARS-CoV-2 incidence rate was 9.87 events (95% C.I.: 8.91-10.83) per 100 person-months of observation. The use of flushing toilet systems (instead of open latrines) increased 1.5 times the possibility of remaining seronegative. Likewise, every additional bedroom in the house increased by 15% the possibility of remaining seronegative. In contrast, every additional person in the house and having high cholesterol levels significantly reduced the possibility of remaining seronegative. Conclusions The use of flushing toilet systems and the number of bedrooms in the house directly influenced the possibility of remaining seronegative among individuals living in this rural setting. Study results also demonstrated a sustained transmission of the virus even after a significant proportion of the population has been infected. Our findings reinforce the mass spread of SARS-CoV-2 in rural communities.
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Affiliation(s)
| | - Aldo F Costa
- Hospital Universitario Reina Sofía, Córdoba, Andalucía, Spain
| | - Bettsy Y Recalde
- Universidad Espíritu Santo - Ecuador, Samborondón, Guayaquil, Ecuador
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177
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Rahman A, Kuddus MA, Ip RHL, Bewong M. A Review of COVID-19 Modelling Strategies in Three Countries to Develop a Research Framework for Regional Areas. Viruses 2021; 13:2185. [PMID: 34834990 PMCID: PMC8623457 DOI: 10.3390/v13112185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/18/2021] [Accepted: 10/26/2021] [Indexed: 12/17/2022] Open
Abstract
At the end of December 2019, an outbreak of COVID-19 occurred in Wuhan city, China. Modelling plays a crucial role in developing a strategy to prevent a disease outbreak from spreading around the globe. Models have contributed to the perspicacity of epidemiological variations between and within nations and the planning of desired control strategies. In this paper, a literature review was conducted to summarise knowledge about COVID-19 disease modelling in three countries-China, the UK and Australia-to develop a robust research framework for the regional areas that are urban and rural health districts of New South Wales, Australia. In different aspects of modelling, summarising disease and intervention strategies can help policymakers control the outbreak of COVID-19 and may motivate modelling disease-related research at a finer level of regional geospatial scales in the future.
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Affiliation(s)
- Azizur Rahman
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW 2678, Australia; (M.A.K.); (R.H.L.I.); (M.B.)
- Institute for Land, Water and Society (ILWS), Charles Sturt University, Albury, NSW 2640, Australia
| | - Md Abdul Kuddus
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW 2678, Australia; (M.A.K.); (R.H.L.I.); (M.B.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4814, Australia
- Department of Mathematics, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Ryan H. L. Ip
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW 2678, Australia; (M.A.K.); (R.H.L.I.); (M.B.)
| | - Michael Bewong
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW 2678, Australia; (M.A.K.); (R.H.L.I.); (M.B.)
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178
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Al Dossary R, Alnimr A, Aljindan R, Alkharsah KR, Al-Qurayn AK, Eltreifi O, Alkuwaiti FA, Almashouf AB, Alsahlawi AM, Alshammari A, Hudhaiah D, Alshahrani MS, Bukhari H. Predictors of Illness Severity in COVID-19 Cases in Saudi Arabia. Infect Drug Resist 2021; 14:4097-4105. [PMID: 34675555 PMCID: PMC8502032 DOI: 10.2147/idr.s333300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/28/2021] [Indexed: 01/04/2023] Open
Abstract
Purpose Multiple studies worldwide have reported the clinical and epidemiological features of coronavirus disease 2019 (COVID-19), with limited reports from the Middle East. This study describes the clinical and epidemiological features of COVID-19 cases in the Eastern Province of Saudi Arabia and identified factors associated with the severity of illness. Patients and Methods This was an observational study of 341 COVID-19 cases. These cases were reported in the first three months after the first case in the country was identified. Clinical and demographic data were analyzed and described to identify the effects of age, sex, and ethnicity on illness severity. In addition, the duration of viral shedding and cycle threshold (Ct) values of real-time PCR were evaluated as predictors of severity. Results The median age was 45 years. Males were twice as likely to be infected than females (p <0.0001). The duration of viral shedding ranged from 9 to 36 days. The most common clinical presentations include fever, shortness of breath, cough, myalgia, sore throat, vomiting, and headache. Critical cases were significantly higher in men (23% vs 8.7%), senior adults (>65 years), individuals of Bengali ethnicity, and in patients with comorbidities including diabetes, hypertension, and dyslipidemia (p =0.001). The case fatality rate was found to be 10%. The fatality was significantly higher in males than females (13.8% vs 2.6%), and in Asians (17.9%) than Arabs (6%) and Africans (0) (p =0.002). No association was found between viral load, represented by the RT-PCR cycle threshold (Ct) values, and severity of illness. Conclusion Age, sex, and ethnicity are important predictors of COVID-19 severity. The cycle threshold (Ct) of the SARS-CoV-2 RT-PCR test cannot be used as a predictor of the criticality of illness.
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Affiliation(s)
- Reem Al Dossary
- Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Amani Alnimr
- Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Reem Aljindan
- Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Khaled R Alkharsah
- Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Ahmed K Al-Qurayn
- Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Obeid Eltreifi
- Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Feras A Alkuwaiti
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Abdullah B Almashouf
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Ahmed M Alsahlawi
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Amal Alshammari
- Department of Medical Laboratory, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Dhoha Hudhaiah
- Department of Medical Laboratory, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Mohammed S Alshahrani
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Huda Bukhari
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
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179
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Gama A, Alves J, Costa D, Laires PA, Soares P, Pedro AR, Moniz M, Solinho L, Nunes C, Dias S. Double jeopardy from the COVID-19 pandemic: risk of exposure and income loss in Portugal. Int J Equity Health 2021; 20:231. [PMID: 34670581 PMCID: PMC8527282 DOI: 10.1186/s12939-021-01569-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increasing evidence indicates that the first wave of the COVID-19 pandemic had immediate health and social impact, disproportionately affecting certain socioeconomic groups. Assessing inequalities in risk of exposure and in adversities faced during the pandemic is critical to inform targeted actions that effectively prevent disproportionate spread and reduce social and health inequities. This study examines i) the socioeconomic and mental health characteristics of individuals working in the workplace, thus at increased risk of COVID-19 exposure, and ii) individual income losses resulting from the pandemic across socioeconomic subgroups of a working population, during the first confinement in Portugal. METHODS This study uses data from 'COVID-19 Barometer: Social Opinion', a community-based online survey in Portugal. The sample for analysis comprised n = 129,078 workers. Logistic regressions were performed to estimate the adjusted odds ratios (AOR) of factors associated with working in the workplace during the confinement period and with having lost income due to the pandemic. RESULTS Over a third of the participants reported working in the workplace during the first confinement. This was more likely among those with lower income [AOR = 2.93 (2.64-3.25)], lower education [AOR = 3.17 (3.04-3.30)] and working as employee [AOR = 1.09 (1.04-1.15)]. Working in the workplace was positively associated with frequent feelings of agitation, anxiety or sadness [AOR = 1.14 (1.09-1.20)] and perception of high risk of infection [AOR = 11.06 (10.53-11.61)]. About 43% of the respondents reported having lost income due to the pandemic. The economic consequences affected greatly the groups at increased risk of COVID-19 exposure, namely those with lower education [AOR = 1.36 (1.19-1.56)] and lower income [AOR = 3.13 (2.47-3.96)]. CONCLUSIONS The social gradient in risk of exposure and in economic impact of the pandemic can result in an accumulated vulnerability for socioeconomic deprived populations. The COVID-19 pandemic seems to have a double effect in these groups, contributing to heightened disparities and poor health outcomes, including in mental health. Protecting the most vulnerable populations is key to prevent the spread of the disease and mitigate the deepening of social and health disparities. Action is needed to develop policies and more extensive measures for reducing disproportionate experiences of adversity from the COVID-19 pandemic among most vulnerable populations.
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Affiliation(s)
- Ana Gama
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal. .,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal.
| | - Joana Alves
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Daniela Costa
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Pedro A Laires
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Patrícia Soares
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Ana Rita Pedro
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Marta Moniz
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Luísa Solinho
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal
| | - Carla Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Sónia Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
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180
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Smith J, Aboumrad M, Reyes C, Satram S, Young-Xu Y. Predictors of Incident Severe Acute Respiratory Syndrome Coronavirus 2 Positivity in a Veteran Population. Mil Med 2021; 188:e1268-e1275. [PMID: 34668962 DOI: 10.1093/milmed/usab428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/30/2021] [Accepted: 10/06/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We explored factors related to testing positive for severe acute respiratory coronavirus 2 (SARS-CoV-2) to identify populations most at risk for this airborne pathogen. METHODS Data were abstracted from the medical record database of the U.S. Department of Veterans Affairs and from public sources. Veterans testing positive were matched in a 1:4 ratio to those at a similar timepoint and local disease burden who remained negative between March 1, 2020, and December 31, 2020. Multivariable logistic regression was used to calculate odds ratios for the association of each potential risk factor with a positive test result. RESULTS A total of 24,843 veterans who tested positive for SARS-CoV-2 were matched with 99,324 controls. Cases and controls were similar in age, sex, ethnicity, and rurality, but cases were more likely to be Black, reside in low-income counties, and suffer from dementia. Multivariable analysis demonstrated highest risk for Black veterans, those with dementia or diabetes, and those living in nursing homes or high-poverty areas. Veterans living in counties likely to be more adherent to public health guidelines were at the lowest risk. CONCLUSIONS Our results are similar to those from studies of other populations and add to that work by accounting for several important proxies for risk. In particular, this work has implications for the value of infection control measures at the population level in helping to stem widespread outbreaks of this type.
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Affiliation(s)
- Jeremy Smith
- US Department of Veterans Affairs, Clinical Epidemiology Program, White River Jct, VT 05009, USA
| | - Maya Aboumrad
- US Department of Veterans Affairs, Clinical Epidemiology Program, White River Jct, VT 05009, USA
| | - Carolina Reyes
- Division of Health Economics and Outcomes Research, VIR Biotechnology, San Francisco, CA 94158, USA
| | - Sacha Satram
- Division of Health Economics and Outcomes Research, VIR Biotechnology, San Francisco, CA 94158, USA
| | - Yinong Young-Xu
- US Department of Veterans Affairs, Clinical Epidemiology Program, White River Jct, VT 05009, USA
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181
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Horta BL, Silveira MF, Barros AJD, Barros FC, Hartwig FP, Dias MS, Menezes AMB, Hallal PC, Victora CG. [Prevalence of antibodies against SARS-CoV-2 according to socioeconomic and ethnic status in a nationwide Brazilian surveyPrevalência de anticorpos contra o SARS-CoV-2 de acordo com o status socioeconômico e étnico em uma pesquisa nacional no Brasil]. Rev Panam Salud Publica 2021; 45:e105. [PMID: 34703458 PMCID: PMC8530005 DOI: 10.26633/rpsp.2021.105] [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] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To investigate socioeconomic and ethnic group inequalities in prevalence of antibodies against SARS-CoV-2 in the 27 federative units of Brazil. METHODS In this cross-sectional study, three household surveys were carried out on May 14-21, June 4-7, and June 21-24, 2020 in 133 Brazilian urban areas. Multi-stage sampling was used to select 250 individuals in each city to undergo a rapid antibody test. Subjects answered a questionnaire on household assets, schooling and self-reported skin color/ethnicity using the standard Brazilian classification in five categories: white, black, brown, Asian or indigenous. Principal component analyses of assets was used to classify socioeconomic position into five wealth quintiles. Poisson regression was used for the analyses. RESULTS 25 025 subjects were tested in the first, 31 165 in the second, and 33 207 in the third wave of the survey, with prevalence of positive results equal to 1.4%, 2.4%, and 2.9% respectively. Individuals in the poorest quintile were 2.16 times (95% confidence interval 1.86; 2.51) more likely to test positive than those in the wealthiest quintile, and those with 12 or more years of schooling had lower prevalence than subjects with less education. Indigenous individuals had 4.71 (3.65; 6.08) times higher prevalence than whites, as did those with black or brown skin color. Adjustment for region of the country reduced the prevalence ratios according to wealth, education and ethnicity, but results remained statistically significant. CONCLUSIONS The prevalence of antibodies against SARS-CoV-2 in Brazil shows steep class and ethnic gradients, with lowest risks among white, educated and wealthy individuals.
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Affiliation(s)
- Bernardo L Horta
- Universidad Federal de PelotasPelotasBrasilUniversidad Federal de Pelotas, Pelotas, Brasil.
| | - Mariângela F Silveira
- Universidad Federal de PelotasPelotasBrasilUniversidad Federal de Pelotas, Pelotas, Brasil.
| | - Aluísio J D Barros
- Universidad Federal de PelotasPelotasBrasilUniversidad Federal de Pelotas, Pelotas, Brasil.
| | - Fernando C Barros
- Universidad Federal de PelotasPelotasBrasilUniversidad Federal de Pelotas, Pelotas, Brasil.
| | - Fernando P Hartwig
- Universidad Federal de PelotasPelotasBrasilUniversidad Federal de Pelotas, Pelotas, Brasil.
| | - Mariane S Dias
- Universidad Federal de PelotasPelotasBrasilUniversidad Federal de Pelotas, Pelotas, Brasil.
| | - Ana M B Menezes
- Universidad Federal de PelotasPelotasBrasilUniversidad Federal de Pelotas, Pelotas, Brasil.
| | - Pedro C Hallal
- Universidad Federal de PelotasPelotasBrasilUniversidad Federal de Pelotas, Pelotas, Brasil.
| | - Cesar G Victora
- Universidad Federal de PelotasPelotasBrasilUniversidad Federal de Pelotas, Pelotas, Brasil.
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182
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Filip R, Anchidin-Norocel L, Gheorghita R, Savage WK, Dimian M. Changes in Dietary Patterns and Clinical Health Outcomes in Different Countries during the SARS-CoV-2 Pandemic. Nutrients 2021; 13:3612. [PMID: 34684615 PMCID: PMC8539259 DOI: 10.3390/nu13103612] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 02/07/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to an excess in community mortality across the globe. We review recent evidence on the clinical pathology of COVID-19, comorbidity factors, immune response to SARS-CoV-2 infection, and factors influencing infection outcomes. The latter specifically includes diet and lifestyle factors during pandemic restrictions. We also cover the possibility of SARS-CoV-2 transmission through food products and the food chain, as well as virus persistence on different surfaces and in different environmental conditions, which were major public concerns during the initial days of the pandemic, but have since waned in public attention. We discuss useful measures to avoid the risk of SARS-CoV-2 spread through food, and approaches that may reduce the risk of contamination with the highly contagious virus. While hygienic protocols are required in food supply sectors, cleaning, disinfection, avoidance of cross-contamination across food categories, and foodstuffs at different stages of the manufacturing process are still particularly relevant because the virus persists at length on inert materials such as food packaging. Moreover, personal hygiene (frequent washing and disinfection), wearing gloves, and proper use of masks, clothes, and footwear dedicated to maintaining hygiene, provide on-site protections for food sector employees as well as supply chain intermediates and consumers. Finally, we emphasize the importance of following a healthy diet and maintaining a lifestyle that promotes physical well-being and supports healthy immune system function, especially when government movement restrictions ("lockdowns") are implemented.
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Affiliation(s)
- Roxana Filip
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- Regional County Emergency Hospital, 720224 Suceava, Romania
| | - Liliana Anchidin-Norocel
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Roxana Gheorghita
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- Integrated Center for Research, Development and Innovation in Advanced Materials, Nanotechnologies, and Distributed Systems for Fabrication and Control, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Wesley K Savage
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- Integrated Center for Research, Development and Innovation in Advanced Materials, Nanotechnologies, and Distributed Systems for Fabrication and Control, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Mihai Dimian
- Integrated Center for Research, Development and Innovation in Advanced Materials, Nanotechnologies, and Distributed Systems for Fabrication and Control, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- Department of Computers, Electronics and Automation, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
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183
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Jung Y, Wee JH, Kim JH, Choi HG. The Effects of Previous Asthma and COPD on the Susceptibility to and Severity of COVID-19: A Nationwide Cohort Study in South Korea. J Clin Med 2021; 10:jcm10204626. [PMID: 34682749 PMCID: PMC8541474 DOI: 10.3390/jcm10204626] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/02/2021] [Accepted: 10/05/2021] [Indexed: 01/08/2023] Open
Abstract
Background: There is controversial evidence of the associations of asthma and chronic obstructive pulmonary disease (COPD) with the risk and outcomes of Coronavirus Disease 2019 (COVID-19). We aimed to evaluate the effects of asthma and COPD on the susceptibility to and severity of COVID-19. Methods: Data from a nationwide COVID-19 cohort database by the Korea National Health Insurance Corporation were utilized. A total of 4066 COVID-19 patients (1 January 2020 through 4 June 2020) were 1:4 matched with 16,264 controls with regard to age, sex, and income. Asthma and COPD were defined as diagnostic codes (ICD-10) and medication claim codes. Conditional and unconditional multivariate logistic regression were applied to analyze the susceptibility to and severity of COVID-19 associated with asthma and COPD. Results: The prevalence of mild and severe asthma/COPD did not differ between the COVID-19 and control patients in the multivariate analyses. Among the total 4066 COVID-19 patients, 343 (8.4%) had severe COVID-19, of whom 132 (3.2% of the total COVID-19 patients) died. Regarding the outcomes of COVID-19, neither mild nor severe asthma were associated with the severity or mortality of COVID-19 after adjusting for other variables. However, severe COPD was a significant risk factor for severe COVID-19 (odds ratio (OR) = 2.23, 95% confidence intervals (CI): 1.08–4.60, p = 0.030) and the mortality of COVID-19 in the multivariate analyses (OR = 3.06, 95% CI: 1.14–8.2, p = 0.026). Conclusions: In a Korean nationwide cohort, neither asthma nor COPD were associated with COVID-19, but severe COPD was associated with the severity and mortality of COVID-19.
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Affiliation(s)
- Younghee Jung
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea;
| | - Jee Hye Wee
- Department of Otorhinolaryngology, College of Medicine, Hallym University, Anyang 14068, Korea;
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy and Critical Care Medicine Department of Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea;
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Hallym University, Anyang 14068, Korea
- Hallym Data Science Laboratory, College of Medicine, Hallym University, Anyang 14068, Korea
- Correspondence:
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184
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Androgen deprivation therapy and excess mortality in men with prostate cancer during the initial phase of the COVID-19 pandemic. PLoS One 2021; 16:e0255966. [PMID: 34618806 PMCID: PMC8496782 DOI: 10.1371/journal.pone.0255966] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 07/18/2021] [Indexed: 12/02/2022] Open
Abstract
Background Men have a higher risk of death from COVID-19 than women and androgens facilitate entrance of the SARS-CoV-2 virus into respiratory epithelial cells. Thus, androgen deprivation therapy may reduce infection rates and improve outcomes for COVID-19. In the spring of 2020, Sweden was highly affected by COVID-19. The aim was to estimate the impact of androgen deprivation therapy on mortality from COVID-19 in men with prevalent prostate cancer by comparing all-cause mortality in the spring of 2020 to that in previous years. Patients and methods Using the Prostate Cancer data Base Sweden all men with prostate cancer on March 1 each year in 2015–2020 were followed until June 30 the same year. Exposure to androgen deprivation therapy was ascertained from filled prescriptions for bicalutamide monotherapy, gonadotropin-releasing hormone agonists (GnRH), or bilateral orchidectomy. Results A total of 9,822 men died in March-June in the years 2015–2020, of whom 5,034 men were on androgen deprivation therapy. There was an excess mortality in 2020 vs previous years in all men. The crude relative mortality rate ratio for 2020 vs 2015–2019 was 0.93 (95% confidence interval (CI) 0.83 to 1.04) in men on GnRH, and 0.90 (95% CI 0.78 to 1.05) in men on bicalutamide monotherapy. After multivariable adjustment these ratios were attenuated to 1.00 (95% CI 0.89 to 1.12) and 0.97 (95% CI 0.84 to 1.12), respectively. When restricting the analysis to the regions with the highest incidence of COVID-19 or to the time period between 2 April to 10 June when mortality in 2020 was increased >30% compared to previous years, the results were similar to the main analysis. Conclusions In this large national population-based cohort of men with prevalent prostate cancer, there was no clear evidence in support for an effect of androgen deprivation therapy on COVID-19 mortality.
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185
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Violato C, Violato EM, Violato EM. Impact of the stringency of lockdown measures on covid-19: A theoretical model of a pandemic. PLoS One 2021; 16:e0258205. [PMID: 34610042 PMCID: PMC8491873 DOI: 10.1371/journal.pone.0258205] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/20/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND How effective have lockdowns been at reducing the covid-19 infection and mortality rates? Lockdowns influence contact among persons within or between populations including restricting travel, closing schools, prohibiting public gatherings, requiring workplace closures, all designed to slow the contagion of the virus. The purpose of the present study was to assess the impact of lockdown measures on the spread of covid-19 and test a theoretical model of the covid-19 pandemic employing structural equation modelling. METHODS Lockdown variables, population demographics, mortality rates, infection rates, and health were obtained for eight countries: Austria, Belgium, France, Germany, Italy, Netherlands, Spain, and the United Kingdom. The dataset, owid-covid-data.csv, was downloaded on 06/01/2020 from: https://github.com/owid/covid-19-data/tree/master/public/data. Infection spread and mortality data were depicted as logistic growth and analyzed with stepwise multiple regression. The overall structure of the covid-19 data was explored through factor analyses leading to a theoretical model that was tested using latent variable path analysis. RESULTS Multiple regression indicated that the time from lockdown had a small but significant effect (β = 0.112, p< 0.01) on reducing the number of cases per million. The stringency index produced the most important effect for mortality and infection rates (β = 0.588,β = 0.702, β = 0.518, β = 0.681; p< 0.01). Exploratory and confirmatory analyses resulted in meaningful and cohesive latent variables: 1) Mortality, 2) Infection Spread, 3) Pop Health Risk, and 4) Health Vulnerability (Comparative Fit Index = 0.91; Standardized Root Mean Square Residual = 0.08). DISCUSSION The stringency index had a large impact on the growth of covid-19 infection and mortality rates as did percentage of population aged over 65, median age, per capita GDP, diabetes prevalence, cardiovascular death rates, and ICU hospital beds per 100K. The overall Latent Variable Path Analysis is theoretically meaningful and coherent with acceptable fit indices as a model of the covid-19 pandemic.
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Affiliation(s)
- Claudio Violato
- Professor and Assistant Dean, University of Minnesota Medical School, Minneapolis, MN, United States of America
| | | | - Efrem Mauro Violato
- Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada
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186
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Wong KCY, Xiang Y, Yin L, So HC. Uncovering Clinical Risk Factors and Predicting Severe COVID-19 Cases Using UK Biobank Data: Machine Learning Approach. JMIR Public Health Surveill 2021; 7:e29544. [PMID: 34591027 PMCID: PMC8485986 DOI: 10.2196/29544] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/24/2021] [Accepted: 07/31/2021] [Indexed: 01/08/2023] Open
Abstract
Background COVID-19 is a major public health concern. Given the extent of the pandemic, it is urgent to identify risk factors associated with disease severity. More accurate prediction of those at risk of developing severe infections is of high clinical importance. Objective Based on the UK Biobank (UKBB), we aimed to build machine learning models to predict the risk of developing severe or fatal infections, and uncover major risk factors involved. Methods We first restricted the analysis to infected individuals (n=7846), then performed analysis at a population level, considering those with no known infection as controls (ncontrols=465,728). Hospitalization was used as a proxy for severity. A total of 97 clinical variables (collected prior to the COVID-19 outbreak) covering demographic variables, comorbidities, blood measurements (eg, hematological/liver/renal function/metabolic parameters), anthropometric measures, and other risk factors (eg, smoking/drinking) were included as predictors. We also constructed a simplified (lite) prediction model using 27 covariates that can be more easily obtained (demographic and comorbidity data). XGboost (gradient-boosted trees) was used for prediction and predictive performance was assessed by cross-validation. Variable importance was quantified by Shapley values (ShapVal), permutation importance (PermImp), and accuracy gain. Shapley dependency and interaction plots were used to evaluate the pattern of relationships between risk factors and outcomes. Results A total of 2386 severe and 477 fatal cases were identified. For analyses within infected individuals (n=7846), our prediction model achieved area under the receiving-operating characteristic curve (AUC–ROC) of 0.723 (95% CI 0.711-0.736) and 0.814 (95% CI 0.791-0.838) for severe and fatal infections, respectively. The top 5 contributing factors (sorted by ShapVal) for severity were age, number of drugs taken (cnt_tx), cystatin C (reflecting renal function), waist-to-hip ratio (WHR), and Townsend deprivation index (TDI). For mortality, the top features were age, testosterone, cnt_tx, waist circumference (WC), and red cell distribution width. For analyses involving the whole UKBB population, AUCs for severity and fatality were 0.696 (95% CI 0.684-0.708) and 0.825 (95% CI 0.802-0.848), respectively. The same top 5 risk factors were identified for both outcomes, namely, age, cnt_tx, WC, WHR, and TDI. Apart from the above, age, cystatin C, TDI, and cnt_tx were among the top 10 across all 4 analyses. Other diseases top ranked by ShapVal or PermImp were type 2 diabetes mellitus (T2DM), coronary artery disease, atrial fibrillation, and dementia, among others. For the “lite” models, predictive performances were broadly similar, with estimated AUCs of 0.716, 0.818, 0.696, and 0.830, respectively. The top ranked variables were similar to above, including age, cnt_tx, WC, sex (male), and T2DM. Conclusions We identified numerous baseline clinical risk factors for severe/fatal infection by XGboost. For example, age, central obesity, impaired renal function, multiple comorbidities, and cardiometabolic abnormalities may predispose to poorer outcomes. The prediction models may be useful at a population level to identify those susceptible to developing severe/fatal infections, facilitating targeted prevention strategies. A risk-prediction tool is also available online. Further replications in independent cohorts are required to verify our findings.
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Affiliation(s)
- Kenneth Chi-Yin Wong
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Yong Xiang
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Liangying Yin
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Hon-Cheong So
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China.,KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research of Common Diseases, Kunming Institute of Zoology and The Chinese University of Hong Kong, Kunming, China.,CUHK Shenzhen Research Institute, Shenzhen, China.,Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China.,Margaret K.L. Cheung Research Centre for Management of Parkinsonism, The Chinese University of Hong Kong, Hong Kong, China.,Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Branch of the Chinese Academy of Sciences Center for Excellence in Animal Evolution and Genetics, The Chinese University of Hong Kong, Hong Kong, China
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187
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Al-Kuraishy HM, Al-Gareeb AI, Faidah H, Alexiou A, Batiha GES. Testosterone in COVID-19: An Adversary Bane or Comrade Boon. Front Cell Infect Microbiol 2021; 11:666987. [PMID: 34568081 PMCID: PMC8455954 DOI: 10.3389/fcimb.2021.666987] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/16/2021] [Indexed: 12/17/2022] Open
Abstract
COVID-19 is a pandemic disease caused by severe acute respiratory coronavirus 2 (SARS-CoV-2), which leads to pulmonary manifestations like acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). In addition, COVID-19 may cause extra-pulmonary manifestation such as testicular injury. Both high and low levels of testosterone could affect the severity of COVID-19. Herein, there is substantial controversy regarding the potential role of testosterone in SARS-CoV-2 infection and COVID-19 severity. Therefore, the present study aimed to review and elucidate the assorted view of preponderance regarding the beneficial and harmful effects of testosterone in COVID-19. A related literature search in PubMed, Scopus, Web of Science, Google Scholar, and Science Direct was done. All published articles related to the role of testosterone and COVID-19 were included in this mini-review. The beneficial effects of testosterone in COVID-19 are through inhibition of pro-inflammatory cytokines, augmentation of anti-inflammatory cytokines, modulation of the immune response, attenuation of oxidative stress, and endothelial dysfunction. However, its harmful effects in COVID-19 are due to augmentation of transmembrane protease serine 2 (TMPRSS2), which is essential for cleaving and activating SARS-CoV-2 spike protein during acute SARS-CoV-2 infection. Most published studies illustrated that low testosterone levels are linked to COVID-19 severity. A low testosterone level in COVID-19 is mainly due to testicular injury, the primary source of testosterone.
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Affiliation(s)
- Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, ALmustansiriyia University, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, ALmustansiriyia University, Baghdad, Iraq
| | - Hani Faidah
- Faculty of Medicine, Umm Al Qura University, Mecca, Saudi Arabia
| | - Athanasios Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, NSW, Australia.,AFNP Med Austria, Wien, Austria
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
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188
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Direct and Indirect Effects of SARS-CoV-2 Pandemic in Subjects with Familial Hypercholesterolemia: A Single Lipid-Center Real-World Evaluation. J Clin Med 2021; 10:jcm10194363. [PMID: 34640388 PMCID: PMC8509350 DOI: 10.3390/jcm10194363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 01/08/2023] Open
Abstract
We evaluated the impact of direct and indirect effects of SARS-CoV-2 infection in subjects with familial hypercholesterolemia (FH). In this observational, retrospective study, 260 FH subjects participated in a telephone survey concerning lipid profile values, lipidologist and cardiologist consultations and vascular imaging evaluation during the 12 months before and after the Italian lockdown. The direct effect was defined as SARS-CoV-2 infection; the indirect effect was defined as the difference in one of the parameters evaluated by the telephone survey before and after lockdown. Among FH subjects, the percentage of the lipid profile evaluation was lower after lockdown than before lockdown (56.5% vs. 100.0%, p < 0.01), HDL-C was significantly reduced (47.78 ± 10.12 vs. 53.2 ± 10.38 mg/dL, p < 0.05) and a significant increase in non-HDL-C was found (117.24 ± 18.83 vs. 133.09 ± 19.01 mg/dL, p < 0.05). The proportions of lipidologist and/or cardiologist consultations and/or vascular imaging were lower after lockdown than before lockdown (for lipidologist consultation 33.5% vs. 100.0%, p < 0.001; for cardiologist consultation 22.3% vs. 60.8%, p < 0.01; for vascular imaging 19.6% vs. 100.0%, p < 0.001); the main cause of missed lipid profile analysis and/or healthcare consultation was the fear of SARS-CoV-2 contagion. The percentage of FH subjects affected by SARS-CoV-2 was 7.3%. In conclusion, a lower percentage of FH subjects underwent a lipid profile analysis, lipidologist and cardiologist consultations and vascular imaging evaluation after SARS-CoV-2 Italian lockdown.
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Barletta WA. Risk Factors of SARS-CoV-2 Infection: Global Epidemiological Study. ACTA ACUST UNITED AC 2021; 2:e28843. [PMID: 34547061 PMCID: PMC8404263 DOI: 10.2196/28843] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/22/2022]
Abstract
Background Since the first recognition of the pandemic characteristics of SARS-CoV-2 infection, and before substantial case fatality data were available worldwide, public health agencies warned the public about the increased dangers of SARS-CoV-2 to persons with a variety of underlying physical conditions, many of which are more commonly found in persons over 50 years of age or in certain ethnic groups. Objective To investigate the statistical rather than the physiological basis in support of the abovementioned warnings, this study examines correlations globally on a nation-by-nation basis between the statistical data concerning COVID-19 fatalities and the statistics of potential comorbidities that may influence the severity of infection. Methods This study considers the statistics describing the populations of the 99 countries with the greatest numbers of SARS-CoV-2 infections at the time of the data cutoff. As national compilations of direct measures of immune system strength are not publicly available, the frequency of fatalities in those countries due to a variety of serious diseases is used as a proxy for the susceptibility of those populations to those same diseases. Results The analysis produces plots and calculations of correlations and cross-correlations of COVID-19 case fatality rates and the risks of other potential cofactors. It exposes some reasons that may underlie the degree to which advanced age increases the risk of mortality of infection with SARS-CoV-2. In contrast with the strong influences of comorbidities on the seriousness of consequences of influenzas and their associated pneumonias, the correlations of the same set of risk factors with SARS-CoV-2 infection are considerably weaker. The general characteristics of the observed correlations strengthened through 3 cycles of analysis, starting in September 2020. The strongest correlations were with chronic kidney disease and coronary disease (approximately 0.28 and 0.20, respectively). Conclusions This study confirms early clinical observations that infection with SARS-CoV-2 presents an increased risk to persons over the age of 65 years. It does not support the suggestions presented by government agencies early in the pandemic that the risks are much greater for persons with certain common potential comorbidities.
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190
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Paleiron N, Mayet A, Marbac V, Perisse A, Barazzutti H, Brocq FX, Janvier F, Dautzenberg B, Bylicki O. Impact of Tobacco Smoking on the Risk of COVID-19: A Large Scale Retrospective Cohort Study. Nicotine Tob Res 2021; 23:1398-1404. [PMID: 33420786 PMCID: PMC7953961 DOI: 10.1093/ntr/ntab004] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 01/06/2021] [Indexed: 01/08/2023]
Abstract
Introduction Preliminary reports indicated that smokers could be less susceptible to coronavirus SARS-CoV-2, which causes Covid-19. However, once infected an increased risk of severe disease is reported. We investigated the association between smoking and COVID-19 during an outbreak of the disease on a naval vessel. Methods We conducted a cross-sectional, observational study on the 1769 sailors of the same navy aircraft carrier at sea exposed at the same time to SARS-CoV2 to investigate the link between tobacco consumption and Covid-19. Results Among the 1688 crewmembers (87% men; median age = 28 [interquartile range 23–35]) included, 1279 (76%) developed Covid-19 (1038 [62%] reverse-transcriptase- polymerase chain reaction testing–positive and 241 [14%] with only clinical signs). One hundred and seven patients were hospitalized. The univariable analysis odds ratio (OR) for Covid-19 infection was 0.59 (95% confidence interval [CI], 0.45–0.78; p < .001) for current smokers versus former and nonsmokers; sex, body mass index or blood group had no significant impact. Crewmembers >50 years old had an increased risk of contracting Covid-19 (OR, 2.84 [95% CI, 1.30–7.5]; p = .01). Multivariable analysis retained the lower risk of current smokers becoming infected (OR, 0.64 [0.49–0.84]; p < .001) and age >50 years was significatively associated with Covid-19 (OR, 2.6 [1.17–6.9]; p = .03). Conclusions Current smoking status was associated with a lower risk of developing Covid-19 but cannot be considered as efficient protection against infection. The mechanism of the lower susceptibility of smokers to SARS-CoV-2 requires further research. Trial Registration IRB no.: 0011873-2020-09 Implications (1) Recent epidemiologic data suggest a paradoxical link between smoking and COVID-19. (2) Among the 1688 crewmembers (with an attack rate of 76% and exposed at the same time in the same place to SARS-CoV2), we found a significantly lower risk for developing COVID-19 in current smokers (71%) versus former and nonsmokers (80%). This finding strongly supports the need for further research on nicotine physiological pathway and its impact on COVID-19 infection whilst emphasizing that tobacco smoking should not be considered as efficient protection against COVID-19.
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Affiliation(s)
| | - Aurélie Mayet
- French Military Center for Epidemiology and Public Health (CESPA), Marseille, and UMR 912 SESSTIM: INSERM-IRD-Université Aix-Marseille, Marseille, France
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191
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Alsaïdi I, De Sousa Santos F, Plard B, Janvier E, Tinland A, Hafni A, Mosnier E. Factors associated with SARS-CoV2 infection and care pathways among the most vulnerable populations living in Marseille: a case control study. BMC Public Health 2021; 21:1704. [PMID: 34538240 PMCID: PMC8449995 DOI: 10.1186/s12889-021-11716-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 09/01/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The Covid-19 pandemic has led to substantial and unexpected increases in morbidity and mortality in France. Vulnerable populations housed in accommodation centres have a greater risk of infection because collective housing and their dependence on social support services mean it is more difficult to apply preventive measures. They are also at greater risk of developing severe forms of Covid-19 and waiting longer before seeking healthcare (for Covid-19 or other) treatment. We aimed to identify the factors associated with SARS-CoV2 infection in the most vulnerable populations in the city of Marseille. METHODS The study sample comprised users of various services provided by the association AAJT in Marseille, France, some presenting symptoms suggestive of Covid-19 and others not. All had routine health surveillance provided by AAJT's dedicated healthcare team between March 2020 and May 2020. Using univariate and multivariate analyses, we studied the influence of several variables on morbidity associated with Covid-19. RESULTS The study included 64 participants, 29 of whom tested positive for Covid-19 and 35 control subjects. Median age was 21.16 years old. Individuals in the 'Covid-19 case' group (p < 0.005) - which included persons testing positive and those suspected of being infected - were younger. The study sample's male/female ratio was seven. In our multivariate analyses, living in a shared apartment and poor adherence to social distancing measures were factors associated with Covid-19 infection. Furthermore, mental health problems - such as anxiety disorder - were very frequent in the study sample. CONCLUSIONS Allocating more and specific housing units to structures providing accommodation services to the most vulnerable people would seem to be a decisive factor in controlling the spread of SARS-CoV2, and deserves more attention from public authorities.
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Affiliation(s)
- Ismaïl Alsaïdi
- Aix-Marseille University, School of Medicine - La Timone Medical Campus, Marseille, France.
- INSERM, IRD, SESSTIM, ISSPAM, Marseille, France.
| | | | - Bérengère Plard
- Association d'Aide aux Jeunes Travailleurs, Marseille, France
| | - Elise Janvier
- Association d'Aide aux Jeunes Travailleurs, Marseille, France
| | - Aurélie Tinland
- Aix-Marseille University, School of Medicine - La Timone Medical Campus, Marseille, France
- CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | | | - Emilie Mosnier
- Aix-Marseille University, School of Medicine - La Timone Medical Campus, Marseille, France
- Centre Hospitalier d'Alès-Cévenne, Alès, France
- INSERM, IRD, SESSTIM, ISSPAM, Marseille, France
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192
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Gustafsson PE, San Sebastian M, Fonseca-Rodriguez O, Fors Connolly AM. Inequitable impact of infection: social gradients in severe COVID-19 outcomes among all confirmed SARS-CoV-2 cases during the first pandemic wave in Sweden. J Epidemiol Community Health 2021; 76:261-267. [PMID: 34526373 PMCID: PMC8449839 DOI: 10.1136/jech-2021-216778] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/06/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND The backdrop of the ubiquitous social inequalities has increasingly come into foreground in research on the COVID-19 pandemic, but the lack of high-quality population-based studies limits our understanding of the inequitable outcomes of the disease. The present study seeks to estimate social gradients in COVID-19 hospitalisations, intensive care admissions and death by education, income and country of birth, while taking into account disparities in comorbidities. METHODS We used a register-based retrospective open cohort design enrolling all 74 659 confirmed SARS-CoV-2-positive cases aged >25 years in Sweden during the first wave of the pandemic (until 14 September 2020). Information was retrieved from multiple registers and linked by the unique Swedish personal identity number concerning COVID-19 case identification; COVID-19 hospitalisations, intensive care admissions and death; comorbidities as measured by the Charlson Comorbidity Index; and sociodemographic information. Social gradients were estimated by the Relative Index of Inequality (RII) using Cox regression. RESULTS Adjusted analyses showed significant social gradients in COVID-19 hospitalisation, intensive care admission, across education, income and country of birth, which were unaffected by adjustment for comorbidities. Education and country of birth gradients were stronger for hospitalisation and intensive care admissions but small to non-existent for death. In contrast, income gradients were consistent across all three COVID-19 outcomes. CONCLUSION Social gradients in severe COVID-19 outcomes are widespread in Sweden, but appear to be unrelated to pre-existing health disparities. Inequitable outcomes of SARS-CoV-2 infection may therefore be at least partially avoidable and could rely on equitable management of confirmed COVID-19 cases.
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Affiliation(s)
- Per E Gustafsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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193
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Roy MP. Risk factors for Covid-19 in India. Monaldi Arch Chest Dis 2021; 92. [PMID: 34523326 DOI: 10.4081/monaldi.2021.1954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/09/2021] [Indexed: 01/08/2023] Open
Abstract
Like many developing countries, India was devastated by the raging pandemic of Covid 19. With the active involvement of the government and the community, the disaster was fought with. However, the impact was uneven across the country. The present study aimed to identify the factors responsible for variation in case burden of Covid-19. Data on demographic factors and co-morbidities were obtained from different sources available in the public domain. Descriptive statistics were used for comparison between states. A total of 30 states were taken into account. Correlation was used to find out association between different factors and the burden of Covid-19. Data on Covid were collected till 9th May, 2021. The burden of Covid-19 was strongly related to the literacy status and economy of the state (r = 0.574 and 0.730, respectively). The burden of self-reported hypertension and diabetes was also statistically linked to the burden of Covid-19 (r = 0.539 and 0.721, respectively). Overweight and obesity were also associated with the burden of Covid-19 (r = 0.614 and 0.561, respectively). Therefore, in areas with a high proportion of patients with co-morbidities, limited resources may be mobilized for a better outcome. As the states with poor literacy and health condition suffered the most. Tailored intervention is wanted to reach the poor and vulnerable.
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Affiliation(s)
- Manas Pratim Roy
- Public Health Specialist, Ministry of Health and Family Welfare, New Delhi.
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194
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Lyu T, Hair N, Yell N, Li Z, Qiao S, Liang C, Li X. Temporal Geospatial Analysis of COVID-19 Pre-Infection Determinants of Risk in South Carolina. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9673. [PMID: 34574599 PMCID: PMC8469413 DOI: 10.3390/ijerph18189673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 12/15/2022]
Abstract
Disparities and their geospatial patterns exist in morbidity and mortality of COVID-19 patients. When it comes to the infection rate, there is a dearth of research with respect to the disparity structure, its geospatial characteristics, and the pre-infection determinants of risk (PIDRs). This work aimed to assess the temporal-geospatial associations between PIDRs and COVID-19 infection at the county level in South Carolina. We used the spatial error model (SEM), spatial lag model (SLM), and conditional autoregressive model (CAR) as global models and the geographically weighted regression model (GWR) as a local model. The data were retrieved from multiple sources including USAFacts, U.S. Census Bureau, and the Population Estimates Program. The percentage of males and the unemployed population were positively associated with geodistributions of COVID-19 infection (p values < 0.05) in global models throughout the time. The percentage of the white population and the obesity rate showed divergent spatial correlations at different times of the pandemic. GWR models fit better than global models, suggesting nonstationary correlations between a region and its neighbors. Characterized by temporal-geospatial patterns, disparities in COVID-19 infection rate and their PIDRs are different from the mortality and morbidity of COVID-19 patients. Our findings suggest the importance of prioritizing different populations and developing tailored interventions at different times of the pandemic.
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Affiliation(s)
- Tianchu Lyu
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (T.L.); (N.H.)
| | - Nicole Hair
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (T.L.); (N.H.)
| | - Nicholas Yell
- Department of Statistics, College of Arts and Sciences, University of South Carolina, Columbia, SC 29208, USA;
| | - Zhenlong Li
- Department of Geography, College of Arts and Sciences, University of South Carolina, Columbia, SC 29208, USA;
| | - Shan Qiao
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (S.Q.); (X.L.)
| | - Chen Liang
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (T.L.); (N.H.)
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (S.Q.); (X.L.)
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195
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Rai P, Chuong C, LeRoith T, Smyth JW, Panov J, Levi M, Kehn-Hall K, Duggal NK, Lucarelli JW. Adenovirus transduction to express human ACE2 causes obesity-specific morbidity in mice, impeding studies on the effect of host nutritional status on SARS-CoV-2 pathogenesis. Virology 2021; 563:98-106. [PMID: 34509029 PMCID: PMC8414371 DOI: 10.1016/j.virol.2021.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic has paralyzed the global economy and resulted in millions of deaths globally. People with co-morbidities like obesity, diabetes and hypertension are at an increased risk for severe COVID-19 illness. This is of overwhelming concern because 42% of Americans are obese, 30% are pre-diabetic and 9.4% have clinical diabetes. Here, we investigated the effect of obesity on disease severity following SARS-CoV-2 infection using a well-established mouse model of diet-induced obesity. Diet-induced obese and lean control C57BL/6 N mice, transduced for ACE2 expression using replication-defective adenovirus, were infected with SARS-CoV-2, and monitored for lung pathology, viral titers, and cytokine expression. No significant differences in tissue pathology or viral replication was observed between AdV transduced lean and obese groups, infected with SARS-CoV-2, but certain cytokines were expressed more significantly in infected obese mice compared to the lean ones. Notably, significant weight loss was observed in obese mice treated with the adenovirus vector, independent of SARS-CoV-2 infection, suggesting an obesity-dependent morbidity induced by the vector. These data indicate that the adenovirus-transduced mouse model of SARS-CoV-2 infection, as described here and elsewhere, may be inappropriate for nutrition studies.
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Affiliation(s)
- Pallavi Rai
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, VA-MD Regional College of Veterinary Medicine, Blacksburg, VA, USA
| | - Christina Chuong
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, VA-MD Regional College of Veterinary Medicine, Blacksburg, VA, USA
| | - Tanya LeRoith
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, VA-MD Regional College of Veterinary Medicine, Blacksburg, VA, USA
| | - James W Smyth
- Center for Heart and Reparative Medicine, Fralin Biomedical Research Institute, Roanoke, VA, USA; Department of Biological Sciences, College of Science, Virginia Polytechnic State Institute and State University, Blacksburg, VA, USA; Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Julia Panov
- Tauber Bioinformatics Research Center, Haifa 3498838, Israel; Sagol Department of Neurobiology, University of Haifa, Haifa 3498838, Israel
| | - Moshe Levi
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University, Washington, DC, USA
| | - Kylene Kehn-Hall
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, VA-MD Regional College of Veterinary Medicine, Blacksburg, VA, USA
| | - Nisha K Duggal
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, VA-MD Regional College of Veterinary Medicine, Blacksburg, VA, USA
| | - James-Weger Lucarelli
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, VA-MD Regional College of Veterinary Medicine, Blacksburg, VA, USA.
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196
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Feng GC, Zhu S, Zhao X. Antecedents and Consequences of Smoking Cessation Intention in the Context of the Global COVID-19 Infodemic. Front Public Health 2021; 9:684683. [PMID: 34497791 PMCID: PMC8419308 DOI: 10.3389/fpubh.2021.684683] [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: 03/23/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022] Open
Abstract
A growing body of scientific studies has been published to inform responses to the ongoing coronavirus pandemic, and some have claimed that cigarette smoking has a beneficial or mixed effect on the prevention and treatment of COVID-19. The presentation of such findings, unfortunately, has created an infodemic. This study integrated the theory of planned behavior and the health belief model and incorporated findings on addiction from the medical literature to predict cessation intention and support for tobacco control measures in the context of the COVID-19 infodemic. The study found that cessation intention partially mediated the effect of perceived severity and fully mediated the effects of perceived benefits, self-efficacy, and addiction on support for control measures. In addition, a positively-valenced message of the effect of smoking on the prevention and treatment of COVID-19 vs. a mixedly-valenced message was significant in predicting cessation intention, and the positively-valenced message of smoking indirectly predicted support for tobacco control measures. Perceived susceptibility, barriers, and subjective norms, however, exerted neither direct nor indirect effects on the two outcome variables.
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Affiliation(s)
| | - Shan Zhu
- College of Communication, Shenzhen University, Shenzhen, China
| | - Xinshu Zhao
- Department of Communication, University of Macau, Macau, China
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Factors Associated with a Lack of Willingness to Vaccinate against COVID-19 in Poland: A 2021 Nationwide Cross-Sectional Survey. Vaccines (Basel) 2021; 9:vaccines9091000. [PMID: 34579237 PMCID: PMC8472927 DOI: 10.3390/vaccines9091000] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 11/16/2022] Open
Abstract
We aimed to assess the factors associated with a lack of willingness to vaccinate against COVID-19 among adults in Poland three months after the introduction of mass vaccination against COVID-19 in Poland. This cross-sectional study was carried out between 8 and 18 April 2021 on a representative nationwide sample of 1131 inhabitants of Poland aged 18 and over. Almost one-third of adult inhabitants of Poland (30%; 95%CI: 27.4–32.7%) declared a lack of willingness to vaccinate against COVID-19. Females had higher odds of refusing COVID-19 vaccination compared with males (OR = 1.68; 95%CI: 1.25–2.27). The lack of higher education was significantly (p < 0.001) associated with greater odds of refusing the COVID-19 vaccination. Participants living in rural areas compared with those living in the largest cities (over 500,000 inhabitants) had three times higher odds of refusing the COVID-19 vaccination (OR = 3.20; 95%CI: 1.71–6.01). Respondents who declared willingness to vote for one of the right-wing political parties publicly supporting the anti-vaccination movement in Poland had eight times higher odds (OR = 8.01; 95%CI: 3.65–17.60) of refusing the COVID-19 vaccination compared with other groups. Moreover, those who had three children or more, respondents who declared passivity towards participating in religious practices as well as active internet users had significantly higher odds of refusing the COVID-19 vaccination.
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198
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Taquet M, Dercon Q, Luciano S, Geddes JR, Husain M, Harrison PJ. Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19. PLoS Med 2021; 18:e1003773. [PMID: 34582441 PMCID: PMC8478214 DOI: 10.1371/journal.pmed.1003773] [Citation(s) in RCA: 465] [Impact Index Per Article: 155.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/18/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Long-COVID refers to a variety of symptoms affecting different organs reported by people following Coronavirus Disease 2019 (COVID-19) infection. To date, there have been no robust estimates of the incidence and co-occurrence of long-COVID features, their relationship to age, sex, or severity of infection, and the extent to which they are specific to COVID-19. The aim of this study is to address these issues. METHODS AND FINDINGS We conducted a retrospective cohort study based on linked electronic health records (EHRs) data from 81 million patients including 273,618 COVID-19 survivors. The incidence and co-occurrence within 6 months and in the 3 to 6 months after COVID-19 diagnosis were calculated for 9 core features of long-COVID (breathing difficulties/breathlessness, fatigue/malaise, chest/throat pain, headache, abdominal symptoms, myalgia, other pain, cognitive symptoms, and anxiety/depression). Their co-occurrence network was also analyzed. Comparison with a propensity score-matched cohort of patients diagnosed with influenza during the same time period was achieved using Kaplan-Meier analysis and the Cox proportional hazard model. The incidence of atopic dermatitis was used as a negative control. Among COVID-19 survivors (mean [SD] age: 46.3 [19.8], 55.6% female), 57.00% had one or more long-COVID feature recorded during the whole 6-month period (i.e., including the acute phase), and 36.55% between 3 and 6 months. The incidence of each feature was: abnormal breathing (18.71% in the 1- to 180-day period; 7.94% in the 90- to180-day period), fatigue/malaise (12.82%; 5.87%), chest/throat pain (12.60%; 5.71%), headache (8.67%; 4.63%), other pain (11.60%; 7.19%), abdominal symptoms (15.58%; 8.29%), myalgia (3.24%; 1.54%), cognitive symptoms (7.88%; 3.95%), and anxiety/depression (22.82%; 15.49%). All 9 features were more frequently reported after COVID-19 than after influenza (with an overall excess incidence of 16.60% and hazard ratios between 1.44 and 2.04, all p < 0.001), co-occurred more commonly, and formed a more interconnected network. Significant differences in incidence and co-occurrence were associated with sex, age, and illness severity. Besides the limitations inherent to EHR data, limitations of this study include that (i) the findings do not generalize to patients who have had COVID-19 but were not diagnosed, nor to patients who do not seek or receive medical attention when experiencing symptoms of long-COVID; (ii) the findings say nothing about the persistence of the clinical features; and (iii) the difference between cohorts might be affected by one cohort seeking or receiving more medical attention for their symptoms. CONCLUSIONS Long-COVID clinical features occurred and co-occurred frequently and showed some specificity to COVID-19, though they were also observed after influenza. Different long-COVID clinical profiles were observed based on demographics and illness severity.
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Affiliation(s)
- Maxime Taquet
- Department of Psychiatry, University of Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- * E-mail:
| | - Quentin Dercon
- Department of Psychiatry, University of Oxford, United Kingdom
| | - Sierra Luciano
- TriNetX Inc., Cambridge, Massachusetts, United States of America
| | - John R. Geddes
- Department of Psychiatry, University of Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Paul J. Harrison
- Department of Psychiatry, University of Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
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199
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Khan N, Mahmud N, Trivedi C, Reinisch W, Lewis JD. Risk factors for SARS-CoV-2 infection and course of COVID-19 disease in patients with IBD in the Veterans Affair Healthcare System. Gut 2021; 70:1657-1664. [PMID: 33753416 PMCID: PMC7985980 DOI: 10.1136/gutjnl-2021-324356] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/01/2021] [Accepted: 03/08/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Our aim was to explore the risk of infection with all classes of inflammatory bowel disease (IBD) medications and the impact of these medications on the disease course in a nationwide cohort of patients with IBD. DESIGN This was a retrospective national cohort study of patients with IBD in the Veterans Affairs Healthcare System. We categorised IBD medication use immediately prior to the COVID-19 pandemic and used survival analysis methods to study associations with SARS-CoV-2 infection, as well as a combined secondary outcome of COVID-19 hospitalisation or COVID-19-related mortality. RESULTS The analytical cohort of 30 911 patients was primarily male (90.9%), white (78.6%) and with ulcerative colitis (58.8%). Over a median follow-up of 10.7 months, 649 patients (2.1%) were diagnosed with SARS-CoV-2 infection and 149 (0.5%) met the combined secondary outcome. In adjusted models, vedolizumab (VDZ) use was significantly associated with infection relative to mesalazine alone (HR 1.70, 95% CI 1.16 to 2.48, p=0.006). Patients on no IBD medications had increased risk of the combined secondary outcome relative to mesalazine alone (sub-HR 1.64, 95% CI 1.12 to 2.42, p=0.01), however, no other IBD medication categories were significantly associated with this outcome, relative to mesalazine alone (each p>0.05). Corticosteroid use was independently associated with both SARS-CoV-2 infection (HR 1.60, 95% CI 1.23 to 2.09, p=0.001) and the combined secondary outcome (sub-HR 1.90, 95% CI 1.14 to 3.17, p=0.01). CONCLUSION VDZ and corticosteroid were associated with an increased risk of SARS-CoV-2 infection. Except for corticosteroids no medications including mesalazine were associated with an increased risk of severe COVID-19.
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Affiliation(s)
- Nabeel Khan
- Gastroenterology, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA .,Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nadim Mahmud
- Gastroenterology, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA,Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Chinmay Trivedi
- Gastroenterology, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Walter Reinisch
- Department of Medicine IV, Medical University Vienna, Vienna, Austria
| | - James D Lewis
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA,University of Pennsylvania Center for Clinical Epidemiology and Biostatistics, Philadelphia, Pennsylvania, USA
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Tomchaney M, Contoli M, Mayo J, Baraldo S, Li S, Cabel CR, Bull DA, Lick S, Malo J, Knoper S, Kim SS, Tram J, Rojas-Quintero J, Kraft M, Ledford JG, Tesfaigzi Y, Martinez FD, Thorne CA, Kheradmand F, Campos SK, Papi A, Polverino F. Paradoxical effects of cigarette smoke and COPD on SARS-CoV-2 infection and disease. BMC Pulm Med 2021; 21:275. [PMID: 34425811 PMCID: PMC8381712 DOI: 10.1186/s12890-021-01639-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/11/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND How cigarette smoke (CS) and chronic obstructive pulmonary disease (COPD) affect severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection and severity is controversial. We investigated the effects of COPD and CS on the expression of SARS-CoV-2 entry receptor ACE2 in vivo in COPD patients and controls and in CS-exposed mice, and the effects of CS on SARS-CoV-2 infection in human bronchial epithelial cells in vitro. METHODS We quantified: (1) pulmonary ACE2 protein levels by immunostaining and ELISA, and both ACE2 and/or TMPRSS2 mRNA levels by RT-qPCR in two independent human cohorts; and (2) pulmonary ACE2 protein levels by immunostaining and ELISA in C57BL/6 WT mice exposed to air or CS for up to 6 months. The effects of CS exposure on SARS-CoV-2 infection were evaluated after in vitro infection of Calu-3 cells and differentiated human bronchial epithelial cells (HBECs), respectively. RESULTS ACE2 protein and mRNA levels were decreased in peripheral airways from COPD patients versus controls but similar in central airways. Mice exposed to CS had decreased ACE2 protein levels in their bronchial and alveolar epithelia versus air-exposed mice. CS treatment decreased viral replication in Calu-3 cells, as determined by immunofluorescence staining for replicative double-stranded RNA (dsRNA) and western blot for viral N protein. Acute CS exposure decreased in vitro SARS-CoV-2 replication in HBECs, as determined by plaque assay and RT-qPCR. CONCLUSIONS ACE2 levels were decreased in both bronchial and alveolar epithelial cells from COPD patients versus controls, and from CS-exposed versus air-exposed mice. CS-pre-exposure potently inhibited SARS-CoV-2 replication in vitro. These findings urge to investigate further the controversial effects of CS and COPD on SARS-CoV-2 infection.
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Affiliation(s)
- M Tomchaney
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, 85719, USA
| | - M Contoli
- Respiratory Unit, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - J Mayo
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, 85719, USA
| | - S Baraldo
- Department of Cardiological, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - S Li
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, USA
| | - C R Cabel
- Department of Cellular and Molecular Medicine, University of Arizona Cancer Center, Tucson, USA
| | - D A Bull
- Thoracic Surgery, University of Arizona, Tucson, USA
| | - S Lick
- Thoracic Surgery, University of Arizona, Tucson, USA
| | - J Malo
- Thoracic Surgery, University of Arizona, Tucson, USA
| | - S Knoper
- Thoracic Surgery, University of Arizona, Tucson, USA
| | - S S Kim
- Thoracic Surgery, Northwester University, Chicago, IL, USA
| | - J Tram
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, 85719, USA
| | - J Rojas-Quintero
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - M Kraft
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, 85719, USA
| | - J G Ledford
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, 85719, USA
| | - Y Tesfaigzi
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - F D Martinez
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, 85719, USA
| | - C A Thorne
- Department of Cellular and Molecular Medicine, University of Arizona Cancer Center, Tucson, USA
| | | | - S K Campos
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, USA
- BIO5 Institute, University of Arizona, Tucson, USA
| | - A Papi
- Respiratory Unit, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - F Polverino
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, 85719, USA.
- BIO5 Institute, University of Arizona, Tucson, USA.
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