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Expressive Flexibility and Dispositional Optimism Contribute to the Elderly's Resilience and Health-Related Quality of Life during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041698. [PMID: 33578873 PMCID: PMC7916547 DOI: 10.3390/ijerph18041698] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 12/22/2022]
Abstract
The COVID-19 outbreak had a negative impact on psychological status among elderly subjects, negatively affecting their health-related quality of life (HRQoL). Psychological factors that promote resilience might beneficially contribute also to promoting a better HRQoL among elderly subjects. The main purpose of the present study was to investigate the contribution of dispositional optimism and expressive flexibility on the HRQoL of elderly outpatients during the COVID-19 outbreak. The outpatients were recruited from October 2018 to October 2019, and then followed-up during April 2020, by evaluating their HRQoL. The baseline sample consisted of 141 elderly outpatients (mean age 80.31 ± 6.84 years); the final number of outpatients included in the follow-up evaluation was 104 (mean age 80.26 ± 6.39). Univariate and multivariate linear regressions were developed to explore significant associations with the physical and mental component of HRQoL. Baseline dispositional optimism was a predictor of the mental component of HRQoL at follow-up; the flexible suppression of emotional expression was a predictor of the physical component of HRQoL at follow-up. From a psychogeriatric perspective, the accurate assessment of psychological factors, such as dispositional optimism and expressive flexibility, might help physicians and psychologists to recognize additional patients' vulnerabilities during the current emergency.
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202
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Budimir S, Pieh C, Dale R, Probst T. Severe Mental Health Symptoms during COVID-19: A Comparison of the United Kingdom and Austria. Healthcare (Basel) 2021; 9:191. [PMID: 33572425 PMCID: PMC7916211 DOI: 10.3390/healthcare9020191] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 12/23/2022] Open
Abstract
This study evaluated severe psychological symptoms in the United Kingdom and Austria after four weeks of lockdown due to COVID-19. Two cross-sectional online surveys were performed with representative population samples according to age, gender, region, and education. Depressive symptoms were measured with the Patient Health Questionnaire (PHQ-9), anxiety symptoms with the Generalized Anxiety Disorder scale (GAD-7), and insomnia symptoms with the Insomnia Severity Index (ISI). The sample size was N = 1005 for Austria (52% women) and N = 1006 (54% women) for the UK. In total, 3.2% of the Austrian sample and 12.1% of the UK sample had severe depressive symptoms (PHQ-9 ≥ 20 points; χ2(1) = 57.24; p < 0.001), 6.0% in Austria vs. 18.9% in the UK had severe anxiety symptoms (GAD-7 ≥ 15 points; χ2(1) = 76.17; p < 0.001), and 2.2% in Austria and 7.3% in the UK had severe insomnia (ISI; ≥22 points; χ2(1) = 28.89; p < 0.001). The prevalence of severe depressive, anxiety or insomnia symptoms was around three times higher in the UK than in Austria.
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Affiliation(s)
- Sanja Budimir
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems an der Donau, Austria; (C.P.); (R.D.); (T.P.)
- Department of Work, Organization and Society, Ghent University, 9000 Gent, Belgium
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems an der Donau, Austria; (C.P.); (R.D.); (T.P.)
| | - Rachel Dale
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems an der Donau, Austria; (C.P.); (R.D.); (T.P.)
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems an der Donau, Austria; (C.P.); (R.D.); (T.P.)
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Ashcroft P, Lehtinen S, Angst DC, Low N, Bonhoeffer S. Quantifying the impact of quarantine duration on COVID-19 transmission. eLife 2021; 10:e63704. [PMID: 33543709 PMCID: PMC7963476 DOI: 10.7554/elife.63704] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/04/2021] [Indexed: 12/13/2022] Open
Abstract
The large number of individuals placed into quarantine because of possible severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) exposure has high societal and economic costs. There is ongoing debate about the appropriate duration of quarantine, particularly since the fraction of individuals who eventually test positive is perceived as being low. We use empirically determined distributions of incubation period, infectivity, and generation time to quantify how the duration of quarantine affects onward transmission from traced contacts of confirmed SARS-CoV-2 cases and from returning travellers. We also consider the roles of testing followed by release if negative (test-and-release), reinforced hygiene, adherence, and symptoms in calculating quarantine efficacy. We show that there are quarantine strategies based on a test-and-release protocol that, from an epidemiological viewpoint, perform almost as well as a 10-day quarantine, but with fewer person-days spent in quarantine. The findings apply to both travellers and contacts, but the specifics depend on the context.
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Affiliation(s)
- Peter Ashcroft
- Institute of Integrative Biology, ETH ZürichZürichSwitzerland
| | - Sonja Lehtinen
- Institute of Integrative Biology, ETH ZürichZürichSwitzerland
| | - Daniel C Angst
- Institute of Integrative Biology, ETH ZürichZürichSwitzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of BernBernSwitzerland
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González-Olmo MJ, Delgado-Ramos B, Ortega-Martínez AR, Romero-Maroto M, Carrillo-Díaz M. Fear of COVID-19 in Madrid. Will patients avoid dental care? Int Dent J 2021; 72:76-82. [PMID: 33743992 PMCID: PMC7970159 DOI: 10.1016/j.identj.2021.01.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Introduction The objective of this research is to describe how perceived infectability, germ aversion, and fear of COVID-19 in adults in Madrid have changed from the beginning of the pandemic until the lockdown exit phase and their influence on dental care behaviour. Materials and Methods Some 961 participants were monitored in a study in Madrid at 2 time points: before lockdown (T0) and after completion of the total lockdown (T1). A questionnaire that included basic sociodemographic variables, the perceived vulnerability to disease scale (including perceived infectability and germ aversion), the fear of COVID-19 scale, and dental visiting behaviour after confinement for fear of COVID was administered. Results The participants had higher scores for infectability and germ aversion at T1 than at T0 (P < 0.01). Of those studied, 24.5% (235) of the participants would not go to the dentist for fear of COVID-19. Those who had a high perceived infectability scale score were at least 5 times more likely to not visit the dentist. Those with high COVID-19 fear were at least 6 times more likely to not visit the dentist, and those older than 60 years were 8 times more likely to not visit. Conclusions The population's high levels of vulnerability to infectability and perceived germ aversion associated with fear of COVID-19 and the resultant avoidance behaviour to dental care will remain until an effective drug or vaccine for SARS-CoV2 is found.
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Wang Q, Zhao Y, Zhang Y, Qiu J, Li J, Yan N, Li N, Zhang J, Tian D, Sha X, Jing J, Yang C, Wang K, Xu R, Zhang Y, Yang H, Zhao S, Zhao Y. Could the ambient higher temperature decrease the transmissibility of COVID-19 in China? ENVIRONMENTAL RESEARCH 2021; 193:110576. [PMID: 33279494 PMCID: PMC7713592 DOI: 10.1016/j.envres.2020.110576] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Existing literatures demonstrated that meteorological factors could be of importance in affecting the spread patterns of the respiratory infectious diseases. However, how ambient temperature may influence the transmissibility of COVID-19 remains unclear. OBJECTIVES We explore the association between ambient temperature and transmissibility of COVID-19 in different regions across China. METHODS The surveillance data on COVID-19 and meteorological factors were collected from 28 provincial level regions in China, and estimated the instantaneous reproductive number (Rt). The generalized additive model was used to assess the relationship between mean temperature and Rt. RESULTS There were 12,745 COVID-19 cases collected in the study areas. We report the associated effect of temperature on Rt is likely to be negative but not of statistical significance, which holds for most Chinese regions. CONCLUSIONS We found little statistical evidence for that the higher temperature may reduce the transmissibility of COVID-19. Since intensive control measures against the COVID-19 epidemics were implemented in China, we acknowledge this may impact the underlying effect size estimation, and thus cautiousness should be taken when interpreting our findings.
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Affiliation(s)
- Qingan Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Yu Zhao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Yajuan Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Jiangwei Qiu
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Juan Li
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Ni Yan
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Nan Li
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Jiaxing Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Di Tian
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Xiaolan Sha
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Jinyun Jing
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Chan Yang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Kairong Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Rongbin Xu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Yuhong Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Huifang Yang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China; CUHK Shenzhen Research Institute, Shenzhen, China.
| | - Yi Zhao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia, China; The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, 750001, Ningxia, China.
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Chandy SJ, Ranjalkar J, Chandy SS. Collateral effects and ethical challenges in healthcare due to COVID-19 - A dire need to support healthcare workers and systems. J Family Med Prim Care 2021; 10:22-26. [PMID: 34017697 PMCID: PMC8132839 DOI: 10.4103/jfmpc.jfmpc_1653_20] [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: 08/15/2020] [Revised: 10/06/2020] [Accepted: 10/23/2020] [Indexed: 11/04/2022] Open
Abstract
COVID-19 has affected the daily activities of people across the globe. The effects of the pandemic have not just been medical, but also societal and economical. The responses of government and the public have varied in different countries. Measures have ranged from improving hygiene, information dissemination, and social distancing to more radical measures such as social isolation, quarantine and lockdown. The disease and human responses have had consequences on the way we live, work, eat and rest. Life and livelihoods have been affected. This article highlights how the response to the pandemic has affected various aspects of healthcare and ethical dilemmas this has raised. As the pandemic progresses, awareness and evaluation of the unintended consequences of the pandemic and responses on our health and healthcare systems are needed. Discussing these points and being aware of the ethical issues may help countries and policy makers plan suitable strategies to mitigate these collateral effects, especially as the pandemic continues. It is hoped that this article will support healthcare workers, especially those in primary and secondary healthcare, as they overcome various challenges to treat patients with existing and prior diseases, and encourage them to advocate for robust and sustainable healthcare systems for public health. This would then help effectively combat future epidemics. Most importantly, it can mitigate the adverse collateral effects on healthcare that the public are experiencing and the treatment dilemmas that family and primary care physicians are facing.
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Affiliation(s)
- Sujith J Chandy
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Jaya Ranjalkar
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Sheeba S Chandy
- Ethicist, College Campus, Christian Medical College, Vellore, Tamil Nadu, India
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Sánchez-Romero M, di Lego V, Prskawetz A, L. Queiroz B. An indirect method to monitor the fraction of people ever infected with COVID-19: An application to the United States. PLoS One 2021; 16:e0245845. [PMID: 33508030 PMCID: PMC7842943 DOI: 10.1371/journal.pone.0245845] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/10/2021] [Indexed: 01/16/2023] Open
Abstract
The number of COVID-19 infections is key for accurately monitoring the pandemics. However, due to differential testing policies, asymptomatic individuals and limited large-scale testing availability, it is challenging to detect all cases. Seroprevalence studies aim to address this gap by retrospectively assessing the number of infections, but they can be expensive and time-intensive, limiting their use to specific population subgroups. In this paper, we propose a complementary approach that combines estimated (1) infection fatality rates (IFR) using a Bayesian melding SEIR model with (2) reported case-fatality rates (CFR) in order to indirectly estimate the fraction of people ever infected (from the total population) and detected (from the ever infected). We apply the technique to the U.S. due to their remarkable regional diversity and because they count with almost a quarter of all global confirmed cases and deaths. We obtain that the IFR varies from 1.25% (0.39-2.16%, 90% CI) in Florida, the most aged population, to 0.69% in Utah (0.21-1.30%, 90% CI), the youngest population. By September 8, 2020, we estimate that at least five states have already a fraction of people ever infected between 10% and 20% (New Jersey, New York, Massachussets, Connecticut, and District of Columbia). The state with the highest estimated fraction of people ever infected is New Jersey with 17.3% (10.0, 55.8, 90% CI). Moreover, our results indicate that with a probability of 90 percent the fraction of detected people among the ever infected since the beginning of the epidemic has been less than 50% in 15 out of the 20 states analyzed in this paper. Our approach can be a valuable tool that complements seroprevalence studies and indicates how efficient have testing policies been since the beginning of the outbreak.
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Affiliation(s)
- Miguel Sánchez-Romero
- Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Vienna Institute of Demography/Austrian Academy of Sciences, Vienna, Austria
| | - Vanessa di Lego
- Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Vienna Institute of Demography/Austrian Academy of Sciences, Vienna, Austria
| | - Alexia Prskawetz
- Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Vienna Institute of Demography/Austrian Academy of Sciences, Vienna, Austria
- Institute of Statistics and Mathematical Methods in Economics, TU Wien, Vienna, Austria
| | - Bernardo L. Queiroz
- Universidade Federal de Minas Gerais, Cedeplar, Belo Horizonte, State of Minas Gerais, Brazil
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Fotheringham P, Anderson T, Shaw M, Jewitt J, Storey H, Hutchings O, Cartwright J, Gupta L. Control of COVID-19 in Australia through quarantine: the role of special health accommodation (SHA) in New South Wales, Australia. BMC Public Health 2021; 21:225. [PMID: 33504347 PMCID: PMC7838858 DOI: 10.1186/s12889-021-10244-7] [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: 06/03/2020] [Accepted: 01/14/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The first COVID-19 cases were diagnosed in Australia on 25 January 2020. Initial epidiemiology showed that the majority of cases were in returned travellers from overseas. One aspect of Public Health response was to introduce compulsory 14 day quarantine for all travellers returning to New South Wales (NSW) by air or sea in Special Health Accommodation (SHA). We aim to outline the establishment of a specialised health quarantine accommodation service in the context of the COVID-19 pandemic, and describe the first month of COVID-19 screening. METHODS The SHA was established with a comprehensive governance structure, remote clinical management through Royal Prince Alfred Virtual Hospital (rpavirtual) and site management with health care workers, NSW Police and accommodation staff. RESULTS From 29 March to 29 April 2020, 373 returning travellers were admitted to the SHA from Sydney Airport. 88 (26.1%) of those swabbed were positive for SARS-CoV 2. The day of diagnosis of COVID-19 varied from Day 1 to Day 13, with 63.6% (n = 56) of these in the first week of quarantine. 50% of the people in the SHA were referred to rpavirtual for ongoing clinical management. Seven people required admission to hospital for ongoing clinical care. CONCLUSION The Public Health response to COVID-19 in Australia included early and increased case detection through testing, tracing of contacts of confirmed cases, social distancing and prohibition of gatherings. In addition to these measures, the introduction of mandated quarantine for travellers to Australia was integral to the successful containment of COVID-19 in NSW and Australia through the prevention of transmission locally and interstate from returning travellers.
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Affiliation(s)
| | | | - Miranda Shaw
- Sydney Local Health District (SLHD), Camperdown, Australia
| | - Joseph Jewitt
- Sydney Local Health District (SLHD), Camperdown, Australia
| | - Hannah Storey
- Sydney Local Health District (SLHD), Camperdown, Australia
| | - Owen Hutchings
- Sydney Local Health District (SLHD), Camperdown, Australia
| | | | - Leena Gupta
- Sydney Local Health District (SLHD), Camperdown, Australia
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Staton M, Tillson M, Webster JM. A Description of COVID-19 Lifestyle Restrictions Among a Sample of Rural Appalachian Women. JOURNAL OF APPALACHIAN HEALTH 2021; 3:4-17. [PMID: 35769440 PMCID: PMC9138730 DOI: 10.13023/jah.0301.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background COVID-19 has led to swift federal and state response to control virus transmission, which has resulted in unprecedented lifestyle changes for U.S. citizens including social distancing and isolation. Understanding the impact of COVID-19 lifestyle restrictions and related behavioral risks is important, particularly among individuals who may be more vulnerable (such as rural women with a history of substance use living in Appalachia). Purpose The overall purpose of this study was to better understand the perceptions of lifestyle changes due to COVID-19 restrictions among this vulnerable group. Methods The study included a mixed methods survey with a convenience sample of rural women (n=33) recruited through a closed, private Facebook group. Results Study findings indicated that COVID-19 restrictions related to limited social activities and interactions with family and friends had a significant impact on women. Implications Findings suggest that social isolation may have a number of unintended consequences for rural women, and implications for rural health practitioners are discussed.
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210
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Cicero AFG, Fogacci F, Giovannini M, Mezzadri M, Grandi E, Borghi C. COVID-19-Related Quarantine Effect on Dietary Habits in a Northern Italian Rural Population: Data from the Brisighella Heart Study. Nutrients 2021; 13:nu13020309. [PMID: 33499027 PMCID: PMC7911934 DOI: 10.3390/nu13020309] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/17/2021] [Accepted: 01/19/2021] [Indexed: 02/06/2023] Open
Abstract
North of Italy was severely hit by the COVID-19 (Coronavirus disease 19) pandemic. This induced the government to adopt severely restrictive measures to reduce the contagion risk, forcing most of the population to stop working and from leisure activities, and to remain at home for several weeks. Our study aimed to evaluate the effect of COVID-related quarantine on smoking and dietary habits of a well-characterized northern Italian rural population. For this purpose, while lockdown restrictions were in place (February–April 2020), 359 subjects from the Brisighella Heart Study cohort underwent a phone interview about their lifestyle habit changes during COVID-19-related quarantine. Quarantine did not significantly modify smoking habit nor body mass index. Subjects significantly increased daily carbohydrates consumption, all fresh vegetables, healthy vegetable oils, milk and yogurt, alcoholic drinks, sugars and sweets, and coffee. The weekly consumption of low-fat meat, cured meat other than ham, cheeses, eggs, nuts and mixed seed oils significantly increased, while the weekly intake of fish, mussels, and legumes significantly decreased during lockdown. The Dietary Quality Index was reduced from 42.4 ± 4.1 to 37.8 ± 4.7 (p < 0.03). In accordance with our findings, COVID-19-related quarantine might worsen the quality of diet, also leading to an increased intake of almost all food categories.
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Affiliation(s)
- Arrigo F. G. Cicero
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (M.G.); (M.M.); (E.G.); (C.B.)
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Correspondence: ; Tel.: +39-512142224; Fax: +39-51390646
| | - Federica Fogacci
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (M.G.); (M.M.); (E.G.); (C.B.)
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Marina Giovannini
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (M.G.); (M.M.); (E.G.); (C.B.)
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Martina Mezzadri
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (M.G.); (M.M.); (E.G.); (C.B.)
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Elisa Grandi
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (M.G.); (M.M.); (E.G.); (C.B.)
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Claudio Borghi
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (M.G.); (M.M.); (E.G.); (C.B.)
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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Eyawo O, Viens AM, Ugoji UC. Lockdowns and low- and middle-income countries: building a feasible, effective, and ethical COVID-19 response strategy. Global Health 2021; 17:13. [PMID: 33472638 PMCID: PMC7816147 DOI: 10.1186/s12992-021-00662-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/04/2021] [Indexed: 01/02/2023] Open
Abstract
Lockdowns can be an effective pandemic response strategy that can buy much needed time to slow disease transmission and adequately scale up preventative, diagnostic, and treatment capacities. However, the broad restrictive measures typically associated with lockdowns, though effective, also comes at a cost – imposing significant social and economic burdens on individuals and societies, especially for those in low- and middle-income countries (LMICs). Like most high-income countries (HICs), many LMICs initially adopted broad lockdown strategies for COVID-19 in the first wave of the pandemic. While many HICs experiencing subsequent waves have returned to employing lockdown strategies until they can receive the first shipments of COVID-19 vaccine, many LMICs will likely have to wait much longer to get comparable access for their own citizens. In leaving LMICs vulnerable to subsequent waves for a longer period of time without vaccines, there is a risk LMICs will be tempted to re-impose lockdown measures in the meantime. In response to the urgent need for more policy development around the contextual challenges involved in employing such measures, we propose some strategies LMICs could adopt for safe and responsible lockdown entrance/exit or to avoid re-imposing coercive restrictive lockdown measures altogether.
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Affiliation(s)
- Oghenowede Eyawo
- School of Global Health, York University, Victor Dahdaleh Building, Room 5022, 88 The Pond Road, Toronto, ON, M3J 2S5, Canada.
| | - A M Viens
- School of Global Health, York University, Victor Dahdaleh Building, Room 5022, 88 The Pond Road, Toronto, ON, M3J 2S5, Canada
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Tedeschi S, Badia L, Berveglieri F, Ferrari R, Coladonato S, Gabrielli S, Maestri A, Peroni G, Giannella M, Rossi A, Viale P. Effective Containment of a COVID-19 Subregional Outbreak in Italy Through Strict Quarantine and Rearrangement of Local Health Care Services. Open Forum Infect Dis 2021; 8:ofab024. [PMID: 33623806 PMCID: PMC7888567 DOI: 10.1093/ofid/ofab024] [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: 10/27/2020] [Accepted: 01/16/2021] [Indexed: 01/16/2023] Open
Abstract
Background Since the beginning of the pandemic, the epidemiology of coronavirus disease 2019 (COVID-19) in Italy has been characterized by the occurrence of subnational outbreaks. The World Health Organization recommended building the capacity to rapidly control COVID-19 clusters of cases in order to avoid the spread of the disease. This study describes a subregional outbreak of COVID-19 that occurred in the Emilia Romagna region, Italy, and the intervention undertaken to successfully control it. Methods Cases of COVID-19 were defined by a positive reverse transcriptase polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on nasopharyngeal swab. The outbreak involved the residential area of a small town, with ~10 500 inhabitants in an area of 9 km2. After the recognition of the outbreak, local health care authorities implemented strict quarantine and a rearrangement of health care services, consisting of closure of general practitioner outpatient clinics, telephone contact with all residents, activation of health care units to visit at-home patients with symptoms consistent with COVID-19, and a dedicated Infectious Diseases ambulatory unit at the nearest hospital. Results The outbreak lasted from February 24 to April 6, 2020, involving at least 170 people with a cumulative incidence of 160 cases/10 000 inhabitants; overall, 448 inhabitants of the municipality underwent at least 1 nasopharyngeal swab to detect SARS-CoV-2 (positivity rate, 38%). Ninety-three people presented symptoms before March 11 (pre-intervention period), and 77 presented symptoms during the postintervention period (March 11-April 6). Conclusions It was possible to control this COVID-19 outbreak by prompt recognition and implementation of a targeted local intervention.
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Affiliation(s)
- Sara Tedeschi
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Lorenzo Badia
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | | | | | - Simona Coladonato
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | | | | | | | - Maddalena Giannella
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | | | - Pierluigi Viale
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
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213
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Sayed AA. The Progressive Public Measures of Saudi Arabia to Tackle Covid-19 and Limit Its Spread. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E783. [PMID: 33477645 PMCID: PMC7831479 DOI: 10.3390/ijerph18020783] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/26/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022]
Abstract
Since the beginning of the global novel coronavirus disease (Covid-19) pandemic, the response of governments has varied significantly across the world. This was one of the main reasons behind the difference in the disease fatality rates between countries. In this study, the public progressive measures taken in Saudi Arabia (SA) are described in detail. This is a descriptive study in which measures were retrieved via the government official news agency-Saudi Press Agency (SPA). The total number of Covid-19 cases and its fatality rate were obtained/calculated from the Saudi Ministry of Health (MoH) official Covid-19 port, as well as the WHO COVID-19 dashboard. SA took active measures in order to interrupt the spread of Covid-19 which were strict, rapid, and progressive in nature. Social distancing was at the heart of almost every measure taken by the government. The main themes of these interventions are as follows: travel bans, suspending religious activities, closure of non-essential shops, enforcing changes at workplaces, and imposing curfews. This was followed by the gradual return to working life with various precautions to prevent a spike in the number of cases. The imposed measures in SA succeeded in reducing the burden of Covid-19 and its fatality rate. Comparatively, the fatality rate in SA was significantly lower compared to developed countries with better healthcare infrastructure such as the United States and United Kingdom.
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Affiliation(s)
- Anwar A. Sayed
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Taibah University, Medina 42353, Saudi Arabia;
- Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
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214
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Rainero I, Bruni AC, Marra C, Cagnin A, Bonanni L, Cupidi C, Laganà V, Rubino E, Vacca A, Di Lorenzo R, Provero P, Isella V, Vanacore N, Agosta F, Appollonio I, Caffarra P, Bussè C, Sambati R, Quaranta D, Guglielmi V, Logroscino G, Filippi M, Tedeschi G, Ferrarese C. The Impact of COVID-19 Quarantine on Patients With Dementia and Family Caregivers: A Nation-Wide Survey. Front Aging Neurosci 2021; 12:625781. [PMID: 33536898 PMCID: PMC7849158 DOI: 10.3389/fnagi.2020.625781] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/21/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Previous studies showed that quarantine for pandemic diseases is associated with several psychological and medical effects. The consequences of quarantine for COVID-19 pandemic in patients with dementia are unknown. We investigated the clinical changes in patients with Alzheimer's disease and other dementias, and evaluated caregivers' distress during COVID-19 quarantine. METHODS The study involved 87 Italian Dementia Centers. Patients with Alzheimer's Disease (AD), Dementia with Lewy Bodies (DLB), Frontotemporal Dementia (FTD), and Vascular Dementia (VD) were eligible for the study. Family caregivers of patients with dementia were interviewed by phone in April 2020, 45 days after quarantine declaration. Main outcomes were patients' changes in cognitive, behavioral, and motor symptoms. Secondary outcomes were effects on caregivers' psychological features. RESULTS 4913 patients (2934 females, 1979 males) fulfilled the inclusion criteria. Caregivers reported a worsening in cognitive functions in 55.1% of patients, mainly in subjects with DLB and AD. Aggravation of behavioral symptoms was observed in 51.9% of patients. In logistic regression analysis, previous physical independence was associated with both cognitive and behavioral worsening (odds ratio 1.85 [95% CI 1.42-2.39], 1.84 [95% CI 1.43-2.38], respectively). On the contrary, pandemic awareness was a protective factor for the worsening of cognitive and behavioral symptoms (odds ratio 0.74 [95% CI 0.65-0.85]; and 0.72 [95% CI 0.63-0.82], respectively). Approximately 25.9% of patients showed the onset of new behavioral symptoms. A worsening in motor function was reported by 36.7% of patients. Finally, caregivers reported a high increase in anxiety, depression, and distress. CONCLUSION Our study shows that quarantine for COVID-19 is associated with an acute worsening of clinical symptoms in patients with dementia as well as increase of caregivers' burden. Our findings emphasize the importance to implement new strategies to mitigate the effects of quarantine in patients with dementia.
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Affiliation(s)
- Innocenzo Rainero
- Aging Brain and Memory Clinic, Department of Neuroscience “Rita Levi Montalcini”, University of Torino, Turin, Italy
- Department of Neuroscience and Mental Health, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Amalia C. Bruni
- Regional Neurogenetic Centre, Department of Primary Care, ASP-CZ, Catanzaro, Italy
| | - Camillo Marra
- Memory Clinic, Fondazione Policlinico Agostino Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti–Pescara, Chieti, Italy
| | - Chiara Cupidi
- CDCD Ospedale del Delta, AUSL Ferrara, Ferrara, Italy
| | - Valentina Laganà
- Regional Neurogenetic Centre, Department of Primary Care, ASP-CZ, Catanzaro, Italy
| | - Elisa Rubino
- Department of Neuroscience and Mental Health, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Alessandro Vacca
- Aging Brain and Memory Clinic, Department of Neuroscience “Rita Levi Montalcini”, University of Torino, Turin, Italy
| | - Raffaele Di Lorenzo
- Regional Neurogenetic Centre, Department of Primary Care, ASP-CZ, Catanzaro, Italy
| | - Paolo Provero
- Department of Neuroscience “Rita Levi Montalcini”, University of Torino, Turin, Italy
- Center for Omics Sciences, IRCCS S. Raffaele Scientific Institute, Milan, Italy
| | - Valeria Isella
- Department of Medicine and Surgery and Milan Center for Neuroscience (NeuroMi), University of Milano–Bicocca, Monza, Italy
| | | | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, Neurorehabilitation Unit, and Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Ildebrando Appollonio
- Department of Medicine and Surgery and Milan Center for Neuroscience (NeuroMi), University of Milano–Bicocca, Monza, Italy
| | | | - Cinzia Bussè
- Department of Neuroscience, University of Padua, Padua, Italy
| | - Renato Sambati
- Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari, Bari, Italy
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Davide Quaranta
- Memory Clinic, Fondazione Policlinico Agostino Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valeria Guglielmi
- Memory Clinic, Fondazione Policlinico Agostino Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giancarlo Logroscino
- Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari, Bari, Italy
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, Neurorehabilitation Unit, and Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Gioacchino Tedeschi
- Department of Medical and Surgical Sciences, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Carlo Ferrarese
- Department of Medicine and Surgery and Milan Center for Neuroscience (NeuroMi), University of Milano–Bicocca, Monza, Italy
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Khosravi M. COVID-19 quarantine: Two-way interaction between physical activity and mental health. Eur J Transl Myol 2021; 30:9509. [PMID: 33520149 PMCID: PMC7844403 DOI: 10.4081/ejtm.2020.9509] [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: 09/13/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022] Open
Abstract
Recent studies have revealed that physical activity significantly reduces the risk of coronavirus disease 2019 (COVID-19) infection by strengthening the immune system. Also, regular physical activity can reduce the risks of developing physical and mental health problems such as diabetes, hypertension, coronary heart disease, stress, anxiety, depression, etc. However, the two-way interaction between physical activity and psychological symptoms has not been well addressed yet. This paper is intended to examine various dimensions of this interaction and its effects on mental health at the time of COVID-19 quarantine.
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Affiliation(s)
- Mohsen Khosravi
- Department of Psychiatry and Clinical Psychology, Zahedan University of Medical Sciences, Zahedan, Iran
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216
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Khalid A, Younas MW, Khan H, Khan MS, Malik AR, Butt AUA, Ali B. Relationship between knowledge on COVID-19 and psychological distress among students living in quarantine: an email survey. AIMS Public Health 2021; 8:90-99. [PMID: 33575409 PMCID: PMC7870380 DOI: 10.3934/publichealth.2021007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/07/2021] [Indexed: 12/23/2022] Open
Abstract
Psychological distress is a generic term which refers to "feeling of emotional strain" that affects our normal mental and physical functioning. The aim of this study is to investigate the psychological distress perceived by the Pakistani students living in quarantine and to determine risk and protective factors, including knowledge of COVD-19, among this population. It is a descriptive cross-sectional study conducted from February to May 2020. Students enrolled at different colleges and universities of Pakistan participated in this survey. One-way analysis of variance (ANOVA) is computed for comparing knowledge scores of participants having different levels of psychological distress. A total of 937 participants completed the survey questionnaire, with slightly more male respondents (60.6%) than female (39.4%). The average age of survey participants is 22.0 years (SD = 3.01), with majority (76.2%) belonging to urban areas. The mean COVID-19 knowledge score is 8.91 (SD = 1.69, range: 1-12), suggesting an overall 74.25% precision rate for this knowledge test for individual participant. The participants scored least knowledge regarding the disease transmission, showing a percentage correctness of only 40%. Majority of the participants (57.3%) are likely to be well, while others (42.7%) have shown symptoms of mental distress. The analysis reveals that participants with moderate mental distress (M = 8.81, SD = 2.37) and those with severe mental distress (M = 8.75, SD = 2.69) scored lower than participants who were likely to be well (M = 9.49, SD = 1.71). Our study concludes that a higher knowledge base regarding the disease will help to mitigate distress levels. Our study suggests that in order to deal with this pandemic effectively, the knowledge regarding COVID-19 should be properly conveyed to general public. It is need of the hour to address mental issues of the population aggressively along with providing awareness about COVID-19.
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Affiliation(s)
| | | | - Hashim Khan
- MBBS, Rawalpindi Medical University, Pakistan
| | | | | | | | - Basit Ali
- Benazir Bhutto Hospital, Rawalpindi, Pakistan
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217
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Balay-odao EM, Alquwez N, Inocian EP, Alotaibi RS. Hospital Preparedness, Resilience, and Psychological Burden Among Clinical Nurses in Addressing the COVID-19 Crisis in Riyadh, Saudi Arabia. Front Public Health 2021; 8:573932. [PMID: 33490012 PMCID: PMC7821043 DOI: 10.3389/fpubh.2020.573932] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/26/2020] [Indexed: 11/24/2022] Open
Abstract
In the continuous effort to minimize the devastating effects of coronavirus disease (COVID-19) and to curb the spread of the disease, hospital preparedness and resilience play significant roles in the psychological well-being of clinical nurses given that their work demands immediate action to adapt and adjust to stressors. Thus, this study investigates the hospital preparedness, psychological burden, and resilience of clinical nurses in addressing COVID-19 in Riyadh, Saudi Arabia. A total of 281 clinical nurses participated in the survey from April 2020 to June 2020. Results show that clinical nurses perceived a high self-assessed COVID-19 hospital preparedness (49.65, SD = 2.30); high self-assessed nurses' resilience (4.03, SD = 0.36); and most have normal levels of depression, anxiety, and stress. The variables were predicted to be statistically significant (F 18,262 = 4.14, p = 0.001) and accounted for 16.8% of the variance in the nurses' perception of hospital preparedness (R 2 = 0.221; adjusted R 2 = 0.168). The regression analysis was statistically significant (F 30,250 = 6.71, p = 0.001) and accounted for 38% of the variance in nurses' resilience (R 2 = 0.446, Adjusted R 2 = 0.380). The predictors of depression, anxiety, and stress show that the overall relationship was statistically significant at (F 23,257 = 6.71, p < 0.001), (F 23,257 = 6.675, p 0.000), and (F 23,257 = 6.692, p 0.000) with 31.9% of the variance (R 2 = 0.375, Adjusted R 2 = 0.319), 31.8% of the variance (R 2 = 0.374, Adjusted R 2 = 0.318), and 31.9 % of the variance (R 2 = 0.375, Adjusted R 2 = 0.319), respectively. The findings of this study helps in improving the continuing education program, psychological support, and mental health program to ensure that the needs of clinical nurses are addressed during the outbreak of a disease.
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Affiliation(s)
| | - Nahed Alquwez
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
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218
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Silva-Sobrinho RA, Zilly A, Silva RMMD, Arcoverde MAM, Deschutter EJ, Palha PF, Bernardi AS. Coping with COVID-19 in an international border region: health and economy. Rev Lat Am Enfermagem 2021; 29:e3398. [PMID: 33439950 PMCID: PMC7798397 DOI: 10.1590/1518-8345.4659.3398] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/21/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE to analyze how the social isolation measures and closed borders affected the health and economy in an international border region. METHOD descriptive cross-sectional study conducted in the western region of Paraná, Brazil, using an electronic form created using Google® forms. A sample of 2,510 people was addressed. Descriptive analysis and the Chi-square test were performed, with a level of significance established at 5%. This public opinion survey, addressing unidentified participants, is in accordance with Resolutions 466/2012 and 510/2016. RESULTS the participants were 41.5 years old on average, most were women and worked in the education sector; 41.9% reported that the closing of borders/commercial businesses negatively influenced income; 17.7% reported the possibility of losing their jobs; 89.0% consider that a larger number of people would be sick if the borders/commercial had not been closed; 63.7% believe the health services are not prepared to deal with the pandemic; 74.9% realize that the Brazilian Unified Health System may not have sufficient service capacity; 63.4% reported anxiety; and 75.6% of commercial workers will experience changes in their income level. CONCLUSION the closing of international borders and commercial businesses was related to a perception of physical and mental changes, job loss, and decreased income.
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Affiliation(s)
| | - Adriana Zilly
- Universidade Estadual do Oeste do Paraná, Campus de Foz do Iguaçu, Foz do Iguaçu, PR, Brazil
| | | | | | | | - Pedro Fredemir Palha
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Angela Sobral Bernardi
- Universidade Estadual do Oeste do Paraná, Campus de Foz do Iguaçu, Foz do Iguaçu, PR, Brazil
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219
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Marques NP, Silveira DMM, Marques NCT, Martelli DRB, Oliveira EA, Martelli-Júnior H. Cancer diagnosis in Brazil in the COVID-19 era. Semin Oncol 2021; 48:156-159. [PMID: 33478743 PMCID: PMC7789866 DOI: 10.1053/j.seminoncol.2020.12.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/28/2020] [Accepted: 12/28/2020] [Indexed: 12/14/2022]
Abstract
The comprehensive care and treatment for cancer patients in Brazil, regulated by the National Cancer Prevention and Control Policy, is provided by Brazilian Unified Healthcare System (SUS) in certified health institution. Due the COVID-19 pandemic, several restrictive measures have been implemented by the State federation's governments, and cancer diagnosis reference centers were also impacted by these measures. Thus, this study aimed to compare SUS-oriented cancer diagnosis in Brazil before and during the pandemic so far. The average number of cancer diagnoses has dropped considerably in all Brazilian Regions since the pandemic period started. The number of new cancer cases has plunged in all regions, ranged from -24.3% in the North to -42.7% in Northeast region. The overall Brazilian average deficit reached 35.5%, corresponding to about 15,000 undiagnosed cases of cancer monthly. The pandemic period has dramatically reduced the diagnosis of new cases of cancer in Brazil, since consultations in public health services were compromised by restrictive measures. Therefore, effective measures must be urgently put in action in order to minimize the damage, and consequently, the negative health impacts caused by the COVID-19 pandemic in the care of cancer patients.
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Affiliation(s)
| | - Denise Maria M Silveira
- Primary Care Postgraduate Program, State University of Montes Claros Unimontes, Minas Gerais, Brazil
| | - Nádia Carolina Teixeira Marques
- José do Rosario Vellano University, Minas Gerais, Brazil; Center for Rehabilitation of Craniofacial Anomalies, University of Alfenas, Minas Gerais, Brazil
| | - Daniella Reis Barbosa Martelli
- Primary Care Postgraduate Program, State University of Montes Claros Unimontes, Minas Gerais, Brazil; University of California, San Diego, La Jolla, CA, USA
| | - Eduardo A Oliveira
- University of California, San Diego, La Jolla, CA, USA; Department of Pediatrics, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Minas Gerais, Brazil
| | - Hercílio Martelli-Júnior
- Primary Care Postgraduate Program, State University of Montes Claros Unimontes, Minas Gerais, Brazil; Center for Rehabilitation of Craniofacial Anomalies, University of Alfenas, Minas Gerais, Brazil
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220
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The Impact of Isolation Due to COVID-19 on Physical Activity Levels in Adult Students. SUSTAINABILITY 2021. [DOI: 10.3390/su13020446] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The lockdown with a prohibition of free mobility introduced in many countries has affected restrictions in physical activity (PA). The purpose of the study was to compare PA during restrictions and the “unfreezing” stage. The study group consisted of 89 healthy adult students. To assess the level of PA, a long version of the International Physical Activity Questionnaire (IPAQ) was used. The first evaluation was carried out in the period from 16 to 20 April 2020 at the time of the lockdown and the second in the period from 11 to 14 May 2020 during the so-called “unfreezing”. The average total PA rate during the first measurement was 8640 metabolic equivalent (MET)-min/week and in the second, 10,560 MET-min/week. The analysis of total energy expenditure showed a statistically significant difference (p < 0.029). The establishment of “unfreezing” laws for sport and recreation and the reduction of restrictions have significantly contributed to an increase in the overall level of PA. Based on our outcomes, we recommend students follow the scientific guidelines for undertaking PA (i.e., WHO) during the pandemic in order to maintain an appropriate pro-healthy dose of exercise.
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221
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Efimov D, Ushirobira R. On an interval prediction of COVID-19 development based on a SEIR epidemic model. ANNUAL REVIEWS IN CONTROL 2021; 51:477-487. [PMID: 33623479 PMCID: PMC7891093 DOI: 10.1016/j.arcontrol.2021.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 01/08/2021] [Accepted: 01/26/2021] [Indexed: 05/13/2023]
Abstract
In this paper, a new version of the well-known epidemic mathematical SEIR model is used to analyze the pandemic course of COVID-19 in eight different countries. One of the proposed model's improvements is to reflect the societal feedback on the disease and confinement features. The SEIR model parameters are allowed to be time-varying, and the ranges of their values are identified by using publicly available data for France, Italy, Spain, Germany, Brazil, Russia, New York State (US), and China. The identified model is then applied to predict the SARS-CoV-2 virus propagation under various conditions of confinement. For this purpose, an interval predictor is designed, allowing variations and uncertainties in the model parameters to be taken into account. The code and the utilized data are available on Github.
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Affiliation(s)
- Denis Efimov
- Inria, Univ. Lille, CNRS, UMR 9189 - CRIStAL, F-59000 Lille, France
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222
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Altuntas F, Gok MS. The effect of COVID-19 pandemic on domestic tourism: A DEMATEL method analysis on quarantine decisions. INTERNATIONAL JOURNAL OF HOSPITALITY MANAGEMENT 2021; 92:102719. [PMID: 33519015 PMCID: PMC7833637 DOI: 10.1016/j.ijhm.2020.102719] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/27/2020] [Accepted: 10/06/2020] [Indexed: 05/05/2023]
Abstract
Countries' most effective methods to reduce the impact of outbreaks are quarantine the regions during the pandemic periods. Quarantine decisions during a pandemic directly affect the hospitality industry. There is no universal guideline regarding the quarantine decision during a pandemic. There is a gap in the literature on making the right quarantine decisions to decrease the negative effect of a pandemic on the hospitality industry. To fill this gap, this study uses a decision-making trial and evaluation laboratory (DEMATEL) method to help countries for quarantine decisions due to the COVID-19 pandemic. One of the critical hospitality industry indicators is the inter-regional travel flow between regions for local tourism. Data from the household domestic tourism survey obtained from the Turkish Statistical Institute (TurkStat) is used to acquire the number of people entering and exiting among regions. This study's findings indicate that Istanbul has an essential impact on Turkey's rest. The results also demonstrate that the DEMATEL method provides convenient solutions for quarantine decisions during a pandemic. The DEMATEL application results concerning the COVID-19 pandemic effect might shed light on the hospitality industry's prospects and challenges. This study's findings might be adopted to prepare the hospitality industry for the COVID-19 pandemic and similar pandemic.
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Affiliation(s)
- Fatma Altuntas
- Department of Management, Gebze Technical University, Kocaeli, Turkey
| | - Mehmet Sahin Gok
- Department of Management, Gebze Technical University, Kocaeli, Turkey
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223
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Ruissen MM, Regeer H, Landstra CP, Schroijen M, Jazet I, Nijhoff MF, Pijl H, Ballieux BEPB, Dekkers O, Huisman SD, de Koning EJP. Increased stress, weight gain and less exercise in relation to glycemic control in people with type 1 and type 2 diabetes during the COVID-19 pandemic. BMJ Open Diabetes Res Care 2021; 9:9/1/e002035. [PMID: 33431602 PMCID: PMC7802391 DOI: 10.1136/bmjdrc-2020-002035] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/02/2020] [Accepted: 12/05/2020] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Lockdown measures have a profound effect on many aspects of daily life relevant for diabetes self-management. We assessed whether lockdown measures, in the context of the COVID-19 pandemic, differentially affect perceived stress, body weight, exercise and related this to glycemic control in people with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS We performed a short-term observational cohort study at the Leiden University Medical Center. People with type 1 and type 2 diabetes ≥18 years were eligible to participate. Participants filled out online questionnaires, sent in blood for hemoglobin A1c (HbA1c) analysis and shared data of their flash or continuous glucose sensors. HbA1c during the lockdown was compared with the last known HbA1c before the lockdown. RESULTS In total, 435 people were included (type 1 diabetes n=280, type 2 diabetes n=155). An increase in perceived stress and anxiety, weight gain and less exercise was observed in both groups. There was improvement in glycemic control in the group with the highest HbA1c tertile (type 1 diabetes: -0.39% (-4.3 mmol/mol) (p<0.0001 and type 2 diabetes: -0.62% (-6.8 mmol/mol) (p=0.0036). Perceived stress was associated with difficulty with glycemic control (p<0.0001). CONCLUSIONS An increase in perceived stress and anxiety, weight gain and less exercise but no deterioration of glycemic control occurs in both people with relatively well-controlled type 1 and type 2 diabetes during short-term lockdown measures. As perceived stress showed to be associated with glycemic control, this provides opportunities for healthcare professionals to put more emphasis on psychological aspects during diabetes care consultations.
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Affiliation(s)
- Merel M Ruissen
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Hannah Regeer
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Cyril P Landstra
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Marielle Schroijen
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Ingrid Jazet
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Michiel F Nijhoff
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Hanno Pijl
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Bart E P B Ballieux
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Olaf Dekkers
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
- Department of Epidemiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Sasja D Huisman
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Eelco J P de Koning
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
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Polcwiartek LB, Polcwiartek C, Andersen MP, Østergaard L, Broccia MD, Gislason GH, Køber L, Torp-Pedersen C, Schou M, Fosbøl E, Kragholm K, Hagstrøm S. Consequences of coronavirus disease-2019 (COVID-19) lockdown on infection-related hospitalizations among the pediatric population in Denmark. Eur J Pediatr 2021; 180:1955-1963. [PMID: 33555426 PMCID: PMC7868522 DOI: 10.1007/s00431-021-03934-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/30/2020] [Accepted: 01/06/2021] [Indexed: 12/12/2022]
Abstract
It remains unknown how Coronavirus disease-2019 (COVID-19) prevention measures implemented on March 12, 2020, have affected the rate of pediatric infection-related hospitalizations in Denmark. Therefore, we investigated the rate of pediatric infection-related hospitalizations during the COVID-19 pandemic. We used a retrospective cohort design and included all Danish children < 18 years. Infection-related hospitalizations were assessed during study periods in 2020 vs. 2018/2019, and we computed incidence rate ratios (IRRs) with 95% confidence intervals (CIs) using Poisson regression. In the 2020 study period, 3093 children were hospitalized with an infection, while the corresponding figures for 2018 and 2019 study periods were 4824 and 3830, respectively. When comparing the 2020 to the 2018/2019 study period prior to nationwide lockdown, we observed a decline in infection-related hospitalizations (12.68 (95% CI, 12.22-13.16) vs. 15.49 (95% CI, 15.12-15.86) per 1000 person-years). We further observed decreased IRRs, especially during the lockdown period (week 11: 0.64 (95% CI, 0.55-0.75); week 12: 0.26 (95% CI, 0.21-0.33); week 13: 0.13 (95% CI, 0.10-0.19)).Conclusion: The rate of pediatric infection-related hospitalizations in Denmark declined during the COVID-19 pandemic in 2020 compared to that in 2018/2019, with a 36% decline during initiation of the nationwide lockdown period. What is Known: • Due to the COVID-19 pandemic, several countries have implemented mitigation strategies such as lockdown of non-critical business functions. Most of these strategies have previously been proven effective on interruption of infection transmission. • It remains unclear how the mitigation strategies have affected the rate of pediatric infection-related hospitalizations. What is New: • Insight on how COVID-19 prevention measures have affected the frequency of infection-related hospitalization. • Valuable knowledge on how to act in potential future pandemics.
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Affiliation(s)
- Laura Bech Polcwiartek
- Department of Pediatrics, Aalborg University Hospital, Reberbansgade 15, 9000, Aalborg, Denmark.
| | - Christoffer Polcwiartek
- Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark
| | - Mikkel Porsborg Andersen
- Department of Clinical Research, Nordsjaellands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark
| | - Lauge Østergaard
- Department of Cardiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Marcella D. Broccia
- Department of Clinical Research, Nordsjaellands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark ,Department of Obstetrics and Gynecology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark
| | - Gunnar H. Gislason
- The Danish Heart Foundation, Vognmagergade 7, 3. sal, 1120 Copenhagen, Denmark ,Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
| | - Lars Køber
- Department of Cardiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark ,Department of Clinical Research, Nordsjaellands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark
| | - Morten Schou
- Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
| | - Emil Fosbøl
- Department of Cardiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Kristian Kragholm
- Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark ,Department of Cardiology, North Denmark Regional Hospital, Bispensgade 37, 9800 Hjørring, Denmark ,Unit of Clinical Biostatistics and Epidemiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark
| | - Søren Hagstrøm
- Department of Pediatrics, Aalborg University Hospital, Reberbansgade 15, 9000 Aalborg, Denmark ,Center for Clinical Research, North Denmark Regional Hospital, Bispensgade 37, 9800 Hjørring, Denmark ,Department of Clinical Medicine, Aalborg University, Hobrovej 18-22, 9000 Aalborg, Denmark
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225
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Feter N, Caputo EL, Doring IR, Leite JS, Cassuriaga J, Reichert FF, da Silva MC, Coombes JS, Rombaldi AJ. Sharp increase in depression and anxiety among Brazilian adults during the COVID-19 pandemic: findings from the PAMPA cohort. Public Health 2021; 190:101-107. [PMID: 33387848 PMCID: PMC7773543 DOI: 10.1016/j.puhe.2020.11.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES We aimed to compare the prevalence of depression and anxiety symptoms before and during the pandemic and identify factors associated with aggravated mental health symptoms. STUDY DESIGN Retrospective cohort study. METHODS We identified the proportion of normal, mild, moderate, and severe symptoms of depression and anxiety before and during the social distancing restrictions in adults from southern Brazil. An online, self-administered questionnaire was delivered for residents within the state of Rio Grande do Sul. Depressive and anxiety symptoms were examined by the Hospital Anxiety and Depression Scale. RESULTS Most of the participants (n = 2314) aged between 31 and 59 years (54.2%), were women (76.6%), White (90.6%) with a university degree (66.6%). Moderate-to-severe symptoms of depression and anxiety were reported in 3.9% and 4.5% of participants, respectively, before COVID-19. During the pandemic (June-July, 2020), these proportions increased to 29.1% (6.6-fold increase) and 37.8% (7.4-fold increase), respectively. Higher rates of depressive and anxiety symptoms were observed among women, those aged 18-30 years, diagnosed with chronic disease and participants who had their income negatively affected by social restrictions. Remaining active or becoming physically active during social distancing restrictions reduced the probability of aggravated mental health disorders. CONCLUSIONS Depressive and anxiety symptoms had a 6.6- and 7.4-fold increase since the COVID-19 pandemic. Public policies such as physical activity promotion and strategies to reduce the economic strain caused by this pandemic are urgently needed to mitigate the impact of the pandemic on mental health.
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Affiliation(s)
- N Feter
- Postgraduate Program in Physical Education, Federal University of Pelotas, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil; GEEAF - Physical Activity Epidemiology Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil; School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, 4067, Australia; Neuroscience and Physical Activity Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil.
| | - E L Caputo
- Postgraduate Program in Physical Education, Federal University of Pelotas, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil; GEEAF - Physical Activity Epidemiology Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil; Neuroscience and Physical Activity Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil
| | - I R Doring
- GEEAF - Physical Activity Epidemiology Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil
| | - J S Leite
- Neuroscience and Physical Activity Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil; Postgraduate Program in Cardiology, Federal University of Rio Grande Do Sul, Rua Ramiro Barcelos, 2400, 90035003, Porto Alegre, Brazil
| | - J Cassuriaga
- Postgraduate Program in Physical Education, Federal University of Pelotas, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil; Neuroscience and Physical Activity Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil
| | - F F Reichert
- Postgraduate Program in Physical Education, Federal University of Pelotas, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil; GEEAF - Physical Activity Epidemiology Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil
| | - M C da Silva
- Postgraduate Program in Physical Education, Federal University of Pelotas, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil; GEEAF - Physical Activity Epidemiology Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil
| | - J S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, 4067, Australia
| | - A J Rombaldi
- Postgraduate Program in Physical Education, Federal University of Pelotas, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil; GEEAF - Physical Activity Epidemiology Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil; Neuroscience and Physical Activity Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil
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Hatmi ZN. A Systematic Review of Systematic Reviews on the COVID-19 Pandemic. SN COMPREHENSIVE CLINICAL MEDICINE 2021; 3:419-436. [PMID: 33521564 PMCID: PMC7835449 DOI: 10.1007/s42399-021-00749-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/10/2021] [Indexed: 01/31/2023]
Abstract
COVID-19 a systemic inflammation involving multiple organs, affecting all age groups, with high mortality rate, severe adverse outcomes, and high economic burden need to be described. A systematic review of systematic reviews conducted. We searched PubMed, OVID Medline, Cochrane library, COVID-19 resource centers of N Engl. J Med, AHA, and LITCOVID. Certainty of evidences was evaluated by GRADE approach. Meta-analysis according to random effects model was conducted. Seventy-one eligible systematic reviews are included in the study. A total of 86.5% of them had high quality, and 13.5% had medium quality. Meta-analysis results are presented in tabular format, and the remaining results are presented in narration fashion. COVID-19 involves blood vessels, lung, heart, nervous system, liver, gastrointestinal system, kidney, eyes, and other organs and infects adult and children, neonates, pregnant women, and elderly, transmitted via air born and droplet. Comorbidities associated with COVID-19 are HTN 20.7%, CVD 9.6%, DM 9.55%, respiratory diseases 7%, and 9% of cigarette smoking. Prognostic factors for mortality among COVID-19 cases are acute cardiac injury, diagnosed CVD, DM, respiratory disease, and HTN. Prognostic factors for disease severity are CVD and HTN. Prognostic factors for disease progression were fever, shortness of breath, and smoking. There is no specific antiviral treatment. Preventive measures including physical distancing of 2 m and more, using PPE, avoiding social gatherings, quarantine, and isolation have been recommended. Encouraging telemedicine, online training, and homeschooling are highly recommended. Vaccine is approaching, and concerns exist about vaccine with a high efficacy. Modification of CVD and cardiometabolic risk became the cornerstone for sustainable control of pandemic.
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Affiliation(s)
- Zinat Nadia Hatmi
- Department of preventive medicine, Medical school, Tehran University of Medical Sciences, Purcina Ave, Medical Faculty, Building No 4, Second floor, Tehran, Iran ,Department of Epidemiology, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
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227
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Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection. Am J Med 2021; 134:16-22. [PMID: 32771461 PMCID: PMC7410805 DOI: 10.1016/j.amjmed.2020.07.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 12/14/2022]
Abstract
Approximately 9 months of the severe acute respiratory syndrome coronavius-2 (SARS-CoV-2 [COVID-19]) spreading across the globe has led to widespread COVID-19 acute hospitalizations and death. The rapidity and highly communicable nature of the SARS-CoV-2 outbreak has hampered the design and execution of definitive randomized, controlled trials of therapy outside of the clinic or hospital. In the absence of clinical trial results, physicians must use what has been learned about the pathophysiology of SARS-CoV-2 infection in determining early outpatient treatment of the illness with the aim of preventing hospitalization or death. This article outlines key pathophysiological principles that relate to the patient with early infection treated at home. Therapeutic approaches based on these principles include 1) reduction of reinoculation, 2) combination antiviral therapy, 3) immunomodulation, 4) antiplatelet/antithrombotic therapy, and 5) administration of oxygen, monitoring, and telemedicine. Future randomized trials testing the principles and agents discussed will undoubtedly refine and clarify their individual roles; however, we emphasize the immediate need for management guidance in the setting of widespread hospital resource consumption, morbidity, and mortality.
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228
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Saadeh H, Saadeh M, Almobaideen W, Al Refaei A, Shewaikani N, Al Fayez RQ, Khawaldah H, Abu-Shanab S, Al-Hussaini M. Effect of COVID-19 Quarantine on the Sleep Quality and the Depressive Symptom Levels of University Students in Jordan During the Spring of 2020. Front Psychiatry 2021; 12:605676. [PMID: 33664681 PMCID: PMC7920987 DOI: 10.3389/fpsyt.2021.605676] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/25/2021] [Indexed: 01/08/2023] Open
Abstract
Objectives: This study was designed to assess the effect of COVID-19 home quarantine and its lifestyle challenges on the sleep quality and mental health of a large sample of undergraduate University students in Jordan. It is the first study applied to the Jordanian population. The aim was to investigate how quarantine for several weeks changed the students' habits and affected their mental health. Methods: A cross-sectional study was conducted using a random representative sample of 6,157 undergraduate students (mean age 19.79 ± 1.67 years, males 28.7%) from the University of Jordan through voluntarily filling an online questionnaire. The Pittsburgh Sleep Quality Index (PSQI) and the Center for Epidemiologic Studies-Depression Scale (CES-D) were used to assess sleep quality and depressive symptoms, respectively. Results: The PSQI mean score for the study participants was 8.1 ± 3.6. The sleep quality of three-quarters of the participants was negatively affected by the extended quarantine. Nearly half of the participants reported poor sleep quality. The prevalence of poor sleep quality among participants was 76% (males: 71.5% and females: 77.8%). Similarly, the prevalence of the depressive symptoms was 71% (34% for moderate and 37% for high depressive symptoms), with females showing higher prevalence than males. The overall mean CES-D score for the group with low depressive symptoms is 9.3, for the moderate group is 19.8, while it is 34.3 for the high depressive symptoms group. More than half of the students (62.5%) reported that the quarantine had a negative effect on their mental health. Finally, females, smokers, and students with decreased income levels during the extended quarantine were the common exposures that are significantly associated with a higher risk of developing sleep disturbances and depressive symptoms. Conclusions: Mass and extended quarantine succeeded in controlling the spread of the COVID-19 virus; however, it comes with a high cost of potential psychological impacts. Most of the students reported that they suffer from sleeping disorders and had a degree of depressive symptoms. Officials should provide psychological support and clear guidance to help the general public to reduce these potential effects and overcome the quarantine period with minimum negative impacts.
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Affiliation(s)
- Heba Saadeh
- Computer Science Department, King Abdullah II School of Information Technology Faculty, The University of Jordan, Amman, Jordan
| | - Maha Saadeh
- Computer Engineering and Informatics, Middlesex University Dubai, Dubai, United Arab Emirates
| | - Wesam Almobaideen
- Computer Science Department, King Abdullah II School of Information Technology Faculty, The University of Jordan, Amman, Jordan.,Electrical Engineering and Computing Sciences, Rochester Institute of Technology, Dubai, United Arab Emirates
| | | | | | - Reem Qadan Al Fayez
- Computer Information System Department, King Abdullah II School of Information Technology Faculty, The University of Jordan, Amman, Jordan
| | - Hamzah Khawaldah
- Geography Department, School of Arts, The University of Jordan, Amman, Jordan
| | | | - Maysa Al-Hussaini
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan.,Human Research Protection Program Office, King Hussein Cancer Center, Amman, Jordan
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229
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Meer MS, Mishra AK. GIS approach for mapping novel coronavirus in northern state of India, Jammu and Kashmir. ENVIRONMENTAL EARTH SCIENCES 2021; 80:540. [PMID: 34413906 PMCID: PMC8363868 DOI: 10.1007/s12665-021-09856-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/30/2021] [Indexed: 05/17/2023]
Abstract
Novel coronavirus "COVID-19" has affected worldwide. At initial stage, the way out to curb the deadly virus was lockdown, isolating the symptomatic people, quarantining travellers and educating the people about the coronavirus infection so that precautionary measures are followed by people. The present research focuses on the application of Geographic Information System on mapping the coronavirus cases in Jammu and Kashmir. The research attributes the role of dense population and urbanization responsible for increasing the coronavirus cases in the study area. The districts like Srinagar and Jammu with high population and urbanization (census 2011) attribute high number of corona cases in year 2020. This high population experiences the highest number of corona cases (Jammu 23,339, Srinagar 24,996), deaths (Jammu 350, Srinagar 444) and COVID-19 recoveries (Jammu 22,141, Srinagar 23,957). The highly urbanized and populated area are much exposed towards infection. The high number of corona case experiences heart-related issues. The number of heart-related deaths are increased to 29.6% during winter in study area by extreme weather conditions limiting regular exercising and outdoor activities. But, due to COVID-19 the amount of heart-related deaths has significantly increased, which is crucial for the study area. This study will serve as replica study for managing COVID-19 in Jammu and Kashmir and help the medical fraternity by giving the priority for vaccinating the people and managing the facility related to COVID-19. The GIS was used to mitigate the infection of COVID-19 on life.
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Affiliation(s)
- Mohammad Suhail Meer
- Centre for Remote Sensing and Geoinformatics, Sathyabama Institute of Science and Technology, Chennai, India
| | - Anoop Kumar Mishra
- Satmet Division, Office of Director General of Meteorology, India Meteorological Department, Ministry of Earth Sciences, Mausam Bhavan, New Delhi, 110003 India
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230
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Pal SC, Chowdhuri I, Saha A, Chakrabortty R, Roy P, Ghosh M, Shit M. Improvement in ambient-air-quality reduced temperature during the COVID-19 lockdown period in India. ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2021; 23:9581-9608. [PMID: 33110388 PMCID: PMC7580820 DOI: 10.1007/s10668-020-01034-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 10/01/2020] [Indexed: 05/20/2023]
Abstract
The COVID-19 pandemic forced India as a whole to lockdown from 24 March 2020 to 14 April 2020 (first phase), extended to 3 May 2020 (second phase) and further extended to 17 May 2020 (third phase) and 31 May 2020 (fourth phase) with only some limited relaxation in non-hot spot areas. This lockdown has strictly controlled human activities in the entire India. Although this long lockdown has had a serious impact on the social and economic fronts, it has many positive impacts on environment. During this lockdown phase, a drastic fall in emissions of major pollutants has been observed throughout all the parts of India. Therefore, in this research study we have tried to establish a relationship among the fall in emission of pollutants and their impact on reducing regional temperature. This analysis was tested through the application of Mann-Kendall and Sen's slope statistical index with air quality index and temperature data for several stations across the country, during the lockdown period. After the analysis, it has been observed that daily emissions of pollutants (PM10, PM2.5, CO, NO2, SO2 and NH3) decreased by - 1- - 2%, allowing to reduce the average daily temperature by 0.3 °C compared with the year of 2019. Moreover, this lockdown period reduces overall emissions of pollutants by - 51- - 72% on an average and hence decreases the average monthly temperature by 2 °C. The same findings have been found in the four megacities in India, i.e., Delhi, Kolkata, Mumbai and Chennai; the rate of temperature fall in the aforementioned megacities is close to 3 °C, 2.5 °C, 2 °C and 2 °C, respectively. It is a clear indicator that a major change occurs in air quality, and as a result it reduced lower atmospheric temperature due to the effect of lockdown. It is also a clear indicator that a major change in air quality and favorable temperature can be expected if the strict implementations of several pollution management measures have been implemented by the concern authority in the coming years.
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Affiliation(s)
- Subodh Chandra Pal
- Department of Geography, The University of Burdwan, Barddhaman, West Bengal 713104 India
| | - Indrajit Chowdhuri
- Department of Geography, The University of Burdwan, Barddhaman, West Bengal 713104 India
| | - Asish Saha
- Department of Geography, The University of Burdwan, Barddhaman, West Bengal 713104 India
| | - Rabin Chakrabortty
- Department of Geography, The University of Burdwan, Barddhaman, West Bengal 713104 India
| | - Paramita Roy
- Department of Geography, The University of Burdwan, Barddhaman, West Bengal 713104 India
| | - Manoranjan Ghosh
- Rural Development Centre, Indian Institute of Technology Kharagpur, Kharagpur, West Bengal India
| | - Manisa Shit
- Department of Geography, Raiganj University, Uttar Dinajpur, West Bengal, Raiganj, 733134 India
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231
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Dawoud D. Emerging from the other end: Key measures for a successful COVID-19 lockdown exit strategy and the potential contribution of pharmacists. Res Social Adm Pharm 2021; 17:1950-1953. [PMID: 32405277 PMCID: PMC7219380 DOI: 10.1016/j.sapharm.2020.05.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/11/2020] [Accepted: 05/11/2020] [Indexed: 12/22/2022]
Abstract
As the world edges towards relaxing the lockdown measures taken to control the spread of the novel coronavirus SARS-CoV-2 (COVID-19), governments have started putting in place a variety of measures to avoid a second peak in the number of infections. The implementation of and adherence to such measures will be key components of any successful lockdown exit strategy. Ranging from expanded testing and widespread use of technology to building the public's trust in the post COVID-19 world, there is a role for pharmacists to play. In this commentary, these measures and the potential contribution of pharmacists to their successful implementation are outlined and discussed.
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Affiliation(s)
- Dalia Dawoud
- Clinical Pharmacy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
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232
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Abstract
INTRODUCTION The effect of non pharmacological interventions (NPIs) during an epidemic disease outbreak is well accepted dating back to historical events. NPIs involve numerous measurements like hygiene rules or contact restriction that are applied during given situations, while so far only limited quantitative data exist to rate the overall effectiveness. METHODS Using the official counts of Robert Koch Institute in Berlin/Germany, press reports and Twitter messages, the early phase of the current COVID-19/Sars-CoV2 in Bavaria is being reconstructed. RESULTS The first cases have been observed in Munich by the end of January 2020. While the initial outbreak could be sufficiently covered using isolation and quarantine measurements, the consecutive early spreading falls into three phases, starting with winter school holidays at the end of February, a number of beer festivals in the following week, and general elections on March, 15. The disaster plan on March, 16 indicates the end of the early phase. Using the official case counts, a rather coherent picture evolves although representative epidemiological studies are still missing. The epidemic started with a few cases during the winter holidays, increased exponentially afterwards including significant more cases by beer festivals and another significant excess of cases following the election that occurred in Bavaria only. Compared to other German countries, Bavaria reached the highest prevalence which could not be reversed by even the most restrictive containment measurements. CONCLUSION To be effective, NPIs need to applied early, if possible even before the beginning of the exponential phase.
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Affiliation(s)
- Matthias Wjst
- Institut für Lungenbiologie (iLBD), Helmholtz-Zentrum München, German Research Center for Environmental Health (GmbH), München-Neuherberg
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Klinikum rechts der Isar, München
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Mojtabavi H, Javidi N, Naviaux AF, Janne P, Gourdin M, Mohammadpour M, Saghazadeh A, Rezaei N. Exploration of the Epidemiological and Emotional Impact of Quarantine and Isolation During the COVID-19 Pandemic. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:687-703. [PMID: 33973206 DOI: 10.1007/978-3-030-63761-3_38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Starting in December 2019 in Wuhan Municipal Health Commission, the coronavirus disease 2019 (COVID-19) has crossed the borders forming a pandemic in 2020. The absence of pharmacological interventions has pushed governments to apply different sets of old, non-pharmacological interventions, which are, though temporary, helpful to prevent further pandemic propagation. In the context of COVID-19, research confirms that quarantine is useful, mainly if applied early and if combined with other public health measures. However, the efficacy of quarantine and isolation is limited in many ways, ranging from legal issues and suspension of economic activities to mental health considerations. This chapter is an exploration of (i) epidemiological impact of isolation and quarantine; (ii) emotional impact of isolation and quarantine; and (iii) the possible effect of culture on quarantine experience.
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Affiliation(s)
- Helia Mojtabavi
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran.,MetaCognition Interest Group (MCIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nasirudin Javidi
- Behavioral Sciences Research Center, Life style institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Clinical Psychology and Psychotherapy Studies (CPPS), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Anne-Frédérique Naviaux
- College of Psychiatrists of Ireland and Health Service Executive (HSE), Summerhill Community Mental Health Service, Summerhill, Wexford, Ireland.,Faculty of Medicine, Université catholique de Louvain, Woluwé-Saint-Lambert, Belgium
| | - Pascal Janne
- Université catholique de Louvain, CHU UCL Namur, Avenue Dr. G. Thérasse, Yvoir, Belgium.,Faculty of Psychology, Université catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | - Maximilien Gourdin
- Faculty of Medicine, Université catholique de Louvain, Woluwé-Saint-Lambert, Belgium.,Université catholique de Louvain, CHU UCL Namur, Avenue Dr. G. Thérasse, Yvoir, Belgium
| | - Mahsa Mohammadpour
- MetaCognition Interest Group (MCIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amene Saghazadeh
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran.,Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. .,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
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Khademi M, Vaziri-Harami R, Shams J. Prevalence of Mental Health Problems and Its Associated Factors Among Recovered COVID-19 Patients During the Pandemic: A Single-Center Study. Front Psychiatry 2021; 12:602244. [PMID: 33868043 PMCID: PMC8044784 DOI: 10.3389/fpsyt.2021.602244] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/08/2021] [Indexed: 01/05/2023] Open
Abstract
Introduction: The coronavirus disease 2019 (COVID-19), is profoundly affecting the mental health status. Although the burden of mental health problems has been reported in the general population and health care workers, little is known about the prevalence of mental health disorders among recovered COVID-19 patients and their associated factors. Methods: A cross-sectional telephonic-study of recovered COVID-19 patients with and without a history of hospitalization was conducted from April 20 to June 20, 2020, in Tehran, Iran. We assessed the anxiety symptoms, depression, and post-traumatic stress disorder (PTSD) among participants, using the Patient Health Questionnaire (PHQ-4) and PTSD checklist for DSM-5 (PCL-5). Logistic regression analyses were used to explore the risk factors associated with mental health problems. Results: A total of 602 individuals with a mean age of 53.2 years (SD: 14.7), completed the study. The rates of mental health symptoms among the respondents were 5.8% (95% CI: 4.2-7.8%) for anxiety, 5.0% (95% CI: 3.5-7.0%) for depression, and 3.8% (95% CI: 2.3-5.3%) for PTSD disorders. Moreover, being younger than 50 years and female gender was significantly associated with a higher probability of reporting anxiety (p < 0.01), and depression (p < 0.001 for being younger than 50 years, p < 0.02 for female gender). Conclusions: The current study indicated that patients with COVID-19 presented features of anxiety, depression, and PTSD. These results may help implement appropriate mental health intervention policies for those at risk and minimize the mental health consequences of the COVID-19.
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Affiliation(s)
- Mojgan Khademi
- Department of Psychiatry, School of Medicine, Imam Hossein Hospital Clinical Research Development Unit, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Vaziri-Harami
- Department of Psychiatry, School of Medicine, Imam Hossein Hospital Clinical Research Development Unit, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jamal Shams
- Behavioral Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Garre-Olmo J, Turró-Garriga O, Martí-Lluch R, Zacarías-Pons L, Alves-Cabratosa L, Serrano-Sarbosa D, Vilalta-Franch J, Ramos R. Changes in lifestyle resulting from confinement due to COVID-19 and depressive symptomatology: A cross-sectional a population-based study. Compr Psychiatry 2021; 104:152214. [PMID: 33186837 PMCID: PMC7574785 DOI: 10.1016/j.comppsych.2020.152214] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/07/2020] [Accepted: 10/16/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The measures adopted to control the spread of the COVID-19 pandemic in several countries included mobility and social restrictions that produced an immediate impact on the lifestyle of their inhabitants. METHODS We assessed the association between the consequences of these measures and depressive symptomatology using a population-based sample of 692 individuals aged 18 or over from an ongoing study in the province of Girona (Catalonia, Spain). Participants responded to a telephone-based survey that included questions related to the consequences of confinement and the Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptomatology. Multivariate logistic and linear regressions were used to identify which changes in lifestyle resulting from confinement were independently associated with a possible depression episode and depressive symptomatology. RESULTS The prevalence of a possible depressive episode during the confinement was 12.7% (95% CI = 10.3-15.4). An adverse work situation, expected economic distress, self-reported worsening of the mental health and of the dietary pattern, and worries about a relative's potential infection were variables related to an increased risk of having a possible depressive episode. The changes in lifestyle accounted for 32% of the variance of the PHQ-9 score. CONCLUSION The findings indicate an association of the job situation, the expected negative economic consequences, the perceived worsening of health and habits, and the worries about COVID-19 infection with depressive symptomatology during the confinement.
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Affiliation(s)
- Josep Garre-Olmo
- Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain; Institut d'Assistència Sanitària, Catalonia, Spain; Department of Medical Sciences, School of Medicine, University of Girona, Catalonia, Spain.
| | - Oriol Turró-Garriga
- Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain,Institut d'Assistència Sanitària, Catalonia, Spain
| | - Ruth Martí-Lluch
- Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain,Vascular Health Research Group (ISV-Girona), Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina, Catalonia, Spain
| | | | - Lia Alves-Cabratosa
- Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain,Vascular Health Research Group (ISV-Girona), Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina, Catalonia, Spain
| | - Domènec Serrano-Sarbosa
- Institut d'Assistència Sanitària, Catalonia, Spain,Department of Medical Sciences, School of Medicine, University of Girona, Catalonia, Spain
| | | | - Rafel Ramos
- Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain,Department of Medical Sciences, School of Medicine, University of Girona, Catalonia, Spain,Vascular Health Research Group (ISV-Girona), Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina, Catalonia, Spain
| | - on behalf of the Girona Healthy Region Study GroupMantéXavier Aldeguer1CasedevallJudit Bassols2GinestaJordi Barretina3TerradellasRamon Brugada4PerxasLaia Calvó5ColomJordi Cid6RealJosé Manuel Fernández7QuiciosJaume Heredia8BermejoAbel López9GrageraRafael Marcos10del RioAna Molina11NavarreteJosé Maria Moreno7NicolauJosep Lluís11MartinezPascual Ramon Orriols12ComptaAna Prada11GutierrezSalvador Pedraza13AlcántaraJosep Puig13TorrentàLluís Ramió14GarcíaGlòria Reig15SerenaJoaquin14RelatMontse Vendrell12VilanovaJoan C.13Department of Gastroenterology, Dr. Josep Trueta University Hospital, Girona, SpainPediatrics Research Group, Girona Biomedical Research Institute, Girona, SpainGirona Biomedical Research Institute, Girona, SpainDepartment of Cardiology, Dr. Josep Trueta University Hospital, Girona, SpainTechnical Office, Institut d'Assistència Sanitaria, Girona, SpainMental Health Network, Institut d'Assistència Sanitaria, Girona, SpainDepartment of Diabetes, Endocrinology and Nutrition, Dr. Josep Trueta University Hospital, Girona, SpainHospital d'Olot, Girona, SpainDepartment of Pediatrics, Dr. Josep Trueta University Hospital, Girona, SpainEpidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, SpainPrimary Care, Institut Català de la Salut, Girona, SpainDepartment of Pneumology, Dr. Josep Trueta University Hospital, Girona, SpainDepartment of Radiology (IDI), Dr. Josep Trueta University Hospital, Girona, SpainDepartment of Neurology, Dr. Josep Trueta University Hospital, Girona, SpainPrimary Care, Institut d'Assistència Sanitària, Girona, Spain
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Abubakar AR, Sani IH, Godman B, Kumar S, Islam S, Jahan I, Haque M. Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications. Infect Drug Resist 2020; 13:4673-4695. [PMID: 33402839 PMCID: PMC7778508 DOI: 10.2147/idr.s289037] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/10/2020] [Indexed: 01/08/2023] Open
Abstract
A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globally. Several treatments have been proposed, many of which have proven ineffective. Consequently, there is a need to review the published evidence of drug clinical trials to guide future prescribing. A systematic review of published clinical trials and retrospective observational studies was carried out. The search was made using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and October 2020 and written in the English language were retrieved and included in the study. Researches that used traditional medicine, in-vitro and in-vivo animal studies, as well as reviews were excluded. Seventy-three relevant articles that fulfilled the inclusion criteria were finally selected and reviewed. Hydroxychloroquine, chloroquine, and azithromycin produced no clinical evidence of efficacy in randomized controlled clinical trials (RCT). However, retrospective observational studies reported the efficacy of remdesivir and lopinavir/ritonavir in reducing viral load, although there have been concerns with lopinavir/ritonavir and, more recently, remdesivir. Recently, tocilizumab, dexamethasone, and methylprednisolone significantly relieved lung inflammation and decreased mortality in patients with severe COVID-19. In addition, convalescent plasma was effective in boosting strong immunity among patients with mild COVID-19. There is currently no single worldwide approved therapeutic option for patients with COVID-19 despite the initial hype with medicines, including hydroxychloroquine. Nonetheless, dexamethasone has shown promise in symptomatic treatment and convalescent plasma in boosting immunity. New treatments are currently being researched, and the findings will be reported accordingly to provide evidence-based guidance for prescribers and policymakers.
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Affiliation(s)
- Abdullahi Rabiu Abubakar
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Bayero University, Kano, Nigeria
| | - Ibrahim Haruna Sani
- Unit of Pharmacology, College of Health Sciences, Yusuf Maitama Sule University, Kano, Nigeria
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Santosh Kumar
- Department of Periodontology and Implantology, Karnavati University, Gandhinagar382422, India
| | - Salequl Islam
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka1342, Bangladesh
| | - Iffat Jahan
- Department of Physiology, Eastern Medical College, Cumilla, Bangladesh
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
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237
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Krishnaratne S, Pfadenhauer LM, Coenen M, Geffert K, Jung-Sievers C, Klinger C, Kratzer S, Littlecott H, Movsisyan A, Rabe JE, Rehfuess E, Sell K, Strahwald B, Stratil JM, Voss S, Wabnitz K, Burns J. Measures implemented in the school setting to contain the COVID-19 pandemic: a scoping review. Cochrane Database Syst Rev 2020; 12:CD013812. [PMID: 33331665 PMCID: PMC9206727 DOI: 10.1002/14651858.cd013812] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND In response to the spread of SARS-CoV-2 and the impact of COVID-19, national and subnational governments implemented a variety of measures in order to control the spread of the virus and the associated disease. While these measures were imposed with the intention of controlling the pandemic, they were also associated with severe psychosocial, societal, and economic implications on a societal level. One setting affected heavily by these measures is the school setting. By mid-April 2020, 192 countries had closed schools, affecting more than 90% of the world's student population. In consideration of the adverse consequences of school closures, many countries around the world reopened their schools in the months after the initial closures. To safely reopen schools and keep them open, governments implemented a broad range of measures. The evidence with regards to these measures, however, is heterogeneous, with a multitude of study designs, populations, settings, interventions and outcomes being assessed. To make sense of this heterogeneity, we conducted a rapid scoping review (8 October to 5 November 2020). This rapid scoping review is intended to serve as a precursor to a systematic review of effectiveness, which will inform guidelines issued by the World Health Organization (WHO). This review is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and was registered with the Open Science Framework. OBJECTIVES To identify and comprehensively map the evidence assessing the impacts of measures implemented in the school setting to reopen schools, or keep schools open, or both, during the SARS-CoV-2/COVID-19 pandemic, with particular focus on the types of measures implemented in different school settings, the outcomes used to measure their impacts and the study types used to assess these. SEARCH METHODS We searched the Cochrane COVID-19 Study Register, MEDLINE, Embase, the CDC COVID-19 Research Articles Downloadable Database for preprints, and the WHO COVID-19 Global literature on coronavirus disease on 8 October 2020. SELECTION CRITERIA We included studies that assessed the impact of measures implemented in the school setting. Eligible populations were populations at risk of becoming infected with SARS-CoV-2, or developing COVID-19 disease, or both, and included people both directly and indirectly impacted by interventions, including students, teachers, other school staff, and contacts of these groups, as well as the broader community. We considered all types of empirical studies, which quantitatively assessed impact including epidemiological studies, modelling studies, mixed-methods studies, and diagnostic studies that assessed the impact of relevant interventions beyond diagnostic test accuracy. Broad outcome categories of interest included infectious disease transmission-related outcomes, other harmful or beneficial health-related outcomes, and societal, economic, and ecological implications. DATA COLLECTION AND ANALYSIS We extracted data from included studies in a standardized manner, and mapped them to categories within our a priori logic model where possible. Where not possible, we inductively developed new categories. In line with standard expectations for scoping reviews, the review provides an overview of the existing evidence regardless of methodological quality or risk of bias, and was not designed to synthesize effectiveness data, assess risk of bias, or characterize strength of evidence (GRADE). MAIN RESULTS We included 42 studies that assessed measures implemented in the school setting. The majority of studies used mathematical modelling designs (n = 31), while nine studies used observational designs, and two studies used experimental or quasi-experimental designs. Studies conducted in real-world contexts or using real data focused on the WHO European region (EUR; n = 20), the WHO region of the Americas (AMR; n = 13), the West Pacific region (WPR; n = 6), and the WHO Eastern Mediterranean Region (EMR; n = 1). One study conducted a global assessment and one did not report on data from, or that were applicable to, a specific country. Three broad intervention categories emerged from the included studies: organizational measures to reduce transmission of SARS-CoV-2 (n = 36), structural/environmental measures to reduce transmission of SARS-CoV-2 (n = 11), and surveillance and response measures to detect SARS-CoV-2 infections (n = 19). Most studies assessed SARS-CoV-2 transmission-related outcomes (n = 29), while others assessed healthcare utilization (n = 8), other health outcomes (n = 3), and societal, economic, and ecological outcomes (n = 5). Studies assessed both harmful and beneficial outcomes across all outcome categories. AUTHORS' CONCLUSIONS We identified a heterogeneous and complex evidence base of measures implemented in the school setting. This review is an important first step in understanding the available evidence and will inform the development of rapid reviews on this topic.
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Affiliation(s)
- Shari Krishnaratne
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Karin Geffert
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Caroline Jung-Sievers
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Carmen Klinger
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Suzie Kratzer
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Hannah Littlecott
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Ani Movsisyan
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Julia E Rabe
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Kerstin Sell
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Brigitte Strahwald
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Jan M Stratil
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Stephan Voss
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Katharina Wabnitz
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Jacob Burns
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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238
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Letizia AG, Ramos I, Obla A, Goforth C, Weir DL, Ge Y, Bamman MM, Dutta J, Ellis E, Estrella L, George MC, Gonzalez-Reiche AS, Graham WD, van de Guchte A, Gutierrez R, Jones F, Kalomoiri A, Lizewski R, Lizewski S, Marayag J, Marjanovic N, Millar EV, Nair VD, Nudelman G, Nunez E, Pike BL, Porter C, Regeimbal J, Rirak S, Santa Ana E, Sealfon RSG, Sebra R, Simons MP, Soares-Schanoski A, Sugiharto V, Termini M, Vangeti S, Williams C, Troyanskaya OG, van Bakel H, Sealfon SC. SARS-CoV-2 Transmission among Marine Recruits during Quarantine. N Engl J Med 2020; 383:2407-2416. [PMID: 33176093 PMCID: PMC7675690 DOI: 10.1056/nejmoa2029717] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND The efficacy of public health measures to control the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not been well studied in young adults. METHODS We investigated SARS-CoV-2 infections among U.S. Marine Corps recruits who underwent a 2-week quarantine at home followed by a second supervised 2-week quarantine at a closed college campus that involved mask wearing, social distancing, and daily temperature and symptom monitoring. Study volunteers were tested for SARS-CoV-2 by means of quantitative polymerase-chain-reaction (qPCR) assay of nares swab specimens obtained between the time of arrival and the second day of supervised quarantine and on days 7 and 14. Recruits who did not volunteer for the study underwent qPCR testing only on day 14, at the end of the quarantine period. We performed phylogenetic analysis of viral genomes obtained from infected study volunteers to identify clusters and to assess the epidemiologic features of infections. RESULTS A total of 1848 recruits volunteered to participate in the study; within 2 days after arrival on campus, 16 (0.9%) tested positive for SARS-CoV-2, 15 of whom were asymptomatic. An additional 35 participants (1.9%) tested positive on day 7 or on day 14. Five of the 51 participants (9.8%) who tested positive at any time had symptoms in the week before a positive qPCR test. Of the recruits who declined to participate in the study, 26 (1.7%) of the 1554 recruits with available qPCR results tested positive on day 14. No SARS-CoV-2 infections were identified through clinical qPCR testing performed as a result of daily symptom monitoring. Analysis of 36 SARS-CoV-2 genomes obtained from 32 participants revealed six transmission clusters among 18 participants. Epidemiologic analysis supported multiple local transmission events, including transmission between roommates and among recruits within the same platoon. CONCLUSIONS Among Marine Corps recruits, approximately 2% who had previously had negative results for SARS-CoV-2 at the beginning of supervised quarantine, and less than 2% of recruits with unknown previous status, tested positive by day 14. Most recruits who tested positive were asymptomatic, and no infections were detected through daily symptom monitoring. Transmission clusters occurred within platoons. (Funded by the Defense Health Agency and others.).
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Affiliation(s)
- Andrew G Letizia
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Irene Ramos
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Ajay Obla
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Carl Goforth
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Dawn L Weir
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Yongchao Ge
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Marcas M Bamman
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Jayeeta Dutta
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Ethan Ellis
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Luis Estrella
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Mary-Catherine George
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Ana S Gonzalez-Reiche
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - William D Graham
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Adriana van de Guchte
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Ramiro Gutierrez
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Franca Jones
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Aspasia Kalomoiri
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Rhonda Lizewski
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Stephen Lizewski
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Jan Marayag
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Nada Marjanovic
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Eugene V Millar
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Venugopalan D Nair
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - German Nudelman
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Edgar Nunez
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Brian L Pike
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Chad Porter
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - James Regeimbal
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Stas Rirak
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Ernesto Santa Ana
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Rachel S G Sealfon
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Robert Sebra
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Mark P Simons
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Alessandra Soares-Schanoski
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Victor Sugiharto
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Michael Termini
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Sindhu Vangeti
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Carlos Williams
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Olga G Troyanskaya
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Harm van Bakel
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
| | - Stuart C Sealfon
- From the Naval Medical Research Center, Silver Spring (A.G.L., C.G., D.L.W., L.E., W.D.G., R.G., F.J., J.M., E.N., B.L.P., C.P., J.R., E.S.A., M.P.S., V.S., C.W.) and the Infectious Disease Clinical Research Program, Uniformed Services University (E.V.M.), Bethesda - both in Maryland; the Naval Medical Research Unit 6, Lima, Peru (R.L., S.L.); the Departments of Neurology (I.R., Y.G., M.-C.G., A.K., N.M., V.D.N., G.N., S.R., A.S.-S., S.V., S.C.S.) and Genetics and Genomic Sciences (A.O., J.D., E.E., A.S.G.-R., A.G., R.S., H.B.), Icahn Institute for Data Science and Genomic Technology (E.E., R.S., H.B.), the Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai (R.S.), and the Center for Computational Biology, Flatiron Institute (R.S.G.S., O.G.T.) - all in New York; the University of Alabama at Birmingham Center for Exercise Medicine, University of Alabama Medical School, Birmingham (M.M.B.); Sema4, Stamford, CT (R.S.); the Navy Medicine Readiness and Training Command Beaufort, Beaufort, SC (M.T.); and the Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ (O.G.T.)
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Kaur RJ, Charan J, Dutta S, Sharma P, Bhardwaj P, Sharma P, Lugova H, Krishnapillai A, Islam S, Haque M, Misra S. Favipiravir Use in COVID-19: Analysis of Suspected Adverse Drug Events Reported in the WHO Database. Infect Drug Resist 2020; 13:4427-4438. [PMID: 33364790 PMCID: PMC7751706 DOI: 10.2147/idr.s287934] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 11/20/2020] [Indexed: 12/13/2022] Open
Abstract
Background COVID-19 caused by SARS-CoV-2 virus emerged as an unprecedented challenge to discover effective drugs for its prevention and cure. Hyperinflammation-induced lung damage is one of the poor prognostic indicators causing a higher rate of morbidity and mortality of COVID-19 patients. Favipiravir, an antiviral drug, is being used for COVID-19 treatment, and we currently have limited information regarding its efficacy and safety. Thus, the present study was undertaken to evaluate the adverse drug events (ADEs) reported in the WHO pharmacovigilance database. Methods This study analyzed all suspected ADEs related to favipiravir reported from 2015. The reports were analyzed based on age, gender, and seriousness of ADEs at the System Organ Classification (SOC) level and the individual Preferred Term (PT) level. Results This study is based on 194 ADEs reported from 93 patients. Most frequent ADEs suspected to be caused by the favipiravir included increased hepatic enzymes, nausea and vomiting, tachycardia, and diarrhea. Severe and fatal ADEs occurred more frequently in men and those over the age of 64 years. Blood and lymphatic disorders, cardiac disorders, hepatobiliary disorders, injury poisoning, and procedural complications were more common manifestations of severe ADEs. Conclusion This study revealed that favipiravir appears to be a relatively safe drug. An undiscovered anti-inflammatory activity of favipiravir may explain the improvement in critically ill patients and reduce inflammatory markers. Currently, the data is based on very few patients. A more detailed assessment of the uncommon ADEs needs to be analyzed when more information will be available.
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Affiliation(s)
- Rimple Jeet Kaur
- Department of Pharmacology, Dr. S.N Medical College, Jodhpur, Rajasthan, India
| | - Jaykaran Charan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Siddhartha Dutta
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Paras Sharma
- Department of Pharmacognosy, BVM College of Pharmacy, Gwalior, India
| | - Pankaj Bhardwaj
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Praveen Sharma
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Halyna Lugova
- The Unit of Community Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur
| | - Ambigga Krishnapillai
- Family Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia
| | - Salequl Islam
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
| | - Mainul Haque
- The Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia
| | - Sanjeev Misra
- All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
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240
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Maples LS. A rapid review of quarantine and/or other public health measures to control COVID-19. Int J Nurs Pract 2020; 26:e12903. [PMID: 33305477 PMCID: PMC7883195 DOI: 10.1111/ijn.12903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Laura S Maples
- Clinical Quality Programs and Data Analytics, Northern California Kaiser Permanente, Oakland, California, USA
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241
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Bhatt N, Bhatt B, Gurung S, Dahal S, Jaishi AR, Neupane B, Budhathoki SS. Perceptions and experiences of the public regarding the COVID-19 pandemic in Nepal: a qualitative study using phenomenological analysis. BMJ Open 2020; 10:e043312. [PMID: 33310812 PMCID: PMC7735126 DOI: 10.1136/bmjopen-2020-043312] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/09/2020] [Accepted: 11/30/2020] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Perceptions of people regarding COVID-19 influences their health behaviour in terms of seeking public health services. This helps the government in planning appropriate public health strategies. Therefore, this study intends to explore the perceptions of people towards COVID-19 and their experiences during the pandemic in Nepal. DESIGN, SETTING AND PARTICIPANTS This qualitative study was conducted among the public in Kathmandu, Kanchanpur, Bajura and Jhapa districts of Nepal. Eight focus group discussions and 40 in-depth interviews were conducted by using a maximum variation sampling method. RESULTS The findings were organised into the following themes: General understanding of COVID-19, Disease prevention, Source of information and misconceptions, Expectation and challenges; and Personal and societal consequences of COVID-19, social distancing and lockdown. There was a good general understanding among respondents about COVID-19, personal preventive measures and population-level strategies. They responded that the use of masks, sanitisers, handwashing and proper lockdown would help to prevent the disease. The respondents acknowledged the vital role of media in increasing awareness. Participants also expressed concerns over the misleading news spread by some media. The lack of social interaction, isolation and loss of income were raised as pertinent issues by the participants as potentially leading to psychological consequences. Health workers and public both raised concerns over inadequate Personal Protective Equipment, under-prepared health system, unorganised public quarantine centres, and public violation of lockdown CONCLUSIONS: This study reports participants' views on disease prevention measures such as maintaining personal hygiene, adhering to physical distancing, and using personal protective equipments. Additionally, it illuminates the confusion among public due to conflicting public health messages from different sources of information which was deemed as misleading by the participants. This research sheds light on people's perspectives and experiences that can inform population-targeted policies in the future.
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Affiliation(s)
- Navin Bhatt
- Bayalpata Hospital, Nyaya Health Nepal, Achham, Nepal
| | - Bandana Bhatt
- Department of Health Services, Government of Nepal Ministry of Health and Population, Kathmandu, Nepal
| | - Soniya Gurung
- Central Department of Public Health, Tribhuvan University Institute of Medicine, Kathmandu, Nepal
| | - Suresh Dahal
- College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Amrit Raj Jaishi
- College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Bandana Neupane
- Nepal Health Sector Support Programme (NHSSP)/DFID, Government of Nepal Ministry of Health and Population, Kathmandu, Nepal
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242
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Yen YF, Tsai YF, Su VYF, Chan SY, Yu WR, Ho H, Hou CM, Chen CC, Woung LC, Huang SJ. Use and Cost-Effectiveness of a Telehealth Service at a Centralized COVID-19 Quarantine Center in Taiwan: Cohort Study. J Med Internet Res 2020; 22:e22703. [PMID: 33259324 PMCID: PMC7735809 DOI: 10.2196/22703] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 12/31/2022] Open
Abstract
Background Telehealth is a recommended method for monitoring the progression of nonsevere infections in patients with COVID-19. However, telehealth has not been widely implemented to monitor SARS-CoV-2 infection in quarantined individuals. Moreover, studies on the cost-effectiveness of quarantine measures during the COVID-19 pandemic are scarce. Objective In this cohort study, we aimed to use telehealth to monitor COVID-19 infections in 217 quarantined Taiwanese travelers and to analyze the cost-effectiveness of the quarantine program. Methods Travelers were quarantined for 14 days at the Taiwan Yangmingshan quarantine center and monitored until they were discharged. The travelers’ clinical symptoms were evaluated twice daily. A multidisciplinary medical team used the telehealth system to provide timely assistance for ill travelers. The cost of the mandatory quarantine was calculated according to data from the Ministry of Health and Welfare of Taiwan. Results All 217 quarantined travelers tested negative for SARS-CoV-2 upon admission to the quarantine center. During the quarantine, 28/217 travelers (12.9%) became ill and were evaluated via telehealth. Three travelers with fever were hospitalized after telehealth assessment, and subsequent tests for COVID-19 were negative for all three patients. The total cost incurred during the quarantine was US $193,938, which equated to US $894 per individual. Conclusions Telehealth is an effective instrument for monitoring COVID-19 infection in quarantined travelers and could help provide timely disease management for people who are ill. It is imperative to screen and quarantine international travelers for SARS-CoV-2 infection to reduce the nationwide spread of COVID-19.
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Affiliation(s)
- Yung-Feng Yen
- Section of Infectious Diseases, Taipei City Hospital, Yangming Branch, Taipei City, Taiwan.,Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.,University of Taipei, Taipei, Taiwan
| | - Yi-Fan Tsai
- Department of Nursing, Taipei City Hospital Yangming Branch, Taipei, Taiwan
| | - Vincent Yi-Fong Su
- Department of Internal Medicine, Taipei City Hospital Yangming Branch, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shang-Yih Chan
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,University of Taipei, Taipei, Taiwan.,Department of Internal Medicine, Taipei City Hospital Yangming Branch, Taipei, Taiwan
| | - Wen-Ruey Yu
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsuan Ho
- University of Taipei, Taipei, Taiwan
| | | | - Chu-Chieh Chen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Lin-Chung Woung
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
| | - Sheng-Jean Huang
- Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan.,Department of Surgery, Medical College, National Taiwan University Hospital, Taipei, Taiwan
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Kolesar JM, Gayheart T, Poston L, Monday E, Forster D, Belcher E, Jaiswal R, Turner JK, Arnett DK, Durbin EB, Monroe J, Romanelli F, Arnold SM, Jennings CD, Weiss H, DiPaola R. COVID-19 Test Strategy to Guide Quarantine Interval in University Student. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.12.09.20246785. [PMID: 33330888 PMCID: PMC7743099 DOI: 10.1101/2020.12.09.20246785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Following COVID-19 exposure, the CDC recommends a 10-14 day quarantine for asymptomatic individuals and more recently a 7 day quarantine with a negative PCR test. We performed a university-based prospective student cohort study to determine if early PCR negativity predicts day 14 negativity. METHODS We enrolled 101 asymptomatic, quarantining, students, performed nasopharyngeal swabs for viral testing on days 3 or 4, 5, 7, 10 and 14 and determined the proportion of concordant negative results for each day versus day 14 with a two-sided 95% exact binomial confidence interval. RESULTS Overall, 14 of 90 (16%, 95% CI: 9% - 25%) tested positive while in quarantine, with 7 initial positive tests on day 3 or 4, 5 on day 5, 2 on day 7, and none on day 10 or 14. Rates of concordant negative test results are: day 5 vs. day 14 = 45/50 (90%, 95% CI: 78% - 97%); day 7 vs. day 14 = 47/52 (90%, 95% CI: 79% - 97%); day 10 vs. day 14 = 48/53 (91%, 95% CI:79% - 97%), with no evidence of different negative rates between earlier days and day 14 by McNemar's test, p > 0.05. CONCLUSIONS The 16% positive rate supports the ongoing need to quarantine close contacts of COVID-19 cases, but this prospective study provides the first direct evidence that exposed asymptomatic students ages 18-44 years in a university setting are at low risk if released from quarantine at 7 days if they test negative PCR test prior to release.
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Al-Ashwal FY, Kubas M, Zawiah M, Bitar AN, Mukred Saeed R, Sulaiman SAS, Khan AH, Ghadzi SMS. Healthcare workers' knowledge, preparedness, counselling practices, and perceived barriers to confront COVID-19: A cross-sectional study from a war-torn country, Yemen. PLoS One 2020; 15:e0243962. [PMID: 33306750 PMCID: PMC7732096 DOI: 10.1371/journal.pone.0243962] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 12/02/2020] [Indexed: 12/23/2022] Open
Abstract
Background The coronavirus disease of 2019 (COVID-19) represents a difficult challenge and could have devastating consequences for the healthcare system and healthcare workers in war-torn countries with poor healthcare facilities such as Yemen. Our study aimed to evaluate the knowledge, preparedness, counselling practices of healthcare workers regarding COVID-19, and the perceived barriers to adequately prevent and control COVID-19 in Yemen. Methods Healthcare workers (HCWs) from major healthcare facilities participated in this cross-sectional study. A self-administered questionnaire comprising of five main domains (demographics, knowledge, self-preparedness, counselling practice, perceived barriers) was distributed among HCWs after obtaining informed consent. A convenient sampling technique was used. Descriptive and inferential analyses were applied using SPSS software. Results A total of 1000 participants were initially targeted to participate in the study with 514 (51.4%) responding, of which 55.3% were female. Physicians and nurses constituted the largest proportion of participants, with 39.5% and 33.3%, respectively. The median scores for knowledge, self-preparedness, and counselling practice were 8 (out of 9), 9 (out of 15), and 25 (out of 30), respectively. The physician group showed a statistically significant association with better knowledge compared to the nurse group only, P<0.001. Males had higher preparedness scores than females, p<0.001. Also, the intensive care unit (ICU) and emergency departments presented a statistically significant difference by which the participants from these departments were more prepared compared to the others (e.g. outpatients, paediatrics and surgery) with P < 0.0001. The lack of awareness among the general population about COVID-19 preventive measures was perceived as the most common barrier for the adequate prevention and control of COVID-19 in Yemen (89.1%). Conclusion The major highlight of this study is that HCWs have, overall, good knowledge, suboptimal preparedness, and adequate counselling practices prior to the outbreak of COVID-19 in Yemen, despite the high number of perceived barriers. However, urgent action and interventions are needed to improve the preparedness of HCWs to manage COVID-19. The perceived barriers also need to be fully addressed by the local healthcare authorities and international organisations working in Yemen for adequate prevention and control measures to be in place in managing COVID-19.
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Affiliation(s)
- Fahmi Y. Al-Ashwal
- Clinical Pharmacy Department, University of Science and Technology Hospital (USTH), Sana'a, Yemen
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Mohammed Kubas
- Clinical Pharmacy Department, University of Science and Technology Hospital (USTH), Sana'a, Yemen
- Pharmacy Practice Department, Kulliyyah of Pharmacy, International Islamic University Malaysia (IIUM), Kuantan, Pahang, Malaysia
| | - Mohammed Zawiah
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Department of Pharmacy Practice, College of Clinical Pharmacy, University of Al Hodeida, Al Hodeida, Yemen
- * E-mail:
| | - Ahmad Naoras Bitar
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Ramzi Mukred Saeed
- Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology (UST), Sana'a, Yemen
- Department of Pharmaceutical sciences, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Syed Azhar Syed Sulaiman
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Teherán AA, Camero Ramos G, Prado de la Guardia R, Hernández C, Herrera G, Pombo LM, Avila AA, Flórez C, Barros EC, Perez-Garcia L, Paniz-Mondolfi A, Ramírez JD. Epidemiological characterisation of asymptomatic carriers of COVID-19 in Colombia: a cross-sectional study. BMJ Open 2020; 10:e042122. [PMID: 33293326 PMCID: PMC7722836 DOI: 10.1136/bmjopen-2020-042122] [Citation(s) in RCA: 9] [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: 06/27/2020] [Revised: 11/14/2020] [Accepted: 11/23/2020] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Asymptomatic carriers (AC) of the new SARS-CoV-2 represent an important source of spread for COVID-19. Early diagnosis of these cases is a powerful tool to control the pandemic. Our objective was to characterise patients with AC status and identify associated sociodemographic factors. METHODS Using a cross-sectional design and the national database of daily occurrence of COVID-19, we characterised both socially and demographically all ACs. Additional correspondence analysis and logistic regression model were performed to identify characteristics associated with AC state (OR, 95% CI). RESULTS 76.162 ACs (12.1%; 95% CI 12.0% to 12.2%) were identified, mainly before epidemiological week 35. Age≤26 years (1.18; 1.09 to 1.28), male sex (1.51; 1.40 to 1.62), cases imported from Venezuela, Argentina, Brazil, Germany, Puerto Rico, Spain, USA or Mexico (12.6; 3.03 to 52.5) and autochthonous cases (22.6; 5.62 to 91.4) increased the risk of identifying ACs. We also identified groups of departments with moderate (1.23; 1.13 to 1.34) and strong (19.8; 18.6 to 21.0) association with ACs. CONCLUSION Sociodemographic characteristics strongly associated with AC were identified, which may explain its epidemiological relevance and usefulness to optimise mass screening strategies and prevent person-to-person transmission.
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Affiliation(s)
- Aníbal A Teherán
- Grupo de investigación COMPLEXUS, Fundación Universitaria Juan N Corpas, Bogotá, Colombia
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | | | | | - Carolina Hernández
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Giovanny Herrera
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Luis M Pombo
- Grupo de investigación COMPLEXUS, Fundación Universitaria Juan N Corpas, Bogotá, Colombia
| | - Albert Alejandro Avila
- Cruz Roja Colombiana Seccional Cundinamarca-Bogotá, Bogota, Colombia
- Hospital Simon Bolívar, Bogotá, Colombia
| | | | | | - Luis Perez-Garcia
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | | | - Juan David Ramírez
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
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Bielecki M, Patel D, Hinkelbein J, Komorowski M, Kester J, Ebrahim S, Rodriguez-Morales AJ, Memish ZA, Schlagenhauf P. Reprint of: Air travel and COVID-19 prevention in the pandemic and peri-pandemic period: A narrative review. Travel Med Infect Dis 2020; 38:101939. [PMID: 33291000 PMCID: PMC7831384 DOI: 10.1016/j.tmaid.2020.101939] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Air travel during the COVID-19 pandemic is challenging for travellers, airlines, airports, health authorities, and governments. We reviewed multiple aspects of COVID peri-pandemic air travel, including data on traveller numbers, peri-flight prevention, and testing recommendations and in-flight SARS-CoV-2 transmission, photo-epidemiology of mask use, the pausing of air travel to mass gathering events, and quarantine measures and their effectiveness. Flights are reduced by 43% compared to 2019. Hygiene measures, mask use, and distancing are effective, while temperature screening has been shown to be unreliable. Although the risk of in-flight transmission is considered to be very low, estimated at one case per 27 million travellers, confirmed in-flight cases have been published. Some models exist and predict minimal risk but fail to consider human behavior and airline procedures variations. Despite aircraft high-efficiency filtering, there is some evidence that passengers within two rows of an index case are at higher risk. Air travel to mass gatherings should be avoided. Antigen testing is useful but impaired by time lag to results. Widespread application of solutions such as saliva-based, rapid testing or even detection with the help of “sniffer dogs” might be the way forward. The “traffic light system” for traveling, recently introduced by the Council of the European Union is a first step towards normalization of air travel. Quarantine of travellers may delay introduction or re-introduction of the virus, or may delay the peak of transmission, but the effect is small and there is limited evidence. New protocols detailing on-arrival, rapid testing and tracing are indicated to ensure that restricted movement is pragmatically implemented. Guidelines from airlines are non-transparent. Most airlines disinfect their flights and enforce wearing masks and social distancing to a certain degree. A layered approach of non-pharmaceutical interventions, screening and testing procedures, implementation and adherence to distancing, hygiene measures and mask use at airports, in-flight and throughout the entire journey together with pragmatic post-flight testing and tracing are all effective measures that can be implemented. Ongoing research and systematic review are indicated to provide evidence on the utility of preventive measures and to help answer the question “is it safe to fly?“.
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Affiliation(s)
- Michel Bielecki
- University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Epidemiology Biostatistics and Prevention Institute, Hirschengraben 84, CH-8001, Zürich, Switzerland
| | - Dipti Patel
- National Travel Health Network and Centre, UCLH NHS Foundation Trust, 250 Euston Road London, NW1 2PG, United Kingdom
| | - Jochen Hinkelbein
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital and Medical Faculty, Cologne, Germany; Space Medicine Group, European Society of Aerospace Medicine (ESAM), Cologne, Germany; German Society of Aerospace Medicine (DGLRM), Munich, Germany
| | - Matthieu Komorowski
- Space Medicine Group, European Society of Aerospace Medicine (ESAM), Cologne, Germany Department of Surgery & Cancer, Imperial College Healthcare NHS Trust, St Mary's Campus, Praed St, Paddington, London, W2 1NY, UK; Intensive Care Unit, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK
| | - John Kester
- Independent Researcher and Expert on Tourism, Former Director of Statistics, Trends and Policy at the United Nations World Tourism Organization (UNWTO), Spain
| | - Shahul Ebrahim
- Faculty of Medicine, University of Sciences, Techniques, and Technology, Bamako, Mali
| | - Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia; Grupo de Investigación, Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de Las Américas, Pereira, Risaralda, Colombia
| | - Ziad A Memish
- Alfaisal University, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Patricia Schlagenhauf
- University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Epidemiology Biostatistics and Prevention Institute, Hirschengraben 84, CH-8001, Zürich, Switzerland.
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Dawoud D, Chalkidou K, Sullivan R, Ruiz FJ, Adler A. USA stockpiling of remdesivir: How should the world respond? J Comp Eff Res 2020; 9:1243-1246. [PMID: 33274643 PMCID: PMC7717394 DOI: 10.2217/cer-2020-0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The race to find an effective treatment for coronavirus disease 2019 (COVID-19) is still on, with only two treatment options currently authorized for emergency use and/or recommended for patients hospitalized with severe respiratory symptoms: low-dose dexamethasone and remdesivir. The USA decision to stockpile the latter has resulted in widespread condemnation and in similar action being taken by some other countries. In this commentary we discuss whether stockpiling remdesivir is justified in light of the currently available evidence.
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Affiliation(s)
- Dalia Dawoud
- Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Kalipso Chalkidou
- Global Health Policy & Center for Global Development, London, UK.,Practice in Global Health, Imperial College London, London, UK
| | | | - Francis J Ruiz
- Center for Global Development, Imperial College London, London, UK
| | - Amanda Adler
- NICE Technology Appraisal Committee B, University of Oxford, Oxford, UK
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Pan J, Tian J, Xiong H, Liu Z, Yao Y, Wang Y, Zhu W, Wang Y, Wang W. Risk assessment and evaluation of China's policy to prevent COVID-19 cases imported by plane. PLoS Negl Trop Dis 2020; 14:e0008908. [PMID: 33284804 PMCID: PMC7746261 DOI: 10.1371/journal.pntd.0008908] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 12/17/2020] [Accepted: 10/21/2020] [Indexed: 12/13/2022] Open
Abstract
As of October 5, 2020, China has reported 2,921 cases imported from overseas. Assessing the effectiveness of China's current policies on imported cases abroad is very important for China and other countries that are facing or will face overseas imported cases. In April, we used a susceptible-exposed-infectious-recovered metapopulation model to simulate the epidemic in seven foreign countries, China and the three Chinese key cities. Based on the model outside China, we estimated the proportion of people in incubation period and calculated the risk indexes for Chinese cities through analyzing aviation traffic data from these countries. Based on the model in China and the three key cities, we collected information on control measures and quantified the effectiveness of implementing the current policies at different times and intensities. Our model results showed that Shanghai, Beijing, Qingdao, Guangzhou, and Tianjin have the top five risk indexes. As of April 20, 2020, under current measures, the number of confirmed cases could be reduced by 99% compared with no air traffic restrictions and isolation measures; the reduction could be 93% with isolation of passengers only from key countries. If the current policy were postponed for 7, 10, or 20 days, the increase in the number of confirmed cases would be 1,329, 5,524, and 779,245 respectively, which is 2.1, 5.7, and 662.9 times the number of confirmed cases under current measures. Our research indicates that the importation control measures currently taken by China were implemented at an appropriate time to prevent the epidemic spreading and have achieved relatively good control results. However, it is necessary to remain vigilant; otherwise, another outbreak peak could occur.
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Affiliation(s)
- Jinhua Pan
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jie Tian
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Haiyan Xiong
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Zhixi Liu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Ye Yao
- Department of Biostatics, School of Public Health, Fudan University, Shanghai, China
| | - Yesheng Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Wenlong Zhu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Yue Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Weibing Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
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McCarthy Z, Xiao Y, Scarabel F, Tang B, Bragazzi NL, Nah K, Heffernan JM, Asgary A, Murty VK, Ogden NH, Wu J. Quantifying the shift in social contact patterns in response to non-pharmaceutical interventions. JOURNAL OF MATHEMATICS IN INDUSTRY 2020; 10:28. [PMID: 33282625 PMCID: PMC7707617 DOI: 10.1186/s13362-020-00096-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/25/2020] [Indexed: 05/03/2023]
Abstract
Social contact mixing plays a critical role in influencing the transmission routes of infectious diseases. Moreover, quantifying social contact mixing patterns and their variations in a rapidly evolving pandemic intervened by changing public health measures is key for retroactive evaluation and proactive assessment of the effectiveness of different age- and setting-specific interventions. Contact mixing patterns have been used to inform COVID-19 pandemic public health decision-making; but a rigorously justified methodology to identify setting-specific contact mixing patterns and their variations in a rapidly developing pandemic, which can be informed by readily available data, is in great demand and has not yet been established. Here we fill in this critical gap by developing and utilizing a novel methodology, integrating social contact patterns derived from empirical data with a disease transmission model, that enables the usage of age-stratified incidence data to infer age-specific susceptibility, daily contact mixing patterns in workplace, household, school and community settings; and transmission acquired in these settings under different physical distancing measures. We demonstrated the utility of this methodology by performing an analysis of the COVID-19 epidemic in Ontario, Canada. We quantified the age- and setting (household, workplace, community, and school)-specific mixing patterns and their evolution during the escalation of public health interventions in Ontario, Canada. We estimated a reduction in the average individual contact rate from 12.27 to 6.58 contacts per day, with an increase in household contacts, following the implementation of control measures. We also estimated increasing trends by age in both the susceptibility to infection by SARS-CoV-2 and the proportion of symptomatic individuals diagnosed. Inferring the age- and setting-specific social contact mixing and key age-stratified epidemiological parameters, in the presence of evolving control measures, is critical to inform decision- and policy-making for the current COVID-19 pandemic.
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Affiliation(s)
- Zachary McCarthy
- Fields-CQAM Laboratory of Mathematics for Public Health (MfPH), York University, Toronto, Ontario Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario Canada
| | - Yanyu Xiao
- Department of Mathematical Sciences, University of Cincinnati, Cincinnati, OH USA
| | - Francesca Scarabel
- Fields-CQAM Laboratory of Mathematics for Public Health (MfPH), York University, Toronto, Ontario Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario Canada
- CDLab—Computational Dynamics Laboratory, Department of Mathematics, Computer Science and Physics, University of Udine, 33100 Udine, Italy
| | - Biao Tang
- Fields-CQAM Laboratory of Mathematics for Public Health (MfPH), York University, Toronto, Ontario Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario Canada
| | - Nicola Luigi Bragazzi
- Fields-CQAM Laboratory of Mathematics for Public Health (MfPH), York University, Toronto, Ontario Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario Canada
| | - Kyeongah Nah
- Fields-CQAM Laboratory of Mathematics for Public Health (MfPH), York University, Toronto, Ontario Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario Canada
| | - Jane M. Heffernan
- Modelling Infection and Immunity Lab, Centre for Disease Modelling, Department of Mathematics and Statistics, York University, Toronto, Ontario Canada
| | - Ali Asgary
- Disaster & Emergency Management, School of Administrative Studies & Advanced Disaster & Emergency Rapid-Response Simulation (ADERSIM), York University, Toronto, Ontario Canada
| | - V. Kumar Murty
- Department of Mathematics, University of Toronto, Toronto, Ontario Canada
- The Fields Institute for Research in Mathematical Sciences, Toronto, Ontario Canada
| | - Nicholas H. Ogden
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, St-Hyacinthe, Quebec Canada
| | - Jianhong Wu
- Fields-CQAM Laboratory of Mathematics for Public Health (MfPH), York University, Toronto, Ontario Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario Canada
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250
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Depression in and after COVID-19 lockdown in Austria and the role of stress and loneliness in lockdown: A longitudinal study. J Affect Disord 2020; 277:962-963. [PMID: 33065839 PMCID: PMC7487145 DOI: 10.1016/j.jad.2020.09.047] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/08/2020] [Indexed: 11/24/2022]
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