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Wang C, Wang D, Abbas J, Duan K, Mubeen R. Global Financial Crisis, Smart Lockdown Strategies, and the COVID-19 Spillover Impacts: A Global Perspective Implications From Southeast Asia. Front Psychiatry 2021; 12:643783. [PMID: 34539457 PMCID: PMC8446391 DOI: 10.3389/fpsyt.2021.643783] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/09/2021] [Indexed: 01/09/2023] Open
Abstract
This present study primarily emphasizes to seek the COVID-19 adverse impacts posing health challenges and global economic crisis. The pandemic (COVID-19) continues to hit the global economies adversely. Pakistan is the 5th-most-populous nation, and recorded positive cases with the third-highest positivity ratio in South Asia, and 26th-highest deaths toll of 21,450 and 29th number of most COVID-19 positive cases with 933,750 worldwide, as of June 6, 2021. The first wave appeared at the end of May 2020, and mid of June reported its peak, which ended by mid-July 2020. Early November 2020 witnessed the second wave with low intensity reached the climax by mid-December. The COVID-19's third wave severely affected the country during mid-March 2021. It exhibited the highest positivity rate, around 20%. New positive patients and deaths toll commenced to skyrocket and reported peak by April 15, 2021. Then situation gradually improved with effective measures and restrictions. The pandemic coronavirus (COVID-19) has affected 220 territories, regions, and countries and resulted in more than 174.116 million infections, deaths, 3.75 million, and 157.157 million positive cases fully recovered from this infectious disease, as of June 7, 2021. The pandemic has caused a severe crisis of healthcare facilities and economic challenges worldwide. Pakistani economy reported GPD's negative growth (-0.05) for the first time over the last 60 years in 2020, which caused a massive financial crisis. The Government's relief package intervened to reduce public mental stress and improve the quality of their lives. IMF reported that Pakistan's GPD bounced back at 4% growth by June 2021. This article determines that economic instability and health burden happened in Pakistan for a longer time than financial disequilibrium that occurred globally. Pakistan encountered this crisis due to its feeble healthcare systems and fragile economy. This study explores adverse health issues and spillover consequences on the economic crisis in Pakistan with global implications. It recommends smart lockdown restrictions in most affected areas to reopen the economic cycle with strict preventive measures to minimize the COVD-19 adverse consequences.
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Affiliation(s)
- Chunlei Wang
- School of International Economics and Trade, Shanghai Lixin University of Accounting and Finance, Shanghai, China
| | - Dake Wang
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Jaffar Abbas
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
- Antai College of Economics and Management, Shanghai Jiao Tong University, Shanghai, China
| | - Kaifeng Duan
- School of Economics and Management, Tongji University, Shanghai, China
| | - Riaqa Mubeen
- School of Management, Harbin Institute of Technology, Harbin, China
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Pérez-Segura V, Caro-Carretero R, Rua A. Multivariate Analysis of Risk Factors of the COVID-19 Pandemic in the Community of Madrid, Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9227. [PMID: 34501817 PMCID: PMC8430670 DOI: 10.3390/ijerph18179227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 12/23/2022]
Abstract
It has been more than one year since Chinese authorities identified a deadly new strain of coronavirus, SARS-CoV-2. Since then, the scientific work regarding the transmission risk factors of COVID-19 has been intense. The relationship between COVID-19 and environmental conditions is becoming an increasingly popular research topic. Based on the findings of the early research, we focused on the community of Madrid, Spain, which is one of the world's most significant pandemic hotspots. We employed different multivariate statistical analyses, including principal component analysis, analysis of variance, clustering, and linear regression models. Principal component analysis was employed in order to reduce the number of risk factors down to three new components that explained 71% of the original variance. Cluster analysis was used to delimit the territory of Madrid according to these new risk components. An ANOVA test revealed different incidence rates between the territories delimited by the previously identified components. Finally, a set of linear models was applied to demonstrate how environmental factors present a greater influence on COVID-19 infections than socioeconomic dimensions. This type of local research provides valuable information that could help societies become more resilient in the face of future pandemics.
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Affiliation(s)
- Víctor Pérez-Segura
- University Institute of Studies on Migrations, Comillas Pontifical University, 28015 Madrid, Spain
| | - Raquel Caro-Carretero
- Industrial Organization Department, ICAI-School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain;
| | - Antonio Rua
- Department of Quantitative Methods, Comillas Pontifical University, 28015 Madrid, Spain;
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203
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Rudolf Virchow, poverty and global health: from “politics as medicine on a grand scale” to “health in all policies”. GLOBAL HEALTH JOURNAL 2021. [DOI: 10.1016/j.glohj.2021.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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204
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Aguiar VRC, Augusto DG, Castelli EC, Hollenbach JA, Meyer D, Nunes K, Petzl-Erler ML. An immunogenetic view of COVID-19. Genet Mol Biol 2021; 44:e20210036. [PMID: 34436508 PMCID: PMC8388242 DOI: 10.1590/1678-4685-gmb-2021-0036] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/12/2021] [Indexed: 02/06/2023] Open
Abstract
Meeting the challenges brought by the COVID-19 pandemic requires an interdisciplinary approach. In this context, integrating knowledge of immune function with an understanding of how genetic variation influences the nature of immunity is a key challenge. Immunogenetics can help explain the heterogeneity of susceptibility and protection to the viral infection and disease progression. Here, we review the knowledge developed so far, discussing fundamental genes for triggering the innate and adaptive immune responses associated with a viral infection, especially with the SARS-CoV-2 mechanisms. We emphasize the role of the HLA and KIR genes, discussing what has been uncovered about their role in COVID-19 and addressing methodological challenges of studying these genes. Finally, we comment on questions that arise when studying admixed populations, highlighting the case of Brazil. We argue that the interplay between immunology and an understanding of genetic associations can provide an important contribution to our knowledge of COVID-19.
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Affiliation(s)
- Vitor R. C. Aguiar
- Universidade de São Paulo, Departamento de Genética e Biologia
Evolutiva, São Paulo, SP, Brazil
| | - Danillo G. Augusto
- University of California, UCSF Weill Institute for Neurosciences,
Department of Neurology, San Francisco, CA, USA
- Universidade Federal do Paraná, Departamento de Genética, Curitiba,
PR, Brazil
| | - Erick C. Castelli
- Universidade Estadual Paulista, Faculdade de Medicina de Botucatu,
Departamento de Patologia, Botucatu, SP, Brazil
| | - Jill A. Hollenbach
- University of California, UCSF Weill Institute for Neurosciences,
Department of Neurology, San Francisco, CA, USA
| | - Diogo Meyer
- Universidade de São Paulo, Departamento de Genética e Biologia
Evolutiva, São Paulo, SP, Brazil
| | - Kelly Nunes
- Universidade de São Paulo, Departamento de Genética e Biologia
Evolutiva, São Paulo, SP, Brazil
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Ghonimi TAL, Alkad MM, Abuhelaiqa EA, Othman MM, Elgaali MA, Ibrahim RAM, Joseph SM, Al-Malki HA, Hamad AI. Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study. PLoS One 2021; 16:e0254246. [PMID: 34293004 PMCID: PMC8297751 DOI: 10.1371/journal.pone.0254246] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 06/23/2021] [Indexed: 01/16/2023] Open
Abstract
Context Patients on maintenance dialysis are more susceptible to COVID-19 and its severe form. We studied the mortality and associated risks of COVID-19 infection in dialysis patients in the state of Qatar. Methods This was an observational, analytical, retrospective, nationwide study. We included all adult patients on maintenance dialysis therapy who tested positive for COVID-19 (PCR assay of the nasopharyngeal swab) during the period from February 1, 2020, to July 19, 2020. Our primary outcome was to study the mortality of COVID-19 in dialysis patients in Qatar and risk factors associated with it. Our secondary objectives were to study incidence and severity of COVID-19 in dialysis patients and comparing outcomes between hemodialysis and peritoneal dialysis patients. Patient demographics and clinical features were collected from a national electronic medical record. Univariate Cox regression analysis was performed to evaluate potential risk factors for mortality in our cohort. Results 76 out of 1064 dialysis patients were diagnosed with COVID-19 (age 56±13.6, 56 hemodialysis and 20 peritoneal dialysis, 56 males). During the study period, 7.1% of all dialysis patients contracted COVID-19. Male dialysis patients had double the incidence of COVID-19 than females (9% versus 4.5% respectively; p<0.01). The most common symptoms on presentation were fever (57.9%), cough (56.6%), and shortness of breath (25%). Pneumonia was diagnosed in 72% of dialysis patients with COVID-19. High severity manifested as 25% of patients requiring admission to the intensive care unit, 18.4% had ARDS, 17.1% required mechanical ventilation, and 14.5% required inotropes. The mean length of hospital stay was 19.2 ± -12 days. Mortality due to COVID-19 among our dialysis cohort was 15%. Univariate Cox regression analysis for risk factors associated with COVID-19-related death in dialysis patients showed significant increases in risks with age (OR 1.077, CI 95%(1.018–1.139), p = 0.01), CHF and COPD (both same OR 8.974, CI 95% (1.039–77.5), p = 0.046), history of DVT (OR 5.762, CI 95% (1.227–27.057), p = 0.026), Atrial fibrillation (OR 7.285, CI 95%(2.029–26.150), p = 0.002), hypoxia (OR: 16.6; CI 95%(3.574–77.715), p = <0.001), ICU admission (HR30.8, CI 95% (3.9–241.2), p = 0.001), Mechanical ventilation (HR 50.07 CI 95% (6.4–391.2)), p<0.001) and using inotropes(HR 19.17, CI 95% (11.57–718.5), p<0.001). In a multivariate analysis, only ICU admission was found to be significantly associated with death [OR = 32.8 (3.5–305.4), p = 0.002)]. Conclusion This is the first study to be conducted at a national level in Qatar exploring COVID-19 in a dialysis population. Dialysis patients had a high incidence of COVID-19 infection and related mortality compared to previous reports of the general population in the state of Qatar (7.1% versus 4% and 15% versus 0.15% respectively). We also observed a strong association between death related to COVID-19 infection in dialysis patients and admission to ICU.
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Miller S, Wherry LR, Mazumder B. Estimated Mortality Increases During The COVID-19 Pandemic By Socioeconomic Status, Race, And Ethnicity. Health Aff (Millwood) 2021; 40:1252-1260. [PMID: 34288698 DOI: 10.1377/hlthaff.2021.00414] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This article estimates changes in all-cause mortality due to the COVID-19 pandemic by socioeconomic characteristics and occupation for nonelderly adults in the US, using large-scale, national survey data linked to administrative mortality records. Mortality increases were largest for adults living in correctional facilities or in health care-related group quarters, those without health insurance coverage, those with family incomes below the federal poverty level, and those in occupations with limited work-from-home options. For almost all subgroups, mortality increases were higher among non-Hispanic Black respondents than among non-Hispanic White respondents. Hispanic respondents with health insurance, those not living in group quarters, those with work-from-home options, and those in essential industries also experienced larger increases in mortality during the COVID-19 crisis compared with non-Hispanic Whites in those categories. Occupations that experienced the largest mortality increases were related to installation, maintenance, and repair and production. This research highlights the relevance of individual economic, social, and demographic characteristics during the COVID-19 crisis.
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Affiliation(s)
- Sarah Miller
- Sarah Miller is an assistant professor of business economics and public policy, Stephen M. Ross School of Business, University of Michigan, in Ann Arbor, Michigan
| | - Laura R Wherry
- Laura R. Wherry is an assistant professor of economics and public service in the Wagner Graduate School of Public Service, New York University, in New York, New York
| | - Bhashkar Mazumder
- Bhashkar Mazumder is a senior economist in the Economic Research Department, Federal Reserve Bank of Chicago, in Chicago, Illinois
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207
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Su C, Zhang Y, Flory JH, Weiner MG, Kaushal R, Schenck EJ, Wang F. Clinical subphenotypes in COVID-19: derivation, validation, prediction, temporal patterns, and interaction with social determinants of health. NPJ Digit Med 2021; 4:110. [PMID: 34262117 PMCID: PMC8280198 DOI: 10.1038/s41746-021-00481-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/21/2021] [Indexed: 02/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) is heterogeneous and our understanding of the biological mechanisms of host response to the viral infection remains limited. Identification of meaningful clinical subphenotypes may benefit pathophysiological study, clinical practice, and clinical trials. Here, our aim was to derive and validate COVID-19 subphenotypes using machine learning and routinely collected clinical data, assess temporal patterns of these subphenotypes during the pandemic course, and examine their interaction with social determinants of health (SDoH). We retrospectively analyzed 14418 COVID-19 patients in five major medical centers in New York City (NYC), between March 1 and June 12, 2020. Using clustering analysis, 4 biologically distinct subphenotypes were derived in the development cohort (N = 8199). Importantly, the identified subphenotypes were highly predictive of clinical outcomes (especially 60-day mortality). Sensitivity analyses in the development cohort, and rederivation and prediction in the internal (N = 3519) and external (N = 3519) validation cohorts confirmed the reproducibility and usability of the subphenotypes. Further analyses showed varying subphenotype prevalence across the peak of the outbreak in NYC. We also found that SDoH specifically influenced mortality outcome in Subphenotype IV, which is associated with older age, worse clinical manifestation, and high comorbidity burden. Our findings may lead to a better understanding of how COVID-19 causes disease in different populations and potentially benefit clinical trial development. The temporal patterns and SDoH implications of the subphenotypes may add insights to health policy to reduce social disparity in the pandemic.
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Affiliation(s)
- Chang Su
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Yongkang Zhang
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - James H Flory
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Mark G Weiner
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Rainu Kaushal
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
- New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA.
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
| | - Edward J Schenck
- New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA.
- Division of Pulmonary & Critical Care Medicine, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
| | - Fei Wang
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
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208
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Bergeron CD, Boolani A, Jansen EC, Smith ML. Practical Solutions to Address COVID-19-Related Mental and Physical Health Challenges Among Low-Income Older Adults. Front Public Health 2021; 9:674847. [PMID: 34322471 PMCID: PMC8311292 DOI: 10.3389/fpubh.2021.674847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/11/2021] [Indexed: 12/11/2022] Open
Abstract
Low-income older adults are disproportionately impacted by the COVID-19 pandemic. In this perspective article, we review the context in which low-income older people experience the pandemic and the mental and physical health consequences they have faced to date. Then, we offer practical solutions to help improve low-income older adults' sleep, physical activity, nutrition, and stress that require no or low financial commitment. We argue that governments, communities, and organizations should make greater efforts to promote healthy living for low-income older adults in times of health emergencies to ensure their ability to be universally adopted, regardless of income and resources.
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Affiliation(s)
- Caroline D. Bergeron
- Public Health Agency of Canada, Division of Aging, Seniors and Dementia, Ottawa, ON, Canada
- Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
| | - Ali Boolani
- Department of Physical Therapy, Clarkson University, Potsdam, NY, United States
- Department of Biology, Clarkson University, Potsdam, NY, United States
| | - Erica C. Jansen
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, MI, United States
| | - Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, United States
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209
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Ou MT, Boyarsky BJ, Zeiser LB, Po-Yu Chiang T, Ruddy J, Van Pilsum Rasmussen SE, Martin J, St Clair Russell J, Durand CM, Avery RK, Werbel WA, Cooper M, Massie AB, Segev DL, Garonzik-Wang JM. Kidney Transplant Recipient Attitudes Toward a SARS-CoV-2 Vaccine. Transplant Direct 2021; 7:e713. [PMID: 34131585 PMCID: PMC8196090 DOI: 10.1097/txd.0000000000001171] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/25/2021] [Accepted: 04/08/2021] [Indexed: 11/26/2022] Open
Abstract
A widely accepted severe acute respiratory syndrome 2 (SARS-CoV-2) vaccine could protect vulnerable populations, but the willingness of solid organ transplant recipients (SOTRs) to accept a potential vaccine remains unknown. METHODS We conducted a national survey of 1308 SOTRs and 1617 non-SOTRs between November 11 and December 2, 2020 through the network of the National Kidney Foundation. RESULTS Respondents were largely White (73.2%), female (61.1%), and college graduates (56.2%). Among SOTRs, half (49.5%) were unsure or would be unwilling to receive a SARS-CoV-2 vaccine once available. Major concerns included potential side effects (85.2%), lack of rigor in the testing and development process (69.7%), and fear of incompatibility with organ transplants (75.4%). Even after the announcement of the high efficacy of the mRNA-1273 vaccine (Moderna Inc.) at the time of survey distribution, likeliness to receive a vaccine only slightly increased (53.5% before announcement versus 57.8% after the announcement). However, 86.8% of SOTRs would accept a vaccine if recommended by a transplant provider. CONCLUSIONS SOTRs reported skepticism in receiving a potential SARS-CoV-2 vaccine, even after announcements of high vaccine efficacy. Reassuringly, transplant providers may be the defining influence in vaccine acceptance and will likely have a critical role to play in promoting vaccine adherence.
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Affiliation(s)
- Michael T Ou
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Brian J Boyarsky
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Laura B Zeiser
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Teresa Po-Yu Chiang
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jake Ruddy
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | | | | | - Christine M Durand
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Robin K Avery
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - William A Werbel
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Allan B Massie
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Dorry L Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
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Abstract
IMPORTANCE Socioeconomic factors in the disparities in COVID-19 outcomes have been reported in studies from the US and other Western countries. However, no studies have documented national- or subnational-level outcome disparities in Asian countries. OBJECTIVE To assess the association between regional COVID-19 outcome disparities and socioeconomic characteristics in Japan. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study collected and analyzed confirmed COVID-19 cases and deaths (through February 13, 2021) as well as population and socioeconomic data in all 47 prefectures in Japan. The data sources were government surveys for which prefecture-level data were available. EXPOSURES Prefectural socioeconomic characteristics included mean annual household income, Gini coefficient, proportion of the population receiving public assistance, educational attainment, unemployment rate, employment in industries with frequent close contacts with the public, household crowding, smoking rate, and obesity rate. MAIN OUTCOMES AND MEASURES Rate ratios (RRs) of COVID-19 incidence and mortality by prefecture-level socioeconomic characteristics. RESULTS All 47 prefectures in Japan (with a total population of 126.2 million) were included in this analysis. A total of 412 126 confirmed COVID-19 cases (326.7 per 100 000 people) and 6910 deaths (5.5 per 100 000 people) were reported as of February 13, 2021. Elevated adjusted incidence and mortality RRs of COVID-19 were observed in prefectures with the lowest household income (incidence RR: 1.45 [95% CI, 1.43-1.48] and mortality RR: 1.81 [95% CI, 1.59-2.07]); highest proportion of the population receiving public assistance (1.55 [95% CI, 1.52-1.58] and 1.51 [95% CI, 1.35-1.69]); highest unemployment rate (1.56 [95% CI, 1.53-1.59] and 1.85 [95% CI, 1.65-2.09]); highest percentage of workers in retail industry (1.36 [95% CI, 1.34-1.38] and 1.45 [95% CI, 1.31-1.61]), transportation and postal industries (1.61 [95% CI, 1.57-1.64] and 2.55 [95% CI, 2.21-2.94]), and restaurant industry (2.61 [95% CI, 2.54-2.68] and 4.17 [95% CI, 3.48-5.03]); most household crowding (1.35 [95% CI, 1.31-1.38] and 1.04 [95% CI, 0.87-1.24]); highest smoking rate (1.63 [95% CI, 1.60-1.66] and 1.54 [95% CI, 1.33-1.78]); and highest obesity rate (0.93 [95% CI, 0.91-0.95] and 1.17 [95% CI, 1.01-1.34]) compared with prefectures with the most social advantages. Among potential mediating variables, higher smoking rate (RR, 1.54; 95% CI, 1.33-1.78) and obesity rate (RR, 1.17; 95% CI, 1.01-1.34) were associated with higher mortality RRs, even after adjusting for prefecture-level covariates and other socioeconomic variables. CONCLUSIONS AND RELEVANCE This cross-sectional study found a pattern of socioeconomic disparities in COVID-19 outcomes in Japan that was similar to that observed in the US and Europe. National policy in Japan could consider prioritizing populations in socially disadvantaged regions in the COVID-19 response, such as vaccination planning, to address this pattern.
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Affiliation(s)
- Yuki Yoshikawa
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Al-Kuwari MG, Al-Nuaimi AA, Abdulmajeed J, Semaan S, Al-Romaihi HE, Kandy MC, Swamy S. COVID-19 infection across workplace settings in Qatar: a comparison of COVID-19 positivity rates of screened workers from March 1st until July 31st, 2020. J Occup Med Toxicol 2021; 16:21. [PMID: 34140020 PMCID: PMC8210512 DOI: 10.1186/s12995-021-00311-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 06/08/2021] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION COVID-19 transmission was significant amongst Qatar's working population during the March-July 2020 outbreak. The study aimed to estimate the risk of exposure for COVID-19 across various workplace settings and demographics in the State of Qatar. METHODS A cross-sectional study was conducted utilizing surveillance data of all workplaces with 10 or more laboratory-confirmed cases of COVID-19. These workplaces were categorized using a mapping table adapted from the North American Industry Classification System (NAICS) codes, 2017 version. The data was then analyzed to estimate and compare the positivity rate as an indicator of the risk of developing COVID-19 infection across various workplace settings in the State of Qatar. RESULTS The highest positivity rate was reported amongst the Construction & Related (40.0%) and the Retail & Wholesale Trade sectors (40.0%), whereas, the lowest positivity rate was attributed to the healthcare workplace setting (11.0%). The highest incidence of COVID-19 infections occurred in South Asian nationalities and in the male gender. The private funded sector employees have seen higher positivity rate than employees of the governmental funded sector. CONCLUSION The elevated risk of infection in Construction and Retail & Wholesale Trade is probably due to environmental and educational vulnerabilities. The predominant labor force of those workplace categories is South Asian craft and male manual workers. Alternatively, the better containment of the healthcare workplace setting can be attributed to the enforcement of infection control and occupational safety measures. These findings imply the importance of using preventive and surveillance strategies for high-risk workplace settings appropriately.
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212
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Sen-Crowe B, Lin IC, Alfaro R, McKenney M, Elkbuli A. COVID-19 fatalities by zip codes and socioeconomic indicators across various U.S. regions. Ann Med Surg (Lond) 2021; 67:102471. [PMID: 34150208 PMCID: PMC8196232 DOI: 10.1016/j.amsu.2021.102471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/30/2021] [Accepted: 06/04/2021] [Indexed: 02/08/2023] Open
Abstract
Background There is a paucity of literature addressing COVID-19 case-fatality ratios (CFR) by zip code (ZC). We aim to analyze trends in COVID-19 CFR, population density, and socioeconomic status (SES) indicators (unemployment, median household income) to identify ZCs heavily burdened by COVID-19. Methods Cross-sectional study to investigate the US prevalence of COVD-19 fatalities by ZC and SES. CFRs were calculated from state/county Departments of Health. Inclusion criteria were counties that reported cases/deaths by ZC and a CFR≥2%. This study was reported in line with the STROCSS criteria. Results 609/1,853 ZCs, spanning 327 counties in 7 states had CFRs ≥2%. A significant positive correlation was found between the CFR and median household income (Pearson correlation:0.107; 95% CI [289.1,1937.9]; p < 0.001). No significant correlations exist between the CFR, and population/mi (Sen-Crowe et al., 2020) [2] or unemployment rate. Significant associations exist between the CFR and young males and elderly females without public insurance. CFR was inversely associated with persons aged <44 and individuals aged ≥65. The percentage of nursing homes (NHs) within cities residing within high CFR ZCs range from 8.7% to 67.6%. Conclusion Significant positive association was found between the CFR and median household income. Population/mi (Sen-Crowe et al., 2020) [2] and unemployment rates, did not correlate to CFR. NHs were heavily distributed in high CFR zip codes. We recommend the targeted vaccination of zip codes with a large proportion of long-term care facilities. Finally, we recommend for improved screening and safety guidelines for vulnerable populations (e.g nursing home residents) and established protocols for when there is evidence of substantial infectious spread. First national sampling of COVID-19 Case Fatality Ratio (CFR) at the zip code level. Population density and unemployment rate did not correlate to COVID-19 CFR. Significant positive correlation was found between CFR and median household income. Nursing homes were concentrated in zip codes with high COVID-19 CFR. States should make COVID-19 data available at the zip code level.
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Affiliation(s)
- Brendon Sen-Crowe
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
| | - I-Chun Lin
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
| | - Robert Alfaro
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
| | - Mark McKenney
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA.,Department of Surgery, University of South Florida, Tampa, FL, USA
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA
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213
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Rontos K, Syrmali ME, Salvati L. Unravelling the Role of Socioeconomic Forces in the Early Stage of COVID-19 Pandemic: A Global Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126340. [PMID: 34208187 PMCID: PMC8296180 DOI: 10.3390/ijerph18126340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/06/2021] [Accepted: 06/09/2021] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has rapidly evolved into an acute health crisis with extensive socioeconomic and demographic consequences. The severity of the COVID-19 pandemic requires a refined (and more comprehensive) understanding of virus dissemination over space, transmission mechanisms, clinical features, and risk factors. In line with this assumption, the present study illustrates a comparative, empirical analysis of the role of socioeconomic and demographic dimensions in the early stages of the COVID-19 pandemic grounded on a large set of indicators comparing the background context across a global sample of countries. Results indicate that-in addition to epidemiological factors-basic socioeconomic forces significantly shaped contagions as well as hospitalization and death rates across countries. As a response to the global crisis driven by the COVID-19 pandemic, all-embracing access to healthcare services should be strengthened along with the development of sustainable health systems supported by appropriate resources and skills. The empirical findings of this study have direct implications for the coordination of on-going, global efforts aimed at containing COVID-19 (and other, future) pandemics.
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Affiliation(s)
- Kostas Rontos
- Department of Sociology, University of the Aegean and Greece, University Hill, 81100 Lesvos Mytilene, Greece; (K.R.); (M.-E.S.)
| | - Maria-Eleni Syrmali
- Department of Sociology, University of the Aegean and Greece, University Hill, 81100 Lesvos Mytilene, Greece; (K.R.); (M.-E.S.)
| | - Luca Salvati
- Department of Economics and Law, University of Macerata, Corso Cefalonia, 70, AP 63023 Fermo, Italy
- Correspondence:
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214
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Trends in COVID-19 Testing and Positivity Rates from a Mobile Testing Program in the Phoenix Metropolitan Area. J Community Health 2021; 46:1221-1225. [PMID: 34115310 PMCID: PMC8193177 DOI: 10.1007/s10900-021-01011-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 11/08/2022]
Abstract
The coronavirus (COVID-19) pandemic continues to be a global concern, with over 150 million cases worldwide. Arizona, which was recently a hotspot for COVID-19, has over 860 thousand cases. Reviewing the COVID-19 trends over time is crucial in understanding the pandemic and evaluating the impact of mitigation techniques. This current study analyzes the trends in COVID-19 testing and positivity rates from a mobile testing program in the Phoenix metropolitan area between December 2020 and April 2021. Of the 32,234 tests performed there was a total of 3654 COVID positive cases, yielding an overall positivity rate of 11.3%. COVID-19 positivity rates were significantly higher in December (12.9%) and January (12.7%), compared to February (7.5%), March (4.9%), and April (6.7%), p < 0.05. The peak of COVID-19 cases is likely attributable to the holiday season and family gatherings, followed by a steady decline, likely due to fewer gatherings and an increase in individuals receiving the COVID-19 vaccines. Continued public health measures, including vaccinations, are critical in reducing COVID-19 transmission.
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215
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Yoshikawa M, Asaba K. Educational Attainment Decreases the Risk of COVID-19 Severity in the European Population: A Two-Sample Mendelian Randomization Study. Front Public Health 2021; 9:673451. [PMID: 34150709 PMCID: PMC8212884 DOI: 10.3389/fpubh.2021.673451] [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] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/12/2021] [Indexed: 01/19/2023] Open
Abstract
Observational studies have reported that the severity of COVID-19 depends not only on physical conditions but also on socioeconomic status, including educational level. Because educational attainment (EA), which measures the number of years of schooling, is moderately heritable, we investigated the causal association of EA on the risk of COVID-19 severity using the Mendelian randomization (MR) approach. A two-sample MR analysis was performed using publicly available summary-level data sets of genome-wide association studies (GWASs). A total of 235 single-nucleotide polymorphisms (SNPs) were extracted as instrumental variables for the exposure of EA from the Social Science Genetic Association Consortium GWAS summary data of 766,345 participants of European ancestry. The effect of each SNP on the outcome of COVID-19 severity risk was obtained from the GWAS summary data of 1,059,456 participants of European ancestry gathered from the COVID-19 Host Genetics Initiative. Using inverse variance weighted method, our MR study shows that EA was significantly associated with a lower risk of COVID-19 severity (odds ratio per one standard deviation increase in years of schooling, 0.540; 95% confidence interval, 0.376–0.777, P = 0.0009). A series of sensitivity analyses showed little evidence of bias. In conclusion, we show for the first time using a two-sample MR approach the associations between higher EA and the lower risk of COVID-19 severity in the European population. However, the genetic or epidemiological mechanisms underlying the association between EA and the risk of COVID-19 severity remain unknown, and further studies are warranted to validate the MR findings and investigate underlying mechanisms.
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Affiliation(s)
- Masahiro Yoshikawa
- Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Kensuke Asaba
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan
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216
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Why We Can't Wait. REHABILITATION ONCOLOGY 2021. [DOI: 10.1097/01.reo.0000000000000267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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217
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Webb NE, Osburn TS. Characteristics of Hospitalized Children Positive for SARS-CoV-2: Experience of a Large Center. Hosp Pediatr 2021; 11:e133-e141. [PMID: 34011567 DOI: 10.1542/hpeds.2021-005919] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Define the spectrum of disease in pediatric inpatients with a positive SARS-CoV-2 test result in a manner relevant to pediatric hospital medicine. METHODS Retrospective case series of all patients aged <22 years hospitalized at our institution with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction test result between May 1, 2020, and September 30, 2020. Demographic, clinical, and outcome data were collected and analyzed. RESULTS Three distinct presentations were associated with acute SARS-CoV-2 positivity. Patients had incidental infection (40%), were potentially symptomatic (47%), or were significantly symptomatic (14%). The average length of stay differed between the significantly symptomatic group and the incidental and potentially symptomatic groups (P =.002). Average age differed among these groups, with significantly symptomatic patients older by >2 years. Fifty-five percent of incidental and 47% of potentially symptomatic patients had at least 1 identified comorbidity, whereas 90% of significantly symptomatic patients had at least 1 (P = .01). There was a significant relationship between obesity (P = .001) and asthma (P = .004) and severe disease. Additionally, there was a statistically significant difference between groups with respect to fever, hypoxia, supplemental oxygen use, duration of supplemental oxygen, and ICU admission, with a significantly higher percentage of patients in the significantly symptomatic group meeting each of these criteria (P < .001 for all categories). CONCLUSIONS Pediatric patients hospitalized with SARS-CoV-2 fall into distinct categories, which are critical to understanding the true pathology of SARS-Cov-2 as it relates to hospitalized pediatric patients. Most hospitalized patients who test positive for SARS-CoV-2 are asymptomatic or have a reason for hospitalization other than coronavirus disease 2019.
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Affiliation(s)
- Nicole E Webb
- Division of Hospital Medicine, Valley Children's Healthcare, Madera, California
| | - T Shea Osburn
- Division of Hospital Medicine, Valley Children's Healthcare, Madera, California
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218
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Clarke AC, Hull S, Semciw AI, Jessup RL, Campbell D, Fabri AM, Tully N, Bramston C, Hayes J. Descriptive Analysis of a Telephone Based Community Monitoring Service for COVID-19. J Community Health 2021; 46:1124-1131. [PMID: 33977436 PMCID: PMC8112833 DOI: 10.1007/s10900-021-00996-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 02/08/2023]
Abstract
The coronavirus disease (COVID-19) pandemic has required health services to rapidly respond to the needs of people diagnosed with the virus. Over 80% of people diagnosed with COVID-19 experience a mild illness and there is a need for community management to support these people in their home. In this paper we present, a telephone based COVID-19 community monitoring service developed in an Australian public health network, and we describe the rapid implementation of the service and the demographic and clinical characteristics of those enrolled. A retrospective mixed methods evaluation of the COVID-19 community monitoring service using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Eight hundred and fifty COVID-19 positive patients were enrolled, 54% female, 45% male, mean age 34 years SD 17. Four hundred and nine (48%) patients were born outside Australia. Among the 850 patients, 305 (36%) were classified as having a high risk of serious illness from COVID-19. The most prevalent risk factors were cardiovascular disease (37%), lung disease (30%) and age over 60 years (26%). The most common reported ongoing symptoms were fatigue (55%), breathing issues (26%) and mental health issues such as low mood (19%). There were no deaths in patients that participated in the service. The process of risk stratification undertaken with telephone triage was effective in determining risk of prolonged illness from COVID-19. Telephone monitoring by trained health professionals has a strong potential in the effective management of patients with a mild COVID-19 illness.
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Affiliation(s)
- A C Clarke
- Hospital Without Walls Directorate, Northern Health, 1231 Plenty Road, Bundoora, Melbourne, VIC, 3083, Australia.
| | - S Hull
- Hospital Without Walls Directorate, Northern Health, 1231 Plenty Road, Bundoora, Melbourne, VIC, 3083, Australia
| | - A I Semciw
- Allied Health Research, Northern Health, Melbourne, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - R L Jessup
- Allied Health Research, Northern Health, Melbourne, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.,School of Rural Health, Monash University, Warragul, Australia
| | - D Campbell
- Hospital Without Walls Directorate, Northern Health, 1231 Plenty Road, Bundoora, Melbourne, VIC, 3083, Australia
| | - A M Fabri
- Hospital Without Walls Directorate, Northern Health, 1231 Plenty Road, Bundoora, Melbourne, VIC, 3083, Australia
| | - N Tully
- Hospital Without Walls Directorate, Northern Health, 1231 Plenty Road, Bundoora, Melbourne, VIC, 3083, Australia
| | - C Bramston
- Hospital Without Walls Directorate, Northern Health, 1231 Plenty Road, Bundoora, Melbourne, VIC, 3083, Australia
| | - J Hayes
- Hospital Without Walls Directorate, Northern Health, 1231 Plenty Road, Bundoora, Melbourne, VIC, 3083, Australia
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219
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Demichelis-Gómez R, Alvarado-Ibarra M, Vasquez-Chávez J, Delgado-López N, Gómez-Cortés C, Espinosa-Bautista K, Cooke-Tapia A, Milán-Salvatierra A, Gómez-De León A, Lee-Tsai YL, Rosales-López D, Cabrera-García Á, Amador-Medina F, Córdoba-Ramírez A, Murrieta-Álvarez I, Solís-Poblano JC, Apodaca-Chávez E, Rangel-Patiño J, Álvarez-Vera JL, Arana-Luna L, De la Peña-Celaya JA, Espitia-Ríos ME, Hernández-Ruiz E, Pérez-Zúñiga JM, Peña-López E, González-Rivera R, García-Leyva MF, Tejeda-Romero M, Cruz-Rico J, Balderas-Delgado C, Ruíz-Argüelles GJ, Gómez-Almaguer D. Treating Acute Leukemia During the COVID-19 Pandemic in an Environment With Limited Resources: A Multicenter Experience in Four Latin American Countries. JCO Glob Oncol 2021; 7:577-584. [PMID: 33891480 PMCID: PMC8162972 DOI: 10.1200/go.20.00620] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America. METHODS Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020. RESULTS We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of cases. The main reason for such modifications was logistic issues (55.0%) and the most frequent modification was chemotherapy delay (42.0%). A total of 13.1% patients developed COVID-19 disease, with a mortality of 37.7%. Several factors were identified as independently associated with mortality, including a diagnosis of acute myeloid leukemia (odds ratio 2.38 [95% CI, 1.47 to 3.84]; P < .001), while the use of telemedicine was identified as a protective factor (odds ratio 0.36 [95% CI, 0.18 to 0.82]; P = .014). CONCLUSION These results highlight the collateral damage of COVID-19 in oncology patients.
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Affiliation(s)
| | | | | | - Nancy Delgado-López
- Hospital de Especialidades, Centro Médico Nacional siglo XXI, Mexico City, Mexico
| | - Cynthia Gómez-Cortés
- Hospital de Especialidades, Centro Médico Nacional siglo XXI, Mexico City, Mexico
| | | | - Ana Cooke-Tapia
- Complejo Hospitalario Doctor Arnulfo Arias Madrid, Panama, Panama
| | | | - Andrés Gómez-De León
- Universidad Autónoma de Nuevo Léon, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | | | | | | | | | | | | | | | - Elia Apodaca-Chávez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Juan Rangel-Patiño
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Luara Arana-Luna
- Centro Médico Nacional 20 de noviembre, ISSSTE, Mexico City, Mexico
| | | | | | | | | | | | - Rosa González-Rivera
- Hospital de Especialidades, Centro Médico Nacional siglo XXI, Mexico City, Mexico
| | | | | | | | | | | | - David Gómez-Almaguer
- Universidad Autónoma de Nuevo Léon, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
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220
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Sulyok M, Walker MD. Mobility and COVID-19 mortality across Scandinavia: A modeling study. Travel Med Infect Dis 2021; 41:102039. [PMID: 33785456 PMCID: PMC7999697 DOI: 10.1016/j.tmaid.2021.102039] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND In response to COVID-19, the Swedish government imposed few travel and mobility restrictions. This contrasted with its Scandinavian neighbours which implemented stringent restrictions. The influence these different approaches had on mobility, and thus on COVID-19 mortality was investigated. METHODS Datasets indicating restriction severity and community mobility were examined; Google's 'Community Movement Reports' (CMR) show activity at key location categories; the Oxford COVID-19 Government Response Tracker collates legislative restrictions into a 'Stringency Index' (SI). RESULTS CMR mobility categories were negatively correlated with COVID-19 mortality. The strongest correlations were obtained by negatively time lagging mortality data, suggesting restrictions had a delayed influence. During the 'first wave' a model using SI (AIC 632.87) proved favorable to one using contemporaneous CMR data and SI (AIC 1193.84), or lagged CMR data and SI (AIC 642.35). Validation using 'second wave' data confirmed this; the model using SI solely again being optimal (RMSE: 0.2486 vs. 0.522 and 104.62). Cross-country differences were apparent in all models; Swedish data, independent of SI and CMR, proved significant throughout. There was a significant association for Sweden and the death number across models. CONCLUSION SI may provide a broader, more accurate, representation of changes in movement in response to COVID-19 restrictions.
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Affiliation(s)
- Mihály Sulyok
- Institute of Tropical Medicine, Eberhard Karls University, University Clinics Tübingen, Wilhelmstr. 27, 72074, Tübingen, Germany; Institute of Pathology and Neuropathology, Department of Pathology, Eberhard Karls University, University Clinics Tübingen, Liebermeisterstr. 8, 72076, Tübingen, Germany
| | - Mark David Walker
- Department of the Natural and Built Environment, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB, United Kingdom.
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221
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Petersen JA, Naish C, Ghoneim D, Cabaj JL, Doyle-Baker PK, McCormack GR. Impact of the COVID-19 Pandemic on Physical Activity and Sedentary Behaviour: A Qualitative Study in a Canadian City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4441. [PMID: 33922094 PMCID: PMC8122654 DOI: 10.3390/ijerph18094441] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 12/19/2022]
Abstract
Public health measures introduced to combat the COVID-19 pandemic have impacted the physical activity, health, and well-being of millions of people. This grounded theory study explored how the COVID-19 pandemic has affected physical activity and perceptions of health among adults in a Canadian city (Calgary). Twelve adults (50% females; 20-70 years) were interviewed between June and October (2020) via telephone or videoconferencing. Using a maximum variation strategy, participants with a range of sociodemographic characteristics, physical activity levels, and perceptions of seriousness and anxiety related to COVID-19 were selected. Semi-structured interviews captured participant perceptions of how their physical activity and perceptions of health changed during the pandemic. Using thematic analysis, four themes were identified: (1) Disruption to Daily Routines, (2) Changes in Physical Activity, (3) Balancing Health, and (4) Family Life. Participants experienced different degrees of disruption in their daily routines and physical activity based on their individual circumstances (e.g., pre-pandemic physical activity, family life, and access to resources). Although participants faced challenges in modifying their daily routines and physical activity, many adapted. Some participants reported enhanced feelings of well-being. Public health strategies that encourage physical activity and promote health should be supported as they are needed during pandemics, such as COVID-19.
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Affiliation(s)
- Jennie A. Petersen
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (C.N.); (D.G.); (J.L.C.); (G.R.M.)
- Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Calli Naish
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (C.N.); (D.G.); (J.L.C.); (G.R.M.)
- Department of Communication, Media and Film, Faculty of Arts, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Dalia Ghoneim
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (C.N.); (D.G.); (J.L.C.); (G.R.M.)
| | - Jason L. Cabaj
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (C.N.); (D.G.); (J.L.C.); (G.R.M.)
- Provincial Population & Public Health, Alberta Health Services, 10301 Southport Lane SW, Calgary, AB T2W 1S7, Canada
| | - Patricia K. Doyle-Baker
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
- School of Planning, Architecture, and Landscape, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Gavin R. McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (C.N.); (D.G.); (J.L.C.); (G.R.M.)
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
- School of Planning, Architecture, and Landscape, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
- Faculty of Sport Sciences, Waseda University, 1-104 Totsukamachi, Shinjuku-ku, Tokyo 169-8050, Japan
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222
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Bubbico L, Bellizzi S, Ferlito S, Cegolon L. The role of social medicine in the COVID-19 pandemic era. J Glob Health 2021; 11:03068. [PMID: 33884190 PMCID: PMC8053395 DOI: 10.7189/jogh.11.03068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Luciano Bubbico
- Department of Sensorineural Disabilities, INAPP/Italian Institute of Social Medicine, Rome, Italy
| | - Saverio Bellizzi
- Medical Epidemiologist, Independent Consultant, Geneva, Switzerland
| | - Salvatore Ferlito
- University of Catania School of Medicine, Department of Surgical Medical Sciences and Advanced Technologies, Catania, Italy
| | - Luca Cegolon
- Local Health Unit N.2 "Marca Trevigiana", Public Health Department, Treviso, Italy
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223
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Bechard LE, Bergelt M, Neudorf B, DeSouza TC, Middleton LE. Using the Health Belief Model to Understand Age Differences in Perceptions and Responses to the COVID-19 Pandemic. Front Psychol 2021; 12:609893. [PMID: 33935865 PMCID: PMC8082183 DOI: 10.3389/fpsyg.2021.609893] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/19/2021] [Indexed: 11/13/2022] Open
Abstract
COVID-19 severity and mortality risk are greater for older adults whereas economic impact is deeper for younger adults. Using the Health Belief Model (HBM) as a framework, this study used a web-based survey to examine how perceived COVID-19 susceptibility and severity and perceived efficacy of recommended health behaviors varied by age group and were related to the adoption of health behaviors. Proportional odds logistic regression was used to examine the relationship between age group and perceived COVID-19 susceptibility, severity, impact, and health behavior efficacy and adoption. Structural equation modeling based on HBM constructs examined the relationships between health beliefs and behaviors. Data from 820 participants (Ontario, Canada) were analyzed (age: 42.7, 16.2 years; 79% women). Middle-aged and older adults reported greater concerns about the personal risk of hospitalization and mortality, economic impact, and social impact of COVID-19 than young adults. Middle-aged adults also reported greatest concern for other age groups. Adoption and perceived efficacy of health behaviors was similar across age groups with few exceptions. Both middle-aged and older-adults were more likely to perceive their own and each other's age groups as responding adequately to COVID-19 compared to young adults. Structural equation modeling indicated perceived benefits of health behaviors were the primary driver of behavior uptake, with socioeconomic factors and perceived severity and susceptibility indirectly associated with uptake through their influence on perceived benefits. Overall, these results suggest adoption of health behaviors is very high with few differences between age groups, despite differences in perceived impact of COVID-19. Public health communications should focus on the benefits of health behaviors to drive adoption.
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Affiliation(s)
- Lauren E Bechard
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | | | - Bobby Neudorf
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Tamara C DeSouza
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Laura E Middleton
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
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224
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Jung E, Ro YS, Ryu HH, Shin SD, Moon S. Interaction Effects between COVID-19 Outbreak and Community Income Levels on Excess Mortality among Patients Visiting Emergency Departments. J Korean Med Sci 2021; 36:e100. [PMID: 33821595 PMCID: PMC8021976 DOI: 10.3346/jkms.2021.36.e100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/25/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The objective of this study was to examine the effect of the coronavirus disease 2019 (COVID-19) outbreak on excess in-hospital mortality among patients who visited emergency departments (EDs) and to assess whether the excess mortality during the COVID-19 pandemic varies by community income level. METHODS This is a cross-sectional study using the National Emergency Department Information System (NEDIS) database in Korea. The study population was defined as patients who visited all 402 EDs with medical conditions other than injuries between January 27 and May 31, 2020 (after-COVID) and for the corresponding time period in 2019 (before-COVID). The primary outcome was in-hospital mortality. The main exposure was the COVID-19 outbreak, and the interaction variable was county per capita income tax. We calculated the risk-adjusted in-hospital mortality rates by COVID-19 outbreak, as well as the difference-in-difference of risk-adjusted rates between the before-COVID and after-COVID groups according to the county income tax using a multilevel linear regression model with the interaction term. RESULTS A total of 11,662,167 patients (6,765,717 in before-COVID and 4,896,450 in after-COVID) were included in the study with a 1.6% crude in-hospital mortality rate. The risk-adjusted mortality rate in the after-COVID group was higher than that in the before-COVID group (1.82% vs. 1.50%, difference: 0.31% [0.30 to 0.33]; adjusted odds ratio: 1.22 [1.18 to 1.25]). The excess in-hospital mortality rate of the after-COVID in the lowest quartile group of county income tax was significantly higher than that in the highest quartile group (difference-in-difference: 0.18% (0.14 to 0.23); P-for-interaction: < 0.01). CONCLUSION During the COVID-19 pandemic, there was excess in-hospital mortality among patients who visited EDs, and there were disparities in excess mortality depending on community socioeconomic positions.
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Affiliation(s)
- Eujene Jung
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Young Sun Ro
- National Emergency Medical Center, National Medical Center, Seoul, Korea
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.
| | - Hyun Ho Ryu
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sungwoo Moon
- National Emergency Medical Center, National Medical Center, Seoul, Korea
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Korea
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Bery AI, Kulkarni HS, Kreisel D. Editorial: COVID-19 immunology and organ transplantation. Curr Opin Organ Transplant 2021; 26:258-265. [PMID: 33651004 PMCID: PMC8297460 DOI: 10.1097/mot.0000000000000862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW The aim of this study was to provide a critical appraisal of the literature on the effects of the COVID-19 pandemic on organ transplantation, with a specific focus on lung transplantation given the predominant pulmonary involvement of the virus. RECENT FINDINGS There was a significant decrease in lung transplant volumes during the first wave of the COVID-19 pandemic due to a combination of reduced availability of donors and an imbalance between waitlist additions and inactivations. SARS-CoV-2 infection was subsequently associated with an exuberant immune response that can lead to the development of postinfectious fibrotic lung disease. Few lung transplants have been performed in previously infected recipients and long-term outcomes remain unknown. Although the lung transplant volume rebounded during the second wave, it is unclear what the long-term effects of healthcare resource limitation and public health measures will have on transplant volumes in the future. Outcomes after SARS-CoV-2 infection in previous lung transplant recipients appear to be worse than the general public, and, although an immunosuppressed state likely contributes to these outcomes, whether immunosuppression should be altered in those exposed to or infected with SARS-CoV-2 remains unanswered in the absence of unequivocal data. SUMMARY The COVID-19 pandemic has presented a number of challenges for lung transplant programs across the globe. Multiple research questions remain to be answered in order to optimally manage lung transplant recipients in the context of this pandemic.
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Affiliation(s)
- Amit I Bery
- Division of Pulmonary and Critical Care Medicine, Department of Medicine
| | | | - Daniel Kreisel
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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226
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Boden M, Zimmerman L, Azevedo KJ, Ruzek JI, Gala S, Abdel Magid HS, Cohen N, Walser R, Mahtani ND, Hoggatt KJ, McLean CP. Addressing the mental health impact of COVID-19 through population health. Clin Psychol Rev 2021; 85:102006. [PMID: 33714167 PMCID: PMC7934657 DOI: 10.1016/j.cpr.2021.102006] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 12/17/2022]
Abstract
The COVID-19 pandemic has and will continue to result in negative mental health outcomes such as depression, anxiety and traumatic stress in people and populations throughout the world. A population mental health perspective informed by clinical psychology, psychiatry and dissemination and implementation science is ideally suited to address the broad, multi-faceted and long-lasting mental health impact of the pandemic. Informed by a systematic review of the burgeoning empirical research on the COVID-19 pandemic and research on prior coronavirus pandemics, we link pandemic risk factors, negative mental health outcomes and appropriate intervention strategies. We describe how social risk factors and pandemic stressors will contribute to negative mental health outcomes, especially among vulnerable populations. We evaluate the scalability of primary, secondary and tertiary interventions according to mental health target, population, modality, intensity and provider type to provide a unified strategy for meeting population mental health needs. Traditional models, in which evidence-based therapies delivered are delivered in-person, by a trained expert, at a specialty care location have proved difficult to scale. The use of non-traditional models, tailoring preventive interventions to populations based on their needs, and ongoing coordinated evaluation of intervention implementation and effectiveness will be critical to refining our efforts to increase reach.
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Affiliation(s)
- Matt Boden
- Center for Innovation to Implementation, VA Palo Alto Healthcare System, United States of America.
| | - Lindsey Zimmerman
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Care Healthcare System, United States of America; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States of America; Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Kathryn J Azevedo
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Care Healthcare System, United States of America
| | - Josef I Ruzek
- Center for m2 Health, Palo Alto University, Palo Alto, CA, United States of America; Department of Psychology, University of Colorado, Colorado Springs, United States of America
| | - Sasha Gala
- Mission Rock Enterprise, LLC, United States of America
| | - Hoda S Abdel Magid
- Department of Epidemiology and Population Health, Stanford University, United States of America
| | - Nichole Cohen
- Department of Psychology, University of Kansas, United States of America
| | - Robyn Walser
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Care Healthcare System, United States of America; University of California, Berkeley, United States of America
| | - Naina D Mahtani
- Center for Innovation to Implementation, VA Palo Alto Healthcare System, United States of America; School of Behavioral Health, Loma Linda University, United States of America
| | - Katherine J Hoggatt
- San Francisco VA Health Care System, United States of America; Department of Medicine, University of California, San Francisco, United States of America
| | - Carmen P McLean
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Care Healthcare System, United States of America; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States of America
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227
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Sandhu A, Korzeniewski SJ, Polistico J, Pinnamaneni H, Reddy SN, Oudeif A, Meyers J, Sidhu N, Levy P, Samavati L, Badr M, Sobel JD, Sherwin R, Chopra T. Elevated COVID19 mortality risk in detroit area hospitals among patients from census tracts with extreme socioeconomic vulnerability. EClinicalMedicine 2021; 34:100814. [PMID: 33842873 PMCID: PMC8022031 DOI: 10.1016/j.eclinm.2021.100814] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/01/2021] [Accepted: 03/15/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND the incidence of novel coronavirus disease (COVID19) is elevated in areas with heightened socioeconomic vulnerability. Early reports from US hospitals also implicated social disadvantage and chronic disease history as COVID19 mortality risk factors. However, the relationship between race and COVID19 mortality remains unclear. METHODS we examined in-hospital COVID19 mortality risk factors in a multi-hospital tertiary health care system that serves greater Detroit, Michigan, a predominantly African American city with high rates of poverty and chronic disease. Consecutive adult patients who presented to emergency departments and tested positive for COVID19 from 3/11/2020 through 4/18/2020 were included. Using log-binomial regression, we assessed the relationship between in-hospital mortality and residence in census tracts that were flagged for extreme socioeconomic vulnerability, patient-level demographics, and clinical comorbidities. FINDINGS a total of 1,015 adults tested positive for COVID19 during the study period; 80% identified as Black people, 52% were male and 53% were ≥ 65 years of age. The median body mass index was 30•4 and the median Charlson Comorbidity Index score was 4. Patients from census tracts that were flagged for vulnerability related to socioeconomic status had a higher mortality rate than their peers who resided in less vulnerable census tracts (β 0.26, standard error (SE) 0.11, degrees of freedom (df) 378, t-value (t) 2.27, exp(β) 1.29, p-value 0.02). Adjustment for age category, Black race, sex and/or the Charlson Comorbidity Index score category reduced the magnitude of association by less than 10% [exp(β) 1.29 vs. 1.21]. Black race [p = 0.38] and sex [p = 0.62] were not associated with mortality in this sample. INTERPRETATION people who lived in areas flagged for extreme socioeconomic vulnerability had elevated mortality risk in our predominantly African-American cohort of COVID19 patients who were able to seek hospital care during the so-called 'first wave' of the pandemic. By contrast, Black race was not associated with mortality in our sample.
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Affiliation(s)
- Avnish Sandhu
- Department of Internal Medicine, Division of Infectious Diseases, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, United States
| | - Steven J. Korzeniewski
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, United States
- Corresponding authors.
| | - Jordan Polistico
- Department of Internal Medicine, Division of Infectious Diseases, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, United States
| | | | | | - Ahmed Oudeif
- Wayne State University School of Medicine, Detroit, MI, United States
| | - Jessica Meyers
- Wayne State University School of Medicine, Detroit, MI, United States
| | - Nikki Sidhu
- Wayne State University School of Medicine, Detroit, MI, United States
| | - Phillip Levy
- Department of Emergency Medicine, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, United States
| | - Lobelia Samavati
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, United States
| | - M.Safwan Badr
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, United States
| | - Jack D. Sobel
- Department of Internal Medicine, Division of Infectious Diseases, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, United States
| | - Robert Sherwin
- Department of Emergency Medicine, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, United States
| | - Teena Chopra
- Department of Internal Medicine, Division of Infectious Diseases, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, United States
- Corresponding authors.
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228
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Inselman JW, Rank MA, Zawada SK, Jeffery MM. Which people with asthma are most likely to be hospitalized with COVID-19 in the United States? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2080-2082. [PMID: 33684636 PMCID: PMC7934792 DOI: 10.1016/j.jaip.2021.02.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Jonathan W Inselman
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minn
| | - Matthew A Rank
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minn; Division of Allergy, Asthma, and Clinical Immunology, Mayo Clinic, Scottsdale, Ariz; Division of Pulmonology, Phoenix Children's Hospital, Phoenix, Ariz.
| | - Stephanie K Zawada
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minn
| | - Molly M Jeffery
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minn
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229
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Talbot LR, Romeiser JL, Spitzer ED, Gan TJ, Singh SM, Fries BC, Bennett-Guerrero E. Prevalence of IgM and IgG antibodies to SARS-CoV-2 in health care workers at a tertiary care New York hospital during the Spring COVID-19 surge. Perioper Med (Lond) 2021; 10:7. [PMID: 33648573 PMCID: PMC7920632 DOI: 10.1186/s13741-021-00177-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/31/2021] [Indexed: 02/08/2023] Open
Abstract
Background Health care workers (HCW) such as anesthesiologists, surgeons, and intensivists face high rates of exposure to SARS-CoV-2 through direct contact with COVID-19 patients. While there are initial reports of the prevalence of COVID-19 antibodies among the general population, there are few reports comparing the seroprevalence of IgM/IgG COVID-19 antibodies in HCW of different exposure levels as well as different HCW professions. Methods A convenience sample of health care workers provided blood for COVID-19 antibody testing and a review of medical history and work exposure for correlative analyses. Results Overall, 474 HCW were enrolled in April 2020 including 102 front-line physicians (e.g., anesthesiologists, surgeons, intensivists, emergency medicine), 91 other physicians, 135 nurses, 134 other clinical staff, and 12 non-clinical HCW. The prevalence of IgM or IgG antibodies to SARS-CoV-2 was 16.9% (95% CI 13.6–20.6) (80/474). The proportion of positive antibodies in the PCR + group was significantly higher than health care workers without symptoms (84.6% [95% CI 54.6–98.1] vs. 12.3% [95% CI 8.5–17.2], p < 0.001). No significant differences in proportions of COVID-19 antibodies were observed among the different exposure groups (e.g., high vs minimal/no exposure) and among the different HCW professionals. Conclusions Despite exposure to COVID-19 patients, the prevalence of antibodies in our HCW was similar to what has been reported for the general population of New York State (14%) and for another New York HCW cohort (13.7%). Health care workers with higher exposure rates were not more likely to have been infected with COVID-19. Therefore, these data suggest that infection of HCW may result from exposure in the community rather than at work. Trial registration This investigator-initiated study was observational; therefore, no registration was required. Not applicable. Supplementary Information The online version contains supplementary material available at 10.1186/s13741-021-00177-5.
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Affiliation(s)
| | | | - Eric D Spitzer
- Renaissance Stony Brook School of Medicine, Stony Brook, USA
| | - Tong J Gan
- Renaissance Stony Brook School of Medicine, Stony Brook, USA
| | - Sunitha M Singh
- Renaissance Stony Brook School of Medicine, Stony Brook, USA
| | - Bettina C Fries
- Renaissance Stony Brook School of Medicine, Stony Brook, USA.,U.S. Department of Veterans Affairs - Northport VA Medical Center, Northport, NY, USA
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230
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Filgueira TO, Castoldi A, Santos LER, de Amorim GJ, de Sousa Fernandes MS, Anastácio WDLDN, Campos EZ, Santos TM, Souto FO. The Relevance of a Physical Active Lifestyle and Physical Fitness on Immune Defense: Mitigating Disease Burden, With Focus on COVID-19 Consequences. Front Immunol 2021; 12:587146. [PMID: 33613573 PMCID: PMC7892446 DOI: 10.3389/fimmu.2021.587146] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/13/2021] [Indexed: 12/15/2022] Open
Abstract
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a fast spreading virus leading to the development of Coronavirus Disease-2019 (COVID-19). Severe and critical cases are characterized by damage to the respiratory system, endothelial inflammation, and multiple organ failure triggered by an excessive production of proinflammatory cytokines, culminating in the high number of deaths all over the world. Sedentarism induces worse, continuous, and progressive consequences to health. On the other hand, physical activity provides benefits to health and improves low-grade systemic inflammation. The aim of this review is to elucidate the effects of physical activity in physical fitness, immune defense, and its contribution to mitigate the severe inflammatory response mediated by SARS-CoV-2. Physical exercise is an effective therapeutic strategy to mitigate the consequences of SARS-CoV-2 infection. In this sense, studies have shown that acute physical exercise induces the production of myokines that are secreted in tissues and into the bloodstream, supporting its systemic modulatory effect. Therefore, maintaining physical activity influence balance the immune system and increases immune vigilance, and also might promote potent effects against the consequences of infectious diseases and chronic diseases associated with the development of severe forms of COVID-19. Protocols to maintain exercise practice are suggested and have been strongly established, such as home-based exercise (HBE) and outdoor-based exercise (OBE). In this regard, HBE might help to reduce levels of physical inactivity, bed rest, and sitting time, impacting on adherence to physical activity, promoting all the benefits related to exercise, and attracting patients in different stages of treatment for COVID-19. In parallel, OBE must improve health, but also prevent and mitigate COVID-19 severe outcomes in all populations. In conclusion, HBE or OBE models can be a potent strategy to mitigate the progress of infection, and a coadjutant therapy for COVID-19 at all ages and different chronic conditions.
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Affiliation(s)
| | - Angela Castoldi
- Keizo Asami Immunopathology Laboratory, Universidade Federal de Pernambuco, Recife, Brazil
| | - Lucas Eduardo R. Santos
- Pós Graduação em Educação Física, Universidade Federal de Pernambuco, Recife, Brazil
- Pós Graduação em Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco, Recife, Brazil
| | - Geraldo José de Amorim
- Keizo Asami Immunopathology Laboratory, Universidade Federal de Pernambuco, Recife, Brazil
- Serviço de Nefrologia do Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Matheus Santos de Sousa Fernandes
- Pós Graduação em Educação Física, Universidade Federal de Pernambuco, Recife, Brazil
- Pós Graduação em Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco, Recife, Brazil
| | | | | | - Tony Meireles Santos
- Pós Graduação em Educação Física, Universidade Federal de Pernambuco, Recife, Brazil
| | - Fabrício Oliveira Souto
- Keizo Asami Immunopathology Laboratory, Universidade Federal de Pernambuco, Recife, Brazil
- Núcleo de Ciências da Vida, Centro Acadêmico do Agreste, Universidade Federal de Pernambuco, Caruaru, Brazil
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231
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Wirawan GBS, Januraga PP. Correlation of Demographics, Healthcare Availability, and COVID-19 Outcome: Indonesian Ecological Study. Front Public Health 2021; 9:605290. [PMID: 33598443 PMCID: PMC7882903 DOI: 10.3389/fpubh.2021.605290] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/05/2021] [Indexed: 01/19/2023] Open
Abstract
Objective: To analyze the correlation between demographic and healthcare availability indicators with COVID-19 outcome among Indonesian provinces. Methods: We employed an ecological study design to study the correlation between demographics, healthcare availability, and COVID-19 indicators. Demographic and healthcare indicators were obtained from the Indonesian Health Profile of 2019 by the Ministry of Health while COVID-19 indicators were obtained from the Indonesian COVID-19 website in August 31st 2020. Non-parametric correlation and multivariate regression analyses were conducted with IBM SPSS 23.0. Results: We found the number of confirmed cases and case growth to be significantly correlated with demographic indicators, especially with distribution of age groups. Confirmed cases and case growth was significantly correlated (p < 0.05) with population density (correlation coefficient of 0.461 and 0.491) and proportion of young people (-0.377; -0.394). Incidence and incidence growth were correlated with ratios of GPs (0.426; 0.534), hospitals (0.376; 0.431), primary care clinics (0.423; 0.424), and hospital beds (0.472; 0.599) per capita. For mortality, case fatality rate (CFR) was correlated with population density (0.390) whereas mortality rate was correlated with ratio of hospital beds (0.387). Multivariate analyses found confirmed case independently associated with population density (β of 0.638) and demographic structure (-0.289). Case growth was independently associated with density (0.763). Incidence growth was independently associated with hospital bed ratio (0.486). Conclusion: Pre-existing inequality of healthcare availability correlates with current reported incidence and mortality rate of COVID-19. Lack of healthcare availability in some provinces may have resulted in artificially low numbers of cases being diagnosed, lower demands for COVID-19 tests, and eventually lower case-findings.
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Affiliation(s)
| | - Pande Putu Januraga
- Center for Public Health Innovation, Faculty of Medicine, Udayana University, Bali, Indonesia
- Discipline of Public Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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232
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Maripuu M, Bendix M, Öhlund L, Widerström M, Werneke U. Death Associated With Coronavirus (COVID-19) Infection in Individuals With Severe Mental Disorders in Sweden During the Early Months of the Outbreak-An Exploratory Cross-Sectional Analysis of a Population-Based Register Study. Front Psychiatry 2021; 11:609579. [PMID: 33488430 PMCID: PMC7819873 DOI: 10.3389/fpsyt.2020.609579] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/07/2020] [Indexed: 01/04/2023] Open
Abstract
Background: Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population. We set up a population-based study to assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD. Methods: Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymized tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four comorbidities, namely diabetes, cardiovascular disease, hypertension, chronic lung disease. Results: The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4,945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p < 0.001). The odds were 4-fold for the age groups between 60 and 79 years and 1.5-fold for cardiovascular diseases. Individuals with SMD without any of the risk factors under study had 3-fold odds of COVID-19 associated death. Conclusion: Our preliminary results identify individuals with SMD as a further group at increased risk of COVID-19 associated death. In regard to comorbidities, future studies should explore the potential confounding or mediation role in the relationship between SMD and COVID-19 associated deaths.
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Affiliation(s)
- Martin Maripuu
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Marie Bendix
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden
- Department of Clinical Neuroscience, Center for Psychiatry Research & Stockholm Health Care Services, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden
| | - Louise Öhlund
- Division of Psychiatry, Sunderby Research Unit, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | | | - Ursula Werneke
- Division of Psychiatry, Sunderby Research Unit, Department of Clinical Sciences, Umeå University, Umeå, Sweden
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233
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Hassaan MA, Abdelwahab RG, Elbarky TA, Ghazy RM. GIS-Based Analysis Framework to Identify the Determinants of COVID-19 Incidence and Fatality in Africa. J Prim Care Community Health 2021; 12:21501327211041208. [PMID: 34435530 PMCID: PMC8404668 DOI: 10.1177/21501327211041208] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/30/2021] [Accepted: 07/31/2021] [Indexed: 12/22/2022] Open
Abstract
Corona virus diseases 2019 (COVID-19) pandemic is an extraordinary threat with significant implications in all aspects of human life; therefore, it represents the most immediate challenge for the countries all over the world. This study, hence, is intended to identify the best GIS-based model that can explore, quantify, and model the determinants of COVID-19 incidence and fatality. For this purpose, geospatial models were developed to estimate COVID-19 incidence and fatality rates in Africa, up to 16th of August 2020 at the national level. The models involved Ordinary Least Squares (OLS) and Geographically Weighted Regression (GWR) analysis using ArcGIS. Spatial autocorrelation analysis recorded a positive spatial autocorrelation in COVID-19 incidence (Moran index 0.16, P = 0.1) and fatality (Moran index 0.26, P = 0.01) rates within different African countries. GWR model had higher R2 than OLS for prediction of incidence and mortality (58% vs 45% and 55% vs 53%). The main predictors of COVID-19 incidence rate were overcrowding, health expenditure, HIV infections, air pollution, and BCG vaccination (mean β = 3.10, 1.66, 0.01, 3.79, and -66.60 respectively, P < 0.05). The main determinants of COVID-19 fatality were prevalence of bronchial asthma, tobacco use, poverty, aging, and cardiovascular diseases fatality (mean β = 0.00162, 0.00004, -0.00025, -0.00144, and -0.00027 respectively, P < 0.05). Application of the suggested model can assist in guiding intervention strategies, particularly at the local and community level whenever the data on COVID-19 cases and predictors variables are available.
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Affiliation(s)
| | | | - Toka A. Elbarky
- Institute of Graduate Studies & Research, Alexandria University Egypt
| | - Ramy Mohamed Ghazy
- High Institute of Public Health, Alexandria University, Alexandria, Egypt
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234
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Lin C, Tu P, Beitsch LM. Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review. Vaccines (Basel) 2020; 9:16. [PMID: 33396832 PMCID: PMC7823859 DOI: 10.3390/vaccines9010016] [Citation(s) in RCA: 481] [Impact Index Per Article: 120.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/22/2020] [Accepted: 12/29/2020] [Indexed: 12/31/2022] Open
Abstract
While COVID-19 continues raging worldwide, effective vaccines are highly anticipated. However, vaccine hesitancy is widespread. Survey results on uptake intentions vary and continue to change. This review compared trends and synthesized findings in vaccination receptivity over time across US and international polls, assessing survey design influences and evaluating context to inform policies and practices. Data sources included academic literature (PubMed, Embase, and PsycINFO following PRISMA guidelines), news and official reports published by 20 October 2020. Two researchers independently screened potential peer-reviewed articles and syndicated polls for eligibility; 126 studies and surveys were selected. Declining vaccine acceptance (from >70% in March to <50% in October) with demographic, socioeconomic, and partisan divides was observed. Perceived risk, concerns over vaccine safety and effectiveness, doctors' recommendations, and inoculation history were common factors. Impacts of regional infection rates, gender, and personal COVID-19 experience were inconclusive. Unique COVID-19 factors included political party orientation, doubts toward expedited development/approval process, and perceived political interference. Many receptive participants preferred to wait until others have taken the vaccine; mandates could increase resistance. Survey wording and answer options showed influence on responses. To achieve herd immunity, communication campaigns are immediately needed, focusing on transparency and restoring trust in health authorities.
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Affiliation(s)
- Cheryl Lin
- Policy and Organizational Management Program, Duke University, 2204 Erwin Rd, Durham, NC 27705, USA;
| | - Pikuei Tu
- Policy and Organizational Management Program, Duke University, 2204 Erwin Rd, Durham, NC 27705, USA;
| | - Leslie M. Beitsch
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, 1115 W. Call St, Tallahassee, FL 32306, USA;
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