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Aveyard J, Richards S, Li M, Pitt G, Hughes GL, Akpan A, Akhtar R, Kazaili A, D'Sa RA. Nitric oxide releasing coatings for the prevention of viral and bacterial infections. Biomater Sci 2024. [PMID: 38980705 DOI: 10.1039/d4bm00172a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Healthcare associated infections (HCAI) represent a significant burden worldwide contributing to morbidity and mortality and result in substantial economic consequences equating to billions annually. Although the impacts of HCAI have been felt for many years, the coronavirus pandemic has had a profound effect, escalating rates of HCAI, even with extensive preventative measures such as vaccination, personal protective equipment, and deep cleaning regimes. Therefore, there is an urgent need for new solutions to mitigate this serious health emergency. In this paper, the fabrication of nitric oxide (NO) releasing dual action polymer coatings for use in healthcare applications is described. The coatings are doped with the NO donor S-nitroso-N-acetylpenicillamine (SNAP) and release high payloads of NO in a sustained manner for in excess of 50 hours. These coatings are extensively characterized in multiple biologically relevant solutions and the antibacterial/antiviral efficacy is studied. For the first time, we assess antibacterial activity in a time course study (1, 2, 4 and 24 h) in both nutrient rich and nutrient poor conditions. Coatings exhibit excellent activity against Pseudomonas aeruginosa and methicillin resistant Staphylococcus aureus (MRSA), with up to complete reduction observed over 24 hours. Additionally, when tested against SARS-CoV-2, the coatings significantly reduced active virus in as little as 10 minutes. These promising results suggest that these coatings could be a valuable addition to existing preventative measures in the fight against HCAIs.
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Affiliation(s)
- Jenny Aveyard
- School of Engineering, University of Liverpool, Harrison Hughes Building, Brownlow Hill, Liverpool, L69 3GH, UK.
| | - Siobhan Richards
- Departments of Vector Biology and Tropical Disease Biology, Centre for Neglected Tropical Disease, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Man Li
- School of Engineering, University of Liverpool, Harrison Hughes Building, Brownlow Hill, Liverpool, L69 3GH, UK.
| | - Graeme Pitt
- School of Engineering, University of Liverpool, Harrison Hughes Building, Brownlow Hill, Liverpool, L69 3GH, UK.
| | - Grant L Hughes
- Departments of Vector Biology and Tropical Disease Biology, Centre for Neglected Tropical Disease, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Asangaedem Akpan
- Department of Musculoskeletal & Ageing Sciences, University of Liverpool, Liverpool L69 3GL, UK
- Liverpool University Hospitals NHS FT, Liverpool L7 8XP, UK
| | - Riaz Akhtar
- School of Engineering, University of Liverpool, Harrison Hughes Building, Brownlow Hill, Liverpool, L69 3GH, UK.
| | - Ahmed Kazaili
- Department of Biochemistry & Systems Biology, University of Liverpool, Liverpool, L69 7ZB, UK
| | - Raechelle A D'Sa
- School of Engineering, University of Liverpool, Harrison Hughes Building, Brownlow Hill, Liverpool, L69 3GH, UK.
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Mccarthy A, Robinson K, Dockery F, McLoughlin K, O'Connor M, Milos A, Corey G, Carey L, Steed F, Haaksma M, Whiston A, Tierney A, Galvin R. Long-term outcomes of older adults with acute COVID-19 following inpatient geriatric rehabilitation: a prospective cohort study from the Republic of Ireland. Ir J Med Sci 2024:10.1007/s11845-024-03723-4. [PMID: 38856964 DOI: 10.1007/s11845-024-03723-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/19/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND There is a paucity of research reporting the long-term outcomes of older adults who have completed geriatric rehabilitation following COVID-19. AIM The primary aim of this study is to describe the long-term functional outcomes of a cohort of older adults with acute COVID-19 who have completed inpatient geriatric rehabilitation. METHODS This is a subgroup analysis of Irish data from a pan-European prospective cohort study. Functional ability, patient reported symptoms, and quality of life were measured using the Barthel index, the COVID-19 Yorkshire Rehabilitation Screen, and the EQ-5D-5L, respectively. RESULTS Thirty patients enrolled in the study. The rate of mortality was 23.3% at 6 months after discharge from rehabilitation. Patients achieved a return to pre-admission functional ability but reported a significant increase in patient reported symptoms and their quality of life did not return to pre-admission levels when assessed at 6 months after discharge from rehabilitation. CONCLUSIONS Multidisciplinary rehabilitation for older adults with acute COVID-19 infection can assist patients to return to their premorbid functional ability. On discharge from rehabilitation, ongoing follow-up of older adults is recommended to assist them to negotiate and manage ongoing symptomatology such as breathlessness or fatigue.
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Affiliation(s)
- Aoife Mccarthy
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute and Ageing Research Centre, University of Limerick, Limerick, Ireland.
- UL Hospitals Group, University Hospital Limerick, Limerick, Ireland.
| | - Katie Robinson
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute and Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Frances Dockery
- Department of Geriatric and Stroke Medicine, and Integrated Care Team for Older People North Dublin, Beaumont Hospital, Dublin, Ireland
| | - Kara McLoughlin
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute and Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Margaret O'Connor
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Antonella Milos
- UL Hospitals Group, University Hospital Limerick, Limerick, Ireland
| | - Gillian Corey
- UL Hospitals Group, University Hospital Limerick, Limerick, Ireland
| | - Leonora Carey
- UL Hospitals Group, University Hospital Limerick, Limerick, Ireland
| | - Fiona Steed
- Department of Health, Baggot Street, Dublin, Ireland
| | - Miriam Haaksma
- Coordinator EU-COGER Study, Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- University Network for the Care Sector South-Holland, Leiden University Medical Center, Leiden, the Netherlands
| | - Aoife Whiston
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute and Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Audrey Tierney
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute and Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute and Ageing Research Centre, University of Limerick, Limerick, Ireland
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Shaikh OS, Yan P, Rogal S, Butt AA. The impact of COVID-19 on the clinical course and outcome of patients with cirrhosis: An observational study. Health Sci Rep 2024; 7:e2207. [PMID: 38915355 PMCID: PMC11194291 DOI: 10.1002/hsr2.2207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 05/25/2024] [Accepted: 06/06/2024] [Indexed: 06/26/2024] Open
Abstract
Background and Aims Severe outcomes of COVID-19 are associated with advancing age and comorbidities. The specific aim of our study was to determine the impact of COVID-19 on the clinical course and outcome of patients with cirrhosis. Methods We retrieved data from VA national repository and identified patients tested for SARS-CoV-2 RNA who had cirrhosis. Each virus positive patient was propensity-matched with virus negative subjects by demographics and comorbidities. Primary endpoint was death within 30 days of COVID-19 diagnosis and secondary endpoint was hospitalization within 14 days. Results Among 1,115,037 individuals tested for SARS-CoV-2 RNA, 31,680 had cirrhosis. Of those patients, 4456 virus positive patients were propensity-matched with 8752 virus negative subjects. In this cohort of 13,208, median age was 67 years and 95% were male. Most had multiple comorbidities. Alcohol use, hepatitis C and MASH were the dominant etiologies of cirrhosis. At baseline, median MELD was 6% and 21% had hepatic decompensation. Advanced age was the most significant determinant of hospitalization and mortality. Comorbidities, alcohol use and MELD increased the likelihood of hospitalization whereas SARS-CoV-2 positivity had lower Day-14 hospitalization hazard. MELD was associated with higher mortality hazard whereas vaccination reduced the hazard of hospitalization and death. SARS-CoV-2 positivity increased the hazard of death at Day-30 by 72% and at Day-90 by 26%. Conclusion Although patients with cirrhosis who developed COVID-19 were less likely to be hospitalized, they were more likely to die within 30 days compared to their virus negative counterparts. Vaccination was effective in reducing both hospitalization and death.
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Affiliation(s)
- Obaid S. Shaikh
- Veterans Affairs Pittsburgh Healthcare SystemPittsburghPennsylvaniaUSA
- University of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Peng Yan
- Veterans Affairs Pittsburgh Healthcare SystemPittsburghPennsylvaniaUSA
| | - Shari Rogal
- Veterans Affairs Pittsburgh Healthcare SystemPittsburghPennsylvaniaUSA
- University of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Adeel A. Butt
- Veterans Affairs Pittsburgh Healthcare SystemPittsburghPennsylvaniaUSA
- Weill Cornell MedicineDohaQatar
- Hamad Medical CorporationDohaQatar
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Radomyslsky Z, Kivity S, Alon Y, Saban M. Modeling mortality prediction in older adults with dementia receiving COVID-19 vaccination. BMC Geriatr 2024; 24:454. [PMID: 38789939 PMCID: PMC11127399 DOI: 10.1186/s12877-024-04982-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 04/16/2024] [Indexed: 05/26/2024] Open
Abstract
OBJECTIVE This study compared COVID-19 outcomes between vaccinated and unvaccinated older adults with and without cognitive impairment. METHOD Electronic health records from Israel from March 2020-February 2022 were analyzed for a large cohort (N = 85,288) aged 65 + . Machine learning constructed models to predict mortality risk from patient factors. Outcomes examined were COVID-19 mortality and hospitalization post-vaccination. RESULTS Our study highlights the significant reduction in mortality risk among older adults with cognitive disorders following COVID-19 vaccination, showcasing a survival rate improvement to 93%. Utilizing machine learning for mortality prediction, we found the XGBoost model, enhanced with inverse probability of treatment weighting, to be the most effective, achieving an AUC-PR value of 0.89. This underscores the importance of predictive analytics in identifying high-risk individuals, emphasizing the critical role of vaccination in mitigating mortality and supporting targeted healthcare interventions. CONCLUSIONS COVID-19 vaccination strongly reduced poor outcomes in older adults with cognitive impairment. Predictive analytics can help identify highest-risk cases requiring targeted interventions.
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Affiliation(s)
- Zorian Radomyslsky
- Maccabi Healthcare Services, 6812509, Tel Aviv-Jaffa, Israel.
- Ariel University, School of Health Sciences, Ariel, Israel.
| | - Sara Kivity
- Maccabi Healthcare Services, 6812509, Tel Aviv-Jaffa, Israel.
| | - Yaniv Alon
- Nursing Department, School of Health Professions, Faculty of Medical & Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel
| | - Mor Saban
- Nursing Department, School of Health Professions, Faculty of Medical & Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel
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Xu RH, Sun R, Fu SN. Out-of-Hospital Cardiac Arrest Before and During the COVID-19 Pandemic in Hong Kong: Registry-Based Study From 2017 to 2023. JMIR Public Health Surveill 2024; 10:e56054. [PMID: 38771620 DOI: 10.2196/56054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/03/2024] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has exerted a significant toll on individual health and the efficacy of health care systems. However, the influence of COVID-19 on the frequency and outcomes of out-of-hospital cardiac arrest (OHCA) within the Chinese population, both before and throughout the entire pandemic period, remains to be clarified. OBJECTIVE This study aimed to fill the gaps by investigating the prevalence and outcomes of OHCA in Hong Kong (HK) both before and during the whole pandemic period. METHODS This is a retrospective regional registry study. The researchers matched OHCA data with COVID-19-confirmed case records between December 2017 and May 2023. The data included information on response times, location of OHCA, witness presence, initial rhythm, bystander cardiopulmonary resuscitation (CPR), use of public-access defibrillation, resuscitation in the accident and emergency department, and survival to admission. Descriptive analyses were conducted, and statistical tests such as analysis of variance and χ2 were used to examine differences between variables. The incidence of OHCA and survival rates were calculated, and logistic regression analysis was performed to assess associations. The prevalence of OHCA and COVID-19 during the peak of the pandemic was also described. RESULTS A total of 43,882 cases of OHCA were reported in HK and included in our analysis. Around 13,946 cases were recorded during the prepandemic period (2017-2019), and the remaining 29,936 cases were reported during the pandemic period (2020-2023). During the pandemic period, the proportion of female patients increased to 44.1% (13,215/29,936), and the average age increased slightly to 76.5 (SD 18.5) years. The majority of OHCAs (n=18,143, 61.1% cases) occurred at home. A witness was present in 45.9% (n=10,723) of the cases, and bystander CPR was initiated in 44.6% (n=13,318) of the cases. There was a significant increase in OHCA incidence, with a corresponding decrease in survival rates compared to the prepandemic period. The location of OHCA shifted, with a decrease in incidents in public places and a potential increase in incidents at home. We found that CPR (odds ratio 1.48, 95% CI 1.17-1.86) and public-access defibrillation (odds ratio 1.16, 95% CI 1.05-1.28) were significantly associated with a high survival to admission rate during the pandemic period. There was a correlation between the development of OHCA and the prevalence of COVID-19 in HK. CONCLUSIONS The COVID-19 pandemic has had a significant impact on OHCA in HK, resulting in increased incidence and decreased survival rates. The findings highlight the importance of addressing the indirect effects of the pandemic, such as increased stress levels and strain on health care systems, on OHCA outcomes. Strategies should be developed to improve OHCA prevention, emergency response systems, and health care services during public health emergencies to mitigate the impact on population health.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | - Ruiqi Sun
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | - Siu-Ngor Fu
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
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Choe C, Moon Y, Yu S. COVID-19 and depressive symptoms among older adults in South Korea. J Women Aging 2024:1-13. [PMID: 38736377 DOI: 10.1080/08952841.2024.2345467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 04/12/2024] [Indexed: 05/14/2024]
Abstract
This study analyzed the effects of COVID-19 and gender differences in depressive symptoms in older adults using data from the 7th (2018) and 8th (2020) surveys of the Korean Longitudinal Study of Aging. A panel two-way-fixed effects model was used to control for individual fixed effects and time effects. A 0.1% point increase in the intensity of COVID-19 was associated with an average increase of 1.5 points out of 10 on the Center of Epidemiologic Studies Depression Scale, 10-item version (CES-D10) among older adults. The increase in depression was greater among women. Depressive factors due to COVID-19 among older adults are more likely to be related to negative emotions or interpersonal relationships than to physical and behavioral decline. Depression prevention policies for older adults should be informed by these gender differences. While older men require assistance with instrumental activities of daily living such as housework, meal preparation, etc., older women should be provided with online socialization opportunities to interact with others.
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Affiliation(s)
- Chung Choe
- Department of Economics, Konkuk University, Seoul, Korea
| | - Yeogyoung Moon
- Department of Economics, Konkuk University, Seoul, Korea
| | - Seunghee Yu
- General Education, Kookmin University, Seoul, Korea
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Dones I, Ciobanu RO. Older adults' experiences of wellbeing during the COVID-19 pandemic: a comparative qualitative study in Italy and Switzerland. FRONTIERS IN SOCIOLOGY 2024; 9:1243760. [PMID: 38751995 PMCID: PMC11094362 DOI: 10.3389/fsoc.2024.1243760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024]
Abstract
Background Particularly at the beginning of the pandemic, adults aged 65 and older were portrayed as a homogeneously vulnerable population due to the elevated health risks associated with contracting the COVID-19 disease. This portrayal, combined with travel restrictions, closures of economic sectors, country-wide lockdowns, and suggestions by governmental authorities to limit social contact, had important implications for the wellbeing of older individuals. However, older adults are a heterogeneous population who relies on different resources to cope with stressful periods, like the COVID-19 pandemic. Simultaneously, countries also employed different measures to contain the virus. Research thus far has focused on the short-term consequences of the pandemic, but studies have yet to address its long-term consequences. Objectives We explore older adults' lived experiences nearly 2 years after the pandemic onset. Moreover, we focus on the bordering countries of Switzerland and Italy, who employed contrasting containment measures. This paper analyzes (1) How the COVID-19 pandemic impacted the experiences of wellbeing of older adults in these regions and (2) How older adults coped with the stressors brought about by the pandemic, in particular social distancing. Methods The paper draws on 31 semi-structured interviews with 11 Swiss natives residing in Switzerland, 10 Italian migrants residing in Switzerland, and 10 Italian natives residing in Italy. Interviews were conducted from December 2021 to March 2022. Results Coping mechanisms of the three groups related to acceptance, hobbies, cognitive reframing, telephone use, vaccine use and social distancing. However, results show heterogeneous experiences of wellbeing, with Swiss natives sharing more positive narratives than the other two groups. Moreover, Italian migrants and Italian natives expressed the long-term negative consequences of the pandemic on their experienced wellbeing.
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Affiliation(s)
- Iuna Dones
- Faculty of Social Sciences, University of Geneva, Geneva, Switzerland
- Swiss Center of Expertise in Life Course Research (LIVES), Geneva, Switzerland
- Faculty of Social Work, University of Applied Sciences and Arts Western Switzerland (HETSL/HES-SO), Lausanne, Switzerland
| | - Ruxandra Oana Ciobanu
- Swiss Center of Expertise in Life Course Research (LIVES), Geneva, Switzerland
- Faculty of Social Work, University of Applied Sciences and Arts Western Switzerland (HETSL/HES-SO), Lausanne, Switzerland
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Ciaccio L, Donnan PT, Parcell BJ, Marwick CA. Community antibiotic prescribing in patients with COVID-19 across three pandemic waves: a population-based study in Scotland, UK. BMJ Open 2024; 14:e081930. [PMID: 38643000 PMCID: PMC11033633 DOI: 10.1136/bmjopen-2023-081930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/04/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES This study aims to examine community antibiotic prescribing across a complete geographical area for people with a positive COVID-19 test across three pandemic waves, and to examine health and demographic factors associated with antibiotic prescribing. DESIGN A population-based study using administrative data. SETTING A complete geographical region within Scotland, UK. PARTICIPANTS Residents of two National Health Service Scotland health boards with SARS-CoV-2 virus test results from 1 February 2020 to 31 March 2022 (n=184 954). Individuals with a positive test result (n=16 025) had data linked to prescription and hospital admission data ±28 days of the test, general practice data for high-risk comorbidities and demographic data. OUTCOME MEASURES The associations between patient factors and the odds of antibiotic prescription in COVID-19 episodes across three pandemic waves from multivariate binary logistic regression. RESULTS Data included 768 206 tests for 184 954 individuals, identifying 16 240 COVID-19 episodes involving 16 025 individuals. There were 3263 antibiotic prescriptions ±28 days for 2395 episodes. 35.6% of episodes had a prescription only before the test date, 52.3% of episodes after and 12.1% before and after. Antibiotic prescribing reduced over time: 20.4% of episodes in wave 1, 17.7% in wave 2 and 12.0% in wave 3. In multivariate logistic regression, being female (OR 1.31, 95% CI 1.19 to 1.45), older (OR 3.02, 95% CI 2.50 to 3.68 75+ vs <25 years), having a high-risk comorbidity (OR 1.45, 95% CI 1.31 to 1.61), a hospital admission ±28 days of an episode (OR 1.58, 95% CI 1.42 to 1.77) and health board region (OR 1.14, 95% CI 1.03 to 1.25, board B vs A) increased the odds of receiving an antibiotic. CONCLUSION Community antibiotic prescriptions in COVID-19 episodes were uncommon in this population and likelihood was associated with patient factors. The reduction over pandemic waves may represent increased knowledge regarding COVID-19 treatment and/or evolving symptomatology.
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Affiliation(s)
- Laura Ciaccio
- Division of Population Health and Genomics, University of Dundee School of Medicine, Dundee, UK
| | - Peter T Donnan
- Division of Population Health and Genomics, University of Dundee School of Medicine, Dundee, UK
| | - Benjamin J Parcell
- Department of Medical Microbiology, Ninewells Hospital and Medical School, Dundee, UK
| | - Charis A Marwick
- Division of Population Health and Genomics, University of Dundee School of Medicine, Dundee, UK
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Martín-Martínez A, Viñas P, Carrillo I, Martos J, Clavé P, Ortega O. The Impact of Frailty, Oropharyngeal Dysphagia and Malnutrition on Mortality in Older Patients Hospitalized for Covid-19. Aging Dis 2024; 15:927-938. [PMID: 37548930 PMCID: PMC10917529 DOI: 10.14336/ad.2023.0425-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/25/2023] [Indexed: 08/08/2023] Open
Abstract
COVID-19 hospital mortality is higher among older patients through as yet little-known factors. We aimed to assess the effect of frailty (FR), oropharyngeal dysphagia (OD) and malnutrition (MN) on mortality in hospitalized COVID-19 older patients. Prospective cohort study of older patients (>70 years) with COVID-19 admitted to a general hospital from April 2020 to January 2021. Patients were evaluated on admission, discharge and at 1- and 3-months follow up. FR was assessed with FRAIL-VIG, OD with Volume-Viscosity Swallowing Test and MN with GLIM criteria. Clinical characteristics and outcomes, including intra-hospital, 1- and 3-month mortality, were analyzed. 258 patients were included (82.5±7.6 years; 58.9% women); 66.7% had FR (mild 28.7%, moderate 27.1% and severe 10.9%); 65.4%, OD and 50.6%, MN. OD prevalence increased from non-FR patients through the severity levels of FR: mild, moderate and severe (29.8%, 71.6%, 90.0%, 96.2%; p<0.0001, respectively), but not that of MN (50.6%, 47.1%, 52.5%, 56.0%). Mortality over the whole study significantly increased across FR categories (9.3% non-FR; 23.0% mild; 35.7% moderate; 75.0% severe; p<.001). Functionality (Barthel pre-admission, HR=0.983, CI-95%:0.973-0.993; p=0.001), OD (HR=2.953, CI-95%:0.970-8.989; p=0.057) and MN (HR=4.279, CI-95%:1.658-11.049; p=0.003) were independent risk factors for intra-hospital mortality. FR, OD and MN are highly prevalent conditions in older patients hospitalized with COVID-19. Functionality, OD and MN were independent risk factors for intra-hospital mortality.
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Affiliation(s)
- Alberto Martín-Martínez
- Gastrointestinal Physiology Laboratory CIBERehd CSdM-UAB, Hospital de Mataró, Consorci Sanitari del Maresme, Universitat Autònoma de Barcelona, 08304 Mataró, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain.
| | - Paula Viñas
- Gastrointestinal Physiology Laboratory CIBERehd CSdM-UAB, Hospital de Mataró, Consorci Sanitari del Maresme, Universitat Autònoma de Barcelona, 08304 Mataró, Spain.
| | - Irene Carrillo
- Department of Geriatrics, Hospital de Mataró, Consorci Sanitari del Maresme, 08304 Mataró, Spain.
| | - Josep Martos
- Department of Geriatrics, Hospital de Mataró, Consorci Sanitari del Maresme, 08304 Mataró, Spain.
| | - Pere Clavé
- Gastrointestinal Physiology Laboratory CIBERehd CSdM-UAB, Hospital de Mataró, Consorci Sanitari del Maresme, Universitat Autònoma de Barcelona, 08304 Mataró, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain.
| | - Omar Ortega
- Gastrointestinal Physiology Laboratory CIBERehd CSdM-UAB, Hospital de Mataró, Consorci Sanitari del Maresme, Universitat Autònoma de Barcelona, 08304 Mataró, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain.
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Harriman NW, Ohene-Kwofie D, Jung SJ, Hermosilla S, Gómez-Olivé FX, Jennings EA. In-Person Social Interactions and Anxiety During the COVID-19 Pandemic: Exploring the Role of Household Size and Virtual Social Contact Among Midlife and Older Black South African Adults. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad175. [PMID: 38124487 PMCID: PMC10941638 DOI: 10.1093/geronb/gbad175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES The current study investigates how physical distancing during the coronavirus disease 2019 (COVID-19) pandemic was associated with increased anxiety among a cohort of midlife older Black South African adults and the extent to which household size and virtual social contact modify this association for men and women. METHODS We analyze data from a phone survey conducted from July 2021 to March 2022 as part of Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (n = 2,080). We employ logistic regression to estimate the association between changes in in-person social interactions and anxiety symptoms and examine whether the association is modified by household size and changes in virtual social contact. We perform analyses separately for women and men. RESULTS Declines in in-person social interactions were associated with increased anxiety for women and men (odds ratios [OR] = 2.52, p < .001). For women only, declines were greater for those living in larger households (OR = 1.11, p = .032). Declines were buffered by increased virtual social contact for both women (OR = 0.55, p = .025) and men (OR = 0.45, p = .019). DISCUSSION Although the anxiety symptoms of women and men were similarly affected by declines in in-person social interaction, the modifying influence of household size is unique to women, likely due to gender-specific social roles. For women, living in larger households may mean greater caregiving burden, exacerbating the detrimental association between physical distancing and anxiety. On the other hand, both women and men may have used virtual means to connect with friends and family living outside their homes, buffering against increased anxiety.
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Affiliation(s)
- Nigel Walsh Harriman
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, Massachusetts, USA
| | - Daniel Ohene-Kwofie
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Sun Jae Jung
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, Massachusetts, USA
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Sabrina Hermosilla
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Elyse A Jennings
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, Massachusetts, USA
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Fang X, Tao G, Zhou H, Zhou Y. Vaccines reduced hospital length of stay and fraction of inspired oxygen of COVID-19 patients: A retrospective cohort study. Prev Med Rep 2024; 39:102632. [PMID: 38348219 PMCID: PMC10859302 DOI: 10.1016/j.pmedr.2024.102632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/15/2024] Open
Abstract
Few studies have focused on the evaluation of vaccine effectiveness (VE) in mainland China. This study was to characterize the VE including the frequent symptoms, laboratory indices, along with endotracheal intubation, hospital length of stay (LoS), and survival status. This retrospective cohort study included patients with COVID-19 admitted to our hospital. Statistical comparisons of continuous variables were carried out with an independent Student's t-test or Mann-Whitney U test. For categorical variables, the Chi-square test and Fisher exact test were used. Multivariable regression analysis was performed to adjust the confounding factors such as age, gender, body mass index (BMI), residential area, smoking status, the Charlson comorbidity index (CCI) score, followed by investigating the effects of vaccination on critical ill prevention, reduced mortality and endotracheal intubation, LoS and inspired oxygen. This study included 549 hospitalized patients with COVID-19, including 222 (40.43 %) vaccinated participants and 327 (59.57 %) unvaccinated counterparts. There was no obvious difference between the two groups in typical clinical symptoms of COVID-19, clinical laboratory results and mortality. Multivariable analysis showed that COVID-19 vaccine obviously reduced LoS by 1.2 days (lnLoS = -0.14, 95 %CI[-0.24,-0.04]; P = 0.005) and decreased fraction of inspired oxygen by 40 % (OR: 0.60; 95 %CI[0.40,0.90]; P = 0.013) after adjusting age, gender, BMI, residential area, smoking status and CCI score. In contrast, vaccination induced reduction in the critically ill, mortality, and endotracheal intubation compared with the unvaccinated counterparts, but with no statistical differences. Vaccinated patients hospitalized with COVID-19 have a reduced LoS and fraction of inspired oxygen compared to unvaccinated cases in China.
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Affiliation(s)
- Xiaomei Fang
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, P. R. China
| | - Guofang Tao
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, P. R. China
| | - Hua Zhou
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, P. R. China
| | - Yuxia Zhou
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, P. R. China
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12
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Yu Y, Zhang X, Lau MMC, Lau JTF. The intention to get COVID-19 booster vaccination and its association with cognitive and emotional factors: A survey of Chinese COVID-19 infected people in Hong Kong. Vaccine 2024; 42:206-212. [PMID: 38065769 DOI: 10.1016/j.vaccine.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/01/2023] [Accepted: 12/02/2023] [Indexed: 01/01/2024]
Abstract
BACKGROUND Although the pandemic has ended officially, COVID-19 remains impactful. Booster COVID-19 vaccination is still needed to protect individuals against COVID-19 and the disease's harmful consequences. This study investigated the prevalence of the intention to get booster COVID-19 vaccination after receiving the COVID-19 diagnosis and its associated factors among people reporting prior COVID-19. METHODS A population-based anonymous telephone survey was conducted in Hong Kong, China from June to August 2022 among Chinese people reporting prior COVID-1 between February and August 2022 and having taken up ≥2 doses of COVID-19 vaccines prior to COVID-19 diagnosis. RESULTS The prevalence of the intention to get booster vaccination was 59.2 %. Older age (>60 years), being currently married, not employed full-time, and having chronic diseases were positively associated with the intention to get booster vaccination. Adjusted for the background factors, higher levels of the cognitive factors of perceived susceptibility to COVID-19, perceived acquired moderate-to-strong immunity against COVID-19, and perceived adequate knowledge of COVID-19 were positively associated with the intention to get booster vaccination; stronger perceived severity of prior infection despite vaccination was negatively associated with the intention outcome. In contrast, stronger mental distress due to COVID-19, illness concern, and emotional representation were positively associated with the intention. Self-perceived long COVID status was not a significant factor. DISCUSSION The prevalence of the intention to get booster COVID-19 vaccination was limited, especially among younger people reporting prior COVID-19. Health promotion is still required among people reporting prior COVID-19 and may emphasize the significant cognitive factors positively associated with the intention. Future studies are needed to confirm the findings, clarify the role of emotional factors on booster vaccination, and explore other factors of the intention to get booster vaccination among people reporting prior COVID-19.
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Affiliation(s)
- Yanqiu Yu
- School of Public Health, Fudan University, Shanghai, China
| | - Xiaoying Zhang
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Mason M C Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph T F Lau
- Public Mental Health Center, School of Mental Health, Wenzhou Medical University, Wenzhou, China; Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China.
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13
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Georgakopoulou VE, Gkoufa A, Makrodimitri S, Tsakanikas A, Basoulis D, Voutsinas PM, Karamanakos G, Eliadi I, Samara S, Triantafyllou M, Eleftheriadou I, Kampouropoulou O, Papageorgiou CV, Anastasopoulou A, Papalexis P, Trakas I, Trakas N, Spandidos DA, Steiropoulos P, Sipsas NV. Risk factors for the in‑hospital and 1‑year mortality of elderly patients hospitalized due to COVID‑19‑related pneumonia. Exp Ther Med 2024; 27:22. [PMID: 38125348 PMCID: PMC10728907 DOI: 10.3892/etm.2023.12310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is characterized by poor outcomes and a high mortality rate, particularly among elderly patients. Since the beginning of the pandemic, an older age has been recognized as a critical risk factor for disease severity, with increasing mortality rates in each decade of life. This phenomenon may be a consequence of a poor previous health status, with a higher prevalence of pre-existing comorbidities and a higher degree of frailty. The majority of studies on the outcomes and risk factors of elderly patients refer to the first waves of the pandemic and the predictors of in-hospital mortality in these patients. The aim of the present study was to provide a detailed description of the clinical characteristics and management of a cohort of elderly patients (≥65 years of age) who were hospitalized with COVID-19-related pneumonia in all phases of the pandemic, presenting their outcomes, and investigating predictors of in-hospital and out-of-hospital mortality over a period of 1 year in this particularly vulnerable population. A total of 1,124 elderly patients (603 males, 53.7%) with a mean age of 78.51±7.42 years and a median Charlson comorbidity index (CCI) of 5 were included in the study. Of these patients, 104 (9.3%) were hospitalized during the period of prevalence of the original strain Wuhan, 385 (34.3%) were hospitalized during the period of prevalence of the Alpha variant, 221 (19.7%) were hospitalized during the period of prevalence of the Delta variant, and 414 (36.8%) were hospitalized during the period of prevalence of the Omicron variant. Overall, the in-hospital mortality rate was 33.4% (375 patients), and the 1-year mortality rate was 44.7% (502 patients). The majority of patients had not been vaccinated or had not completed full vaccination against severe acute respiratory syndrome coronavirus-2 (843 patients, 75%), given the period of infection. Age, immature granulocytes, lactate dehydrogenase (LDH) levels, ferritin levels, chest X-ray score, as well as the absence of full vaccination, cough and fatigue, were statistically significantly and independently associated with in-hospital mortality, while age, LDH levels, ferritin levels, alanine aminotransferase levels, CCI, chest X-ray score, the absence of cough and fatigue, and a history of dementia were statistically significantly and independently associated with 1-year mortality. On the whole, the present study demonstrates that both the in-hospital mortality and 1-year mortality rates of elderly patients hospitalized due to COVID-19-related pneumonia are high.
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Affiliation(s)
- Vasiliki Epameinondas Georgakopoulou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aikaterini Gkoufa
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Sotiria Makrodimitri
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aristeidis Tsakanikas
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dimitrios Basoulis
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Pantazis M. Voutsinas
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Georgios Karamanakos
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Eliadi
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Stamatia Samara
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Maria Triantafyllou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Ioanna Eleftheriadou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Kampouropoulou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Chrysovalantis V. Papageorgiou
- Pulmonology Department, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Amalia Anastasopoulou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros Papalexis
- Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Biomedical Sciences, University of West Attica, 12243 Athens, Greece
| | - Ilias Trakas
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Paschalis Steiropoulos
- Department of Pulmonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Nikolaos V. Sipsas
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Ortiz-Prado E, Izquierdo-Condoy JS, Fernández-Naranjo R, Vásconez-González J, Izquierdo-Condoy N, Checa-Jaramillo D, Yanchapaxi-Silva P, Asmal-Iturralde T, Dávila Rosero MG, Carrington SJ, Sanchez-SanMiguel H. Maternal mortality and COVID-19: A nationwide ecological analysis from Ecuador. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057231219607. [PMID: 38553804 PMCID: PMC10981214 DOI: 10.1177/17455057231219607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 10/22/2023] [Accepted: 11/23/2023] [Indexed: 04/02/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, distinct population subsets, including pregnant women, have been differentially affected. While over 90% of COVID-19-infected pregnant women experience a benign course, a subset demonstrates marked clinical exacerbation. Symptomatic pregnant individuals, in particular, present a heightened risk of severe disease in comparison to their non-pregnant counterparts. OBJECTIVE The objective of this study is to systematically evaluate the epidemiological characteristics of COVID-19 in pregnant women, assess related maternal mortalities, ascertain the case fatality rate, and delineate associated risk factors. DESIGN This is a comprehensive population-based ecological study. METHODOLOGY A population-based study was conducted to investigate the epidemiological patterns of COVID-19-associated morbidity and mortality in pregnant women in Ecuador from 27 February 2020 to 14 May 2021. RESULTS A total of 3274 positive COVID-19 cases were identified among pregnant women, with 22 official fatalities, yielding a case fatality rate of 0.67%. The majority of cases were of Mestizo ethnicity (92.66%); however, the highest case fatality rate was noted among indigenous pregnant women (case fatality rate = 1.25%), those aged between 40 and 44 years (case fatality rate = 2.68%), and those with a history of comorbidities (2.08%). Pregnant women residing at lower altitudes (<2500 m) exhibited a higher incidence rate (0.20/100,000) compared to those at higher altitudes (>2500 m), which stood at 0.17/100,000. CONCLUSION The COVID-19 pandemic has profoundly impacted pregnant women in Ecuador during the first 14 months, particularly those with comorbidities, older age, and of indigenous ethnicity. These factors have heightened their vulnerability and susceptibility to severe COVID-19 infection and subsequent mortality. This underscores the urgency for comprehensive protective measures, including prioritization for vaccination. Further studies are needed to inform tailored prevention strategies and therapeutic interventions for these high-risk groups.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad de las Americas, Quito, Ecuador
| | | | - Raúl Fernández-Naranjo
- One Health Research Group, Faculty of Medicine, Universidad de las Americas, Quito, Ecuador
| | | | | | - Diana Checa-Jaramillo
- One Health Research Group, Faculty of Medicine, Universidad de las Americas, Quito, Ecuador
| | - Pablo Yanchapaxi-Silva
- One Health Research Group, Faculty of Medicine, Universidad de las Americas, Quito, Ecuador
| | | | | | - Sarah J Carrington
- One Health Research Group, Faculty of Medicine, Universidad de las Americas, Quito, Ecuador
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15
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Fernández Alonso C, Fuentes Ferrer M, Llorens P, Burillo G, Alquézar-Arbé A, Jacob J, Montero-Pérez FJ, Aguiló S, Abad Cuñado V, Amer Al Arud L, Escudero Sánchez C, Poch Ferret EA, Hong Cho JU, Escolar Martínez-Berganza MT, Gayoso Martín S, Sánchez Sindín G, Prieto Zapico A, Petrus Rivas MC, Doi Grande AL, Llauger L, Rodríguez Valles C, Marquez Quero L, Juárez González R, Ruescas E, Fernández Salgado F, Ríos Gallardo R, de Juan Gómez MÁ, Masid Barco M, González Del Castillo J, Miró Ò. Impact of First Wave of COVID-19 Pandemic on Mortality at Emergency Department in Older Patients with COVID and Non-COVID Diagnoses. Gerontology 2023; 70:379-389. [PMID: 38160663 DOI: 10.1159/000535913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
INTRODUCTION Mortality in emergency departments (EDs) is not well known. This study aimed to assess the impact of the first-wave pandemic on deaths accounted in the ED of older patients with COVID and non-COVID diseases. METHODS We used data from the Emergency Department and Elderly Needs (EDEN) cohort (pre-COVID period) and from the EDEN-COVID cohort (COVID period) that included all patients ≥65 years seen in 52 Spanish EDs from April 1 to 7, 2019, and March 30 to April 5, 2020, respectively. We recorded patient characteristics and final destination at ED. We compared older patients in the pre-COVID period, with older patients with non-COVID and with COVID-19. ED-mortality (before discharge or hospitalization) is the prior outcome and is expressed as an adjusted odds ratio (aOR) with 95% interval confidence. RESULTS We included 23,338 older patients from the pre-COVID period (aged 78.3 [8.1] years), 6,715 patients with non-COVID conditions (aged 78.9 [8.2] years) and 3,055 with COVID (aged 78.3 [8.3] years) from the COVID period. Compared to the older patients, pre-COVID period, patients with non-COVID and with COVID-19 were more often male, referred by a doctor and by ambulance, with more comorbidity and disability, dementia, nursing home, and more risk according to qSOFA, respectively (p < 0.001). Compared to the pre-COVID period, patients with non-COVID and with COVID-19 were more often to be hospitalized from ED (24.8% vs. 44.3% vs. 79.1%) and were more often to die in ED (0.6% vs. 1.2% vs. 2.2%), respectively (p < 0.001). Compared to the pre-COVID period, aOR for age, sex, comorbidity and disability, ED mortality in elderly patients cared in ED during the COVID period was 2.31 (95% confidence interval [CI]: 1.76-3.06), and 3.75 (95% CI: 2.77-5.07) for patients with COVID. By adding the variable qSOFA to the model, such OR were 1.59 (95% CI: 1.11-2.30) and 2.16 (95% CI: 1.47-3.17), respectively. CONCLUSIONS During the early first pandemic wave of COVID-19, more complex and life-threatening older with COVID and non-COVID diseases were seen compared to the pre-COVID period. In addition, the need for hospitalization and the ED mortality doubled in non-COVID and tripled in COVID diagnosis. This increase in ED mortality is not only explained by the complexity or severity of the elderly patients but also because of the system's overload.
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Affiliation(s)
- Cesáreo Fernández Alonso
- Emergency Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain
| | - Manuel Fuentes Ferrer
- Investigation Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Pere Llorens
- Emergency Department, Unidad de Estancia Corta y Hospitalización a Domicilio, Hospital Doctor Balmis de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain
| | - Guillermo Burillo
- Facultad de Ciencias de la Salud, Universidad Europea de Canarias, Santa Cruz de Tenerife, Spain
| | - Aitor Alquézar-Arbé
- Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Javier Jacob
- Emergency Department, Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Sira Aguiló
- Emergency Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Vanesa Abad Cuñado
- Emergency Department, Hospital Universitario Severo Ochoa, Madrid, Spain
| | - Lilia Amer Al Arud
- Emergency Department, Hospital Universitario Virgen Arrixaca, Murcia, Spain
| | | | | | | | | | | | | | | | | | | | - Lluís Llauger
- Emergency Department, Hospital Universitari de Vic, Barcelona, Spain
| | | | | | | | - Esther Ruescas
- Emergency Department, Hospital Universitario Vinalopó, Elche, Spain
| | | | | | | | - Marta Masid Barco
- Emergency Department, Hospital Univeristario Son Espases, Palma de Mallorca, Spain
| | | | - Òscar Miró
- Emergency Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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Marques FRDM, Laranjeira C, Carreira L, Gallo AM, Baccon WC, Paiano M, Baldissera VDA, Salci MA. Illness Experiences of Brazilian People Who Were Hospitalized Due to COVID-19 and Faced Long COVID Repercussions in Their Daily Life: A Constructivist Grounded Theory Study. Behav Sci (Basel) 2023; 14:14. [PMID: 38247666 PMCID: PMC10813415 DOI: 10.3390/bs14010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/04/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Long COVID is a multisystem condition that has multiple consequences for the physical, mental, and social health of COVID-19 survivors. The impact of the long COVID condition remains unclear, particularly among middle-aged and older adults, who are at greater risk than younger people of persisting symptoms associated with COVID-19. Therefore, we aimed to understand the experiences of middle-aged and older people who had been hospitalized for COVID-19 and the repercussions of long-term COVID symptoms in their daily lives. A qualitative study was carried out, adopting the framework of the constructivist grounded theory (CGT) proposed by Kathy Charmaz. Fifty-six middle-aged and older adult participants from the southern region of Brazil were recruited. Data were gathered from semi-structured telephone interviews. Concomitantly a comparative analysis was performed to identify categories and codes using the MaxQDA® software (version 2022). Three subcategories were identified: (1) experiencing COVID-19 in the acute phase; (2) oscillating between 'good days' and 'bad days' in long COVID; and (3) (re)constructing identity. These concepts interact with each other and converge upon the central category of this study: recasting oneself to the uniqueness of the illness experience of long COVID. Our findings provided insights related to the disruption in the lives of long COVID-19 sufferers who still live with persistent symptoms of the disease, including physical, social, family, emotional and spiritual repercussions. Likewise, this study may aid in developing friendly and welcoming social environments, lowering stigma and prejudice towards patients with long COVID, and fostering prompt and suitable policy support and mental health care for these individuals.
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Affiliation(s)
- Francielle Renata Danielli Martins Marques
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Av. Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (F.R.D.M.M.); (L.C.); (A.M.G.); (W.C.B.); (M.P.); (V.D.A.B.); (M.A.S.)
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Rua de Santo André-66-68, Campus 5, 2410-541 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Lígia Carreira
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Av. Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (F.R.D.M.M.); (L.C.); (A.M.G.); (W.C.B.); (M.P.); (V.D.A.B.); (M.A.S.)
| | - Adriana Martins Gallo
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Av. Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (F.R.D.M.M.); (L.C.); (A.M.G.); (W.C.B.); (M.P.); (V.D.A.B.); (M.A.S.)
| | - Wanessa Cristina Baccon
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Av. Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (F.R.D.M.M.); (L.C.); (A.M.G.); (W.C.B.); (M.P.); (V.D.A.B.); (M.A.S.)
| | - Marcelle Paiano
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Av. Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (F.R.D.M.M.); (L.C.); (A.M.G.); (W.C.B.); (M.P.); (V.D.A.B.); (M.A.S.)
| | - Vanessa Denardi Antoniassi Baldissera
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Av. Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (F.R.D.M.M.); (L.C.); (A.M.G.); (W.C.B.); (M.P.); (V.D.A.B.); (M.A.S.)
| | - Maria Aparecida Salci
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Av. Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (F.R.D.M.M.); (L.C.); (A.M.G.); (W.C.B.); (M.P.); (V.D.A.B.); (M.A.S.)
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Alsakarneh S, Duong N, Hashash JG. Racial disparities in COVID-19 and gastrointestinal diseases-related mortality: analysis from CDC-WONDER databases, 2020-2022. Proc AMIA Symp 2023; 37:30-33. [PMID: 38174020 PMCID: PMC10761105 DOI: 10.1080/08998280.2023.2264716] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/23/2023] [Indexed: 01/05/2024] Open
Abstract
Background The COVID-19 pandemic represents an unprecedented global health challenge. Gastrointestinal diseases (GID) have been shown to increase morbidity and mortality in COVID-19 patients, warranting a comprehensive investigation of their combined impact and racial disparities in mortality rates within the United States. Methods Data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) mortality statistics database were analyzed for the period from January 1, 2020, to December 31, 2022. This study focused on adults, considering all deaths related to COVID-19 and GID. Age-adjusted mortality rates (AAMR) per 100,000 population were reported. Sociodemographic data, including age, sex, race/ethnicity, and region of residence, were collected. Results Among 9,925,729 total deaths in the US between 2020 and 2022, 3.9% were GID related only, 9.6% were COVID-19 related only, and 0.4% were attributed to both COVID-19 and GID as underlying causes of death. AAMR for COVID-19 was 121.3 per 100,000, significantly higher than the AAMR for GID (50.3 per 100,000). Age-wise, elderly individuals had the highest AAMR for both COVID-19 and GID-related deaths. Stratified by race/ethnicity, Hispanics exhibited the highest AAMR, nearly twice that of Non-Hispanic Black patients and substantially higher than Non-Hispanic White and Asian patients. Conclusion Our findings reveal substantial disparities in race/ethnicity-specific AAMR associated with both COVID-19 and GID in the US. Further research is crucial to delve deeper into their root causes and develop targeted interventions to strive for health equity for all.
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Affiliation(s)
- Saqr Alsakarneh
- Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Nikki Duong
- Department of Gastroenterology and Hepatology, Stanford University, Stanford, Palo Alto, USA
| | - Jana G. Hashash
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
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Bejaoui Y, Humaira Amanullah F, Saad M, Taleb S, Bradic M, Megarbane A, Ait Hssain A, Abi Khalil C, El Hajj N. Epigenetic age acceleration in surviving versus deceased COVID-19 patients with acute respiratory distress syndrome following hospitalization. Clin Epigenetics 2023; 15:186. [PMID: 38017502 PMCID: PMC10685564 DOI: 10.1186/s13148-023-01597-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/06/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Aging has been reported as a major risk factor for severe symptoms and higher mortality rates in COVID-19 patients. Molecular hallmarks such as epigenetic alterations and telomere attenuation reflect the biological process of aging. Epigenetic clocks have been shown to be valuable tools for measuring biological age in various tissues and samples. As such, these epigenetic clocks can determine accelerated biological aging and time-to-mortality across various tissues. Previous reports have shown accelerated biological aging and telomere attrition acceleration following SARS-CoV-2 infection. However, the effect of accelerated epigenetic aging on outcome (death/recovery) in COVID-19 patients with acute respiratory distress syndrome (ARDS) has not been well investigated. RESULTS In this study, we measured DNA methylation age and telomere attrition in 87 severe COVID-19 cases with ARDS under mechanical ventilation. Furthermore, we compared dynamic changes in epigenetic aging across multiple time points until recovery or death. Epigenetic age was measured using the Horvath, Hannum, DNAm skin and blood, GrimAge, and PhenoAge clocks, whereas telomere length was calculated using the surrogate marker DNAmTL. Our analysis revealed significant accelerated epigenetic aging but no telomere attrition acceleration in severe COVID-19 cases. In addition, we observed epigenetic age deceleration at inclusion versus end of follow-up in recovered but not in deceased COVID-19 cases using certain clocks. When comparing dynamic changes in epigenetic age acceleration (EAA), we detected higher EAA using both the Horvath and PhenoAge clocks in deceased versus recovered patients. The DNAmTL measurements revealed telomere attrition acceleration in deceased COVID-19 patients between inclusion and end of follow-up and a significant change in dynamic telomere attrition acceleration when comparing patients who recovered versus those who died. CONCLUSIONS EAA and telomere attrition acceleration were associated with treatment outcomes in hospitalized COVID-19 patients with ARDS. A better understanding of the long-term effects of EAA in COVID-19 patients and how they might contribute to long COVID symptoms in recovered individuals is urgently needed.
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Affiliation(s)
- Yosra Bejaoui
- College of Health and Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Education City, Doha, Qatar
| | - Fathima Humaira Amanullah
- College of Health and Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Education City, Doha, Qatar
| | - Mohamad Saad
- Qatar Computing Research Institute, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Sara Taleb
- College of Health and Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Education City, Doha, Qatar
- Proteomics Core Lab, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Martina Bradic
- Department of Genetic Medicine, Weill Cornell Medicine, New York, USA
- Marie-Josee and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andre Megarbane
- Gilbert and Rose-Mary Chagoury School of Medicine, Lebanese American Univeristy, Beirut, Lebanon
| | - Ali Ait Hssain
- Medical Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar
| | - Charbel Abi Khalil
- Department of Genetic Medicine, Weill Cornell Medicine, New York, USA.
- Epigenetics Cardiovascular Lab, Weill Cornell Medicine-Qatar, Doha, Qatar.
- Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, USA.
| | - Nady El Hajj
- College of Health and Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Education City, Doha, Qatar.
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar.
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Maguire C, Soloveichik E, Blinchevsky N, Miller J, Morrison R, Busch J, Brode WM, Wylie D, Rousseau J, Melamed E. Dissecting Clinical Features of COVID-19 in a Cohort of 21,312 Acute Care Patients. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.27.23297171. [PMID: 38076907 PMCID: PMC10705621 DOI: 10.1101/2023.11.27.23297171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
COVID-19 has resulted in over 645 million hospitalization and 7 million deaths globally. However, many questions still remain about clinical complications in COVID-19 and if these complications changed with different circulating SARS-CoV-2 strains. We analyzed a 2.5-year retrospective cohort of 47,063 encounters for 21,312 acute care patients at five Central Texas hospitals and define distinct trajectory groups (TGs) with latent class mixed modeling, based on the World Health Organization COVID-19 Ordinal Scale. Using this TG framework, we evaluated the association of demographics, diagnoses, vitals, labs, imaging, consultations, and medications with COVID-19 severity and broad clinical outcomes. Patients within 6 distinct TGs differed in manifestations of multi-organ disease and multiple clinical factors. The proportion of mild patients increased over time, particularly during Omicron waves. Age separated mild and fatal patients, though did not distinguish patients with severe versus critical disease. Male and Hispanic/Latino demographics were associated with more severe/critical TGs. More severe patients had a higher rate of neuropsychiatric diagnoses, consultations, and brain imaging, which did not change significantly in severe patients across SARS-CoV-2 variant waves. More severely affected patients also demonstrated an immunological signature of high neutrophils and immature granulocytes, and low lymphocytes and monocytes. Interestingly, low albumin was one of the best lab predictors of COVID-19 severity in association with higher malnutrition in severe/critical patients, raising concern of nutritional insufficiency influencing COVID-19 outcomes. Despite this, only a small fraction of severe/critical patients had nutritional labs checked (pre-albumin, thiamine, Vitamin D, B vitamins) or received targeted interventions to address nutritional deficiencies such as vitamin replacement. Our findings underscore the significant link between COVID-19 severity, neuropsychiatric complications, and nutritional insufficiency as key risk factors of COVID-19 outcomes and raise the question of the need for more widespread early assessment of patients' neurological, psychiatric, and nutritional status in acute care settings to help identify those at risk of severe disease outcomes.
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Affiliation(s)
- Cole Maguire
- Department of Neurology, The University of Texas at Austin, Dell Medical School
| | - Elie Soloveichik
- Department of Neurology, The University of Texas at Austin, Dell Medical School
| | - Netta Blinchevsky
- Department of Neurology, The University of Texas at Austin, Dell Medical School
| | - Jaimie Miller
- Enterprise Data Intelligence, The University of Texas at Austin, Dell Medical School
| | - Robert Morrison
- Department of Internal Medicine, The University of Texas at Austin, Dell Medical School
| | - Johanna Busch
- Department of Internal Medicine, The University of Texas at Austin, Dell Medical School
| | - W Michael Brode
- Department of Internal Medicine, The University of Texas at Austin, Dell Medical School
| | - Dennis Wylie
- Center for Biomedical Support, The University of Texas at Austin
| | | | - Esther Melamed
- Department of Neurology, The University of Texas at Austin, Dell Medical School
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20
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Nakamura A, Kotani K, Hatakeyama S, Obayashi S, Nagai R. Regional Variations in Coronavirus Disease 2019 Mortality in Japan: An Ecological Study. JMA J 2023; 6:397-403. [PMID: 37941702 PMCID: PMC10628200 DOI: 10.31662/jmaj.2023-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/07/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction As the characteristics of coronavirus disease 2019 (COVID-19) vary across regions and countries, the relationship between regional characteristics, such as the distribution of physicians and hospital beds, and COVID-19 mortality was assessed in the 47 prefectures of Japan. Methods This ecological study was based on the number of patients with COVID-19 by prefecture during the seventh wave of COVID-19 in Japan (June-October 2022). COVID-19 mortality was indexed as the number of COVID-19 deaths divided by the number of new COVID-19 cases. Data on regional factors, such as population size, number of physicians, and hospital beds by prefecture, were obtained from government statistics. Correlations between regional characteristics and COVID-19 mortality index were analyzed by dividing the 47 prefectures into two groups at the median level of population size (more populated group [MPG] ≥ 1.6 million and less populated group [LPG] < 1.6 million). Results The COVID-19 mortality index (mean 12.7, minimum-maximum: 4.7-25.7) was correlated negatively with the number of physicians per hospital bed (r = -0.386, p = 0.007) and positively with the number of long-term care facilities per 10,000 population (r = 0.397, p = 0.006) and aging rate (the proportion of population aged ≥ 65 years) (r = 0.471, p = 0.001). The two groups varied with respect to the number of physicians (28.7 physicians in the LPG vs. 26.1 physicians in the MPG, p = 0.038) and hospital beds (156 beds in the LPG vs. 119 beds in the MPG, p < 0.001) per 10,000 population. In the multiple regression analysis, the COVID-19 mortality index was correlated negatively with the number of physicians per hospital bed (β = -0.543, p = 0.024) and positively with the aging rate (β = 0.434, p = 0.032) in the LPG, with nonsignificant correlations in the MPG. Conclusions The data may suggest a need of improvement in the distribution of physicians and hospital beds in the healthcare system in regions with smaller and older populations to reduce the rate of COVID-19.
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Affiliation(s)
- Akihisa Nakamura
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Kazuhiko Kotani
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Shuji Hatakeyama
- Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Japan
- Division of Infectious Diseases, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Senichi Obayashi
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
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21
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Tahavvori A, Mosaddeghi-Heris R, Ghanbari Sevari F, Alavi SMA, Panahi P, Abbasi N, Rahmani Youshanlouei H, Hejazian SS. Combined systemic inflammatory indexes as reflectors of outcome in patients with COVID‑19 infection admitted to ICU. Inflammopharmacology 2023; 31:2337-2348. [PMID: 37550520 DOI: 10.1007/s10787-023-01308-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 07/25/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION The principal etiology of mortality in COVID-19 patients is the systemic pro-inflammatory processes which may lead to acute respiratory distress syndrome. Hematologic indices are reachable representatives of inflammation in patients with COVID-19 infection. The purpose of the current study was to evaluate the potential predictive value of these inflammatory indices in the in-hospital mortality of ICU-admitted COVID-19 patients. The studied indexes included AISI, dNLR, NLPR, NLR, SII, and SIRI. METHOD 315 COVID-19 patients admitted to ICU managed in Imam Khomeini Hospital of Urmia, Iran, during the last 6 months of 2020 were retrospectively enrolled in the study and divided into two subgroups based on their final outcome, discharge or death. RESULTS Total leucocyte count (TLC), absolute neutrophil count (NLC), urea, Cr, RDW, AISI, dNLR, NLPR, NLR, SII, and SIRI were drastically elevated in the dead patients (P < 0.05). The optimal cut-off points for AISI (378.81), dNLR (5.66), NLPR (0.03), NLR (5.97), SII (1589.25), and SIRI (2.31) were obtained using ROC curves. NLR and SII had the highest sensitivity (71.4%) and specificity (73.6%), respectively. Patients with above-cut-off levels of ISI, dNLR, NLPR, NLR, and SII had lower average survival time. Age (OR = 1.057, CI95%: 1.030-1.085, p < 0.001) and dNLR (OR = 1.131, CI95%: 1.061-1.206, p < 0.001) were the independent predictors for mortality in the studied COVID-19 patients based on multivariate logistic regression. CONCLUSION Age and dNLR are valuable predictive factors for in-hospital death of ICU-admitted COVID-19 patients. Besides, other indices, AISI, NLPR, NLR, SII, and SIRI, may have an additional role that requires further investigation.
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Affiliation(s)
- Amir Tahavvori
- Department of Internal Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Reza Mosaddeghi-Heris
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faezeh Ghanbari Sevari
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Peghah Panahi
- Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Niloufar Abbasi
- Department of Internal Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | | | - Seyyed Sina Hejazian
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran.
- Immunology Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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22
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Kumar D, Sood SK, Rawat KS. Empowering elderly care with intelligent IoT-Driven smart toilets for home-based infectious health monitoring. Artif Intell Med 2023; 144:102666. [PMID: 37783534 DOI: 10.1016/j.artmed.2023.102666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/04/2023]
Abstract
The COVID-19 pandemic highlights the need for effective and non-intrusive methods to monitor the well-being of elderly individuals in their homes, especially for early detection of potential viral infections. Conspicuously, the present paper develops a Multi-scaled Long Short Term Memory (Ms-LSTM) model for the routine health monitoring of elderly patients to detect COVID-19. The proposed method offers home-based health diagnostics through urine analysis by leveraging the IoT-Fog-Cloud paradigm. Mainly, the proposed model constitutes a four-layered architecture: data acquisition, fog layer, cloud layer, and interface layer. Each layer serves distinct functionalities and provides specific services, thereby collectively enhancing the overall effectiveness of the model. The statistical results of the study demonstrate the superior performance of the proposed Ms-LSTM model in comparison to state-of-the-art methods, including Artificial Neural Networks (ANN), K-Nearest Neighbors (K-NN), Support Vector Machine (SVM), Random Forest, and LSTM. Further, the proposed model attains a mean temporal efficiency of 39.23 seconds. It exhibits high reliability (92.97%), stability (70.06%), and predictive accuracy (93.25%).
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Affiliation(s)
- Dheeraj Kumar
- Central University of Himachal Pradesh, Dharmashala, Himachal Pradesh, India.
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23
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Spannella F, Giulietti F, Laureti G, Di Rosa M, Di Pentima C, Allevi M, Garbuglia C, Giordano P, Landolfo M, Ferrara L, Fumagalli A, Lattanzio F, Bonfigli AR, Sarzani R. Role of Cardio-Renal Dysfunction, Inflammation Markers, and Frailty on In-Hospital Mortality in Older COVID-19 Patients: A Cluster Analysis. Biomedicines 2023; 11:2473. [PMID: 37760914 PMCID: PMC10525261 DOI: 10.3390/biomedicines11092473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Our study aimed to identify clusters of hospitalized older COVID-19 patients according to their main comorbidities and routine laboratory parameters to evaluate their association with in-hospital mortality. We performed an observational study on 485 hospitalized older COVID-19 adults (aged 80+ years). Patients were aggregated in clusters by a K-medians cluster analysis. The primary outcome was in-hospital mortality. Medical history and laboratory parameters were collected on admission. Frailty, defined by the Clinical Frailty Scale (CFS), referred to the two weeks before hospitalization and was used as a covariate. The median age was 87 (83-91) years, with a female prevalence (59.2%). Three different clusters were identified: cluster 1 (337), cluster 2 (118), and cluster 3 (30). In-hospital mortality was 28.5%, increasing from cluster 1 to cluster 3: cluster 1 = 21.1%, cluster 2 = 40.7%, and cluster 3 = 63.3% (p < 0.001). The risk for in-hospital mortality was higher in clusters 2 [HR 1.96 (95% CI: 1.28-3.01)] and 3 [HR 2.87 (95% CI: 1.62-5.07)] compared to cluster 1, even after adjusting for age, sex, and frailty. Patients in cluster 3 were older and had a higher prevalence of atrial fibrillation, higher admission NT-proBNP and C-reactive protein levels, higher prevalence of concurrent bacterial infections, and lower estimated glomerular filtration rates. The addition of CFS significantly improved the predictive ability of the clusters for in-hospital mortality. Our cluster analysis on older COVID-19 patients provides a characterization of those subjects at higher risk for in-hospital mortality, highlighting the role played by cardio-renal impairment, higher inflammation markers, and frailty, often simultaneously present in the same patient.
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Affiliation(s)
- Francesco Spannella
- Internal Medicine and Geriatrics, IRCCS INRCA, 60127 Ancona, Italy
- Department of Clinical and Molecular Sciences, “Politecnica delle Marche” University, 60126 Ancona, Italy
| | | | - Giorgia Laureti
- Internal Medicine and Geriatrics, IRCCS INRCA, 60127 Ancona, Italy
- Department of Clinical and Molecular Sciences, “Politecnica delle Marche” University, 60126 Ancona, Italy
| | - Mirko Di Rosa
- Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, 60127 Ancona, Italy
| | | | - Massimiliano Allevi
- Internal Medicine and Geriatrics, IRCCS INRCA, 60127 Ancona, Italy
- Department of Clinical and Molecular Sciences, “Politecnica delle Marche” University, 60126 Ancona, Italy
| | - Caterina Garbuglia
- Internal Medicine and Geriatrics, IRCCS INRCA, 60127 Ancona, Italy
- Department of Clinical and Molecular Sciences, “Politecnica delle Marche” University, 60126 Ancona, Italy
| | - Piero Giordano
- Internal Medicine and Geriatrics, IRCCS INRCA, 60127 Ancona, Italy
| | - Matteo Landolfo
- Internal Medicine and Geriatrics, IRCCS INRCA, 60127 Ancona, Italy
- Department of Clinical and Molecular Sciences, “Politecnica delle Marche” University, 60126 Ancona, Italy
| | - Letizia Ferrara
- Medical Direction, Risk Manager, IRCCS INRCA, 60127 Ancona, Italy
| | | | | | | | - Riccardo Sarzani
- Internal Medicine and Geriatrics, IRCCS INRCA, 60127 Ancona, Italy
- Department of Clinical and Molecular Sciences, “Politecnica delle Marche” University, 60126 Ancona, Italy
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24
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Shaikh A, Khan SD, Baloch F, Virani SS, Samad Z. The COVID-19 Pandemic and Coronary Heart Disease: the Next Surge. Curr Atheroscler Rep 2023; 25:559-569. [PMID: 37531071 DOI: 10.1007/s11883-023-01131-0] [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] [Accepted: 07/02/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE OF REVIEW In this narrative review, we highlight different ways in which the COVID-19 pandemic has impacted coronary heart disease (CHD) burden and how a surge in morbidity and mortality may be expected in the near future. We also discuss potential solutions, and the direction subsequent research and corrective actions should take. RECENT FINDINGS COVID-19 has been implicated in the development and worsening of CHD via acute and chronic mechanisms in the form of plaque rupture, destabilization, and sustenance of a chronic inflammatory state leading to long COVID syndrome and increased rates of myocardial infarction. However, indirectly the pandemic is likely to further escalate the CHD burden through poor health behaviors such as tobacco consumption, reduced physical activity, economic devastation and its associated sequelae, and regular cardiac care interruptions and delays. COVID-19 has increased the total CHD burden and will require extensive resource allocation and multifaceted strategies to curb future rise.
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25
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Al-Azzam N, Al-Azzam S, Khassawneh B, Araydah M, Karasneh RA, Aldeyab MA. Factors contributing to poor COVID-19 outcomes in diabetic patients: Findings from a single-center cohort study. PLoS One 2023; 18:e0290946. [PMID: 37651383 PMCID: PMC10470961 DOI: 10.1371/journal.pone.0290946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/20/2023] [Indexed: 09/02/2023] Open
Abstract
Diabetes Mellitus (DM) is a frequent comorbidity in patients infected with the SARS-CoV-2 virus. The risk of developing severe or critical COVID-19 and higher mortality was observed to be increased in diabetic patients hospitalized due to COVID-19. In this study we aimed to find out the impact of clinical characteristics, comorbidities, laboratory results, and complications on the outcomes of diabetic patients hospitalized due to COVID-19. This article is a retrospective cohort study that include diabetic patients hospitalized with COVID-19 infection. A definition of diabetes was based on the past history of diabetes or if the HbA1c was 6.5% or higher. Demographics, clinical characteristics, comorbidities, laboratory results, and complications were extracted from the electronic medical records. The mortality rate increased with increasing age (from 5.56% in younger patients to 46% in the elderly) and with severity (from 25.71% in moderate cases to 43.77% in critical cases). We found that a critical severity on admission (OR: 5.26, 95% CI: 1.28-21.66, p = 0.0214), a history of stroke (OR: 8.37, 95% CI: 2.2-31.88, p = 0.0018), and low calcium levels on admission (OR: 2.23, 95% CI: 1.01-4.91, p = 0.0475) were significant risk factors predicting higher COVID-19 mortality in diabetic patients. The findings of this study suggest that reduced calcium levels could potentially indicate higher mortality due to COVID-19 in patients with DM. Furthermore, careful monitoring of diabetic patients hospitalized due to COVID-19 infection, especially those with critical disease severity or those with a history of stroke, may improve their outcome and lessen mortality.
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Affiliation(s)
- Nosayba Al-Azzam
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sayer Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Basheer Khassawneh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Reema A. Karasneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Mamoon A. Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
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Koziol JA, Schnitzer JE. Worldwide Regional Differences in Obesity, Elderly, and COVID-19 Mortality: Do the Exceptions Prove the Rule? MEDICAL RESEARCH ARCHIVES 2023; 11:4248. [PMID: 37674672 PMCID: PMC10482002 DOI: 10.18103/mra.v11i8.4248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Objectives Obesity and old age are commonly assumed to be risk factors for COVID-19 mortality. On a worldwide basis, we examine quantitative measures of obesity and elderly in the populations of individual countries and territories, and investigate whether these measures are predictive of COVID-19 mortality in those countries. In particular, we highlight regional differences relative to obesity and elderly metrics, and how these relate to COVID-19 mortality. Methods In this retrospective, population-based study, we obtained data relating to percentages of obese or elderly individuals in 199 countries, as well as COVID-19 mortality rates in these countries. We used negative binomial regression analyses to assess associations between COVID-19 mortality rates and the putative risk factors, in six regions - Africa, Asia, Europe, North America, Oceania, and South America. Results We found significant differences between regions relative to COVID-19 mortality, as well as obesity and elderly population proportions. There were also substantial differences between countries within regions relative to proportions of obesity and elderly individuals, and COVID-19 mortality. Conclusions There are significant differences both between regions and within regions relative to COVID-19 mortality rates, as well as proportions of obese or elderly individuals. A global pronouncement that obesity and elderly constitute definitive risk factors for COVID-19 mortality masks the subtleties engendered by these intra- and inter-regional differences.
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Affiliation(s)
- James A Koziol
- Proteogenomics Research Institute for Systems Medicine La Jolla, California USA
| | - Jan E Schnitzer
- Proteogenomics Research Institute for Systems Medicine La Jolla, California USA
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27
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Datta D, George Dalmida S, Martinez L, Newman D, Hashemi J, Khoshgoftaar TM, Shorten C, Sareli C, Eckardt P. Using machine learning to identify patient characteristics to predict mortality of in-patients with COVID-19 in south Florida. Front Digit Health 2023; 5:1193467. [PMID: 37588022 PMCID: PMC10426497 DOI: 10.3389/fdgth.2023.1193467] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/12/2023] [Indexed: 08/18/2023] Open
Abstract
Introduction The SARS-CoV-2 (COVID-19) pandemic has created substantial health and economic burdens in the US and worldwide. As new variants continuously emerge, predicting critical clinical events in the context of relevant individual risks is a promising option for reducing the overall burden of COVID-19. This study aims to train an AI-driven decision support system that helps build a model to understand the most important features that predict the "mortality" of patients hospitalized with COVID-19. Methods We conducted a retrospective analysis of "5,371" patients hospitalized for COVID-19-related symptoms from the South Florida Memorial Health Care System between March 14th, 2020, and January 16th, 2021. A data set comprising patients' sociodemographic characteristics, pre-existing health information, and medication was analyzed. We trained Random Forest classifier to predict "mortality" for patients hospitalized with COVID-19. Results Based on the interpretability of the model, age emerged as the primary predictor of "mortality", followed by diarrhea, diabetes, hypertension, BMI, early stages of kidney disease, smoking status, sex, pneumonia, and race in descending order of importance. Notably, individuals aged over 65 years (referred to as "older adults"), males, Whites, Hispanics, and current smokers were identified as being at higher risk of death. Additionally, BMI, specifically in the overweight and obese categories, significantly predicted "mortality". These findings indicated that the model effectively learned from various categories, such as patients' sociodemographic characteristics, pre-hospital comorbidities, and medications, with a predominant focus on characterizing pre-hospital comorbidities. Consequently, the model demonstrated the ability to predict "mortality" with transparency and reliability. Conclusion AI can potentially provide healthcare workers with the ability to stratify patients and streamline optimal care solutions when time is of the essence and resources are limited. This work sets the platform for future work that forecasts patient responses to treatments at various levels of disease severity and assesses health disparities and patient conditions that promote improved health care in a broader context. This study contributed to one of the first predictive analyses applying AI/ML techniques to COVID-19 data using a vast sample from South Florida.
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Affiliation(s)
- Debarshi Datta
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, United States
| | - Safiya George Dalmida
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, United States
| | - Laurie Martinez
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, United States
| | - David Newman
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, United States
| | - Javad Hashemi
- College of Engineering & Computer Science, Florida Atlantic University, Boca Raton, FL, United States
| | - Taghi M. Khoshgoftaar
- College of Engineering & Computer Science, Florida Atlantic University, Boca Raton, FL, United States
| | - Connor Shorten
- College of Engineering & Computer Science, Florida Atlantic University, Boca Raton, FL, United States
| | - Candice Sareli
- Memorial Healthcare System, Hollywood, FL, United States
| | - Paula Eckardt
- Memorial Healthcare System, Hollywood, FL, United States
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Cheong HH, Sio FI, Chan CC, Neng SI, Sam IP, Cheang T, Tou WI, Lei HS, Cheong TF, Lao EPL, Cheong TH, Kuok CU, Lo IL. Clinical characteristics of COVID-19 patients infected by the Omicron variants in Macao, China: A cross-sectional study. Health Sci Rep 2023; 6:e1361. [PMID: 37404450 PMCID: PMC10316466 DOI: 10.1002/hsr2.1361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/26/2023] [Accepted: 06/07/2023] [Indexed: 07/06/2023] Open
Abstract
Background and Aims The evolving mutants of SARS-CoV-2 have made the COVID-19 pandemic sustained for over 3 years. In 2022, BA.4 and BA.5 were the Omicron variants dominating the spread globally. Although COVID-19 was no longer a Public Health Emergency of International Concern (PHEIC) as announced by WHO, the SARS-CoV-2 variants remain a challenge to global healthcare under the circumstances of withdrawal and loosening of personal protective behavior in the post-quarantine era. This study aims to acknowledge the clinical characteristics caused by Omicron BA.4/BA.5 in COVID-19 naive people and analyze possible factors affecting disease severities. Methods In this retrospective study, we report and analyze the clinical features of 1820 COVID-19 patients infected with the BA.4/BA.5 Omicron variants of SARS-CoV-2 during a local outbreak that occurred in Macao SAR, China, from June to July 2022. Results A total of 83.5% of patients were symptomatic eventually. The most common symptoms were fever, cough, and sore throat. Hypertension, dyslipidemia, and diabetes mellitus were the leading comorbidities. There were significantly more elderly patients (p < 0.001), more patients with comorbidity (p < 0.001) and more patients without vaccination or not completing the series (p < 0.001) in the "Severe to Critical" group. All deceased patients were elderly with at least three comorbidities and were partial to totally dependent in their daily lives. Conclusion Our data are consistent with a milder disease caused by BA.4/5 Omicron variants in the general population, while patients with old age and comorbidities have developed severe to critical diseases. Complete vaccination series and booster doses are effective strategies to reinforce protection against severe diseases and avoid mortality.
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Retraction statement: COVID-19 mortality and its predictors in the elderly: A systematic review. Health Sci Rep 2023; 6:e1455. [PMID: 37502111 PMCID: PMC10368961 DOI: 10.1002/hsr2.1455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
[This retracts the article DOI: 10.1002/hsr2.657.].
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Sirois AC, Haase KR, Pesut J, Ahmed S, Sattar S. Impact of the COVID-19 pandemic on physical activity among older adults with cancer in a central Canadian province: Results from a survey study. Can Oncol Nurs J 2023; 33:348-354. [PMID: 38919898 PMCID: PMC11195794 DOI: 10.5737/23688076333348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Abstract
Background Physical activity is important for individuals with cancer. Older adults with cancer (OACA) have been disproportionally vulnerable to both COVID-19 infection and its outcomes. This study investigated how the COVID-19 pandemic and associated restrictions affected physical activity in OACA in one Canadian province. Method An online cross-sectional survey was conducted. Quantitative data were analyzed using descriptive and inferential statistics, with SPSS® Version 27. Answers to free-text questions were grouped, based on thematic categories. Results One hundred and fifteen OACA participated in this study; more than 46% reported lower levels of physical activity since the COVID-19 pandemic. Participants described increases in sedentary behaviour and reduced physical activity overall. They also described barriers to physical activity, and remained open to remotely delivered physical activity interventions. Conclusion The pandemic disrupted physical activity routines among OACA. Future efforts should include an acceleration of research related to remotely delivered interventions given older adults' growing acceptance of such technologies.
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Affiliation(s)
- Ailsa C Sirois
- Faculty of Applied Science, School of Nursing, University of British Columbia, Vancouver, Canada
| | - Kristen R Haase
- Faculty of Applied Science, School of Nursing, University of British Columbia, Vancouver, Canada
| | - Jennifer Pesut
- Faculty of Applied Science, School of Nursing, University of British Columbia, Vancouver, Canada; British Columbia Cancer, Surrey, Canada
| | - Shahid Ahmed
- College of Medicine, University of Saskatchewan, Saskatoon, Canada; Saskatchewan Cancer Agency
| | - Schroder Sattar
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
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Charkowick SV, Logothetis CN, Tsay K, Jordan A, Hanna C, Zhang S, Coughlin E, Weppelmann TA, Mhaskar R, Oxner A. A Retrospective Analysis of Vitamin D Levels in Hospitalized COVID-19 Patients With Suspected Pulmonary Embolism. Cureus 2023; 15:e41805. [PMID: 37575807 PMCID: PMC10422855 DOI: 10.7759/cureus.41805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Despite using anti-coagulation therapy in hospitalized coronavirus disease 2019 (COVID-19) patients, they have high rates of pulmonary embolism (PE) and deep vein thrombosis (DVT). The main objective of this study was to evaluate the association between vitamin D deficiency and thrombotic events (defined as the occurrence of a new PE or DVT) in hospitalized COVID-19 patients. Materials and Methods This was a retrospective, cross-sectional study of 208 hospitalized COVID-19 patients who received a computed tomographic pulmonary angiography (CTPA) based on clinical suspicion of PE between January 1, 2020, and February 5, 2021. A <20 ng/mL serum vitamin D level was used to categorize vitamin D deficiency. Nonparametric tests and multivariate binary logistic regression were used to evaluate the association between serum vitamin D levels and clinical outcomes. Results The mean vitamin D level was 26.7±13.0 ng/mL (n=208), and approximately one-third of patients were vitamin D deficient (n=68, 32.7%). No association was found between vitamin D deficiency and the occurrence of thrombotic events. The incidence of PE was 19.1% in vitamin D deficient patients compared to 11.4% in vitamin D sufficient patients (p=0.13). Vitamin D deficiency was positively associated with ICU admission (OR 3.047, 95%CI 1.57-5.91, p=0.001) and mortality (OR 3.76, 95%CI 1.29-11.01, p=0.016). Conclusions This study found no association between vitamin D deficiency and the occurrence of a new PE or DVT in hospitalized COVID-19 patients. Patients with vitamin D deficiency were more likely to be admitted to the ICU and had increased overall mortality.
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Affiliation(s)
- Shaun V Charkowick
- College of Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Constantine N Logothetis
- Department of Internal Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Katherine Tsay
- College of Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Aryanna Jordan
- Department of Internal Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Catherine Hanna
- College of Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Sherry Zhang
- College of Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
- Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, USA
| | - Emily Coughlin
- College of Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Thomas A Weppelmann
- Department of Ophthalmology, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Rahul Mhaskar
- Department of Internal Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Asa Oxner
- Department of Internal Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
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Sirois AC, Haase KR, Pesut J, Ahmed S, Sattar S. Répercussions de la pandémie de COVID-19 sur l’activité physique des personnes âgées atteintes de cancer dans une province des Prairies canadiennes: résultat d’un sondage. Can Oncol Nurs J 2023; 33:355-362. [PMID: 38919896 PMCID: PMC11195790 DOI: 10.5737/23688076333355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Abstract
Contexte L’activité physique apporte des bienfaits majeurs aux personnes atteintes de cancer. Les personnes âgées atteintes de cancer ont été disproportionnellement touchées par la pandémie de COVID-19 et ses contrecoups. La présente étude examine les effets de la pandémie de COVID-19 et de ses restrictions sur l’activité physique des personnes âgées atteintes de cancer en Saskatchewan, une province située au centre du Canada. Méthodologie Des données quantitatives ont été recueillies au moyen d’une enquête transversale en ligne pour ensuite faire l’objet d’une analyse statistique descriptive et inférentielle à l’aide de la version 27 du logiciel SPSSMD. Les réponses aux questions ouvertes ont été regroupées par thème. Résultats L’échantillon était composé de 115 personnes âgées atteintes de cancer; plus de 46 % d’entre elles ont déclaré avoir diminué leur niveau d’activité physique au cours de la pandémie de COVID-19. En général, les participants ont été plus sédentaires et moins actifs. Ils ont également fait état des obstacles à l’activité physique, et se sont montrés ouverts à des solutions accessibles en ligne. Conclusion La pandémie a perturbé les habitudes d’activité physique des personnes âgées atteintes de cancer. Les personnes âgées acceptent de plus en plus les interventions en ligne; des efforts devront donc être engagés pour accélérer la recherche sur ce type d’outils technologiques.
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Affiliation(s)
- Ailsa C Sirois
- Faculté des sciences appliquées, École des sciences infirmières, Université de la Colombie-Britannique, Vancouver, Canada
| | - Kristen R Haase
- Faculté des sciences appliquées, École des sciences infirmières, Université de la Colombie-Britannique, Vancouver, Canada
| | - Jennifer Pesut
- Faculté des sciences appliquées, École des sciences infirmières, Université de la Colombie-Britannique, Vancouver, Canada; British Columbia Cancer, Surrey, Canada
| | - Shahid Ahmed
- Collège de médecine, Université de la Saskatchewan, Saskatoon, Canada; Saskatchewan Cancer Agency
| | - Schroder Sattar
- Collège des sciences infirmières, Université de la Saskatchewan, Saskatoon, Canada
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McCarthy A, Galvin R, Dockery F, McLoughlin K, O'Connor M, Corey G, Whiston A, Carey L, Steed F, Tierney A, Robinson K. Multidisciplinary inpatient rehabilitation for older adults with COVID-19: a systematic review and meta-analysis of clinical and process outcomes. BMC Geriatr 2023; 23:391. [PMID: 37365515 DOI: 10.1186/s12877-023-04098-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Older adults are at increased risk for disease severity and poorer prognosis following COVID-19 infection. The aim of this systematic review and meta-analysis is to explore the impact of multidisciplinary rehabilitation in the acute or post-acute hospital setting for older adults with COVID-19. METHODS The Cochrane library, EMBASE, Cinahl and Medline (via EBSCO), PubMed, and Web of Science were systematically searched in June 2022 and a repeat search was completed in March 2023. Screening, data extraction and quality appraisal were conducted independently by two reviewers. Studies reporting outcomes for older adults following multidisciplinary rehabilitation (provided by two or more Health and Social Care Professionals) were included. Both observational and experimental study designs were included. The primary outcome was functional ability. Secondary outcomes included discharge disposition, acute hospital and rehabilitation unit length of stay, mortality, primary and secondary healthcare utilisation, and long-term effects of COVID-19. RESULTS Twelve studies met the inclusion criteria, comprising a total of 570 older adults. Where reported, older adults stayed in the acute hospital for a mean of 18 days (95%CI, 13.35- 23.13 days) and in rehabilitation units for 19 days (95%CI, 15.88-21.79 days). There was a significant improvement in functional ability among older adults with COVID-19 who received multidisciplinary rehabilitation (REM, SMD = 1.46, 95% CI 0.94 to 1.98). The proportion of older adults who were discharged directly home following rehabilitation ranged from 62 to 97%. Two studies reported a 2% inpatient mortality rate of older persons during rehabilitative care. No study followed up patients after the point of discharge and no study reported on long term effects of COVID-19. CONCLUSIONS Multidisciplinary rehabilitation may result in improved functional outcomes on discharge from rehabilitation units/centres for older adults with COVID-19. Findings also highlight the need for further research into the long-term effect of rehabilitation for older adults following COVID-19. Future research should comprehensively describe multidisciplinary rehabilitation in terms of disciplines involved and the intervention provided.
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Affiliation(s)
- Aoife McCarthy
- School of Allied Health, Faculty of Education and Health Sciences, Post Graduate Member HRI, University of Limerick, Limerick, Ireland.
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Frances Dockery
- Department of Geriatric and Stroke Medicine, and Integrated Care Team for Older People North Dublin, Beaumont Hospital, Dublin, Ireland
| | - Kara McLoughlin
- Department of Occupational Therapy, Beaumont Hospital, Dublin, Ireland
| | - Margaret O'Connor
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Gillian Corey
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - Aoife Whiston
- Post Doctoral Researcher, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Leonora Carey
- UL Hospitals Group, University Hospital Limerick, Limerick, Ireland
| | - Fiona Steed
- UL Hospitals Group, University Hospital Limerick, Limerick, Ireland
| | - Audrey Tierney
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Katie Robinson
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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Castelli C, Castellini M, Comincioli N, Parisi ML, Pontarollo N, Vergalli S. Ecosystem degradation and the spread of Covid-19. ENVIRONMENTAL MONITORING AND ASSESSMENT 2023; 195:836. [PMID: 37308607 DOI: 10.1007/s10661-023-11403-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/17/2023] [Indexed: 06/14/2023]
Abstract
The linkages between the emergence of zoonotic diseases and ecosystem degradation have been widely acknowledged by the scientific community and policy makers. In this paper we investigate the relationship between human overexploitation of natural resources, represented by the Human Appropriation of Net Primary Production Index (HANPP) and the spread of Covid-19 cases during the first pandemic wave in 730 regions of 63 countries worldwide. Using a Bayesian estimation technique, we highlight the significant role of HANPP as a driver of Covid-19 diffusion, besides confirming the well-known impact of population size and the effects of other socio-economic variables. We believe that these findings could be relevant for policy makers in their effort towards a more sustainable intensive agriculture and responsible urbanisation.
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Affiliation(s)
- Chiara Castelli
- The Vienna Institute for International Economic Studies, Vienna, Austria
| | - Marta Castellini
- Department of Economics and Management "Marco Fanno", University of Padua, Padua, Italy
- Fondazione Eni Enrico Mattei, Milan, Italy
| | - Nicola Comincioli
- Fondazione Eni Enrico Mattei, Milan, Italy
- Department of Economics and Management, University of Brescia, Brescia, Italy
| | - Maria Laura Parisi
- Department of Economics and Management, University of Brescia, Brescia, Italy
| | - Nicola Pontarollo
- Department of Economics and Management, University of Brescia, Brescia, Italy.
| | - Sergio Vergalli
- Fondazione Eni Enrico Mattei, Milan, Italy
- Department of Economics and Management, University of Brescia, Brescia, Italy
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Thompson C, Porter Starr KN, Kemp EC, Chan J, Jackson E, Phun J. Feasibility of Virtually Delivering Functional Fitness Assessments and a Fitness Training Program in Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5996. [PMID: 37297600 PMCID: PMC10252352 DOI: 10.3390/ijerph20115996] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/07/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023]
Abstract
The COVID-19 pandemic limited older adults' access to preventative and diagnostic services and negatively affected accessibility to age-appropriate exercise programs. The purpose of this study was to assess the feasibility of conducting guided virtual functional fitness assessments before and after participation in an 8-week virtual, live fitness program (Vivo) designed for older adults. It was hypothesized there would be no significant difference between in-person and virtual functional fitness assessments and function would improve following the program. Thirteen community-dwelling older adults were recruited, screened, and randomly assigned to in-person-first or virtual-first fitness assessment groups. Validated assessments were delivered using standardized scripts by trained researchers and included Short Physical Performance Battery (SPPB) balance, a 30 s Chair Stand Test, 8 Foot Up-and-Go Test, 30 s Arm Curl Test, and 2 min Step Test. The eight-week, twice-a-week live virtual fitness program involved cardiovascular, balance, agility, Dual-Task, and strength training. Results showed no significant differences between all but one assessment measures, and several measures improved following the eight-week program. Fidelity checks demonstrated the high fidelity of program delivery. These findings illustrate that virtual assessments can be a feasible method to measure functional fitness in community-dwelling older adults.
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Affiliation(s)
- Christian Thompson
- Department of Kinesiology, University of San Francisco, San Francisco, CA 94117, USA
| | - Kathryn N. Porter Starr
- Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA
- Geriatric Research Education and Clinical Center, Durham VA Health Care System, Durham, NC 27710, USA
| | | | - June Chan
- Department of Kinesiology, University of San Francisco, San Francisco, CA 94117, USA
| | - Emily Jackson
- Department of Kinesiology, University of San Francisco, San Francisco, CA 94117, USA
| | - Justin Phun
- Department of Kinesiology, University of San Francisco, San Francisco, CA 94117, USA
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Yu Y, Yen SHY, Jiang LC, Ming WK, Lau MMC, Lau JTF. Levels and Determinants of COVID-19 Vaccination at a Later Phase among Chinese Older People Aged 60 Years or Older: A Population-Based Survey. Vaccines (Basel) 2023; 11:1029. [PMID: 37376418 DOI: 10.3390/vaccines11061029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
The early attainment of high COVID-19 vaccination rates can minimize avoidable hospitalizations/deaths. The fifth wave COVID-19 outbreak in Hong Kong caused >9000 deaths, and most of them were unvaccinated older people. This study hence investigated determinants of taking the first dose vaccination at a later phase (Phase 3: during the fifth wave outbreak, i.e., February-July 2022) versus two earlier phases (Phase 1: first six months since vaccine rollout, i.e., February-July 2021; Phase 2: six months prior to the outbreak, i.e., August 2021-January 2022) via a random telephone survey among 386 ever-vaccinated Hong Kong older people aged ≥60 (June/July 2022). A total of 27.7%, 51.1%, and 21.3% took the first dose at Phase 1, Phase 2, and Phase 3, respectively. Unfavorable perceptions related to COVID-19/vaccination, exposure to conflicting/counter-information about the suitability of older people's vaccination from various sources, unsupportive family influences prior to the outbreak, and depressive symptoms were significantly associated with taking the first dose at Phase 3 instead of Phase 1 and Phase 2. To speed up COVID-19 vaccination and avoid unnecessary deaths, the government and health professionals should rectify misinformation, provide clear/consistent information for older people and their family members, and focus on those having depressive symptoms at an earlier stage of the pandemic.
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Affiliation(s)
- Yanqiu Yu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
- Health Communication Institute, Fudan University, Shanghai 200032, China
| | - Stefanie Hoi Ying Yen
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li Crystal Jiang
- Department of Media and Communication, City University of Hong Kong, Hong Kong SAR, China
| | - Wai-Kit Ming
- Department of Infectious Disease and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Mason M C Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joseph T F Lau
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, China
- School of Mental Health, Wenzhou Medical University, Wenzhou 325000, China
- School of Public Health, Zhejiang University, Hangzhou 310058, China
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Smadi M, Kaburis M, Schnapper Y, Reina G, Molero P, Molendijk ML. SARS-CoV-2 susceptibility and COVID-19 illness course and outcome in people with pre-existing neurodegenerative disorders: systematic review with frequentist and Bayesian meta-analyses. Br J Psychiatry 2023:1-14. [PMID: 37183681 DOI: 10.1192/bjp.2023.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND People with neurodegenerative disease and mild cognitive impairment (MCI) may have an elevated risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may be disproportionally affected by coronavirus disease 2019 (COVID-19) once infected. AIMS To review all eligible studies and quantify the strength of associations between various pre-existing neurodegenerative disorders and both SARS-CoV-2 susceptibility and COVID-19 illness course and outcome. METHOD Pre-registered systematic review with frequentist and Bayesian meta-analyses. Systematic searches were executed in PubMed, Web of Science and preprint servers. The final search date was 9 January 2023. Odds ratios (ORs) were used as measures of effect. RESULTS In total, 136 primary studies (total sample size n = 97 643 494), reporting on 268 effect-size estimates, met the inclusion criteria. The odds for a positive SARS-CoV-2 test result were increased for people with pre-existing dementia (OR = 1.83, 95% CI 1.16-2.87), Alzheimer's disease (OR = 2.86, 95% CI 1.44-5.66) and Parkinson's disease (OR = 1.65, 95% CI 1.34-2.04). People with pre-existing dementia were more likely to experience a relatively severe COVID-19 course, once infected (OR = 1.43, 95% CI 1.00-2.03). People with pre-existing dementia or Alzheimer's disease were at increased risk for COVID-19-related hospital admission (pooled OR range: 1.60-3.72). Intensive care unit admission rates were relatively low for people with dementia (OR = 0.54, 95% CI 0.40-0.74). All neurodegenerative disorders, including MCI, were at higher risk for COVID-19-related mortality (pooled OR range: 1.56-2.27). CONCLUSIONS Our findings confirm that, in general, people with neurodegenerative disease and MCI are at a disproportionally high risk of contracting COVID-19 and have a poor outcome once infected.
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Affiliation(s)
- Muhannad Smadi
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Melina Kaburis
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Youval Schnapper
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Gabriel Reina
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; and Clínica Universidad de Navarra, Department of Microbiology, Pamplona, Spain
| | - Patricio Molero
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; and Clínica Universidad de Navarra, Department of Psychiatry and Medical Psychology, Pamplona, Spain
| | - Marc L Molendijk
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands; and Leiden Institute for Brain and Cognition, Leiden University Medical Centre, Leiden, The Netherlands
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Kyagambiddwa T, Kintu TM, Miiro E, Nabalamba F, Asiimwe GS, Namutebi AM, Abeya FC, Lumori BA, Ijuka I, Muhindo RK, Mutekanga A, Musinguzi R, Natuhwera F, Ngonzi J, Nuwagira E. Thirty-Day Outcomes of Young and Middle-Aged Adults Admitted with Severe COVID-19 in Uganda: A Retrospective Cohort Study. Infect Drug Resist 2023; 16:2923-2932. [PMID: 37197696 PMCID: PMC10184892 DOI: 10.2147/idr.s405256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/28/2023] [Indexed: 05/19/2023] Open
Abstract
Background There is scarcity of data regarding young and middle-aged adults hospitalized with severe Corona Virus Disease 2019 (COVID-19) in Africa. In this study, we describe the clinical characteristics and 30-day survival among adults aged 18 to 49 years admitted with severe COVID-19 in Uganda. Methods We reviewed treatment records of patients admitted with severe COVID-19 across five COVID-19 treatment units (CTU) in Uganda. We included individuals aged 18 to 49 years, who had a positive test or met the clinical criteria for COVID-19. We defined severe COVID-19 as having an oxygen saturation <94%, lung infiltrates >50% on imaging and presence of a co-morbidity that required admission in the CTU. Our main outcome was the 30-day survival from the time of admission. We used a Cox proportional hazards model to determine the factors associated with 30-day survival at a 5% level of significance. Results Of the 246 patient files reviewed, 50.8% (n = 125) were male, the mean ± (standard deviation) age was 39 ± 8 years, majority presented with cough, 85.8% (n = 211) and median C-reactive protein (interquartile range) was 48 (47.5, 178.8) mg/L. The 30-day mortality was 23.9% (59/246). At admission, anemia (hazard ratio (HR): 3.00, 95% confidence interval (CI), 1.32-6.82; p = 0.009) and altered mental state (GCS <15) (HR: 6.89, 95% CI: 1.48-32.08, p = 0.014) were significant predictors of 30-day mortality. Conclusion There was a high 30-day mortality among young and middle-aged adults with severe COVID-19 in Uganda. Early recognition and targeted management of anemia and altered consciousness are needed to improve clinical outcomes.
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Affiliation(s)
- Tonny Kyagambiddwa
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Timothy Mwanje Kintu
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Emmanuel Miiro
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Franchesca Nabalamba
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Gloria Suubi Asiimwe
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Fardous C Abeya
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Boniface A Lumori
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Rose K Muhindo
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Andrew Mutekanga
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | - Joseph Ngonzi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Edwin Nuwagira
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Tuberculosis Treatment Unit, Mbarara Regional Referral Hospital, Mbarara, Uganda
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Thirupathi A, Yong W, Oflaz O, Agascioglu E, Gu Y. Exercise and COVID-19: exercise intensity reassures immunological benefits of post-COVID-19 condition. Front Physiol 2023; 14:1036925. [PMID: 37275224 PMCID: PMC10233405 DOI: 10.3389/fphys.2023.1036925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 04/18/2023] [Indexed: 06/07/2023] Open
Abstract
Any form of physical activity, including exercise, has various benefits at the physiological (improving cardiac and respiratory functions, increasing skeletal muscle mass, and maintaining homeostasis) and psychological levels (improving cognitive function, reducing anxiety and depression) which help to combat any type of infection. In contrast, the infectivity ratio could reduce the physical activity of an individual, such as performing a habitual exercise. Adaptation to different exercise strategies including intensity and duration may better increase physical performance and improve the symptoms. For example, low to moderate intensity perhaps fails to induce this adaptive process, while high-intensity of exercise compromises immune health. This can aggravate the infection rate (Open window theory). However, high intensity with a shorter time produces various morphological alterations in the primary organs including the lungs and heart, which facilitate life support in COVID-19 patients. However, less information about exercise protocols failed to assure the benefits of exercise to COVID-19 patients, particularly post-COVID-19 conditions. Therefore, this review will answer how exercise intensity is crucial to reassure the exercise benefits for promoting safe participation before infection and post-COVID-19 conditions.
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Affiliation(s)
- Anand Thirupathi
- Research Academy of Medicine Combining Sports, Ningbo No 2 Hospital, Ningbo, China
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Wang Yong
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Ofcan Oflaz
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Eda Agascioglu
- Department of Medical Biology, Faculty of Medicine, Lokman Hekim University, Ankara, Türkiye
| | - Yaodong Gu
- Research Academy of Medicine Combining Sports, Ningbo No 2 Hospital, Ningbo, China
- Faculty of Sports Science, Ningbo University, Ningbo, China
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40
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Kamanzi P, Mulundu G, Mutale K, Mumba C, Ngalamika O. HIV and inflammatory markers are associated with persistent COVID-19 symptoms. Immun Inflamm Dis 2023; 11:e859. [PMID: 37249281 DOI: 10.1002/iid3.859] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/25/2023] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND A proportion of COVID19 survivors may present with long-COVID, which is persistent symptoms lasting four or more weeks post SARS-CoV-2 infection. These symptoms may be mild to severe, and may affect different organ-systems of the body. AIMS The main objective of this study was to determine the demographic, clinical and immunological factors associated with long COVID. MATERIALS & METHODS We conducted a nested case control study, with a total of 94 study participants initially included, and 64 participants matched for age and sex for biomarker analyses. RESULTS 32/94 (34.1%) of all the participants had long COVID. Respiratory symptoms were the most common (59.5%) followed by the musculoskeletal symptoms (28.1%). HIV was an independent predictor of long COVID (adjusted odds ratio = 2.7; p = .037). In all the 64 matched cases and controls, IFN-β was significantly higher among controls than cases. After stratifying by HIV, IL6 was significantly higher among cases than controls in the HIV- group (2.06 vs. 0.81 pg/mL; p = .02). On the other hand, IFN-β was significantly higher among controls than cases in the HIV+ group (251 vs. 0 pg/mL; p = .01). CONCLUSION HIV infection is a risk factor for long COVID, and inflammatory markers associated with long COVID may be slightly different for HIV- and HIV+ individuals.
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Affiliation(s)
- Patrick Kamanzi
- Dermatology and Venereology Division, Department of Medicine, University of Teaching Hospital, University of Zambia School of Medicine, Lusaka, Zambia
| | - Gina Mulundu
- Department of Pathology and Microbiology, University of Teaching Hospital, University of Zambia School of Medicine, Lusaka, Zambia
| | - Keagan Mutale
- HHV-8 Molecular Virology Laboratory, University Teaching Hospital, Lusaka, Zambia
| | - Chibamba Mumba
- Department of Pathology and Microbiology, University of Teaching Hospital, University of Zambia School of Medicine, Lusaka, Zambia
| | - Owen Ngalamika
- Dermatology and Venereology Division, Department of Medicine, University of Teaching Hospital, University of Zambia School of Medicine, Lusaka, Zambia
- HHV-8 Molecular Virology Laboratory, University Teaching Hospital, Lusaka, Zambia
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Mantovani S, Oliviero B, Varchetta S, Renieri A, Mondelli MU. TLRs: Innate Immune Sentries against SARS-CoV-2 Infection. Int J Mol Sci 2023; 24:ijms24098065. [PMID: 37175768 PMCID: PMC10178469 DOI: 10.3390/ijms24098065] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been responsible for a devastating pandemic since March 2020. Toll-like receptors (TLRs), crucial components in the initiation of innate immune responses to different pathogens, trigger the downstream production of pro-inflammatory cytokines, interferons, and other mediators. It has been demonstrated that they contribute to the dysregulated immune response observed in patients with severe COVID-19. TLR2, TLR3, TLR4 and TLR7 have been associated with COVID-19 severity. Here, we review the role of TLRs in the etiology and pathogenesis of COVID-19, including TLR7 and TLR3 rare variants, the L412F polymorphism in TLR3 that negatively regulates anti-SARS-CoV-2 immune responses, the TLR3-related cellular senescence, the interaction of TLR2 and TLR4 with SARS-CoV-2 proteins and implication of TLR2 in NET formation by SARS-CoV-2. The activation of TLRs contributes to viral clearance and disease resolution. However, TLRs may represent a double-edged sword which may elicit dysregulated immune signaling, leading to the production of proinflammatory mediators, resulting in severe disease. TLR-dependent excessive inflammation and TLR-dependent antiviral response may tip the balance towards the former or the latter, altering the equilibrium that drives the severity of disease.
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Affiliation(s)
- Stefania Mantovani
- Department of Research, Division of Clinical Immunology-Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Barbara Oliviero
- Department of Research, Division of Clinical Immunology-Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Stefania Varchetta
- Department of Research, Division of Clinical Immunology-Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Alessandra Renieri
- Medical Genetics, University of Siena, 53100 Siena, Italy
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
- Genetica Medica, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy
| | - Mario U Mondelli
- Department of Research, Division of Clinical Immunology-Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
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Morioka N, Kashiwagi M, Machida A, Hanari K, Sugiyama T, Inokuchi R, Tamiya N. Japanese Local Governments' Dissemination Activities for Advance Care Planning: A Descriptive Analysis of a Nationwide Survey during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5408. [PMID: 37048022 PMCID: PMC10094607 DOI: 10.3390/ijerph20075408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 06/19/2023]
Abstract
This study aims to compare the awareness-raising activities between municipalities with and without focused anti-infection measures during the 2019 coronavirus disease (COVID-19) pandemic. Descriptive analysis was conducted using a nationwide self-administered questionnaire survey on municipalities' activities for residents and for healthcare providers and care workers (HCPs) in October 2022 in Japan. This study included 433 municipalities that had conducted awareness-raising activities before 2019 Fiscal Year. Workshops for residents were conducted in 85.2% of the municipalities, and they were more likely to be conducted in areas with focused anti-infection measures than those without measures (86.8% vs. 75.4%). Additionally, 85.9% of the municipalities were impacted by the pandemic; 50.1% canceled workshops, while 26.0% switched to a web-based style. Activities for HCPs were conducted in 55.2-63.7% of the municipalities, and they were more likely to be conducted in areas with focused anti-infection measures. A total of 50.6-62.1% of the municipalities changed their workshops for HCPs to a web-based style. Comparisons between areas with and without focused anti-infection measures indicated that the percentages of those impacted for all activities were not significantly different. In conclusion, awareness-raising activities in municipalities were conducted with new methods during the COVID-19 pandemic. Using information technology is essential to further promote such activities for residents.
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Affiliation(s)
- Noriko Morioka
- Department of Nursing Health Service Research, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Masayo Kashiwagi
- Department of Nursing Health Service Research, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Ako Machida
- Department of Nursing Health Service Research, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo 1138510, Japan
| | - Kyoko Hanari
- Health Services Research and Development Center, University of Tsukuba, Tsukuba 3058575, Japan
| | - Takehiro Sugiyama
- Health Services Research and Development Center, University of Tsukuba, Tsukuba 3058575, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 1628655, Japan
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo 1628655, Japan
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba 3058575, Japan
| | - Ryota Inokuchi
- Health Services Research and Development Center, University of Tsukuba, Tsukuba 3058575, Japan
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba 3058575, Japan
| | - Nanako Tamiya
- Health Services Research and Development Center, University of Tsukuba, Tsukuba 3058575, Japan
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba 3058575, Japan
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Oliaei S, Paranjkhoo P, SeyedAlinaghi S, Mehraeen E, Hackett D. Is There a Role for Hyperbaric Oxygen Therapy in Reducing Long-Term COVID-19 Sequelae? J Clin Med 2023; 12:2270. [PMID: 36983270 PMCID: PMC10057206 DOI: 10.3390/jcm12062270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/06/2023] [Indexed: 03/17/2023] Open
Abstract
The COVID-19 pandemic has plagued our society for approximately three years [...].
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Affiliation(s)
- Shahram Oliaei
- HBOT Research Center, Golestan Hospital, Airspace and Diving Medicine Faculty, Navy and AJA Medical University, Tehran 166861955, Iran
| | - Parinaz Paranjkhoo
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan 0019, Armenia
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran 1419733141, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal 5681761351, Iran
| | - Daniel Hackett
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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Slaets H, Fonteyn L, Eijnde BO, Hellings N. Train your T cells: How skeletal muscles and T cells keep each other fit during aging. Brain Behav Immun 2023; 110:237-244. [PMID: 36893922 DOI: 10.1016/j.bbi.2023.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/13/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Frailty and a failing immune system lead to significant morbidities in the final years of life and bring along a significant burden on healthcare systems. The good news is that regular exercise provides an effective countermeasure for losing muscle tissue when we age while supporting proper immune system functioning. For a long time, it was assumed that exercise-induced immune responses are predominantly mediated by myeloid cells, but it has become evident that they receive important help from T lymphocytes. Skeletal muscles and T cells interact, not only in muscle pathology but also during exercise. In this review article, we provide an overview of the most important aspects of T cell senescence and discuss how these are modulated by exercise. In addition, we describe how T cells are involved in muscle regeneration and growth. A better understanding of the complex interactions between myocytes and T cells throughout all stages of life provides important insights needed to design strategies that effectively combat the wave of age-related diseases the world is currently faced with.
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Affiliation(s)
- Helena Slaets
- Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Lena Fonteyn
- Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium; SMRC - Sports Medical Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Bert O Eijnde
- SMRC - Sports Medical Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Niels Hellings
- Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium; UMSC - University MS Center, Campus Diepenbeek, Diepenbeek, Belgium.
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45
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Septimiu-Radu S, Gadela T, Gabriela D, Oancea C, Rosca O, Lazureanu VE, Fericean RM, Bratosin F, Dumitrescu A, Stoicescu ER, Bagiu I, Murariu M, Mavrea A. A Systematic Review of Lung Autopsy Findings in Elderly Patients after SARS-CoV-2 Infection. J Clin Med 2023; 12:jcm12052070. [PMID: 36902856 PMCID: PMC10004532 DOI: 10.3390/jcm12052070] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/27/2023] [Accepted: 03/05/2023] [Indexed: 03/08/2023] Open
Abstract
Although COVID-19 may cause various and multiorgan diseases, few research studies have examined the postmortem pathological findings of SARS-CoV-2-infected individuals who died. Active autopsy results may be crucial for understanding how COVID-19 infection operates and preventing severe effects. In contrast to younger persons, however, the patient's age, lifestyle, and concomitant comorbidities might alter the morpho-pathological aspects of the damaged lungs. Through a systematic analysis of the available literature until December 2022, we aimed to provide a thorough picture of the histopathological characteristics of the lungs in patients older than 70 years who died of COVID-19. A thorough search was conducted on three electronic databases (PubMed, Scopus, and Web of Science), including 18 studies and a total of 478 autopsies performed. It was observed that the average age of patients was 75.6 years, of which 65.4% were men. COPD was identified in an average of 16.7% of all patients. Autopsy findings indicated significantly heavier lungs, with an average weight of the right lung of 1103 g, while the left lung mass had an average weight of 848 g. Diffuse alveolar damage was a main finding in 67.2% of all autopsies, while pulmonary edema had a prevalence of between 50% and 70%. Thrombosis was also a significant finding, while some studies described focal and extensive pulmonary infarctions in 72.7% of elderly patients. Pneumonia and bronchopneumonia were observed, with a prevalence ranging from 47.6% to 89.5%. Other important findings described in less detail comprise hyaline membranes, the proliferation of pneumocytes and fibroblasts, extensive suppurative bronchopneumonic infiltrates, intra-alveolar edema, thickened alveolar septa, desquamation of pneumocytes, alveolar infiltrates, multinucleated giant cells, and intranuclear inclusion bodies. These findings should be corroborated with children's and adults' autopsies. Postmortem examination as a technique for studying the microscopic and macroscopic features of the lungs might lead to a better knowledge of COVID-19 pathogenesis, diagnosis, and treatment, hence enhancing elderly patient care.
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Affiliation(s)
- Susa Septimiu-Radu
- Department XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, ‘’Victor Babes’’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Tejaswi Gadela
- School of General Medicine, Bhaskar Medical College, Amdapur Road 156-162, Hyderabad 500075, India
| | - Doros Gabriela
- Department of Pediatrics, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Cristian Oancea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ovidiu Rosca
- Department XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Voichita Elena Lazureanu
- Department XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Roxana Manuela Fericean
- Department XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, ‘’Victor Babes’’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Felix Bratosin
- Department XIII, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, ‘’Victor Babes’’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Andreea Dumitrescu
- Cardioprevent Foundation, Calea Dorobantilor 3, Timisoara 300134, Romania
| | - Emil Robert Stoicescu
- Doctoral School, ‘’Victor Babes’’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Department of Radiology and Medical Imaging, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Iulia Bagiu
- Department of Microbiology, Multidisciplinary Research Center on Antimicrobial Resistance, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Correspondence:
| | - Mircea Murariu
- Doctoral School, ‘’Victor Babes’’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Department of Pediatrics, Discipline of Infectious Disease, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Adelina Mavrea
- Department of Internal Medicine I, Cardiology Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Prommas P, Lwin KS, Chen YC, Hyakutake M, Ghaznavi C, Sakamoto H, Miyata H, Nomura S. The impact of social isolation from COVID-19-related public health measures on cognitive function and mental health among older adults: A systematic review and meta-analysis. Ageing Res Rev 2023; 85:101839. [PMID: 36596396 PMCID: PMC9804967 DOI: 10.1016/j.arr.2022.101839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/24/2022] [Accepted: 12/30/2022] [Indexed: 01/01/2023]
Abstract
We aimed to estimate the impact of social isolation on cognitive function and mental health among older adults during the two-year-and-a-half COVID-19 period. Pubmed Central, Medline, CINAHL Plus and PsychINFO were searched between March 1, 2020, and September 30, 2022. We included all studies that assessed proportions of older adults with the mean or the median with a minimum age above 60 reporting worsening cognitive function and mental health. Thirty-two studies from 18 countries met the eligibility criteria for meta-analyses. We found that the proportions of older adults with dementia who experienced worsening cognitive impairment and exacerbation or new onset of behavioral and psychological symptoms of dementia (BPSD) were approximately twice larger than that of older adults with HC experiencing SCD and worsening mental health. Stage of dementia, care options, and severity of mobility restriction measures did not yield significant differences in the number of older adults with dementia reporting worsening cognitive impairment and BPSD, while the length of isolation did for BPSD but not cognitive impairment. Our study highlights the impact of social isolation on cognitive function and mental health among older adults. Public health strategies should prioritize efforts to promote healthy lifestyles and proactive assessments.
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Affiliation(s)
- Prapichaya Prommas
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan.
| | - Kaung Suu Lwin
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yi Chi Chen
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Division of Health Medical Intelligence, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Misa Hyakutake
- Medical Education Center, Keio University School of Medicine, Tokyo, Japan
| | - Cyrus Ghaznavi
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan; Medical Education Program, Washington University School of Medicine in St Louis, Saint Louis, USA
| | - Haruka Sakamoto
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan; Department of Hygiene and Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Hiroaki Miyata
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Shuhei Nomura
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan
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Yahata H, Kato K, Shimokawa M, Kawamura K, Shimono N, Kawana K, Okamoto A, Aoki D, Kimura T. Study of the effects of in-person attendance at academic conferences on the health of the attendees under COVID-19 pandemic. J Obstet Gynaecol Res 2023; 49:1083-1089. [PMID: 36812688 DOI: 10.1111/jog.15626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVE To analyze the effects of in-person attendance at an academic conference held during the Covid-19 pandemic on the health of the attendees, as assessed based on symptoms such as fever and cough attributed to infection with the Covid-19 virus. METHODS A questionnaire was used to survey the members of the Japan Society of Obstetrics and Gynecology (JSOG) about their health during the period from August 7 to August 12, 2022, after the 74th Annual Congress of the JSOG, which was held August 5 to 7. RESULTS Our survey yielded responses from 3054 members (1566 of whom had attended the congress in person and 1488 of whom had not attended in person); 102 (6.5%) of the in-person attendees and 93 (6.2%) of the people who did not attend in person reported problems with their health. No statistically significant difference was found between these two groups (p = 0.766). In a univariate analysis of factors affecting the presence of health problems, attendees with age ≥60 years had significantly fewer health problems than attendees who were in their 20s (odds ratio: 0.366 [0.167-0.802; p = 0.0120]). In a multivariate analysis, attendees who had received four vaccine shots had significantly fewer health problems than attendees who had received three shots (odds ratio: 0.397 [0.229-0.690, p = 0.0010]). CONCLUSION Congress attendees who took precautions at the congress to avoid being infected and who had a high vaccination rate did not develop significantly more health problems associated with in-person attendance at the congress.
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Affiliation(s)
- Hideaki Yahata
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Kiyoko Kato
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Mototsugu Shimokawa
- Department of Biostatistics, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Keiko Kawamura
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Kei Kawana
- Department of Obstetrics and Gynecology, Nihon University School of Medicine, Tokyo, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
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Clinical factors associated with adverse clinical outcomes in elderly versus non-elderly COVID-19 emergency patients: a multi-center observational study. Int J Emerg Med 2023; 16:11. [PMID: 36814202 PMCID: PMC9944782 DOI: 10.1186/s12245-023-00482-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has caused over 6 million deaths worldwide. The elderly accounted for a large proportion of patients with their mortality rate largely higher than the non-elderly. However, limited studies have explored clinical factors associated with poor clinical outcomes in this important population. Therefore, this study aimed to determine factors independently associated with adverse clinical outcomes among COVID-19 elderly patients. METHODS We conducted a multicenter observational study at five emergency departments (EDs) in Thailand. Patients over 18 years old diagnosed with COVID-19 between January and December 2021 were included. We classified patients into elderly (age ≥ 65 years) and non-elderly (age < 65 years). The primary clinical outcome was in-hospital mortality. The secondary outcomes were endotracheal intubation and intensive care unit admission. We identified independent factors associating with these outcomes both in the whole population and separately by age group using multivariate logistic regression models. RESULTS A total of 978 patients were included, 519 (53.1%) were elderly and 459 (46.9%) were non-elderly, and 254 (26%) died at hospital discharge. The mortality rate was significantly higher in the elderly group (39.1% versus 14.3%, p<0.001)). In the elderly, age (adjusted odds ratio (aOR) 1.13; 95% confidence interval (CI) 1.1-1.2; p<0.001), male sex (aOR 3.64; 95%CI 1.5-8.8; p=0.004), do-not-resuscitate (DNR) status (aOR 12.46; 95%CI 3.8-40.7; p<0.001), diastolic blood pressure (aOR 0.96; 95%CI 0.9-1.0; p=0.002), body temperature (aOR 1.74; 95%CI 1.0-2.9; p=0.036), and Glasgow Coma Scale (GCS) score (aOR 0.71; 95%CI 0.5-1.0; p=0.026) were independent baseline and physiologic factors associated with in-hospital mortality. Only DNR status and GCS score were associated with in-hospital mortality in both the elderly and non-elderly, as well as the overall population. Lower total bilirubin was independently associated with in-hospital mortality in the elderly (aOR 0.34; 95%CI 0.1-0.9; p=0.035), while a higher level was associated with the outcome in the non-elderly. C-reactive protein (CRP) was the only laboratory factor independently associated with all three study outcomes in the elderly (aOR for in-hospital mortality 1.01; 95%CI 1.0-1.0; p=0.006). CONCLUSION Important clinical factors associated with in-hospital mortality in elderly COVID-19 patients were age, sex, DNR status, diastolic blood pressure, body temperature, GCS score, total bilirubin, and CRP. These parameters may aid in triage and ED disposition decision-making in this very important patient population during times of limited resources during the COVID-19 pandemic.
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A systematic review of artificial intelligence-based COVID-19 modeling on multimodal genetic information. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2023; 179:1-9. [PMID: 36809830 PMCID: PMC9938959 DOI: 10.1016/j.pbiomolbio.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/07/2023] [Accepted: 02/12/2023] [Indexed: 02/21/2023]
Abstract
This study systematically reviews the Artificial Intelligence (AI) methods developed to resolve the critical process of COVID-19 gene data analysis, including diagnosis, prognosis, biomarker discovery, drug responsiveness, and vaccine efficacy. This systematic review follows the guidelines of Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA). We searched PubMed, Embase, Web of Science, and Scopus databases to identify the relevant articles from January 2020 to June 2022. It includes the published studies of AI-based COVID-19 gene modeling extracted through relevant keyword searches in academic databases. This study included 48 articles discussing AI-based genetic studies for several objectives. Ten articles confer about the COVID-19 gene modeling with computational tools, and five articles evaluated ML-based diagnosis with observed accuracy of 97% on SARS-CoV-2 classification. Gene-based prognosis study reviewed three articles and found host biomarkers detecting COVID-19 progression with 90% accuracy. Twelve manuscripts reviewed the prediction models with various genome analysis studies, nine articles examined the gene-based in silico drug discovery, and another nine investigated the AI-based vaccine development models. This study compiled the novel coronavirus gene biomarkers and targeted drugs identified through ML approaches from published clinical studies. This review provided sufficient evidence to delineate the potential of AI in analyzing complex gene information for COVID-19 modeling on multiple aspects like diagnosis, drug discovery, and disease dynamics. AI models entrenched a substantial positive impact by enhancing the efficiency of the healthcare system during the COVID-19 pandemic.
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Children's SARS-CoV-2 Infection and Their Vaccination. Vaccines (Basel) 2023; 11:vaccines11020418. [PMID: 36851295 PMCID: PMC9962844 DOI: 10.3390/vaccines11020418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
SARS-CoV-2, a novel coronavirus, causes respiratory tract infections and other complications in affected individuals, and has resulted in numerous deaths worldwide. The unprecedented pace of its transmission worldwide, and the resultant heavy burden on healthcare systems everywhere, prompted efforts to have effective therapeutic strategies and vaccination candidates available to the global population. While aged and immunocompromised individuals form a high-risk group for COVID-19 and have severe disease outcome, the rate of infections among children has also increased with the emergence of the Omicron variant. In addition, recent reports of threatening SARS-CoV-2-associated complications in children have brought to the forefront an urgent necessity for vaccination. In this article, we discuss the current scenario of SARS-CoV-2 infections in children with a special focus on the differences in their immune system response as compared to adults. Further, we describe the various available COVID-19 vaccines, including the recent bivalent vaccines for children, in detail, intending to increase willingness for their acceptance.
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