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Kanat BB, Avci GU, Bayramlar OF, Suzan V, Can G, Balkan II, Borekci S, Korkmazer B, Dikmen Y, Aygun G, Erdincler DS, Yavuzer H, Doventas A. Predictors of 2-year mortality in geriatric patients hospitalized with COVID-19 in Türkiye: a retrospective cohort study. Biomark Med 2024:1-11. [PMID: 39140394 DOI: 10.1080/17520363.2024.2352416] [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: 11/20/2023] [Accepted: 04/22/2024] [Indexed: 08/15/2024] Open
Abstract
Aim: To reveal factors affecting 2-year mortality in geriatric patients hospitalized with COVID-19.Methods: Demographic characteristics, clinical and laboratory data, thorax computed tomography (CT) images, second-year survival status, and causes of death were analyzed.Results: The 2-year post-discharge mortality rate of 605 patients was 21.9%. Mean age of patients in the deceased group was 76.8 ± 8.1 years, which was shorter than the life expectancy at birth in Türkiye. Older age (≥85), delirium, some co-morbidities, and atypical thorax CT involvement were associated with a significant increase in 2-year mortality (p < 0.05).Conclusion: This is the first study to evaluate factors associated with 2-year mortality in older COVID-19 patients. Identifying risk factors for long-term mortality in geriatric COVID-19 patients is important.
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Affiliation(s)
- Bahar Bektan Kanat
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpasa, Istanbul, Turkey
| | - Gulru Ulugerger Avci
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpasa, Istanbul, Turkey
| | - Osman Faruk Bayramlar
- Bakırkoy District Health Directorate, Turkish Ministry of Health - Istanbul Health Directorate, Istanbul, Turkey
| | - Veysel Suzan
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpasa, Istanbul, Turkey
| | - Gunay Can
- Department of Public Health, Cerrahpasa Medical Faculty, İstanbul University, Cerrahpaşa, İstanbul, Turkey
| | - Ilker Inanc Balkan
- Department of Infectious Diseases, Cerrahpasa Medical Faculty, İstanbul University, Cerrahpaşa, İstanbul, Turkey
| | - Sermin Borekci
- Department of Pulmonary Diseases, Cerrahpasa Medical Faculty, İstanbul University, Cerrahpaşa, İstanbul, Turkey
| | - Bora Korkmazer
- Department of Radiology, Cerrahpasa Medical Faculty, İstanbul University, Cerrahpaşa, İstanbul, Turkey
| | - Yalim Dikmen
- Department of Anesthesiology & Reanimation, Cerrahpasa Medical Faculty, İstanbul University, Cerrahpaşa, İstanbul, Turkey
| | - Gokhan Aygun
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, İstanbul University, Cerrahpaşa, İstanbul, Turkey
| | - Deniz Suna Erdincler
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpasa, Istanbul, Turkey
| | - Hakan Yavuzer
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpasa, Istanbul, Turkey
| | - Alper Doventas
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpasa, Istanbul, Turkey
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Antar SA, Ashour NA, Hamouda AO, Noreddin AM, Al-Karmalawy AA. Recent advances in COVID-19-induced liver injury: causes, diagnosis, and management. Inflammopharmacology 2024:10.1007/s10787-024-01535-7. [PMID: 39126569 DOI: 10.1007/s10787-024-01535-7] [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: 10/14/2023] [Accepted: 03/29/2024] [Indexed: 08/12/2024]
Abstract
Since the start of the pandemic, considerable advancements have been made in our understanding of the effects of SARS-CoV-2 infection and the associated COVID-19 on the hepatic system. There is a broad range of clinical symptoms for COVID-19. It affects multiple systems and has a dominant lung illness depending on complications. The progression of COVID-19 in people with pre-existing chronic liver disease (CLD) has also been studied in large multinational groups. Notably, SARS-CoV-2 infection is associated with a higher risk of hepatic decompensation and death in patients with cirrhosis. In this review, the source, composition, mechanisms, transmission characteristics, clinical characteristics, therapy, and prevention of SARS-CoV-2 were clarified and discussed, as well as the evolution and variations of the virus. This review briefly discusses the causes and effects of SARS-CoV-2 infection in patients with CLD. As part of COVID-19, In addition, we assess the potential of liver biochemistry as a diagnostic tool examine the data on direct viral infection of liver cells, and investigate potential pathways driving SARS-CoV-2-related liver damage. Finally, we explore how the pandemic has had a significant impact on patient behaviors and hepatology services, which may increase the prevalence and severity of liver disease in the future. The topics encompassed in this review encompass the intricate relationships between SARS-CoV-2, liver health, and broader health management strategies, providing valuable insights for both current clinical practice and future research directions.
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Affiliation(s)
- Samar A Antar
- Center for Vascular and Heart Research, Fralin Biomedical Research Institute, Virginia Tech, Roanoke, VA, 24016, USA
- Department of Pharmacology, Faculty of Pharmacy, Horus University-Egypt, New Damietta, 34518, Egypt
| | - Nada A Ashour
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, Tanta, 31527, Egypt
| | - Amir O Hamouda
- Department of Biochemistry, Faculty of Pharmacy, Horus University-Egypt, New Damietta, 34518, Egypt
| | - Ayman M Noreddin
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ahram Canadian University, 6Th of October City, Giza, 12566, Egypt
- Department of Internal Medicine, School of Medicine, University of California -Irvine, Irvine, USA
| | - Ahmed A Al-Karmalawy
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Horus University-Egypt, New Damietta, New Damietta, 34518, Egypt.
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Ahram Canadian University, 6Th of October City, Giza, 12566, Egypt.
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Yang Y, Yang H, Kiskin FN, Zhang JZ. The new era of cardiovascular research: revolutionizing cardiovascular research with 3D models in a dish. MEDICAL REVIEW (2021) 2024; 4:68-85. [PMID: 38515776 PMCID: PMC10954298 DOI: 10.1515/mr-2023-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/18/2024] [Indexed: 03/23/2024]
Abstract
Cardiovascular research has heavily relied on studies using patient samples and animal models. However, patient studies often miss the data from the crucial early stage of cardiovascular diseases, as obtaining primary tissues at this stage is impracticable. Transgenic animal models can offer some insights into disease mechanisms, although they usually do not fully recapitulate the phenotype of cardiovascular diseases and their progression. In recent years, a promising breakthrough has emerged in the form of in vitro three-dimensional (3D) cardiovascular models utilizing human pluripotent stem cells. These innovative models recreate the intricate 3D structure of the human heart and vessels within a controlled environment. This advancement is pivotal as it addresses the existing gaps in cardiovascular research, allowing scientists to study different stages of cardiovascular diseases and specific drug responses using human-origin models. In this review, we first outline various approaches employed to generate these models. We then comprehensively discuss their applications in studying cardiovascular diseases by providing insights into molecular and cellular changes associated with cardiovascular conditions. Moreover, we highlight the potential of these 3D models serving as a platform for drug testing to assess drug efficacy and safety. Despite their immense potential, challenges persist, particularly in maintaining the complex structure of 3D heart and vessel models and ensuring their function is comparable to real organs. However, overcoming these challenges could revolutionize cardiovascular research. It has the potential to offer comprehensive mechanistic insights into human-specific disease processes, ultimately expediting the development of personalized therapies.
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Affiliation(s)
- Yuan Yang
- Institute of Neurological and Psychiatric Disorders, Shenzhen Bay Laboratory, Shenzhen, Guangdong Province, China
| | - Hao Yang
- Institute of Neurological and Psychiatric Disorders, Shenzhen Bay Laboratory, Shenzhen, Guangdong Province, China
| | - Fedir N. Kiskin
- Institute of Neurological and Psychiatric Disorders, Shenzhen Bay Laboratory, Shenzhen, Guangdong Province, China
| | - Joe Z. Zhang
- Institute of Neurological and Psychiatric Disorders, Shenzhen Bay Laboratory, Shenzhen, Guangdong Province, China
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4
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Dassie-Leite AP, Gueths TP, Ribeiro VV, Pereira EC, Martins PDN, Daniel CR. Vocal Signs and Symptoms Related to COVID-19 and Risk Factors for their Persistence. J Voice 2024; 38:189-194. [PMID: 34583881 PMCID: PMC8354794 DOI: 10.1016/j.jvoice.2021.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/15/2021] [Accepted: 07/21/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To compare the occurrence of vocal signs and symptoms before, during, and after coronavirus disease (COVID-19) and analyze possible risk factors for the persistence of these signs and symptoms after disease resolution. METHODS This was an observational, analytical, and cross-sectional study. The participants were 45 individuals of both sexes, with a mean age of 44 years, who were previously affected by COVID-19. All participants answered a questionnaire about sociodemographic data, smoking history, disease course, vocal complaints, and the vocal signs and symptoms list (SSL), referring to three timepoints (before, during, and after COVID-19). RESULTS The most commonly reported vocal signs and symptoms before COVID-19 were phlegm (26.67%; n=12) and dry throat (24.44%; n=11). During COVID-19, the most frequent vocal signs and symptoms were tired voice after short-term use (73.33%; n=33) and dry throat (71.11%; n=32). After the disease, the most reported vocal signs and symptoms were dry throat (57.78%; n=26) and phlegm (53.33; n=24). The self-perception of vocal signs and symptoms before COVID-19 was lower than that during and after COVID-19 (P < 0.001). Vocal complaints after COVID-19 and oxygen therapy were predictors of self-perception of vocal signs and symptoms after COVID-19. CONCLUSIONS Individuals affected by COVID-19 had a higher frequency of vocal signs and symptoms during the disease. However, after remission, the frequency of vocal signs and symptoms was higher than that at baseline. The need for oxygen therapy may indicate a risk for a higher occurrence of vocal signs and symptoms after COVID-19.
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Affiliation(s)
- Ana Paula Dassie-Leite
- Professor at the Speech-Language Pathology Department, Universidade Estadual do Centro-Oeste - UNICENTRO. PR 156, Km 07; Irati, Paraná, Brazil; Professor at the Interdisciplinary Postgraduate Program in Community Development, Universidade Estadual do Centro-Oeste - UNICENTRO. PR 156, Km 07; Irati, Paraná, Brazil.
| | - Tatiane Prestes Gueths
- Speech Language Pahologist. Saldanha Marinho st, 2820. Bairro dos Estados; Guarapuava, Paraná, Brazil
| | - Vanessa Veis Ribeiro
- Professor at the Speech-Language Pathology Department, Universidade Federal de Sergipe - UFS. Governador Marcelo Dedá Avenue, 13, Centro, Lagarto, Sergipe, Brazil; Professor at the Associate Postgraduate Program in Speech-Language Pathology, Universidade Federal da Paraíba - UFPB. Cidade Universitária, Conjunto Presidente Castelo Branco III, João Pessoa, Paraíba, Brazil
| | - Eliane Cristina Pereira
- Professor at the Speech-Language Pathology Department, Universidade Estadual do Centro-Oeste - UNICENTRO. PR 156, Km 07; Irati, Paraná, Brazil
| | - Perla do Nascimento Martins
- Professor at the Speech-Language Pathology Department, Universidade Estadual do Centro-Oeste - UNICENTRO. PR 156, Km 07; Irati, Paraná, Brazil
| | - Christiane Riedi Daniel
- Professor at the Physioterapy Department, Universidade Estadual do Centro-Oeste - UNICENTRO. Alameda Élio Antonio Dalla Vecchia, 838 - CEP 85040-167 - Bairro - Vila Carli, Guarapuava, Brazil
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5
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Dent E, Hanlon P, Sim M, Jylhävä J, Liu Z, Vetrano DL, Stolz E, Pérez-Zepeda MU, Crabtree DR, Nicholson C, Job J, Ambagtsheer RC, Ward PR, Shi SM, Huynh Q, Hoogendijk EO. Recent developments in frailty identification, management, risk factors and prevention: A narrative review of leading journals in geriatrics and gerontology. Ageing Res Rev 2023; 91:102082. [PMID: 37797723 DOI: 10.1016/j.arr.2023.102082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/07/2023]
Abstract
Frailty is an age-related clinical condition characterised by an increased susceptibility to stressors and an elevated risk of adverse outcomes such as mortality. In the light of global population ageing, the prevalence of frailty is expected to soar in coming decades. This narrative review provides critical insights into recent developments and emerging practices in frailty research regarding identification, management, risk factors, and prevention. We searched journals in the top two quartiles of geriatrics and gerontology (from Clarivate Journal Citation Reports) for articles published between 01 January 2018 and 20 December 2022. Several recent developments were identified, including new biomarkers and biomarker panels for frailty screening and diagnosis, using artificial intelligence to identify frailty, and investigating the altered response to medications by older adults with frailty. Other areas with novel developments included exercise (including technology-based exercise), multidimensional interventions, person-centred and integrated care, assistive technologies, analysis of frailty transitions, risk-factors, clinical guidelines, COVID-19, and potential future treatments. This review identified a strong need for the implementation and evaluation of cost-effective, community-based interventions to manage and prevent frailty. Our findings highlight the need to better identify and support older adults with frailty and involve those with frailty in shared decision-making regarding their care.
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Affiliation(s)
- Elsa Dent
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia
| | - Peter Hanlon
- School of Health and Wellbeing, University of Glasgow, Scotland, UK
| | - Marc Sim
- Nutrition and Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia; Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Juulia Jylhävä
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Faculty of Social Sciences, Unit of Health Sciences and Gerontology Research Center, University of Tampere, Tampere, Finland
| | - Zuyun Liu
- Second Affiliated Hospital and School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Erwin Stolz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | - Mario Ulises Pérez-Zepeda
- Instituto Nacional de Geriatría, Dirección de Investigación, ciudad de México, Mexico; Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Huixquilucan Edo. de México
| | | | - Caroline Nicholson
- Centre for Health System Reform & Integration, Mater Research Institute-University of Queensland, Brisbane, Australia
| | - Jenny Job
- Centre for Health System Reform & Integration, Mater Research Institute-University of Queensland, Brisbane, Australia
| | - Rachel C Ambagtsheer
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia
| | - Paul R Ward
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia
| | - Sandra M Shi
- Hinda and Arthur Marcus Institute for Aging, Hebrew Senior Life, Boston, Massachusetts, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Quan Huynh
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science and Department of General Practice, Amsterdam UMC, Location VU University Medical Center, Amsterdam, Netherlands; Amsterdam Public Health research institute, Ageing & Later Life Research Program, Amsterdam UMC, Amsterdam, the Netherlands.
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6
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Tosato M, Calvani R, Ciciarello F, Galluzzo V, Martone AM, Zazzara MB, Pais C, Savera G, Robles MC, Ramirez M, Landi F. Malnutrition in COVID-19 survivors: prevalence and risk factors. Aging Clin Exp Res 2023; 35:2257-2265. [PMID: 37665556 PMCID: PMC10520154 DOI: 10.1007/s40520-023-02526-4] [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: 12/19/2022] [Accepted: 07/31/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Nutritional status is a critical factor throughout COVID-19 disease course. Malnutrition is associated with poor outcomes in hospitalized COVID-19 patients. AIM To assess the prevalence of malnutrition and identify its associated factors in COVID-19 survivors. METHODS Study cohort included 1230 COVID-19 survivors aged 18-86 attending a post-COVID-19 outpatient service. Data on clinical parameters, anthropometry, acute COVID-19 symptoms, lifestyle habits were collected through a comprehensive medical assessment. Malnutrition was assessed according to Global Leadership Initiative on Malnutrition (GLIM) criteria. RESULTS Prevalence of malnutrition was 22% at 4-5 months after acute disease. Participants who were not hospitalized during acute COVID-19 showed a higher frequency of malnutrition compared to those who needed hospitalization (26% versus 19%, p < 0.01). Malnutrition was found in 25% COVID-19 survivors over 65 years of age compared to 21% younger participants (p < 0.01). After multivariable adjustment, the likelihood of being malnourished increased progressively and independently with advancing age (Odds ratio [OR] 1.02; 95% CI 1.01-1.03) and in male participants (OR 5.56; 95% CI 3.53-8.74). Malnutrition was associated with loss of appetite (OR 2.50; 95% CI 1.73-3.62), and dysgeusia (OR 4.05; 95% CI 2.30-7.21) during acute COVID-19. DISCUSSION In the present investigation we showed that malnutrition was highly prevalent in a large cohort of COVID-19 survivors at 4-5 months from acute illness. CONCLUSIONS Our findings highlight the need to implement comprehensive nutritional assessment and therapy as an integral part of care for COVID-19 patients.
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Affiliation(s)
- Matteo Tosato
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy.
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
| | - Francesca Ciciarello
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Vincenzo Galluzzo
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Anna Maria Martone
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Maria Beatrice Zazzara
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Cristina Pais
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Giulia Savera
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Maria Camprubi Robles
- Abbott Nutrition, Research and Development, Camino de Purchil 68, 18004, Granada, Spain
| | - Maria Ramirez
- Abbott Nutrition, Research and Development, Camino de Purchil 68, 18004, Granada, Spain
| | - Francesco Landi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
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Bayuo J, Wong FKY. Transitional and aftercare needs of persons recovering from COVID-19 using the Omaha System: A Scoping Review. J Clin Nurs 2023; 32:6894-6916. [PMID: 37353967 DOI: 10.1111/jocn.16798] [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: 09/11/2021] [Revised: 08/09/2022] [Accepted: 06/01/2023] [Indexed: 06/25/2023]
Abstract
AIM To identify and classify the transitional and aftercare needs of persons hospitalised with and recovering from COVID-19. BACKGROUND Several studies exist that describe the patient needs at the acute phase of COVID-19. The transitional and aftercare needs that emerge during recovery, however, remain vague. METHODS A scoping review was conducted and reported according to the PRISMA extension guidelines for scoping reviews (PRISMA-ScR). Primary studies were identified from database search. Narrative synthesis was undertaken, with the Omaha System as a framework. RESULTS Forty studies were included. Persons recovering from the infection may have several needs in all domains of the Omaha System. Although the severity and persistence of the needs may be unrelated to the severity of the initial infection, they may vary based on factors such as age and pre-morbid factors. CONCLUSION Recovering from COVID-19 is associated with varied biopsychosocial-environmental needs which can adversely affect the quality-of-life experience. The review findings represent an inventory of needs that can guide the development of multi-disciplinary post-acute or aftercare programmes. RELEVANCE TO CLINICAL PRACTICE Recovering from COVID-19 can be a protracted process requiring ongoing professional support after discharge. Policies are required to support the development and implementation of post-acute programmes of care. Comprehensive transitional and aftercare rehabilitative programmes are needed to support the recovery process.
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Affiliation(s)
- Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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Wang X, Deng W, Zhao J, Guo Y, Lai H, Hu Y, Kang W, Li Y, Zuo J. Improving Nutritional Status Was Associated with Decreasing Disease Severity and Shortening of Negative Conversion Time of PCR Test in Non-ICU Patients with COVID-19. Infect Drug Resist 2023; 16:4443-4452. [PMID: 37435236 PMCID: PMC10332416 DOI: 10.2147/idr.s409615] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/14/2023] [Indexed: 07/13/2023] Open
Abstract
Background Nutrition is an important prevention in old patients with COVID-19. However, in China, there are few studies on the correlation between nutrition and COVID-19. Methods A total of 148 hospitalized COVID-19 (65.7 ± 16.0 [range: from 21 to 101] years old) patients were enrolled in this study. The information of demographic, biochemical results, vaccination doses, types of COVID-19, PCR test negative conversion time, and scores of Mini Nutritional Assessment Short Form (MNA-SF) for evaluating nutritional status were recorded. We first explored the relationships between MNA-SF performance and the severities of COVID-19 in the groups with non-vaccinated, vaccinated, and all the patients using multivariable ordinal logistic regression. Further, we explored the relationships between performance of MNA-SF and the time of negative conversion of PCR in the groups with non-vaccinated, vaccinated, and all the patients using COX proportional hazards survival regression. Results Group of patients with malnutrition or at risk of malnutrition group was associated with older of the age, those who had not been vaccinated, in fewer people who were asymptomatic type and in more people who showed longer of the negative conversion time of PCR, lower of the BMI, and the lower of the hemoglobin level. Each additional increase of one point of MNA-SF was associated with a 17% decrease in the odds of a worse type of COVID-19 in all patients, and the significant result exists in non-vaccinated patients. One point increase of MNA-SF was associated with increased 11% of hazard ratios of turning negative of PCR and well-nourished group was associated with increased 46% of hazard ratio of turning negative of PCR. Conclusion Higher nutrition is associated with less severity of COVID-19, especially in the non-vaccinated group. Higher nutrition is also associated with shorter time of turning negative of PCR in non-ICU COVID-19 patients.
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Affiliation(s)
- Xiaodan Wang
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Weiping Deng
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Jiehui Zhao
- Department of General Practice, Daning Community Health Service Center, Shanghai, 200072, People’s Republic of China
| | - Yongchao Guo
- Department of Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Haifang Lai
- Department of Rehabilitation Medicine Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Yueliang Hu
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Wenyan Kang
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
| | - Yong Li
- Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
- Institute of Respiratory Disease, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Disease, Shanghai, People’s Republic of China
| | - Junli Zuo
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China
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Sidhwani SK, Mirza T, Khatoon A, Shaikh F, Khan R, Shaikh OA, Nashwan AJ. Angiotensin-converting enzyme 2 (ACE2) polymorphisms and susceptibility of severe SARS-CoV-2 in a subset of Pakistani population. Virol J 2023; 20:120. [PMID: 37308887 DOI: 10.1186/s12985-023-02091-2] [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: 02/24/2023] [Accepted: 06/02/2023] [Indexed: 06/14/2023] Open
Abstract
Science is digging for the varied presentation of COVID-19 patients exposed to the same risk factors, and medical conditions may be influenced by the presence of polymorphic genetic variants. This study investigated the link between ACE2 gene polymorphisms and the severity of SARS-CoV-2. This cross-sectional study recruited COVID-19 PCR-positive patients by consecutive sampling from Ziauddin Hospital from April to September 2020. DNA was extracted from whole blood, followed by gene amplification and Sanger's sequencing. Most of the patients, 77: 53.8%, were serious. Males were higher (80; 55.9%) with age more than 50 years (106: 74.1%). We found 22 ACE2 SNPs. rs2285666 SNP was most prevalent with 49.2% CC, 45.2% TT, 4.8% CT heterozygosity, and 0.8% AA genotypes. Variants with multiple genotypes were also insignificantly associated with the severity of COVID-19 in the analysis of the dominant model. Only rs2285666 had a significant statistical link with gender (p-value 0.034, OR; 1.438, CI; 1.028-2.011) while rs768883316 with age groups (p-value 0.026, OR; 1.953, CI; 1.085-3.514). Haplotypes ATC of three polymorphisms (rs560997634, rs201159862, and rs751170930) commonly found in 120 (69.77%) and TTTGTAGTTAGTA haplotype consisting of 13 polymorphisms (rs756737634, rs146991645, rs1601703288, rs1927830489, rs1927831624, rs764947941, rs752242172, rs73195521, rs781378335, rs756597390, rs780478736, rs148006212, rs768583671) in 112 (90.32%) had statistically significant association with the severity having p = value 0.029 and 0.001 respectively. Males of old age and diabetics are found to have more severe COVID-19 infection in the current study. We also found that common ACE2 polymorphism rs2285666 influences the susceptibility of acquiring the severe SARS-CoV-2 infection.
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Affiliation(s)
| | - Talat Mirza
- Department of Research, Ziauddin University, Karachi, Pakistan
- Department of Molecular Medicine, Ziauddin University, Karachi, Pakistan
| | - Ambrina Khatoon
- Department of Molecular Medicine, Ziauddin University, Karachi, Pakistan.
| | - Fouzia Shaikh
- Department of Pathology, Ziauddin University, Karachi, Pakistan
| | - Rizma Khan
- Department of Molecular Genetics, Ziauddin University, Karachi, Pakistan
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10
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Cook EJ, Elliott E, Donald L, Gaitan A, Randhawa G, Cartwright S, Waqar M, Egbutah C, Nduka I, Guppy A, Ali N. Knowledge, perceived risk, and attitudes towards COVID-19 protective measures amongst ethnic minorities in the UK: A cross-sectional study. Front Public Health 2023; 10:1060694. [PMID: 36711414 PMCID: PMC9880421 DOI: 10.3389/fpubh.2022.1060694] [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: 10/03/2022] [Accepted: 12/19/2022] [Indexed: 01/15/2023] Open
Abstract
Background Minority ethnic groups are at increased risk of COVID-19 related mortality or morbidity yet continue to have a disproportionally lower uptake of the vaccine. The importance of adherence to prevention and control measures to keep vulnerable populations and their families safe therefore remains crucial. This research sought to examine the knowledge, perceived risk, and attitudes toward COVID-19 among an ethnically diverse community. Methods A cross-sectional self-administered questionnaire was implemented to survey ethnic minority participants purposefully recruited from Luton, an ethnically diverse town in the southeast of England. The questionnaire was structured to assess participants knowledge, perceived risk, attitudes toward protective measures as well as the sources of information about COVID-19. The questionnaire was administered online via Qualtrics with the link shared through social media platforms such as Facebook, Twitter, and WhatsApp. Questionnaires were also printed into brochures and disseminated via community researchers and community links to individuals alongside religious, community and outreach organisations. Data were analysed using appropriate statistical techniques, with the significance threshold for all analyses assumed at p = 0.05. Findings 1,058 participants (634; 60% females) with a median age of 38 (IQR, 22) completed the survey. National TV and social networks were the most frequently accessed sources of COVID-19 related information; however, healthcare professionals, whilst not widely accessed, were viewed as the most trusted. Knowledge of transmission routes and perceived susceptibility were significant predictors of attitudes toward health-protective practises. Conclusion/recommendation Improving the local information provision, including using tailored communication strategies that draw on trusted sources, including healthcare professionals, could facilitate understanding of risk and promote adherence to health-protective actions.
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Affiliation(s)
- Erica Jane Cook
- School of Psychology, University of Bedfordshire, Luton, United Kingdom,*Correspondence: Erica Jane Cook ✉
| | | | - Louisa Donald
- School of Psychology, University of Bedfordshire, Luton, United Kingdom
| | - Alfredo Gaitan
- School of Psychology, University of Bedfordshire, Luton, United Kingdom
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom
| | - Sally Cartwright
- Public Health Luton, Luton Borough Council, Luton, United Kingdom
| | - Muhammad Waqar
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom
| | - Chimeme Egbutah
- Public Health Luton, Luton Borough Council, Luton, United Kingdom
| | - Ifunanya Nduka
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom
| | - Andy Guppy
- School of Psychology, University of Bedfordshire, Luton, United Kingdom
| | - Nasreen Ali
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom
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11
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Experiencing a significant life event during the COVID-19 pandemic: The role of perceived control. PLoS One 2023; 18:e0279820. [PMID: 36598921 PMCID: PMC9812308 DOI: 10.1371/journal.pone.0279820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 12/14/2022] [Indexed: 01/05/2023] Open
Abstract
The COVID-19 pandemic represents a context that might influence how people experience significant life events (such as marriage, job change, or relocation). In the present research, we argue that one important factor of how positively or negatively the pandemic influences the experience of significant life events is how much control people perceive in the situation. An online sample of N = 882 participants aged 18-82 years reported a significant life event that occurred during the COVID-19 pandemic. The participants described whether the pandemic influenced the life event, to what extent they perceived control over the life event and how they experienced the life event in terms of valence (i.e., positively or negatively). The results showed that the self-reported pandemic influence was significantly associated with the life-event experience. Furthermore, perceived control partly mediated this association. The results persisted even after controlling for the age of the participants. The present research underscores the important role of control for experiencing significant life events in challenging times such as during the pandemic.
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12
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Rahman MS, Harun MGD, Sumon SA, Mohona TM, Abdullah SAHM, Khan MNH, Gazi MI, Islam MS, Anwar MMU. Hospitalization and Mortality by Vaccination Status among COVID-19 Patients Aged ≥ 25 Years in Bangladesh: Results from a Multicenter Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10121987. [PMID: 36560397 PMCID: PMC9786706 DOI: 10.3390/vaccines10121987] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
The COVID-19 pandemic has inflicted a massive disease burden globally, involving 623 million confirmed cases with 6.55 million deaths, and in Bangladesh, over 2.02 million clinically confirmed cases of COVID-19, with 29,371 deaths, have been reported. Evidence showed that vaccines significantly reduced infection, severity, and mortality across a wide age range of populations. This study investigated the hospitalization and mortality by vaccination status among COVID-19 patients in Bangladesh and identified the vaccine's effectiveness against severe outcomes in real-world settings. Between August and December 2021, we conducted this cross-sectional survey among 783 RT-PCR-confirmed COVID-19 hospitalized patients admitted to three dedicated COVID-19 hospitals in Bangladesh. The study used a semi-structured questionnaire to collect information. We reviewed the patient's records and gathered COVID-19 immunization status from the study participants or their caregivers. Patients with incomplete or partial data from the record were excluded from enrollment. Logistic regression analyses were performed to determine the association between key variables with a patient's vaccination status and mortality. The study revealed that overall hospitalization, severity, and morality were significantly high among unvaccinated study participants. Only one-fourth (25%) of hospitalized patients were found COVID-19 vaccinated. Morality among unvaccinated COVID-19 study participants was significantly higher (AOR: 7.17) than the vaccinated (11.17% vs. 1.53%). Severity was found to be seven times higher among unvaccinated patients. Vaccination coverage was higher in urban areas (29.8%) compared to rural parts (20.8%), and vaccine uptake was lower among female study participants (22.7%) than male (27.6%). The study highlighted the importance of COVID-19 vaccines in reducing mortality, hospitalization, and other severe consequences. We found a gap in vaccination coverage between urban and rural settings. The findings would encourage the entire population toward immunization and aid the policymakers in the ground reality so that more initiatives are taken to improve vaccination coverage among the pocket population.
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Affiliation(s)
- Md. Saydur Rahman
- Department of Administration, DNCC Dedicated COVID-19 Hospital, Dhaka 1212, Bangladesh
| | - Md. Golam Dostogir Harun
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Dhaka 1212, Bangladesh
- Department of Public Health, Daffodil International University, Dhaka 1341, Bangladesh
- Correspondence:
| | - Shariful Amin Sumon
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Dhaka 1212, Bangladesh
- Department of Public Health, Daffodil International University, Dhaka 1341, Bangladesh
| | - Tahrima Mohsin Mohona
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Dhaka 1212, Bangladesh
| | | | - Md. Nazuml Huda Khan
- Department of Administration, Kurmitola General Hospital, Dhaka 1206, Bangladesh
| | - Md. Ismail Gazi
- Sheikh Russel National Gastroliver Institute and Hospital, Dhaka 1212, Bangladesh
| | - Md. Saiful Islam
- School of Medical Science, University of New South Wales, Sydney 2052, Australia
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13
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Kaur D, Agrawal KC, Deep A, Choudhary H, Soni L, Saran R, Sankhla V. Post-COVID-19 manifestations: A study of analyzing symptoms, complications following hospitalization. J Family Med Prim Care 2022; 11:6015-6022. [PMID: 36618168 PMCID: PMC9810890 DOI: 10.4103/jfmpc.jfmpc_219_22] [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: 01/27/2022] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 11/11/2022] Open
Abstract
Background Post-COVID-19 symptoms and diseases appeared on recovered from COVID-19. Hence, the study aims to investigate and characterize the manifestations which appear after recovery from the corona virus infection. Objectives To investigate the post-COVID-19 Manifestation, to demonstrate different symptoms or signs that appeared during COVID and after recovery from the disease and to see association of independent factors (like age, sex, BMI, Comorbidities) with Post-COVID complication. Methods The study was conducted using cross-sectional study among COVID positive patients admitted and then recovered in Bangur Hospital, Pali, Rajasthan, including ICU and Isolation wards from March to December 2020. Sample size calculated was 423 with simple random sampling. Findings In our study of these 421 COVID-19 cases, median age was 36 year (Interquartile Range: 26-55 years). Post-COVID manifestation (at least one symptom) significantly associated with age of subjects (p = 0.001), subjects who were in ICU during COVID-19 positive (p = 0.003), symptomatic subjects (p = 0.009) during COVID positive and SPO2 level at the time of admission during COVID positive (p = 0.01). Conclusion The recovered subjects should be highly vigilant in maintaining and monitoring their health status as there is a risk of future complications after recovery.
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Affiliation(s)
- Daljeet Kaur
- Department of Community Medicine, Government Medical College and Bangur Hospital, Pali, Rajasthan, India
| | - Kailash Chandra Agrawal
- Department of Respiratory Medicine, Government Medical College and Bangur Hospital, Pali, Rajasthan, India
| | - Aman Deep
- Department of Community Medicine, Government Medical College and Bangur Hospital, Pali, Rajasthan, India
| | - Hazarimal Choudhary
- Department of General Medicine, Government Medical College and Bangur Hospital, Pali, Rajasthan, India
| | - Laxman Soni
- Department of Respiratory Medicine, Government Medical College and Bangur Hospital, Pali, Rajasthan, India,Address for correspondence: Dr. Laxman Soni, Department of Respiratory Medicine, Government Medical College & Bangur Hospital, Pali, Rajasthan, India. E-mail:
| | - Rajendra Saran
- Department of Community Medicine, Government Medical College and Bangur Hospital, Pali, Rajasthan, India
| | - Vasudev Sankhla
- Department of Biochemistry, Government Medical College and Bangur Hospital, Pali, Rajasthan, India
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14
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Martone AM, Tosato M, Ciciarello F, Galluzzo V, Zazzara MB, Pais C, Savera G, Calvani R, Marzetti E, Robles MC, Ramirez M, Landi F. Sarcopenia as potential biological substrate of long COVID-19 syndrome: prevalence, clinical features, and risk factors. J Cachexia Sarcopenia Muscle 2022; 13:1974-1982. [PMID: 35698920 PMCID: PMC9349974 DOI: 10.1002/jcsm.12931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/18/2021] [Accepted: 01/05/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Severe clinical pictures and sequelae of COVID-19 disease are immune mediated and characterized by a 'cytokine storm'. Skeletal muscle has emerged as a potent regulator of immune system function. The aim of the present study is to define the prevalence of sarcopenia among COVID-19 survivors and the negative impact of sarcopenia on the post-acute COVID-19 syndrome and its related risk factors. METHODS A total of 541 subjects recovered from COVID-19 disease were enrolled in the Gemelli Against COVID-19 Post-Acute Care between April 2020 and February 2021. They underwent a multidisciplinary clinical evaluation and muscle strength and physical performance assessment. RESULTS Mean age was 53.1 years (SD 15.2, range from 18 to 86 years), and 274 (51%) were women. The prevalence of sarcopenia was 19.5%, and it was higher in patients with a longer hospital stay and lower in patients who were more physically active and had higher levels of serum albumin. Patients with sarcopenia had a higher number of persistent symptoms than non-sarcopenic patients (3.8 ± 2.9 vs. 3.2 ± 2.8, respectively; P = 0.06), in particular fatigue, dyspnoea, and joint pain. CONCLUSIONS Sarcopenia identified according to the EWGSOP2 criteria is high in patients recovered from COVID-19 acute illness, particularly in those who had experienced the worst clinical picture reporting the persistence of fatigue and dyspnoea. Our data suggest that sarcopenia, through the persistence of inflammation, could be the biological substrate of long COVID-19 syndrome. Physical activity, especially if associated with adequate nutrition, seems to be an important protective factor.
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Affiliation(s)
- Anna Maria Martone
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Matteo Tosato
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Vincenzo Galluzzo
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Cristina Pais
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giulia Savera
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Maria Ramirez
- Research and Development, Abbott Nutrition, Granada, Spain
| | - Francesco Landi
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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15
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Shoaee S, Rezaie F, Payab M, Bakhtiari F, Heydari MH. Experiences from the management of COVID-19 pandemic in a nursing home in Iran (March-April, 2020). J Diabetes Metab Disord 2022; 21:1195-1199. [PMID: 35317104 PMCID: PMC8929716 DOI: 10.1007/s40200-022-01005-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/07/2022] [Indexed: 11/28/2022]
Abstract
As the first outbreak of COVID-19 in Wuhan, China, the elder population and those with comorbidities were at higher risk of COVID-19 infection. The mortality rate was also higher in this population. Hence, the management and prevention of this novel disease in nursing homes was of utmost importance. The health management team in Kahrizak Charity Foundation (KCF), a nursing home in Iran with more than 1400 elder or comorbid resident, have tackled the COVID-19 outbreak with a novel approach towards this problem. This commentary aims at sharing the insights and lessons learned in the management of COVID-19 in KCF.
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Affiliation(s)
- Shervan Shoaee
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshid Rezaie
- Education and Health Promotion Department, Ministry of Health and Education, Tehran, Iran
| | - Moloud Payab
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular- Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariborz Bakhtiari
- Kahrizak Nursing Home of Disabled and Elderly, University of Applied Science and Technology, Tehran, Iran
| | - Mohammad-Hossein Heydari
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,School of Dentistry, Shahid Beheshti University of Medical Sciences, Shahid Chamran Highway, Velenjak St, Tehran, Iran
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16
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Preface: COVID-19 IN THE GERIATRIC PATIENT. Clin Geriatr Med 2022; 38:xv-xvii. [PMID: 35868677 PMCID: PMC9080052 DOI: 10.1016/j.cger.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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17
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Cagan E, Tezcan G, Simsek A, Kizmaz MA, Dombaz F, Asan A, Demir HI, Bal H, Yoyen Ermis D, Gorek Dilektasli A, Kazak E, Akalin EH, Oral HB, Budak F. The Age-Dependent Role of Th22, Tc22, and Tc17 Cells in the Severity of Pneumonia in COVID-19 Immunopathogenesis. Viral Immunol 2022; 35:318-327. [PMID: 35363081 DOI: 10.1089/vim.2021.0132] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has clinical manifestations ranging from mild symptoms to respiratory failure, septic shock, and multi-organ failure. Lymphocytes are divided into different subtypes based on their cytokine production pattern. In this study, we investigated the role of cytokine expressions of CD4+ T (T helper [Th]1, Th2, Th17, Th22) and CD8+ T cell subtypes (T cytotoxic [Tc]1, Tc2, Tc17, Tc22) in the pathogenesis of COVID-19. Peripheral blood mononuclear cells (PBMCs) were extracted with Ficoll by density gradient centrifugation from blood samples of 180 COVID-19 patients (children and adults) and 30 healthy controls. PBMCs were stimulated with PMA and Ionomycin and treated with Brefeldin A in the fourth hour, and a 10-colored monoclonal antibody panel was evaluated at the end of the sixth hour using flow cytometry. According to our findings, the numbers of Th22 (CD3+, CD4+, and interleukin [IL]-22+) and Tc22 (CD3+, CD8+, IL-22+) cells increased in adult patients regardless of the level of pneumonia (mild, severe, or symptom-free) as compared with healthy controls (p < 0.05). In addition, the number of Tc17 (CD3+, CD8+, and IL-17A+) cells increased in low pneumonia and severe pneumonia groups compared with the healthy controls (p < 0.05). Both IL-22 and IL-17A production decreased during a follow-up within 6 weeks of discharge. Our findings suggest that the increase in only IL-22 expressed Tc22 cells in the 0-12 age group with a general symptom-free course and higher levels of Th22 and Tc22 in uncomplicated adult cases may indicate the protective effect of IL-22. On the contrary, the association between the severity of pneumonia and the elevation of Tc17 cells in adults may reveal the damaging effect of IL-22 when it is co-expressed with IL-17.
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Affiliation(s)
- Eren Cagan
- Department of Immunology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey.,Department of Pediatric Infectious Diseases, Bursa Yüksek Ihtisas Training and Research Hospital, Health Sciences University, Bursa, Turkey
| | - Gulcin Tezcan
- Department of Fundamental Sciences, Faculty of Dentistry, Bursa Uludag University, Bursa, Turkey
| | - Abdurrahman Simsek
- Department of Immunology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey.,Institution of Health Sciences, Department of Immunology, Bursa Uludag University, Bursa, Turkey
| | - Muhammed Ali Kizmaz
- Department of Immunology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey.,Institution of Health Sciences, Department of Immunology, Bursa Uludag University, Bursa, Turkey
| | - Fatma Dombaz
- Department of Immunology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey.,Institution of Health Sciences, Department of Immunology, Bursa Uludag University, Bursa, Turkey
| | - Ali Asan
- Department of Infectious Diseases, Bursa Yuksek Ihtisas Training and Research Hospital, Health Sciences University, Bursa, Turkey
| | - H Ibrahim Demir
- Department of Immunology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey.,Institution of Health Sciences, Department of Immunology, Bursa Uludag University, Bursa, Turkey
| | - Haldun Bal
- Department of Immunology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Digdem Yoyen Ermis
- Department of Immunology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Aslı Gorek Dilektasli
- Department of Pulmonary Medicine, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Esra Kazak
- Department of Clinical Microbiology and Infection Diseases, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - E Halis Akalin
- Department of Clinical Microbiology and Infection Diseases, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - H Barbaros Oral
- Department of Immunology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Ferah Budak
- Department of Immunology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
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18
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Leon L, Perez-Sancristobal I, Madrid A, Lopez-Pedraza L, Colomer JI, Lerma S, Lois P, Mucientes A, Rodriguez-Rodriguez L, Fernandez-Gutierrez B, Abasolo L. Persistent post-discharge symptoms after COVID-19 in rheumatic and musculoskeletal diseases. Rheumatol Adv Pract 2022; 6:rkac008. [PMID: 35233480 PMCID: PMC8882379 DOI: 10.1093/rap/rkac008] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/07/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Objectives
We aimed to describe persistent symptoms and sequelae in patients with rheumatic and musculoskeletal diseases (RMD) after admission due to Covid-19, assessing the role of autoimmune rheumatic diseases (ARD) compared with and non-autoimmune rheumatic and musculoskeletal diseases (NARD) on persistent symptoms and sequelae.
Methods
We performed an observational study including RMD patients who attended a rheumatology clinic in Madrid that required admission due to Covid-19 (March to May 2020) and survived. The study began at discharge and ran until October 2020. Main outcomes were persistence of symptoms and sequelae related to Covid-19. The independent variable was the RMD group (ARD and NARD). Covariates included sociodemographics, clinical and treatment data. We ran a multivariate logistic regression model to assess the risk of the main outcomes by RMD group.
Results
We included 105 patients, of whom 51.5% had ARD and 68.57% reported at least 1 persistent symptom. Most frequent were dyspnea, fatigue, and chest pain. Sequelae were recorded in 31 patients. These included lung damage in 10.4% of patients, lymphopenia in 10%, a central retinal vein occlusion, and an optic neuritis. Two patients died. Eleven patients required readmission owing to Covid-19 problems (16.7% ARD vs 3.9% NARD; p = 0.053). No statistically significant differences were found between RMD groups in the final models.
Conclusions
Many RMD patients have persistent symptoms, as in other populations. Lung damage is the most frequent sequela. ARD compared with NARD does not seem to differ in terms of persistent symptoms or consequences, although ARD might have more readmissions due to Covid-19.
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Affiliation(s)
- Leticia Leon
- Rheumatology Department and IDISSC, Hospital Clinico San Carlos, Madrid, Spain
- Health Sciences Faculty, Universidad Camilo Jose Cela, Madrid, Spain
| | | | - Alfredo Madrid
- Rheumatology Department and IDISSC, Hospital Clinico San Carlos, Madrid, Spain
| | | | | | - Sergio Lerma
- Health Sciences Faculty, Physical Therapy Department, Centro Superior de Estudios universitarios La Salle, Universidad Autonoma de Madrid, Madrid, Spain
| | - Pia Lois
- Rheumatology Department and IDISSC, Hospital Clinico San Carlos, Madrid, Spain
| | - Arkaitz Mucientes
- Rheumatology Department and IDISSC, Hospital Clinico San Carlos, Madrid, Spain
| | | | | | - Lydia Abasolo
- Rheumatology Department and IDISSC, Hospital Clinico San Carlos, Madrid, Spain
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19
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Ulugerger Avci G, Bektan Kanat B, Suzan V, Can G, Korkmazer B, Karaali R, Tabak F, Borekci S, Aygun G, Yavuzer H, Doventas A. Clinical outcomes of geriatric patients with COVID-19: review of one-year data. Aging Clin Exp Res 2022; 34:465-474. [PMID: 35064542 PMCID: PMC8782714 DOI: 10.1007/s40520-021-02047-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/02/2021] [Indexed: 12/15/2022]
Abstract
Aims In this study, we aimed to reveal mortality rates and factors affecting survival in geriatric patients infected with COVID-19. Methods This is a retrospective study of 873 geriatric patients with COVID-19 who were hospitalized between March 11, 2020 and March 11, 2021. Demographic, clinical, laboratory data, and treatment options were obtained from electronic medical records. Multivariate logistic regression was used to explore the risk factors for in-hospital death. Results During the specified period, 643 patients were discharged, and 230 patients died in the hospital. The mean age was 75.08 ± 7.39 years (mean ± SD) and 51.8% were males. We found that older age (≥ 85), polypharmacy, dyspnea, abnormal thorax computed tomography (CT), lower doses of anticoagulation, and high values of white blood cell, aspartate aminotransferase, C-reactive protein, lactate dehydrogenase, ferritin were associated with a significant increase in mortality (P < 0.001 for all). Although all of these values were significant in multivariate logistic regression analysis, the most important ones were dyspnea (Odds ratio (OR) 57.916, 95% confidence interval (CI) 23.439–143.104, P < 0.001), polypharmacy (OR 6.782, 95% CI 3.082–14.927, P < 0.001), and thorax CT classification (typical; OR 9.633, 95% CI 2.511–37.122, P < 0.001). Conclusion Older age, polypharmacy, dyspnea, and abnormal thorax CT were the most significant mortality criteria and in addition appropriate anticoagulant use was associated with reduced mortality. Identifying the risk factors to predict mortality in older adults with COVID-19 is important to treat future cases successfully.
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Affiliation(s)
- Gulru Ulugerger Avci
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Bahar Bektan Kanat
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Veysel Suzan
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gunay Can
- Department of Public Health, Cerrahpasa Medical Faculty, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Bora Korkmazer
- Department of Radiology, Cerrahpasa Medical Faculty, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Ridvan Karaali
- Department of Infectious Diseases, Cerrahpasa Medical Faculty, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases, Cerrahpasa Medical Faculty, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Sermin Borekci
- Department of Pulmonary Diseases, Cerrahpasa Medical Faculty, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Gokhan Aygun
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Hakan Yavuzer
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Alper Doventas
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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20
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Azimirad M, Noori M, Raeisi H, Yadegar A, Shahrokh S, Asadzadeh Aghdaei H, Bentivegna E, Martelletti P, Petrosillo N, Zali MR. How Does COVID-19 Pandemic Impact on Incidence of Clostridioides difficile Infection and Exacerbation of Its Gastrointestinal Symptoms? Front Med (Lausanne) 2021; 8:775063. [PMID: 34966759 PMCID: PMC8710593 DOI: 10.3389/fmed.2021.775063] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/22/2021] [Indexed: 12/19/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has rapidly spread all over the world with a very high rate of mortality. Different symptoms developed by COVID-19 infection and its impacts on various organs of the human body have highlighted the importance of both coinfections and superinfections with other pathogens. The gastrointestinal (GI) tract is vulnerable to infection with COVID-19 and can be exploited as an alternative transmission route and target for virus entry and pathogenesis. The GI manifestations of COVID-19 disease are associated with severe disease outcomes and death in all age groups, in particular, elderly patients. Empiric antibiotic treatments for microbial infections in hospitalized patients with COVID-19 in addition to experimental antiviral and immunomodulatory drugs may increase the risk of antibiotic-associated diarrhea (AAD) and Clostridioides difficile infection (CDI). Alterations of gut microbiota are associated with depletion of beneficial commensals and enrichment of opportunistic pathogens such as C. difficile. Hence, the main purpose of this review is to explain the likely risk factors contributing to higher incidence of CDI in patients with COVID-19. In addition to lung involvement, common symptoms observed in COVID-19 and CDI such as diarrhea, highlight the significance of bacterial infections in COVID-19 patients. In particular, hospitalized elderly patients who are receiving antibiotics might be more prone to CDI. Indeed, widespread use of broad-spectrum antibiotics such as clindamycin, cephalosporins, penicillin, and fluoroquinolones can affect the composition and function of the gut microbiota of patients with COVID-19, leading to reduced colonization resistance capacity against opportunistic pathogens such as C. difficile, and subsequently develop CDI. Moreover, patients with CDI possibly may have facilitated the persistence of SARS-CoV-2 viral particles in their feces for approximately one month, even though the nasopharyngeal test turned negative. This coinfection may increase the potential transmissibility of both SARS-CoV-2 and C. difficile by fecal materials. Also, CDI can complicate the outcome of COVID-19 patients, especially in the presence of comorbidities or for those patients with prior exposure to the healthcare setting. Finally, physicians should remain vigilant for possible SARS-CoV-2 and CDI coinfection during the ongoing COVID-19 pandemic and the excessive use of antimicrobials and biocides.
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Affiliation(s)
- Masoumeh Azimirad
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Noori
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Raeisi
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Yadegar
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shabnam Shahrokh
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Asadzadeh Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Enrico Bentivegna
- Internal Medicine and Emergency Medicine, St'Andrea Hospital, Sapienza University, Rome, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Nicola Petrosillo
- Infectious Diseases Service, University Hospital Campus Bio-Medico, Rome, Italy
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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21
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Popova AY, Tarasenko AA, Smolensky VY, Egorova SA, Smirnov VS, Dashkevich AM, Svetogor TN, Glinskaya IN, Skuranovich AL, Milichkina AM, Dronina AM, Samoilovich EO, Khamitova IV, Semeiko GV, Amvrosyeva TV, Shmeleva NP, Rubanik LV, Esmanchik OP, Karaban IA, Drobyshevskaya VG, Sadovnikova GV, Shilovich MV, Podushkina EA, Kireichuk VV, Petrova OA, Bondarenko SV, Salazhkova IF, Tkach LM, Shepelevich LP, Autukhova NL, Ivanov VM, Babilo AS, Navyshnaya MV, Belyaev NN, Zueva EV, Volosar LA, Verbov VN, Likhachev IV, Zagorskaya TO, Morozova NF, Korobova ZR, Gubanova AV, Totolian AA. Herd immunity to SARS-CoV-2 among the population of the Republic of Belarus amid the COVID-19 pandemic. RUSSIAN JOURNAL OF INFECTION AND IMMUNITY 2021. [DOI: 10.15789/2220-7619-hit-1798] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objective was to investigate the SARS-CoV-2 collective immunity status of the population of Belarus within the context of the COVID-19 pandemic. Materials and methods. The work was carried out according to the methodology for assessing SARS-CoV-2 population immunity, developed by Rospotrebnadzor Russia and the Ministry of Health of Belarus with the participation of the St. Petersburg Pasteur Institute, taking into account WHO recommendations. The Bioethics Committee of Belarus and the local ethics committee of the St. Petersburg Pasteur Institute approved the study. Selection of participants was carried out using a questionnaire method and online technology (internet, cloud server). Volunteers were randomized into seven age groups (years of age): 1–17; 18–29; 30–39; 40–49; 50–59; 60–69; and 70+. Regional randomization ensured proportional representation of volunteers from each region, and no more than 30 people were included from one enterprise. In accordance with manufacturer instructions, blood plasma samples were analyzed for: IgG antibodies (Abs) to the SARS-CoV-2 nucleocapsid (Nc) using a quantitative ELISA test system; and IgG Abs to the receptor binding domain (RBD) of the SARS-CoV-2 S (spike) surface glycoprotein using a qualitative ELISA test system. Statistical processing was carried out using Excel 2010 and other software. Statistical differences were designated as significant when p 0.05, unless otherwise indicated. Results. The level of seroprevalence, in terms of Abs to Nc among the Belarusian population, was 38.4% (95% CI 37.6–45.4). The highest Ab levels were found among individuals in older age groups (50-70+ years old). The lowest were found in children 1–17 years old and in young people 18–39 years old The distribution of seroprevalence across Belarusian regions was relatively homogeneous, with the exception of the Minsk Region, where a statistically significant decrease in the indicator was noted. In terms of profession, the largest share of seropositive individuals was found among transportation workers; the smallest was found in business. The moderate COVID-19 incidence has not led to a dramatic increase in the number of contacts. The base reproduction number (R0) was 1.3. In the Republic of Belarus, there was a moderate level of asymptomatic COVID-19 among seropositive individuals (45.3% [95% CI 44.0–46.7]). This form of infection was observed most often among children aged 1–17 years old (65.0% [95% CI 61.3–68.6]). In parallel with seroprevalence assessment, SARS-CoV-2 vaccination was carried out. We used two vaccines: Gam-COVID-Vac (also known as Sputnik V, developed by Gamaleya National Center for Epidemiology and Microbiology, Russia); and BBIBP-CorV (Sinopharm, PRC). Vaccination against SARS-CoV-2 was accompanied by an increase in the level of anti-RBD Abs (95% [95% CI 94.7–96.7]). Taking into account the vaccination of a subset of the population with BBIBP-CorV, the overall herd immunity, inferred from the analyzed indicators (presence of anti-Nc or anti-RBD Abs), was 47.1% (95% CI 46.3–48.0). Conclusion. COVID-19 in Belarus was characterized by a moderately pronounced course of the epidemic process. The threshold level of herd immunity to SARS-CoV-2 has not yet been reached, as a result of which the conditions for progression of the epidemic remain.
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Cobos-Campos R, Apiñaniz A, Parraza N, Cordero J, García S, Orruño E. Potential use of ivermectin for the treatment and prophylaxis of SARS-CoV-2 infection. Curr Res Transl Med 2021; 69:103309. [PMID: 34418758 PMCID: PMC8354804 DOI: 10.1016/j.retram.2021.103309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/30/2021] [Accepted: 08/07/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE OF THE STUDY Currently no treatment has been proven to be efficacious for patients with early symptoms of COVID-19. Although most patients present mild or moderate symptoms, up to 5-10% may have a poor disease progression, so there is an urgent need for effective drugs, which can be administered even before the onset of severe symptoms, i.e. when the course of the disease is modifiable. Recently, promising results of several studies on oral ivermectin have been published, which has prompted us to conduct the present review of the scientific literature. METHODS A narrative review has been carried out, focusing on the following four main topics: a) short-term efficacy in the treatment of the disease, b) long-term efficacy in the treatment of patients with post-acute symptoms of COVID-19, c) efficacy in the prophylaxis of the disease, and c) safety of ivermectin. RESULTS The reviewed literature suggests that there seems to be sufficient evidence about the safety of oral ivermectin, as well as the efficacy of the drug in the early-treatment and the prophylaxis of COVID-19. CONCLUSIONS In the view of the available evidence, the Frontline COVID-19 Critical Care Alliance (FLCCC) recommends the use of oral ivermectin for both prophylaxis and early-treatment of COVID-19. Further well-designed studies should be conducted in order to explore the efficacy and safety of invermectin at low and high doses, following different dosing schedules, in both, the short and long-term treatment.
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Affiliation(s)
- R Cobos-Campos
- Bioaraba Health Research Institute, Epidemiology and Public Health Research Group, Vitoria-Gasteiz, Spain.
| | - A Apiñaniz
- Bioaraba Health Research Institute, Epidemiology and Public Health Research Group, Vitoria-Gasteiz, Spain; Osakidetza Basque Health Service, Aranbizkarra I Health Centre, Vitoria-Gasteiz, Spain; Department of Preventive Medicine and Public Health, EHU/UPV, Vitoria-Gasteiz, Spain.
| | - N Parraza
- Bioaraba Health Research Institute, Epidemiology and Public Health Research Group, Vitoria-Gasteiz, Spain.
| | - J Cordero
- Bioaraba Health Research Institute, Epidemiology and Public Health Research Group, Vitoria-Gasteiz, Spain.
| | - S García
- Bioaraba Health Research Institute, Epidemiology and Public Health Research Group, Vitoria-Gasteiz, Spain.
| | - E Orruño
- Bioaraba Health Research Institute, Epidemiology and Public Health Research Group, Vitoria-Gasteiz, Spain.
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23
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Cheval B, Sieber S, Maltagliati S, Millet GP, Formánek T, Chalabaev A, Cullati S, Boisgontier MP. Muscle strength is associated with COVID-19 hospitalization in adults 50 years of age or older. J Cachexia Sarcopenia Muscle 2021; 12:1136-1143. [PMID: 34363345 PMCID: PMC8426913 DOI: 10.1002/jcsm.12738] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/22/2021] [Accepted: 05/21/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Weak muscle strength has been associated with a wide range of adverse health outcomes. Yet, whether individuals with weaker muscle strength are more at risk for hospitalization due to severe COVID-19 is still unclear. The objective of this study was to investigate the independent association between muscle strength and COVID-19 hospitalization. METHODS Data from adults 50 years of age or older were analysed using logistic models adjusted for several chronic conditions, body-mass index, age, and sex. Hand-grip strength was repeatedly measured between 2004 and 2017 using a handheld dynamometer. COVID-19 hospitalization during the lockdown was self-reported in summer 2020 and was used as an indicator of COVID-19 severity. RESULTS The study was based on the Survey of Health, Ageing and Retirement in Europe (SHARE) and included 3600 older adults (68.8 ± 8.8 years, 2044 female), among whom 316 were tested positive for the severe acute respiratory syndrome coronavirus 2 (8.8%), and 83 (2.3%) were hospitalized due to COVID-19. Results showed that higher grip strength was associated with a lower risk of COVID-19 hospitalization [adjusted odds ratio (OR) per increase of 1 standard deviation in grip strength = 0.64, 95% confidence interval (95% CI) = 0.45-0.87, P = 0.015]. Results also showed that age (OR for a 10 -year period = 1.70, 95% CI = 1.32-2.20, P < 0.001) and obesity (OR = 2.01, 95% CI = 1.00-3.69, P = 0.025) were associated with higher risk of COVID-19 hospitalization. Sensitivity analyses using different measurements of grip strength as well as robustness analyses based on rare-events logistic regression and a different sample of participants (i.e. COVID-19 patients) were consistent with the main results. CONCLUSIONS Muscle strength is an independent risk factor for COVID-19 severity in adults 50 years of age or older.
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Affiliation(s)
- Boris Cheval
- Swiss Center for Affective SciencesUniversity of GenevaGenevaSwitzerland
- Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of PsychologyUniversity of GenevaGenevaSwitzerland
| | - Stefan Sieber
- Swiss NCCR ‘LIVES—Overcoming Vulnerability: Life Course Perspectives’University of GenevaGenevaSwitzerland
| | | | | | - Tomáš Formánek
- Department of Public Mental HealthNational Institute of Mental HealthKlecanyCzech Republic
- EpiCentre, Department of PsychiatryUniversity of CambridgeCambridgeUK
| | | | - Stéphane Cullati
- Population Health LaboratoryUniversity of FribourgFribourgSwitzerland
- Department of Readaptation and GeriatricsUniversity of GenevaGenevaSwitzerland
| | - Matthieu P. Boisgontier
- School of Rehabilitation Sciences, Faculty of Health SciencesUniversity of OttawaOttawaOntarioCanada
- Bruyère Research InstituteOttawaOntarioCanada
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24
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Mohamed Hussein AA, Saad M, Zayan HE, Abdelsayed M, Moustafa M, Ezzat AR, Helmy R, Abd-Elaal H, Aly K, Abdelrheem S, Sayed I. Post-COVID-19 functional status: Relation to age, smoking, hospitalization, and previous comorbidities. Ann Thorac Med 2021; 16:260-265. [PMID: 34484441 PMCID: PMC8388571 DOI: 10.4103/atm.atm_606_20] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 04/08/2021] [Indexed: 01/30/2023] Open
Abstract
RATIONAL: Recently, a new “Post-COVID-19 Functional Status (PCFS) scale” is recommended in the current COVID-19 pandemic. It is proposed that it could be used to display direct retrieval and the functional sequelae of COVID-19. AIM OF THE STUDY: The aim of the study was to assess the PCFS and to evaluate if age, gender, smoking, hospitalization, and comorbidities have any effect on functional limitations in recovered COVID-19 patients. METHODS: A total of 444 registered confirmed COVID-19 patients were included. They were interviewed in our follow-up clinics and filled an Arabic translated PCFS scale as well as their demographic and clinical data. RESULTS: Eighty percent of COVID-19 recovered cases have diverse degrees of functional restrictions ranging from negligible (63.1%), slight (14.4%), moderate (2%), to severe (0.5%) based on PCFS. Furthermore, there was a substantial variance between the score of PCFS with age (P = 0.003), gender (P = 0.014), the duration since the onset of the symptoms of COVID-19 (P < 0.001), need for oxygen supplementation (P < 0.001), need for intensive care unit (ICU) admittance (P = 0.003), previous periodic influenza vaccination (P < 0.001), smoking status (P < 0.001), and finally, the presence of any comorbid disorder (P < 0.001). CONCLUSIONS: Most of the COVID-19 recovered cases have diverse degrees of functional restrictions ranging from negligible to severe based on PCFS. These restrictions were affected by age, gender, periodic influenza vaccination, smoking, duration since symptoms onset, need for oxygen or ICU admittance, and finally the presence of coexisting comorbidity.
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Affiliation(s)
| | - Mahmoud Saad
- Faculty of Medicine, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hossam E Zayan
- Department of Gastroenterology and Infectious Disease, Assiut University Hospitals, Assiut, Egypt
| | | | | | | | - Radwa Helmy
- Faculty of Pharmacy, Asswan University, Aswan, Egypt
| | - Howaida Abd-Elaal
- Faculty of Medicine, Faculty of Nursing, Assiut University, Assiut, Egypt
| | - Karim Aly
- Department of Cardiology, Assiut University Hospitals, Assiut, Egypt
| | | | - Islam Sayed
- Faculty of Medicine, Aswan Faculty of Medicine, Aswan University, Aswan, Egypt
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25
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Tosato M, Carfì A, Martis I, Pais C, Ciciarello F, Rota E, Tritto M, Salerno A, Zazzara MB, Martone AM, Paglionico A, Petricca L, Brandi V, Capalbo G, Picca A, Calvani R, Marzetti E, Landi F. Prevalence and Predictors of Persistence of COVID-19 Symptoms in Older Adults: A Single-Center Study. J Am Med Dir Assoc 2021; 22:1840-1844. [PMID: 34352201 PMCID: PMC8286874 DOI: 10.1016/j.jamda.2021.07.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/03/2021] [Accepted: 07/10/2021] [Indexed: 12/15/2022]
Abstract
Objectives Symptom persistence weeks after laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) clearance is a relatively common long-term complication of Coronavirus disease 2019 (COVID-19). Little is known about this phenomenon in older adults. The present study aimed at determining the prevalence of persistent symptoms among older COVID-19 survivors and identifying symptom patterns. Design Cross-sectional study. Setting and Participants We analyzed data collected in people 65 years and older (n = 165) who were hospitalized for COVID-19 and then admitted to the Day Hospital Post-COVID 19 of the Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS (Rome, Italy) between April and December 2020. All patients tested negative for SARS-CoV-2 and met the World Health Organization criteria for quarantine discontinuation. Measures Patients were offered multidisciplinary individualized assessments. The persistence of symptoms was evaluated on admission using a standardized questionnaire. Results The mean age was 73.1 ± 6.2 years (median 72, interquartile range 27), and 63 (38.4%) were women. The average time elapsed from hospital discharge was 76.8 ± 20.3 days (range 25−109 days). On admission, 137 (83%) patients reported at least 1 persistent symptom. Of these, more than one-third reported 1 or 2 symptoms and 46.3% had 3 or more symptoms. The rate of symptom persistence was not significantly different when patients were stratified according to median age. Compared with those with no persistent symptoms, patients with symptom persistence reported a greater number of symptoms during acute COVID-19 (5.3 ± 3.0 vs 3.3 ± 2.0; P < .001). The most common persistent symptoms were fatigue (53.1%), dyspnea (51.5%), joint pain (22.2%), and cough (16.7%). The likelihood of symptom persistence was higher in those who had experienced fatigue during acute COVID-19. Conclusions and Implications Persistent symptoms are frequently experienced by older adults who have been hospitalized for COVID-19. Follow-up programs should be implemented to monitor and care for long-term COVID-19–related health issues.
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Affiliation(s)
- Matteo Tosato
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Angelo Carfì
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Ilaria Martis
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Cristina Pais
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | | | - Elisabetta Rota
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Marcello Tritto
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Andrea Salerno
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | | | - Anna Maria Martone
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | | | - Luca Petricca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Vincenzo Brandi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Gennaro Capalbo
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Landi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy
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26
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Yang Q, Wang Y, Tian C, Chen Y, Mao J. The Experiences of Community-dwelling older adults during the COVID-19 Lockdown in Wuhan: A qualitative study. J Adv Nurs 2021; 77:4805-4814. [PMID: 34258806 PMCID: PMC8447433 DOI: 10.1111/jan.14978] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/27/2021] [Accepted: 06/27/2021] [Indexed: 01/10/2023]
Abstract
AIMS To explore the experiences of community-dwelling older adults in Wuhan during the coronavirus disease 2019 lockdown. DESIGN An empirical phenomenological approach was used to conduct a qualitative study. METHODS We performed semi-structured, in-depth telephone interviews between July 24 and August 2, 2020. A purposive sample of 18 participants (≥65 years old) who lived in Wuhan during the lockdown was recruited, including both infected and uninfected people. Data summarization and theme categories refinement were performed following Colaizzi's phenomenological approach. RESULTS Four main theme categories emerged. First, the 'Challenges' posed by the epidemic. Older adults were challenged with barriers in seeing a doctor and daily life inconveniences. And they experienced negative emotions, whether infected or not. The second domain was 'multi-dimensional support', which helped older people went through the difficult period. The third domain was 'resilience amid challenges'. Although they experienced physical and psychological distress, most of them could self-adjust and achieve transcendence from the unique experience. Lastly, the remaining impact after the epidemic affected older adults. Some still had mental burdens, while others thought they have benefited from the quarantine time (e.g. regular diet, learning new skills). CONCLUSION The epidemic and lockdown of the city brought significant physical and mental challenges to community-dwelling older adults. Active adaptation and multifaceted support helped them through this period. However, the mental burdens after the epidemic still require attention. These experiences would provide guidelines for the protection of vulnerable populations during public health emergencies. IMPACT The results of the study suggested that certain social dynamics and individual behaviours helped the elderly to better cope with the stressful lockdown period. The findings in this study provided guidelines on how to reduce the negative effects on older adults during the pandemic and enlighten studies concerning the well-being of older adults or other vulnerable people in future crises.
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Affiliation(s)
- Qing Yang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuxin Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chong Tian
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuan Chen
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Soytas RB. A bibliometric analysis of publications on COVID-19 and older adults. Ann Geriatr Med Res 2021; 25:197-203. [PMID: 34229370 PMCID: PMC8497949 DOI: 10.4235/agmr.21.0060] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/06/2021] [Indexed: 01/03/2023] Open
Abstract
Background Bibliometric analysis is important to guide future research priorities. We aimed to evaluate the most relevant scientific research on COVID-19 and older adults, analyze the current hot topics and identify the 50 most cited publications. Methods Articles published between December 2019-March 17, 2021 were analyzed. A list was obtained that contained the terms "COVID-19" or "Novel Coronavirus" or "SARS-CoV-2" or "2019-nCoV" and "geriatrics" or "older adults" or "elderly" in the title, abstract, keywords, or keywords plus. Original research articles, reviews, editorial materials, letters were included. The information for the articles contained the year, journal, title, author, country, affiliation, keywords, document type, and counts of citation. VOSviewer was used to analyze the keywords. The most cited 50 articles were identified. Results Totally 784 publications were included. The keywords that appeared most were "COVID-19" and "older adults," which had a strong link to "social isolation," "dementia," "mortality," and "loneliness." The most active (40.8%) and most cited (1,578) country was the United States. The journal with the largest number of publications (22.7%) and citations (947) was the Journal of the American Geriatric Society. The most researched (84.0%) and most cited area was geriatrics-gerontology (2,882). The median number of citations for the most cited 50 articles was 46.8. Conclusion The current bibliometric analysis provides information about the quality and research areas of the studies concerning COVID-19 and older adults that have been published so far. Social and psychological support, nutrition, vaccines, and telemedicine may be hot research topics for the future.
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Affiliation(s)
- Rabia Bag Soytas
- Division of Geriatrics, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Babadaei MMN, Hasan A, Bloukh SH, Edis Z, Sharifi M, Kachooei E, Falahati M. The expression level of angiotensin-converting enzyme 2 determines the severity of COVID-19: lung and heart tissue as targets. J Biomol Struct Dyn 2021; 39:3780-3786. [PMID: 32397951 PMCID: PMC7284141 DOI: 10.1080/07391102.2020.1767211] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 05/05/2020] [Indexed: 02/06/2023]
Abstract
Researchers have reported some useful information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leading to CoV disease 2019 (COVID-19). Several studies have been performed in order to develop antiviral drugs, from which a few have been prescribed to patients. Also, several diagnostic tests have been designed to accelerate the process of identifying and treating COVID-19. It has been well-documented that the surface of host cells is covered by some receptors, known as angiotensin-converting enzyme 2 (ACE2), which mediates the binding and entry of CoV. After entering, the viral RNA interrupts the cell proliferation system to activate self-proliferation. However, having all the information about the outbreakof the SARS-COV-2, it is not still clear which factors determine the severity of lung and heart function impairment induced by COVID-19. A major step in exploring SARS-COV-2 pathogenesis is to determine the distribution of ACE2 in different tissues . In this review, the structure and origin of CoV, the role of ACE2 as a receptor of SARS-COV-2 on the surface of host cells, and the ACE2 distribution in different tissues with a focus on lung and cardiovascular system have been discussed. It was also revealed that acute and chronic cardiovascular diseases (CVDs) may result in the clinical severity of COVID-19. In conclusion, this review may provide useful information in developing some promising strategies to end up with a worldwide COVID-19 pandemic.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Mohammad Mahdi Nejadi Babadaei
- Department of Molecular Genetics, Faculty of Biological Science, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha, Qatar
- Biomedical Research Center, Qatar University, Doha, Qatar
| | - Samir Haj Bloukh
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Zehra Edis
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Majid Sharifi
- Department of Nanotechnology, Faculty of Advanced Sciences and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Ehsan Kachooei
- Department of Molecular Sciences, Macquarie University, Sydney, Australia
| | - Mojtaba Falahati
- Department of Nanotechnology, Faculty of Advanced Sciences and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Verholt AB, Gregersen M, Gonzalez-Bofill N, Hansen TK, Ebdrup L, Foss CH, Lietzen LW. Clinical presentation and outcomes of COVID-19 in older hospitalised patients assessed by the record-based multidimensional prognostic index, a cross-sectional study. Eur Geriatr Med 2021; 12:1147-1157. [PMID: 34118057 PMCID: PMC8196927 DOI: 10.1007/s41999-021-00522-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/19/2021] [Indexed: 12/22/2022]
Abstract
Aim Confusion was more prevalent in frail than in non-frail older patients at hospital admission. Finding COVID-19 and accelerated functional decline were associated among frail older hospitalised patients when compared to non-frail. Message Ninety-day all-cause mortality was 70% among frail hospitalised patients with COVID-19 and 15% among non-frail. Purpose Older people are the most frequently hospital admitted patients with COVID-19. We aimed to describe the clinical presentation of COVID-19 among frail and nonfrail older hospitalised patients and to evaluate the potential association between frailty and clinical course, decision of treatment level with outcomes change in functional capacity and survival. Methods We performed a multi-center, retrospective cross-sectional cohort study examining data on clinical presentation and frailty-related domains for hospitalised people aged 75 + years with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test. Frailty was assessed at admission using record-based MPI (rMPI) and Clinical Frailty Scale (CFS). Decision on treatment level about invasive ventilation and cardiopulmonary resuscitation (CPR), change in CFS-score from admission to discharge, changed need of home care, and in-hospital, 30-day and 90-day mortality were registered. Results 100 patients (median age 82 years (IQR 78–86), 56% female) with COVID-19 were included. 54 patients were assessed moderately or severely frail (rMPI-score = 2 or 3) and compared to non-frail (rMPI-score = 1). At admission, frail patients presented more frequently with confusion. At discharge, functional decline measured by change in CFS and increased home care was more prevalent among frail than the non-frail. Decisions about no invasive ventilation or CPR were more prevalent among frail older patients with COVID-19 than non-frail. Ninety-day mortality was 70% among frail patients versus 15% in non-frail. Conclusion Frailty seems to be associated with confusion, more frequent decisions about treatment level, larger functional decline at discharge and a higher mortality rate among older patients with COVID-19.
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Affiliation(s)
- Ane Borgbjerg Verholt
- Department of Geriatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
| | - Merete Gregersen
- Department of Geriatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark
| | | | - Troels K Hansen
- Department of Geriatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark
| | - Lotte Ebdrup
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Catherine H Foss
- Department of Geriatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark
| | - Lone Winther Lietzen
- Department of Geriatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark
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Orrù G, Bertelloni D, Diolaiuti F, Mucci F, Di Giuseppe M, Biella M, Gemignani A, Ciacchini R, Conversano C. Long-COVID Syndrome? A Study on the Persistence of Neurological, Psychological and Physiological Symptoms. Healthcare (Basel) 2021; 9:575. [PMID: 34068009 PMCID: PMC8152255 DOI: 10.3390/healthcare9050575] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/06/2021] [Accepted: 05/10/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Emerging aspects of the Covid-19 clinical presentation are its long-term effects, which are characteristic of the so-called "long COVID". The aim of the present study was to investigate the prevalence of physical, psychological, and sleep disturbances and the quality of life in the general population during the ongoing pandemic. METHODS This study, based on an online survey, collected demographic data, information related to COVID-19, sleep disturbances, and quality of life data from 507 individuals. The level of sleep disturbances and quality of life was assessed through the Insomnia Severity Index (ISI) and the EuroQol-5D (EQ-5D), respectively. RESULTS In total, 507 individuals (M = 91 and F = 416 women) completed the online survey. The main symptoms associated with "long COVID" were headache, fatigue, muscle aches/myalgia, articular pains, cognitive impairment, loss of concentration, and loss of smell. Additionally, the subjects showed significant levels of insomnia (p < 0.05) and an overall reduced quality of life (p < 0.05). CONCLUSIONS The results of the study appear in line with recent publications, but uncertainty regarding the definition and specific features of "long COVID" remains. Further studies are needed in order to better define the clinical presentation of the "long COVID" condition and related targeted treatments.
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Affiliation(s)
- Graziella Orrù
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126 Pisa, Italy; (D.B.); (F.D.); (M.D.G.); (M.B.); (A.G.); (R.C.); (C.C.)
| | - Davide Bertelloni
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126 Pisa, Italy; (D.B.); (F.D.); (M.D.G.); (M.B.); (A.G.); (R.C.); (C.C.)
| | - Francesca Diolaiuti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126 Pisa, Italy; (D.B.); (F.D.); (M.D.G.); (M.B.); (A.G.); (R.C.); (C.C.)
| | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy;
| | - Mariagrazia Di Giuseppe
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126 Pisa, Italy; (D.B.); (F.D.); (M.D.G.); (M.B.); (A.G.); (R.C.); (C.C.)
| | - Marco Biella
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126 Pisa, Italy; (D.B.); (F.D.); (M.D.G.); (M.B.); (A.G.); (R.C.); (C.C.)
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126 Pisa, Italy; (D.B.); (F.D.); (M.D.G.); (M.B.); (A.G.); (R.C.); (C.C.)
| | - Rebecca Ciacchini
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126 Pisa, Italy; (D.B.); (F.D.); (M.D.G.); (M.B.); (A.G.); (R.C.); (C.C.)
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126 Pisa, Italy; (D.B.); (F.D.); (M.D.G.); (M.B.); (A.G.); (R.C.); (C.C.)
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Menéndez-Colino R, Argentina F, de Miguel AM, Barcons Marqués M, Chaparro Jiménez B, Figueroa Poblete C, Alarcón T, Martínez Peromingo FJ, González-Montalvo JI. [Liaison geriatrics with nursing homes in COVID time. A new coordination model arrived to stay]. Rev Esp Geriatr Gerontol 2021; 56:157-165. [PMID: 33642134 PMCID: PMC7836697 DOI: 10.1016/j.regg.2021.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 12/22/2020] [Accepted: 01/07/2021] [Indexed: 01/15/2023]
Abstract
Older people living in nursing homes fulfil the criteria to be considered as geriatric patients, but they often do not have met their health care needs. Current deficits appeared as a result of COVID-19 pandemic. The need to improve the coordination between hospitals and nursing homes emerged, and in Madrid it materialized with the implantation of Liaison Geriatrics teams or units at public hospitals. The Sociedad Española de Geriatría y Gerontología has defined the role of the geriatricians in the COVID-19 pandemic and they have given guidelines about prevention, early detection, isolation and sectorization, training, care homes classification, patient referral coordination, and the role of the different care settings, among others. These units and teams also must undertake other care activities that have a shortfall currently, like nursing homes-hospital coordination, geriatricians visits to the homes, telemedicine sessions, geriatric assessment in emergency rooms, and primary care and public health services coordination. This paper describes the concept of Liaison Geriatrics and its implementation at the Autonomous Community of Madrid hospitals as a result of COVID-19 pandemic. Activity data from a unit at a hospital with a huge number of nursing homes in its catchment area are reported. The objective is to understand the need of this activity in order to avoid the current fragmentation of care between hospitals and nursing homes. This activity should be consolidated in the future.
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Affiliation(s)
- Rocío Menéndez-Colino
- Servicio de Geriatría. Hospital Universitario La Paz, Madrid, España; Facultad de Medicina. Universidad Autónoma de Madrid, Madrid, España; Instituto de Investigación IdiPAZ, Hospital Universitario La Paz, Madrid, España; Unidad de Geriatría de Enlace, Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España.
| | - Francesca Argentina
- Servicio de Geriatría. Hospital Universitario La Paz, Madrid, España; Unidad de Geriatría de Enlace, Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España
| | - Ana Merello de Miguel
- Servicio de Geriatría. Hospital Universitario La Paz, Madrid, España; Unidad de Geriatría de Enlace, Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España
| | - Montserrat Barcons Marqués
- Servicio de Geriatría. Hospital Universitario La Paz, Madrid, España; Unidad de Geriatría de Enlace, Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España
| | - Blanca Chaparro Jiménez
- Servicio de Geriatría. Hospital Universitario La Paz, Madrid, España; Unidad de Geriatría de Enlace, Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España
| | - Carolina Figueroa Poblete
- Servicio de Geriatría. Hospital Universitario La Paz, Madrid, España; Unidad de Geriatría de Enlace, Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España
| | - Teresa Alarcón
- Servicio de Geriatría. Hospital Universitario La Paz, Madrid, España; Facultad de Medicina. Universidad Autónoma de Madrid, Madrid, España; Instituto de Investigación IdiPAZ, Hospital Universitario La Paz, Madrid, España; Unidad de Geriatría de Enlace, Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España
| | | | - Juan Ignacio González-Montalvo
- Servicio de Geriatría. Hospital Universitario La Paz, Madrid, España; Facultad de Medicina. Universidad Autónoma de Madrid, Madrid, España; Instituto de Investigación IdiPAZ, Hospital Universitario La Paz, Madrid, España; Unidad de Geriatría de Enlace, Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España
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Kaur H, Thakur JS, Paika R, Advani SM. Impact of Underlying Comorbidities on Mortality in SARS-COV-2 Infected Cancer Patients: A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev 2021; 22:1333-1349. [PMID: 34048161 PMCID: PMC8408376 DOI: 10.31557/apjcp.2021.22.5.1333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 05/02/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The evidence has shown that SARS CoV-2 infected patients with comorbidities are more likely to have severe disease sequel and mortality. In SARS-CoV-2 infected cancer patients risks associated with other underlying comorbidities might vary from those in non-cancer SARS CoV-2 infected patients. The relative impact of different underlying health conditions among patients with cancer and SARS CoV-2 infection remains yet to be explored. This systematic review aims to explore the prevalence of comorbidities among cancer patients with SARS CoV-2 infection and their impact on mortality. METHODS Online databases PubMed, Embase, Scopus and Web of science were searched for articles published between 9th July 2019 to July 8th 2020.Studies of cancer patients (>18 years) with diagnosis of SARS CoV-2 infection, published in English were included. A random-effects modelling for the meta-analyses was applied to assess the pooled prevalence and odds ratio for mortality due to comorbidities in SARS CoV-2 infected cancer patients. RESULTS Total 31studies with 4086 SARS-CoV-2 infectedcancer patientsmet the inclusion criteria. Most prevalent co-morbidities in cancer patients with SARS CoV-2 infection were hypertension [42.3% (95%CI:37.5- 47.0)], diabetes [17.8% (95% CI: 15.3-20.4)] and cardiovascular diseases [16.7% (95%CI:12.9-20.4)].The risk of mortality (pOR) was significantly higher in individuals with hypertension[1.6(95%CI 1.24-2.00)], cardiovascular diseases [2.2 (95%CI 1.49- 3.27)], chronic obstructive pulmonary diseases [1.4(95% CI 1.05-2.00)] and diabetes [1.35(95%CI 1.06-1.73)]. CONCLUSION Our results indicates that the mortality in SARS-CoV-2 infected cancer patients is affected by preexisting non-cancer comorbidities. By identifying the comorbidities predictive for mortality, clinicians can better stratify the risk of cancer patients presenting with SARS-COV-2, on their initial contact with health services. .
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Affiliation(s)
- Harmanjeet Kaur
- Department of Community Medicine & School of Public Health, PGIMER, Chandigarh, India.
| | - JS Thakur
- Department of Community Medicine & School of Public Health, PGIMER, Chandigarh, India.
| | - Ronika Paika
- Department of Community Medicine & School of Public Health, PGIMER, Chandigarh, India.
| | - Shailesh M Advani
- Cancer Prevention and Control Program, Georgetown University School of Medicine, Georgetown University, Washington DC, USA.
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Bağ Soytaş R, Ünal D, Arman P, Suzan V, Emiroğlu Gedik T, Can G, Korkmazer B, Karaali R, Börekçi Ş, Kuşkucu MA, Yavuzer H, Suna Erdinçler D, Döventaş A. Factors affecting mortality in geriatric patients hospitalized with COVID-19. Turk J Med Sci 2021; 51:454-463. [PMID: 33315348 PMCID: PMC8203128 DOI: 10.3906/sag-2008-91] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/12/2020] [Indexed: 12/17/2022] Open
Abstract
Background/aim We aimed to investigate the factors affecting the mortality of patients aged 65 years or older who were hospitalized with the diagnosis of new coronavirus pneumonia (COVID-19). Materials and methods This is a retrospective study of patients 65 years old or older with COVID-19 who were hospitalized in İstanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty Hospital, between March 11 and May 28, 2020. Demographic, clinical, treatment, and laboratory data were extracted from electronic medical records. We used univariate and multivariate logistic regression methods to explore the risk factors for in-hospital death. Results A total of 218 patients (112 men, 106 women) were included, of whom 166 were discharged and 52 died in hospital. With univariate analysis, various clinical features and laboratory variables were found to be significantly different (i.e. P < 0.05). In multivariate logistic regression analysis the following were independently associated with mortality: present malignancy [odds ratio (OR) = 4.817, 95% confidence interval (CI) = 1.107–20.958, P: 0.036]; dyspnea (OR = 4.652, 95% CI = 1.473–14.688, P: 0.009); neutrophil/lymphocyte ratio (NLR; OR = 1.097, 95% CI = 1.012–1.188, P: 0.025); the highest values of C-reactive protein (CRP; OR = 1.006, 95% CI = 1.000–1.012, P: 0.049), lactate dehydrogenase (LDH; OR = 1.002, 95% CI = 1.001–1.004, P: 0.003), and creatinine levels (OR = 1.497, 95% CI = 1.126–1.990, P: 0.006); oxygen saturation (SpO2) values on admission (OR = 0.897, 95% CI = 0.811–0.993, P: 0.036); and azithromycin use (OR = 0.239, 95% CI = 0.065–0.874, P: 0.031). Conclusion The presence of malignancy; symptoms of dyspnea; high NLR; highest CRP, LDH, and creatinine levels; and low SpO2 on admission predicted mortality. On the other hand, azithromycin use was found to be protective against mortality. Knowing the causes predicting mortality will be important to treat future cases more successfully.
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Affiliation(s)
- Rabia Bağ Soytaş
- Division of Geriatrics, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Damla Ünal
- Division of Geriatrics, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Pınar Arman
- Division of Geriatrics, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Veysel Suzan
- Division of Geriatrics, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Tuğçe Emiroğlu Gedik
- Division of Geriatrics, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Günay Can
- Department of Public Health, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Bora Korkmazer
- Department of Radiology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Rıdvan Karaali
- Department of Infectious Diseases, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Şermin Börekçi
- Department of Pulmonary Diseases, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Mert Ahmet Kuşkucu
- Department of Medical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Hakan Yavuzer
- Division of Geriatrics, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Deniz Suna Erdinçler
- Division of Geriatrics, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Alper Döventaş
- Division of Geriatrics, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
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Andrés-Esteban EM, Quintana-Diaz M, Ramírez-Cervantes KL, Benayas-Peña I, Silva-Obregón A, Magallón-Botaya R, Santolalla-Arnedo I, Juárez-Vela R, Gea-Caballero V. Outcomes of hospitalized patients with COVID-19 according to level of frailty. PeerJ 2021; 9:e11260. [PMID: 33954054 PMCID: PMC8051355 DOI: 10.7717/peerj.11260] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/22/2021] [Indexed: 01/28/2023] Open
Abstract
Background The complications from coronavirus disease 2019 (COVID-19) have been the subject of study in diverse scientific reports. However, many aspects that influence the prognosis of the disease are still unknown, such as frailty, which inherently reduces resistance to disease and makes people more vulnerable. This study aimed to explore the complications of COVID-19 in patients admitted to a third-level hospital and to evaluate the relationship between these complications and frailty. Methods An observational, descriptive, prospective study was performed in 2020. A sample of 254 patients from a database of 3,112 patients admitted to a high-level hospital in Madrid, Spain was analyzed. To assess frailty (independent variable) the Clinical Frailty Scale (CFS) was used. The outcome variables were sociodemographic and clinical, which included complications, length of stay, intensive care unit (ICU) admission and prognosis. Results A total of 13.39% of the patients were pre-frail and 17.32% were frail. Frail individuals had a shorter hospital stay, less ICU admission, higher mortality and delirium, with statistical significance. Conclusion Frailty assessment is a crucial approach in patients with COVID-19, given a higher mortality rate has been demonstrated amongst frail patients. The CFS could be a predictor of mortality in COVID-19.
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Affiliation(s)
- Eva María Andrés-Esteban
- Grupo PBM, Instituto de Investigación-IdiPaz, Madrid, Madrid, Spain.,Universidad Rey Juan Carlos, Madrid, Madrid, Spain
| | - Manuel Quintana-Diaz
- Grupo PBM, Instituto de Investigación-IdiPaz, Madrid, Madrid, Spain.,Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, Madrid, Spain
| | - Karen Lizzette Ramírez-Cervantes
- Grupo PBM, Instituto de Investigación-IdiPaz, Madrid, Madrid, Spain.,Departamento de Prevención, Asociación Española contra el Cáncer, Madrid, Madrid, Spain
| | | | - Alberto Silva-Obregón
- Grupo PBM, Instituto de Investigación-IdiPaz, Madrid, Madrid, Spain.,Servicio de Medicina Intensiva, Hospital Universitario de Guadalajara, Guadalajara, Guadalajara, Spain
| | - Rosa Magallón-Botaya
- Departamento de Medicina, Psiquiatría y Dermatología, Universidad de Zaragoza, Zargoza, Aragón, Spain
| | - Ivan Santolalla-Arnedo
- Universidad de La Rioja, Centro de Investigación Biomédica de La Rioja-CIBIR, Logroño, La Rioja, Spain
| | - Raúl Juárez-Vela
- Grupo PBM, Instituto de Investigación-IdiPaz, Madrid, Madrid, Spain.,Universidad de La Rioja, Centro de Investigación Biomédica de La Rioja-CIBIR, Logroño, La Rioja, Spain
| | - Vicente Gea-Caballero
- Nursing School La Fe., Adscript center of Universidad de Valencia., Valencia, Valencia, Spain.,Research Group GREIACC, Health Research Institute La Fe., Valencia, Valencia, Spain
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Alboksmaty A, Kumar S, Parekh R, Aylin P. Management and patient safety of complex elderly patients in primary care during the COVID-19 pandemic in the UK-Qualitative assessment. PLoS One 2021; 16:e0248387. [PMID: 33780464 PMCID: PMC8006979 DOI: 10.1371/journal.pone.0248387] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/25/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES The study aims to investigate GPs' experiences of how UK COVID-19 policies have affected the management and safety of complex elderly patients, who suffer from multimorbidity, at the primary care level in North West London (NWL). DESIGN This is a service evaluation adopting a qualitative approach. SETTING Individual semi-structured interviews were conducted between 6 and 22 May 2020, 2 months after the introduction of the UK COVID-19 Action Plan, allowing GPs to adapt to the new changes and reflect on their impact. PARTICIPANTS Fourteen GPs working in NWL were interviewed, until data saturation was reached. OUTCOME MEASURES The impact of COVID-19 policies on the management and safety of complex elderly patients in primary care from the GPs' perspective. RESULTS Participants' average experience was fourteen years working in primary care for the NHS. They stated that COVID-19 policies have affected primary care at three levels, patients' behaviour, work conditions, and clinical practice. GPs reflected on the impact through five major themes; four of which have been adapted from the Safety Attitudes Questionnaire (SAQ) framework, changes in primary care (at the three levels mentioned above), involvement of GPs in policy making, communication and coordination (with patients and in between medical teams), stressors and worries; in addition to a fifth theme to conclude the GPs' suggestions for improvement (either proposed mitigation strategies, or existing actions that showed relative success). A participant used an expression of "infodemic" to describe the GPs' everyday pressure of receiving new policy updates with their subsequent changes in practice. CONCLUSION The COVID-19 pandemic has affected all levels of the health system in the UK, particularly primary care. Based on the GPs' perspective in NWL, changes to practice have offered opportunities to maintain safe healthcare as well as possible drawbacks that should be of concern.
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Affiliation(s)
- Ahmed Alboksmaty
- NIHR Patient Safety Translational Research Centre (PSTRC), Imperial College London, London, United Kingdom
- * E-mail: ,
| | - Sonia Kumar
- Undergraduate Primary Care Education and Medical Education Innovation and Research Centre (MEdIC), Imperial College London, London, United Kingdom
| | - Ravi Parekh
- Medical Education Innovation and Research Centre (MEdIC), Imperial College London, London, United Kingdom
| | - Paul Aylin
- Epidemiology and Public Health, Director Dr Foster Unit, School of Public Health, Imperial College London, London, United Kingdom
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Xu Y, Lin G, Spada C, Zhao H, Wang S, Chen X, Chen Y, Zhang Y, Marraro GA, Zeng X, Ye X, Zhang L, Zeng Y. Public Knowledge, Attitudes, and Practices Behaviors Towards Coronavirus Disease 2019 (COVID-19) During a National Epidemic-China. Front Public Health 2021; 9:638430. [PMID: 33816423 PMCID: PMC8017307 DOI: 10.3389/fpubh.2021.638430] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The rapid outbreak of coronavirus disease 2019 (COVID-19) posed a serious threat to China, followed by compulsive measures taken against the national emergency to control its further spread. This study was designed to describe residents' knowledge, attitudes, and practice behaviors (KAP) during the outbreak of COVID-19. Methods: An anonymous online questionnaire was randomly administrated to residents in mainland China between Mar 7 and Mar 16, 2020. Residents' responses to KAP were quantified by descriptive and stratified analyses. A Multiple Logistic Regression model was employed to identify risk factors associated with KAP scores. Results: A total of 10,195 participants were enrolled from 32 provinces of China. Participants of the ≥61 years group had higher KAP scores [adjusted Odds Ratio (ORadj) = 4.8, 95% Confidence Interval (CI): 3.0-7.7, P < 0.0001], and the married participants and those in low-income families had higher scores of KAP (ORadj = 1.2, 95% CI: 1.1-1.3; ORadj = 1.8, 95% CI: 1.6-2.2, respectively, both P < 0.0001). The participants living with more than two family members had higher scores in an increasing ORs when the family members increased (ORadj = 1.3, 95% CI: 1.1-1.6, P = 0.013; ORadj = 1.3, 95% CI: 1.1-1.6, P = 0.003; ORadj = 1.3, 95% CI: 1.0-1.6, P = 0.02; for groups of 2, 3-4 and ≥5, respectively). Conclusions: Out of the enrolled participants who completed the survey, 85.5% responded positively toward the mandatory public health interventions implemented nationwide by the Chinese authorities. These effective practices seem to be related to a proper attitude generated by the increased knowledge and better awareness of the risks related to the COVID-19 pandemic and the consequent need for safe and responsible behavior.
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Affiliation(s)
- Yuan Xu
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, Quanzhou, China
| | - Guofu Lin
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, Quanzhou, China.,The Second Clinical College, Fujian Medical University, Quanzhou, China
| | - Claudio Spada
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Healthcare Accountability Lab, University of Milan, Milan, Italy
| | - Huifen Zhao
- Department of Nursing Teaching and Research, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Shuo Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xiaoyang Chen
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, Quanzhou, China
| | - Yunfeng Chen
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, Quanzhou, China
| | - Yixiang Zhang
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, Quanzhou, China
| | - Giuseppe A Marraro
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,The Second Clinical College, Fujian Medical University, Quanzhou, China
| | - Xiaohong Zeng
- Department of Preventive Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Xiangjia Ye
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, Quanzhou, China
| | - Li Zhang
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, Quanzhou, China
| | - Yiming Zeng
- Department of Respiratory Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Respiratory Medicine Center of Fujian Province, Quanzhou, China
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Human talent in geriatrics in Colombia and its relevance for the management of COVID-19. LANCET HEALTHY LONGEVITY 2021; 2:e123-e124. [PMID: 33817684 PMCID: PMC8009756 DOI: 10.1016/s2666-7568(21)00005-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Marschalko EE, Kotta I, Kalcza-Janosi K, Szabo K, Jancso-Farcas S. Psychological Predictors of COVID-19 Prevention Behavior in Hungarian Women Across Different Generations. Front Psychol 2021; 12:596543. [PMID: 33574787 PMCID: PMC7870484 DOI: 10.3389/fpsyg.2021.596543] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/04/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Age related differences were found in prevention behavior, showing that older individuals tend to be the most proactive. The aim of the study was the identification of psychological predictors on COVID-19 prevention behavior in women, across four generations. In addition, the predictive role of the psychological variables was explored through the lens of negative and positive information processing perspective on total and domain-specific COVID-19 prevention behavior. METHODS A cross-sectional research was conducted. The sample included 834 Hungarian speaking women. The assessed variables were: COVID-19 knowledge, risk perception, COVID-19 health anxiety, negative automatic thoughts, psychological flexibility, and four domains of COVID-19 prevention behavior (social distancing, general hygiene, information seeking, health behavior). A three-level hierarchical linear regression analysis was conducted to investigate the predictors of preventive behavior in each generation. RESULTS A diversity across generations was found. In case of baby boomer generation, the final model explained 32.4% of the variance for total prevention behavior [F(14,215) = 8.847, p < 0.001], and only perceived risk made a significant contribution. For Gen X the final model accounted for 21.1% of variance of total prevention behavior [F(14,341) = 7.788, p < 0.001], marital status, perceived risk, COVID-19 health anxiety, and negative automatic thoughts made significant contributions. In case of Gen Y the final model accounted for 6.2% of variance on total prevention behavior [F(14,147) = 1.761, p = 0.05], only perceived risk had a contribution to the final model. For Gen Z the final model accounted for 23.4% of variance on total preventive behavior [F(13,71) = 2.979, p = 0.002], and only psychological flexibility made a contribution to the model. The results on the distinct domains of COVID-19 prevention behavior emphasized details in the dissimilarity among generations. CONCLUSION The role of generational identity on COVID-19 prevention behavior is relevant. The coexistence of negative and positive information processing may have its beneficial role in certain areas of prevention.
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Ahmad Y, Paul S, Varshney R, Kumar B. Comments on potential re-purposing of medicines against high-altitude illnesses towards SARS-CoV2: possibilities and pitfalls. JOURNAL OF PROTEINS AND PROTEOMICS 2021; 12:15-17. [PMID: 33495677 PMCID: PMC7815497 DOI: 10.1007/s42485-020-00055-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/08/2020] [Accepted: 12/30/2020] [Indexed: 11/03/2022]
Abstract
In the ongoing COVID-19 pandemic, the global fraternity of researchers has been assiduously investigating pharmacological interventions against the SARS-CoV2. This novel virus is known to gain entry through the ACE 2 receptor of pulmonary epithelial cells lining the respiratory tract. Many of its initial symptoms (e.g. difficulty breathing) resemble acute high altitude illnesses, particularly HAPE. Based on these overt symptoms, a number of high altitude researchers have speculated on repurposing of drugs used to treat acute altitude illnesses (especially HAPE). However, eminent high altitude researchers with medical expertise as well as some studies on the deeper causes underlying the overt symptoms have found that such repurposing maybe counter-productive. Other factors, (e.g. contra-indications of these drugs), make their use in COVID-19 patients hazardous. The fit-for-repurposing options maybe experimental prophylactic interventions (e.g. silymarin, curcumin) which have proven anti-oxidant and anti-inflammatory effects. Another line of thought focuses on proteomics-based investigations of such patients. However, apart from the logistical and safety issues, a targeted proteomics approach based on prior sound molecular investigations is a more logical approach instead of mere shotgun proteomics. In this commentary, we shed light on such issues associated with COVID-19.
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Affiliation(s)
- Yasmin Ahmad
- Defence Institute of Physiology and Allied Sciences (DIPAS), Defence R and D Organization (DRDO), Timarpur, New Delhi-110054 India
| | - Subhojit Paul
- Defence Institute of Physiology and Allied Sciences (DIPAS), Defence R and D Organization (DRDO), Timarpur, New Delhi-110054 India
| | - Rajeev Varshney
- Defence Institute of Physiology and Allied Sciences (DIPAS), Defence R and D Organization (DRDO), Timarpur, New Delhi-110054 India
| | - Bhuvnesh Kumar
- Defence Institute of Physiology and Allied Sciences (DIPAS), Defence R and D Organization (DRDO), Timarpur, New Delhi-110054 India
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Córdova LDS, Vega APM, Luján-Carpio E, Parodi JF, Moncada-Mapelli E, Armacanqui-Valencia I, Salvador-Ruiz J, Pawer-Pucurimay D, Ydrogo-Cruz E, Chevarría-Arriaga MJ, Ganoza-Farro M, Meza-Romero A, Zegarra-Rodríguez CA, Albán-Murguia PG, Bailón-Valdez Z, Palacios-Garcia N, Quevedo-La-Torre D, Alcós-Mamani AL, Gómez-Martel LA, Roca-Moscoso MA, Gamboa-Orozco M, Salazar-Granara A. Clinical characteristics of older patients with COVID-19: a systematic review of case reports. Dement Neuropsychol 2021; 15:1-15. [PMID: 33907593 PMCID: PMC8049578 DOI: 10.1590/1980-57642021dn15-010001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 10/15/2020] [Indexed: 01/08/2023] Open
Abstract
In the context of the current COVID-19 pandemic, higher morbidity and mortality have been reported in older adults. This age group presents physiological changes and its own clinical conditions such as frailty, dementia, among others. OBJECTIVE To describe the characteristics of COVID-19 patients, both over and under 80 years old, by conducting a systematic review of the literature describing case reports, and to summarize and critically assess these characteristics. METHODS Systematic review. The study was registered on the Registry of Health Research Projects (PRISA) of the Peruvian National Institute of Health (code EI00000631). Five electronic databases (Scopus, PubMed, PubMed Central, LILACS, and SCIELO) were systematically searched during the period between December 31, 2019 and April 16, 2020. The search focused on case reports, case studies, and case series of older people with COVID-19 infection aged over or under 80 years. When selecting the cases, priority was given to clinical and epidemiological profile, laboratory and imaging patterns, and comprehensive geriatric evaluation. RESULTS 1,149 articles were identified; after applying the filters, a total of 15 publications of case reports and complete records of 27 older adults were obtained. The most frequent age group was between 60 to 69 years old. There is little literature regarding case reports of older adults aged over 80 years. The most frequent parameters were hypertension, fever, cough, respiratory distress, ground-glass opacification in chest radiography and tomography. Furthermore, decrease in PaO2/FiO2 ratio and lymphocytes, and increase in C-reactive protein and Interleukin 6 were observed. CONCLUSIONS This systematic review found little available information of patients under 80 years old, and far less for those over 80 years old, and an absence of comprehensive geriatric assessment.
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Affiliation(s)
- Luisser Dainner Saavedra Córdova
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
| | - Alexander Pieter Mayor Vega
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
| | - Elmer Luján-Carpio
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
| | - José Francisco Parodi
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Aging, School of Medicine, Universidad de San
Martín de Porres. – Lima, Peru
| | - Enrique Moncada-Mapelli
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
- Scientific Society of Medical Students, Universidad de San
Martín de Porres – Lima, Peru
| | - Isai Armacanqui-Valencia
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
- Scientific Society of Medical Students, Universidad de San
Martín de Porres – Lima, Peru
| | - Jhonatanael Salvador-Ruiz
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
| | - Dalia Pawer-Pucurimay
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
- Scientific Society of Medical Students, Universidad de San
Martín de Porres – Lima, Peru
| | - Erickson Ydrogo-Cruz
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
- Scientific Society of Medical Students, Universidad Pedro Ruiz
Gallo – Lambayeque, Peru
| | - Mylenka Jennifer Chevarría-Arriaga
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
- Scientific Society of Medical Students, Universidad de San
Martín de Porres – Lima, Peru
| | - Macarena Ganoza-Farro
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
- Scientific Society of Medical Students, Universidad de San
Martín de Porres – Lima, Peru
| | - Araceli Meza-Romero
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
| | - Cynthia Alejandra Zegarra-Rodríguez
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
- Scientific Society of Medical Students, Universidad Pedro Ruiz
Gallo – Lambayeque, Peru
| | - Pedro Gustavo Albán-Murguia
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
- Scientific Society of Medical Students, Universidad de San
Martín de Porres – Lima, Peru
| | - Zaira Bailón-Valdez
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
| | - Naheilli Palacios-Garcia
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
| | - Danae Quevedo-La-Torre
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
| | - Angelica Lizeth Alcós-Mamani
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
- Scientific Association of Medical Students, Universidad del
Altiplano – Puno, Peru
| | - Luisa Alisson Gómez-Martel
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
| | - Max Antonio Roca-Moscoso
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
- Scientific Society of Medical Students, Universidad de San
Martín de Porres – Lima, Peru
| | - Martin Gamboa-Orozco
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Extracurricular Research Internship Program, Research Centre of
Traditional Medicine and Pharmacoly, School of Medicine, Universidad de San
Martín de Porres – Lima, Peru
- Scientific Society of Medical Students, Universidad de San
Martín de Porres – Lima, Peru
| | - Alberto Salazar-Granara
- Universidad de San Martín de Porres, School of Medicine – Lima,
Peru
- Research Centre of Traditional Medicine and Pharmacology, School
of Medicine, Universidad de San Martín de Porres – Lima, Peru
- Sociedad Peruana de Farmacología y Terapéutica Experimental –
Lima, Peru
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Nafakhi H, Alareedh M, Al-Buthabhak K, Shaghee F, Nafakhi A, Kasim S. Predictors of adverse in-hospital outcome and recovery in patients with diabetes mellitus and COVID-19 pneumonia in Iraq. Diabetes Metab Syndr 2021; 15:33-38. [PMID: 33296788 PMCID: PMC7832757 DOI: 10.1016/j.dsx.2020.12.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 11/26/2020] [Accepted: 12/04/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS There is limited data about the prognosis and impact of COVID-19 pneumonia on patients with diabetes mellitus (DM). We aimed to assess blood indices, ECG markers of sudden death and malignant arrhythmias on admission, and diabetes lowering drugs as possible predictors of adverse in-hospital outcome and COVID-19 pneumonia recovery status. METHODS A retrospective study included patients with newly diagnosed COVID-19 pneumonia from August 20, to October 5, 2020. RESULTS A total of 192 patients with COVID-19 pneumonia were included in the present study, of whom 67 patients had DM. Low lymphocytes % [0.4(0.1-0.9), P = .011] and QTc interval prolongation [0.4(0.1-0.8), P = .022] were associated with increased length of ICU stay. On the other hand, metformin use [0.3(0.2-4), P = .032] and DPP-4 inhibitors use [0.3(0.2-3), P = .040] were associated with decreased length of ICU stay. QTc interval prolongation [0.4(0.1-0.9), P = .017] was associated with increased length of hospital stay, while using metformin [0.4(0.2-3), P = .022] was associated with decreased length of hospital stay. Low lymphocytes % [0.5(0.4-1.6), P = .001], insulin use [0.4(0.3-5), P = .003], and old age [0.5(0.1-2.3), P = .025] were associated with extensive lung injury. The risk for in-hospital death was associated with high neutrophil% [1(1-1.4), P = .045], while metformin use was associated with decreased risk for in-hospital death [0.1(0.1-0.6), P = .025]. Insulin use [0.3(0.2-4), P = .013] was associated with partial recovery following acute COVID pneumonia. CONCLUSIONS Metformin and DPP-4 inhibitors use were associated with favorable in-hospital outcomes, while insulin use was associated with extensive lung injury and post-acute COVID-19 pneumonia partial recovery.
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Affiliation(s)
- Hussein Nafakhi
- Internal Medicine Department, Medicine College, University of Kufa, Najaf, Iraq.
| | - Mohammed Alareedh
- Internal Medicine Department, Medicine College, University of Kufa, Najaf, Iraq.
| | - Karrar Al-Buthabhak
- Internal Medicine Department, Medicine College, University of Kufa, Najaf, Iraq.
| | - Foaad Shaghee
- Internal Medicine Department, Jabir Ibn Hayyan Medical University Faculty of Medicine, Kufa, Iraq.
| | - Ahmed Nafakhi
- Research Unit, Najaf Health Bureau, Ministry of Health, Iraq.
| | - Samet Kasim
- Internal Medicine Department, Medicine College, University of Kufa, Najaf, Iraq.
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Predictive Factors for a New Positive Nasopharyngeal Swab Among Patients Recovered From COVID-19. Am J Prev Med 2021; 60:13-19. [PMID: 33041095 PMCID: PMC7500946 DOI: 10.1016/j.amepre.2020.08.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/16/2020] [Accepted: 08/11/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION As an emerging infectious disease, the clinical and virologic course of COVID-19 requires better investigation. The aim of this study is to identify the potential risk factors associated with persistent positive nasopharyngeal swab real-time reverse transcription‒polymerase chain reaction tests in a large sample of patients who recovered from COVID-19. METHODS After the acute phase of SARS-CoV-2 epidemic infection, the Fondazione Policlinico A. Gemelli IRCSS of Rome established a post-acute care service for patients discharged from the hospital and recovered from COVID-19. Between April 21 and May 21, 2020, a total of 137 individuals who officially recovered from COVID-19 were enrolled in this study. All patients were tested for the SARS-CoV-2 virus with nucleic acid RT-PCR tests. Analysis was conducted in June 2020. RESULTS Of the 131 patients who repeated the nasopharyngeal swab, 22 patients (16.7%) tested positive again. Some symptoms such as fatigue (51%), dyspnea (44%), and coughing (17%) were still present in a significant percentage of the patients, with no difference between patients with a negative test and those who tested positive. The likelihood of testing positive for SARS-CoV-2 infection was significantly higher among participants with persistent sore throat (prevalence ratio=6.50, 95% CI=1.38, 30.6) and symptoms of rhinitis (prevalence ratio=3.72, 95% CI=1.10, 12.5). CONCLUSIONS This study is the first to provide a given rate of patients (16.7%) who test positive on RT-PCR test for SARS-CoV-2 nucleic acid after recovering from COVID-19. These findings suggest that a significant proportion of patients who have recovered from COVID-19 still could be potential carriers of the virus. In particular, if patients continue to have symptoms related to COVID-19, such as sore throat and rhinitis, it is reasonable to be cautious by avoiding close contact, wearing a face mask, and possibly repeating a nasopharyngeal swab.
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Predictors for development of critical illness amongst older adults with COVID-19: Beyond age to age-associated factors. Arch Gerontol Geriatr 2020; 94:104331. [PMID: 33476755 PMCID: PMC7834606 DOI: 10.1016/j.archger.2020.104331] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 12/14/2020] [Accepted: 12/22/2020] [Indexed: 12/18/2022]
Abstract
Introduction Older adults with COVID-19 have disproportionately higher rates of severe disease and mortality. It is unclear whether this is attributable to age or attendant age-associated risk factors. This retrospective cohort study aims to characterize hospitalized older adults and examine if comorbidities, frailty and acuity of clinical presentation exert an age-independent effect on COVID-19 severity. Methods We studied 275 patients admitted to the National Centre of Infectious Disease, Singapore. We measured: 1)Charlson Comorbidity Index(CCI) as burden of comorbidities; 2)Clinical Frailty Scale(CFS) and Frailty Index(FI); and 3)initial acuity. We studied characteristics and outcomes of critical illness, stratified by age groups (50–59,60–69 and ≥70). We conducted hierarchical logistic regression in primary model(N = 262, excluding direct admissions to intensive care unit) and sensitivity analysis(N = 275): age and gender in base model, entering CCI, frailty (CFS or FI) and initial acuity sequentially. Results The ≥70 age group had highest CCI(p<.001), FI(p<.001) and CFS(p<.001), and prevalence of geriatric syndromes (polypharmacy,53.5%; urinary symptoms,37.5%; chronic pain,23.3% and malnutrition,23.3%). Thirty-two (11.6%) developed critical illness. In the primary regression model, age was not predictive for critical illness when a frailty predictor was added. Significant predictors in the final model (AUC 0.809) included male gender (p=.012), CFS (p=.038), and high initial acuity (p=.021) but not CCI or FI. In sensitivity analysis, FI (p=.028) but not CFS was significant. Conclusions In hospitalized older adults with COVID-19, geriatric syndromes are not uncommon. Acuity of clinical presentation and frailty are important age-independent predictors of disease severity. CFS and FI provide complimentary information in predicting interval disease progression and rapid disease progression respectively.
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Tosato M, Varone F, Ciccullo A, Calvani R, Moschese D, Potenza A, Siciliano M, Fantoni M. "Say Ninetynine": It's Never too Late to Recover from COVID-19. J Frailty Aging 2020; 10:70-71. [PMID: 33331625 PMCID: PMC7412775 DOI: 10.14283/jfa.2020.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
COVID-19, the disease caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection, showed higher severity and lethality in male older adults. There are currently no specific treatments. Studies are evaluating the efficacy of monoclonal antibodies against interleukin-6 receptor. Here we present the case of a 98-years old man admitted to our COVID-Hospital with acute respiratory failure. Comprehensive geriatric assessment showed no signs of frailty. First-line therapy with hydroxychloroquine and anticoagulants was not effective. Patient was administered intravenous monoclonal antibodies, and he showed remarkable clinical improvement. This case suggests that age alone should not preclude access to new therapeutic approaches. Comprehensive, multisciplinary, multidomain approaches are needed to develop patient-tailored treatments against COVID-19.
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Affiliation(s)
- M Tosato
- Matteo Tosato, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy,
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Barek MA, Aziz MA, Islam MS. Impact of age, sex, comorbidities and clinical symptoms on the severity of COVID-19 cases: A meta-analysis with 55 studies and 10014 cases. Heliyon 2020; 6:e05684. [PMID: 33344791 PMCID: PMC7737518 DOI: 10.1016/j.heliyon.2020.e05684] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/14/2020] [Accepted: 12/04/2020] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Severe acute respiratory coronavirus 2 (SARS-CoV-2) cases are overgrowing globally and now become a pandemic. A meta-analysis was conducted to evaluate the impact of age, sex, comorbidities, and clinical characteristics on the severity of COVID-19 to help diagnose and evaluate the current outbreak in clinical decision-making. METHODS PubMed, ScienceDirect, and BMC were searched to collect data about demographic, clinical characteristics, and comorbidities of COVID-19 patients. Meta-analysis was conducted with Review Manager 5.3. Publication bias was assessed using Egger's test and Begg-Mazumdar's rank correlation. RESULTS Fifty-five studies were included in this meta-analysis, including 10014 patients with SARS-CoV-2 infection. Male cases and cases with an age of ≥50 years (OR = 2.41, p < 0.00001; RR = 3.36, p = 0.0002, respectively) were severely affected by SARS-CoV-2. Patients having age≥65 years are not associated (p = 0.110) with the severity of COVID-19. Presence of at least one comorbidity or hypertension, diabetes, cerebrovascular disease, cardiovascular diseases, respiratory disease, malignancy, chronic kidney disease and chronic liver diseases individually increased the severity of COVID-19 cases significantly (OR = 3.13, p < 0.00001; OR = 2.35, p < 0.00001; OR = 2.42, p < 0.00001; OR = 3.78, p < 0.00001; OR = 3.33, p < 0.00001; OR = 2.58, p < 0.00001; OR = 2.32, p < 0.00001; OR = 2.27, p = 0.0007; OR = 1.70, p = 0.003, respectively). Clinical manifestation such as fever, cough, fatigue, anorexia, dyspnea, chest tightness, hemoptysis, diarrhea and abdominal pain (OR = 1.68, p = 0.0001; OR = 1.41, p = 0.004; OR = 1.26, p = 0.03; OR = 2.38, p < 0.0001; OR = 4.30, p < 0.00001; OR = 2.11, p = 0.002; OR = 4.93, p < 0.0001; OR = 1.35, p = 0.03; OR = 2.38, p = 0.008, respectively) were significantly associated with the severity of cases. No association of severity was found with myalgia, pharyngalgia, nausea, vomiting, headache, dizziness and sore throat (p > 0.05). No publication bias was found in case of age (≥50 years, age≥65 years), comorbidities and clinical manifestations. CONCLUSIONS Males patients and elderly or older patients (age ≥50 years) are at higher risk of developing severity, whereas comorbidities and clinical manifestations could significantly affect the prognosis and severity of COVID-19.
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Affiliation(s)
- Md. Abdul Barek
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Md. Abdul Aziz
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Mohammad Safiqul Islam
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
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Martone AM, Ciciarello F, Landi F. Treatment of COVID-19 disease in older people with cognitive impairment: a challenge into the challenge. JOURNAL OF GERONTOLOGY AND GERIATRICS 2020. [DOI: 10.36150/2499-6564-271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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47
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Petersen MS, Kristiansen MF, Hanusson KD, Danielsen ME, Á Steig B, Gaini S, Strøm M, Weihe P. Long COVID in the Faroe Islands - a longitudinal study among non-hospitalized patients. Clin Infect Dis 2020; 73:e4058-e4063. [PMID: 33252665 PMCID: PMC7799340 DOI: 10.1093/cid/ciaa1792] [Citation(s) in RCA: 219] [Impact Index Per Article: 54.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Indexed: 01/08/2023] Open
Abstract
Background Little is known about long-term recovery from COVID-19 disease, especially in non-hospitalized individuals. In this longitudinal study we present symptoms registered during the acute phase as well as long COVID, i.e. long-lasting COVID-19 symptoms, in patients from the Faroe Islands. Methods All consecutive patients with confirmed RT-PCR testing from April to June 2020 were invited to participate in this study for the assessment of long COVID. Demographic and clinical characteristics and self-reported acute and persistent symptoms were assessed using a standardized detailed questionnaire administered at enrollment and at repeated phone interviews in the period 22 th April to Aug 16 th. Results Of the 180 participants (96.3% of the 187 eligible COVID-19 patients), 53.1% reported persistence of at least one symptom after a mean of 125 days after symptoms onset, 33.3% reported one or two symptoms and 19.4% three or more symptoms. At the last follow-up, 46.7% were asymptomatic compared with 4.4 % during the acute phase. The most prevalent persistent symptoms were fatigue, loss of smell and taste, and arthralgias. Conclusions Our results show that it might take months for symptoms to resolve, even among non-hospitalized persons with mild illness course in the acute phase. Continued monitoring for long COVID is needed.
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Affiliation(s)
- Maria Skaalum Petersen
- Centre of Health Sciences, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands, FO.,Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands, FO
| | - Marnar Fríðheim Kristiansen
- Centre of Health Sciences, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands, FO.,Medical Department, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands, FO.,COVID-19 Task Force, Ministry of Health, Faroe Islands, FO
| | - Katrin Dahl Hanusson
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands, FO
| | - Marjun Eivindardóttir Danielsen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands, FO.,COVID-19 Task Force, Ministry of Health, Faroe Islands, FO
| | - Bjarni Á Steig
- Medical Department, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands, FO.,COVID-19 Task Force, Ministry of Health, Faroe Islands, FO
| | - Shahin Gaini
- Medical Department, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands, FO.,Department of Infectious Diseases, Odense University Hospital, J.B. Winsløwsvej, Odense, Denmark, DK.,Department of Clinical Research, University of Southern Denmark, Winsløwparken, Odense, Denmark, DK
| | - Marin Strøm
- Centre of Health Sciences, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands, FO.,Department of Epidemiology Research, Statens Serum Institut, Artillerivej, Copenhagen S, Denmark, DK
| | - Pál Weihe
- Centre of Health Sciences, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands, FO.,Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands, FO
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Sagarra-Romero L, Viñas-Barros A. COVID-19: Short and Long-Term Effects of Hospitalization on Muscular Weakness in the Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8715. [PMID: 33255233 PMCID: PMC7727674 DOI: 10.3390/ijerph17238715] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 12/15/2022]
Abstract
The COVID-19 pandemic has recently been the cause of a global public health emergency. Frequently, elderly patients experience a marked loss of muscle mass and strength during hospitalization, resulting in a significant functional decline. This paper describes the impact of prolonged immobilization and current pharmacological treatments on muscular metabolism. In addition, the scientific evidence for an early strength intervention, neuromuscular electrical stimulation or the application of heat therapy during hospitalization to help prevent COVID-19 functional sequels is analyzed. This review remarks the need to: (1) determine which potential pharmacological interventions have a negative impact on muscle quality and quantity; (2) define a feasible and reliable pharmacological protocol to achieve a balance between desired and undesired medication effects in the treatment of this novel disease; (3) implement practical strategies to reduce muscle weakness during bed rest hospitalization and (4) develop a specific, early and safe protocol-based care of functional interventions for older adults affected by COVID-19 during and after hospitalization.
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Penteado CT, Loureiro JC, Pais MV, Carvalho CL, Sant'Ana LFG, Valiengo LCL, Stella F, Forlenza OV. Mental Health Status of Psychogeriatric Patients During the 2019 New Coronavirus Disease (COVID-19) Pandemic and Effects on Caregiver Burden. Front Psychiatry 2020; 11:578672. [PMID: 33312138 PMCID: PMC7704440 DOI: 10.3389/fpsyt.2020.578672] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/08/2020] [Indexed: 12/22/2022] Open
Abstract
Introduction: There is a growing awareness about the noxious effects of the 2019 Coronavirus Disease (COVID-19) pandemic on the mental health of the elderly. However, there is limited information from clinically driven research. The objectives of the present study were to examine the magnitude of psychiatric symptoms and to determine their association with caregiver distress, in a cross-section of community-dwelling older adults and a subsample of aging adults with Down syndrome (DS) attending a psychogeriatric service in São Paulo, Brazil. Method: Telephone-based interviews and electronically filled self-assessment questionnaires were used to collect information from patients and caregivers, addressing their impressions and concerns about the pandemic and related effects on the patient's emotional state and behavior. Clinical information was obtained from hospital charts, medical records, and psychometric tests administered through telephone interviews [Hospital Anxiety and Depression Scale (HADS) and Neuropsychiatric Inventory Questionnaire (NPI-Q)]. Results: We included 100 consecutive participants, comprising 71 older adults with psychogeriatric/neurocognitive disorders and 29 aging adults with DS. Higher HADS and NPI-Q scores were significantly associated with caregiver distress (p < 0.05) in both groups. Correlation analyses indicated strong, positive associations between caregiver burden and scores in HADS anxiety (HADS-A) and HADS depression (HADS-D) scales in the subsamples of euploid and DS subjects. Higher NPI-Q scores in the former group were also correlated with caregiver distress, with stronger associations for neuropsychiatric symptoms. Similar findings were observed among DS subjects. ANOVA tests indicated significant associations between NPI-Q scores and caregiver distress among dementia patients, as well as with HADS scores. Similar results were found after multiple linear regressions; as such, among the elderly subsample, higher scores in HADS-A (p = 0.002) and HADS-D (p = 0.001) predict a significant impact on caregiver burden (p < 0.00001, R 2 0.46); taking into consideration caregiver burden as a dependent variable and NPI-Q total score as an independent variable, we obtained significant strong prediction values for either DS (p < 0.00001, R 2 0.95) or elderly adults (p < 0.00001, R 2 0.88). Conclusion: During the COVID-19 pandemic, patients with neurocognitive disorders present with clinically relevant neuropsychiatric symptoms, with significant impact on caregiver distress. Apathy, aberrant motor behavior, sleep disorders, and psychoses were the main psychopathological domains, which had determined caregiver burden worsening.
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Affiliation(s)
- Camila T. Penteado
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Julia C. Loureiro
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Marcos V. Pais
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Cláudia L. Carvalho
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Lívea F. G. Sant'Ana
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Leandro C. L. Valiengo
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Florindo Stella
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
| | - Orestes V. Forlenza
- Laboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, Brazil
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Bustos Sierra N, Bossuyt N, Braeye T, Leroy M, Moyersoen I, Peeters I, Scohy A, Van der Heyden J, Van Oyen H, Renard F. All-cause mortality supports the COVID-19 mortality in Belgium and comparison with major fatal events of the last century. ACTA ACUST UNITED AC 2020; 78:117. [PMID: 33292536 PMCID: PMC7662738 DOI: 10.1186/s13690-020-00496-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/28/2020] [Indexed: 01/19/2023]
Abstract
Background The COVID-19 mortality rate in Belgium has been ranked among the highest in the world. To assess the appropriateness of the country’s COVID-19 mortality surveillance, that includes long-term care facilities deaths and deaths in possible cases, the number of COVID-19 deaths was compared with the number of deaths from all-cause mortality. Mortality during the COVID-19 pandemic was also compared with historical mortality rates from the last century including those of the Spanish influenza pandemic. Methods Excess mortality predictions and COVID-19 mortality data were analysed for the period March 10th to June 21st 2020. The number of COVID-19 deaths and the COVID-19 mortality rate per million were calculated for hospitals, nursing homes and other places of death, according to diagnostic status (confirmed/possible infection). To evaluate historical mortality, monthly mortality rates were calculated from January 1900 to June 2020. Results Nine thousand five hundred ninety-one COVID-19 deaths and 39,076 deaths from all-causes were recorded, with a correlation of 94% (Spearman’s rho, p < 0,01). During the period with statistically significant excess mortality (March 20th to April 28th; total excess mortality 64.7%), 7917 excess deaths were observed among the 20,159 deaths from all-causes. In the same period, 7576 COVID-19 deaths were notified, indicating that 96% of the excess mortality were likely attributable to COVID-19. The inclusion of deaths in nursing homes doubled the COVID-19 mortality rate, while adding deaths in possible cases increased it by 27%. Deaths in laboratory-confirmed cases accounted for 69% of total COVID-19-related deaths and 43% of in-hospital deaths. Although the number of deaths was historically high, the monthly mortality rate was lower in April 2020 compared to the major fatal events of the last century. Conclusions Trends in all-cause mortality during the first wave of the epidemic was a key indicator to validate the Belgium’s high COVID-19 mortality figures. A COVID-19 mortality surveillance limited to deaths from hospitalised and selected laboratory-confirmed cases would have underestimated the magnitude of the epidemic. Excess mortality, daily and monthly number of deaths in Belgium were historically high classifying undeniably the first wave of the COVID-19 epidemic as a fatal event. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-020-00496-x.
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Affiliation(s)
- Natalia Bustos Sierra
- Scientific Directorate of Epidemiology and public health, Sciensano, J.Wytsmanstraat 14, 1050, Brussels, Belgium.
| | - Nathalie Bossuyt
- Scientific Directorate of Epidemiology and public health, Sciensano, J.Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Toon Braeye
- Scientific Directorate of Epidemiology and public health, Sciensano, J.Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Mathias Leroy
- Scientific Directorate of Epidemiology and public health, Sciensano, J.Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Isabelle Moyersoen
- Scientific Directorate of Epidemiology and public health, Sciensano, J.Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Ilse Peeters
- Scientific Directorate of Epidemiology and public health, Sciensano, J.Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Aline Scohy
- Scientific Directorate of Epidemiology and public health, Sciensano, J.Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Johan Van der Heyden
- Scientific Directorate of Epidemiology and public health, Sciensano, J.Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Herman Van Oyen
- Scientific Directorate of Epidemiology and public health, Sciensano, J.Wytsmanstraat 14, 1050, Brussels, Belgium.,Public Health and Primary Care, Faculty of Medicine, Ghent University, Ghent, Belgium
| | - Françoise Renard
- Scientific Directorate of Epidemiology and public health, Sciensano, J.Wytsmanstraat 14, 1050, Brussels, Belgium
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