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Bjerke K, Brænd AM, Fossum GH. Parental Concerns for Children With Cold-like Symptoms With Reduced Access to Evaluation in Primary Care Settings During the COVID-19 Pandemic: A Qualitative Study. J Pediatr Health Care 2024; 38:695-702. [PMID: 38904595 DOI: 10.1016/j.pedhc.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/06/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION We aimed to explore the concerns of parents when their children had symptoms of infection during the COVID-19 pandemic. METHOD Two Norwegian internet forums were searched for parents' experiences when their children had upper respiratory infection symptoms in 2020-2021. A total of 197 posts were included and analyzed using thematic analysis. RESULTS Parents described COVID-19-related and general worries regarding their children with upper respiratory infection symptoms. The first theme, "It is not 'just a cold' during the pandemic," captures how infection control measures influenced parents' concerns. The second theme, "Concerns and consequences of fever and cold symptoms," describes general parental worries. Varying levels of worries regarding health care services, limitations of family life, and concerns for relatives were highlighted. DISCUSSION Knowledge of parents' concerns about cold symptoms may help primary health care providers target individual patient counseling and provide background information when policymakers develop information material for infection prevention and treatment.
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Zhao Y, Xu Y, Yao D, Wu Q, Chen H, Hu X, Huang Y, Zhang X. Changes in Infectious Disease-Specific Health Literacy in the Post-COVID-19 Pandemic Period: Two-Round Cross-Sectional Survey Study. JMIR Public Health Surveill 2024; 10:e52666. [PMID: 39213137 PMCID: PMC11378864 DOI: 10.2196/52666] [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: 09/12/2023] [Revised: 06/22/2024] [Accepted: 06/24/2024] [Indexed: 09/04/2024] Open
Abstract
Background Infectious disease-specific health literacy (IDSHL) is a crucial factor in the development of infectious diseases. It plays a significant role not only in mitigating the resurgence of infectious diseases but also in effectively averting the emergence of novel infections such as COVID-19. During the 3 years of the COVID-19 pandemic, China primarily adopted nonpharmaceutical interventions, advocating for people to avoid crowded places and wear masks to prevent the spread of COVID-19. Consequently, there has been a dearth of research concerning IDSHL and its corresponding focal points for health education. Objective This study aimed to (1) evaluate the changes in IDSHL scores between 2019 (before the COVID-19 pandemic) and 2022 (the postepidemic period of COVID-19) and (2) explore the risk factors affecting IDSHL using a multivariate logistic regression analysis. Methods This study used 2-round cross-sectional surveys, conducted in 2019 and 2022, respectively, in 30 counties in Zhejiang Province, China. Multiple-stage stratified random sampling was used to select households, and a Kish grid was used to identify participants. An identical standardized questionnaire consisting of 12 closed-ended questions was used to measure IDSHL scores before and after the COVID-19 pandemic (2019 and 2022). Standard descriptive statistics, chi-square tests, t tests, and multivariate logistic regression analyses were used to analyze the data. Results The 2-round cross-sectional surveys conducted in 2019 and 2022 yielded, out of 19,366 and 19,221 total questionnaires, 19,257 (99.44% response rate) and 18,857 (98.11% response rate) valid questionnaires, respectively. The correct response rate for the respiratory infectious diseases question "When coughing or sneezing, which of the following is correct?" increased from 29.10% in 2019 to 37.92% in 2022 (χ²1=332.625; P<.001). The correct response rate for the nonrespiratory infectious diseases question "In which of the following ways can hepatitis B be transmitted to others?" decreased from 64.28% to 59.67% (χ²1=86.059; P<.001). In terms of IDSHL scores, a comparison between 2022 and 2019 revealed notable statistical differences in the overall scores (t1=10.829; P<.001) and across the 3 dimensions of knowledge (t1=8.840; P<.001), behavior (t1=16.170; P<.001), and skills (t1=9.115; P<.001). With regard to the questions, all but 4 exhibited statistical differences (P<.001). Multivariate logistic regression analyses indicated that the 2022 year group had a higher likelihood of possessing acquired IDSHL than the 2019 group (odds ratio 1.323, 95% CI 1.264-1.385; P<.001). Conclusions When conducting health education, it is imperative to enhance efforts in nonrespiratory infectious disease health education, as well as respiratory infectious diseases such as COVID-19. Health education interventions should prioritize ethnic minority populations with a poor self-health status and low education.
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Affiliation(s)
- Yusui Zhao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yue Xu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Dingming Yao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Qingqing Wu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Heni Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiujing Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yu Huang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuehai Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Hamidi F, Rostami A, Hosseini SA, Calero-Bernal R, Hajavi J, Ahmadi R, Pazoki H. Anti-Toxoplasma gondii IgG seroprevalence in the general population in Iran: A systematic review and meta-analysis, 2000-2023. PLoS One 2024; 19:e0307941. [PMID: 39208344 PMCID: PMC11361691 DOI: 10.1371/journal.pone.0307941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 07/16/2024] [Indexed: 09/04/2024] Open
Abstract
Toxoplasmosis ranks among the most prevalent parasitic diseases globally. It seems that chronic toxoplasmosis is associated with several neuropsychiatric and other harmful effects in infected people, therefore, there is a need to investigate the prevalence of toxoplasmosis across various world regions. In this study, we conducted a meticulous meta-analysis to estimate the seroprevalence of anti-Toxoplasma gondii IgG antibodies within the general population in Iran (GPI). International and national scientific databases for studies published between January 1, 2000, and September 30, 2023, were searched. Observational studies reporting anti-T. gondii IgG seroprevalence in the GPI was selected/included. The data were synthesized using a random-effects model to calculate with a 95% confidence interval (95% CI) the national and regional anti-T. gondii IgG seroprevalence rates in Iran. Additionally, subgroup analyses were conducted to investigate the frequency of exposition to T. gondii in different socio-demographic, climatic, and geographical scenarios. From 18661 identified studies, 327 were included in the present meta-analysis, encompassing 122,882 individuals across the 31 Iranian provinces. The pooled nationwide anti-T. gondii IgG seroprevalence among the GPI was determined to be 32.9% (95% CI: 30.9-35.1%). The highest anti-T. gondii IgG seroprevalence was observed in Mazandaran province (North of Iran) (61%), whereas the lowest was in Semnan province (12.5%).Anti-T. gondii IgG seroprevalence demonstrated a higher occurrence in provinces characterized by moderate temperatures of 16-21°C, high relative humidity, and annual precipitation. Additionally, a higher anti-T. gondii IgG seroprevalence was identified among individuals with a habit of consumption of undercooked meat, raw fruits or vegetables, and untreated water. Moreover, those reporting direct contact with cats, possessing a lower level of education, residing in rural areas, being engaged in farming occupations, or playing the role of housewives exhibited higher anti-T. gondii IgG seroprevalence figures.The anti-T. gondii IgG seroprevalence within GPI closely aligns with the estimated worldwide average exposition rates. This underscores the imperative for public health policymakers to prioritize educational efforts regarding toxoplasmosis transmission pathways and its link to harmful effects.
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Affiliation(s)
- Faezeh Hamidi
- Faculty of Medical Sciences, Department of Laboratory Sciences and Microbiology, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Ali Rostami
- Health Research Institute, Infectious Diseases and Tropical Medicine Research Centre, Babol University of Medical Sciences, Babol, Iran
| | - Seyed Abdollah Hosseini
- Communicable Disease Institute, Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
- Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
| | - Rafael Calero-Bernal
- Veterinary Faculty, Animal Health Department, SALUVET, Complutense University of Madrid, Madrid, Spain
| | - Jafar Hajavi
- Faculty of Medicine, Department of Medical Microbiology, Infectious Diseases Research Center, Gonabad University of Medical Science, Gonabad, Iran
| | - Reza Ahmadi
- Faculty of Medicine, Department of Medical Microbiology, Infectious Diseases Research Center, Gonabad University of Medical Science, Gonabad, Iran
| | - Hossein Pazoki
- Faculty of Medicine, Department of Medical Microbiology, Infectious Diseases Research Center, Gonabad University of Medical Science, Gonabad, Iran
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Ciaccio L, Fountain H, Beech E, Brown CS, Demirjian A, Gerver S, Muller-Pebody B, Bou-Antoun S. Trends in urine sampling rates of general practice patients with suspected lower urinary tract infections in England, 2015-2022: a population-based study. BMJ Open 2024; 14:e084485. [PMID: 39107033 PMCID: PMC11308898 DOI: 10.1136/bmjopen-2024-084485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 07/03/2024] [Indexed: 08/09/2024] Open
Abstract
OBJECTIVES Inappropriate prescribing of antibiotics is a key driver of antimicrobial resistance. This study aimed to describe urine sampling rates and antibiotic prescribing for patients with lower urinary tract infections (UTIs) in English general practice. DESIGN A retrospective population-based study using administrative data. SETTING IQVIA Medical Research Database (IMRD) data from general practices in England, 2015-2022. PARTICIPANTS Patients who have consulted with an uncomplicated UTI in England general practices captured in the IMRD. OUTCOME MEASURES Trends in UTI episodes (episodes were defined as UTI diagnosis codes occurring within 14 days of each other), testing and antibiotic prescribing on the same day as initial UTI consultation were assessed from January 2015 to December 2022. Associations, using univariate and multivariate logistic regressions, were examined between consultation and demographic factors on the odds of a urine test. RESULTS There were 743 350 UTI episodes; 50.8% had a urine test. Testing rates fluctuated with an upward trend and large decline in 2020. Same-day UTI antibiotic prescribing occurred in 78.2% of episodes. In multivariate modelling, factors found to decrease odds of a urine test included age ≥85 years (0.83, 95% CI 0.82 to 0.84), consultation type (remote vs face to face, 0.45, 95% CI 0.45 to 0.46), episodes in London compared with the South (0.74, 95% CI 0.72 to 0.75) and increasing practice size (0.77, 95% CI 0.76 to 0.78). Odds of urine tests increased in males (OR 1.11, 95% CI 1.10 to 1.13), for those episodes without a same-day UTI antibiotic (1.10, 95% CI 1.04 to 1.16) for episodes for those with higher deprivation status (Indices of Multiple Deprivation 8 vs 1, 1.51, 95% CI 1.48 to 1.54). Compared with 2015, 2016-2019 saw increased odds of testing while 2020 and 2021 saw decreases, with 2022 showing increased odds. CONCLUSION Urine testing for UTI in general practice in England showed an upward trend, with same-day antibiotic prescribing remaining consistent, suggesting greater alignment to national guidelines. The COVID-19 pandemic impacted testing rates, though as of 2022, they began to recover.
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Affiliation(s)
- Laura Ciaccio
- Division of Population Health and Genomics, University of Dundee School of Medicine, Dundee, UK
- Healthcare-Associated Infection (HCAI), Fungal, Antimicrobial Resistance (AMR), Antimicrobial Use (AMU) & Sepsis Division, UK Health Security Agency, London, UK
| | - Holly Fountain
- Healthcare-Associated Infection (HCAI), Fungal, Antimicrobial Resistance (AMR), Antimicrobial Use (AMU) & Sepsis Division, UK Health Security Agency, London, UK
| | | | - Colin S Brown
- Healthcare-Associated Infection (HCAI), Fungal, Antimicrobial Resistance (AMR), Antimicrobial Use (AMU) & Sepsis Division, UK Health Security Agency, London, UK
- UKHSA and NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | - Alicia Demirjian
- Healthcare-Associated Infection (HCAI), Fungal, Antimicrobial Resistance (AMR), Antimicrobial Use (AMU) & Sepsis Division, UK Health Security Agency, London, UK
- Department of Paediatric Infectious Diseases & Immunology, Evelina London Children's Hospital, London, UK
- Faculty of Life Sciences & Medicine, King’s College London, London, UK
| | - Sarah Gerver
- Healthcare-Associated Infection (HCAI), Fungal, Antimicrobial Resistance (AMR), Antimicrobial Use (AMU) & Sepsis Division, UK Health Security Agency, London, UK
| | - Berit Muller-Pebody
- Healthcare-Associated Infection (HCAI), Fungal, Antimicrobial Resistance (AMR), Antimicrobial Use (AMU) & Sepsis Division, UK Health Security Agency, London, UK
- UKHSA and NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | - Sabine Bou-Antoun
- Healthcare-Associated Infection (HCAI), Fungal, Antimicrobial Resistance (AMR), Antimicrobial Use (AMU) & Sepsis Division, UK Health Security Agency, London, UK
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Cuyàs B, Huerta A, Poca M, Alvarado-Tapias E, Brujats A, Román E, Guarner C, Escorsell À, Soriano G. Impact of the COVID-19 pandemic on the incidence and type of infections in hospitalized patients with cirrhosis: a retrospective study. Sci Rep 2024; 14:2718. [PMID: 38302563 PMCID: PMC10834517 DOI: 10.1038/s41598-024-52452-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 01/18/2024] [Indexed: 02/03/2024] Open
Abstract
Infections are a major cause of morbidity and mortality in cirrhosis, especially those caused by multi-drug resistant bacteria. During the COVID-19 pandemic, the incidence and type of infection in these patients may have been influenced by the restrictive measures implemented. We aimed to compare the infections in patients with cirrhosis hospitalized before the COVID-19 pandemic versus those hospitalized during the pandemic. We retrospectively compared infections in patients with cirrhosis hospitalized in the hepatology unit during the pre-pandemic period (3/2019-2/2020) with infections in patients hospitalized during the pandemic (3/2020-2/2021). Baseline characteristics, type of infections, type of bacteria, antimicrobial resistance and mortality were evaluated. There were 251 hospitalizations in 170 patients during the pre-pandemic period and 169 hospitalizations in 114 patients during the pandemic period. One or more infections were identified in 40.6% of hospitalizations during the pre-pandemic period and 43.8% of hospitalizations during the pandemic, P = 0.52. We found 131 infections in the pre-pandemic period and 75 infections during the pandemic. The percentage of nosocomial infections decreased in the pandemic period (25.3% vs. 37.4% in the pre-pandemic period, P = 0.06). We found a non-significant trend to a higher incidence of infections by multi-drug resistant organisms (MDRO) in the pandemic period than in the pre-pandemic period (6.5% vs. 4%). The incidence of infections was similar in both periods. However, during the pandemic, we observed a trend to a lower incidence of nosocomial infections with a higher incidence of MDRO infections.
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Affiliation(s)
- Berta Cuyàs
- Department of Gastroenterology, Hospital Santa Creu i Sant Pau, Institut de Recerca Sant Pau, Barcelona, Spain.
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Anna Huerta
- Department of Gastroenterology, Hospital Santa Creu i Sant Pau, Institut de Recerca Sant Pau, Barcelona, Spain
| | - Maria Poca
- Department of Gastroenterology, Hospital Santa Creu i Sant Pau, Institut de Recerca Sant Pau, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Edilmar Alvarado-Tapias
- Department of Gastroenterology, Hospital Santa Creu i Sant Pau, Institut de Recerca Sant Pau, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Brujats
- Department of Gastroenterology, Hospital Santa Creu i Sant Pau, Institut de Recerca Sant Pau, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eva Román
- Department of Gastroenterology, Hospital Santa Creu i Sant Pau, Institut de Recerca Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Escola Universitària d'Infermeria EUI-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carlos Guarner
- Department of Gastroenterology, Hospital Santa Creu i Sant Pau, Institut de Recerca Sant Pau, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Àngels Escorsell
- Department of Gastroenterology, Hospital Santa Creu i Sant Pau, Institut de Recerca Sant Pau, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - German Soriano
- Department of Gastroenterology, Hospital Santa Creu i Sant Pau, Institut de Recerca Sant Pau, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
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Cohen B, Shapiro Ben David S, Rahamim-Cohen D, Nakhleh A, Shahar A, Yehoshua I, Bilitzky-Kopit A, Azuri J, Mizrahi Reuveni M, Adler L. Common Bacterial Infections during the 3-Month Period after SARS-CoV-2 Infection: A Retrospective Cohort Study. Healthcare (Basel) 2023; 11:3151. [PMID: 38132041 PMCID: PMC10742933 DOI: 10.3390/healthcare11243151] [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: 09/15/2023] [Revised: 11/12/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION Correlations between SARS-CoV-2 and bacterial infections have mainly been studied in hospitals, and these studies have shown that such interactions may be lethal for many. In the context of community flora, less is known of the trends and consequences of viral infections relative to subsequent bacterial infections. PURPOSE This study aims to explore the prevalence and characteristics of bacterial infections in the three months following SARS-CoV-2 infections, in a community, real-world setting. METHODS In this retrospective cohort study, we compared patients who completed a polymerase chain reaction (PCR) test or an antigen test for SARS-CoV-2 during January 2022, the peak of the Omicron wave, and examined bacterial infections following the test. We searched these cases for diagnoses of the following four bacterial infections for three months following the test: Group A Streptococcus (GAS) pharyngitis, pneumonia, cellulitis, and urinary tract infections (UTI). RESULTS During January 2022, 267,931 patients tested positive and 261,909 tested negative for SARS-CoV-2. Test-positive compared to test-negative patients were significantly younger (42.5 years old vs. 48.5 years old, p < 0.001), smoked less, and had fewer comorbidities (including ischemic heart disease, diabetes mellitus, hypertension, chronic obstructive pulmonary disease, and chronic renal failure). In the multivariable analysis, test-positive patients had an increased risk for GAS pharyngitis (adjusted odds ratio [aOR] = 1.25, 95% CI 1.14-1.38, p-value < 0.001) and pneumonia (aOR = 1.25, 95% CI 1.15-1.35, p-value < 0.001), a trend towards an increased prevalence of UTI (aOR = 1.05, 95% CI 0.99-1.12, p-value = 0.092), and lower risk for cellulitis (aOR = 0.92, 95% CI 0.86-0.99, p-value < 0.05). CONCLUSIONS A history of SARS-CoV-2 infection in the past three months increased susceptibility to respiratory tract bacterial infections and the prevalence of UTI.
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Affiliation(s)
- Bar Cohen
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel; (B.C.); (S.S.B.D.); (D.R.-C.); (A.S.); (I.Y.); (A.B.-K.); (J.A.)
- The Faculty of Health Science, Ben Gurion University, Beer Sheva 8443944, Israel
| | - Shirley Shapiro Ben David
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel; (B.C.); (S.S.B.D.); (D.R.-C.); (A.S.); (I.Y.); (A.B.-K.); (J.A.)
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Daniella Rahamim-Cohen
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel; (B.C.); (S.S.B.D.); (D.R.-C.); (A.S.); (I.Y.); (A.B.-K.); (J.A.)
| | - Afif Nakhleh
- Diabetes and Endocrinology Clinic, Maccabi Healthcare Services, Haifa 3299001, Israel;
- Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, Haifa 3109601, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Arnon Shahar
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel; (B.C.); (S.S.B.D.); (D.R.-C.); (A.S.); (I.Y.); (A.B.-K.); (J.A.)
| | - Ilan Yehoshua
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel; (B.C.); (S.S.B.D.); (D.R.-C.); (A.S.); (I.Y.); (A.B.-K.); (J.A.)
- The Faculty of Health Science, Ben Gurion University, Beer Sheva 8443944, Israel
| | - Avital Bilitzky-Kopit
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel; (B.C.); (S.S.B.D.); (D.R.-C.); (A.S.); (I.Y.); (A.B.-K.); (J.A.)
| | - Joseph Azuri
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel; (B.C.); (S.S.B.D.); (D.R.-C.); (A.S.); (I.Y.); (A.B.-K.); (J.A.)
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Miri Mizrahi Reuveni
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel; (B.C.); (S.S.B.D.); (D.R.-C.); (A.S.); (I.Y.); (A.B.-K.); (J.A.)
| | - Limor Adler
- Health Division, Maccabi Healthcare Services, Tel Aviv 6812509, Israel; (B.C.); (S.S.B.D.); (D.R.-C.); (A.S.); (I.Y.); (A.B.-K.); (J.A.)
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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Niemöller U, Tanislav C, Kostev K. Incidences for Fractures 2017-2021: What Do We Learn from the COVID-19 Pandemic? Healthcare (Basel) 2023; 11:2804. [PMID: 37893878 PMCID: PMC10606036 DOI: 10.3390/healthcare11202804] [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: 09/21/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
PURPOSE/INTRODUCTION In the present study, we aimed to assess the long-term incidence of fractures and during the COVID-19 pandemic. METHODS The current cohort study included patients who had received an initial fracture diagnosis of any type documented anonymously in the Disease Analyzer database (IQVIA) between 2017 and 2021 by physicians in 941 general practices in Germany. We investigated the development of fracture incidence over this period. RESULTS A total of 196,211 patients had a fracture diagnosis between 2017 and 2021. The number of patients with fracture diagnosis was highest in 2019 (n = 50,084) and lowest in 2020 (n = 46,227). The mean age of patients increased from 60.8 years in 2017 to 63.3 years in 2021. Between 58% and 60% of patients were female. From 2017 to 2019, the number of fractures documented in the younger age categories remained constant. Between 2019 and 2020, an incidence decrease was documented in the younger age groups (age group 16-40 years: -17.17%; age group 41-60 years: -18.71%; age group 61-80 years: -6.43%). By contrast, a slight increase of 3.03% was identified in the age group >80 years of age. No relevant changes in fracture incidences were noted between 2020 and 2021. Incidence rates decreased for both sexes from 2019 to 2020 (female patients: -6.27%; male patients: -10.18%). In the youngest age group (16-40 years), the decrease observed in 2020 was due to lower incidences for fractures of the upper and lower extremities (-11.9%; -12.5%) and ribs (-50.0%). In the age group ≥80 years, fracture incidences increased for the upper extremity (+2.8%), lower extremity (+8.3%), and femur (+8.3%). CONCLUSIONS The circumstances of the pandemic reduced the incidence of fractures in younger people, probably due to reduced recreational activities, while fracture incidence increased in older people, presumably as a result of lack of support.
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Affiliation(s)
- Ulrich Niemöller
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, 57074 Siegen, Germany;
| | - Christian Tanislav
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, 57074 Siegen, Germany;
| | - Karel Kostev
- Epidemiology, IQVIA, 60549 Frankfurt am Main, Germany
- Institute for Healthcare Research and Clinical Epidemiology, Philipps University Marburg, 35037 Marburg, Germany
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Meena S, Bharti G, Mathur P. Pre- and Post-COVID-19 Appraisal of Antimicrobial Susceptibility for Urinary Tract Infections at an Outpatient Setting of a Tertiary Care Hospital in Delhi. Cureus 2023; 15:e47095. [PMID: 38021575 PMCID: PMC10646440 DOI: 10.7759/cureus.47095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND This study was conducted to understand the effect of the COVID-19 pandemic on urine culture and sensitivity results in an outpatient setting. There are plenty of data from inpatient and ICU settings but there is a paucity of data in outpatient or community settings. Thus, this study primarily targeted change in antibiotic resistance of urinary tract infection (UTI) agents in the pre- and post-COVID-19 period. METHODS In the study, urine samples received in the Department of Laboratory Medicine (microbiology laboratory) with a preliminary diagnosis of UTI between April 2019 and March 2021 were analyzed. Urine cultures and antibiotic susceptibility tests of the patients included in the study were examined in two periods (pre-pandemic and post-pandemic). RESULTS A total of 22,372 urine samples were received in the pre-pandemic period (April 2019 to March 2020) and 4885 samples in the post-pandemic period (April 2020 to March 2021). The positivity rate obtained from urine cultures sent post-COVID-19 pandemic (16%) was significantly higher than those sent before the COVID-19 pandemic (8%). According to cultures and antibiogram results, resistance to ampicillin, amikacin, ceftazidime (p < 0.05), co-trimoxazole, levofloxacin, gentamicin (p < 0.05), nitrofurantoin, fosfomycin, and tetracycline decreased compared with the pre-COVID-19 period. CONCLUSIONS In this study, we found that the frequency of significant bacteriuria increased significantly in the post-pandemic period. However, resistance to antibiotics decreased significantly in the post-COVID-19 period compared to the pre-COVID-19 period. There was no significant change in the etiology of UTI during the two time periods.
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Affiliation(s)
- Suneeta Meena
- Laboratory Medicine - Microbiology, All India Institute of Medical Sciences, New Delhi, IND
| | - Ginni Bharti
- Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Purva Mathur
- Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, IND
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9
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Bassanello M, Geppini R, Bonsembiante E, Coli U, Farencena A, D’Aquino M, Gambaro A, Buja A, Baldovin T. Risk of SARS-CoV-2 transmission in the close contacts in a small rural area in the Veneto Region (NE-Italy): past evidence for future scenarios. Front Public Health 2023; 11:1223109. [PMID: 37732097 PMCID: PMC10507707 DOI: 10.3389/fpubh.2023.1223109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
Background During the first pandemic phase of COVID-19, an epidemiological study, named First survey, was conducted on the population of a small rural area in northern Italy. In spring 2020, the results showed how a prolonged lockdown slowed down the spread of the virus. Methods After contacting positive First Survey subjects and their families, those who decided to join voluntarily underwent a blood test to assess the presence of qualitative lgG about 2 months after the previous one. This was to determine if IgG persisted in individuals who tested positive in the First Survey as well as to assess the antibody status of their close family members, to determine if they were unintentionally infected. Results Based on serological analysis, 35.1% of the samples contained blood IgG. In subjects who tested positive during the First Survey, 62.5% remained IgG positive more than 2 months later. Among family members who were exposed to a positive relative, 23.7% were infected. Linear regression analysis showed that the presence of an infected person within a household resulted in the infection spreading to the others, but not excessively. Induced isolation extinguished the infection regardless of the extent of the contagion (intra-family or extra-family). Micro-outbreaks of SARS-Cov-2 infection which arose in the same household from extra-familial infections played a decisive role on the statistical significance of IgG-positive subjects (p < 0.001). Discussion The study reveal 52.6% of the IgG-positive subjects in the Second Survey came from the First Survey and 47.4% were family members previously in contact with positive subjects. Data suggest that there have been undiagnosed patients feeding the spread of the virus since the beginning of the pandemic. In conclusion, for future pandemics, it will be necessary: i) to ensure the rapid isolation of symptomatic patients and the early identification of their close contacts, ii) to carry out the maximum number of tests in the shortest possible time, both on symptomatic and asymptomatic subjects, and iii) to implement information campaigns to make people aware of their risks, and implement clear, non-conflicting communication.
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Affiliation(s)
- Marco Bassanello
- Emergency and Health Department, Monastier di Treviso Hospital, Treviso, Italy
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
| | - Ruggero Geppini
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
| | | | - Ugo Coli
- Health Department, Monastier di Treviso Hospital, Treviso, Italy
| | - Aldo Farencena
- Laboratory and Microbiology Monastier di Treviso Hospital, Treviso, Italy
| | | | - Andrea Gambaro
- Department of Environmental Sciences, Informatics and Statistics (DAIS), Ca’ Foscari University of Venice, Venice, Italy
| | - Alessandra Buja
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
| | - Tatjana Baldovin
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
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Love NK, Douglas A, Gharbia S, Hughes H, Morbey R, Oliver I, Smith GE, Elliot AJ. Understanding the impact of the COVID-19 pandemic response on GI infection surveillance trends in England, January 2020-April 2022. Epidemiol Infect 2023; 151:e147. [PMID: 37622322 PMCID: PMC10540168 DOI: 10.1017/s095026882300136x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/13/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
Stepwise non-pharmaceutical interventions and health system changes implemented as part of the COVID-19 response have had implications on the incidence, diagnosis, and reporting of other communicable diseases. Here, we established the impact of the COVID-19 outbreak response on gastrointestinal (GI) infection trends using routinely collected surveillance data from six national English laboratory, outbreak, and syndromic surveillance systems using key dates of governmental policy to assign phases for comparison between pandemic and historic data. Following decreases across all indicators during the first lockdown (March-May 2020), bacterial and parasitic pathogens associated with foodborne or environmental transmission routes recovered rapidly between June and September 2020, while those associated with travel and/or person-to-person transmission remained lower than expected for 2021. High out-of-season norovirus activity was observed with the easing of lockdown measures between June and October 2021, with this trend reflected in laboratory and outbreak systems and syndromic surveillance indicators. Above expected increases in emergency department (ED) attendances may have reflected changes in health-seeking behaviour and provision. Differential reductions across specific GI pathogens are indicative of the underlying routes of transmission. These results provide further insight into the drivers for transmission, which can help inform control measures for GI infections.
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Affiliation(s)
- Nicola K. Love
- North East Field Services, Health Protection Operations, UK Health Security Agency, Newcastle upon Tyne, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
| | - Amy Douglas
- Gastrointestinal Infections and Food Safety (One Health) Division, UK Health Security Agency, London, UK
| | - Saheer Gharbia
- Gastrointestinal Infections and Food Safety (One Health) Division, UK Health Security Agency, London, UK
| | - Helen Hughes
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Real-time Syndromic Surveillance Team, Field Service, Health Protection Operations, UK Health Security Agency, Birmingham, UK
- Farr Institute@HeRC, University of Liverpool, Liverpool, UK
| | - Roger Morbey
- Real-time Syndromic Surveillance Team, Field Service, Health Protection Operations, UK Health Security Agency, Birmingham, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, King’s College London, London, UK
| | - Isabel Oliver
- Science Group, UK Health Security Agency, London, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation, Population Health Sciences, University of Bristol, Bristol, UK
| | - Gillian E. Smith
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Real-time Syndromic Surveillance Team, Field Service, Health Protection Operations, UK Health Security Agency, Birmingham, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, King’s College London, London, UK
| | - Alex J. Elliot
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- Real-time Syndromic Surveillance Team, Field Service, Health Protection Operations, UK Health Security Agency, Birmingham, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, King’s College London, London, UK
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Jang W, Kang H, Shin H, Kim C, Lee H, Choi H. Introduction of Infection Prevention Tracheal Intubation Protocol during the COVID-19 Pandemic Is Not Associated with First-Pass Success Rates of Endotracheal Intubation in the Emergency Department: A Before-and-After Comparative Study. J Pers Med 2023; 13:1017. [PMID: 37374006 DOI: 10.3390/jpm13061017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
Aerosols and droplets have put healthcare workers performing airway management at high risk of contracting coronavirus disease 2019 (COVID-19). Experts have developed endotracheal intubation (ETI) guidelines and protocols to protect intubators from infection. We aimed to determine whether changes in the emergency department (ED) intubation protocol to prevent COVID-19 infection were associated with first-pass success (FPS) rates in ETI. We used data from the airway management registries in two academic EDs. The study was divided into pre-pandemic (January 2018 to January 2020) and pandemic (February 2020 to February 2022) periods. We selected 2476 intubation cases, including 1151 and 1325 cases recorded before and during the pandemic, respectively. During the pandemic, the FPS rate was 92.2%, which did not change significantly, and major complications increased slightly but not significantly compared with the pre-pandemic period. The OR for the FPS of applying infection prevention intubation protocols was 0.72 (p = 0.069) in a subgroup analysis, junior emergency physicians (PGY1 residents) had an FPS of less than 80% regardless of pandemic protocol implementation. The FPS rate of senior emergency physicians in physiologically difficult airways decreased significantly during the pandemic (98.0% to 88.5%). In conclusion, the FPS rate and complications for adult ETI performed by emergency physicians using COVID-19 infection prevention intubation protocols were similar to pre-pandemic conditions.
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Affiliation(s)
- Wooseok Jang
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Hyunggoo Kang
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Hyungoo Shin
- Department of Emergency Medicine, Hanyang University Guri Hospital, Guri 11923, Republic of Korea
| | - Changsun Kim
- Department of Emergency Medicine, Hanyang University Guri Hospital, Guri 11923, Republic of Korea
| | - Heekyung Lee
- Department of Emergency Medicine, Hanyang University Guri Hospital, Guri 11923, Republic of Korea
| | - Hyukjoong Choi
- Department of Emergency Medicine, Hanyang University Guri Hospital, Guri 11923, Republic of Korea
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Cool R, Vandenplas Y. The Link between Different Types of Prebiotics in Infant Formula and Infection Rates: A Review. Nutrients 2023; 15:nu15081942. [PMID: 37111161 PMCID: PMC10140947 DOI: 10.3390/nu15081942] [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: 03/12/2023] [Revised: 04/08/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Breastfeeding plays a protective role against infections, partially through the prebiotic effect of human milk oligosaccharides (HMOs). Aiming to mimic these beneficial capacities, there is an ongoing search to make infant formula closer to human milk, including by adding oligosaccharides. Over the past two decades, multiple studies have been published on different types of prebiotics and their role in reducing infection rates in infants. This review aims to answer the question of whether there is evidence that the addition of oligosaccharides to infant formula decreases the prevalence of infection, and whether the effect is influenced by the kind of oligosaccharide added. The review of the literature reveals an important heterogeneity, including different types and dosages of prebiotics, different intervention periods and inclusion criteria, etc., making it impossible to formulate a consensus about the efficacy of adding prebiotics to infant formula. We would cautiously suggest that supplementation with galactooligosaccharides (GOSs)/fructooligosaccharides (FOSs) seems to have a beneficial effect on infection rates. For HMOs, more studies about the different types of HMOs are necessary to make any deductions. GOSs alone, inulin, and MOSs (bovine-milk-derived oligosaccharides) do not reduce the incidence of infections. The combination of GOSs and PDX (polydextrose) was found to play a protective role in one study. The evidence of the effect of prebiotics in reducing the use of antibiotics is low. The many lacunas in the direction of study uniformity offer many opportunities for further research.
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Affiliation(s)
- Roxane Cool
- Vrije Universiteit Brussel (VUB), UZ Brussel, KidZ Health Castle, 1090 Brussels, Belgium
| | - Yvan Vandenplas
- Vrije Universiteit Brussel (VUB), UZ Brussel, KidZ Health Castle, 1090 Brussels, Belgium
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13
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Lim AH, Ab Rahman N, Hashim H, Kamal M, Velvanathan T, Chok MCF, Sivasampu S. Impact of COVID-19 Pandemic on Antibiotic Utilisation in Malaysian Primary Care Clinics: An Interrupted Time Series Analysis. Antibiotics (Basel) 2023; 12:antibiotics12040659. [PMID: 37107021 PMCID: PMC10135109 DOI: 10.3390/antibiotics12040659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/23/2023] [Accepted: 03/26/2023] [Indexed: 03/30/2023] Open
Abstract
The COVID-19 pandemic has resulted in a dramatic change in the delivery of primary healthcare across the world, presumably changing trends in consultations for infectious diseases and antibiotic use. This study aimed at describing and evaluating the impact of COVID-19 on antibiotic use in public primary care clinics in Malaysia between 2018 and 2021. Data from the nationwide procurement database of systemic antibiotics from public primary care clinics in Malaysia between January 2018 and December 2021 were analysed using interrupted time series analysis. The monthly number of defined daily doses per 1000 inhabitants per day (DID) was calculated and grouped by antibiotic class. The trend of antibiotic utilisation rates had been decreasing by 0.007 DID monthly before March 2020 (p = 0.659). With the introduction of national lockdown due to COVID-19 beginning March 2020, there was a significant reduction in the level of antibiotic utilisation rates of 0.707 (p = 0.022). Subsequently, the monthly trend showed a slight upward change until the end of the study period (p = 0.583). Our findings indicate that there was a significant decrease in antibiotic utilisation for systemic use in primary care following the COVID-19 pandemic compared with the preceding years (January 2018–March 2020).
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Endaryanto A, Dewi A, Kusbaryanto, Nugraha RA. Trend in the admissions of patients with non-COVID-19 respiratory symptoms during COVID-19 pandemic and its impact on hospital finances in surabaya, Indonesia. Heliyon 2023; 9:e15122. [PMID: 37035376 PMCID: PMC10065813 DOI: 10.1016/j.heliyon.2023.e15122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 03/11/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Background COVID-19 cases surge, it has a crucial impact on healthcare systems, with rapidly increasing demand for healthcare resources in hospitals and intensive care units (ICUs) in Indonesia and worldwide. It is necessary to quantify the extent to which the effects of the COVID-19 pandemic on the hospital admissions, and clinical and financial outcomes of patients with non-COVID-19 respiratory symptoms. Objective To determine whether the COVID-19 pandemic changed the hospitalisation of child and adult patients with non-COVID-19 respiratory conditions and whether these changes affected the patient's disease condition, clinical outcomes, and hospital finances. Methods A retrospective cohort study was conducted from May 1, 2018 (before the COVID-19 pandemic) until December 31, 2021. Total sampling was done to compare hospital admission of patients with non-COVID-19 respiratory symptoms before versus during the COVID-19 pandemic. The results were analyzed using SPSS 26.0 and SmartPLS.v.3.2.9. Results There was a reduction in hospitalisations for respiratory disorders unrelated to COVID-19 during the pandemic by 55.3% in children and 47.8% in adult patients. During the pandemic, the average hospital revenue per patient of child and adult patients increased significantly, but the profit per patient decreased. Pathway analysis showed that in children, the COVID-19 Pandemic changed disease severity and complexity (β = 0.132, P < 0.001), as well as clinical outcomes (β = 0.029, P < 0.05). In adults, the COVID-19 pandemic improves disease severity and complexity (β = -0.020, P < 0.001), as well as clinical outcomes (β = -0.013, P < 0.001). COVID-19 pandemic increases care charges (in children with β = 0.135, P < 0.001; and in the adult patients with β = 0.110, P < 0.001), worsens hospital financial outcomes relating to child (β = -0.093, P < 0.001) and adult patient (β = -0.073, P < 0.001). In adult patients, seasonal variations moderate the impact of the COVID-19 pandemic on improving disease conditions (β = -0.032, P=<0.001). The child structural model effectively predicted clinical outcomes (Q2 = 0.215) and financial outcomes (Q2 = 0.462). The adult structural model effectively predicted clinical outcomes (Q2 = 0.06) and financial outcomes (Q2 = 0.472). Conclusion The conclusions are that the number of non-COVID respiratory patients decreased during the COVID-19 pandemic (47.8% in adult patients, 55.3% in child patients). Disease severity and complexity increased in child patients but decreased in adult patient. Costs of care and insurance payments increased. Since the insurance payments did not increase as much as the cost of care, hospital profit decreased.
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15
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Kanda N, Hashimoto H, Imai T, Yoshimoto H, Goda K, Mitsutake N, Hatakeyama S. Indirect impact of the COVID-19 pandemic on the incidence of non-COVID-19 infectious diseases: a region-wide, patient-based database study in Japan. Public Health 2023; 214:20-24. [PMID: 36436277 PMCID: PMC9595362 DOI: 10.1016/j.puhe.2022.10.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/12/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The COVID-19 pandemic has forced people to change many behaviours, including physical distancing, hygiene measures and lifestyles. This study aimed to evaluate the indirect impact of the COVID-19 pandemic on the incidence of non-COVID-19 infections and medical care costs/visits using health insurance claims. STUDY DESIGN This was an observational study using patient-based administrative claims covering approximately 800,000 insured persons and their dependents in the Mie Prefecture in Japan. METHODS This study identified non-COVID-19 infectious disease incidences, number of outpatient visits and healthcare costs between 2017 and 2021. Each year was divided into quarters. The adjusted incidence rate ratios (IRRs) during the pandemic (January 2020 to September 2021) and during the prepandemic period (January 2017 to December 2019) were determined using Poisson regression. RESULTS The adjusted influenza IRRs from April 2020 were close to zero. The incidence of upper respiratory tract infections and bacterial pneumonia was significantly reduced (IRRs range: 0.39-0.73 and 0.43-0.84, respectively). Gastrointestinal and urinary tract infection incidences decreased by approximately 30% and 10%, respectively. In contrast, sexually transmitted infections (STIs), including syphilis, gonococcal infection and Chlamydia trachomatis infection, did not decrease during the pandemic but increased significantly between April and June 2021 (adjusted IRR, 1.37; 95% confidence interval, 1.18-1.60). The adjusted IRRs for outpatient visits and healthcare costs were 0.86-0.93 and 0.91-0.97, respectively. CONCLUSIONS In contrast to other infections, STIs did not decrease during the COVID-19 pandemic. The IRR of STIs during the pandemic period is an area of public health concern. Appropriate screening and medical consultations are strongly recommended.
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Affiliation(s)
- N. Kanda
- Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan
| | - H. Hashimoto
- Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan,Department of Infectious Diseases, University of Tokyo Hospital, Tokyo, Japan
| | - T. Imai
- Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan
| | - H. Yoshimoto
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - K. Goda
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - N. Mitsutake
- Institute for Health Economics and Policy, Tokyo, Japan
| | - S. Hatakeyama
- Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan,Division of Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan,Corresponding author. Division of General Internal Medicine, Jichi Medical University Hospital, Yakushiji, Shimotsuke-shi, Tochigi 329-0498, Japan. Tel.: +81 285 58-7498; fax: +81 285 40-5160
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16
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Association between Antihypertensive Therapy and Risk of Acute Lower Respiratory Infections (ALRI): A Retrospective Cohort Study. Healthcare (Basel) 2022; 10:healthcare10112318. [PMID: 36421642 PMCID: PMC9690450 DOI: 10.3390/healthcare10112318] [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: 09/13/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose: The aim of this study was to analyze the association between antihypertensive drugs and the incidence of acute lower respiratory infections in patients treated in general practices in Germany. Methods: After propensity score matching of five antihypertensive drug classes, a total of 377,470 patients aged ≥18 years were available for analysis. The association between each antihypertensive drug class and ALRI incidence as compared to all other antihypertensive drug classes (as a group) was studied using conditional Cox regression analyses. Because of multiple comparisons and large patient samples, findings were clinically considered relevant when the hazard ratio was <0.85 or >1.15. Results: The regression analyses applied found no clinically relevant associations between antihypertensive drugs and the incidence of acute lower respiratory infections, as all hazard ratios were between 0.85 and 1.15. Conclusion: In the present study, only slight and not clinically relevant increases or decreases in the ALRI incidence were observed. Additional studies are necessary to further explore the risks associated with antihypertensive agents that are widely embedded in today’s clinical practice.
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Bohlken J, Weber K, Riedel Heller S, Michalowsky B, Kostev K. Mild Cognitive Disorder in Post-COVID-19 Syndrome: A Retrospective Cohort Study of 67,000 Primary Care Post-COVID Patients. J Alzheimers Dis Rep 2022; 6:297-305. [PMID: 35891640 PMCID: PMC9277697 DOI: 10.3233/adr-220020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/15/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Little is known about the impact of COVID-19 on mild cognitive disorder. Objective: The aim of this retrospective cohort study was to investigate whether COVID-19 diagnosis is associated with subsequent mild cognitive disorder (MCD) compared to acute upper respiratory infections (AURI). Methods: This retrospective cohort study used data from the Disease Analyzer database (IQVIA) and included 67,046 patients with first-time symptomatic or asymptomatic COVID-19 diagnoses in 1,172 general practices in Germany between March 2020 and September 2021. Diagnoses were based on ICD-10 codes. Patients diagnosed with AURI were matched to 67,046 patients with COVID-19 using propensity scores based on sex, age, index month, and comorbidities. The index date was the diagnosis date for either COVID-19 or AURI. Associations between the COVID-19 and MCD were studied using conditional Poisson regression models. Results: The incidence of MCD was 7.6 cases per 1,000 person-years in the COVID-19 group and 5.1 cases per 1,000 person-years in the AURI group (IRR = 1.49, 95% CI = 1.22–1.82). The incidence rate ratio decreased strongly with increasing age from 10.08 (95% CI = 4.00–24.42) in the age group≤50 to 1.03 (95% CI = 0.81–1.31) in the age group > 70. In addition, the association between COVID-19 and MCD was significant in women (IRR: 1.70, 95% CI: 1.34–2.16) but not in men (IRR: 1.08, 95% CI: 0.75–1.56). Conclusion The incidence of MCD was low but significantly higher in COVID-19 than in AURI patients, especially among younger patients. If a cognitive disorder is suspected, referral to a specialist is recommended.
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Affiliation(s)
- Jens Bohlken
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP) der Medizinischen Fakultät der Universität Leipzig, Germany
| | | | - Steffi Riedel Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP) der Medizinischen Fakultät der Universität Leipzig, Germany
| | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald site, Greifswald, Germany
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Loosen SH, Bohlken J, Weber K, Konrad M, Luedde T, Roderburg C, Kostev K. Factors Associated with Non-Severe Adverse Reactions after Vaccination against SARS-CoV-2: A Cohort Study of 908,869 Outpatient Vaccinations in Germany. Vaccines (Basel) 2022; 10:566. [PMID: 35455315 PMCID: PMC9032707 DOI: 10.3390/vaccines10040566] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Vaccination against SARS-CoV-2 significantly reduces the transmissibility of the virus and the likelihood of a severe course of COVID-19, and is thus a critical component in overcoming the current pandemic. The factors associated with adverse reactions after vaccination against SARS-CoV-2 have not yet been sufficiently evaluated. METHODS We used the Disease Analyzer database (IQVIA) to identify 531,468 individuals who received a total of 908,869 SARS-CoV-2 vaccinations in 827 general practices in Germany between April and September 2021. Cox regression models were used to analyze the frequency of vaccination-related side effects reported within 14 days after SARS-CoV-2 vaccination, as well as subjects' demographic characteristics and comorbidities. RESULTS The total number of side effects documented was 28,287 (3.1% of all vaccinations). Pain in the limb (24.3%), fatigue (21.0%), dizziness (17.9%), joint pain (15.7%), fever (9.5%), nausea (7.5%), and myalgia (6.4%) were the most common side effects documented among the 12,575 vaccinations with definite side effects. In the multivariate regression analysis, young age was associated with much higher odds of reported side effects (OR18-30 years: 4.45, OR31-40 years: 3.50, OR41-50 years: 2.89). In addition, pre-existing comorbidities such as dementia (OR: 1.54), somatoform disorder (OR: 1.53), anxiety disorder (OR: 1.43), depression (OR: 1.37), chronic respiratory tract disease (OR: 1.27), hypertension (OR: 1.20), and obesity (1.14) significantly increased the odds of side effects. Finally, the male sex was associated with increased odds of reported side effects (OR: 1.17). CONCLUSION Our study, based on a large outpatient database from Germany, identified young age, male sex, and pre-existing comorbidities such as dementia, somatoform disorders, anxiety disorders, and depression as factors associated with vaccine-related adverse events diagnosed in GP practices. These data could help to identify subgroups needing particular advice and care in the context of SARS-CoV-2 vaccinations.
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Affiliation(s)
- Sven H Loosen
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Jens Bohlken
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | | | - Marcel Konrad
- Health & Social, FOM University of Applied Sciences for Economics and Management, 60549 Frankfurt, Germany
| | - Tom Luedde
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Christoph Roderburg
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
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