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Lopes TRR, Silva Júnior JVJ, Trindade PDA, Gregianini TS, Weiblen R, Flores EF. An end-point multiplex RT-PCR for SARS-CoV-2, Influenza A and B detection, including simultaneous RNAse P amplification: a timely tool for more accessible differential diagnosis. J Med Microbiol 2024; 73. [PMID: 39140993 DOI: 10.1099/jmm.0.001868] [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] [Indexed: 08/15/2024] Open
Abstract
The multiplex molecular diagnostic assays described for severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), influenza A (IAV) and B (IBV) viruses have been mainly based on real-time reaction, which limits their access to many laboratories or diagnostic institutions. To contribute to available strategies and expand access to differential diagnosis, we describe an end-point multiplex RT-PCR targeting SARS-CoV-2, IAV and IBV with simultaneous endogenous control amplification. Initially, we looked for well-established primers sets for SARS-CoV-2, IAV, IBV and RNAse P whose amplicons could be distinguished on agarose gel. The multiplex assay was then standardized by optimizing the reaction mix and cycle conditions. The limit of detection (LoD) was determined using titrated viruses (for SARS-CoV-2 and IAV) and by dilution from a pool of IBV-positive samples. The diagnostic performance of the multiplex was evaluated by testing samples with different RNAse P and viral loads, previously identified as positive or negative for the target viruses. The amplicons of IAV (146 bp), SARS-CoV-2 (113 bp), IBV (103 bp) and RNAse P (65 bp) were adequately distinguished in our multiplex. The LoD for SARS-CoV-2, IAV and IBV was 0.02 TCID50/ml, 0.07 TCID50/ml and 10-3 from a pool of positive samples, respectively. All samples positive for SARS-CoV-2 (n=70, Ct 17.2-36.9), IAV (n=53, Ct 14-34.9) and IBV (n=12, Ct 23.9-31.9) remained positive in our multiplex assay. RNAse P from negative samples (n=40, Ct 25.2-30.2) was also amplified in the multiplex. Overall, our assay is a timely and alternative tool for detecting SARS-CoV-2 and influenza viruses in laboratories with limited access to supplies/equipment.
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Affiliation(s)
- Thaísa Regina Rocha Lopes
- Programa de Pós-graduação em Medicina Veterinária, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
- Setor de Virologia, Departamento de Medicina Veterinária Preventiva, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
| | - José Valter Joaquim Silva Júnior
- Setor de Virologia, Departamento de Medicina Veterinária Preventiva, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
- Setor de Virologia, Instituto Keizo Asami, Universidade Federal de Pernambuco, Pernambuco, Brazil
- Laboratório NB3 de Neuroimunologia, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
| | - Priscila de Arruda Trindade
- Laboratório de Biologia Molecular e Bioinformática Aplicada à Microbiologia Clínica, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
| | - Tatiana Schäffer Gregianini
- Laboratório Central de Saúde, Centro Estadual de Vigilância em Saúde da Secretaria de Saúde do estado do Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - Rudi Weiblen
- Setor de Virologia, Departamento de Medicina Veterinária Preventiva, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
| | - Eduardo Furtado Flores
- Setor de Virologia, Departamento de Medicina Veterinária Preventiva, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil
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Noble J, Hatter L, Eathorne A, Hills T, Bean O, Bruce P, Weatherall M, Beasley R. Patterns of asthma medication use and hospital discharges in New Zealand. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100258. [PMID: 38745868 PMCID: PMC11090902 DOI: 10.1016/j.jacig.2024.100258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/13/2023] [Accepted: 02/08/2024] [Indexed: 05/16/2024]
Abstract
Background In New Zealand a progressive increase in budesonide/formoterol dispensing, accompanied by a reduction in dispensing of short-acting β2-agonists (SABAs), inhaled corticosteroids (ICSs), and other ICS/long-acting β2-agonists (ICSs/LABAs), occurred in the 18-month period following publication of the 2020 New Zealand asthma guidelines, which recommended budesonide/formoterol anti-inflammatory reliever therapy. Objective Our aim was to investigate more recent trends in asthma medication use and asthma hospital discharges in New Zealand. Methods New Zealand national dispensing data for inhalers for the period from January 2010 to December 2022 were reviewed for patients aged 12 years and older. Monthly rates of dispensing of budesonide/formoterol, ICSs, other ICS/LABAs, and SABAs were displayed graphically by locally weighted scatterplot smoother plots. The rates of dispensing and hospital discharge for asthma were compared between the past 6 months for which dispensing data were available (July-December 2022) and the corresponding period from July to December 2019. Results There has been a progressive increase in dispensing of budesonide/formoterol since 2019, with a 108% increase between the period from July to December 2019 and the period from July to December 2022 in adolescents and adults. In contrast, there was a reduction in rates of dispensing of other ICS/LABAs, ICSs, and SABAs by 3%, 18%, and 5%, respectively. During this period, there was a 17% reduction in hospital discharges for asthma. Conclusion There has been a further widespread uptake of ICS/formoterol reliever and/or maintenance therapy in adolescents and adults with asthma in New Zealand. The changes in prescribing practice have been temporally associated with a reduction in hospital admissions for asthma.
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Affiliation(s)
- Jonathan Noble
- Medical Research Institute of New Zealand, Wellington, New Zealand
- Victoria University of Wellington, Wellington, New Zealand
| | - Lee Hatter
- Medical Research Institute of New Zealand, Wellington, New Zealand
- Victoria University of Wellington, Wellington, New Zealand
| | - Allie Eathorne
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Thomas Hills
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Orlagh Bean
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Pepa Bruce
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | | | - Richard Beasley
- Medical Research Institute of New Zealand, Wellington, New Zealand
- Victoria University of Wellington, Wellington, New Zealand
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Nagel LE, Reisch B, Schwenk U, Kimmig KR, Darkwah Oppong M, Dzietko M, Gellhaus A, Iannaccone A. Impact of 2 years of COVID-19 pandemic on preterm birth: Experience from a tertiary center of obstetrics in western Germany. Int J Gynaecol Obstet 2024; 166:404-411. [PMID: 38230894 DOI: 10.1002/ijgo.15379] [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: 10/26/2023] [Revised: 12/26/2023] [Accepted: 01/02/2024] [Indexed: 01/18/2024]
Abstract
OBJECTIVE To compare preterm birth rates and reasons before and during the COVID-19-pandemic using a monocentric, retrospective study. METHODS Univariate analysis identified differences in rates and reasons for preterm birth and neonatal outcomes between the pre-pandemic period (January 1, 2018 to December 31, 2019) and during the pandemic (January 1, 2020 to December 31, 2021) among all births at our tertiary obstetrical center, the University Hospital of Essen. RESULTS The cohort consisted of 6086 deliveries with 593 liveborn preterm singletons. During the pandemic, the incidence of preterm birth decreased (10.7% vs. 8.6%; odds ratio [OR] 0.79; 95% confidence interval [CI] 0.66-0.93). Spontaneous preterm birth (43.2% vs. 52.3%; OR 1.47; 95% CI 1.05-2.03), and placenta accreta spectrum disorder (3.7% vs. 8.2%; OR 2.36; 95% CI 1.15-4.84) were more common reasons for preterm birth. Placental dysfunction was a less common reason (34.1% vs. 24.3%; OR 0.62; 95% CI 0.43-0.90). Incidences of preterm premature rupture of membranes (28.13% vs. 40.25%; OR 1.72; 95% CI 1.12-2.43) and oligo-/anhydramnios (3.98% vs. 7.88%; OR 2.06; 95% CI 1.02-4.21) increased. Iatrogenic preterm birth decreased (54.5% vs. 49.5%; OR 0.81; 95% CI 0.58-1.13). Stillbirth rates did not change significantly. Among term births, there were fewer spontaneous deliveries (71.0% vs. 65.8%; OR 0.78; 95% CI 0.69-0.88), and more elective (12.3% vs. 15.1%; OR 1.26; 95% CI 1.07-1.50) and unplanned (9.3% vs. 10.9%; OR 1.19; 95% CI 0.98-1.45) cesarean sections. During the pandemic, more term newborns were admitted to neonatal intensive care (1.4% vs. 2.5%; OR 1.86; 95% CI 1.20-2.88). CONCLUSION Our results, in line with data from other high-income countries, suggest that the likely reason for the decreased preterm birth rates is the underdiagnosis of pregnancy complications.
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Affiliation(s)
- Laura E Nagel
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
| | - Beatrix Reisch
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
| | - Udo Schwenk
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
| | - Klaus Rainer Kimmig
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
| | - Marvin Darkwah Oppong
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
| | - Mark Dzietko
- Department of Pediatrics, University Hospital Essen, Essen, Germany
| | - Alexandra Gellhaus
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
| | - Antonella Iannaccone
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
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Savagner J, Trémeaux P, Baudou E, Mansuy JM, Cheuret E. Neurological involvement related to the influenza virus in children: A 5-year single-centre retrospective study. Eur J Paediatr Neurol 2024; 51:100-109. [PMID: 38908343 DOI: 10.1016/j.ejpn.2024.05.012] [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: 12/03/2023] [Revised: 05/19/2024] [Accepted: 05/26/2024] [Indexed: 06/24/2024]
Abstract
INTRODUCTION Inflammation related to influenza virus infection can lead to multiple neurological presentations. Encephalitis is one of them, mostly accompanied by seizures, with different profiles depending on the epidemics and previous medical conditions. MATERIALS AND METHODS All children presenting neurological symptoms and positive for influenza virus RNA detection in a respiratory sample between November 2018 and April 2023, hospitalized in the Department of Paediatric Neurology of Toulouse Children's Hospital, were retrospectively analysed. RESULTS Among the 1,277 children diagnosed with influenza in our centre, 131 (10.3 %) were hospitalized for neurological features. The year 2020-2021 was marked by zero incidence of positive influenza tests, associated with the COVID-19 pandemic. Among the 131 patients included, 71.6 % were under 5 years old. Most of them (80.9 %) were infected by influenza A virus. The first neurological symptoms were mainly seizures in 73.3 % of patients. Possible or confirmed encephalitis was observed in 29 % of cases, including one acute necrotizing encephalopathy. Few children (6.1 %) presented with acute myositis. Twenty-seven patients (20.6 %) had a personal history of significant previous neurological disorders. Most patients (88.5 %) displayed a rapid favourable outcome, marked by the disappearance of their neurological symptoms within the first 2 days. Anti-epileptic drugs were introduced in 1.5 % of cases, and adapted in 16.8 %, mainly in patients with febrile status epilepticus and an abnormal EEG. CONCLUSION Neurological features were frequently associated with influenza infection in children; most were transient. Effects on long-term neurodevelopmental outcomes need to be clarified as our follow-up was limited, especially in children with pre-existing neurological conditions.
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Affiliation(s)
- Julie Savagner
- Department of Paediatric Neurology, Toulouse Children's Hospital, 330 Avenue de Grande Bretagne, 31300, Toulouse, France.
| | - Pauline Trémeaux
- Department of Virology, Toulouse University Hospital, Federative Institute of Biology (IFB), 330 Avenue de Grande Bretagne, 31300, Toulouse, France.
| | - Eloïse Baudou
- Department of Paediatric Neurology, Toulouse Children's Hospital, 330 Avenue de Grande Bretagne, 31300, Toulouse, France.
| | - Jean Michel Mansuy
- Department of Virology, Toulouse University Hospital, Federative Institute of Biology (IFB), 330 Avenue de Grande Bretagne, 31300, Toulouse, France.
| | - Emmanuel Cheuret
- Department of Paediatric Neurology, Toulouse Children's Hospital, 330 Avenue de Grande Bretagne, 31300, Toulouse, France.
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Rosenblatt KP, Romeu H, Romeu C, Granger E. Performance evaluation of a SARS-CoV-2 and influenza A/B combo rapid antigen test. Front Mol Biosci 2024; 11:1308202. [PMID: 38845778 PMCID: PMC11154013 DOI: 10.3389/fmolb.2024.1308202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/30/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction: The global COVID-19 pandemic and seasonal influenza outbreaks have drawn attention to the critical need for accurate and efficient diagnostic tools. Methods: The performance of the InstaView COVID-19/Flu Ag Combo Test, which was designed to simultaneously detect the SARS-CoV-2, influenza A, and influenza B viruses, was analytically and clinically evaluated. Results: The InstaView COVID-19/Flu Ag Combo Test exhibited robust detection capabilities, accurately identifying SARS-CoV-2, influenza A, and influenza B viruses over a wide concentration range (1.41 × 103 to 7.05 × 104 TCID50/mL). Extensive testing against potential cross-reactants and interferences yielded no false-positive results, indicating the high specificity of the test. Clinical evaluation further confirmed the kit's reliability, with sensitivity ranging from 95.1% to 98.2% for SARS-CoV-2, 88.9%-95.2% for influenza A, and 91.7%-100% for influenza B depending on the sample type. The specificity was consistently 100% for all of the targeted viruses. Discussion: The InstaView COVID-19/Flu Ag Combo Test thus demonstrated high performance, ease of use, rapid results, and the ability to precisely detect SARS-CoV-2 and influenza A/B infections, making it an effective tool in streamlining diagnostic workflows, optimizing resource allocation, and improving patient outcomes.
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Affiliation(s)
- Kevin P. Rosenblatt
- Consultative Genomics, PLLC, Bellaire, TX, United States
- Healix Pathology, LLP, Bellaire, TX, United States
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He L, Chen L, Zheng H, Zhang Y, Tang S, Chen H. Investigation of COVID-19 vaccination among maintenance hemodialysis patients in Sichuan, China. Jpn J Nurs Sci 2024; 21:e12556. [PMID: 37559431 DOI: 10.1111/jjns.12556] [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: 04/05/2023] [Revised: 06/19/2023] [Accepted: 07/11/2023] [Indexed: 08/11/2023]
Abstract
AIM To investigate the current status of COVID-19 vaccination in maintenance hemodialysis (MHD) patients and its influencing factors. METHODS In total, 585 patients undergoing regular hemodialysis in Sichuan Province of China from January to March 2022 were selected to complete a questionnaire survey on their knowledge, attitudes and practices regarding COVID-19 vaccination. Independent t tests and logistic multivariate analysis were used to analyze the influencing factors of COVID-19 vaccination in hemodialysis patients. RESULTS The survey showed that 37.44% of MHD patients had been vaccinated with the COVID-19 vaccine. Being married was associated with COVID-19 vaccination in patients with MHD (odds ratio [OR] = 1.969 95% CI 0 .870 ~ 4.453). MHD patients living in county areas have higher rates of COVID-19 vaccination (OR = 0.572 95% CI 0.301 ~ 1.087). Family /relatives/friends who are healthcare workers are associated with COVID-19 vaccination for MHD patients (OR = 1.840 95% CI 1.140 ~ 2.970). Other vaccination history within 5 years was a factor in COVID-19 vaccination for MHD patients (OR = 5.592 95% CI 2.997 ~ 10.434). Attitude (OR = 0.885 95% CI 0.808 ~ 0.905), and practice (OR = 0.756 95% CI 0.697 ~ 0.819) scores on the COVID-19 vaccination knowledge and practice questionnaire were related to the vaccination status of MHD patients. CONCLUSIONS MHD patients had lower rates of COVID-19 vaccination. Marital status, living environment, whether family/relatives/friends were medical workers, and the score of the COVID-19 vaccine knowledge and practice questionnaire were the factors influencing their vaccination status. Clinical attention should be given to the adverse reactions of COVID-19 vaccination in MHD patients to improve the awareness of primary medical staff on hemodialysis, and families and society should pay more attention to COVID-19 vaccination in MHD patients.
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Affiliation(s)
- Li He
- Hemodialysis Center, Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Lin Chen
- Hemodialysis Center, Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Haotian Zheng
- Hemodialysis Center, Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Yingjun Zhang
- Hemodialysis Center, Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Sikai Tang
- Hemodialysis Center, Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Hui Chen
- Hemodialysis Center, Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
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González IS, Valle HA, Abejez LG, Molas AC, Alonso-Molero J, Dierssen-Sotos T, Gómez-Acebo I. Impact of the COVID-19 pandemic on visits to the hospital emergency service in two hospitals in Spain, from March 14, 2020 to June 21, 2020. Intern Emerg Med 2023; 18:2093-2103. [PMID: 37308693 PMCID: PMC10259810 DOI: 10.1007/s11739-023-03328-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 05/25/2023] [Indexed: 06/14/2023]
Abstract
This study will describe trends in the use of emergency departments before and after the Spanish State of Alarm, especially in pathologies not directly related to this infection. A cross-sectional study was conducted of all visits to the emergency departments in two third-level hospitals in two Spanish communities during the Spanish State of Alarm, compared with the same period of the previous year. The variables collected included the day of the week, the time of the visit, the duration of the visit, the final destination of the patients (home, admission to a conventional hospitalization ward, admission to the intensive care unit, and death), and the diagnosis at discharge according to the International Classification of Diseases 10th Revision. During the Spanish State of Alarm period, an overall decrease in care demand of 48% was observed, which reached 69.5% in pediatric emergency departments. We also saw a drop of between 20 and 30% in time-dependent pathologies (heart attack, stroke, sepsis, poisoning). The decrease in overall attendance in the emergency departments and absence of serious pathologies, such as time-dependent diseases, observed during the Spanish State of Alarm compared to the previous year highlights the need to strengthen the messages addressed to the population to encourage them to seek care without delay in case of alarming symptoms and reduce the high morbidity and mortality rate if the diagnosis is delayed.
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Affiliation(s)
- Iria Sanlés González
- Department of Emergency Medicine, Germans Trias i Pujol University Hospital, c/ Canyet, 08916 Badalona, Spain
| | - Héctor Alonso Valle
- Department of Emergency Medicine, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Laura Grimal Abejez
- Department of Emergency Medicine, Germans Trias i Pujol University Hospital, c/ Canyet, 08916 Badalona, Spain
| | - Anna Carreres Molas
- Department of Emergency Medicine, Germans Trias i Pujol University Hospital, c/ Canyet, 08916 Badalona, Spain
| | - Jéssica Alonso-Molero
- Medicine School, Cantabria University, Santander, Spain
- IDIVAL Valdecilla Health Research Institute, Santander, Spain
| | - Trinidad Dierssen-Sotos
- Medicine School, Cantabria University, Santander, Spain
- IDIVAL Valdecilla Health Research Institute, Santander, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Inés Gómez-Acebo
- Medicine School, Cantabria University, Santander, Spain
- IDIVAL Valdecilla Health Research Institute, Santander, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
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McLoughlin LC, Perlis N, Lajkosz K, Boasie A, Esmail T, Nielson C, Lavrencic N, Jackson T, Kulkarni GS. Surgical Site Infections During the Pandemic: The Impact of the "COVID Bundle". World J Surg 2023; 47:2310-2318. [PMID: 37488332 DOI: 10.1007/s00268-023-07112-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND A reduction in surgical site infections (SSIs) has been reported in several discrete patient populations during the COVID-19 pandemic. Herein, this study evaluates the impact of the COVID-19 pandemic on SSI in a large patient cohort incorporating multiple surgical disciplines. We hypothesize that enhanced infection control and heightened awareness of such measures is analogous to an SSI care bundle, the hypothetical "COVID bundle", and may impact SSI rates. METHOD Data collected for the American College of Surgeons National Surgical Quality Improvement Program between January 1, 2015, and April 1, 2021, were retrospectively analyzed. SSI rates were compared among time-dependent patient cohorts: Cohort A (pre-pandemic, N = 24,060, 87%) and Cohort B (pandemic, N = 3698, 13%). Time series and multivariable analyses predicted pre-pandemic and pandemic SSI trends and tested for association with timing of surgery. RESULTS The overall SSI incidence was reduced in Cohort B versus Cohort A (2.8% vs. 4.5%, p < 0.001). Multivariable analysis indicated a downward SSI trend before pandemic onset (IRR 0.997, 95% CI 0.994, 1). At pandemic onset, the trend reduced by a relative factor of 39% (IRR 0.601, 95% CI 0.338, 1.069). SSI then trended upward during the pandemic (IRR 1.035, 95% CI 0.965, 1.111). SSI rates significantly trended downward in general surgical patients at pandemic onset (IRR 0.572, 95% CI 0.353, 0.928). CONCLUSION Although overall SSI incidence was reduced during the pandemic, a statistically significant decrease in the predicted SSI rate only occurred in general surgical patients at pandemic onset. This trend may suggest a positive impact of the "COVID bundle" on SSI rates in these patients.
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Affiliation(s)
- Louise Catherine McLoughlin
- Division of Surgical Oncology (Urology), Department of Surgery, University Health Network, University of Toronto, Toronto, Canada.
- Department of Urology, St. James's Hospital, Dublin 8, Ireland.
- Department of Surgery, Trinity College Dublin, Dublin, Ireland.
| | - Nathan Perlis
- Division of Surgical Oncology (Urology), Department of Surgery, University Health Network, University of Toronto, Toronto, Canada
| | - Katherine Lajkosz
- Division of Surgical Oncology (Urology), Department of Surgery, University Health Network, University of Toronto, Toronto, Canada
| | - Alexandra Boasie
- Department of Surgery, University Health Network, University of Toronto, Toronto, Canada
| | - Tariq Esmail
- Department of Anesthesiology and Pain Management, University Health Network, University of Toronto, Toronto, Canada
| | - Chantelle Nielson
- Department of Quality, Safety and Clinical Adoption, University of Toronto, Toronto, Canada
| | - Natalia Lavrencic
- Department of Quality, Safety and Clinical Adoption, University of Toronto, Toronto, Canada
| | - Timothy Jackson
- Department of Surgery, University Health Network, University of Toronto, Toronto, Canada
| | - Girish S Kulkarni
- Division of Surgical Oncology (Urology), Department of Surgery, University Health Network, University of Toronto, Toronto, Canada
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Hatter L, Eathorne A, Hills T, Bruce P, Houghton C, Weatherall M, Beasley R. Patterns of Asthma Medication Use in New Zealand After Publication of National Asthma Guidelines. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2757-2764.e5. [PMID: 37178765 DOI: 10.1016/j.jaip.2023.04.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND In June 2020, the New Zealand (NZ) adolescent and adult asthma guidelines recommended budesonide/formoterol, taken as maintenance and/or reliever therapy, as the preferred therapeutic approach. OBJECTIVE To investigate whether these recommendations were associated with changes in clinical practice indicated by asthma medication use trends. METHODS NZ national dispensing data for inhaler medications from January 2010 to December 2021 were reviewed. Monthly "dispensings" of inhaled budesonide/formoterol, inhaled corticosteroid (ICS), other ICS/long-acting β2-agonists (LABA), and inhaled short-acting β2-agonists (SABA), for the 12+ age group, were displayed graphically with piecewise regression used to produce plots of rates by time with a July 1, 2020, break point. The number of dispensings in the last 6 months that data were available (July-December 2021) was compared with the corresponding period, July-December 2019. RESULTS Budesonide/formoterol dispensing increased markedly after July 1, 2020 (regression coefficient 41.1 inhalers dispensed/100,000 population per month [95% confidence interval (CI): 36.3-45.6, P < .0001]; 64.7% increase in the number of dispensings between July-December 2019 and July-December 2021), in contrast to "other ICS/LABA" (regression coefficient: -15.9 [95% CI: -22.2 to -9.6, P < .0001]; -1.7% decrease) and SABA (regression coefficient: -14.7 [95% CI: -29.7 to 0.3, P = .055]; -10.6% decrease), respectively. CONCLUSION In NZ, a progressive increase in budesonide/formoterol dispensing, accompanied by a reduction in SABA and "other ICS/LABA" dispensing, occurred after publication of the 2020 NZ asthma guidelines. While acknowledging the limitations in the interpretation of temporal associations, these findings suggest that the transition to ICS/formoterol reliever-based therapy can be achieved if recommended and promoted as the preferred therapeutic approach in national guidelines.
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Affiliation(s)
- Lee Hatter
- Medical Research Institute of New Zealand, Wellington, New Zealand; School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand
| | - Allie Eathorne
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Tom Hills
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Pepa Bruce
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Claire Houghton
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Mark Weatherall
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Richard Beasley
- Medical Research Institute of New Zealand, Wellington, New Zealand; School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand.
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10
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Bloom CI. Covid-19 pandemic and asthma: What did we learn? Respirology 2023; 28:603-614. [PMID: 37154075 DOI: 10.1111/resp.14515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/28/2023] [Indexed: 05/10/2023]
Abstract
This review addresses some of the major lessons we have learnt regarding asthma and the covid-19 pandemic, including susceptibility to SARS-CoV-2 infection and severe covid-19, potentially protective factors, comparison to other respiratory infections, changes in healthcare behaviour from the perspective of patients and clinicians, medications to treat or prevent covid-19, and post-covid syndrome.
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Affiliation(s)
- Chloe I Bloom
- Imperial College London, National Heart and Lung Institute, London, UK
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11
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Chow EJ, Uyeki TM, Chu HY. The effects of the COVID-19 pandemic on community respiratory virus activity. Nat Rev Microbiol 2023; 21:195-210. [PMID: 36253478 PMCID: PMC9574826 DOI: 10.1038/s41579-022-00807-9] [Citation(s) in RCA: 106] [Impact Index Per Article: 106.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 01/14/2023]
Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused substantial global morbidity and deaths, leading governments to turn to non-pharmaceutical interventions to slow down the spread of infection and lessen the burden on health care systems. These policies have evolved over the course of the COVID-19 pandemic, including after the availability of COVID-19 vaccines, with regional and country-level differences in their ongoing use. The COVID-19 pandemic has been associated with changes in respiratory virus infections worldwide, which have differed between virus types. Reductions in respiratory virus infections, including by influenza virus and respiratory syncytial virus, were most notable at the onset of the COVID-19 pandemic and continued in varying degrees through subsequent waves of SARS-CoV-2 infections. The decreases in community infection burden have resulted in reduced hospitalizations and deaths associated with non-SARS-CoV-2 respiratory infections. Respiratory virus evolution relies on the maintaining of a diverse genetic pool, but evidence of genetic bottlenecking brought on by case reduction during the COVID-19 pandemic has resulted in reduced genetic diversity of some respiratory viruses, including influenza virus. By describing the differences in these changes between viral species across different geographies over the course of the COVID-19 pandemic, we may better understand the complex factors involved in community co-circulation of respiratory viruses.
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Affiliation(s)
- Eric J Chow
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Timothy M Uyeki
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Helen Y Chu
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA.
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12
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Nessle CN, Braun T, Chopra V, Choi SW, Mody R. Impact of socio-behavioral measures implemented during the SARS-CoV-2 pandemic on the outcomes of febrile neutropenia episodes in pediatric cancer patients: a single center quasi-experimental pre-post study. Pediatr Hematol Oncol 2022; 40:412-421. [PMID: 36125251 PMCID: PMC10025165 DOI: 10.1080/08880018.2022.2107746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
During COVID-19, public health measures including masks and social distancing decreased viral upper respiratory infections (URI). Upper respiratory infections are the most common infectious etiology for low-risk pediatric febrile neutropenia (FN). This single-center, quasi-experimental, pre-post study was designed to understand the impact of public health measures on FN admissions and outcomes in the general pediatric oncology population during the COVID (March 2020-February 2021) vs. pre-COVID era (January 2018-February 2020) and their respective respiratory seasons (November-February). Episodes were risk-stratified using a tool recommended by the Children's Oncology Group. Descriptive and bivariate statistics were used to compare admission characteristics and outcomes. Comparing respiratory seasons, the Covid-era season had 60% fewer URI diagnoses (5/12), while high-risk episodes (63.6% [28/44] vs. 44.2% [23/52]) and intensive care admissions (18.2% [8/44] vs. 3.8% [2/52]) increased. Between eras, URIs were lower in the COVID-era (10.8% [16/148] vs. 19.9% [67/336]; p = 0.01), but admission characteristics and severe outcomes were not different. The impact of public health measures was most prominent during the respiratory season. Despite decreased incidence of URIs, the overall admission characteristics and severe outcomes were minimally impacted due to the brevity of respiratory seasons, but larger studies are warranted.
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Affiliation(s)
- Charles Nathaniel Nessle
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Tom Braun
- School of Public Health, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Vineet Chopra
- Department of Internal Medicine, University of Colorado, Boulder, Colorado, USA
| | - Sung Won Choi
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Rajen Mody
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
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13
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Shen DP, Vermeulen F, Debeer A, Lagrou K, Smits A. Impact of COVID-19 on viral respiratory infection epidemiology in young children: A single-center analysis. Front Public Health 2022; 10:931242. [PMID: 36203684 PMCID: PMC9530989 DOI: 10.3389/fpubh.2022.931242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/22/2022] [Indexed: 01/24/2023] Open
Abstract
Background The COVID-19 pandemic impacts different health aspects. Concomitant with the adoption of non-pharmaceutical interventions (NPIs) to reduce the spread of SARS-CoV-2, global surveillance studies reported a reduction in occurrence of respiratory pathogens like influenza A and B virus (IAV & IBV) and respiratory syncytial virus (RSV). We hypothesized to observe this collateral benefit on viral respiratory infection epidemiology in young children. Methods Respiratory samples of children aged below 6 years, presenting at the outpatient clinic, emergency department, or pediatric infectious diseases department of the University Hospitals Leuven, between April 2017 and April 2021 were retrospectively analyzed. The occurrence (positivity rate), and seasonal patterns of viral respiratory infections were described. Chi-squared or Fisher's exact test (and Bonferroni correction) were used to explore differences in occurrence between 2020-2021 and previous 12-month (April to April) periods. Results We included 3020 samples (453 respiratory panels, 2567 single SARS-CoV-2 PCR tests). IAV and IBV were not detected from March and January 2020, respectively. For IAV, positivity rate in 2020-2021 (0%, n = 0) was significantly different from 2018-2019 (12.4%, n = 17) (p < 0.001) and 2019-2020 (15.4%, n = 19) (p < 0.001). IBV positivity rate in 2020-2021 (0%, n = 0) was not significantly different from previous periods. RSV occurrence was significantly lower in 2020-2021 (3.2%, n = 3), compared to 2017-2018 (15.0%, n = 15) (p = 0.006), 2018-2019 (16.1%, n = 22) (p = 0.002) and 2019-2020 (22.8%, n = 28) (p < 0.001). The RSV (winter) peak was absent and presented later (March-April 2021). Positivity rate of parainfluenza virus 3 (PIV-3) was significantly higher in 2020-2021 (11.8%, n = 11) than 2017-2018 (1%, n = 1) (p = 0.002). PIV-3 was absent from April 2020 to January 2021, whereas no clear seasonal pattern was distinguished the other years. For the other viruses tested, no significant differences in occurrence were observed between 2020-2021 and previous periods. From March 2020 onwards, 20 cases (0.7%) of SARS-CoV-2 were identified. Conclusion These findings reinforce the hypothesis of NPIs impacting the epidemiology of influenza viruses and RSV in young children. Compared to previous periods, no IAV and IBV cases were observed in the 2020-2021 study period, and the RSV peak occurred later. Since the pandemic is still ongoing, continuation of epidemiological surveillance, even on a larger scale, is indicated.
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Affiliation(s)
| | - François Vermeulen
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Anne Debeer
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Katrien Lagrou
- Department of Laboratory Medicine and National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Anne Smits
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
- L-C&Y, KU Leuven Child & Youth Institute, Leuven, Belgium
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14
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Axenhus M, Schedin-Weiss S, Winblad B, Wimo A. Changes in mortality trends amongst common diseases during the COVID-19 pandemic in Sweden. Scand J Public Health 2022; 50:748-755. [PMID: 34933630 PMCID: PMC9361422 DOI: 10.1177/14034948211064656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 11/09/2021] [Accepted: 11/15/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE It has been found that COVID-19 increases deaths within common diseases in countries that have implemented strict lockdowns. In order to elucidate the proper national response to a pandemic, the mortality rates within COVID-19 and various diseases need to be studied in countries whose pandemic response differ. Sweden represents a country with lax pandemic restrictions, and we aimed to study the effects of COVID-19 on historical mortality rates within common diseases during 2020. METHODS Regression models and moving averages were used to predict expected premature mortality per the ICD-10 during 2020 using historical data sets. Predicted values were then compared to recorded premature mortality to identify changes in mortality trends. RESULTS Seasonal increased mortality was found within neurological diseases. Infectious diseases, tumours and cardiac disease mortality rates decreased compared to expected outcome. CONCLUSIONS Changes in mortality trends were observed for several common diseases during the COVID-19 pandemic. Neurological and cardiac conditions, infections and tumours are examples of diseases that were heavily affected by the pandemic. The indirect effects of COVID-19 on certain patient populations should be considered when determining pandemic impact.
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Affiliation(s)
- Michael Axenhus
- Division of Neurogeriatrics, Centre for
Alzheimer Research, Department of Neurobiology, Care Sciences and Society,
Karolinska Institutet, Sweden
- Theme Inflammation and Aging,
Karolinska University Hospital, Sweden
| | - Sophia Schedin-Weiss
- Division of Neurogeriatrics, Centre for
Alzheimer Research, Department of Neurobiology, Care Sciences and Society,
Karolinska Institutet, Sweden
| | - Bengt Winblad
- Division of Neurogeriatrics, Centre for
Alzheimer Research, Department of Neurobiology, Care Sciences and Society,
Karolinska Institutet, Sweden
- Theme Inflammation and Aging,
Karolinska University Hospital, Sweden
| | - Anders Wimo
- Division of Neurogeriatrics, Centre for
Alzheimer Research, Department of Neurobiology, Care Sciences and Society,
Karolinska Institutet, Sweden
- Primary Care, Hudiksvall-Nordanstig,
Sweden
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15
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Valentin B, Steuwe A, Wienemann T, Andree M, Keitel V, Ljimani A, Appel E, Köhler MH, Rademacher C, Aissa J, Antoch G, Loberg C. Applicability of CO-RADS in an Anonymized Cohort Including Early and Advanced Stages of COVID-19 in Comparison to the Recommendations of the German Radiological Society and Radiological Society of North America. ROFO-FORTSCHR RONTG 2022; 194:862-872. [PMID: 35211925 DOI: 10.1055/a-1740-4310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Classifications were created to facilitate radiological evaluation of the novel coronavirus disease 2019 (COVID-19) on computed tomography (CT) images. The categorical CT assessment scheme (CO-RADS) categorizes lung parenchymal changes according to their likelihood of being caused by SARS-CoV-2 infection. This study investigates the diagnostic accuracy of diagnosing COVID-19 with CO-RADS compared to the Thoracic Imaging Section of the German Radiological Society (DRG) classification and Radiological Society of North America (RSNA) classification in an anonymized patient cohort. To mimic advanced disease stages, follow-up examinations were included as well. METHOD This study includes all patients undergoing chest CT in the case of a suspected SARS-CoV-2 infection or an already confirmed infection between March 13 and November 30, 2020. During the study period, two regional lockdowns occurred due to high incidence values, increasing the pre-test probability of COVID-19. Anonymized CT images were reviewed retrospectively and in consensus by two radiologists applying CO-RADS, DRG, and RSNA classification. Afterwards, CT findings were compared to results of sequential real-time reverse transcriptase polymerase chain reaction (qPCR) test performed during hospitalization to determine statistical analysis for diagnosing COVID-19. RESULTS 536 CT examinations were included. CO-RADS, DRG and RSNA achieved an NPV of 96 %/94 %/95 % (CO-RADS/DRG/RSNA), PPV of 83 %/80 %/88 %, sensitivity of 86 %/76 %/80 %, and specificity of 96 %/95 %/97 %. The disease prevalence was 20 %. CONCLUSION All applied classifications can reliably exclude a SARS-CoV-2 infection even in an anonymous setting. Nevertheless, pre-test probability was high in our study setting and has a great influence on the classifications. Therefore, the applicability of the individual classifications will become apparent in the future with lower prevalence and incidence of COVID-19. KEY POINTS · CO-RADS, DRG, and RSNA classifications help to reliably detect infected patients in an anonymized setting. · Pre-test probability has a great influence on the individual classifications. · Difficulties in an anonymized study setting are severe pulmonary changes and residuals.. CITATION FORMAT · Valentin B, Steuwe A, Wienemann T et al. Applicability of CO-RADS in an Anonymized Cohort Including Early and Advanced Stages of COVID-19 in Comparison to the Recommendations of the German Radiological Society and Radiological Society of North America. Fortschr Röntgenstr 2022; 194: 862 - 872.
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Affiliation(s)
- Birte Valentin
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Dusseldorf, Germany
| | - Andrea Steuwe
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Dusseldorf, Germany
| | - Tobias Wienemann
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital Düsseldorf, Germany
| | - Marcel Andree
- Institute of Virology, University Hospital Düsseldorf, Dusseldorf, Germany
| | - Verena Keitel
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Dusseldorf, Germany
| | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Dusseldorf, Germany
| | - Elisabeth Appel
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Dusseldorf, Germany
| | - Marie-Helen Köhler
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Dusseldorf, Germany
| | - Christin Rademacher
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Dusseldorf, Germany
| | - Joel Aissa
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Dusseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Dusseldorf, Germany
| | - Christina Loberg
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Dusseldorf, Germany
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16
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Proesmans M, Rector A, Keyaerts E, Vandendijck Y, Vermeulen F, Sauer K, Reynders M, Verschelde A, Laffut W, Garmyn K, Fleischhackl R, Bollekens J, Ispas G. Risk factors for disease severity and increased medical resource utilization in respiratory syncytial virus (+) hospitalized children: A descriptive study conducted in four Belgian hospitals. PLoS One 2022; 17:e0268532. [PMID: 35666728 PMCID: PMC9170098 DOI: 10.1371/journal.pone.0268532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 05/02/2022] [Indexed: 11/18/2022] Open
Abstract
Background We aimed to provide regional data on clinical symptoms, medical resource utilization (MRU), and risk factors for increased MRU in hospitalized respiratory syncytial virus (RSV)-infected Belgian pediatric population. Methods This prospective, multicenter study enrolled RSV (+) hospitalized children (aged ≤5y) during the 2013–2015 RSV seasons. RSV was diagnosed within 24h of hospitalization. Disease severity of RSV (+) patients was assessed until discharge or up to maximum six days using a Physical Examination Score (PES) and a derived score based on ability to feed, dyspnea and respiratory effort (PES3). MRU (concomitant medications, length of hospitalization [LOH], and oxygen supplementation) was evaluated. Kaplan-Meier survival analysis was performed to compare MRU by age and presence of risk factors for severe disease. Association between baseline covariates and MRU was analyzed using Cox regression models. Results In total, 75 children were included, Median (range) age was 4 (0–41) months, risk factors were present in 18.7%, and early hospitalization (≤3 days of symptom onset) was observed in 57.3% of patients. Cough (100%), feeding problems (82.2%), nasal discharge (87.8%), and rales and rhonchi (82.2%) were frequently observed. Median (range) LOH and oxygen supplementation was 5 (2–7) and 3 (1–7) days. Oxygen supplementation, bronchodilators, and antibiotics were administered to 58.7%, 64.0%, and 41.3% of the patients, respectively. Age <3 months and baseline total PES3 score were associated with probability and the duration of receiving oxygen supplementation. LOH was not associated with any covariate. Conclusion RSV is associated with high disease burden and MRU in hospitalized children. Oxygen supplementation but not length of hospitalization was associated with very young age and the PES3 score. These results warrant further assessment of the PES3 score as a predictor for the probability of receiving and length of oxygen supplementation in RSV hospitalized children. Registration NCT02133092
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Affiliation(s)
- Marijke Proesmans
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Annabel Rector
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Els Keyaerts
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Clinical and Epidemiological Virology, Leuven, Belgium
| | | | | | - Kate Sauer
- Department of Pediatrics, AZ Sint-Jan Brugge—Oostende, Campus Brugge, Brugge, Belgium
| | - Marijke Reynders
- Department of Microbiology, AZ Sint-Jan Brugge—Oostende, Campus Brugge, Brugge, Belgium
| | - Ann Verschelde
- Department of Pediatrics, AZ Sint-Jan Brugge–Oostende, Campus Henri Serruys, Oostende, Belgium
| | - Wim Laffut
- Department of Microbiology, Heilig-Hartziekenhuis, Lier, Belgium
| | - Kristien Garmyn
- Department of Pediatrics, Heilig-Hartziekenhuis, Lier, Belgium
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17
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Mølholm Hansen B, Cueto H, Padkaer Petersen J, Zachariassen G, Sønderby Christensen P, Breindahl M, Schiøler Kesmodel U, Brink Henriksen T. Preterm birth rates were slightly lower in Denmark during the first year of the COVID-19 pandemic compared with the previous 4 years. Acta Paediatr 2022; 111:1695-1700. [PMID: 35535429 PMCID: PMC9347617 DOI: 10.1111/apa.16401] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 12/26/2022]
Abstract
Aim Our aim was to investigate the rates of preterm births, live births and stillbirths in Denmark during the first year of the COVID‐19 pandemic. Methods This was a national, cross‐sectional registry‐based study that used the Danish Newborn Quality database, which covers all births in Denmark. The proportions of preterm births were compared between the COVID‐19 pandemic period of 1 March 2020 to 28 February 2021 and the preceding 4‐year pre‐pandemic period. Results We studied 60 323 and 244 481 newborn infants from the pandemic and pre‐pandemic periods, respectively. The proportion of preterm live births and stillbirths declined slightly, from 6.29% during the pre‐pandemic period to 6.02% during the pandemic period. This corresponded to a relative risk (RR) of 0.96, with a 95% confidence interval (CI) of 0.93–0.99 during the pandemic. The RRs for extremely preterm, very preterm and moderately preterm infants were 0.88 (95% CI 0.76–1.02), 0.91 (95% CI 0.82–1.02) and 0.97 (95% CI 0.93–1.01), respectively. Conclusion This comparative study showed a small reduction in just over 4%, from 6.29 to 6.02% in the proportion of all preterm births during the pandemic period, compared with the previous four pandemic‐free years. There were no differences between subcategories of preterm births.
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Affiliation(s)
- Bo Mølholm Hansen
- Department of Paediatrics and Adolescent Medicine Nordsjaellands Hospital in Hilleroed Hilleroed Denmark
| | - Heidi Cueto
- The Danish Clinical Quality Program – National Clinical Registries (RKKP) Aarhus Denmark
| | | | - Gitte Zachariassen
- Hans Christian Andersen Children's Hospital Odense University Hospital and University of Southern Denmark Odense Denmark
| | | | - Morten Breindahl
- Department of Intensive Care for Newborns and Infants Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark
| | | | - Tine Brink Henriksen
- Department of Paediatrics and Adolescent Medicine Aarhus University Hospital Aarhus Denmark
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18
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Qiu Z, Cao Z, Zou M, Tang K, Zhang C, Tang J, Zeng J, Wang Y, Sun Q, Wang D, Du X. The effectiveness of governmental nonpharmaceutical interventions against COVID-19 at controlling seasonal influenza transmission: an ecological study. BMC Infect Dis 2022; 22:331. [PMID: 35379168 PMCID: PMC8977560 DOI: 10.1186/s12879-022-07317-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/28/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND A range of strict nonpharmaceutical interventions (NPIs) were implemented in many countries to combat the coronavirus 2019 (COVID-19) pandemic. These NPIs may also be effective at controlling seasonal influenza virus infections, as influenza viruses have the same transmission path as severe acute respiratory syndrome coronavirus 2. The aim of this study was to evaluate the effects of different NPIs on the control of seasonal influenza. METHODS Data for 14 NPIs implemented in 33 countries and the corresponding influenza virological surveillance data were collected. The influenza suppression index was calculated as the difference between the influenza positivity rate during its period of decline from 2019 to 2020 and during the influenza epidemic seasons in the previous 9 years. A machine learning model was developed using an extreme gradient boosting tree regressor to fit the NPI and influenza suppression index data. The SHapley Additive exPlanations tool was used to characterize the NPIs that suppressed the transmission of influenza. RESULTS Of all NPIs tested, gathering limitations had the greatest contribution (37.60%) to suppressing influenza transmission during the 2019-2020 influenza season. The three most effective NPIs were gathering limitations, international travel restrictions, and school closures. For these three NPIs, their intensity threshold required to generate an effect were restrictions on the size of gatherings less than 1000 people, ban of travel to all regions or total border closures, and closing only some categories of schools, respectively. There was a strong positive interaction effect between mask-wearing requirements and gathering limitations, whereas merely implementing a mask-wearing requirement, and not other NPIs, diluted the effectiveness of mask-wearing requirements at suppressing influenza transmission. CONCLUSIONS Gathering limitations, ban of travel to all regions or total border closures, and closing some levels of schools were found to be the most effective NPIs at suppressing influenza transmission. It is recommended that the mask-wearing requirement be combined with gathering limitations and other NPIs. Our findings could facilitate the precise control of future influenza epidemics and other potential pandemics.
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Affiliation(s)
- Zekai Qiu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, People's Republic of China.,School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China
| | - Zicheng Cao
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, People's Republic of China.,School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China
| | - Min Zou
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, People's Republic of China.,School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China
| | - Kang Tang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, People's Republic of China.,School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China
| | - Chi Zhang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, People's Republic of China.,School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China
| | - Jing Tang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, People's Republic of China.,School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China
| | - Jinfeng Zeng
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, People's Republic of China.,School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China
| | - Yaqi Wang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, People's Republic of China.,School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China
| | - Qianru Sun
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, People's Republic of China.,School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China
| | - Daoze Wang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, People's Republic of China.,School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China
| | - Xiangjun Du
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, People's Republic of China. .,School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, 510275, People's Republic of China. .,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-Sen University, Guangzhou, 510030, People's Republic of China.
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20
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Has the COVID-19 pandemic increased tuberculosis mortality? THE LANCET. INFECTIOUS DISEASES 2022; 22:165-166. [PMID: 35092788 PMCID: PMC8797027 DOI: 10.1016/s1473-3099(22)00006-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/20/2021] [Indexed: 12/25/2022]
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21
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Doroshenko A, Lee N, MacDonald C, Zelyas N, Asadi L, Kanji JN. Decline of Influenza and Respiratory Viruses With COVID-19 Public Health Measures: Alberta, Canada. Mayo Clin Proc 2021; 96:3042-3052. [PMID: 34863395 PMCID: PMC8450272 DOI: 10.1016/j.mayocp.2021.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/13/2021] [Indexed: 12/05/2022]
Abstract
OBJECTIVE To determine the incidence of influenza and noninfluenza respiratory viruses (NIRVs) pre-/post-implementation of public health measures aimed to decrease coronavirus disease 2019 (COVID-19) transmission using population-based surveillance data. We hypothesized that such measures could reduce the burden of respiratory viruses (RVs) transmitting via the same routes. PATIENTS AND METHODS An interrupted time-series analysis of RV surveillance data in Alberta, Canada, from May 2017 to July 2020 was conducted. The burden of influenza and NIRVs before and after intervention initiation at week 11 was compared. The analysis was adjusted for seasonality, overdispersion, and autocorrelation. RESULTS During the study period, an average of 708 and 4056 weekly respiratory multiplex molecular panels were conducted pre-/post-intervention, respectively. We found significant reductions in test positivity rates in the postintervention period for influenza (-94.3%; 95% CI, -93.8 to 97.4%; P<.001) and all NIRVs (-76.5%; 95% CI, -77.3 to -75.8%; P<.001) in the crude model, and -86.2% (95% CI, -91.5 to -77.4%: P<.001) and -75% (95% CI, -79.7 to -69.3%; P<.001), respectively, in the adjusted models. Subanalyses for individual viruses showed significant decreases in respiratory syncytial virus, human metapneumovirus, enterovirus/rhinovirus, and parainfluenza. For non-severe acute respiratory coronavirus 2 human coronaviruses, the decline was not statistically significant after adjustment (-22.3%; 95% CI, -49.3 to +19%, P=.246). CONCLUSION The implementation of COVID-19 public health measures likely resulted in reduced transmission of common RVs. Although drastic lockdowns are unlikely to be required given widespread COVID-19 vaccination, targeted implementation of such measures can lower RV disease burden. Studies to evaluate relative contributions of individual interventions are warranted.
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Key Words
- hcov, human coronavirus
- herv, human entero/rhinovirus
- hmpv, human metapneumovirus
- irr, incident rate ratio
- its, interrupted time series
- nirv, noninfluenza respiratory virus
- pcr, polymerase chain reaction
- piv, parainfluenza virus
- rsv, respiratory syncytial virus
- tpr, test positivity rate
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Affiliation(s)
- Alexander Doroshenko
- Division of Preventive Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Nelson Lee
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Clayton MacDonald
- Department of Medical Microbiology and Infection Control, Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Nathan Zelyas
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Alberta, Canada
| | - Leyla Asadi
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Jamil N Kanji
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Alberta, Canada.
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Ota MOC, Badur S, Romano-Mazzotti L, Friedland LR. Impact of COVID-19 pandemic on routine immunization. Ann Med 2021; 53:2286-2297. [PMID: 34854789 PMCID: PMC8648038 DOI: 10.1080/07853890.2021.2009128] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/16/2021] [Indexed: 11/04/2022] Open
Abstract
The current COVID-19 global pandemic continues to impact healthcare services beyond those directly related to the management of SARS-CoV-2 transmission and disease. We reviewed the published literature to assess the pandemic impact on existing global immunization activities and how the impact may be addressed. Widespread global disruption in routine childhood immunization has impacted a majority of regions and countries, especially in the initial pandemic phases. While data indicate subsequent recovery in immunization rates, a substantial number of vulnerable people remain unvaccinated. The downstream impact may be even greater in resource-limited settings and economically poorer populations, and consequently there are growing concerns around the resurgence of vaccine-preventable diseases, particularly measles. Guidance on how to address immunization deficits are available and continue to evolve, emphasizing the importance of maintaining and restoring routine immunization and necessary mass vaccination campaigns during and after pandemics. In this, collaboration between a broad range of stakeholders (governments, industry, healthcare decision-makers and frontline healthcare professionals) and clear communication and engagement with the public can help achieve these goals.Key messagesThe COVID-19 pandemic has a substantial impact on essential immunization activities.Disruption to mass vaccination campaigns increase risk of VPD resurgence.Catch-up campaigns are necessary to limit existing shortfalls in vaccine uptake.Guidance to mitigate these effects continues to evolve.
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Martinón-Torres F, García-Sastre A, Pollard AJ, Martín C, Osterhaus A, Ladhani SN, Ramilo O, Gómez Rial J, Salas A, Bosch FX, Martinón-Torres M, Mina MJ, Cherry J. TIPICO XI: report of the first series and podcast on infectious diseases and vaccines (aTIPICO). Hum Vaccin Immunother 2021; 17:4299-4327. [PMID: 34762551 PMCID: PMC8828069 DOI: 10.1080/21645515.2021.1953351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
TIPiCO is an annual expert meeting and workshop on infectious diseases and vaccination. The edition of 2020 changed its name and format to aTIPiCO, the first series and podcasts on infectious diseases and vaccines. A total of 13 prestigious experts from different countries participated in this edition launched on the 26 November 2020. The state of the art of coronavirus disease-2019 (COVID-19) and the responsible pathogen, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and the options to tackle the pandemic situation were discussed in light of the knowledge in November 2020. Despite COVID-19, the status of other infectious diseases, including influenza infections, respiratory syncytial virus disease, human papillomavirus infection, measles, pertussis, tuberculosis, meningococcal disease, and pneumococcal disease, were also addressed. The essential lessons that can be learned from these diseases and their vaccines to use in the COVID-19 pandemic were also commented with the experts.
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Affiliation(s)
- Federico Martinón-Torres
- Department of Paediatrics Translational Paediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, Universidad de Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Carlos Martín
- Department of Microbiology, Faculty of Medicine, IIS Aragon, Universidad de Zaragoza, CIBERES, Instituto de Salud Carlos III, Madrid, Spain
| | - Albert Osterhaus
- Research Center Emerging Infections and Zoonoses (RIZ, University of Veterinary Medicine Hannover, Hannover, Germany
| | | | - Octavio Ramilo
- Nationwide Children's Hospital and the Ohio State University, Columbus, Ohio, US
| | - Jose Gómez Rial
- Immunology Department, Hospital Clínico Universitario de Santiago de Compostela, Spain
| | - Antonio Salas
- Unidade de Xenética, Instituto de Ciencias Forenses (INCIFOR), Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigacinó Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Galicia, Spain
| | | | | | - Michael J Mina
- Harvard School of Public Health and Harvard Medical School, Boston, MA, US
| | - James Cherry
- The David Geffen School of Medicine at UCLA, Los Angeles, CA, US
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24
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Cruz-Lopez F, Garza-González E, Morfin-Otero R, Villarreal-Treviño L, Rodriguez-Noriega E, Martínez-Meléndez A. Analysis of influenza and dengue cases in Mexico before and during the COVID-19 pandemic. Infect Dis (Lond) 2021; 54:232-234. [PMID: 34751092 DOI: 10.1080/23744235.2021.1999496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Flora Cruz-Lopez
- Facultad de Ciencias Químicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
| | - Elvira Garza-González
- Facultad de Medicina/Hospital Universitario "Dr. José Eleuterio González", Laboratorio de Microbiología Molecular, Departamento de Bioquímica y Medicina Molecular, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Rayo Morfin-Otero
- Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Hospital Civil de Guadalajara "Fray Antonio Alcalde" e Instituto de Patología Infecciosa y Experimental, Guadalajara, México
| | - Licet Villarreal-Treviño
- Facultad de Ciencias Biológicas, Departamento de Microbiología e Inmunología, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - Eduardo Rodriguez-Noriega
- Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Hospital Civil de Guadalajara "Fray Antonio Alcalde" e Instituto de Patología Infecciosa y Experimental, Guadalajara, México
| | - Adrián Martínez-Meléndez
- Facultad de Ciencias Químicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
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25
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Santos AMD, Souza BFD, Carvalho CAD, Campos MAG, Oliveira BLCAD, Diniz EM, Branco MDRFC, Queiroz RCDS, Carvalho VAD, Araújo WRM, Silva AAMD. Excess deaths from all causes and by COVID-19 in Brazil in 2020. Rev Saude Publica 2021; 55:71. [PMID: 34730751 PMCID: PMC8522736 DOI: 10.11606/s1518-8787.2021055004137] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE To estimate the 2020 all-cause and COVID-19 excess mortality according to sex, age, race/color, and state, and to compare mortality rates by selected causes with that of the five previous years in Brazil. METHODS Data from the Mortality Information System were used. Expected deaths for 2020 were estimated from 2015 to 2019 data using a negative binomial log-linear model. RESULTS Excess deaths in Brazil in 2020 amounted to 13.7%, and the ratio of excess deaths to COVID-19 deaths was 0.90. Reductions in deaths from cardiovascular diseases (CVD), respiratory diseases, and external causes, and an increase in ill-defined causes were all noted. Excess deaths were also found to be heterogeneous, being higher in the Northern, Center-Western, and Northeastern states. In some states, the number of COVID-19 deaths was lower than that of excess deaths, whereas the opposite occurred in others. Moreover, excess deaths were higher in men aged 20 to 59, and in black, yellow, or indigenous individuals. Meanwhile, excess mortality was lower in women, in individuals aged 80 years or older, and in whites. Additionally, deaths among those aged 0 to 19 were 7.2% lower than expected, with reduction in mortality from respiratory diseases and external causes. There was also a drop in mortality due to external causes in men and in those aged 20 to 39 years. Moreover, reductions in deaths from CVD and neoplasms were noted in some states and groups. CONCLUSION There is evidence of underreporting of COVID-19 deaths and of the possible impact of restrictive measures in the reduction of deaths from external causes and respiratory diseases. The impacts of COVID-19 on mortality were heterogeneous among the states and groups, revealing that regional, demographic, socioeconomic, and racial differences expose individuals in distinct ways to the risk of death from both COVID-19 and other causes.
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Affiliation(s)
| | - Bruno Feres de Souza
- Universidade Federal do Maranhão. Departamento de Engenharia da Computação. São Luís, MA, Brasil
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26
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Pantvaidya G, Joshi S, Nayak P, Kannan S, DeSouza A, Poddar P, Prakash G, Vijaykumaran P, Nair D, Vaish R, Patkar S, Niyogi D, Joshi P, Chaudhari V, Singh V, Mathews S, Pramesh CS, Badwe RA, Puri A. Surgical Site Infections in patients undergoing major oncological surgery during the COVID-19 paNdemic (SCION): A propensity-matched analysis. J Surg Oncol 2021; 125:327-335. [PMID: 34729779 PMCID: PMC8661874 DOI: 10.1002/jso.26738] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 10/23/2021] [Indexed: 11/10/2022]
Abstract
Background and Objectives There are reports of outcomes of elective major cancer surgery during the COVID‐19 pandemic. We evaluated if reinforcement of hand hygiene, universal masking, and distancing as a part of pandemic precautions led to a decrease in the incidence of surgical site infections (SSIs) in major oncologic resections. Methods Propensity score matching using the nearest neighbor algorithm was performed on 3123 patients over seven covariates (age, comorbidities, surgery duration, prior treatment, disease stage, reconstruction, and surgical wound type) yielding 2614 matched (pre‐COVID 1612 and COVID 1002) patients. Conditional logistic regression was used to identify if SSI incidence was lower amongst patients operated during the pandemic. Results There was a 4.2% (p = 0.006) decrease in SSI in patients operated during the pandemic. On multivariate regression, surgery during the COVID‐19 period (odds ratio [OR] = 0.77; 95% confidence interval [CI] = 0.61–0.98; p = 0.03), prior chemoradiation (OR = 2.46; CI = 1.45–4.17; p < 0.001), duration of surgery >4 h (OR = 2.17; 95%CI = 1.55–3.05; p < 0.001) and clean contaminated wounds (OR = 2.50; 95% CI = 1.09–2.18; p = 0.012) were significantly associated with SSI. Conclusion Increased compliance with hand hygiene, near‐universal mask usage, and social distancing during the COVID‐19 pandemic possibly led to a 23% decreased odds of SSI in major oncologic resections. Extending these low‐cost interventions in the post‐pandemic era can decrease morbidity associated with SSI in cancer surgery.
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Affiliation(s)
- Gouri Pantvaidya
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Shalaka Joshi
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Prakash Nayak
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Sadhana Kannan
- Clinical Research Secreteriat, Advanced Centre for Treatment, Research and Education in Cancer, Mumbai, India
| | - Ashwin DeSouza
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Pabashi Poddar
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Gagan Prakash
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Preeti Vijaykumaran
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Deepa Nair
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Richa Vaish
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Shraddha Patkar
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Devayani Niyogi
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Poonam Joshi
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Vikram Chaudhari
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Vikas Singh
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Saumya Mathews
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - C S Pramesh
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Rajendra A Badwe
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
| | - Ajay Puri
- Department of Surgery, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, India
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27
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Harper JCP, Semprini R, Kearns NA, Hatter L, Bird GE, Braithwaite I, Eathorne A, Weatherall M, Beasley R. Determination of oxygen saturation compared to a prescribed target range using continuous pulse oximetry in acutely unwell medical patients. BMC Pulm Med 2021; 21:332. [PMID: 34702236 PMCID: PMC8546386 DOI: 10.1186/s12890-021-01700-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Both inadequate and excessive administration of oxygen to acutely unwell patients results in risk of harm. Guidelines recommend titration of oxygen to achieve a target oxygen saturation (SpO2) range. Information regarding whether this is being achieved is limited. METHODS In this two-centre non-interventional study we used continuous pulse oximetry in acutely unwell medical patients over a 24-h period to determine the proportion of time spent with SpO2 within the prescribed target range and whether this is influenced by the target range, age, care in a high-dependency area and the number of oxygen adjustments. RESULTS Eighty participants were included in the analysis. The mean (SD) proportion of time spent in target range was 55.6% (23.6), this was lower in those with a reduced hypercapnic target range (88-92% or below) compared to those with a range of 92-96%; difference - 13.1% (95% CI - 3.0 to - 23.2), P = 0.012. The proportion of time spent above range was 16.2% (22.9); this was higher in those with a reduced hypercapnic range; difference 21.6% (31.4 to 12), P < 0.001. The proportion of time below range was 28.4% (25.2); there was no difference between target ranges. The proportion of time spent in range was higher for those in a high dependency area in the multivariate model; difference 15.5% (95% CI 2.3 to 28.7), P = 0.02. CONCLUSIONS Medical patients receiving oxygen in a ward setting spend significant periods of time with SpO2 both above and below the prescribed target range while receiving oxygen therapy.
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Affiliation(s)
- James C P Harper
- Medical Research Institute of New Zealand, Private Bag 7902, Newtown, Wellington, 6242, New Zealand.
- Victoria University, Wellington, New Zealand.
- Capital & Coast District Health Board, Wellington, New Zealand.
| | - Ruth Semprini
- Medical Research Institute of New Zealand, Private Bag 7902, Newtown, Wellington, 6242, New Zealand
- Hutt Valley District Health Board, Wellington, New Zealand
| | - Nethmi A Kearns
- Medical Research Institute of New Zealand, Private Bag 7902, Newtown, Wellington, 6242, New Zealand
- Capital & Coast District Health Board, Wellington, New Zealand
| | - Lee Hatter
- Medical Research Institute of New Zealand, Private Bag 7902, Newtown, Wellington, 6242, New Zealand
- Capital & Coast District Health Board, Wellington, New Zealand
| | - Grace E Bird
- Medical Research Institute of New Zealand, Private Bag 7902, Newtown, Wellington, 6242, New Zealand
- Victoria University, Wellington, New Zealand
- Capital & Coast District Health Board, Wellington, New Zealand
| | - Irene Braithwaite
- Medical Research Institute of New Zealand, Private Bag 7902, Newtown, Wellington, 6242, New Zealand
| | - Allie Eathorne
- Medical Research Institute of New Zealand, Private Bag 7902, Newtown, Wellington, 6242, New Zealand
| | | | - Richard Beasley
- Medical Research Institute of New Zealand, Private Bag 7902, Newtown, Wellington, 6242, New Zealand
- Victoria University, Wellington, New Zealand
- Capital & Coast District Health Board, Wellington, New Zealand
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COVID-19 border controls prevent a 2021 seasonal influenza epidemic in New Zealand. Public Health 2021; 200:e6-e7. [PMID: 34654573 PMCID: PMC8511893 DOI: 10.1016/j.puhe.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 12/04/2022]
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Nijman RG. The impact of the COVID-19 pandemic on child health. J LAB MED 2021. [DOI: 10.1515/labmed-2021-0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Most Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections in children are mild or asymptomatic. Severe Coronavirus Disease 2019 (COVID-19) in children is infrequent. An estimated 0.3–1.3% of children with SARS-CoV-2 infection were admitted to hospital, and of these 13–23% needed critical care. SARS-CoV-2 related deaths were very rare in children, estimated at 2 per million. The vast majority of admitted children had one of shortness of breath, fever, and cough, but atypical symptoms are more common in children. Cases of Multisystem Inflammatory Syndrome in Children (MIS-C) have been linked to SARS-CoV-2 infection. Cardinal symptoms include prolonged fever, clinical signs of inflammation, gastro-intestinal symptoms, and cardiac dysfunction. Twenty two to 80% of patients with MIS-C needed critical care; mortality of MIS-C is around 2%. Six to 24% of children with MIS-C had coronary artery dilatation or cardiac aneurysms. Equipoise still exists between first-line treatment with immunoglobulins and steroids. Outcomes for children with MIS-C are generally very good in those recognised early and started on appropriate treatment. Vaccination schemes for children are rapidly expanding, with the benefits of preventing severe COVID-19 disease and MIS-C and reducing community transmission outweighing the risks of adverse events of, amongst others, myocarditis temporally related to COVID-19 vaccination in children and young adults. The imposed social distancing measures reduced the overall number of children with acute illness or injury presenting to urgent and emergency care facilities worldwide. No clear signal was seen that large numbers of children had a delayed presentation to emergency care departments with a serious illness. The social distancing measures negatively impacted the mental health of children.
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Affiliation(s)
- Ruud G. Nijman
- Department of Infectious Disease , Section of Paediatric Infectious Diseases, Imperial College London , London , UK
- Centre for Paediatrics and Child Health , Imperial College London , London , UK
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Lazova S, Velikova T. DYNAMICS OF CHILDHOOD RESPIRATORY INFECTIONS DURING THE COVID-19 PANDEMIC: THE EFFECT OF QUARANTINE АND BEYOND. CENTRAL ASIAN JOURNAL OF MEDICAL HYPOTHESES AND ETHICS 2021. [DOI: 10.47316/cajmhe.2021.2.3.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Monitoring epidemic processes and the dynamics of the spread of infectious diseases is essential for predicting their distribution and effective planning in healthcare. The importance of studying seasonal trends in the spread of respiratory viral infections and the specific effects of non-pharmaceutical interventions in nationwide scales and the use of available vaccines stand out even more in the context of the coronavirus disease-19 (COVID-19) pandemic. Even if the dynamics of pediatric respiratory viral infections show some variation at the national and local levels, depending on health regulation, respiratory viral pathogens follow a typical pattern of incidence. Therefore, we hypothesize that anticipated reduction of the incidence of common respiratory viral infections would undoubtedly exert positive effects, such as ease of burdening healthcare that combates the COVID-19 pandemic. However, we suspect a shift in familiar seasonal characteristics of common respiratory viral infections. We also speculate that strict long-term limitations of the natural spread of respiratory viral infections can lead to the development of hard-to-predict epidemiological outliers. Additionally, the tricky balance between humanity’s natural impulse to return to normalcy and control the new and still dynamically evolving infection could lead to new threats from old and well-known pathogens. Finally, we hypothesize that the absence of regular influenza virus circulation may lead to a high mismatch rate and a significant reduction in flu vaccine efficacy.
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Cellerino M, Boffa G, Lapucci C, Tazza F, Sbragia E, Mancuso E, Bruschi N, Minguzzi S, Ivaldi F, Poirè I, Laroni A, Mancardi G, Capello E, Uccelli A, Novi G, Inglese M. Predictors of Ocrelizumab Effectiveness in Patients with Multiple Sclerosis. Neurotherapeutics 2021; 18:2579-2588. [PMID: 34553320 PMCID: PMC8457546 DOI: 10.1007/s13311-021-01104-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 12/26/2022] Open
Abstract
Data regarding effectiveness and safety of ocrelizumab in the post-marking setting are lacking. The aim of our study was to provide effectiveness and safety data of ocrelizumab treatment in patients with relapsing-remitting (RR-) and progressive multiple sclerosis (PMS) and to evaluate clinical and immunological predictors of early treatment response. In this single-center prospective observational study, we investigated effectiveness outcomes (time-to-confirmed disability worsening, time-to-first relapse, time-to-first evidence of MRI activity and time-to-first evidence of disease activity), clinical and immunological predictors of early treatment response, and incidence of adverse events (AEs). One hundred and fifty-three subjects were included (93 RRMS; 84 females). Median follow-up was 1.9 (1.3-2.7). At 2-year follow-up (FU), disability worsening-free survival were 90.5%, 64.7%, and 68.8% for RRMS, primary-progressive MS (PPMS), and secondary-progressive MS (SPMS) patients, respectively. At 2-year FU, 67.1%, 72.7%, and 81.3% of patients with RRMS, PPMS, and SPMS were free of MRI activity, with NEDA-3 percentages of 62.1%, 54.6%, and 55.1%, respectively. Lower baseline EDSS was independently associated with a reduced risk of disability worsening (HR(95%CI) = 1.45(1.05-2.00), p = 0.024) and previous treatment exposure was independently associated with increased probability of radiological activity (HR = 2.53(1.05-6.10), p = 0.039). At 6-month FU, CD8 + cell decrease was less pronounced in patients with inflammatory activity (p = 0.022). Six patients (3.9%) discontinued ocrelizumab due to severe AEs. Our findings suggest that ocrelizumab is an effective treatment in real-world patients with RRMS and PMS, with a manageable safety profile. Better outcomes were observed in treatment-naïve patients and in patients with a low baseline disability level. Depletion of CD8 + cells could underlie early therapeutic effects of ocrelizumab.
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Affiliation(s)
- Maria Cellerino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Largo Paolo Daneo 3, 16100, Genoa, Italy
| | - Giacomo Boffa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Largo Paolo Daneo 3, 16100, Genoa, Italy
| | - Caterina Lapucci
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Largo Paolo Daneo 3, 16100, Genoa, Italy
- Laboratory of Experimental Neurosciences, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Tazza
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Largo Paolo Daneo 3, 16100, Genoa, Italy
| | - Elvira Sbragia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Largo Paolo Daneo 3, 16100, Genoa, Italy
| | - Elisabetta Mancuso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Largo Paolo Daneo 3, 16100, Genoa, Italy
| | - Nicolò Bruschi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Largo Paolo Daneo 3, 16100, Genoa, Italy
| | | | - Federico Ivaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Largo Paolo Daneo 3, 16100, Genoa, Italy
| | - Ilaria Poirè
- Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Alice Laroni
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Largo Paolo Daneo 3, 16100, Genoa, Italy
- Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Gianluigi Mancardi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Largo Paolo Daneo 3, 16100, Genoa, Italy
- Scientific Clinical Institutes Maugeri IRCCS, Pavia, Italy
| | | | - Antonio Uccelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Largo Paolo Daneo 3, 16100, Genoa, Italy
- Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Giovanni Novi
- Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Largo Paolo Daneo 3, 16100, Genoa, Italy.
- Departments of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, NY, New York, USA.
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Ineichen C, Baumann-Vogel H, Sitzler M, Waldvogel D, Baumann CR. Worsened Parkinson's Disease Progression: Impact of the COVID-19 Pandemic. JOURNAL OF PARKINSONS DISEASE 2021; 11:1579-1583. [PMID: 34397421 DOI: 10.3233/jpd-212779] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Whilst some studies investigated the impact of viral infection or reduced access to medication during the COVID-19 pandemic in patients with Parkinson's disease (PD), data on the effects of pandemic restrictions are still scarce. We retrospectively analyzed motor symptoms of longitudinally followed PD patients (n = 264) and compared motor disease progression before and during the COVID-19 pandemic. Additionally, we performed a trend analysis of the yearly evolution of motor symptoms in 755 patients from 2016 until 2021. We observed a worsening of motor symptoms and a significantly increased motor disease progression during pandemic-related restrictions as compared to before the COVID-19 outbreak.
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Affiliation(s)
- Christian Ineichen
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Heide Baumann-Vogel
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Matthias Sitzler
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Daniel Waldvogel
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christian R Baumann
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Finkelstein Y, Maguire B, Zemek R, Osmanlliu E, Kam AJ, Dixon A, Desai N, Sawyer S, Emsley J, Lynch T, Mater A, Schuh S, Rumantir M, Freedman SB. Effect of the COVID-19 Pandemic on Patient Volumes, Acuity, and Outcomes in Pediatric Emergency Departments: A Nationwide Study. Pediatr Emerg Care 2021; 37:427-434. [PMID: 34074990 PMCID: PMC8327936 DOI: 10.1097/pec.0000000000002484] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aim of this study was to quantify the effect of the COVID-19 pandemic on pediatric emergency department (ED) utilization and outcomes. METHODS This study is an interrupted-time-series observational study of children presenting to 11 Canadian tertiary-care pediatric EDs. Data were grouped into weeks in 3 study periods: prepandemic (January 1, 2018-January 27, 2020), peripandemic (January 28, 2020-March 10, 2020), and early pandemic (March 11, 2020-April 30, 2020). These periods were compared with the same time intervals in the 2 preceding calendar years. Primary outcomes were number of ED visits per week. The secondary outcomes were triage acuity, hospitalization, intensive care unit (ICU) admission, mortality, length of hospital stay, ED revisits, and visits for trauma and mental health concerns. RESULTS There were 577,807 ED visits (median age, 4.5 years; 52.9% male). Relative to the prepandemic period, there was a reduction [-58%; 95% confidence interval (CI), -63% to -51%] in the number of ED visits during the early-pandemic period, with concomitant higher acuity. There was a concurrent increase in the proportion of ward [odds ratio (OR), 1.39; 95% CI, 1.32-1.45] and intensive care unit (OR, 1.20; 95% CI, 1.01-1.42) admissions, and trauma-related ED visits among children less than 10 years (OR, 1.51; 95% CI, 1.45-1.56). Mental health-related visits in children declined in the early-pandemic period (in <10 years, -60%; 95% CI, -67% to -51%; in children ≥10 years: -56%; 95% CI, -63% to -47%) relative to the pre-COVID-19 period. There were no differences in mortality or length of stay; however, ED revisits within 72 hours were reduced during the early-pandemic period (percent change: -55%; 95% CI, -61% to -49%; P < 0.001). CONCLUSIONS After the declaration of the COVID-19 pandemic, dramatic reductions in pediatric ED visits occurred across Canada. Children seeking ED care were sicker, and there was an increase in trauma-related visits among children more than 10 years of age, whereas mental health visits declined during the early-pandemic period. When faced with a future pandemic, public health officials must consider the impact of the illness and the measures implemented on children's health and acute care needs.
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Affiliation(s)
- Yaron Finkelstein
- From the Divisions of Pediatric Emergency Medicine and Clinical Pharmacology and Toxicology
| | - Bryan Maguire
- Biostatistical Design and Analysis team, The Hospital for Sick Children, University of Toronto, Toronto
| | - Roger Zemek
- Department of Pediatrics and Emergency Medicine, University of Ottawa and Children’s Hospital of Eastern Ontario, Ottawa, Ontario
| | - Esli Osmanlliu
- Division of Pediatric Emergency Medicine, Montreal Children’s Hospital, McGill University, Montreal, Quebec
| | - April J. Kam
- Department of Pediatrics, Division of Emergency Medicine, McMaster Children’s Hospital, Hamilton, Ontario
| | - Andrew Dixon
- Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta
| | - Neil Desai
- Division of Pediatric Emergency Medicine, British Columbia Children’s Hospital, Vancouver, British Columbia
| | - Scott Sawyer
- Department of Pediatrics and Emergency Medicine, University of Manitoba, Winnipeg, Manitoba
| | - Jason Emsley
- Department of Emergency Medicine, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia
| | - Tim Lynch
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Schulich School of Medicine, Western University, London, Ontario
| | - Ahmed Mater
- Division Pediatric Emergency Medicine, Jim Pattison Children’s Hospital, University of Saskatchewan, Saskatoon, Saskatchewan
| | - Suzanne Schuh
- Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario
| | - Maggie Rumantir
- Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario
| | - Stephen B. Freedman
- Sections of Pediatric Emergency Medicine and Gastroenterology, Departments of Pediatrics and Emergency Medicine, Alberta Children’s Hospital, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Ye Y, Wu R, Ge Y, Wang T, Yao X, Yang Y, Long C, Chen F, Tang S, Huang R. Preventive behaviours and family inequalities during the COVID-19 pandemic: a cross-sectional study in China. Infect Dis Poverty 2021; 10:100. [PMID: 34284821 PMCID: PMC8290209 DOI: 10.1186/s40249-021-00884-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 07/07/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is an international public health threat, and people's participation in disease-related preventive behaviours is the key to controlling infectious diseases. This study aimed to assess the differences in adopting preventive behaviours among populations to explore potential individual and household factors and inequalities within families. METHODS This online survey was conducted in April 2020. The directional stratified convenient sampling method was used to select 4704 participants from eight provinces in eastern, central, and western China. The questionnaire included demographic information, household variables, and five target prevention behaviours. The chi-squared test, binary multilevel model, and Mantel-Haenszel hierarchical analysis were used for data analysis in the study. RESULTS Approximately 71.2% of the participants had appropriate outdoor prevention, and 32.9% of the participants had indoor protection in place. Sharing behaviours (P < 0.001) and education level (P < 0.001) were positively associated with adopting preventive measures. The inhibiting effect of household crowding and stimulating effect of high household income on preventive behaviours were determined in this study. Household size was negatively associated with living area (β = -0.057, P < 0.05) and living style (β = -0.077, P < 0.05). Household income was positively associated with age (β = 0.023, P < 0.05), and relationship with friends (β = 0.053, P < 0.05). Vulnerable groups, such as older adults or women, are more likely to have inadequate preventive behaviours. Older adults (OR = 1.53, 95% CI 1.09-2.15), women (OR = 1.37, 95% CI 1.15-1.64), and those with more than 2 suspected symptoms (OR = 1.85, 95% CI 1.07-3.19) were more likely to be affected by the inhibiting effect of household crowding, while the stimulating effect of high household income was limited in these groups. CONCLUSIONS Inequalities in COVID-19 prevention behaviours exist between families and inadequate adoption of prevention by vulnerable groups are noteworthy. This study expands the research perspective by emphasizing the role of household factors in preventive behaviours and by focusing on family inequalities. The government should use traditional media as a platform to enhance residents' public health knowledge. Targeted additional wage subsidies, investments in affordable housing, financial support for multigenerational households, and temporary relocation policies may deserve more attention. Communities could play a critical role in COVID-19 prevention.
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Affiliation(s)
- Yisheng Ye
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
| | - Ruijun Wu
- China National Center for Biotechnology Development, Beijing, China
| | - Yao Ge
- China National Center for Biotechnology Development, Beijing, China
| | - Tao Wang
- China Science and Technology Exchange Center, Beijing, China
| | - Xin Yao
- High Technology Research and Development Center, Beijing, China
| | - Yao Yang
- National Center for Science and Technology Evaluation, Beijing, China
| | - Chengxu Long
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
| | - Fangfei Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
| | - Rui Huang
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
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Kim JH, Roh YH, Ahn JG, Kim MY, Huh K, Jung J, Kang JM. Respiratory syncytial virus and influenza epidemics disappearance in Korea during the 2020-2021 season of COVID-19. Int J Infect Dis 2021; 110:29-35. [PMID: 34245886 DOI: 10.1016/j.ijid.2021.07.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/28/2021] [Accepted: 07/02/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES We investigated whether non-pharmaceutical interventions (NPIs) reduce winter-prevalent respiratory viral infections represented by a respiratory syncytial virus (RSV) and influenza virus (IFV) during the winter in Korea. METHODS The Korean Influenza and Respiratory Virus Monitoring System database was used. From January 2016 through January 2021, the weekly positivity of respiratory viruses and the weekly number of hospitalizations with acute respiratory infections were collected. The NPI period was defined as February 2020-January 2021. We analyzed whether hospitalization and sample positivity by respiratory viruses changed after NPIs. Bayesian structural time-series models and Poisson analyses were used. Data from other countries/regions reporting positive rates of RSV and IFV were also investigated. RESULTS Compared with the pre-NPI period, the positive rates of RSV and IFV decreased significantly to 19% and 6%, and 23% and 6% of the predicted value. Also, hospitalization significantly decreased to 9% and 8%, and 10% and 5% of the predicted value. The positive rates of IFV in 14 countries during the NPI period were almost 0, whereas sporadic outbreaks of RSV occurred in some countries. CONCLUSIONS No RSV and IFV winter epidemics were observed during the 2020-2021 season in Korea.
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Affiliation(s)
- Jong-Hun Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Gyeonggi-do, South Korea
| | - Yun Ho Roh
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Gyun Ahn
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea; Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South Korea
| | - Min Young Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea; Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jaehun Jung
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea; Department of Preventive Medicine, Gachon University College of Medicine, Incheon, South Korea
| | - Ji-Man Kang
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea; Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South Korea.
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Müller O, Razum O, Jahn A. Effects of non-pharmaceutical interventions against COVID-19 on the incidence of other diseases. THE LANCET REGIONAL HEALTH. EUROPE 2021; 6:100139. [PMID: 34223441 PMCID: PMC8236073 DOI: 10.1016/j.lanepe.2021.100139] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Olaf Müller
- Institute of Global Health, Ruprecht-Karls-University Heidelberg, Germany
| | - Oliver Razum
- School of Public Health, Bielefeld University, Germany
| | - Albrecht Jahn
- Institute of Global Health, Ruprecht-Karls-University Heidelberg, Germany
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37
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Li Q, Wang J, Lv H, Lu H. Impact of China's COVID-19 prevention and control efforts on outbreaks of influenza. Biosci Trends 2021; 15:192-195. [PMID: 34176827 DOI: 10.5582/bst.2021.01242] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a serious public health burden. As the COVID-19 epidemic in China would coincide with a seasonal outbreak of influenza, there were serious concerns about whether influenza would be aggravated by the SARS-CoV-2 infection and COVID-19 pandemic. This article provides a brief overview of the impacts of the COVID-19 epidemic on influenza activity in China. The percentage of positive influenza tests decreased during the COVID-19 pandemic. During the first stage of the COVID-19 outbreak, the percentage of positive influenza tests reached to a peak of 47.7%. At the second stage, the percentage of positive influenza tests was dramatically decreased from 40.4% to 14.0%. Thereafter, it remains at a low level of less than 6.2%. In addition, the possible causes of this phenomenon have been summarized, including prevention and control measures and ecological competition. Lastly, this article suggests that the public health approach to preventing COVID-19 may also help to control other respiratory infectious diseases. Public health measures need to be maintained even in the later stages of the COVID-19 epidemic.
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Affiliation(s)
- Qian Li
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China
| | - Jun Wang
- Center of Clinical Laboratory, The Fifth People's Hospital of Wuxi, Jiangnan University, Wuxi, China
| | - Haiwei Lv
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China
| | - Hongzhou Lu
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China
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38
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Van Brusselen D, De Troeyer K, Ter Haar E, Vander Auwera A, Poschet K, Van Nuijs S, Bael A, Stobbelaar K, Verhulst S, Van Herendael B, Willems P, Vermeulen M, De Man J, Bossuyt N, Vanden Driessche K. Bronchiolitis in COVID-19 times: a nearly absent disease? Eur J Pediatr 2021; 180:1969-1973. [PMID: 33517482 PMCID: PMC7847293 DOI: 10.1007/s00431-021-03968-6] [Citation(s) in RCA: 126] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 12/04/2022]
Abstract
Stay-at-home orders, physical distancing, face masks and other non-pharmaceutical interventions (NPIs) do not only impact COVID-19, but also the dynamics of various other infectious diseases. Bronchiolitis is a clinically diagnosed viral infection of the lower respiratory tract, and causes a yearly seasonal wave of admissions in paediatric wards worldwide. We counted 92,5% less bronchiolitis hospitalisations in Antwerp before the expected end of the peak this year (of which only 1 RSV positive), as compared to the last 3 years. Furthermore, there was a >99% reduction in the number of registered RSV cases in Belgium.Conslusion: The 2020 winter bronchiolitis peak is hitherto nonexistent, but we fear a 'delayed' spring/summer bronchiolitis peak when most NPIs will be relaxed and pre-pandemic life restarts. What is known? • Bronchiolitis causes a yearly seasonal wave of admissions in paediatric departments worldwide. • Non-pharmaceutical interventions (NPIs) do not only impact COVID-19, but also the dynamics of various other infectious diseases. What is new? • The 2020 winter bronchiolitis peak is hitherto nonexistent. • A 'delayed' spring or summer bronchiolitis peak could happen when most NPIs will be relaxed and pre-pandemic life restarts.
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Affiliation(s)
- Daan Van Brusselen
- Department of Paediatric Infectious Diseases, GZA Hospitals, Antwerp, Belgium. .,Multidisciplinary Unit of Infectious Diseases, GZA Hospitals, Antwerp, Belgium. .,Department of Public Health & Primary Care, Ghent University, Ghent, Belgium.
| | - Katrien De Troeyer
- Department of Public Health and Primary Care, University of Leuven, Ghent, Belgium
| | - Eva Ter Haar
- Division of Paediatric Pulmonology, ZNA Jan Palfijn Hospital, Antwerp, Belgium
| | - Ann Vander Auwera
- Department of Paediatric Infectious Diseases, GZA Hospitals, Antwerp, Belgium
| | - Katleen Poschet
- Department of Paediatric Infectious Diseases, GZA Hospitals, Antwerp, Belgium
| | - Sascha Van Nuijs
- Department of Paediatric Infectious Diseases, GZA Hospitals, Antwerp, Belgium
| | - An Bael
- Department of Paediatrics, ZNA Queen Paola Children's Hospital, Antwerp, Belgium.,Faculty of Medicine, Antwerp University, Antwerp, Belgium
| | - Kim Stobbelaar
- Division of Paediatric Pulmonology, Department of Paediatrics, University Hospital Antwerp, Edegem, Belgium.,Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Stijn Verhulst
- Division of Paediatric Pulmonology, Department of Paediatrics, University Hospital Antwerp, Edegem, Belgium.,Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Bruno Van Herendael
- Multidisciplinary Unit of Infectious Diseases, GZA Hospitals, Antwerp, Belgium.,Department of Microbiology, GZA Hospitals, Antwerp, Belgium
| | - Philippe Willems
- Multidisciplinary Unit of Infectious Diseases, GZA Hospitals, Antwerp, Belgium.,Department of Microbiology, GZA Hospitals, Antwerp, Belgium
| | - Melissa Vermeulen
- Scientific Directorate of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Jeroen De Man
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Nathalie Bossuyt
- Scientific Directorate of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Koen Vanden Driessche
- Division of Paediatric Pulmonology, Department of Paediatrics, University Hospital Antwerp, Edegem, Belgium.,Section Paediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Centre for Infectious Diseases, Radboud Institute for Life Sciences, Nijmegen, The Netherlands
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Beasley R, Hills T, Kearns N. Asthma and COVID-19: Preconceptions about Predisposition. Am J Respir Crit Care Med 2021; 203:799-801. [PMID: 33600744 PMCID: PMC8017587 DOI: 10.1164/rccm.202102-0266ed] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Richard Beasley
- Medical Research Institute of New Zealand Wellington, New Zealand and
| | - Thomas Hills
- Department of Clinical Immunology Auckland District Health Board Auckland, New Zealand
| | - Nethmi Kearns
- Medical Research Institute of New Zealand Wellington, New Zealand and
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40
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MacDonald MI, Bardin PG. Contemporary Concise Review 2020: Chronic obstructive pulmonary disease. Respirology 2021; 26:493-500. [PMID: 33749929 DOI: 10.1111/resp.14037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/24/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Martin I MacDonald
- Monash Lung and Sleep, Monash Health, Melbourne, VIC, Australia.,Department of Medicine, Monash University, Melbourne, VIC, Australia.,Lung Research Laboratory, Hudson Institute, Melbourne, VIC, Australia
| | - Philip G Bardin
- Monash Lung and Sleep, Monash Health, Melbourne, VIC, Australia.,Department of Medicine, Monash University, Melbourne, VIC, Australia.,Lung Research Laboratory, Hudson Institute, Melbourne, VIC, Australia
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41
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Velasco JM, Valderama MT, Diones PC, Navarro FC, Develos M, Lopez MN, Liao C, Chua D, Macareo L, Fernandez S. Performance of a Rapid Diagnostic Test for Influenza in a Tertiary Military Hospital, Philippines. Mil Med 2021; 187:e197-e200. [PMID: 33480421 DOI: 10.1093/milmed/usab006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/03/2020] [Accepted: 01/12/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION It is important to evaluate the performance of existing rapid influenza diagnostic tests (RIDTs) and the factors that can affect performance especially when the circulation dynamics of influenza strains change such as the displacement and replacement of the circulating seasonal influenza strains. MATERIALS AND METHODS Nasal swabs were collected from patients presenting at V Luna Medical Center, Armed Forces of the Philippines Health Service Command, with influenza-like illness (ILI) with one swab tested using Quickvue (QV) influenza A+B RIDT (Quidel) and the other swab tested using the ABI 7500 (Applied Biosystems) real-time reverse transcriptase-polymerase chain reaction. Sensitivity, specificity, positive predictive value, and negative predictive value were estimated. We identified clinical symptoms predictive of influenza subtype and evaluated the independence of QV sensitivity on (1) Cycle threshold (Ct) value, controlling for timing of collection; (2) timing of collection, controlling for Ct value; and (3) Ct value and timing of collection taken together. RESULTS Between August 2011 and October 2016, patients presenting with ILI (n = 2333) underwent testing. Quickvue sensitivity across all subtypes was significantly correlated with lower Ct values (higher virus titers) (P <.001) and, except for flu A/H3 (P = .974), was also significantly associated with timing of specimen collection (P <.05). No statistically significant difference was noted in QV sensitivity for Flu A/H3 (P = .130), pandemic H1/N1 (P = .207), Flu A/H3 + pandemic H1/N1 (P = .341), and Flu B (P = .103) across different age groups but sensitivity of QV significantly differed (P <.001) across the different influenza subtypes. CONCLUSION Overall specificity of QV was high across all flu subtypes, but overall sensitivity was low (Flu A/pdm H1) to moderate (Flu A/H3 and Flu B). The findings highlight the need to develop more sensitive influenza RDTs to detect circulating influenza strains and the use of the quadrivalent flu vaccine during the annual influenza vaccination.
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Affiliation(s)
- John Mark Velasco
- Department of Virology, U.S. Army Medical Directorate-Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand.,University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Maria Theresa Valderama
- Department of Virology, U.S. Army Medical Directorate-Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Paula Corazon Diones
- Department of Virology, U.S. Army Medical Directorate-Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Fatima Claire Navarro
- V Luna Medical Center, Armed Forces of the Philippines Health Service Command, Quezon City, 0840, Philippines
| | - Maribel Develos
- V Luna Medical Center, Armed Forces of the Philippines Health Service Command, Quezon City, 0840, Philippines
| | - Ma Nila Lopez
- V Luna Medical Center, Armed Forces of the Philippines Health Service Command, Quezon City, 0840, Philippines
| | - Cynthia Liao
- V Luna Medical Center, Armed Forces of the Philippines Health Service Command, Quezon City, 0840, Philippines
| | - Domingo Chua
- V Luna Medical Center, Armed Forces of the Philippines Health Service Command, Quezon City, 0840, Philippines
| | - Louis Macareo
- Department of Virology, U.S. Army Medical Directorate-Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
| | - Stefan Fernandez
- Department of Virology, U.S. Army Medical Directorate-Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand
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Kung S, Doppen M, Black M, Hills T, Kearns N. Reduced mortality in New Zealand during the COVID-19 pandemic. Lancet 2021; 397:25. [PMID: 33333005 PMCID: PMC7833946 DOI: 10.1016/s0140-6736(20)32647-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/20/2020] [Accepted: 11/30/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Stacey Kung
- Medical Research Institute of New Zealand, Wellington 6242, New Zealand
| | - Marjan Doppen
- Medical Research Institute of New Zealand, Wellington 6242, New Zealand
| | - Melissa Black
- Medical Research Institute of New Zealand, Wellington 6242, New Zealand
| | - Tom Hills
- Medical Research Institute of New Zealand, Wellington 6242, New Zealand; Auckland District Health Board, Auckland, New Zealand
| | - Nethmi Kearns
- Medical Research Institute of New Zealand, Wellington 6242, New Zealand; Capital and Coast District Health Board, Wellington, New Zealand.
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43
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Rupp J, Härtel C. COVID-19 Pandemic and Its Effects on the Development of Immunity in Infancy. Neonatology 2021; 118:734-735. [PMID: 34515184 PMCID: PMC8450837 DOI: 10.1159/000518658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 07/19/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Jan Rupp
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein/Campus Lübeck, Lübeck, Germany.,German Center for Infection Research, Hamburg-Lübeck-Borstel-Riems, Lübeck, Germany
| | - Christoph Härtel
- University Children's Hospital, University of Würzburg, Würzburg, Germany
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44
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Kim JY. The Special Issue in the Special Time. Tuberc Respir Dis (Seoul) 2020; 83:S75-S76. [PMID: 33291192 PMCID: PMC7837380 DOI: 10.4046/trd.2020.0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jae Yeol Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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