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Dziadzko M, Belhassen M, Van Ganse E, Heritier F, Berard M, Marant-Micallef C, Aubrun F. Health Care Resource Use and Total Mortality After Hospital Admission for Severe COVID-19 Infections During the Initial Pandemic Wave in France: Descriptive Study. JMIR Public Health Surveill 2024; 10:e56398. [PMID: 39259961 DOI: 10.2196/56398] [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: 01/16/2024] [Revised: 06/28/2024] [Accepted: 07/21/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Little is known about post-hospital health care resource use (HRU) of patients admitted for severe COVID-19, specifically for the care of patients with postacute COVID-19 syndrome (PACS). OBJECTIVE A list of HRU domains and items potentially related to PACS was defined, and potential PACS-related HRU (PPRH) was compared between the pre- and post-COVID-19 periods, to identify new outpatient care likely related to PACS. METHODS A retrospective cohort study was conducted with the French National Health System claims data (SNDS). All patients hospitalized for COVID-19 between February 1, 2020, and June 30, 2020 were described and investigated for 6 months, using discharge date as index date. Patients who died during index stay or within 30 days after discharge were excluded. PPRH was assessed over the 5 months from day 31 after index date to end of follow-up, that is, for the post-COVID-19 period. For each patient, a pre-COVID-19 period was defined that covered the same calendar time in 2019, and pre-COVID-19 PPRH was assessed. Post- or pre- ratios (PP ratios) of the percentage of users were computed with their 95% CIs, and PP ratios>1.2 were considered as "major HRU change." RESULTS The final study population included 68,822 patients (median age 64.8 years, 47% women, median follow-up duration 179.3 days). Altogether, 23% of the patients admitted due to severe COVID-19 died during the hospital stay or within the 6 months following discharge. A total of 8 HRU domains were selected to study PPRH: medical visits, technical procedures, dispensed medications, biological analyses, oxygen therapy, rehabilitation, rehospitalizations, and nurse visits. PPRs showed novel outpatient care in all domains and in most items, without specificity, with the highest ratios observed for the care of thoracic conditions. CONCLUSIONS Patients hospitalized for severe COVID-19 during the initial pandemic wave had high morbi-mortality. The analysis of HRU domains and items most likely to be related to PACS showed that new care was commonly initiated after discharge but with no specificity, potentially suggesting that any impact of PACS was part of the overall high HRU of this population after hospital discharge. These purely descriptive results need to be completed with methods for controlling for confusion bias through subgroup analyses. TRIAL REGISTRATION ClinicalTrials.gov NCT05073328; https://clinicaltrials.gov/ct2/show/NCT05073328.
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Affiliation(s)
- Mikhail Dziadzko
- Hospices Civils de Lyon, Hôpital de la Croix Rousse, Département d'Anesthésie-Réanimation, Douleur, Lyon, France
- Laboratoire RESHAPE, Université Claude Bernard Lyon 1, INSERM UMR 1290, Lyon, France
| | | | - Eric Van Ganse
- Laboratoire RESHAPE, Université Claude Bernard Lyon 1, INSERM UMR 1290, Lyon, France
- PELyon, Lyon, France
- Hospices Civils de Lyon, Hôpital de la Croix Rousse, Département de la Médecine Respiratoire, Lyon, France
| | - Fabrice Heritier
- Centre Hospitalier de Roanne, Département d'Anesthésie-Réanimation, Roanne, France
| | | | | | - Frederic Aubrun
- Hospices Civils de Lyon, Hôpital de la Croix Rousse, Département d'Anesthésie-Réanimation, Douleur, Lyon, France
- Laboratoire RESHAPE, Université Claude Bernard Lyon 1, INSERM UMR 1290, Lyon, France
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Demongeot J, Magal P. Data-driven mathematical modeling approaches for COVID-19: A survey. Phys Life Rev 2024; 50:166-208. [PMID: 39142261 DOI: 10.1016/j.plrev.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 08/02/2024] [Indexed: 08/16/2024]
Abstract
In this review, we successively present the methods for phenomenological modeling of the evolution of reported and unreported cases of COVID-19, both in the exponential phase of growth and then in a complete epidemic wave. After the case of an isolated wave, we present the modeling of several successive waves separated by endemic stationary periods. Then, we treat the case of multi-compartmental models without or with age structure. Eventually, we review the literature, based on 260 articles selected in 11 sections, ranging from the medical survey of hospital cases to forecasting the dynamics of new cases in the general population. This review favors the phenomenological approach over the mechanistic approach in the choice of references and provides simulations of the evolution of the number of observed cases of COVID-19 for 10 states (California, China, France, India, Israel, Japan, New York, Peru, Spain and United Kingdom).
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Affiliation(s)
- Jacques Demongeot
- Université Grenoble Alpes, AGEIS EA7407, La Tronche, F-38700, France.
| | - Pierre Magal
- Department of Mathematics, Faculty of Arts and Sciences, Beijing Normal University, Zhuhai, 519087, China; Univ. Bordeaux, IMB, UMR 5251, Talence, F-33400, France; CNRS, IMB, UMR 5251, Talence, F-33400, France
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Fruleux A, Gaudart J, Franke F, Nauleau S, Dutrey Kaiser A, Legendre E, Balma D, Lescaudron M, Tamalet L, Malfait P, Chaud P, Rebaudet S. Reviving health mediation during the COVID-19 crisis and beyond: an implementation study in deprived neighbourhoods of Marseille, France. Front Public Health 2024; 12:1313575. [PMID: 39022414 PMCID: PMC11251881 DOI: 10.3389/fpubh.2024.1313575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/31/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction In 2020, during France's COVID-19 response, healthcare professionals from a hospital and an association initiated health mediation interventions in Marseille's vulnerable neighbourhoods, funded by the regional health authorities. This mixed method research evaluates the CORHESAN program that lasted until June 2022. Methods We examined CORHESAN documents and reports, conducted interviews, and analysed activity data, comparing it to the COVID-19 hotspots identified on a weekly basis at the neighbourhood level, using generalised linear mixed models (GLMMs). Results CORHESAN was implemented by a team of up to nine health mediators, six private nurses hired on an ad hoc basis, supervised by a general coordinator and two part-time medical and nursing coordinators. Multiple partnerships were established with shelters, associations, social-housing landlords and local institutions. The team accompanied 6,253 people affected by COVID-19 or contact in the practical implementation of their isolation and contact tracing. Of the 5,180 nasopharyngeal samples for RT-PCR and 1,875 for antigenic testing: 12% were taken at home and 27% in partner facilities in the targeted neighbourhoods; 32% were taken from symptomatic patients and 30% in the context of contact tracing; and 40% were positive. Multiple awareness sessions on prevention methods and distributions of personal protection kits and self-diagnostic tests were conducted in the streets, in shelters, in associations or at home. A total of 5,929 doses of COVID-19 vaccine were administered in a walk-in vaccination centre, at temporary street vaccination posts, during operations at partner facilities, or during home-visits to patients with limited autonomy. GLMMs showed that the intervention significantly targeted its testing interventions in neighbourhoods with socioeconomic disadvantage and/or past under-testing (adjusted odds ratio (aOR), 2.75 [1.50-5.00]) and those with high hotspot level (aOR for level-3 versus level-0, 1.83 [1.24-2.71]). Discussion The pandemic emphasised the potential of health mediation interventions to address health disparities. Building on this, a new program began in July 2022, aiming at enhancing cancer screening and vaccinations in deprived areas of Marseille. Evaluations are ongoing to assess its activities and impact, and provide evidence to future implementation initiatives.
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Affiliation(s)
- Alix Fruleux
- Ville de Marseille, Direction de la Santé publique et de l'Inclusion, Marseille, France
| | - Jean Gaudart
- Aix-Marseille Université, Inserm, IRD, UMR1252 SESSTIM, ISSPAM, Marseille, France
- Santé publique France, Saint-Maurice, France
| | | | - Steve Nauleau
- Agence régionale de santé Provence-Alpes-Côte d'Azur (ARS Paca), Marseille, France
| | | | | | | | | | | | | | | | - Stanislas Rebaudet
- Aix-Marseille Université, Inserm, IRD, UMR1252 SESSTIM, ISSPAM, Marseille, France
- Hôpital Européen, Marseille, France
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d'Andrea V, Trentini F, Marziano V, Zardini A, Manica M, Guzzetta G, Ajelli M, Petrone D, Del Manso M, Sacco C, Andrianou X, Bella A, Riccardo F, Pezzotti P, Poletti P, Merler S. Spatial spread of COVID-19 during the early pandemic phase in Italy. BMC Infect Dis 2024; 24:450. [PMID: 38684947 PMCID: PMC11057115 DOI: 10.1186/s12879-024-09343-8] [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: 07/19/2023] [Accepted: 04/22/2024] [Indexed: 05/02/2024] Open
Abstract
Quantifying the potential spatial spread of an infectious pathogen is key to defining effective containment and control strategies. The aim of this study is to estimate the risk of SARS-CoV-2 transmission at different distances in Italy before the first regional lockdown was imposed, identifying important sources of national spreading. To do this, we leverage on a probabilistic model applied to daily symptomatic cases retrospectively ascertained in each Italian municipality with symptom onset between January 28 and March 7, 2020. Results are validated using a multi-patch dynamic transmission model reproducing the spatiotemporal distribution of identified cases. Our results show that the contribution of short-distance ( ≤ 10 k m ) transmission increased from less than 40% in the last week of January to more than 80% in the first week of March 2020. On March 7, 2020, that is the day before the first regional lockdown was imposed, more than 200 local transmission foci were contributing to the spread of SARS-CoV-2 in Italy. At the time, isolation measures imposed only on municipalities with at least ten ascertained cases would have left uncontrolled more than 75% of spillover transmission from the already affected municipalities. In early March, national-wide restrictions were required to curb short-distance transmission of SARS-CoV-2 in Italy.
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Affiliation(s)
- Valeria d'Andrea
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
- Department of Physics and Astronomy "Galileo Galilei", University of Padua, Padua, Italy
| | - Filippo Trentini
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
- Dondena Centre for Research On Social Dynamics and Public Policy, Bocconi University, Milan, Italy
- Department of Decision Sciences, Bocconi University, Milan, Italy
| | | | - Agnese Zardini
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
| | - Mattia Manica
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
| | - Giorgio Guzzetta
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Daniele Petrone
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
- Department of Statistics, Sapienza University of Rome, Rome, Italy
| | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Chiara Sacco
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Xanthi Andrianou
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Piero Poletti
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy
| | - Stefano Merler
- Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy.
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Istvan M, Duval M, Hodel K, Aquizerate A, Chaslerie A, Artarit P, Laforgue EJ, Victorri-Vigneau C. Evolution of the profiles of new psychotropic drug users before and during the COVID-19 crisis: an original longitudinal approach through multichannel sequence analysis using the French health-care database. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01774-3. [PMID: 38499795 DOI: 10.1007/s00406-024-01774-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 02/02/2024] [Indexed: 03/20/2024]
Abstract
The COVID-19 pandemic has had a substantial impact on mental health. An increase in the use of anxiolytic, hypnotic, and antidepressant drugs has been highlighted in France, but with no information at the individual level (trajectories) or concerning patient characteristics. The objective of this study was to describe the profile of new psychotropic drug users since the beginning of the pandemic. We formed two historical cohorts using the Pays-de-la-Loire regional component of the National Health Data System (SNDS): a "COVID-19 crisis cohort" (2020-2021) and a "control cohort" (2018-2019). We analyzed reimbursements for psychotropic medications (anxiolytics, antidepressants, hypnotics, mood stabilizers, and antipsychotics) using a multichannel sequence analysis and performed clustering analysis of sequences. The proportion of new consumers of psychotropic drugs was higher in the COVID-19 crisis cohort (18.0%) than that in the control cohort (16.0%). In the COVID-19 cohort, three clusters of psychotropic drug users were identified, whereas four clusters were identified in the control cohort. A time lag in treatment initiation was observed in the COVID-19 crisis cohort (September) compared with the control cohort (July). This study is one of the first to analyze the profile of psychotropic treatment users during the COVID-19 crisis. Our analysis sheds light on changes in patterns of psychotropic drug use during the COVID-19 pandemic, possibly associated with changes in prescribing conditions and mental health conditions during the crisis. This study also provides an example of the application of an innovative longitudinal analysis methodology in the field of pharmacoepidemiology.
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Affiliation(s)
- Marion Istvan
- Nantes Université, CHU Nantes, Centre d'Évaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, F-44000, Nantes, France.
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France.
| | - Mélanie Duval
- Nantes Université, CHU Nantes, Centre d'Évaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, F-44000, Nantes, France
| | - Karl Hodel
- Direction Régionale du Service Médical des Pays de la Loire, F-44034, Nantes, France
| | - Aurélie Aquizerate
- Nantes Université, CHU Nantes, Centre d'Évaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, F-44000, Nantes, France
| | - Anicet Chaslerie
- Direction Régionale du Service Médical des Pays de la Loire, F-44034, Nantes, France
| | - Pascal Artarit
- Direction Régionale du Service Médical des Pays de la Loire, F-44034, Nantes, France
| | - Edouard-Jules Laforgue
- Nantes Université, CHU Nantes, Centre d'Évaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, F-44000, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France
| | - Caroline Victorri-Vigneau
- Nantes Université, CHU Nantes, Centre d'Évaluation et d'Information sur la Pharmacodépendance-Addictovigilance (CEIP-A), Service de Pharmacologie Clinique, F-44000, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000, Nantes, France
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Pradelle A, Mainbourg S, Provencher S, Massy E, Grenet G, Lega JC. Deaths induced by compassionate use of hydroxychloroquine during the first COVID-19 wave: an estimate. Biomed Pharmacother 2024; 171:116055. [PMID: 38171239 DOI: 10.1016/j.biopha.2023.116055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND During the first wave of COVID-19, hydroxychloroquine (HCQ) was used off-label despite the absence of evidence documenting its clinical benefits. Since then, a meta-analysis of randomised trials showed that HCQ use was associated with an 11% increase in the mortality rate. We aimed to estimate the number of HCQ-related deaths worldwide. METHODS AND FINDINGS We estimated the worldwide in-hospital mortality attributable to HCQ use by combining the mortality rate, HCQ exposure, number of hospitalised patients, and the increased relative risk of death with HCQ. The mortality rate in hospitalised patients for each country was calculated using pooled prevalence estimated by a meta-analysis of published cohorts. The HCQ exposure was estimated using median and extreme estimates from the same systematic review. The number of hospitalised patients during the first wave was extracted from dedicated databases. The systematic review included 44 cohort studies (Belgium: k = 1, France: k = 2, Italy: k = 12, Spain: k = 6, Turkey: k = 3, USA: k = 20). HCQ prescription rates varied greatly from one country to another (range 16-84%). Overall, using median estimates of HCQ use in each country, we estimated that 16,990 HCQ-related in-hospital deaths (range 6267-19256) occurred in the countries with available data. The median number of HCQ-related deaths in Belgium, Turkey, France, Italy, Spain, and the USA was 240 (range not estimable), 95 (range 92-128), 199 (range not estimable), 1822 (range 1170-2063), 1895 (range 1475-2094) and 12739 (3244- 15570), respectively. CONCLUSIONS Although our estimates are limited by their imprecision, these findings illustrate the hazard of drug repurposing with low-level evidence.
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Affiliation(s)
- Alexiane Pradelle
- Univ Lyon, Université Claude Bernard University of Lyon 1, Equipe Evaluation et Modélisation des Effets Thérapeutiques, Laboratoire de Biométrie et Biologie Évolutive, UMR CNRS 5558 LBBE, Lyon F-69100, France
| | - Sabine Mainbourg
- Univ Lyon, Université Claude Bernard University of Lyon 1, Equipe Evaluation et Modélisation des Effets Thérapeutiques, Laboratoire de Biométrie et Biologie Évolutive, UMR CNRS 5558 LBBE, Lyon F-69100, France; Unité bases de données cliniques et épidémiologiques, Hospices Civils de Lyon, Lyon F-69310, France; Lyon Immunopathology Federation (LIFe), Hospices Civils de Lyon, Lyon F69000, France
| | - Steeve Provencher
- Pulmonary Hypertension Research Group (http://phrg.ca), Institut universitaire de cardiologie et de pneumologie de Québec Research Center, Department of medicine, Université Laval, Québec City, Canada
| | - Emmanuel Massy
- Lyon Immunopathology Federation (LIFe), Hospices Civils de Lyon, Lyon F69000, France; Service de rhumatologie, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite F69000, France
| | - Guillaume Grenet
- Univ Lyon, Université Claude Bernard University of Lyon 1, Equipe Evaluation et Modélisation des Effets Thérapeutiques, Laboratoire de Biométrie et Biologie Évolutive, UMR CNRS 5558 LBBE, Lyon F-69100, France; Service hospitalo-universitaire de pharmacotoxicologie, Hospices Civils de Lyon, Lyon F69000, France
| | - Jean-Christophe Lega
- Univ Lyon, Université Claude Bernard University of Lyon 1, Equipe Evaluation et Modélisation des Effets Thérapeutiques, Laboratoire de Biométrie et Biologie Évolutive, UMR CNRS 5558 LBBE, Lyon F-69100, France; Lyon Immunopathology Federation (LIFe), Hospices Civils de Lyon, Lyon F69000, France; Service de rhumatologie, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite F69000, France; Service hospitalo-universitaire de pharmacotoxicologie, Hospices Civils de Lyon, Lyon F69000, France.
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Battakova Z, Imasheva B, Slazhneva T, Imashev M, Beloussov V, Pignatelli M, Tursynkhan A, Askarov A, Abdrakhmanova S, Adayeva A, Akimbayeva A, Suleimanova N. Public Health Response Measures for COVID-19 in Kazakhstan. Disaster Med Public Health Prep 2023; 17:e524. [PMID: 37941110 DOI: 10.1017/dmp.2023.181] [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: 11/10/2023]
Abstract
The article describes measures developed to counter the spread of coronavirus infection in the Republic of Kazakhstan. The first cases of coronavirus disease 2019 (COVID-19) in Kazakhstan were detected on March 13, 2020, among people who arrived from Germany. After declaring the state of emergency in the country, the Ministry of Healthcare of the Republic of Kazakhstan began to formulate and implement a comprehensive package of measures aimed at slowing down and stopping the transmission of infection, preventing outbreaks, ensuring optimal care for all patients, especially the seriously ill, minimizing the negative impact of the pandemic on health systems, social services, and economic activities. Developed set of restrictive measures was approved by the Country Office of Word Health Organization (WHO) in Kazakhstan, being later adapted by the European Union (EU) countries and applied in Kyrgyzstan. In addition, article identifies Kazakhstan's experience in creating epidemiological surveillance systems, studying virus mutations, and the clinical aspects of dealing with it to combat the infection. It also indicates the impact of the epidemic on health-care workers and the development of measures to protect them, strengthening infection prevention, and control in medical organizations.
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Affiliation(s)
- Zhamilya Battakova
- National center of public health care of the Ministry of health of the Republic of Kazakhstan, Astana, Kazakhstan
| | | | - Tatyana Slazhneva
- National center of public health care of the Ministry of health of the Republic of Kazakhstan, Astana, Kazakhstan
| | | | | | | | | | - Albert Askarov
- National center of public health care of the Ministry of health of the Republic of Kazakhstan, Astana, Kazakhstan
| | - Shynar Abdrakhmanova
- National center of public health care of the Ministry of health of the Republic of Kazakhstan, Astana, Kazakhstan
| | - Assel Adayeva
- National center of public health care of the Ministry of health of the Republic of Kazakhstan, Astana, Kazakhstan
| | - Anara Akimbayeva
- National center of public health care of the Ministry of health of the Republic of Kazakhstan, Astana, Kazakhstan
| | - Natalya Suleimanova
- National center of public health care of the Ministry of health of the Republic of Kazakhstan, Astana, Kazakhstan
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Waku J, Oshinubi K, Adam UM, Demongeot J. Forecasting the Endemic/Epidemic Transition in COVID-19 in Some Countries: Influence of the Vaccination. Diseases 2023; 11:135. [PMID: 37873779 PMCID: PMC10594474 DOI: 10.3390/diseases11040135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/20/2023] [Accepted: 09/26/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE The objective of this article is to develop a robust method for forecasting the transition from endemic to epidemic phases in contagious diseases using COVID-19 as a case study. METHODS Seven indicators are proposed for detecting the endemic/epidemic transition: variation coefficient, entropy, dominant/subdominant spectral ratio, skewness, kurtosis, dispersion index and normality index. Then, principal component analysis (PCA) offers a score built from the seven proposed indicators as the first PCA component, and its forecasting performance is estimated from its ability to predict the entrance in the epidemic exponential growth phase. RESULTS This score is applied to the retro-prediction of endemic/epidemic transitions of COVID-19 outbreak in seven various countries for which the first PCA component has a good predicting power. CONCLUSION This research offers a valuable tool for early epidemic detection, aiding in effective public health responses.
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Affiliation(s)
- Jules Waku
- IRD UMI 209 UMMISCO and LIRIMA, University of Yaounde I, Yaounde P.O. Box 337, Cameroon;
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Plat R, Vasile M, Roubille F, Mercier G. Relationships between the COVID-19 lockdown, socioeconomic factors and acute coronary syndrome hospitalisations in France. PLoS One 2023; 18:e0286700. [PMID: 37285371 DOI: 10.1371/journal.pone.0286700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/19/2023] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION Worldwide, the COVID-19 pandemic has been associated with an overall drop in acute coronary syndrome (ACS) hospitalizations. Additionally, there is a well-known association between ACS and socioeconomic status. This study aims to assess the COVID-19 effect on ACS admissions in France during the first national lockdown and investigate the factors associated with its spatial heterogeneity. MATERIALS AND METHODS In this retrospective study, we used the French hospital discharge database (PMSI) to estimate ACS admission rates in all public and private hospitals in 2019 and 2020. A negative binomial regression explored the nationwide change in ACS admissions during lockdown compared with 2019. A multivariate analysis explored the factors associated with the ACS admission incidence rate ratio (IRR, 2020 incidence rate/2019 incidence rate) variation at the county level. RESULTS We found a significant but geographically heterogeneous nationwide reduction in ACS admissions during lockdown (IRR 0·70 [0·64-0·76]). After adjustment for cumulative COVID-19 admissions and the ageing index, a higher share of people on short-term working arrangements during lockdown at the county level was associated with a lower IRR, while a higher share of individuals with a high school degree and a higher density of acute care beds were associated with a higher ratio. CONCLUSIONS During the first national lockdown, there was an overall decrease in ACS admissions. Local provision of inpatient care and socioeconomic determinants linked to occupation were independently associated with the variation in hospitalizations.
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Affiliation(s)
- Rodney Plat
- Data Science Unit, Montpellier University Hospital, Montpellier, France
- Faculty of Medicine, University of Montpellier, Montpellier, France
| | - Maria Vasile
- Data Science Unit, Montpellier University Hospital, Montpellier, France
| | - François Roubille
- Cardiology Department, INI-CRT, CHU de Montpellier, PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France
| | - Grégoire Mercier
- Data Science Unit, Montpellier University Hospital, Montpellier, France
- UMR UA11 IDESP CNRS, University of Montpellier, Montpellier, France
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Landier J, Bassez L, Bendiane MK, Chaud P, Franke F, Nauleau S, Danjou F, Malfait P, Rebaudet S, Gaudart J. Social deprivation and SARS-CoV-2 testing: a population-based analysis in a highly contrasted southern France region. Front Public Health 2023; 11:1162711. [PMID: 37250096 PMCID: PMC10213643 DOI: 10.3389/fpubh.2023.1162711] [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: 02/09/2023] [Accepted: 04/05/2023] [Indexed: 05/31/2023] Open
Abstract
Background Testing was the cornerstone of the COVID-19 epidemic response in most countries until vaccination became available for the general population. Social inequalities generally affect access to healthcare and health behaviors, and COVID-19 was rapidly shown to impact deprived population more drastically. In support of the regional health agency in Provence-Alpes-Côte d'Azur (PACA) in South-Eastern France, we analyzed the relationship between testing rate and socio-demographic characteristics of the population, to identify gaps in testing coverage and improve targeting of response strategies. Methods We conducted an ecological analysis of SARS-CoV-2/COVID-19 testing rate in the PACA region, based on data aggregated at the finest spatial resolution available in France (IRIS) and by periods defined by public health implemented measures and major epidemiological changes. Using general census data, population density, and specific deprivation indices, we used principal component analysis followed by hierarchical clustering to define profiles describing local socio-demographic characteristics. We analyzed the association between these profiles and testing rates in a generalized additive multilevel model, adjusting for access to healthcare, presence of a retirement home, and the age profile of the population. Results We identified 6 socio-demographic profiles across the 2,306 analyzed IRIS spatial units: privileged, remote, intermediate, downtown, deprived, and very deprived (ordered by increasing social deprivation index). Profiles also ranged from rural (remote) to high density urban areas (downtown, very deprived). From July 2020 to December 2021, we analyzed SARS-CoV-2/COVID-19 testing rate over 10 periods. Testing rates fluctuated strongly but were highest in privileged and downtown areas, and lowest in very deprived ones. The lowest adjusted testing rate ratios (aTRR) between privileged (reference) and other profiles occurred after implementation of a mandatory healthpass for many leisure activities in July 2021. Periods of contextual testing near Christmas displayed the largest aTRR, especially during the last periods of 2021 after the end of free convenience testing for unvaccinated individuals. Conclusion We characterized in-depth local heterogeneity and temporal trends in testing rates and identified areas and circumstances associated with low testing rates, which the regional health agency targeted specifically for the deployment of health mediation activities.
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Affiliation(s)
- Jordi Landier
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France
| | - Léa Bassez
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France
| | - Marc-Karim Bendiane
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France
| | - Pascal Chaud
- Santé Publique France Cellule Régionale Paca-Corse, Marseille, France
| | - Florian Franke
- Santé Publique France Cellule Régionale Paca-Corse, Marseille, France
| | - Steve Nauleau
- Agence Régionale de la Santé Provence Alpes Côte d’Azur, Marseille, France
| | - Fabrice Danjou
- Agence Régionale de la Santé Provence Alpes Côte d’Azur, Marseille, France
| | - Philippe Malfait
- Santé Publique France Cellule Régionale Paca-Corse, Marseille, France
| | - Stanislas Rebaudet
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France
- Hôpital Européen Marseille, Marseille, France
| | - Jean Gaudart
- Aix Marseille Univ, APHM, Inserm, IRD, SESSTIM, ISSPAM, Hop Timone, BioSTIC, Marseille, France
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11
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Aldea-Ramos N, Le Strat Y, Fouillet A. Place of death in France: impact of the first wave (March-May 2020) of the Covid-19 epidemic. BMC Public Health 2023; 23:776. [PMID: 37118715 PMCID: PMC10140713 DOI: 10.1186/s12889-023-15651-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 04/11/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The Covid-19 epidemic entailed a major public health issue in France challenging the efficiency of the public health system. The distribution of deaths by place in France may have been affected by the epidemic and mitigation actions. This article presents mortality rate ratios by place of death in France during the first lockdown (17 March - 10 May, 2020) of the Covid-19 epidemic. METHODS We considered five places of death recorded in death certificates. Deaths in 2020 were compared to deaths from 2015 to 2019. We employed quasi-Poisson regressions in order to stablish mortality rate ratios (MRR) during the Covid-19 epidemic, for all-cause and non-Covid-19 deaths. Analysis was conducted in Metropolitan France, and for three groups of regions defined according to the intensity of the first COVID-19 epidemic wave. RESULTS A significant increase in all-cause and non-COVID-19 mortality at home was observed for all age groups. Also, an increase in mortality was observed in nursing homes, mostly due to Covid-19. Non-covid-19 mortality in public hospitals decreased significantly in all the country. These trends were mainly observed for cancers. CONCLUSIONS Overall mortality increased during the first wave of the Covid-19 epidemic. Most Covid-19 deaths took place in public hospitals and nursing homes at old ages. There was a displacement of non-Covid-19 mortality from public hospitals to home and nursing homes, particularly in the most highly exposed area. Among hypotheses to explain such a displacement, population avoidance of hospital care, or redeployment of hospital activity in this emergent context can be cited. Further analysis is needed to understand the reasons of the increase in non-Covid-19 mortality in nursing homes and at home.
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Affiliation(s)
- Néstor Aldea-Ramos
- Division of Data Science, Santé Publique France, 12 Rue du Val d'Osne, Saint-Maurice, 94410, France
| | - Yann Le Strat
- Division of Data Science, Santé Publique France, 12 Rue du Val d'Osne, Saint-Maurice, 94410, France
| | - Anne Fouillet
- Division of Data Science, Santé Publique France, 12 Rue du Val d'Osne, Saint-Maurice, 94410, France.
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12
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Nassar A, Tzedakis S, Marchese U, Dhote A, Dallel MS, Naveendran G, Gaillard M, Coriat R, Marty JR, Fuchs B, Fuks D. Impact of COVID-19 lockdowns on postoperative morbidity after hepatectomy: A propensity-score matching study on a national French database. Surgery 2023:S0039-6060(23)00130-7. [PMID: 37150714 PMCID: PMC10086106 DOI: 10.1016/j.surg.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/14/2023] [Accepted: 03/08/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND The impact of the SARS-CoV-2 pandemic on managing liver malignancies worldwide is unknown. This study aimed to determine the impact of lockdowns on patient clinical pathways and postoperative morbi-mortality. METHODS This study evaluated all adults' hospital stays for liver tumors between 2019 and 2021 from the national French discharge database. The primary outcome was the clinical pathway, especially surgical care and postoperative outcomes, between patients admitted during COVID-19 lockdown periods (lockdown group) and during the same periods of 2019 and 2021 (control groups). RESULTS The overall population included 58,508 patients: 18,907 patients in the lockdown group, 20,045 in the 2019 control group, and 19,556 in the 2021 control group. Surgical activity decreased by 11.6% during lockdowns, with 1,514 (8.0%) of patients in the lockdown group treated by surgery, 1,514 (8.6%) in the 2019 control group (P < .001), and 1,466 (7.4%) in the 2021 control group. Chemotherapy was considered more during the lockdowns (P < .001). More patients were operated in small-volume centers during the lockdowns (34% vs 32% vs 32%, P = .034), and fewer were hospitalized in highly populated regions (P < .001). Postoperative morbidity (47% vs 47% vs 47%, P = .90) and mortality (3.3% vs 3.6% vs 3.1%, P = .80) were comparable in the 3 periods, with no influence of lockdowns on morbidity (risk ratio = 0.94, 95% confidence interval = 0.81-1.09, P = .40) or mortality (odds ratio = 1.12, 95% confidence interval = 0.72-1.74, P = .6). Postoperative pulmonary (17% vs 13%, P = .024) and septic complications (20% vs 15%, P = .022) were significantly higher during the first lockdown compared to the second. CONCLUSION This study provides a French overview of liver malignancy management during the COVID-19 pandemic. Moreover, surgical activity decreased by 11.6% in high-volume centers, with no impact on postoperative morbidity and mortality.
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Affiliation(s)
- Alexandra Nassar
- Department of Hepato-Pancreatic-Biliary and Endocrine Surgery, Cochin Hospital, Assistance Publique - Hôpitaux de Paris Centre and University of Paris, France.
| | - Stylianos Tzedakis
- Department of Hepato-Pancreatic-Biliary and Endocrine Surgery, Cochin Hospital, Assistance Publique - Hôpitaux de Paris Centre and University of Paris, France
| | - Ugo Marchese
- Department of Hepato-Pancreatic-Biliary and Endocrine Surgery, Cochin Hospital, Assistance Publique - Hôpitaux de Paris Centre and University of Paris, France
| | - Alix Dhote
- Department of Hepato-Pancreatic-Biliary and Endocrine Surgery, Cochin Hospital, Assistance Publique - Hôpitaux de Paris Centre and University of Paris, France
| | - Mohamed Sabri Dallel
- Department of Anesthesiology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris Centre and University of Paris, France
| | - Gaanan Naveendran
- Department of Hepato-Pancreatic-Biliary and Endocrine Surgery, Cochin Hospital, Assistance Publique - Hôpitaux de Paris Centre and University of Paris, France
| | - Martin Gaillard
- Department of Hepato-Pancreatic-Biliary and Endocrine Surgery, Cochin Hospital, Assistance Publique - Hôpitaux de Paris Centre and University of Paris, France
| | - Romain Coriat
- Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris Centre and University of Paris, France
| | - Jeanne Reboul Marty
- Department of Medical Information, Cochin Hospital, Assistance Publique - Hôpitaux de Paris Centre and University of Paris, France
| | - Basile Fuchs
- Department of Medical Information, Cochin Hospital, Assistance Publique - Hôpitaux de Paris Centre and University of Paris, France
| | - David Fuks
- Department of Hepato-Pancreatic-Biliary and Endocrine Surgery, Cochin Hospital, Assistance Publique - Hôpitaux de Paris Centre and University of Paris, France
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13
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Wang Y, Zhang C. Impact of policy response on health protection and economic recovery in OECD and BRIICS countries during the early stages of the COVID-19 pandemic. Public Health 2023; 217:7-14. [PMID: 36827784 PMCID: PMC9870755 DOI: 10.1016/j.puhe.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/05/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES During the early stages of the COVID-19 pandemic, the full reopening of the economy typically accelerated viral transmission. This study aims to determine whether policy response could contribute to the dual objective of both reducing the spread of the epidemic and revitalising economic activities. STUDY DESIGN This is a longitudinal study of Organization for Economic Cooperation and Development (OECD) and Brazil, Russia, India, Indonesia, China, and South Africa (BRIICS) from the first quarter (Q1) of 2020 to the same period of 2021. METHODS From a health-economic perspective, this study established a framework to illustrate the following outcomes: suppression-prosperity, outbreak-stagnancy, outbreak-prosperity and suppression-stagnancy scenarios. Multinomial logistic models were used to analyse the associations between policy response with both the pandemic and the economy. The study further examined two subtypes of policy response, stringency/health measures and economic support measures, separately. The probabilities of the different scenarios were estimated. RESULTS Economic prosperity and epidemic suppression were significantly associated with policy response. The effects of policy response on health-economic scenarios took the form of inverse U-shapes with the increase in intensity. 'Leptokurtic', 'bimodal' and 'long-tailed' curves demonstrated the estimated possibilities of suppression-prosperity, outbreak-prosperity and suppression-stagnancy scenarios, respectively. In addition, stringency/health policies followed the inverted U-shaped pattern, whereas economic support policies showed a linear pattern. CONCLUSIONS It was possible to achieve the dual objective of economic growth and epidemic control simultaneously, and the effects of policy response were shaped like an inverse U. These findings provide a new perspective for balancing the economy with public health during the early stages of the pandemic.
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Affiliation(s)
| | - C. Zhang
- Corresponding author. Department of Sociology, School of Social Sciences, Tsinghua University, Beijing, 100084, China. Tel.: +86 10 62794966
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14
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Vallée A. Geo-epidemiological approach of the COVID-19 pandemic in France and in Europe for public health policies. J Public Health Policy 2023:10.1057/s41271-023-00402-z. [PMID: 36997623 DOI: 10.1057/s41271-023-00402-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2023] [Indexed: 04/01/2023]
Abstract
The spread of the COVID-19 pandemic has shown great heterogeneity between countries that merits investigation. There is a need to better highlight the variability in the pandemic trajectories in different geographic areas. By using openly available data from 'GitHub' COVID-19 dataset for Europe and from the official dataset of France for the period 2020 to 2021, I present the three COVID-19 waves in France and Europe in maps. The epidemic trends across areas display different evolutions for different time periods. National and European public health authorities will be able to improve allocation of resources for more effective public health measures based on geo-epidemiological analyses.
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Affiliation(s)
- Alexandre Vallée
- Department Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation, Foch Hospital, 92150, Suresnes, France.
- Department of Clinical Research and Innovation, Foch Hospital, 92150, Suresnes, France.
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15
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Zeng L. Changes in health communication in the age of COVID-19: A study on the dissemination of preprints to the public. Front Public Health 2023; 11:1078115. [PMID: 36844813 PMCID: PMC9944950 DOI: 10.3389/fpubh.2023.1078115] [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: 10/24/2022] [Accepted: 01/05/2023] [Indexed: 02/10/2023] Open
Abstract
Introduction Preprints have become an important tool for meeting the challenges of health communication in the context of COVID-19. They allow scientists to disseminate their results more quickly due to the absence of a peer review process. Preprints have been well-received by scientists, however, there have been concerns about the exposure of wider public audiences to preprints due in part to this lack of peer review. Methods The aim of this study is to examine the dissemination of preprints on medRxiv and bioRxiv during the COVID-19 pandemic using content analysis and statistical analysis. Results Our findings show that preprints have played an unprecedented role in disseminating COVID-19-related science results to the public. Discussion While the overall media coverage of preprints is unsatisfactory, digital native news media performed better than legacy media in reporting preprints, which means that we could make the most of digital native media to improve health communication. This study contributes to understanding how science communication has evolved in response to the COVID-19 pandemic and provides some practical recommendations.
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16
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Reingruber J, Papale A, Ruckly S, Timsit JF, Holcman D. Data-driven multiscale dynamical framework to control a pandemic evolution with non-pharmaceutical interventions. PLoS One 2023; 18:e0278882. [PMID: 36649271 PMCID: PMC9844884 DOI: 10.1371/journal.pone.0278882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/26/2022] [Indexed: 01/18/2023] Open
Abstract
Before the availability of vaccines, many countries have resorted multiple times to drastic social restrictions to prevent saturation of their health care system, and to regain control over an otherwise exponentially increasing COVID-19 pandemic. With the advent of data-sharing, computational approaches are key to efficiently control a pandemic with non-pharmaceutical interventions (NPIs). Here we develop a data-driven computational framework based on a time discrete and age-stratified compartmental model to control a pandemic evolution inside and outside hospitals in a constantly changing environment with NPIs. Besides the calendrical time, we introduce a second time-scale for the infection history, which allows for non-exponential transition probabilities. We develop inference methods and feedback procedures to successively recalibrate model parameters as new data becomes available. As a showcase, we calibrate the framework to study the pandemic evolution inside and outside hospitals in France until February 2021. We combine national hospitalization statistics from governmental websites with clinical data from a single hospital to calibrate hospitalization parameters. We infer changes in social contact matrices as a function of NPIs from positive testing and new hospitalization data. We use simulations to infer hidden pandemic properties such as the fraction of infected population, the hospitalisation probability, or the infection fatality ratio. We show how reproduction numbers and herd immunity levels depend on the underlying social dynamics.
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Affiliation(s)
- Jürgen Reingruber
- Department of Biology, Ecole Normale Superieure, University PSL, CNRS, Paris, France
- INSERM U1024, Paris, France
| | - Andrea Papale
- Department of Biology, Ecole Normale Superieure, University PSL, CNRS, Paris, France
| | | | - Jean-Francois Timsit
- Université de Paris, UMR 1137, IAME, Paris, France
- AP-HP, Medical and Infectious Diseases Intensive Care Unit, Bichat-Claude Bernard Hospital, Paris, France
| | - David Holcman
- Department of Biology, Ecole Normale Superieure, University PSL, CNRS, Paris, France
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17
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Peretti M, Rebaudet S, Chiche L, Pegliasco H, Coquet E. Concerted and multidisciplinary management of COVID-19 drug therapies during the first two epidemic waves in a tertiary hospital in Marseille, France: Results of the PHARMA-COVID study. PLoS One 2023; 18:e0283165. [PMID: 36930624 PMCID: PMC10022761 DOI: 10.1371/journal.pone.0283165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 02/21/2023] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVES To evaluate the impact of local therapeutic recommendation updates made by the COVID multidisciplinary consultation meeting (RCP) at the Hôpital Européen Marseille (HEM) through the description of the drug prescriptions for COVID-19 during the first two waves of the epidemic. METHODS This retrospective observational study analysed data from the hospital's pharmaceutical file. We included all patients hospitalized for COVID-19 between February 1, 2020 and January 21, 2021 and extracted specific anti-COVID-19 therapies (ST) from computerized patient record, as well as patients' demographic characteristics, comorbidities and outcome. The evolution of ST prescriptions during the study period was described and put into perspective with the updates of local recommendations made during the first (V1, from 2/24/2020 to 7/27/2020), and second (V2, from 7/28/2020 to 1/21/2021) epidemic waves. RESULTS A total of 607 COVID-19 hospitalized patients, 197 during V1 and 410 during V2. Their mean age was 65 years-old, and they presented frequent comorbidities. In total, 93% of hospitalized patients received ST: anticoagulants (90%), glucocorticoids (39%) mainly during V2 (49% vs 17%, P<0.001), and azithromycin (30%) mainly during V1 (71% vs 10%, P<0.001). Lopinavir/ritonavir and hydroxychloroquine were prescribed to 17 and 7 inpatients, respectively, and only during V1. Remdesivir was never administered. A total of 22 inpatients were enrolled into clinical trials. CONCLUSIONS The effective dissemination of evidence-based and concerted recommendations seems to have allowed an optimized management of COVID-19 drug therapies in the context of this emerging infection with rapidly evolving therapeutic questions.
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Affiliation(s)
| | - Stanislas Rebaudet
- Service d’Infectiologie et de Médecine Interne, Hôpital Européen, Marseille, France
- UMR1252 SESSTIM, Aix-Marseille Univ, Inserm, IRD, ISSPAM, Marseille, France
| | - Laurent Chiche
- Service d’Infectiologie et de Médecine Interne, Hôpital Européen, Marseille, France
- * E-mail:
| | | | - Emilie Coquet
- Service de Pharmacie, Hôpital Européen, Marseille, France
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18
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Chen B, Liu Y, Yan B, Wu L, Zhang X. Why were some countries more successful than others in curbing early COVID-19 mortality impact? A cross-country configurational analysis. PLoS One 2023; 18:e0282617. [PMID: 36888633 PMCID: PMC9994757 DOI: 10.1371/journal.pone.0282617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
Why was there considerable variation in initial COVID-19 mortality impact across countries? Through a configurational lens, this paper examines which configurations of five conditions-a delayed public-health response, past epidemic experience, proportion of elderly in population, population density, and national income per capita-influence early COVID-19 mortality impact measured by years of life lost (YLL). A fuzzy-set qualitative comparative analysis (fsQCA) of 80 countries identifies four distinctive pathways associated with high YLL rate and four other different pathways leading to low YLL rate. Results suggest that there is no singular "playbook"-a set of policies that countries can follow. Some countries failed differently, whereas others succeeded differently. Countries should take into account their situational contexts to adopt a holistic response strategy to combat any future public-health crisis. Regardless of the country's past epidemic experience and national income levels, a speedy public-health response always works well. For high-income countries with high population density or past epidemic experience, they need to take extra care to protect elderly populations who may otherwise overstretch healthcare capacity.
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Affiliation(s)
- Bin Chen
- Marxe School of Public and International Affairs, Baruch College & The Graduate Center, The City University of New York, New York, New York, United States of America
| | - Yao Liu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Bo Yan
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- * E-mail:
| | - Long Wu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Xiaomin Zhang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
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19
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Keller K, Farmakis IT, Valerio L, Koelmel S, Wild J, Barco S, Schmidt FP, Espinola-Klein C, Konstantinides S, Münzel T, Sagoschen I, Hobohm L. Predisposing factors for admission to intensive care units of patients with COVID-19 infection-Results of the German nationwide inpatient sample. Front Public Health 2023; 11:1113793. [PMID: 36875366 PMCID: PMC9975593 DOI: 10.3389/fpubh.2023.1113793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/25/2023] [Indexed: 02/17/2023] Open
Abstract
Background Intensive care units (ICU) capacities are one of the most critical determinants in health-care management of the COVID-19 pandemic. Therefore, we aimed to analyze the ICU-admission and case-fatality rate as well as characteristics and outcomes of patient admitted to ICU in order to identify predictors and associated conditions for worsening and case-fatality in this critical ill patient-group. Methods We used the German nationwide inpatient sample to analyze all hospitalized patients with confirmed COVID-19 diagnosis in Germany between January and December 2020. All hospitalized patients with confirmed COVID-19 infection during the year 2020 were included in the present study and were stratified according ICU-admission. Results Overall, 176,137 hospitalizations of patients with COVID-19-infection (52.3% males; 53.6% aged ≥70 years) were reported in Germany during 2020. Among them, 27,053 (15.4%) were treated in ICU. COVID-19-patients treated on ICU were younger [70.0 (interquartile range (IQR) 59.0-79.0) vs. 72.0 (IQR 55.0-82.0) years, P < 0.001], more often males (66.3 vs. 48.8%, P < 0.001), had more frequently cardiovascular diseases (CVD) and cardiovascular risk-factors with increased in-hospital case-fatality (38.4 vs. 14.2%, P < 0.001). ICU-admission was independently associated with in-hospital death [OR 5.49 (95% CI 5.30-5.68), P < 0.001]. Male sex [OR 1.96 (95% CI 1.90-2.01), P < 0.001], obesity [OR 2.20 (95% CI 2.10-2.31), P < 0.001], diabetes mellitus [OR 1.48 (95% CI 1.44-1.53), P < 0.001], atrial fibrillation/flutter [OR 1.57 (95% CI 1.51-1.62), P < 0.001], and heart failure [OR 1.72 (95% CI 1.66-1.78), P < 0.001] were independently associated with ICU-admission. Conclusion During 2020, 15.4% of the hospitalized COVID-19-patients were treated on ICUs with high case-fatality. Male sex, CVD and cardiovascular risk-factors were independent risk-factors for ICU admission.
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Affiliation(s)
- Karsten Keller
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Ioannis T Farmakis
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Luca Valerio
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sebastian Koelmel
- Department of Internal Medicine, Triemli Hospital Zurich, Zurich, Switzerland
| | - Johannes Wild
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Stefano Barco
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Department of Angiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Christine Espinola-Klein
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Stavros Konstantinides
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Thomas Münzel
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany
| | - Ingo Sagoschen
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Lukas Hobohm
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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20
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Hayashi K, Nishiura H. Time-dependent risk of COVID-19 death with overwhelmed health-care capacity in Japan, 2020-2022. BMC Infect Dis 2022; 22:933. [PMID: 36510193 PMCID: PMC9744068 DOI: 10.1186/s12879-022-07929-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND It has been descriptively argued that the case fatality risk (CFR) of coronavirus disease (COVID-19) is elevated when medical services are overwhelmed. The relationship between CFR and pressure on health-care services should thus be epidemiologically explored to account for potential epidemiological biases. The purpose of the present study was to estimate the age-dependent CFR in Tokyo and Osaka over time, investigating the impact of caseload demand on the risk of death. METHODS We estimated the time-dependent CFR, accounting for time delay from diagnosis to death. To this end, we first determined the time distribution from diagnosis to death, allowing variations in the delay over time. We then assessed the age-dependent CFR in Tokyo and Osaka. In Osaka, the risk of intensive care unit (ICU) admission was also estimated. RESULTS The CFR was highest among individuals aged 80 years and older and during the first epidemic wave from February to June 2020, estimated as 25.4% (95% confidence interval [CI] 21.1 to 29.6) and 27.9% (95% CI 20.6 to 36.1) in Tokyo and Osaka, respectively. During the fourth wave of infection (caused by the Alpha variant) in Osaka the CFR among the 70s and ≥ 80s age groups was, respectively, 2.3 and 1.5 times greater than in Tokyo. Conversely, despite the surge in hospitalizations, the risk of ICU admission among those aged 80 and older in Osaka decreased. Such time-dependent variation in the CFR was not seen among younger patients < 70 years old. With the Omicron variant, the CFR among the 80s and older in Tokyo and Osaka was 3.2% (95% CI 3.0 to 3.5) and 2.9% (95% CI 2.7 to 3.1), respectively. CONCLUSION We found that without substantial control, the CFR can increase when a surge in cases occurs with an identifiable elevation in risk-especially among older people. Because active treatment options including admission to ICU cannot be offered to the elderly with an overwhelmed medical service, the CFR value can potentially double compared with that in other areas of health care under less pressure.
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Affiliation(s)
- Katsuma Hayashi
- grid.258799.80000 0004 0372 2033Graduate School of Medicine, Kyoto University, Yoshidakonoecho, Sakyo-ku, Kyoto, 606-8501 Japan
| | - Hiroshi Nishiura
- grid.258799.80000 0004 0372 2033Graduate School of Medicine, Kyoto University, Yoshidakonoecho, Sakyo-ku, Kyoto, 606-8501 Japan
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21
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Corvol A, Charras K, Prud'homm J, Lemoine F, Ory F, Viel JF, Somme D. Structural and Managerial Risk Factors for COVID-19 Occurrence in French Nursing Homes. Int J Health Policy Manag 2022; 11:2630-2637. [PMID: 35279036 PMCID: PMC9818122 DOI: 10.34172/ijhpm.2022.6741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/01/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Nursing home (NH) residents accounted for half of the deaths during the 2020 spring wave of the coronavirus disease 2019 (COVID-19) epidemic in France. Our objective was to identify structural and managerial factors associated with COVID-19 outbreaks in NHs. METHODS We conducted in July 2020 a retrospective study by questionnaire addressed to NH directors in the Brittany region of France. The questions related to structural characteristics of the establishment, human resources, and crisis management decisions. The primary endpoint was the occurrence of at least one confirmed case of COVID-19 among residents between March 1, 2020 and May 31, 2020. The secondary endpoint was total mortality during this period. We used multivariate regressions to identify factors associated with these outcomes. RESULTS Responses were collected from 231 NHs hosting 20,881 residents, representing a participation rate of 47%. In 24 (10%) NHs, at least one resident presented confirmed COVID-19. NHs often implemented stringent protective measures, with 65% of them choosing to confine residents to their rooms. In multivariate analysis, factors associated with a reduced risk of case occurrence were in-room meal service, early ban of family visits, and daily access to an outdoor space. No association was found between mortality and the factors studied. Our results show an early and strict implementation of lockdown measures, with good epidemiological results in a context of shortage of personal protective equipment (PPE) and non-vaccination. Nevertheless, it raises ethical questions concerning respect of residents' wellbeing and rights. CONCLUSION Cessation of communal dining seems to be the main measure likely to be effective in preventive terms. It does not seem that room lockdown and cessation of group activities should be recommended, particularly if mask wearing is possible.
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Affiliation(s)
- Aline Corvol
- CIC 1414, Inserm, CHU Rennes, Univ Rennes, Rennes, France
- ARENES, UMR 6051, ARENES, CHU Rennes, Univ Rennes, Rennes, France
- Department of Geriatrics, CHU Rennes, Rennes, France
| | - Kevin Charras
- Living Lab Ageing and Vulnerability, CHU Rennes, Rennes, France
| | - Joaquim Prud'homm
- Department of Geriatrics, CHU Rennes, Rennes, France
- Inserm, LTSI, UMR 1099, Univ Rennes, Rennes, France
| | | | - Fabien Ory
- CIC 1414, Inserm, CHU Rennes, Univ Rennes, Rennes, France
| | - Jean François Viel
- Department of Epidemiology and Public Health, CHU Rennes, Univ Rennes, Rennes, France
| | - Dominique Somme
- CIC 1414, Inserm, CHU Rennes, Univ Rennes, Rennes, France
- ARENES, UMR 6051, ARENES, CHU Rennes, Univ Rennes, Rennes, France
- Department of Geriatrics, CHU Rennes, Rennes, France
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22
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Inward RP, Jackson F, Dasgupta A, Lee G, Battle AL, Parag KV, Kraemer MU. Impact of spatiotemporal heterogeneity in COVID-19 disease surveillance on epidemiological parameters and case growth rates. Epidemics 2022; 41:100627. [PMID: 36099708 PMCID: PMC9443927 DOI: 10.1016/j.epidem.2022.100627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/04/2022] [Accepted: 09/03/2022] [Indexed: 02/08/2023] Open
Abstract
SARS-CoV-2 case data are primary sources for estimating epidemiological parameters and for modelling the dynamics of outbreaks. Understanding biases within case-based data sources used in epidemiological analyses is important as they can detract from the value of these rich datasets. This raises questions of how variations in surveillance can affect the estimation of epidemiological parameters such as the case growth rates. We use standardised line list data of COVID-19 from Argentina, Brazil, Mexico and Colombia to estimate delay distributions of symptom-onset-to-confirmation, -hospitalisation and -death as well as hospitalisation-to-death at high spatial resolutions and throughout time. Using these estimates, we model the biases introduced by the delay from symptom-onset-to-confirmation on national and state level case growth rates (rt) using an adaptation of the Richardson-Lucy deconvolution algorithm. We find significant heterogeneities in the estimation of delay distributions through time and space with delay difference of up to 19 days between epochs at the state level. Further, we find that by changing the spatial scale, estimates of case growth rate can vary by up to 0.13 d-1. Lastly, we find that states with a high variance and/or mean delay in symptom-onset-to-diagnosis also have the largest difference between the rt estimated from raw and deconvolved case counts at the state level. We highlight the importance of high-resolution case-based data in understanding biases in disease reporting and how these biases can be avoided by adjusting case numbers based on empirical delay distributions. Code and openly accessible data to reproduce analyses presented here are available.
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Affiliation(s)
- Rhys P.D. Inward
- Department of Biology, University of Oxford, United Kingdom,Corresponding author
| | - Felix Jackson
- Department of Biology, University of Oxford, United Kingdom,Department of Computer Science, University of Oxford, United Kingdom
| | - Abhishek Dasgupta
- Department of Biology, University of Oxford, United Kingdom,Department of Computer Science, University of Oxford, United Kingdom
| | - Graham Lee
- Department of Biology, University of Oxford, United Kingdom,Department of Computer Science, University of Oxford, United Kingdom
| | | | - Kris V. Parag
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, United Kingdom,NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
| | - Moritz U.G. Kraemer
- Department of Biology, University of Oxford, United Kingdom,Reuben College, University of Oxford, United Kingdom,Corresponding author at: Department of Biology, University of Oxford, United Kingdom
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23
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Zeleke AJ, Miglio R, Palumbo P, Tubertini P, Chiari L. Spatiotemporal heterogeneity of SARS-CoV-2 diffusion at the city level using geographically weighted Poisson regression model: The case of Bologna, Italy. GEOSPATIAL HEALTH 2022; 17. [PMID: 36468589 DOI: 10.4081/gh.2022.1145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
This paper aimed to analyse the spatio-temporal patterns of the diffusion of SARS-CoV-2, the virus causing coronavirus 2019 (COVID-19, in the city of Bologna, the capital and largest city of the Emilia-Romagna Region in northern Italy. The study took place from February 1st, 2020 to November 20th, 2021 and accounted for space, sociodemographic characteristics and health conditions of the resident population. A second goal was to derive a model for the level of risk of being infected by SARS-CoV-2 and to identify and measure the place-specific factors associated with the disease and its determinants. Spatial heterogeneity was tested by comparing global Poisson regression (GPR) and local geographically weighted Poisson regression (GWPR) models. The key findings were that different city areas were impacted differently during the first three epidemic waves. The area-to-area influence was estimated to exert its effect over an area with 4.7 km radius. Spatio-temporal heterogeneity patterns were found to be independent of the sociodemographic and the clinical characteristics of the resident population. Significant single-individual risk factors for detected SARS-CoV-2 infection cases were old age, hypertension, diabetes and co-morbidities. More specifically, in the global model, the average SARS-CoV-2 infection rate decreased 0.93-fold in the 21-65 years age group compared to the >65 years age group, whereas hypertension, diabetes, and any other co-morbidities (present vs absent), increased 1.28-, 1.39- and 1.15-fold, respectively. The local GWPR model had a better fit better than GPR. Due to the global geographical distribution of the pandemic, local estimates are essential for mitigating or strengthening security measures.
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Affiliation(s)
- Addisu Jember Zeleke
- Department of Electrical, Electronic, and Information Engineering Guglielmo Marconi, University of Bologna, Bologna.
| | - Rossella Miglio
- Department of Statistical Sciences, University of Bologna, Bologna.
| | - Pierpaolo Palumbo
- Department of Electrical, Electronic, and Information Engineering Guglielmo Marconi, University of Bologna, Bologna.
| | - Paolo Tubertini
- Enterprise information systems for integrated care and research data management (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, Bologna.
| | - Lorenzo Chiari
- Department of Electrical, Electronic, and Information Engineering Guglielmo Marconi, University of Bologna, Bologna; Health Sciences and Technologies Interdepartmental Center for Industrial Research (CIRI SDV), University of Bologna, Bologna.
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24
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Comparison of Clinical Features, Complete Blood Count Parameters, and Outcomes between Two Distinct Waves of COVID-19: A Monocentric Report from Italy. Healthcare (Basel) 2022; 10:healthcare10122427. [PMID: 36553950 PMCID: PMC9778399 DOI: 10.3390/healthcare10122427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Since the beginning of the SARS-CoV-2 pandemic, the ability to predict the trajectory of the disease has represented a major challenge for clinicians. There is recent evidence that complete blood cell count (CBC)-derived inflammation indexes have predictive value in COVID-19. We aimed to describe any changes in the clinical features, CBC-derived ratios, and outcomes of patients admitted to our hospital across two temporally distinct waves. METHODS We retrospectively assessed and compared the clinical characteristics and blood cell count values of patients hospitalized during the second and fourth waves of COVID-19, and explored any outcome differences in terms of the level of respiratory support required and transfer to intensive care. RESULTS We observed that fourth-wave patients were older, less male-predominant, and carried more comorbidities compared to the second-wave patients but, nevertheless, experienced more favorable outcomes. A strong internal correlation was documented for both waves between outcomes and CBC-derived ratios, with the fourth-wave cases displaying lower admission values of the neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation index (SII). No significant differences were found for lymphocyte-to-monocyte ratio (LMR), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). CONCLUSIONS We observed that both admission values of CBC-derived indexes and adverse respiratory outcomes decreased from the second to the fourth wave of COVID-19. These data represent a contribution to the existing knowledge on the role of CBC-derived indexes as a potential tool to help clinicians to quickly differentiate in-hospital patients at increased risk of serious illness and death.
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25
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Goupil de Bouillé J, Luong Nguyen LB, Crépey P, Garlantezec R, Doré V, Dumas A, Ben Mechlia M, Tattevin P, Gaudart J, Spire B, Lert F, Yazdanpanah Y, Delaugerre C, Noret M, Zeggagh J. Transmission of SARS-CoV-2 during indoor clubbing events: A clustered randomized, controlled, multicentre trial protocol. Front Public Health 2022; 10:981213. [PMID: 36438274 PMCID: PMC9687087 DOI: 10.3389/fpubh.2022.981213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction The SARS-CoV-2 pandemic led to the implementation of several non-pharmaceutical interventions (NPIs), from closings of bars and restaurants to curfews and lockdowns. Vaccination campaigns started hoping it could efficiently alleviate NPI. The primary objective of the "Indoor Transmission of COVID-19" (ITOC) study is to determine among a fully vaccinated population the relative risk of SARS-CoV-2 transmission during one indoor clubbing event. Secondary objectives are to assess the transmission of other respiratory viruses, risk exposure, and attitudes toward COVID-19 vaccination, health pass, and psychological impact of indoor club closing. Methods and analysis Four thousand four hundred healthy volunteers aged 18-49 years and fully vaccinated will be included in Paris region. The intervention is an 8-hour indoor clubbing event with no masks, no social distance, maximum room capacity, and ventilation. A reservation group of up to 10 people will recruit participants, who will be randomized 1:1 to either the experimental group (2,200 volunteers in two venues with capacities of 1,000 people each) or the control group (2,200 volunteers asked not to go to the club). All participants will provide a salivary sample on the day of the experiment and 7 days later. They also will answer several questionnaires. Virological analyses include polymerase chain reaction (PCR) of salivary samples and air of the venue, investigating SARS-CoV-2 and 18 respiratory viruses. Ethics and dissemination Ethical clearance was first obtained in France from the institutional review board (Comité de Protection des Personnes Ile de France VII - CPP), and the trial received clearance from the French National Agency for Medicines and Health Products (Agence National de Sécurité du Médicament - ANSM). The trial is supported and approved by The Agence Nationale Recherche sur le SIDA, les hépatites et maladies émergences (ANRS-MIE). Positive, negative, and inconclusive results will be published in peer-reviewed scientific journals. Trial registration number IDR-CB 2021-A01473-38. Clinicaltrial.gov, identifier: NCT05311865.
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Affiliation(s)
- Jeanne Goupil de Bouillé
- Service de Maladies Infectieuses et Tropicales, Hôpital Avicenne, AP-HP, Bobigny, France,LEPS Laboratoire Éducations et Pratiques de Santé, Université Paris 13, Bobigny, France,*Correspondence: Jeanne Goupil de Bouillé
| | | | - Pascal Crépey
- Univ Rennes, EHESP, CNRS, INSERM, Arènes - UMR 6051, RSMS - U 1309, Rennes, France
| | - Ronan Garlantezec
- CHU de Rennes, University Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
| | | | - Audrey Dumas
- ANRS, Agence Nationale Recherche Sida, Paris, France
| | | | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Jean Gaudart
- Aix Marseille University, APHM, INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Hop Timone, BioSTIC, Biostatistic and ICT, Marseille, France
| | - Bruno Spire
- Aix Marseille University, APHM, INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Marseille, France
| | - France Lert
- ANRS, Agence Nationale Recherche Sida, Paris, France
| | - Yazdan Yazdanpanah
- ANRS, Agence Nationale Recherche Sida, Paris, France,Service de Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France
| | - Constance Delaugerre
- Service de Virologie, Hôpital Saint-Louis, AP-HP, INSERM U944, Université de Paris, Paris, France
| | | | - Jeremy Zeggagh
- Service de Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, AP-HP, Paris, France
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26
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Benita F, Rebollar-Ruelas L, Gaytán-Alfaro ED. What have we learned about socioeconomic inequalities in the spread of COVID-19? A systematic review. SUSTAINABLE CITIES AND SOCIETY 2022; 86:104158. [PMID: 36060423 PMCID: PMC9428120 DOI: 10.1016/j.scs.2022.104158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 05/23/2023]
Abstract
This article aims to provide a better understanding of the associations between groups of socioeconomic variables and confirmed cases of COVID-19. The focus is on cross-continental differences of reported positive, negative, unclear, or no associations. A systematic review of the literature is conducted on the Web of Science and SCOPUS databases. Our search identifies 314 eligible studies published on or before 31 December 2021. We detect nine groups of frequently used socioeconomic variables and results are presented by region of the world (Africa, Asia, Europe, Middle East, North American and South America). The review expands to describe the most used statistical and modelling techniques as well as inclusion of additional dimensions such as demographic, healthcare weather and mobility. Meanwhile findings agree on the generalized positive impact of population density, per capita GDP and urban areas on transmission of infections, contradictory results have been found concerning to educational level and income.
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Affiliation(s)
- Francisco Benita
- Engineering Systems and Design, Singapore University of Technology and Design, 8 Somapah Road, Singapore 487372, Singapore
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27
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Otunla A, Rees K, Dennison P, Hobbs R, Suklan J, Schofield E, Gunnell J, Mighiu A, Hartmann-Boyce J. Risks of infection, hospital and ICU admission, and death from COVID-19 in people with asthma: systematic review and meta-analyses. BMJ Evid Based Med 2022; 27:263-273. [PMID: 34933924 DOI: 10.1136/bmjebm-2021-111788] [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] [Accepted: 10/29/2021] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To determine if and to what degree asthma may predispose to worse COVID-19 outcomes in order to inform treatment and prevention decisions, including shielding and vaccine prioritisation. DESIGN Systematic review and meta-analysis. SETTING Electronic databases were searched (October 2020) for clinical studies reporting at least one of the following stratified by asthma status: risk of infection with SARS-CoV-2; hospitalisation, intensive care unit (ICU) admission or mortality with COVID-19. PARTICIPANTS Adults and children who tested positive for or were suspected to have COVID-19. MAIN OUTCOME MEASURES Main outcome measures were the following stratified by asthma status: risk of infection with SARS-CoV-2; hospitalisation, ICU admission or mortality with COVID-19. We pooled odds ratios (ORs) and presented these with 95% confidence intervals (CI). Certainty was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluations). RESULTS 30 (n=112 420) studies were included (12 judged high quality, 15 medium, 3 low). Few provided indication of asthma severity. Point estimates indicated reduced risks in people with asthma for all outcomes, but in all cases the evidence was judged to be of very low certainty and 95% CIs all included no difference and the possibility of increased risk (death: OR 0.90, 95% CI 0.72 to 1.13, I2=58%; hospitalisation: OR 0.95, 95% CI 0.71 to 1.26; ICU admission: OR 0.96, 95% CI 0.75 to 1.24). Findings on hospitalisation are also limited by substantial unexplained statistical heterogeneity. Within people with asthma, allergic asthma was associated with less COVID-19 risk and concurrent chronic obstructive pulmonary disease was associated with increased risk. In some studies, corticosteroids were associated with increased risk, but this may reflect increased risk in people with more severe asthma. CONCLUSIONS Though absence of evidence of a clear association between asthma and worse outcomes from COVID-19 should not be interpreted as evidence of absence, the data reviewed indicate that risks from COVID-19 in people with asthma, as a whole, may be less than originally anticipated.
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Affiliation(s)
| | - Karen Rees
- Freelance systematic reviewer, Warwickshire, UK
| | - Paddy Dennison
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jana Suklan
- NIHR Newcastle In Vitro Diagnostics, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Ella Schofield
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - James Gunnell
- Medical Sciences Division, University of Oxford, Oxford, UK
| | | | - Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Meynard JB, de Laval F, Texier G, Gorgé O, Degui H, Pommier de Santi V. [Management of the COVID-19 epidemic in the carrier battle group (January-April 2020) by the Armed Forces Epidemiology and Public Health Center]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 2022; 206:997-1010. [PMID: 35879932 PMCID: PMC9301959 DOI: 10.1016/j.banm.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objectives Faced with the COVID-19 epidemic that occurred within the naval air group and the nuclear aircraft carrier Charles de Gaulle, the French Armed Forces Epidemiology and Public Health Center (CESPA) carried out an investigation (January - April 2020) whose objectives were: to identify the possible routes of introduction of the virus ; to describe the characteristics of the epidemic and to describe and model the dynamics of the epidemic's spread. Methods A telephone survey was conducted. The biological diagnoses were transmitted by the medical antennas. A time/place/population analysis was carried out, as well as the description of the clinical pictures with their exposure factors. The instantaneous reproduction rate Rt of the epidemic was modeled. A spatial analysis of the epidemic on board was carried out. Forty-three viral genomes were sequenced and compared to the reference bases. Results 0f 1767 sailors, 1568 (89%) participated in the telephone survey and 1064 (67.9%) were confirmed cases. Four patient profiles have been described: asymptomatic (13.0%); non-specific symptomatic (8.1%); specific symptomatic (76.3%); severe cases (2.6%). In univariate and multivariate analysis, age, overweight and obesity were significantly associated with the risk of having a severe form. Smoking was a protective factor. The evolution kinetics of Rt was in favor of an introduction of the virus at the end of February with a reintroduction during the stopover in Brest. Analysis of viral genomes ruled out introduction and spread of a single strain. Conclusion Despite the control measures taken, an epidemic occurred. The often pauci-symptomatic clinical pictures resulted in a delay in identification. CESPA was able to carry out this epidemiological investigation within a highly constrained timeframe, showing all the interest of its integrated public health model.
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Affiliation(s)
- J-B Meynard
- Direction de la formation, de la recherche et de l'innovation du service de santé des armées, Val-de-Grâce, 1, place Alphonse Laveran, 75005 Paris, France
- UMR 1252-sciences économiques et sociales de la santé et traitement de l'information médicale, SESSTIM, Inserm/IRD/Aix-Marseille université, faculté de médecine, 27, boulevard Jean Moulin, 13385 Marseille cedex 5, France
- École du Val-de-Grâce, Val-de-Grâce, 1, place Alphonse Laveran, 75005 Paris, France
| | - F de Laval
- UMR 1252-sciences économiques et sociales de la santé et traitement de l'information médicale, SESSTIM, Inserm/IRD/Aix-Marseille université, faculté de médecine, 27, boulevard Jean Moulin, 13385 Marseille cedex 5, France
- Centre d'épidémiologie et de santé publique des armées, base de défense Marseille Aubagne - 111, avenue de la Corse BP40026, 13568 Marseille cedex 02, France
| | - G Texier
- École du Val-de-Grâce, Val-de-Grâce, 1, place Alphonse Laveran, 75005 Paris, France
- Centre d'épidémiologie et de santé publique des armées, base de défense Marseille Aubagne - 111, avenue de la Corse BP40026, 13568 Marseille cedex 02, France
- UMR 257-Vecteurs, infections tropicales et méditerranéennes-VITROME-IRD/SSA/AP-HM/Aix-Marseille université, 19-21, boulevard Jean Moulin, 13005 Marseille, France
| | - O Gorgé
- Institut de recherche biomédicale des armées, 1, place du général Valérie André BP 73, 91223 Brétigny-sur-Orge, France
| | - H Degui
- Centre d'épidémiologie et de santé publique des armées, base de défense Marseille Aubagne - 111, avenue de la Corse BP40026, 13568 Marseille cedex 02, France
| | - V Pommier de Santi
- Centre d'épidémiologie et de santé publique des armées, base de défense Marseille Aubagne - 111, avenue de la Corse BP40026, 13568 Marseille cedex 02, France
- UMR 257-Vecteurs, infections tropicales et méditerranéennes-VITROME-IRD/SSA/AP-HM/Aix-Marseille université, 19-21, boulevard Jean Moulin, 13005 Marseille, France
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Lesaine E, Francis-Oliviero F, Domecq S, Bijon M, Cetran L, Coste P, Lhuaire Q, Miganeh-Hadi S, Pradeau C, Rouanet F, Sevin F, Sibon I, Saillour-Glenisson F. Effects of healthcare system transformations spurred by the COVID-19 pandemic on management of stroke and STEMI: a registry-based cohort study in France. BMJ Open 2022; 12:e061025. [PMID: 36130741 PMCID: PMC9494013 DOI: 10.1136/bmjopen-2022-061025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess the impact of changes in use of care and implementation of hospital reorganisations spurred by the COVID-19 pandemic (first wave) on the acute management times of patients who had a stroke and ST-segment elevation myocardial infarction (STEMI). DESIGN Two cohorts of patients who had an STEMI and stroke in the Aquitaine Cardio-Neuro-Vascular (CNV) registry. SETTING 6 emergency medical services, 30 emergency units (EUs), 14 hospitalisation units and 11 cathlabs in the Aquitaine region. PARTICIPANTS This study involved 9218 patients (6436 patients who had a stroke and 2782 patients who had an STEMI) in the CNV Registry from January 2019 to August 2020. METHOD Hospital reorganisations, retrieved in a scoping review, were collected from heads of hospital departments. Other data were from the CNV Registry. Associations between reorganisations, use of care and care management times were analysed using multivariate linear regression mixed models. Interaction terms between use-of-care variables and period (pre-wave, per-wave and post-wave) were introduced. MAIN OUTCOME MEASURES STEMI cohort, first medical contact-to-procedure time; stroke cohort, EU admission-to-imaging time. RESULTS Per-wave period management times deteriorated for stroke but were maintained for STEMI. Per-wave changes in use of care did not affect STEMI management. No association was found between reorganisations and stroke management times. In the STEMI cohort, the implementation of systematic testing at admission was associated with a 41% increase in care management time (exp=1.409, 95% CI 1.075 to 1.848, p=0.013). Implementation of plan blanc, which concentrated resources in emergency activities, was associated with a 19% decrease in management time (exp=0.801, 95% CI 0.639 to 1.023, p=0.077). CONCLUSIONS The pandemic did not markedly alter the functioning of the emergency network. Although stroke patient management deteriorated, the resilience of the STEMI pathway was linked to its stronger structuring. Transversal reorganisations, aiming at concentrating resources on emergency care, contributed to maintenance of the quality of care. TRIAL REGISTRATION NUMBER NCT04979208.
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Affiliation(s)
- Emilie Lesaine
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Florence Francis-Oliviero
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
| | - Sandrine Domecq
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Marine Bijon
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
| | - Laura Cetran
- Coronary Care Unit, CHU de Bordeaux Hôpital Cardiologique, Pessac, France
| | - Pierre Coste
- Coronary Care Unit, CHU de Bordeaux Hôpital Cardiologique, Pessac, France
- University of Bordeaux, Talence, France
| | - Quentin Lhuaire
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
| | - Sahal Miganeh-Hadi
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | | | | | - Floriane Sevin
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Igor Sibon
- Neurology, Stroke Unit, CHU de Bordeaux, Bordeaux, France
- INCIA CNRS UMR 5287, University of Bordeaux, Talence, France
| | - Florence Saillour-Glenisson
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
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Muller J, Tran Ba Loc P, Binder Foucard F, Borde A, Bruandet A, Le Bourhis-Zaimi M, Lenne X, Ouattara É, Séguret F, Gilleron V, Tezenas du Montcel S. Major interregional differences in France of COVID-19 hospitalization and mortality from January to June 2020. Rev Epidemiol Sante Publique 2022; 70:265-276. [PMID: 36207228 PMCID: PMC9468311 DOI: 10.1016/j.respe.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 08/24/2022] [Accepted: 08/31/2022] [Indexed: 10/26/2022] Open
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Nazia N, Butt ZA, Bedard ML, Tang WC, Sehar H, Law J. Methods Used in the Spatial and Spatiotemporal Analysis of COVID-19 Epidemiology: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8267. [PMID: 35886114 PMCID: PMC9324591 DOI: 10.3390/ijerph19148267] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 02/04/2023]
Abstract
The spread of the COVID-19 pandemic was spatially heterogeneous around the world; the transmission of the disease is driven by complex spatial and temporal variations in socioenvironmental factors. Spatial tools are useful in supporting COVID-19 control programs. A substantive review of the merits of the methodological approaches used to understand the spatial epidemiology of the disease is hardly undertaken. In this study, we reviewed the methodological approaches used to identify the spatial and spatiotemporal variations of COVID-19 and the socioeconomic, demographic and climatic drivers of such variations. We conducted a systematic literature search of spatial studies of COVID-19 published in English from Embase, Scopus, Medline, and Web of Science databases from 1 January 2019 to 7 September 2021. Methodological quality assessments were also performed using the Joanna Briggs Institute (JBI) risk of bias tool. A total of 154 studies met the inclusion criteria that used frequentist (85%) and Bayesian (15%) modelling approaches to identify spatial clusters and the associated risk factors. Bayesian models in the studies incorporated various spatial, temporal and spatiotemporal effects into the modelling schemes. This review highlighted the need for more local-level advanced Bayesian spatiotemporal modelling through the multi-level framework for COVID-19 prevention and control strategies.
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Affiliation(s)
- Nushrat Nazia
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada; (Z.A.B.); (M.L.B.); (W.-C.T.); (H.S.); (J.L.)
| | - Zahid Ahmad Butt
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada; (Z.A.B.); (M.L.B.); (W.-C.T.); (H.S.); (J.L.)
| | - Melanie Lyn Bedard
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada; (Z.A.B.); (M.L.B.); (W.-C.T.); (H.S.); (J.L.)
| | - Wang-Choi Tang
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada; (Z.A.B.); (M.L.B.); (W.-C.T.); (H.S.); (J.L.)
| | - Hibah Sehar
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada; (Z.A.B.); (M.L.B.); (W.-C.T.); (H.S.); (J.L.)
| | - Jane Law
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada; (Z.A.B.); (M.L.B.); (W.-C.T.); (H.S.); (J.L.)
- School of Planning, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada
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Hitchings MDT, Lewnard JA, Dean NE, Ko AI, Ranzani OT, Andrews JR, Cummings DAT. Use of Recently Vaccinated Individuals to Detect Bias in Test-Negative Case-Control Studies of COVID-19 Vaccine Effectiveness. Epidemiology 2022; 33:450-456. [PMID: 35384900 PMCID: PMC9148635 DOI: 10.1097/ede.0000000000001484] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 03/17/2022] [Indexed: 11/30/2022]
Abstract
Postauthorization observational studies play a key role in understanding COVID-19 vaccine effectiveness following the demonstration of efficacy in clinical trials. Although bias due to confounding, selection bias, and misclassification can be mitigated through careful study design, unmeasured confounding is likely to remain in these observational studies. Phase III trials of COVID-19 vaccines have shown that protection from vaccination does not occur immediately, meaning that COVID-19 risk should be similar in recently vaccinated and unvaccinated individuals, in the absence of confounding or other bias. Several studies have used the estimated effectiveness among recently vaccinated individuals as a negative control exposure to detect bias in vaccine effectiveness estimates. In this paper, we introduce a theoretical framework to describe the interpretation of such a bias indicator in test-negative studies, and outline strong assumptions that would allow vaccine effectiveness among recently vaccinated individuals to serve as a negative control exposure.
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Affiliation(s)
- Matt D. T. Hitchings
- From the Department of Biology, University of Florida, Gainesville, FL
- Emerging Pathogens Institute, University of Florida, Gainesville, FL
| | - Joseph A. Lewnard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA
- Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA
- Center for Computational Biology, College of Engineering, University of California, Berkeley, Berkeley, CA
| | - Natalie E. Dean
- Emerging Pathogens Institute, University of Florida, Gainesville, FL
- Department of Biostatistics, University of Florida, Gainesville, FL
| | - Albert I. Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brazil
| | - Otavio T. Ranzani
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
- Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Jason R. Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA
| | - Derek A. T. Cummings
- From the Department of Biology, University of Florida, Gainesville, FL
- Emerging Pathogens Institute, University of Florida, Gainesville, FL
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Darques R, Trottier J, Gaudin R, Ait-Mouheb N. Clustering and mapping the first COVID-19 outbreak in France. BMC Public Health 2022; 22:1279. [PMID: 35778679 PMCID: PMC9247918 DOI: 10.1186/s12889-022-13537-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 04/21/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND With more than 160 000 confirmed COVID-19 cases and about 30 000 deceased people at the end of June 2020, France was one of the countries most affected by the coronavirus crisis worldwide. We aim to assess the efficiency of global lockdown policy in limiting spatial contamination through an in-depth reanalysis of spatial statistics in France during the first lockdown and immediate post-lockdown phases. METHODS To reach that goal, we use an integrated approach at the crossroads of geography, spatial epidemiology, and public health science. To eliminate any ambiguity relevant to the scope of the study, attention focused at first on data quality assessment. The data used originate from official databases (Santé Publique France) and the analysis is performed at a departmental level. We then developed spatial autocorrelation analysis, thematic mapping, hot spot analysis, and multivariate clustering. RESULTS We observe the extreme heterogeneity of local situations and demonstrate that clustering and intensity are decorrelated indicators. Thematic mapping allows us to identify five "ghost" clusters, whereas hot spot analysis detects two positive and two negative clusters. Our re-evaluation also highlights that spatial dissemination follows a twofold logic, zonal contiguity and linear development, thus determining a "metastatic" propagation pattern. CONCLUSIONS One of the most problematic issues about COVID-19 management by the authorities is the limited capacity to identify hot spots. Clustering of epidemic events is often biased because of inappropriate data quality assessment and algorithms eliminating statistical-spatial outliers. Enhanced detection techniques allow for a better identification of hot and cold spots, which may lead to more effective political decisions during epidemic outbreaks.
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Affiliation(s)
- Regis Darques
- UMR 7300 ESPACE, CNRS, Aix Marseille Univ, Université Côte d'Azur, Avignon Université, Case 41, 74 rue Louis Pasteur, 84029, Avignon cedex, France.
| | - Julie Trottier
- CNRS, PRODIG, Campus Condorcet, Bat. Recherche Sud, 5 cours des Humanités, 12 rue des Fillettes, 93322, Aubervilliers cedex, France
| | - Raphael Gaudin
- Institut de Recherche en Infectiologie de Montpellier (IRIM), CNRS, Univ Montpellier, 1919 Route de Mende, 34293, Montpellier, France
| | - Nassim Ait-Mouheb
- UMR G-Eau, INRAE, University of Montpellier, 361 rue Jean-François Breton, 34196, Montpellier cedex 5, France
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Tkachenko M, Morozova N, Tanasichuk-Gazhyeva N, Cherkasova L. Characteristics of X-ray pattern of lung lesion in COVID-19 in adult patients with cystic fibrosis. УКРАЇНСЬКИЙ РАДІОЛОГІЧНИЙ ТА ОНКОЛОГІЧНИЙ ЖУРНАЛ 2022. [DOI: 10.46879/ukroj.2.2022.9-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background. Patients with cystic fibrosis (CF) fall into the risk group of breathing passages infection as a result of clinical features of the disease. During the period of COVID-19 pandemic,the necessity of understanding how infection affects the course of the main disease has appeared, taking into account that viability of patients is essentially determined by the degree of lung lesion. Early diagnostics and complex therapy of coronavirus infection increase the lifespan of CF patients and improve quality of life. X-ray examinations play the leading role in solving this problem.
Purpose – to establish risk factors of the main pathological process aggravation by determining diagnostic significance of roentgen sings of lung lesion in COVID-19 in CF adult patients.
Materials and methods. Theanalysis of radiography and computed tomography results of 11 adult patients with CF of moderate and severe degree who were also diagnosed with coronavirus infection.
Results. The main X-ray symptoms in observed patients with CF with confirmed diagnosis of coronavirus infection was pneumonic infiltration of different degrees in the setting of diffuse changes of lung pattern and features of pulmonary emphysema. Besides symptoms of the main disease, computed tomography allowed us to find the signs, which we consider to be the signs of pneumonia caused by COVID-19 infection – induration of lung tissue in the form of ground-glass opacity, presence of ground-glass areas of different shapes with reticular changes and consolidation of lung tissue, bilateral localization of pathological changes, predominantly in basal and subpleural areas.
Conclusions. Lung lesion conditioned by COVID-19 in radiography of CF patients may be disguised by the features of the main disease manifestations. Therefore, any X-ray evidence of inflammatory lung changes in CF patients during the epidemic period must be regarded as COVID-19 suspected, and polymerase chain reaction and computed tomography must be performed.
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Rapin A, Noujaim PJ, Taiar R, Carazo-Mendez S, Deslee G, Jolly D, Boyer FC. Characteristics of COVID-19 Inpatients in Rehabilitation Units during the First Pandemic Wave: A Cohort Study from a Large Hospital in Champagne Region. BIOLOGY 2022; 11:biology11060937. [PMID: 35741459 PMCID: PMC9219626 DOI: 10.3390/biology11060937] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/06/2022] [Accepted: 06/14/2022] [Indexed: 06/01/2023]
Abstract
Background: Data describing patients hospitalized in medical rehabilitation wards after the acute phase of COVID-19 could help to better understand the rehabilitation needs in the current pandemic situation. Methods: Cohort including all patients with COVID-19 hospitalized in a single, large university hospital in Northeast France from 25 February to 30 April 2020. Results: 479 patients were admitted with COVID-19 during the study period, of whom 128 died (26.7%). Among the 351 survivors, 111 were referred to rehabilitation units, including 63 (17.9%) referred to physical and rehabilitation medicine (PRM) units. The median age of patients referred to rehabilitation units was 72 years. Patients who had been in intensive care, or who had had a long hospital stay, required referral to PRM units. Two biomarkers were associated with referral to rehabilitation units, namely, elevated troponin (p = 0.03) and impaired renal function (p = 0.03). Age was associated with referral to PRM units (p = 0.001). Conclusions: Almost one-third of COVID-19 patients required post-acute care, but only one-fifth had access to PRM units. The optimal strategy for post-acute management of COVID-19 patients remains to be determined. The need for rehabilitation wards during a pandemic is a primary concern in enabling the long-term functioning of infected patients.
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Affiliation(s)
- Amandine Rapin
- Faculté de Médecine, Université de Reims Champagne Ardennes, UR 3797 VieFra, 51097 Reims, France; (A.R.); (D.J.); (F.C.B.)
- Service de Médecine Physique et de Réadaptation, Hôpital Sébastopol, CHU de Reims, 51092 Reims, France;
| | - Peter-Joe Noujaim
- Unité D’aide Méthodologique, Pôle Recherche et Santé Publique, Hôpital Robert Debré, CHU de Reims, 51092 Reims, France;
| | - Redha Taiar
- Matériaux et Ingénierie Mécanique MATIM, Université de Reims Champagne Ardennes, CEDEX 2, 51687 Reims, France
| | - Sandy Carazo-Mendez
- Service de Médecine Physique et de Réadaptation, Hôpital Sébastopol, CHU de Reims, 51092 Reims, France;
| | - Gaetan Deslee
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU de Reims, 51092 Reims, France;
- Inserm UMR-S1250, P3Cell, University of Reims Champagne-Ardenne, SFR CAP-SANTE, 51092 Reims, France
| | - Damien Jolly
- Faculté de Médecine, Université de Reims Champagne Ardennes, UR 3797 VieFra, 51097 Reims, France; (A.R.); (D.J.); (F.C.B.)
- Unité D’aide Méthodologique, Pôle Recherche et Santé Publique, Hôpital Robert Debré, CHU de Reims, 51092 Reims, France;
| | - François Constant Boyer
- Faculté de Médecine, Université de Reims Champagne Ardennes, UR 3797 VieFra, 51097 Reims, France; (A.R.); (D.J.); (F.C.B.)
- Service de Médecine Physique et de Réadaptation, Hôpital Sébastopol, CHU de Reims, 51092 Reims, France;
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Geographical distribution of cystic fibrosis carriers as population genetic determinant of COVID-19 spread and fatality in 37 countries. J Infect 2022; 85:318-321. [PMID: 35700866 PMCID: PMC9188282 DOI: 10.1016/j.jinf.2022.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 01/07/2023]
Abstract
COVID-19 has shown a relevant heterogeneity in spread and fatality among countries together with a significant variability in its clinical presentation, indicating that host genetic factors may influence COVID-19 pathogenicity. Indeed, subjects carrying single pathogenic variants of the Cystic Fibrosis (CF) Transmembrane Conductance Regulator (CFTR) gene – i.e. CF carriers – are more susceptible to respiratory tract infections and are more likely to undergo severe COVID-19 with higher risk of 14-day mortality. Given that CF carrier prevalence varies among ethnicities and nations, an ecological study in 37 countries was conducted, in order to determine to what extent the diverse CF carrier geographical distribution may have affected COVID-19 spread and fatality during the first pandemic wave. The CF prevalence in countries, as indicator of the geographical distribution of CF carriers, significantly correlated in a direct manner with both COVID-19 prevalence and its Case Fatality Rate (CFR). In a regression study weighted for the number of tests performed, COVID-19 prevalence positively correlated with CF prevalence, while CFR correlated with population percentage older than 65-year, cancer and CF prevalence. Multivariate regression model also confirmed COVID-19 CFR to be associated with CF prevalence, after adjusting for elderly, cancer prevalence, and weighting for the number of tests performed. This study suggests a putative contribution of population genetics of CFTR in understanding the spatial distribution of COVID-19 spread and fatality.
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de Laval F, Chaudet H, Gorgé O, Marchi J, Lacrosse C, Dia A, Marbac V, Mmadi Mrenda B, Texier G, Letois F, Chapus C, Sarilar V, Tournier JN, Levasseur A, Cobola J, Nolent F, Dutasta F, Janvier F, Meynard JB, Pommier de Santi V. Investigation of a COVID-19 outbreak on the Charles de Gaulle aircraft carrier, March to April 2020: a retrospective cohort study. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2022; 27. [PMID: 35620999 PMCID: PMC9137271 DOI: 10.2807/1560-7917.es.2022.27.21.2100612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background SARS-CoV-2 emergence was a threat for armed forces. A COVID-19 outbreak occurred on the French aircraft carrier Charles de Gaulle from mid-March to mid-April 2020. Aim To understand how the virus was introduced, circulated then stopped circulation, risk factors for infection and severity, and effectiveness of preventive measures. Methods We considered the entire crew as a cohort and collected personal, clinical, biological, and epidemiological data. We performed viral genome sequencing and searched for SARS-CoV-2 in the environment. Results The attack rate was 65% (1,148/1,767); 1,568 (89%) were included. The male:female ratio was 6.9, and median age was 29 years (IQR: 24–36). We examined four clinical profiles: asymptomatic (13.0%), non-specific symptomatic (8.1%), specific symptomatic (76.3%), and severe (i.e. requiring oxygen therapy, 2.6%). Active smoking was not associated with severe COVID-19; age and obesity were risk factors. The instantaneous reproduction rate (Rt) and viral sequencing suggested several introductions of the virus with 4 of 5 introduced strains from within France, with an acceleration of Rt when lifting preventive measures. Physical distancing prevented infection (adjusted OR: 0.55; 95% CI: 0.40–0.76). Transmission may have stopped when the proportion of infected personnel was large enough to prevent circulation (65%; 95% CI: 62–68). Conclusion Non-specific clinical pictures of COVID-19 delayed detection of the outbreak. The lack of an isolation ward made it difficult to manage transmission; the outbreak spread until a protective threshold was reached. Physical distancing was effective when applied. Early surveillance with adapted prevention measures should prevent such an outbreak.
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Affiliation(s)
- Franck de Laval
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France.,Aix-Marseille University, INSERM, IRD, SESSTIM (Economic and Social Sciences, Health Systems, and Medical Informatics), Marseille, France
| | - Hervé Chaudet
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France.,Aix-Marseille University, IRD, AP-HM, SSA (French Military Health Service), VITROME, Marseille, France.,University Hospital Institute Méditerranée Infection, Marseille, France
| | - Olivier Gorgé
- French Armed Forces Biomedical Research Institute (IRBA), Brétigny-sur-Orge, France
| | - Joffrey Marchi
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Constance Lacrosse
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Aissata Dia
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | | | - Bakridine Mmadi Mrenda
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Gaëtan Texier
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France.,Aix-Marseille University, IRD, AP-HM, SSA (French Military Health Service), VITROME, Marseille, France
| | - Flavie Letois
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Charles Chapus
- French Armed Forces Biomedical Research Institute (IRBA), Brétigny-sur-Orge, France
| | - Véronique Sarilar
- French Armed Forces Biomedical Research Institute (IRBA), Brétigny-sur-Orge, France
| | | | - Anthony Levasseur
- University Hospital Institute Méditerranée Infection, Marseille, France.,Aix Marseille University, IRD, AP-HM, MEPHI, Marseille, France
| | | | - Flora Nolent
- French Armed Forces Biomedical Research Institute (IRBA), Brétigny-sur-Orge, France
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- PA-CDG COVID-19 investigation group members are listed under Collaborators
| | - Jean-Baptiste Meynard
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France.,Aix-Marseille University, INSERM, IRD, SESSTIM (Economic and Social Sciences, Health Systems, and Medical Informatics), Marseille, France
| | - Vincent Pommier de Santi
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France.,Aix-Marseille University, IRD, AP-HM, SSA (French Military Health Service), VITROME, Marseille, France
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Who Were Hospitalized Deceased Patients from COVID-19 During the First Year of Pandemic? Retrospective Analysis of 1104 Deceased Patients in South of France. J Epidemiol Glob Health 2022; 12:196-205. [PMID: 35486358 PMCID: PMC9053122 DOI: 10.1007/s44197-022-00039-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/05/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Following the first year of the COVID-19 pandemic, a complete analysis of the characteristics of the deceased hospitalized patients was performed, to identify factors related to premature mortality and to compare patient profiles according to the epidemic periods. Methods Retrospective analysis of 1104 deceased patients in two University Hospitals in South-eastern France, between March 1, 2020 and March 12, 2021 from Hospital’s electronic medical records was performed. Results Mean age was 80 years (± 11.1) and 10% of the deceased were younger than 65 years with specific comorbidities, e.g., genetic conditions, metastatic cancer, or massive obesity. Among the three clusters identified, two clusters (75% of deceased patients) include very elderly patients with numerous comorbidities, and differ by their proportion of dependent institutionalized patients. The third cluster is made up of younger patients with fewer but severe comorbidities. Deceased patients’ profiles varied according to the epidemic periods: during the first period (March–June 2020), more patients were institutionalized. The second period (September–December2020) coincided with a higher mortality rate. Conclusions This study confirmed that most patients hospitalized and dying from COVID-19 were frail, i.e., elderly and/or highly comorbid and that the small proportion of young patients had severe comorbidities. Supplementary Information The online version contains supplementary material available at 10.1007/s44197-022-00039-3.
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Oshinubi K, Buhamra SS, Al-Kandari NM, Waku J, Rachdi M, Demongeot J. Age Dependent Epidemic Modeling of COVID-19 Outbreak in Kuwait, France, and Cameroon. Healthcare (Basel) 2022; 10:healthcare10030482. [PMID: 35326960 PMCID: PMC8954002 DOI: 10.3390/healthcare10030482] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/21/2022] [Accepted: 02/28/2022] [Indexed: 02/01/2023] Open
Abstract
Revisiting the classical model by Ross and Kermack-McKendrick, the Susceptible−Infectious−Recovered (SIR) model used to formalize the COVID-19 epidemic, requires improvements which will be the subject of this article. The heterogeneity in the age of the populations concerned leads to considering models in age groups with specific susceptibilities, which makes the prediction problem more difficult. Basically, there are three age groups of interest which are, respectively, 0−19 years, 20−64 years, and >64 years, but in this article, we only consider two (20−64 years and >64 years) age groups because the group 0−19 years is widely seen as being less infected by the virus since this age group had a low infection rate throughout the pandemic era of this study, especially the countries under consideration. In this article, we proposed a new mathematical age-dependent (Susceptible−Infectious−Goneanewsusceptible−Recovered (SIGR)) model for the COVID-19 outbreak and performed some mathematical analyses by showing the positivity, boundedness, stability, existence, and uniqueness of the solution. We performed numerical simulations of the model with parameters from Kuwait, France, and Cameroon. We discuss the role of these different parameters used in the model; namely, vaccination on the epidemic dynamics. We open a new perspective of improving an age-dependent model and its application to observed data and parameters.
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Affiliation(s)
- Kayode Oshinubi
- Laboratory AGEIS EA 7407, Team Tools for e-Gnosis Medical, Faculty of Medicine, University Grenoble Alpes (UGA), 38700 La Tronche, France; (K.O.); (M.R.); (J.D.)
| | - Sana S. Buhamra
- Department of Information Science, Kuwait University, P.O. Box 5969, Safat 13060, Kuwait
- Correspondence:
| | - Noriah M. Al-Kandari
- Department of Statistics and Operations Research, Kuwait University, P.O. Box 5969, Safat 13060, Kuwait;
| | - Jules Waku
- UMMISCO UMI IRD 209 & LIRIMA, University of Yaoundé I, Yaoundé P.O. Box 337, Cameroon;
| | - Mustapha Rachdi
- Laboratory AGEIS EA 7407, Team Tools for e-Gnosis Medical, Faculty of Medicine, University Grenoble Alpes (UGA), 38700 La Tronche, France; (K.O.); (M.R.); (J.D.)
| | - Jacques Demongeot
- Laboratory AGEIS EA 7407, Team Tools for e-Gnosis Medical, Faculty of Medicine, University Grenoble Alpes (UGA), 38700 La Tronche, France; (K.O.); (M.R.); (J.D.)
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Ngandu NK, Mmotsa TM, Dassaye R, Thabetha A, Odendaal W, Langdown N, Ndwandwe D. Hospital acquired COVID-19 infections amongst patients before the rollout of COVID-19 vaccinations, a scoping review. BMC Infect Dis 2022; 22:140. [PMID: 35144556 PMCID: PMC8830001 DOI: 10.1186/s12879-022-07128-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/04/2022] [Indexed: 01/16/2023] Open
Abstract
Background Hospital settings are at increased risk of spreading Coronavirus Disease 2019 (COVID-19) infections, hence non-pharmaceutical prevention interventions (NPPIs) and prioritized vaccination of healthcare workers and resident patients are critical. The status of COVID-19 hospital acquired infections (HAIs) in low-income settings is unclear. We aimed to identify and summarize the existing evidence on COVID-19 HAIs amongst patients, prior to the rollout of vaccines in countries worldwide. Methods We conducted a scoping review of English peer-reviewed literature in PubMed, Web of Science and Scopus using a combination of selected search terms. Full texts articles presenting results on COVID-19 HAIs in hospitalised patients before the rollout of vaccines in countries worldwide were eligible. Data extracted from eligible articles included estimates of COVID-19 HAIs, country, and type of hospital setting, and was summarized narratively. Quality assessment of included articles was not possible. Results Literature searches generated a total of 5920 articles, and 45 were eligible for analysis. Eligible articles were from Europe, North America, Asia, and Brazil and none were from low-income countries. The proportion of COVID-19 HAIs ranged from 0% when strict NPPIs were applied, to 65% otherwise. The estimates of COVID-19 HAIs did not differ by country but were lower in studies conducted after implementation of NPPIs and in specialized hospital settings for operative surgery. Studies conducted before the implementation of NPPIs or in long-term care and psychiatric wards often reported high estimates of HAI. Although there was no clear trend in general wards, those situated in academic hospitals managed to reduce HAI rates under strict NPPI protocols. Operative surgery settings, unlike psychiatric settings, effectively prevented COVID-19 HAI using tailored NPPIs. Conclusion The available evidence shows a high risk of COVID-19 HAIs, the feasibility of preventing HAIs in different healthcare settings and the importance of appropriately tailored NPPIs. There were no data from low-income settings, therefore, it is unclear whether the reported NPPI approaches could be equally effective elsewhere. We recommend routine monitoring of COVID-19 HAIs in countries with low vaccination coverage, to identify and close gaps in NPPIs and understand gains made from vaccinating healthcare workers and hospitalized patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07128-5.
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Affiliation(s)
- Nobubelo K Ngandu
- HIV Prevention Research Unit, South African Medical Research Council, Cape Town, South Africa.
| | - Tshiamo M Mmotsa
- HIV Prevention Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Reshmi Dassaye
- HIV Prevention Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Alice Thabetha
- Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Willem Odendaal
- HIV Prevention Research Unit, South African Medical Research Council, Cape Town, South Africa.,Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Natasha Langdown
- Knowledge and Information Management Services, South African Medical Research Council, Cape Town, South Africa
| | - Duduzile Ndwandwe
- Cochrane, South African Medical Research Council, Cape Town, South Africa
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Garcia-Morata M, Gonzalez-Rubio J, Segura T, Najera A. Spatial analysis of COVID-19 hospitalised cases in an entire city: The risk of studying only lattice data. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150521. [PMID: 34844333 PMCID: PMC8461325 DOI: 10.1016/j.scitotenv.2021.150521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/18/2021] [Accepted: 09/18/2021] [Indexed: 06/01/2023]
Abstract
We live in a global pandemic caused by the COVID-19 disease where severe social distancing measures are necessary. Some of these measures have been taken into account by the administrative boundaries within cities (neighborhoods, postal districts, etc.). However, considering only administrative boundaries in decision making can prove imprecise, and could have consequences when it comes to taking effective measures. To solve the described problems, we present an epidemiological study that proposes using spatial point patterns to delimit spatial units of analysis based on the highest local incidence of hospitalisations instead of administrative limits during the first COVID-19 wave. For this purpose, the 579 addresses of the cases hospitalised between March 3 and April 6, 2020, in Albacete (Spain), and the addresses of the random sample of 383 controls from the Inhabitants Register of the city of Albacete, were georeferenced. The risk ratio in those hospitalised for COVID-19 was compatible with the constant risk ratio in Albacete (p = 0.49), but areas with a significantly higher risk were found and coincided with those with greater economic inequality (Gini Index). Moreover, two districts had areas with a significantly high incidence that were masked by others with a significantly low incidence. In conclusion, taking measures conditioned exclusively by administrative limits in a pandemic can cause problems caused by managing entire districts with lax measures despite having interior areas with high significant incidences. In a pandemic context, georeferencing disease cases in real time and spatially comparing them to updated random population controls to automatically and accurately detect areas with significant incidences are suggested. This would facilitate decision making, which must be fast and accurate in these situations.
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Affiliation(s)
- Marta Garcia-Morata
- Department of Medical Sciences, Faculty of Medicine of Albacete, University of Castilla-La Mancha, Albacete, Spain.
| | - Jesus Gonzalez-Rubio
- Department of Medical Sciences, Faculty of Medicine of Albacete, University of Castilla-La Mancha, Albacete, Spain; Centro Regional de Investigaciones Biomédicas (CRIB), University of Castilla-La Mancha, Albacete, Spain.
| | - Tomas Segura
- Department of Medical Sciences, Faculty of Medicine of Albacete, University of Castilla-La Mancha, Albacete, Spain; Servicio de Neurología, Hospital General Universitario de Albacete, Albacete, Spain; Instituto de Investigación en Discapacidades Neurológicas (IDINE), University of Castilla-La Mancha, Albacete, Spain.
| | - Alberto Najera
- Department of Medical Sciences, Faculty of Medicine of Albacete, University of Castilla-La Mancha, Albacete, Spain; Centro Regional de Investigaciones Biomédicas (CRIB), University of Castilla-La Mancha, Albacete, Spain.
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Vallée A. Heterogeneity of the COVID-19 Pandemic in the United States of America: A Geo-Epidemiological Perspective. Front Public Health 2022; 10:818989. [PMID: 35155328 PMCID: PMC8826232 DOI: 10.3389/fpubh.2022.818989] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/03/2022] [Indexed: 12/23/2022] Open
Abstract
The spread of the COVID-19 pandemic has shown great heterogeneity between regions of countries, e. g., in the United States of America (USA). With the growing of the worldwide COVID-19 pandemic, there is a need to better highlight the variability in the trajectory of this disease in different worldwide geographic areas. Indeed, the epidemic trends across areas can display completely different evolution at a given time. Geo-epidemiological analyses using data, that are publicly available, could be a major topic to help governments and public administrations to implement health policies. Geo-epidemiological analyses could provide a basis for the implementation of relevant public health policies. With the COVID-19 pandemic, geo-epidemiological analyses can be readily utilized by policy interventions and USA public health authorities to highlight geographic areas of particular concern and enhance the allocation of resources.
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Affiliation(s)
- Alexandre Vallée
- Department of Clinical Research and Innovation, Foch Hospital, Suresnes, France
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43
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Adin A, Congdon P, Santafé G, Ugarte MD. Identifying extreme COVID-19 mortality risks in English small areas: a disease cluster approach. STOCHASTIC ENVIRONMENTAL RESEARCH AND RISK ASSESSMENT : RESEARCH JOURNAL 2022; 36:2995-3010. [PMID: 35075346 PMCID: PMC8771626 DOI: 10.1007/s00477-022-02175-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic is having a huge impact worldwide and has highlighted the extent of health inequalities between countries but also in small areas within a country. Identifying areas with high mortality is important both of public health mitigation in COVID-19 outbreaks, and of longer term efforts to tackle social inequalities in health. In this paper we consider different statistical models and an extension of a recent method to analyze COVID-19 related mortality in English small areas during the first wave of the epidemic in the first half of 2020. We seek to identify hotspots, and where they are most geographically concentrated, taking account of observed area factors as well as spatial correlation and clustering in regression residuals, while also allowing for spatial discontinuities. Results show an excess of COVID-19 mortality cases in small areas surrounding London and in other small areas in North-East and and North-West of England. Models alleviating spatial confounding show ethnic isolation, air quality and area morbidity covariates having a significant and broadly similar impact on COVID-19 mortality, whereas nursing home location seems to be slightly less important.
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Affiliation(s)
- A. Adin
- Department of Statistics, Computer Science and Mathematics, Public University of Navarre, Pamplona, Spain
- Institute for Advanced Materials and Mathematics (INAMAT2), Public University of Navarre, Pamplona, Spain
| | - P. Congdon
- School of Geography, Queen Mary University of London, London, UK
| | - G. Santafé
- Department of Statistics, Computer Science and Mathematics, Public University of Navarre, Pamplona, Spain
- Institute for Advanced Materials and Mathematics (INAMAT2), Public University of Navarre, Pamplona, Spain
| | - M. D. Ugarte
- Department of Statistics, Computer Science and Mathematics, Public University of Navarre, Pamplona, Spain
- Institute for Advanced Materials and Mathematics (INAMAT2), Public University of Navarre, Pamplona, Spain
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Adin A, Congdon P, Santafé G, Ugarte MD. Identifying extreme COVID-19 mortality risks in English small areas: a disease cluster approach. STOCHASTIC ENVIRONMENTAL RESEARCH AND RISK ASSESSMENT : RESEARCH JOURNAL 2022; 36:2995-3010. [PMID: 35075346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic is having a huge impact worldwide and has highlighted the extent of health inequalities between countries but also in small areas within a country. Identifying areas with high mortality is important both of public health mitigation in COVID-19 outbreaks, and of longer term efforts to tackle social inequalities in health. In this paper we consider different statistical models and an extension of a recent method to analyze COVID-19 related mortality in English small areas during the first wave of the epidemic in the first half of 2020. We seek to identify hotspots, and where they are most geographically concentrated, taking account of observed area factors as well as spatial correlation and clustering in regression residuals, while also allowing for spatial discontinuities. Results show an excess of COVID-19 mortality cases in small areas surrounding London and in other small areas in North-East and and North-West of England. Models alleviating spatial confounding show ethnic isolation, air quality and area morbidity covariates having a significant and broadly similar impact on COVID-19 mortality, whereas nursing home location seems to be slightly less important.
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Affiliation(s)
- A Adin
- Department of Statistics, Computer Science and Mathematics, Public University of Navarre, Pamplona, Spain
- Institute for Advanced Materials and Mathematics (INAMAT2), Public University of Navarre, Pamplona, Spain
| | - P Congdon
- School of Geography, Queen Mary University of London, London, UK
| | - G Santafé
- Department of Statistics, Computer Science and Mathematics, Public University of Navarre, Pamplona, Spain
- Institute for Advanced Materials and Mathematics (INAMAT2), Public University of Navarre, Pamplona, Spain
| | - M D Ugarte
- Department of Statistics, Computer Science and Mathematics, Public University of Navarre, Pamplona, Spain
- Institute for Advanced Materials and Mathematics (INAMAT2), Public University of Navarre, Pamplona, Spain
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Georeferencing of COVID-19 Positive Nasopharyngeal Swabs to Support Emergency Management in an Area of Northern Italy. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2021. [DOI: 10.3390/ijgi11010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Spatial distribution heterogeneity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been observed in several countries. While previous studies have covered vast geographic areas, detailed analyses on smaller territories are not available to date. The aim of our study was to understand the spatial spread of SARS-CoV-2 in a province of Northern Italy through the analysis of positive nasopharyngeal (NP) swabs. The study was conducted on subjects who lived in the province of Alessandria with at least one positive NP swab between 2 March and 22 December 2020. To investigate if clustering occurred, the proportion of SARS-CoV-2 positive subjects over the total number of residents in each small administrative subregion was calculated and then mapped. A total of 17,260 subjects with at least one positive NP swab were included; the median age was 54 years (Interquartile range 38–72) and 54.9% (n = 9478) of our study population were female. Among the 192 towns scanned, 26 showed a prevalence between 5% and 7.5%, one between 7.5% and 10% and two with more than 10% positive swabs. The territories with a higher prevalence of positive subjects were located in areas with at least one nursing home and potential clusters were observed within these structures. The maps produced may be considered a useful and important monitoring system to identify areas with a significant and relevant diffusion of SARS-CoV-2.
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Domenech de Cellès M, Casalegno JS, Lina B, Opatowski L. Estimating the impact of influenza on the epidemiological dynamics of SARS-CoV-2. PeerJ 2021; 9:e12566. [PMID: 34950537 PMCID: PMC8647717 DOI: 10.7717/peerj.12566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022] Open
Abstract
As in past pandemics, co-circulating pathogens may play a role in the epidemiology of coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In particular, experimental evidence indicates that influenza infection can up-regulate the expression of ACE2-the receptor of SARS-CoV-2 in human cells-and facilitate SARS-CoV-2 infection. Here we hypothesized that influenza impacted the epidemiology of SARS-CoV-2 during the early 2020 epidemic of COVID-19 in Europe. To test this hypothesis, we developed a population-based model of SARS-CoV-2 transmission and of COVID-19 mortality, which simultaneously incorporated the impact of non-pharmaceutical control measures and of influenza on the epidemiological dynamics of SARS-CoV-2. Using statistical inference methods based on iterated filtering, we confronted this model with mortality incidence data in four European countries (Belgium, Italy, Norway, and Spain) to systematically test a range of assumptions about the impact of influenza. We found consistent evidence for a 1.8-3.4-fold (uncertainty range across countries: 1.1 to 5.0) average population-level increase in SARS-CoV-2 transmission associated with influenza during the period of co-circulation. These estimates remained robust to a variety of alternative assumptions regarding the epidemiological traits of SARS-CoV-2 and the modeled impact of control measures. Although further confirmatory evidence is required, our results suggest that influenza could facilitate the spread and hamper effective control of SARS-CoV-2. More generally, they highlight the possible role of co-circulating pathogens in the epidemiology of COVID-19.
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Affiliation(s)
| | - Jean-Sebastien Casalegno
- Laboratoire de Virologie des HCL, IAI, CNR des Virus à Transmission Respiratoire (dont la grippe) Hôpital de la Croix-Rousse F-69317 Lyon Cedex 04, France, Lyon, France
- Virpath, Centre International de Recherche en Infectiologie (CIRI), Université de Lyon Inserm U1111, CNRS UMR 5308, ENS de Lyon, UCBL F-69372, Lyon, France
| | - Bruno Lina
- Laboratoire de Virologie des HCL, IAI, CNR des Virus à Transmission Respiratoire (dont la grippe) Hôpital de la Croix-Rousse F-69317 Lyon Cedex 04, France, Lyon, France
- Virpath, Centre International de Recherche en Infectiologie (CIRI), Université de Lyon Inserm U1111, CNRS UMR 5308, ENS de Lyon, UCBL F-69372, Lyon, France
| | - Lulla Opatowski
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-Infective Evasion and Pharma- Coepidemiology Team, Montigny-Le-Bretonneux, France
- Institut Pasteur, Epidemiology and Modelling of Evasion to Antibiotics, Paris, France
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Pilkington H, Feuillet T, Rican S, Goupil de Bouillé J, Bouchaud O, Cailhol J, Bihan H, Lombrail P, Julia C. Spatial determinants of excess all-cause mortality during the first wave of the COVID-19 epidemic in France. BMC Public Health 2021; 21:2157. [PMID: 34819057 PMCID: PMC8611998 DOI: 10.1186/s12889-021-12203-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 11/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The first wave of the COVID-19 pandemic in France was associated with high excess mortality, and anecdotal evidence pointed to differing excess mortality patterns depending on social and environmental determinants. In this study we aimed to investigate the spatial distribution of excess mortality during the first wave of the COVID-19 pandemic in France and relate it at the subnational level to contextual determinants from various dimensions (socioeconomic, population density, overall health status, healthcare access etc.). We also explored whether the determinants identified at the national level varied depending on geographical location. METHODS We used available national data on deaths in France to calculate excess mortality by department for three age groups: 0-49, 50-74 and > 74 yrs. between March 1st and April 27th, 2020. We selected 15 variables at the department level that represent four dimensions that may be related to overall mortality at the ecological level, two representing population-level vulnerabilities (morbidity, social deprivation) and two representing environmental-level vulnerabilities (primary healthcare supply, urbanization). We modelled excess mortality by age group for our contextual variables at the department level. We conducted both a global (i.e., country-wide) analysis and a multiscale geographically weighted regression (MGWR) model to account for the spatial variations in excess mortality. RESULTS In both age groups, excess all-cause mortality was significantly higher in departments where urbanization was higher (50-74 yrs.: β = 15.33, p < 0.001; > 74 yrs.: β = 18.24, p < 0.001) and the supply of primary healthcare providers lower (50-74 yrs.: β = - 8.10, p < 0.001; > 74 yrs.: β = - 8.27, p < 0.001). In the 50-74 yrs. age group, excess mortality was negatively associated with the supply of pharmacists (β = - 3.70, p < 0.02) and positively associated with work-related mobility (β = 4.62, p < 0.003); in the > 74 yrs. age group our measures of deprivation (β = 15.46, p < 0.05) and morbidity (β = 0.79, p < 0.008) were associated with excess mortality. Associations between excess mortality and contextual variables varied significantly across departments for both age groups. CONCLUSIONS Public health strategies aiming at mitigating the effects of future epidemics should consider all dimensions involved to develop efficient and locally tailored policies within the context of an evolving, socially and spatially complex situation.
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Affiliation(s)
- Hugo Pilkington
- Département de Géographie, Université Paris 8 Vincennes-Saint-Denis, UMR7533 Ladyss, 2 rue de la Liberté, F-93526, Saint-Denis, France.
| | - Thierry Feuillet
- Département de Géographie, Université Paris 8 Vincennes-Saint-Denis, UMR7533 Ladyss, 2 rue de la Liberté, F-93526, Saint-Denis, France
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Stéphane Rican
- Département de Géographie-Aménagement, Université Paris Nanterre, UMR7533 Ladyss, 200 avenue de la République, F-9200, Nanterre, France
| | - Jeanne Goupil de Bouillé
- Infectious and Tropical Diseases Department, Avicenne Hospital (AP-HP), Bobigny, France
- LEPS, Laboratoire Educations Pratiques Santé, UR3412, Université Sorbonne Paris Nord Bobigny, Villetaneuse, France
| | - Olivier Bouchaud
- Infectious and Tropical Diseases Department, Avicenne Hospital (AP-HP), Bobigny, France
- LEPS, Laboratoire Educations Pratiques Santé, UR3412, Université Sorbonne Paris Nord Bobigny, Villetaneuse, France
| | - Johann Cailhol
- Infectious and Tropical Diseases Department, Avicenne Hospital (AP-HP), Bobigny, France
- LEPS, Laboratoire Educations Pratiques Santé, UR3412, Université Sorbonne Paris Nord Bobigny, Villetaneuse, France
| | - Hélène Bihan
- LEPS, Laboratoire Educations Pratiques Santé, UR3412, Université Sorbonne Paris Nord Bobigny, Villetaneuse, France
- Endocrinology, Diabetology and Metabolic diseases Department, Avicenne Hospital (AP-HP), Bobigny, France
| | - Pierre Lombrail
- LEPS, Laboratoire Educations Pratiques Santé, UR3412, Université Sorbonne Paris Nord Bobigny, Villetaneuse, France
- Public Health Department, Avicenne Hospital (AP-HP), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Nutritional Epidemiology Research Team (EREN), Bobigny, France
- Public Health Department, Avicenne Hospital (AP-HP), Bobigny, France
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Abstract
(1) Background: The estimation of daily reproduction numbers throughout the contagiousness period is rarely considered, and only their sum R0 is calculated to quantify the contagiousness level of an infectious disease. (2) Methods: We provide the equation of the discrete dynamics of the epidemic’s growth and obtain an estimation of the daily reproduction numbers by using a deconvolution technique on a series of new COVID-19 cases. (3) Results: We provide both simulation results and estimations for several countries and waves of the COVID-19 outbreak. (4) Discussion: We discuss the role of noise on the stability of the epidemic’s dynamics. (5) Conclusions: We consider the possibility of improving the estimation of the distribution of daily reproduction numbers during the contagiousness period by taking into account the heterogeneity due to several host age classes.
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Mazzoli M, Pepe E, Mateo D, Cattuto C, Gauvin L, Bajardi P, Tizzoni M, Hernando A, Meloni S, Ramasco JJ. Interplay between mobility, multi-seeding and lockdowns shapes COVID-19 local impact. PLoS Comput Biol 2021; 17:e1009326. [PMID: 34648495 PMCID: PMC8516261 DOI: 10.1371/journal.pcbi.1009326] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/06/2021] [Indexed: 11/22/2022] Open
Abstract
Assessing the impact of mobility on epidemic spreading is of crucial importance for understanding the effect of policies like mass quarantines and selective re-openings. While many factors affect disease incidence at a local level, making it more or less homogeneous with respect to other areas, the importance of multi-seeding has often been overlooked. Multi-seeding occurs when several independent (non-clustered) infected individuals arrive at a susceptible population. This can lead to independent outbreaks that spark from distinct areas of the local contact (social) network. Such mechanism has the potential to boost incidence, making control efforts and contact tracing less effective. Here, through a modeling approach we show that the effect produced by the number of initial infections is non-linear on the incidence peak and peak time. When case importations are carried by mobility from an already infected area, this effect is further enhanced by the local demography and underlying mixing patterns: the impact of every seed is larger in smaller populations. Finally, both in the model simulations and the analysis, we show that a multi-seeding effect combined with mobility restrictions can explain the observed spatial heterogeneities in the first wave of COVID-19 incidence and mortality in five European countries. Our results allow us for identifying what we have called epidemic epicenter: an area that shapes incidence and mortality peaks in the entire country. The present work further clarifies the nonlinear effects that mobility can have on the evolution of an epidemic and highlight their relevance for epidemic control.
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Affiliation(s)
- Mattia Mazzoli
- Instituto de Física Interdisciplinar y Sistemas Complejos IFISC (CSIC-UIB), Palma de Mallorca, Spain
- INSERM, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique, IPLESP, Paris, France
| | | | | | | | | | | | | | | | | | - José J. Ramasco
- Instituto de Física Interdisciplinar y Sistemas Complejos IFISC (CSIC-UIB), Palma de Mallorca, Spain
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[White Paper of Anaesthesiologists-Resuscitationists Peri-Operative Physicians: What critical care for tomorrow?]. ACTA ACUST UNITED AC 2021; 25:165-166. [PMID: 34566443 PMCID: PMC8453691 DOI: 10.1016/j.pratan.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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