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Woolf SH, Lee JH, Chapman DA, Sabo RT, Zimmerman E. Excess Death Rates by State During the COVID-19 Pandemic: United States, 2020‒2023. Am J Public Health 2024; 114:882-891. [PMID: 39024530 PMCID: PMC11306623 DOI: 10.2105/ajph.2024.307731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Objectives. To estimate state-level excess death rates during 2020 to 2023 and examine differences by region and partisan orientation. Methods. We modeled death and population counts from the Centers for Disease Control and Prevention to estimate excess death rates for the United States, 9 census divisions, and 50 states. We compared excess death rates for states with different partisan orientations, measured by the party of the seated governor and the level of partisan representation in state legislatures. Results. The United States experienced 1 277 697 excess deaths between March 2020 and July 2023. Almost 90% of these deaths were attributed to COVID-19, and 51.5% occurred after vaccines were available. The highest excess death rates first occurred in the Northeast and then shifted to the South and Mountain states. Between weeks ending June 20, 2020, through March 19, 2022, excess death rates were higher in states with Republican governors and greater Republican representation in state legislatures. Conclusions. Excess death rates during the COVID-19 pandemic varied considerably across the US states and were associated with partisan representation in state government, although the influence of confounding variables cannot be excluded. (Am J Public Health. 2024;114(9):882-891. https://doi.org/10.2105/AJPH.2024.307731).
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Affiliation(s)
- Steven H Woolf
- Steven H. Woolf and Jong Hyung Lee are with the Department of Family Medicine, Virginia Commonwealth University (VCU) School of Medicine, Richmond. Derek A. Chapman and Emily Zimmerman are with the Department of Epidemiology, VCU School of Population Health, Richmond. Roy T. Sabo is with the Department of Biostatistics, VCU School of Population Health
| | - Jong Hyung Lee
- Steven H. Woolf and Jong Hyung Lee are with the Department of Family Medicine, Virginia Commonwealth University (VCU) School of Medicine, Richmond. Derek A. Chapman and Emily Zimmerman are with the Department of Epidemiology, VCU School of Population Health, Richmond. Roy T. Sabo is with the Department of Biostatistics, VCU School of Population Health
| | - Derek A Chapman
- Steven H. Woolf and Jong Hyung Lee are with the Department of Family Medicine, Virginia Commonwealth University (VCU) School of Medicine, Richmond. Derek A. Chapman and Emily Zimmerman are with the Department of Epidemiology, VCU School of Population Health, Richmond. Roy T. Sabo is with the Department of Biostatistics, VCU School of Population Health
| | - Roy T Sabo
- Steven H. Woolf and Jong Hyung Lee are with the Department of Family Medicine, Virginia Commonwealth University (VCU) School of Medicine, Richmond. Derek A. Chapman and Emily Zimmerman are with the Department of Epidemiology, VCU School of Population Health, Richmond. Roy T. Sabo is with the Department of Biostatistics, VCU School of Population Health
| | - Emily Zimmerman
- Steven H. Woolf and Jong Hyung Lee are with the Department of Family Medicine, Virginia Commonwealth University (VCU) School of Medicine, Richmond. Derek A. Chapman and Emily Zimmerman are with the Department of Epidemiology, VCU School of Population Health, Richmond. Roy T. Sabo is with the Department of Biostatistics, VCU School of Population Health
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Liu RJ, Yang GB. Molecular characteristics of rhesus macaque interferon-lambda receptor 1 (mmuIFNLR1): Sequence identity, distribution and alteration after simian-human immunodeficiency virus infection in the skin and buccal mucosa. DEVELOPMENTAL AND COMPARATIVE IMMUNOLOGY 2024; 160:105236. [PMID: 39103005 DOI: 10.1016/j.dci.2024.105236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/01/2024] [Accepted: 08/01/2024] [Indexed: 08/07/2024]
Abstract
Interferon-lambda receptor 1 (IFNLR1) is the key to interferon-lambda's biological activities. Rhesus macaques (Macaca mulatta) are supposedly more suitable for translational studies on interferon lambda-associated human diseases, yet little is known about their IFNLR1 (mmuIFNLR1). In this study, we cloned the coding sequence of mmuIFNLR1, examined its variants, and determined the distribution of mmuIFNLR1 mRNA and immunoreactivity in the buccal mucosa and arm skin of normal and immunodeficiency virus (SHIV/SIV) infected rhesus macaques. It was found that mmuIFNLR1 has 93.1% amino acid sequence identity to that of humans; all the amino acid residues of mmuIFNLR1 signal peptide, transmembrane region, PxxLxF motif and those essential for ligand binding are identical to that of humans; 6 variants of mmuIFNLR1, including the ones corresponding to that of humans were detected; IFNLR1 immunoreactivity was localized in primarily the epithelia of buccal mucosa and arm skin; SHIV/SIV infection could affect the levels of mmuIFNLR1 mRNA and immunoreactivity. These data expanded our knowledge on mmuIFNLR1 and provided a scientific basis for rational use of rhesus macaques in studies of IFN-λ associated human diseases like AIDS. Future studies testing IFNLR1-targeting therapeutics in rhesus macaques were warranted.
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Affiliation(s)
- Rui-Jie Liu
- National Center for AIDS/STD Control and Prevention, China-CDC, Beijing, 102206, PR China
| | - Gui-Bo Yang
- National Center for AIDS/STD Control and Prevention, China-CDC, Beijing, 102206, PR China.
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3
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Yan X, Jia X, Feng L, Ge W, Kong B, Xia M, Yan X. Enhancing nursing competence in China: The interplay of resilience, mindfulness and social support. Nurse Educ Pract 2024; 79:104087. [PMID: 39142120 DOI: 10.1016/j.nepr.2024.104087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 07/20/2024] [Accepted: 07/30/2024] [Indexed: 08/16/2024]
Abstract
OBJECTIVES To address the nursing crisis, it is imperative to comprehend the factors that influence nursing competencies, which are crucial for the delivery of quality patient care. BACKGROUND Facing demographic shifts and increasingly complex healthcare demands, China's nursing sector struggles with workforce shortages and the need to enhance core competencies. This research explores the interplay of social support, psychological resilience, mindfulness and nursing competencies in various hospital environments in China. METHODS Through a cross-sectional survey, 941 nurses across tertiary, secondary and private healthcare settings completed self-assessment questionnaires. The analysis included multiple linear regression and comparative methods to assess how psychological resilience, mindfulness and social support have an impact on nursing competencies. RESULTS Findings revealed a strong relationship between psychological resilience and nursing competencies, with resilience being a key predictor. Mindfulness and social support also significantly contributed to competency levels. Nurses in tertiary hospitals showed greater competencies than those in secondary or private facilities. CONCLUSION Enhancing nursing competencies requires targeted interventions focusing on professional development and supportive workplace cultures. Incorporating psychological resilience, social support and mindfulness into nurse training is crucial for improving practice and policy.
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Affiliation(s)
- Xiaoting Yan
- Department of Central Sterile Supply, Taizhou Central Hospital, Taizhou University Hospital, Jiaojiang, Zhejiang 318000, China
| | - Xiang Jia
- Department of Rehabilitation, Taizhou Central Hospital, Taizhou University Hospital, Jiaojiang, Zhejiang 318000, China
| | - Lili Feng
- Department of Nursing, Taizhou Central Hospital, Taizhou University Hospital, Jiaojiang, Zhejiang 318000, China
| | - Weiwei Ge
- Department of Orthopedics, Taizhou Central Hospital, Taizhou University Hospital, Jiaojiang, Zhejiang 318000, China
| | - Beilei Kong
- Department of Nursing, Yuhuan Second People's Hospital, Yuhuan, Zhejiang 317600, China
| | - Mengjie Xia
- School of Medicine, Taizhou University, Jiaojiang, Zhejiang 318000, China; School of Nursing, Faculty of Medicine Bioscience & Nursing, MAHSA University, Jenjarom, Selangor 42610, Malaysia.
| | - Xiaoting Yan
- Department of Central Sterile Supply, Taizhou Central Hospital, Taizhou University Hospital, Jiaojiang, Zhejiang 318000, China.
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Sonnhoff M, Graff M, Paal K, Becker JN, Hermann RM, Christiansen H, Nitsche M, Merten R. Influence of demographic change on the demand for radiotherapy using forecasted predictions for prostate cancer in Germany. Strahlenther Onkol 2024; 200:671-675. [PMID: 37638976 PMCID: PMC11272801 DOI: 10.1007/s00066-023-02133-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/27/2023] [Indexed: 08/29/2023]
Abstract
PURPOSE Demographic change will lead to an increase in age-associated cancers. The demand for primary treatment, especially oncologic therapies, is difficult to predict. This work is an attempt to project the demand for radiation therapy (RT) in 2030, taking into account demographic changes using prostate cancer (PC) as an example. MATERIALS AND METHODS Using the GENESIS database of the Federal Statistical Office, we retrieved demographic population projections for 2030 and retrospective demographic surveys from 1999 to 2019. Additionally, we queried incidence rates for PC in the respective age groups of 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, and +85 years from 1999-2019 via the Federal Cancer Registry of the Robert Koch Institute. We used a regression method to determine the age-dependent correlation between the incidence of PC and the population size of the respective age group by combining the data from 1999 to 2019. This information was used to calculate the incidence rates in the age groups of the expected population for 2030 and the expected new cases of PC in 2030. Finally, we extrapolated the indications for the demand for RT based on data from the Report on Cancer Incidence in Germany from 2016. RESULTS Considering a population-dependent incidence rate, an increase in new cases of PC is expected. This increase is particularly evident in the age groups of 70-74 and 80-84 years. With regards to RT, the estimate indicates an overall increase of 27.4% in demand. There is also a shift in RT demands towards older patients, especially in the 80- to 84-year-old age group. CONCLUSION We observe an age-associated increase in primary cases of PC. This is likely to result in an increased demand for RT. The exact demand cannot be predicted. However, trends can be estimated to plan for the demand. This, though, requires a good database from cancer registries.
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Affiliation(s)
- M Sonnhoff
- Department of Radiotherapy and Special Oncology, Hannover Medical School, 30625, Hannover, Germany.
- Center for Radiotherapy and Radiooncology Bremen and Westerstede, 28239, Bremen, Germany.
| | - M Graff
- Center for Radiotherapy and Radiooncology Bremen and Westerstede, 28239, Bremen, Germany
| | - K Paal
- Depatment für Radiotherapy University Hospital Graz, 8036, Graz, Austria
| | - J-N Becker
- Department of Radiotherapy and Special Oncology, Hannover Medical School, 30625, Hannover, Germany
| | - R-M Hermann
- Department of Radiotherapy and Special Oncology, Hannover Medical School, 30625, Hannover, Germany
- Center for Radiotherapy and Radiooncology Bremen and Westerstede, 28239, Bremen, Germany
| | - H Christiansen
- Department of Radiotherapy and Special Oncology, Hannover Medical School, 30625, Hannover, Germany
| | - M Nitsche
- Center for Radiotherapy and Radiooncology Bremen and Westerstede, 28239, Bremen, Germany
| | - R Merten
- Department of Radiotherapy and Special Oncology, Hannover Medical School, 30625, Hannover, Germany
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Forthun I, Madsen C, Emilsson L, Nilsson A, Kepp KP, Björk J, Vollset SE, Lallukka T, Skrindo Knudsen AK. Excess mortality in Denmark, Finland, Norway and Sweden during the COVID-19 pandemic 2020-2022. Eur J Public Health 2024; 34:737-743. [PMID: 38758188 PMCID: PMC11293825 DOI: 10.1093/eurpub/ckae091] [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] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The Nordic countries represent a unique case study for the COVID-19 pandemic due to socioeconomic and cultural similarities, high-quality comparable administrative register data and notable differences in mitigation policies during the pandemic. We aimed to compare weekly excess mortality in the Nordic countries across the three full pandemic years 2020-2022. METHODS Using data on weekly all-cause mortality from official administrative registers in Denmark, Finland, Norway and Sweden, we employed time series regression models to assess mortality developments within each pandemic year, with the period 2010-2019 used as reference period. We then compared excess mortality across the countries in 2020-2022, taking differences in population size and age- and sex-distribution into account. Results were age- and sex-standardized to the Danish population of 2020. Robustness was examined with a variety of sensitivity analyses. RESULTS While Sweden experienced excess mortality in 2020 [75 excess deaths per 100 000 population (95% prediction interval 29-122)], Denmark, Finland and Norway experienced excess mortality in 2022 [52 (14-90), 130 (83-177) and 88 (48-128), respectively]. Weekly death data reveal how mortality started to increase in mid-2021 in Denmark, Finland and Norway, and continued above the expected level through 2022. CONCLUSION Although the Nordic countries experienced relatively low pandemic excess mortality, the impact and timing of excess mortality differed substantially. These estimates-arguably the most accurate available for any region in capturing pandemic-related excess deaths-may inform future research and policy regarding the complex mortality dynamics in times of a health crisis such as the COVID-19 pandemic.
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Affiliation(s)
- Ingeborg Forthun
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Christian Madsen
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Louise Emilsson
- General Practice Research Unit (AFE) and Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
- Vårdcentralen Värmlands Nysäter and Centre for Clinical Research, County Council of Värmland, Varmland, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden
| | - Anton Nilsson
- Unit of Epidemiology, Population Studies and Infrastructures (EPI@LUND), Division of Occupational and Environmental Medicine, Epidemiology, Lund University, Lund, Sweden
| | - Kasper P Kepp
- Section of Biophysical and Biomedicinal Chemistry, DTU Chemistry, Technical University of Denmark, Kongens Lyngby, Denmark
- Epistudia, Bern, Switzerland
| | - Jonas Björk
- Unit of Epidemiology, Population Studies and Infrastructures (EPI@LUND), Division of Occupational and Environmental Medicine, Epidemiology, Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Stein Emil Vollset
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Science, School of Medicine, University of Washington, Seattle, WA, USA
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Chidambaram V, Kumar A, Sadaf MI, Lu E, Al’Aref SJ, Tarun T, Galiatsatos P, Gulati M, Blumenthal RS, Leucker TM, Karakousis PC, Mehta JL. COVID-19 in the Initiation and Progression of Atherosclerosis: Pathophysiology During and Beyond the Acute Phase. JACC. ADVANCES 2024; 3:101107. [PMID: 39113913 PMCID: PMC11304887 DOI: 10.1016/j.jacadv.2024.101107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 04/24/2024] [Accepted: 06/01/2024] [Indexed: 08/10/2024]
Abstract
The incidence of atherosclerotic cardiovascular disease is increasing globally, especially in low- and middle-income countries, despite significant efforts to reduce traditional risk factors. Premature subclinical atherosclerosis has been documented in association with several viral infections. The magnitude of the recent COVID-19 pandemic has highlighted the need to understand the association between SARS-CoV-2 and atherosclerosis. This review examines various pathophysiological mechanisms, including endothelial dysfunction, platelet activation, and inflammatory and immune hyperactivation triggered by SARS-CoV-2 infection, with specific attention on their roles in initiating and promoting the progression of atherosclerotic lesions. Additionally, it addresses the various pathogenic mechanisms by which COVID-19 in the post-acute phase may contribute to the development of vascular disease. Understanding the overlap of these syndromes may enable novel therapeutic strategies. We further explore the need for guidelines for closer follow-up for the often-overlooked evidence of atherosclerotic cardiovascular disease among patients with recent COVID-19, particularly those with cardiometabolic risk factors.
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Affiliation(s)
- Vignesh Chidambaram
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Amudha Kumar
- Division of Cardiology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois, USA
| | - Murrium I. Sadaf
- Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Emily Lu
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Subhi J. Al’Aref
- Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Tushar Tarun
- Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Panagis Galiatsatos
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Martha Gulati
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Roger S. Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Thorsten M. Leucker
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Petros C. Karakousis
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jawahar L. Mehta
- Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Division of Cardiovascular Medicine, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA
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Singh A, Laffin LJ, Sarraju A, Michael Lincoff A, Nicholls SJ, Bloedon L, Sasiela WJ, Li N, Robinson P, Kelly S, Mason D, Nissen SE. Impact of the COVID-19 Pandemic on Conduct and Results of CLEAR Outcomes Trial. Clin Cardiol 2024; 47:e24328. [PMID: 39077851 PMCID: PMC11287323 DOI: 10.1002/clc.24328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/11/2024] [Accepted: 07/18/2024] [Indexed: 07/31/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic disrupted clinical research. CLEAR Outcomes investigated the effect of bempedoic acid (BA) versus placebo in 13 970 patients with statin intolerance and high cardiovascular (CV) risk. BA reduced the risk of the primary endpoint (composite of CV death, nonfatal myocardial infarction, nonfatal stroke, or coronary revascularization) by 13%. CLEAR Outcomes began before and continued for 2.7 years after the start of the pandemic. METHODS The impact of the COVID-19 pandemic on patient disposition, adverse events, and major adverse CV events (MACE) in CLEAR Outcomes was assessed. RESULTS Rates of severe infection, hospitalization, or first MACE associated with a positive COVID-19 test were low and balanced between treatment groups. Rates of all-cause death, non-CV death, and undetermined death increased in the pandemic period compared with the pre-pandemic period, while rates of CV death with a known etiology remained stable. A sensitivity analysis excluding undetermined deaths occurring after the onset of the pandemic from the CV death designation yielded hazard ratios of 0.84 (95% CI, 0.76-0.93) for the primary endpoint and 0.94 (95% CI, 0.76-1.16) for the secondary endpoint of CV death, compared with 0.87 (95% CI, 0.79-0.96) and 1.04 (95% CI, 0.88-1.24), respectively, in the original analysis. CONCLUSION The CLEAR Outcomes trial continued uninterrupted throughout the COVID-19 pandemic. Certain trial endpoints may have been impacted by the pandemic. Specifically, the classification of undetermined deaths as CV deaths may have attenuated the effect of BA on key efficacy endpoints.
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Affiliation(s)
- Abhayjit Singh
- Section of Preventive Cardiology and Rehabilitation, Department of Cardiovascular MedicineCleveland Clinic FoundationClevelandOhioUSA
| | - Luke J. Laffin
- Section of Preventive Cardiology and Rehabilitation, Department of Cardiovascular MedicineCleveland Clinic FoundationClevelandOhioUSA
- Cleveland Clinic Coordinating Center for Clinical Research (C5Research)ClevelandOhioUSA
| | - Ashish Sarraju
- Section of Preventive Cardiology and Rehabilitation, Department of Cardiovascular MedicineCleveland Clinic FoundationClevelandOhioUSA
- Cleveland Clinic Coordinating Center for Clinical Research (C5Research)ClevelandOhioUSA
| | - A. Michael Lincoff
- Cleveland Clinic Coordinating Center for Clinical Research (C5Research)ClevelandOhioUSA
| | | | | | | | - Na Li
- Esperion Therapeutics Inc.Ann ArborMichiganUSA
| | | | | | - Denise Mason
- Cleveland Clinic Coordinating Center for Clinical Research (C5Research)ClevelandOhioUSA
| | - Steven E. Nissen
- Section of Preventive Cardiology and Rehabilitation, Department of Cardiovascular MedicineCleveland Clinic FoundationClevelandOhioUSA
- Cleveland Clinic Coordinating Center for Clinical Research (C5Research)ClevelandOhioUSA
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Pohl R, Stallmann C, Marquardt P, Bank U, Färber J, Scheibler L, Heuft HG, Kaasch AJ, Apfelbacher C. Sociodemographic influences on private and professional contact behaviour during the COVID-19 pandemic in Germany: cross-sectional analysis based on a Regional Blood Donor Cohort. BMC Res Notes 2024; 17:206. [PMID: 39068489 PMCID: PMC11283687 DOI: 10.1186/s13104-024-06867-9] [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: 03/22/2024] [Accepted: 07/16/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVE The COVID-19 pandemic has had significant health and socioeconomic impacts worldwide. Extensive measures, including contact restrictions, were implemented to control the spread of the virus. This study aims to examine the factors that influenced private and professional contact behaviour during the COVID-19 pandemic. RESULTS We used baseline data (January-April 2021) from the SeMaCo study (Serologische Untersuchungen bei Blutspendern des Großraums Magdeburg auf Antikörper gegen SARS-CoV-2), a longitudinal, regional cohort study assessing COVID-19 seroprevalence in blood donors from Magdeburg and surrounding areas in Germany. In the blood donor cohort (n = 2,195), there was a general reduction in private contacts (by 78.9%) and professional contacts (by 54.4%) after March 18, 2020. Individuals with higher education reduced both private (by 84.1%) and professional (by 70.1%) contacts more than those with lower education levels (private contacts 59.5%; professional contacts 37%). Younger age groups (18-30 years) reduced private contacts more frequently (by 85.4%) than older individuals (61-83 years, by 68.6%) and demonstrated a higher likelihood of private contact reduction compared to older age groups (51-60 years: odds ratio (OR) 0.45 [95% [CI] 0.32-0.65]; 61-83 years: OR 0.33 [95% [CI] 0.22-0.48]).
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Affiliation(s)
- Robert Pohl
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany.
| | - Christoph Stallmann
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Pauline Marquardt
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Ute Bank
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Jacqueline Färber
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Lotte Scheibler
- Institute for Transfusion Medicine and Immunohaematology, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Hans-Gert Heuft
- Institute for Transfusion Medicine and Immunohaematology, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Achim J Kaasch
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Xu Z, Zhang H, Tian J, Ku X, Wei R, Hou J, Zhang C, Yang F, Zou X, Li Y, Kaji H, Tao SC, Kuno A, Yan W, Da LT, Zhang Y. O-glycosylation of SARS-CoV-2 spike protein by host O-glycosyltransferase strengthens its trimeric structure. Acta Biochim Biophys Sin (Shanghai) 2024. [PMID: 39066577 DOI: 10.3724/abbs.2024127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024] Open
Abstract
Protein O-glycosylation, also known as mucin-type O-glycosylation, is one of the most abundant glycosylation in mammalian cells. It is initially catalyzed by a family of polypeptide GalNAc transferases (ppGalNAc-Ts). The trimeric spike protein (S) of SARS-CoV-2 is highly glycosylated and facilitates the virus's entry into host cells and membrane fusion of the virus. However, the functions and relationship between host ppGalNAc-Ts and O-glycosylation on the S protein remain unclear. Herein, we identify 15 O-glycosites and 10 distinct O-glycan structures on the S protein using an HCD-product-dependent triggered ETD mass spectrometric analysis. We observe that the isoenzyme T6 of ppGalNAc-Ts (ppGalNAc-T6) exhibits high O-glycosylation activity for the S protein, as demonstrated by an on-chip catalytic assay. Overexpression of ppGalNAc-T6 in HEK293 cells significantly enhances the O-glycosylation level of the S protein, not only by adding new O-glycosites but also by increasing O-glycan heterogeneity. Molecular dynamics simulations reveal that O-glycosylation on the protomer-interface regions, modified by ppGalNAc-T6, potentially stabilizes the trimeric S protein structure by establishing hydrogen bonds and non-polar interactions between adjacent protomers. Furthermore, mutation frequency analysis indicates that most O-glycosites of the S protein are conserved during the evolution of SARS-CoV-2 variants. Taken together, our finding demonstrate that host O-glycosyltransferases dynamically regulate the O-glycosylation of the S protein, which may influence the trimeric structural stability of the protein. This work provides structural insights into the functional role of specific host O-glycosyltransferases in regulating the O-glycosylation of viral envelope proteins.
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Affiliation(s)
- Zhijue Xu
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
- SCSB (China)-AIST (Japan) Joint Medical Glycomics Laboratory, Shanghai 200240, China
| | - Han Zhang
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jiaqi Tian
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
- School of Medical Information and Engineering, Xuzhou Medical University, Xuzhou 221000, China
| | - Xin Ku
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Rumeng Wei
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jingli Hou
- Intrumental Analysis Center, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Can Zhang
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Fang Yang
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Xia Zou
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Yang Li
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Hiroyuki Kaji
- SCSB (China)-AIST (Japan) Joint Medical Glycomics Laboratory, Shanghai 200240, China
| | - Sheng-Ce Tao
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Atsushi Kuno
- SCSB (China)-AIST (Japan) Joint Medical Glycomics Laboratory, Shanghai 200240, China
- Molecular and Cellular Glycoproteomics Research Group, Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba 305-8577, Japan
| | - Wei Yan
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Lin-Tai Da
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Yan Zhang
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
- SCSB (China)-AIST (Japan) Joint Medical Glycomics Laboratory, Shanghai 200240, China
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10
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Brant LCC, Miranda JJ, Carrillo-Larco RM, Flood D, Irazola V, Ribeiro ALP. Epidemiology of cardiometabolic health in Latin America and strategies to address disparities. Nat Rev Cardiol 2024:10.1038/s41569-024-01058-2. [PMID: 39054376 DOI: 10.1038/s41569-024-01058-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2024] [Indexed: 07/27/2024]
Abstract
In Latin America and the Caribbean (LAC), sociodemographic context, socioeconomic disparities and the high level of urbanization provide a unique entry point to reflect on the burden of cardiometabolic disease in the region. Cardiovascular diseases are the main cause of death in LAC, precipitated by population growth and ageing together with a rapid increase in the prevalence of cardiometabolic risk factors, predominantly obesity and diabetes mellitus, over the past four decades. Strategies to address this growing cardiometabolic burden include both population-wide and individual-based initiatives tailored to the specific challenges faced by different LAC countries, which are heterogeneous. The implementation of public policies to reduce smoking and health system approaches to control hypertension are examples of scalable strategies. The challenges faced by LAC are also opportunities to foster innovative approaches to combat the high burden of cardiometabolic diseases such as implementing digital health interventions and team-based initiatives. This Review provides a summary of trends in the epidemiology of cardiometabolic diseases and their risk factors in LAC as well as context-specific disease determinants and potential solutions to improve cardiometabolic health in the region.
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Affiliation(s)
- Luisa C C Brant
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
- Hospital das Clínicas Telehealth Center, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - J Jaime Miranda
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Rodrigo M Carrillo-Larco
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - David Flood
- Department of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Vilma Irazola
- Center of Excellence for Cardiovascular Health, Department of Research in Chronic Diseases, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Antonio Luiz P Ribeiro
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Hospital das Clínicas Telehealth Center, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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11
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Papaneophytou C. Breaking the Chain: Protease Inhibitors as Game Changers in Respiratory Viruses Management. Int J Mol Sci 2024; 25:8105. [PMID: 39125676 PMCID: PMC11311956 DOI: 10.3390/ijms25158105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 07/14/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
Respiratory viral infections (VRTIs) rank among the leading causes of global morbidity and mortality, affecting millions of individuals each year across all age groups. These infections are caused by various pathogens, including rhinoviruses (RVs), adenoviruses (AdVs), and coronaviruses (CoVs), which are particularly prevalent during colder seasons. Although many VRTIs are self-limiting, their frequent recurrence and potential for severe health complications highlight the critical need for effective therapeutic strategies. Viral proteases are crucial for the maturation and replication of viruses, making them promising therapeutic targets. This review explores the pivotal role of viral proteases in the lifecycle of respiratory viruses and the development of protease inhibitors as a strategic response to these infections. Recent advances in antiviral therapy have highlighted the effectiveness of protease inhibitors in curtailing the spread and severity of viral diseases, especially during the ongoing COVID-19 pandemic. It also assesses the current efforts aimed at identifying and developing inhibitors targeting key proteases from major respiratory viruses, including human RVs, AdVs, and (severe acute respiratory syndrome coronavirus-2) SARS-CoV-2. Despite the recent identification of SARS-CoV-2, within the last five years, the scientific community has devoted considerable time and resources to investigate existing drugs and develop new inhibitors targeting the virus's main protease. However, research efforts in identifying inhibitors of the proteases of RVs and AdVs are limited. Therefore, herein, it is proposed to utilize this knowledge to develop new inhibitors for the proteases of other viruses affecting the respiratory tract or to develop dual inhibitors. Finally, by detailing the mechanisms of action and therapeutic potentials of these inhibitors, this review aims to demonstrate their significant role in transforming the management of respiratory viral diseases and to offer insights into future research directions.
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Affiliation(s)
- Christos Papaneophytou
- Department of Life Sciences, School of Life and Health Sciences, University of Nicosia, Nicosia 2417, Cyprus
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12
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Khadka A. The effect of adaptive capacity on resilience to the COVID-19 pandemic: A cross-country analysis. JAMBA (POTCHEFSTROOM, SOUTH AFRICA) 2024; 16:1697. [PMID: 39113929 PMCID: PMC11304176 DOI: 10.4102/jamba.v16i1.1697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/14/2024] [Indexed: 08/10/2024]
Abstract
The COVID-19 pandemic's profound impacts on global health, driven by preparedness gaps and systemic risks, underscore the need to enhance societies' ability to manage both predictable risks and uncertainties inherent in disasters. While disaster research emphasises risk management for predictable threats and adaptive capacity for unexpected challenges, there is a lack of empirical examination of the impact of adaptive capacity on disaster resilience. This study addresses this gap by identifying three key adaptive capacities - quality of institutions, collaborative governance, and social capital - and examining their effects on COVID-19 resilience outcomes, measured by the ability to reduce excess mortality. Analysing secondary data from 129 nations using partial least squares structural equation modelling, the research finds significant positive effects of institutional quality and social capital on resilience outcomes. Conversely, collaborative governance shows a significant negative association, suggesting potentially intricate impacts beyond initial expectations. The findings highlight the need to enhance institutional quality and social capital to address preparedness gaps and unexpected challenges posed by biological hazards such as COVID-19. Future research should explore collaborative governance using a disaggregated approach that considers the roles of different stakeholders in various disaster phases. Contribution This study advances disaster research by presenting practical methodologies for operationalising adaptive capacities and empirically examining their effects on disaster resilience. For practitioners and policymakers, it highlights the need to adopt a long-term perspective in building disaster resilience, focussing on improving institutional quality and social capital to manage the uncertainties and complexities inherent in disaster scenarios effectively.
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Affiliation(s)
- Asmita Khadka
- Graduate School of Public Administration, National Institute of Development Administration, Bangkok, Thailand
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13
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Al-Kindi SG, Shami B, Janus SE, Hajjari J, Mously H, Badhwar A, Chami T, Chahine N, Al-Jammal M, Karnib M, Noman A, Bunte MC. Retrospective analysis of ethnic/racial disparities and excess vascular mortality associated with the COVID-19 pandemic. Curr Probl Cardiol 2024; 49:102763. [PMID: 39059784 DOI: 10.1016/j.cpcardiol.2024.102763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024]
Abstract
The Sars coronavirus 2019 (COVID-19) pandemic has resulted in increased morbidity and mortality; however, there is limited understanding of how excess mortality is distributed among different racial and ethnic subgroups and vascular diseases. METHODS We conducted a retrospective, cross-sectional study design using data from the United States (US) Center for Disease Control (CDC) Wide Ranging Online Data for Epidemiologic Research (Wonder) database. The database contains death certificate information for all US residents by cause of death as ascertained by the treating physician. We examined the trends of excess death by vascular disease specific mortality among different racial and ethnicity subgroups. Excess deaths were defined as the difference between observed numbers of deaths in specific time periods and the expected numbers of deaths in the same time periods. We compared mortality rates during the reference period of 2018-2019 (pre-pandemic) with the study period of 2020-2021 (pandemic years). We also compared excess mortality rates among racial and ethnic subgroups (Non-Hispanic white, Non-Hispanic Black, and Hispanic individuals). Vascular disease was categorized by administrative diagnostic codes (ICD10): Vascular disease (I26, I82, I70-73, I74) and its subtypes Arterial thrombosis (I74), venous thromboembolism (I26, I82) and atherosclerotic disease (I70-73). RESULTS Compared to 2018-2019, there was a 1.3 % excess mortality associated with vascular disease, a 12.2 % excess mortality due to arterial thrombosis mortality, and an 8.0 % excess mortality due to thromboembolism in 2020-2021. Black individuals demonstrated higher excess vascular mortality (6.9 %) compared to white individuals (-0.3 %) P < .001, higher excess venous thromboembolism mortality (14.1 % vs 5.1 % P = 0.002) and higher atherosclerosis mortality (2.1 % vs -2.6 % P = 0.002). Hispanics compared to white individuals had higher excess vascular mortality (5.1 % vs -0.3 % P = 0.03) and excess venous thromboembolism mortality (24.2 % vs 5.1 % P < 0.001). CONCLUSION The COVID-19 pandemic has led to a significant and persistent increase in vascular mortality. Excess mortality has disproportionately affected Black and Hispanic individuals compared to white individuals, highlighting the need for further studies to address and eliminate these health care disparities.
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Affiliation(s)
| | | | | | | | | | - Anshul Badhwar
- Marin Health, University of San Francisco, San Francisco, CA, USA
| | - Tarek Chami
- First Coast Cardiovascular Institute, Jacksonville, FL, USA
| | | | | | | | - Anas Noman
- St Luke's Mid America, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Matthew C Bunte
- St Luke's Mid America, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
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14
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Mahmud MA, Xu LH, Usatinsky A, Dos Santos CC, Little DJ, Tsai SSH, Rackus DG. Semiquantitative Paper-Based Microfluidic Surrogate Virus Neutralization Test for SARS-CoV-2 Neutralizing Antibodies. Anal Chem 2024; 96:11751-11759. [PMID: 38980117 DOI: 10.1021/acs.analchem.4c01165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Neutralizing antibodies (nAbs) produced from infection or vaccination play an important role in acquired immunity. Determining virus-specific nAb titers is a useful tool for measuring aquired immunity in an individual. The standard methods to do so rely on titrating serum samples against live virus and monitoring viral infection in cultured cells which requires high biosafety level containment. The surrogate virus neutralization test (sVNT) reduces the biohazards and it is suitable for designing rapid test device in a lateral flow assay (LFA) format. Here, we introduce the fabrication and development of a unique paper-based LFA device for determining the level of SARS-CoV-2 nAb in a sample with a semiquantitative direct colorimetric readout. A LFA-based gradient assay design was used to facilitate the sVNT, where the spike glycoprotein receptor binding domain (RBD) and angiotensin-converting enzyme 2 (ACE2) stand in as proxies for viruses and cells, respectively. The gradient assay employed multiple test dots of ACE2 spotted in increasing concentration along the sample flow path and gold nanoparticle-conjugated RBD for readout. In this way, the number of developed spots is inversely proportional to the concentration of nAbs present in the sample. The assay was tested with both standard solutions of nAb as well as human serum samples. We have demonstrated that the device can effectively provide semiquantitative test results of nAbs by direct instrument-free colorimetric detection.
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Affiliation(s)
- Md Almostasim Mahmud
- Department of Chemistry and Biology, Toronto Metropolitan University, Toronto, Ontario M5B 2K3, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST), a partnership between St. Michael's Hospital, a site of Unity Health Toronto and Toronto Metropolitan University, Toronto, Ontario M5B 1T8, Canada
- Department of Mechanical, Industrial, and Mechatronics Engineering, Toronto Metropolitan University, Toronto, Ontario M5B 2K3, Canada
- Keenan Research Centre for Biomedical Science at St. Michael's Hospital, Toronto, Ontario M5B 1T8, Canada
| | - Liangcheng Henry Xu
- Department of Chemistry and Biology, Toronto Metropolitan University, Toronto, Ontario M5B 2K3, Canada
| | - Anat Usatinsky
- Department of Chemistry and Biology, Toronto Metropolitan University, Toronto, Ontario M5B 2K3, Canada
| | - Claudia C Dos Santos
- Keenan Research Centre for Biomedical Science at St. Michael's Hospital, Toronto, Ontario M5B 1T8, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario M5S 3H2, Canada
| | - Dustin J Little
- Department of Chemistry and Biology, Toronto Metropolitan University, Toronto, Ontario M5B 2K3, Canada
| | - Scott S H Tsai
- Institute for Biomedical Engineering, Science and Technology (iBEST), a partnership between St. Michael's Hospital, a site of Unity Health Toronto and Toronto Metropolitan University, Toronto, Ontario M5B 1T8, Canada
- Department of Mechanical, Industrial, and Mechatronics Engineering, Toronto Metropolitan University, Toronto, Ontario M5B 2K3, Canada
- Keenan Research Centre for Biomedical Science at St. Michael's Hospital, Toronto, Ontario M5B 1T8, Canada
| | - Darius G Rackus
- Department of Chemistry and Biology, Toronto Metropolitan University, Toronto, Ontario M5B 2K3, Canada
- Institute for Biomedical Engineering, Science and Technology (iBEST), a partnership between St. Michael's Hospital, a site of Unity Health Toronto and Toronto Metropolitan University, Toronto, Ontario M5B 1T8, Canada
- Keenan Research Centre for Biomedical Science at St. Michael's Hospital, Toronto, Ontario M5B 1T8, Canada
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15
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Gupta A, Hathi P, Banaji M, Gupta P, Kashyap R, Paikra V, Sharma K, Somanchi A, Sudharsanan N, Vyas S. Large and unequal life expectancy declines during the COVID-19 pandemic in India in 2020. SCIENCE ADVANCES 2024; 10:eadk2070. [PMID: 39028821 PMCID: PMC11259167 DOI: 10.1126/sciadv.adk2070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 06/17/2024] [Indexed: 07/21/2024]
Abstract
Global population health during the COVID-19 pandemic is poorly understood because of weak mortality monitoring in low- and middle-income countries. High-quality survey data on 765,180 individuals, representative of one-fourth of India's population, uncover patterns missed by incomplete vital statistics and disease surveillance. Compared to 2019, life expectancy at birth was 2.6 years lower and mortality was 17% higher in 2020, implying 1.19 million excess deaths in 2020. Life expectancy declines in India were larger and had a younger age profile than in high-income countries. Increases in mortality were greater than expected based on observed seroprevalence and international infection fatality rates, most prominently among the youngest and older age groups. In contrast to global patterns, females in India experienced a life expectancy decline that was 1 year larger than losses for males. Marginalized social groups experienced greater declines than the most privileged social group. These findings uncover large and unequal mortality impacts during the pandemic in the world's most populous country.
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Affiliation(s)
- Aashish Gupta
- Department of Sociology, University of Oxford, 42-43 Park End Street, Oxford OX1 1JD, England
- Nuffield College, New Road, Oxford OX1 1NF, England
- Leverhulme Centre for Demographic Science, University of Oxford, 42-43 Park End Street, Oxford OX1 1JD, England
- Research Institute for Compassionate Economics, 472 Old Colchester Rd., Amston, CT 06231, USA
| | - Payal Hathi
- Research Institute for Compassionate Economics, 472 Old Colchester Rd., Amston, CT 06231, USA
- Department of Demography and Sociology, University of California, Berkeley, 310 Social Sciences Building, Berkeley, CA 94720, USA
| | - Murad Banaji
- Mathematical Institute, University of Oxford, Andrew Wiles Building, Radcliffe Observatory Quarter (550), Woodstock Road, Oxford OX2 6GG, England
| | - Prankur Gupta
- Department of Economics, University of Texas at Austin, 2225 Speedway, Austin, TX 78712, USA
| | - Ridhi Kashyap
- Department of Sociology, University of Oxford, 42-43 Park End Street, Oxford OX1 1JD, England
- Nuffield College, New Road, Oxford OX1 1NF, England
- Leverhulme Centre for Demographic Science, University of Oxford, 42-43 Park End Street, Oxford OX1 1JD, England
| | - Vipul Paikra
- Research Institute for Compassionate Economics, 472 Old Colchester Rd., Amston, CT 06231, USA
| | - Kanika Sharma
- Department of Sociology, Emory University, 1555 Dickey Dr, Atlanta, GA 30322, USA
| | - Anmol Somanchi
- Paris School of Economics, 48 Boulevard Jourdan, 75014 Paris, France
| | - Nikkil Sudharsanan
- TUM School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 60, 80992 Munich, Germany
- Heidelberg Institute of Global Health, Heidelberg University, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Sangita Vyas
- Research Institute for Compassionate Economics, 472 Old Colchester Rd., Amston, CT 06231, USA
- Department of Economics, Hunter College (CUNY), 695 Park Ave., New York, NY 10065, USA
- CUNY Institute for Demographic Research, 135 E. 22nd St., New York, NY 10010, USA
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16
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Laing R, Donnelly CA. Evolution of an epidemic: Understanding the opioid epidemic in the United States and the impact of the COVID-19 pandemic on opioid-related mortality. PLoS One 2024; 19:e0306395. [PMID: 38980856 PMCID: PMC11233025 DOI: 10.1371/journal.pone.0306395] [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: 11/08/2023] [Accepted: 05/31/2024] [Indexed: 07/11/2024] Open
Abstract
We conduct this research with a two-fold aim: providing a quantitative analysis of the opioid epidemic in the United States (U.S.), and exploring the impact of the COVID-19 pandemic on opioid-related mortality. The duration and persistence of the opioid epidemic lends itself to the need for an overarching analysis with extensive scope. Additionally, studying the ramifications of these concurrent severe public health crises is vital for informing policies to avoid preventable mortality. Using data from CDC WONDER, we consider opioid-related deaths grouped by Census Region spanning January 1999 to October 2022 inclusive, and later add on a demographic component with gender-stratification. Through the lens of key events in the opioid epidemic, we build an interrupted time series model to reveal statistically significant drivers of opioid-related mortality. We then employ a counterfactual to approximate trends in the absence of COVID-19, and estimate excess opioid-related deaths (defined as observed opioid-related deaths minus projected opioid-related deaths) associated with the pandemic. According to our model, the proliferation of fentanyl contributed to sustained increases in opioid-related death rates across three of the four U.S. census regions, corroborating existing knowledge in the field. Critically, each region has an immediate increase to its opioid-related monthly death rate of at least 0.31 deaths per 100,000 persons at the start of the pandemic, highlighting the nationwide knock-on effects of COVID-19. There are consistent positive deviations from the expected monthly opioid-related death rate and a sizable burden from cumulative excess opioid-related deaths, surpassing 60,000 additional deaths nationally from March 2020 to October 2022, ∼70% of which were male. These results suggest that robust, multi-faceted measures are even more important in light of the COVID-19 pandemic to prevent overdoses and educate users on the risks associated with potent synthetic opioids such as fentanyl.
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Affiliation(s)
- Rachel Laing
- Department of Statistics, University of Oxford, Oxford, United Kingdom
- Division of Infectious Diseases, Massachusetts General Hospital, Cambridge, Massachusetts, United States of America
| | - Christl A Donnelly
- Department of Statistics, University of Oxford, Oxford, United Kingdom
- Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, United Kingdom
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Tancredi S, Cullati S, Chiolero A. Surveillance bias in the assessment of the size of COVID-19 epidemic waves: a case study. Public Health 2024; 234:98-104. [PMID: 38972230 DOI: 10.1016/j.puhe.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/13/2024] [Accepted: 06/07/2024] [Indexed: 07/09/2024]
Abstract
OBJECTIVES To estimate the size of COVID-19 waves using four indicators across three pandemic periods and assess potential surveillance bias. STUDY DESIGN Case study using data from one region of Switzerland. METHODS We compared cases, hospitalizations, deaths, and seroprevalence during three periods including the first three pandemic waves (period 1: Feb-Oct 2020; period 2: Oct 2020-Feb 2021; period 3: Feb-Aug 2021). Data were retrieved from the Federal Office of Public Health or estimated from population-based studies. To assess potential surveillance bias, indicators were compared to a reference indicator, i.e. seroprevalence during periods 1 and 2 and hospitalizations during the period 3. Timeliness of indicators (the duration from data generation to the availability of the information to decision-makers) was also evaluated. RESULTS Using seroprevalence (our reference indicator for period 1 and 2), the 2nd wave size was slightly larger (by a ratio of 1.4) than the 1st wave. Compared to seroprevalence, cases largely overestimated the 2nd wave size (2nd vs 1st wave ratio: 6.5), while hospitalizations (ratio: 2.2) and deaths (ratio: 2.9) were more suitable to compare the size of these waves. Using hospitalizations as a reference, the 3rd wave size was slightly smaller (by a ratio of 0.7) than the 2nd wave. Cases or deaths slightly underestimated the 3rd wave size (3rd vs 2nd wave ratio for cases: 0.5; for deaths: 0.4). The seroprevalence was not useful to compare the size of these waves due to high vaccination rates. Across all waves, timeliness for cases and hospitalizations was better than for deaths or seroprevalence. CONCLUSIONS The usefulness of indicators for assessing the size of pandemic waves depends on the type of indicator and the period of the pandemic.
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Affiliation(s)
- S Tancredi
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland; Swiss School of Public Health (SSPH+), Zurich, Switzerland.
| | - S Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland; Swiss School of Public Health (SSPH+), Zurich, Switzerland; Quality of Care Service, University Hospitals of Geneva, Geneva, Switzerland
| | - A Chiolero
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland; Swiss School of Public Health (SSPH+), Zurich, Switzerland; School of Population and Global Health, McGill University, Montreal, Canada; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
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18
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Kim E, Lee W, Cho SI. Regional inequalities in excess mortality and its community determinants during the early COVID-19 pandemic in South Korea. J Epidemiol Community Health 2024:jech-2023-221763. [PMID: 38955462 DOI: 10.1136/jech-2023-221763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 06/17/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Excess mortality during the COVID-19 pandemic provides a comprehensive measure of disease burden, and its local variation highlights regional health inequalities. We investigated local excess mortality in 2020 and its determinants at the community level. METHODS We collected data from 250 districts in South Korea, including monthly all-cause mortality for 2015-2020 and community characteristics from 2019. Excess mortality rate was defined as the difference between observed and expected mortality rates. A Seasonal Autoregressive Integrated Moving Average model was applied to predict the expected rates for each district. Penalized regression methods were used to derive relevant community predictors of excess mortality based on the elastic net. RESULTS In 2020, South Korea exhibited significant variation in excess mortality rates across 250 districts, ranging from no excess deaths in 46 districts to more than 100 excess deaths per 100 000 residents in 30 districts. Economic status or the number of medical centres in the community did not correlate with excess mortality rates. The risk was higher in ageing, remote communities with limited cultural and sports infrastructure, a higher density of welfare facilities, and a higher prevalence of hypertension. Physical distancing policies and active social engagement in voluntary activities protected from excess mortality. CONCLUSION Substantial regional disparities in excess mortality existed within South Korea during the early stages of COVID-19 pandemic. Weaker segments of the community were more vulnerable. Local governments should refine their preparedness for future novel infectious disease outbreaks, considering community circumstances.
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Affiliation(s)
- Eunah Kim
- Seoul National University Institute of Health and Environment, Seoul, Korea (the Republic of)
| | - Woojoo Lee
- Department of Public Health Science, Seoul National University Graduate School of Public Health, Seoul, Korea (the Republic of)
| | - Sung-Il Cho
- Seoul National University Institute of Health and Environment, Seoul, Korea (the Republic of)
- Department of Public Health Science, Seoul National University Graduate School of Public Health, Seoul, Korea (the Republic of)
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19
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Rasmussen L, Sanders S, Sosa M, McKellip S, Nebane NM, Martinez-Gzegozewska Y, Reece A, Ruiz P, Manuvakhova A, Zhai L, Warren B, Curry A, Zeng Q, Bostwick JR, Vinson PN. A high-throughput response to the SARS-CoV-2 pandemic. SLAS DISCOVERY : ADVANCING LIFE SCIENCES R & D 2024; 29:100160. [PMID: 38761981 DOI: 10.1016/j.slasd.2024.100160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/24/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
Four years after the beginning of the COVID-19 pandemic, it is important to reflect on the events that have occurred during that time and the knowledge that has been gained. The response to the pandemic was rapid and highly resourced; it was also built upon a foundation of decades of federally funded basic and applied research. Laboratories in government, pharmaceutical, academic, and non-profit institutions all played roles in advancing pre-2020 discoveries to produce clinical treatments. This perspective provides a summary of how the development of high-throughput screening methods in a biosafety level 3 (BSL-3) environment at Southern Research Institute (SR) contributed to pandemic response efforts. The challenges encountered are described, including those of a technical nature as well as those of working under the pressures of an unpredictable virus and pandemic.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Ling Zhai
- Southern Research, Birmingham, AL, USA
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20
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Mawoyo T, Steventon Roberts KJ, Laurenzi C, Skeen S, Toit SD, Hisham R, Cluver L, Sherr L, Tomlinson M. How do new crises impact HIV risk behaviour - exploring HIV risk behaviour according to COVID-19-related orphanhood status in South Africa? AIDS Care 2024; 36:126-136. [PMID: 38709951 DOI: 10.1080/09540121.2024.2333435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 03/15/2024] [Indexed: 05/08/2024]
Abstract
The COVID-19 pandemic resulted in high death rates globally, and over 10.5 million children lost a parent or primary caregiver. Because HIV-related orphanhood has been associated with elevated HIV risk, we sought to examine HIV risk in children affected by COVID-19 orphanhood. Four hundred and twenty-one children and adolescents were interviewed, measuring seven HIV risk behaviours: condom use, age-disparate sex, transactional sex, multiple partners, sex associated with drugs/alcohol, mental health and social risks. Approximately 50% (211/421) experienced orphanhood due to COVID-19, 4.8% (20/421) reported living in an HIV-affected household, and 48.2% (203/421) did not know the HIV status of their household. The mean age of the sample was 12.7 years (SD:2.30), of whom 1.2% (5/421) were living with HIV. Eighty percent (337/421) reported at least one HIV risk behaviour. HIV sexual risk behaviours were more common among children living in HIV-affected households compared to those not living in HIV-affected households and those with unknown household status (35.0% vs. 13.6% vs.10.8%, X2 = 9.25, p = 0.01). Children living in HIV-affected households had poorer mental health and elevated substance use (70.0% vs. 48.5%, X2 = 6.21, p = 0.05; 35.0% vs. 19.9%, X2 = 4.02, p = 0.1306, respectively). HIV-affected households may require specific interventions to support the health and well-being of children and adolescents.
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Affiliation(s)
- Tatenda Mawoyo
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | | | - Christina Laurenzi
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Sarah Skeen
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
- Faculty of Social and Behavioural Sciences, Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - Stefani Du Toit
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Ramsha Hisham
- Department for Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Lucie Cluver
- Department for Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
- School of Nursing and Midwifery, Queens University, Belfast, UK
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21
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Barnett CR, Krolikowski K, Postelnicu R, Mukherjee V, Sulaiman I, Chung M, Angel L, Tsay JCJ, Wu BG, Yeung ST, Duerr R, Desvignes L, Khanna K, Li Y, Schluger R, Rafeq S, Collazo D, Kyeremateng Y, Amoroso N, Pradhan D, Das S, Evans L, Uyeki TM, Ghedin E, Silverman GJ, Segal LN, Brosnahan SB. Impaired immune responses in the airways are associated with poor outcome in critically ill COVID-19 patients. ERJ Open Res 2024; 10:00789-2023. [PMID: 38978558 PMCID: PMC11228597 DOI: 10.1183/23120541.00789-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/27/2024] [Indexed: 07/10/2024] Open
Abstract
Introduction Mounting evidence indicates that an individual's humoral adaptive immune response plays a critical role in the setting of SARS-CoV-2 infection, and that the efficiency of the response correlates with disease severity. The relationship between the adaptive immune dynamics in the lower airways with those in the systemic circulation, and how these relate to an individual's clinical response to SARS-CoV-2 infection, are less understood and are the focus of this study. Material and methods We investigated the adaptive immune response to SARS-CoV-2 in paired samples from the lower airways and blood from 27 critically ill patients during the first wave of the pandemic (median time from symptom onset to intubation 11 days). Measurements included clinical outcomes (mortality), bronchoalveolar lavage fluid (BALF) and blood specimen antibody levels, and BALF viral load. Results While there was heterogeneity in the levels of the SARS-CoV-2-specific antibodies, we unexpectedly found that some BALF specimens displayed higher levels than the paired concurrent plasma samples, despite the known dilutional effects common in BALF samples. We found that survivors had higher levels of anti-spike, anti-spike-N-terminal domain and anti-spike-receptor-binding domain IgG antibodies in their BALF (p<0.05), while there was no such association with antibody levels in the systemic circulation. Discussion Our data highlight the critical role of local adaptive immunity in the airways as a key defence mechanism against primary SARS-CoV-2 infection.
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Affiliation(s)
- Clea R. Barnett
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Kelsey Krolikowski
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Radu Postelnicu
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Vikramjit Mukherjee
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Imran Sulaiman
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Matthew Chung
- Systems Genomics Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Luis Angel
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Jun-Chieh J. Tsay
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Division of Pulmonary and Critical Care Medicine, VA New York Harbor Healthcare System, New York, NY, USA
| | - Benjamin G. Wu
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Division of Pulmonary and Critical Care Medicine, VA New York Harbor Healthcare System, New York, NY, USA
| | - Stephen T. Yeung
- Department of Microbiology, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Ralf Duerr
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Microbiology, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Vaccine Center, NYU Grossman School of Medicine, New York, NY, USA
| | - Ludovic Desvignes
- Department of Microbiology, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Kamal Khanna
- Department of Microbiology, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Yonghua Li
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Rosemary Schluger
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Samaan Rafeq
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Destiny Collazo
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Yaa Kyeremateng
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Nancy Amoroso
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Deepak Pradhan
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Sanchita Das
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Laura Evans
- Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA
| | - Timothy M. Uyeki
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elodie Ghedin
- Systems Genomics Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Gregg J. Silverman
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Leopoldo N. Segal
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine, NYU Langone Health, New York, NY, USA
| | - Shari B. Brosnahan
- Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
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22
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Tsuruga T, Fujimoto H, Yasuma T, D'Alessandro-Gabazza CN, Toda M, Ito T, Tomaru A, Saiki H, Okano T, Alhawsawi MAB, Takeshita A, Nishihama K, Takei R, Kondoh Y, Cann I, Gabazza EC, Kobayashi T. Role of microbiota-derived corisin in coagulation activation during SARS-CoV-2 infection. J Thromb Haemost 2024; 22:1919-1935. [PMID: 38453025 DOI: 10.1016/j.jtha.2024.02.014] [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: 09/27/2023] [Revised: 01/23/2024] [Accepted: 02/13/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Coagulopathy is a major cause of morbidity and mortality in COVID-19 patients. Hypercoagulability in COVID-19 results in deep vein thrombosis, thromboembolic complications, and diffuse intravascular coagulation. Microbiome dysbiosis influences the clinical course of COVID-19. However, the role of dysbiosis in COVID-19-associated coagulopathy is not fully understood. OBJECTIVES The present study tested the hypothesis that the microbiota-derived proapoptotic corisin is involved in the coagulation system activation during SARS-CoV-2 infection. METHODS This cross-sectional study included 47 consecutive patients who consulted for symptoms of COVID-19. A mouse acute lung injury model was used to recapitulate the clinical findings. A549 alveolar epithelial, THP-1, and human umbilical vein endothelial cells were used to evaluate procoagulant and anticoagulant activity of corisin. RESULTS COVID-19 patients showed significantly high circulating levels of corisin, thrombin-antithrombin complex, D-dimer, tumor necrosis factor-α, and monocyte-chemoattractant protein-1 with reduced levels of free protein S compared with healthy subjects. The levels of thrombin-antithrombin complex, D-dimer, and corisin were significantly correlated. A monoclonal anticorisin-neutralizing antibody significantly inhibited the inflammatory response and coagulation system activation in a SARS-CoV-2 spike protein-associated acute lung injury mouse model, and the levels of corisin and thrombin-antithrombin complex were significantly correlated. In an in vitro experiment, corisin increased the tissue factor activity and decreased the anticoagulant activity of thrombomodulin in epithelial, endothelial, and monocytic cells. CONCLUSION The microbiota-derived corisin is significantly increased and correlated with activation of the coagulation system during SARS-CoV-2 infection, and corisin may directly increase the procoagulant activity in epithelial, endothelial, and monocytic cells.
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Affiliation(s)
- Tatsuki Tsuruga
- Department of Pulmonary and Critical Care Medicine, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Hajime Fujimoto
- Department of Pulmonary and Critical Care Medicine, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Taro Yasuma
- Department of Pulmonary and Critical Care Medicine, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan; Department of Immunology, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan; Microbiome Research Center, Mie University, Tsu, Mie, Japan; Department of Diabetes, Endocrinology and Metabolism, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Corina N D'Alessandro-Gabazza
- Department of Immunology, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan; Microbiome Research Center, Mie University, Tsu, Mie, Japan; Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Masaaki Toda
- Department of Immunology, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Toshiyuki Ito
- Department of Pulmonary and Critical Care Medicine, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Atsushi Tomaru
- Department of Pulmonary and Critical Care Medicine, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Haruko Saiki
- Department of Pulmonary and Critical Care Medicine, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Tomohito Okano
- Department of Pulmonary and Critical Care Medicine, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Manal A B Alhawsawi
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA; Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Atsuro Takeshita
- Department of Pulmonary and Critical Care Medicine, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan; Department of Diabetes, Endocrinology and Metabolism, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Kota Nishihama
- Department of Diabetes, Endocrinology and Metabolism, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan
| | - Reoto Takei
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Aichi, Japan
| | - Yasuhiro Kondoh
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Aichi, Japan
| | - Isaac Cann
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA; Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana, Illinois, USA; Department of Animal Science, University of Illinois Urbana-Champaign, Urbana, Illinois, USA; Department of Microbiology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Esteban C Gabazza
- Department of Immunology, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan; Microbiome Research Center, Mie University, Tsu, Mie, Japan; Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
| | - Tetsu Kobayashi
- Department of Pulmonary and Critical Care Medicine, Faculty and Graduate School of Medicine, Mie University, Tsu, Mie, Japan; Microbiome Research Center, Mie University, Tsu, Mie, Japan
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23
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Han Q, Rutayisire G, Mbogning Fonkou MD, Avusuglo WS, Ahmadi A, Asgary A, Orbinski J, Wu J, Kong JD. The determinants of COVID-19 case reporting across Africa. Front Public Health 2024; 12:1406363. [PMID: 38993699 PMCID: PMC11236565 DOI: 10.3389/fpubh.2024.1406363] [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: 03/24/2024] [Accepted: 06/13/2024] [Indexed: 07/13/2024] Open
Abstract
Background According to study on the under-estimation of COVID-19 cases in African countries, the average daily case reporting rate was only 5.37% in the initial phase of the outbreak when there was little or no control measures. In this work, we aimed to identify the determinants of the case reporting and classify the African countries using the case reporting rates and the significant determinants. Methods We used the COVID-19 daily case reporting rate estimated in the previous paper for 54 African countries as the response variable and 34 variables from demographics, socioeconomic, religion, education, and public health categories as the predictors. We adopted a generalized additive model with cubic spline for continuous predictors and linear relationship for categorical predictors to identify the significant covariates. In addition, we performed Hierarchical Clustering on Principal Components (HCPC) analysis on the reporting rates and significant continuous covariates of all countries. Results 21 covariates were identified as significantly associated with COVID-19 case detection: total population, urban population, median age, life expectancy, GDP, democracy index, corruption, voice accountability, social media, internet filtering, air transport, human development index, literacy, Islam population, number of physicians, number of nurses, global health security, malaria incidence, diabetes incidence, lower respiratory and cardiovascular diseases prevalence. HCPC resulted in three major clusters for the 54 African countries: northern, southern and central essentially, with the northern having the best early case detection, followed by the southern and the central. Conclusion Overall, northern and southern Africa had better early COVID-19 case identification compared to the central. There are a number of demographics, socioeconomic, public health factors that exhibited significant association with the early case detection.
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Affiliation(s)
- Qing Han
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), Toronto, ON, Canada
- Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Ghislain Rutayisire
- Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Maxime Descartes Mbogning Fonkou
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), Toronto, ON, Canada
- Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Wisdom Stallone Avusuglo
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), Toronto, ON, Canada
| | - Ali Ahmadi
- Faculty of Computer Engineering, K. N. Toosi University of Technology, Tehran, Iran
| | - Ali Asgary
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), Toronto, ON, Canada
- Disaster and Emergency Management, School of Administrative Studies, York University, Toronto, ON, Canada
| | - James Orbinski
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), Toronto, ON, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, ON, Canada
| | - Jianhong Wu
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), Toronto, ON, Canada
- Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Jude Dzevela Kong
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), Toronto, ON, Canada
- Department of Mathematics and Statistics, York University, Toronto, ON, Canada
- Artificial Intelligence & Mathematical Modeling Lab (AIMM Lab), Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Mathematics, Bahen Centre for Information Technology, University of Toronto, Toronto, ON, Canada
- Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), Toronto, ON, Canada
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24
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Xiao Z, Lin M, Song N, Wu X, Hou J, Wang L, Tian X, An C, Dela Cruz CS, Sharma L, Chang D. Clinical features and multiomics profiles indicate coagulation and platelet dysfunction in COVID-19 viral sepsis. iScience 2024; 27:110110. [PMID: 38974472 PMCID: PMC11225851 DOI: 10.1016/j.isci.2024.110110] [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: 03/01/2024] [Revised: 04/16/2024] [Accepted: 05/23/2024] [Indexed: 07/09/2024] Open
Abstract
Increased cases of sepsis during COVID-19 in the absence of known bacterial pathogens highlighted role of viruses as causative agents of sepsis. In this study, we investigated clinical, laboratory, proteomic, and metabolomic characteristics of viral sepsis patients (n = 45) and compared them to non-sepsis patients with COVID-19 (n = 186) to identify molecular mechanisms underlying the pathology of viral sepsis in COVID-19. We identified unique metabolomic and proteomic signatures that suggest a substantial perturbation in the coagulation, complement, and platelet activation pathways in viral sepsis. Our proteomic data indicated elevated coagulation pathway protein (fibrinogen), whereas a decrease in many of the complement proteins was observed. These alterations were associated with the functional consequences such as susceptibility to secondary bacterial infections and potentially contributing to both local and systemic disease phenotypes. Our data provide novel aspect of COVID-19 pathology that is centered around presence of sepsis phenotype in COVID-19.
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Affiliation(s)
- Zhiqing Xiao
- Department of Pulmonary and Critical Care Medicine at The Seventh Medical Center, College of Pulmonary and Critical Care Medicine of The Eighth Medical Center, Chinese PLA General Hospital, Beijing 100853, China
- Hebei North University, Zhangjiakou 075000, Hebei, China
| | - Minggui Lin
- Beijing Tsinghua Changgung Hospital, Tsinghua University School of Medicine, Beijing 102218, China
| | - Ning Song
- Department of Infectious Diseases, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Xue Wu
- Department of Pulmonary and Critical Care Medicine at The Seventh Medical Center, College of Pulmonary and Critical Care Medicine of The Eighth Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Jingyu Hou
- Department of Infectious Diseases, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Lili Wang
- Beijing Tsinghua Changgung Hospital, Tsinghua University School of Medicine, Beijing 102218, China
| | - XinLun Tian
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chunge An
- Department of Pulmonary and Critical Care Medicine at The Seventh Medical Center, College of Pulmonary and Critical Care Medicine of The Eighth Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Charles S. Dela Cruz
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Lokesh Sharma
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - De Chang
- Department of Pulmonary and Critical Care Medicine at The Seventh Medical Center, College of Pulmonary and Critical Care Medicine of The Eighth Medical Center, Chinese PLA General Hospital, Beijing 100853, China
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25
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Hulscher N, Alexander PE, Amerling R, Gessling H, Hodkinson R, Makis W, Risch HA, Trozzi M, McCullough PA. Withdrawn: A systematic review of autopsy findings in deaths after COVID-19 vaccination. Forensic Sci Int 2024:112115. [PMID: 39120477 DOI: 10.1016/j.forsciint.2024.112115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/17/2024] [Accepted: 06/17/2024] [Indexed: 08/10/2024]
Abstract
This Article-in-Press has been withdrawn at the request of the Editors-in-Chief. Members of the scientific community raised concerns about this Article-in-Press following its posting online. The concerns encompassed. • Inappropriate citation of references. • Inappropriate design of methodology. • Errors, misrepresentation, and lack of factual support for the conclusions. • Failure to recognise and cite disconfirming evidence. The concerns were shared with the authors, who prepared a response and submitted a revised manuscript for consideration by the journal. In consideration of the extent of the concerns raised and the responses from the authors, the journal sent the revised manuscript to two independent peer-reviewers. The peer-reviewers concluded that the revised manuscript did not sufficiently address the concerns raised by the community and that it was not suitable for publication in the journal. The authors disagree with this withdrawal and dispute the grounds for it. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.
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Affiliation(s)
- Nicolas Hulscher
- University of Michigan School of Public Health, Ann Arbor, MI, United States.
| | | | | | | | | | - William Makis
- Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada
| | - Harvey A Risch
- Professor Emeritus, Yale University School of Public Health, New Haven, CT, United States
| | | | - Peter A McCullough
- The Wellness Company, Boca Raton, FL, United States; Truth for Health Foundation, Tucson, AZ, United States
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26
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Gmanyami JM, Quentin W, Lambert O, Jarynowski A, Belik V, Amuasi JH. Excess mortality during the COVID-19 pandemic in low-and lower-middle-income countries: a systematic review and meta-analysis. BMC Public Health 2024; 24:1643. [PMID: 38902661 PMCID: PMC11188207 DOI: 10.1186/s12889-024-19154-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/14/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Although the COVID-19 pandemic claimed a great deal of lives, it is still unclear how it affected mortality in low- and lower-middle-income countries (LLMICs). This review summarized the available literature on excess mortality during the COVID-19 pandemic in LLMICs, including methods, sources of data, and potential contributing factors that might have influenced excess mortality. METHODS We conducted a systematic review and meta-analysis on excess mortality during the COVID-19 pandemic in LLMICs in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines We searched PubMed, Embase, Web of Science, Cochrane Library, Google Scholar, and Scopus. We included studies published from 2019 onwards with a non-COVID-19 period of at least one year as a comparator. The meta-analysis included studies reporting data on population size, as well as observed and expected deaths. We used the Mantel-Haenszel method to estimate the pooled risk ratio with 95% confidence intervals. The protocol was registered in PROSPERO (ID: CRD42022378267). RESULTS The review covered 29 countries, with 10 countries included in the meta-analysis. The pooled meta-analysis included 1,405,128,717 individuals, for which 2,152,474 deaths were expected, and 3,555,880 deaths were reported. Calculated excess mortality was 100.3 deaths per 100,000 population per year, with an excess risk of death of 1.65 (95% CI: 1.649, 1.655, p < 0.001). The data sources used in the studies included civil registration systems, surveys, public cemeteries, funeral counts, obituary notifications, burial site imaging, and demographic surveillance systems. The primary techniques used to estimate excess mortality were statistical forecast modelling and geospatial analysis. One out of the 24 studies found higher excess mortality in urban settings. CONCLUSION Our findings demonstrate that excess mortality in LLMICs during the pandemic was substantial. However, estimates of excess mortality are uncertain due to relatively poor data. Understanding the drivers of excess mortality, will require more research using various techniques and data sources.
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Affiliation(s)
- Jonathan Mawutor Gmanyami
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
- German West-African Centre for Global Health and Pandemic Prevention, Berlin, Germany.
- Global Health and Infectious Diseases Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana.
| | - Wilm Quentin
- German West-African Centre for Global Health and Pandemic Prevention, Berlin, Germany
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
- Chair of Planetary & Public Health, University of Bayreuth, Bayreuth, Germany
| | - Oscar Lambert
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Andrzej Jarynowski
- Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Vitaly Belik
- Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - John Humphrey Amuasi
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- German West-African Centre for Global Health and Pandemic Prevention, Berlin, Germany
- Global Health and Infectious Diseases Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
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27
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Lin TY, Hsu CY, Yen AMF, Chen SLS, Chen THH. Assessing Excess Mortality of Baby Boomers from the COVID-19 Pandemic: Taiwan Omicron-naïve Cohort. J Epidemiol Glob Health 2024:10.1007/s44197-024-00262-0. [PMID: 38902563 DOI: 10.1007/s44197-024-00262-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 06/04/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Asia's elderly Baby Boomer demographic (born between 1946 and 1964) faced a huge problem during the COVID-19 pandemic due to increased all-cause mortality. We aimed to provide a unique Taiwan situation regarding the impact of Baby Boomers on excess mortalities from all causes relative to non-Baby Boomers throughout distinct times of SARS-CoV-2 mutations during the COVID-19 pandemic. METHODS We used the Poisson time series design with a Bayesian directed acyclic graphic approach to build the background mortality prior to the COVID-19 pandemic between 2015 and 2019. It was then used for predicting the expected all-cause deaths compared to the reported figures during the COVID-19 pandemic period based on Taiwan residents, an Omicron-naïve cohort. RESULTS Baby Boomers experienced a 2% negative excess mortality in 2020 (Wuhan/D614G) and a 4% excess mortality in 2021 (Alpha/Delta) with a rising background mortality trend whereas non-Baby Boomers showed the corresponding figures of 4% negative excess and 1% excess with a stable trend. Baby Boomer and non-Baby Boomer excess mortality soared to 9% (95% CI: 7-10%) and 10% (95% CI: 9-11%), respectively, during the epidemic Omicron period from January to June 2022. Surprisingly, Baby Boomers aged 58-76 experienced the same 9% excess mortality as non-Baby Boomers aged 77 and beyond. Non-COVID-19 deaths were more prevalent among Baby Boomers than non-Baby Boomers (33% vs. 29%). CONCLUSION Baby Boomers were more likely to die from COVID-19 in early pandemic and had more non-COVID-19 deaths in late pandemic than older non-Baby Boomers demonstrated in Taiwan Omicron-naïve cohort. For this vulnerable population, adequate access to medical care and medical capacity require more consideration.
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Affiliation(s)
- Ting-Yu Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Room 533, No. 17, Xu-Zhou Road, Taipei, 100, Taiwan
| | - Chen-Yang Hsu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Room 533, No. 17, Xu-Zhou Road, Taipei, 100, Taiwan
- Department of Emergency, Dachung Hospital, Miaoli, Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tony Hsiu-Hsi Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Room 533, No. 17, Xu-Zhou Road, Taipei, 100, Taiwan.
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Mitura KM, Celiński D, Snarska J, Szajda SD. Impact of COVID-19 Pandemic on Health and Life Emergencies Resulting from Illness Cases and Injuries-A Preliminary Study. J Clin Med 2024; 13:3552. [PMID: 38930081 PMCID: PMC11205222 DOI: 10.3390/jcm13123552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/13/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Despite organised efforts, the COVID-19 pandemic had a significant impact on the health status of the population and health services including the emergency medical system. The objective of the study was to investigate, based on the Emergency Medical Teams' (EMT) interventions, the impact of the COVID-19 pandemic on health and life emergencies resulting from illness cases and injuries of Polish females and males. Material and Methods: The data under analysis concern EMT interventions carried out in central and eastern Poland from 1 January 2017 to 31 December 2022 (n = 226,038). The study used descriptive statistics, the Mann-Whitney U Test, and the Chi-square test. Results: A significant increase was observed in the proportion of EMT interventions (p < 0.001) to patients with illness cases (80.30% vs. 83.17%) and a decrease in interventions to patients with injuries (19.70% vs. 16.83%) during the pandemic as compared to the pre-pandemic period. As for illness cases, the patients' ages during both periods were similar (Me = 66.00 vs. 66.00, p = 0.071). On the other hand, during the pandemic, injuries mainly affected elderly patients as compared to the pre-pandemic period (Me = 50.00 vs. 47.00, p < 0.001). The increase in the proportion of EMT interventions to patients with illness cases and the decrease in patients with injuries during the pandemic, as compared to the pre-pandemic period, concerned the area of intervention, patient's sex, and age. During the pandemic period, a significantly lower proportion of patients transported to the hospital (p < 0.001) and an increase in the proportion of patients left at the place of call (p < 0.001) were noted. Conclusions: The restrictions aimed at preventing the spread of the SARS-CoV-2 virus contributed to a reduced number of injuries without, however, reducing the number of illness cases. During the pandemic, the elderly were affected by injuries. The study indicates the need for further in-depth analyses to prepare the pre-hospital care system in Poland for the occurrence of other or similar emergencies.
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Affiliation(s)
- Krzysztof Marek Mitura
- Independent Public Health Care Center RM-MEDITRANS Emergency Station and Sanitary Transport in Siedlce, 08-110 Siedlce, Poland
| | - Daniel Celiński
- Department of Emergency Medical Service, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Jadwiga Snarska
- Department of Surgery, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Sławomir Dariusz Szajda
- Department of Emergency Medical Service, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
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Lei R, He Y, Liu W, Hussain J, Liu L, Han J, Li C, Xing Y, Su W. Unintentional persistent organic pollutants in cremation process: Emissions, characteristics, and inventory. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 929:172495. [PMID: 38649056 DOI: 10.1016/j.scitotenv.2024.172495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/11/2024] [Accepted: 04/13/2024] [Indexed: 04/25/2024]
Abstract
Pollutants produced by cremation furnaces have gradually caused concern because of the increasing rate of cremation around the world. In this study, the levels, patterns, and emission factors of unintentional persistent organic pollutants (UPOPs) from cremation were investigated. The toxic equivalent (TEQ) concentrations (11 % O2 normalized) of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in flue gas ranged from 0.036 to 22 ng TEQ/Nm3, while the levels of polychlorinated biphenyls (PCBs) and polychlorinated naphthalenes (PCNs) in flue gas samples ranged from 0.0023 to 1.2 ng TEQ/Nm3 and 0.17-44 pg TEQ/Nm3, respectively. The average concentrations of UPOPs in flue gas from car-type furnaces were higher than those from flat-panel furnaces. Secondary chambers and air pollution control devices were effective for controlling UPOPs emissions. However, heat exchangers were not as effective for reducing UPOPs emissions. It was observed that the UPOPs profiles exhibited dissimilarities between fly ash and flue gas samples. HxCDF, OCDD, and PeCDF were the dominant homologs of PCDD/Fs in flue gas, while HxCDF, PeCDF, and HpCDF were the dominant homologs in fly ash. The fractions of MoCBs and MoCNs in fly ash were higher than those in flue gas. Finally, we conducted an assessment of the global emissions of UPOPs from cremation in the years of 2019 and 2021. The total emission of UPOPs in 47 countries was estimated at 239 g TEQ in 2021, which was during the peak period of the COVID-19 pandemic worldwide. The emissions in 2021 increased by approximately 24 % compared to 2019, with the impact of COVID-19 being a significant factor that cannot be disregarded.
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Affiliation(s)
- Rongrong Lei
- School of Energy and Environmental Engineering, The University of Science and Technology Beijing, Beijing 100083, China
| | - Yunchen He
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 101408, China; Research Center for Eco-Environmental Sciences, Beijing 100085, China
| | - Wenbin Liu
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 101408, China; Hangzhou Institute for Advanced Study, UCAS, Hangzhou 310024, China.
| | - Javid Hussain
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 101408, China; Department of Environmental Sciences, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87100, Pakistan
| | - Lijun Liu
- South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Jinglei Han
- South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Changliang Li
- Research Center for Eco-Environmental Sciences, Beijing 100085, China
| | - Yi Xing
- School of Energy and Environmental Engineering, The University of Science and Technology Beijing, Beijing 100083, China
| | - Wei Su
- School of Energy and Environmental Engineering, The University of Science and Technology Beijing, Beijing 100083, China.
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Ledesma JR, Papanicolas I, Stoto MA, Chrysanthopoulou SA, Isaac CR, Lurie MN, Nuzzo JB. Pandemic preparedness improves national-level SARS-CoV-2 infection and mortality data completeness: a cross-country ecologic analysis. Popul Health Metr 2024; 22:12. [PMID: 38879515 PMCID: PMC11179302 DOI: 10.1186/s12963-024-00333-1] [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: 01/12/2024] [Accepted: 06/11/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Heterogeneity in national SARS-CoV-2 infection surveillance capabilities may compromise global enumeration and tracking of COVID-19 cases and deaths and bias analyses of the pandemic's tolls. Taking account of heterogeneity in data completeness may thus help clarify analyses of the relationship between COVID-19 outcomes and standard preparedness measures. METHODS We examined country-level associations of pandemic preparedness capacities inventories, from the Global Health Security (GHS) Index and Joint External Evaluation (JEE), on SARS-CoV-2 infection and COVID-19 death data completion rates adjusted for income. Analyses were stratified by 100, 100-300, 300-500, and 500-700 days after the first reported case in each country. We subsequently reevaluated the relationship of pandemic preparedness on SARS-CoV-2 infection and age-standardized COVID-19 death rates adjusted for cross-country differentials in data completeness during the pre-vaccine era. RESULTS Every 10% increase in the GHS Index was associated with a 14.9% (95% confidence interval 8.34-21.8%) increase in SARS-CoV-2 infection completion rate and a 10.6% (5.91-15.4%) increase in the death completion rate during the entire observation period. Disease prevention (infections: β = 1.08 [1.05-1.10], deaths: β = 1.05 [1.04-1.07]), detection (infections: β = 1.04 [1.01-1.06], deaths: β = 1.03 [1.01-1.05]), response (infections: β = 1.06 [1.00-1.13], deaths: β = 1.05 [1.00-1.10]), health system (infections: β = 1.06 [1.03-1.10], deaths: β = 1.05 [1.03-1.07]), and risk environment (infections: β = 1.27 [1.15-1.41], deaths: β = 1.15 [1.08-1.23]) were associated with both data completeness outcomes. Effect sizes of GHS Index on infection completion (Low income: β = 1.18 [1.04-1.34], Lower Middle income: β = 1.41 [1.16-1.71]) and death completion rates (Low income: β = 1.19 [1.09-1.31], Lower Middle income: β = 1.25 [1.10-1.43]) were largest in LMICs. After adjustment for cross-country differences in data completeness, each 10% increase in the GHS Index was associated with a 13.5% (4.80-21.4%) decrease in SARS-CoV-2 infection rate at 100 days and a 9.10 (1.07-16.5%) decrease at 300 days. For age-standardized COVID-19 death rates, each 10% increase in the GHS Index was with a 15.7% (5.19-25.0%) decrease at 100 days and a 10.3% (- 0.00-19.5%) decrease at 300 days. CONCLUSIONS Results support the pre-pandemic hypothesis that countries with greater pandemic preparedness capacities have larger SARS-CoV-2 infection and mortality data completeness rates and lower COVID-19 disease burdens. More high-quality data of COVID-19 impact based on direct measurement are needed.
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Affiliation(s)
- Jorge R Ledesma
- Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA.
| | - Irene Papanicolas
- Department of Health Services, Policy and Practice, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA
| | - Michael A Stoto
- Department of Health Management and Policy, School of Health, Georgetown University, 3700 Reservoir Road, N.W., Washington, DC, 20057, USA
| | - Stavroula A Chrysanthopoulou
- Department of Biostatistics, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA
| | - Christopher R Isaac
- Nuclear Threat Initiative, 1776 Eye Street, NW, Suite 600, Washington, DC, 20006, USA
| | - Mark N Lurie
- Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA
- International Health Institute, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA
- Population Studies and Training Center, Brown University, 68 Waterman St., Box 1836, Providence, RI, 02912, USA
| | - Jennifer B Nuzzo
- Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA
- Pandemic Center, Brown University School of Public Health, 121 S Main St, Providence, RI, 02912, USA
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31
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Lima EECD, Costa LCCD, Souza RF, Rocha CODE, Ichihara MYT. Presidential election results in 2018-2022 and its association with excess mortality during the 2020-2021 COVID-19 pandemic in Brazilian municipalities. CAD SAUDE PUBLICA 2024; 40:e00194723. [PMID: 38896596 PMCID: PMC11178372 DOI: 10.1590/0102-311xen194723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 06/21/2024] Open
Abstract
We evaluated the hypothesis of an association between excess mortality and political partisanship in Brazil using municipal death certificates registered in the Brazilian Ministry of Health database and first-round electoral results of Presidential elections in 2018 and 2022. Considering the former Brazilian President's stance of discrediting and neglecting the severity of the pandemic, we expect a possible relationship between excessive mortality rates during the COVID-19 health crisis and the number of municipal votes for Bolsonaro. Our results showed that, in both elections, the first-round percentage of municipal votes for Bolsonaro was positively associated with the peaks of excess deaths across Brazilian municipalities in 2020 and 2021. Despite the excess mortality during the pandemic, the political loyalty to Bolsonaro remained the same during the electoral period of 2022. A possible explanation for this is linked to the Brazilian political scenario, which presents an environment of tribal politics and affective polarization.
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Affiliation(s)
| | | | - Rafael F Souza
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brasil
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32
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Morgenstern C, Laydon DJ, Whittaker C, Mishra S, Haw D, Bhatt S, Ferguson NM. The interaction of disease transmission, mortality, and economic output over the first 2 years of the COVID-19 pandemic. PLoS One 2024; 19:e0301785. [PMID: 38870106 PMCID: PMC11175517 DOI: 10.1371/journal.pone.0301785] [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: 10/13/2023] [Accepted: 03/21/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has caused over 7.02 million deaths as of January 2024 and profoundly affected most countries' Gross Domestic Product (GDP). Here, we study the interaction of SARS-CoV-2 transmission, mortality, and economic output between January 2020 and December 2022 across 25 European countries. METHODS We use a Bayesian mixed effects model with auto-regressive terms to estimate the temporal relationships between disease transmission, excess deaths, changes in economic output, transit mobility and non-pharmaceutical interventions (NPIs) across countries. RESULTS Disease transmission intensity (logRt) decreases GDP and increases excess deaths, where the latter association is longer-lasting. Changes in GDP as well as prior week transmission intensity are both negatively associated with each other (-0.241, 95% CrI: -0.295 - -0.189). We find evidence of risk-averse behaviour, as changes in transit and prior week transmission intensity are negatively associated (-0.055, 95% CrI: -0.074 to -0.036). Our results highlight a complex cost-benefit trade-off from individual NPIs. For example, banning international travel is associated with both increases in GDP (0.014, 0.002-0.025) and decreases in excess deaths (-0.014, 95% CrI: -0.028 - -0.001). Country-specific random effects, such as the poverty rate, are positively associated with excess deaths while the UN government effectiveness index is negatively associated with excess deaths. INTERPRETATION The interplay between transmission intensity, excess deaths, population mobility and economic output is highly complex, and none of these factors can be considered in isolation. Our results reinforce the intuitive idea that significant economic activity arises from diverse person-to-person interactions. Our analysis quantifies and highlights that the impact of disease on a given country is complex and multifaceted. Long-term economic impairments are not fully captured by our model, as well as long-term disease effects (Long COVID).
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Affiliation(s)
- Christian Morgenstern
- MRC Centre for Global Infectious Disease Analysis & WHO Collaborating Centre for Infectious Disease Modelling, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
| | - Daniel J. Laydon
- MRC Centre for Global Infectious Disease Analysis & WHO Collaborating Centre for Infectious Disease Modelling, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
| | - Charles Whittaker
- MRC Centre for Global Infectious Disease Analysis & WHO Collaborating Centre for Infectious Disease Modelling, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
| | - Swapnil Mishra
- MRC Centre for Global Infectious Disease Analysis & WHO Collaborating Centre for Infectious Disease Modelling, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
- University of Copenhagen, Copenhagen, Denmark
| | - David Haw
- MRC Centre for Global Infectious Disease Analysis & WHO Collaborating Centre for Infectious Disease Modelling, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
| | - Samir Bhatt
- MRC Centre for Global Infectious Disease Analysis & WHO Collaborating Centre for Infectious Disease Modelling, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
- University of Copenhagen, Copenhagen, Denmark
| | - Neil M. Ferguson
- MRC Centre for Global Infectious Disease Analysis & WHO Collaborating Centre for Infectious Disease Modelling, Jameel Institute, School of Public Health, Imperial College London, London, United Kingdom
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Han J, Li W, Zhang X. An effective and rapidly degradable disinfectant from disinfection byproducts. Nat Commun 2024; 15:4888. [PMID: 38849332 PMCID: PMC11161644 DOI: 10.1038/s41467-024-48752-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
Chloroxylenol is a worldwide commonly used disinfectant. The massive consumption and relatively high chemical stability of chloroxylenol have caused eco-toxicological threats in receiving waters. We noticed that chloroxylenol has a chemical structure similar to numerous halo-phenolic disinfection byproducts. Solar detoxification of some halo-phenolic disinfection byproducts intrigued us to select a rapidly degradable chloroxylenol alternative from them. In investigating antimicrobial activities of disinfection byproducts, we found that 2,6-dichlorobenzoquinone was 9.0-22 times more efficient than chloroxylenol in inactivating the tested bacteria, fungi and viruses. Also, the developmental toxicity of 2,6-dichlorobenzoquinone to marine polychaete embryos decreased rapidly due to its rapid degradation via hydrolysis in receiving seawater, even without sunlight. Our work shows that 2,6-dichlorobenzoquinone is a promising disinfectant that well addresses human biosecurity and environmental sustainability. More importantly, our work may enlighten scientists to exploit the slightly alkaline nature of seawater and develop other industrial products that can degrade rapidly via hydrolysis in seawater.
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Affiliation(s)
- Jiarui Han
- Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Wanxin Li
- Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Xiangru Zhang
- Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China.
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Moore S, Cavany S, Perkins TA, España GFC. Projecting the future impact of emerging SARS-CoV-2 variants under uncertainty: Modeling the initial Omicron outbreak. Epidemics 2024; 47:100759. [PMID: 38452455 DOI: 10.1016/j.epidem.2024.100759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/26/2024] [Accepted: 03/01/2024] [Indexed: 03/09/2024] Open
Abstract
Over the past several years, the emergence of novel SARS-CoV-2 variants has led to multiple waves of increased COVID-19 incidence. When the Omicron variant emerged, there was considerable concern about its potential impact in the winter of 2021-2022 due to its increased fitness. However, there was also considerable uncertainty regarding its likely impact due to questions about its relative transmissibility, severity, and degree of immune escape. We sought to evaluate the ability of an agent-based model to forecast incidence in the context of this emerging pathogen variant. To project COVID-19 cases and deaths in Indiana, we calibrated our model to COVID-19 hospitalizations, deaths, and test-positivity rates through November 2021, and then projected COVID-19 incidence through April 2022 under four different scenarios that covered the plausible ranges of Omicron's severity, transmissibility, and degree of immune escape. Our initial projections from December 2021 through March 2022 indicated that under a pessimistic scenario with high disease severity, the peak in weekly COVID-19 deaths in Indiana would be larger than the previous peak in December 2020. However, retrospective analyses indicate that Omicron's severity was closer to the optimistic scenario, and even though cases and hospitalizations reached a new peak, fewer deaths occurred than during the previous peak. According to our results, Omicron's rapid spread was consistent with a combination of higher transmissibility and immune escape relative to earlier variants. Our updated projections starting in January 2022 accurately predicted that cases would peak in mid-January and decline rapidly over the next several months. The performance of our projections shows that following the emergence of a new pathogen variant, models can help quantify the potential range of outbreak magnitudes and trajectories. Agent-based models are particularly useful in these scenarios because they can efficiently track individual vaccination and infection histories with multiple variants with varying degrees of cross-protection.
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Affiliation(s)
- Sean Moore
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556, United States.
| | - Sean Cavany
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556, United States
| | - T Alex Perkins
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556, United States
| | - Guido Felipe Camargo España
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556, United States
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Tabarsi P, Hemmatian M, Moradi M. Long COVID-19 leading to Good's syndrome diagnosis: A clinical case-report and literature review. Clin Case Rep 2024; 12:e8962. [PMID: 38808198 PMCID: PMC11130229 DOI: 10.1002/ccr3.8962] [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: 02/16/2024] [Revised: 03/20/2024] [Accepted: 04/12/2024] [Indexed: 05/30/2024] Open
Abstract
Key Clinical Message Good's syndrome (GS) in conjunction with a severe COVID-19 infection, shedding light on the complexities of managing this rare condition that combines thymoma and immunodeficiency. Abstract This study delves into the clinical presentation and management of a 63-year-old male diagnosed with Good's syndrome (GS) amid a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. GS, an uncommon association between thymoma and immunodeficiency, remains a clinical mystery, necessitating increased awareness and understanding. Our patient's intricate clinical course, marked by recurrent COVID-19 symptoms and multiple hospitalizations, exemplifies the challenges posed by GS. Through a systematic review of GS cases globally, we highlight its worldwide distribution, with a substantial proportion reported in Europe. Notably, the diagnosis of thymoma often precedes immunodeficiency, emphasizing the importance of vigilance in clinical assessments.
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Affiliation(s)
- Payam Tabarsi
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute for Tuberculosis and Lung Disease (NRITLD)Shahid Beheshti University of Medical SciencesTehranIran
| | - Marjan Hemmatian
- Infectious Diseases and Tropical Medicine, Loghman Hospital, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Maryam Moradi
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram HospitalIran University of Medical SciencesTehranIran
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Bonnet F, Grigoriev P, Sauerberg M, Alliger I, Mühlichen M, Camarda CG. Spatial Variation in Excess Mortality Across Europe: A Cross-Sectional Study of 561 Regions in 21 Countries. J Epidemiol Glob Health 2024; 14:470-479. [PMID: 38376764 PMCID: PMC11176282 DOI: 10.1007/s44197-024-00200-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/24/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVE To measure the burden of the COVID-19 pandemic in 2020 at the subnational level by estimating excess mortality, defined as the increase in all-cause mortality relative to an expected baseline mortality level. METHODS Statistical and demographic analyses of regional all-cause mortality data provided by the vital statistics systems of 21 European countries for 561 regions in Central and Western Europe. Life expectancy losses at ages 0 and 60 for males and females were estimated. RESULTS We found evidence of a loss in life expectancy in 391 regions, whilst only three regions exhibit notable gains in life expectancy in 2020. For 12 regions, losses of life expectancy amounted to more than 2 years and three regions showed losses greater than 3 years. We highlight geographical clusters of high mortality in Northern Italy, Spain and Poland, whilst clusters of low mortality were found in Western France, Germany/Denmark and Norway/Sweden. CONCLUSIONS Regional differences of loss of life expectancy are impressive, ranging from a loss of more than 4 years to a gain of 8 months. These findings provide a strong rationale for regional analysis, as national estimates hide significant regional disparities.
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Affiliation(s)
- Florian Bonnet
- French Institute for Demographic Studies (INED), 9 cours des Humanités, 93300, Aubervilliers, France.
| | - Pavel Grigoriev
- French Institute for Demographic Studies (INED), 9 cours des Humanités, 93300, Aubervilliers, France
| | - Markus Sauerberg
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
| | - Ina Alliger
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
| | | | - Carlo-Giovanni Camarda
- French Institute for Demographic Studies (INED), 9 cours des Humanités, 93300, Aubervilliers, France
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Richmond DiBello J, Raziano VT, Liu X, Puenpatom A, Peebles K, Khan NF, Hill DD. Molnupiravir Use Among Patients with COVID-19 in Real-World Settings: A Systematic Literature Review. Infect Dis Ther 2024; 13:1177-1198. [PMID: 38743192 PMCID: PMC11128428 DOI: 10.1007/s40121-024-00976-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 04/08/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Molnupiravir (MOV) is an oral antiviral for the treatment of individuals with mild-to-moderate COVID-19 and at high risk of progression to severe disease. Our objective was to conduct a systematic literature review (SLR) of evidence on the effectiveness of MOV in reducing the risk of severe COVID-19 outcomes in real-world outpatient settings. METHODS The SLR was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and using pre-determined population, intervention, comparison, outcome, time, and study design inclusion criteria. Eligible studies were published between January 1, 2021, and March 10, 2023, and evaluated the real-world effectiveness of MOV compared to no treatment in reducing the risk of severe COVID-19 outcomes among outpatients ≥ 18 years of age with a laboratory-confirmed diagnosis of SARS-CoV-2 infection. RESULTS Nine studies from five countries were included in the review. The size of the MOV-treated group ranged from 359 to 7818 individuals. Omicron variants of SARS-CoV-2 were dominant in all study periods. Most studies noted differences in the baseline characteristics of the MOV-treated and untreated control groups, with the treated groups generally being older and with more comorbidities. Eight studies reported that treatment with MOV was associated with a significantly reduced risk of at least one severe COVID-19 outcome in at least one age group, with greater benefits consistently observed among older age groups. CONCLUSIONS In this SLR study, treatment with MOV was effective in reducing the risk of severe outcomes from COVID-19 caused by Omicron variants, especially for older individuals. Differences in the ages and baseline comorbidities of the MOV-treated and control groups may have led to underestimation of the effectiveness of MOV in many observational studies. Real-world studies published to date thus provide additional evidence supporting the continued benefits of MOV in non-hospitalized adults with COVID-19.
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Affiliation(s)
- Julia Richmond DiBello
- Biostatistics and Research Decision Sciences (BARDS), Epidemiology, Merck & Co., Inc., Rahway, NJ, USA
| | - Valerie T Raziano
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ, USA.
- Merck & Co., Inc., 351 N Sumneytown Pike, North Wales, PA, 19454, USA.
| | - Xinyue Liu
- Biostatistics and Research Decision Sciences (BARDS), Epidemiology, Merck & Co., Inc., Rahway, NJ, USA
| | - Amy Puenpatom
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ, USA
| | - Kathryn Peebles
- Biostatistics and Research Decision Sciences (BARDS), Epidemiology, Merck & Co., Inc., Rahway, NJ, USA
| | - Nazleen F Khan
- Biostatistics and Research Decision Sciences (BARDS), Epidemiology, Merck & Co., Inc., Rahway, NJ, USA
| | - Deanna D Hill
- Biostatistics and Research Decision Sciences (BARDS), Epidemiology, Merck & Co., Inc., Rahway, NJ, USA
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Krishnan A, Dubey M, Kumar R, Salve HR, Upadhyay AD, Gupta V, Malhotra S, Kaur R, Nongkynrih B, Bairwa M. Construction and validation of a covariate-based model for district-level estimation of excess deaths due to COVID-19 in India. J Glob Health 2024; 14:05013. [PMID: 38813676 PMCID: PMC11140283 DOI: 10.7189/jogh.14.05013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Abstract
Background Different statistical approaches for estimating excess deaths due to coronavirus disease 2019 (COVID-19) pandemic have led to varying estimates. In this study, we developed and validated a covariate-based model (CBM) with imputation for prediction of district-level excess deaths in India. Methods We used data extracted from deaths registered under the Civil Registration System for 2015-19 for 684 of 713 districts in India to estimate expected deaths for 2020 through a negative binomial regression model (NBRM) and to calculate excess observed deaths. Specifically, we used 15 covariates across four domains (state, health system, population, COVID-19) in a zero inflated NBRM to identify covariates significantly (P < 0.05) associated with excess deaths estimate in 460 districts. We then validated this CBM in 140 districts by comparing predicted and estimated excess. For 84 districts with missing covariates, we validated the imputation with CBM by comparing estimated with predicted excess deaths. We imputed covariate data to predict excess deaths for 29 districts which did not have data on deaths. Results The share of elderly and urban population, the under-five mortality rate, prevalence of diabetes, and bed availability were significantly associated with estimated excess deaths and were used for CBM. The mean of the CBM-predicted excess deaths per district (x̄ = 989, standard deviation (SD) = 1588) was not significantly different from the estimated one (x̄ = 1448, SD = 3062) (P = 0.25). The estimated excess deaths (n = 67 540; 95% confidence interval (CI) = 35 431, 99 648) were similar to the predicted excess death (n = 64 570; 95% CI = 54 140, 75 000) by CBM with imputation. The total national estimate of excess deaths for all 713 districts was 794 989 (95% CI = 664 895, 925 082). Conclusions A CBM with imputation can be used to predict excess deaths in an appropriate context.
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Affiliation(s)
- Anand Krishnan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi
| | - Mahasweta Dubey
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi
| | - Rakesh Kumar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi
| | - Harshal R Salve
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi
| | | | - Vivek Gupta
- Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi
| | - Sumit Malhotra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi
- Clinical Research Unit, All India Institute of Medical Sciences, New Delhi
- Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi
| | - Ravneet Kaur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi
| | | | - Mohan Bairwa
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi
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Economidou EC, Soteriades ES. Excess mortality in Cyprus during the COVID-19 vaccination campaign. Vaccine 2024; 42:3375-3376. [PMID: 37996289 DOI: 10.1016/j.vaccine.2023.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023]
Affiliation(s)
| | - Elpidoforos S Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia, Cyprus; Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA.
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40
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Song K, Xue W, Li X, Chang Y, Liu M. Self-Assembly of Single-Virus SERS Hotspots for Highly Sensitive In Situ Detection of SARS-CoV-2 on Solid Surfaces. Anal Chem 2024; 96:8830-8836. [PMID: 38693713 DOI: 10.1021/acs.analchem.4c01607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Microbial surface transmission has aroused great attention since the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Developing a simple in situ detection method for viruses on solid surfaces is of great significance for timely public health surveillance. Taking advantage of the natural structure of SARS-CoV-2, we reported the assembly of Au@AgNPs on the surface of a single virus by the specific aptamer-spike protein interaction. Multiple hotspots can be created between the neighboring Au@AgNPs for the highly sensitive surface-enhanced Raman scattering (SERS) detection of SARS-CoV-2. Using two different aptamers labeled with Cy3 and Au@AgNPs, in situ SERS detection of pseudotyped SARS-CoV-2 (PSV) on packaging surfaces was achieved within 20 min, with a detection limit of 5.26 TCID50/mL. For the blind testing of 20 PSV-contaminated packaging samples, this SERS aptasensor had a sensitivity of 100% and an accuracy of 100%. This assay has been successfully applied to in situ detection of PSV on the surfaces of different packaging materials, suggesting its potential applicability.
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Affiliation(s)
- Kaiyun Song
- School of Environmental Science and Technology, Key Laboratory of Industrial Ecology and Environmental Engineering (Ministry of Education), Dalian POCT laboratory, Dalian University of Technology, Dalian 116024, China
| | - Wei Xue
- School of Environmental Science and Technology, Key Laboratory of Industrial Ecology and Environmental Engineering (Ministry of Education), Dalian POCT laboratory, Dalian University of Technology, Dalian 116024, China
| | - Xiaona Li
- School of Environmental Science and Technology, Key Laboratory of Industrial Ecology and Environmental Engineering (Ministry of Education), Dalian POCT laboratory, Dalian University of Technology, Dalian 116024, China
| | - Yangyang Chang
- School of Environmental Science and Technology, Key Laboratory of Industrial Ecology and Environmental Engineering (Ministry of Education), Dalian POCT laboratory, Dalian University of Technology, Dalian 116024, China
| | - Meng Liu
- School of Environmental Science and Technology, Key Laboratory of Industrial Ecology and Environmental Engineering (Ministry of Education), Dalian POCT laboratory, Dalian University of Technology, Dalian 116024, China
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41
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Heino MTJ, Proverbio D, Saurio K, Siegenfeld A, Hankonen N. From a false sense of safety to resilience under uncertainty. Front Psychol 2024; 15:1346542. [PMID: 38860037 PMCID: PMC11164187 DOI: 10.3389/fpsyg.2024.1346542] [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: 11/29/2023] [Accepted: 04/24/2024] [Indexed: 06/12/2024] Open
Abstract
Understanding and acting upon risk is notably challenging, and navigating complexity with understandings developed for stable environments may inadvertently build a false sense of safety. Neglecting the potential for non-linear change or "black swan" events - highly impactful but uncommon occurrences - may lead to naive optimisation under assumed stability, exposing systems to extreme risks. For instance, loss aversion is seen as a cognitive bias in stable environments, but it can be an evolutionarily advantageous heuristic when complete destruction is possible. This paper advocates for better accounting of non-linear change in decision-making by leveraging insights from complex systems and psychological sciences, which help to identify blindspots in conventional decision-making and to develop risk mitigation plans that are interpreted contextually. In particular, we propose a framework using attractor landscapes to visualize and interpret complex system dynamics. In this context, attractors are states toward which systems naturally evolve, while tipping points - critical thresholds between attractors - can lead to profound, unexpected changes impacting a system's resilience and well-being. We present four generic attractor landscape types that provide a novel lens for viewing risks and opportunities, and serve as decision-making contexts. The main practical contribution is clarifying when to emphasize particular strategies - optimisation, risk mitigation, exploration, or stabilization - within this framework. Context-appropriate decision making should enhance system resilience and mitigate extreme risks.
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Affiliation(s)
- Matti T. J. Heino
- Faculty of Social Sciences, Unit of Social Research, Tampere University, Tampere, Finland
- Faculty of Social Sciences, Discipline of Social Psychology, University of Helsinki, Helsinki, Finland
| | - Daniele Proverbio
- Department of Industrial Engineering, University of Trento, Trento, Italy
| | - Kaisa Saurio
- Faculty of Social Sciences, Unit of Social Research, Tampere University, Tampere, Finland
| | | | - Nelli Hankonen
- Faculty of Social Sciences, Unit of Social Research, Tampere University, Tampere, Finland
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42
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Zaha DC, Ilea CDN, Dorobanțu FR, Pantiș C, Pop ON, Dascal DG, Dorobanțu CD, Manole F. The Impact of SARS-CoV-2 Pandemic on Antibiotic Prescriptions and Resistance in a University Hospital from Romania. Antibiotics (Basel) 2024; 13:477. [PMID: 38927144 PMCID: PMC11200525 DOI: 10.3390/antibiotics13060477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
This paper aimed to evaluate the effects of the COVID-19 pandemic on prescription rates and antibiotic resistance in a university hospital. A retrospective study was conducted on the medical records of patients admitted to the Bihor Emergency Clinical County Hospital in Romania in 2019 (pre-pandemic) and 2021 (during the pandemic period). We evaluated the antibiotic consumption index (ACI) and susceptibility rates. The overall percentage of antibiotic prescribing increased in 2021, while the total number of patients decreased. Genito-urinary, digestive, respiratory infections, heart diseases and wounds were the most common conditions for antibiotic prescriptions, but the number of them decreased in 2021. There was a decrease in the proportion of antibiotics from the Watch and Reserve class and an increase in the proportion of antibiotics from the Access class. Antibiotic use has been reduced despite an increase in the number of patients, with a high consumption in the Watch group in the ICU wards. By contrast, surgical wards had the highest rate of antibiotic prescriptions, but a decrease in the number of patients. The patients who were administered antibiotics were hospitalized for diagnoses other than COVID-19. Almost all prescribed antibiotics displayed decreasing sensitivity rates. The number of isolated ESKAPE pathogens, except for Staphylococcus aureus methicillin-resistant strains, were increased. Strategies to control antibiotic prescriptions and the spread of resistant pathogens should be improved.
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Affiliation(s)
- Dana Carmen Zaha
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania; (D.C.Z.); (D.G.D.)
| | - Codrin Dan Nicolae Ilea
- Bihor Emergency Clinical County Hospital, 410087 Oradea, Romania
- Department of Biostatistics, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania
| | - Florica Ramona Dorobanțu
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania;
| | - Carmen Pantiș
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania; (C.P.); (C.D.D.); (F.M.)
| | - Ovidiu Nicolae Pop
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania; (C.P.); (C.D.D.); (F.M.)
| | - Dorina Gabriela Dascal
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania; (D.C.Z.); (D.G.D.)
| | - Cătălin Dorin Dorobanțu
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania; (C.P.); (C.D.D.); (F.M.)
| | - Felicia Manole
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania; (C.P.); (C.D.D.); (F.M.)
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Lo YTE, Mitchell DM, Gasparrini A. Compound mortality impacts from extreme temperatures and the COVID-19 pandemic. Nat Commun 2024; 15:4289. [PMID: 38782899 PMCID: PMC11116452 DOI: 10.1038/s41467-024-48207-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
Extreme weather and coronavirus-type pandemics are both leading global health concerns. Until now, no study has quantified the compound health consequences of the co-occurrence of them. We estimate the mortality attributable to extreme heat and cold events, which dominate the UK health burden from weather hazards, in England and Wales in the period 2020-2022, during which the COVID-19 pandemic peaked in terms of mortality. We show that temperature-related mortality exceeded COVID-19 mortality by 8% in South West England. Combined, extreme temperatures and COVID-19 led to 19 (95% confidence interval: 16-22 in North West England) to 24 (95% confidence interval: 20-29 in Wales) excess deaths per 100,000 population during heatwaves, and 80 (95% confidence interval: 75-86 in Yorkshire and the Humber) to 127 (95% confidence interval: 123-132 in East of England) excess deaths per 100,000 population during cold snaps. These numbers are at least ~2 times higher than the previous decade. Society must increase preparedness for compound health crises such as extreme weather coinciding with pandemics.
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Affiliation(s)
- Y T Eunice Lo
- Cabot Institute for the Environment, University of Bristol, Bristol, UK.
- Elizabeth Blackwell Institute for Health Research, University of Bristol, Bristol, UK.
| | - Dann M Mitchell
- Cabot Institute for the Environment, University of Bristol, Bristol, UK
- School of Geographical Sciences, University of Bristol, Bristol, UK
| | - Antonio Gasparrini
- Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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Vishweshwaraiah YL, Hnath B, Wang J, Chandler M, Mukherjee A, Yennawar NH, Booker SJ, Afonin KA, Dokholyan NV. A Piecewise Design Approach to Engineering a Miniature ACE2 Mimic to Bind SARS-CoV-2. ACS APPLIED BIO MATERIALS 2024; 7:3238-3246. [PMID: 38700999 DOI: 10.1021/acsabm.4c00222] [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] [Indexed: 05/05/2024]
Abstract
As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues its global spread, the exploration of novel therapeutic and diagnostic strategies is still needed. The virus enters host cells by binding the angiotensin-converting enzyme 2 (ACE2) receptor through the spike protein. Here, we develop an engineered, small, stable, and catalytically inactive version of ACE2, termed miniature ACE2 (mACE2), designed to bind the spike protein with high affinity. Employing a magnetic nanoparticle-based assay, we harnessed the strong binding affinity of mACE2 to develop a sensitive and specific platform for the detection or neutralization of SARS-CoV-2. Our findings highlight the potential of engineered mACE2 as a valuable tool in the fight against SARS-CoV-2. The success of developing such a small reagent based on a piecewise molecular design serves as a proof-of-concept approach for the rapid deployment of such agents to diagnose and fight other viral diseases.
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Affiliation(s)
| | - Brianna Hnath
- Department of Pharmacology, Penn State College of Medicine, Hershey, Pennsylvania 17033-0850, United States
- Department of Biomedical Engineering, Penn State University, University Park, Pennsylvania 16802, United States
| | - Jian Wang
- Department of Pharmacology, Penn State College of Medicine, Hershey, Pennsylvania 17033-0850, United States
| | - Morgan Chandler
- Department of Chemistry, University of North Carolina at Charlotte, Charlotte, North Carolina 28223, United States
| | - Arnab Mukherjee
- Department of Chemistry, Penn State University, University Park, Pennsylvania 16802, United States
- The Howard Hughes Medical Institute, Penn State University, University Park, Pennsylvania 16802, United States
| | - Neela H Yennawar
- The Huck Institutes of the Life Sciences, Penn State University, University Park, Pennsylvania 16802, United States
| | - Squire J Booker
- Department of Chemistry, Penn State University, University Park, Pennsylvania 16802, United States
- The Howard Hughes Medical Institute, Penn State University, University Park, Pennsylvania 16802, United States
- Department of Biochemistry & Molecular Biology, Penn State University, University Park, Pennsylvania 16802, United States
| | - Kirill A Afonin
- Department of Chemistry, University of North Carolina at Charlotte, Charlotte, North Carolina 28223, United States
| | - Nikolay V Dokholyan
- Department of Pharmacology, Penn State College of Medicine, Hershey, Pennsylvania 17033-0850, United States
- Department of Biomedical Engineering, Penn State University, University Park, Pennsylvania 16802, United States
- Department of Chemistry, University of North Carolina at Charlotte, Charlotte, North Carolina 28223, United States
- Department of Biochemistry & Molecular Biology, Penn State College of Medicine, Hershey, Pennsylvania 17033-0850, United States
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Bonnet F, Grigoriev P, Sauerberg M, Alliger I, Mühlichen M, Camarda CG. Spatial disparities in the mortality burden of the covid-19 pandemic across 569 European regions (2020-2021). Nat Commun 2024; 15:4246. [PMID: 38762653 PMCID: PMC11102496 DOI: 10.1038/s41467-024-48689-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/08/2024] [Indexed: 05/20/2024] Open
Abstract
Since its emergence in December 2019, the COVID-19 pandemic has resulted in a significant increase in deaths worldwide. This article presents a detailed analysis of the mortality burden of the COVID-19 pandemic across 569 regions in 25 European countries. We produce age and sex-specific excess mortality and present our results using Age-Standardised Years of Life Lost in 2020 and 2021, as well as the cumulative impact over the two pandemic years. Employing a forecasting approach based on CP-splines that considers regional diversity and provides confidence intervals, we find notable losses in 362 regions in 2020 (440 regions in 2021). Conversely, only seven regions experienced gains in 2020 (four regions in 2021). We also estimate that eight regions suffered losses exceeding 20 years of life per 1000 population in 2020, whereas this number increased to 75 regions in 2021. The contiguity of the regions investigated in our study also reveals the changing geographical patterns of the pandemic. While the highest excess mortality values were concentrated in the early COVID-19 outbreak areas during the initial pandemic year, a clear East-West gradient appeared in 2021, with regions of Slovakia, Hungary, and Latvia experiencing the highest losses. This research underscores the importance of regional analyses for a nuanced comprehension of the pandemic's impact.
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Affiliation(s)
- Florian Bonnet
- French Institute for Demographic Studies (INED), Aubervilliers, France.
| | - Pavel Grigoriev
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
| | - Markus Sauerberg
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
| | - Ina Alliger
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
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Schumacher AE, Kyu HH, Aali A, Abbafati C, Abbas J, Abbasgholizadeh R, Abbasi MA, Abbasian M, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdelwahab A, Abdollahi M, Abdoun M, Abdullahi A, Abdurehman AM, Abebe M, Abedi A, Abedi A, Abegaz TM, Abeldaño Zuñiga RA, Abhilash ES, Abiodun OO, Aboagye RG, Abolhassani H, Abouzid M, Abreu LG, Abrha WA, Abrigo MRM, Abtahi D, Abu Rumeileh S, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Acuna JM, Adair T, Addo IY, Adebayo OM, Adegboye OA, Adekanmbi V, Aden B, Adepoju AV, Adetunji CO, Adeyeoluwa TE, Adeyomoye OI, Adha R, Adibi A, Adikusuma W, Adnani QES, Adra S, Afework A, Afolabi AA, Afraz A, Afyouni S, Afzal S, Agasthi P, Aghamiri S, Agodi A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad F, Ahmad MM, Ahmad T, Ahmadi K, Ahmadzade AM, Ahmadzade M, Ahmed A, Ahmed H, Ahmed LA, Ahmed MB, Ahmed SA, Ajami M, Aji B, Ajumobi O, Akalu GT, Akara EM, Akinosoglou K, Akkala S, Akyirem S, Al Hamad H, Al Hasan SM, Al Homsi A, Al Qadire M, Ala M, Aladelusi TO, AL-Ahdal TMA, Alalalmeh SO, Al-Aly Z, Alam K, Alam M, Alam Z, Al-amer RM, Alanezi FM, Alanzi TM, Albashtawy M, AlBataineh MT, Aldridge RW, Alemi S, Al-Eyadhy A, Al-Gheethi AAS, Alhabib KF, Alhalaiqa FAN, Al-Hanawi MK, Ali A, Ali A, Ali BA, Ali H, Ali MU, Ali R, Ali SSS, Ali Z, Alian Samakkhah S, Alicandro G, Alif SM, Aligol M, Alimi R, Aliyi AA, Al-Jumaily A, Aljunid SM, Almahmeed W, Al-Marwani S, Al-Maweri SAA, Almazan JU, Al-Mekhlafi HM, Almidani O, Alomari MA, Alonso N, Alqahtani JS, Alqutaibi AY, Al-Sabah SK, Altaf A, Al-Tawfiq JA, Altirkawi KA, Alvi FJ, Alwafi H, Al-Worafi YM, Aly H, Alzoubi KH, Amare AT, Ameyaw EK, Amhare AF, Amin TT, Amindarolzarbi A, Aminian Dehkordi J, Amiri S, Amu H, Amugsi DA, Amzat J, Ancuceanu R, Anderlini D, Andrade PP, Andrei CL, Andrei T, Angappan D, Anil A, Anjum A, Antony CM, Antriyandarti E, Anuoluwa IA, Anwar SL, Anyasodor AE, Appiah SCY, Aqeel M, Arabloo J, Arabzadeh Bahri R, Arab-Zozani M, Arafat M, Araújo AM, Aravkin AY, Aremu A, Ariffin H, Aripov T, Armocida B, Arooj M, Artamonov AA, Artanti KD, Arulappan J, Aruleba IT, Aruleba RT, Arumugam A, Asaad M, Asgary S, Ashemo MY, Ashraf M, Asika MO, Athari SS, Atout MMW, Atreya A, Attia S, Aujayeb A, Avan A, Awotidebe AW, Ayala Quintanilla BP, Ayanore MA, Ayele GM, Ayuso-Mateos JL, Ayyoubzadeh SM, Azadnajafabad S, Azhar GS, Aziz S, Azzam AY, Babashahi M, Babu AS, Badar M, Badawi A, Badiye AD, Baghdadi S, Bagheri N, Bagherieh S, Bah S, Bahadorikhalili S, Bai J, Bai R, Baker JL, Bakkannavar SM, Bako AT, Balakrishnan S, Balogun SA, Baltatu OC, Bam K, Banach M, Bandyopadhyay S, Banik B, Banik PC, Bansal H, Barati S, Barchitta M, Bardhan M, Barker-Collo SL, Barone-Adesi F, Barqawi HJ, Barr RD, Barrero LH, Basharat Z, Bashir AIJ, Bashiru HA, Baskaran P, Basnyat B, Bassat Q, Basso JD, Basu S, Batra K, Batra R, Baune BT, Bayati M, Bayileyegn NS, Beaney T, Bedi N, Begum T, Behboudi E, Behnoush AH, Beiranvand M, Bejarano Ramirez DF, Belgaumi UI, Bell ML, Bello AK, Bello MB, Bello OO, Belo L, Beloukas A, Bendak S, Bennett DA, Bensenor IM, Benzian H, Berezvai Z, Berman AE, Bermudez ANC, Bettencourt PJG, Beyene HB, Beyene KA, Bhagat DS, Bhagavathula AS, Bhala N, Bhalla A, Bhandari D, Bhardwaj N, Bhardwaj P, Bhardwaj PV, Bhargava A, Bhaskar S, Bhat V, Bhatti GK, Bhatti JS, Bhatti MS, Bhatti R, Bhutta ZA, Bikbov B, Binmadi N, Bintoro BS, Biondi A, Bisignano C, Bisulli F, Biswas A, Biswas RK, Bitaraf S, Bjørge T, Bleyer A, Boampong MS, Bodolica V, Bodunrin AO, Bolarinwa OA, Bonakdar Hashemi M, Bonny A, Bora K, Bora Basara B, Borodo SB, Borschmann R, Botero Carvajal A, Bouaoud S, Boudalia S, Boyko EJ, Bragazzi NL, Braithwaite D, Brenner H, Britton G, Browne AJ, Brunoni AR, Bulamu NB, Bulto LN, Buonsenso D, Burkart K, Burns RA, Burugina Nagaraja S, Busse R, Bustanji Y, Butt ZA, Caetano dos Santos FL, Cai T, Calina D, Cámera LA, Campos LA, Campos-Nonato IR, Cao C, Cardenas CA, Cárdenas R, Carr S, Carreras G, Carrero JJ, Carugno A, Carvalho F, Carvalho M, Castaldelli-Maia 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Abdulkader R, Sultana A, Sun J, Sunkersing D, Susanty S, Swain CK, Sykes BL, Szarpak L, Szeto MD, Szócska M, Tabaee Damavandi P, Tabatabaei Malazy O, Tabatabaeizadeh SA, Tabatabai S, Tabb KM, Tabish M, Taborda-Barata LM, Tabuchi T, Tadesse BT, Taheri A, Taheri Abkenar Y, Taheri Soodejani M, Taherkhani A, Taiba J, Tajbakhsh A, Talaat IM, Talukder A, Tamuzi JL, Tan KK, Tang H, Tang HK, Tat NY, Tat VY, Tavakoli Oliaee R, Tavangar SM, Taveira N, Tebeje TM, Tefera YM, Teimoori M, Temsah MH, Temsah RMH, Teramoto M, Tesfaye SH, Thangaraju P, Thankappan KR, Thapa R, Thapar R, Thomas N, Thrift AG, Thum CCC, Tian J, Tichopad A, Ticoalu JHV, Tiruye TY, Tohidast SA, Tonelli M, Touvier M, Tovani-Palone MR, Tram KH, Tran NM, Trico D, Trihandini I, Tromans SJ, Truong VT, Truyen TTTT, Tsermpini EE, Tumurkhuu M, Tung K, Tyrovolas S, Ubah CS, Udoakang AJ, Udoh A, Ulhaq I, Ullah S, Ullah S, Umair M, Umar TP, Umeokonkwo CD, Umesh A, Unim B, Unnikrishnan B, Upadhyay E, Urso D, Vacante M, Vahdani AM, Vaithinathan AG, Valadan Tahbaz S, Valizadeh R, Van den Eynde J, Varavikova E, Varga O, Varma SA, Vart P, Varthya SB, Vasankari TJ, Veerman LJ, Venketasubramanian N, Venugopal D, Verghese NA, Verma M, Verma P, Veroux M, Verras GI, Vervoort D, Vieira RJ, Villafañe JH, Villani L, Villanueva GI, Villeneuve PJ, Violante FS, Visontay R, Vlassov V, Vo B, Vollset SE, Volovat SR, Volovici V, Vongpradith A, Vos T, Vujcic IS, Vukovic R, Wado YD, Wafa HA, Waheed Y, Wamai RG, Wang C, Wang D, Wang F, Wang S, Wang S, Wang Y, Wang YP, Ward P, Watson S, Weaver MR, Weerakoon KG, Weiss DJ, Weldemariam AH, Wells KM, Wen YF, Werdecker A, Westerman R, Wickramasinghe DP, Wickramasinghe ND, Wijeratne T, Wilson S, Wojewodzic MW, Wool EE, Woolf AD, Wu D, Wulandari RD, Xiao H, Xu B, Xu X, Yadav L, Yaghoubi S, Yang L, Yano Y, Yao Y, Ye P, Yesera GE, Yesodharan R, Yesuf SA, Yiğit A, Yiğit V, Yip P, Yon DK, Yonemoto N, You Y, Younis MZ, Yu C, Zadey S, Zadnik V, Zafari N, Zahedi M, Zahid MN, Zahir M, Zakham F, Zaki N, Zakzuk J, Zamagni G, Zaman BA, Zaman SB, Zamora N, Zand R, Zandi M, Zandieh GGZ, Zanghì A, Zare I, Zastrozhin MS, Zeariya MGM, Zeng Y, Zhai C, Zhang C, Zhang H, Zhang H, Zhang Y, Zhang Z, Zhang Z, Zhao H, Zhao Y, Zhao Y, Zheng P, Zhong C, Zhou J, Zhu B, Zhu Z, Ziaeefar P, Zielińska M, Zou Z, Zumla A, Zweck E, Zyoud SH, Lim SS, Murray CJL. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:1989-2056. [PMID: 38484753 PMCID: PMC11126395 DOI: 10.1016/s0140-6736(24)00476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020-21 COVID-19 pandemic period. METHODS 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5-65·1] decline), and increased during the COVID-19 pandemic period (2020-21; 5·1% [0·9-9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98-5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50-6·01) in 2019. An estimated 131 million (126-137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7-17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8-24·8), from 49·0 years (46·7-51·3) to 71·7 years (70·9-72·5). Global life expectancy at birth declined by 1·6 years (1·0-2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67-8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4-52·7]) and south Asia (26·3% [9·0-44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING Bill & Melinda Gates Foundation.
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Boon ACM, Bricker TL, Fritch EJ, Leist SR, Gully K, Baric RS, Graham RL, Troan BV, Mahoney M, Janetka JW. Efficacy of host cell serine protease inhibitor MM3122 against SARS-CoV-2 for treatment and prevention of COVID-19. J Virol 2024; 98:e0190323. [PMID: 38593045 PMCID: PMC11092322 DOI: 10.1128/jvi.01903-23] [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: 02/09/2024] [Accepted: 03/12/2024] [Indexed: 04/11/2024] Open
Abstract
We developed a novel class of peptidomimetic inhibitors targeting several host cell human serine proteases, including transmembrane protease serine 2 (TMPRSS2), matriptase, and hepsin. TMPRSS2 is a membrane-associated protease that is highly expressed in the upper and lower respiratory tracts and is utilized by SARS-CoV-2 and other viruses to proteolytically process their glycoproteins, enabling host cell entry, replication, and dissemination of new virus particles. We have previously shown that compound MM3122 exhibited subnanomolar potency against all three proteases and displayed potent antiviral effects against SARS-CoV-2 in a cell viability assay. Herein, we demonstrate that MM3122 potently inhibits viral replication in human lung epithelial cells and is also effective against the EG.5.1 variant of SARS-CoV-2. Furthermore, we evaluated MM3122 in a mouse model of COVID-19 and demonstrated that MM3122 administered intraperitoneally (IP) before (prophylactic) or after (therapeutic) SARS-CoV-2 infection had significant protective effects against weight loss and lung congestion and reduced pathology. Amelioration of COVID-19 disease was associated with a reduction in proinflammatory cytokine and chemokine production after SARS-CoV-2 infection. Prophylactic, but not therapeutic, administration of MM3122 also reduced virus titers in the lungs of SARS-CoV-2-infected mice. Therefore, MM3122 is a promising lead candidate small-molecule drug for the treatment and prevention of infections caused by SARS-CoV-2 and other coronaviruses. IMPORTANCE SARS-CoV-2 and other emerging RNA coronaviruses are a present and future threat in causing widespread endemic and pandemic infection and disease. In this paper, we have shown that the novel host cell protease inhibitor, MM3122, blocks SARS-CoV-2 viral replication and is efficacious as both a prophylactic and a therapeutic drug for the treatment of COVID-19 given intraperitoneally in mice. Targeting host proteins and pathways in antiviral therapy is an underexplored area of research, but this approach promises to avoid drug resistance by the virus, which is common in current antiviral treatments.
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Affiliation(s)
- Adrianus C. M. Boon
- Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Traci L. Bricker
- Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Ethan J. Fritch
- Department of Microbiology and Immunology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah R. Leist
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kendra Gully
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ralph S. Baric
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rachel L. Graham
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Matthew Mahoney
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - James W. Janetka
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, Saint Louis, Missouri, USA
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Svirsky R, Rabbi ML, Hamad RA, Sharabi-Nov A, Kugler N, Galoyan N, Sharon NZ, Meiri H, Maymon R, Levtzion-Korach O. Vaccination in twin pregnancies: comparison between immunization before conception and during pregnancy. Sci Rep 2024; 14:10813. [PMID: 38734805 PMCID: PMC11088702 DOI: 10.1038/s41598-024-61504-6] [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: 05/29/2023] [Accepted: 05/07/2024] [Indexed: 05/13/2024] Open
Abstract
To evaluate the development of neutralizing Anti-Spike Protein IgG (Anti-S-IgG) during twin pregnancies before conception vs. during pregnancy. In this prospective study, three blood samples were collected from pregnant women and subjected to anti-S-IgG immunodiagnostics. The patient's medical records, including vaccination and PCR test results, were collected from the hospital's electronic database. Age-matched non-pregnant women were used as a control group. We enrolled 83 women with twin pregnancies. 49 women were vaccinated before conception, 21 women were vaccinated during pregnancy, and 13 were not vaccinated. Of the 13 women who weren't vaccinated, three became positive during pregnancy, and all three were severely ill. By contrast, in women who were vaccinated during or before pregnancy, COVID-19 infection during pregnancy caused only mild symptoms. A ten-fold lower level of neutralizing Anti-S-IgG in the 3rd trimester was observed in healthy women who were vaccinated before conception and remained healthy until discharge from the hospital after delivery 1605 (IQR: 763-2410) compared to the healthy women who were vaccinated during pregnancy 152 AU/mL (IQR: 54-360). This difference was higher among women who were infected by COVID-19 (as verified by a positive PCR test). The third-trimester level of neutralizing Ant-S-IgG in the infected group was 4770 AU/mL (4760-6100) in infected women vaccinated before conception compared to those vaccinated during pregnancy who had 70 AU/mL (IQR: 20-170) (p < 0.001). In women vaccinated at 13-16 weeks gestation, neutralizing Anti-S-IgG at 20-22 weeks went up to 372 AU/mL (IQR: 120-1598) but rapidly dropped to 112 AU/mL (IQR: 54-357) at 28-30 weeks, (p < 0.001), a faster decline than in women vaccinated at a median 22 weeks before conception. Being infected by COVID-19 before conception was linked to having low Anti-S-IgG levels during pregnancy, whereas being infected by COVID-19 during pregnancy led to a very high response in the 3rd trimester. In twin pregnancies, significantly lower neutralizing Anti-S-IgG levels were observed in women vaccinated during pregnancy compared to those vaccinated before conception, whether infected or not infected by COVID-19. A full course of vaccination before conception is recommended.Trial registration. ClinicalTrials.gov Protocol Registration and Results System (PRS) Receipt Release Date: October 4, 2021. https://clinicaltrials.gov/ ID: NCT04595214.
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Affiliation(s)
- Ran Svirsky
- Department of Obstetrics and Gynecology, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel.
- Medical Genetic Unit, Department of Obstetrics and Gynecology, Samson Assuta Ashdod University Hospital, Ashdod, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
| | - Moran Landau Rabbi
- Department of Obstetrics and Gynecology, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | | | - Adi Sharabi-Nov
- Department of Statistics, Ziv Medical Center, and Tel Hai Academic College, Safed and Tel Hai, Israel
| | - Nadav Kugler
- Department of Obstetrics and Gynecology, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Narina Galoyan
- Department of Obstetrics and Gynecology, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Nataly Zilberman Sharon
- Department of Obstetrics and Gynecology, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Hamutal Meiri
- PreTwin Screen Consortium and TeleMarpe Ltd, Tel Aviv, Israel
| | - Ron Maymon
- Department of Obstetrics and Gynecology, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
- School of Medicine, Faculty of Medicine and Health Science, Tel Aviv University, Tel Aviv, Israel
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Noda H. The Scabbard of Excalibur: An Allegory on the Role of an Efficient and Effective Healthcare System under Universal Health Coverage during the Pandemic Response. Healthcare (Basel) 2024; 12:979. [PMID: 38786389 PMCID: PMC11120855 DOI: 10.3390/healthcare12100979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
During the COVID-19 pandemic, while some countries succeeded in reducing their rate of death after SARS-CoV-2 infection via vaccination by the end of 2021, some of them also faced hospital capacity strain, leading to social anxiety about delays in the diagnosis and treatment of patients with other diseases. This essay presents an allegory to explain the situation during the COVID-19 pandemic. Through an allegory and Le Morte d'Arthur (Arthur's Death), this essay indicates that "the scabbard of Excalibur" that we are looking for is an efficient and effective healthcare system that can diagnose patients who might become severely ill due to COVID-19 and to treat them without hospital capacity strain. In Le Morte d'Arthur, the scabbard of Excalibur was lost, and we have not been able to find any alternatives to end the COVID-19 pandemic. We can choose a future in which "the scabbard of Excalibur" exists, providing a different ending for the next pandemic.
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Affiliation(s)
- Hiroyuki Noda
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan; ; Tel.: +81-6-6879-3911
- Public Health Bureau, Ministry of Health, Labour and Welfare, Tokyo 100-8916, Japan
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Das S, Khan R, Banerjee S, Ray S, Ray S. Alterations in Circadian Rhythms, Sleep, and Physical Activity in COVID-19: Mechanisms, Interventions, and Lessons for the Future. Mol Neurobiol 2024:10.1007/s12035-024-04178-5. [PMID: 38702566 DOI: 10.1007/s12035-024-04178-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/04/2024] [Indexed: 05/06/2024]
Abstract
Although the world is acquitting from the throes of COVID-19 and returning to the regularity of life, its effects on physical and mental health are prominently evident in the post-pandemic era. The pandemic subjected us to inadequate sleep and physical activities, stress, irregular eating patterns, and work hours beyond the regular rest-activity cycle. Thus, perturbing the synchrony of the regular circadian clock functions led to chronic psychiatric and neurological disorders and poor immunological response in several COVID-19 survivors. Understanding the links between the host immune system and viral replication machinery from a clock-infection biology perspective promises novel avenues of intervention. Behavioral improvements in our daily lifestyle can reduce the severity and expedite the convalescent stage of COVID-19 by maintaining consistent eating, sleep, and physical activity schedules. Including dietary supplements and nutraceuticals with prophylactic value aids in combating COVID-19, as their deficiency can lead to a higher risk of infection, vulnerability, and severity of COVID-19. Thus, besides developing therapeutic measures, perpetual healthy practices could also contribute to combating the upcoming pandemics. This review highlights the impact of the COVID-19 pandemic on biological rhythms, sleep-wake cycles, physical activities, and eating patterns and how those disruptions possibly contribute to the response, severity, and outcome of SARS-CoV-2 infection.
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Affiliation(s)
- Sandip Das
- Department of Biotechnology, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, 502284, Telangana, India
| | - Rajni Khan
- National Institute of Pharmaceutical Education and Research (NIPER) - Hajipur, Vaishali, Hajipur, 844102, Bihar, India
| | - Srishti Banerjee
- Department of Biotechnology, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, 502284, Telangana, India
| | - Shashikant Ray
- Department of Biotechnology, Mahatma Gandhi Central University, Motihari, 845401, India.
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Sandipan Ray
- Department of Biotechnology, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, 502284, Telangana, India.
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