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Mussie KM, Setchell J, Kaba M, Elger BS. "I was afraid to go to the hospital": A qualitative analysis and ethical implications of the impacts of COVID-19 on the health and medical care of older adults in Ethiopia. SAGE Open Med 2024; 12:20503121241263305. [PMID: 39092158 PMCID: PMC11292689 DOI: 10.1177/20503121241263305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 05/31/2024] [Indexed: 08/04/2024] Open
Abstract
Objective The COVID-19 pandemic has brought severe health consequences among older adults and posed ethical challenges. The aim of this study was to explore the impacts of COVID-19 on the health and medical care of older adults in Ethiopia and associated ethical implications, regardless of older adults' COVID-19 infection status. Methods In this qualitative study, we followed an inductive exploratory approach based on reflexive thematic analysis. We conducted semistructured interviews between March 2021 and November 2021 with 20 older adults and 26 health professionals who were selected from healthcare facilities and communities in Ethiopia using purposive and snowball sampling techniques. We audio-recorded, transcribed, translated, and inductively analyzed the interviews using thematic analysis. Results Participants reported that the pandemic compromised the accessibility and quality of both COVID and non-COVID healthcare services for older adults, which negatively impacted older adults' health conditions and medical care. Moreover, participants elaborated on the health conditions and care of older patients with COVID-19 and highlighted that older COVID-19 patients often have severe health conditions, do not get adequate COVID-19 care, and may receive lower priority for admission to intensive care units compared to younger patients when resources are limited. Conclusions Results of this study showed that practices of COVID-19 care and measures may have led to adverse consequences such as limited availability and access to aged care in Ethiopia, which could have further health consequences on older patients. Our results contribute to a better understanding of ethical issues such as distributive justice and prioritization arising in the healthcare of older patients in times of global pandemic. It is imperative for local and international health policymakers and ethicists to further analyze and address the challenges that compromise the accessibility and continuity of quality care for older persons during a public healthcare crisis.
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Affiliation(s)
| | - Jenny Setchell
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Mirgissa Kaba
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bernice Simone Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
- Center for Legal Medicine, University of Geneva, Geneva, Switzerland
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2
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Mangialavori S, Riva F, Caimi B, Baruffi S, Delle Fave A. Mental distress and well-being in geriatric professionals: The role of job satisfaction. Geriatr Nurs 2024; 58:498-505. [PMID: 38972076 DOI: 10.1016/j.gerinurse.2024.06.042] [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: 02/28/2024] [Revised: 06/19/2024] [Accepted: 06/27/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND As limited evidence is available on health professionals' experience during the post-pandemic period, the interplay between job satisfaction components, mental distress and well-being was investigated among workers of an Italian geriatric institution. METHODS In Spring 2022, 205 participants (females =75.6%), primarily healthcare assistants (36.6%), nurses (16.6%), and rehabilitation professionals (14.1%), completed the General Health Questionnaire (GHQ), the Mental Health Continuum-Short Form (MHC-SF), and the Job Satisfaction Questionnaire. Data analyses comprised Multiple Regressions, Relative Weight Analyses, and ANOVA. FINDINGS Satisfaction with working conditions and leadership exhibited negative associations with distress, while satisfaction with patients, colleagues, results, and leadership were positively correlated with well-being. Participants with high well-being levels scored significantly lower across mental distress dimensions than participants reporting poor well-being levels. CONCLUSIONS Results showed that specific job satisfaction components relate differently to distress and well-being, suggesting the need for implementing organizational resources, psychological support, and interprofessional collaboration in healthcare services.
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Affiliation(s)
- Sonia Mangialavori
- Department of Pathophysiology and Transplantation, University of Milano, Milan, Italy.
| | - Fabiana Riva
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Barbara Caimi
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Sonia Baruffi
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Antonella Delle Fave
- Department of Pathophysiology and Transplantation, University of Milano, Milan, Italy
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3
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Zazzara MB, Ornago AM, Cocchi C, Serafini E, Bellelli G, Onder G. A pandemic of delirium: an updated systematic review and meta-analysis of occurrence of delirium in older adults with COVID-19. Eur Geriatr Med 2024; 15:397-406. [PMID: 38498073 PMCID: PMC10997697 DOI: 10.1007/s41999-023-00906-7] [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: 09/17/2023] [Accepted: 11/22/2023] [Indexed: 03/19/2024]
Abstract
PURPOSE Delirium has been recognized as an atypical presenting feature of COVID-19 in older adults and is independently associated with mortality. We aimed to perform an updated systematic review of the literature and proportional meta-analysis to assess prevalence and incidence of delirium in older adults with COVID-19, addressing differences according to sex, frailty status, and settings. METHODS We searched databases for English-language articles on prevalence and incidence of delirium in older adults with COVID-19, published between March 2020 and January 2023. RESULTS Of the 1171 articles identified, 66 met selection criteria and were included in the meta-analysis (n = 35,035 participants, age-range 66-90 years old, 46.6% females). We observed similar pooled prevalence (20.6% [95% Confidence Interval (CI) 17.8-23.8%]) and incidence (21.3% [95% CI 14.7-30%]) of delirium. Pooled occurrence (both prevalence and incidence) of delirium was similar according to sex (females 21.3% [95% CI 16-27.5%] vs. males 23.8%% [95% CI 18.2-30.4%], p-value = 0.55) and study setting (nursing homes 22.5% [95% CI 14.2-33.6%] vs. hospital 20.3% [95% CI 17-24%], p = 0.68), but it was significantly higher in frail versus non-frail patients (37% [95% CI 26.6-48.8%] vs. 12.5% [95% CI 7.8-19.6%], p-value < 0.01). Delirium definitions and assessment tools largely varied across studies. CONCLUSION This review delineates delirium as a common feature of COVID-19, particularly in frail older adults, and supports its formal inclusion among COVID-19 symptoms. The considerable heterogeneity in delirium assessment highlights the need for an operational strategy to standardize definitions and tools utilization in the management of frail older adults.
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Affiliation(s)
- Maria Beatrice Zazzara
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
- Department of Aging, Orthopaedics and Rheumatological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.
| | | | - Camilla Cocchi
- Department of Aging, Orthopaedics and Rheumatological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elisabetta Serafini
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Giuseppe Bellelli
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Acute Geriatrics Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Graziano Onder
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
- Department of Aging, Orthopaedics and Rheumatological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
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Rajlic G, Sorensen JM, Mithani A. Exploring Post-COVID-19 Functional Outcomes in Residents in Long-Term Care Homes in British Columbia, Canada. Gerontol Geriatr Med 2024; 10:23337214241245551. [PMID: 38779377 PMCID: PMC11110507 DOI: 10.1177/23337214241245551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/04/2024] [Accepted: 03/20/2024] [Indexed: 05/25/2024] Open
Abstract
Research on functional outcomes in long-term care (LTC) home residents after COVID-19 infection is limited. In the current study, we examined outcomes in 1,310 LTC residents with a positive COVID-19 test in the period from March 2020 to April 2022 ("COVID" group). We also reviewed outcomes in residents in the same LTC homes without a history of COVID-19 during the same period ("No-COVID" group, n = 2,301). In a retrospective longitudinal design, we explored activities of daily living (ADLs), cognitive function, and clinical care needs over time. Change was assessed from the last assessment before contracting COVID-19 to three assessments subsequent to COVID-19, over on average seven months after infection. We found deterioration over time in ADLs and cognitive performance in both groups. The change in ADLs and clinical care needs was slightly greater in the COVID than the No-COVID group from baseline to the first follow-up assessment; in subsequent assessments, the change was similar in both groups. Overall, we observed similar functional outcomes among surviving residents in the two groups, with initially greater deterioration in ADLs and clinical care needs in residents with a history of COVID-19 followed by a trajectory resembling the one in the No-COVID residents.
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Hickey J, Rancourt DG. Predictions from standard epidemiological models of consequences of segregating and isolating vulnerable people into care facilities. PLoS One 2023; 18:e0293556. [PMID: 37903148 PMCID: PMC10615287 DOI: 10.1371/journal.pone.0293556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/15/2023] [Indexed: 11/01/2023] Open
Abstract
OBJECTIVES Since the declaration of the COVID-19 pandemic, many governments have imposed policies to reduce contacts between people who are presumed to be particularly vulnerable to dying from respiratory illnesses and the rest of the population. These policies typically address vulnerable individuals concentrated in centralized care facilities and entail limiting social contacts with visitors, staff members, and other care home residents. We use a standard epidemiological model to investigate the impact of such circumstances on the predicted infectious disease attack rates, for interacting robust and vulnerable populations. METHODS We implement a general susceptible-infectious-recovered (SIR) compartmental model with two populations: robust and vulnerable. The key model parameters are the per-individual frequencies of within-group (robust-robust and vulnerable-vulnerable) and between-group (robust-vulnerable and vulnerable-robust) infectious-susceptible contacts and the recovery times of individuals in the two groups, which can be significantly longer for vulnerable people. RESULTS Across a large range of possible model parameters including degrees of segregation versus intermingling of vulnerable and robust individuals, we find that concentrating the most vulnerable into centralized care facilities virtually always increases the infectious disease attack rate in the vulnerable group, without significant benefit to the robust group. CONCLUSIONS Isolated care homes of vulnerable residents are predicted to be the worst possible mixing circumstances for reducing harm in epidemic or pandemic conditions.
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Affiliation(s)
- Joseph Hickey
- Correlation Research in the Public Interest, Ottawa, Ontario, Canada
| | - Denis G. Rancourt
- Correlation Research in the Public Interest, Ottawa, Ontario, Canada
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Schnettler B, Lobos G, Orellana L, Adasme-Berríos C, Lapo M, Beroíza K. Profiles of older adults according to their life and food-related life satisfaction during the COVID-19 pandemic: the importance of the social environment. Front Public Health 2023; 11:1165256. [PMID: 37663848 PMCID: PMC10470648 DOI: 10.3389/fpubh.2023.1165256] [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: 02/14/2023] [Accepted: 07/20/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Older adults are a highly heterogeneous population, as individuals of the same age can show considerable variations in personal characteristics and living conditions. Risk and protective factors for older adults' subjective wellbeing during the COVID-19 pandemic can be explored by examining how life satisfaction, food-related life satisfaction, and associated variables coexist among these individuals. On this basis, this study aimed to identify older adult profiles based on their levels of life and food-related life satisfaction; to characterize these profiles by diet quality, social support, financial wellbeing, and sociodemographic characteristics; and to identify variables associated with higher life and food-related life satisfaction. Methods The sample included 1,371 institutionalized and non-institutionalized individuals over the age of 60, from four cities in Chile. Participants answered a survey, either online or face to face, with questions about life and food-related life satisfaction, perceived social support from family, friends, and others, food quality, financial wellbeing/distress, sociodemographic characteristics, and prior COVID-19 infection. Results Using a latent profile analysis, we identified three profiles of older adults: Profile 1: Unsatisfied with their life, somewhat satisfied with their food-related life (5.40%); Profile 2: Somewhat satisfied with their life, satisfied with their food-related life (65.06%); Profile 3: Extremely satisfied with their life and food-related life (29.54%). Profiles differed by residence (institutionalized vs. independent), age, marital status, social support, financial wellbeing, COVID-19 infection, and city of residence. Discussion The patterns of association between life and food-related satisfaction and related variables indicate conditions of vulnerability and protection related to living conditions, the social dimensions of food consumption, and social support. These results underscore the need for identifying groups of older adults based on diverse characteristics and conditions outside of chronological age.
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Affiliation(s)
- Berta Schnettler
- Facultad de Ciencias Agropecuarias y Medioambiente, Universidad de La Frontera, Temuco, Chile
- Scientific and Technological Bioresource Nucleus (BIOREN-UFRO), Universidad de La Frontera, Temuco, Chile
- Centro de Excelencia en Psicología Económica y del Consumo, Universidad de La Frontera, Temuco, Chile
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Germán Lobos
- Facultad de Economía y Negocios, Universidad de Talca, Talca, Chile
| | - Ligia Orellana
- Centro de Excelencia en Psicología Económica y del Consumo, Universidad de La Frontera, Temuco, Chile
- Núcleo de Ciencias Sociales y Humanidades, Universidad de La Frontera, Temuco, Chile
- Departamento de Psicología, Universidad de La Frontera, Temuco, Chile
| | | | - María Lapo
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Katherine Beroíza
- Centro de Excelencia en Psicología Económica y del Consumo, Universidad de La Frontera, Temuco, Chile
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Lahiri A, Jha SS, Chakraborty A, Dey A, Dobe M. Home-Isolation Care in Newly COVID-19-Positive Elderly Patients: A Caregiver-Centric Explanatory Framework. Int J Public Health 2023; 68:1606060. [PMID: 37538233 PMCID: PMC10394230 DOI: 10.3389/ijph.2023.1606060] [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: 04/03/2023] [Accepted: 06/29/2023] [Indexed: 08/05/2023] Open
Abstract
Objectives: This community-based study aimed to identify the effect of different behavioral factors of family caregivers on the decision for home-isolation-based treatment of a new COVID-19-diagnosed elderly individual. It also explored the facilitators and barriers contributing to the decision-making process. Methods: A mixed-methods design was adopted to study the role of behavioral constructs such as risk tolerance, risk aversion, regret aversion, loss aversion, self-efficacy, and risk perception in healthcare-seeking decisions. By integrating the findings from the quantitative and qualitative parts, a framework was developed. Results: Self-efficacy, risk perception, and risk tolerance related to different issues were crucial factors behind the healthcare decision. However, regarding the various issues under consideration, risk perception followed by risk tolerance were the significant predictors for decision-making. Conclusion: To enhance appropriateness and equity in emergency healthcare-seeking, interventions should target risk tolerance and risk perception, taking into account the awareness levels of caregivers and the target population's risk and regret aversion. Such integrated approaches can improve the quality of care for elderly patients in home-based settings.
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Affiliation(s)
- Arista Lahiri
- Dr. B. C. Roy Multi-Speciality Medical Research Centre, Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, India
| | - Sweety Suman Jha
- Dr. B. C. Roy Multi-Speciality Medical Research Centre, Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, India
| | - Arup Chakraborty
- Department of Community Medicine, Medical College and Hospital, Kolkata, West Bengal, India
| | - Abhijit Dey
- WHO-NTEP Technical Support Network, Swasthya Bhawan, Kolkata, West Bengal, India
| | - Madhumita Dobe
- Foundation for Actions and Innovations Towards Health Promotion (FAITH), Kolkata, West Bengal, India
- All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
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Mazzilli S, Scardina G, Collini F, Forni S, Gianolio G, Bisceglia L, Lopalco PL, Chieti A, Onder G, Vanacore N, Bonaccorsi G, Gemmi F, Tavoschi L. Hospital admission and mortality rates for non-Covid diseases among residents of the long-term care facilities before and during the pandemic: a cohort study in two Italian regions. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-13. [PMID: 37361287 PMCID: PMC10185456 DOI: 10.1007/s10389-023-01925-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 04/28/2023] [Indexed: 06/28/2023]
Abstract
Aim Long-term-care facility residents are a vulnerable population who experienced reduced healthcare access during the pandemic. This study aimed to assess the indirect impact of the COVID-19 pandemic, in terms of hospitalisation and mortality rates, among this population in two Italian Regions, Tuscany and Apulia, during 2020 in comparison with the pre-pandemic period. Subject and methods We conducted a retrospective cohort study on people residing in long-term-care facilities from 1 January 2018 to 31 December 2020 (baseline period: 1 January 2018-8 March 2020; pandemic period: and 9 March-31 December 2020). Hospitalisation rates were stratified by sex and major disease groups. Standardised weekly rates were estimated with a Poisson regression model. Only for Tuscany, mortality risk at 30 days after hospitalisation was calculated with the Kaplan-Meier estimator. Mortality risk ratios were calculated using Cox proportional regression models. Results Nineteen thousand two hundred and fifty individuals spent at least 7 days in a long-term-care facility during the study period. The overall mean non-Covid hospital admission rate per 100 000 residents/week was 144.1 and 116.2 during the baseline and pandemic periods, with a decrease to 99.7 and 77.3 during the first (March-May) and second lockdown (November-December). Hospitalisation rates decreased for all major disease groups. Thirty-day mortality risk ratios for non-Covid conditions increased during the pandemic period (1.2, 1.1 to 1.4) compared with baseline. Conclusion The pandemic resulted in worse non-COVID-related health outcomes for long-term-care facilities' residents. There is a need to prioritise these facilities in national pandemic preparedness plans and to ensure their full integration in national surveillance systems. Supplementary information The online version contains supplementary material available at 10.1007/s10389-023-01925-1.
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Affiliation(s)
- Sara Mazzilli
- Scuola Normale Superiore, Pisa, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giuditta Scardina
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Francesca Collini
- Quality and Equity Unit, Regional Health Agency of Tuscany, Florence, Italy
| | - Silvia Forni
- Quality and Equity Unit, Regional Health Agency of Tuscany, Florence, Italy
| | - Giulio Gianolio
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Lucia Bisceglia
- Strategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
| | - Antonio Chieti
- Strategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | - Nicola Vanacore
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | | | - Fabrizio Gemmi
- Quality and Equity Unit, Regional Health Agency of Tuscany, Florence, Italy
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Amanzio M, Cipriani GE, Bartoli M, Canessa N, Borghesi F, Chirico A, Cipresso P. The neuropsychology of healthy aging: the positive context of the University of the Third Age during the COVID-19 pandemic. Sci Rep 2023; 13:6355. [PMID: 37076567 PMCID: PMC10115807 DOI: 10.1038/s41598-023-33513-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/13/2023] [Indexed: 04/21/2023] Open
Abstract
Older adults have been reported to have increased susceptibility to the adverse effects of SARS-CoV-2 infection, such as fatal outcomes, cognitive decline, and changes in physical and/or mental health. However, few studies have examined neuropsychological changes by comparing measurements before and during the pandemic in healthy older people. In addition, no longitudinal studies have examined whether older adults may have responded positively to the pandemic. We examined these issues through a 2-year neuropsychological study before and during the pandemic period. Results showed that scores before and during the pandemic were the same in memory and attention, whereas global cognitive, executive, and language functions improved. Participants also showed no longitudinal changes in depression, hypomania, and disinhibition, while apathy and, to a lesser extent, anxiety increased significantly. To examine possible signs of pandemic-related emotional (dys)regulation, subjects were shown images at follow-up that recalled the most dramatic lockdown phase while heart rate variability was recorded. Higher apathy was predicted by poorer global cognitive performance, increased anxiety, and emotional dysregulation as measured by a higher ratio of low-to-high frequency heart rate variability. Thus, preserved global cognition appears to play a protective role against the effects of pandemic-related anxiety and emotional dysregulation on apathy.
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Affiliation(s)
- Martina Amanzio
- Department of Psychology, University of Turin, 10024, Turin, Italy.
| | | | - Massimo Bartoli
- Department of Psychology, University of Turin, 10024, Turin, Italy
| | - Nicola Canessa
- ICoN Center, Scuola Universitaria Superiore IUSS, 27100, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, 27100, Pavia, Italy
| | | | - Alice Chirico
- Department of Psychology, Research Center in Communication Psychology, Università Cattolica del Sacro Cuore, 20123, Milan, Italy
| | - Pietro Cipresso
- Department of Psychology, University of Turin, 10024, Turin, Italy
- Istituto Auxologico Italiano, IRCCS, 20145, Milan, Italy
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Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains asymptomatic in 33% to 90% of older adults depending on their immune status from prior infection, vaccination, and circulating strain. Older adults symptomatic with SARS-CoV-2 often both present atypically, such as with a blunted fever response, and develop more severe disease. Early and late reports showed that older adults have increased severity of coronavirus disease 2019 (COVID-19) with higher case fatality rates and higher intensive care needs compared with younger adults. Infection and vaccine-induced antibody response and long-term effects of COVID-19 also differ in older adults.
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11
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Li J. Reducing the risk of COVID-19 transmission during nursing home visits in the United States. J Public Health Policy 2023; 44:163-166. [PMID: 36639427 PMCID: PMC9838496 DOI: 10.1057/s41271-023-00393-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2023] [Indexed: 01/15/2023]
Affiliation(s)
- Jingquan Li
- Department of Information Systems and Business Analytics, Frank G. Zarb School of Business, Hofstra University, 148 Hofstra University, Hempstead, NY, 11549, USA.
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12
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D’Anna T, Argo A, Albano GD, Puntarello M, Rizzo C, Guadagnino D, Zerbo S. Focus on Liability of Residences for Elderly and Sick People: A Case Series and Medico-Legal Issues. Healthcare (Basel) 2023; 11:healthcare11040539. [PMID: 36833073 PMCID: PMC9956670 DOI: 10.3390/healthcare11040539] [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: 12/30/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
Residences for elderly and sick people, self-sufficient or dependent, are varied. To date, the liability profiles of these structures are not clearly delineated, and increasingly often, their operating and organization criteria are entrusted to subnational, regional, or local regulations. Among the various deficits, there is the keeping of a complete and detailed documentation/diary of the patient, the lack of which can generate medico-legal problems. In this paper, we present three cases of guests in residences for a dependent person brought to the attention of the Institute of Forensic Medicine of the University Hospital of Palermo due to criminal proceedings, where the lack of existing documentation in the structure and, in some cases, the behavior of the professionals working there, led the evaluator to deduce the organization's culpability.
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Affiliation(s)
- Tommaso D’Anna
- Policlinic Hospital, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
- Correspondence: (T.D.); (A.A.); Tel.: +39-39-3771-4629 (T.D.); +39-09-1238-6301 (A.A.)
| | - Antonina Argo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, 90127 Palermo, Italy
- Correspondence: (T.D.); (A.A.); Tel.: +39-39-3771-4629 (T.D.); +39-09-1238-6301 (A.A.)
| | - Giuseppe Davide Albano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, 90127 Palermo, Italy
| | - Maria Puntarello
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, 90127 Palermo, Italy
| | - Chiara Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, 90127 Palermo, Italy
| | - Daniela Guadagnino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, 90127 Palermo, Italy
| | - Stefania Zerbo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, 90127 Palermo, Italy
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Vicentini C, Zotti CM, Cornio AR, Garlasco J, Marengo N, Meddis D, Ditommaso S, Giacomuzzi M, Memoli G, Bordino V, Gianino MM. Antibody responses to BNT162b2 SARS-CoV-2 mRNA vaccine among healthcare workers and residents of long-term care facilities: A cohort study in Northern Italy. Health Sci Rep 2023; 6:e1087. [PMID: 36789400 PMCID: PMC9922049 DOI: 10.1002/hsr2.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 02/13/2023] Open
Abstract
Background and Aims Long-term care facilities (LTCFs) have been severely impacted by COVID-19, with a disproportionate amount of SARS-CoV-2 infections and related deaths occurring among residents. Methods This study is part of an ongoing multicenter, prospective cohort study conducted among healthcare workers (HCWs) and residents of 13 LTCFs in Northern Italy designed to evaluate SARS-CoV-2 specific immunoglobulin class G (IgG) titers before and following vaccination with Pfizer/BNT162b2 SARS-CoV-2 mRNA vaccine (two doses of vaccine, 21 days apart). Serum samples were obtained from participants (t0) before vaccination, and (t1) 2 weeks after and analyzed to determine anti-S1 IgG antibodies. Results Five hundred and thirty-four participants were enrolled (404 subjects participated in both blood draws). Seropositivity was 50.19% at t0 and 99% at t1, with a significant difference in IgG titers. A higher proportion of residents were seropositive at t0 compared with HCWs, with significantly higher IgG titers among residents at both t0 and t1. Pre-existing immunity also had a significant effect on postvaccination IgG titers. However, a significant difference in titers at t1 between HCWs and residents considering only participants seropositive at t0 was found, with higher median titers among previously seropositive residents. Conclusion Findings of this study provide scientific evidence endorsing the policy of universal vaccination in LTCFs.
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Affiliation(s)
- Costanza Vicentini
- Department of Public Health and PaediatricsUniversity of TurinTurinItaly
| | - Carla Maria Zotti
- Department of Public Health and PaediatricsUniversity of TurinTurinItaly
| | | | - Jacopo Garlasco
- Department of Public Health and PaediatricsUniversity of TurinTurinItaly
| | - Noemi Marengo
- Department of Public Health and PaediatricsUniversity of TurinTurinItaly
| | - Davide Meddis
- Department of Public Health and PaediatricsUniversity of TurinTurinItaly
| | - Savina Ditommaso
- Department of Public Health and PaediatricsUniversity of TurinTurinItaly
| | - Monica Giacomuzzi
- Department of Public Health and PaediatricsUniversity of TurinTurinItaly
| | - Gabriele Memoli
- Department of Public Health and PaediatricsUniversity of TurinTurinItaly
| | - Valerio Bordino
- Department of Public Health and PaediatricsUniversity of TurinTurinItaly
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Kong JD, Akpudo UE, Effoduh JO, Bragazzi NL. Leveraging Responsible, Explainable, and Local Artificial Intelligence Solutions for Clinical Public Health in the Global South. Healthcare (Basel) 2023; 11:healthcare11040457. [PMID: 36832991 PMCID: PMC9956248 DOI: 10.3390/healthcare11040457] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/12/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
In the present paper, we will explore how artificial intelligence (AI) and big data analytics (BDA) can help address clinical public and global health needs in the Global South, leveraging and capitalizing on our experience with the "Africa-Canada Artificial Intelligence and Data Innovation Consortium" (ACADIC) Project in the Global South, and focusing on the ethical and regulatory challenges we had to face. "Clinical public health" can be defined as an interdisciplinary field, at the intersection of clinical medicine and public health, whilst "clinical global health" is the practice of clinical public health with a special focus on health issue management in resource-limited settings and contexts, including the Global South. As such, clinical public and global health represent vital approaches, instrumental in (i) applying a community/population perspective to clinical practice as well as a clinical lens to community/population health, (ii) identifying health needs both at the individual and community/population levels, (iii) systematically addressing the determinants of health, including the social and structural ones, (iv) reaching the goals of population's health and well-being, especially of socially vulnerable, underserved communities, (v) better coordinating and integrating the delivery of healthcare provisions, (vi) strengthening health promotion, health protection, and health equity, and (vii) closing gender inequality and other (ethnic and socio-economic) disparities and gaps. Clinical public and global health are called to respond to the more pressing healthcare needs and challenges of our contemporary society, for which AI and BDA can help unlock new options and perspectives. In the aftermath of the still ongoing COVID-19 pandemic, the future trend of AI and BDA in the healthcare field will be devoted to building a more healthy, resilient society, able to face several challenges arising from globally networked hyper-risks, including ageing, multimorbidity, chronic disease accumulation, and climate change.
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Affiliation(s)
- Jude Dzevela Kong
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON M3J 1P3, Canada
- Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), York University, Toronto, ON M3J 1P3, Canada
- Correspondence: (J.D.K.); (N.L.B.)
| | - Ugochukwu Ejike Akpudo
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON M3J 1P3, Canada
| | - Jake Okechukwu Effoduh
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON M3J 1P3, Canada
- Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), York University, Toronto, ON M3J 1P3, Canada
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, ON M3J 1P3, Canada
- Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), York University, Toronto, ON M3J 1P3, Canada
- Correspondence: (J.D.K.); (N.L.B.)
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Serological Responses up to 9 Months following COVID-19 mRNA Vaccination in Residents and Health-Care Workers of Long-Term Care Facilities: A Multicenter Prospective Cohort Study in Northern Italy. Vaccines (Basel) 2022; 10:vaccines10122183. [PMID: 36560593 PMCID: PMC9784767 DOI: 10.3390/vaccines10122183] [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: 11/18/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Long-term care facilities (LTCFs) were severely affected by COVID-19, in particular in Northern Italy. We aimed to assess antibody responses among residents and healthcare workers (HCWs) of 13 LTCFs through serum samples collected at three time points: prior to, two weeks, and 9 months after receiving Pfizer/BNT162b2 SARS-CoV-2 mRNA vaccine (respectively t0, t1, and t2). IgG antibodies targeted towards the S1 domain of the spike protein were measured, and results were expressed in binding antibody units (BAU/mL). Friedman's average rank test was performed to compare antibody titres between the three time points. Two logistic regression models were built to identify independent predictors of (1) developing and (2) maintaining a significant antibody response to vaccination, using a previously identified threshold. In total, 534 subjects were enrolled (371 HCWs and 163 residents). The antibody titres at t1 were the highest; at t2, the IgG titres significantly decreased, remaining however 10 times higher compared to titres at t0. Previous infection was the only significant predictor of developing and maintaining a response over threshold in both models. Results of this study provided further insights on the humoral response elicited by vaccination, and on host factors determining variations in its magnitude and kinetics.
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Rodriguez-Rodriguez V, Rojo-Perez F, Perez de Arenaza Escribano C, Molina-Martínez MÁ, Fernandez-Mayoralas G, Sánchez-González D, Rojo-Abuin JM, Rodríguez-Blázquez C, Forjaz MJ, Martín García S. The Impact of COVID-19 on Nursing Homes: Study Design and Population Description. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16629. [PMID: 36554508 PMCID: PMC9779101 DOI: 10.3390/ijerph192416629] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/30/2022] [Accepted: 12/06/2022] [Indexed: 05/15/2023]
Abstract
Nursing homes for the elderly in Spain have experienced high rates of infection and mortality from COVID-19, although rates have varied from one region to another. Madrid is the region where most institutionalized older adults have died from the coronavirus. However, there is little known about the psychosocial and environmental factors involved in the high incidence of COVID-19 among the institutionalised population in this region. This article describes the protocol of a study on nursing homes during the SARS-CoV-2 pandemic in the Autonomous Community of Madrid (hereafter: Region of Madrid or Madrid Region) and provides information on the study design, measures used, and characteristics of the population studied. A questionnaire about life in nursing homes during the COVID-19 pandemic was designed and a total of 447 persons over 60 years of age without cognitive impairment-220 in private nursing homes and 227 in public nursing homes-participated by answering questions about different topics: personal situations during the pandemic, feelings and methods of coping, residential environment, health, quality of life, ageism, and self-perception of ageing. The institutionalised person profile discussed in this study was an old woman, widowed, without children, with a low level of education, with multimorbidity, and who perceived her health and quality of life positively. Most of the participants were very concerned about COVID-19 and its effects. In fact, 38% had been diagnosed with COVID-19, of whom 20% were admitted to hospital and 20% had suffered negative impacts, such as pain and neurological problems. In addition, 70% of the residents remained confined to their rooms, which increased their perceptions of loneliness and social isolation. The worst-rated aspects of the nursing home resulted from the restrictive measures imposed on nursing homes during the pandemic. This research offers useful material for understanding the pandemic and its consequences from the perspective of the older institutionalised population, which could provide insights for designing public policies.
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Affiliation(s)
| | - Fermina Rojo-Perez
- Grupo de Investigacion sobre Envejecimiento (GIE), IEGD, CSIC, 28037 Madrid, Spain
| | | | - María-Ángeles Molina-Martínez
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain
| | | | - Diego Sánchez-González
- Departamento de Geografía, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain
| | | | - Carmen Rodríguez-Blázquez
- National Epidemiology Centre, Carlos III Institute of Health, Network Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Maria João Forjaz
- National Epidemiology Centre, Carlos III Institute of Health, Health Service Research Network on Chronic Diseases (REDISSEC) and Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 28029 Madrid, Spain
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de Castro MV, Silva MVR, Naslavsky MS, Scliar MO, Nunes K, Passos-Bueno MR, Castelli EC, Magawa JY, Adami FL, Moretti AIS, de Oliveira VL, Boscardin SB, Cunha-Neto E, Kalil J, Jouanguy E, Bastard P, Casanova JL, Quiñones-Vega M, Sosa-Acosta P, Guedes JDS, de Almeida NP, Nogueira FCS, Domont GB, Santos KS, Zatz M. The oldest unvaccinated Covid-19 survivors in South America. Immun Ageing 2022; 19:57. [PMID: 36384671 PMCID: PMC9666972 DOI: 10.1186/s12979-022-00310-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although older adults are at a high risk of severe or critical Covid-19, there are many cases of unvaccinated centenarians who had a silent infection or recovered from mild or moderate Covid-19. We studied three Brazilian supercentenarians, older than 110 years, who survived Covid-19 in 2020 before being vaccinated. RESULTS Despite their advanced age, humoral immune response analysis showed that these individuals displayed robust levels of IgG and neutralizing antibodies (NAbs) against SARS-CoV-2. Enrichment of plasma proteins and metabolites related to innate immune response and host defense was also observed. None presented autoantibodies (auto-Abs) to type I interferon (IFN). Furthermore, these supercentenarians do not carry rare variants in genes underlying the known inborn errors of immunity, including particular inborn errors of type I IFN. CONCLUSION These observations suggest that their Covid-19 resilience might be a combination of their genetic background and their innate and adaptive immunity.
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Affiliation(s)
- Mateus V de Castro
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Monize V R Silva
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Michel S Naslavsky
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, São Paulo, Brazil
- Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Marilia O Scliar
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, São Paulo, Brazil
- Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Kelly Nunes
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, São Paulo, Brazil
- Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Maria Rita Passos-Bueno
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, São Paulo, Brazil
- Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Erick C Castelli
- Department of Pathology, School of Medicine, UNESP - São Paulo State University, Botucatu, São Paulo, Brazil
| | - Jhosiene Y Magawa
- Laboratório de Imunologia, Instituto do Coração (InCor), LIM19, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, Brazil
- Instituto de Investigação em Imunologia-Instituto Nacional de Ciências e Tecnologia-iii-INCT, São Paulo, Brazil
- Departamento de Clínica Médica, Disciplina de Imunologia Clínica e Alergia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Flávia L Adami
- Laboratory of Antigen Targeting to Dendritic Cells, Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Ana I S Moretti
- Laboratório de Imunologia, Instituto do Coração (InCor), LIM19, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, Brazil
| | - Vivian L de Oliveira
- Laboratório de Imunologia, Instituto do Coração (InCor), LIM19, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, Brazil
| | - Silvia B Boscardin
- Laboratory of Antigen Targeting to Dendritic Cells, Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Edecio Cunha-Neto
- Instituto de Investigação em Imunologia-Instituto Nacional de Ciências e Tecnologia-iii-INCT, São Paulo, Brazil
- Departamento de Clínica Médica, Disciplina de Imunologia Clínica e Alergia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jorge Kalil
- Laboratório de Imunologia, Instituto do Coração (InCor), LIM19, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, Brazil
- Instituto de Investigação em Imunologia-Instituto Nacional de Ciências e Tecnologia-iii-INCT, São Paulo, Brazil
| | - Emmanuelle Jouanguy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris, Paris, France
| | - Paul Bastard
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris, Paris, France
| | - Jean-Laurent Casanova
- Imagine Institute, University of Paris, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Mauricio Quiñones-Vega
- Proteomics Unit, Department of Biochemistry, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratory of Proteomics (LabProt), Institute of Chemistry, LADETEC, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Patricia Sosa-Acosta
- Proteomics Unit, Department of Biochemistry, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratory of Proteomics (LabProt), Institute of Chemistry, LADETEC, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jéssica de S Guedes
- Proteomics Unit, Department of Biochemistry, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratory of Proteomics (LabProt), Institute of Chemistry, LADETEC, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Natália P de Almeida
- Proteomics Unit, Department of Biochemistry, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratory of Proteomics (LabProt), Institute of Chemistry, LADETEC, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fábio C S Nogueira
- Proteomics Unit, Department of Biochemistry, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratory of Proteomics (LabProt), Institute of Chemistry, LADETEC, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gilberto B Domont
- Proteomics Unit, Department of Biochemistry, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Keity S Santos
- Laboratório de Imunologia, Instituto do Coração (InCor), LIM19, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, Brazil
- Instituto de Investigação em Imunologia-Instituto Nacional de Ciências e Tecnologia-iii-INCT, São Paulo, Brazil
- Departamento de Clínica Médica, Disciplina de Imunologia Clínica e Alergia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Mayana Zatz
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, São Paulo, Brazil.
- Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, São Paulo, São Paulo, Brazil.
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Castelli EC, de Castro MV, Naslavsky MS, Scliar MO, Silva NSB, Pereira RN, Ciriaco VAO, Castro CFB, Mendes-Junior CT, Silveira EDS, de Oliveira IM, Antonio EC, Vieira GF, Meyer D, Nunes K, Matos LRB, Silva MVR, Wang JYT, Esposito J, Cória VR, Magawa JY, Santos KS, Cunha-Neto E, Kalil J, Bortolin RH, Hirata MH, Dell’Aquila LP, Razuk-Filho A, Batista-Júnior PB, Duarte-Neto AN, Dolhnikoff M, Saldiva PHN, Passos-Bueno MR, Zatz M. MUC22, HLA-A, and HLA-DOB variants and COVID-19 in resilient super-agers from Brazil. Front Immunol 2022; 13:975918. [PMID: 36389712 PMCID: PMC9641602 DOI: 10.3389/fimmu.2022.975918] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/15/2022] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Although aging correlates with a worse prognosis for Covid-19, super elderly still unvaccinated individuals presenting mild or no symptoms have been reported worldwide. Most of the reported genetic variants responsible for increased disease susceptibility are associated with immune response, involving type I IFN immunity and modulation; HLA cluster genes; inflammasome activation; genes of interleukins; and chemokines receptors. On the other hand, little is known about the resistance mechanisms against SARS-CoV-2 infection. Here, we addressed polymorphisms in the MHC region associated with Covid-19 outcome in super elderly resilient patients as compared to younger patients with a severe outcome. METHODS SARS-CoV-2 infection was confirmed by RT-PCR test. Aiming to identify candidate genes associated with host resistance, we investigated 87 individuals older than 90 years who recovered from Covid-19 with mild symptoms or who remained asymptomatic following positive test for SARS-CoV-2 as compared to 55 individuals younger than 60 years who had a severe disease or died due to Covid-19, as well as to the general elderly population from the same city. Whole-exome sequencing and an in-depth analysis of the MHC region was performed. All samples were collected in early 2020 and before the local vaccination programs started. RESULTS We found that the resilient super elderly group displayed a higher frequency of some missense variants in the MUC22 gene (a member of the mucins' family) as one of the strongest signals in the MHC region as compared to the severe Covid-19 group and the general elderly control population. For example, the missense variant rs62399430 at MUC22 is two times more frequent among the resilient super elderly (p = 0.00002, OR = 2.24). CONCLUSION Since the pro-inflammatory basal state in the elderly may enhance the susceptibility to severe Covid-19, we hypothesized that MUC22 might play an important protective role against severe Covid-19, by reducing overactive immune responses in the senior population.
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Affiliation(s)
- Erick C. Castelli
- Department of Pathology, School of Medicine, São Paulo State University (UNESP), Botucatu, Brazil
- Molecular Genetics and Bioinformatics Laboratory, Experimental Research Unit (Unipex), School of Medicine, São Paulo State University (UNESP), Botucatu, Brazil
| | - Mateus V. de Castro
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, Brazil
| | - Michel S. Naslavsky
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, Brazil
- Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, São Paulo, Brazil
| | - Marilia O. Scliar
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, Brazil
| | - Nayane S. B. Silva
- Molecular Genetics and Bioinformatics Laboratory, Experimental Research Unit (Unipex), School of Medicine, São Paulo State University (UNESP), Botucatu, Brazil
| | - Raphaela N. Pereira
- Molecular Genetics and Bioinformatics Laboratory, Experimental Research Unit (Unipex), School of Medicine, São Paulo State University (UNESP), Botucatu, Brazil
| | - Viviane A. O. Ciriaco
- Molecular Genetics and Bioinformatics Laboratory, Experimental Research Unit (Unipex), School of Medicine, São Paulo State University (UNESP), Botucatu, Brazil
| | - Camila F. B. Castro
- Molecular Genetics and Bioinformatics Laboratory, Experimental Research Unit (Unipex), School of Medicine, São Paulo State University (UNESP), Botucatu, Brazil
- Centro Universitário Sudoeste Paulista, Avaré, Brazil
| | - Celso T. Mendes-Junior
- Departamento de Química, Faculdade de Filosofa, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Etiele de S. Silveira
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Iuri M. de Oliveira
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Eduardo C. Antonio
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Gustavo F. Vieira
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Laboratório de Saúde Humana In Silico, Programa de Pós-Graduação em Saúde e Desenvolvimento Humano, Universidade La Salle, Canoas, Brazil
| | - Diogo Meyer
- Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, São Paulo, Brazil
| | - Kelly Nunes
- Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, São Paulo, Brazil
| | - Larissa R. B. Matos
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, Brazil
| | - Monize V. R. Silva
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, Brazil
| | - Jaqueline Y. T. Wang
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, Brazil
| | - Joyce Esposito
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, Brazil
| | - Vivian R. Cória
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, Brazil
| | - Jhosiene Y. Magawa
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Imunologia, Instituto do Coração (InCor), LIM19, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, Brazil
- Instituto de Investigação em Imunologia, Instituto Nacional de Ciências e Tecnologia-iii (INCT), São Paulo, Brazil
| | - Keity S. Santos
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Imunologia, Instituto do Coração (InCor), LIM19, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, Brazil
- Instituto de Investigação em Imunologia, Instituto Nacional de Ciências e Tecnologia-iii (INCT), São Paulo, Brazil
| | - Edecio Cunha-Neto
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Imunologia, Instituto do Coração (InCor), LIM19, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, Brazil
- Instituto de Investigação em Imunologia, Instituto Nacional de Ciências e Tecnologia-iii (INCT), São Paulo, Brazil
| | - Jorge Kalil
- Departamento de Clínica Médica, Disciplina de Alergia e Imunologia Clínica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Imunologia, Instituto do Coração (InCor), LIM19, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, Brazil
- Instituto de Investigação em Imunologia, Instituto Nacional de Ciências e Tecnologia-iii (INCT), São Paulo, Brazil
| | - Raul H. Bortolin
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Mário Hiroyuki Hirata
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Amaro N. Duarte-Neto
- Department of Pathology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Marisa Dolhnikoff
- Department of Pathology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Paulo H. N. Saldiva
- Department of Pathology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Maria Rita Passos-Bueno
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, Brazil
- Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, São Paulo, Brazil
| | - Mayana Zatz
- Human Genome and Stem Cell Research Center, University of São Paulo, São Paulo, Brazil
- Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo, São Paulo, Brazil
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Lallo C, Pasqualini M, Tomassini C. Trends in the Use of Home LTC Services in Large, Medium and Small Municipalities in Italy: Lessons for the Post-COVID-19 Reappraisal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12796. [PMID: 36232094 PMCID: PMC9566680 DOI: 10.3390/ijerph191912796] [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: 09/06/2022] [Revised: 09/29/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Italian Long-Term Care is considered largely inadequate, and the recent COVID-19 pandemic has dramatically exposed its limitations. Public Home Care Services in particular were revealed as under-financed and unable to cover the potential demand for care from the older population. But does the type of municipality and its geographic location play a role in creating or mitigating unmet demand? This is the first study addressing this research question in Italy. Our hypothesis is that older people's care preferences and care possibilities may vary between small, medium and metropolitan areas, as will the organisation, funding and availability of services, and the combination will influence (unmet) demand for public home care services. In this paper, using nationally representative survey data collected by the Italian National Statistical Institute in 2003 and 2016, we investigate changes and differences in the use of public and private home care services among people aged 75 or older in Italy by size of the municipality. Our results reveal inequalities in service use between Northern and Southern areas of the country and in particular between metropolitan areas, medium and small municipalities. Such differences reinforce post-pandemic calls for new investment and changes in the design of the Italian Long-Term Care system.
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Affiliation(s)
- Carlo Lallo
- Department of Economics, University of Molise, Via F. De Sanctis, 86100 Campobasso, Italy
| | - Marta Pasqualini
- Department MEMOTEF, Sapienza University of Rome, Via del Castro Laurenziano 9, 00161 Rome, Italy
| | - Cecilia Tomassini
- Department of Economics, University of Molise, Via F. De Sanctis, 86100 Campobasso, Italy
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Syed Elias SM, Rohinmi NR. Knowledge, attitudes, and sociodemographic factors related to COVID-19 among older people living in the community in Malaysia. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:298. [PMID: 36439003 PMCID: PMC9683454 DOI: 10.4103/jehp.jehp_1637_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/03/2022] [Accepted: 02/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Although older people are at a higher risk of COVID-19 infection, there is a lack of research that focuses on COVID-19 in older people in Malaysia. Therefore, the aim of this study was to assess the level of knowledge and attitudes related to COVID-19, and to identify the association of sociodemographic background with knowledge and attitudes towards COVID-19 among older people. MATERIALS AND METHODS This is a cross-sectional study involving 382 older people living in the community in Malaysia. Data was collected using convenience sampling through an online questionnaire that consisted of three parts: sociodemographic details, knowledge, and attitude related to COVID-19. RESULTS The overall correct rate of knowledge was 77.3%, indicating that participants had slightly good knowledge related to COVID-19. The participants showed a positive attitude with a mean score of 26.0 (SD = 5.0). There were significant associations between knowledge and education level (P = 0.00) and marital status (P = 0.02). Marital status was significantly associated with attitude towards COVID-19 (P = 0.03). A weak positive correlation was found between knowledge and attitude (r = 0.17, P = 0.00) suggesting that an increase in knowledge will increase the positive attitude among older people. CONCLUSION Older people reported good knowledge and positive attitudes towards COVID-19. The Malaysian government should provide relevant health education for those with lower education levels and divorced or widowed to improve knowledge and attitudes towards COVID-19.
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Affiliation(s)
- Sharifah Munirah Syed Elias
- Department of Special Care Nursing, Kulliyyah (Faculty) of Nursing, International Islamic University Malaysia, Pahang, Malaysia
| | - Nur Rasyidah Rohinmi
- Department of Operation Theatre, Thomson Hospital Kota Damansara, Selangor, Malaysia
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Cascini S, Agabiti N, Marino C, Acampora A, Balducci M, Calandrini E, Davoli M, Bargagli AM. Incidence and Outcomes of SARS-CoV-2 Infection in Older Adults Living with Dementia: A Population-Based Cohort Study. J Alzheimers Dis 2022; 89:681-693. [PMID: 35912744 PMCID: PMC9535569 DOI: 10.3233/jad-220369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: The identification of risk factors for SARS-CoV-2 infection and mortality in patients with dementia is a key aspect to support clinical decisions and public health interventions. Objective: To assess the incidence of SARS-CoV-2 infection and COVID-19 related death in a cohort of patients with dementia residing in the Lazio region and to investigate predicting factors for both infection and mortality. Methods: This population-based study used information from administrative databases and the SARS-CoV-2 infection surveillance system. Patients with dementia (age ≥65) were enrolled as of December 31, 2019 and followed-up until February 28, 2021. Cumulative risk of infection and death within 60 days of infection onset, and age-standardized incidence (SIR) and mortality (SMR) ratios were calculated. Logistic regression models were applied to identify factors associated with infection and mortality. Results: Among 37,729 dementia patients, 2,548 had a diagnosis of SARS-CoV-2 infection. The crude risk of infection was 6.7%. An increase in risk of infection was observed both in women (SIR 1.72; 95% CI 1.64–1.80) and men (SIR 1.43; 95% CI 1.33–1.54). Pneumonia, cerebrovascular and blood diseases, femur fracture, anxiety, antipsychotic and antithrombotic use were associated with an increased risk of infection. The crude risk of death was 31.0%, the SMRs 2.32 (95% CI 2.05–2.65) for men, and 2.82 (95% CI 2.55–3.11) for women. Factors associated with mortality included: male gender, age ≥85, symptoms at the diagnosis, antipsychotic and systemic antibiotics treatment. Conclusion: These findings emphasize the need of close and tailored monitoring of dementia patients to reduce the impact of COVID-19 on this fragile population.
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Affiliation(s)
- Silvia Cascini
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
| | - Nera Agabiti
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
| | - Claudia Marino
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
| | - Anna Acampora
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
| | - Maria Balducci
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
| | - Enrico Calandrini
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
| | - Marina Davoli
- Department of Epidemiology of the Regional HealthService-Lazio, Rome, Italy
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22
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Pereira FM, Salomão de Araujo A, Catarina Martins Reis A, Santos da Hora A, Pinotti F, Paton RS, Vilas Boas Figueiredo C, Lopes Damasceno C, Carlos dos Santos D, Souza de Santana D, Freitas Sales D, Ariana Andrade Brandão E, da Silva Batista E, Campos de Sousa FS, Santana Menezes G, Silveira dos Santos J, Gomes Lima J, Tadeu Brito J, Dandara dos Santos L, Reboredo L, Santana Santos M, Kelly Astete Gomez M, Freitas da Cruz M, Rosa Ampuero M, Guerra Lemos da Silva M, S. da Paixão Melo M, Ferreira da Silva M, de Jesus Gonçalves dos Santos N, de Souza Pessoa N, Silva de Araujo R, de Macedo Godim T, Fraga de Oliveira Tosta S, Brandão Nardy V, Cristina Faria E, Frederico de Carvalho Dominguez Souza B, Laís Almeida dos Santos J, Wikramaratna P, Giovanetti M, Alcântara LCJ, Lourenço J, Leal e Silva de Mello A. Dynamics and Determinants of SARS-CoV-2 RT-PCR Testing on Symptomatic Individuals Attending Healthcare Centers during 2020 in Bahia, Brazil. Viruses 2022; 14:v14071549. [PMID: 35891528 PMCID: PMC9321627 DOI: 10.3390/v14071549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 02/05/2023] Open
Abstract
RT-PCR testing data provides opportunities to explore regional and individual determinants of test positivity and surveillance infrastructure. Using Generalized Additive Models, we explored 222,515 tests of a random sample of individuals with COVID-19 compatible symptoms in the Brazilian state of Bahia during 2020. We found that age and male gender were the most significant determinants of test positivity. There was evidence of an unequal impact among socio-demographic strata, with higher positivity among those living in areas with low education levels during the first epidemic wave, followed by those living in areas with higher education levels in the second wave. Our estimated probability of testing positive after symptom onset corroborates previous reports that the probability decreases with time, more than halving by about two weeks and converging to zero by three weeks. Test positivity rates generally followed state-level reported cases, and while a single laboratory performed ~90% of tests covering ~99% of the state's area, test turn-around time generally remained below four days. This testing effort is a testimony to the Bahian surveillance capacity during public health emergencies, as previously witnessed during the recent Zika and Yellow Fever outbreaks.
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Affiliation(s)
- Felicidade Mota Pereira
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Aline Salomão de Araujo
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Ana Catarina Martins Reis
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Anadilton Santos da Hora
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Francesco Pinotti
- Department of Zoology, University of Oxford, Oxford OX1 3SZ, UK; (F.P.); (R.S.P.)
| | - Robert S. Paton
- Department of Zoology, University of Oxford, Oxford OX1 3SZ, UK; (F.P.); (R.S.P.)
| | - Camylla Vilas Boas Figueiredo
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Caroline Lopes Damasceno
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Daiana Carlos dos Santos
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Daniele Souza de Santana
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Danielle Freitas Sales
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Evelyn Ariana Andrade Brandão
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Everton da Silva Batista
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Fulvia Soares Campos de Sousa
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Gabriela Santana Menezes
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Jackeline Silveira dos Santos
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Jaqueline Gomes Lima
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Jean Tadeu Brito
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Lenisa Dandara dos Santos
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Luciana Reboredo
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Maiara Santana Santos
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Marcela Kelly Astete Gomez
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Marcia Freitas da Cruz
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Mariana Rosa Ampuero
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Mariele Guerra Lemos da Silva
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Mariza S. da Paixão Melo
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Marta Ferreira da Silva
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Nadja de Jesus Gonçalves dos Santos
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Núbia de Souza Pessoa
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Ramile Silva de Araujo
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Taiane de Macedo Godim
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | | | - Vanessa Brandão Nardy
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Elaine Cristina Faria
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Breno Frederico de Carvalho Dominguez Souza
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Jessica Laís Almeida dos Santos
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | | | - Marta Giovanetti
- Laboratório de Flavivírus, Instituto Oswaldo Cruz Fiocruz, Rio de Janeiro 21045-900, Brazil;
- Department of Science and Technology for Humans and the Environment, University of Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Luiz Carlos Junior Alcântara
- Laboratório de Flavivírus, Instituto Oswaldo Cruz Fiocruz, Rio de Janeiro 21045-900, Brazil;
- Correspondence: (L.C.J.A.); (J.L.)
| | - José Lourenço
- Biosystems and Integrative Sciences Institute, Faculdade de Ciências, 1749-016 Lisboa, Portugal
- Correspondence: (L.C.J.A.); (J.L.)
| | - Arabela Leal e Silva de Mello
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
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Delbrück M, Hoehl S, Toptan T, Schenk B, Grikscheit K, Metzler M, Herrmann E, Ciesek S. Low But Recoverable Markers of Humoral Immune Response to BNT162b2 in Elderly LTCF Residents Five to Seven Months After Two-Dose Vaccination. FRONTIERS IN AGING 2022; 3:883724. [PMID: 35821813 PMCID: PMC9261435 DOI: 10.3389/fragi.2022.883724] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/29/2022] [Indexed: 12/31/2022]
Abstract
The immune response is known to wane after vaccination with BNT162b2, but the role of age, morbidity and body composition is not well understood. We conducted a cross-sectional study in long-term care facilities (LTCFs) for the elderly. All study participants had completed two-dose vaccination with BNT162b2 five to 7 months before sample collection. In 298 residents (median age 86 years, range 75–101), anti-SARS-CoV-2 rector binding IgG antibody (anti-RBD-IgG) concentrations were low and inversely correlated with age (mean 51.60 BAU/ml). We compared the results to Health Care Workers (HCW) aged 18–70 years (n = 114, median age: 53 years), who had a higher mean anti-RBD-IgG concentration of 156.99 BAU/ml. Neutralization against the Delta variant was low in both groups (9.5% in LTCF residents and 31.6% in HCWs). The Charlson Comorbidity Index was inversely correlated with anti-RBD-IgG, but not the body mass index (BMI). A control group of 14 LTCF residents with known breakthrough infection had significant higher antibody concentrations (mean 3,199.65 BAU/ml), and 85.7% had detectable neutralization against the Delta variant. Our results demonstrate low but recoverable markers of immunity in LTCF residents five to 7 months after vaccination.
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Affiliation(s)
- Marla Delbrück
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt, Germany
| | - Sebastian Hoehl
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt, Germany
| | - Tuna Toptan
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt, Germany
| | - Barbara Schenk
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt, Germany
| | | | - Melinda Metzler
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Frankfurt, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, Goethe University Frankfurt, Frankfurt, Germany.,Fraunhofer Institute for Molecular Biology and Applied Ecology (IME), Branch Translational Medicine and Pharmacology, Frankfurt, Germany.,German Center for Infection Research, DZIF, External Partner Site Frankfurt, Braunschweig, Germany
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Families coping with the COVID-19 pandemic: Risk perceptions associated with preventive intention across three generations of Chinese families. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03340-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Wilasang C, Modchang C, Lincharoen T, Chadsuthi S. Estimation of Excess All-Cause Mortality Due to COVID-19 in Thailand. Trop Med Infect Dis 2022; 7:tropicalmed7070116. [PMID: 35878128 PMCID: PMC9322618 DOI: 10.3390/tropicalmed7070116] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/14/2022] [Accepted: 06/18/2022] [Indexed: 01/27/2023] Open
Abstract
Thailand has experienced the most prominent COVID-19 outbreak in 2021, resulting in a new record for COVID-19 cases and deaths. To assess the influence of the COVID-19 outbreak on mortality, we estimated excess all-cause and pneumonia mortality in Thailand during the COVID-19 outbreak from April to October 2021. We used mortality from the previous 5 years to estimate the baseline number of deaths using generalized linear mixed models. The models were adjusted for seasonality and demographics. We found that, during the outbreak in 2021, there was a significant rise in excess fatalities, especially in the older age groups. The estimated cumulative excess death was 14.3% (95% CI: 8.6–18.8%) higher than the baseline. The results also showed that the excess deaths in males were higher than in females by approximately 26.3%. The excess deaths directly caused by the COVID-19 infections accounted for approximately 75.0% of the all-cause excess deaths. Furthermore, excess pneumonia deaths were also found to be 26.2% (95% CI: 4.8–46.0%) above baseline.
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Affiliation(s)
- Chaiwat Wilasang
- Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok 10400, Thailand; (C.W.); (C.M.); (T.L.)
| | - Charin Modchang
- Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok 10400, Thailand; (C.W.); (C.M.); (T.L.)
- Centre of Excellence in Mathematics, MHESI, Bangkok 10400, Thailand
- Thailand Center of Excellence in Physics, Ministry of Higher Education, Science, Research and Innovation, 328 Si Ayutthaya Road, Bangkok 10400, Thailand
| | - Thanchanok Lincharoen
- Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok 10400, Thailand; (C.W.); (C.M.); (T.L.)
| | - Sudarat Chadsuthi
- Department of Physics, Research Center for Academic Excellence in Applied Physics, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
- Correspondence:
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Oberemok VV, Andreeva OA, Laikova KV, Novikov IA, Puzanova YV, Kubyshkin AV. Anti-coronavirus vaccines will not accelerate the transition of humanity to a non-pandemic period, but the pandemic will take fewer victims. Inflamm Res 2022; 71:521-536. [PMID: 35397666 PMCID: PMC8994861 DOI: 10.1007/s00011-022-01567-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 11/05/2022] Open
Abstract
The vaccination rate worldwide has reached enormous proportions, and it is likely that at least 75% of the world's population will be vaccinated. The controversy is that, while people aged 65 and older suffer a significantly higher mortality rate from COVID-19, plans are being made to vaccinate young people under the age of 20. Equally thorny is the question of vaccinating people who already have antibodies to SARS-CoV-2, as well as B and T memory cells, because they contracted and survived the virus. The possible consequences of large-scale vaccination are difficult to predict, when some people do not have access to the vaccine at all and others have already received 3 doses of the vaccine. SARS-CoV-2 will circulate through the human population forever and continue to mutate, as viruses do. Therefore, in the coming years, the need to develop and use effective vaccines and medicines for the prevention and treatment of COVID-19 will remain urgent in view of the high mortality rate from this disease. To date, three vaccine platforms have been most used: adenoviral vector, inactivated, and mRNA. There is some concern about the side effects that occur after vaccination. Whether modern anti-coronavirus vaccines can raise the safety threshold, only time will answer. It is obvious that the pandemic will end, but the virus will remain in the human population, leaving behind invaluable experience and tens of millions of victims. This article is based on search retrieves in research articles devoted to COVID-19 mainly published in 2020-2021 and examines the possible consequences of the worldwide vaccination against SARS-CoV-2 and suggests that, while anti-coronavirus vaccines will not magically transport humanity to a non-pandemic world, they may greatly reduce the number of victims of the pandemic and help us learn how to live with COVID-19.
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Affiliation(s)
- V V Oberemok
- Department of Molecular Genetics and Biotechnologies, V.I. Vernadsky Crimean Federal University, Simferopol, Crimea.
- Department of DNA Technologies of Engineering Center, V.I. Vernadsky Crimean Federal University, Simferopol, Crimea.
| | - O A Andreeva
- Department of Molecular Genetics and Biotechnologies, V.I. Vernadsky Crimean Federal University, Simferopol, Crimea
- Department of DNA Technologies of Engineering Center, V.I. Vernadsky Crimean Federal University, Simferopol, Crimea
| | - K V Laikova
- Department of Molecular Genetics and Biotechnologies, V.I. Vernadsky Crimean Federal University, Simferopol, Crimea
- Department of DNA Technologies of Engineering Center, V.I. Vernadsky Crimean Federal University, Simferopol, Crimea
| | - I A Novikov
- Department of Molecular Genetics and Biotechnologies, V.I. Vernadsky Crimean Federal University, Simferopol, Crimea
| | - Y V Puzanova
- Department of Molecular Genetics and Biotechnologies, V.I. Vernadsky Crimean Federal University, Simferopol, Crimea
- Department of DNA Technologies of Engineering Center, V.I. Vernadsky Crimean Federal University, Simferopol, Crimea
| | - A V Kubyshkin
- Department of DNA Technologies of Engineering Center, V.I. Vernadsky Crimean Federal University, Simferopol, Crimea
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Emergency Medical Services Calls Analysis for Trend Prediction during Epidemic Outbreaks: Interrupted Time Series Analysis on 2020-2021 COVID-19 Epidemic in Lazio, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105951. [PMID: 35627487 PMCID: PMC9140838 DOI: 10.3390/ijerph19105951] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/27/2022] [Accepted: 05/11/2022] [Indexed: 01/18/2023]
Abstract
(1) Background: During the COVID-19 outbreak in the Lazio region, a surge in emergency medical service (EMS) calls has been observed. The objective of present study is to investigate if there is any correlation between the variation in numbers of daily EMS calls, and the short-term evolution of the epidemic wave. (2) Methods: Data from the COVID-19 outbreak has been retrieved in order to draw the epidemic curve in the Lazio region. Data from EMS calls has been used in order to determine Excess of Calls (ExCa) in the 2020−2021 years, compared to the year 2019 (baseline). Multiple linear regression models have been run between ExCa and the first-order derivative (D’) of the epidemic wave in time, each regression model anticipating the epidemic progression (up to 14 days), in order to probe a correlation between the variables. (3) Results: EMS calls variation from baseline is correlated with the slope of the curve of ICU admissions, with the most fitting value found at 7 days (R2 0.33, p < 0.001). (4) Conclusions: EMS calls deviation from baseline allows public health services to predict short-term epidemic trends in COVID-19 outbreaks, and can be used as validation of current data, or as an independent estimator of future trends.
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Spread of COVID-19 Infection in Long-Term Care Facilities of Trieste (Italy) during the Pre-Vaccination Era. Integrating Findings of 41 Forensic Autopsies with Geriatric Comorbidity Index as a Valid Option for the Assessment of Strength of Causation. Vaccines (Basel) 2022; 10:vaccines10050774. [PMID: 35632530 PMCID: PMC9146610 DOI: 10.3390/vaccines10050774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/02/2022] [Accepted: 05/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background: in 2020, a new form of coronavirus spread around the world starting from China. The older people were the population most affected by the virus worldwide, in particular in Italy where more than 90% of deaths were people over 65 years. In these people, the definition of the cause of death is tricky due to the presence of numerous comorbidities. Objective: to determine whether COVID-19 was the cause of death in a series of older adults residents of nursing care homes. Methods: 41 autopsies were performed from May to June 2020. External examination, swabs, and macroscopic and microscopic examination were performed. Results: the case series consisted of nursing home guests; 15 men and 26 women, with a mean age of 87 years. The average number of comorbidities was 4. Based only on the autopsy results, the defined cause of death was acute respiratory failure due to diffuse alveolar damage (8%) or (31%) bronchopneumonia with one or more positive swabs for SARS-CoV-2. Acute cardiac failure with one or more positive swabs for SARS-CoV-2 was indicated as the cause of death in in symptomatic (37%) and asymptomatic (10%) patients. Few patients died for septic shock (three cases), malignant neoplastic diseases (two cases), and massive digestive bleeding (one case). Conclusions: Data from post-mortem investigation were integrated with previously generated Geriatric Index of Comorbidity (GIC), resulting in four different degrees of probabilities: high (12%), intermediate (10%), low (59%), and none (19%), which define the level of strength of causation and the role of COVID-19 disease in determining death.
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COVID-19 Medical and Pharmacological Management in the European Countries Compared to Italy: An Overview. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074262. [PMID: 35409942 PMCID: PMC8998583 DOI: 10.3390/ijerph19074262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/16/2022] [Accepted: 03/30/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: Italy accounts for more than 150,000 deaths due to the COVID-19 pandemic, leading the top rank in SARS-CoV-2-caused deceases in Europe. A survey on the different ways by which the COVID-19 pandemic emergency was managed in the foreign European countries compared to Italy is the purpose of this paper. (2) Methods: A literature search and various mathematical algorithms to approach a rank scoring scale were used to describe in detail the different approaches used by European countries to manage the COVID-19 pandemic emergency. (3) Results: The study showed that Italy stands at the bottom ranking for COVID-19 management due to its high mortality rate. Possible causes of the observed huge numbers of hospitalization and deaths were (a) the demographic composition of the European country; (b) its decentralized healthcare system organization; (c) the role of correct pharmacology in the early stages before hospitalization. Post-mortem examinations were of paramount importance to elucidate the etiopathogenesis of COVID-19 and to tailor a suitable and proper therapy in the early symptomatic stages of COVID-19, preventing hospitalization. (4) Conclusions: Factors such as the significant impact on elderly people, the public health organization prevalently state-owned and represented mainly by hospitals, and criticism of the home therapy approach toward SARS-CoV-2-infected people, may have concurred in increasing the number of COVID-19 deaths in Italy.
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The 90 plus: longevity and COVID-19 survival. Mol Psychiatry 2022; 27:1936-1944. [PMID: 35136227 DOI: 10.1038/s41380-022-01461-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/11/2022] [Accepted: 01/20/2022] [Indexed: 11/08/2022]
Abstract
The world population is getting older and studies aiming to enhance our comprehension of the underlying mechanisms responsible for health span are of utmost interest for longevity and as a measure for health care. In this review, we summarized previous genetic association studies (GWAS) and next-generation sequencing (NGS) of elderly cohorts. We also present the updated hypothesis for the aging process, together with the factors associated with healthy aging. We discuss the relevance of studying older individuals and build databanks to characterize the presence and resistance against late-onset disorders. The identification of about 2 million novel variants in our cohort of more than 1000 elderly Brazilians illustrates the importance of studying highly admixed populations of non-European ancestry. Finally, the ascertainment of nonagenarians and particularly of centenarians who were recovered from COVID-19 or remained asymptomatic opens new avenues of research aiming to enhance our comprehension of biological mechanisms associated with resistance against pathogens.
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Palavras MJ, Faria C, Fernandes P, Lagarto A, Ponciano A, Alçada F, Banza MJ. The Impact of the Third Wave of the COVID-19 Pandemic on the Elderly and Very Elderly Population in a Tertiary Care Hospital in Portugal. Cureus 2022; 14:e22653. [PMID: 35371715 PMCID: PMC8963478 DOI: 10.7759/cureus.22653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background: COVID-19 poses a significantly more serious threat to adults aged 65 and above, with a higher mortality rate. This study aims to describe the outcome of COVID-19 patients in the elderly and very elderly population admitted to a tertiary care Portuguese hospital. The authors defined the elderly population (65 to 79 years) and the very elderly population (≥ 80 years). Methods: We conducted a retrospective observational single center study in the internal medicine ward of a tertiary hospital from November 1, 2020 to January 31, 2021. All COVID-19 patients aged over 65 years were enrolled. Results: Of the 824 patients with SARS-CoV-2 infection, 586 (71%) were aged above 65 years. Of them, 61.7% were very elderly and 32.9% were elderly. The hospital recorded 53 (27.5%) deaths in the elderly group and 182 (46.3%) in the over-80 group. In the elderly population, only 32 patients had critical illness compared to the 79 in the very elderly group. In addition to respiratory complications, acute kidney failure and liver dysfunction were noted. In both groups, mortality was higher when there was acute kidney injury (AKI). With respect to treatment, dexamethasone and azithromycin did not show a statistically significant difference between the groups. The need for oxygen therapy over 4L/min, high-flow therapy, and mechanical invasive ventilation was related to higher mortality in both groups. Conclusion: The very elderly group had a higher number of deaths compared to the elderly group due to multiple comorbidities. Respiratory failure was the most frequently occurring complication. Surprisingly, dexamethasone and azithromycin therapy did not show a statistically significant effect in both age groups despite their current widespread usage in COVID-19 treatment worldwide.
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Zhang L, Tao Y, Hou W, Niu H, Ma Z, Zheng Z, Wang S, Zhang S, Lv Y, Li Q, Liu X. Seeking bridge symptoms of anxiety, depression, and sleep disturbance among the elderly during the lockdown of the COVID-19 pandemic-A network approach. Front Psychiatry 2022; 13:919251. [PMID: 35990065 PMCID: PMC9381922 DOI: 10.3389/fpsyt.2022.919251] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/11/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Besides physical changes, elderly adults are prone to have mental disorders such as anxiety, depression, and sleep disturbance, and the pandemic of COVID-19 worsened the situation. However, internal relationships and co-occurrence of psychopathologies were scarcely examined. Therefore, in the current study, through network analysis, we inspected relationships among symptoms of depression, anxiety, and sleep disturbance and identified key symptoms that espoused the disease. METHODS We asked 1,302 elderly adults to fill in Patient Health Questionnaire-2 (depressive symptoms), the Generalized Anxiety Disorder-2 (anxiety symptoms), and the Youth Self-rating Insomnia Scale (sleep disturbance) and then constructed three networks for elderly adults, male elderly, and female elderly. Via network analysis, we accomplished four goals. First, we identified symptom with the highest centrality (i.e., strength) index for each network; then, we found the strongest correlation (i.e., edges) in each network; thirdly, we confirmed specific nodes that could bridge anxiety, depression, and sleep disturbance; the last was to compare networks based on genders. Network stability and accuracy tests were performed. RESULTS Networks of elderly adults, male elderly, and female elderly were stable, accurate, and intelligible. Among all networks, "Nervousness"- "Excessive worry" (GAD-1- GAD-2) had the strongest correlation, and "Nervousness" (GAD-1) had the highest strength and bridge strength value. When we made a comparison between female elderly's and male elderly's networks, except for the significant difference in the mean value of "Difficulty initiating sleep" (YSIS-3), the findings showed that the two networks were similar. Network stability and accuracy proved to be reliable. CONCLUSIONS In networks of anxiety, depression, and sleep disturbance, anxiety played a conspicuous role in comorbidity, which could be a target for practical intervention and prevention.
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Affiliation(s)
- Liang Zhang
- College Students' Mental Health Education Center, Northeast Agricultural University, Harbin, China.,College of Education for the Future, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Yanqiang Tao
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Wenxin Hou
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Haiqun Niu
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - Zijuan Ma
- School of Psychology, South China Normal University, Guangzhou, China
| | - Zeqing Zheng
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Shujian Wang
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Shuang Zhang
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yichao Lv
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Qiubai Li
- Political and Legal Committee of Xiangfang District, Harbin, China
| | - Xiangping Liu
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
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Mehta A, Kumar Ratre Y, Sharma K, Soni VK, Tiwari AK, Singh RP, Dwivedi MK, Chandra V, Prajapati SK, Shukla D, Vishvakarma NK. Interplay of Nutrition and Psychoneuroendocrineimmune Modulation: Relevance for COVID-19 in BRICS Nations. Front Microbiol 2021; 12:769884. [PMID: 34975797 PMCID: PMC8718880 DOI: 10.3389/fmicb.2021.769884] [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: 09/02/2021] [Accepted: 11/16/2021] [Indexed: 11/21/2022] Open
Abstract
The consequences of COVID-19 are not limited to physical health deterioration; the impact on neuropsychological well-being is also substantially reported. The inter-regulation of physical health and psychological well-being through the psychoneuroendocrineimmune (PNEI) axis has enduring consequences in susceptibility, treatment outcome as well as recuperation. The pandemic effects are upsetting the lifestyle, social interaction, and financial security; and also pose a threat through perceived fear. These consequences of COVID-19 also influence the PNEI system and wreck the prognosis. The nutritional status of individuals is also reported to have a determinative role in COVID-19 severity and convalescence. In addition to energetic demand, diet also provides precursor substances [amino acids (AAs), vitamins, etc.] for regulators of the PNEI axis such as neurotransmitters (NTs) and immunomodulators. Moreover, exaggerated immune response and recovery phase of COVID-19 demand additional nutrient intake; widening the gap of pre-existing undernourishment. Mushrooms, fresh fruits and vegetables, herbs and spices, and legumes are few of such readily available food ingredients which are rich in protein and also have medicinal benefits. BRICS nations have their influences on global development and are highly impacted by a large number of confirmed COVID-19 cases and deaths. The adequacy and access to healthcare are also low in BRICS nations as compared to the rest of the world. Attempt to combat the COVID-19 pandemic are praiseworthy in BRICS nations. However, large population sizes, high prevalence of undernourishment (PoU), and high incidence of mental health ailments in BRICS nations provide a suitable landscape for jeopardy of COVID-19. Therefore, appraising the interplay of nutrition and PNEI modulation especially in BRICS countries will provide better understanding; and will aid in combat COVID-19. It can be suggested that the monitoring will assist in designing adjunctive interventions through medical nutrition therapy and psychopsychiatric management.
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Affiliation(s)
- Arundhati Mehta
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | | | - Krishna Sharma
- Department of Psychology, Government Bilasa Girls Post Graduate Autonomous College, Bilaspur, India
| | - Vivek Kumar Soni
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | - Atul Kumar Tiwari
- Department of Zoology, Bhanwar Singh Porte Government Science College, Pendra, India
| | - Rajat Pratap Singh
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | - Mrigendra Kumar Dwivedi
- Department of Biochemistry, Government Nagarjuna Post Graduate College of Science, Raipur, India
| | - Vikas Chandra
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | | | - Dhananjay Shukla
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
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Clinical and Radiological Deterioration in a Case of Creutzfeldt-Jakob Disease following SARS-CoV-2 Infection: Hints to Accelerated Age-Dependent Neurodegeneration. Biomedicines 2021; 9:biomedicines9111730. [PMID: 34829958 PMCID: PMC8615966 DOI: 10.3390/biomedicines9111730] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 01/16/2023] Open
Abstract
Systemic inflammation and the host immune responses associated with certain viral infections may accelerate the rate of neurodegeneration in patients with Creutzfeldt–Jakob disease (CJD), a rare, transmissible neurodegenerative disease. However, the effects of the newly emerged SARS-CoV-2 infection on the pathogenesis of CJD are unknown. In this study, we describe the case of an elderly female patient with sporadic CJD that exhibited clinical deterioration with the emergence of seizures and radiological neurodegenerative progression following an infection with SARS-CoV-2 and severe COVID-19. Despite efforts to control the progression of the disease, a dismal outcome ensued. This report further evidences the age-dependent neurological effects of SARS-CoV-2 infection and proposes a vulnerability to CJD and increased CJD progression following COVID-19.
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Farag MA, Hamouda S, Gomaa S, Agboluaje AA, Hariri MLM, Yousof SM. Dietary Micronutrients from Zygote to Senility: Updated Review of Minerals' Role and Orchestration in Human Nutrition throughout Life Cycle with Sex Differences. Nutrients 2021; 13:nu13113740. [PMID: 34835995 PMCID: PMC8625354 DOI: 10.3390/nu13113740] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 12/15/2022] Open
Abstract
Micronutrients such as selenium, fluoride, zinc, iron, and manganese are minerals that are crucial for many body homeostatic processes supplied at low levels. The importance of these micronutrients starts early in the human life cycle and continues across its different stages. Several studies have emphasized the critical role of a well-balanced micronutrient intake. However, the majority of studies looked into or examined such issues in relation to a specific element or life stage, with the majority merely reporting the effect of either excess or deficiency. Herein, in this review, we will look in depth at the orchestration of the main element requirements across the human life cycle beginning from fertility and pregnancy, passing through infancy, childhood, adolescence, and reaching adulthood and senility, with insight on the interactions among them and underlying action mechanisms. Emphasis is given towards approaches to the role of the different minerals in the life cycle, associated symptoms for under- or overdoses, and typical management for each element, with future perspectives. The effect of sex is also discussed for each micronutrient for each life stage as literature suffice to highlight the different daily requirements and or effects.
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Affiliation(s)
- Mohamed A. Farag
- Department of Pharmacognosy, College of Pharmacy, Cairo University, Cairo 11562, Egypt
- Department of Chemistry, School of Sciences & Engineering, the American University in Cairo, New Cairo 11835, Egypt; (S.H.); (S.G.); (A.A.A.); (M.L.M.H.)
- Correspondence: (M.A.F.); (S.M.Y.)
| | - Samia Hamouda
- Department of Chemistry, School of Sciences & Engineering, the American University in Cairo, New Cairo 11835, Egypt; (S.H.); (S.G.); (A.A.A.); (M.L.M.H.)
| | - Suzan Gomaa
- Department of Chemistry, School of Sciences & Engineering, the American University in Cairo, New Cairo 11835, Egypt; (S.H.); (S.G.); (A.A.A.); (M.L.M.H.)
| | - Aishat A. Agboluaje
- Department of Chemistry, School of Sciences & Engineering, the American University in Cairo, New Cairo 11835, Egypt; (S.H.); (S.G.); (A.A.A.); (M.L.M.H.)
| | - Mohamad Louai M. Hariri
- Department of Chemistry, School of Sciences & Engineering, the American University in Cairo, New Cairo 11835, Egypt; (S.H.); (S.G.); (A.A.A.); (M.L.M.H.)
| | - Shimaa Mohammad Yousof
- Department of Medical Physiology, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Medical Physiology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
- Correspondence: (M.A.F.); (S.M.Y.)
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Montalti M, Di Valerio Z, Rallo F, Squillace L, Costantino C, Tomasello F, Mauro GL, Stillo M, Perrone P, Resi D, Gori D, Vitale F, Fantini MP. Attitudes toward the SARS-CoV-2 and Influenza Vaccination in the Metropolitan Cities of Bologna and Palermo, Italy. Vaccines (Basel) 2021; 9:vaccines9101200. [PMID: 34696308 PMCID: PMC8538834 DOI: 10.3390/vaccines9101200] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/15/2021] [Accepted: 10/16/2021] [Indexed: 11/27/2022] Open
Abstract
Vaccine hesitancy (VH) is known to play a relevant role in thwarting the efforts toward reaching satisfactory influenza vaccination coverage, and has caused similar difficulties during the COVID-19 pandemic. This study aims to describe the phenomenon and produce insights on the reasons behind VH. A survey was administered between December 2020 and February 2021 to adults living in the cities of Bologna and Palermo. Of the 443 subjects enrolled, 47.3% were likely to get the influenza vaccination, while 75.6% were willing to receive the COVID-19 vaccination. The most frequent determinants that motivated the willingness to get the COVID-19 vaccine were trust in the safety of vaccines and belief that the vaccine is an effective tool. As for people’s unwillingness to be vaccinated, being exposed to information that produced doubts about the vaccine and lack of trust in a newly developed vaccine were the most frequently involved determinants. Statistically significant positive associations were found between the willingness to be vaccinated and postgraduate education and the propensity towards influenza vaccination. A negative association with being over 40 years old and of female gender was also found. These results might have an impact in better understanding individual reasons behind VH, identifying which categories are more exposed to it and which strategies should be implemented.
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Affiliation(s)
- Marco Montalti
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
| | - Zeno Di Valerio
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
| | - Flavia Rallo
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
- Correspondence: ; Tel.: +39-051-209-4802
| | - Lorena Squillace
- Department of Public Health, Bologna Local Health Authority, 40124 Bologna, Italy; (L.S.); (M.S.); (P.P.); (D.R.)
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (F.T.); (F.V.)
| | - Francesco Tomasello
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (F.T.); (F.V.)
| | - Giulia Letizia Mauro
- Department of Surgical, Oncological, and Stomatological Sciences, University of Palermo, 90127 Palermo, Italy;
| | - Michela Stillo
- Department of Public Health, Bologna Local Health Authority, 40124 Bologna, Italy; (L.S.); (M.S.); (P.P.); (D.R.)
| | - Paola Perrone
- Department of Public Health, Bologna Local Health Authority, 40124 Bologna, Italy; (L.S.); (M.S.); (P.P.); (D.R.)
| | - Davide Resi
- Department of Public Health, Bologna Local Health Authority, 40124 Bologna, Italy; (L.S.); (M.S.); (P.P.); (D.R.)
| | - Davide Gori
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (C.C.); (F.T.); (F.V.)
| | - Maria Pia Fantini
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (M.M.); (Z.D.V.); (D.G.); (M.P.F.)
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37
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Gallè F, Sabella EA, Roma P, Ferracuti S, Da Molin G, Diella G, Montagna MT, Orsi GB, Liguori G, Napoli C. Knowledge and Lifestyle Behaviors Related to COVID-19 Pandemic in People over 65 Years Old from Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010872. [PMID: 34682618 PMCID: PMC8535846 DOI: 10.3390/ijerph182010872] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Control measures adopted during the COVID-19 pandemic had a considerable impact on human daily life and lifestyles. Adherence to the recommended measures is influenced by knowledge and attitudes towards the disease. This cross-sectional study aimed to assess the level of knowledge regarding COVID-19, the related control measures, and lifestyle behaviors adopted during the pandemic in a sample of elderly Italian people. METHODS A web-based questionnaire investigating socio-demographic characteristics, knowledge of COVID-19, the related preventive measures, and lifestyle changes that occurred during the pandemic, were distributed to ≥65 years old people living in South Italy. RESULTS A satisfactory level of knowledge about COVID-19 and the related control measures has been found in the enrolled sample. However, a decrease in physical activity, as well as worsening sleeping and dietary habits, were found in roughly 60% of participants. Females were impacted greater by these lifestyle changes. CONCLUSIONS Participants in this study showed a good level of knowledge regarding COVID-19 and its prevention. Nevertheless, they reported an increase in unhealthy habits that may have important health consequences in the long term and should be addressed by public health interventions targeted at older people.
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Affiliation(s)
- Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, Via Medina n. 40, 80133 Naples, Italy;
- Correspondence:
| | - Elita Anna Sabella
- Inter-University Research Centre “Population, Environment and Health”, University of Bari “Aldo Moro”, Piazza Umberto I, 1, 70121 Bari, Italy; (E.A.S.); (G.D.M.)
| | - Paolo Roma
- Department of Human Neurosciences, “Sapienza” University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (P.R.); (S.F.)
| | - Stefano Ferracuti
- Department of Human Neurosciences, “Sapienza” University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (P.R.); (S.F.)
| | - Giovanna Da Molin
- Inter-University Research Centre “Population, Environment and Health”, University of Bari “Aldo Moro”, Piazza Umberto I, 1, 70121 Bari, Italy; (E.A.S.); (G.D.M.)
| | - Giusy Diella
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (G.D.); (M.T.M.)
| | - Maria Teresa Montagna
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (G.D.); (M.T.M.)
| | - Giovanni Battista Orsi
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, Via Medina n. 40, 80133 Naples, Italy;
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy;
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38
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Hong D, Lee S, Choi YJ, Moon S, Jang Y, Cho YM, Lee H, Min S, Park H, Hahn S, Choi JY, Shin A, Kang D. The age-standardized incidence, mortality, and case fatality rates of COVID-19 in 79 countries: a cross-sectional comparison and their correlations with associated factors. Epidemiol Health 2021; 43:e2021061. [PMID: 34525501 PMCID: PMC8611321 DOI: 10.4178/epih.e2021061] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/08/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES During the coronavirus disease 2019 (COVID-19) pandemic, crude incidence and mortality rates have been widely reported; however, age-standardized rates are more suitable for comparisons. In this study, we estimated and compared the age-standardized incidence, mortality, and case fatality rates (CFRs) among countries and investigated the relationship between these rates and factors associated with healthcare resources: gross domestic product per capita, number of hospital beds per population, and number of doctors per population. METHODS The incidence, mortality, and CFRs of 79 countries were age-standardized using the World Health Organization standard population. The rates for persons 60 years or older were also calculated. The relationships among the rates were analysed using trend lines and coefficients of determination (R2). Pearson correlation coefficients between the rates and the healthcare resource-related factors were calculated. RESULTS The countries with the highest age-standardized incidence, mortality, and CFRs were Czechia (14,253 cases/100,000), Mexico (182 deaths/100,000), and Mexico (6.7%), respectively. The R2 between the incidence and mortality rates was 0.852 for all ages and 0.945 for those 60 years or older. The healthcare resources-related factors were associated positively with incidence rates and negatively with CFRs, with weaker correlations among the elderly. CONCLUSIONS Compared to age-standardized rates, crude rates showed greater variation among countries. Medical resources may be important in preventing COVID-19-related deaths; however, considering the small variation in fatality among the elderly, preventive measures such as vaccination are more important, especially for the elderly population, to minimize the mortality rates.
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Affiliation(s)
- Dongui Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea
| | - Sohyae Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea
| | - Yoon-Jung Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sungji Moon
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yoonyoung Jang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon-Min Cho
- Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Hyojung Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sukhong Min
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeree Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seokyung Hahn
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea.,Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ji-Yeob Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea
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