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Wu CH, Chang TH, Tan BF, Wu JL, Huang SM, Yen TY, Wu ET, Wang CC, Lin MT, Lu CY, Chang LY, Huang LM. Clinical manifestations and risk factors of shock in children with multisystem inflammatory syndrome. J Formos Med Assoc 2024; 123:496-500. [PMID: 37903693 DOI: 10.1016/j.jfma.2023.10.002] [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: 02/20/2023] [Revised: 09/14/2023] [Accepted: 10/01/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Multisystem inflammatory syndrome in children (MIS-C) is a novel disease associated with COVID-19. The COVID-19 epidemic peaked in May 2022 in Taiwan, and we encountered our first case of MIS-C in late May 2022. We aimed to present patients' clinical manifestations and identify risk factors for shock. METHODS We included patients diagnosed with MIS-C at two medical centers from May 2022 to August 2022. We separated those patients into two groups according to whether they experienced shock. We collected demographic, clinical manifestation, and laboratory data of the patients and performed statistical analysis between the two groups. RESULTS We enrolled 28 patients, including 13 (46 %) with shock and 15 (54 %) without shock. The median age was 6.4 years (IQR: 1.9-7.5). In single variable analysis, patients with shock tended to be older, had more neurological symptoms, more conjunctivitis and strawberry tongue, lower lymphocyte count, lower platelet counts, and higher C-reactive protein, higher procalcitonin, higher ferritin, and higher D-dimer levels than those without shock. The area under the ROC curve that used procalcitonin to be the risk factor of shock with MIS-C was 0.815 (95 % CI 0.644 to 0.987). The cutoff value obtained by ROC analysis of procalcitonin was 1.68 ng/mL. With this cutoff, the test characteristics of procalcitonin were as follows: sensitivity 77 %, specificity 93 %, positive predictive value 91 %, negative predictive value 82 %. Multivariable analysis revealed that procalcitonin was the only independent risk factor of shock with MIS-C on admission (OR, 26.00, 95 % CI, 1.01-668.89). CONCLUSIONS MIS-C patients with high initial procalcitonin levels have higher risks of experiencing shock and may need ICU admission.
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Affiliation(s)
- Chi-Hsien Wu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tu-Hsuan Chang
- Department of Pediatrics, Chi-Mei Medical Center, Tainan, Taiwan
| | - Boon-Fatt Tan
- Department of Pediatrics, National Taiwan University Hospital, Hsin-Chu Branch, Taiwan
| | - Jong-Lin Wu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Song-Ming Huang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ting-Yu Yen
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - En-Ting Wu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ching-Chia Wang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Min-Tai Lin
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chun-Yi Lu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Luan-Yin Chang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Li-Min Huang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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Yang CR, Chang SY, Gong YN, Huang CG, Tung TH, Liu W, Chan TC, Hung KS, Shang HS, Tsai JJ, Kao CL, Wu HL, Daisy Liu LY, Lin WY, Fan YC, King CC, Ku CC. The emergence and successful elimination of SARS-CoV-2 dominant strains with increasing epidemic potential in Taiwan's 2021 outbreak. Heliyon 2023; 9:e22436. [PMID: 38107297 PMCID: PMC10724543 DOI: 10.1016/j.heliyon.2023.e22436] [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: 10/22/2022] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 12/19/2023] Open
Abstract
Taiwan's experience with severe acute respiratory syndrome coronavirus (SARS-CoV) in 2003 guided its development of strategies to defend against SARS-CoV-2 in 2020, which enabled the successful control of Coronavirus disease 2019 (COVID-19) cases from 2020 through March 2021. However, in late-April 2021, the imported Alpha variant began to cause COVID-19 outbreaks at an exceptional rate in Taiwan. In this study, we aimed to determine what epidemiological conditions enabled the SARS-CoV-2 Alpha variant strains to become dominant and decline later during a surge in the outbreak. In conjunction with contact-tracing investigations, we used our bioinformatics software, CoVConvert and IniCoV, to analyze whole-genome sequences of 101 Taiwan Alpha strains. Univariate and multivariable regression analyses revealed the epidemiological factors associated with viral dominance. Univariate analysis showed the dominant Alpha strains were preferentially selected in the surge's epicenter (p = 0.0024) through intensive human-to-human contact and maintained their dominance for 1.5 months until the Zero-COVID Policy was implemented. Multivariable regression found that the epidemic periods (p = 0.007) and epicenter (p = 0.001) were two significant factors associated with the dominant virus strains spread in the community. These dominant virus strains emerged at the outbreak's epicenter with frequent human-to-human contact and low vaccination coverage. The Level 3 Restrictions and Zero-COVID policy successfully controlled the outbreak in the community without city lockdowns. Our integrated method can identify the epidemiological conditions for emerging dominant virus with increasing epidemiological potential and support decision makers in rapidly containing outbreaks using public health measures that target fast-spreading virus strains.
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Affiliation(s)
- Chin-Rur Yang
- Graduate Institute of Immunology, College of Medicine, National Taiwan University, 1 Jen-Ai Road Section 1, Taipei, 10051, Taiwan, ROC
| | - Sui-Yuan Chang
- Department (Dept.) of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan, ROC
- Dept. of Laboratory Medicine, National Taiwan University Hospital, Taipei, 10051, Taiwan, ROC
| | - Yu-Nong Gong
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan, ROC
- Dept. of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, 33302, Taiwan, ROC
| | - Chung-Guei Huang
- Dept. of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, 33302, Taiwan, ROC
- Dept. of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan, ROC
| | - Tsung-Hua Tung
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, NTU 17 Xu-Zhou Road, Taipei, 10055, Taiwan, ROC
- Dept. of Health, Taipei City Government, Taipei, Taiwan, ROC
| | - Wei Liu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, NTU 17 Xu-Zhou Road, Taipei, 10055, Taiwan, ROC
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, 11529, Taiwan, ROC
| | - Kuo-Sheng Hung
- Center for Precision Medicine and Genomics, Tri-Service General Hospital, National Defense Medical Center, Taipei, 11490, Taiwan, ROC
| | - Hung-Sheng Shang
- Division of Clinical Pathology, Dept. of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, 11490, Taiwan, ROC
| | - Jih-Jin Tsai
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan, ROC
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan, ROC
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan, ROC
| | - Chuan-Liang Kao
- Department (Dept.) of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan, ROC
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, NTU 17 Xu-Zhou Road, Taipei, 10055, Taiwan, ROC
| | - Hui-Lin Wu
- Hepatitis Research Center, National Taiwan University Hospital, Taipei, 10051, Taiwan, ROC
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan, ROC
| | - Li-Yu Daisy Liu
- Division of Biometry, Department of Agronomy, National Taiwan University, Taipei, 10617, Taiwan, ROC
| | - Wan-Yu Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, NTU 17 Xu-Zhou Road, Taipei, 10055, Taiwan, ROC
| | - Yi-Chin Fan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, NTU 17 Xu-Zhou Road, Taipei, 10055, Taiwan, ROC
| | - Chwan-Chuen King
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, NTU 17 Xu-Zhou Road, Taipei, 10055, Taiwan, ROC
| | - Chia-Chi Ku
- Graduate Institute of Immunology, College of Medicine, National Taiwan University, 1 Jen-Ai Road Section 1, Taipei, 10051, Taiwan, ROC
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Su YJ. COVID-19 Outbreak in Taiwan: Spring 2022. Asia Pac J Public Health 2023; 35:561-563. [PMID: 37752800 DOI: 10.1177/10105395231203117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Affiliation(s)
- Yu-Jang Su
- Toxicology Division, Department of Emergency Medicine, MacKay Memorial Hospital, Taipei
- Department of Medicine, MacKay Medical College, New Taipei City
- MacKay Junior College of Medicine, Nursing, and Management, Taipei City
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu
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Wu CF, Trac LVT, Chen SH, Menakanit A, Le QT, Tu HM, Tsou CP, Huang HC, Chookoh N, Weng CC, Chou LW, Chen CC. Enhancing human resilience beyond COVID-19-related stress: public responses to multi-benefits of home gardening. Sci Rep 2023; 13:10534. [PMID: 37386291 PMCID: PMC10310725 DOI: 10.1038/s41598-023-37426-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/21/2023] [Indexed: 07/01/2023] Open
Abstract
The SARS-CoV-2 virus has caused a public health crisis globally. Against the backdrop of global resilience, studies have demonstrated the therapeutic value of home gardening as a measure to strengthen human health. However, there is a lack of comparative studies on its benefits across countries. Studies need to examine the role of home gardening in improving public health in various societies to understand and encourage this practice broadly and effectively. We chose Taiwan, Thailand, and Vietnam as case studies, which have suffered substantial pandemic impacts, with millions of infections and thousands of deaths. We explored and compared the perceptions of people on home gardening and its health benefits during the COVID-19 pandemic. We conducted online surveys in three countries between May 1 and September 30, 2022, with a total of 1172 participants. Data were collated on perceived pandemic stress, challenges and solutions in gardening, home gardening intentions, and mental and physical health benefits. In these countries, we found that perceived pandemic stress positively affects home gardening intentions, whereby the motivation of Vietnamese people is the highest. Challenges hinder gardening intentions, while the solutions only positively affect gardening intentions in Taiwan and Vietnam. Home gardening intentions positively affect mental and physical health, whereby there are higher mental health benefits in Taiwanese people than in Thai people. Our findings potentially support public health recovery and promote healthy lifestyles during the COVID-19 pandemic.
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Affiliation(s)
- Chen-Fa Wu
- Department of Horticulture, National Chung Hsing University, Taichung City, 402, Taiwan
- Innovation and Development Center of Sustainable Agriculture, National Chung Hsing University, Taichung City, 402, Taiwan
| | - Luu Van Thong Trac
- Department of Horticulture, National Chung Hsing University, Taichung City, 402, Taiwan.
| | - Szu-Hung Chen
- International Master Program of Agriculture, National Chung Hsing University, Taichung City, 402, Taiwan.
| | - Alisara Menakanit
- Department of Horticulture, Kasetsart University, Bangkok, 10900, Thailand
| | - Quoc Tuan Le
- Department of Environmental Sciences, Faculty of Environment and Natural Resources, Nong Lam University - Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam
| | - Hung-Ming Tu
- Department of Horticulture, National Chung Hsing University, Taichung City, 402, Taiwan
- Innovation and Development Center of Sustainable Agriculture, National Chung Hsing University, Taichung City, 402, Taiwan
| | - Chih-Peng Tsou
- Department of Horticulture, National Chung Hsing University, Taichung City, 402, Taiwan
| | - Hsi-Chih Huang
- Department of Horticulture, National Chung Hsing University, Taichung City, 402, Taiwan
| | - Nittaya Chookoh
- Department of Horticulture, Kasetsart University, Bangkok, 10900, Thailand
| | - Chih-Cheng Weng
- Department of Horticulture, National Chung Hsing University, Taichung City, 402, Taiwan
- Miaoli Management Office, Irrigation Agency, Council of Agriculture, Executive Yuan, Miaoli County, 360, Taiwan
| | - Li-Wei Chou
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, 404332, Taiwan
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, 406040, Taichung, Taiwan
- Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung, 413505, Taiwan
| | - Chiu-Chuan Chen
- Department of Landscape Architecture, Chung Chou University of Science and Technology, Changhua County, 510, Taiwan
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Polwiang S. The lockdown and vaccination distribution in Thailand's COVID-19 epidemic: A model study. Infect Dis Model 2023; 8:551-561. [PMID: 37275749 PMCID: PMC10225064 DOI: 10.1016/j.idm.2023.05.002] [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: 11/08/2022] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/07/2023] Open
Abstract
Background Several countries used varied degrees of social isolation measures in response to the COVID-19 outbreak. In 2021, the lockdown in Thailand began on July 20 and lasted for the following six weeks. The lockdown has extremely detrimental effects on the economy and society, even though it may reduce the number of COVID-19 instances. Our goals are to assess the impact of the lockdown policy, the commencement time of lockdown, and the vaccination rate on the number of COVID-19 cases in Thailand in 2021. Methods We modeled the dynamics of COVID-19 in Thailand throughout 2021 using the SEIR model. The Google Mobility Index, vaccine distribution rate, and lockdown were added to the model. The Google Mobility Index represents the movement of individuals during a pandemic and shows how people react to lockdown. The model also examines the effect of vaccination rate on the incidence of COVID-19. Results The modeling approach demonstrates that a 6-week lockdown decreases the incidence number of COVID-19 by approximately 15.49-18.17%, depending on the timing of the lockdown compared to a non-lockdown scenario. An increasing vaccination rate potentially reduce the incidence number of COVID-19 by 5.12-18.35% without launching a lockdown. Conclusion Lockdowns can be an effective method to slow down the spread of COVID-19 when the vaccination program is not fully functional. When the vaccines are easily accessible on a large scale, the lockdown may terminated.
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Affiliation(s)
- Sittisede Polwiang
- Department of Mathematics, Faculty of Science, Silpakorn University, Nakhon Pathom, 73000, Thailand
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Chen SC, Huy LD, Lin CY, Lai CF, Nguyen NTH, Hoang NY, Nguyen TTP, Dang LT, Truong NLT, Phan TN, Duong TV. Association of Digital Health Literacy with Future Anxiety as Mediated by Information Satisfaction and Fear of COVID-19: A Pathway Analysis among Taiwanese Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15617. [PMID: 36497691 PMCID: PMC9736687 DOI: 10.3390/ijerph192315617] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/01/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
Digital Health Literacy (DHL) helps online users with navigating the infodemic and co-existing conspiracy beliefs to avoid mental distress and maintain well-being. We aimed to investigate the association between DHL and future anxiety (FA); and examine the potential mediation roles of information satisfaction and fear of COVID-19 (F-CoV). A web-based cross-sectional survey was carried out among 1631 Taiwanese university students aged 18 years and above from June 2021 to March 2022. Data collected were socio-demographic characteristics (sex, age, social status, university location), information satisfaction, F-CoV, DHL and FA (using Future Dark scale). The linear regression model was used to explore factors associated with FA. The pathway analysis was further used to evaluate the direct and indirect relationship between DHL and FA. A higher score of DHL (B = -0.21; 95% CI, -0.37, -0.06; p = 0.006), and information satisfaction (B = -0.16; 95% CI, -0.24, -0.08; p < 0.001) were associated with a lower FA score, whereas a higher F-CoV score was associated with a higher FA score (B = 0.43; 95% CI, 0.36, 0.50; p < 0.001). DHL showed the direct impact (B = -0.1; 95% CI, -0.17, -0.04; p = 0.002) and indirect impact on FA as mediated by information satisfaction (B = -0.04; 95% CI, -0.06, -0.01; p = 0.002) and F-CoV (B = -0.06, 95% CI, -0.08, -0.04; p < 0.001). Strategic approaches to promote DHL, information satisfaction, lower F-CoV are suggested to reduce FA among students.
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Affiliation(s)
- Sheng-Chih Chen
- Graduate Program of Digital Content and Technologies, College of Communication, National Chengchi University, Taipei 116-05, Taiwan
| | - Le Duc Huy
- Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue 491-20, Vietnam
| | - Cheng-Yu Lin
- Department of Radio, Television & Film, Shih Hsin University, Taipei 116-42, Taiwan
| | - Chih-Feng Lai
- Department of Education, National Taichung University of Education, Taichung 403-06, Taiwan
| | - Nhi Thi Hong Nguyen
- Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue 491-20, Vietnam
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei 110-31, Taiwan
| | - Nhi Y. Hoang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110-31, Taiwan
| | - Thao T. P. Nguyen
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue 491-20, Vietnam
| | - Loan T. Dang
- Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi 115-20, Vietnam
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112-19, Taiwan
| | - Nguyen L. T. Truong
- Pharmacy Department, School of Medicine, Vietnam National University, Ho Chi Minh City 700-00, Vietnam
- Pharmacy Department, Thong Nhat Hospital, Ho Chi Minh City 721-18, Vietnam
| | - Tan N. Phan
- Department of Tropical Diseases, Cho Ray Hospital, Ho Chi Minh City 727-13, Vietnam
- International Health Program, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112-304, Taiwan
| | - Tuyen Van Duong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110-31, Taiwan
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 110-31, Taiwan
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