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Spada MS, Biffi AM, Belotti L, Cremaschi L, Palumbo C, Locatelli C, Cesana BM, Bondi E. Psychological impact of COVID-19 after hospital discharge: A follow-up study on Italian recovered patients. J Affect Disord 2022; 317:84-90. [PMID: 36029882 PMCID: PMC9400369 DOI: 10.1016/j.jad.2022.08.086] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 05/31/2022] [Accepted: 08/22/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Since COVID-19 outbreak, clinical experience on its management during the acute phase has rapidly grown, including potential effects on the psychopathological dimension. However, still few data are available regarding the impact on survivors' mental health over the long-term. METHODS A sample of 1457 COVID-19 patients underwent a multidisciplinary follow-up protocol, approximately 3 months after hospital discharge, including a psychological evaluation. The primary outcomes were anxiety, depression, resilience, post-traumatic symptoms, and health-related quality of life. Furthermore, we examined the potential role of hospitalization and delay in the follow-up assessment on the increased burden of illness. RESULTS Although a general high level of resilience emerged, suggesting most patients relied on their individual and interpersonal resources to face difficulties related to the pandemic, almost one third of the sample reported signs of psychological distress over time, especially post-traumatic symptoms, with anxiety being more represented than depression. Furthermore, hospitalization - regardless of the setting of care - and promptness in follow-up evaluation were found to play a protective role on patients' recovery and mental wellbeing. LIMITATIONS Selection bias of patients exclusively admitted to the hospital; absence of a control group; psychological assessment relying on self-reported instruments. CONCLUSIONS The current crisis demands resilience and adjustment resources, either in the acute and post-acute phase. Thus, the clinical effort should aim at relieving the traumatic impact of such condition through timely interventions. Further investigation may address potential predictors of developing a traumatic stress response, in order to identify and promptly treat at-risk subpopulations.
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Affiliation(s)
| | - Ave Maria Biffi
- Department of Psychology, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Luca Belotti
- Department of Psychology, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Laura Cremaschi
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
| | - Claudia Palumbo
- Department of Psychiatry, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Clara Locatelli
- Department of Psychiatry, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Bruno Mario Cesana
- Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometry and Bioinformatics “Giulio A. Maccacaro”, Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Emi Bondi
- Department of Psychiatry, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
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Abstract
BACKGROUND In influenza epidemiology, analysis of paired sera collected from people before and after influenza seasons has been used for decades to study the cumulative incidence of influenza virus infections in populations. However, interpretation becomes challenging when sera are collected after the start or before the end of an epidemic, and do not neatly bracket the epidemic. METHODS Serum samples were collected longitudinally in a community-based study. Most participants provided their first serum after the start of circulation of influenza A(H1N1)pdm09 virus in 2009. We developed a Bayesian hierarchical model to correct for nonbracketing sera and estimate the cumulative incidence of infection from the serological data and surveillance data in Hong Kong. RESULTS We analyzed 4,843 sera from 2,097 unvaccinated participants in the study, collected from April 2009 to December 2010. After accounting for nonbracketing, we estimated that the cumulative incidence of H1N1pdm09 virus infection was 45% (95% credible interval [CI] = 40%, 49%), 17% (95% CI = 13%, 20%), and 11% (95% CI = 6%, 18%) for children ages 0-18 years, adults 19-50 years, and older adults >50 years, respectively. Including all available data substantially increased precision compared with a simpler analysis based only on sera collected at 6-month intervals in a subset of participants. CONCLUSIONS We developed a framework for the analysis of antibody titers that accounted for the timing of sera collection with respect to influenza activity and permitted robust estimation of the cumulative incidence of infection during an epidemic.
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Garraud O, Heshmati F, Pozzetto B, Lefrere F, Girot R, Saillol A, Laperche S. Plasma therapy against infectious pathogens, as of yesterday, today and tomorrow. Transfus Clin Biol 2016; 23:39-44. [PMID: 26775794 PMCID: PMC7110444 DOI: 10.1016/j.tracli.2015.12.003] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Indexed: 12/20/2022]
Abstract
Plasma therapy consists in bringing to a patient in need – in general suffering a severe, resistant to current therapy, and even lethal infection – plasma or specific, fractioned, antibodies, along with other immunoglobulins and possibly healing factors that can be obtained from immunized blood donors; donors (voluntary and benevolent) can be either actively immunized individuals or convalescent persons. Plasma therapy has been used since the Spanish flu in 1917–1918, and regularly then when viral epidemics threatened vulnerable populations, the last reported occurrence being the 2013–2015 Ebola virus outbreak in West Africa. The precise action mechanism of plasma therapy is not fully delineated as it may function beyond purified, neutralizing antibodies.
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Affiliation(s)
- O Garraud
- Faculté de médecine de Saint-Étienne, université de Lyon, 42023 Saint-Étienne, France; Institut national de la transfusion sanguine, 75015 Paris, France.
| | - F Heshmati
- Hôpital Cochin, Assistance publique des Hôpitaux de Paris, 75005 Paris, France
| | - B Pozzetto
- Faculté de médecine de Saint-Étienne, université de Lyon, 42023 Saint-Étienne, France; Laboratoire des agents infectieux et d'hygiène, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - F Lefrere
- Groupe Necker-Enfants malades, Assistance publique des Hôpitaux de Paris, 75015, Paris, France
| | - R Girot
- Hôpital Tenon, Assistance publique des Hôpitaux de Paris, 75020 Paris, France; Université Pierre-et-Marie-Curie-Paris 6, 75005 Paris, France
| | - A Saillol
- Centre de transfusion sanguine des armées, 92140 Clamart, France
| | - S Laperche
- Institut national de la transfusion sanguine, 75015 Paris, France
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Cross species influenza: emerging zoonosis. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2014; 4:S642-S643. [PMID: 32289027 PMCID: PMC7128874 DOI: 10.1016/s2222-1808(14)60696-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 03/09/2014] [Accepted: 08/08/2014] [Indexed: 11/25/2022]
Abstract
Emerging infection is usually an important public health concern. Within the past decade, there are many new emerging infectious diseases. An important concern is on the pandemic of those new emerging infections. The cross species infection from animal to human, zoonosis, is usually problematic and hard to manage. The well-known situations are on new emerging atypical influenza infections. In this brief article, the author discuss on three important cross species emerging influenza, H5N1 bird flu, H1N1 swine flu and H7N9 bird flu. The basic details of those new influenzas genetic aberration and the concept for surveillance and prediction of new mutation that result in the new cross species emerging zoonosis are also mentioned in this article.
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Tsang TK, Cauchemez S, Perera RAPM, Freeman G, Fang VJ, Ip DKM, Leung GM, Malik Peiris JS, Cowling BJ. Association between antibody titers and protection against influenza virus infection within households. J Infect Dis 2014; 210:684-92. [PMID: 24676208 DOI: 10.1093/infdis/jiu186] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Previous studies have established that antibody titer measured by the hemagglutination-inhibiting (HAI) assay is correlated with protection against influenza virus infection, with an HAI titer of 1:40 generally associated with 50% protection. METHODS We recruited index cases with confirmed influenza virus infection from outpatient clinics, and followed up their household contacts for 7-10 days to identify secondary infections. Serum samples collected from a subset of household contacts were tested by HAI and microneutralization (MN) assays against prevalent influenza viruses. We analyzed the data using an individual hazard-based transmission model that adjusted for age and vaccination history. RESULTS Compared to a reference group with antibody titers <1:10, we found that HAI titers of 1:40 against influenza A(H1N1) and A(H3N2) were associated with 31% (95% confidence interval [CI], 13%-46%) and 31% (CI, 1%-53%) protection against polymerase chain reaction (PCR)-confirmed A(H1N1) and A(H3N2) virus infection, respectively, while an MN titer of 1:40 against A(H3N2) was associated with 49% (95% CI, 7%-81%) protection against PCR-confirmed A(H3N2) virus infection. CONCLUSIONS An HAI titer of 1:40 was associated with substantially less than 50% protection against PCR-confirmed influenza virus infection within households, perhaps because of exposures of greater duration or intensity in that confined setting.
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Affiliation(s)
- Tim K Tsang
- Division of Epidemiology and Biostatistics, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France
| | - Ranawaka A P M Perera
- Division of Public Health Laboratory Sciences, School of Public Health Centre of Influenza Research
| | - Guy Freeman
- Division of Epidemiology and Biostatistics, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Vicky J Fang
- Division of Epidemiology and Biostatistics, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Dennis K M Ip
- Division of Community Medicine and Public Health Practice, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Gabriel M Leung
- Division of Community Medicine and Public Health Practice, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | | | - Benjamin J Cowling
- Division of Epidemiology and Biostatistics, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Pamaran RR, Kamigaki T, Hewe TT, Flores KMC, Mercado ES, Alday PP, Tan AG, Oshitani H, Olveda RM, Tallo VL. Epidemiological characterization of influenza A(H1N1)pdm09 cases from 2009 to 2010 in Baguio City, the Philippines. PLoS One 2013; 8:e79916. [PMID: 24244578 PMCID: PMC3823603 DOI: 10.1371/journal.pone.0079916] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 09/27/2013] [Indexed: 11/18/2022] Open
Abstract
Background Baguio City, Philippines experienced its first influenza A(H1N1)pdm09 [A(H1)pdm09] case in May 2009. In spite of numerous reports describing the epidemiological and clinical features of A(H1)pdm09 cases, there are no studies about A(H1)pdm09 epidemiology in the Philippines, where year-round influenza activity was observed. Objectives We aimed to investigate the epidemiological and clinical features of A(H1)pdm09 in pandemic and post-pandemic periods. Methods Data were collected under enhanced surveillance of influenza-like illness (ILI) and severe acute respiratory infection (SARI) from January 2009 to December 2010. RT-PCR was used to detect A(H1)pdm09, following the protocol of the United States Centers for Disease Control and Prevention. The reproduction number was computed as a simple exponential growth rate. Differences in proportional and categorical data were examined using chi-square test or Fishers’ exact test. Results and Conclusions The outbreak was observed from week 25 to 35 in 2009 and from week 24 to 37 in 2010. The highest proportion of cases was among children aged 5–14 years. The number of ILI outpatients was 2.3-fold higher in 2009 than in 2010, while the number of inpatients was 1.8-fold higher in 2009. No significant difference in gender was observed during the two periods. The clinical condition of all patients was generally mild and self-limiting, with only 2 mortalities among inpatients in 2009. The basic reproduction number was estimated as 1.16 in 2009 and 1.05 in 2010 in the assumption of mean generation time as 2.6 days. School children played a significant role in facilitating influenza transmission.
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Affiliation(s)
| | - Taro Kamigaki
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
- * E-mail:
| | | | | | | | - Portia P. Alday
- Research Institute of Tropical Medicine, Manila, Philippines
| | - Alvin G. Tan
- Research Institute of Tropical Medicine, Manila, Philippines
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Mizumoto K, Nishiura H, Yamamoto T. Effectiveness of antiviral prophylaxis coupled with contact tracing in reducing the transmission of the influenza A (H1N1-2009): a systematic review. Theor Biol Med Model 2013; 10:4. [PMID: 23324555 PMCID: PMC3563494 DOI: 10.1186/1742-4682-10-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 01/14/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND During the very early stage of the 2009 pandemic, mass chemoprophylaxis was implemented as part of containment measure. The purposes of the present study were to systematically review the retrospective studies that investigated the effectiveness of antiviral prophylaxis during the 2009 pandemic, and to explicitly estimate the effectiveness by employing a mathematical model. METHODS A systematic review identified 17 articles that clearly defined the cases and identified exposed individuals based on contact tracing. Analysing a specific school-driven outbreak, we estimated the effectiveness of antiviral prophylaxis using a renewal equation model. Other parameters, including the reproduction number and the effectiveness of antiviral treatment and school closure, were jointly estimated. RESULTS Based on the systematic review, median secondary infection risks (SIRs) among exposed individuals with and without prophylaxis were estimated at 2.1% (quartile: 0, 12.2) and 16.6% (quartile: 8.4, 32.4), respectively. A very high heterogeneity in the SIR was identified with an estimated I2 statistic at 71.8%. From the outbreak data in Madagascar, the effectiveness of mass chemoprophylaxis in reducing secondary transmissions was estimated to range from 92.8% to 95.4% according to different model assumptions and likelihood functions, not varying substantially as compared to other parameters. CONCLUSIONS Only based on the meta-analysis of retrospective studies with different study designs and exposure settings, it was not feasible to estimate the effectiveness of antiviral prophylaxis in reducing transmission. However, modelling analysis of a single outbreak successfully yielded an estimate of the effectiveness that appeared to be robust to model assumptions. Future studies should fill the data gap that has existed in observational studies and allow mathematical models to be used for the analysis of meta-data.
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Affiliation(s)
- Kenji Mizumoto
- School of Public Health, The University of Hong Kong, 100 Cyberport Road, Pokfulam, Hong Kong, China
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The Pandemic H1N1 Influenza Experience. Curr Top Microbiol Immunol 2013. [DOI: 10.1007/978-3-662-45792-4_309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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