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Gao Y, Feng X, Yuan T, Li M, Wei M, Li S. Post-pandemic trends: Epidemiological and etiological insights into acute respiratory infections in southern China. Diagn Microbiol Infect Dis 2024; 109:116293. [PMID: 38598951 DOI: 10.1016/j.diagmicrobio.2024.116293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 04/12/2024]
Abstract
Data on people suspected with acute respiratory infections (ARIs) from August 2022 to December 2023 in southern China were analyzed. Following the COVID-19 pandemic, the positive detection rates of respiratory pathogens increased to 56.9%. Influenza A virus (IAV) emerged as the predominant prevalence pathogen (52.1%), followed by Mycoplasma pneumoniae (Mp: 21.2%), and SARS-CoV-2 (11.6%). Mp, IAV, and Human rhinovirus (HRV) infection were the primary etiologies of ARIs patients under age 18, accounting for 49.4%, 48.6%, and 21.7%, respectively. Mp, HRV, Respiratory syncytial virus (RSV), and Adenovirus (ADV) contributed to ARIs cases in virtually every month in this group, with Mp being particularly notable for its consistent presence and high co-infection rate (31.0%). IAV was predominant in the 19 to 59 age group (88.6%), SARS-CoV-2 was responsible for most of ARIs in the elderly group (82.5%). This study provides valuable insights into the dynamic nature of respiratory pathogens post COVID-19 era.
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Affiliation(s)
- Yuquan Gao
- Department of Laboratory Medicine, Ningbo Hospital, Ren Ji Hospital, Shanghai Jiao Tong University School of medicine, Ningbo Hangzhou Bay Hospital, Ningbo, Zhejiang, PR China
| | - Xudong Feng
- Department of Clinical Laboratory, Ningbo Medical Center Lihuili Hospital, Affiliated Lihuili Hospital of Ningbo University, Ningbo, PR China
| | - Ting Yuan
- Department of Laboratory Medicine, Ningbo Hospital, Ren Ji Hospital, Shanghai Jiao Tong University School of medicine, Ningbo Hangzhou Bay Hospital, Ningbo, Zhejiang, PR China; Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Min Li
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Muyun Wei
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Shuangshuang Li
- Department of Laboratory Medicine, Ningbo Hospital, Ren Ji Hospital, Shanghai Jiao Tong University School of medicine, Ningbo Hangzhou Bay Hospital, Ningbo, Zhejiang, PR China; Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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2
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Wei M, Li S, Lu X, Hu K, Li Z, Li M. Changing respiratory pathogens infection patterns after COVID-19 pandemic in Shanghai, China. J Med Virol 2024; 96:e29616. [PMID: 38634514 DOI: 10.1002/jmv.29616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/21/2024] [Accepted: 04/08/2024] [Indexed: 04/19/2024]
Abstract
To assess the positive rate of 11 respiratory pathogens in 2023, providing a comprehensive summary and analysis of the respiratory infection patterns after COVID-19 pandemic. The study comprised 7544 inpatients suspected of respiratory infections who underwent respiratory pathogen multiplex polymerase chain reaction tests from July 2022 to December 31, 2023. We analyzed the positive rate of 11 pathogens over 18 months and the characterization of infection patterns among different age groups and immune states. Among 7544 patients (age range 4 months to 104 years, 44.99% female), the incidence of infected by at least one of the 11 pathogens was 26.07%. Children (55.18%, p < 0.05) experienced a significantly higher infection probability than adults (20.88%) and old (20.66%). Influenza A virus (8.63%), Mycoplasma pneumoniae (5.47%), and human rhinovirus (5.12%) were the most common pathogens. In children, M. pneumoniae (35.96%) replaced the predominant role of human respiratory syncytial virus (HRSV) (5.91%) in the pathogen spectrum. Age, immunosuppressed state, and respiratory chronic conditions were associated with a significantly higher risk of mixed infection. Immunosuppressed patients were more vulnerable to human coronavirus (4.64% vs. 1.65%, p < 0.05), human parainfluenza virus (3.46% vs. 1.69%, p < 0.05), and HRSV (2.27% vs. 0.55%, p < 0.05). Patterns in respiratory infections changed following regional epidemic control measures and the COVID-19 pandemic.
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Affiliation(s)
- Muyun Wei
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuangshuang Li
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinhua Lu
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kaiming Hu
- Department of Laboratory Medicine, Chaohu Hospital, Anhui Medical University, Hefei, China
| | - Zhilan Li
- Department of Laboratory Medicine, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Li
- Department of Laboratory Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Maiti AK. Therapeutic Challenges in COVID-19. Curr Mol Med 2024; 24:14-25. [PMID: 36567277 DOI: 10.2174/1566524023666221222162641] [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: 09/02/2022] [Revised: 10/18/2022] [Accepted: 11/10/2022] [Indexed: 12/27/2022]
Abstract
SARS-CoV2 is a novel respiratory coronavirus and, understanding its molecular mechanism is a prerequisite to developing effective treatment for COVID-19. This RNA genome-carrying virus has a protein coat with spikes (S) that attaches to the ACE2 receptor at the cell surface of human cells. Several repurposed drugs are used to treat COVID-19 patients that are proven to be largely unsuccessful or have limited success in reducing mortalities. Several vaccines are in use to reduce the viral load to prevent developing symptoms. Major challenges to their efficacy include the inability of antibody molecules to enter cells but remain effective in the bloodstream to kill the virus. The efficacy of vaccines also depends on their neutralizing ability to constantly evolve new virus strains due to novel mutations and evolutionary survival dynamics. Taken together, SARS-CoV2 antibody vaccines may not be very effective and other approaches based on genetic, genomic, and protein interactome could be fruitful to identify therapeutic targets to reduce disease-related mortalities.
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Affiliation(s)
- Amit K Maiti
- Department of Genetics and Genomics, Mydnavar, 28475 Greenfield Rd, Southfield MI 48076, USA
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Gertz A, Rader B, Sewalk K, Varrelman TJ, Smolinski M, Brownstein JS. Decreased Seasonal Influenza Rates Detected in a Crowdsourced Influenza-Like Illness Surveillance System During the COVID-19 Pandemic: Prospective Cohort Study. JMIR Public Health Surveill 2023; 9:e40216. [PMID: 38153782 PMCID: PMC10784978 DOI: 10.2196/40216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/24/2023] [Accepted: 11/14/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Seasonal respiratory viruses had lower incidence during their 2019-2020 and 2020-2021 seasons, which overlapped with the COVID-19 pandemic. The widespread implementation of precautionary measures to prevent transmission of SARS-CoV-2 has been seen to also mitigate transmission of seasonal influenza. The COVID-19 pandemic also led to changes in care seeking and access. Participatory surveillance systems have historically captured mild illnesses that are often missed by surveillance systems that rely on encounters with a health care provider for detection. OBJECTIVE This study aimed to assess if a crowdsourced syndromic surveillance system capable of detecting mild influenza-like illness (ILI) also captured the globally observed decrease in ILI in the 2019-2020 and 2020-2021 influenza seasons, concurrent with the COVID-19 pandemic. METHODS Flu Near You (FNY) is a web-based participatory syndromic surveillance system that allows participants in the United States to report their health information using a brief weekly survey. Reminder emails are sent to registered FNY participants to report on their symptoms and the symptoms of household members. Guest participants may also report. ILI was defined as fever and sore throat or fever and cough. ILI rates were determined as the number of ILI reports over the total number of reports and assessed for the 2016-2017, 2017-2018, 2018-2019, 2019-2020, and 2020-2021 influenza seasons. Baseline season (2016-2017, 2017-2018, and 2018-2019) rates were compared to the 2019-2020 and 2020-2021 influenza seasons. Self-reported influenza diagnosis and vaccination status were captured and assessed as the total number of reported events over the total number of reports submitted. CIs for all proportions were calculated via a 1-sample test of proportions. RESULTS ILI was detected in 3.8% (32,239/848,878) of participants in the baseline seasons (2016-2019), 2.58% (7418/287,909) in the 2019-2020 season, and 0.27% (546/201,079) in the 2020-2021 season. Both influenza seasons that overlapped with the COVID-19 pandemic had lower ILI rates than the baseline seasons. ILI decline was observed during the months with widespread implementation of COVID-19 precautions, starting in February 2020. Self-reported influenza diagnoses decreased from early 2020 through the influenza season. Self-reported influenza positivity among ILI cases varied over the observed time period. Self-reported influenza vaccination rates in FNY were high across all observed seasons. CONCLUSIONS A decrease in ILI was detected in the crowdsourced FNY surveillance system during the 2019-2020 and 2020-2021 influenza seasons, mirroring trends observed in other influenza surveillance systems. Specifically, the months within seasons that overlapped with widespread pandemic precautions showed decreases in ILI and confirmed influenza. Concerns persist regarding respiratory pathogens re-emerging with changes to COVID-19 guidelines. Traditional surveillance is subject to changes in health care behaviors. Systems like FNY are uniquely situated to detect disease across disease severity and care seeking, providing key insights during public health emergencies.
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Affiliation(s)
- Autumn Gertz
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA, United States
| | - Benjamin Rader
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA, United States
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Kara Sewalk
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA, United States
| | - Tanner J Varrelman
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA, United States
| | | | - John S Brownstein
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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Rodríguez JP, Eguíluz VM. Coupling between infectious diseases leads to synchronization of their dynamics. CHAOS (WOODBURY, N.Y.) 2023; 33:021103. [PMID: 36859206 DOI: 10.1063/5.0137380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/04/2023] [Indexed: 06/18/2023]
Abstract
Interactions between different diseases may change their dynamics. Thus, these interactions represent a source of uncertainty in the modeling of empirical data when the symptoms of both infections are hard to distinguish. We recall previously proposed models of interacting infections, generalizing them to non-symmetric scenarios, showing that both cooperative and competitive interactions lead to synchronization of the maximum fraction of infected individuals in their dynamics. We exemplify this framework with a model coupling the dynamics of COVID-19 and seasonal influenza, simulating cooperation, competition, and asymmetric interactions. We find that the coupling synchronizes both infections, with a stronger influence on the dynamics of influenza.
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Affiliation(s)
- Jorge P Rodríguez
- Instituto Mediterráneo de Estudios Avanzados (IMEDEA), CSIC-UIB, 07190 Esporles, Spain
| | - Víctor M Eguíluz
- Instituto de Física Interdisciplinar y Sistemas Complejos (IFISC), CSIC-UIB, 07122 Palma de Mallorca, Spain
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Prognosis of Myocarditis Developing After mRNA COVID-19 Vaccination Compared With Viral Myocarditis. J Am Coll Cardiol 2022; 80:2255-2265. [PMID: 36480967 PMCID: PMC9721305 DOI: 10.1016/j.jacc.2022.09.049] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/23/2022] [Accepted: 09/30/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Association between messenger RNA (mRNA) COVID-19 vaccines and myocarditis has aroused public concern over vaccine safety. OBJECTIVES The goal of this study was to compare the prognosis of this condition with viral infection-related myocarditis over 180 days. METHODS A territory-wide electronic public health care database in Hong Kong linked with population-based vaccination records was used to conduct a retrospective cohort study. Since the roll-out of BNT162b2 (Pfizer-BioNTech), patients aged ≥12 years hospitalized with myocarditis within 28 days after BNT162b2 vaccination were compared against viral infection-related myocarditis recorded before the pandemic (2000-2019), over a 180-day follow-up period (starting from diagnosis of myocarditis). All-cause mortality, heart failure, dilated cardiomyopathy, heart transplant, and postdischarge health care utilization were examined with Cox proportional hazards models. RESULTS A total of 866 patients were included for analysis. Over the follow-up period, 1 death (1.0%) of 104 patients with postvaccination myocarditis and 84 deaths (11.0%) of 762 patients with viral infection-related myocarditis were identified. One case (1.0%) of dilated cardiomyopathy and 2 cases (1.9%) of heart failure were identified in the postvaccination group, compared with 28 (3.7%) and 93 (12.2%) in the viral infection-related myocarditis group, respectively. Adjusted analysis showed that the postvaccination myocarditis group had a 92% lower mortality risk (adjusted HR: 0.08; 95% CI: 0.01-0.57). No significant differences in other prognostic outcomes were seen. CONCLUSIONS This study found a significantly lower rate of mortality among individuals with myocarditis after mRNA vaccination compared with those with viral infection-related myocarditis. Prognosis of this iatrogenic condition may be less severe than naturally acquired viral infection-related myocarditis.
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Wong KL, Wong WHS, Yau YS, Lee SL, Chiu SSS. Asthma admission among children in Hong Kong during the first year of the COVID-19 pandemic. Pediatr Pulmonol 2022; 57:3104-3110. [PMID: 36097891 DOI: 10.1002/ppul.26141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/17/2022] [Accepted: 09/11/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Multiple nonpharmaceutical interventions (NPIs) had been introduced in Hong Kong during coronavirus disease 2019 (COVID-19) pandemic. The impact on asthma admission, which was closely related to viral infection, was of concern. OBJECTIVE The study aimed to identify the impact of NPIs on pediatric asthma admissions and their association with respiratory viruses. METHODS We conducted a retrospective observational study to compare the difference in pediatric asthma hospital admission rates between pre-COVID-19 and COVID-19 periods. Information on demographics, nasopharyngeal specimen results, ventilatory support, intensive care admission, hospital stay duration, asthma control therapy, and previous admission episodes was collected. Weather parameters including temperature, rainfall, humidity, and air quality data that was reflected by the air quality health index were recorded. RESULTS A total of 1808 pediatric asthma admissions were recorded during the pre-COVID-19 period while there were 62 admissions during COVID-19 period, among which 54 admissions from the pre-COVID-19 period and 4 admissions from COVID-19 period were excluded. Weekly pediatric asthma admissions per total pediatric admissions during COVID-19 was one-third of that during the pre-COVID-19 period (0.3% vs. 0.9%, p < 0.001). During COVID-19 period, a significantly lower percentage of respiratory virus isolates was noted (58.6% vs. 72.6%, p = 0.019). Poisson regression analysis showed that the COVID-19 period (odds ratio [OR] = 0.202, 95% confidence interval [CI, 0.16-0.26]; p ≤ 0.001), summer vacation period (OR = 0.512, 95% CI [0.43-0.62]; p ≤ 0.001), and humidity (OR = 0.99, 95% CI [0.98-1.00]; p = 0.004) were independent protective factors for asthma admission. CONCLUSIONS There was a significant reduction in pediatric asthma hospitalizations and respiratory virus isolates in the first year of COVID-19 pandemic in Hong Kong with the implementation of NPIs. Rhinovirus remained the key respiratory virus isolate. Incorporation of appropriate NPIs in long run could reduce virus infection-related pediatric asthma admission.
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Affiliation(s)
- K L Wong
- Department of Paediatrics, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Wilfred H S Wong
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Y S Yau
- Department of Paediatrics, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - S L Lee
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Susan S S Chiu
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
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Jacob AS, Kaul H, Fuchs M, Gillessen S, Kreissl S, Pluetschow A, Momotow J, Schaub V, Huettmann A, Haenel M, Zimmermann A, Dierlamm J, Meissner J, Mathas S, Martin S, Engert A, Hallek M, Borchmann P, Lehmann C. Impact of the first COVID-19 lockdown in Germany on the rate of acute infections during intensive chemotherapy for Hodgkin lymphoma. Infection 2022; 50:925-932. [PMID: 35182355 PMCID: PMC8857743 DOI: 10.1007/s15010-022-01765-3] [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: 11/23/2021] [Accepted: 01/28/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE Evidence on the effect of self-protection via social distancing and wearing face-masks on infections during chemotherapy is currently not available. We asked if the occurrence of acute infections during chemotherapy for advanced-stage Hodgkin lymphoma (HL) decreased when COVID-19 protection measures were in effect. METHODS We analyzed the occurrence of infections during all documented eBEACOPP cycles starting between 01 March and 30 June of 2017 to 2020 in patients treated within the GHSG HD21 study in Germany and compared the infection rates and characteristics by logistic regression models and means of descriptive statistics. RESULTS We analyzed 911 cycles of 313 adult patients treated with 4 to 6 cycles of eBEACOPP. We found a significant decrease in the occurrence of infections during chemotherapy for HL during COVID-19 lockdown from 131 (19.6%) of 670 cycles in 2017-2019 to 30 (12.6%) of 239 cycles during COVID-19 lockdown [OR 0.574 (95% CI 0.354-0.930), P = 0.024]. The strongest effect was evident for unspecified infections with 39 cycles (5.8%) during 2017-2019 in comparison to 5 cycles (2.1%) during COVID-19 lockdown. 20 (24.1%) of 83 patients had an infection during the COVID-19 lockdown versus 99 (43.2%) of 229 patients in the years 2017-2019 (P = 0.0023). CONCLUSION The significant decrease of infections during chemotherapy for HL during COVID-19 lockdown reveals the protective measures' potential to shield patients from transmissible pathogens. We conclude that these measures could be recommended for HL patients at risk for infections during chemotherapy.
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Affiliation(s)
- Anne Sophie Jacob
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany
| | - Helen Kaul
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany
| | - Michael Fuchs
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany
| | - Sarah Gillessen
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany
| | - Stefanie Kreissl
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany
| | - Annette Pluetschow
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany
| | - Jesko Momotow
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany
| | - Valdete Schaub
- Eberhard-Karls-Universität-Universitätsklinik Tübingen, Inneren Medizin II, Tübingen, Germany
| | - Andreas Huettmann
- Universitätsklinik Essen, Klinik Für Hämatologie/WTZ Ambulanz, Essen, Germany
| | - Mathias Haenel
- Klinikum Chemnitz, Krankenhaus Küchwald, Klinik Für Innere Medizin III/Studiensekretariat, Chemnitz, Germany
| | - Andreas Zimmermann
- Medizinische Klinik Und Poliklinik III, Klinikum Der Universität München, LMU München, Munich, Germany
| | - Judith Dierlamm
- Abt. Hämatologie/Onkologie, Onkologisches Zentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Meissner
- Universitätsklinikum Heidelberg, Medizinische Klinik Und Poliklinik V, Heidelberg, Germany
| | - Stephan Mathas
- Charite Campus Benjamin Franklin, Universitätsmedizin Berlin, Hämatologie, Onkologie u. Tumorimmunologie, Berlin, Germany
| | - Sonja Martin
- Robert-Bosch-Krankenhaus Stuttgart, Innere Medizin II, Hämatologie/Onkologie, Stuttgart, Germany
| | - Andreas Engert
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany
| | - Michael Hallek
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, Center for Molecular Medicine Cologne, Cologne, Germany
| | - Peter Borchmann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
- German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany.
| | - Clara Lehmann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, Center for Molecular Medicine Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Bonn-Cologne, Cologne, Germany
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Froese H, A Prempeh AG. Mask Use to Curtail Influenza in a Post-COVID-19 World: Modeling Study. JMIRX MED 2022; 3:e31955. [PMID: 35666696 PMCID: PMC9153293 DOI: 10.2196/31955] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/04/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022]
Abstract
Background Face mask mandates have been instrumental in the reduction of transmission of airborne COVID-19. Thus, the question arises whether comparatively mild measures should be kept in place after the pandemic to reduce other airborne diseases such as influenza. Objective In this study, we aim to simulate the quantitative impact of face masks on the rate of influenza illnesses in the United States. Methods Using the Centers for Disease Control and Prevention data from 2010 to 2019, we used a series of differential equations to simulate past influenza seasons, assuming that people wore face masks. This was achieved by introducing a variable to account for the efficacy and prevalence of masks and then analyzing its impact on influenza transmission rate in a susceptible-exposed-infected-recovered model fit to the actual past seasons. We then compared influenza rates in this hypothetical scenario with the actual rates over the seasons. Results Our results show that several combinations of mask efficacy and prevalence can substantially reduce the burden of seasonal influenza. Across all the years modeled, a mask prevalence of 0.2 (20%) and assumed moderate inward and outward mask efficacy of 0.45 (45%) reduced influenza infections by >90%. Conclusions A minority of individuals wearing masks substantially reduced the number of influenza infections across seasons. Considering the efficacy rates of masks and the relatively insignificant monetary cost, we highlight that it may be a viable alternative or complement to influenza vaccinations.
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Affiliation(s)
- Henri Froese
- Goethe-University Frankfurt am Main Frankfurt Germany
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10
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Cullinan SM, Heaton HA, Mullan A, O'Horo J, Binnicker MJ, Tande AJ, Post JA, Campbell RL, Raukar NP. Impact of the COVID-19 Pandemic on Respiratory Infection Rates. Mayo Clin Proc 2022; 97:1023-1025. [PMID: 35512874 PMCID: PMC8942707 DOI: 10.1016/j.mayocp.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 03/15/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Susan M Cullinan
- Department of Emergency Medicine, Mayo Clinic Health System, Eau Claire, WI
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11
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Zhao C, Hu X, Xue Q, Chen L. Reduced Counts of Various Subsets of Peripheral Blood T Lymphocytes in Patients with Severe Course of COVID-19. Bull Exp Biol Med 2022; 172:721-724. [PMID: 35501642 PMCID: PMC9059903 DOI: 10.1007/s10517-022-05464-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Indexed: 12/04/2022]
Abstract
This study was intended to define T lymphocyte subsets in different clinical groups of COVID-19-infected patients to explore the interaction between T cell-mediated immune response and the severity of COVID-19 course. Lymphopenia in patients with severe COVID-19 was found. In patients with severe COVID-19 course, the absolute counts of CD3+, CD4+, and CD8+ T lymphocytes at admission were lower than on day 14 after discharge. Further analysis showed that the older were the patients with COVID-19, the more likely they developed severe infection. The results confirmed the significance of T lymphocytes in the clearance of the COVID-19.
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Affiliation(s)
- C Zhao
- Infectious Hospital Area, the First Affiliated Hospital of University of Science and Technology of China, Hefei, China.
| | - X Hu
- Infectious Hospital Area, the First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Q Xue
- Infectious Hospital Area, the First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - L Chen
- Infectious Hospital Area, the First Affiliated Hospital of University of Science and Technology of China, Hefei, China
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12
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Hek K, Ramerman L, Weesie YM, Lambooij AC, Lambert M, Heins MJ, Hendriksen JMT, Verheij RA, Cals JWL, van Dijk L. Antibiotic Prescribing in Dutch Daytime and Out-of-Hours General Practice during the COVID-19 Pandemic: A Retrospective Database Study. Antibiotics (Basel) 2022; 11:309. [PMID: 35326772 PMCID: PMC8944515 DOI: 10.3390/antibiotics11030309] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
COVID-19 restrictions have resulted in major changes in healthcare, including the prescribing of antibiotics. We aimed to monitor antibiotic prescribing trends during the COVID-19 pandemic in Dutch general practice, both during daytime and out-of-hours (OOH). Routine care data were used from 379 daytime general practices (DGP) and 28 OOH-services over the period 2019-2021. Per week, we analyzed prescription rates per 100,000 inhabitants, overall, for respiratory and urinary tract infections (RTIs and UTIs) specifically and within age categories. We assessed changes in antibiotic prescribing during different phases of the pandemic using interrupted time series analyses. Both at DGPs and OOH-services significantly fewer antibiotics were prescribed during the COVID-19 pandemic after government measures became effective. Furthermore, the number of contacts decreased in both settings. When restrictions were revoked in 2021 prescription rates increased both at DGP and OOH-services, returning to pre-pandemic levels at OOH-services, but not in DGP. Changes in antibiotic prescribing rates were prominent for RTIs and among children up to 11 years old, but not for UTIs. To conclude, while antibiotic prescribing decreased during the first year of the COVID-19 pandemic both in daytime and out-of-hours, the pandemic does not seem to have a lasting effect on antibiotic prescribing.
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Affiliation(s)
- Karin Hek
- Nivel, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands; (L.R.); (Y.M.W.); (M.J.H.); (J.M.T.H.); (R.A.V.); (L.v.D.)
| | - Lotte Ramerman
- Nivel, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands; (L.R.); (Y.M.W.); (M.J.H.); (J.M.T.H.); (R.A.V.); (L.v.D.)
| | - Yvette M. Weesie
- Nivel, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands; (L.R.); (Y.M.W.); (M.J.H.); (J.M.T.H.); (R.A.V.); (L.v.D.)
| | - Anke C. Lambooij
- IVM, The Dutch Institute for Rational Use of Medicine, P.O. Box 3089, 3502 GB Utrecht, The Netherlands;
| | - Maarten Lambert
- Unit of PharmacoTherapy, Groningen Research Institute of Pharmacy, Epidemiology & Economics, University of Groningen, P.O. Box 72, 9700 AB Groningen, The Netherlands;
| | - Marianne J. Heins
- Nivel, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands; (L.R.); (Y.M.W.); (M.J.H.); (J.M.T.H.); (R.A.V.); (L.v.D.)
| | - Janneke M. T. Hendriksen
- Nivel, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands; (L.R.); (Y.M.W.); (M.J.H.); (J.M.T.H.); (R.A.V.); (L.v.D.)
| | - Robert A. Verheij
- Nivel, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands; (L.R.); (Y.M.W.); (M.J.H.); (J.M.T.H.); (R.A.V.); (L.v.D.)
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands
| | - Jochen W. L. Cals
- Department of Family Medicine, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | - Liset van Dijk
- Nivel, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands; (L.R.); (Y.M.W.); (M.J.H.); (J.M.T.H.); (R.A.V.); (L.v.D.)
- Unit of PharmacoTherapy, Groningen Research Institute of Pharmacy, Epidemiology & Economics, University of Groningen, P.O. Box 72, 9700 AB Groningen, The Netherlands;
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13
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Lampejo DT. The impact of the COVID-19 pandemic on the global burden of influenza. J Med Virol 2022; 94:2357-2359. [PMID: 35146774 PMCID: PMC9088378 DOI: 10.1002/jmv.27653] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Dr Temi Lampejo
- Department of Infection Sciences, King's College Hospital, London, United Kingdom
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14
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Ha D, Ong’uti S, Chang A, Mui E, Nelligan I, Betts B, Lentz C, Alegria W, Fox E, Meng L, Stenehjem E, Hersh AL, Deresinski S, Artandi M, Holubar M. Sustained Reduction in Urgent Care Antibiotic Prescribing During the COVID-19 pandemic: An Academic Medical Center’s Experience. Open Forum Infect Dis 2022; 9:ofab662. [PMID: 35111874 PMCID: PMC8802794 DOI: 10.1093/ofid/ofab662] [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: 10/04/2021] [Accepted: 01/04/2022] [Indexed: 11/29/2022] Open
Abstract
We compared antibiotic prescribing before and during the coronavirus disease 2019 (COVID-19) pandemic at 2 academic urgent care clinics and found a sustained decrease in prescribing driven by respiratory encounters and despite transitioning to telemedicine. Antibiotics were rarely prescribed during encounters for COVID-19 or COVID-19 symptoms. COVID-19 revealed opportunities for outpatient stewardship programs.
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Affiliation(s)
- David Ha
- Stanford Antimicrobial Safety and Sustainability Program, Stanford Health Care, Stanford, California, USA
| | - Sharon Ong’uti
- Stanford Antimicrobial Safety and Sustainability Program, Stanford Health Care, Stanford, California, USA
| | - Amy Chang
- Stanford Antimicrobial Safety and Sustainability Program, Stanford Health Care, Stanford, California, USA
| | - Emily Mui
- Stanford Antimicrobial Safety and Sustainability Program, Stanford Health Care, Stanford, California, USA
| | - Ian Nelligan
- Primary Care and Population Health, Stanford, California, USA
| | - Brooke Betts
- Department of Pharmacy, Stanford Health Care, Stanford, California, USA
| | | | - William Alegria
- Stanford Antimicrobial Safety and Sustainability Program, Stanford Health Care, Stanford, California, USA
| | - Emily Fox
- Department of Pharmacy, Stanford Health Care, Stanford, California, USA
| | - Lina Meng
- Stanford Antimicrobial Safety and Sustainability Program, Stanford Health Care, Stanford, California, USA
| | - Edward Stenehjem
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Adam L Hersh
- Department of Pediatrics, Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Stanley Deresinski
- Stanford Antimicrobial Safety and Sustainability Program, Stanford Health Care, Stanford, California, USA
| | - Maja Artandi
- Express Care, Stanford Health Care, Stanford, California, USA
| | - Marisa Holubar
- Stanford Antimicrobial Safety and Sustainability Program, Stanford Health Care, Stanford, California, USA
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15
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Fischell SZ, Fischell JM, Olexa G, Callahan C, Bollinger ME. Impact of coronavirus disease 2019 pandemic on frequency and severity of asthma exacerbations in an inner-city population. Ann Allergy Asthma Immunol 2021; 128:322-324. [PMID: 34923126 PMCID: PMC8674655 DOI: 10.1016/j.anai.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 11/27/2022]
Affiliation(s)
| | - Jonathan M Fischell
- Department of Neurology, University of Maryland Medical Center, Baltimore, Maryland
| | - Gloribel Olexa
- Department of Pediatrics, University of Maryland Medical Center, Baltimore, Maryland
| | - Charles Callahan
- Population Health, University of Maryland Medical Center, Baltimore, Maryland
| | - Mary E Bollinger
- Division of Pediatric Pulmonology/Allergy & Immunology, University of Maryland School of Medicine, Baltimore, Maryland
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16
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Tan LF, Soh RYH, Seetharaman SK. Impact of the COVID-19 pandemic on hospital admissions of nursing home residents. Australas J Ageing 2021; 41:330-334. [PMID: 34913228 DOI: 10.1111/ajag.13032] [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: 08/16/2021] [Revised: 11/03/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has impacted nursing home care and activities in profound ways. We sought to understand whether the COVID-19 pandemic had any impact on hospital admissions of nursing home residents. METHODS A retrospective analysis of hospital admissions of nursing home residents to a tertiary general hospital in Singapore during the COVID-19 pandemic in 2020 was conducted and compared to admissions in the preceding year. Patients' demographics, length of stay, primary diagnosis on admission, death and causes of death were recorded. RESULTS Our study found reduced number of hospital admissions of nursing home residents to a tertiary hospital in Singapore. There was a significant decrease in pneumonia (p < 0.001) and fall (p = 0.001) as a primary diagnosis on admission and a decrease in pneumonia as the cause of death (p < 0.001) for nursing home residents admitted to hospital during the COVID-19 pandemic. CONCLUSIONS This suggests that measures implemented during the pandemic may have impacted outcomes of nursing home residents. Further study is warranted to lead to practise changing outcomes for nursing home settings.
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Affiliation(s)
- Li Feng Tan
- Healthy Ageing Programme, Alexandra Hospital, Singapore City, Singapore
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17
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Phamduy TT, Smith S, Herbst KW, Phamduy PT, Brimacombe M, Hogan AH, Salazar JC, Sturm J. Kawasaki Disease Hospitalizations in the United States 2016-2020: A Comparison of Before and During the Coronavirus Disease 2019 Era. Pediatr Infect Dis J 2021; 40:e407-e412. [PMID: 34382611 PMCID: PMC8505141 DOI: 10.1097/inf.0000000000003289] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/14/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Kawasaki disease (KD) is an acute vasculitis of young children. A comparison of US hospitalization rates and epidemiologic features of KD in 2020 to those of precoronavirus disease years has yet to be reported. METHODS Using a large, inpatient database, we conducted a retrospective cohort study and analyzed data for patients with (1) diagnosis coding for KD, (2) IV immunoglobulin treatment administered during hospitalization and (3) discharge date between January 1, 2016, and December 30, 2020. Severe cases were defined as those requiring adjunctive therapy or IV immunoglobulin-resistant therapy. RESULTS The annual number of KD hospitalizations were stable from 2016 to 2019 (n = 1652, 1796, 1748, 1692, respectively) but decreased in 2020 (n = 1383). KD hospitalizations demonstrated seasonal variation with an annual peak between December and April. A second peak of KD admissions was observed in May 2020. The proportion of KD cases classified as severe increased to 40% in 2020 from 33% during the years 2016-2019 (P < 0.01). Median age in years increased from 2.9 in subjects hospitalized from 2016 to 2019 to 3.2 in 2020 (P = 0.002). CONCLUSIONS Compared with the previous 4 years, the annual number of pediatric KD admissions decreased, and children discharged with diagnostic codes for KD in 2020 were generally older and more likely to have severe morbidity possibly reflective of misdiagnosed multisystem inflammatory syndrome in children. Clinicians should be wary of a possible rise in KD rates in the postcoronavirus disease 2019 era as social distancing policies are lifted and other viruses associated with KD return.
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Affiliation(s)
- Timothy T. Phamduy
- From the Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Sharon Smith
- From the Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
- Division of Emergency Medicine, Connecticut Children’s Medical Center
| | | | - Paul T. Phamduy
- From the Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
- Division of Emergency Medicine, Connecticut Children’s Medical Center
- Division of Research, Connecticut Children’s Medical Center
- Division of Pediatric Hospital Medicine, Connecticut Children’s Medical Center
- Division of Pediatric Infectious Diseases and Immunology, Connecticut Children’s Medical Center, Hartford, Connecticut
| | | | - Alexander H. Hogan
- From the Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
- Division of Pediatric Hospital Medicine, Connecticut Children’s Medical Center
| | - Juan C. Salazar
- From the Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
- Division of Pediatric Infectious Diseases and Immunology, Connecticut Children’s Medical Center, Hartford, Connecticut
| | - Jesse Sturm
- From the Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
- Division of Emergency Medicine, Connecticut Children’s Medical Center
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18
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Chan KPF, Ma TF, Ip MSM, Ho PL. Invasive pneumococcal disease, pneumococcal pneumonia and all-cause pneumonia in Hong Kong during the COVID-19 pandemic compared with the preceding 5 years: a retrospective observational study. BMJ Open 2021; 11:e055575. [PMID: 34635536 PMCID: PMC8506049 DOI: 10.1136/bmjopen-2021-055575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To compare the incidence and severity of invasive pneumococcal diseases (IPDs), pneumococcal pneumonia and all-cause pneumonia during the COVID-19 pandemic period with universal masking and social distancing with that of previous 5 years. DESIGN Retrospective observational study on incidence of IPDs, pneumococcal pneumonia and all-cause pneumonia between January 2015-December 2019 and March 2020-March 2021. January-February 2020 was excluded from analysis as it was treated as a transitional period between normal time and pandemic. SETTING Episode-based data by retrieval of hospitalisation records from the Hospital Authority's territory-wide electronic medical record database in Hong Kong. PARTICIPANTS Hospitalised patients with IPD (n=742), pneumococcal pneumonia (n=2163) and all-cause pneumonia (including COVID-19 pneumonia, n=453 999) aged 18 years or above. Control diagnoses were included to assess confounding from health-seeking behaviours. PRIMARY AND SECONDARY OUTCOMES Primary outcome is the incidence of diseases between two periods. Secondary outcomes include disease severity surrogated by length of stay and mortality. RESULTS Monthly average number of IPD, pneumococcal pneumonia and all-cause pneumonia hospitalisation significantly decreased by 88.9% (95% CI 79.8% to 98.0%, p<0.0005), 72.5% (95% CI 65.9% to 79.1%, p<0.0005) and 17.5% (95% CI 16.8% to 18.2%, p<0.0005), respectively. Changes in trend from January 2015-December 2019 to March 2020-March 2021 were -70% (95% CI -87% to -35%, p=0.0025), -43% (95% CI -59% to -19%, p=0.0014) and -11% (95% CI -13% to -10%, p<0.0005), respectively. Length of stay for IPD and pneumococcal pneumonia episodes were insignificantly different in the two periods. No reductions in hospitalisations for control diagnoses were observed. CONCLUSIONS Incidence of IPD, pneumococcal pneumonia and all-cause pneumonia decreased during the COVID-19 pandemic. This was observed with universal masking and social distancing. We postulated this is related to reduced transmission of respiratory viruses and bacteria.
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Affiliation(s)
| | - Ting-Fung Ma
- Department of Statistics, University of Wisconsin, Madison, Wisconsin, USA
| | - Mary Sau-Man Ip
- Department of Medicine, University of Hong Kong, Hong Kong, People's Republic of China
| | - Pak-Leung Ho
- Department of Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong, People's Republic of China
- Carol Yu Centre for Infection, University of Hong Kong, Hong Kong, People's Republic of China
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19
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Violato C, Violato EM, Violato EM. Impact of the stringency of lockdown measures on covid-19: A theoretical model of a pandemic. PLoS One 2021; 16:e0258205. [PMID: 34610042 PMCID: PMC8491873 DOI: 10.1371/journal.pone.0258205] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/20/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND How effective have lockdowns been at reducing the covid-19 infection and mortality rates? Lockdowns influence contact among persons within or between populations including restricting travel, closing schools, prohibiting public gatherings, requiring workplace closures, all designed to slow the contagion of the virus. The purpose of the present study was to assess the impact of lockdown measures on the spread of covid-19 and test a theoretical model of the covid-19 pandemic employing structural equation modelling. METHODS Lockdown variables, population demographics, mortality rates, infection rates, and health were obtained for eight countries: Austria, Belgium, France, Germany, Italy, Netherlands, Spain, and the United Kingdom. The dataset, owid-covid-data.csv, was downloaded on 06/01/2020 from: https://github.com/owid/covid-19-data/tree/master/public/data. Infection spread and mortality data were depicted as logistic growth and analyzed with stepwise multiple regression. The overall structure of the covid-19 data was explored through factor analyses leading to a theoretical model that was tested using latent variable path analysis. RESULTS Multiple regression indicated that the time from lockdown had a small but significant effect (β = 0.112, p< 0.01) on reducing the number of cases per million. The stringency index produced the most important effect for mortality and infection rates (β = 0.588,β = 0.702, β = 0.518, β = 0.681; p< 0.01). Exploratory and confirmatory analyses resulted in meaningful and cohesive latent variables: 1) Mortality, 2) Infection Spread, 3) Pop Health Risk, and 4) Health Vulnerability (Comparative Fit Index = 0.91; Standardized Root Mean Square Residual = 0.08). DISCUSSION The stringency index had a large impact on the growth of covid-19 infection and mortality rates as did percentage of population aged over 65, median age, per capita GDP, diabetes prevalence, cardiovascular death rates, and ICU hospital beds per 100K. The overall Latent Variable Path Analysis is theoretically meaningful and coherent with acceptable fit indices as a model of the covid-19 pandemic.
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Affiliation(s)
- Claudio Violato
- Professor and Assistant Dean, University of Minnesota Medical School, Minneapolis, MN, United States of America
| | | | - Efrem Mauro Violato
- Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada
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20
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Gerver SM, Guy R, Wilson K, Thelwall S, Nsonwu O, Rooney G, Brown CS, Muller-Pebody B, Hope R, Hall V. National surveillance of bacterial and fungal coinfection and secondary infection in COVID-19 patients in England: lessons from the first wave. Clin Microbiol Infect 2021; 27:1658-1665. [PMID: 34481722 PMCID: PMC8186130 DOI: 10.1016/j.cmi.2021.05.040] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/13/2021] [Accepted: 05/25/2021] [Indexed: 12/28/2022]
Abstract
Objectives The impact of bacterial/fungal infections on the morbidity and mortality of persons with coronavirus disease 2019 (COVID-19) remains unclear. We have investigated the incidence and impact of key bacterial/fungal infections in persons with COVID-19 in England. Methods We extracted laboratory-confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (1st January 2020 to 2nd June 2020) and blood and lower-respiratory specimens positive for 24 genera/species of clinical relevance (1st January 2020 to 30th June 2020) from Public Health England's national laboratory surveillance system. We defined coinfection and secondary infection as a culture-positive key organism isolated within 1 day or 2–27 days, respectively, of the SARS-CoV-2-positive date. We described the incidence and timing of bacterial/fungal infections and compared characteristics of COVID-19 patients with and without bacterial/fungal infection. Results 1% of persons with COVID-19 (2279/223413) in England had coinfection/secondary infection, of which >65% were bloodstream infections. The most common causative organisms were Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae. Cases with coinfection/secondary infections were older than those without (median 70 years (IQR 58–81) versus 55 years (IQR 38–77)), and a higher percentage of cases with secondary infection were of Black or Asian ethnicity than cases without (6.7% versus 4.1%, and 9.9% versus 8.2%, respectively, p < 0.001). Age-sex-adjusted case fatality rates were higher in COVID-19 cases with a coinfection (23.0% (95%CI 18.8–27.6%)) or secondary infection (26.5% (95%CI 14.5–39.4%)) than in those without (7.6% (95%CI 7.5–7.7%)) (p < 0.005). Conclusions Coinfection/secondary bacterial/fungal infections were rare in non-hospitalized and hospitalized persons with COVID-19, varied by ethnicity and age, and were associated with higher mortality. However, the inclusion of non-hospitalized persons with asymptomatic/mild COVID-19 likely underestimated the rate of secondary bacterial/fungal infections. This should inform diagnostic testing and antibiotic prescribing strategy.
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Affiliation(s)
- Sarah M Gerver
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK.
| | - Rebecca Guy
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Kate Wilson
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Simon Thelwall
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Olisaeloka Nsonwu
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Graeme Rooney
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Colin S Brown
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Berit Muller-Pebody
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Russell Hope
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
| | - Victoria Hall
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK
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21
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Chan YW, Wong ML, Kwok FY, Au AKW, Leung ECM, Chuang SK. The effect of seasonal influenza vaccine on medically-attended influenza and non-influenza respiratory viruses infections at primary care level, Hong Kong SAR, 2017/18 to 2019/20. Vaccine 2021; 39:3372-3378. [PMID: 34016472 DOI: 10.1016/j.vaccine.2021.04.059] [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: 12/30/2020] [Revised: 03/31/2021] [Accepted: 04/28/2021] [Indexed: 11/25/2022]
Abstract
Effectiveness of seasonal influenza vaccine (SIV) varies with the degree of matching with the vaccine and circulating viruses. We continued our SIV effectiveness against medically-attended influenza-like illness (ILI) under the Department of Health Hong Kong's sentinel private medical practitioners (PMP) network, using the test-negative case-control design, for the 2018/19 and 2019/20 season. In addition, we studied the potential interference between SIV and ILI caused by non-influenza respiratory viruses (NIRV) based on data collated from 2017/18 to 2019/20 seasons. 3404 patients were analysed. Across the 2017/18 to 2019/20 seasons, the vaccine effectiveness (VE) of SIV was 44% (95% CI 30-56%) against pan-negative controls, 57% (95%CI. 42-68%) against NIRV controls and 50% (95%CI 38-59%) against both. SIV was moderately effective against medically-attended ILI caused by influenza A/B in both 2018/19 and 2019/20 winter seasons (53.2% (95%CI 36.7-65.5%) and 41.8% (95%CI 6.3-64.1%), respectively). The VE against the main circulating subtype, influenza A(H1), was higher for the 2018/19 season (57.2% (95%CI 39.8-69.9%), compared to 34.6% (95%CI -9.6-61.4%) in the 2019/20 season). When compared to pan negative controls, those with single NIRV infections were similarly likely to have received SIV (OR 1.05 (95%CI 0.72-1.54) within the influenza season; OR 0.97 (95%CI 0.73-1.29) when including non-influenza seasons). Analyses by type of virus showed no increased risk of SIV identified among those with single infections of EV/RV, HMPV and parainfluenza but a 2-fold increased risk was shown for those with single infections of adenovirus and parainfluenza virus (adenovirus: OR 2.54 (95%CI 1.24-5.14) within influenza season and OR 1.78 (95%CI 1.01-3.09) for the whole period; parainfluenza virus: OR 2.01 (95%CI 1.22-3.29) within influenza season and OR 1.89 (95%CI 1.29-2.76) for the whole period). SIV programme and surveillance of influenza and NIRV, including SARS-CoV-2, should continue during the COVID-19 pandemic.
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Affiliation(s)
- Yung-Wai Chan
- Communicable Disease Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region.
| | - Miu-Ling Wong
- Communicable Disease Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Fong-Yuen Kwok
- Communicable Disease Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Albert Ka-Wing Au
- Communicable Disease Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Emily Chi-Mei Leung
- Communicable Disease Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Shuk-Kwan Chuang
- Communicable Disease Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
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22
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Teng JLL, Fok KMN, Lin KPK, Chan E, Ma Y, Lau SKP, Woo PCY. Substantial decline in invasive pneumococcal disease (IPD) during COVID-19 pandemic in Hong Kong. Clin Infect Dis 2021; 74:335-338. [PMID: 33907808 PMCID: PMC8135303 DOI: 10.1093/cid/ciab382] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Indexed: 12/17/2022] Open
Abstract
Compared with other countries, a more substantial decrease in the incidence of invasive pneumococcal disease was observed in Hong Kong, which is most likely attributable to the proactive mass adoption of face masks by the public. Human behavioral changes, particularly mask wearing, should be considered as an additional preventive strategy against invasive pneumococcal disease.
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Affiliation(s)
- Jade L L Teng
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kenny M N Fok
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Ken P K Lin
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Elaine Chan
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yuanchao Ma
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Susanna K P Lau
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Patrick C Y Woo
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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23
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Tanner AR, Dorey RB, Brendish NJ, Clark TW. Influenza vaccination: protecting the most vulnerable. Eur Respir Rev 2021; 30:200258. [PMID: 33650528 PMCID: PMC9488965 DOI: 10.1183/16000617.0258-2020] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/03/2020] [Indexed: 11/30/2022] Open
Abstract
Influenza virus infection causes seasonal epidemics and occasional pandemics, leading to huge morbidity and mortality worldwide. Vaccination against influenza is needed annually as protection from constantly mutating strains is required. Groups at high risk of poor outcomes include the elderly, the very young, pregnant women and those with chronic health conditions. However, vaccine effectiveness in the elderly is generally poor due to immunosenescence and may be altered due to "original antigenic sin". Strategies to overcome these challenges in the elderly include high-dose or adjuvant vaccines. Other options include vaccinating healthcare workers and children as this reduces community-level influenza transmission. Current guidelines in the UK are that young children receive a live attenuated nasal spray vaccine, adults aged >65 years receive an adjuvanted trivalent inactivated vaccine and adults aged <65 years with comorbidities receive a quadrivalent inactivated vaccine. The goal of a universal influenza vaccine targeting conserved regions of the virus and avoiding the need for annual vaccination is edging closer with early-phase trials under way.
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Affiliation(s)
- Alex R Tanner
- Dept of Medicine for the Elderly, The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, UK
| | - Robert B Dorey
- NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nathan J Brendish
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Dept of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Tristan W Clark
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Dept of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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24
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Shaunak M, Patel R, Driessens C, Mills L, Leahy A, Gbesemete D, Owens DR, Lucas JS, Faust SN, de Graaf H. COVID-19 symptom surveillance in immunocompromised children and young people in the UK: a prospective observational cohort study. BMJ Open 2021; 11:e044899. [PMID: 33737439 PMCID: PMC7977081 DOI: 10.1136/bmjopen-2020-044899] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To describe the frequency of symptoms compatible with SARS-CoV-2 infection in immunocompromised children and young people in the UK during the SARS-CoV-2 pandemic. To describe patient/parent anxiety regarding SARS-CoV-2 infection in this cohort. DESIGN A prospective observational cohort study. SETTING 46 centres across the UK between 16 March and 4 July 2020. A weekly online questionnaire based on the International Severe Acute Respiratory and emerging Infections Consortium-WHO Case Report Form was used to collect participant reported data on symptoms, test results, National Health Service attendance, hospital admission and impact on daily life. PARTICIPANTS 1490 immunocompromised children, defined as those requiring an annual influenza vaccination due to their underlying condition or medication. MAIN OUTCOME MEASURES Incidence of SARS-CoV-2-like symptoms and patient/parent anxiety score. RESULTS Over 16 weeks during the first wave of the pandemic, no SARS-CoV-2 infection was diagnosed in this large immunocompromised paediatric cohort (median age 11 years, 54.4% female). 110 symptomatic participants underwent a test for SARS-CoV-2; all were negative. 922 (67.4%) participants reported at least one symptom consistent with suspected SARS-CoV-2 infection over the study period. 476 (34.8%) reported three or more symptoms. The most frequently reported symptoms included joint pain, fatigue, headache, nausea and muscle pain. SARS-CoV-2 testing during this period was performed on admitted patients only. 137 participants had their medication suspended or changed during the study period due to assumed COVID-19 disease risk. 62% reported high levels of anxiety (scores of 7-10 out of 10) at the start of the study, with anxiety levels remaining high throughout the study period. CONCLUSIONS Although symptoms related to SARS-CoV-2 infection in children were common, there were no positive tests in this large immunocompromised cohort. Symptom-based screening to facilitate early detection of SARS-CoV-2 infection may not be helpful in these individuals. Patient/parent anxiety about SARS-CoV-2 infection was high. TRIAL REGISTRATION NUMBER NCT04382508.
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Affiliation(s)
- Meera Shaunak
- NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Ravin Patel
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Corine Driessens
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
- PCD Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lynne Mills
- NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Alice Leahy
- Paediatric Rheumatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Diane Gbesemete
- NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Daniel R Owens
- NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Jane S Lucas
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
- PCD Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Saul N Faust
- NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Hans de Graaf
- NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
- Paediatric Rheumatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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25
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Shu Z, Chang K, Zhou Y, Peng C, Li X, Cai W, Wei L, Zheng Q, Tian H, Xia J, Yang K, Wang N, Liu J, Min X, Yan D, Sun J, Wu H, Li X, Zheng Y, Yu Z, Lu X, Yang Y, Jia T, Ji J, Zou Q, Wang Y, Xiao M, Zhang Q, Xiong Y, Sun F, Zhu Q, Jiang X, Wang G, Tang SCW, Zhang J, Li X, Zhang N, Zhang B, Tong X, Liu B, Zhou X, Chan KW, Li X. Add-On Chinese Medicine for Coronavirus Disease 2019 (ACCORD): A Retrospective Cohort Study of Hospital Registries. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2021; 49:543-575. [PMID: 33683189 DOI: 10.1142/s0192415x21500257] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Chinese medicine (CM) was extensively used to treat COVID-19 in China. We aimed to evaluate the real-world effectiveness of add-on semi-individualized CM during the outbreak. A retrospective cohort of 1788 adult confirmed COVID-19 patients were recruited from 2235 consecutive linked records retrieved from five hospitals in Wuhan during 15 January to 13 March 2020. The mortality of add-on semi-individualized CM users and non-users was compared by inverse probability weighted hazard ratio (HR) and by propensity score matching. Change of biomarkers was compared between groups, and the frequency of CMs used was analyzed. Subgroup analysis was performed to stratify disease severity and dose of CM exposure. The crude mortality was 3.8% in the semi-individualized CM user group and 17.0% among the non-users. Add-on CM was associated with a mortality reduction of 58% (HR = 0.42, 95% CI: 0.23 to 0.77, [Formula: see text] = 0.005) among all COVID-19 cases and 66% (HR = 0.34, 95% CI: 0.15 to 0.76, [Formula: see text] = 0.009) among severe/critical COVID-19 cases demonstrating dose-dependent response, after inversely weighted with propensity score. The result was robust in various stratified, weighted, matched, adjusted and sensitivity analyses. Severe/critical patients that received add-on CM had a trend of stabilized D-dimer level after 3-7 days of admission when compared to baseline. Immunomodulating and anti-asthmatic CMs were most used. Add-on semi-individualized CM was associated with significantly reduced mortality, especially among severe/critical cases. Chinese medicine could be considered as an add-on regimen for trial use.
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Affiliation(s)
- Zixin Shu
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Kai Chang
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China.,College of Information Engineering, Hubei University of Chinese Medicine, Wuhan 430065, P. R. China
| | - Yana Zhou
- Hepatic Disease Institute, Hubei Key Laboratory of Theoretical and Applied, Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, P. R. China.,Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan 430061, P. R. China
| | - Chaoan Peng
- Wuhan Huangpi District Chinese Medicine Hospital, Wuhan 432200, P. R. China
| | - Xugui Li
- Hubei 672 Orthopedics Hospital of Integrated Chinese & Western Medicine, Wuhan 430079, P. R. China
| | - Wei Cai
- Wuhan Hospital of Traditional Chinese Medicine, Wuhan 430014, P. R. China
| | - Li Wei
- Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan 430033, P. R. China
| | - Qiguang Zheng
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Haoyu Tian
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Jianan Xia
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Kuo Yang
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Ning Wang
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Jifen Liu
- Hepatic Disease Institute, Hubei Key Laboratory of Theoretical and Applied, Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, P. R. China.,Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan 430061, P. R. China
| | - Xiaojun Min
- Hepatic Disease Institute, Hubei Key Laboratory of Theoretical and Applied, Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, P. R. China.,Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan 430061, P. R. China
| | - Dengying Yan
- Hepatic Disease Institute, Hubei Key Laboratory of Theoretical and Applied, Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, P. R. China.,Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan 430061, P. R. China
| | - Jing Sun
- Hepatic Disease Institute, Hubei Key Laboratory of Theoretical and Applied, Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, P. R. China.,Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan 430061, P. R. China
| | - Huan Wu
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Xiaomeng Li
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Yi Zheng
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Zecong Yu
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Xi Lu
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Yuxia Yang
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Ting Jia
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Jinghui Ji
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Qunzheng Zou
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Yinyan Wang
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Minzhong Xiao
- Hepatic Disease Institute, Hubei Key Laboratory of Theoretical and Applied, Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, P. R. China.,Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan 430061, P. R. China
| | - Qing Zhang
- Hepatic Disease Institute, Hubei Key Laboratory of Theoretical and Applied, Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, P. R. China.,Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan 430061, P. R. China
| | - Yajuan Xiong
- Hepatic Disease Institute, Hubei Key Laboratory of Theoretical and Applied, Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, P. R. China.,Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan 430061, P. R. China
| | - Feng Sun
- Hepatic Disease Institute, Hubei Key Laboratory of Theoretical and Applied, Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, P. R. China.,Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan 430061, P. R. China
| | - Qiang Zhu
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Xingxing Jiang
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Guodong Wang
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | | | - Junhua Zhang
- Evidence-based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
| | - Xiuyang Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
| | - Nevin Zhang
- Department of Computer Science, University of Science & Technology, Hong Kong, P. R. China
| | - Boli Zhang
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
| | - Xiaolin Tong
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
| | - Baoyan Liu
- China Academy of Chinese Medical Sciences, Beijing 100700, P. R. China
| | - Xuezhong Zhou
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing 100044, P. R. China
| | - Kam Wa Chan
- Department of Medicine, The University of Hong Kong, P. R. China
| | - Xiaodong Li
- Hepatic Disease Institute, Hubei Key Laboratory of Theoretical and Applied, Research of Liver and Kidney in Traditional Chinese Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, P. R. China.,Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan 430061, P. R. China
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26
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Territory-wide Study on Hospital Admissions for Asthma exacerbation in COVID-19 Pandemic. Ann Am Thorac Soc 2021; 18:1624-1633. [PMID: 33636091 PMCID: PMC8522301 DOI: 10.1513/annalsats.202010-1247oc] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Rationale: Patients with asthma were advised to avoid coronavirus disease (COVID-19) and comply with medication during the COVID-19 pandemic. Respiratory tract infection is a common cause of asthma exacerbations. There has not been evidence suggesting the link between COVID-19 and asthma exacerbation, especially in places with dramatic responses in infection control with universal masking and aggressive social distancing. Objectives: To assess the number for admissions of asthma exacerbations in January to April 2020 in Hong Kong with reference to admission in the past 5 years. Methods: Admission records of asthma exacerbations were retrieved from the Clinical Data Analysis and Reporting System. Patients aged 18 years or older with a known history of asthma admitted for asthma exacerbation were included. Log-linear was used to model count, with year and masking used as covariate and further analysis on ambient temperature and length of hospital stays. Fisher’s exact test was used to compare the mortality rate and mechanical ventilation between the periods. Admissions for myocardial infarction, ischemic stroke, and gastric ulcer were included as controls. Results: The number of admissions for asthma exacerbations significantly decreased by 53.2% (95% confidence interval [CI], 50.4–55.8%) in 2020 compared with monthly average admission in 2015–2019, with a higher magnitude of decrease compared with control diagnoses. Admissions for asthma exacerbations decreased by 2.0% (95% CI, 1.8–2.2%) with every 1°C (1.8°F) increase in temperature and by 0.8% with every 1% increase in masking (95% CI, 0.8–0.9%). Conclusions: Hospitalization number for asthma exacerbations significantly decreased in early 2020, with similar length of stay. This was observed with concomitant practice of universal masking and social distancing during the COVID-19 pandemic in Hong Kong. We proposed that universal masking and social distancing reduced respiratory viral infection, leading to fewer hospital admissions for asthma exacerbations.
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27
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Liu J, Zhang L, Yan Y, Zhou Y, Yin P, Qi J, Wang L, Pan J, You J, Yang J, Zhao Z, Wang W, Liu Y, Lin L, Wu J, Li X, Chen Z, Zhou M. Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries. BMJ 2021; 372:n415. [PMID: 33627311 PMCID: PMC7900645 DOI: 10.1136/bmj.n415] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess excess all cause and cause specific mortality during the three months (1 January to 31 March 2020) of the coronavirus disease 2019 (covid-19) outbreak in Wuhan city and other parts of China. DESIGN Nationwide mortality registries. SETTING 605 urban districts and rural counties in China's nationally representative Disease Surveillance Point (DSP) system. PARTICIPANTS More than 300 million people of all ages. MAIN OUTCOME MEASURES Observed overall and weekly mortality rates from all cause and cause specific diseases for three months (1 January to 31 March 2020) of the covid-19 outbreak compared with the predicted (or mean rates for 2015-19) in different areas to yield rate ratio. RESULTS The DSP system recorded 580 819 deaths from January to March 2020. In Wuhan DSP districts (n=3), the observed total mortality rate was 56% (rate ratio 1.56, 95% confidence interval 1.33 to 1.87) higher than the predicted rate (1147 v 735 per 100 000), chiefly as a result of an eightfold increase in deaths from pneumonia (n=1682; 275 v 33 per 100 000; 8.32, 5.19 to 17.02), mainly covid-19 related, but a more modest increase in deaths from certain other diseases, including cardiovascular disease (n=2347; 408 v 316 per 100 000; 1.29, 1.05 to 1.65) and diabetes (n=262; 46 v 25 per 100 000; 1.83, 1.08 to 4.37). In Wuhan city (n=13 districts), 5954 additional (4573 pneumonia) deaths occurred in 2020 compared with 2019, with excess risks greater in central than in suburban districts (50% v 15%). In other parts of Hubei province (n=19 DSP areas), the observed mortality rates from pneumonia and chronic respiratory diseases were non-significantly 28% and 23% lower than the predicted rates, despite excess deaths from covid-19 related pneumonia. Outside Hubei (n=583 DSP areas), the observed total mortality rate was non-significantly lower than the predicted rate (675 v 715 per 100 000), with significantly lower death rates from pneumonia (0.53, 0.46 to 0.63), chronic respiratory diseases (0.82, 0.71 to 0.96), and road traffic incidents (0.77, 0.68 to 0.88). CONCLUSIONS Except in Wuhan, no increase in overall mortality was found during the three months of the covid-19 outbreak in other parts of China. The lower death rates from certain non-covid-19 related diseases might be attributable to the associated behaviour changes during lockdown.
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Affiliation(s)
- Jiangmei Liu
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
| | - Lan Zhang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Yaqiong Yan
- Wuhan Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Yuchang Zhou
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
| | - Peng Yin
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
| | - Jinlei Qi
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
| | - Lijun Wang
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
| | - Jingju Pan
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Jinling You
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
| | - Jing Yang
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
| | - Zhenping Zhao
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
| | - Wei Wang
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
| | - Yunning Liu
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
| | - Lin Lin
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
| | - Jing Wu
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
| | - Xinhua Li
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhengming Chen
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Maigeng Zhou
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, 100050, Beijing, China
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28
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Yang Q, Xiao X, Gu X, Liang D, Cao T, Mou J, Huang C, Chen L, Liu J. Surveillance of common respiratory infections during the COVID-19 pandemic demonstrates the preventive efficacy of non-pharmaceutical interventions. Int J Infect Dis 2021; 105:442-447. [PMID: 33582375 PMCID: PMC7877810 DOI: 10.1016/j.ijid.2021.02.027] [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: 11/25/2020] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 02/08/2023] Open
Abstract
Objective The emergence of a novel coronavirus, SARS-CoV-2, and its subsequent spread outside of Wuhan, China, led to the human society experiencing a pandemic of coronavirus disease 2019 (COVID-19). While the development of vaccines and pharmaceutical treatments are ongoing, government authorities in China have implemented unprecedented non-pharmaceutical interventions as primary barriers to curb the spread of the deadly SARS-CoV-2 virus. Although the decline of COVID-19 cases coincided with the implementation of such interventions, we searched for evidence to demonstrate the efficacy of these interventions, since artifactual factors, such as the environment, the pathogen itself, and the phases of epidemic, may also alter the patterns of case development. Methods We surveyed common viral respiratory infections that have a similar pattern of transmission, tropism, and clinical manifestation, as COVID-19 under a series of non-pharmaceutical interventions during the current pandemic season. We then compared this data with historical data from previous seasons without such interventions. Results Our survey showed that the rates of common respiratory infections, such as influenza and respiratory syncytial virus infections, decreased dramatically from 13.7% (95% CI, 10.82–16.58) and 4.64% (95% CI, 2.88–7.64) in previous years to 0.73% (95% CI, 0.02–1.44) and 0.0%, respectively, in the current season. Conclusions Our surveillance provides compelling evidence that non-pharmaceutical interventions are cost-effective ways to curb the spread of contagious agents, and may represent the only practical approach to limit the evolving epidemic until specific vaccines and pharmaceutical treatments are available.
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Affiliation(s)
- Qi Yang
- Laboratory of Infectious Diseases and Vaccine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Xia Xiao
- Chengdu CapitalBio Medical Laboratory, Chengdu, China
| | - Xinxia Gu
- Laboratory of Infectious Diseases and Vaccine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Dong Liang
- Chengdu CapitalBio Medical Laboratory, Chengdu, China
| | - Ting Cao
- Laboratory of Infectious Diseases and Vaccine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Jun Mou
- Laboratory of Infectious Diseases and Vaccine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Chunxu Huang
- Laboratory of Infectious Diseases and Vaccine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Lei Chen
- Department of Clinical Research, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Jie Liu
- Laboratory of Infectious Diseases and Vaccine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China.
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29
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Fricke LM, Glöckner S, Dreier M, Lange B. Impact of non-pharmaceutical interventions targeted at COVID-19 pandemic on influenza burden - a systematic review. J Infect 2021; 82:1-35. [PMID: 33278399 PMCID: PMC9183207 DOI: 10.1016/j.jinf.2020.11.039] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/21/2020] [Accepted: 11/28/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To better understand the impact of comprehensive COVID-19 targeted non-pharmaceutical interventions (NPIs) on influenza burden worldwide. METHODS We conducted a systematic literature search in selected databases (PubMed, WHO COVID-19), preprint servers (medRxiv, bioRxiv) and websites of European Public Health institutes. Documents that compared influenza estimates in the 2019/2020 season with previous seasons were included. Information synthesis was qualitative due to a high heterogeneity in the number and periods of comparative seasons, outcome measures and statistical methods. RESULTS We included 23 records reporting from 15 countries/regions as well as 8 reports from European Public Health agencies. Estimates in the 2019/2020 season based on influenza virus tests (4 out of 7 countries/regions), defined influenza cases (8 out of 9), influenza positivity rate (7 out of 8), and severe complications (1 out of 2) were lower than in former seasons. Results from syndromic indicators, such as influenza-like-illness (ILI), were less clear or even raised (4 out of 7) after the influenza season indicating a misclassification with COVID-19 cases. CONCLUSIONS Evidence synthesis suggests that NPIs targeted at SARS-CoV-2-transmission reduce influenza burden as well. Low threshold NPIs need to be more strongly emphasized in influenza prevention strategies.
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Affiliation(s)
- Lara Marleen Fricke
- Helmholtz Centre for Infection Research (HZI), Inhoffenstraße 7, 38124 Braunschweig, Germany; Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - Stephan Glöckner
- Helmholtz Centre for Infection Research (HZI), Inhoffenstraße 7, 38124 Braunschweig, Germany; German Center for Infection Research, Inhoffenstraße 7, 38124 Braunschweig, Germany.
| | - Maren Dreier
- Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - Berit Lange
- Helmholtz Centre for Infection Research (HZI), Inhoffenstraße 7, 38124 Braunschweig, Germany; German Center for Infection Research, Inhoffenstraße 7, 38124 Braunschweig, Germany.
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Wang X, Kulkarni D, Dozier M, Hartnup K, Paget J, Campbell H, Nair H. Influenza vaccination strategies for 2020-21 in the context of COVID-19. J Glob Health 2020. [DOI: 10.7189/jogh.10.0201102] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Wang X, Kulkarni D, Dozier M, Hartnup K, Paget J, Campbell H, Nair H. Influenza vaccination strategies for 2020-21 in the context of COVID-19. J Glob Health 2020. [DOI: 10.7189/jogh.10.020110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Wang X, Kulkarni D, Dozier M, Hartnup K, Paget J, Campbell H, Nair H. Influenza vaccination strategies for 2020-21 in the context of COVID-19. J Glob Health 2020; 10:021102. [PMID: 33312512 PMCID: PMC7719353 DOI: 10.7189/jogh.10.021102] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Influenza vaccination prevents people from influenza-related diseases and thereby mitigates the burden on national health systems when COVID-19 circulates and public health measures controlling respiratory viral infections are relaxed. However, it is challenging to maintain influenza vaccine services as the COVID-19 pandemic has the potential to disrupt vaccination programmes in many countries during the 2020/21 winter. We summarise available recommendations and strategies on influenza vaccination, specifically the changes in the context of the COVID-19 pandemic. METHODS We searched websites and databases of national and international public health agencies (focusing on Europe, North and South America, Australia, New Zealand, and South Africa). We also contacted key influenza immunization focal points and experts in respective countries and organizations including WHO and ECDC. RESULTS Available global and regional guidance emphasises the control of COVID-19 infection in immunisation settings by implementing multiple measures, such as physical distancing, hand hygiene practice, appropriate use of personal protective equipment by health care workers and establishing separate vaccination sessions for medically vulnerable people. The guidance also emphasises using alternative models or settings (eg, outdoor areas and pharmacies) for vaccine delivery, communication strategies and developing registry and catch-up programmes to achieve high coverage. Several novel national strategies have been adopted, such as combining influenza vaccination with other medical visits and setting up outdoor and drive through vaccination clinics. Several Southern Hemisphere countries have increased influenza vaccine coverage substantially for the 2020 influenza season. Most of the countries included in our review have planned a universal or near universal influenza vaccination for health care workers, or have made influenza vaccination for health care workers mandatory. Australia has requested that all workers and visitors in long term care facilities receive influenza vaccine. The UK has planned to expand the influenza programme to provide free influenza vaccine for the first time to all adults 50-64 years of age, people on the shielded patient list and their household members and children in the first year of secondary school. South Africa has additionally prioritised people with hypertension for influenza vaccination. CONCLUSIONS This review of influenza vaccination guidance and strategies should support strategy development on influenza vaccination in the context of COVID-19.
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Affiliation(s)
- Xin Wang
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Durga Kulkarni
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Marshall Dozier
- Information Services, University of Edinburgh, Edinburgh, UK
| | - Karen Hartnup
- Information Services, University of Edinburgh, Edinburgh, UK
| | - John Paget
- Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
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Shah S, Danda D, Kavadichanda C, Das S, Adarsh MB, Negi VS. Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment. Rheumatol Int 2020; 40:1539-1554. [PMID: 32666137 PMCID: PMC7360125 DOI: 10.1007/s00296-020-04639-9] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/28/2020] [Indexed: 12/15/2022]
Abstract
The coronavirus disease-2019 (COVID-19) pandemic is likely to pose new challenges to the rheumatology community in the near and distant future. Some of the challenges, like the severity of COVID-19 among patients on immunosuppressive agents, are predictable and are being evaluated with great care and effort across the globe. A few others, such as atypical manifestations of COVID-19 mimicking rheumatic musculoskeletal diseases (RMDs) are being reported. Like in many other viral infections, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can potentially lead to an array of rheumatological and autoimmune manifestations by molecular mimicry (cross-reacting epitope between the virus and the host), bystander killing (virus-specific CD8 + T cells migrating to the target tissues and exerting cytotoxicity), epitope spreading, viral persistence (polyclonal activation due to the constant presence of viral antigens driving immune-mediated injury) and formation of neutrophil extracellular traps. In addition, the myriad of antiviral drugs presently being tried in the treatment of COVID-19 can result in several rheumatic musculoskeletal adverse effects. In this review, we have addressed the possible spectrum and mechanisms of various autoimmune and rheumatic musculoskeletal manifestations that can be precipitated by COVID-19 infection, its therapy, and the preventive strategies to contain the infection.
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Affiliation(s)
- Sanket Shah
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Debashish Danda
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - Chengappa Kavadichanda
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Saibal Das
- Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - M. B. Adarsh
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Vir Singh Negi
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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Norrie J. Some challenges of sparse data necessitating strong assumptions in investigating early COVID-19 disease. EClinicalMedicine 2020; 26:100499. [PMID: 32838243 PMCID: PMC7422823 DOI: 10.1016/j.eclinm.2020.100499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 07/26/2020] [Indexed: 11/26/2022] Open
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Mahévas M, Moulis G, Andres E, Riviere E, Garzaro M, Crickx E, Guillotin V, Malphettes M, Galicier L, Noel N, Darnige L, Terriou L, Guerveno C, Sanchis-Borja M, Moulinet T, Meunier B, Ebbo M, Michel M, Godeau B. Clinical characteristics, management and outcome of COVID-19-associated immune thrombocytopenia: a French multicentre series. Br J Haematol 2020; 190:e224-e229. [PMID: 32678953 PMCID: PMC7404899 DOI: 10.1111/bjh.17024] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Matthieu Mahévas
- Department of Internal Medicine, National Referral Center for Adult's Immune Cytopenias Henri Mondor University Hospital, Assistance Publique Hôpitaux de Paris, Université Paris-Est Créteil, Créteil, France
| | - Guillaume Moulis
- Department of Internal Medicine, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,CIC 1436, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,UMR 1027 Inserm, University of Toulouse, Toulouse, France
| | - Emmanuel Andres
- Department of Internal Medicine, University Hospital of Strasbourg, Research Team EA, 3072 "Mitochondrie, Stress oxydant et Protection musculaire", University of Strasbourg, Strasbourg, France
| | - Etienne Riviere
- Department of Internal Medicine, Bordeaux University Hospital (CHU de Bordeaux), Bordeaux, France.,Inserm U1034-University of Bordeaux, Bordeaux, France
| | - Margaux Garzaro
- Department of Clinical Immunology, Saint Louis University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Etienne Crickx
- Department of Internal Medicine, National Referral Center for Adult's Immune Cytopenias Henri Mondor University Hospital, Assistance Publique Hôpitaux de Paris, Université Paris-Est Créteil, Créteil, France
| | - Vivien Guillotin
- Department of Internal Medicine, University Hospital of Strasbourg, Research Team EA, 3072 "Mitochondrie, Stress oxydant et Protection musculaire", University of Strasbourg, Strasbourg, France
| | - Marion Malphettes
- Department of Clinical Immunology, Saint Louis University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Lionel Galicier
- Department of Clinical Immunology, Saint Louis University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Nicolas Noel
- Department of internal medicine, Kremlin-Bicêtre, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Luc Darnige
- Inserm UMR-S 1140, Service d'Hématologie Biologique, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
| | - Louis Terriou
- Department of Internal Medicine and Immunology, Claude-Huriez University Hospital, Université Lille Nord de France, Lille, France
| | - Claire Guerveno
- Department of Internal Medicine, Albi Hospital, Albi, France
| | - Mateo Sanchis-Borja
- Department of pneumology, Hôpital européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Thomas Moulinet
- Department of internal medicine, Nancy University Hospital (CHU de Nancy), University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Benoit Meunier
- Department of internal medicine, Hôpital la Timone, Assistance Publique Hôpitaux de Marseille, Aix Marseille Université, Marseille, France
| | - Mikael Ebbo
- Department of internal medicine, Hôpital la Timone, Assistance Publique Hôpitaux de Marseille, Aix Marseille Université, Marseille, France
| | - Marc Michel
- Department of Internal Medicine, National Referral Center for Adult's Immune Cytopenias Henri Mondor University Hospital, Assistance Publique Hôpitaux de Paris, Université Paris-Est Créteil, Créteil, France
| | - Bertrand Godeau
- Department of Internal Medicine, National Referral Center for Adult's Immune Cytopenias Henri Mondor University Hospital, Assistance Publique Hôpitaux de Paris, Université Paris-Est Créteil, Créteil, France
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Chan KPF, Ma TF, Kwok WC, Leung JKC, Chiang KY, Ho JCM, Lam DCL, Tam TCC, Ip MSM, Ho PL. Significant reduction in hospital admissions for acute exacerbation of chronic obstructive pulmonary disease in Hong Kong during coronavirus disease 2019 pandemic. Respir Med 2020; 171:106085. [PMID: 32917356 PMCID: PMC7354382 DOI: 10.1016/j.rmed.2020.106085] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/16/2020] [Accepted: 07/04/2020] [Indexed: 12/21/2022]
Abstract
Background Chronic respiratory diseases are risk factors for severe disease in coronavirus disease 2019 (COVID-19). Respiratory tract infection is one of the commonest causes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). There has not been evidence suggesting the link between COVID-19 and AECOPD, especially in places with dramatic responses in infection control with universal masking and aggressive social distancing. Methods This is a retrospective study to assess the number of admissions of AECOPD in the first three months of 2020 in Queen Mary Hospital with reference to the admissions in past five years. Log-linear model was used for statistical inference of covariates, including percentage of masking, air quality health index and air temperature. Results The number of admissions for AECOPD significantly decreased by 44.0% (95% CI 36.4%–52.8%, p < 0.001) in the first three months of 2020 compared with the monthly average admission in 2015–2019. Compare to same period of previous years, AECOPD decreased by 1.0% with each percent of increased masking (p < 0.001) and decreased by 3.0% with increase in 1 °C in temperature (p = 0.045). The numbers of admissions for control diagnoses (heart failure, intestinal obstruction and iron deficiency anaemia) in the same period in 2020 were not reduced. Conclusions The number of admissions for AECOPD decreased in first three months of 2020, compared with previous years. This was observed with increased masking percentage and social distancing in Hong Kong. We postulated universal masking and social distancing during COVID-19 pandemics both contributed in preventing respiratory tract infections hence AECOPD.
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Affiliation(s)
- King Pui Florence Chan
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.
| | - Ting Fung Ma
- Department of Statistics, University of Wisconsin-Madison, USA
| | - Wang Chun Kwok
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Jackson Ka Chun Leung
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Ka Yan Chiang
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - James Chung Man Ho
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - David Chi Leung Lam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Terence Chi Chun Tam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Mary Sau Man Ip
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Pak Leung Ho
- Department of Microbiology, The University of Hong Kong, Hong Kong SAR, China
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