1
|
Dam D, Chen M, Rees EE, Cheng B, Sukkarieh L, McGill E, Tehami Y, Bellos A, Edwin J, Patterson K. Risk factors associated with the intensity of COVID-19 outbreaks in Canadian community settings: a retrospective analysis of outbreak-level surveillance data. BMC Public Health 2024; 24:2409. [PMID: 39232726 PMCID: PMC11375942 DOI: 10.1186/s12889-024-19853-4] [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: 11/14/2023] [Accepted: 08/22/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND The severity of COVID-19 outbreaks is disproportionate across settings (e.g., long-term care facilities (LTCF), schools) across Canada. Few studies have examined factors associated with outbreak severity to inform prevention and response. Our study objective was to assess how outbreak severity, as measured using outbreak intensity and defined as number of outbreak-associated cases divided by outbreak duration, differed by setting and factors known to influence SARS-CoV-2 transmission. METHODS We described outbreak intensity trends in 2021 using data from the Canadian COVID-19 Outbreak Surveillance System from seven provinces/territories, representing 93% of the Canadian population. A negative binomial fixed-effects model was used to assess for associations between the outcome, outbreak intensity, and characteristics of outbreaks: setting type, median age of cases, number at risk, and vaccination coverage of at least 1 dose. Also included were variables previously reported to influence SARS-CoV-2 transmission: stringency of non-pharmaceutical interventions (NPI) and the predominant SARS-CoV-2 variant detected by surveillance. RESULTS The longest outbreaks occurred in LTCF (mean = 25.4 days) and correctional facilities (mean = 20.6 days) which also reported the largest outbreaks (mean = 29.6 cases per outbreak). Model results indicated that outbreak intensity was highest in correctional facilities. Relative to correctional facilities (referent), the second highest adjusted intensity ratio was in childcare centres (intensity ratio = 0.58 [95% CI: 0.51-0.66]), followed by LTCF (0.56 [95% CI: 0.51-0.66]). Schools had the lowest adjusted intensity ratio (0.46 [95% CI: 0.40-0.53]) despite having the highest proportion of outbreaks (37.5%). An increase in outbreak intensity was associated with increases in median age, the number at risk, and stringency of NPI. Greater vaccination coverage with at least 1 dose was associated with reduced outbreak intensity. CONCLUSION Descriptive and multivariable model results indicated that in Canada during 2021, outbreak intensity was greatest in closed congregate living facilities: correctional facilities and LTCF. Findings from this study support the importance of vaccination in reducing outbreak intensity when vaccines are effective against infection with circulating variants, which is especially important for closed congregate living facilities where NPIs are more challenging to implement.
Collapse
Affiliation(s)
- Demy Dam
- Centre for Emerging and Respiratory Infections and Pandemic Preparedness, Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, 130 Colonnade Rd, Ottawa, ON, K1A 0K9, Canada.
| | - Michelle Chen
- Centre for Emerging and Respiratory Infections and Pandemic Preparedness, Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, 130 Colonnade Rd, Ottawa, ON, K1A 0K9, Canada
| | - Erin E Rees
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Bethany Cheng
- Centre for Emerging and Respiratory Infections and Pandemic Preparedness, Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, 130 Colonnade Rd, Ottawa, ON, K1A 0K9, Canada
| | - Lynn Sukkarieh
- Centre for Emerging and Respiratory Infections and Pandemic Preparedness, Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, 130 Colonnade Rd, Ottawa, ON, K1A 0K9, Canada
| | - Erin McGill
- Centre for Emerging and Respiratory Infections and Pandemic Preparedness, Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, 130 Colonnade Rd, Ottawa, ON, K1A 0K9, Canada
| | - Yasmina Tehami
- Centre for Emerging and Respiratory Infections and Pandemic Preparedness, Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, 130 Colonnade Rd, Ottawa, ON, K1A 0K9, Canada
| | - Anna Bellos
- Centre for Emerging and Respiratory Infections and Pandemic Preparedness, Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, 130 Colonnade Rd, Ottawa, ON, K1A 0K9, Canada
| | - Jonathan Edwin
- Centre for Emerging and Respiratory Infections and Pandemic Preparedness, Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, 130 Colonnade Rd, Ottawa, ON, K1A 0K9, Canada
| | - Kaitlin Patterson
- Centre for Emerging and Respiratory Infections and Pandemic Preparedness, Infectious Diseases and Vaccination Programs Branch, Public Health Agency of Canada, 130 Colonnade Rd, Ottawa, ON, K1A 0K9, Canada
| |
Collapse
|
2
|
Aguilar-Palacio I, Maldonado L, Malo S, Castel-Feced S, Cebollada A, Aguilar-Latorre A, Rabanaque MJ. Differences in healthcare use and mortality in older adults during the COVID-19 pandemic: Exploring long-term care users' vulnerability. Heliyon 2024; 10:e34840. [PMID: 39148983 PMCID: PMC11324964 DOI: 10.1016/j.heliyon.2024.e34840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/05/2024] [Accepted: 07/17/2024] [Indexed: 08/17/2024] Open
Abstract
Background The objective of our study is to analyze the health care received by older adults with COVID-19 according to their place of residence (whether or not they live in a long-term care [LTC] facility) and to find out the effect of health care on mortality. Methods Retrospective cohort study based in Aragón (Spain) from March 2020 to March 2021 in patients aged 65 years or older with a confirmed COVID-19 infection. The population was classified according to their place of residence (living in a LTC or not). A propensity score was used to match individuals by sex and age. The effect of living in a LTC facility on healthcare delivery and mortality was conducted using adjusted multivariate models. Varimp was used to estimate the best predictors of mortality for both groups. Results Healthcare services utilization varied depending on whether the patients lived in a LTC facility or not. The time to diagnosis was shorter in institutionalized patients, but the time to hospital admission was longer. Length of hospital stays, risk of ICU admission and 30-day mortality were also different and remained statistically significant in the adjusted models. The variables that were more important in the association between healthcare utilization and mortality were those associated with greater severity of COVID-19. Conclusions There were differences in health care for older adults diagnosed with COVID-19 according to their place of residence. There is a need to strengthen collaboration between professionals in LTC centers and health services to provide equitable health care.
Collapse
Affiliation(s)
- Isabel Aguilar-Palacio
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Lina Maldonado
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Department of Applied Economics, University of Zaragoza, Zaragoza, Spain
| | - Sara Malo
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Sara Castel-Feced
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Alberto Cebollada
- Biocomputing Unit, Institute for Health Sciences in Aragon (IACS), Zaragoza, Spain
| | - Alejandra Aguilar-Latorre
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute (ISCIII), Madrid, Spain
- Aragonese Primary Care Research Group (GAIAP), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - M José Rabanaque
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute (ISCIII), Madrid, Spain
| |
Collapse
|
3
|
Kim H, Hong SH. Potentially inappropriate medication as a predictor of poor prognosis of COVID-19 in older adults: a South Korean nationwide cohort study. BMJ Open 2024; 14:e073367. [PMID: 39019633 PMCID: PMC11256064 DOI: 10.1136/bmjopen-2023-073367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/27/2024] [Indexed: 07/19/2024] Open
Abstract
OBJECTIVES To investigate the association between exposure to potentially inappropriate medication (PIM) and poor prognosis of COVID-19 in older adults, controlling for comorbidity and sociodemographic factors. DESIGN AND SETTING Nationwide retrospective cohort study based on the national registry of COVID-19 patients, established through the linkage of South Korea's national insurance claims database with the Korea Disease Control and Prevention Agency registry of patients with COVID-19, up to 31 July 2020. PARTICIPANTS A total of 2217 COVID-19 patients over 60 years of age who tested positive between 20 January 2022 and 4 June 2020. Exposure to PIM was defined based on any prescription record of PIM during the 30 days prior to the date of testing positive for COVID-19. PRIMARY OUTCOME MEASURES Mortality and utilisation of critical care from the date of testing positive until the end of isolation. RESULTS Among the 2217 COVID-19 patients over 60 years of age, 604 were exposed to PIM prior to infection. In the matched cohort of 583 pairs, PIM-exposed individuals exhibited higher rates of mortality (19.7% vs 9.8%, p<0.0001) and critical care utilisation (13.4% vs 8.9%, p=0.0156) compared with non-exposed individuals. The temporal association of PIM exposure with mortality was significant across all age groups (RR=1.68, 95% CI: 1.23~2.24), and a similar trend was observed for critical care utilisation (RR: 1.75, 95% CI: 1.26~2.39). The risk of mortality and critical care utilisation increased with exposure to a higher number of PIMs in terms of active pharmaceutical ingredients and drug categories. CONCLUSION Exposure to PIM exacerbates the poor outcomes of older patients with COVID-19 who are already at high risk. Effective interventions are urgently needed to address PIM exposure and improve health outcomes in this vulnerable population.
Collapse
Affiliation(s)
- Hyungmin Kim
- College of Pharmacy, Seoul National University, Seoul, Republic of Korea
- National Health Insurance Service, Wonju, Republic of Korea
| | - Song Hee Hong
- College of Pharmacy, Seoul National University, Seoul, Republic of Korea
- Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
4
|
Fess LJ, Fell A, O'Toole S, D'Heilly P, Holzbauer S, Kollmann L, Markelz A, Morris K, Ruhland A, Seys S, Schiffman E, Wienkes H, Zirnhelt Z, Meyer S, Como-Sabetti K. COVID-19 Death Determination Methods, Minnesota, USA, 2020-2022 1. Emerg Infect Dis 2024; 30:1352-1360. [PMID: 38916546 PMCID: PMC11210668 DOI: 10.3201/eid3007.231522] [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] [Indexed: 06/26/2024] Open
Abstract
Accurate and timely mortality surveillance is crucial for elucidating risk factors, particularly for emerging diseases. We compared use of COVID-19 keywords on death certificates alone to identify COVID-19 deaths in Minnesota, USA, during 2020-2022, with use of a standardized mortality definition incorporating additional clinical data. For analyses, we used likelihood ratio χ2 and median 1-way tests. Death certificates alone identified 96% of COVID-19 deaths confirmed by the standardized definition and an additional 3% of deaths that had been classified as non-COVID-19 deaths by the standardized definition. Agreement between methods was >90% for most groups except children, although agreement among adults varied by demographics and location at death. Overall median time from death to filing of death certificate was 3 days; decedent characteristics and whether autopsy was performed varied. Death certificates are an efficient and timely source of COVID-19 mortality data when paired with SARS-CoV-2 testing data.
Collapse
|
5
|
Humaira Amanullah F, Alam T, El Hajj N, Bejaoui Y. The impact of COVID-19 on "biological aging". Front Immunol 2024; 15:1399676. [PMID: 38919619 PMCID: PMC11197383 DOI: 10.3389/fimmu.2024.1399676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
The global impact of the SARS-CoV-2 pandemic has been unprecedented, posing a significant public health challenge. Chronological age has been identified as a key determinant for severe outcomes associated with SARS-CoV-2 infection. Epigenetic age acceleration has previously been observed in various diseases including human immunodeficiency virus (HIV), Cytomegalovirus (CMV), cardiovascular diseases, and cancer. However, a comprehensive review of this topic is still missing in the field. In this review, we explore and summarize the research work focusing on biological aging markers, i.e., epigenetic age and telomere attrition in COVID-19 patients. From the reviewed articles, we identified a consistent pattern of epigenetic age dysregulation and shortened telomere length, revealing the impact of COVID-19 on epigenetic aging and telomere attrition.
Collapse
Affiliation(s)
| | - Tanvir Alam
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Nady El Hajj
- College of Health and Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
- College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Yosra Bejaoui
- College of Health and Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| |
Collapse
|
6
|
Boutkourt F, van Haaps T, Brüggemann R, Bhoelan S, ten Cate H, Kruip MJHA, Spaetgens B, van Es N, Roest T, Joling KJ, Meijer K, Hugtenburg J. The effect of current antithrombotic therapy on mortality in nursing home residents with COVID-19: a multicentre retrospective cohort study. Age Ageing 2024; 53:afae094. [PMID: 38748450 PMCID: PMC11095411 DOI: 10.1093/ageing/afae094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 01/31/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The first wave of COVID led to an alarmingly high mortality rate among nursing home residents (NHRs). In hospitalised patients, the use of anticoagulants may be associated with a favourable prognosis. However, it is unknown whether the use of antithrombotic medication also protected NHRs from COVID-19-related mortality. OBJECTIVES To investigate the effect of current antithrombotic therapy in NHRs with COVID-19 on 30-day all-cause mortality during the first COVID-19 wave. METHODS We performed a retrospective cohort study linking electronic health records and pharmacy data in NHRs with COVID-19. A propensity score was used to match NHRs with current use of therapeutic dose anticoagulants to NHRs not using anticoagulant medication. The primary outcome was 30-day all-cause mortality, which was evaluated using a logistic regression model. In a secondary analysis, multivariable logistic regression was performed in the complete study group to compare NHRs with current use of therapeutic dose anticoagulants and those with current use of antiplatelet therapy to those without such medication. RESULTS We included 3521 NHRs with COVID-19 based on a positive RT-PCR for SARS-CoV-2 or with a well-defined clinical suspicion of COVID-19. In the matched propensity score analysis, NHRs with current use of therapeutic dose anticoagulants had a significantly lower all-cause mortality (OR = 0.73; 95% CI: 0.58-0.92) compared to NHRs who did not use therapeutic anticoagulants. In the secondary analysis, current use of therapeutic dose anticoagulants (OR: 0.62; 95% CI: 0.48-0.82) and current use of antiplatelet therapy (OR 0.80; 95% CI: 0.64-0.99) were both associated with decreased mortality. CONCLUSIONS During the first COVID-19 wave, therapeutic anticoagulation and antiplatelet use were associated with a reduced risk of all-cause mortality in NHRs. Whether these potentially protective effects are maintained in vaccinated patients or patients with other COVID-19 variants, remains unknown.
Collapse
Affiliation(s)
- Firdaouss Boutkourt
- Department of Clinical Pharmacology and Pharmacy, Amsterdam UMC, location VUmc, De Boelelaan 1117, Amsterdam, The Netherlands
- Farmadam Pharmacy Group, Contactweg 127, Amsterdam, The Netherlands
| | - Thijs van Haaps
- Department of Vascular Medicine, Amsterdam UMC, location AMC Meibergdreef 9, Amsterdam, The Netherlands
- Pulmonary Hypertension & Thrombosis, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Reneé Brüggemann
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Soerajja Bhoelan
- Department of Hematology, UMC Groningen, University of Groningen, The Netherlands
| | - Hugo ten Cate
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Erasmus MC Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Bart Spaetgens
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Nick van Es
- Department of Vascular Medicine, Amsterdam UMC, location AMC Meibergdreef 9, Amsterdam, The Netherlands
- Pulmonary Hypertension & Thrombosis, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Tineke Roest
- Farmadam Pharmacy Group, Contactweg 127, Amsterdam, The Netherlands
| | - Karlijn J Joling
- Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands, Department of Medicine for Older People, Amsterdam UMC, Location VUmc, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Karina Meijer
- Department of Hematology, UMC Groningen, University of Groningen, The Netherlands
| | - Jacqueline Hugtenburg
- Department of Clinical Pharmacology and Pharmacy, Amsterdam UMC, location VUmc, De Boelelaan 1117, Amsterdam, The Netherlands
| |
Collapse
|
7
|
Gohil VS, Shah VR, Shukla RP. Household secondary attack rate amongst the susceptible contacts of COVID-19 cases and its epidemiological profile: A retrospective study from central Gujarat, India. J Family Med Prim Care 2024; 13:1448-1453. [PMID: 38827718 PMCID: PMC11141985 DOI: 10.4103/jfmpc.jfmpc_1474_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 06/04/2024] Open
Abstract
Introduction Secondary attack rate (SAR) is a proportion of primary contacts developing the diseases within the incubation period upon exposure to a primary case among the total susceptible household contacts. The epidemiological profile and SAR will help in understanding the transmission dynamics of COVID-19 for further strengthening preventive and effective control measures. Objectives of the Study The study was conducted with the primary objective to estimate the household SAR of COVID-19 cases at Mahisagar District, Gujarat, and to study the epidemiological profile of primary and secondary cases of COVID-19. Methodology A retrospective study was conducted to estimate SAR among 245 confirmed cases of COVID-19 and 898 susceptible household contacts in Mahisagar district through telephonic interview and questionnaire by the Investigator team. Results The household SAR was calculated from the current study in Mahisagar district, Gujarat, and was 13.9%. Among primary cases, 74.7% males were affected, and among secondary cases, 52.8% females were affected. The SAR among elderly was 23.9%, and the SAR among children was 3.9%. 74.1% household contacts had developed disease among symptomatic contacts as compared to asymptomatic household contacts. Conclusion The household SAR in Mahisagar district, Gujarat, was found to be 13.9%. In primary cases, more males, and in secondary cases, more females were found to be affected. The household SAR was increased in elderly as compared to the younger age group. The SAR was more among the contacts of symptomatic cases than asymptomatic cases. Overall hospitalization in public hospitals was more than that in private hospitals.
Collapse
Affiliation(s)
- Vaidehi S. Gohil
- Community Medicine Department, Dr. M. K. Shah Medical College, Ahmedabad, Gujarat, India
| | - Venu R. Shah
- Community Medicine Department GCS Medical College, Ahmedabad, Gujarat, India
| | - Rujul P. Shukla
- Community Medicine Department, Ananya Medical College, Ahmedabad, Gujarat, India
| |
Collapse
|
8
|
Zemni I, Bennasrallah C, Charrada I, Dhouib W, Maatouk A, Hassine DB, Klii R, Kacem M, Fredj MB, Abroug H, Mhalla S, Mastouri M, Loussaief C, Jlassi I, Bouanène I, Belguith AS. Comparison of time to negative conversion of SARS-CoV-2 between young and elderly among asymptomatic and mild COVID-19 patients: a cohort study from a national containment center. Front Med (Lausanne) 2024; 11:1217849. [PMID: 38562375 PMCID: PMC10983848 DOI: 10.3389/fmed.2024.1217849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/29/2024] [Indexed: 04/04/2024] Open
Abstract
Objective We aimed to study the relationship between age and time to negative conversion of SARS-CoV-2 in patients with asymptomatic and mild forms of COVID-19. Methods We conducted a cohort study including all patients diagnosed with COVID-19 from the national COVID-19 containment center of Tunisia. Patients were subdivided into two cohorts: (under 60 years) and (over 60 years) and were followed up until PCR negativization. Log rank test and Cox regression were applied to compare time to negative conversion between the old group and the young group. Results The study included 289 patients with non-severe forms of COVID-19. Age over 60 was significantly associated with delayed negative conversion in male sex (Hazard ratio (HR): 1.9; 95% CI: 1.2-3.07) and among patients with morbid conditions (HR:1.68; 95% CI: 1.02-2.75) especially diabetics (HR: 2.06; 95% CI: 1.01-4.21). This association increased to (HR:2.3; 95% CI: 1.13-4.66) when male sex and comorbidities were concomitantly present and rose to (HR: 2.63; 95% CI: 1.02-6.80) for men with diabetes. Cox regression analysis revealed a significantly delayed negative conversion in symptomatic patients. Significant interaction was observed between gender and age and between age and chronic conditions. Conclusion Age is associated with delayed negative conversion of viral RNA in certain subgroups. Identifying these subgroups is crucial to know how prioritize preventive strategies in elderly.
Collapse
Affiliation(s)
- Imen Zemni
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory, University of Monastir, Monastir, Tunisia
| | - Cyrine Bennasrallah
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory, University of Monastir, Monastir, Tunisia
| | - Ines Charrada
- Department of Endocrinology, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Wafa Dhouib
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory, University of Monastir, Monastir, Tunisia
| | - Amani Maatouk
- Department of Microbiology, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Donia Ben Hassine
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
| | - Rim Klii
- Department of Internal Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Meriem Kacem
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory, University of Monastir, Monastir, Tunisia
| | - Manel Ben Fredj
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory, University of Monastir, Monastir, Tunisia
| | - Hela Abroug
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory, University of Monastir, Monastir, Tunisia
| | - Salma Mhalla
- Department of Microbiology, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Maha Mastouri
- Department of Microbiology, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Chawki Loussaief
- Department of Infectiology, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Ines Jlassi
- Faculty of Sciences of Monastir, Department of Mathematics and Statistics, University of Monastir, Monastir, Tunisia
| | - Ines Bouanène
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
| | - Asma Sriha Belguith
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Faculty of Medicine of Monastir, Department of Epidemiology, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory, University of Monastir, Monastir, Tunisia
| |
Collapse
|
9
|
Sciacchitano S, Carola V, Nicolais G, Sciacchitano S, Napoli C, Mancini R, Rocco M, Coluzzi F. To Be Frail or Not to Be Frail: This Is the Question-A Critical Narrative Review of Frailty. J Clin Med 2024; 13:721. [PMID: 38337415 PMCID: PMC10856357 DOI: 10.3390/jcm13030721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/07/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Many factors have contributed to rendering frailty an emerging, relevant, and very popular concept. First, many pandemics that have affected humanity in history, including COVID-19, most recently, have had more severe effects on frail people compared to non-frail ones. Second, the increase in human life expectancy observed in many developed countries, including Italy has led to a rise in the percentage of the older population that is more likely to be frail, which is why frailty is much a more common concern among geriatricians compared to other the various health-care professionals. Third, the stratification of people according to the occurrence and the degree of frailty allows healthcare decision makers to adequately plan for the allocation of available human professional and economic resources. Since frailty is considered to be fully preventable, there are relevant consequences in terms of potential benefits both in terms of the clinical outcome and healthcare costs. Frailty is becoming a popular, pervasive, and almost omnipresent concept in many different contexts, including clinical medicine, physical health, lifestyle behavior, mental health, health policy, and socio-economic planning sciences. The emergence of the new "science of frailty" has been recently acknowledged. However, there is still debate on the exact definition of frailty, the pathogenic mechanisms involved, the most appropriate method to assess frailty, and consequently, who should be considered frail. This narrative review aims to analyze frailty from many different aspects and points of view, with a special focus on the proposed pathogenic mechanisms, the various factors that have been considered in the assessment of frailty, and the emerging role of biomarkers in the early recognition of frailty, particularly on the role of mitochondria. According to the extensive literature on this topic, it is clear that frailty is a very complex syndrome, involving many different domains and affecting multiple physiological systems. Therefore, its management should be directed towards a comprehensive and multifaceted holistic approach and a personalized intervention strategy to slow down its progression or even to completely reverse the course of this condition.
Collapse
Affiliation(s)
- Salvatore Sciacchitano
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy;
- Unit of Anaesthesia, Intensive Care and Pain Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy; (M.R.); (F.C.)
- Department of Life Sciences, Health and Health Professions, Link Campus University, 00165 Rome, Italy
| | - Valeria Carola
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00189 Rome, Italy; (V.C.); (G.N.)
| | - Giampaolo Nicolais
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00189 Rome, Italy; (V.C.); (G.N.)
| | - Simona Sciacchitano
- Department of Psychiatry, La Princesa University Hospital, 28006 Madrid, Spain;
| | - Christian Napoli
- Department of Surgical and Medical Science and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy;
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy;
| | - Monica Rocco
- Unit of Anaesthesia, Intensive Care and Pain Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy; (M.R.); (F.C.)
- Department of Surgical and Medical Science and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy;
| | - Flaminia Coluzzi
- Unit of Anaesthesia, Intensive Care and Pain Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy; (M.R.); (F.C.)
- Department Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| |
Collapse
|
10
|
Liu XQ, Lu GZ, Yin DL, Kang YY, Zhou YY, Wang YH, Xu J. Analysis of clinical characteristics and risk factors between elderly patients with severe and nonsevere Omicron variant infection. World J Clin Infect Dis 2023; 13:37-48. [DOI: 10.5495/wjcid.v13.i4.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to millions of confirmed cases and deaths worldwide. Elderly patients are at high risk of developing and dying from COVID-19 due to advanced age, decreased immune function, intense inflammatory response, and comorbidities. Shanghai has experienced a wave of infection with Omicron, a new variant of SARS-CoV-2, since March 2022. There is a pressing need to identify clinical features and risk factors for disease progression among elderly patients with Omicron infection to provide solid evidence for clinical policy-makers, public health officials, researchers, and the general public.
AIM To investigate clinical characteristic differences and risk factors between elderly patients with severe and nonsevere Omicron SARS-CoV-2 variant infection.
METHODS A total of 328 elderly patients with COVID-19 admitted to the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 2022 to June 2022 were enrolled and divided into a severe group (82 patients) and a nonsevere group (246 patients) according to the diagnosis and treatment protocol of COVID-19 (version 7). The clinical data and laboratory results of both groups were collected and compared. A chi-square test, t test, Mann-Whitney U test, hierarchical log-rank test, univariate and multivariate logistic regression, and hierarchical analyses were used to determine significant differences.
RESULTS The severe group was older (84 vs 74 years, P < 0.001), included more males (57.3% vs 43.9%, P = 0.037), had a lower vaccination rate (P < 0.001), and had a higher proportion of comorbidities, including chronic respiratory disease (P = 0.001), cerebral infarction (P < 0.001), chronic kidney disease (P = 0.002), and neurodegenerative disease (P < 0.001), than the nonsevere group. In addition, severe disease patients had a higher inflammatory index (P < 0.001), greater need for symptomatic treatment (P < 0.001), longer hospital stay (P = 0.011), extended viral shedding time (P = 0.014), and higher mortality than nonsevere disease patients (P < 0.001). No difference was observed in the application of Paxlovid in the severe and nonsevere groups (P = 0.817). Oxygen saturation, cerebral infarction, and D-dimer were predictive factors for developing severe disease in patients with COVID-19, with D-dimer having an excellent role (area under the curve: 90.1%, 95%CI: 86.1-94.0%). In addition, D-dimer was a risk factor for developing severe COVID-19 according to multivariate stratified analysis.
CONCLUSION The clinical course of severe COVID-19 is complex, with a higher need for symptomatic treatment. D-dimer is a suitable biomarker for identifying patients at risk for developing severe COVID-19.
Collapse
Affiliation(s)
- Xiao-Qin Liu
- Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Guan-Zhu Lu
- Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Dong-Lin Yin
- Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Yao-Yue Kang
- Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Yuan-Yuan Zhou
- Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Yu-Huan Wang
- Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Jie Xu
- Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| |
Collapse
|
11
|
Werner P, AboJabel H. The Conceptual and Methodological Characteristics of Ageism During COVID-19: A Scoping Review of Empirical Studies. THE GERONTOLOGIST 2023; 63:1526-1535. [PMID: 35932468 PMCID: PMC9384679 DOI: 10.1093/geront/gnac118] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Printed and social media, as well as professional and scholarly platforms, have extensively discussed the proliferation of ageism during the coronavirus disease 2019 (COVID-19) pandemic. However, no study has systematically examined the body of knowledge on the topic. Framed around the characteristics of ageism in general, the aim of this review was to identify and characterize the conceptual and methodological underpinnings of the global, peer-reviewed, and empirical literature on ageism during COVID-19. RESEARCH DESIGN AND METHODS We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, using PubMed, CINAHL, AgeLine, and PsycINFO. Quantitative and/or qualitative, English-language, and peer-reviewed articles were included. Data were tabulated and synthesized. RESULTS Thirty six articles examining ageism during the COVID-19 pandemic met inclusion criteria. Most were quantitative (64%) and cross-sectional (81%). The level, correlates, and consequences of ageism during the pandemic were similar to the ones reported before it. Studies about ageism during COVID-19 had similar conceptualization and measurement problems to those before the pandemic. DISCUSSION AND IMPLICATIONS Empirical studies did not find ageism during COVID-19 to be a unique phenomenon, as suggested by the media. More theoretically sound and methodologically rigorous studies, using longitudinal designs and validated unique measures are needed to examine this unique phenomenon.
Collapse
Affiliation(s)
- Perla Werner
- Department of Community Mental Health, University of Haifa, Mt. Carmel, Haifa, Israel
| | - Hanan AboJabel
- Department of Community Mental Health, University of Haifa, Mt. Carmel, Haifa, Israel
| |
Collapse
|
12
|
Stubbs A, Dawson E, Campbell E, Van Buskirk J, Johnson G, Spalding N, Cullen J, Chee K, McLeod J, Knibbs LD, O'Callaghan J, Jones C, Maduka C, Fleming P, Haupt R, Penman A. Factors impacting resident outcomes from COVID-19 outbreaks in Residential Aged Care Facilities in Sydney Local Health District: testing an infection prevention and control scoring system. BMC Public Health 2023; 23:1763. [PMID: 37697365 PMCID: PMC10494338 DOI: 10.1186/s12889-023-16634-3] [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: 01/24/2023] [Accepted: 08/28/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND COVID-19 outbreaks have disproportionately affected Residential Aged Care Facilities (RACFs) around the world, with devastating impacts for residents and their families. Many factors such as community prevalence, facility layout, and infection control practices have been linked to resident outcomes. At present, there are no scoring systems designed to quantify these factors and assess their level of association with resident attack rates and mortality rates. METHODS We constructed a novel Infection Prevention and Control (IPC) scoring system to quantify facility layout, ability to cohort residents, and IPC practices in RACFs. We conducted a retrospective observational cohort study of COVID-19 outbreaks, applying our IPC scoring system to all COVID-19 outbreaks occurring in RACFs in Sydney Local Health District during the Delta and Omicron waves of the COVID-19 pandemic in New South Wales, Australia. RESULTS Twenty-six COVID-19 outbreaks in 23 facilities in the Delta wave, and 84 outbreaks in 53 facilities in the Omicron wave were included in the study. A linear Generalised Estimating Equation model was fitted to the Omicron data. Higher IPC scores were associated with higher attack rates and mortality rates. Facilities with IPC scores greater than 75.0% had attack rates 19.6% higher [95% CI: 6.4%-32.8%] and mortality rates 1.7% higher [95% CI: 0.6%-2.7%] than facilities with an IPC score of less than 60.0%. CONCLUSIONS The results of this study suggest the utility of the IPC scoring system for identifying facilities at greater risk of adverse outcomes from COVID-19 outbreaks. While further validation and replication of accuracy is required, the IPC scoring system could be used and adapted to improve planning, policy, and resource allocation for future outbreaks.
Collapse
Affiliation(s)
- Alison Stubbs
- Sydney Local Health District Public Health Unit, Sydney, NSW, Australia
| | - Elizabeth Dawson
- Sydney Local Health District, Infection Prevention and Control, Sydney, NSW, Australia
| | - Elise Campbell
- Sydney Local Health District Residential Aged Care Facility Outreach Team, Sydney, NSW, Australia
| | - Joseph Van Buskirk
- Sydney Local Health District Public Health Unit, Sydney, NSW, Australia
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - George Johnson
- Sydney Local Health District Public Health Unit, Sydney, NSW, Australia.
| | - Natasha Spalding
- Sydney Local Health District Residential Aged Care Facility Outreach Team, Sydney, NSW, Australia
| | - John Cullen
- Sydney Local Health District Residential Aged Care Facility Outreach Team, Sydney, NSW, Australia
| | - Karen Chee
- Sydney Local Health District Public Health Unit, Sydney, NSW, Australia
| | - Jodi McLeod
- Sydney Local Health District Residential Aged Care Facility Outreach Team, Sydney, NSW, Australia
| | - Luke D Knibbs
- Sydney Local Health District Public Health Unit, Sydney, NSW, Australia
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Jodie O'Callaghan
- Sydney Local Health District Public Health Unit, Sydney, NSW, Australia
| | - Christian Jones
- Sydney Local Health District Public Health Unit, Sydney, NSW, Australia
| | - Chinonye Maduka
- Sydney Local Health District Public Health Unit, Sydney, NSW, Australia
| | - Patricia Fleming
- Sydney Local Health District Public Health Unit, Sydney, NSW, Australia
| | - Reuben Haupt
- Sydney Local Health District Executive, Sydney, NSW, Australia
| | - Andrew Penman
- Sydney Local Health District Public Health Unit, Sydney, NSW, Australia
| |
Collapse
|
13
|
Zhang Y, Li X, Zhang S, Chen W, Lu J, Xie Y, Wu S, Zhuang F, Bi X, Chu M, Wang F, Huang Y, Ding F, Hu C, Pan Y. Clinical Features and Predictive Nomogram of Acute Kidney Injury in Aging Population Infected with SARS-CoV-2 Omicron Variant. J Inflamm Res 2023; 16:2967-2978. [PMID: 37484995 PMCID: PMC10362882 DOI: 10.2147/jir.s413318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023] Open
Abstract
Background Since little is known about the acute kidney injury (AKI) in aging population infected with SARS-CoV-2 Omicron variant, we investigated the incidence, clinical features, risk factors and mid-term outcomes of AKI in hospitalized geriatric patients with and without COVID-19 and established a prediction model for mortality. Methods A real-time data from the Shanghai Ninth People's Hospital information system of inpatients with COVID-19 from 1 April 2022 to 30 June 2022 were extracted. Clinical spectrum, laboratory results, and clinical prognosis were included for the risk analyses. Moreover, Cox and Lasso regression analyses were applied to predict the 90-day death and a nomogram was established. Results A total of 1607 SARS-CoV-2 infected patients were enrolled; hypertension was the most common comorbidity, followed by chronic cardiovascular disease, diabetes mellitus, and lung disease. Most of the participants were non-vaccinated and the mean age of patients was 82.6 years old (range, 60-103 years). The AKI incidence was higher in relatively older patients (16.29% vs 3.63% in patients older than 80 years and 60 to 80 years, respectively). Linear regression models identified some variables associated with the incidence of AKI, such as older age, clinical spectrum, D-dimer level, number of comorbidities, baseline eGFR, and antibiotic or corticosteroid treatment. In this cohort, 11 patients died in-hospital and 21 patients died at 90-day follow-up. The predictive nomogram of 90-day death achieved a good C-index of 0.823 by using 5 predictor variables: ICU admission, D-dimer, peak of serum creatinine, rate of serum creatinine decline and white blood cell count (WBC). Conclusion Older age, clinical spectrum, D-dimer level, number of comorbidities, baseline eGFR, and antibiotic or corticosteroid treatment are clinical risk factors for the incidence of AKI in geriatric COVID-19 patients. The prediction nomogram achieved an excellent performance at the prediction of 90-day mortality.
Collapse
Affiliation(s)
- Yumei Zhang
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Xin Li
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Suning Zhang
- Division of Emergency, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Wei Chen
- Division of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Jianxin Lu
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yingxin Xie
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Shengbin Wu
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Feng Zhuang
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Xiao Bi
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Mingzi Chu
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Feng Wang
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yemin Huang
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Feng Ding
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Chun Hu
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yu Pan
- Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| |
Collapse
|
14
|
Hodge E, Oversby S, Chor J. Why are some outbreaks worse than others? COVID-19 outbreak management strategies from a PHU perspective. BMC Public Health 2023; 23:597. [PMID: 36997870 PMCID: PMC10060923 DOI: 10.1186/s12889-023-15498-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/21/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND From a Public Health Unit (PHU) perspective, this review aimed to examine factors associated with adverse outbreak outcomes, to identify evidence based focal strategies of managing COVID-19 outbreaks in aged care settings. METHODS A retrospective review of PHU documentation examined all 55 COVID-19 outbreaks in Wide Bay RACFs across the first 3 COVID-19 waves in Queensland, through thematic and statistical analysis. . RESULTS Thematic analysis using the framework approach identified 5 themes associated with outcomes of COVID-19 outbreaks in RACFs. These were analysed for statistical significance against outbreak outcomes including duration, attack rate and case fatality rate. There was a significant relationship between memory support unit (MSU) involvement and adverse outbreak outcomes. Attack rate was significantly associated with communication frequency, symptom monitoring and case detection approach, staff shortages and cohorting. Staff shortages were also significantly associated with a prolonged outbreak duration. There was no statistically significant relationship between outbreak outcomes and resource availability or infection control strategy. . CONCLUSIONS This emphasises the importance of frequent communication between PHUs and RACFs during active outbreaks, as well as the need for regular symptom monitoring and prompt case detection, to minimise viral transmission. Staff shortages and cohorting are also crucial factors to be addressed during outbreak management. IMPLICATIONS FOR PUBLIC HEALTH This review adds to the evidence basis of COVID-19 outbreak management strategies to improve PHU advice to RACFs, to mitigate viral transmission and ultimately reduce the burden of disease associated with COVID-19 and other communicable diseases.
Collapse
Affiliation(s)
- Emma Hodge
- Wide Bay Public Health Unit (WBPHU), Queensland Health, Hervey Bay, Australia.
| | - Shannen Oversby
- Wide Bay Public Health Unit (WBPHU), Queensland Health, Hervey Bay, Australia
| | - Josette Chor
- Wide Bay Public Health Unit (WBPHU), Queensland Health, Hervey Bay, Australia
| |
Collapse
|
15
|
Effectiveness of Vaccination in Preventing COVID-19: A Community Study Comparing Four Vaccines. Vaccines (Basel) 2023; 11:vaccines11030544. [PMID: 36992128 DOI: 10.3390/vaccines11030544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 03/02/2023] Open
Abstract
The course of the COVID-19 pandemic has been critically altered by the availability of vaccines. To assess the risk of COVID-19 in the vaccinated, as compared to the unvaccinated population, as well as the comparative effectiveness of the BBIBP-CorV (Sinopharm), BNT162b2 (Pfizer/BioNTech), Gam-COVID-Vac (Sputnik V) and ChAdOx1 (AstraZeneca) vaccines in the prevention of clinical infection, we carried out a retrospective study of the incidence of clinical COVID-19 in the Belgrade city municipality of Voždovac among both vaccinated and unvaccinated individuals during a 4-month period between 1 July and 31 October 2021. The study included all individuals with a symptomatic infection confirmed by a positive PCR and/or antigen test. Only those who received two vaccine doses were considered as vaccinated. The results showed that of the Voždovac population of 169,567, a total of 81,447 (48%) individuals were vaccinated by the end of the study. Vaccination coverage increased with age, ranging from 1.06% in those below age 18, to even 78.8% in those above 65 years of age. More than one half (57.5%) of all those vaccinated received BBIBP-CorV, while 25.2% received BNT162b2, 11.7% Gam-COVID-Vac and 5.6% ChAdOx1. The overall risk of infection of the vaccinated vs. the unvaccinated was 0.53 (95% CI 0.45–0.61). Compared to the incidence of COVID-19 of 8.05 per 1000 in the unvaccinated population, the relative risk in the vaccinated was 0.35 (95% CI 0.3–0.41). The overall VE was 65%, differing widely among age groups and by vaccine. VE was 79% for BNT162b2, 62% for BBIBP-CorV, 60% for ChAdOx1 and 54% for Gam-COVID-Vac. The VE for BBIBP-CorV and BNT162b2 increased with age. The obtained results demonstrate a significant overall effectiveness of anti-COVID-19 vaccination, which, however, varied significantly among the analyzed vaccines, and was the highest for BNT162b2.
Collapse
|
16
|
Čokić V, Popovska Z, Lijeskić O, Šabić L, Djurković-Djaković O. Three Outbreaks of COVID-19 in a Single Nursing Home over Two Years of the SARS-CoV-2 Pandemic. Aging Dis 2023; 14:99-111. [PMID: 36818555 PMCID: PMC9937707 DOI: 10.14336/ad.2022.0624] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/24/2022] [Indexed: 11/18/2022] Open
Abstract
Older people in nursing homes (NH) have been hit particularly hard by the COVID-19 pandemic. We conducted a retrospective study of three outbreaks of COVID-19, occurring during the waves of the initial pre-Alpha, Delta and Omicron SARS-CoV-2 variants, in one NH in suburban Belgrade, Serbia. All staff and 95% residents were vaccinated in February 2021, mostly with BBIBP-CorV, and two thirds were boosted with a third dose in August 2021. COVID-19 was diagnosed by positive PCR and/or antigen test. After the first outbreak, 80 affected individuals were tested for SARS-CoV-2 specific antibodies. The first outbreak involved 64/126 (50.8%) residents and 45/64 (70.3%) staff, the second 22/75 (29.3%) residents and 3/40 (7.5%) staff, and the third involved 36/110 (32.7%) residents and 19/56 (33.9%) staff. Clinical presentation ranged from asymptomatic to severe, with severe cases referred to hospital ICUs. Deaths occurred only in residents, and the case fatality rate was 31.2%, 9.1% and 0%, respectively in outbreaks 1, 2 and 3. Specific IgG antibodies were detected in all 35 residents and 44 of the 45 staff, and higher IgG levels were detected in the residents (417.3±273.5) than in the staff (201.9±192.9, p<0.0001) despite a double difference in age (79.0±7.4 vs. 40.1±11.5 years). Outbreaks 2 and 3 involved four and 23 breakthrough infections, respectively. Older individuals mounted a good immunological response to SARS-CoV-2 infection and vaccination, which prevented significant mortality and severe morbidity in the subsequent outbreaks, despite a significant number of breakthrough infections.
Collapse
Affiliation(s)
- Vladan Čokić
- Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | | | - Olivera Lijeskić
- Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | | | - Olgica Djurković-Djaković
- Institute for Medical Research, University of Belgrade, Belgrade, Serbia,Correspondence should be addressed to: Dr. Olgica Djurković-Djaković, Center of Excellence for Food- and Vector-borne Zoonoses, Institute for Medical Research, University of Belgrade, Belgrade, Serbia. e-mail address: .
| |
Collapse
|
17
|
Jiang M, Corna L, Amati R, Piumatti G, Franscella G, Crivelli L, Albanese E. Prevalence and association of frailty with SARS-CoV-2 infection in older adults in Southern Switzerland-Findings from the Corona Immunitas Ticino Study. BMC Geriatr 2023; 23:18. [PMID: 36631745 PMCID: PMC9834033 DOI: 10.1186/s12877-023-03730-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/04/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Frailty is an age-associated state of increased vulnerability to stressors that strongly predicts poor health outcomes. Epidemiological evidence on frailty is limited during the COVID-19 pandemic, and whether frailty is associated with the risk of infection is unknown. OBJECTIVES We derived a robust Frailty Index (FI) to measure the prevalence of frailty and its risk factors in community-dwelling older adults in Southern Switzerland (Ticino), and we explored the association between frailty and serologically confirmed SARS-CoV-2 infection. METHODS In September 2020, we recruited a random sample of community-dwelling older adults (65 +) in the Corona Immunitas Ticino prospective cohort study (CIT) and assessed a variety of lifestyle and health characteristics. We selected 30 health-related variables, computed the Rockwood FI, and applied standard thresholds for robust (FI < 0.1), pre-frail (0.1 ≤ FI < 0.21), and frail (FI ≥ 0.21). RESULTS Complete data for the FI was available for 660 older adults. The FI score ranged between zero (no frailty) and 0.59. The prevalence of frailty and pre-frailty were 10.3% and 48.2% respectively. The log-transformed FI score increased by age similarly in males and females, on average by 2.8% (p < 0.001) per one-year increase in age. Out of 481 participants with a valid serological test, 11.2% were seropositive to either anti-SARS-CoV-2 IgA or IgG. The frailty status and seropositivity were not statistically associated (p = 0.236). CONCLUSION Advanced age increases the risk of frailty. The risk of COVID-19 infection in older adults may not differ by frailty status.
Collapse
Affiliation(s)
- Miao Jiang
- grid.29078.340000 0001 2203 2861Institute of Public Health, Università della Svizzera italiana, Lugano, Switzerland
| | - Laurie Corna
- grid.16058.3a0000000123252233Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Rebecca Amati
- grid.29078.340000 0001 2203 2861Institute of Public Health, Università della Svizzera italiana, Lugano, Switzerland
| | | | - Giovanni Franscella
- grid.29078.340000 0001 2203 2861Institute of Public Health, Università della Svizzera italiana, Lugano, Switzerland
| | - Luca Crivelli
- grid.29078.340000 0001 2203 2861Institute of Public Health, Università della Svizzera italiana, Lugano, Switzerland ,grid.16058.3a0000000123252233Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Emiliano Albanese
- grid.29078.340000 0001 2203 2861Institute of Public Health, Università della Svizzera italiana, Lugano, Switzerland ,grid.8591.50000 0001 2322 4988Department of Psychiatry, University of Geneva, Geneva, Switzerland
| |
Collapse
|
18
|
Islam MI, Chadwick V, Martiniuk A. Identifying potential factors associated with PCR testing for COVID-19 among Australian young people: cross-sectional findings from a longitudinal study. BMC Public Health 2022; 22:2424. [PMID: 36564788 PMCID: PMC9786417 DOI: 10.1186/s12889-022-14892-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Testing has played a crucial role in reducing the spread of COVID-19. Though COVID-19 symptoms tend to be less severe in adolescents and young adults, their highly social lifestyles can lead to increased transmission of the virus. In this study, we aimed to provide population-based estimates of polymerase chain reaction testing (PCR) for the COVID-19 pandemic and identify factors associated with PCR testing in Australian youth using the latest survey data from the Longitudinal Study of Australian Children (LSAC). METHODS We used the latest wave (9C1) of the LSAC, collected from 16 to 21-year-old Australians via an online survey between October and December 2020. In total, 2291 youths responded to the questions about COVID-19 testing including factors related to the coronavirus restriction period (CRP) in Australia. Both bivariate and multivariate logistic regression analyses were performed to identify variables (sociodemographic factors and factors related to CRP) associated with COVID-19 testing. RESULTS During the study period, 26% (n = 587) of Australian youth aged between 16 and 21 years were tested for COVID-19. The strongest predictor of COVID-19 testing was living in major cities (aOR 1.82, 95% CI:1.34-2.45; p < 0.01). Increased age (aOR 1.97, 1.00-3.89; p < 0.05) and having a pre-existing medical condition (aOR 1.27, 1.02-1.59; p < 0.05) were also significantly associated with a higher likelihood of COVID-19 testing. CONCLUSION Age, remoteness and having a pre-existing medical illness were associated with PCR COVID-19 testing among Australian youth aged between 16 and 21 years in the first year of the COVID-19 pandemic. More research is warranted to identify factors associated with other COVID-19 testing methods and address the specific barriers that may limit COVID-19 testing in this age group.
Collapse
Affiliation(s)
- Md Irteja Islam
- grid.1013.30000 0004 1936 834XSydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Edward Ford Building, A27 Fisher Road, Camperdown, Sydney, NSW 2006 Australia ,grid.1048.d0000 0004 0473 0844Centre for Health Research and Faculty of Health, Engineering and Sciences, The University of Southern Queensland, West Street, Darling Heights, Toowoomba, QLD 4350 Australia
| | - Verity Chadwick
- grid.412703.30000 0004 0587 9093Royal North Shore Hospital, Reserve Rd, St Leonard’s, Sydney, NSW 2065 Australia
| | - Alexandra Martiniuk
- grid.1013.30000 0004 1936 834XSydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Edward Ford Building, A27 Fisher Road, Camperdown, Sydney, NSW 2006 Australia ,grid.415508.d0000 0001 1964 6010Office of the Chief Scientist, The George Institute for Global Health, Level 5/1 King Street, Newtown, Sydney, NSW 2042 Australia ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, The University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7 Canada
| |
Collapse
|
19
|
N’dilimabaka N, Mounguegui DM, Lekana-Douki SE, Yattara MK, Obame-Nkoghe J, Longo-Pendy NM, Koumba IPK, Mve-Ella OLB, Moukouama SK, Dzembo CE, Bolo LY, Biyie-Bi-Ngoghe P, Mangouka GL, Nzenze JR, Lekana-Douki JB. Biochemical and hematological factors associated with COVID-19 severity among Gabonese patients: A retrospective cohort study. Front Cell Infect Microbiol 2022; 12:975712. [PMID: 36619758 PMCID: PMC9816336 DOI: 10.3389/fcimb.2022.975712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022] Open
Abstract
The COVID-19 disease presents a large range of clinical manifestations and includes asymptomatic, mild, and severe cases. The level of severity is related to parameters associated with immunity, genetics, and biochemistry. Africa shows one of the lowest COVID-19 fatality rates but very few data on the biochemical markers of COVID-19 in patients and the factors associated with disease severity are available for the continent. In Gabon, the COVID-19 fatality rate is only 0.63% but almost no data on biomarkers in COVID-19 patients have been published. Both the number of COVID-19 cases and the mortality rate reported in Africa in general, and in Gabon in particular, are lower than in non-African countries. As such, understanding the factors associated with disease severity in Gabonese patients is a crucial step to better understand the disease in the African context and prepare for future COVID-19 waves and other epidemics of emerging diseases. Here, we compared biochemical and hematological markers among 753 Gabonese COVID-19 patients with asymptomatic (184/753), mild/moderate (420/753), and severe/critical (149/753) forms of the disease using an Analysis of Variance (ANOVA) or a Kruskal-Wallis (KW) test. We modeled these parameters together with comorbidities, age, and sex to predict factors associated with disease severity by using a "binomial generalized linear model" utilizing the "package" stats of R software version 4.0.2. Our results showed that almost all the biochemical and hematological parameters (except creatinine, phosphorus, D-dimers, platelets, and monocytes) varied according to disease severity. However, age and the dysfunction of organs like the kidney, liver, and lung together with the decrease of electrolytes (chloride, potassium, and sodium) are the best predictors of disease severity in Gabonese patients.
Collapse
Affiliation(s)
- Nadine N’dilimabaka
- Unité Emergence des Maladies Virales, Département de Virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon,Département de Biologie, Faculté des Sciences, Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon,*Correspondence: Nadine N’dilimabaka,
| | | | - Sonia Etenna Lekana-Douki
- Unité Emergence des Maladies Virales, Département de Virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | | | - Judicaël Obame-Nkoghe
- Département de Biologie, Faculté des Sciences, Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon,Unité Écologie des Systèmes Vectoriels (ESV), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Neil Michel Longo-Pendy
- Unité Écologie des Systèmes Vectoriels (ESV), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Ingrid Precilya Koumba Koumba
- Unité Emergence des Maladies Virales, Département de Virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Octavie Lauris Banga Mve-Ella
- Unité Emergence des Maladies Virales, Département de Virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Schedy Koumba Moukouama
- Unité Emergence des Maladies Virales, Département de Virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Cresh Emelya Dzembo
- Unité Emergence des Maladies Virales, Département de Virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Lauriane Yacka Bolo
- Unité Emergence des Maladies Virales, Département de Virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | | | | | - Jean-Raymond Nzenze
- Site Coronavirus, Hôpital d’Instruction des Armes d’Akanda, Libreville-Nord, Gabon
| | - Jean-Bernard Lekana-Douki
- Unité Evolution Epidémiologie et Résistances Parasitaires (UNEEREP), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon,Département de Parasitologie-Mycologie Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Sante, Libreville, Gabon
| |
Collapse
|
20
|
Mavragani A, Hardy F, Tucker K, Hopper A, Marchã MJM, Navaratnam AV, Briggs TWR, Yates J, Day J, Wheeler A, Eve-Jones S, Gray WK. Frailty, Comorbidity, and Associations With In-Hospital Mortality in Older COVID-19 Patients: Exploratory Study of Administrative Data. Interact J Med Res 2022; 11:e41520. [PMID: 36423306 PMCID: PMC9746678 DOI: 10.2196/41520] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Older adults have worse outcomes following hospitalization with COVID-19, but within this group there is substantial variation. Although frailty and comorbidity are key determinants of mortality, it is less clear which specific manifestations of frailty and comorbidity are associated with the worst outcomes. OBJECTIVE We aimed to identify the key comorbidities and domains of frailty that were associated with in-hospital mortality in older patients with COVID-19 using models developed for machine learning algorithms. METHODS This was a retrospective study that used the Hospital Episode Statistics administrative data set from March 1, 2020, to February 28, 2021, for hospitalized patients in England aged 65 years or older. The data set was split into separate training (70%), test (15%), and validation (15%) data sets during model development. Global frailty was assessed using the Hospital Frailty Risk Score (HFRS) and specific domains of frailty were identified using the Global Frailty Scale (GFS). Comorbidity was assessed using the Charlson Comorbidity Index (CCI). Additional features employed in the random forest algorithms included age, sex, deprivation, ethnicity, discharge month and year, geographical region, hospital trust, disease severity, and International Statistical Classification of Disease, 10th Edition codes recorded during the admission. Features were selected, preprocessed, and input into a series of random forest classification algorithms developed to identify factors strongly associated with in-hospital mortality. Two models were developed; the first model included the demographic, hospital-related, and disease-related items described above, as well as individual GFS domains and CCI items. The second model was similar to the first but replaced the GFS domains and CCI items with the HFRS as a global measure of frailty. Model performance was assessed using the area under the receiver operating characteristic (AUROC) curve and measures of model accuracy. RESULTS In total, 215,831 patients were included. The model using the individual GFS domains and CCI items had an AUROC curve for in-hospital mortality of 90% and a predictive accuracy of 83%. The model using the HFRS had similar performance (AUROC curve 90%, predictive accuracy 82%). The most important frailty items in the GFS were dementia/delirium, falls/fractures, and pressure ulcers/weight loss. The most important comorbidity items in the CCI were cancer, heart failure, and renal disease. CONCLUSIONS The physical manifestations of frailty and comorbidity, particularly a history of cognitive impairment and falls, may be useful in identification of patients who need additional support during hospitalization with COVID-19.
Collapse
Affiliation(s)
| | - Flavien Hardy
- Getting It Right First Time programme, National Health Service England and National Health Service Improvement, London, United Kingdom
| | - Katie Tucker
- Innovation and Intelligent Automation Unit, Royal Free London National Health Service Foundation Trust, London, United Kingdom
| | - Adrian Hopper
- Getting It Right First Time programme, National Health Service England and National Health Service Improvement, London, United Kingdom.,Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom
| | - Maria J M Marchã
- Science and Technology Facilities Council Distributed Research Utilising Advanced Computing High Performance Computing Facility, University College London, London, United Kingdom
| | - Annakan V Navaratnam
- University College London Hospitals National Health Service Foundation Trust, London, United Kingdom
| | - Tim W R Briggs
- Getting It Right First Time programme, National Health Service England and National Health Service Improvement, London, United Kingdom.,Royal National Orthopaedic Hospital National Health Service Trust, London, United Kingdom
| | - Jeremy Yates
- Department of Computer Science, University College London, London, United Kingdom
| | - Jamie Day
- Getting It Right First Time programme, National Health Service England and National Health Service Improvement, London, United Kingdom
| | - Andrew Wheeler
- Getting It Right First Time programme, National Health Service England and National Health Service Improvement, London, United Kingdom
| | - Sue Eve-Jones
- Getting It Right First Time programme, National Health Service England and National Health Service Improvement, London, United Kingdom
| | - William K Gray
- Getting It Right First Time programme, National Health Service England and National Health Service Improvement, London, United Kingdom
| |
Collapse
|
21
|
Lu G, Zhang Y, Zhang H, Ai J, He L, Yuan X, Bao S, Chen X, Wang H, Cai J, Wang S, Zhang W, Xu J. Geriatric risk and protective factors for serious COVID-19 outcomes among older adults in Shanghai Omicron wave. Emerg Microbes Infect 2022; 11:2045-2054. [PMID: 35924388 PMCID: PMC9448390 DOI: 10.1080/22221751.2022.2109517] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/31/2022] [Indexed: 01/22/2023]
Abstract
Shanghai has been experiencing the Omicron wave since March 2022. Though several studies have evaluated the risk factors of severe infections, the analyses of BA.2 infection risk and protective factors among geriatric people were much limited. This multicentre cohort study described clinical characteristics, and assessed risk and protective factors for geriatric Omicron severe infections. A total of 1377 patients older than 60 were enrolled, with 75.96% having comorbidities. The median viral shedding time and hospitalization time were nine and eight days, respectively. Severe and critical were associated with longer virus clearance time (aOR [95%CI]:0.706 (0.533-0.935), P = .015), while fully vaccinated/booster and paxlovid use shortened viral shedding time (1.229 [1.076-1.402], P = .002; 1.140 [0.019-1.274], P = .022, respectively). Older age (>80), cerebrovascular disease, and chronic kidney disease were risk factors of severe/critical. Fully vaccination was a significant protective factor against severe infections (0.237 [0.071-0.793], P = .019). We found patients with more than two comorbidities were more likely to get serious outcomes. These findings demonstrated that in the elderly older than 60 years old, older age (aged over 80), cerebrovascular disease, and chronic kidney disease were risk factors for severe infection. Patients with more than two comorbidities were more likely to get serious outcomes. Fully vaccinated/booster patients were less likely to be severe and vaccinations could shorten viral shedding time. The limitation of lacking an overall spectrum of COVID-19 infections among elders could be compensated in other larger-scale studies in the future.
Collapse
Affiliation(s)
- Guanzhu Lu
- Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yi Zhang
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Haocheng Zhang
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jingwen Ai
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
- Huashen Institute of Microbes and Infections, Shanghai, People’s Republic of China
| | - Liu He
- Medical section, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Xiaoling Yuan
- Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Suxia Bao
- Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Xiaohua Chen
- Department of Infectious Disease, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Hongyu Wang
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jianpeng Cai
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Sen Wang
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
- Huashen Institute of Microbes and Infections, Shanghai, People’s Republic of China
| | - Wenhong Zhang
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
- Huashen Institute of Microbes and Infections, Shanghai, People’s Republic of China
| | - Jie Xu
- Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| |
Collapse
|
22
|
Katipoglu B, Naharci MI, Yurdakul ES. Risk factors predicting hospital length of stay in older patients with type 2 diabetes with Covid-19. J Diabetes Metab Disord 2022; 21:1443-1449. [PMID: 35822155 PMCID: PMC9261895 DOI: 10.1007/s40200-022-01078-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/10/2022] [Accepted: 06/21/2022] [Indexed: 01/08/2023]
Abstract
Background Patients with Covid-19 disease could present with flu-like symptoms. However, nearly half of the subjects with positive test results for Covid-19 remain asymptomatic. Data on factors related to the duration of hospital stay in Covid-19 patients with diabetes mellitus remain limited. Objective We aimed to identify risk factors predicting prolonged hospital length of stay (LOS) among diabetic patients hospitalized with Covid-19. Methods This cohort study involved patients with type 2 diabetes (T2D) admitted to a tertiary hospital with mild or moderate Covid-19 between August 1 and November 31, 2020. Data on demographics, laboratory parameters, and clinical treatments were extracted from the medical records. Prolonged LOS was defined as equal to or greater than the median hospitable stay time. We used univariate and multivariate logistic regression analyses to explore risk factors associated with LOS. Results We included 87 hospitalized T2D patients with mild or moderate Covid-19. The mean age was 69.5 ± 6.9 years, and 59.8% were female. In the unadjusted analysis, factors influencing the length of hospitalization were as follows: undertreatment of diabetes, high procalcitonin level, glycated hemoglobin, and low lymphocyte count. After adjustment for all covariates, subjects with a low lymphocyte had a 3.9 fold increased risk of prolonged LOS (OR:3.925 CI:1.044-14.755 p = 0.043). Conclusions A lower lymphocyte count on admission was associated with prolonged hospital LOS in older T2D patients with Covid-19, suggesting this marker could help clinicians predict complications for an adverse outcome.
Collapse
Affiliation(s)
- Bilal Katipoglu
- Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, Division of Geriatrics, University of Health Sciences, 06010 Ankara, Turkey
- Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, 06010 Ankara, Turkey
| | - Mehmet Ilkin Naharci
- Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, Division of Geriatrics, University of Health Sciences, 06010 Ankara, Turkey
| | - Eray Serdar Yurdakul
- Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, Department of History of Medicine and Ethics, University of Health Sciences, 06010 Ankara, Turkey
| |
Collapse
|
23
|
Kananen L, Eriksdotter M, Boström A, Kivipelto M, Annetorp M, Metzner C, Bäck Jerlardtz V, Engström M, Johnson P, Lundberg L, Åkesson E, Sühl Öberg C, Hägg S, Religa D, Jylhävä J, Cederholm T. Body mass index and Mini Nutritional Assessment-Short Form as predictors of in-geriatric hospital mortality in older adults with COVID-19. Clin Nutr 2022; 41:2973-2979. [PMID: 34389208 PMCID: PMC8318666 DOI: 10.1016/j.clnu.2021.07.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/06/2021] [Accepted: 07/20/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Overweight and obesity have been consistently reported to carry an increased risk for poorer outcomes in coronavirus disease 2019 (COVID-19) in adults. Existing reports mainly focus on in-hospital and intensive care unit mortality in patient cohorts usually not representative of the population with the highest mortality, i.e. the very old and frail patients. Accordingly, little is known about the risk patterns related to body mass and nutrition in very old patients. Our aim was to assess the relationship between body mass index (BMI), nutritional status and in-geriatric hospital mortality among geriatric patients treated for COVID-19. As a reference, the analyses were performed also in patients treated for other diagnoses than COVID-19. METHODS We analyzed up to 10,031 geriatric patients with a median age of 83 years of which 1409 (14%) were hospitalized for COVID-19 and 8622 (86%) for other diagnoses in seven geriatric hospitals in the Stockholm region, Sweden during March 2020-January 2021. Data were available in electronic hospital records. The associations between 1) BMI and 2) nutritional status, assessed using the Mini-Nutritional Assessment - Short Form (MNA-SF) scale, and short-term in-geriatric hospital mortality were analyzed using logistic regression. RESULTS After adjusting for age, sex, comorbidity, polypharmacy, frailty and the wave of the pandemic (first vs. second), underweight defined as BMI<18.5 increased the risk of in-hospital mortality in COVID-19 patients (odds ratio [OR] = 2.30; confidence interval [CI] = 1.17-4.31). Overweight and obesity were not associated with in-hospital mortality. Malnutrition; i.e. MNA-SF 0-7 points, increased the risk of in-hospital mortality in patients treated for COVID-19 (OR = 2.03; CI = 1.16-3.68) and other causes (OR = 6.01; CI = 2.73-15.91). CONCLUSIONS Our results indicate that obesity is not a risk factor for very old patients with COVID-19, but emphasize the role of underweight and malnutrition for in-hospital mortality in geriatric patients with COVID-19.
Collapse
Affiliation(s)
- L. Kananen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Faculty of Social Sciences (Health Sciences), Gerontology Research Center, Tampere University, Tampere, Finland,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland,Corresponding author. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - M. Eriksdotter
- Division Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - A.M. Boström
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden,Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - M. Kivipelto
- Division Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden,Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - M. Annetorp
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - C. Metzner
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - V. Bäck Jerlardtz
- Department of Geriatric Medicine, Jakobsbergsgeriatriken, Stockholm, Sweden
| | - M. Engström
- Department of Geriatric Medicine, Sabbatsbergsgeriatriken, Stockholm, Sweden
| | - P. Johnson
- Department of Geriatric Medicine, Capio Geriatrik Nacka AB, Nacka, Sweden
| | - L.G. Lundberg
- Department of Geriatric Medicine, Dalengeriatriken Aleris Närsjukvård AB, Stockholm, Sweden
| | - E. Åkesson
- Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - C. Sühl Öberg
- Department of Geriatric Medicine, Handengeriatriken, Aleris Närsjukvård AB, Stockholm, Sweden
| | - S. Hägg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - D. Religa
- Division Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - J. Jylhävä
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Faculty of Social Sciences (Health Sciences), Gerontology Research Center, Tampere University, Tampere, Finland
| | - T. Cederholm
- Division Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| |
Collapse
|
24
|
Rodrigues AR, Teixeira-Lemos E, Mascarenhas-Melo F, Lemos LP, Bell V. Pharmacist Intervention in Portuguese Older Adult Care. Healthcare (Basel) 2022; 10:1833. [PMID: 36292280 PMCID: PMC9602367 DOI: 10.3390/healthcare10101833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 09/07/2024] Open
Abstract
Healthy ageing has become one of the most significant challenges in a society with an increasing life expectancy. Older adults have a greater prevalence of chronic disease, with the need for multiple medications to appropriately control these issues. In addition to their health concerns, ageing individuals are prone to loneliness, dependence, and economic issues, which may affect their quality of life. Governments and health professionals worldwide have developed various strategies to promote active and healthy ageing to improve the quality of life of older adults. Pharmacists are highly qualified health professionals, easily accessible to the population, thus playing a pivotal role in medication management. Their proximity to the patient puts them in a unique position to provide education and training to improve therapeutic adherence and identify medication-related problems. This paper aims to address the importance of Portuguese community pharmacists in the medication management of older adults, emphasising their intervention in health promotion, patient education, medication-related problems, deprescription, dose administration aids, and medication review and reconciliation. We also discuss home delivery services and medication management in long-term care facilities.
Collapse
Affiliation(s)
- Ana Rita Rodrigues
- Laboratory of Social Pharmacy and Public Health, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Edite Teixeira-Lemos
- CERNAS-IPV Research Centre, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal
| | - Filipa Mascarenhas-Melo
- Drug Development and Technology Laboratory, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, 3000-548 Coimbra, Portugal
- REQUIMTE/LAQV, Group of Pharmaceutical Technology, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Luís Pedro Lemos
- Nuclear Medicine Department, Centro Hospitalar e Universitário de Coimbra, 3000-548 Coimbra, Portugal
| | - Victoria Bell
- Laboratory of Social Pharmacy and Public Health, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, 3000-548 Coimbra, Portugal
| |
Collapse
|
25
|
Santillo E, Migale M. Beta receptor blocker therapy for the elderly in the COVID-19 era. World J Clin Cases 2022; 10:8088-8096. [PMID: 36159512 PMCID: PMC9403662 DOI: 10.12998/wjcc.v10.i23.8088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/26/2022] [Accepted: 07/11/2022] [Indexed: 02/06/2023] Open
Abstract
When the coronavirus disease 2019 (COVID-19) pandemic spread globally from the Hubei region of China in December 2019, the impact on elderly people was particularly unfavorable. The mortality associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was highest in older individuals, in whom frailty and comorbidities increased susceptibility to severe forms of COVID-19. Unfortunately, in older patients, the course of COVID-19 was often characterized by significant cardiovascular complications, such as heart failure decompensation, arrhythmias, pericarditis, and myopericarditis. Ensuring that the elderly have adequate therapeutic coverage against known cardiovascular diseases and risk factors is particularly important in the COVID-19 era. Beta blockers are widely used for the treatment and prevention of cardiovascular disease. The clinical benefits of beta blockers have been confirmed in elderly patients, and in addition to their negative chronotropic effect, sympathetic inhibition and anti-inflammatory activity are theoretically of great benefit for the treatment of COVID-19 infection. Beta blockers have not been clearly shown to prevent SARS-CoV-2 infection, but there is evidence from published studies including elderly patients that beta blockers are associated with a more favorable clinical course of COVID-19 and reduced mortality. In this minireview, we summarize the most important evidence available in the literature on the usefulness of beta blocker therapy for older patients in the context of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Elpidio Santillo
- Geriatric Rehabilitative Department, IRCCS-INRCA, Fermo 63900, Italy
| | - Monica Migale
- Geriatric Rehabilitative Department, IRCCS-INRCA, Fermo 63900, Italy
| |
Collapse
|
26
|
Benet M, Celi-Medina P, Fernández M, Ezquerra S. The COVID-19 Pandemic in Care Homes: An Exploration of Its Impact across Regions in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9617. [PMID: 35954969 PMCID: PMC9368388 DOI: 10.3390/ijerph19159617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022]
Abstract
This article provides an updated picture of the enormous consequences that the first wave of the COVID-19 pandemic (March-June 2020) had for older adults living in Spanish care homes. It aims to describe the regional variation in deaths among home care residents through a methodological triangulation of descriptive quantitative, ecological and documentary analysis. Figures of five different indicators of care home mortality are provided and some factors related to higher mortality rates are presented and analysed in the descriptive ecological analysis in order to depict trends and, in a linear regression, to determine their statistical significance. The clearest trend reflected by the data is that the higher the cumulative incidence and the number of care home beds in the surrounding area, the higher the COVID-19 care home mortality. We argue that the pandemic has brought to light the historical fragility and underdevelopment of the Spanish LTC sector, and that these factors have exacerbated the consequences of the pandemic. Finally, we conclude that publicly available and disaggregated data would allow a deeper and more accurate analysis of potentially explanatory factors such as the type of care home ownership and management, and that further qualitative research would shed more light on people's experiences.
Collapse
Affiliation(s)
- Marta Benet
- Campus Docent Sant Joan de Déu, School of Nursing, Universitat de Barcelona, Carrer Sant Benito Menni, 18-20, 08830 Sant Boi del Llobregat, Barcelona, Spain
| | - Patricia Celi-Medina
- Research Group on Inclusive Societies, Politics, and Communities, Universitat de Vic-Universitat Central de Catalunya, Masia Torre dels Frares, Carrer Perot Rocaguinarda, 17, 08500 Vic, Barcelona, Spain
- UNESCO Chair on Women, Development, and Cultures, Universitat de Vic-Universitat Central de Catalunya, Masia Torre dels Frares, Carrer Perot Rocaguinarda, 17, 08500 Vic, Barcelona, Spain
| | - Montserrat Fernández
- Research Group on Inclusive Societies, Politics, and Communities, Universitat de Vic-Universitat Central de Catalunya, Masia Torre dels Frares, Carrer Perot Rocaguinarda, 17, 08500 Vic, Barcelona, Spain
- UNESCO Chair on Women, Development, and Cultures, Universitat de Vic-Universitat Central de Catalunya, Masia Torre dels Frares, Carrer Perot Rocaguinarda, 17, 08500 Vic, Barcelona, Spain
| | - Sandra Ezquerra
- Research Group on Inclusive Societies, Politics, and Communities, Universitat de Vic-Universitat Central de Catalunya, Masia Torre dels Frares, Carrer Perot Rocaguinarda, 17, 08500 Vic, Barcelona, Spain
- UNESCO Chair on Women, Development, and Cultures, Universitat de Vic-Universitat Central de Catalunya, Masia Torre dels Frares, Carrer Perot Rocaguinarda, 17, 08500 Vic, Barcelona, Spain
- Department of Social Sciences and Community Health, School of Health and Welfare, Universitat de Vic-Universitat Central de Catalunya, Masia Torre dels Frares, Carrer Perot Rocaguinarda, 17, 08500 Vic, Barcelona, Spain
| |
Collapse
|
27
|
Bakuri AZ, Antwi-Berko D. " What Other Information Is There?": Identifying Information Gaps, Perceptions and Misconceptions on COVID-19 Among Minority Ethnic Groups in the Netherlands. FRONTIERS IN HEALTH SERVICES 2022; 2:824591. [PMID: 36925797 PMCID: PMC10012720 DOI: 10.3389/frhs.2022.824591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/21/2022] [Indexed: 11/13/2022]
Abstract
Background Multiple media platforms and various resources are available for information on the novel coronavirus disease (COVID-19). Identifying people's preferences is key to building public confidence and planning for successful national or regional health intervention strategies. Methods Using exploratory mixed-methods including a short survey, interviews and participant observation, this cross-sectional study of 160 respondents from the Ghanaian-Dutch, Afro and Hindustani Surinamese-Dutch communities in Amsterdam, the Netherlands was conducted. Data collected between February to April 2021, included demographics characteristics, knowledge, opinions, preferred source of information, behavioral factors, and information gaps on COVID-19 prevention measures, responses and decision-making of respondents. Descriptive statistics and follow-up in-depth interviews were conducted to determine the relationship between respondents' demographics, information sources, and attitudes/behaviors toward COVID-19. Results The findings of this study indicated that although many of the respondents from these communities had good knowledge on COVID-19, its modes of transmission and prevention measures, their willingness to take up initiatives and prioritize self responsibility toward their health are tied to their communal life. The respondents in this study demonstrated high value for social lives and relied on their connections with friends and families in shaping, obtaining, processing and utilizing COVID-19 information to build a sense of responsibility toward the uptake of COVID-19 prevention measures despite recent decline in number of cases. Conclusion This sense of responsibility means their active participation and ownership of interventions to address the specific personal concerns and that of their community. However, different factors play influential roles toward the behavior choices of our respondents regarding the COVID-19 prevention.
Collapse
Affiliation(s)
- Amisah Zenabu Bakuri
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, Netherlands
- Center for Conflict Studies-History of International Relations, Utrecht Unviversity, Utrecht, Netherlands
| | - Daniel Antwi-Berko
- Department of Basic and Applied Biology, University of Energy and Natural Resources, Sunyani, Ghana
| |
Collapse
|
28
|
Ramos-Rincon JM, Cobos-Palacios L, López-Sampalo A, Ricci M, Rubio-Rivas M, Nuñez-Rodriguez MV, Miranda-Godoy R, García-Leoni ME, Fernández-Madera-Martínez R, García-García GM, Beato-Perez JL, Monge-Monge D, Asín-Samper U, Bustamante-Vega M, Rábago-Lorite I, Freire-Castro SJ, Miramontes-González JP, Magallanes-Gamboa JO, Alcalá-Pedrajas JN, García-Gómez M, Cano-Llorente V, Carrasco-Sánchez FJ, Martinez-Carrilero J, Antón-Santos JM, Gómez-Huelgas R. Differences in clinical features and mortality in very old unvaccinated patients (≥ 80 years) hospitalized with COVID-19 during the first and successive waves from the multicenter SEMI-COVID-19 Registry (Spain). BMC Geriatr 2022; 22:546. [PMID: 35773622 PMCID: PMC9244878 DOI: 10.1186/s12877-022-03191-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/03/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Old age is one of the most important risk factors for severe COVID-19. Few studies have analyzed changes in the clinical characteristics and prognosis of COVID-19 among older adults before the availability of vaccines. This work analyzes differences in clinical features and mortality in unvaccinated very old adults during the first and successive COVID-19 waves in Spain. METHODS This nationwide, multicenter, retrospective cohort study analyzes unvaccinated patients ≥ 80 years hospitalized for COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry). Patients were classified according to whether they were admitted in the first wave (March 1-June 30, 2020) or successive waves (July 1-December 31, 2020). The endpoint was all-cause in-hospital mortality, expressed as the case fatality rate (CFR). RESULTS Of the 21,461 patients hospitalized with COVID-19, 5,953 (27.7%) were ≥ 80 years (mean age [IQR]: 85.6 [82.3-89.2] years). Of them, 4,545 (76.3%) were admitted during the first wave and 1,408 (23.7%) during successive waves. Patients hospitalized in successive waves were older, had a greater Charlson Comorbidity Index and dependency, less cough and fever, and met fewer severity criteria at admission (qSOFA index, PO2/FiO2 ratio, inflammatory parameters). Significant differences were observed in treatments used in the first (greater use of antimalarials, lopinavir, and macrolides) and successive waves (greater use of corticosteroids, tocilizumab and remdesivir). In-hospital complications, especially acute respiratory distress syndrome and pneumonia, were less frequent in patients hospitalized in successive waves, except for heart failure. The CFR was significantly higher in the first wave (44.1% vs. 33.3%; -10.8%; p < 0.001) and was higher among patients ≥ 95 years (54.4% vs. 38.5%; -15.9%; p < 0.001). After adjustments to the model, the probability of death was 33% lower in successive waves (OR: 0.67; 95% CI: 0.57-0.79). CONCLUSIONS Mortality declined significantly between the first and successive waves in very old unvaccinated patients hospitalized with COVID-19 in Spain. This decline could be explained by a greater availability of hospital resources and more effective treatments as the pandemic progressed, although other factors such as changes in SARS-CoV-2 virulence cannot be ruled out.
Collapse
Affiliation(s)
- Jose-Manuel Ramos-Rincon
- Department of Clinical Medicine, Miguel Hernández University of Elche, Ctra N332 s/n, 03550, Sant Joan d'Alacant, Alicante, Spain.
| | - Lidia Cobos-Palacios
- Department of Internal Medicine, Instituto de Investigación Biomédica de Málaga (IBIMA), Regional University Hospital of Málaga & University of Málaga, Málaga, Spain
| | - Almudena López-Sampalo
- Department of Internal Medicine, Instituto de Investigación Biomédica de Málaga (IBIMA), Regional University Hospital of Málaga & University of Málaga, Málaga, Spain
| | - Michele Ricci
- Department of Internal Medicine, Instituto de Investigación Biomédica de Málaga (IBIMA), Regional University Hospital of Málaga & University of Málaga, Málaga, Spain
| | - Manel Rubio-Rivas
- Internal Medicine Department, Bellvitge University Hospital, , Barcelona, L'Hospitalet de Llobregat, Spain
| | | | | | | | | | | | | | | | - Uxua Asín-Samper
- Internal Medicine Department, Miguel Servet University Hospital, Zaragoza, Spain
| | | | - Isabel Rábago-Lorite
- Internal Medicine Department, Infanta Sofía University Hospital, S. S. de los Reyes, Madrid, Spain
| | | | | | | | | | - Miriam García-Gómez
- Internal Medicine Department, Alfredo Espinosa Hospital, Urduliz, Vizcaya, Spain
| | | | | | | | | | - Ricardo Gómez-Huelgas
- Department of Internal Medicine, Instituto de Investigación Biomédica de Málaga (IBIMA), Regional University Hospital of Málaga & University of Málaga, Málaga, Spain
- CIBER de Fisiopatología de La Obesidad Y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
29
|
Rauhala AS, Fagerström LM, Lindholst AC, Sinervo TS, Bertelsen TM, Bliksvær T, Lunde BV, Solli R, Wolmesjö MG, Hansen MB. Which factors are associated with COVID-19 infection incidence in care services for older people in Nordic countries? A cross-sectional survey. Scand J Public Health 2022; 50:787-794. [PMID: 35546571 PMCID: PMC9361421 DOI: 10.1177/14034948221085398] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: To investigate the differences between Sweden, Denmark, Finland and Norway
regarding residential/home care units’ and frontline managers’ background
factors, the resources allocated and measures taken during the initial
phases of the COVID-19 pandemic, and whether and how these differences were
associated with COVID-19 among older people in residential/home units. Methods: Register- and survey-based data. Responses from managers in municipal and
private residential/home units. Number of municipal COVID-19 cases from
national registries. Multilevel logistic multivariate regression analysis
with presence of COVID-19 among older people in residential/home units as
the outcome variable. Results: The proportions of residential/home units with client COVID-19 cases,
mid-March–April 2020 were Denmark 22.7%, Finland 9.0%, Norway 9.7% and
Sweden 38.8%, most cases found in clusters. The proportions were similar
among employees. Client likelihood of having COVID-19 was six-fold higher if
the employees had COVID-19. Mean client cases per residential/home unit were
Denmark 0.78, Finland 0.46, Norway 0.22 and Sweden 1.23. For the same
municipal infection incidence class, Sweden’s mean client infection levels
were three-fold those of other countries. The regression analysis variables
country, municipal COVID-19 incidence proportion, and care type were
associated with client cases at p ⩽ .001. Compared with
Denmark, the odds ratios (ORs) for Sweden, Norway and Finland were 1.86,
0.41 and 0.35 respectively. The variable difficulties in preventive testing
had an OR of 1.56, p ⩽ .05. Conclusions: Municipal COVID-19 incidence, employee cases, and the lack of testing
resources somewhat explained the confirmed COVID-19 cases among older
people in residential/home units. A two- to five-fold unexplained
inter-country difference in ORs in the multivariate analyses was
notable. The level of protection of vulnerable older clients in
municipal and private residential/home units differed between the
included countries.
Collapse
Affiliation(s)
- Auvo S Rauhala
- Åbo Akademi University, Turku, Finland.,Vaasa Central Hospital, Finland
| | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Dembek ZF, Lordo RA. Influence of Perfluoroalkyl Substances on Occurrence of Coronavirus Disease 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095375. [PMID: 35564774 PMCID: PMC9103108 DOI: 10.3390/ijerph19095375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/23/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022]
Abstract
Epidemiologic evidence indicates exposure to polyfluoroalkyl substances (PFAS) influences immunosuppression, with diminished vaccination response. The relationship between PFAS blood levels and coronavirus disease 2019 (COVID-19) occurrence by age warrants further examination. This assessment identified blood PFAS exposure levels in discrete populations. Recent PFAS population studies summarizing age and gender results were identified and included. Geographically corresponding COVID-19 incidence data were determined for selected counties in North Carolina (NC) and Ohio (OH), and the state of New Jersey (NJ). Centers for Disease Control and Prevention COVID-19 databases were accessed for national incidence data by age groupings. We assessed associations between blood PFAS concentrations, COVID-19 incidence rates, and key demographic characteristics, within subpopulations. COVID-19 incidence counts and blood PFAS concentration were obtained for each age group, along with estimated U.S. Census total population. A general trend observed is higher PFAS levels in older age groups. Younger age groups contained fewer COVID-19 cases. Global COVID-19 mortality is highest in elderly populations with hospitalization and death greatly increasing from age 50. PFAS exposures occurring early in life may cause deleterious health effects later in life, including decreased antibody response and reduced disease resistance. Highest levels of both PFAS exposure and COVID-19 were found in the oldest populations. While this does not determine causality, such associations should help promote further study.
Collapse
|
31
|
ÇİFTÇİ M. THE INCREASE IN THE SOCIAL UTILITY OF THE GERIATRIC POPULATION GAINED FROM THE HUMAN HEALTH WORKERS DURING THE PANDEMIC. KONURALP TIP DERGISI 2022. [DOI: 10.18521/ktd.1059885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
32
|
Matsumoto K, Hamatani S, Shimizu E, Käll A, Andersson G. Impact of post-COVID conditions on mental health: a cross-sectional study in Japan and Sweden. BMC Psychiatry 2022; 22:237. [PMID: 35379224 PMCID: PMC8977559 DOI: 10.1186/s12888-022-03874-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 03/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Due to the coronavirus disease 2019 (COVID-19) pandemic, people have undermined their mental health. It has been reported that post-COVID conditions at a certain rate. However, information on the mental health of people with post-COVID conditions is limited. Thus, this study investigated the relationship between post-COVID conditions and mental health. METHODS Design of the present study was an International and collaborative cross-sectional study in Japan and Sweden from March 18 to June 15, 2021. The analyzed data included 763 adults who participated in online surveys in Japan and Sweden and submitted complete data. In addition to demographic data including terms related to COVID-19, psychiatric symptoms such as depression, anxiety, and post-traumatic stress were measured by using the fear of COVID-19 scale (FCV-19S), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 item (GAD-7), and Impact of Event Scale-Revised (IES-R). RESULTS Of the 135 COVID-19 survivors among the 763 total participants, 37.0% (n = 50/135) had COVID-19-related sequelae. First, the results of the Bonferroni-corrected Mann Whitney U test showed that the group infected SARS-CoV-2 with post-COVID conditions scored significantly higher than those without one and the non-infected group on all clinical symptom scales (P ≤ .05). Next, there was a significant difference that incidence rates of clinical-significant psychiatric symptoms among each group from the results of the Chi-squared test (P ≤ .001). Finally, the results of the multivariate logistic model revealed that the risk of having more severe clinical symptoms were 2.44-3.48 times higher among participants with post-COVID conditions. CONCLUSION The results showed that approximately half had some physical symptoms after COVID-19 and that post-COVID conditions may lead to the onset of mental disorders. TRIAL REGISTRATION The ethics committee of Chiba University approved this cross-sectional study (approval number: 4129). However, as no medical intervention was conducted, a clinical trial registration was not necessary.
Collapse
Affiliation(s)
- Kazuki Matsumoto
- grid.136304.30000 0004 0370 1101Research Center for Child Mental Development, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba, Japan ,grid.474800.f0000 0004 0377 8088Division of Clinical Psychology, Kagoshima University Hospital, Kagoshima, Japan
| | - Sayo Hamatani
- Research Center for Child Mental Development, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba, Japan. .,Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden. .,Research Center for Child Mental Development, University of Fukui, Fukui, Japan.
| | - Eiji Shimizu
- grid.136304.30000 0004 0370 1101Research Center for Child Mental Development, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba City, Chiba, Japan ,grid.136304.30000 0004 0370 1101Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Anton Käll
- grid.5640.70000 0001 2162 9922Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Gerhard Andersson
- grid.5640.70000 0001 2162 9922Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
33
|
Ismail SNA, Abdul Halim Zaki I, Noordin ZM, Md Hussin NS, Ming LC, Zulkifly HH. Clinical characteristics and risk factors for mortality in patients with COVID-19: A retrospective nationwide study in Malaysia. PROCEEDINGS OF SINGAPORE HEALTHCARE 2022. [PMCID: PMC8919107 DOI: 10.1177/20101058221085743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Age and multiple comorbidities have been reported to influence the case fatality rate of COVID-19 worldwide, so also in Malaysia; however, to date, no scientific study among the local population has been published to confirm this. This study aimed to determine the overall demographics and clinical characteristics of COVID-19 non-survivors in Malaysia, stratified by age (< 65 vs. ≥ 65 years old). The mortality was also compared between two half-year periods: March–August 2020 and September 2020–March 2021. Method Daily reports containing demographics and medical history of COVID-19 non-survivors from March 2020 to March 2021 were obtained from the Malaysian Ministry of Health website. All information was extracted retrospectively and analysed using descriptive and inferential statistics with SPSS. Results Of 1192 COVID-19 non-survivors, the overall mean (SD) age was 64.8 (15.7) years, with 64.7% male. Death was seen mostly among 50- to 64-year-olds (33.1%) and 65- to 74-year-olds (24.8%). The presence of underlying hypertension (61.8%) and diabetes mellitus (48.2%) were the most common comorbid diseases encountered in the COVID-19 non-survivors. Underlying hypertension, stroke, heart disease and dyslipidaemia were significantly higher among COVID-19 non-survivors who were ≥ 65 years old compared to those < 65 ( p < 0.05). Mortality was a lot higher in September 2020–March 2021 compared to March 2020–August 2020 (91.3% vs. 8.3%). Conclusion Older age, male gender and the presence of multimorbidity (hypertension, diabetes mellitus, stroke and heart disease) are risk factors that contribute to mortality due to COVID-19 in Malaysia, especially among those ≥ 65 years old.
Collapse
Affiliation(s)
- Siti NA Ismail
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Izzati Abdul Halim Zaki
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
- Cardiology Therapeutics Research Group, Universiti Teknologi MARA, Bandar Puncak Alam, Malaysia
| | - Zakiah Mohd Noordin
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
- Cardiology Therapeutics Research Group, Universiti Teknologi MARA, Bandar Puncak Alam, Malaysia
| | - Nur Sabiha Md Hussin
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Long Chiau Ming
- Pengiran Anak Puteri Rashidah Sa’adatul Bolkiah (PAPRSB) Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei
| | - Hanis Hanum Zulkifly
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
- Cardiology Therapeutics Research Group, Universiti Teknologi MARA, Bandar Puncak Alam, Malaysia
- Hanis Hanum Zulkifly, Department of Pharmacy Practice, UiTM Cawangan Selangor, Kampus Puncak Alam, Selangor, Malaysia.
| |
Collapse
|
34
|
Rojanaworarit C, Lambert DC, Conigliaro J, Kim EJ. Prevalence and risk characteristics of COVID-19 in outpatients: A cross-sectional study of New York-area clinics. J Med Life 2022; 14:645-650. [PMID: 35027966 PMCID: PMC8742885 DOI: 10.25122/jml-2021-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022] Open
Abstract
Outpatients can be at heightened risk of COVID-19 due to interaction between existing non-communicable diseases in outpatients and infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study measured the magnitude of COVID-19 prevalence and explored related risk characteristics among adult outpatients visiting medicine clinics within a New York state-based tertiary hospital system. Data were compiled from 63,476 adult patients visiting outpatient medicine clinics within a New York-area hospital system between March 1, 2020, and August 28, 2020. The outcome was a clinical diagnosis of COVID-19. Crude and adjusted prevalence ratios (PR) of a COVID-19 were analyzed using univariable and multivariable Poisson regression with robust standard errors. The prevalence of COVID-19 was higher among these outpatients (3.0%) than in the total population in New York State (2.2%) as of August 28, 2020. Multivariable analysis revealed adjusted prevalence ratios significantly greater than one for male sex (PR=1.10), age 40 to 64 compared to <40 (PR=1.19), and racial/ethnic minorities in comparison to White patients (Hispanic: PR=2.76; Black: PR=1.89; and Asian/others: PR=1.56). Nonetheless, factors including the advanced age of ≥65 compared to <40 (PR=0.69) and current smoking compared to non-smoking (PR=0.60) were related to significantly lower prevalence. Therefore, the prevalence of COVID-19 in outpatients was higher than that of the general population. The findings also enabled hypothesis generation that routine clinical measures comprising sex, age, race/ethnicity, and smoking were candidate risk characteristics of COVID-19 in outpatients to be further verified by designs capable of assessing temporal association.
Collapse
Affiliation(s)
- Chanapong Rojanaworarit
- Department of Health Professions, School of Health Professions and Human Services, Hofstra University, Hempstead, NY, USA
| | - Douglas Charles Lambert
- Department of General Internal Medicine, Northwell Health, Great Neck, NY, USA.,Section of Obesity Medicine, Northwell Health, Great Neck, NY, USA
| | - Joseph Conigliaro
- Department of General Internal Medicine, Northwell Health, Great Neck, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Eun Ji Kim
- Department of General Internal Medicine, Northwell Health, Great Neck, NY, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.,Feinstein Institutes for Medical Research, Great Neck, NY, USA
| |
Collapse
|
35
|
Rahayu R, Winarto W, Nasihun T. Interleukin-6 and C-reactive Protein on Admission as Predictor of Mortality in Severe COVID-19 Patients: A Retrospective Cohort Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Predictors of mortality, an important factor to guide management in COVID-19 patients, have not been fully understood. The common laboratory test for assessing severity in COVID-19 patients include Interleukin-6 (IL-6) and C-Reactive Protein (CRP). The aims of this study were determine the relationship between the two inflammatory biomarkers and mortality as well as their cut-off values in severe COVID-19 patients. We retrospectively analyzed 80 confirmed patients with severe COVID-19 admitted to an intensive care unit of a secondary hospital in Indonesia between August and December 2020. They were analyzed for baseline clinical and laboratory findings at admission and during the disease. The primary outcome was mortality within 14 days from admission. CRP and IL-6 levels were evaluated as prognostic factors for outcome using the ROC curve. A total of 80 confirmed patients consisting of 53 (71.25%) survivors, and 23 (28.75%) non-survivors. Mortality was weakly correlated with levels of IL-6 (r = 0.249) and CRP (r = 0.247). The IL-6 cut-off was 101.64 pg/ml (AUROC 0.658 (95% CI 0.529 – 0.787); p = 0.028). The CRP cut-off was 46.45 mg/L (AUROC 0.659 (95% CI 0.532 – 0.786); p = 0.027). Levels of IL-6 and CRP at the first day of admission were weak predictors of mortality in severe COVID-19 patients.
Collapse
|
36
|
Sciacchitano S, Capalbo C, Napoli C, Anibaldi P, Salvati V, De Vitis C, Mancini R, Coluzzi F, Rocco M. Nonthyroidal Illness Syndrome: To Treat or Not to Treat? Have We Answered the Question? A Review of Metanalyses. Front Endocrinol (Lausanne) 2022; 13:850328. [PMID: 35620389 PMCID: PMC9128382 DOI: 10.3389/fendo.2022.850328] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/16/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Nonthyroidal Illness Syndrome (NTIS) occurs in approximately 70% of patients admitted to Intensive Care Units (ICU)s and has been associated with increased risk of death. Whether patients with NTIS should receive treatment with thyroid hormones (TH)s is still debated. Since many interventional randomized clinical trials (IRCT)s were not conclusive, current guidelines do not recommend treatment for these patients. In this review, we analyze the reasons why TH treatment did not furnish convincing results regarding possible beneficial effects in reported IRCTs. METHODS We performed a review of the metanalyses focused on NTIS in critically ill patients. After a careful selection, we extracted data from four metanalyses, performed in different clinical conditions and diseases. In particular, we analyzed the type of TH supplementation, the route of administration, the dosages and duration of treatment and the outcomes chosen to evaluate the results. RESULTS We observed a marked heterogeneity among the IRCTs, in terms of type of TH supplementation, route of administration, dosages and duration of treatment. We also found great variability in the primary outcomes, such as prevention of neurological alterations, reduction of oxygen requirements, restoration of endocrinological and clinical parameters and reduction of mortality. CONCLUSIONS NTIS is a frequent finding in critical ill patients. Despite several available IRCTs, it is still unclear whether NTIS should be treated or not. New primary endpoints should be identified to adequately validate the efficacy of TH treatment and to obtain a clear answer to the question raised some years ago.
Collapse
Affiliation(s)
- Salvatore Sciacchitano
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
- Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy
| | - Carlo Capalbo
- Unit of Medical Oncology, Sant’Andrea University Hospital, Rome, Italy
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Christian Napoli
- Department of Surgical and Medical Science and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Paolo Anibaldi
- Health Management Director, Sant’Andrea University Hospital, Rome, Italy
| | - Valentina Salvati
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Claudia De Vitis
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Flaminia Coluzzi
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant’Andrea University Hospital, Rome, Italy
- Department Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Latina, Italy
- *Correspondence: Flaminia Coluzzi,
| | - Monica Rocco
- Department of Surgical and Medical Science and Translational Medicine, Sapienza University of Rome, Rome, Italy
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant’Andrea University Hospital, Rome, Italy
| |
Collapse
|
37
|
Ogboghodo EO, Osaigbovo II, Obaseki DE, Iduitua MTN, Asamah D, Oduware E, Okwara BU. Implementation of a COVID-19 screening tool in a southern Nigerian tertiary health facility. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000578. [PMID: 36962763 PMCID: PMC10021546 DOI: 10.1371/journal.pgph.0000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 07/25/2022] [Indexed: 11/18/2022]
Abstract
Screening for coronavirus disease 2019 (COVID-19) in emergency rooms of health facilities during outbreaks prevents nosocomial transmission. However, effective tools adapted for use in African countries are lacking. This study appraised an indigenous screening and triage tool for COVID-19 deployed at the medical emergency room of a Nigerian tertiary facility and determined the predictors of a positive molecular diagnostic test for COVID-19. A cross-sectional study of all patients seen between May and July 2020 at the Accident and Emergency of the University of Benin Teaching Hospital was conducted. Patients with any one of the inputs- presence of COVID-19 symptoms, history of international travel, age 60 years and above, presence of comorbidities and oxygen saturation < 94%- were stratified as high-risk and subjected to molecular testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Data was obtained from the screening record book patterned after a modified screening tool for COVID-19, deidentified and entered into IBM-SPSS version 25.0. Binary logistic regression was conducted to determine significant predictors of a positive SARS-CoV-2 test. The level of significance was set at p < 0.05. In total, 1,624 patients were screened. Mean age (standard deviation) was 53.9±18.0 years and 651 (40.1%) were 60 years and above. One or more symptoms of COVID-19 were present in 586 (36.1%) patients. Overall, 1,116 (68.7%) patients were designated high risk and tested for SARS-CoV-2, of which 359 (32.2%) were positive. Additional inputs, besides symptoms, increased COVID-19 detection by 108%. Predictors of a positive test were elderly age [AOR = 1.545 (1.127-2.116)], co-morbidity [AOR = 1.811 (1.296-2.530)] and oxygen saturation [AOR = 3.427 (2.595-4.528)]. This protocol using additional inputs such as oxygen saturation improved upon symptoms-based screening for COVID-19. Models incorporating identified predictors will be invaluable in resource limited settings.
Collapse
Affiliation(s)
- Esohe O Ogboghodo
- Department of Public Health and Community Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Iriagbonse I Osaigbovo
- Department of Medical Microbiology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Darlington E Obaseki
- Chief Medical Director's Office, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Micah T N Iduitua
- Accident and Emergency Department, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Doris Asamah
- Department of Nursing Services, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Emmanuel Oduware
- Department of Family Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Benson U Okwara
- Department of Internal Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| |
Collapse
|
38
|
Sadeghi F, Pournajaf A, Halaji M, Chehrazi M, Amiri FH, Amoli SS, Hasanzadeh A, Javanian M, Bayani M, Haddad Zavareh MS, Shokri M, Babazadeh A, Mohammadi M, Mehdinezhad H, Monadi M, Maleh PA, Nouri HR, Daraei A, Pasha MY, Tourani M, Ahmadian SR, Esmailzadeh N, Mirtabar SM, Asadi S, Nasiraie E, Ezami N, Gorjinejad S, Fallhpour K, Fakhraie F, Beheshti Y, Baghershiroodi M, Rasti F, Salehi M, Aleahmad A, Babapour R, Malekzadeh R, Kashi RH, Yahyapour Y. A Large Retrospective Study of Epidemiological Characteristics of COVID-19 Patients in the North of Iran: Association between SARS-CoV-2 RT-PCR Ct Values with Demographic Data. Int J Clin Pract 2022; 2022:1455708. [PMID: 35685485 PMCID: PMC9159227 DOI: 10.1155/2022/1455708] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/28/2022] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To avoid worsening from mild, moderate, and severe diseases and to reduce mortality, it is necessary to identify the subpopulation that is more vulnerable to the development of COVID-19 unfavorable consequences. This study aims to investigate the demographic information, prevalence rates of common comorbidities among negative and positive real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) patients, and the association between SARS-CoV-2 cycle threshold (Ct) at hospital admission, demographic data, and outcomes of the patients in a large population in Northern Iran. METHODS This large retrospective cross-sectional study was performed from 7 March to 20 December 2020. Demographic data, including gender, age, underlying diseases, clinical outcomes, and Ct values, were obtained from 8,318 cases suspected of COVID-19, who were admitted to four teaching hospitals affiliated to Babol University of Medical Sciences (MUBABOL), in the north of Iran. RESULTS Since 7 March 2020, the data were collected from 8,318 cases suspected of COVID-19 (48.5% female and 51.5% male) with a mean age of 53 ± 25.3 years. Among 8,318 suspected COVID-19 patients, 3,250 (39.1%) had a positive rRT-PCR result; 1,632 (50.2%) patients were male and 335 (10.3%) patients died during their hospital stay. The distribution of positive rRT-PCR revealed that most patients (464 (75.7%)) had a Ct between 21 and 30 (Group B). CONCLUSION Elderly patients, lower Ct, patients having at least one comorbidity, and male cases were significantly associated with increased risk for COVID-19-related mortality. Moreover, mortality was significantly higher in patients with diabetes, kidney disease, and respiratory disease.
Collapse
Affiliation(s)
- Farzin Sadeghi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Abazar Pournajaf
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mehrdad Halaji
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Hejazi Amiri
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Saghar Saber Amoli
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Ali Hasanzadeh
- Department of Medical Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mostafa Javanian
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Masoumeh Bayani
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahmoud Sadeghi Haddad Zavareh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mehran Shokri
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohsen Mohammadi
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hamed Mehdinezhad
- Department of Internal Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mahmoud Monadi
- Department of Internal Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Parviz Amri Maleh
- Department of Anesthesiology, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Hamid Reza Nouri
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Abdolreza Daraei
- Department of Medical Genetics, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | | | - Mehdi Tourani
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | | | - Nadia Esmailzadeh
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | | | - Shakiba Asadi
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ebrahim Nasiraie
- Part of Infectious Control, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Nafiseh Ezami
- Part of Medical Records, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Shahrbano Gorjinejad
- Part of Infectious Control, Amirkola Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Kobra Fallhpour
- Part of Infectious Control, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Fakhraie
- Part of Infectious Control, Shahid Yahyanejad Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Yousef Beheshti
- Department of Medical Genetics, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mahnaz Baghershiroodi
- Genetics Laboratory, Shafizadeh Amirkola Children's Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Faeze Rasti
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Salehi
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Atiyeh Aleahmad
- Department of Clinical Biochemistry, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Rahman Babapour
- Babol Health Center, Babol University of Medical Sciences, Babol, Iran
| | - Rahim Malekzadeh
- Babol Health Center, Babol University of Medical Sciences, Babol, Iran
| | | | - Yousef Yahyapour
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| |
Collapse
|
39
|
Akbari A, Fathabadi A, Razmi M, Zarifian A, Amiri M, Ghodsi A, Vafadar Moradi E. Characteristics, risk factors, and outcomes associated with readmission in COVID-19 patients: A systematic review and meta-analysis. Am J Emerg Med 2021; 52:166-173. [PMID: 34923196 PMCID: PMC8665665 DOI: 10.1016/j.ajem.2021.12.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND We aimed to determine the characteristics, risk factors, and outcomes associated with readmission in COVID-19 patients. METHODS PubMed, Embase, Web of Science, and Scopus databases were searched to retrieve articles on readmitted COVID-19 patients, available up to September 25, 2021. All studies comparing characteristics of readmitted and non-readmitted COVID-19 patients were included. We also included articles reporting the reasons for readmission in COVID-19 patients. Data were pooled and meta-analyzed using random or fixed-effect models, as appropriate. Subgroup analyses were conducted based on the place and duration of readmission. RESULTS Our meta-analysis included 4823 readmitted and 63,413 non-readmitted COVID-19 patients. The re-hospitalization rate was calculated at 9.3% with 95% Confidence Interval (CI) [5.5%-15.4%], mostly associated with respiratory or cardiac complications (48% and 14%, respectively). Comorbidities including cerebrovascular disease (Odds Ratio (OR) = 1.812; 95% CI [1.547-2.121]), cardiovascular (2.173 [1.545-3.057]), hypertension (1.608 [1.319-1.960]), ischemic heart disease (1.998 [1.495-2.670]), heart failure (2.556 [1.980-3.300]), diabetes (1.588 [1.443-1.747]), cancer (1.817 [1.526-2.162]), kidney disease (2.083 [1.498-2.897]), chronic pulmonary disease (1.601 [1.438-1.783]), as well as older age (1.525 [1.175-1.978]), male sex (1.155 [1.041-1.282]), and white race (1.263 [1.044-1.528]) were significantly associated with higher readmission rates (P < 0.05 for all instances). The mortality rate was significantly lower in readmitted patients (OR = 0.530 [0.329-0.855], P = 0.009). CONCLUSIONS Male sex, white race, comorbidities, and older age were associated with a higher risk of readmission among previously admitted COVID-19 patients. These factors can help clinicians and policy-makers predict, and conceivably reduce the risk of readmission in COVID-19 patients.
Collapse
Affiliation(s)
- Abolfazl Akbari
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Fathabadi
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahya Razmi
- Student Research Committee, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ahmadreza Zarifian
- Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran; Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Amiri
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Ghodsi
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elnaz Vafadar Moradi
- Emergency Department, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
| |
Collapse
|
40
|
Sciacchitano S, Capalbo C, Napoli C, Negro A, De Biase L, Marcolongo A, Anibaldi P, Salvati V, Petrella L, Merlo L, Alampi D, Alessandri E, Loffredo C, Ulivieri A, Lavra L, Magi F, Morgante A, Salehi LB, De Vitis C, Mancini R, Coluzzi F, Rocco M. Nonthyroidal illness syndrome (NTIS) in severe COVID-19 patients: role of T3 on the Na/K pump gene expression and on hydroelectrolytic equilibrium. J Transl Med 2021; 19:491. [PMID: 34861865 PMCID: PMC8640710 DOI: 10.1186/s12967-021-03163-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/23/2021] [Indexed: 12/27/2022] Open
Abstract
Background Nonthyroidal Illness Syndrome (NTIS) can be detected in many critical illnesses. Recently, we demonstrated that this condition is frequently observed in COVID-19 patients too and it is correlated with the severity the disease. However, the exact mechanism through which thyroid hormones influence the course of COVID-19, as well as that of many other critical illnesses, is not clear yet and treatment with T4, T3 or a combination of both is still controversial. Aim of this study was to analyze body composition in COVID-19 patients in search of possible correlation with the thyroid function. Methods and findings We report here our experience performed in 74 critically ill COVID-19 patients hospitalized in the intensive care unit (ICU) of our University Hospital in Rome. In these patients, we evaluated the thyroid hormone function and body composition by Bioelectrical Impedance Analysis (BIA) during the acute phase of the disease at admission in the ICU. To examine the effects of thyroid function on BIA parameters we analyzed also 96 outpatients, affected by thyroid diseases in different functional conditions. We demonstrated that COVID-19 patients with low FT3 serum values exhibited increased values of the Total Body Water/Free Fat Mass (TBW/FFM) ratio. Patients with the lowest FT3 serum values had also the highest level of TBW/FFM ratio. This ratio is an indicator of the fraction of FFM as water and represents one of the best-known body-composition constants in mammals. We found an inverse correlation between FT3 serum values and this constant. Reduced FT3 serum values in COVID-19 patients were correlated with the increase in the total body water (TBW), the extracellular water (ECW) and the sodium/potassium exchangeable ratio (Nae:Ke), and with the reduction of the intracellular water (ICW). No specific correlation was observed in thyroid patients at different functional conditions between any BIA parameters and FT3 serum values, except for the patient with myxedema, that showed a picture similar to that seen in COVID-19 patients with NTIS. Since the Na+/K+ pump is a well-known T3 target, we measured the mRNA expression levels of the two genes coding for the two major isoforms of this pump. We demonstrated that COVID-19 patients with NTIS had lower levels of mRNA of both genes in the peripheral blood mononuclear cells (PBMC)s obtained from our patients during the acute phase of the disease. In addition, we retrieved data from transcriptome analysis, performed on human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM)s treated with T3 and we demonstrated that in these cells T3 is able to stimulate the expression of these two genes in a dose-dependent manner. Conclusions In conclusion, we demonstrated that measurement of BIA parameters is a useful method to analyze water and salt retention in COVID-19 patients hospitalized in ICU and, in particular, in those that develop NTIS. Our results indicate that NTIS has peculiar similarities with myxedema seen in severe hypothyroid patients, albeit it occurs more rapidly. The Na+/K+ pump is a possible target of T3 action, involved in the pathogenesis of the anasarcatic condition observed in our COVID-19 patients with NTIS. Finally, measurement of BIA parameters may represent good endpoints to evaluate the benefit of future clinical interventional trials, based on the administration of T3 in patients with NTIS.
Collapse
Affiliation(s)
- Salvatore Sciacchitano
- Department of Clinical and Molecular Medicine, Sapienza University, Viale Regina Elena n. 324, 00161, Rome, Italy. .,Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy.
| | - Carlo Capalbo
- Department of Medical Oncology, Sant'Andrea University Hospital, 00189, Rome, Italy.,Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Christian Napoli
- Department of Clinical and Surgical Translational Medicine, Sapienza University, Rome, Italy
| | - Andrea Negro
- Department of Clinical and Molecular Medicine, Sapienza University, Viale Regina Elena n. 324, 00161, Rome, Italy
| | - Luciano De Biase
- Heart Failure Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Paolo Anibaldi
- Health Management Director, Sant'Andrea Hospital, Rome, Italy
| | - Valentina Salvati
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Lea Petrella
- Department of Methods and Models for Economics, Territory and Finance (MEMOTEF), Sapienza University of Rome, Rome, Italy
| | - Luca Merlo
- Department of Statistical Sciences, Sapienza University of Rome, Rome, Italy
| | - Daniela Alampi
- Department of Clinical and Surgical Translational Medicine, Sapienza University, Rome, Italy.,Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, Rome, Italy
| | - Elisa Alessandri
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, Rome, Italy
| | - Chiara Loffredo
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, Rome, Italy
| | - Alessandra Ulivieri
- Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy
| | - Luca Lavra
- Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy
| | - Fiorenza Magi
- Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy
| | - Alessandra Morgante
- Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy
| | - Leila B Salehi
- Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy.,U.O.C. of Medical Genetics, Policlinic of Tor Vergata, Rome, Italy
| | - Claudia De Vitis
- Department of Clinical and Molecular Medicine, Sapienza University, Viale Regina Elena n. 324, 00161, Rome, Italy
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sapienza University, Viale Regina Elena n. 324, 00161, Rome, Italy
| | - Flaminia Coluzzi
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Monica Rocco
- Department of Clinical and Surgical Translational Medicine, Sapienza University, Rome, Italy.,Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, Rome, Italy
| |
Collapse
|
41
|
Ahmed AA, Ad'hiah AH. Interleukin-37 is down-regulated in serum of patients with severe coronavirus disease 2019 (COVID-19). Cytokine 2021; 148:155702. [PMID: 34534925 PMCID: PMC8439667 DOI: 10.1016/j.cyto.2021.155702] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/17/2021] [Accepted: 09/03/2021] [Indexed: 01/08/2023]
Abstract
Pro-inflammatory and anti-inflammatory cytokines are indicated to play a prominent role in mediating the immunopathogenesis of coronavirus disease 19 (COVID-19). Interleukin (IL-37) is one of the anti-inflammatory cytokines that has been proposed to be involved in disease progression but the data are not overwhelming. Therefore, a case-control study was performed to analyze IL-37 levels in serum of 100 patients with severe COVID-19 and 100 blood donors (control group). Median age was significantly higher in COVID-19 cases than in controls. Stratification by gender, body mass index and ABO and Rh blood group systems showed no significant differences between patients and controls. Chronic diseases (cardiovascular and diabetes) were observed in 57.0% of patients. Serum levels of IL-37 and vitamin D were significantly decreased in patients compared to controls. The low level of IL-37 was more pronounced in males, overweight/obese cases, blood group B or AB cases, Rh-positive cases, and cases with no chronic disease. Low producers of IL-37 were more likely to develop COVID-19 (odds ratio = 2.66; 95% confidence interval = 1.51-4.70; corrected probability = 0.015). Receiver operating characteristic curve analysis demonstrated that a low serum level of IL-37 was a good predictor of COVID-19. Spearman's rank correlation analysis showed that IL-37 and vitamin D were significantly correlated. In conclusion, IL-37 was down-regulated in serum of patients with severe COVID-19 compared to controls. This down-regulation may be associated with an increased risk of disease. Gender, body mass index, blood groups and chronic disease status may also affect IL-37 levels.
Collapse
Affiliation(s)
- Aeshah A Ahmed
- Biotechnology Department, College of Science, University of Baghdad, Baghdad, Iraq
| | - Ali H Ad'hiah
- Tropical-Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq.
| |
Collapse
|
42
|
Oduro-Mensah D, Oduro-Mensah E, Quashie P, Awandare G, Okine L. Explaining the unexpected COVID-19 trends and potential impact across Africa. F1000Res 2021; 10:1177. [PMID: 36605410 PMCID: PMC9763772 DOI: 10.12688/f1000research.74363.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 11/03/2023] Open
Abstract
Official COVID-19 case counts and mortality rates across Africa are lower than had been anticipated. Research reports, however, indicate far higher exposure rates than the official counts in some countries. Particularly in Western and Central Africa, where mortality rates are disproportionately lower than the rest of the continent, this occurrence may be due to immune response adaptations resulting from (1) frequent exposure to certain pro-inflammatory pathogens, and (2) a prevalence of low-grade inflammation coupled with peculiar modifications to the immune response based on one's immunobiography. We suggest that the two factors lead to a situation where post infection, there is a rapid ramp-up of innate immune responses, enough to induce effective defense and protection against plethora pathogens. Alongside current efforts at procuring and distributing vaccines, we draw attention to the need for work towards appreciating the impact of the apparently widespread, asymptomatic SARS-CoV-2 infections on Africa's populations vis a vis systemic inflammation status and long-term consequences for public health.
Collapse
Affiliation(s)
- Daniel Oduro-Mensah
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | | | - Peter Quashie
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, LG 581, Ghana
| | - Gordon Awandare
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Laud Okine
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| |
Collapse
|
43
|
Oduro-Mensah D, Oduro-Mensah E, Quashie P, Awandare G, Okine L. Explaining the unexpected COVID-19 trends and potential impact across Africa. F1000Res 2021; 10:1177. [PMID: 36605410 PMCID: PMC9763772 DOI: 10.12688/f1000research.74363.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
Official COVID-19 case counts and mortality rates across Africa are lower than had been anticipated. Research reports, however, indicate far higher exposure rates than the official counts in some countries. Particularly in Western and Central Africa, where mortality rates are disproportionately lower than the rest of the continent, this occurrence may be due to immune response adaptations resulting from (1) frequent exposure to certain pro-inflammatory pathogens, and (2) a prevalence of low-grade inflammation coupled with peculiar modifications to the immune response based on one's immunobiography. We suggest that the two factors lead to a situation where post infection, there is a rapid ramp-up of innate immune responses, enough to induce effective defense and protection against plethora pathogens. Alongside current efforts at procuring and distributing vaccines, we draw attention to the need for work towards appreciating the impact of the apparently widespread, asymptomatic SARS-CoV-2 infections on Africa's populations vis a vis systemic inflammation status and long-term consequences for public health.
Collapse
Affiliation(s)
- Daniel Oduro-Mensah
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | | | - Peter Quashie
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, LG 581, Ghana
| | - Gordon Awandare
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Laud Okine
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| |
Collapse
|
44
|
Asukai Y, Briggs A, Garrison LP, Geisler BP, Neumann PJ, Ollendorf DA. Principles of Economic Evaluation in a Pandemic Setting: An Expert Panel Discussion on Value Assessment During the Coronavirus Disease 2019 Pandemic. PHARMACOECONOMICS 2021; 39:1201-1208. [PMID: 34557996 PMCID: PMC8460393 DOI: 10.1007/s40273-021-01088-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 05/15/2023]
Abstract
As the coronavirus disease 2019 (COVID-19) pandemic continues to generate significant morbidity and mortality as well as economic and societal impacts, the landscape of potential treatments has slowly begun to broaden. In the case of a novel disease with widespread consequences, society is more likely to place significant value on interventions that reduce the outsized economic burden of COVID-19. Treatments for severe disease will have a different value profile to that of large-scale vaccines because of their application in targeted and potentially small subsets of those with symptomatic disease vs broad deployment as a preventative measure. Where vaccines reduce transmissibility of COVID-19, use of therapeutics will target symptoms, up to and including death for infected individuals. This paper describes discussions from a virtual expert panel that met to attempt a consensus on how existing principles of economic evaluation should be applied to therapeutics that emerge in a pandemic setting, with specific focus on severe hospitalised cases of COVID-19. The panel concluded that the core principles of economic evaluation do not need to be drastically overhauled to meet the challenges of a pandemic, but that there are several additional elements of value such as equity, disease severity, insurance value, and scientific and family spillover effects that should be considered when presenting results to decision makers. The panel also highlighted the persistent challenges on how society should value novel therapies, such as the appropriate cost-effectiveness threshold to apply, which are particularly salient during a pandemic.
Collapse
Affiliation(s)
- Yumi Asukai
- Value Evidence and Outcomes, GSK, Brentford, England, UK.
| | - Andrew Briggs
- London School of Hygiene and Tropical Medicine, London, England, UK
| | - Louis P Garrison
- The Comparative Health Outcomes, Policy, and Economics Institute, University of Washington, Seattle, WA, USA
| | - Benjamin P Geisler
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig Maximilian University, Munich, Germany
- Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Peter J Neumann
- Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, Boston, MA, USA
| | - Daniel A Ollendorf
- Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, Boston, MA, USA
| |
Collapse
|
45
|
Sarabia-Cobo CM, Delgado Uria A, García Lecue M, Izaguirre Palazuelos E, Martínez Ruiz C, Fernández-Rodríguez Á. Predictive Model of Preventive Behaviors against COVID-19 in the Older Adult: The PREASOC-COVID-19 Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111067. [PMID: 34769587 PMCID: PMC8583025 DOI: 10.3390/ijerph182111067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022]
Abstract
Background: The purpose of this study was to analyze the relationship between COVID-19 preventive behaviors, as the dependent variable, with risk perception, coping style and sense of coherence, as independent variables, in older people living in the community. Methods: An observational design for predictive model development. This study was reported following the STROBE statement. The subjects were people over 65 years of age living in the community. Data collection included sociodemographic variables related to COVID-19, risk perception and types, coping styles in the face of contagion, sense of coherence, and preventive behaviors in the face of COVID-19. The data collection period was from November 2020 to January 2021. Results: A total of 305 people participated in this study (71.5% women, mean age 71.34 years; 6.9% suffered from COVID-19 and 44.3% knew someone close to them who suffered from the virus). The coping style variables problem-focused, emotion-focused, and sense of coherence subscales Significance and manageability explained 17% of the variable preventive behaviors against COVID-19. There were statistically significant differences by gender in all subscales, with women scoring higher in all of them; Conclusions: Men with low risk perception, extrinsic risk perception, and low sense of coherence presented worse COVID-19 preventive behaviors. It would be interesting to develop specific prevention and health education campaigns for this population.
Collapse
Affiliation(s)
- Carmen María Sarabia-Cobo
- Nursing Research Group IDIVAL, Geriatric Nursing Research Group, Faculty of Nursing, Universidad de Cantabria, 39011 Santander, Spain
- Correspondence:
| | - Aroa Delgado Uria
- Gerencia de Atención Primaria, Servicio Cántabro de Salud, Cantabria, IDIVAL, Universidad de Cantabria, 39011 Santander, Spain; (A.D.U.); (M.G.L.); (E.I.P.); (C.M.R.)
| | - Marta García Lecue
- Gerencia de Atención Primaria, Servicio Cántabro de Salud, Cantabria, IDIVAL, Universidad de Cantabria, 39011 Santander, Spain; (A.D.U.); (M.G.L.); (E.I.P.); (C.M.R.)
| | - Eva Izaguirre Palazuelos
- Gerencia de Atención Primaria, Servicio Cántabro de Salud, Cantabria, IDIVAL, Universidad de Cantabria, 39011 Santander, Spain; (A.D.U.); (M.G.L.); (E.I.P.); (C.M.R.)
| | - César Martínez Ruiz
- Gerencia de Atención Primaria, Servicio Cántabro de Salud, Cantabria, IDIVAL, Universidad de Cantabria, 39011 Santander, Spain; (A.D.U.); (M.G.L.); (E.I.P.); (C.M.R.)
| | | |
Collapse
|
46
|
Romon I, Dominguez-Garcia JJ, Arroyo JL, Suberviola B, Cabezón I, Abascal B, Baldeón C, Cuesta A, Portilla R, Casuso E, Ocio E, Briz M. Convalescent plasma treatment for patients of 80 years and older with COVID-19 pneumonia. BMC Geriatr 2021; 21:566. [PMID: 34663227 PMCID: PMC8521266 DOI: 10.1186/s12877-021-02447-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/30/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Older patients, frequently with multiple comorbidities, have a high mortality from COVID-19 infection. Convalescent plasma (CP) is a therapeutic option for these patients. Our objective is to retrospectively evaluate the efficacy and adverse events of CP treatment in this population group. METHODS Forty one patients over 80 years old with COVID-19 pneumonia received CP added to standard treatment, 51.2% with high anti-SARS-CoV-2 IgG titers and 48.8% with low titers. Median time between the onset of symptoms and the infusion of plasma was 7 days (IQR 4-10). A similar group of 82 patients who received only standard treatment, during a period in which CP was not available, were selected as a control group. RESULTS In-hospital mortality was 26.8% for controls and 14.6% for CP patients (P = 0.131) and ICU admission was 8.5% for controls and 4.9% for CP patients (P = 0.467). Mortality tended to be lower in the high-titer group (9.5%) than in the low-titer group (20%), and in patients transfused within the first 7 days of symptom onset (10%) than in patients transfused later (19.1%), although the differences were not statistically significant (P = 0.307 and P = 0.355 respectively). There was no difference in the length of hospitalization. No significant adverse events were associated with CP treatment. CONCLUSIONS Convalescent plasma treatment in patients over 80 years old with COVID-19 pneumonia was well tolerated but did not present a statistically significant difference in hospital mortality, ICU admission, or length of hospitalization. The results should be interpreted with caution as only half the patients received high-titer CP and the small number of patients included in the study limits the statistical power to detect significant differences. TRIAL REGISTRATION CEIm Cantabria # 2020.127.
Collapse
Affiliation(s)
- Iñigo Romon
- Hematology and Hemotherapy Service, Hospital Universitario Marqués de Valdecilla, Avenida Valdecilla, s/n, 39008, Santander, Spain.
| | - Juan J Dominguez-Garcia
- Hematology and Hemotherapy Service, Hospital Universitario Marqués de Valdecilla, Avenida Valdecilla, s/n, 39008, Santander, Spain
| | - Jose L Arroyo
- Banco de Sangre y Tejidos de Cantabria, 39121, Liencres, Spain
| | - Borja Suberviola
- Intensive Care Service, Hospital Universitario Marqués de Valdecilla, 39008, Santander, Spain
| | - Itxasne Cabezón
- Infectious Diseases Service, Hospital Universitario Marqués de Valdecilla, 39008, Santander, Spain
| | - Beatriz Abascal
- Pneumology Service, Hospital Universitario Marqués de Valdecilla, 39008, Santander, Spain
| | - Cristina Baldeón
- Internal Medicine Service, Hospital Universitario Marqués de Valdecilla, 39008, Santander, Spain
| | - Amalia Cuesta
- Haematology Service, Hospital de Sierrallana, 39300, Torrelavega, Spain
| | - Raquel Portilla
- Internal Medicine Service, Hospital de Sierrallana, 39300, Torrelavega, Spain
| | - Elena Casuso
- Internal Medicine Service, Hospital de Laredo, 39770, Laredo, Spain
| | - Enrique Ocio
- Hematology and Hemotherapy Service, Hospital Universitario Marqués de Valdecilla, Avenida Valdecilla, s/n, 39008, Santander, Spain
| | - Montserrat Briz
- Hematology and Hemotherapy Service, Hospital Universitario Marqués de Valdecilla, Avenida Valdecilla, s/n, 39008, Santander, Spain
| |
Collapse
|
47
|
Mahmoud M, Carmisciano L, Tagliafico L, Muzyka M, Rosa G, Signori A, Bassetti M, Nencioni A, Monacelli F. Patterns of Comorbidity and In-Hospital Mortality in Older Patients With COVID-19 Infection. Front Med (Lausanne) 2021; 8:726837. [PMID: 34604262 PMCID: PMC8486012 DOI: 10.3389/fmed.2021.726837] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/13/2021] [Indexed: 01/11/2023] Open
Abstract
Introduction: Older adults are more susceptible to severe COVID-19, with increased all-cause mortality. This has been attributed to their multimorbidity and disability. However, it remains to be established which clinical features of older adults are associated with severe COVID-19 and mortality. This information would aid in an accurate prognosis and appropriate care planning. Here, we aimed to identify the chronic clinical conditions and the comorbidity clusters associated with in-hospital mortality in a cohort of older COVID-19 patients who were admitted to the IRCCS Policlinico San Martino Hospital, Genoa, Italy, between January and April 2020. Methods: This was a retrospective cohort study including 219 consecutive patients aged 70 years or older and is part of the GECOVID-19 study group. During the study period, upon hospital admission, demographic information (age, sex) and underlying chronic medical conditions (multimorbidity) were recorded from the medical records at the time of COVID-19 diagnosis before any antiviral or antibiotic treatment was administered. The primary outcome measure was in-hospital mortality. Results: The vast majority of the patients (90%) were >80 years; the mean patient age was 83 ± 6.2 years, and 57.5% were men. Hypertension and cardiovascular disease, along with dementia, cerebrovascular diseases, and vascular diseases were the most prevalent clinical conditions. Multimorbidity was assessed with the Cumulative Illness Rating Scale. The risk of in-hospital mortality due to COVID-19 was higher for males, for older patients, and for patients with dementia or cerebral-vascular disease. We clustered patients into three groups based on their comorbidity pattern: the Metabolic-renal-cancer cluster, the Neurocognitive cluster and the Unspecified cluster. The Neurocognitive and Metabolic-renal-cancer clusters had a higher mortality compared with the Unspecified cluster, independent of age and sex. Conclusion: We defined patterns of comorbidity that accurately identified older adults who are at higher risk of death from COVID-19. These associations were independent of chronological age, and we suggest that the identification of comorbidity clusters that have a common pathophysiology may aid in the early assessment of COVID-19 patients with frailty to promote timely interventions that, in turn, may result in a significantly improved prognosis.
Collapse
Affiliation(s)
- Mona Mahmoud
- Geriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Martino Hospital, Genoa, Italy
| | - Luca Carmisciano
- DISSAL, Department of Health Science, University of Genoa, Genoa, Italy
| | - Luca Tagliafico
- Geriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Martino Hospital, Genoa, Italy
| | - Mariya Muzyka
- Geriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Martino Hospital, Genoa, Italy
| | - Gianmarco Rosa
- Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Martino Hospital, Genoa, Italy.,Cardiology Clinic, Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - Alessio Signori
- DISSAL, Department of Health Science, University of Genoa, Genoa, Italy
| | - Matteo Bassetti
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa and Policlinico San Martino Hospital, Genoa, Italy
| | - Alessio Nencioni
- Geriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Martino Hospital, Genoa, Italy
| | - Fiammetta Monacelli
- Geriatrics Clinic, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Martino Hospital, Genoa, Italy
| | | |
Collapse
|
48
|
RAHMAN MOHAMMADMESHBAHUR, BHATTACHARJEE BADHAN, FARHANA ZAKI, HAMIDUZZAMAN MOHAMMAD, CHOWDHURY MUHAMMADABDULBAKER, HOSSAIN MOHAMMADSOROWAR, SIDDIQEE MAHBUBULH, ISLAM MDZIAUL, RAHEEM ENAYETUR, UDDIN MDJAMAL. Age-related risk factors and severity of SARS-CoV-2 infection: a systematic review and meta-analysis. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E329-E371. [PMID: 34604574 PMCID: PMC8451365 DOI: 10.15167/2421-4248/jpmh2021.62.2.1946] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/29/2021] [Indexed: 01/08/2023]
Abstract
Objectives We aimed to estimate the prevalence of reported symptoms and comorbidities, and investigate the factors associated with age of the SARS-CoV-2 infected patients. Methods We performed a systematic review with meta-analysis (PROSPERO registration: CRD42020182677) where the databases (PubMed, SCOPUS, EMBASE, WHO, Semantic Scholar, and COVID-19 Primer) were searched for clinical studies published from January to April, 2020. Initially, the pooled prevalence of symptoms and comorbidity of COVID-19 patients were estimated using random effect model and the age -related factors were identified performing multivariate analysis [factor analysis]. Results Twenty-nine articles with 4,884 COVID-19 patients were included in this study. Altogether, we found 33 symptoms and 44 comorbidities where the most frequent 19 symptoms and 11 comorbidities were included in the meta-analysis. The fever (84%), cough/dry cough (61%), and fatigue/weakness (42%) were found more prevalent while acute respiratory distress syndrome, hypertension and diabetes were the most prevalent comorbid condition. The factor analysis showed positive association between a cluster of symptoms and comorbidities with patients' age. The symptoms comprising fever, dyspnea/shortness of breath, nausea, vomiting, abdominal pain, dizziness, anorexia and pharyngalgia; and the comorbidities including diabetes, hypertension, coronary heart disease, COPD/lung disease and ARDS were the factors positively associated with COVID-19 patient's age. Conclusion As an unique effort, this study found a group of symptoms (fever, dyspnea/shortness of breath, nausea, vomiting, abdominal pain, dizziness, anorexia and pharyngalgia) and comorbidities (diabetes, hypertension, coronary heart disease, COPD/lung disease and ARDS), associated with the age of COVID-19 infected patients.
Collapse
Affiliation(s)
- MOHAMMAD MESHBAHUR RAHMAN
- Biomedical Research Foundation, Dhaka, Bangladesh
- Correspondence: Mohammad Meshbahur Rahman, Biomedical Research Foundation, Dhaka-1230, Bangladesh - Tel.: +8801751509801 - E-mail:
| | | | - ZAKI FARHANA
- Department of Community Medicine, National Institute of Preventive and Social Medicine, Mohakhali, Dhaka, Bangladesh
| | - MOHAMMAD HAMIDUZZAMAN
- College of Health, Medicine & Wellbeing, University of Newcastle, New South Wales, Australia
| | | | | | | | - MD. ZIAUL ISLAM
- Department of Community Medicine, National Institute of Preventive and Social Medicine, Mohakhali, Dhaka, Bangladesh
| | | | - MD. JAMAL UDDIN
- Department of Statistics (Biostatistics and Epidemiology), Shahjalal University of Science & Technology, Sylhet, Bangladesh
| |
Collapse
|
49
|
Wilairatana P, Masangkay FR, Kotepui KU, Milanez GDJ, Kotepui M. Prevalence and characteristics of malaria among COVID-19 individuals: A systematic review, meta-analysis, and analysis of case reports. PLoS Negl Trop Dis 2021; 15:e0009766. [PMID: 34597315 PMCID: PMC8486116 DOI: 10.1371/journal.pntd.0009766] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/26/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The world population is currently at a very high risk of Coronavirus disease-2019 (COVID-19), caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). People who live in malaria-endemic areas and get infected by SARS-CoV-2 may be at increased risk of severe COVID-19 or unfavorable disease outcomes if they ignore their malaria status. Therefore, the present study aimed to synthesize, qualitatively and quantitatively, information on the prevalence and characteristics of malaria infection among COVID-19-infected individuals. The findings will help us better understand this particular comorbidity during the COVID-19 pandemic. METHODS The systematic review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) with the identification number: CRD42021247521. We searched for studies reporting on the coinfection of COVID-19 and malaria in PubMed, Web of Science, and Scopus from inception to March 27, 2021 using Medical Subject Headings (MeSH) terms. The study's methodological quality in the search output was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools for cross-sectional study. The pooled prevalence of Plasmodium spp. infection among patients infected with COVID-19 was estimated using the random effect model and then graphically presented as forest plots. The heterogeneity among the included studies was assessed using Cochrane Q and I2 statistics. The characteristics of patients co-infected with COVID-19 and malaria were derived from case reports and series and were formally analyzed using simple statistics. RESULTS Twelve of 1,207 studies reporting the coinfection of COVID-19 and malaria were selected for further analysis. Results of quantitative synthesis show that the pooled prevalence of Plasmodium spp. infection (364 cases) among COVID-19 individuals (1,126 cases) is 11%, with a high degree of heterogeneity (95% CI: 4%-18%, I2: 97.07%, 5 studies). Most of the coinfections were reported in Nigeria (336 cases), India (27 cases), and the Democratic Republic of Congo (1 case). Results of qualitative synthesis indicate that patients with coinfection are typically symptomatic at presentation with mild or moderate parasitemia. An analysis of case reports and series indicates that co-infected individuals often display thrombocytopenia, lymphopenia, and elevated bilirubin levels. Among four patients (30%) who required treatment with intravenous artesunate, one experienced worsened clinical status after administering the drug. One serious outcome of coinfection involved a pregnant woman who experienced fetal abortion due to the initial misdiagnosis of malaria. CONCLUSIONS All individuals in malaria-endemic regions who are febrile or display symptoms of COVID-19 should be evaluated for malaria to avoid serious complications. Further prospective studies are required to investigate the burden and outcomes of COVID-19 in malaria-endemic regions. Prompt management is required to prevent serious outcomes in individuals co-infected with COVID-19 and malaria.
Collapse
Affiliation(s)
- Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Frederick Ramirez Masangkay
- Department of Medical Technology, Institute of Arts and Sciences, Far Eastern University-Manila, Manila, Philippines
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Giovanni De Jesus Milanez
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| |
Collapse
|
50
|
Burgaña Agoües A, Serra Gallego M, Hernández Resa R, Joven Llorente B, Lloret Arabi M, Ortiz Rodriguez J, Puig Acebal H, Campos Hernández M, Caballero Ayala I, Pavón Calero P, Losilla Calle M, Bueno Nieto R, Oliver Messeguer L, Madridejos Mora R, Abellana Sangrà R, Perez-Porcuna TM. Risk Factors for COVID-19 Morbidity and Mortality in Institutionalised Elderly People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10221. [PMID: 34639522 PMCID: PMC8507792 DOI: 10.3390/ijerph181910221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/13/2021] [Accepted: 09/22/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND SARS-CoV-2 has caused a high mortality in institutionalised individuals. There are very few studies on the involvement and the real impact of COVID-19 in nursing homes. This study analysed factors related to morbidity and mortality of COVID-19 in institutionalised elderly people. METHODS This cohort study included 842 individuals from 12 nursing homes in Sant Cugat del Vallès (Spain) from 15 March to 15 May 2020. We evaluated individual factors (demographic, dependence, clinical, and therapeutic) and those related to the nursing homes (size and staff) associated with infection and mortality by SARS-CoV-2. Infection was diagnosed by molecular biology test. RESULTS Of the 842 residents included in the analysis, 784 underwent a Polymerase Chain Reaction (PCR) test; 74.2% were women, the mean age was 87.1 years, and 11.1% died. The PCR test was positive in 44%. A total of 33.4% of the residents presented symptoms compatible with COVID-19 and of these, 80.9% were PCR-positive for SARS-CoV-2. Infection by SARS-CoV-2 among residents was associated with the rate of staff infected in the homes. Mortality by SARS-CoV-2 was related to male sex and a greater grade of dependence measured with the Barthel index. CONCLUSIONS SARS-Cov-2 infection in institutionalised people is associated with the infection rate in nursing home workers and mortality by SARS-Cov-2 with sex and greater dependency according to the Barthel index. Adequate management of nursing home staff and special attention to measures of infection control, especially of individuals with greater dependence, are keys for successful management of future pandemic situations.
Collapse
Affiliation(s)
- Ander Burgaña Agoües
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Marta Serra Gallego
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Raquel Hernández Resa
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Beatriz Joven Llorente
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Maria Lloret Arabi
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Jessica Ortiz Rodriguez
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Helena Puig Acebal
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Mireia Campos Hernández
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Itziar Caballero Ayala
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Pedro Pavón Calero
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Montserrat Losilla Calle
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Rosario Bueno Nieto
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Laura Oliver Messeguer
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | - Rosa Madridejos Mora
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| | | | - Tomás M. Perez-Porcuna
- Atenció Primària, Fundació Assitencial Mútua Terrassa, 08221 Terrassa, Spain; (A.B.A.); (M.S.G.); (R.H.R.); (B.J.L.); (M.L.A.); (J.O.R.); (H.P.A.); (M.C.H.); (I.C.A.); (P.P.C.); (M.L.C.); (R.B.N.); (L.O.M.); (R.M.M.); (T.M.P.-P.)
| |
Collapse
|