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Torres G, Constantinou D, Gradidge P, Patel D, Patricios J. Exercise is the Most Important Medicine for COVID-19. Curr Sports Med Rep 2023; 22:284-289. [PMID: 37549214 DOI: 10.1249/jsr.0000000000001092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
ABSTRACT COVID-19 infection and long COVID affect multiple organ systems, including the respiratory, cardiovascular, renal, digestive, neuroendocrine, musculoskeletal systems, and sensory organs. Exerkines, released during exercise, have a potent crosstalk effect between multiple body systems. This review describes the evidence of how exerkines can mitigate the effects of COVID-19 in each organ system that the virus affects. The evidence presented in the review suggests that exercise should be considered a first-line strategy in the prevention and treatment of COVID-19 infection and long COVID disease.
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Affiliation(s)
- Georgia Torres
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Demitri Constantinou
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Philippe Gradidge
- Department of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Deepak Patel
- Division of Sports & Exercise Medicine, Department of Family Medicine & Primary Care, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jon Patricios
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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2
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Nieman DC, Sakaguchi CA. Physical activity lowers the risk for acute respiratory infections: Time for recognition. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:648-655. [PMID: 35995362 PMCID: PMC9391085 DOI: 10.1016/j.jshs.2022.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/19/2022] [Accepted: 08/04/2022] [Indexed: 05/30/2023]
Abstract
Physical inactivity is a well-established risk factor for chronic diseases, such as cardiovascular disease, cancer, and diabetes mellitus. There is a growing awareness that physical inactivity should also be regarded as a risk factor for acute respiratory infections (ARIs). ARIs, such as the common cold, influenza, pneumonia, and coronavirus disease 2019 (COVID-19), are among the most pervasive diseases on earth and cause widespread morbidity and mortality. Evidence in support of the linkage between ARIs and physical inactivity has been strengthened during the COVID-19 pandemic because of increased scientific scrutiny. Large-scale studies have consistently reported that the risk for severe COVID-19 outcomes is elevated in cohorts with low physical activity and/or physical fitness, even after adjusting for other risk factors. The lowered risk for severe COVID-19 and other ARIs in physically active groups is attributed to exercise-induced immunoprotective effects, including enhanced surveillance of key immune cells and reduced chronic inflammation. Scientific consensus groups, including those who submitted the Physical Activity Guidelines for Americans, have not yet given this area of research the respect that is due. It is time to add "reduced risk for ARIs" to the "Exercise is Medicine" list of physical activity-related health benefits.
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Affiliation(s)
- David C Nieman
- Human Performance Laboratory, Appalachian State University, North Carolina Research Campus, Kannapolis, NC 28081, USA.
| | - Camila A Sakaguchi
- Human Performance Laboratory, Appalachian State University, North Carolina Research Campus, Kannapolis, NC 28081, USA
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3
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Li H, Yuan K, Sun YK, Zheng YB, Xu YY, Su SZ, Zhang YX, Zhong Y, Wang YJ, Tian SS, Gong YM, Fan TT, Lin X, Gobat N, Wong SYS, Chan EYY, Yan W, Sun SW, Ran MS, Bao YP, Shi J, Lu L. Efficacy and practice of facemask use in general population: a systematic review and meta-analysis. Transl Psychiatry 2022; 12:49. [PMID: 35105851 PMCID: PMC8804079 DOI: 10.1038/s41398-022-01814-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 12/14/2021] [Accepted: 01/18/2022] [Indexed: 11/17/2022] Open
Abstract
In recent decades, respiratory infections, including SARS, HINI and the currently spreading COVID-19, caused by various viruses such as influenza and coronavirus have seriously threatened human health. It has generated inconsistent recommendations on the mandatory use of facemasks across countries on a population level due to insufficient evidence on the efficacy of facemask use among the general population. This meta-analysis aimed to explore (1) the efficacy of facemask use on preventing respiratory infections, and (2) the perceptions, intentions, and practice about facemask use among the general population worldwide. We searched PubMed, MEDLINE, Web of Science, Cochrane, bioRxiv, and medRxiv databases since inception to August 17, 2020. From 21,341 records identified, eight RCTs on facemask in preventing infections and 78 studies on perception, intention, and practice of facemask use among the general population were included in the analysis. The meta-analysis of RCTs found a significant protective effect of facemask intervention (OR = 0.84; 95% CI = 0.71-0.99; I2 = 0%). This protective effect was even more pronounced when the intervention duration was more than two weeks (OR = 0.76; 95% CI = 0.66-0.88; I2 = 0%). The meta-analysis of observational studies on perception, intention, and practice on facemask use showed that 71% of respondents perceived facemasks to be effective for infection prevention, 68% of respondents would wear facemasks, and 54% of respondents wore facemasks for preventing respiratory infections. Differences in perception, intention, and practice behavior of facemask use in different regions may be related to the impact of respiratory infections, regional culture, and policies. The governments and relevant organizations should make effort to reduce the barriers in the use of facemasks.
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Affiliation(s)
- Hui Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Yan-Kun Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Yong-Bo Zheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Ying-Ying Xu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China
- School of Public Health, Peking University, 100191, Beijing, China
| | - Si-Zhen Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Yu-Xin Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- School of Public Health, Peking University, 100191, Beijing, China
| | - Yi Zhong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Yi-Jie Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Shan-Shan Tian
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Yi-Miao Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Teng-Teng Fan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Xiao Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Nina Gobat
- Nuffield Dept of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Emily Ying Yang Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, School of Public Health and Primary Care, Prince of Wales Hospital, Sha tin, Hong Kong
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Si-Wei Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China.
- School of Public Health, Peking University, 100191, Beijing, China.
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China.
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China.
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4
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Li C, Li Z, Guo J, Yang Y, Liu C, Wang M, Zhu Y. The hotspots and trends of coronavirus disease 2019 (COVID-19) and physical therapy: a bibliometric and visual analysis. J Phys Ther Sci 2021; 33:903-907. [PMID: 34873371 PMCID: PMC8636920 DOI: 10.1589/jpts.33.903] [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: 07/17/2021] [Accepted: 09/16/2021] [Indexed: 12/23/2022] Open
Abstract
[Purpose] With the COVID-19 pandemic, more and more articles have been published to
explore the role of physical therapy on COVID-19. In order to analyze the research
hotspots and the trends of physical therapy and COVID-19, we conducted bibliometric and
visual analysis. [Methods] Data were collected from the Science Citation Index Expanded
(SCI-EXPANDED) and Social Sciences Citation Index (SSCI) of the Web of Science Core
Collect (WoSCC) from 2019 to 2021. CiteSpace and VOSviewer were used to perform the visual
analysis of keywords and references to help quickly get key information. [Results] A total
of 466 publications were retrieved. Exercise, sedentary behavior, and mental health were
research hotspots. The relationship between exercise and immunity, as well as the
management of COVID-19 patients after discharge were the research trends. [Conclusion]
This study provided relevant information for future research. Findings suggested that
physical therapy is beneficial for suspected or confirmed COVID-19 patients during
isolation. It is hoped that academic exchanges can be quickly established in the face of
infectious diseases. And in the future, we should focus on the rehabilitation of
discharged patients.
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Affiliation(s)
- Conghui Li
- Academy of Medical Sciences, Zhengzhou University, China
| | - Ziwei Li
- Department of Musculoskeletal Pain Rehabilitation, The Fifth Affiliated Hospital of Zhengzhou University: 450000, China
| | - Jiabao Guo
- The Second School of Clinical Medicine, Xuzhou Medical University, China
| | - Yujie Yang
- Department of Biomedical Sciences, City University of Hong Kong, China
| | - Chunyu Liu
- Department of Musculoskeletal Pain Rehabilitation, The Fifth Affiliated Hospital of Zhengzhou University: 450000, China
| | - Mengqi Wang
- Department of Musculoskeletal Pain Rehabilitation, The Fifth Affiliated Hospital of Zhengzhou University: 450000, China
| | - Yi Zhu
- Department of Musculoskeletal Pain Rehabilitation, The Fifth Affiliated Hospital of Zhengzhou University: 450000, China
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5
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Ishibashi Y, Tsujimoto H, Sugasawa H, Mochizuki S, Okamoto K, Kajiwara Y, Shinto E, Takahata R, Kobayashi M, Fujikura Y, Hase K, Kishi Y, Ueno H. How has the COVID-19 pandemic affected gastrointestinal surgery for malignancies and surgical infections? NAGOYA JOURNAL OF MEDICAL SCIENCE 2021; 83:715-725. [PMID: 34916716 PMCID: PMC8648525 DOI: 10.18999/nagjms.83.4.715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/25/2021] [Indexed: 11/30/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected infection control and prevention measures. We investigated the impact of the COVID-19 pandemic on postoperative infections and infection control measures in patients underwent gastrointestinal surgery for malignancies. We retrospectively evaluated changes in clinicopathological features, frequency of alcohol-based hand sanitizer use, frequency of postoperative complications, and microbial findings among our patients in February-May in 2019 (Control group) and 2020 (Pandemic group), respectively. Surgical resection in pathological stage III or IV patients was more frequently performed in the Pandemic group than in the Control group (P = 0.02). The total length of hospitalization and preoperative hospitalization was significantly shorter in the Pandemic group (P = 0.01 and P = 0.008, respectively). During the pandemic, hand sanitizer was used by a patients for an average of 14.9±3.0 times/day during the pandemic as opposed to 9.6±3.0 times/day in 2019 (p<0.0001). Superficial surgical site infection and infectious colitis occurred less frequently during the pandemic (P = 0.04 and P = 0.0002, respectively). In Pandemic group, Enterobacter, Haemophilus, and Candida were significantly decreased in microbiological cultures (P < 0.05, P < 0.05, P = 0.02, respectively) compared with Control group. Furthermore, a significant decrease in Streptococcus from drainage cultures was observed in the Pandemic group (P < 0.05). During the COVID-19 pandemic, a decrease in nosocomial infections was observed in the presence of an increase in alcohol-based hand sanitizer use.
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Affiliation(s)
- Yusuke Ishibashi
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Hironori Tsujimoto
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
,Department of Medical Risk Management and Infection Control, National Defense Medical College, Tokorozawa, Japan
| | - Hidekazu Sugasawa
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Satsuki Mochizuki
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Koichi Okamoto
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Yoshiki Kajiwara
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Eiji Shinto
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Risa Takahata
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
,Department of Medical Risk Management and Infection Control, National Defense Medical College, Tokorozawa, Japan
| | - Minako Kobayashi
- Department of Medical Risk Management and Infection Control, National Defense Medical College, Tokorozawa, Japan
| | - Yuji Fujikura
- Department of Medical Risk Management and Infection Control, National Defense Medical College, Tokorozawa, Japan
| | - Kazuo Hase
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Yoji Kishi
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Hideki Ueno
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
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6
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Burtscher J, Burtscher M, Millet GP. The central role of mitochondrial fitness on antiviral defenses: An advocacy for physical activity during the COVID-19 pandemic. Redox Biol 2021; 43:101976. [PMID: 33932869 PMCID: PMC8062414 DOI: 10.1016/j.redox.2021.101976] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/06/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023] Open
Abstract
Mitochondria are central regulators of cellular metabolism, most known for their role in energy production. They can be "enhanced" by physical activity (including exercise), which increases their integrity, efficiency and dynamic adaptation to stressors, in short "mitochondrial fitness". Mitochondrial fitness is closely associated with cardiorespiratory fitness and physical activity. Given the importance of mitochondria in immune functions, it is thus not surprising that cardiorespiratory fitness is also an integral determinant of the antiviral host defense and vulnerability to infection. Here, we first briefly review the role of physical activity in viral infections. We then summarize mitochondrial functions that are relevant for the antiviral immune response with a particular focus on the current Coronavirus Disease (COVID-19) pandemic and on innate immune function. Finally, the modulation of mitochondrial and cardiorespiratory fitness by physical activity, aging and the chronic diseases that represent the most common comorbidities of COVID-19 is discussed. We conclude that a high mitochondrial - and related cardiorespiratory - fitness should be considered as protective factors for viral infections, including COVID-19. This assumption is corroborated by reduced mitochondrial fitness in many established risk factors of COVID-19, like age, various chronic diseases or obesity. We argue for regular analysis of the cardiorespiratory fitness of COVID-19 patients and the promotion of physical activity - with all its associated health benefits - as preventive measures against viral infection.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, CH-1015, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, CH-1015, Lausanne, Switzerland.
| | | | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, CH-1015, Lausanne, Switzerland
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7
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Calabrese L, Neiman DC. Exercise, infection and rheumatic diseases: what do we know? RMD Open 2021; 7:e001644. [PMID: 34001646 PMCID: PMC8130750 DOI: 10.1136/rmdopen-2021-001644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/04/2021] [Accepted: 05/04/2021] [Indexed: 12/26/2022] Open
Affiliation(s)
| | - David C Neiman
- Department of Biology, Human Performance Laboratory, Appalachian State University, Boone, North Carolina, USA
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8
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Brainard J, Jones NR, Lake IR, Hooper L, Hunter PR. Community use of face masks and similar barriers to prevent respiratory illness such as COVID-19: a rapid scoping review. ACTA ACUST UNITED AC 2021; 25. [PMID: 33303066 PMCID: PMC7730486 DOI: 10.2807/1560-7917.es.2020.25.49.2000725] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BackgroundEvidence for face-mask wearing in the community to protect against respiratory disease is unclear.AimTo assess effectiveness of wearing face masks in the community to prevent respiratory disease, and recommend improvements to this evidence base.MethodsWe systematically searched Scopus, Embase and MEDLINE for studies evaluating respiratory disease incidence after face-mask wearing (or not). Narrative synthesis and random-effects meta-analysis of attack rates for primary and secondary prevention were performed, subgrouped by design, setting, face barrier type, and who wore the mask. Preferred outcome was influenza-like illness. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) quality assessment was undertaken and evidence base deficits described.Results33 studies (12 randomised control trials (RCTs)) were included. Mask wearing reduced primary infection by 6% (odds ratio (OR): 0.94; 95% CI: 0.75-1.19 for RCTs) to 61% (OR: 0.85; 95% CI: 0.32-2.27; OR: 0.39; 95% CI: 0.18-0.84 and OR: 0.61; 95% CI: 0.45-0.85 for cohort, case-control and cross-sectional studies respectively). RCTs suggested lowest secondary attack rates when both well and ill household members wore masks (OR: 0.81; 95% CI: 0.48-1.37). While RCTs might underestimate effects due to poor compliance and controls wearing masks, observational studies likely overestimate effects, as mask wearing might be associated with other risk-averse behaviours. GRADE was low or very low quality.ConclusionWearing face masks may reduce primary respiratory infection risk, probably by 6-15%. It is important to balance evidence from RCTs and observational studies when their conclusions widely differ and both are at risk of significant bias. COVID-19-specific studies are required.
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Affiliation(s)
- Julii Brainard
- The Norwich School of Medicine, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Natalia R Jones
- School of Environmental Sciences, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Iain R Lake
- School of Environmental Sciences, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Lee Hooper
- The Norwich School of Medicine, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Paul R Hunter
- The Norwich School of Medicine, University of East Anglia, Norwich, Norfolk, United Kingdom
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9
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Brainard J, Jones NR, Lake IR, Hooper L, Hunter PR. Community use of face masks and similar barriers to prevent respiratory illness such as COVID-19: a rapid scoping review. Euro Surveill 2020; 25. [PMID: 33303066 DOI: 10.1101/2020.04.01.20049528] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
BackgroundEvidence for face-mask wearing in the community to protect against respiratory disease is unclear.AimTo assess effectiveness of wearing face masks in the community to prevent respiratory disease, and recommend improvements to this evidence base.MethodsWe systematically searched Scopus, Embase and MEDLINE for studies evaluating respiratory disease incidence after face-mask wearing (or not). Narrative synthesis and random-effects meta-analysis of attack rates for primary and secondary prevention were performed, subgrouped by design, setting, face barrier type, and who wore the mask. Preferred outcome was influenza-like illness. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) quality assessment was undertaken and evidence base deficits described.Results33 studies (12 randomised control trials (RCTs)) were included. Mask wearing reduced primary infection by 6% (odds ratio (OR): 0.94; 95% CI: 0.75-1.19 for RCTs) to 61% (OR: 0.85; 95% CI: 0.32-2.27; OR: 0.39; 95% CI: 0.18-0.84 and OR: 0.61; 95% CI: 0.45-0.85 for cohort, case-control and cross-sectional studies respectively). RCTs suggested lowest secondary attack rates when both well and ill household members wore masks (OR: 0.81; 95% CI: 0.48-1.37). While RCTs might underestimate effects due to poor compliance and controls wearing masks, observational studies likely overestimate effects, as mask wearing might be associated with other risk-averse behaviours. GRADE was low or very low quality.ConclusionWearing face masks may reduce primary respiratory infection risk, probably by 6-15%. It is important to balance evidence from RCTs and observational studies when their conclusions widely differ and both are at risk of significant bias. COVID-19-specific studies are required.
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Affiliation(s)
- Julii Brainard
- The Norwich School of Medicine, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Natalia R Jones
- School of Environmental Sciences, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Iain R Lake
- School of Environmental Sciences, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Lee Hooper
- The Norwich School of Medicine, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Paul R Hunter
- The Norwich School of Medicine, University of East Anglia, Norwich, Norfolk, United Kingdom
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10
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Promising effects of exercise on the cardiovascular, metabolic and immune system during COVID-19 period. J Hum Hypertens 2020; 35:1-3. [PMID: 32943741 PMCID: PMC7495974 DOI: 10.1038/s41371-020-00416-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/25/2020] [Accepted: 09/09/2020] [Indexed: 12/24/2022]
Abstract
With 4 billion people in lockdown in the world, COVID-19 outbreak may result in excessive sedentary time, especially in the population of vulnerable and disabled subjects. In many chronic disorders and diseases including type 2 diabetes mellitus and hypertension, cardiovascular and immune beneficial effects of exercise interventions should be reminded.
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11
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Greenhalgh T. Face coverings for the public: Laying straw men to rest. J Eval Clin Pract 2020; 26:1070-1077. [PMID: 32455503 PMCID: PMC8581764 DOI: 10.1111/jep.13415] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 12/24/2022]
Abstract
Background This article responds to one by Graham Martin and colleagues, who offered a critique of my previous publications on face coverings for the lay public in the Covid-19 pandemic. Their paper reflects criticisms that have been made of face coverings policies more generally. Method Narrative rebuttal. Results I address charges that my coauthors and I had misapplied the precautionary principle; drawn conclusions that were not supported by empirical research; and failed to take account of potential harms But before that, I remind my critics that the evidence on face coverings goes beyond the contested trials and observational studies they place centre stage. I set out some key findings from basic science, epidemiology, mathematical modelling, case studies, and natural experiments, and use this rich and diverse body of evidence as the backdrop for my rebuttal of their narrowly framed objections. I challenge my critics' apparent assumption that a particular kind of systematic review should be valorised over narrative and real-world evidence, since stories are crucial to both our scientific understanding and our moral imagination. Conclusion I conclude by thanking my academic adversaries for the intellectual sparring match, but exhort them to remember our professional accountability to a society in crisis. It is time to lay straw men to rest and embrace the full range of evidence in the context of the perilous threat the world is now facing.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
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12
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Nieman DC. Coronavirus disease-2019: A tocsin to our aging, unfit, corpulent, and immunodeficient society. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:293-301. [PMID: 32389882 PMCID: PMC7205734 DOI: 10.1016/j.jshs.2020.05.001] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 05/07/2023]
Abstract
Acute and chronic respiratory illnesses cause widespread morbidity and mortality, and this class of illness now includes the novel coronavirus severe acute respiratory syndrome that is causing coronavirus disease-2019 (COVID-19). The world is experiencing a major demographic shift toward an older, obese, and physically inactive populace. Risk factor assessments based on pandemic data indicate that those at higher risk for severe illness from COVID-19 include older males, and people of all ages with obesity and related comorbidities such as hypertension and type 2 diabetes. Aging in and of itself leads to negative changes in innate and adaptive immunity, a process termed immunosenescence. Obesity causes systemic inflammation and adversely impacts immune function and host defense in a way that patterns immunosenescence. Two primary prevention strategies to reduce the risk for COVID-19 at both the community and individual levels include mitigation activities and the adoption of lifestyle practices consistent with good immune health. Animal and human studies support the idea that, in contrast to high exercise workloads, regular moderate-intensity physical activity improves immunosurveillance against pathogens and reduces morbidity and mortality from viral infection and respiratory illnesses including the common cold, pneumonia, and influenza. The odds are high that infectious disease pandemics spawned by novel pathogens will continue to inflict morbidity and mortality as the world's population becomes older and more obese. COVID-19 is indeed a wake-up call, a tocsin, to the world that primary prevention countermeasures focused on health behaviors and hygiene demand our full attention and support.
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Affiliation(s)
- David C Nieman
- Department of Biology, College of Arts and Sciences, Appalachian State University, North Carolina Research Campus, Kannapolis, NC 28081, USA.
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Ravalli S, Musumeci G. Coronavirus Outbreak in Italy: Physiological Benefits of Home-Based Exercise During Pandemic. J Funct Morphol Kinesiol 2020; 5:jfmk5020031. [PMID: 33467247 PMCID: PMC7739427 DOI: 10.3390/jfmk5020031] [Citation(s) in RCA: 50] [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: 04/24/2020] [Revised: 04/26/2020] [Accepted: 04/30/2020] [Indexed: 12/13/2022] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic has forced the hardest-hit populations, like Italians, to radically change their daily habits, starting with social distancing, strict preventive measures, and self-isolation. These precautions also apply to sport-related facilities and activities. The difficulty to practice physical activity during this dramatic moment in time adds to the risks associated with sedentary habits, due to staying all the time at home. Here, the importance and the benefits of maintaining exercise routine, even at home, are emphasized in order to avoid the consequences of inactivity.
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Affiliation(s)
- Silvia Ravalli
- Department of Biomedical and Biotechnological Sciences, Human, Histology and Movement Science Section, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy;
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Human, Histology and Movement Science Section, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy;
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123 Catania, Italy
- Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA
- Correspondence: ; Tel.: +39-095-378-2043
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Bin Abdulrahman AK, Bin Abdulrahman KA, Almadi MK, Alharbi AM, Mahmoud MA, Almasri MS, Alanazi TR, Alarifi RA, Kilani AA, Albluwi OS, Al Fraih MA, Al Otabi YT, Alanazi HO, Almufarih WA, Alokayli AM, Alwhibi OA. Do various personal hygiene habits protect us against influenza-like illness? BMC Public Health 2019; 19:1324. [PMID: 31640641 PMCID: PMC6805437 DOI: 10.1186/s12889-019-7726-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/09/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Several studies have reported an association between improvements in hand hygiene and the reductions in rates of intestinal parasitic diseases. However, only a some have addressed its link to the frequency of influenza-like illness. The current study aimed to find the correlation between personal hygiene habits and the frequency of influenza-like illness. METHODS A cross-sectional study targeting 3000 participants conducted in Riyadh city, Saudi Arabia. A systematic random sampling methodology was applied for participant from different part of Riyadh city using a computer generating system. The researcher first started by calling each participant. A full explanation was given to each participant in details (from the purpose of the research, consent to answer the questionnaire, to the explanation of the outcome definition). Each point of the questionnaire was explained to them to make sure they had excellent comprehension, and therefore, respond accurately. Descriptive statistics and Odds Ratio and its 95% confidence intervals were used to determine the association between frequency of influenza-like illness and the studied variables. RESULTS Two thousand eighty-two (69.4%) completed the questionnaire. The participants who spent 5-10 s in handwashing with soap and rubbing were at increased risk of more frequent influenza-like illness (odds ratio = 1.37, 1.08-1.75). Handwashing with soap and rubbing after handshaking is an independent protective habit against frequent influenza-like illness (adjusted OR = 0.59, 0.37-0.94). CONCLUSION The decrease of the frequency of influenza-like illness could be done through the following: getting the influenza vaccine annually, washing hands with soap and hand rubbing not less than 15 s after getting out of the bathroom, before and after handshaking and before eating. Soap companies should invent soaps that take less rubbing time to kill bacteria, and subsequently may maximize compliance in the community.
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Affiliation(s)
- Amro K. Bin Abdulrahman
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Khalid A. Bin Abdulrahman
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Mansour K. Almadi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdulrahman M. Alharbi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Mahmoud A. Mahmoud
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Mohammed S. Almasri
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Tariq R. Alanazi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Rakan A. Alarifi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdullah A. Kilani
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Omar S. Albluwi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Muaath A. Al Fraih
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Yaser T. Al Otabi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Hani O. Alanazi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Waleed A. Almufarih
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdullah M. Alokayli
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Omar A. Alwhibi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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15
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Nieman DC, Wentz LM. The compelling link between physical activity and the body's defense system. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:201-217. [PMID: 31193280 PMCID: PMC6523821 DOI: 10.1016/j.jshs.2018.09.009] [Citation(s) in RCA: 597] [Impact Index Per Article: 119.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/26/2018] [Accepted: 09/25/2018] [Indexed: 05/05/2023]
Abstract
This review summarizes research discoveries within 4 areas of exercise immunology that have received the most attention from investigators: (1) acute and chronic effects of exercise on the immune system, (2) clinical benefits of the exercise-immune relationship, (3) nutritional influences on the immune response to exercise, and (4) the effect of exercise on immunosenescence. These scientific discoveries can be organized into distinctive time periods: 1900-1979, which focused on exercise-induced changes in basic immune cell counts and function; 1980-1989, during which seminal papers were published with evidence that heavy exertion was associated with transient immune dysfunction, elevated inflammatory biomarkers, and increased risk of upper respiratory tract infections; 1990-2009, when additional focus areas were added to the field of exercise immunology including the interactive effect of nutrition, effects on the aging immune system, and inflammatory cytokines; and 2010 to the present, when technological advances in mass spectrometry allowed system biology approaches (i.e., metabolomics, proteomics, lipidomics, and microbiome characterization) to be applied to exercise immunology studies. The future of exercise immunology will take advantage of these technologies to provide new insights on the interactions between exercise, nutrition, and immune function, with application down to the personalized level. Additionally, these methodologies will improve mechanistic understanding of how exercise-induced immune perturbations reduce the risk of common chronic diseases.
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Affiliation(s)
- David C. Nieman
- Human Performance Laboratory, Appalachian State University, North Carolina Research Campus, Kannapolis, NC 28081, USA
- Corresponding author.
| | - Laurel M. Wentz
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC 28608, USA
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Effectiveness of hand hygiene practices in preventing influenza virus infection in the community setting: A systematic review. ACTA ACUST UNITED AC 2019; 45:12-23. [PMID: 31015816 PMCID: PMC6461122 DOI: 10.14745/ccdr.v45i01a02] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Hand hygiene is known to be an effective infection prevention and control measure in health care settings. However, the effectiveness of hand hygiene practices in preventing influenza infection and transmission in the community setting is not clear. Objective To identify, review and synthesize available evidence on the effectiveness of hand hygiene in preventing laboratory-confirmed or possible influenza infection and transmission in the community setting. Methods A systematic review protocol was established prior to conducting the review. Three electronic databases (MEDLINE, Embase and the Cochrane Library) were searched to identify relevant studies. Two reviewers independently screened the titles, abstracts and full-texts of studies retrieved from the database searches for potential eligibility. Data extraction and quality assessment of included studies were performed by a single reviewer and validated by a second reviewer. Included studies were synthesized and analyzed narratively. Results A total of 16 studies were included for review. Studies were of low methodological quality and there was high variability in study design, setting, context and outcome measures. Nine studies evaluated the effectiveness of hand hygiene interventions or practices in preventing laboratory-confirmed or possible influenza infection in the community setting; six studies showed a significant difference, three studies did not. Seven studies assessed the effectiveness of hand hygiene practices in preventing laboratory-confirmed or possible influenza transmission in the community setting; two studies found a significant difference and five studies did not. Conclusion The effectiveness of hand hygiene against influenza virus infection and transmission in the community setting is difficult to determine based on the available evidence. In light of its proven effectiveness in other settings, there is no compelling evidence to stop using good hand hygiene practice to reduce the risk of influenza infection and transmission in the community setting.
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Caini S, Spreeuwenberg P, Donker G, Korevaar J, Paget J. Climatic factors and long-term trends of influenza-like illness rates in The Netherlands, 1970-2016. ENVIRONMENTAL RESEARCH 2018; 167:307-313. [PMID: 30081307 DOI: 10.1016/j.envres.2018.07.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/11/2018] [Accepted: 07/27/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Climatic factors affect the survival and transmissibility of respiratory viruses causing influenza-like illness (ILI), and we hypothesized that changes in absolute humidity and temperature may affect long-term trends of ILI incidence rate in temperate countries. We tested this hypothesis using ILI and meteorological time series in the Netherlands for the period 1970-2016. METHODS We described the long-term trends of ILI incidence, absolute humidity and temperature; modelled the association between climatic factors and ILI activity using negative binomial regression models; and assessed the strength of the association between the seasonal average absolute humidity (or temperature) and ILI incidence rate using the Spearman's rank correlation coefficient. RESULTS The ILI incidence rate declined from 1970 and reached a minimum in the season 2002-03, but started to increase again from the season 2003-04 onwards. In the negative binominal regression models, the weekly ILI count was inversely associated (p < 0.001) with 0- and 1-week lagged absolute humidity and temperature. After three decades of rising absolute humidity and temperature (1970-2000), the early 2000s represented a trend-reversal point for the climatic time series. The seasonal average ILI incidence rate and absolute humidity (or temperature) were strongly (inversely) correlated. CONCLUSIONS Our findings suggest that climate change may have played a role in the long-term trends of ILI incidence rates in the Netherlands, as we were able to show that lower humidity and temperature in a given week were associated with higher ILI incidence in the next week, there was a clear time point reversal in climatic parameters and ILI rates in the 2000s, and the average annual ILI incidence was inversely related to average annual temperatures and humidity.
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Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
| | - Peter Spreeuwenberg
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
| | - Gé Donker
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
| | - Joke Korevaar
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
| | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
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Chan TC, Hu TH, Hwang JS. Estimating the Risk of Influenza-Like Illness Transmission Through Social Contacts: Web-Based Participatory Cohort Study. JMIR Public Health Surveill 2018; 4:e40. [PMID: 29631987 PMCID: PMC5913573 DOI: 10.2196/publichealth.8874] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 01/26/2018] [Accepted: 02/11/2018] [Indexed: 12/20/2022] Open
Abstract
Background Epidemiological studies on influenza have focused mostly on enhancing vaccination coverage or promoting personal hygiene behavior. Few studies have investigated potential effects of personal health behaviors and social contacts on the risk of getting influenza-like illness (ILI). Objective Taking advantage of an online participatory cohort, this study aimed to estimate the increased risk of getting ILI after contact with infected persons and examine how personal health behaviors, weather, and air pollution affect the probability of getting ILI. Methods A Web-based platform was designed for participants to record daily health behaviors and social contacts during the influenza season of October 1, 2015 to March 31, 2016, in Taiwan. Data on sleep, diet, physical activity, self-reported ILI, and contact with infected persons were retrieved from the diaries. Measurements of weather and air pollutants were used for calculating environmental exposure levels for the participants. We fitted a mixed-effects logistic regression model to the daily measurements of the diary keepers to estimate the effects of these variables on the risk of getting ILI. Results During the influenza season, 160 participants provided 14,317 health diaries and recorded 124,222 face-to-face contacts. The model estimated odds ratio of getting ILI was 1.87 (95% CI 1.40-2.50) when a person had contact with others having ILI in the previous 3 days. Longer duration of physical exercise and eating more fruits, beans, and dairy products were associated with lower risk of getting ILI. However, staying up late was linked to an elevated risk of getting ILI. Higher variation of ambient temperature and worse air quality were associated with increased risk of developing ILI. Conclusions Developing a healthier lifestyle, avoiding contact with persons having ILI symptoms, and staying alert with respect to temperature changes and air quality can reduce the risk of getting ILI.
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Affiliation(s)
- Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei City, Taiwan
| | - Tsuey-Hwa Hu
- Institute of Statistical Science, Academia Sinica, Taipei City, Taiwan
| | - Jing-Shiang Hwang
- Institute of Statistical Science, Academia Sinica, Taipei City, Taiwan
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19
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Srivastav A, Santibanez TA, Lu PJ, Stringer MC, Dever JA, Bostwick M, Kurtz MS, Qualls NL, Williams WW. Preventive behaviors adults report using to avoid catching or spreading influenza, United States, 2015-16 influenza season. PLoS One 2018; 13:e0195085. [PMID: 29601610 PMCID: PMC5877873 DOI: 10.1371/journal.pone.0195085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 03/16/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Influenza vaccination can prevent influenza and potentially serious influenza-related complications. Although the single best way to prevent influenza is annual vaccination, everyday preventive actions, including good hygiene, health, dietary, and social habits, might help, too. Several preventive measures are recommended, including: avoiding close contact with people who are sick; staying home when sick; covering your mouth and nose when coughing or sneezing; washing your hands often; avoiding touching your eyes, nose, and mouth; and practicing other good health habits like cleaning and disinfecting frequently touched surfaces, getting plenty of sleep, and drinking plenty of fluids. Understanding public acceptance and current usage of these preventive behaviors can be useful for planning both seasonal and pandemic influenza prevention campaigns. This study estimated the percentage of adults in the United States who reported practicing preventive behaviors to avoid catching or spreading influenza, and explored associations of reported behaviors with sociodemographic factors. METHODS We analyzed data from 2015 National Internet Flu Survey, a nationally representative probability-based Internet panel survey of the non-institutionalized U.S. population ≥18 years. The self-reported behaviors used to avoid catching or spreading influenza were grouped into four and three non-mutually exclusive subgroups, respectively. Weighted proportions were calculated. Multivariable logistic regression models were used to calculate adjusted prevalence differences and to determine independent associations between sociodemographic characteristics and preventive behavior subgroups. RESULTS Common preventive behaviors reported were: 83.2% wash hands often, 80.0% cover coughs and sneezes, 78.2% stay home if sick with a respiratory illness, 64.4% avoid people sick with a respiratory illness, 51.7% use hand sanitizers, 50.2% get treatment as soon as possible, and 49.8% report getting the influenza vaccination. Race/ethnicity, gender, age, education, income, region, receipt of influenza vaccination, and household size were associated with use of preventive behaviors after controlling for other factors. CONCLUSION Many adults in the United States reported using preventive behaviors to avoid catching or spreading influenza. Though vaccination is the most important tool available to prevent influenza, the addition of preventive behaviors might play an effective role in reducing or slowing transmission of influenza and complement prevention efforts.
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Affiliation(s)
- Anup Srivastav
- Leidos Inc, Atlanta, Georgia, United States of America
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Tammy A. Santibanez
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - M. Christopher Stringer
- Demographic Statistical Methods Division, U.S. Census Bureau, Durham, North Carolina, United States of America
| | - Jill A. Dever
- Division for Statistical and Data Sciences, RTI International, Washington, D.C., United States of America
| | - Michael Bostwick
- Statistics and Operation Research, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Marshica Stanley Kurtz
- Statistics and Operation Research, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Noreen L. Qualls
- Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Walter W. Williams
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Wu S, Su J, Yang P, Zhang H, Li H, Chu Y, Hua W, Li C, Tang Y, Wang Q. Willingness to accept a future influenza A(H7N9) vaccine in Beijing, China. Vaccine 2017; 36:491-497. [PMID: 29246476 PMCID: PMC7115431 DOI: 10.1016/j.vaccine.2017.12.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 11/21/2017] [Accepted: 12/04/2017] [Indexed: 01/11/2023]
Abstract
To optimize coverage, public willingness of H7N9 vaccination needs to be understood. 59.5% of the general adults would be willing to accept a future H7N9 vaccine. Demographics and public perceptions are the predictors of vaccination willingness. Many people doubt about vaccine’s effectiveness and don’t concern about disease risk. Targeted education programs on disease risk and vaccine’s effectiveness are needed.
Background The present study aimed to estimate residents’ willingness to accept a future H7N9 vaccine and its determinants in the general adult population in Beijing, China. Methods We conducted a multi-stage sampling, cross-sectional survey using self-administered anonymous questionnaires from May to June, in 2014. The main outcome variable was residents’ willingness to accept a future H7N9 vaccine. Logistic regression was used to identify the predictors of vaccination willingness. Results Of the 7264 eligible participants, 14.5% of Beijing residents reported that they had not heard of H7N9. Among those who had heard of H7N9, 59.5% of the general adult population would be willing to accept a future H7N9 vaccine, and approximately half of them reported ‘I am afraid of being infected by H7N9’ and ‘H7N9 vaccine can prevent infections’, and 28.1% reported ‘my daily life is affected by H7N9’. The variables that were significantly associated with a higher likelihood of reporting willingness were being younger adults (aged 18–29 years: OR = 1.52, 95% CI: 1.17–1.97; aged 30–39 years: OR = 1.39, 95% CI: 1.08–1.78), being farmers (OR = 1.61; 95% CI: 1.32–1.96), being unemployed people (OR = 1.36; 95% CI: 1.04–1.78), living in suburban areas (OR = 2.18; 95% CI: 1.89–2.51), having ≥2 children in the family (OR = 1.41; 95% CI: 1.03–1.92), perceived risk in China (OR = 1.30; 95% CI: 1.15–1.48), perceived susceptibility to disease (OR = 3.13; 95% CI: 2.73–3.58), perceived negative effect on daily life (OR = 1.32; 95% CI: 1.13–1.55), perceived effectiveness of vaccination (OR = 2.34; 95% CI: 2.07–2.64), and recent uptake of influenza vaccine (OR = 2.26; 95% CI: 1.92–2.66). Conclusions A great number of Beijing residents had doubts about the vaccine’s effectiveness and were not concerned about disease risk, which were the factors affecting willingness to be vaccinated. Targeted education programs on disease risk as well as vaccine’s effectiveness are needed to improve the willingness of vaccination for potential H7N9 pandemic preparedness.
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Affiliation(s)
- Shuangsheng Wu
- Beijing Center for Disease Prevention and Control, Beijing, China; Beijing Research Center for Preventive Medicine, Beijing, China
| | - Jianting Su
- Beijing Center for Disease Prevention and Control, Beijing, China; Beijing Research Center for Preventive Medicine, Beijing, China
| | - Peng Yang
- Beijing Center for Disease Prevention and Control, Beijing, China; Beijing Research Center for Preventive Medicine, Beijing, China; School of Public Health, Capital Medical University, Beijing, China.
| | - Haiyan Zhang
- Dongcheng District Center for Disease Prevention and Control, Beijing, China
| | - Hongjun Li
- Tongzhou District Center for Disease Prevention and Control, Beijing, China
| | - Yanhui Chu
- Xicheng District Center for Disease Prevention and Control, Beijing, China
| | - Weiyu Hua
- Haidian District Center for Disease Prevention and Control, Beijing, China
| | - Chao Li
- Huairou District Center for Disease Prevention and Control, Beijing, China
| | - Yaqing Tang
- Changping District Center for Disease Prevention and Control, Beijing, China
| | - Quanyi Wang
- Beijing Center for Disease Prevention and Control, Beijing, China; Beijing Research Center for Preventive Medicine, Beijing, China.
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