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Ma R, Lu B, Zhang Y, Shen Y, Xu J, Chen H, Qian Y, Miao P, Xu B, Guo H, Chen B. Duration and severity of COVID-19 symptoms among primary healthcare workers: A cross-sectional survey. J Adv Nurs 2024. [PMID: 38712473 DOI: 10.1111/jan.16212] [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: 09/27/2023] [Revised: 03/29/2024] [Accepted: 04/24/2024] [Indexed: 05/08/2024]
Abstract
AIMS This study aims to investigate the epidemiological characteristics of COVID-19 infection among healthcare workers, including the severity, duration of infection, post-infection symptoms and related influencing factors. METHODS A self-administered questionnaire was utilized to assess the post-infection status of primary healthcare workers in Jiangsu Province. The questionnaire collected information on demographic characteristics, lifestyle habits, post-infection clinical manifestations, work environment and recovery time of the respondents. Customized outcome events were selected as dependent variables and logistic regression models were employed to analyse the risk factors. Phi-coefficient was used to describe the relationship between post-infection symptoms. RESULTS The analysis revealed that several factors, such as female, older age, obesity, previous medical history, exposure to high-risk environments and stress, were associated with a higher likelihood of experiencing more severe outcomes. On the other hand, vaccination and regular exercise were found to contribute to an earlier resolution of the infection. Among the post-infection symptoms, cough, malaise and muscle aches were the most frequently reported. Overall, there was a weak association among symptoms persisting beyond 14 days, with only cough and malaise, malaise and dizziness and headache showing a stronger correlation. CONCLUSION The study findings indicate that the overall severity of the first wave of infection, following the complete lifting of restrictions in China, was low. The impact on primary healthcare workers was limited, and the post-infection symptoms exhibited similarity to those observed in other countries. It is important to highlight that these conclusions are specifically relevant to the population infected with the Omicron variant. IMPACTS This study helps to grasp the impacts of the first wave of COVID-19 infections on healthcare workers in China after the national lockdown was lifted. PATIENTS Primary healthcare workers in Jiangsu Province, including doctors, nurses, pharmacists and other personnel from primary healthcare units such as community health service centres and health centres.
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Affiliation(s)
- Rongji Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Beier Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Yongjie Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Ya Shen
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jinshui Xu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hualing Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Yongkang Qian
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Pengcheng Miao
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Biyun Xu
- Medical Statistics and Analysis Center, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Haijian Guo
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Bingwei Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China
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Tin SS, Wiwanitkit V. COVID-19, Herd Immunity and Vaccine. Int J Prev Med 2023; 14:73. [PMID: 37854983 PMCID: PMC10580207 DOI: 10.4103/ijpvm.ijpvm_57_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 02/18/2021] [Indexed: 10/20/2023] Open
Affiliation(s)
- Sim Sai Tin
- Medical Center, Shantou Medical Center, Shantou, China
| | - Viroj Wiwanitkit
- Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India
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SARS due to COVID-19: Predictors of death and profile of adult patients in the state of Rio de Janeiro, 2020. PLoS One 2022; 17:e0277338. [DOI: 10.1371/journal.pone.0277338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/25/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction
We aimed to describe the profile of adult patients and analyze the predictors of death from severe acute respiratory syndrome (SARS) due to coronavirus disease 2019 (COVID-19) in the state of Rio de Janeiro. Knowledge of the predictors of death by COVID-19 in Rio de Janeiro, a state with one of the highest mortality rates in Brazil, is essential to improve health care for these patients.
Methods
Data from the Information System for Epidemiological Surveillance of Influenza and the Mortality Information System were used. A binary logistic regression model evaluated the outcome of death, sociodemographic data, and clinical-epidemiological and health care covariates. Univariate, bivariate, and multivariate statistics were performed with the R program, version 4.0.0.
Results
Overall, 51,383 cases of SARS due to COVID-19 among adults were reported in the state between March 5 and December 2, 2020. Mortality was high (40.5%). The adjusted final model presented the following predictors of death in SARS patients due to COVID-19: male sex (odds ratio [OR] = 1.10, 95% confidence interval [CI], 1.04–1.17); age (OR = 5.35, 95%CI, 4.88–5.88; ≥75 years); oxygen saturation <95% (OR = 1.48, 95%CI, 1.37–1.59), respiratory distress (OR = 1.31, 95%CI, 1.21–1.41) and dyspnoea (OR = 1.25, 95%CI, 1.15–1.36), the presence of at least one risk factor/comorbidity (OR = 1.32, 95%CI, 1.23–1.42), chronic kidney disease (OR = 1.94, 95%CI, 1.69–2.23), immunosuppression (OR = 1.51, 95%CI, 1.26–1.81) or chronic neurological disease (OR = 1.36, 95%CI, 1.18–1.58), and ventilatory support, invasive (OR = 8.89, 95%CI, 8.08–9.79) or non-invasive (OR = 1.25, 95%CI, 1.15–1.35).
Conclusions
Factors associated with death were male sex, old age, oxygen saturation <95%, respiratory distress, dyspnoea, chronic kidney and neurological diseases, immunosuppression, and use of invasive or noninvasive ventilatory support. Identifying factors associated with disease progression can help the clinical management of patients with COVID-19 and improve outcomes.
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Sukhikh GT, Priputnevich TV, Ogarkova DA, Pochtovyi AA, Kustova DD, Zlobin VI, Logunov DY, Gushchin VA, Gintsburg AL. Sputnik Light and Sputnik V Vaccination Is Effective at Protecting Medical Personnel from COVID-19 during the Period of Delta Variant Dominance. Vaccines (Basel) 2022; 10:1804. [PMID: 36366311 PMCID: PMC9696561 DOI: 10.3390/vaccines10111804] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/18/2022] [Accepted: 10/22/2022] [Indexed: 11/26/2023] Open
Abstract
Medical personnel are a group of people that often encounter infectious agents, leading to greater risk of contracting infectious diseases. Specific prevention of diseases in this group is a priority. The epidemiological effectiveness of COVID-19 prevention in the group of medical workers due to the emergence of new variants of concern of the SARS-CoV-2 virus has not been studied in sufficient depth. We conducted a study of the effectiveness of vaccine use to protect medical workers at a large medical center for obstetrics and gynecology in Moscow. Sputnik V and Sputnik Light were the main vaccines used for the prevention of COVID-19. The vaccines are based on a variant of the S-protein of the SARS-CoV-2 virus, with adenovirus serotypes 5 and 26 as the vector for delivery. Vaccination of employees occurred during the period in which the Delta variant was spreading. The overall epidemiological effectiveness was 81.7% (73.1-87.6%) during the period in which the Delta variant was dominant. During the period from the beginning of vaccination (26 November 2020) until 8 February 2022, the overall effectiveness was 89.1% (86.9-91.0%). As expected, the highest effectiveness during this period was obtained in the group that received the third and fourth doses-96.5% (75.0-99.5%). The severity of COVID-19 in the vaccinated group was significantly lower than in the unvaccinated group.
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Affiliation(s)
- Gennady T Sukhikh
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health, 117997 Moscow, Russia
| | - Tatiana V Priputnevich
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health, 117997 Moscow, Russia
| | - Darya A Ogarkova
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia
| | - Andrei A Pochtovyi
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia
- Department of Virology, Biological Faculty, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Daria D Kustova
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia
- Department of Virology, Biological Faculty, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Vladimir I Zlobin
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia
| | - Denis Y Logunov
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia
| | - Vladimir A Gushchin
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia
- Department of Virology, Biological Faculty, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Alexander L Gintsburg
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia
- Department of Infectiology and Virology, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov, First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119435 Moscow, Russia
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Maier HE, Kuan G, Saborio S, Carrillo FAB, Plazaola M, Barilla C, Sanchez N, Lopez R, Smith M, Kubale J, Ojeda S, Zuniga-Moya JC, Carlson B, Lopez B, Gajewski AM, Chowdhury M, Harris E, Balmaseda A, Gordon A. Clinical Spectrum of Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Protection From Symptomatic Reinfection. Clin Infect Dis 2022; 75:e257-e266. [PMID: 34411230 PMCID: PMC8499752 DOI: 10.1093/cid/ciab717] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There are few data on the full spectrum of disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across the lifespan from community-based or nonclinical settings. METHODS We followed 2338 people in Managua, Nicaragua, aged <94 years from March 2020 through March 2021. SARS-CoV-2 infection was identified through real-time reverse transcription polymerase chain reaction (RT-PCR) or through enzyme-linked immunosorbent assay. Disease presentation was assessed at the time of infection or retrospectively by survey at the time of blood collection. RESULTS There was a large epidemic that peaked between March and August 2020. In total, 129 RT-PCR-positive infections were detected, for an overall incidence rate of 5.3 infections per 100 person-years (95% confidence interval [CI], 4.4-6.3). Seroprevalence was 56.7% (95% CI, 53.5%-60.1%) and was consistent from age 11 through adulthood but was lower in children aged ≤10 years. Overall, 31.0% of the infections were symptomatic, with 54.7% mild, 41.6% moderate, and 3.7% severe. There were 2 deaths that were likely due to SARS-CoV-2 infection, yielding an infection fatality rate of 0.2%. Antibody titers exhibited a J-shaped curve with respect to age, with the lowest titers observed among older children and young adults and the highest among older adults. When compared to SARS-CoV-2-seronegative individuals, SARS-CoV-2 seropositivity at the midyear sample was associated with 93.6% protection from symptomatic reinfection (95% CI, 51.1%-99.2%). CONCLUSIONS This population exhibited a very high SARS-CoV-2 seropositivity with lower-than-expected severity, and immunity from natural infection was protective against symptomatic reinfection.
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Affiliation(s)
- Hannah E Maier
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Saira Saborio
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Fausto Andres Bustos Carrillo
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, California, USA
| | | | | | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Roger Lopez
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Matt Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - John Kubale
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Julio C Zuniga-Moya
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Bradley Carlson
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Brenda Lopez
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | - Mahboob Chowdhury
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, California, USA
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Tobik ER, Kitfield-Vernon LB, Thomas RJ, Steel SA, Tan SH, Allicock OM, Choate BL, Akbarzada S, Wyllie AL. Saliva as a sample type for SARS-CoV-2 detection: implementation successes and opportunities around the globe. Expert Rev Mol Diagn 2022; 22:519-535. [PMID: 35763281 DOI: 10.1080/14737159.2022.2094250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Symptomatic testing and asymptomatic screening for SARS-CoV-2 continue to be essential tools for mitigating virus transmission. Though COVID-19 diagnostics initially defaulted to oropharyngeal or nasopharyngeal sampling, the worldwide urgency to expand testing efforts spurred innovative approaches and increased diversity of detection methods. Strengthening innovation and facilitating widespread testing remains critical for global health, especially as additional variants emerge and other mitigation strategies are recalibrated. AREAS COVERED A growing body of evidence reflects the need to expand testing efforts and further investigate the efficiency, sensitivity, and acceptability of saliva samples for SARS-CoV-2 detection. Countries have made pandemic response decisions based on resources, costs, procedures, and regional acceptability - the adoption and integration of saliva-based testing among them. Saliva has demonstrated high sensitivity and specificity while being less invasive relative to nasopharyngeal swabs, securing saliva's position as a more acceptable sample type. EXPERT OPINION Despite the accessibility and utility of saliva sampling, global implementation remains low compared to swab-based approaches. In some cases, countries have validated saliva-based methods but face challenges with testing implementation or expansion. Here, we review the localities that have demonstrated success with saliva-based SARS-CoV-2 testing approaches and can serve as models for transforming concepts into globally-implemented best practices.
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Affiliation(s)
- Emily R Tobik
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Lily B Kitfield-Vernon
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Russell J Thomas
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Sydney A Steel
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Steph H Tan
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA.,Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
| | - Orchid M Allicock
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Brittany L Choate
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Sumaira Akbarzada
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Anne L Wyllie
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
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Factors associated with the diagnosis of COVID-19 among Brazilian health professionals COVID-19 and health professionals. PLoS One 2022; 17:e0267121. [PMID: 35749441 PMCID: PMC9231739 DOI: 10.1371/journal.pone.0267121] [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] [Received: 06/28/2021] [Accepted: 04/03/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Health professionals are on the front lines against the Coronavirus 2019 (COVID-19) pandemic and are at high risk for acquiring the infection. Failures in precautionary measures, inadequacy/scarcity of Personal Protective Equipment (PPE), and lack of social and family distancing may be associated with increased exposure and contamination by the new coronavirus. This study investigated the prevalence of COVID-19 among Brazilian health professionals and associated factors according to demographic and occupational characteristics. Methods A cross-sectional, analytical study was conducted using an online survey with 12,086 health professionals from all regions of Brazil. Data were collected using an adaptation of the respondent-driven sampling method for the virtual environment. The outcome variable was the diagnosis of COVID-19. Bivariate and multiple logistic regression analyzes were used to identify an association between the diagnosis of COVID-19 and demographic and occupational variables. Variables were considered statistically significant based on p<0.05. Results Most participants were female, from the northeast region, and nursing professionals. A prevalence of 31.95% (95%CI: 31.0%, 32.9%) of COVID-19 was estimated. Following multiple regression analysis, the variables associated with the diagnosis of COVID-19 among health professionals were: male gender, married individuals, professionals who provide care to patients with COVID-19, who work in a field hospital, and those who work in institutions that did not offer enough quality PPE. Conclusions The study found a high prevalence of COVID-19 infection, with male professionals being those with greater chances. Inadequate supply or poor quality of PPE offered by health institutions compromises the health of professionals with an increase in positive diagnosis for COVID-19.
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Birhanu A, Ayana GM, Merga BT, Alemu A, Negash B, Seid A, Dessie Y. Incidence and predictors of organ failure among COVID-19 hospitalized adult patients in Eastern Ethiopia. Hospital-based retrospective cohort study. BMC Infect Dis 2022; 22:412. [PMID: 35484484 PMCID: PMC9048613 DOI: 10.1186/s12879-022-07402-6] [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: 09/04/2021] [Accepted: 04/18/2022] [Indexed: 11/21/2022] Open
Abstract
Background Organ failure is incapability of at least one of the body organs to carry out a normal body functions. Identifying the predictors of the organ failure is crucial for improving COVID-19 patients’ survival. However, the evidence related to this information is not well-established in developing countries, including Ethiopia. Therefore, this study aimed to determine the incidence and predictors of organ failure among adult patients admitted to Hiwot Fana Specialized University Hospital (HFSUH) COVID-19 treatment center from 1st May 2020 to 20th August 2021, Eastern Ethiopia. Methods A hospital-based retrospective cohort study design was implemented. Descriptive measures such as mean with standard deviation (SD), median with interquartile range (IQR), percentages, and frequencies were computed. The binary logistic regression was used to identify the association between outcome variables (organ functional status) and independent variables with an adjusted odds ratio (AOR) at a 95% confidence interval. A significance level was declared at a p-value of less than 0.05. Results The mean age of study participants was 47.69 years with the standard deviation (SD) of ± 17.03. The study participants were followed for the median time of 8 days with IQR of 4, 14. The incidence of organ failure was 11.9 per 1000 person-day contribution (95% CI: 9.5, 14.9). Predictors such as age above 60 years (AOR = 1.71, 95% CI: 1.44, 4.53), smoking history (AOR = 5.07, 95% CI: 1.39, 8.15), cardiovascular disease (AOR = 5.00, 95% CI: (1.83, 11.72), and critical clinical stages of COVID-19 (AOR = 5.42, 95%: 1.47, 14. 84) were significantly associated with organ failure among COVID-19 hospitalized patients. Conclusions The incidence of organ failure was 11.9 per 1000 person-day contribution. Age, smoking, comorbidity, and clinical stages were significantly associated with organ failure among COVID-19 hospitalized cases. Therefore, clinicians should stringently follow the patients experiencing modifiable predictors of organ failure, especially patients with comorbidities and severe clinical stages. Moreover, the prevention programs that target elders and smokers should be strengthening to save this segment of populations before suffering from organ failure following COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07402-6.
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Affiliation(s)
- Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bedasa Taye Merga
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Belay Negash
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ahmed Seid
- Hiwot Fana Specialized University Hospital, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Huete-Pérez JA, Colgrove RC, Cabezas-Robelo C, Páiz-Medina L, Hunsajarupan B, Silva S, Quant C, Huete A. SARS-CoV-2 prevalence at eight urban health clinics in Nicaragua: possible implications for the COVID-19 pandemic. IJID REGIONS 2022; 2:110-117. [PMID: 35721440 PMCID: PMC8730803 DOI: 10.1016/j.ijregi.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 11/23/2022]
Abstract
Objective To assess the prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in selected health clinics in the three largest urban areas in Nicaragua, where data regarding coronavirus disease 2019 (COVID-19) testing, morbidity and mortality is severely limited. Methods In this cross-sectional study, participants were tested for SARS-CoV-2 RNA by loop-mediated isothermal amplification (LAMP), and were tested for antibodies using immunoassays. A questionnaire recorded subjects' COVID-19-associated symptoms and risk factors. Data were collected from 22 February to 19 March 2021, 1 year after the first confirmed cases of SARS-CoV-2 in Nicaragua. Study participants were enrolled while attending routine check-ups or seeking care unrelated to COVID-19. Study participation was random and voluntary. All patients were eligible to participate. Symptom history was not part of the eligibility criteria. Results The prevalence of current SARS-CoV-2 infection was high (14%, LAMP-positive/seronegative). Antibody testing showed higher overall seroprevalence (38%). Cough was the symptom most strongly associated with being LAMP-positive (odds ratio 3.57, 95% confidence interval 2.65-4.81). Loss of smell had the highest positive predictive value, and was significantly associated with being LAMP-positive. Conclusion The prevalence of current SARS-CoV-2 infection and seropositivity were fairly high. More than half of the sample population had evidence of current or past infection. Knowledge of this previously unknown elevated level of infection is crucial for healthcare providers and policy makers.
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Affiliation(s)
| | - Robert C. Colgrove
- Division of Infectious Diseases, Mount Auburn Hospital, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Lucía Páiz-Medina
- Molecular Biology Center, University of Central America, Managua, Nicaragua
| | - Bhanasut Hunsajarupan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | | | - Alejandra Huete
- Division of Infectious Diseases, Mount Auburn Hospital, Cambridge, MA, USA
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Birhanu A, Ayana GM, Bayu M, Mohammed A, Dessie Y. Features associated with SARS-COV-2 positivity among people presenting with acute respiratory tract infections to public Hospitals in Harari region, Ethiopia. SAGE Open Med 2021; 9:20503121211062793. [PMID: 34917383 PMCID: PMC8669875 DOI: 10.1177/20503121211062793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/08/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Despite investigating coronavirus among respiratory tract infected cases is a top priority to prevent further transmission, severe acute respiratory syndrome coronavirus 2 positivity among this group of patients remains unexplored in resource-limited settings. Therefore, this study intended to assess the severe acute respiratory syndrome coronavirus 2 positivity among patients presenting with acute respiratory tract infection from 1 July to 31 December 2020 in Harar Region, Ethiopia, from 15 February to 10 March 2021. Methods: A facility-based cross-sectional study design was used. Severe acute respiratory syndrome coronavirus 2 was tested by assaying oropharyngeal swabs using reverse transcriptase–polymerase chain reaction among patients presenting with acute respiratory tract infection in Harari Public Hospitals. A binary logistic regression was used to identify factors associated with severe acute respiratory syndrome coronavirus 2 positivity with an adjusted odds ratio at a 95% confidence interval. Results: Out of a total of 1692 study participants, 388 (22.9%) of them tested positive for severe acute respiratory syndrome coronavirus 2. Of these severe acute respiratory syndrome coronavirus 2 positive patients, 364 (21.6%) patients presented with lower respiratory tract infection, while the rest only 24 (1.4%) presented with upper respiratory tract infection. Independent variables included separated/divorced in marital status (AOR = 0.53, 95% CI: 0.29–0.95), presenting with cough, fever, and difficulty of breathing (AOR = 2.5, 95% CI: 1.22–4.7), age group of 30–39 years (AOR = 0.35, 95% CI: 0.15–0.79), 40–49 years (AOR = 0.37, 95% CI: 0.14–0.94), and 50–59 years (AOR = 0.31, 95% CI: 0.13–0.76) compared to patients with the age of ⩾ 60 years, had statistically significant association with severe acute respiratory syndrome coronavirus 2 positivity. Conclusion: Severe acute respiratory syndrome coronavirus 2 was positive among 388 (22.9%) acute respiratory tract infected people. Elder age, particular symptoms, such as cough, fever, and difficulty of breathing, and married marital status were associated with a severe acute respiratory syndrome coronavirus 2 positive test. In resource-limited setups, where a shortage of testing equipment is common, these findings could contribute to boosting targeted symptom-oriented screening schemes. Moreover, this study could have paramount clinical importance for further studies in the country.
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Affiliation(s)
- Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Miesso Bayu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ahmed Mohammed
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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11
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Huete-Pérez JA, Ernst KC, Cabezas-Robelo C, Páiz-Medina L, Silva S, Huete A. Prevalence and risk factors for SARS-CoV-2 infection in children with and without symptoms seeking care in Managua, Nicaragua: results of a cross-sectional survey. BMJ Open 2021; 11:e051836. [PMID: 34548362 PMCID: PMC8457995 DOI: 10.1136/bmjopen-2021-051836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE This study aimed to capture key epidemiological data on SARS-CoV-2 infection in Nicaraguan children (≤18 years) seeking medical care, between 6 October and 16 November 2020. DESIGN In this cross-sectional study, 418 children were recruited: 319 with symptoms characteristic of COVID-19 and 99 with no symptoms of illness. Children were tested for SARS-CoV-2 RNA using loop-mediated isothermal amplification. A questionnaire was employed to identify symptoms, risk factors, comorbidities and COVID-19 prevention measures. SETTING Research was carried out in four hospitals and two clinics in Managua, Nicaragua, where schools and businesses remained open throughout the COVID-19 pandemic. PARTICIPANTS Children were enrolled into a possible COVID-19 group if presenting with clinical symptoms. A comparison group included children lacking any COVID-19 symptoms attending routine check-ups or seeking care for issues unrelated to COVID-19. RESULTS A high prevalence (43%) of SARS-CoV-2 infection was found, which was relatively equivalent in symptomatic and non-symptomatic children. Age distribution was similar between symptomatic and non-symptomatic children testing positive for SARS-CoV-2. Symptomatic children who tested positive for SARS-CoV-2 were 2.7 times more likely to have diarrhoea (26.7% in positive vs 12.0% in negative; OR=2.7 (95% CI 1.5 to 4.8), p=0.001) and were 2.0 times more likely to have myalgia (17.8% in positive vs 9.8% in negative; OR=2.0 (95% CI 1.0 to 3.8), p=0.04). Children with COVID-19 symptoms, who tested positive for SARS-CoV-2, were more likely to be under age 5 years and to have a pre-existing comorbid condition than children who tested positive but did not have symptoms. CONCLUSIONS This is the first paediatric study to provide laboratory-confirmed data on SARS-CoV-2 infection in Nicaragua, crucial for paediatric health services planning and a successful COVID-19 response. The high prevalence of the virus suggests widespread and sustained community transmission, underscoring the urgent need for robust data on the true extent of SARS-CoV-2 infection throughout Nicaragua.
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Affiliation(s)
| | - Kacey C Ernst
- Department of Epidemiology and Biostatistics, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | | | - Lucia Páiz-Medina
- Molecular Biology Center, Universidad Centroamericana, Managua, Nicaragua
| | - Sheyla Silva
- Pediatrics Unit, Vivian Pellas Hospital, Managua, Nicaragua
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12
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Sah P, Fitzpatrick MC, Zimmer CF, Abdollahi E, Juden-Kelly L, Moghadas SM, Singer BH, Galvani AP. Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis. Proc Natl Acad Sci U S A 2021; 118:e2109229118. [PMID: 34376550 PMCID: PMC8403749 DOI: 10.1073/pnas.2109229118] [Citation(s) in RCA: 265] [Impact Index Per Article: 88.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Quantification of asymptomatic infections is fundamental for effective public health responses to the COVID-19 pandemic. Discrepancies regarding the extent of asymptomaticity have arisen from inconsistent terminology as well as conflation of index and secondary cases which biases toward lower asymptomaticity. We searched PubMed, Embase, Web of Science, and World Health Organization Global Research Database on COVID-19 between January 1, 2020 and April 2, 2021 to identify studies that reported silent infections at the time of testing, whether presymptomatic or asymptomatic. Index cases were removed to minimize representational bias that would result in overestimation of symptomaticity. By analyzing over 350 studies, we estimate that the percentage of infections that never developed clinical symptoms, and thus were truly asymptomatic, was 35.1% (95% CI: 30.7 to 39.9%). At the time of testing, 42.8% (95% prediction interval: 5.2 to 91.1%) of cases exhibited no symptoms, a group comprising both asymptomatic and presymptomatic infections. Asymptomaticity was significantly lower among the elderly, at 19.7% (95% CI: 12.7 to 29.4%) compared with children at 46.7% (95% CI: 32.0 to 62.0%). We also found that cases with comorbidities had significantly lower asymptomaticity compared to cases with no underlying medical conditions. Without proactive policies to detect asymptomatic infections, such as rapid contact tracing, prolonged efforts for pandemic control may be needed even in the presence of vaccination.
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Affiliation(s)
- Pratha Sah
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
| | - Meagan C Fitzpatrick
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD 21201
| | - Charlotte F Zimmer
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
| | - Elaheh Abdollahi
- Agent-Based Modelling Laboratory, York University, Toronto, ON M3J 1P3, Canada
| | - Lyndon Juden-Kelly
- Agent-Based Modelling Laboratory, York University, Toronto, ON M3J 1P3, Canada
| | - Seyed M Moghadas
- Agent-Based Modelling Laboratory, York University, Toronto, ON M3J 1P3, Canada
| | - Burton H Singer
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
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13
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The Impact of COVID-19 on the Working Equid Community: Responses from 1530 Individuals Accessing NGO Support in 14 Low- and Middle-Income Countries. Animals (Basel) 2021; 11:ani11051363. [PMID: 34064832 PMCID: PMC8151231 DOI: 10.3390/ani11051363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 01/19/2023] Open
Abstract
The COVID-19 pandemic was declared on 11 March 2020. The working equid community includes some of the world's most marginalised people, who rely on animals for their daily lives and livelihoods. A cross-sectional study investigated the effects of COVID-19 on working equid communities, with the intention of developing methods for replication in future unprecedented events. A multi-language survey was developed, involving 38 predominantly closed questions, and carried out face-to-face, over telephone, or online. There were 1530 respondents from a population of individuals who received support from equid welfare projects across 14 low- or middle-income countries projects during November and December 2020. Overall, at the time of survey completion, 57% (875/1522) of respondents reported that their equids were working less, 76% (1130/1478) reported a decreased monthly income from equids, and 78% (1186/1519) reported a reduction in household income compared to pre-pandemic levels. Costs of equid upkeep remained the same for 58% (886/1519) of respondents and 68% (1034/1518) reported no change in the health of their equid. The potential long-term impacts on human and equid welfare due to reported financial insecurities necessitates monitoring. A One Welfare approach, involving collaboration with governments, humanitarian, and animal welfare non-governmental organisations is required to mitigate deep-rooted issues.
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González F, Vielot NA, Sciaudone M, Toval-Ruíz C, Premkumar L, Gutierrez L, Cuadra EC, Blandón P, de Silva AM, Rubinstein R, Bowman N, Becker-Dreps S, Bucardo F. Seroepidemiology of SARS-CoV-2 infections in an urban Nicaraguan population. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021. [PMID: 33688687 DOI: 10.1101/2021.02.25.21252447] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
In a Nicaraguan population-based cohort, SARS-CoV-2 seroprevalence was 34%, with higher prevalence in children compared to adults. Having a seropositive household member was associated with a two-fold probability of individual seropositivity, suggesting a role for household transmission. Co-morbidities and preventive behaviors were not associated with SARS-CoV-2 seroprevalence.
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Seroepidemiology of SARS-CoV-2 infections in an urban population-based cohort in León, Nicaragua. Epidemiol Infect 2021; 149:e247. [PMID: 35172912 PMCID: PMC8674192 DOI: 10.1017/s0950268821002144] [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: 11/14/2022] Open
Abstract
In a Nicaraguan population-based cohort, SARS-CoV-2 seroprevalence reached 28% in the first 6 months of the country's epidemic and reached 35% 6 months later. Immune waning was uncommon. Individuals with a seropositive household member were over three times as likely to be seropositive themselves, suggesting the importance of household transmission.
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