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Pan D, Nishimura H, Tang JW. Information bias for case definitions and mortality between and within studies over time undermines our understanding of COVID-19 transmission and disease severity. Clin Microbiol Infect 2024; 30:700-702. [PMID: 38341144 DOI: 10.1016/j.cmi.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/28/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Affiliation(s)
- Daniel Pan
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom; Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; National Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, United Kingdom; Development Centre for Population Health, University of Leicester, Leicester, United Kingdom; Li Ka Shing Centre for Health Information and Discovery, Oxford Big Data Institute, University of Oxford, United Kingdom.
| | - Hidekazu Nishimura
- Virus Research Center, Clinical Research Division, Sendai Medical Center, National Hospital Organization, Sendai, Japan
| | - Julian W Tang
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom; Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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Tang Y. Socioeconomic inequalities in healthcare system efficiency in Japan during COVID-19 pandemic: an analysis of the moderating role of vaccination. Front Public Health 2024; 12:1170628. [PMID: 38584913 PMCID: PMC10996399 DOI: 10.3389/fpubh.2024.1170628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/07/2024] [Indexed: 04/09/2024] Open
Abstract
Background In the context of the COVID-19 pandemic, limited research has focused on socioeconomic disparities in Local Healthcare System Efficiency (LHSE) among Japanese prefectures. This study seeks to investigate the moderating impact of vaccination on the relationship between LHSE and socioeconomic characteristics and endowments. Methods To explore these relationships, we first utilized the Data Envelopment Analysis with Slack-Based Measure to measure the LHSE, based on data from Japanese prefectures during waves 2 to 5 of the pandemic. Then estimating the impact of socioeconomic variables on LHSE. Finally, we assessed the changes in the way socioeconomic variables affect LHSE before and after vaccine deployment using the Seemingly Unrelated Estimation t-test methodology. Results The research findings suggest an overall reduction in LHSE disparities across various regions due to the utilization of vaccines. Particularly in areas with relatively nsufficient bed resources, a significant improvement in LHSE was observed in most regions. However, there was no evidence supporting the role of vaccine deployment in mitigating socioeconomic inequalities in LHSE. Conversely, the utilization of vaccines showed a positive correlation between the improvement in LHSE and the proportion of older adult population in regions with sufficient bed resources. In regions facing bed shortages, the enhancement of LHSE became more reliant on reducing the occupancy rate of secured beds for severe cases after the introduction of vaccination. Discussion In regions facing bed shortages, the enhancement of LHSE became more reliant on reducing the occupancy rate of secured beds for severe cases. This underscores the importance for policymakers and implementers to prioritize the treatment of severe cases and ensure an effective supply of medical resources, particularly secured beds for severe cases, in their efforts to improve LHSE, in the post-COVID-19 era with rising vaccine coverage.
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Affiliation(s)
- Yin Tang
- Graduate School of Economics, Keio University, Tokyo, Japan
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Kabasawa H, Hosojima M, Narita I. Questionnaire survey of the frequency of dietary intake during hemodialysis and the impact of COVID-19 in Japan. Clin Exp Nephrol 2024; 28:254-260. [PMID: 37982979 DOI: 10.1007/s10157-023-02430-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/24/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND There have been no coherent reports on the effects of dietary intake during hemodialysis in Japan. Furthermore, few studies have reported the impact of the COVID-19 pandemic on them. This study aimed to investigate dietary intake during hemodialysis and its impact on the spread of COVID-19. METHODS This consecutive cross-sectional study included a survey of all hemodialysis facilities in the Niigata Prefecture. The survey form was sent via e-mail or fax. RESULTS Fifty four facilities (98%) responded to the 2018 survey. Twenty-eight facilities (52%) provided meals, with 18% of all patients undergoing dialysis and 41% of patients undergoing nocturnal dialysis consuming meals during hemodialysis. In the 2020 survey, the number of facilities decreased to 17 (33%), and the number of all patients undergoing dialysis and nocturnal dialysis consuming meals decreased to 13% and 32%, respectively. In the 2022 survey, the number of facilities decreased to 14 (27%), and the number of all patients undergoing dialysis and nocturnal dialysis decreased to 9% and 19%, respectively. CONCLUSION The COVID-19 pandemic has caused a decrease in both facilities serving meals and patients' food consumption during hemodialysis. To prevent the loss of meal opportunities, establishing safe methods for food intake and alternatives in hemodialysis facilities is necessary.
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Affiliation(s)
- Hideyuki Kabasawa
- Department of Clinical Nutrition Science, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata Prefecture, 951-8510, Japan
| | - Michihiro Hosojima
- Department of Clinical Nutrition Science, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata Prefecture, 951-8510, Japan.
| | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata Prefecture, 951-8510, Japan
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Hashimoto T, Yahiro T, Khan S, Kimitsuki K, Suzuki M, Fujimoto T, Tanaka T, Saito N, Hiramatsu K, Nishizono A. Seroprevalence kinetics of SARS-CoV-2 antibodies in pediatric patients visiting a hospital during COVID-19 pandemic in Japan. J Infect Chemother 2024; 30:169-171. [PMID: 37734592 DOI: 10.1016/j.jiac.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/21/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023]
Abstract
Children infected with SARS-CoV-2 are often asymptomatic or have mild symptoms. The studies on the seroprevalence kinetics of SARS-CoV-2 antibodies in children are limited. We conducted a cross-sectional survey of the positive rate of the SARS-CoV-2 IgG in pediatric patients without suspected COVID-19 infection between January 2007 and March 2022. We defined the serum samples from the pre-pandemic and pandemic groups (1st-6th waves). Totally, 2557 samples were collected and no samples from the pre-pandemic group or the 1st-4th waves were positive for IgG. There were 4/661 and 16/373 positives at the 5th and 6th waves, respectively. At the 5th wave, the prevalence of IgG was 1.3% in children aged 1-4 years. At the 6th wave, in children <1 year of age, the prevalence was 4.0%, and 2.4%, 5.3%, 5.2% and 10% in age groups 1-4, 5-9, 10-14 and 15-18 years, respectively. In conclusions, the pre-pandemic samples were negative, and the IgG positivity increased during the later period of the pandemic.
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Affiliation(s)
- Takehiro Hashimoto
- Infection Control Center, Oita University Hospital, Oita, Japan; Department of Microbiology, Oita University Faculty of Medicine, Oita, Japan.
| | - Takaaki Yahiro
- Department of Microbiology, Oita University Faculty of Medicine, Oita, Japan; Department of Advanced Medical Sciences, Oita University Faculty of Medicine, Oita, Japan; Research Center for Global and Local Infectious Diseases, Oita, Japan
| | - Sakirul Khan
- Department of Microbiology, Oita University Faculty of Medicine, Oita, Japan
| | - Kazunori Kimitsuki
- Department of Microbiology, Oita University Faculty of Medicine, Oita, Japan
| | | | | | - Toshihiro Tanaka
- Department of Pediatrics, Shizuoka Kosei Hospital, Shizuoka, Japan
| | - Nobuo Saito
- Department of Microbiology, Oita University Faculty of Medicine, Oita, Japan
| | - Kazufumi Hiramatsu
- Infection Control Center, Oita University Hospital, Oita, Japan; Research Center for Global and Local Infectious Diseases, Oita, Japan
| | - Akira Nishizono
- Department of Microbiology, Oita University Faculty of Medicine, Oita, Japan; Research Center for Global and Local Infectious Diseases, Oita, Japan
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Iwasaki M, Hashimoto M, Takeuchi JS, Kusaba Y, Kimura M, Terada-Hirashima J, Sugiura W, Hojo M. Relapse of COVID-19 and Viral Evolution in a Patient With Good Syndrome: A Case Report. Cureus 2024; 16:e52592. [PMID: 38371040 PMCID: PMC10874686 DOI: 10.7759/cureus.52592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/20/2024] Open
Abstract
Delays in clearance and rapid evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported in immunocompromised patients. We encountered a case of recurrent, multi-mutational SARS-CoV-2 infection in a 40-year-old man with severe immunodeficiency due to Good syndrome. The patient had not received the SARS-CoV-2 vaccination. In August 2021, he was first admitted to the hospital owing to coronavirus disease 2019 (COVID-19) pneumonia and was administered dexamethasone, remdesivir, and baricitinib. Although his fever and respiratory condition improved once, chest computed tomography (CT) revealed extensive diffuse consolidation and ground-glass opacities (GGOs), and both methylprednisolone pulse therapy and tocilizumab yielded a limited effect. After a third course of remdesivir without immunosuppressants or steroids, the patient recovered, and he tested negative for SARS-CoV-2. On day 272 since the clinical onset, he was readmitted with dyspnea and mild fever due to a COVID-19 recurrence. He was infected with the Delta variant (AY.29), despite the Omicron (BA.2) variant being predominant at that time. During this admission, additional remdesivir and casirivimab/imdevimab yielded marked effects, and the SARS-CoV-2 quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) tests rapidly returned negative. Phylogenetic analysis demonstrated the accumulation of mutations, including those yielding remdesivir resistance, throughout the SARS-CoV-2 genome. Appropriate use of antivirals and monoclonal antibodies may aid in the recovery of patients with COVID-19 and immunodeficiency and in preventing the emergence of multi-mutational SARS-CoV-2 variants.
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Affiliation(s)
- Mika Iwasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, JPN
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, JPN
| | - Junko S Takeuchi
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, JPN
| | - Yusaku Kusaba
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, JPN
| | - Moto Kimura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, JPN
| | - Junko Terada-Hirashima
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, JPN
| | - Wataru Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, JPN
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, JPN
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Uemura Y, Ozaki R, Shinozaki T, Ohtsu H, Shimizu Y, Izumi K, Saito S, Matsunaga N, Ohmagari N. Comparative effectiveness of tocilizumab vs standard care in patients with severe COVID-19-related pneumonia: a retrospective cohort study utilizing registry data as a synthetic control. BMC Infect Dis 2023; 23:849. [PMID: 38049729 PMCID: PMC10694888 DOI: 10.1186/s12879-023-08840-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/23/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND The severity of coronavirus disease 2019 (COVID-19) infections has led to the development of several therapeutic agents, with tocilizumab becoming increasingly used to treat patients with COVID-19-related pneumonia. This study compared the use of tocilizumab treatment with the standard of care (SOC) to determine its efficacy against severe COVID-19-related pneumonia in Japan. METHODS This retrospective cohort study was designed to evaluate the efficacy of tocilizumab in two different databases: the JA42434 single-arm study and COVID-19 Registry Japan (COVIREGI-JP), with a synthetic control group from the COVIREGI-JP cohort as a benchmark for the tocilizumab group. The study's primary objective was to evaluate the efficacy of tocilizumab in treating severe COVID-19-related pneumonia compared to the SOC among patients included in the above two databases. The SOC group was extracted as the synthetic control group using exact matching and a propensity score matching in sequence per subject. As a secondary objective, the efficacy of tocilizumab compared to the SOC was evaluated exclusively among patients included in the COVIREGI-JP database. In each objective, the primary endpoint was defined as the time to discharge or the status of awaiting discharge. RESULTS For the primary endpoint, the hazard ratio (HR) of the tocilizumab group against the SOC group was 1.070 (95% confidence interval [CI]: 0.565-2.028). The median time from Study Day 1 to discharge or the state of awaiting discharge was 15 days in the tocilizumab group and 16 days in the SOC group. The HRs for the secondary endpoints, namely, time to improvement in the clinical state, time to clinical failure, and time to recovery, were 1.112 (95% CI: 0.596-2.075), 0.628 (95% CI: 0.202-1.953), and 1.019 (95% CI: 0.555-1.871), respectively. Similarly, the HR of the primary endpoint for the secondary objective was 0.846 (95% CI: 0.582-1.230). CONCLUSIONS Tocilizumab did not demonstrate a positive effect on time to discharge or the state of awaiting discharge. Furthermore, no statistically significant differences in other clinical outcomes, such as time to improvement in the clinical state, time to clinical failure, and time to recovery, were observed among the groups.
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Affiliation(s)
- Yukari Uemura
- Biostatistics Section, Department of Data Science, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan.
| | - Ryoto Ozaki
- Biometrics Department, Clinical Development Division, Chugai Pharmaceutical CO., LTD, Tokyo, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Hiroshi Ohtsu
- Clinical Pharmacology and Regulatory Sciences, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yousuke Shimizu
- Biostatistics Section, Department of Data Science, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan
| | - Kazuo Izumi
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuaki Matsunaga
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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Hamaguchi K, Shinohara S, Michida T, Yasumoto M, Hamamoto A, Yamamoto T, Ueda K, Nakamura E. Effects of COVID-19 pandemic on hospital visit of head and neck cancer patients. Auris Nasus Larynx 2023; 50:948-951. [PMID: 37137795 PMCID: PMC10106817 DOI: 10.1016/j.anl.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Head and neck cancer (HNC) often causes respiratory symptoms, so diagnostic delays due to COVID-19 are anticipated. Especially, our institute is a designated medical institute for Class 1 specified infectious diseases, and most of the severe COVID-19 patients in this region were preferentially admitted or transferred. Hereby, we evaluated the trends of the numbers, primary sites and clinical stages of HNC patients before and after COVID-19 pandemic. METHODS A retrospective analysis of all patients diagnosed and treated for HNC from 2015 to 2021 was performed. Especially, 309 cases between 2018 and 2021 were extracted in order to examine a direct impact of COVID-19 pandemic, which were dichotomized into "Pre" group in 2018-2019 and "COVID" group in 2020-2021. They were compared about the distribution of clinical stage, the period between onset of symptom and hospital visit. RESULTS HNC patients decreased by 38% in 2020 and by 18% in 2021 compared to average number of patients from 2015 to 2019. Patients of stage 0 and 1 in "COVID" group significantly decreased compared to that in "Pre" group. Cases performed emergent tracheostomy in hypopharyngeal cancer and laryngeal cancer increased in "COVID" group (10.5% vs 1.3%). CONCLUSION Patients with slight symptoms would hesitated to visit hospital after COVID-19, and only a few delays of HNC diagnosis could have increased tumor burden and caused narrowed airway, especially in advanced HPC and LC.
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Affiliation(s)
- Kiyomi Hamaguchi
- Department of Head and Neck Surgery, Kobe City Medical Center General Hospital, Minatojima-Minamimachi 2-1-1, Chuo-ku, Kobe, 650-0047, Japan.
| | - Shogo Shinohara
- Department of Head and Neck Surgery, Kobe City Medical Center General Hospital, Minatojima-Minamimachi 2-1-1, Chuo-ku, Kobe, 650-0047, Japan
| | - Tetsuhiko Michida
- Department of Head and Neck Surgery, Kobe City Medical Center General Hospital, Minatojima-Minamimachi 2-1-1, Chuo-ku, Kobe, 650-0047, Japan
| | - Mami Yasumoto
- Department of Head and Neck Surgery, Kobe City Medical Center General Hospital, Minatojima-Minamimachi 2-1-1, Chuo-ku, Kobe, 650-0047, Japan
| | - Ayami Hamamoto
- Department of Head and Neck Surgery, Kobe City Medical Center General Hospital, Minatojima-Minamimachi 2-1-1, Chuo-ku, Kobe, 650-0047, Japan
| | - Tomoko Yamamoto
- Department of Head and Neck Surgery, Kobe City Medical Center General Hospital, Minatojima-Minamimachi 2-1-1, Chuo-ku, Kobe, 650-0047, Japan
| | - Keishi Ueda
- Department of Head and Neck Surgery, Kobe City Medical Center General Hospital, Minatojima-Minamimachi 2-1-1, Chuo-ku, Kobe, 650-0047, Japan
| | - Eugene Nakamura
- Department of Head and Neck Surgery, Kobe City Medical Center General Hospital, Minatojima-Minamimachi 2-1-1, Chuo-ku, Kobe, 650-0047, Japan
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