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Dagher O, Passos-Castilho AM, Sareen V, Labbé AC, Barkati S, Luong ML, Rousseau C, Benedetti A, Azoulay L, Greenaway C. Impact of Language Barriers on Outcomes and Experience of COVID-19 Patients Hospitalized in Quebec, Canada, During the First Wave of the Pandemic. J Immigr Minor Health 2024; 26:3-14. [PMID: 37902902 DOI: 10.1007/s10903-023-01561-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 11/01/2023]
Abstract
Language barriers (LB) contribute to coronavirus disease 2019 (COVID-19) health inequities. People with LB were more likely to be SARS-CoV-2 positive despite lower testing and had higher rates of hospitalization. Data on hospital outcomes among immigrants with LB, however, are limited. We aimed to investigate the clinical outcomes of hospitalized COVID-19 cases by LB, immigration status, ethnicity, and access to COVID-19 health information and services prior to admission. Adults with laboratory-confirmed community-acquired COVID-19 hospitalized from March 1 to June 30, 2020, at four tertiary-care hospitals in Montréal, Quebec, Canada were included. Demographics, comorbidities, immigration status, country of birth, ethnicity, presence of LB, and hospital outcomes (ICU admission and death) were obtained through a chart review. Additional socio-economic and access to care questions were obtained through a phone survey. A Fine-Gray competing risk subdistribution hazards model was used to estimate the risk of ICU admission and in-hospital death by immigrant status, region of birth and LB Among 1093 patients, 622 (56.9%) were immigrants and 101 (16.2%) of them had a LB. One third (36%) of immigrants with LB did not have access to an interpreter during hospitalization. Admission to ICU and in-hospital mortality were not significantly different between groups. Prior to admission, one third (14/41) of immigrants with LB had difficulties accessing COVID-19 information in their mother tongue and one third (9/27) of non-white immigrants with a LB had difficulties accessing COVID-19 services. Immigrants with LB were inequitably affected by the first wave of the pandemic in Quebec, Canada. In our study, a large proportion had difficulties accessing information and services related to COVID-19 prior to admission, which may have increased SARS-CoV-2 exposure and hospitalizations. After hospitalization, a large proportion did not have access to interpreters. Providing medical information and care in the language of preference of increasing diverse populations in Canada is important for promoting health equity.
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Affiliation(s)
- Olina Dagher
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Biomedical Sciences, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Ana Maria Passos-Castilho
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Vasu Sareen
- Department of Internal Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Annie-Claude Labbé
- Division of Infectious Diseases, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal, Montreal, QC, Canada
- Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Sapha Barkati
- Division of Infectious Diseases, McGill University Health Center (MUHC), McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Me-Linh Luong
- Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Department of Microbiology and Infectiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Cecile Rousseau
- Department of Psychiatry, McGill University Health Center, McGill University, Montreal, QC, Canada
- SHERPA University Institute, CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Andrea Benedetti
- Departments of Medicine and Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Laurent Azoulay
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Departments of Medicine and Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Christina Greenaway
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.
- Departments of Medicine and Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
- Division of Infectious Disease, Jewish General Hospital, Montreal, QC, Canada.
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Tolossa T, Lema M, Wakuma B, Turi E, Fekadu G, Mulisa D, Fetensa G. Incidence and predictors of diabetes mellitus among severe COVID-19 patients in western Ethiopia: a retrospective cohort study. Journal of Endocrinology, Metabolism and Diabetes of South Africa 2022. [DOI: 10.1080/16089677.2022.2144016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Tadesse Tolossa
- Department of Public Health, Wollega University, Nekemte, Ethiopia
| | - Matiyos Lema
- Department of Public Health, Wollega University, Nekemte, Ethiopia
| | - Bizuneh Wakuma
- Department of Nursing, Wollega University, Nekemte, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Wollega University, Nekemte, Ethiopia
| | - Ginenus Fekadu
- Department of Clinical Pharmacy, Wollega University, Nekemte, Ethiopia
| | - Diriba Mulisa
- Department of Nursing, Wollega University, Nekemte, Ethiopia
| | - Getahun Fetensa
- Department of Nursing, Wollega University, Nekemte, Ethiopia
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Otunla A, Rees K, Dennison P, Hobbs R, Suklan J, Schofield E, Gunnell J, Mighiu A, Hartmann-Boyce J. Risks of infection, hospital and ICU admission, and death from COVID-19 in people with asthma: systematic review and meta-analyses. BMJ Evid Based Med 2022; 27:263-273. [PMID: 34933924 DOI: 10.1136/bmjebm-2021-111788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/29/2021] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To determine if and to what degree asthma may predispose to worse COVID-19 outcomes in order to inform treatment and prevention decisions, including shielding and vaccine prioritisation. DESIGN Systematic review and meta-analysis. SETTING Electronic databases were searched (October 2020) for clinical studies reporting at least one of the following stratified by asthma status: risk of infection with SARS-CoV-2; hospitalisation, intensive care unit (ICU) admission or mortality with COVID-19. PARTICIPANTS Adults and children who tested positive for or were suspected to have COVID-19. MAIN OUTCOME MEASURES Main outcome measures were the following stratified by asthma status: risk of infection with SARS-CoV-2; hospitalisation, ICU admission or mortality with COVID-19. We pooled odds ratios (ORs) and presented these with 95% confidence intervals (CI). Certainty was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluations). RESULTS 30 (n=112 420) studies were included (12 judged high quality, 15 medium, 3 low). Few provided indication of asthma severity. Point estimates indicated reduced risks in people with asthma for all outcomes, but in all cases the evidence was judged to be of very low certainty and 95% CIs all included no difference and the possibility of increased risk (death: OR 0.90, 95% CI 0.72 to 1.13, I2=58%; hospitalisation: OR 0.95, 95% CI 0.71 to 1.26; ICU admission: OR 0.96, 95% CI 0.75 to 1.24). Findings on hospitalisation are also limited by substantial unexplained statistical heterogeneity. Within people with asthma, allergic asthma was associated with less COVID-19 risk and concurrent chronic obstructive pulmonary disease was associated with increased risk. In some studies, corticosteroids were associated with increased risk, but this may reflect increased risk in people with more severe asthma. CONCLUSIONS Though absence of evidence of a clear association between asthma and worse outcomes from COVID-19 should not be interpreted as evidence of absence, the data reviewed indicate that risks from COVID-19 in people with asthma, as a whole, may be less than originally anticipated.
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Affiliation(s)
| | - Karen Rees
- Freelance systematic reviewer, Warwickshire, UK
| | - Paddy Dennison
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jana Suklan
- NIHR Newcastle In Vitro Diagnostics, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Ella Schofield
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - James Gunnell
- Medical Sciences Division, University of Oxford, Oxford, UK
| | | | - Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Passos-Castilho AM, Labbé AC, Barkati S, Luong ML, Dagher O, Maynard N, Tutt-Guérette MA, Kierans J, Rousseau C, Benedetti A, Azoulay L, Greenaway C. Outcomes of hospitalized COVID-19 patients in Canada: impact of ethnicity, migration status and country of birth. J Travel Med 2022; 29:6567954. [PMID: 35417000 PMCID: PMC9047205 DOI: 10.1093/jtm/taac041] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Ethnoracial groups in high-income countries have a 2-fold higher risk of SARS-CoV-2 infection, associated hospitalizations, and mortality than Whites. Migrants are an ethnoracial subset that may have worse COVID-19 outcomes due to additional barriers accessing care, but there are limited data on in-hospital outcomes. We aimed to disaggregate and compare COVID-19 associated hospital outcomes by ethnicity, immigrant status and region of birth. METHODS Adults with community-acquired SARS-CoV-2 infection, hospitalized March 1-June 30, 2020, at four hospitals in Montréal, Quebec, Canada, were included. Age, sex, socioeconomic status, comorbidities, migration status, region of birth, self-identified ethnicity [White, Black, Asian, Latino, Middle East/North African], intensive care unit (ICU) admissions and mortality were collected. Adjusted hazard ratios (aHR) for ICU admission and mortality by immigrant status, ethnicity and region of birth adjusted for age, sex, socioeconomic status and comorbidities were estimated using Fine and Gray competing risk models. RESULTS Of 1104 patients (median [IQR] age, 63.0 [51.0-76.0] years; 56% males), 57% were immigrants and 54% were White. Immigrants were slightly younger (62 vs 65 years; p = 0.050), had fewer comorbidities (1.0 vs 1.2; p < 0.001), similar crude ICU admissions rates (33.0% vs 28.2%) and lower mortality (13.3% vs 17.6%; p < 0.001) than Canadian-born. In adjusted models, Blacks (aHR 1.39, 95% confidence interval 1.05-1.83) and Asians (1.64, 1.15-2.34) were at higher risk of ICU admission than Whites, but there was significant heterogeneity within ethnic groups. Asians from Eastern Asia/Pacific (2.15, 1.42-3.24) but not Southern Asia (0.97, 0.49-1.93) and Caribbean Blacks (1.39, 1.02-1.89) but not SSA Blacks (1.37, 0.86-2.18) had a higher risk of ICU admission. Blacks had a higher risk of mortality (aHR 1.56, p = 0.049). CONCLUSIONS Data disaggregated by region of birth identified subgroups of immigrants at increased risk of COVID-19 ICU admission, providing more actionable data for health policymakers to address health inequities.
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Affiliation(s)
- Ana Maria Passos-Castilho
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Annie-Claude Labbé
- Division of Infectious Diseases, Department of Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal, Montreal, QC, Canada.,Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montreal, QC, Canada
| | - Sapha Barkati
- Division of Infectious Diseases, Department of Medicine, McGill University Health Center (MUHC), McGill University, Montreal, QC, Canada.,Research Institute of the McGill University Health Centre, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
| | - Me-Linh Luong
- Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montreal, QC, Canada.,Department of Medical Microbiology and Infectiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Olina Dagher
- Department of Biomedical Sciences, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Noémie Maynard
- Department of Medicine, McGill University, Montreal, QC, Canada
| | | | - James Kierans
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Cecile Rousseau
- Department of Psychiatry, McGill University Health Center, McGill University, Montreal, QC, Canada.,SHERPA University Institute, CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Andrea Benedetti
- SHERPA University Institute, CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Laurent Azoulay
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada.,Departments of Medicine and Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Christina Greenaway
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada.,Departments of Medicine and Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Division of Infectious Disease, Jewish General Hospital, 3755 Côte St. Catherine Road, Room G-200, Montreal, QC H3T 1E2, Canada
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Abstract
This review describes the impact of coronavirus disease 2019 (COVID-19) in children and adolescents, investigating changes in diabetes presentation during the COVID-19 pandemic, possible links between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection and diabetes, and mechanisms of pancreatic β-cell destruction. Although glycemic control in individuals with already known diabetes mellitus did not worsen during the pandemic, there was a worrying increase in diabetic ketoacidosis in children with new-onset diabetes, probably due to containment measures and delayed access to emergency departments. Moreover, new evidence suggests that SARS-CoV-2 has the capacity to directly and indirectly induce pancreatic β-cell destruction, and the risk of newly diagnosed diabetes after COVID-19 increased in both children and adults. While long-term studies continue to follow children with SARS-CoV-2 infection, this review discusses available findings on the relationship between COVID-19 and diabetes. It is important to emphasize the need to maintain close links between families of children with chronic conditions and their pediatricians, as well as to promote early access to healthcare services, in order to reduce dangerous delays in diabetes diagnosis and prevent diabetic ketoacidosis.
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Affiliation(s)
| | - Francesco Chiarelli
- Address for correspondence: Francesco Chiarelli Department of Pediatrics, University of Chieti, Via dei Vestini, 5, I-66100 Chieti, Italy
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Darwish I, Harrison LB, Passos-Castilho AM, Labbé AC, Barkati S, Luong ML, Kong LY, Tutt-Guérette MA, Kierans J, Rousseau C, Benedetti A, Azoulay L, Greenaway C. In-hospital outcomes of SARS-CoV-2-infected health care workers in the COVID-19 pandemic first wave, Quebec, Canada. PLoS One 2022; 17:e0272953. [PMID: 36001588 PMCID: PMC9401164 DOI: 10.1371/journal.pone.0272953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Health care workers (HCW), particularly immigrants and ethnic minorities are at increased risk for SARS-CoV-2 infection. Outcomes during a COVID-19 associated hospitalization are not well described among HCW. We aimed to describe the characteristics of HCW admitted with COVID-19 including immigrant status and ethnicity and the associated risk factors for Intensive Care unit (ICU) admission and death.
Methods
Adults with laboratory-confirmed community-acquired COVID-19 hospitalized from March 1 to June 30, 2020, at four tertiary-care hospitals in Montréal, Canada were included. Demographics, comorbidities, occupation, immigration status, country of birth, ethnicity, workplace exposures, and hospital outcomes (ICU admission and death) were obtained through a chart review and phone survey. A Fine and Gray competing risk proportional hazards model was used to estimate the risk of ICU admission among HCW stratified by immigrant status and region of birth.
Results
Among 1104 included persons, 150 (14%) were HCW, with a phone survey participation rate of 68%. HCWs were younger (50 vs 64 years; p<0.001), more likely to be female (61% vs 41%; p<0.001), migrants (68% vs 55%; p<0.01), non-White (65% vs 41%; p<0.001) and healthier (mean Charlson Comorbidity Index of 0.3 vs 1.2; p<0.001) compared to non-HCW. They were as likely to be admitted to the ICU (28% vs 31%; p = 0.40) but were less likely to die (4% vs. 17%; p<0.001). Immigrant HCW accounted for 68% of all HCW cases and, compared to Canadian HCW, were more likely to be personal support workers (PSW) (54% vs. 33%, p<0.01), to be Black (58% vs 4%) and to work in a Residential Care Facility (RCF) (59% vs 33%; p = 0.05). Most HCW believed that they were exposed at work, 55% did not always have access to personal protective equipment (PPE) and 40% did not receive COVID-19-specific Infection Control (IPAC) training.
Conclusion
Immigrant HCW were particularly exposed to COVID-19 infection in the first wave of the pandemic in Quebec. Despite being young and healthy, one third of all HCW required ICU admission, highlighting the importance of preventing workplace transmission through strong infection prevention and control measures, including high COVID-19 vaccination coverage.
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Affiliation(s)
- Ilyse Darwish
- Division of Infectious Diseases, McGill University, Montréal, Quebec, Canada
| | - Luke B. Harrison
- Division of Infectious Diseases, McGill University, Montréal, Quebec, Canada
| | - Ana Maria Passos-Castilho
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montréal, Quebec, Canada
| | - Annie-Claude Labbé
- Department of Medicine & Division of Infectious Diseases, Hôpital Maisonneuve-Rosemont, CIUSSS de l’Est-de-l’Île-de-Montréal, Montréal, Quebec, Canada
- Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montréal, Quebec, Canada
- Département des Laboratoires de Biologie Médicale, Grappe Optilab-CHUM, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Canada
| | - Sapha Barkati
- Department of Medicine & Division of Infectious Diseases, McGill University Health Center (MUHC), McGill University, Montréal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montréal, Quebec, Canada
- Department of Medicine, McGill University, Montréal, Quebec, Canada
| | - Me-Linh Luong
- Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montréal, Quebec, Canada
- Département des Laboratoires de Biologie Médicale, Grappe Optilab-CHUM, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Canada
- Department of Medicine & Division of Infectious Diseases CHUM, Montréal, Quebec, Canada
| | - Ling Yuan Kong
- Department of Medicine & Division of Infectious Diseases, Jewish General Hospital, McGill University, Montréal, Quebec, Canada
| | - Marc-Antoine Tutt-Guérette
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montréal, Quebec, Canada
| | - James Kierans
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montréal, Quebec, Canada
| | - Cécile Rousseau
- Department of Psychiatry, McGill University Health Center, McGill University, Montréal, Quebec, Canada
- SHERPA University Institute, CIUSSS du Centre-Ouest-de-l’Île-de-Montréal, Montréal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada
| | - Laurent Azoulay
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montréal, Quebec, Canada
- Department of Medicine, McGill University, Montréal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada
| | - Christina Greenaway
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montréal, Quebec, Canada
- Department of Medicine, McGill University, Montréal, Quebec, Canada
- Department of Medicine & Division of Infectious Diseases, Jewish General Hospital, McGill University, Montréal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada
- * E-mail:
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Duan L, Wang Y, Dong H, Song C, Zheng J, Li J, Li M, Wang J, Yang J, Xu J. The COVID-19 Vaccination Behavior and Correlates in Diabetic Patients: A Health Belief Model Theory-Based Cross-Sectional Study in China, 2021. Vaccines (Basel) 2022; 10:vaccines10050659. [PMID: 35632415 PMCID: PMC9148061 DOI: 10.3390/vaccines10050659] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 02/01/2023] Open
Abstract
The population with diabetes is more susceptible to severe acute respiratory syndrome-associated coronavirus (SARS-CoV)-2, and have a significantly higher coronavirus disease-2019 (COVID-19) mortality rate. Previous studies have shown low willingness for the COVID-19 vaccination, and there are limited reports on the behavior and relevance of the COVID-19 vaccination. This study aimed to determine the uptake behavior and associated factors of the COVID-19 vaccine. In our cross-sectional questionnaire-based clinical study, 645 diabetes patients affiliated with two affiliated hospitals of Changzhi Medical College completed the questionnaire between June to October 2021. The health belief model (HBM) was used in examining factors influencing vaccination behavior. After adjusting for covariates with significant differences in social background characteristics, a multivariable logistic regression was used to determine predictors related to uptake in COVID-19 vaccination. A total of 162 vaccinated and 483 unvaccinated eligible diabetic patients were recruited. Patients who believed that the COVID-19 syndrome is severe (aOR3.67, 95%CI 1.88−7.17; p < 0.001), believe that vaccination can significantly reduce the risk of SARS-Cov-2 infection (aOR3.48, 95%CI 1.80−6.73; p < 0.001), believe that vaccination is beneficial to themselves and others (aOR 4.53, 95%CI 1.71−11.99; p = 0.002), think that relatives’ vaccination status has a positive impact on their vaccination behavior (aOR 5.68, 95%CI 2.83−11.39; p < 0.001), and were more likely to be vaccinated; worrying about the adverse health effects of COVID-19 vaccination (aOR 0.18, 95%CI 0.09−0.35; p < 0.001) was negatively correlated with COVID-19 vaccination behavior. Health care workers should provide targeted informative interventions based on the safety and protective effects theory of HBM to improve vaccination behavior in patients with diabetes.
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Affiliation(s)
- Lingrui Duan
- School of Epidemiology and Public Health, Shanxi Medical University, Taiyuan 032000, China; (L.D.); (Y.W.); (M.L.); (J.W.)
| | - Ying Wang
- School of Epidemiology and Public Health, Shanxi Medical University, Taiyuan 032000, China; (L.D.); (Y.W.); (M.L.); (J.W.)
| | - Haoyu Dong
- Department of Endocrinology, Heping Hospital, Changzhi Medical College, Changzhi 046000, China;
| | - Congying Song
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen 518000, China;
| | - Jinping Zheng
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi 046000, China;
| | - Jing Li
- Renal Division, Peking University Shenzhen Hospital, Peking University, Shenzhen 518000, China;
| | - Mufan Li
- School of Epidemiology and Public Health, Shanxi Medical University, Taiyuan 032000, China; (L.D.); (Y.W.); (M.L.); (J.W.)
| | - Jiayu Wang
- School of Epidemiology and Public Health, Shanxi Medical University, Taiyuan 032000, China; (L.D.); (Y.W.); (M.L.); (J.W.)
| | - Jianzhou Yang
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi 046000, China;
- Correspondence: (J.Y.); (J.X.); Tel.: +86-355-315-1579 (J.Y.); +86-755-8392-3333-6646 (J.X.)
| | - Junjie Xu
- Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen 518000, China;
- Correspondence: (J.Y.); (J.X.); Tel.: +86-355-315-1579 (J.Y.); +86-755-8392-3333-6646 (J.X.)
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8
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Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, disproportionally targets older people, particularly men, ethnic minorities, and individuals with underlying diseases such as compromised immune system, cardiovascular disease, and diabetes. The discrepancy in COVID-19 incidence and severity is multifaceted and likely involves biological, social, as well as nutritional status. Vitamin D deficiency, notably common in Black and Brown people and elderly, is associated with an increased susceptibility to many of the diseases comorbid with COVID-19. Vitamin D deficiency can cause over-activation of the pulmonary renin-angiotensin system (RAS) leading to the respiratory syndrome. RAS is regulated in part at least by angiotensin-converting enzyme 2 (ACE2), which also acts as a primary receptor for SARS-CoV-2 entry into the cells. Hence, vitamin D deficiency can exacerbate COVID-19, via its effects on ACE2. In this review we focus on influence of age, gender, and ethnicity on vitamin D-ACE2 interaction and susceptibility to COVID-19.
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Affiliation(s)
- Bruk Getachew
- Department of PharmacologyCollege of Medicine, Howard UniversityWashington DCUSA
| | - Yousef Tizabi
- Department of PharmacologyCollege of Medicine, Howard UniversityWashington DCUSA
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9
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Bielka W, Przezak A, Pawlik A. Therapy of Type 2 Diabetes in Patients with SARS-CoV-2 Infection. Int J Mol Sci 2021; 22:ijms22147605. [PMID: 34299225 PMCID: PMC8306903 DOI: 10.3390/ijms22147605] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 12/15/2022] Open
Abstract
COVID-19 infection poses an important clinical therapeutic problem, especially in patients with coexistent diseases such as type 2 diabetes. Potential pathogenetic links between COVID-19 and diabetes include inflammation, effects on glucose homeostasis, haemoglobin deoxygenation, altered immune status and activation of the renin-angiotensin-aldosterone system (RAAS). Moreover, drugs often used in the clinical care of diabetes (dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, sodium-glucose cotransporter 2 inhibitors, metformin and insulin) may influence the course of SARS-CoV-2 infection, so it is very important to verify their effectiveness and safety. This review summarises the new advances in diabetes therapy and COVID-19 and provides clinical recommendations that are essential for medical doctors and for patients suffering from type 2 diabetes.
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