1
|
Yokoo P, Castro ADAE, Fonseca EKUN, Chate RC, Teles GBDS, de Queiroz MRG, Szarf G. COVID-19 pneumonia assessed at a private hospital, a field hospital, and a public-referral hospital: population analysis, chest computed tomography findings, and outcomes. Front Public Health 2024; 11:1280662. [PMID: 38235155 PMCID: PMC10793654 DOI: 10.3389/fpubh.2023.1280662] [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] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/30/2023] [Indexed: 01/19/2024] Open
Abstract
Objective To compare a private quaternary referral hospital, a public tertiary hospital, and a field hospital dedicated to patients with COVID-19, regarding patients' characteristics, clinical parameters, laboratory, imaging findings, and outcomes of patients with confirmed diagnosis of COVID-19. Methods Retrospective multicenter observational study that assessed the association of clinical, laboratory and CT data of 453 patients with COVID-19, and also their outcomes (hospital discharge or admission, intensive care unit admission, need for mechanical ventilation, and mortality caused by COVID-19). Results The mean age of patients was 55 years (±16 years), 58.1% of them were male, and 41.9% were female. Considering stratification by the hospital of care, significant differences were observed in the dyspnea, fever, cough, hypertension, diabetes mellitus parameters, and CT score (p < 0.05). Significant differences were observed in ward admission rates, with a lower rate in the private hospital (40.0%), followed by the public hospital (74.1%), and a higher rate in the field hospital (89.4%). Regarding intensive care unit admission, there was a higher rate in the public hospital (25.2%), followed by the private hospital (15.5%), and a lower rate in the field hospital (9.9%). In the analysis of the discharge and death outcomes, it was found that there was a higher number of patients discharged from the private hospital (94.2%), compared to the field hospital (90.1%) and public hospital (82.3%) and a higher number of deaths in the public hospital (17.7%) compared to the private hospital and field hospital (5.8 and 0% respectively). Conclusion The analysis of the data regarding the population treated with COVID-19 during the first wave in different levels of care in the public and private health systems in the city of São Paulo revealed statistically significant differences between the populations, reflecting distinct outcomes.
Collapse
|
2
|
Mahapatra P, Sahoo KC, Desaraju S, Nath B, Pati S. Managing dementia care during COVID-19 pandemic: caregivers' experiences in Odisha, India. Prim Health Care Res Dev 2023; 24:e41. [PMID: 37226696 DOI: 10.1017/s1463423622000664] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
AIM The present study explored the family caregivers' perspectives and elicited their experience while managing dementia care during the COVID-19 pandemic in Odisha, India. BACKGROUND The onset of the COVID-19 pandemic has diverted the attention of health systems away from chronic disease management and health services delivery. Psychiatric care particularly for dementia and the elderly is found to be more compromised in such situation. METHODS We adopted an inductive phenomenological approach to garner key insights into the care continuity for people living with dementia in the context of the COVID-19 pandemic. Telephonic in-depth interviews (IDIs) were carried out with 17 immediate caregivers. All IDIs were digitally recorded, transcribed, and analysed using a thematic approach. FINDINGS Caregivers did not perceive dementia as an overwhelming challenge; instead viewed it as a part of the ageing process. Caring for dementia was being done by family members as a collective responsibility with task-sharing. The caregivers primarily relied on their usual physician for the continuity of dementia care and took utmost precautions to prevent exposure to COVID-19 risk. However, they found it more challenging to ensure adequate care for the multiple illnesses (multimorbidity) coexisting with dementia. Towards this, they adopted all possible measures to keep the chronic conditions under control, lest the vulnerability to COVID-19 infection might heighten. The fear of visiting a hospital, prevailing restrictions in mobility, and diverted attention of health systems to pandemic containment created impediments towards maintaining multimorbidity care. The support of local administration, neighbourhood pharmacy and diagnostic laboratories and teleconsultation with the physicians were vital for care continuity. Caregivers adapted by reducing or deferring physical consultation and seeking treatment via telephonic advice of the treating physicians. Our findings suggest leveraging digitally enabled health care technology and augmenting caregiver activation for home-based dementia care to cruise through any similar catastrophic situations.
Collapse
Affiliation(s)
- Pranab Mahapatra
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha751024, India
| | - Krushna Chandra Sahoo
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha751023, India
| | - Shyama Desaraju
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha751023, India
| | - Binapani Nath
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha751023, India
| | - Sanghamitra Pati
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha751023, India
| |
Collapse
|
3
|
Ahmed MIM, Diepers P, Janke C, Plank M, Eser TM, Rubio-Acero R, Fuchs A, Baranov O, Castelletti N, Kroidl I, Olbrich L, Bauer B, Wang D, Prelog M, Liese JG, Reinkemeyer C, Hoelscher M, Steininger P, Überla K, Wieser A, Geldmacher C. Enhanced Spike-specific, but attenuated Nucleocapsid-specific T cell responses upon SARS-CoV-2 breakthrough versus non-breakthrough infections. Front Immunol 2022; 13:1026473. [PMID: 36582222 PMCID: PMC9792977 DOI: 10.3389/fimmu.2022.1026473] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2 vaccine breakthrough infections frequently occurred even before the emergence of Omicron variants. Yet, relatively little is known about the impact of vaccination on SARS-CoV-2-specific T cell and antibody response dynamics upon breakthrough infection. We have therefore studied the dynamics of CD4 and CD8 T cells targeting the vaccine-encoded Spike and the non-encoded Nucleocapsid antigens during breakthrough infections (BTI, n=24) and in unvaccinated control infections (non-BTI, n=30). Subjects with vaccine breakthrough infection had significantly higher CD4 and CD8 T cell responses targeting the vaccine-encoded Spike during the first and third/fourth week after PCR diagnosis compared to non-vaccinated controls, respectively. In contrast, CD4 T cells targeting the non-vaccine encoded Nucleocapsid antigen were of significantly lower magnitude in BTI as compared to non-BTI. Hence, previous vaccination was linked to enhanced T cell responses targeting the vaccine-encoded Spike antigen, while responses against the non-vaccine encoded Nucleocapsid antigen were significantly attenuated.
Collapse
Affiliation(s)
- Mohamed Ibraheem Mahmoud Ahmed
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany,German Centre for Infection Research (DZIF), Munich, Germany
| | - Paulina Diepers
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Michael Plank
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Tabea M. Eser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany,German Centre for Infection Research (DZIF), Munich, Germany
| | - Raquel Rubio-Acero
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Anna Fuchs
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Olga Baranov
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany,German Centre for Infection Research (DZIF), Munich, Germany
| | - Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany,German Centre for Infection Research (DZIF), Munich, Germany
| | - Laura Olbrich
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany,German Centre for Infection Research (DZIF), Munich, Germany,Oxford Vaccine Group, Department of Paediatrics, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Bernadette Bauer
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Danni Wang
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Martina Prelog
- Pediatric Rheumatology/Special Immunology, Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Johannes G. Liese
- Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Christina Reinkemeyer
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany,German Centre for Infection Research (DZIF), Munich, Germany
| | - Philipp Steininger
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Klaus Überla
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany,German Centre for Infection Research (DZIF), Munich, Germany
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany,German Centre for Infection Research (DZIF), Munich, Germany,*Correspondence: Christof Geldmacher,
| |
Collapse
|
4
|
Curtis L. PM 2.5, NO 2, wildfires, and other environmental exposures are linked to higher Covid 19 incidence, severity, and death rates. Environ Sci Pollut Res Int 2021; 28:54429-54447. [PMID: 34410599 PMCID: PMC8374108 DOI: 10.1007/s11356-021-15556-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/17/2021] [Indexed: 05/09/2023]
Abstract
Numerous studies have linked outdoor levels of PM2.5, PM10, NO2, O3, SO2, and other air pollutants to significantly higher rates of Covid 19 morbidity and mortality, although the rate in which specific concentrations of pollutants increase Covid 19 morbidity and mortality varies widely by specific country and study. As little as a 1-μg/m3 increase in outdoor PM2.5 is estimated to increase rates of Covid 19 by as much as 0.22 to 8%. Two California studies have strongly linked heavy wildfire burning periods with significantly higher outdoor levels of PM2.5 and CO as well as significantly higher rates of Covid 19 cases and deaths. Active smoking has also been strongly linked significantly increased risk of Covid 19 severity and death. Other exposures possibly related to greater risk of Covid 19 morbidity and mortality include incense, pesticides, heavy metals, dust/sand, toxic waste sites, and volcanic emissions. The exact mechanisms in which air pollutants increase Covid 19 infections are not fully understood, but are probably related to pollutant-related oxidation and inflammation of the lungs and other tissues and to the pollutant-driven alternation of the angiotensin-converting enzyme 2 in respiratory and other cells.
Collapse
Affiliation(s)
- Luke Curtis
- East Carolina University, Greenville, NC, 5371 Knollwood Parkway Court #F, Hazelwood, MO, 63042, USA.
| |
Collapse
|