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Visram AS, Jackson IR, Guest H, Plack CJ, Brij S, Chaudhuri N, Munro KJ. Pre-registered controlled comparison of auditory function reveals no difference between hospitalised adults with and without COVID-19. Int J Audiol 2024; 63:300-312. [PMID: 37363933 DOI: 10.1080/14992027.2023.2213841] [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] [Received: 12/06/2022] [Revised: 05/03/2023] [Accepted: 05/08/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Several viruses are known to have a negative impact on hearing health. The global prevalence of COVID-19 means that it is crucial to understand whether and how SARS-CoV2 affects hearing. Evidence to date is mixed, with studies frequently exhibiting limitations in the methodological approaches used or the populations sampled, leading to a substantial risk of bias. This study addressed many of these limitations. DESIGN A comprehensive battery of measures was administered, including lab-based behavioural and physiological measures, as well as self-report instruments. Performance was thoroughly assessed across the auditory system, including measures of cochlear function, neural function and auditory perception. Hypotheses and analyses were pre-registered. STUDY SAMPLES Participants who were hospitalised as a result of COVID-19 (n = 57) were compared with a well-matched control group (n = 40) who had also been hospitalised but had never had COVID-19. RESULTS We find no evidence to support the hypothesis that COVID-19 is associated with deficits in auditory function on any auditory test measure. Of all the confirmatory analyses, only the self-report measure of hearing decline indicated any difference between groups. CONCLUSION Results do not support the hypothesis that COVID-19 infection has a significant long-term impact on the auditory system.
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Affiliation(s)
- A S Visram
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
| | - I R Jackson
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
| | - H Guest
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
| | - C J Plack
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
- Department of Psychology, Lancaster University, Lancaster, UK
| | - S Brij
- Department of Respiratory Medicine, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - N Chaudhuri
- Magee Medical School, The University of Ulster, Londonderry, UK
| | - K J Munro
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
- University of Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Hayward G, Yu LM, Little P, Gbinigie O, Shanyinde M, Harris V, Dorward J, Saville BR, Berry N, Evans PH, Thomas NPB, Patel MG, Richards D, Hecke OV, Detry MA, Saunders C, Fitzgerald M, Robinson J, Latimer-Bell C, Allen J, Ogburn E, Grabey J, de Lusignan S, Hobbs FR, Butler CC. Ivermectin for COVID-19 in adults in the community (PRINCIPLE): An open, randomised, controlled, adaptive platform trial of short- and longer-term outcomes. J Infect 2024; 88:106130. [PMID: 38431155 PMCID: PMC10981761 DOI: 10.1016/j.jinf.2024.106130] [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: 10/26/2023] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND The evidence for whether ivermectin impacts recovery, hospital admissions, and longer-term outcomes in COVID-19 is contested. The WHO recommends its use only in the context of clinical trials. METHODS In this multicentre, open-label, multi-arm, adaptive platform randomised controlled trial, we included participants aged ≥18 years in the community, with a positive SARS-CoV-2 test, and symptoms lasting ≤14 days. Participants were randomised to usual care, usual care plus ivermectin tablets (target 300-400 μg/kg per dose, once daily for 3 days), or usual care plus other interventions. Co-primary endpoints were time to first self-reported recovery, and COVID-19 related hospitalisation/death within 28 days, analysed using Bayesian models. Recovery at 6 months was the primary, longer term outcome. TRIAL REGISTRATION ISRCTN86534580. FINDINGS The primary analysis included 8811 SARS-CoV-2 positive participants (median symptom duration 5 days), randomised to ivermectin (n = 2157), usual care (n = 3256), and other treatments (n = 3398) from June 23, 2021 to July 1, 2022. Time to self-reported recovery was shorter in the ivermectin group compared with usual care (hazard ratio 1·15 [95% Bayesian credible interval, 1·07 to 1·23], median decrease 2.06 days [1·00 to 3·06]), probability of meaningful effect (pre-specified hazard ratio ≥1.2) 0·192). COVID-19-related hospitalisations/deaths (odds ratio 1·02 [0·63 to 1·62]; estimated percentage difference 0% [-1% to 0·6%]), serious adverse events (three and five respectively), and the proportion feeling fully recovered were similar in both groups at 6 months (74·3% and 71·2% respectively (RR = 1·05, [1·02 to 1·08]) and also at 3 and 12 months. INTERPRETATION Ivermectin for COVID-19 is unlikely to provide clinically meaningful improvement in recovery, hospital admissions, or longer-term outcomes. Further trials of ivermectin for SARS-Cov-2 infection in vaccinated community populations appear unwarranted. FUNDING UKRI/National Institute of Health Research (MC_PC_19079).
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Affiliation(s)
- Gail Hayward
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ly-Mee Yu
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Paul Little
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Oghenekome Gbinigie
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Milensu Shanyinde
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Victoria Harris
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jienchi Dorward
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - Benjamin R Saville
- Berry Consultants, TX, USA; Department of Biostatistics, Vanderbilt University School of Medicine, TN, USA
| | | | - Philip H Evans
- College of Medicine and Health, University of Exeter, Exeter, UK; National Institute for Health Research (NIHR) Clinical Research Network, National Institute for Health Research, London, UK
| | - Nicholas P B Thomas
- National Institute for Health Research (NIHR) Clinical Research Network, National Institute for Health Research, London, UK
| | - Mahendra G Patel
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Duncan Richards
- Royal College of General Practitioners, London, UK; Oxford Clinical Trials Research Unit, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Oliver V Hecke
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | | | | | - Jared Robinson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Julie Allen
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Emma Ogburn
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jenna Grabey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Fd Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Christopher C Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
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Goggi G, Moro M, Chilà A, Fatti L, Cangiano B, Federici S, Galazzi E, Carbone E, Soranna D, Vezzoli V, Persani L, Bonomi M. COVID-19 lockdown and the rate of central precocious puberty. J Endocrinol Invest 2024; 47:315-323. [PMID: 37566202 PMCID: PMC10859329 DOI: 10.1007/s40618-023-02146-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/18/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE The aim of our study was to compare the incidence of idiopathic central precocious puberty (CPP) in our highly specialized Endocrinological Center before and after the onset of COVID-19 lockdown; we also aimed to identify any potential difference between girls with CPP from the two different time periods. METHODS We retrospectively analyzed the auxological profile of 49 girls with idiopathic CPP: 30 with pre-lockdown onset and 19 with post-lockdown onset of the disease. We collected patients' characteristics (medical history, physical examination, baseline and dynamic hormonal assessment, bone age, pelvic ultrasound) and compared them between the two groups. RESULTS We registered an almost threefold increase in CPP incidence in the 2020-2021 period compared to the previous six years. In post-lockdown patients we found a trend for an earlier diagnosis in terms of both chronological age (p 0.0866) and days between the onset of first pubertal signs and diagnosis (p 0.0618). We also found that post-lockdown patients had a significantly lower hypothalamus-pituitary-gonadal axis activation (lower ∆LH% after GnRH test, p 0.0497), a significantly lower increase in bone age calculated at RUS with TW3 method (p 0.0438) and a significantly reduced ovarian activation in females (lower delta-4-androstenedione levels, p 0.0115). Interestingly, post-lockdown patients were born from mothers with an older age at menarche (p 0.0039). CONCLUSIONS Besides confirming a significant increase in new diagnoses of CPP in the post-lockdown period, our findings among Post-lockdown girls also suggest a less progressive form of CPP and a stronger environmental influence compared to genetic background in determining the timing of pubertal onset.
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Affiliation(s)
- G Goggi
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - M Moro
- Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, P.le Brescia 20, 20149, Milan, Italy
| | - A Chilà
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - L Fatti
- Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, P.le Brescia 20, 20149, Milan, Italy
| | - B Cangiano
- Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, P.le Brescia 20, 20149, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - S Federici
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - E Galazzi
- Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, P.le Brescia 20, 20149, Milan, Italy
| | - E Carbone
- Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, P.le Brescia 20, 20149, Milan, Italy
| | - D Soranna
- Biostatistic Unit, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - V Vezzoli
- Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, P.le Brescia 20, 20149, Milan, Italy
| | - L Persani
- Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, P.le Brescia 20, 20149, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - M Bonomi
- Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, P.le Brescia 20, 20149, Milan, Italy.
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy.
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Del Vecchio L, Balafa O, Dounousi E, Ekart R, Fernandez BF, Mark PB, Sarafidis P, Valdivielso JM, Ferro CJ, Mallamaci F. COVID-19 and cardiovascular disease in patients with chronic kidney disease. Nephrol Dial Transplant 2024; 39:177-189. [PMID: 37771078 PMCID: PMC10828215 DOI: 10.1093/ndt/gfad170] [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: 05/18/2023] [Indexed: 09/30/2023] Open
Abstract
Millions of people worldwide have chronic kidney disease (CKD). Affected patients are at high risk for cardiovascular (CV) disease for several reasons. Among various comorbidities, CKD is associated with the more severe forms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This is particularly true for patients receiving dialysis or for kidney recipients. From the start of the SARS-CoV-2 pandemic, several CV complications have been observed in affected subjects, spanning acute inflammatory manifestations, CV events, thrombotic episodes and arrythmias. Several pathogenetic mechanisms have been hypothesized, including direct cytopathic viral effects on the myocardium, endothelial damage and hypercoagulability. This spectrum of disease can occur during the acute phase of the infection, but also months after recovery. This review is focussed on the CV complications of coronavirus disease 2019 (COVID-19) with particular interest in their implications for the CKD population.
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Affiliation(s)
- Lucia Del Vecchio
- Department of Nephrology and Dialysis, Sant'Anna Hospital, ASST Lariana, Como, Italy
| | - Olga Balafa
- Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece
| | - Evangelia Dounousi
- Department of Nephrology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Robert Ekart
- Department of Dialysis, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia
| | | | - Patrick B Mark
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Pantelis Sarafidis
- 1st Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Jose M Valdivielso
- Vascular and Renal Translational Research Group, Institute for Biomedical Research on Lleida (IRBLleida), Lleida, Spain
| | - Charles J Ferro
- Department of Renal Medicine, University Hospitals Birmingham and Institute of Cardiovascular Sciences, University of Birmingham, Birmingham,UK
| | - Francesca Mallamaci
- Francesca Mallamaci Department of Nephrology, Dialysis, and Transplantation Azienda Ospedaliera “Bianchi-Melacrino-Morelli” & CNR-IFC, Reggio Calabria, Italy
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Sekimoto O, Chiappelli F. Nipah: The looming post-covid pandemic. Bioinformation 2024; 20:1-3. [PMID: 38352906 PMCID: PMC10859950 DOI: 10.6026/973206300200001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/16/2024] Open
Abstract
First identified as a pathogen in Malaysia and Singapore in 1999, Nipah virus (NiV) caused nearly 300 human cases and over 100 fatalities. It also killed about 1 million pigs. Three years later (2002), it was reported in Pteropus bats in Malaysia, in Cambodia & Thailand, (2005), and as far as Madagascar (2007) and Ghana (2008). India (Kerala) reported its first human NiV-caused fatalities in September 2023. Taken together, these trends emphasize its public health threat. In humans, NiV infection initially leads to fever, headache, body aches and muscle pain, nausea and vomiting. The symptoms rapidly evolve into sore throat, cough and atypical pneumonia leading to severe respiratory distress. The cadre of NiV-induced pathology (Nipah disease, NiD) then includes severe dizziness and drowsiness, progressive alteration in cognition and consciousness, acute encephalitis and seizures. Public health protocols (e.g., mask-wearing, quarantine), essential to contain and control CoViD-19, seem insufficient to contain NiD spread because NiV transmission occurs primarily via direct contacts with body fluids of infected carriers, but presumably not by airborne transmission. As in the case of SARS-C0V2, health care providers (i.e., physicians, dentists, nurses, dental assistants) are greatest risks not only of contracting but of spreading NiV infection. NiV is a high-pathogenicity pathogen, against which, at present, we have no anti-viral medications or preventive vaccine. Taken together, the evidence to date heightens the threat of an upcoming NiD pandemic.
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Affiliation(s)
| | - Francesco Chiappelli
- Dental Group of Sherman Oaks, Sherman Oaks, CA 91403, USA
- UCLA Center for the Health Sciences, Los Angeles, CA 90095, USA
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Rahman MZU, Akbar MA, Leiva V, Martin-Barreiro C, Imran M, Riaz MT, Castro C. An IoT-fuzzy intelligent approach for holistic management of COVID-19 patients. Heliyon 2024; 10:e22454. [PMID: 38163138 PMCID: PMC10756970 DOI: 10.1016/j.heliyon.2023.e22454] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 01/03/2024] Open
Abstract
In this study, an internet of things (IoT)-enabled fuzzy intelligent system is introduced for the remote monitoring, diagnosis, and prescription of treatment for patients with COVID-19. The main objective of the present study is to develop an integrated tool that combines IoT and fuzzy logic to provide timely healthcare and diagnosis within a smart framework. This system tracks patients' health by utilizing an Arduino microcontroller, a small and affordable computer that reads data from various sensors, to gather data. Once collected, the data are processed, analyzed, and transmitted to a web page for remote access via an IoT-compatible Wi-Fi module. In cases of emergencies, such as abnormal blood pressure, cardiac issues, glucose levels, or temperature, immediate action can be taken to monitor the health of critical COVID-19 patients in isolation. The system employs fuzzy logic to recommend medical treatments for patients. Sudden changes in these medical conditions are remotely reported through a web page to healthcare providers, relatives, or friends. This intelligent system assists healthcare professionals in making informed decisions based on the patient's condition.
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Affiliation(s)
- Muhammad Zia Ur Rahman
- Department of Mechanical, Mechatronics and Manufacturing Engineering, University of Engineering and Technology Lahore, Faisalabad, Pakistan
| | | | - Víctor Leiva
- Escuela de Ingeniería Industrial, Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Carlos Martin-Barreiro
- Facultad de Ciencias Naturales y Matemáticas, ESPOL, Guayaquil, Ecuador
- Facultad de Ingeniería, Universidad Espíritu Santo, Samborondón, Ecuador
| | - Muhammad Imran
- Department of Mechanical, Mechatronics and Manufacturing Engineering, University of Engineering and Technology Lahore, Faisalabad, Pakistan
- Department of Mechanical Engineering, Tsinghua University, Beijing, China
| | - Muhammad Tanveer Riaz
- Department of Mechanical, Mechatronics and Manufacturing Engineering, University of Engineering and Technology Lahore, Faisalabad, Pakistan
| | - Cecilia Castro
- Centre of Mathematics, Universidade do Minho, Braga, Portugal
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Mirofsky M, Boietti B, Cirelli D, Rodriguez C, Bibolini J, Young P, Cámera L, Pollan JA, Sanchez Thomas D, Valdez P, Huespe IA. Vaccination impact: mortality and time shift to COVID-19 maximum severity in hospitalized patients. An Argentine multicenter registry. Medicina (B Aires) 2024; 84:19-28. [PMID: 38271929] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION The COVID-19 vaccine became an effective instrument to prevent severe SARS-CoV-2 infections. However, 5% of vaccinated patients will have moderate or severe disease. OBJECTIVE to compare mortality and days between the symptom onset to the peak disease severity, in vaccinated vs. unvaccinated COVID-19 hospitalized patients. METHODS Retrospective observational study in 36 hospitals in Argentina. COVID-19 adults admitted to general wards between January 1, 2021, and May 31, 2022 were included. Days between symptoms onset to peak of severity were compared between vaccinated vs. unvaccinated patients with Cox regression, adjusted by Propensity Score Matching (PSM). Results in patients with one and two doses were also compared. RESULTS A total of 3663 patients were included (3001 [81.9%] unvaccinated and 662 [18%] vaccinated). Time from symptom onset to peak severity was 7 days (IQR 4-12) vs. 7 days (IQR 4-11) in unvaccinated and vaccinated. In crude Cox regression analysis and matched population, no significant differences were observed. Regarding mortality, a Risk Ratio (RR) of 1.51 (IC95% 1.29-1.77) was observed in vaccinated patients, but in the PSM cohort, the RR was 0.73 (IC95% 0.60-0.88). RR in patients with one COVID-19 vaccine dose in PSM adjusted population was 0.7 (IC95% 0.45-1.03), and with two doses 0.6 (IC95% 0.46-0.79). DISCUSSION The time elapsed between the onset of COVID-19 symptoms to the highest severity was similar in vaccinated and unvaccinated patients. However, hospitalized vaccinated patients had a lower risk of mortality than unvaccinated patients.
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Affiliation(s)
- Matias Mirofsky
- Hospital Municipal de Agudos Dr. Leonidas Lucero, Bahía Blanca, Buenos Aires, Argentina. E-mail:
| | | | | | | | - Julian Bibolini
- Hospital Alta Complejidad Pte. Juan D. Perón, Formosa, Argentina
| | - Pablo Young
- Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Luis Cámera
- Hospital Italiano de Buenos Aires, CABA, Argentina
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Plasencia-Rodríguez C, Martínez-Feito A, Hernández M, Del Pino-Molina L, Novella-Navarro M, Serrano Y, González-Muñoz M, Peiteado D, Bonilla G, Monjo I, Nuño L, Tornero C, López-Granados E, Balsa A, Nozal P. Immune response after SARS-CoV-2 vaccination in patients with inflammatory immune-mediated diseases receiving immunosuppressive treatment. Allergy Asthma Clin Immunol 2023; 19:71. [PMID: 37598192 PMCID: PMC10439605 DOI: 10.1186/s13223-023-00832-0] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/06/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Real world data on the response to the SARS-CoV-2 vaccine in patients with immunomediated diseases (IMIDs) treated with immunesuppressants is of great interest because vaccine response may be impaired. The main aim was to study the humoral and cellular immune response after SARS-CoV-2 vaccination in patients with IMIDs treated with immunosuppressants. The secondary aim was to describe the frequency of SARS-CoV-2 infections after vaccination in these patients. MATERIAL AND METHODS This is an observational study including 86 patients with IMIDs. All patients were treated with biologic or targeted synthetic disease-modifying antirheumatic drugs [b/tsDMARDs: TNF inhibitors (TNFi), rituximab, anti-interleukin 6 receptor (anti-IL6R) or JAK inhibitors (JAKi)]. Demographic and clinical information were collected. After 4-6 weeks of 2nd and 3rd vaccine doses, humoral response was assessed using the Thermo Scientific ELiA SARS-CoV-2-Sp1 IgG Test. Also, in patients with serum SARS-CoV-2 antibody levels under 100UI/ml, cellular response was analyzed using the QuantiFERON SARS-CoV-2 Starter Pack. RESULTS A total of 86 patients under b/tsDMARDs and 38 healthy controls were included. Most patients received TNFi (45 with TNFi, 31 with rituximab, 5 with anti-IL6R and 5 with JAKi). SARS-CoV-2 antibodies (Ab) were present in an 86% of patients with IMIDs and in 100% healthy controls (p = 0.017). However, 12 (14%) patients had undetectable SARS-CoV-2 Ab levels, all treated with rituximab. In addition, SARS-CoV-2 Ab (IU/ml) were statistically lower in patients (Mdn (IQR): 59.5 (17-163) in patients vs 625 (405-932) in controls, p < 0.001). Patients treated with rituximab had lower Ab levels than those treated with TNFi and controls (p < 0.001). The cellular response to SARS-CoV-2 vaccine was evaluated in 30 patients. Eleven patients had a positive cellular response, being more frequent in patients treated with rituximab (p = 0.03). SARS-CoV-2 infection was reported in 43% of patients and 34% of controls after vaccination. Only 6 (7%) patients required hospitalization, most of whom treated with rituximab (67%). CONCLUSION SARS-CoV-2 antibody levels were lower in patients than in controls, especially in patients treated with rituximab. A cellular response can be detected despite having a poor humoral response. Severe infections in vaccinated patients with IMIDs are rare, and are observed mainly in patients treated with rituximab.
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Affiliation(s)
| | | | | | - Lucia Del Pino-Molina
- Center for Biomedical Network Research on Rare Diseases, ISCIII (CIBERER U767), Madrid, Spain
- Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute for Health Research (IdiPaz), Madrid, Spain
| | - Marta Novella-Navarro
- Rheumatology Unit, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Yolanda Serrano
- Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute for Health Research (IdiPaz), Madrid, Spain
| | | | - Diana Peiteado
- Rheumatology Unit, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Gema Bonilla
- Rheumatology Unit, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Irene Monjo
- Rheumatology Unit, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Laura Nuño
- Rheumatology Unit, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Carolina Tornero
- Rheumatology Unit, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Eduardo López-Granados
- Immunology, La Paz University Hospital, Madrid, Spain
- Center for Biomedical Network Research on Rare Diseases, ISCIII (CIBERER U767), Madrid, Spain
- Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute for Health Research (IdiPaz), Madrid, Spain
| | - Alejandro Balsa
- Rheumatology Unit, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Pilar Nozal
- Immunology, La Paz University Hospital, Madrid, Spain
- Center for Biomedical Network Research on Rare Diseases, ISCIII (CIBERER U754), Madrid, Spain
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Franconeri L, Stebbings S, Heradstveit P, Johansen M, Løken R, MacDonald E, Ødeskaug L, Naseer U. Experiences with regular testing of students for SARS-CoV-2 in primary and secondary schools: results from a cross-sectional study in two Norwegian counties, autumn 2021. BMC Public Health 2023; 23:1548. [PMID: 37580682 PMCID: PMC10426148 DOI: 10.1186/s12889-023-16452-7] [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] [Received: 01/17/2023] [Accepted: 08/03/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND To allow for normal school attendance during the COVID-19 pandemic, regular testing of students was introduced in the autumn 2021 in Norway to manage COVID-19 transmission. We mapped the experiences of five stakeholders (parents, students, school staff and administration, contact tracing teams) regarding the implementation of regular testing in primary and secondary schools in Oslo and Viken counties, to assess the acceptability through different indicators and improve future guidelines. METHODS A cross-sectional survey was conducted between October and November 2021 to explore experiences of implementation, compliance, satisfaction, difficulties, concerns, confidence in regular testing, quality of teaching and school attendance. Five stakeholder groups were invited to participate: contact tracing teams; school administrators and employees in primary, lower secondary, and upper-secondary school; students in upper-secondary school and parents of primary and lower secondary students. Bivariate analyses were performed for students, parents, and school employees groups. Descriptive analyses were done for contact tracing teams and school administrators. RESULTS Four thousand five hundred sixty-five participants were included in our study. School attendance increased for most of the students in primary and lower secondary schools in Oslo and Viken after the implementation of regular testing. Students across all school levels reported high testing compliance and satisfaction with the implementation. Compliance was significantly associated with an increasing number of weekly tests across all school levels up to two weekly tests. Contact tracing teams were less satisfied with the cooperation with the educational authorities compared to the school employees. Higher educational level of parents was significantly associated with decreased concern of their children getting infected at school after regular testing implementation. Concerned parents were more likely to keep children at home from school, to protect all household members from becoming infected. Lack of time and communication were reported as challenging factors to implementation. CONCLUSION Compliance, satisfaction, and confidence in regular testing of COVID-19 were high among stakeholders. An acceptable testing regime for a future regular testing implementation would be a home-based, bi-weekly test. Increased awareness of the importance of school attendance, safety of regular testing along with good communication and role clarification should be prioritized for stakeholders involved in regular testing.
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Affiliation(s)
- Léa Franconeri
- Division for Infection Control, Norwegian Institute of Public Health, Oslo, Norway.
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden.
| | - Sara Stebbings
- Division for Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Petter Heradstveit
- Division for Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Mia Johansen
- Division for Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Ragnhild Løken
- Division for Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Emily MacDonald
- Division for Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Liz Ødeskaug
- Division for Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Umaer Naseer
- Division for Infection Control, Norwegian Institute of Public Health, Oslo, Norway
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10
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Wang C, Hao W. Cardiac arrhythmia and immune response in COVID-19 patients. Allergol Immunopathol (Madr) 2023; 51:63-70. [PMID: 37422781 DOI: 10.15586/aei.v51i4.883] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/15/2023] [Indexed: 07/11/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has presented substantial challenges for providing health care due to the numerous complications on the respiratory and cardiovascular systems of people. Cardiac arrhythmia is one of the cardiac complications, and it was observed in COVID-19 patients. Moreover, arrhythmia and cardiac arrest are common in COVID-19 patients in the intensive care unit. The occurrence of cardiac arrhythmia in COVID-19 patients is associated with hypoxia, cytokine storm, myocardial ischemia and inflammatory disease such as congestive heart failure. It is necessary to know the occurrence and mechanisms of tachyarrhythmia and bradyarrhythmia in patients with COVID-19 infection for their proper management. This review provides an overview of the association between COVID-19 and arrhythmias by detailing possible pathophysiological mechanisms.
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Affiliation(s)
- Chunlian Wang
- Institute for Prevention and Control of Chronic Non-communicable Diseases, Harbin Center for Disease Control and Prevention, Harbin, China
| | - Wenqiang Hao
- The Second Ward of Internal Medicine, The Second Hospital of Heilongjiang Province, Harbin, China; ;
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11
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Solarino B, Nicolì S, Benevento M, Zedda M, Oliva A. Editorial: Children's health and safety: what we learned from the COVID-19 pandemic and future policy's perspective. Front Public Health 2023; 11:1220977. [PMID: 37346109 PMCID: PMC10280161 DOI: 10.3389/fpubh.2023.1220977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/24/2023] [Indexed: 06/23/2023] Open
Affiliation(s)
- Biagio Solarino
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Simona Nicolì
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Marcello Benevento
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Massimo Zedda
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Oliva
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Università Cattolica del Sacro Cuore, Rome, Italy
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12
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Chaussade S, Pellat A, Chamseddine A, Corre F, Coriat R. Airborne transmission of SARS-Cov2: What consequences for digestive endoscopy? United European Gastroenterol J 2023; 11:171-178. [PMID: 36700355 PMCID: PMC10039792 DOI: 10.1002/ueg2.12355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 12/07/2022] [Indexed: 01/27/2023] Open
Abstract
The SARS-Cov-2 disease disrupted essential hospital procedures, such as gastrointestinal (GI) endoscopy, due to concerns about air transmission and the risk of exposing health care workers. With the spread of the pandemic, air transmission was considered as the main source of SARS-Cov2 transmission. This raised the problem of transmission by aerosolization of viral particles in operating rooms as well as endoscopy units. This is in line with the known airborne transmission of many other respiratory viruses. The risk of SARS-Cov-2 transmission during GI endoscopy was initially reduced by controlled measures, involving personal protections (mask…), restricted access to endoscopy rooms, and detection of infected patients. Gastrointestinal endoscopy generates aerosols, which may carry viruses. In addition, the endoscopy system may facilitate the diffusion of virus particles or fomites considering the forced-air cooling system used to maintain a stable temperature inside the box (25°C). The volume of air that goes through the light source box is high (240-300 m3 for a 1-h period). Moreover, the light system contains an air pump to inflate air inside the gut lumen. In order to isolate people from hazard, different levels of protection and solutions to avoid airborne transmission of microorganisms should be proposed, such as the reinforcement of personal protective equipment, the change in the way people work and engineering control of the risk.
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Affiliation(s)
- Stanislas Chaussade
- Gastroenterology and Digestive Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université Paris Cité, Paris, France
| | - Anna Pellat
- Gastroenterology and Digestive Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université Paris Cité, Paris, France
| | - Ali Chamseddine
- Gastroenterology and Digestive Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université Paris Cité, Paris, France
| | - Felix Corre
- Gastroenterology and Digestive Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université Paris Cité, Paris, France
| | - Romain Coriat
- Gastroenterology and Digestive Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université Paris Cité, Paris, France
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Belen Apak FB, Yuce G, Topcu DI, Gultekingil A, Felek YE, Sencelikel T. Coagulopathy is Initiated with Endothelial Dysfunction and Disrupted Fibrinolysis in Patients with COVID-19 Disease. Indian J Clin Biochem 2023; 38:220-230. [PMID: 36816717 PMCID: PMC9922102 DOI: 10.1007/s12291-023-01118-3] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/31/2023] [Indexed: 02/12/2023]
Abstract
A substantial group of patients suffer from Covid-19 (CAC) coagulopathy and are presented with thrombosis. The pathogenesis involved in CAC is not fully understood. We evaluated the hemostatic and inflammatory parameters of 51 hospitalized Covid-19 adult patients and 21 controls. The parameters analyzed were danger signal molecule (High molecular weight group box protein-1/HMGBP-1), platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimer, fibrinogen, endothelial protein C receptor (EPCR), soluble E-selectin, soluble P-selectin, thrombomodulin, tissue plasminogen activator (TPA), plasminogen activator inhibitor-1 (PAI-1), soluble fibrin monomer complex (SFMC), platelet-derived microparticles (PDMP), β-thromboglobulin, antithrombin and protein C. The main objective of our study was to investigate which part of the hemostatic system was mostly affected at the admission of Covid-19 patients and whether these parameters could differentiate intensive care unit (ICU) and non-ICU patients. In this prospective case-control study, 51 patients ≥ 18 years who are hospitalized with the diagnosis of Covid-19 and 21 healthy control subjects were included. We divided the patients into two groups according to their medical progress, either in ICU or non-ICU group. Regarding the outcome, patients were again categorized as a survivor and non-survivor groups. Blood samples were collected from patients at admission at the time of hospitalization before the administration of any treatment for Covid-19. The analyzes of the study were made with the IBM SPSS V22 program. p < 0.05 was considered statistically significant. A total of 51 adult patients (F/M: 24/27) (13 ICU and 38 non-ICU) were included in the study cohort. The mean age of the patients was 68.1 ± 14.4 years. The control group consisted of 21 age and sex-matched healthy individuals. All of the patients were hospitalized. In a group of 13 patients, Covid-19 progressed to a severe form, and were hospitalized in ICU. We found out that the levels of fibrinogen, prothrombin time (PT), endothelial protein-C receptor (EPCR), D-dimer, soluble E-selectin, soluble P-selectin, plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (TPA) were increased; whereas, the levels of soluble fibrin monomer complex (SFMC), platelet-derived microparticles (PDMP), antithrombin and protein-C were decreased in Covid-19 patients compared to the control group at hospital admission. Tissue plasminogen activator was the only marker with a significantly different median level between ICU and non-ICU groups (p < 0.001). In accordance with the previous literature, we showed that Covid-19 associated coagulopathy is distinct from sepsis-induced DIC with prominent early endothelial involvement and fibrinolytic shut-down. Reconstruction of endothelial function at early stages of infection may protect patients from progressing to ICU hospitalization. We believe that after considering the patient's bleeding risk, early administration of LMWH therapy for Covid-19, even in an outpatient setting, may be helpful both for restoring endothelial function and anticoagulation. The intensity of anticoagulation in non-ICU and ICU Covid-19 patients should be clarified with further studies. Supplementary Information The online version contains supplementary material available at 10.1007/s12291-023-01118-3.
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Affiliation(s)
- Fatma Burcu Belen Apak
- grid.411548.d0000 0001 1457 1144Department of Pediatric Hematology and Oncology, Baskent University Medical Faculty, Sehit Temel Kuguoglu Street No 24, 06490 Bahcelievler/Ankara, Turkey
| | - Gulbahar Yuce
- grid.411548.d0000 0001 1457 1144Department of Chest Diseases, Baskent University Medical Faculty, Ankara, Turkey
| | - Deniz Ilhan Topcu
- grid.411548.d0000 0001 1457 1144Department of Biochemistry, Baskent University Medical Faculty, Ankara, Turkey
| | - Ayse Gultekingil
- grid.411548.d0000 0001 1457 1144Department of Pediatric Emergency, Baskent University Medical Faculty, Ankara, Turkey
| | - Yunus Emre Felek
- grid.411548.d0000 0001 1457 1144Department of Emergency Services, Baskent University Medical Faculty, Ankara, Turkey
| | - Tugce Sencelikel
- Department of Biostatistics, Faculty of Medicine, Ankara Medipol University, Ankara, Turkey
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14
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Rudisill TM, Steinmetz L, Bardes JM. Substance use in rural trauma patients admitted for motor vehicle injuries before and during the COVID-19 pandemic. Inj Epidemiol 2023; 10:5. [PMID: 36650589 PMCID: PMC9844186 DOI: 10.1186/s40621-023-00415-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 11/17/2022] [Accepted: 01/06/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Urban trauma centers reported increased substance use among individuals injured in motor vehicle collisions (MVC) after the start of the COVID-19 pandemic. Little is known about individuals admitted to rural trauma centers during this time. This study's purpose was to describe substance use trends before and during the pandemic among individuals injured in MVC and treated at a rural Level-1 trauma center in West Virginia. METHODS A cross-sectional analysis was performed using patients' medical records. The study population included individuals ≥ 18 years of age who received treatment for a motor vehicle-related injury between September 1, 2018, and September 30, 2021, and were tested for drugs and alcohol upon admittance. The pre-COVID-19 period was defined as September 1, 2018-March 15, 2020. The COVID-19 period was March 16, 2020-September 30, 2021. The primary dependent variable was the patients' drug test results. The primary independent variable was the time period. The data were analyzed using Chi-square tests, logistic regression, and proportional odds models. RESULTS During this time, 1465 patients received treatment. On average, patients were 45 years ± 20 of age and male (57%). During COVID-19, 17% of patients tested positive for alcohol and 58% tested positive for non-alcohol drugs. After adjusting for patients' sex and age, the number of drugs that patients tested positive for was 31% higher during COVID-19 (aOR 1.31; 95% CI 1.08, 1.58). The proportion of patients testing positive for cannabinoids (p = 0.05), opioids (p = 0.001), and stimulants (p = 0.010) increased from pre-COVID-19 to COVID-19 periods. CONCLUSIONS Drug and alcohol use increased among trauma patients admitted to a rural trauma center during COVID-19. Significant increases were seen in the number of drugs and for cannabinoids, opioids, and stimulants.
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Affiliation(s)
- Toni Marie Rudisill
- grid.268154.c0000 0001 2156 6140Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, One Medical Center Drive, PO Box 9190, Morgantown, WV 26506 USA
| | - Lucie Steinmetz
- grid.268154.c0000 0001 2156 6140Department of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV USA
| | - James M. Bardes
- grid.268154.c0000 0001 2156 6140Department of Surgery, Division of Trauma, Surgical Critical Care and Acute Care Surgery, West Virginia University School of Medicine, Morgantown, WV USA ,grid.268154.c0000 0001 2156 6140Department of Emergency Medicine, Division of Pre-Hospital Medicine, West Virginia University School of Medicine, Morgantown, WV USA
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15
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Kalogeropoulos A, Savvidou OD, Bissias C, Sarafis P, Savvidis M, Tanos A, Pikoulis E, Papagelopoulos PJ, Exadaktylos A, Eggli S. Milder impact of the COVID-19 pandemic on the practice of orthopaedic surgery in Greece and Cyprus than other European countries. Knee Surg Sports Traumatol Arthrosc 2023; 31:110-120. [PMID: 36114340 PMCID: PMC9483367 DOI: 10.1007/s00167-022-07159-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/06/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE The aim of this study was to highlight the impact of the COVID-19 pandemic on the practice of orthopaedics in Greece and Cyprus. METHODS The survey used the online questionnaire from AGA (Gesellschaft für Arthroskopie und Gelenkchirurgie; Society for Arthroscopy and Joint Surgery) to facilitate the comparison between different European countries. The questionnaire was distributed online to members of the HAOST (Hellenic Association of Orthopaedic Surgery and Trauma), the ΟΤΑΜΑΤ (Orthopaedic and Trauma Association of Macedonia and Thrace) and the CAOST (Cypriot Association of Orthopaedic Surgery and Trauma). The questionnaire consisted of 29 questions, which included demographic data, questions on the impact of the pandemic on the practice of orthopaedic surgery and questions on the impact on the personal and family life of orthopaedic surgeons. RESULTS The questionnaire was sent to 1350 orthopaedic surgeons in Greece and Cyprus, 303 of whom responded (response rate 22.44%). 11.2% of the participants reported cancellation of overall orthopaedic procedures. According to 35.6-49.8% of the participants, arthroscopic procedures were continued. As regards elective primary arthroplasties, 35.3% of the participants reported that these continued to be performed at their hospitals. Post-operative follow-ups as well as physiotherapy were affected by the pandemic, and changes were also observed in the habits of orthopaedic surgeons in their personal and family lives. CONCLUSION The orthopaedic service in Greece and Cyprus decreased during the first wave of the COVID-19 pandemic. Arthroscopic procedures and total joint replacements decreased significantly, but not to the same extent as in other countries. Health systems were not fully prepared for the first wave of the pandemic and the various countries took social measures at different times and to different extents. Thus, studying the impact of the pandemic on the practice of orthopaedic surgery in different countries can help health systems to better prepare for future pandemics; public health can then be shielded and hospitals can continue to provide high-quality orthopaedic care. LEVEL OF EVIDENCE Level V.
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Affiliation(s)
| | - Olga D. Savvidou
- 1st Department of Orthopedic Surgery, National and Kapodistrian University of Athens, ATTIKON” University General Hospital, Athens, Greece
| | | | - Pavlos Sarafis
- Department of Nursing, University of Thessaly, Volos, Greece
| | | | | | - Emmanouil Pikoulis
- 3rd Department of General Surgery, National and Kapodistrian University of Athens, ATTIKON” University General Hospital, Athens, Greece
| | - Panayiotis J. Papagelopoulos
- 1st Department of Orthopedic Surgery, National and Kapodistrian University of Athens, ATTIKON” University General Hospital, Athens, Greece
| | | | - Stefan Eggli
- Orthopädie Und Traumatologie, Sonnenhofspital, Buchserstrasse 30, 3006 Bern, Switzerland
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16
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Juárez-Salcedo LM, Feijóo Monroy S, García-Herce C, Alonso A, Aguado B, Ortiz J, Figuera A, Cámara JR. Neutropenia Secondary to SARS-Cov2 Vaccination in Post-Hematopoietic Stem Cell Transplant (HSCT) Patients. Mediterr J Hematol Infect Dis 2023; 15:e2023014. [PMID: 36908872 DOI: 10.4084/MJHID.2023.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/15/2023] [Indexed: 03/05/2023] Open
Abstract
SARS-Cov2 s, caused a high mortality in patients with some degree of immunosuppression, like those that receive a hematopoietic progenitor transplant. Since December 2020, several vaccines have been developed having been key in decreasing complications and mortality in this group of patients. Different articles have described the presence of thrombopenia related to the administration of vaccines, however, there are few data on the occurrence of neutropenia as a side effect after administration. We present several cases of neutropenia (defined as absolute neutrophil count (ANC) less than 2,000/mm3), after vaccination in hematopoietic progenitor transplant (HPT) recipients performed in our center during 2021.
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Mongraw-Chaffin M, Tjaden AH, Seals AL, Miller K, Ahmed N, Espeland MA, Gibbs M, Thomas D, Uschner D, Weintraub WS, Edelstein SL. Association of Obesity and Diabetes with SARS-Cov-2 Infection and Symptoms in the COVID-19 Community Research Partnership. J Clin Endocrinol Metab 2022; 108:dgac715. [PMID: 36482096 DOI: 10.1210/clinem/dgac715] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Obesity and diabetes are established risk factors for severe SARS-CoV-2 outcomes, but less is known about their impact on susceptibility to COVID-19 infection and general symptom severity. We hypothesized that those with obesity or diabetes would be more likely to self-report a positive SARS-CoV-2 test, and among those with a positive test, have greater symptom severity and duration. METHODS Among 44,430 COVID-19 Community Research Partnership participants, we evaluated the association of self-reported and electronic health record obesity and diabetes with a self-reported positive COVID-19 test at any time. Among the 2,663 participants with a self-reported positive COVID-19 test during the study, we evaluated the association of obesity and diabetes with self-report of symptom severity, duration, and hospitalization. Logistic regression models were adjusted for age, sex, race/ethnicity, socioeconomic status, and healthcare worker status. RESULTS We found a positive graded association between Body Mass Index (BMI) category and positive COVID-19 test (Overweight OR = 1.14 [1.05-1.25]; Obesity I OR = 1.29 [1.17-2.42]; Obesity II OR = 1.34 [1.19-1.50]; Obesity III OR = 1.53 [1.35-1.73]), and a similar but weaker association with COVID-19 symptoms and severity among those with a positive test. Diabetes was associated with COVID-19 infection but not symptoms after adjustment, with some evidence of an interaction between obesity and diabetes. CONCLUSIONS While the limitations of this health system convenience sample include generalizability and selection around test-seeking, the strong graded association of BMI and diabetes with self-reported COVID-19 infection suggests that obesity and diabetes may play a role in risk for symptomatic SARS-CoV-2 beyond co-occurrence with socioeconomic factors.
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Affiliation(s)
| | | | | | - Kristen Miller
- MedStar Health Research Institute, Georgetown University Washington, District of Columbia
| | | | | | | | - Dorey Thomas
- Wake Forest School of Medicine, Winston-Salem, NC
| | - Diane Uschner
- The Biostatistics Center, George Washington University, Rockville, Maryland
| | - William S Weintraub
- MedStar Health Research Institute, Georgetown University Washington, District of Columbia
| | - Sharon L Edelstein
- The Biostatistics Center, George Washington University, Rockville, Maryland
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18
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Gobbi M, Brunani A, Arreghini M, Baccalaro G, Dellepiane D, La Vela V, Lucchetti E, Barbaglia M, Cova A, Fornara E, Galli S, Cimolin V, Brugliera L, Capodaglio P. Nutritional status in post SARS-Cov2 rehabilitation patients. Clin Nutr 2022; 41:3055-3060. [PMID: 34049750 PMCID: PMC8056781 DOI: 10.1016/j.clnu.2021.04.013] [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: 08/27/2020] [Revised: 12/22/2020] [Accepted: 04/07/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS After prolonged hospitalization, the assessment of nutritional status and the identification of adequate nutritional support is of paramount importance. In this observational study, we aimed at assessing the presence of a malnutrition condition in SARS-Cov2 patients after the acute phase and the effects of a multidisciplinary rehabilitation program on nutritional and functional status. METHODS We recruited 48 patients (26 males/22 females) admitted to our Rehabilitation Unit after discharge from acute Covid Hospitals in northern Italy with negative swab for SARS-Cov2. We used the Global Leadership Initiative on Malnutrition (GLIM) criteria to identify patients with different degrees of malnutrition. Patients underwent a 3 to 4-week individual multidisciplinary rehabilitation program consisting of nutritional intervention (energy intake 27to30 kcal/die/kg and protein intake 1-1.3 g/die/kg), exercise for total body conditioning and progressive aerobic exercise with cycle- and arm-ergometer (45 min, 5 days/week). At admission and discharge from our Rehabilitation Unit, body composition and phase angle (PhA) (BIA101 Akern), muscle strength (handgrip, HG) and physical performance (Timed-Up-and-Go, TUG) were assessed. RESULTS At admission in all patients the mean weight loss, as compared to the habitual weight, was -12.1 (7.6)%, mean BMI was 25.9 (7.9) kg/m2, mean Appendicular Skeletal Muscle Index (ASMI) was 6.6 (1.7) kg/m2 for males and 5.4 (1.4) kg/m2 for females, mean phase angle was 2.9 (0.9)°, mean muscle strength (HG) was 21.1 (7.8) kg for males and 16.4 (5.9) kg for females, mean TUG value was 23.7 (19.2) s. Based on GLIM criteria 29 patients (60% of the total) showed a malnutrition condition. 7 out of those 29 patients (24%) presented a mild/moderate grade and 22 patients (76%) a severe grade. After a rehabilitation program of an average duration of 25 days (range 13-46) ASMI increased, with statistically significant differences only in females (p = 0.001) and HG improved only in males (p = 0.0014). In all of the patients, body weight did not change, CRP/albumin (p < 0.05) and TUG (p < 0.001) were reduced and PhA increased (p < 0.01). CONCLUSIONS We diagnosed a malnutrition condition in 60% of our post SARS-Cov2 patients. An individualized nutritional intervention with adequate energy and protein intake combined with tailored aerobic and strengthening exercise improved nutritional and functional status.
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Affiliation(s)
- M. Gobbi
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy,Corresponding author
| | - A. Brunani
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - M. Arreghini
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - G. Baccalaro
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - D. Dellepiane
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - V. La Vela
- Department of Clinical Nutrition and Eating Disorder, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - E. Lucchetti
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - M. Barbaglia
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - A. Cova
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - E. Fornara
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - S. Galli
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - V. Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico of Milano, Milan, Italy
| | - L. Brugliera
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - P. Capodaglio
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy,Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, Turin, Italy
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19
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Abstract
Monkeypox virus is emerging slowly with the decline of COVID-19 virus infections around the world. People are afraid of it, thinking that it would appear as a pandemic like COVID-19. As such, it is crucial to detect them earlier before widespread community transmission. AI-based detection could help identify them at the early stage. In this paper, we aim to compare 13 different pre-trained deep learning (DL) models for the Monkeypox virus detection. For this, we initially fine-tune them with the addition of universal custom layers for all of them and analyse the results using four well-established measures: Precision, Recall, F1-score, and Accuracy. After the identification of the best-performing DL models, we ensemble them to improve the overall performance using a majority voting over the probabilistic outputs obtained from them. We perform our experiments on a publicly available dataset, which results in average Precision, Recall, F1-score, and Accuracy of 85.44%, 85.47%, 85.40%, and 87.13%, respectively with the help of our proposed ensemble approach. These encouraging results, which outperform the state-of-the-art methods, suggest that the proposed approach is applicable to health practitioners for mass screening.
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Affiliation(s)
- Chiranjibi Sitaula
- Department of Electrical and Computer Systems Engineering, Monash University, Wellignton Rd, Clayton, VIC, 3800, Australia.
| | - Tej Bahadur Shahi
- School of Engineering and Technology, Central Queensland University, Norman Garden, QLD, 4701, Australia.,Central Department of Computer Science and IT, Tribhuvan University, TU Rd, Kirtipur, Kathmandu, 44618, Nepal
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20
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Taghrir MH, Akbarialiabad H, Abdollahi A, Ghahramani N, Bastani B, Paydar S, Razani B, Mwangi J, Asadi-Pooya AA, Roozbeh J, Malekmakan L, Kumar M. Inequity and disparities mar existing global research evidence on Long COVID. Glob Health Promot 2022; 30:63-67. [PMID: 35962520 PMCID: PMC10076956 DOI: 10.1177/17579759221113276] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Since the pandemic began in December 2019, SARS-Cov2 has accentuated the wide gap and disparities in socioeconomic and healthcare access at individual, community, country, and regional levels. More than two years into the current pandemic, up to three-fourths of the patients are reporting continued signs and symptoms beyond the acute phase of COVID-19, and Long COVID portends to be a major challenge in the future ahead. With a comprehensive overview of the literature, we found that most studies concerning long COVID came from high and upper-middle income countries, and people of low-income and lower-and-middle income regions and vulnerable groups with comorbid conditions have been neglected. Apart from the level of income, there is a significant geographical heterogeneity in investigating the Post-Acute Sequelae of COVID-19 (PASC) or what we call now, long COVID. We believe that these recognizing health disparities is crucial from equity perspective and is the first step toward global health promotion.
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Affiliation(s)
- Mohammad Hossein Taghrir
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Iran
| | - Hossein Akbarialiabad
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Iran
| | - Ashkan Abdollahi
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Iran
| | - Nasrollah Ghahramani
- Division of Nephrology, Department of Medicine, Penn State University College of Medicine, Hershey, USA
| | | | - Shahram Paydar
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Iran
| | - Babak Razani
- Cardiology Division, Department of Medicine, Washington University School of Medicine, St. Louis, USA.,Veterans Affairs St. Louis Healthcare System, John Cochran Division, St. Louis, USA.,Department of Pathology & Immunology, Washington University School of Medicine, St Louis, USA
| | - John Mwangi
- Pulmonary and Critical Care Medicine, Saint Louis University School of Medicine, Saint Louis, USA
| | - Ali A Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Iran.,Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, USA
| | - Jamshid Roozbeh
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Iran
| | - Leila Malekmakan
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Iran
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Kenya.,Department of Clinical, Educational and Health Psychology, University College London, UK
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21
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van der Velde MGAM, van der Aa MJ, van Daal MHC, Kremers MNT, Keijsers CJPW, van Kuijk SMJ, Haak HR. Performance of the APOP-screener for predicting in-hospital mortality in older COVID-19 patients: a retrospective study. BMC Geriatr 2022; 22:584. [PMID: 35840904 PMCID: PMC9284964 DOI: 10.1186/s12877-022-03274-2] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 07/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A variety of prediction models concerning COVID-19 have been proposed since onset of the pandemic, but to this date no gold standard exists. Mortality rates show a sharp increase with advancing age but with the large heterogeneity of this population in terms of comorbidities, vulnerability and disabilities, identifying risk factors is difficult. Therefore, we aimed to research the multidimensional concept of frailty, measured by the Acute Presenting Older Patient (APOP)-screener, as a risk factor for in-hospital mortality in older COVID-19 patients. METHODS All consecutive patients of 70 years or older, with a PCR confirmed COVID-19 infection and a completed APOP-score, presenting at the Emergency Department (ED) of the Jeroen Bosch Hospital, the Netherlands, between February 27th 2020 and February 1st 2021 were retrospectively included. We gathered baseline characteristics and scored the CCI and CFS from patient records. The primary outcome was in-hospital mortality. RESULTS A total of 292 patients met the inclusion criteria. Approximately half of the patients were considered frail by the APOP or CFS. 127 patients (43.5%) scored frail on the CFS, 158 (54.1%) scored high risk on the APOP-screener. 79 patients (27.1%) died during their hospital admission. The APOP-screener showed a significantly elevated risk of in-hospital mortality when patients scored both high risk of functional and evidence of cognitive impairment (OR 2.24, 95% 1.18-4.25). Significant elevation of in-hospital mortality was found for the high CCI-scores (≥ 5)(OR 1.78, 95% 1.02-3.11), but not for the highest CFS category (5-9, frail) (OR 1.35, 95% 0.75-2.47). The discriminatory performance of the APOP, CFS and CCI were comparable (AUC resp. 0.59 (0.52-0.66), 0.54 (0.46-0.62) and 0.58 (0.51-0.65)). CONCLUSION Although the elevated risk for in-hospital mortality found for the most frail patients as scored by the APOP, this instrument has poor discriminatory value. Additionally, the CFS did not show significance in predicting in-hospital mortality and had a poor discriminatory value as well. Therefore, treatment decisions based on frailty or comorbidities alone should be made with caution. Approaching the heterogeneity of the older population by adding frailty as assessed by the APOP-score to existing prediction models may enhance the predictive value of these models.
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Affiliation(s)
- Marleen G A M van der Velde
- Department of Internal Medicine, Máxima MC, De Run 4600, Veldhoven-Eindhoven, 5504 DB, The Netherlands. .,Department of Health Services Research, and CAPHRI School for Public Health and Primary Care, Aging and Long Term care Maastricht, Maastricht, the Netherlands.
| | - Merel J van der Aa
- Department of Geriatric Medicine, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands
| | - Merel H C van Daal
- Department of Internal Medicine, Máxima MC, De Run 4600, Veldhoven-Eindhoven, 5504 DB, The Netherlands
| | - Marjolein N T Kremers
- Department of Internal Medicine, Máxima MC, De Run 4600, Veldhoven-Eindhoven, 5504 DB, The Netherlands.,Department of Health Services Research, and CAPHRI School for Public Health and Primary Care, Aging and Long Term care Maastricht, Maastricht, the Netherlands.,Department of Emergency Medicine, Sint Jans Gasthuis, Weert, The Netherlands
| | | | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Harm R Haak
- Department of Internal Medicine, Máxima MC, De Run 4600, Veldhoven-Eindhoven, 5504 DB, The Netherlands.,Department of Health Services Research, and CAPHRI School for Public Health and Primary Care, Aging and Long Term care Maastricht, Maastricht, the Netherlands.,Department of Internal Medicine, Division of General Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
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22
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Elhazmi A, Al-Omari A, Sallam H, Mufti HN, Rabie AA, Alshahrani M, Mady A, Alghamdi A, Altalaq A, Azzam MH, Sindi A, Kharaba A, Al-Aseri ZA, Almekhlafi GA, Tashkandi W, Alajmi SA, Faqihi F, Alharthy A, Al-Tawfiq JA, Melibari RG, Al-Hazzani W, Arabi YM. Machine learning decision tree algorithm role for predicting mortality in critically ill adult COVID-19 patients admitted to the ICU. J Infect Public Health 2022; 15:826-834. [PMID: 35759808 PMCID: PMC9212964 DOI: 10.1016/j.jiph.2022.06.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 06/02/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background Coronavirus disease-19 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is currently a major cause of intensive care unit (ICU) admissions globally. The role of machine learning in the ICU is evolving but currently limited to diagnostic and prognostic values. A decision tree (DT) algorithm is a simple and intuitive machine learning method that provides sequential nonlinear analysis of variables. It is simple and might be a valuable tool for bedside physicians during COVID-19 to predict ICU outcomes and help in critical decision-making like end-of-life decisions and bed allocation in the event of limited ICU bed capacities. Herein, we utilized a machine learning DT algorithm to describe the association of a predefined set of variables and 28-day ICU outcome in adult COVID-19 patients admitted to the ICU. We highlight the value of utilizing a machine learning DT algorithm in the ICU at the time of a COVID-19 pandemic. Methods This was a prospective and multicenter cohort study involving 14 hospitals in Saudi Arabia. We included critically ill COVID-19 patients admitted to the ICU between March 1, 2020, and October 31, 2020. The predictors of 28-day ICU mortality were identified using two predictive models: conventional logistic regression and DT analyses. Results There were 1468 critically ill COVID-19 patients included in the study. The 28-day ICU mortality was 540 (36.8 %), and the 90-day mortality was 600 (40.9 %). The DT algorithm identified five variables that were integrated into the algorithm to predict 28-day ICU outcomes: need for intubation, need for vasopressors, age, gender, and PaO2/FiO2 ratio. Conclusion DT is a simple tool that might be utilized in the ICU to identify critically ill COVID-19 patients who are at high risk of 28-day ICU mortality. However, further studies and external validation are still required.
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Affiliation(s)
- Alyaa Elhazmi
- Department of Critical Care, Dr. Sulaiman Al-Habib Medical Group, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
| | - Awad Al-Omari
- Research Center, Dr. Sulaiman Alhabib Medical Group, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Hend Sallam
- Department of Adult Critical Care Medicine, King Faisal Specialist Hospital & Research Centre, Saudi Arabia
| | - Hani N Mufti
- Section of Cardiac Surgery, Department of Cardiac Sciences, King Faisal Cardiac Center, King Abdulaziz Medical City, MNGHA-WR, Jeddah, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia. King Abdullah International Medical Research Center, Jeddah, Saudi Arabia Intensive Care Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Ahmed A Rabie
- Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.
| | - Mohammed Alshahrani
- Emergency and Critical Care Department, King Fahad Hospital of The University, Imam Abdul Rahman ben Faisal University, Dammam, Saudi Arabia
| | - Ahmed Mady
- Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia; Department of Anesthesiology and Intensive Care, Tanta University Hospitals, Tanta, Egypt
| | - Adnan Alghamdi
- Prince Sultan Military Medical City, Military Medical Services, Ministry of Defence, Riyadh, Saudi Arabia
| | - Ali Altalaq
- Prince Sultan Military Medical City, Military Medical Services, Ministry of Defence, Riyadh, Saudi Arabia
| | - Mohamed H Azzam
- Intensive Care Department, King Abdullah Medical Complex, Jeddah, Saudi Arabia
| | - Anees Sindi
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ayman Kharaba
- Department of Critical Care, King Fahad Hospital, Al Medina Al Monawarah, Saudi Arabia
| | - Zohair A Al-Aseri
- Departments Of Emergency Medicine and Critical Care, College of Medicine, King Saud University, Riyadh, Saudi Arabia; College Of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Ghaleb A Almekhlafi
- Prince Sultan Military Medical City, Military Medical Services, Ministry of Defence, Riyadh, Saudi Arabia
| | - Wail Tashkandi
- Department of Critical Care, Fakeeh Care Group, Jeddah, Saudi Arabia; Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saud A Alajmi
- Prince Sultan Military Medical City, Military Medical Services, Ministry of Defence, Riyadh, Saudi Arabia
| | - Fahad Faqihi
- Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia
| | | | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia. Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Rami Ghazi Melibari
- Department of Critical Care, King Abdullah Medical City, Makah, Saudi Arabia
| | - Waleed Al-Hazzani
- Department of Medicine, McMaster University, Hamilton, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Yaseen M Arabi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Intensive Care Department, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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23
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Keklicek H, Selçuk H, Kurt İ, Ulukaya S, Öztürk G. Individuals with a COVID-19 history exhibit asymmetric gait patterns despite full recovery. J Biomech 2022; 137:111098. [PMID: 35460936 PMCID: PMC9011902 DOI: 10.1016/j.jbiomech.2022.111098] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/16/2022]
Abstract
COVID-19 is a multisystem infectious disease affecting the body systems. Its neurologic complications include -but are not limited to headache, loss of smell, encephalitis, and cerebrovascular accidents. Even though gait analysis is an objective measure of the neuro-motor system and may provide significant information about the pathophysiology of specific diseases, no studies have investigated the gait characteristics in adults after full recovery from COVID-19. This was a cross-sectional, controlled study that included 12 individuals (mean age, 23.0 ± 4.1 years) with mild-to-moderate COVID-19 history (COVD) and 20 sedentary controls (CONT; mean age, 24.0 ± 3.6 years). Gait was evaluated using inertial sensors on a motorized treadmill. Spatial-temporal gait parameters and gait symmetry were calculated by using at least 512 consecutive steps for each participant. The effect-size analyses were utilized to interpret the impact of the results. Spatial-temporal gait characteristics were comparable between the two groups. The COVD group showed more asymmetrical gait patterns than the CONT group in the double support duration symmetry (p = 0.042), single support duration symmetry (p = 0.006), loading response duration symmetry (p = 0.042), and pre-swing duration symmetry (p = 0.018). The effect size analyses of the differences showed large effects (d = 0.68-0.831). Individuals with a history of mild-to-moderate COVID-19 showed more asymmetrical gait patterns than individuals without a disease history. Regardless of its severity, the multifaceted long-term effects of COVID-19 need to be examined and the scope of clinical follow-up should be detailed.
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Affiliation(s)
- Hilal Keklicek
- Trakya Unversity, Faculty of Health Sciences Department of Physiotherapy and Rehabilitation, Edirne, Turkey,Corresponding author at: Trakya University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Edirne, Turkey
| | - Halit Selçuk
- Trakya Unversity, Faculty of Health Sciences Department of Physiotherapy and Rehabilitation, Edirne, Turkey,Marmara University, Faculty of Health Sciences Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - İlke Kurt
- Institute of Science, Department of Computational Sciences, Trakya University, 22030, Edirne, Turkey
| | - Sezer Ulukaya
- Faculty of Engineering, Department of Electrical and Electronics Engineering, Trakya University, 22030, Edirne, Turkey
| | - Gülnur Öztürk
- Trakya Unversity, Faculty of Health Sciences Department of Physiotherapy and Rehabilitation, Edirne, Turkey
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24
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Unione L, Moure MJ, Lenza MP, Oyenarte I, Ereño‐Orbea J, Ardá A, Jiménez‐Barbero J. The SARS-CoV-2 Spike Glycoprotein Directly Binds Exogeneous Sialic Acids: A NMR View. Angew Chem Int Ed Engl 2022; 61:e202201432. [PMID: 35191576 PMCID: PMC9074024 DOI: 10.1002/anie.202201432] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Indexed: 01/07/2023]
Abstract
The interaction of the SARS CoV2 spike glycoprotein with two sialic acid-containing trisaccharides (α2,3 and α2,6 sialyl N-acetyllactosamine) has been demonstrated by NMR. The NMR-based distinction between the signals of those sialic acids in the glycans covalently attached to the spike protein and those belonging to the exogenous α2,3 and α2,6 sialyl N-acetyllactosamine ligands has been achieved by synthesizing uniformly 13 C-labelled trisaccharides at the sialic acid and galactose moieties. STD-1 H,13 C-HSQC NMR experiments elegantly demonstrate the direct interaction of the sialic acid residues of both trisaccharides with additional participation of the galactose moieties, especially for the α2,3-linked analogue. Additional experiments with the spike protein in the presence of a specific antibody for the N-terminal domain and with the isolated receptor binding and N-terminal domains of the spike protein unambiguously show that the sialic acid binding site is located at the N-terminal domain.
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Affiliation(s)
- Luca Unione
- CICbioGUNEBasque Research & Technology Alliance (BRTA)Bizkaia Technology Park, Building 80048162 DerioBizkaiaSpain
| | - María J. Moure
- CICbioGUNEBasque Research & Technology Alliance (BRTA)Bizkaia Technology Park, Building 80048162 DerioBizkaiaSpain
| | - Maria Pia Lenza
- CICbioGUNEBasque Research & Technology Alliance (BRTA)Bizkaia Technology Park, Building 80048162 DerioBizkaiaSpain
| | - Iker Oyenarte
- CICbioGUNEBasque Research & Technology Alliance (BRTA)Bizkaia Technology Park, Building 80048162 DerioBizkaiaSpain
| | - June Ereño‐Orbea
- CICbioGUNEBasque Research & Technology Alliance (BRTA)Bizkaia Technology Park, Building 80048162 DerioBizkaiaSpain
- IkerbasqueBasque Foundation for ScienceMaria Diaz de Haro 348013 BilbaoBizkaiaSpain
| | - Ana Ardá
- CICbioGUNEBasque Research & Technology Alliance (BRTA)Bizkaia Technology Park, Building 80048162 DerioBizkaiaSpain
- IkerbasqueBasque Foundation for ScienceMaria Diaz de Haro 348013 BilbaoBizkaiaSpain
| | - Jesús Jiménez‐Barbero
- CICbioGUNEBasque Research & Technology Alliance (BRTA)Bizkaia Technology Park, Building 80048162 DerioBizkaiaSpain
- IkerbasqueBasque Foundation for ScienceMaria Diaz de Haro 348013 BilbaoBizkaiaSpain
- Department of Organic ChemistryII Faculty of Science and Technology University of the Basque Country, EHU-UPV48940LeioaSpain
- Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES)28029MadridSpain
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25
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Santos LG, da Silva RV, Leal TC, Xavier JE, Figueiredo EVMDS, de Paiva JPS, da Silva LF, Rocha CADO, Nunes BEBR, Santana GBDA, Fernandes TRMDO, Costa FDA, Bezerra-Santos M, Feliciano do Carmo R, Armstrong ADC, de Souza CDF. Impact of the COVID-19 pandemic on hospital admissions and in-hospital lethality from cardiovascular diseases in Brazil: an ecological and time series study COVID-19 and cardiovascular diseases. Curr Probl Cardiol 2022:101216. [PMID: 35460687 PMCID: PMC9021219 DOI: 10.1016/j.cpcardiol.2022.101216] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Since the onset of the coronavirus disease 2019 (COVID-19) pandemic in Brazil, several government policies have been taken. Herein, we aimed to assess the impact of the COVID-19 pandemic on hospital admissions and in-hospital lethality for cardiovascular diseases (CVD) in Brazil in 2020. METHODS An ecological and time-series study on hospitalizations and deaths from CVD in Brazil was conducted from January 2018 to December 2020. RESULTS The hospital admission rate for CVD reduced by 17.1%, with a significantly decreasing trend between January and May 2020 (Annual Percent Change: -8,7%; p-value <0.001). The in-hospital lethality rate increased from 8.2% in 2018 to 9.3% in 2020. During this period, Brazil totaled 21.8 million days of hospital stay. CONCLUSION Indicators of hospital admissions and lethality from CVD in Brazil were impacted by the emergence of the COVID-19 pandemic in different ways in the regions and depending on the nature of the indicator.
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Affiliation(s)
- Lucas Gomes Santos
- Department of Medicine, Federal University of Alagoas, Arapiraca, AL, Brazil.
| | | | | | | | | | | | | | | | | | | | | | | | | | - Rodrigo Feliciano do Carmo
- College of Pharmaceutical Sciences, Federal University of the São Francisco Valley (UNIVASF), Petrolina, Pernambuco, Brazil; Department of Medicine, Federal University of Alagoas, Arapiraca, AL, Brazil
| | - Anderson da Costa Armstrong
- College of Medicine, Federal University of the São Francisco Valley (UNIVASF), Petrolina, Pernambuco, Brazil
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26
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Singh SK, Jethani S, Gupta A, Kamble BD, Singh S, Ahlawat P. Mapping of epidemiological determinants of confirmed COVID-19 cases among health-care workers of municipal corporation of Delhi: A roadmap to risk reduction. J Educ Health Promot 2022; 11:106. [PMID: 35573628 PMCID: PMC9093660 DOI: 10.4103/jehp.jehp_336_21] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/25/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Coronavirus disease (COVID-19) is a respiratory illness caused by a novel coronavirus which can spread from person to person. Health-care workers of any medical college and hospital are at more risk to the coronavirus disease (COVID-19) than the general population. The aim of this study was to assess the epidemiological profile of confirmed COVID-19 cases among health-care workers of Municipal Corporation of Delhi. METHODOLOGY A cross-sectional study was planned among 422 health-care workers of Municipal Corporation of Delhi. The questionnaire consisted of questions about sociodemographic data, personal history, and clinical profile such as signs and symptoms and their duration. Data were analyzed by SPSS software version 21.0, and, Chi-square test and logistic regression were used. RESULTS Mean age of study subjects was 41.1 ± 9.8 years, and males (57.6%) were more as compared to (42.4%) females. Out of total participants, about one-third (36.4%) of study participants were asymptomatic. Study participants with higher education status adjusted odds ratio (AOR) 2.43 (1.25-4.70), living in overcrowding AOR 3.74 (1.86-7.54), and having some comorbidity AOR 2.78 (1.57-4.92) were at higher risk of being symptomatic. CONCLUSION This study concludes that about one-third of study participants were asymptomatic. Factors such as higher education status, living in overcrowding, presence of some comorbidity, and smokeless tobacco consumption were significantly associated with symptomatic COVID-19 cases. Hence, there is a need to identify these risk factors at an early stage in order to design prevention strategies for better control of such pandemics in future.
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Affiliation(s)
| | - Sumit Jethani
- North DMC Medical College and Hindu Rao Hospital Delhi, India
| | - Anshumali Gupta
- North DMC Medical College and Hindu Rao Hospital Delhi, India
| | | | - Saudan Singh
- North DMC Medical College and Hindu Rao Hospital Delhi, India
| | - Pooja Ahlawat
- North DMC Medical College and Hindu Rao Hospital Delhi, India
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27
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D' Abramo M, Saltarocchi S, Vignaroli W, Chourda E, Vinciguerra M, Romiti S, Melina G, Greco E, Miraldi F. Increased incidence of postmyocardial infarction ventricular septal defects during Covid-19 pandemic: A case series. J Card Surg 2022; 37:1759-1763. [PMID: 35315186 PMCID: PMC9115124 DOI: 10.1111/jocs.16430] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 11/27/2022]
Abstract
Introduction Ventricular septal defect (VSD) is one of the mechanical complications of acute myocardial infarction (MI), whose incidence has been decreasing throughout the years because of the emergence of different reperfusion therapy strategies. Methods We present a series of seven patients who underwent surgery for post‐MI VSD repair in our institution in the period between March 2020 and June 2021. Discussion During the recent SARS‐COV2 pandemic, time to hospital admission increased due to patients being overcautious out of fear of exposing themselves to COVID‐19. The increased time to hospital admission, with associated late reperfusion therapy and delayed PCI, is closely related to an augmented incidence of post‐myocardial infarction mechanical complications such as ventricular septal defects. For this reason, we witnessed an increase in the incidence of post‐MI VSD. Conclusion Fear of exposure to SARS‐COV2 in the medical environment was a major source of concern for all our patients. The target of hospital policy should be to reassure patients of freedom from COVID in the emergency department and cardiac wards in order to prevent such dreadful complications.
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Affiliation(s)
- M D' Abramo
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - S Saltarocchi
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - W Vignaroli
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.,Department of Clinical and Molecular Medicine, Cardiac Surgery Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - E Chourda
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - M Vinciguerra
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - S Romiti
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - G Melina
- Department of Clinical and Molecular Medicine, Cardiac Surgery Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - E Greco
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - F Miraldi
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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Monistrol-Mula A, Felez-Nobrega M, Domènech-Abella J, Mortier P, Cristóbal-Narváez P, Vilagut G, Olaya B, Ferrer M, Gabarrell-Pascuet A, Alonso J, Haro JM. The impact of COVID-related perceived stress and social support on generalized anxiety and major depressive disorders: moderating effects of pre-pandemic mental disorders. Ann Gen Psychiatry 2022; 21:7. [PMID: 35164779 PMCID: PMC8845272 DOI: 10.1186/s12991-022-00385-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/03/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND We assessed the moderating effect of pre-pandemic mental disorders on the association of COVID-related perceived stress and social support with mental health. METHODS A nationally representative sample of 3500 Spanish adults was interviewed in June 2020 (mean age 49.25 years, ± 15.64; 51.50% females). Mental health included Generalized Anxiety Disorders (GAD; GAD-7, cut-off point of ≥ 10), Major Depressive Disorders (MDD; PHQ-8, cut-off point of ≥ 10) and the comorbid form (those screening positive for GAD and MDD). COVID-related stress was assessed using an adapted version of the Peri Life Events Scale, and social support using the Oslo Social Support Scale. Logistic regression models were used to assess if COVID-related stress and social support were related to mental health outcomes and interactions were conducted to examine whether these relationships differed according to the presence of pre-pandemic mental disorders. RESULTS Higher COVID-related stress was associated with a higher risk of lower mental health. The association between COVID-related stress with GAD and MDD was significantly moderated by pre-pandemic mental disorders, except for comorbid GAD + MDD. Higher levels of social support were linked to better mental health. Only the association between social support and GAD was significantly moderated by pre-pandemic mental disorders. That is, for those without pre-pandemic mental disorders, higher levels of social support decreased the odds of GAD, while minor decreases were observed in those with pre-pandemic mental disorders. CONCLUSIONS The impact of COVID-related stress and social support on specific indicators of mental health may vary depending on the existence of a previous mental disorder.
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Affiliation(s)
- Anna Monistrol-Mula
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Mireia Felez-Nobrega
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain. .,Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain.
| | - Joan Domènech-Abella
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain.,Department of Sociology, Universitat de Barcelona, Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Paula Cristóbal-Narváez
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Beatriz Olaya
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain
| | - Montse Ferrer
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Aina Gabarrell-Pascuet
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Jordi Alonso
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Life and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - Josep Maria Haro
- Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain.,Departament de Medicine, Universitat de Barcelona, Barcelona, Spain
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Abstract
Neuropathological examination of the temporal lobe provides a better understanding and management of a wide spectrum of diseases. We focused on inflammatory diseases, epilepsy, and neurodegenerative diseases, and highlighted how the temporal lobe is particularly involved in those conditions. Although all these diseases are not specific or restricted to the temporal lobe, the temporal lobe is a key structure to understand their pathophysiology. The main histological lesions, immunohistochemical markers, and molecular alterations relevant for the neuropathological diagnostic reasoning are presented in relation to epidemiology, clinical presentation, and radiological findings. The inflammatory diseases section addressed infectious encephalitides and auto-immune encephalitides. The epilepsy section addressed (i) susceptibility of the temporal lobe to epileptogenesis, (ii) epilepsy-associated hippocampal sclerosis, (iii) malformations of cortical development, (iv) changes secondary to epilepsy, (v) long-term epilepsy-associated tumors, (vi) vascular malformations, and (vii) the absence of histological lesion in some epilepsy surgery samples. The neurodegenerative diseases section addressed (i) Alzheimer's disease, (ii) the spectrum of frontotemporal lobar degeneration, (iii) limbic-predominant age-related TDP-43 encephalopathy, and (iv) α-synucleinopathies. Finally, inflammatory diseases, epilepsy, and neurodegenerative diseases are considered as interdependent as some pathophysiological processes cross the boundaries of this classification.
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Affiliation(s)
- Susana Boluda
- Sorbonne Université, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, Paris, France; Neuropathology Department, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, AP-HP, Paris, France
| | - Danielle Seilhean
- Sorbonne Université, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, Paris, France; Neuropathology Department, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, AP-HP, Paris, France
| | - Franck Bielle
- Sorbonne Université, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, Paris, France; Neuropathology Department, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, AP-HP, Paris, France.
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30
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Chang J, Bulwa Z, Breit H, Cherian LJ, Conners JJ, Song SY, Dafer RM. Acute Large Vessel Ischemic Stroke in Patients With COVID-19-Related Multisystem Inflammatory Syndrome. Pediatr Neurol 2022; 126:104-107. [PMID: 34768033 PMCID: PMC8464033 DOI: 10.1016/j.pediatrneurol.2021.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/14/2021] [Accepted: 09/20/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Acute ischemic stroke (AIS) is rare in children, and diagnosis is often delayed. Neurological involvement may occur in multisystem inflammatory syndrome in children (MIS-C), but very few cases of AIS in patients with MIS-C have been reported. PATIENT DESCRIPTIONS We two patients with AIS presenting with large vessel occlusive disease in previously healthy adolescents recently exposed to SARS-CoV-2 infection. RESULTS Both patients were subsequently diagnosed with and treated for MIS-C. Here, we discuss the course of their treatments and clinical responses. CONCLUSION Early recognition and diagnosis of AIS with large vessel occlusion in children with MIS-C is critical to make available all treatment options to improve clinical outcomes.
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Affiliation(s)
| | | | | | | | | | | | - Rima M. Dafer
- Communications should be addressed to: Dr. Dafer; Professor of Neurology; Department of Neurological Sciences; Section of Cerebrovascular Disease; Rush University Medical Center; Professional Building, Suite 1118, 1725 W. Harrison St; Chicago, IL 60612
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31
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Wong J, Theocharis P, Regan W, Pushparajah K, Stephenson N, Pascall E, Cleary A, O'Byrne L, Savis A, Miller O. Medium-Term Cardiac Outcomes in Young People with Multi-system Inflammatory Syndrome: The Era of COVID-19. Pediatr Cardiol 2022; 43:1728-36. [PMID: 35486129 DOI: 10.1007/s00246-022-02907-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/04/2022] [Indexed: 11/06/2022]
Abstract
Multi-system inflammatory syndrome in children (MIS-C) causes widespread inflammation including a pancarditis in the weeks following a COVID infection. As we prepare for further coronavirus surges, understanding the medium-term cardiac impacts of this condition is important for allocating healthcare resources. A retrospective single-center study of 67 consecutive patients with MIS-C was performed evaluating echocardiographic and electrocardiographic (ECG) findings to determine the point of worst cardiac dysfunction during the admission, then at intervals of 6-8 weeks and 6-8 months. Worst cardiac function occurred 6.8 ± 2.4 days after the onset of fever with mean 3D left ventricle (LV) ejection fraction (EF) 50.5 ± 9.8%. A pancarditis was typically present: 46.3% had cardiac impairment; 31.3% had pericardial effusion; 26.8% demonstrated moderate (or worse) valvar regurgitation; and 26.8% had coronary dilatation. Cardiac function normalized in all patients by 6-8 weeks (mean 3D LV EF 61.3 ± 4.4%, p < 0.001 compared to presentation). Coronary dilatation resolved in all but one patient who initially developed large aneurysms at presentation, which persisted 6 months later. ECG changes predominantly featured T-wave changes resolving at follow-up. Adverse events included need for ECMO (n = 2), death as an ECMO-related complication (n = 1), LV thrombus formation (n = 1), and subendocardial infarction (n = 1). MIS-C causes a pancarditis. In the majority, discharge from long-term follow-up can be considered as full cardiac recovery is expected by 8 weeks. The exception includes patients with medium sized aneurysms or greater as these may persist and require on-going surveillance.
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32
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Larionova R, Byvaltsev K, Kravtsova О, Takha E, Petrov S, Kazarian G, Valeeva A, Shuralev E, Mukminov M, Renaudineau Y, Arleevskaya M. SARS-Cov2 acute and post-active infection in the context of autoimmune and chronic inflammatory diseases. J Transl Autoimmun 2022; 5:100154. [PMID: 35434592 PMCID: PMC9005220 DOI: 10.1016/j.jtauto.2022.100154] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 03/31/2022] [Indexed: 12/11/2022] Open
Abstract
The clinical and immunological spectrum of acute and post-active COVID-19 syndrome overlaps with criteria used to characterize autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Indeed, following SARS-Cov2 infection, the innate immune response is altered with an initial delayed production of interferon type I (IFN-I), while the NF-kappa B and inflammasome pathways are activated. In lung and digestive tissues, an alternative and extrafollicular immune response against SARS-Cov2 takes place with, consequently, an altered humoral and memory T cell response leading to breakdown of tolerance with the emergence of autoantibodies. However, the risk of developing severe COVID-19 among SLE and RA patients did not exceed the general population except in those having pre-existing neutralizing autoantibodies against IFN-I. Treatment discontinuation rather than COVID-19 infection or vaccination increases the risk of developing flares. Last but not least, a limited number of case reports of individuals having developed SLE or RA following COVID-19 infection/vaccination have been reported. Altogether, the SARS-Cov2 pandemic represents an unique opportunity to investigate the dangerous interplay between the immune response against infectious agents and autoimmunity, and to better understand the triggering role of infection as a risk factor in autoimmune and chronic inflammatory disease development.
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Key Words
- ACE2, angiotensin converting enzyme 2
- ACPA, anti-cyclic citrullinated peptide autoAb
- ANA, antinuclear autoAb
- AutoAb, autoantibodies
- BAFF/BlySS, B-cell-activating factor/B lymphocyte stimulator
- CCL, chemokine ligand
- COVID-19, coronavirus disease 2019
- DMARDs, disease-modifying anti-rheumatic drugs
- E, envelope
- HEp-2, human epithelioma cell line 2
- IFN-I, interferon type I
- IFNAR, IFN-alpha receptors
- IL, interleukin
- IRF, interferon regulatory factor
- ISGs, IFN-stimulated genes
- ITP, immune-thrombocytopenic purpura
- Ig, immunoglobulin
- Infection
- Inflammation
- Jak, Janus kinase
- LDH, lactate dehydrogenase
- M, membrane
- MDA-5, melanoma differentiation-associated protein
- MERS-Cov, Middle East respiratory syndrome coronavirus
- MIS-C, multisystem inflammatory syndrome in children
- N, nucleocapsid
- NET, nuclear extracellular traps
- NF-κB, nuclear factor-kappa B
- NK, natural killer
- NLRP3, NOD-like receptor family
- Rheumatoid arthritis
- Risk factors
- SARS-Cov2
- Systemic lupus erythematosus
- T cell receptor, TLR
- Toll-like receptor, TMPRSS2
- aPL, antiphospholipid
- mAb, monoclonal Ab
- open reading frame, PACS
- pathogen-associated molecular patterns, pDC
- pattern recognition receptors, RA
- peptidylarginine deiminase 4, PAMPs
- plasmacytoid dendritic cells, PMN
- polymorphonuclear leukocytes, PRRs
- post-active COVID-19 syndrome, PAD-4
- primary Sjögren's syndrome, SLE
- pyrin domain containing 3, ORF
- reactive oxygen species, rt-PCR
- receptor binding domain, RF
- regulatory T cells, VDJ
- retinoic acid-inducible gene I, ROS
- reverse transcription polymerase chain reaction, S
- rheumatoid arthritis, RBD
- rheumatoid factor, RIG-I
- severe acute respiratory coronavirus 2, SjS
- signal transducer and activator of transcription, TCR
- single-stranded ribonucleic acid, STAT
- spike, SAD
- systemic autoimmune disease, SARS-Cov2
- systemic lupus erythematosus, SSc
- systemic sclerosis, ssRNA
- transmembrane serine protease 2, TNF
- tumor necrosis factor, Treg
- variable, diversity and joining Ig genes
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Affiliation(s)
- Regina Larionova
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - K Byvaltsev
- Institute of Fundamental Medicine, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Оlga Kravtsova
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Elena Takha
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
| | - Sergei Petrov
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Gevorg Kazarian
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
| | - Anna Valeeva
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
| | - Eduard Shuralev
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, Kazan, Russia
- Kazan State Academy of Veterinary Medicine Named After N.E. Bauman, Kazan, Russia
| | - Malik Mukminov
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Yves Renaudineau
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Laboratory of Immunology, CHU Purpan Toulouse, INSERM U1291, CNRS U5051, University Toulouse III, Toulouse, France
| | - Marina Arleevskaya
- Central Research Laboratory, Kazan State Medical Academy, Kazan, Russia
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
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33
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Lawal N, Bello MB, Yakubu Y, Ibrahim AM, Rabiu SA. Appraisal of the knowledge, attitude, perception and practices among northern Nigerians in the wake of the COVID-19 outbreak. Future Sci OA 2021; 8:FSO. [PMID: 34898660 DOI: 10.2144/fsoa-2021-0058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 10/14/2021] [Indexed: 01/13/2023] Open
Abstract
Aim: The aim of this study was to measure the knowledge, attitude, perception and practices of northern Nigerians toward the COVID-19 pandemic. Materials & methods: This was a questionnaire-based cross-sectional study and the data were analyzed using descriptive and inferential statistics. Results & discussions: There were 713 participants, of which 54.0, 57.4, 67.6, 36.2 and 28.9% were between 18 and 30 years of age, married, males, having bachelor's degree and civil servants, respectively. High level of knowledge, attitude, perception and practice was found. Pearson correlation analysis found strong positive (r = 0.622; p < 0.001) relationships between knowledge, attitude, perception (r = 0.454; p < 0.001) and at last, practice (r = 0.282; p < 0.001). Conclusion: Young, male and married northern Nigerians of high socio-economic status had better knowledge, attitudes, perceptions and practices toward COVID-19.
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34
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Iqbal Y, Alabdulla M, Latoo J, Kumar R, Albrahim S, Wadoo O, M Haddad P. Mania and hypomania associated with COVID-19: a series of 15 cases seen by the consultation-liaison psychiatry service in Qatar. Qatar Med J 2021; 2021:65. [PMID: 34888201 PMCID: PMC8631349 DOI: 10.5339/qmj.2021.65] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 06/06/2021] [Accepted: 10/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background: A range of neuropsychiatric diagnoses have been reported in association with coronavirus disease 2019 (COVID-19). However, only sporadic cases of mania or hypomania have been reported in patients with COVID-19. This study aimed to report clinical characteristics of 15 consecutive cases of COVID-19-associated mania or hypomania seen in three general hospitals in Qatar in the early months of the pandemic in 2020. Methods: This study is a retrospective case-note review of 15 cases of COVID-19-associated mania or hypomania (confirmed by polymerase chain reaction test), seen as inpatient consultations out of the first 100 consecutive patients managed by consultation-liaison psychiatric teams in Qatar between 2 March 2020 and 7 July 2020. Results: The mean age of the 15 patients was 40 years. Twelve patients had mania, and three had hypomania. Regarding the physical severity of COVID-19, 10 patients were asymptomatic, two had upper respiratory tract symptoms alone and three had pneumonia. None of the patients were intubated. Potential risk factors for mania/hypomania included pandemic-related psychosocial stress before admission (n = 9), past history of mania/bipolar disorder (n = 6) or psychosis (n = 2), raised inflammatory markers (n = 7) and steroid use (n = 3). None had a history of recent substance misuse. Other than one patient with advanced cancer, none had comorbidity regarded as likely to have caused mania or hypomania. Three patients had mild white matter ischaemic changes on brain imaging. Standard pharmacological treatment for mania (i.e. antipsychotic medication supplemented by prn benzodiazepines) was effective. Ten patients were discharged home from the COVID-19 facility where they presented, but five required transfer to Qatar's psychiatric hospital for further treatment of mania. Conclusion: The association of mania or hypomania with COVID-19 may be spurious (e.g. representing an initial presentation of bipolar disorder) or causal. The reported cases illustrate a range of potential aetiological mechanisms by which COVID-19 could cause mania or hypomania. Cohort studies are necessary to determine the incidence, aetiology and prognosis of COVID-19-associated mania/hypomania.
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Affiliation(s)
- Yousaf Iqbal
- Psychiatry Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Majid Alabdulla
- Psychiatry Hospital, Hamad Medical Corporation, Doha, Qatar E-mail: .,College of Medicine, Qatar University, Qatar
| | - Javed Latoo
- Psychiatry Hospital, Hamad Medical Corporation, Doha, Qatar E-mail: .,College of Medicine, Qatar University, Qatar
| | - Rajeev Kumar
- Psychiatry Hospital, Hamad Medical Corporation, Doha, Qatar E-mail: .,College of Medicine, Qatar University, Qatar
| | - Sultan Albrahim
- Psychiatry Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Ovais Wadoo
- Psychiatry Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
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35
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Badbaran A, Mailer RK, Dahlke C, Woens J, Fathi A, Mellinghoff SC, Renné T, Addo MM, Riecken K, Fehse B. Digital PCR to quantify ChAdOx1 nCoV-19 copies in blood and tissues. Mol Ther Methods Clin Dev 2021; 23:418-423. [PMID: 34786434 PMCID: PMC8566940 DOI: 10.1016/j.omtm.2021.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/01/2021] [Accepted: 10/06/2021] [Indexed: 11/26/2022]
Abstract
Vaccination with the adenoviral-vector-based AstraZeneca ChAdOx1 nCov-19 (Vaxzevria) vaccine is efficient and safe. However, in rare cases vaccinated individuals developed life-threatening thrombotic complications, including thrombosis in cerebral sinus and splanchnic veins. Monitoring of the applied vector in vivo represents an important precondition to study the molecular mechanisms underlying vaccine-driven adverse effects now referred to as vaccine-induced immune thrombotic thrombocytopenia (VITT). We previously have shown that digital PCR (dPCR) is an excellent tool to quantify transgene copies in vivo. Here, we present a highly sensitive dPCR for in situ quantification of ChAdOx1 nCoV-19 copies. Using this method, we quantified vector copies in human plasma 24, 72, and 168 h post vaccination and in a variety of murine tissues in an experimental vaccination model 30 min post injection. We describe a method for high-sensitivity quantitative detection of ChAdOx1 nCoV-19 with possible implications to elucidate the mechanisms of severe ChAdOx1 nCov-19 vaccine complications.
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Affiliation(s)
- Anita Badbaran
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
| | - Reiner K Mailer
- Institute of Clinical Chemistry and Laboratory Medicine, UKE, 20246 Hamburg, Germany
| | - Christine Dahlke
- Division of Infectious Diseases, 1st Department of Medicine, UKE, 20246 Hamburg, Germany.,Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Str. 74, 20359 Hamburg, Germany.,German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany
| | - Jannis Woens
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany.,Research Department Cell and Gene Therapy, UKE, 20246 Hamburg, Germany
| | - Anahita Fathi
- Division of Infectious Diseases, 1st Department of Medicine, UKE, 20246 Hamburg, Germany.,Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Str. 74, 20359 Hamburg, Germany.,German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany
| | - Sibylle C Mellinghoff
- Division of Infectious Diseases, 1st Department of Medicine, UKE, 20246 Hamburg, Germany.,Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Str. 74, 20359 Hamburg, Germany.,German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), 50931 Cologne, Germany.,DZIF, Partner Site Bonn-Cologne, Cologne, Germany
| | - Thomas Renné
- Institute of Clinical Chemistry and Laboratory Medicine, UKE, 20246 Hamburg, Germany
| | - Marylyn M Addo
- Division of Infectious Diseases, 1st Department of Medicine, UKE, 20246 Hamburg, Germany.,Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Str. 74, 20359 Hamburg, Germany.,German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany
| | - Kristoffer Riecken
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany.,Research Department Cell and Gene Therapy, UKE, 20246 Hamburg, Germany
| | - Boris Fehse
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany.,German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany.,Research Department Cell and Gene Therapy, UKE, 20246 Hamburg, Germany
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36
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Panigrahi S, Mohapatra S, Shetty AP, Baby RS, Singh AK. The burden & contributing factors of psychological distress across India during the COVID pandemic. Arch Psychiatr Nurs 2021; 35:678-684. [PMID: 34861964 PMCID: PMC8530789 DOI: 10.1016/j.apnu.2021.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 08/23/2021] [Accepted: 10/18/2021] [Indexed: 01/04/2023]
Abstract
UNLABELLED The unprecedented COVID-19 pandemic spread rapidly and engulfing the entire world, forcing people to stay home, muting the hustle and bustle of modern world with tide of fear for contracting disease and death. This brutal disease has infected millions of people worldwide, many lost their job, world economies have ravaged and many more uncountable consequences. OBJECTIVE To assess the psychological distress due to COVID-19 outbreak and to determine contributing factors towards psychological distress. METHOD A cross-sectional survey was conducted between 12th May to 20th June 2020 & 1537 valid responses were received. Modified K10 scale was used to assess psychological distress. Binary logistic regression analysis was used to determine extent of relationship between the contributing factors and psychological distress scale by estimating the odds of having significant stress with P ≤ 0.05. RESULT A total of 1537 valid responses were obtained. The overall psychological distress score was 19.79 ± .75 which implies mild psychological distress. Analysis of degree of psychological distress revealed 815 (53.0%) with no psychological distress, 385 (25.0%) mild, 194 (12.6%) moderate and 143 respondents (9.3%) had severe degree of psychological distress. Females psychological distress was 1.448 times as compared to male (CI 0.191-10.986). The odds of having significant psychological distress for above 60 years as compared to 16-30 years. Shop owner & business man had more stress in compared to professionals (OR 1.176, CI 0.058-2.362). As compared to married, the psychological distress was 13.203 times higher among divorcee/separated (0.786-221.787) and 3.629 times higher among unmarried (0.376-35.054). CONCLUSION This study showed 39.2% of the subject had psychological distress which is quite high. So, government and other policy makers have to develop strategy to relieve psychological distress among Indian population.
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Affiliation(s)
- Sasmita Panigrahi
- College of Nursing, All India Institute of Medical Sciences, Bhubneswar, India.
| | - Sujata Mohapatra
- College of Nursing, All India Institute of Medical Sciences, Bhubneswar, India.
| | - Asha P Shetty
- College of Nursing, All India Institute of Medical Sciences, Bhubneswar, India.
| | - Renju Sussane Baby
- College of Nursing, All India Institute of Medical Sciences, Bhubneswar, India.
| | - Arvind Kumar Singh
- Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences, Bhubneswar, India.
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Priyadarshi H, Das R. Complexities in viral replication strategies as a potential explanation for prevalence of asymptomatic carriers in Covid-19 infections: analytical observation on SARS-Cov2 genome characteristics. Theory Biosci 2021; 140:241-247. [PMID: 34114198 PMCID: PMC8191711 DOI: 10.1007/s12064-021-00349-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 05/18/2021] [Indexed: 11/29/2022]
Abstract
Analytical observations (in silico) indicate molecular features of SARS-Cov2 genome that potentially explains the high prevalence of asymptomatic cases in Covid-19 pandemic. We observed that the virus maintains a low preference for 'GGG' codon for glycine (3%) in its genome. We also observed multiple putative introns of 26-44 nucleotide (nt) length in the genomic region between the coding regions of Nsp10 and RPol in the viral ORF1ab, like several other beta-coronaviruses of similar infectivity levels. It appears that the virus employs a dual strategy to ensure unhindered replication within the host. One of the strategies employ a (- )1 frameshift translation event through programmed ribosomal slippage at the ribosomal slippage site in the ORF1ab. The alternate strategy relies on intron excision to generate a read through frame. The presence of 'GGG' in this conserved ribosomal slippage site ensures adequate tRNA in cytoplasm to match the codon, implying no additional frameshift translation due to ribosomal stalling. With fewer replication events, viral load remains low and resulting in asymptomatic cases. We suggest that this strategy is the primary reason for the prevalence of asymptomatic cases in the disease, enabling the virus to spread rapidly.
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Affiliation(s)
- Himanshu Priyadarshi
- Department of Genetics and Reproduction, College of Fisheries, Central Agricultural University (Imphal), Lembucherra, Agartala, Tripura, 799210, India.
| | - Rekha Das
- ICAR Research Complex for NEH Region, Tripura Regional Centre, Lembucherra, Agartala, Tripura, 799210, India
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Murphy WJ. The urgent need for more basic research on SARS-Cov2 infection and vaccines in assessing potential psychoneurological effects using maternal immune activation (MIA) and other preclinical modeling. Brain Behav Immun 2021; 97:1-3. [PMID: 34217811 DOI: 10.1016/j.bbi.2021.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/09/2021] [Accepted: 06/12/2021] [Indexed: 11/20/2022] Open
Abstract
The rapid development and application of different SARS-Cov2 vaccines world-wide has resulted in impressive efficacy and protection from this deadly pandemic. However, the existence of different and continuously developing vaccine candidates coupled with the likelihood of continued application due to both waning immune responses and emergence of viral mutants, means that more basic research regarding their efficacy and continued application are needed. This is particularly true with use of preclinical models involving effects when given during pregnancy. The substantial body of data on the impact of maternal immune activation (MIA) on neurologic development and behavior in the progeny necessitates the need to have all vaccine candidates, particularly when inducing strong toll receptor (TLR) responses, involving these models. Use of other preclinical models involving autoimmunity and allergy coupled with incorporation of human modifying variables of aging and obesity should also be applied to better reflect the heterogeneity of the general population and potential off-target effects that may arise. Additionally, the use of human ACE2 receptor transgenic mouse models can shed insights given the differential tissues expression at different stages in development. However, to foster these types of basic research studies involving different vaccine products, initiatives must first be implemented and supported at the governmental level even while clinical data still accumulates.
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Abstract
A central retinal vein occlusion (CRVO) case in a patient developed with sudden blurred vision in some hemifield areas of his left eye, maintaining 20/20 vision 15-days after the COVID-19 vaccination. Initial retinal findings were venous dilation and tortuosity with dispersing dot hemorrhages. Fluorescein angiography (FA) and optical coherence tomography (OCT) confirmed a non-ischemic CRVO diagnosis, and a complete blood panel was requested with average results. An intravitreal steroid dose was applied. A decrease in best-corrected visual acuity (BCVA) (20/30) with more intraretinal hemorrhages was documented. An intravitreal dose of bevacizumab and oral apixaban were added with a final BCVA of 20/20 with decreased hemorrhages. There is no specific causal relationship between COVID-19 vaccines and CRVO. Without previous risk factors and positive treatment response, this case may correlate the first COVID-19 vaccine dose and the event.
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Affiliation(s)
- Beatriz Endo
- Department of Retina, Clinica de Oftalmologia de Cali; Vitreo-Retinal Fellowship Program, Pontificia Universidad Javeriana Cali, Cali, Colombia
| | - Silvana Bahamon
- Department of Retina, Clinica de Oftalmologia de Cali; Vitreo-Retinal Fellowship Program, Pontificia Universidad Javeriana Cali, Cali, Colombia
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Singhavi H, Pai A, Mair M, Singhavi J, Gandhi P, Baker A, Das S, Kumar S, Conboy P. SARS-Cov2: a meta-analysis of symptom distribution by continent in 7310 adult COVID-19 infected patients. Virusdisease 2021. [PMID: 34124318 DOI: 10.1007/s13337-021-00699-y/figures/5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023] Open
Abstract
UNLABELLED There is recent evidence that suggests that there are multiple strains of coronavirus in different parts of the world. Moreover, scientist have noted multiple mutations and postulated that these changes might increase the infective rate of the virus. However literature on varying severity of disease based on these strains is absent. In this meta-analysis, we have made an attempt to correlate the symptoms in different continents with respect to various studied strains of virus. We searched three databases, PubMed, EMBASE and EMCARE to identify studies reporting symptoms of COVID-19. All articles published between December 2019 and May 2020 was included in this meta-analysis. A total of 56 studies consisted of 7310 patients were included in the meta-analysis. Mean age of patients varied from 22 to 69.8 years. The pooled proportion of male patients was 52%. Highest incidence of fever (76%) and cough (56%) was noted in Chinese population. Sore throat (29%) was most common in Asian population. Upper respiratory tract symptom like Rhinorrhoea, Anosmia and dysgeusia (32%, 47% and 39%) were well documented in European population as compared to the other continents. Nausea and diarrhoea were more common in European (17%, 19%) and Australian (12%, 16%) population. Dyspnoea and fatigue were consistently similar in all the continents. We postulate that different mutations in COVID-19 virus may vary its pathogenicity and screening symptoms across all the continents should be not be generalised but continent-specific. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s13337-021-00699-y.
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Affiliation(s)
| | - Ameya Pai
- Tata Memorial Hospital, Mumbai, India
| | - Manish Mair
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | | | - Prachi Gandhi
- Department of Neonatology, University Hospital of Leicester, Leicester, UK
| | - Andrew Baker
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | - Sudip Das
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | - Sanjeev Kumar
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | - Peter Conboy
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
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Singhavi H, Pai A, Mair M, Singhavi J, Gandhi P, Baker A, Das S, Kumar S, Conboy P. SARS-Cov2: a meta-analysis of symptom distribution by continent in 7310 adult COVID-19 infected patients. Virusdisease 2021; 32:400-409. [PMID: 34124318 PMCID: PMC8187893 DOI: 10.1007/s13337-021-00699-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 05/20/2021] [Indexed: 01/19/2023] Open
Abstract
There is recent evidence that suggests that there are multiple strains of coronavirus in different parts of the world. Moreover, scientist have noted multiple mutations and postulated that these changes might increase the infective rate of the virus. However literature on varying severity of disease based on these strains is absent. In this meta-analysis, we have made an attempt to correlate the symptoms in different continents with respect to various studied strains of virus. We searched three databases, PubMed, EMBASE and EMCARE to identify studies reporting symptoms of COVID-19. All articles published between December 2019 and May 2020 was included in this meta-analysis. A total of 56 studies consisted of 7310 patients were included in the meta-analysis. Mean age of patients varied from 22 to 69.8 years. The pooled proportion of male patients was 52%. Highest incidence of fever (76%) and cough (56%) was noted in Chinese population. Sore throat (29%) was most common in Asian population. Upper respiratory tract symptom like Rhinorrhoea, Anosmia and dysgeusia (32%, 47% and 39%) were well documented in European population as compared to the other continents. Nausea and diarrhoea were more common in European (17%, 19%) and Australian (12%, 16%) population. Dyspnoea and fatigue were consistently similar in all the continents. We postulate that different mutations in COVID-19 virus may vary its pathogenicity and screening symptoms across all the continents should be not be generalised but continent-specific. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s13337-021-00699-y.
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Affiliation(s)
| | - Ameya Pai
- Tata Memorial Hospital, Mumbai, India
| | - Manish Mair
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | | | - Prachi Gandhi
- Department of Neonatology, University Hospital of Leicester, Leicester, UK
| | - Andrew Baker
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | - Sudip Das
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | - Sanjeev Kumar
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | - Peter Conboy
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
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Aram K, Patil A, Goldust M, Rajabi F. COVID-19 and exacerbation of dermatological diseases: A review of the available literature. Dermatol Ther 2021; 34:e15113. [PMID: 34453380 PMCID: PMC8646294 DOI: 10.1111/dth.15113] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 01/03/2023]
Abstract
Since the emergence of the new coronavirus disease 19 (COVID‐19) pandemic, there has been a concern for the patients with chronic autoimmune diseases including dermatological conditions over the potential exacerbation of these underlying conditions after infection with severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV2). We performed a systematic review to evaluate presentations, postinfection change in the manifestation, diagnosis, and management of flare‐ups of underlying dermatologic disease in patients with COVID‐19. A total of 17 articles were recovered reporting on flare‐ups of dermatological disease including pemphigus vulgaris, psoriasis, subacute cutaneous lupus erythematosus, acrodermatitis continua of Hallopeau, systemic sclerosis sine scleroderma, and Sézary syndrome (SS). Out of these, psoriasis and alopecia areata were the most common conditions. However, most cases of psoriasis could have been attributed to either antimalarial agents that were initially used for the treatment of COVID‐19 or discontinuation of treatment following SARS‐CoV2 infection.
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Affiliation(s)
- Khashayar Aram
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Network of Dermatology Research (NDR), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, Maharashtra, India
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| | - Fateme Rajabi
- Network of Dermatology Research (NDR), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
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43
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Buyuktas D, Acar K, Sucak G, Toptas T, Kapucu I, Bekoz H, Erdem S, Nalcaci M, Atalay F, Akay MO, Ferhanoglu B. COVID-19 infection in patients with acute leukemia; Istanbul experience. Am J Blood Res 2021; 11:427-437. [PMID: 34540352 PMCID: PMC8446830] [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] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 07/28/2021] [Indexed: 06/13/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has led to a global pandemic that has also challenged the management of various other life-threatening conditions, such as malignant disorders. In this study, we present the clinical features and treatment outcomes of twenty-seven COVID-19 positive patients with leukemia across seven different centers in Istanbul. From March 1st to December 31st 2020, 116 patients were diagnosed with acute leukemia. Thirty-two cases with acute lymphocytic leukemia (ALL), 82 cases with acute myeloid leukemia (AML), and 2 cases with mixed phenotype acute leukemia (MPAL) were identified. Of the 27 patients with the COVID-19 infection, seven patients had ALL, 19 patients had AML and one patient had MPAL. The mortality rate was 37% among the patients with AML, whereas there were no deaths in the ALL group. The mortality rate of AML patients with the COVID-19 infection was higher compared to cases without the infection (P<0.05). We could not detect any significant difference in the ALL cohort. This study, which includes one of the largest acute leukemia series in literature proved that acute myeloid leukemia patients with the COVID-19 infection have worse outcomes than patients without the infection. The high mortality among patients with acute leukemias hospitalized with COVID-19 highlight the need for aggressive infection prevention, increased surveillance and protective isolation and even modification of the therapy, in case of minimal residual disease (MRD) negativity.
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Affiliation(s)
- Deram Buyuktas
- Department of Hematology, School of Medicine, Koc UniversityIstanbul, Turkey
| | - Kadir Acar
- Division of Hematology and Bone Marrow Transplantation Unit, Department of Internal Medicine and Hematology, Bahcelievler Medical Park HospitalIstanbul, Turkey
| | - Gulsan Sucak
- Division of Hematology and Bone Marrow Transplantation Unit, Department of Internal Medicine and Hematology, Bahcelievler Medical Park HospitalIstanbul, Turkey
| | - Tayfur Toptas
- Department of Hematology, Marmara University Medical FacultyIstanbul, Turkey
| | - Irem Kapucu
- Department of Hematology, School of Medicine, Koc UniversityIstanbul, Turkey
| | - Huseyin Bekoz
- Division of Hematology, Department of Internal Medicine, Medipol UniversityIstanbul, Turkey
| | - Simge Erdem
- Division of Hematology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul UniversityIstanbul, Turkey
| | - Meliha Nalcaci
- Division of Hematology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul UniversityIstanbul, Turkey
| | - Figen Atalay
- Department of Hematology, Başkent University Istanbul HospitalIstanbul, Turkey
| | - Meltem Olga Akay
- Department of Hematology, School of Medicine, Koc UniversityIstanbul, Turkey
| | - Burhan Ferhanoglu
- Department of Hematology, School of Medicine, Koc UniversityIstanbul, Turkey
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Cabezas X, García S, Martin-Barreiro C, Delgado E, Leiva V. A Two-Stage Location Problem with Order Solved Using a Lagrangian Algorithm and Stochastic Programming for a Potential Use in COVID-19 Vaccination Based on Sensor-Related Data. Sensors (Basel) 2021; 21:5352. [PMID: 34450794 DOI: 10.3390/s21165352] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 01/21/2023]
Abstract
Healthcare service centers must be sited in strategic locations that meet the immediate needs of patients. The current situation due to the COVID-19 pandemic makes this problem particularly relevant. Assume that each center corresponds to an assigned place for vaccination and that each center uses one or more vaccine brands/laboratories. Then, each patient could choose a center instead of another, because she/he may prefer the vaccine from a more reliable laboratory. This defines an order of preference that might depend on each patient who may not want to be vaccinated in a center where there are only her/his non-preferred vaccine brands. In countries where the vaccination process is considered successful, the order assigned by each patient to the vaccination centers is defined by incentives that local governments give to their population. These same incentives for foreign citizens are seen as a strategic decision to generate income from tourism. The simple plant/center location problem (SPLP) is a combinatorial approach that has been extensively studied. However, a less-known natural extension of it with order (SPLPO) has not been explored in the same depth. In this case, the size of the instances that can be solved is limited. The SPLPO considers an order of preference that patients have over a set of facilities to meet their demands. This order adds a new set of constraints in its formulation that increases the complexity of the problem to obtain an optimal solution. In this paper, we propose a new two-stage stochastic formulation for the SPLPO (2S-SPLPO) that mimics the mentioned pandemic situation, where the order of preference is treated as a random vector. We carry out computational experiments on simulated 2S-SPLPO instances to evaluate the performance of the new proposal. We apply an algorithm based on Lagrangian relaxation that has been shown to be efficient for large instances of the SPLPO. A potential application of this new algorithm to COVID-19 vaccination is discussed and explored based on sensor-related data. Two further algorithms are proposed to store the patient’s records in a data warehouse and generate 2S-SPLPO instances using sensors.
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Saez-de-Ocariz M, Gámez-González LB, Rivas-Larrauri F, Castaño-Jaramillo LM, Toledo-Salinas C, Garrido-García LM, Ulloa-Gutierrez R, Santamaría-Piedra M, Orozco-Covarrubias MDLL, Scheffler-Mendoza S, Yamazaki-Nakashimada MA. Kawasaki disease mimickers. Pediatr Int 2021; 63:880-888. [PMID: 33249696 DOI: 10.1111/ped.14561] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/14/2020] [Accepted: 11/18/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Kawasaki disease (KD) is an acute systemic vasculitis that predominantly affects patients younger than 5 years. In the absence of an available, affordable diagnostic test, detailed clinical history and physical examination are still fundamental to make a diagnosis. METHODS We present five representative cases with KD-like presentations: systemic onset juvenile idiopathic arthritis, mycoplasma-induced rash and mucositis, staphylococcal scalded skin syndrome, BCGosis, and the recently described multisystemic inflammatory syndrome in children (MIS-C) associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) virus. RESULTS Rash, fever, and laboratory markers of inflammation can be present in several childhood diseases that may mimic KD. CONCLUSION The term 'Kawasaki syndrome' instead of 'Kawasaki disease' may be more appropriate. Physicians should consider an alternative diagnosis that may mimic KD, particularly considering MIS-C during the present pandemic, as an aggressive diagnostic and therapeutic approach is needed.
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Affiliation(s)
| | | | | | | | - Carla Toledo-Salinas
- Clinical Immunology Department, Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | - Rolando Ulloa-Gutierrez
- Servicio de Infectología Pediátrica, Hospital Nacional de Niños "Dr. Carlos Sáez Herrera", San José, Costa Rica
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Rojas F, Leiva V, Huerta M, Martin-Barreiro C. Lot-Size Models with Uncertain Demand Considering Its Skewness/Kurtosis and Stochastic Programming Applied to Hospital Pharmacy with Sensor-Related COVID-19 Data. Sensors (Basel) 2021; 21:5198. [PMID: 34372434 PMCID: PMC8347410 DOI: 10.3390/s21155198] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 01/22/2023]
Abstract
Governments have been challenged to provide timely medical care to face the COVID-19 pandemic. Under this pandemic, the demand for pharmaceutical products has changed significantly. Some of these products are in high demand, while, for others, their demand falls sharply. These changes in the random demand patterns are connected with changes in the skewness (asymmetry) and kurtosis of their data distribution. Such changes are critical to determining optimal lots and inventory costs. The lot-size model helps to make decisions based on probabilistic demand when calculating the optimal costs of supply using two-stage stochastic programming. The objective of this study is to evaluate how the skewness and kurtosis of the distribution of demand data, collected through sensors, affect the modeling of inventories of hospital pharmacy products helpful to treat COVID-19. The use of stochastic programming allows us to obtain results under demand uncertainty that are closer to reality. We carry out a simulation study to evaluate the performance of our methodology under different demand scenarios with diverse degrees of skewness and kurtosis. A case study in the field of hospital pharmacy with sensor-related COVID-19 data is also provided. An algorithm that permits us to use sensors when submitting requests for supplying pharmaceutical products in the hospital treatment of COVID-19 is designed. We show that the coefficients of skewness and kurtosis impact the total costs of inventory that involve order, purchase, holding, and shortage. We conclude that the asymmetry and kurtosis of the demand statistical distribution do not seem to affect the first-stage lot-size decisions. However, demand patterns with high positive skewness are related to significant increases in expected inventories on hand and shortage, increasing the costs of second-stage decisions. Thus, demand distributions that are highly asymmetrical to the right and leptokurtic favor high total costs in probabilistic lot-size systems.
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Affiliation(s)
- Fernando Rojas
- School of Nutrition and Dietetics, Faculty of Pharmacy, Universidad de Valparaíso, Valparaíso 2360102, Chile;
- Center of Micro-Bioinnovation, Faculty of Pharmacy, Universidad de Valparaíso, Valparaíso 2360102, Chile
| | - Víctor Leiva
- School of Industrial Engineering, Faculty of Engineering, Pontificia Universidad Católica de Valparaíso, Valparaíso 2362807, Chile;
| | - Mauricio Huerta
- School of Industrial Engineering, Faculty of Engineering, Pontificia Universidad Católica de Valparaíso, Valparaíso 2362807, Chile;
| | - Carlos Martin-Barreiro
- Faculty of Natural Sciences and Mathematics, Universidad Politécnica ESPOL, Guayaquil 090902, Ecuador; or
- Facultad de Ingeniería, Universidad Espíritu Santo, Samborondón 0901952, Ecuador
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Bedock D, Couffignal J, Bel Lassen P, Soares L, Mathian A, Fadlallah JP, Amoura Z, Oppert JM, Faucher P. Evolution of Nutritional Status after Early Nutritional Management in COVID-19 Hospitalized Patients. Nutrients 2021; 13:nu13072276. [PMID: 34209229 PMCID: PMC8308434 DOI: 10.3390/nu13072276] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/15/2021] [Accepted: 06/23/2021] [Indexed: 12/17/2022] Open
Abstract
Background & Aims: SARS-CoV2 infection is associated with an increased risk of malnutrition. Although there are numerous screening and nutritional management protocols for malnutrition, only few studies have reported nutritional evolution after COVID-19. The objectives of this study were to describe the evolution of nutritional parameters between admission and 30 days after hospital discharge, and to determine predictive factors of poor nutritional outcome after recovery in adult COVID-19 patients. Methods: In this observational longitudinal study, we report findings after discharge in 91 out of 114 patients initially admitted for COVID-19 who received early nutritional management. Nutritional status was defined using GLIM criteria and compared between admission and day 30 after discharge. Baseline predictors of nutritional status at day 30 were assessed using logistic regression. Results: Thirty days after discharge, 28.6% of patients hospitalized for COVID-19 were malnourished, compared to 42.3% at admission. Half of malnourished patients (53%) at admission recovered a normal nutritional status after discharge. Weight trajectories were heterogeneous and differed if patients had been transferred to an intensive care unit (ICU) during hospitalization (p = 0.025). High oxygen requirement during hospitalization (invasive ventilation p = 0.016 (OR 8.3 [1.6–61.2]) and/or oxygen therapy over 5 L/min p = 0.021 (OR 3.2 [1.2–8.9]) were strong predictors of malnutrition one month after discharge. Conclusions: With early nutritional management, most patients hospitalized for COVID-19 improved nutritional parameters after discharge. These findings emphasize the importance of nutritional care in COVID-19 patients hospitalized in medicine departments, especially in those transferred from ICU.
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Affiliation(s)
- Dorothée Bedock
- Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (D.B.); (J.C.); (P.B.L.); (L.S.); (P.F.)
| | - Julie Couffignal
- Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (D.B.); (J.C.); (P.B.L.); (L.S.); (P.F.)
| | - Pierre Bel Lassen
- Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (D.B.); (J.C.); (P.B.L.); (L.S.); (P.F.)
- NutriOmics Team, INSERM UMRS U1166, Sorbonne Université, 75006 Paris, France
| | - Leila Soares
- Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (D.B.); (J.C.); (P.B.L.); (L.S.); (P.F.)
| | - Alexis Mathian
- French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Medicine Department, Inserm UMRS, Assistance Publique–Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (A.M.); (J.P.F.); (Z.A.)
| | - Jehane P. Fadlallah
- French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Medicine Department, Inserm UMRS, Assistance Publique–Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (A.M.); (J.P.F.); (Z.A.)
| | - Zahir Amoura
- French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Medicine Department, Inserm UMRS, Assistance Publique–Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (A.M.); (J.P.F.); (Z.A.)
| | - Jean-Michel Oppert
- Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (D.B.); (J.C.); (P.B.L.); (L.S.); (P.F.)
- Correspondence: ; Tel.: +331-4217-5779; Fax: +331-4217-5790
| | - Pauline Faucher
- Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Nutrition Department, Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Sorbonne Université, 47-83 Boulevard de l’Hôpital, 75013 Paris, France; (D.B.); (J.C.); (P.B.L.); (L.S.); (P.F.)
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48
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Emren ZY, Şenöz O, Erseçgin A, Emren SV. Evaluation of Bleeding Rate and Time in Therapeutic Range in Patients Using Warfarin Before and During the COVID-19 Pandemic-Warfarin Treatment in COVID-19. Clin Appl Thromb Hemost 2021; 27:10760296211021495. [PMID: 34142564 PMCID: PMC8216412 DOI: 10.1177/10760296211021495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The treatment process of patients using warfarin is expected to be hindered during the COVID-19 pandemic. Therefore we investigated whether the time in therapeutic range (TTR) and bleeding complications were affected during the COVID-19 pandemic. 355 patients using warfarin were included between March 2019 to March 2021. Demographic parameters, INR (international normalized ratio), and bleeding rates were recorded retrospectively. The TTR value was calculated using Rosendaal’s method. The mean age of the patients was 61 ± 12 years and 55% of them were female. The mean TTR value during the COVID-19 pandemic was lower than the pre-COVID-19 period (56 ± 21 vs 68 ± 21, P < 0.001). Among the patients, 41% had a lack of outpatient INR control. During the COVID-19 pandemic, 71 (20%) patients using VKA suffered bleeding. Among patients with bleeding, approximately 60% did not seek medical help and 6% of patients performed self-reduction of the VKA dose. During the COVID-19 pandemic, TTR values have decreased with the lack of monitoring. Furthermore, the majority of patients did not seek medical help even in case of bleeding.
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Affiliation(s)
- Zeynep Yapan Emren
- Department of Cardiology, Çiğli Training and Education Hospital, Bakırçay University, Izmir, Turkey
| | - Oktay Şenöz
- Department of Cardiology, Çiğli Training and Education Hospital, Bakırçay University, Izmir, Turkey
| | - Ahmet Erseçgin
- Department of Cardiology, Çiğli Training and Education Hospital, Bakırçay University, Izmir, Turkey
| | - Sadık Volkan Emren
- Department of Cardiology, 226844Izmir Katip Celebi University School of Medicine, Izmir, Turkey
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Rabie AA, Azzam MH, Al-Fares AA, Abdelbary A, Mufti HN, Hassan IF, Chakraborty A, Oza P, Elhazmi A, Alfoudri H, Pooboni SK, Alharthy A, Brodie D, Zakhary B, Shekar K, Antonini MV, Barrett NA, Peek G, Combes A, Arabi YM. Implementation of new ECMO centers during the COVID-19 pandemic: experience and results from the Middle East and India. Intensive Care Med 2021; 47:887-895. [PMID: 34156477 PMCID: PMC8217786 DOI: 10.1007/s00134-021-06451-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/02/2021] [Indexed: 01/15/2023]
Abstract
Purpose Extracorporeal membrane oxygenation (ECMO) use for severe coronavirus disease 2019 (COVID-19) patients has increased during the course of the pandemic. As uncertainty existed regarding patient’s outcomes, early guidelines recommended against establishing new ECMO centers. We aimed to explore the epidemiology and outcomes of ECMO for COVID-19 related cardiopulmonary failure in five countries in the Middle East and India and to evaluate the results of ECMO in 5 new centers. Methods This is a retrospective, multicenter international, observational study conducted in 19 ECMO centers in five countries in the Middle East and India from March 1, 2020, to September 30, 2020. We included patients with COVID-19 who received ECMO for refractory hypoxemia and severe respiratory acidosis with or without circulatory failure. Data collection included demographic data, ECMO-related specific data, pre-ECMO patient condition, 24 h post-ECMO initiation data, and outcome. The primary outcome was survival to home discharge. Secondary outcomes included mortality during ECMO, survival to decannulation, and outcomes stratified by center type. Results Three hundred and seven COVID-19 patients received ECMO support during the study period, of whom 78 (25%) were treated in the new ECMO centers. The median age was 45 years (interquartile range IQR 37–52), and 81% were men. New center patients were younger, were less frequently male, had received higher PEEP, more frequently inotropes and prone positioning before ECMO and were less frequently retrieved from a peripheral center on ECMO. Survival to home discharge was 45%. In patients treated in new and established centers, survival was 55 and 41% (p = 0.03), respectively. Multivariable analysis retained only a SOFA score < 12 at ECMO initiation as associated with survival (odds ratio, OR 1.93 (95% CI 1.05–3.58), p = 0.034), but not treatment in a new center (OR 1.65 (95% CI 0.75–3.67)). Conclusions During pandemics, ECMO may provide favorable outcomes in highly selected patients as resources allow. Newly formed ECMO centers with appropriate supervision of regional experts may have satisfactory results. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-021-06451-w.
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Affiliation(s)
- Ahmed A Rabie
- Critical Care Department, King Saud Medical City, 12746 Ulaishah discreet, Riyadh, Saudi Arabia.
| | - Mohamed H Azzam
- Critical Care Department, King Abdullah Medical Complex, Ministry of Health, Jeddah, Saudi Arabia
| | - Abdulrahman A Al-Fares
- Department of Anesthesia, Critical Care Medicine and Pain Medicine, Al-Amiri Hospital Center for Respiratory and Cardiac Failure, Kuwait Extracorporeal Life Support Program, Jaber Al-Ahmed Hospital Critical Care Unit, Ministry of Health, Kuwait City, Kuwait
| | | | - Hani N Mufti
- Section of Cardiac Surgery, Department of Cardiac Sciences, King Faisal Cardiac Center, King Abdulaziz Medical City, MNGHA, Jeddah, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Ibrahim F Hassan
- Medical Critical Care Division, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Arpan Chakraborty
- Cardiac Anesthesia, Critical Care and ECMO Services, Medica Superspecialty Hospital, Kolkata, India
| | - Pranay Oza
- Riddhi Vinayak Multispecialty Hospital, Mumbai, India
| | - Alyaa Elhazmi
- Adult Critical Care Department, Dr. Sulaiman Alhabib Medical Group, Riyadh, Saudi Arabia
| | - Huda Alfoudri
- Department of Anaesthesia, Critical Care, and Pain Management, Al-Adan Hospital Ministry of Health, Hadiya, Kuwait
| | - Suneel Kumar Pooboni
- Department of Pediatric Critical Care, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates
| | - Abdulrahman Alharthy
- Critical Care Department, King Saud Medical City, 12746 Ulaishah discreet, Riyadh, Saudi Arabia
| | - Daniel Brodie
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Columbia College of Physicians and Surgeons, New York, NY, USA.,Center for Acute Respiratory Failure, New York-Presbyterian Hospital, New York, NY, USA
| | - Bishoy Zakhary
- Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Kiran Shekar
- Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, QLD, Australia.,Faculty of Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | | | - Nicholas A Barrett
- Faculty of Life Sciences and Medicine, Department of Critical Care, Centre of Human and Applied Physiological Sciences, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, UK
| | - Giles Peek
- Department of Cardiothoracic Surgery, Congenital Heart Center, University of Florida, Gainesville, FL, USA
| | - Alain Combes
- Institute of Cardio-Metabolism and Nutrition, Sorbonne Université, INSERM, UMRS_1166-ICAN, 75013, Paris, France.,Service de Médecine Intensive-Réanimation, Institute de Cardiologie, APHP Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Yaseen M Arabi
- Intensive Care Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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50
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Yuguero O, Calahorra M, Cuevas S, Giménez N, Hernández I, Lacasta JD, Porque J, Pardos C. Cross-sectional study of SARS-CoV2 clinical characteristics in an immigrant population attended in a Hospital Emergency Department in the Catalunya Health Region in Spain. J Migr Health 2021; 4:100055. [PMID: 34151311 DOI: 10.1016/j.jmh.2021.100055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/02/2021] [Accepted: 06/13/2021] [Indexed: 11/24/2022] Open
Abstract
Aim The COVID pandemic has been the biggest health challenge faced in decades. The aim of this study is to assess the characteristics of immigrant patients who attended a Hospital Emergency Department during the first three waves of the coronavirus pandemic. Methods A retrospective, descriptive study of immigrant patients treated in a Hospital Emergency Department between March 15 and November 30, 2020. A descriptive analysis and a comparative analysis were carried out according to place of origin, gender and age. For the comparative analysis, the chi-square test for qualitative variables was used. For the comparative analysis according to gender, Student's t test or the Mann-Whitney U test was used for normal or non-normal quantitative variables, respectively. The Kruskal-Wallis test was used for normal or non-normal quantitative variables according to age. Results We have analyzed 633 immigrant patients who visited the emergency department during the study period. Of the sample, 50.1% patients were women and 78% of all patients came from Africa. The mean age of the patients was 44.1 years. Most patients (72.5%) were discharged to home after evaluation in the emergency department, especially European patients. One-quarter of patients required social resources to be able to comply with quarantine measures, of whom 87% were African. Forty-seven percent of patients became infected at home and 41% in the workplace. Conclusions The immigrant population is generally younger and less infected than the population at large. In addition, the use of social resources to guarantee patient isolation has often proved essential in controlling outbreaks that have arisen in these communities.
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