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47 ud af 47 tidsskrifter valgt, søgeord (covid) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
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Florencia TorcheJenna NoblesaDepartment of Sociology, Stanford University, Stanford, CA 94305bDepartment of Sociology, Center for Demography and Ecology, University of Wisconsin-Madison, Madison, WI 53706
Proceedings of the National Academy of Sciences, 29.11.2023
Tilføjet 29.11.2023
Proceedings of the National Academy of Sciences, Volume 120, Issue 49, December 2023.
Læs mere Tjek på PubMedCortney A. TurnerHuzefa KhalilVirginia Murphy-WeinbergMegan H. HagenauerLinda GatesYu TangLauren WeinbergRobert GryskoLeonor Floran-GardunoThomas DokasCatherine SamaniegoZhuo ZhaoYu FangSrijan SenJuan F. LopezStanley J. WatsonHuda AkilaMichigan Neuroscience Institute, University of Michigan, Ann Arbor, MI 48109bDepartment of Psychiatry, University of Michigan, Ann Arbor, MI 48109cDepartment of Psychology, University of Michigan, Ann Arbor, MI 48109
Proceedings of the National Academy of Sciences, 29.11.2023
Tilføjet 29.11.2023
Proceedings of the National Academy of Sciences, Volume 120, Issue 49, December 2023.
Læs mere Tjek på PubMedThe PLOS ONE Staff
PLoS One Infectious Diseases, 29.11.2023
Tilføjet 29.11.2023
Rafaella Rabelo Polato, Cristino Carneiro Oliveira, Yuri Augusto de Sousa Miranda, Leandro Ferracini Cabral, Carla Malaguti, Anderson José
PLoS One Infectious Diseases, 29.11.2023
Tilføjet 29.11.2023
by Rafaella Rabelo Polato, Cristino Carneiro Oliveira, Yuri Augusto de Sousa Miranda, Leandro Ferracini Cabral, Carla Malaguti, Anderson José Introduction Several individuals with post-COVID-19 syndrome referred for pulmonary rehabilitation did not participate. This study aimed to explore individuals’ barriers to participating in posthospitalization COVID-19 rehabilitation. Materials and methods This was a qualitative, multicenter study performed using semistructured interviews. This study included 20 individuals hospitalized for COVID-19 who refused to participate in a pulmonary rehabilitation program at a university hospital. Results Individuals reported difficulties accessing the rehabilitation center, mainly due to distance, transport costs and conditions, and lack of companions. Health problems (e.g., surgeries, pain, and mobility difficulties) and lack of time due to work, commuting, and household work were also reported. Another reported theme was not perceiving the need for rehabilitation due to feeling well. Minor themes included the need for more information about rehabilitation and a lack of interest, motivation, and medical encouragement. Conclusion Individuals hospitalized for COVID-19 faced several barriers to participating in a pulmonary rehabilitation program. These barriers included difficulties in accessing the rehabilitation center, health problems, lack of time, and the perception that rehabilitation was unnecessary. There is a need for actions to overcome these barriers to make the program available to a larger number of individuals.
Læs mere Tjek på PubMedSu-Yeon Yu, Miyoung Choi, Seungeun Ryoo, Chelim Cheong, Kyungmin Huh, Young Kyung Yoon, Su Jin Jeong
PLoS One Infectious Diseases, 29.11.2023
Tilføjet 29.11.2023
by Su-Yeon Yu, Miyoung Choi, Seungeun Ryoo, Chelim Cheong, Kyungmin Huh, Young Kyung Yoon, Su Jin Jeong Inhaled corticosteroids are known to be relatively safe for long-term use in inflammatory respiratory diseases and it has been repurposed as one of the potential therapies for outpatients with coronavirus disease 2019 (COVID-19). However, inhaled corticosteroids have not been accepted for COVID-19 as a standard therapy because of its lack of proven benefits. Therefore, this study aimed to evaluate the effectiveness of inhaled corticosteroids in patients with COVID-19. Randomized controlled trials comparing the efficacy of inhaled corticosteroid treatment in patients with COVID-19 were identified through literature electronic database searches up to March 10, 2023. Meta-analyses were conducted for predefined outcomes, and the certainty of evidence was graded using the grading of recommendations, assessment, development, and evaluation approach. Overall, seven trials (eight articles) were included in this systematic review. Compared with usual care, inhaled corticosteroids was associated with significantly improved clinical recovery at 7 and 14 days in patients with COVID-19. In subgroup analysis, only budesonide showed significant efficacy in clinical recovery, whereas no significant benefit was observed for ciclesonide. Moreover, inhaled corticosteroids use was not significantly associated with all-cause hospitalization, all-cause mortality, admission to intensive care unit, or the use of mechanical ventilation. Our systematic review used evidence with very low to moderate certainty. Although based on limited evidence, our results suggest that inhaled corticosteroids treatment, especially budesonide, improves the clinical recovery of patients with COVID-19. More trials and meta-analyses are needed to assess the efficacy of inhaled corticosteroids for COVID-19 treatment.
Læs mere Tjek på PubMedMasoumeh Sayahi, Maryam Nikbina, Azam Jahangirimehr, Barat Barati
PLoS One Infectious Diseases, 29.11.2023
Tilføjet 29.11.2023
by Masoumeh Sayahi, Maryam Nikbina, Azam Jahangirimehr, Barat Barati Background and objective The COVID-19 pandemic impacted every single aspect of life. In addition to being a public health emergency, the COVID-19 outbreak impacted the mental health of individuals, especially pregnant women. This study aimed to examine the mental health status of pregnant women and also the effect of sociodemographic factors on their mental health status during COVID-19 in healthcare centers of Iran. Methods This cross-sectional, analytical-descriptive study was conducted among pregnant women referring to healthcare centers in Shoushtar, Iran, in 2021. Multistage cluster sampling was used to select participants. Data were collected using the General Health Questionnaire-28 (GHQ-28). Data were analyzed using SPSS software version 22. The Pearson correlation coefficient was used to examine the association between quantitative variables. A generalized linear model (GLM) was applied to estimate the effect of independent variables on the dependent variable (mental health). Results A total of 197 participants with a mean ± SD age of 27.85 ± 6.37 years took part in this study. The total mean score of mental health was estimated at 17.47±8.20. The highest mean ± SD score was, respectively, related to social dysfunction (6.63 ± 2.86), anxiety and insomnia (5.28 ± 3.53), and somatic symptoms (4.17 ± 3.27). Mental health disorder was significantly correlated with participants’ age (R = .223, P = .00), number of pregnancy (gravida) (R = .272, P = .00), number of births (para) (R = 0.272, P = .00), and number of abortions (R = .172, P = .015). About 80% of pregnant women did not reveal impaired mental health conditions or psychological distress, while 19.3% showed scores that indicate probable mental health conditions. Conclusion Social dysfunction was the most common mental health problem among pregnant women. It is necessary to pay more attention to the mental health status of pregnant women during a pandemic. Interventions such as practical strategies to promote social support and improve pregnant women’s mental health during pregnancy are highly important.
Læs mere Tjek på PubMedJoshua Brown, Isobel Miller, Matilda Barnes-Harris, Miriam J. Johnson, Mark Pearson, Tim Luckett, Flavia Swan
PLoS One Infectious Diseases, 29.11.2023
Tilføjet 29.11.2023
by Joshua Brown, Isobel Miller, Matilda Barnes-Harris, Miriam J. Johnson, Mark Pearson, Tim Luckett, Flavia Swan Introduction The handheld fan (‘fan’) is useful for chronic breathlessness management, however little is known about clinicians’ implementation of the fan in clinical practice. Aim To explore clinicians’ experiences and views of fan implementation. Methods A qualitative approach, using semi-structured interviews. Participants were purposively sampled from clinicians who had completed an on-line fan implementation survey and were willing to participate. A topic guide was developed using the Theoretical Domains Framework (TDF). Data were analysed using an inductive approach informed by the TDF. Findings Twelve clinicians participated (doctors n = 4; nurses n = 4; allied health professionals n = 4) from respiratory and palliative care. Analysis generated three major themes: i) Clinician knowledge and skills in fan implementation, ii) environmental constraints on fan use and iii) clinician beliefs about the consequences of fan use.Implementation by clinicians was positively influenced by having a scientific rationale for fan use presented (mechanism of action). Clinicians believed that the fan relieved breathlessness and did not carry a significant infection risk. Opportunity for fan use varied across healthcare settings; key environmental influences were COVID-19 restrictions, lack of access to resources and funding to provide fans, particularly in acute and respiratory services. Clinicians commonly encountered scepticism among patients and colleagues who felt the fan was an implausible intervention for breathlessness. Conclusion Implementation of the fan is motivated by clinician beliefs about patient-benefit, a scientific rationale to counter clinician and patient scepticism, and access to fans in clinic. Funding to allow patients to be supplied with and taught how to use a fan would support uptake. Research is needed to address concerns about infection risk.
Læs mere Tjek på PubMedSung‐Woon Kang, Jun‐Won Kim, Ji Yeun Kim, So Yun Lim, Choi‐Young Jang, Euijin Chang, Jeong‐Sun Yang, Kyung‐Chang Kim, Hee‐Chang Jang, Dasol Kim, Younmin Shin, Joo‐Yeon Lee, Sung‐Han Kim
Journal of Medical Virology, 28.11.2023
Tilføjet 28.11.2023
Zhourong Li, Yu Xiong, Jiang Long, Tingting Li, Xiaoqing Fu, Shuang Yang, Dechao Tian, Yong Zhao, Li Qi
Journal of Medical Virology, 28.11.2023
Tilføjet 28.11.2023
Houssem Redha Chenane, Guillaume Lingas, Reyene Menidjel, Cédric Laouenan, Sarah Tubiana, Diane Descamps, Quentin Le Hingrat, Laurent Abel, Jérémie Guedj, Surbhi Malhotra, Samir Kumar‐Singh, Benoit Visseaux, Jade Ghosn, Charlotte Charpentier, Samuel Lebourgeois, the French COVID Cohort Study Group
Journal of Medical Virology, 28.11.2023
Tilføjet 28.11.2023
Rui Mao, Zhihua Fan, Meihui He, Ji Li
Journal of Medical Virology, 28.11.2023
Tilføjet 28.11.2023
BMC Infectious Diseases, 28.11.2023
Tilføjet 28.11.2023
Abstract Background The Omicron variant of SARS-CoV-2, currently the most prevalent strain, has rapidly spread in Jingzhou, China, due to changes in the country’s epidemic prevention policy, resulting in an unprecedented increase in cases. Previous studies reported hematological parameters’ predictive value in COVID-19 severity and prognosis, but their relevance for early diagnosis in patients infected by the Omicron variant, particularly in high-risk pneumonia cases, remains unclear. Our study aimed to evaluate these parameters as early warning indicators for Omicron-infected patients in fever clinics and those with pulmonary infections (PI). Methods A total of 2,021 COVID-19 patients admitted to the fever clinic and infectious disease department of Jingzhou Hospital Affiliated to Yangtze University from November 1, 2022, to December 31, 2022, were retrospectively recruited. Demographic and hematological parameters were obtained from the electronic medical records of eligible patients. These hematological parameters were analyzed by receiver operating characteristic (ROC) curves to determine whether they can be used for early diagnosis of COVID-19 patients in fever clinics and the presence of PI in COVID-19 patients. Results Statistical differences in hematological parameters were observed between COVID-19 patients with fever and PI and control groups (P
Læs mere Tjek på PubMedTony Kirby
Lancet Respiratory Medicine, 28.11.2023
Tilføjet 28.11.2023
The last time that an infectious disease ranked in the top five causes of death in Australia was in 1970 (influenza and pneumonia combined). However, COVID-19, after being successfully kept under control when Australia closed borders between 2020 and 2021, has surged into the top three causes of death in 2022. There were 9859 deaths due to COVID-19 registered in Australia in 2022, and the infection was mentioned as a contributing factor on a further 2782 death certificates. Ischaemic heart disease (19 858 deaths) and dementia, including Alzheimer\'s disease (17 106 deaths), were the only top two causes of death above COVID-19.
Læs mere Tjek på PubMedDjillali Annane, Sean J Pittock, Hrishikesh S Kulkarni, Brian W Pickering, Matt R Khoshnevis, Jason L Siegel, Charles A Powell, Pedro Castro, Tomoko Fujii, Derek Dunn, Keisha Smith, Sanjay Mitter, Shamsah Kazani, Austin Kulasekararaj
Lancet Respiratory Medicine, 28.11.2023
Tilføjet 28.11.2023
Addition of ravulizumab to BSC did not improve survival or other secondary outcomes. Safety findings were consistent with the known safety profile of ravulizumab in its approved indications. Despite the lack of efficacy, the study adds value for future research into complement therapeutics in critical illnesses by showing that C5 inhibition can be accomplished in severely ill patients.
Læs mere Tjek på PubMedFrances C Hall, Joseph Cheriyan, Andrew P Cope, James Galloway, Ian Wilkinson, Simon Bond, Sam Norton, Edward Banham-Hall, Hannah Bayes, Michalis Kostapanos, Marianna Nodale, William G Petchey, Thomas Sheeran, Jonathan Underwood, David R Jayne, TACTIC-R Investigators Group
Lancet Respiratory Medicine, 28.11.2023
Tilføjet 28.11.2023
Neither baricitinib nor ravulizumab, as administered in this study, was effective in reducing disease severity in patients selected for severe COVID-19. Safety was similar between treatments and standard of care. The short period of dosing with baricitinib might explain the discrepancy between our findings and those of other trials. The therapeutic potential of targeting complement C5 activation product C5a, rather than the cleavage of C5, warrants further evaluation.
Læs mere Tjek på PubMedFengcai Zhu, Shoujie Huang, Xiaohui Liu, Qi Chen, Chunlan Zhuang, Hui Zhao, Jinle Han, Anjuli May Jaen, Thai Hung Do, Jonathan Grant Peter, Alexander Gonzalez Dorado, Louie S Tirador, Gelza Mae A Zabat, Ralph Elvi M Villalobos, Gemalyn Pineda Gueco, Lauren Livia Greta Botha, Shirley Patricia Iglesias Pertuz, Jiaxiang Tan, Kongxin Zhu, Jiali Quan, Hongyan Lin, Yue Huang, Jizong Jia, Xiafei Chu, Junyu Chen, Yixin Chen, Tianying Zhang, Yingying Su, Changgui Li, Xiangzhong Ye, Ting Wu, Jun Zhang, Ningshao Xia, COVID-19-PRO-003 Study Team
Lancet Respiratory Medicine, 28.11.2023
Tilføjet 28.11.2023
Although this trial did not meet the predefined efficacy criteria for success, dNS1-RBD was well tolerated and protective against omicron variants, both as a primary immunisation and as a heterologous booster.
Læs mere Tjek på PubMedSara Y Tartof, Jeff M Slezak, Laura Puzniak, Vennis Hong, Timothy B Frankland, Bradley K Ackerson, Fagen Xie, Harpreet Takhar, Oluwaseye A Ogun, Sarah Simmons, Joann M Zamparo, Srinivas R Valluri, Luis Jodar, John M McLaughlin
Lancet Respiratory Medicine, 28.11.2023
Tilføjet 28.11.2023
By mid-April, 2023, individuals previously vaccinated only with wild-type vaccines had little protection against COVID-19—including hospital admission. A BNT162b2 BA.4/5 bivalent booster restored protection against a range of COVID-19 outcomes, including against XBB-related sublineages, with the most substantial protection observed against hospital admission and critical illness.
Læs mere Tjek på PubMedSarah L Gorst, Nina Seylanova, Susanna R Dodd, Nicola L Harman, Margaret O'Hara, Caroline B Terwee, Paula R Williamson, Dale M Needham, Daniel Munblit, Timothy R Nicholson, PC-COS study group
Lancet Respiratory Medicine, 28.11.2023
Tilføjet 28.11.2023
Post-COVID-19 condition (also known as long COVID) is a new, complex, and poorly understood disorder. A core outcome set (COS) for post-COVID-19 condition in adults has been developed and agreement is now required on the most appropriate measurement instruments for these core outcomes. We conducted an international consensus study involving multidisciplinary experts and people with lived experience of long COVID. The study comprised a literature review to identify measurement instruments for the core outcomes, a three-round online modified Delphi process, and an online consensus meeting to generate a core outcome measurement set (COMS).
Læs mere Tjek på PubMedRaymond Duch, Edward Asiedu, Ryota Nakamura, Thomas Rouyard, Alberto Mayol, Adrian Barnett, Laurence Roope, Mara Violato, Dorcas Sowah, Piotr Kotlarz, Philip Clarke
Nature, 28.11.2023
Tilføjet 28.11.2023
Stella Iacovides, Shane K. Maloney, Sindeep Bhana, Zareena Angamia, Rebecca M. Meiring
PLoS One Infectious Diseases, 28.11.2023
Tilføjet 28.11.2023
by Stella Iacovides, Shane K. Maloney, Sindeep Bhana, Zareena Angamia, Rebecca M. Meiring
Læs mere Tjek på PubMedMuntequa Imtiaz Siraji, Ahnaf Akif Rahman, Mirza Muntasir Nishat, Md Abdullah Al Mamun, Fahim Faisal, Lamim Ibtisam Khalid, Ashik Ahmed
PLoS One Infectious Diseases, 28.11.2023
Tilføjet 28.11.2023
by Muntequa Imtiaz Siraji, Ahnaf Akif Rahman, Mirza Muntasir Nishat, Md Abdullah Al Mamun, Fahim Faisal, Lamim Ibtisam Khalid, Ashik Ahmed Depression is a psychological state of mind that often influences a person in an unfavorable manner. While it can occur in people of all ages, students are especially vulnerable to it throughout their academic careers. Beginning in 2020, the COVID-19 epidemic caused major problems in people’s lives by driving them into quarantine and forcing them to be connected continually with mobile devices, such that mobile connectivity became the new norm during the pandemic and beyond. This situation is further accelerated for students as universities move towards a blended learning mode. In these circumstances, monitoring student mental health in terms of mobile and Internet connectivity is crucial for their wellbeing. This study focuses on students attending an International University of Bangladesh to investigate their mental health due to their continual use of mobile devices (e.g., smartphones, tablets, laptops etc.). A cross-sectional survey method was employed to collect data from 444 participants. Following the exploratory data analysis, eight machine learning (ML) algorithms were used to develop an automated normal-to-extreme severe depression identification and classification system. When the automated detection was incorporated with feature selection such as Chi-square test and Recursive Feature Elimination (RFE), about 3 to 5% increase in accuracy was observed by the method. Similarly, a 5 to 15% increase in accuracy has been observed when a feature extraction method such as Principal Component Analysis (PCA) was performed. Also, the SparsePCA feature extraction technique in combination with the CatBoost classifier showed the best results in terms of accuracy, F1-score, and ROC-AUC. The data analysis revealed no sign of depression in about 44% of the total participants. About 25% of students showed mild-to-moderate and 31% of students showed severe-to-extreme signs of depression. The results suggest that ML models, incorporating a proper feature engineering method can serve adequately in multi-stage depression detection among the students. This model might be utilized in other disciplines for detecting early signs of depression among people.
Læs mere Tjek på PubMedMalaria Journal, 28.11.2023
Tilføjet 28.11.2023
Abstract Background Coronavirus disease 2019 (COVID-19) pandemic affected malaria control activities in sub-Saharan Africa (SSA) resulting in 690,000 excess deaths in the year 2021. The authors hypothesized that COVID-19 affected the World Health Organization (WHO) Test, Treat and Track (T3) strategy that has been implemented in Uganda since 2010. In this study, health worker’s adherence to the T3 strategy during COVID-19 pandemic in Eastern Uganda was studied by assessing their knowledge, skills and practices. Methods A cross-sectional study utilizing mixed quantitative and qualitative data collections methods was conducted at Mbale Regional Referral Hospital in Eastern Uganda between November and December in 2020. Data were captured on demographics, knowledge, skills and practices for both health workers (HWs) and patients. Quantitative data were analysed using STATA 15.0 and reported as descriptive statistics, proportions and statistical associations. Moreover, qualitative data were collected via key informant interviews (KII) among purposively sampled study participants and analysed thematically using NVIVO software. Ethical approval was obtained prior to the study. Results A total of 436 study participants, of whom 103/436 (24%) and 333/436 (76%) were HWs and patients, respectively were studied. Among the HWs with mean age of 34 years (SD = 8.8 years), 81/103 (79%) had good practices, most 63/103 (61%) had good knowledge, and only 11/103 (10.7%) had good skills. Specifically, on the cadres, the laboratory personnel 19/103 (18%) had good knowledge 14/19 (74%) OR: 2.0 (95% CI 0.7–6) and were highly skilled OR: 4.6 (95% CI 1.2—18.1; P
Læs mere Tjek på PubMedJulio Flores-Gonzalez, Leslie Chavez-Galan, Ramcés Falfán-Valencia, Ivette Buendía Roldán, Ingrid Fricke-Galindo, Abigail Veronica-Aguilar, Alfonso Martínez-Morales, Rafael de Jesús Hernández-Zenteno, Iris Paola Guzmán-Guzmán, Gloria Pérez-Rubio
International Journal of Infectious Diseases, 27.11.2023
Tilføjet 27.11.2023
COVID-19 patients display a broad clinical spectrum, from asymptomatic infections to critical [1, 2]; the pathophysiology that explains these differences between individuals needs to be clarified. Some authors focus on the innate immune response that acts as the first line of defense against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), sensing the virus through pattern recognition receptors (PRR) like Toll-like receptors (TLR) and activating inflammatory pathways that promote viral clearance [3].
Læs mere Tjek på PubMedMichinobu Yoshimura, Atsuhiko Sakamoto, Ryo Ozuru, Yusuke Kurihara, Ryota Itoh, Kazunari Ishii, Akinori Shimizu, Bin Chou, Shigeki Nabeshima, Kenji Hiromatsu
International Journal of Infectious Diseases, 27.11.2023
Tilføjet 27.11.2023
Although it has been reported that repeated boosting with mRNA-based COVID-19 vaccines has been protective [1], some concerns about repeated vaccination of mRNA-based COVID-19 vaccines have emerged. Repeated vaccination with COVID-19 vaccines back-boosts previous memory and dampens the immune response to a new antigenically related but distinct virus strain, so-called vaccine-induced immune imprinting or original antigenic sin [2]. It has been also reported that the class switches toward noninflammatory, spike-specific IgG4 antibodies (Ab) after repeated SARS-CoV-2 mRNA-type vaccination [3-5].
Læs mere Tjek på PubMedAnahita Mostaghim, Samuel Minkove, Juan Aguilar-Company, Isabel Ruiz-Camps, Simeon Eremiev-Eremiev, Gino M Dettorre, Laura Fox, Carlo Tondini, Joan Brunet, MCarmen Carmona-García, Matteo Lambertini, Mark Bower, Thomas Newsom-Davis, Rachel Sharkey, Alessia Dalla Pria, Maura Rossi, Andrea Plaja, Ramon Salazar, Anna Sureda, Aleix Prat, Vasiliki Michalarea, Mieke Van Hemelrijck, Ailsa Sita-Lumsden, Alexia Bertuzzi, Lorenza Rimassa, Sabrina Rossi, Gianpiero Rizzo, Paolo Pedrazzoli, Alvin JX Lee, Cian Murphy, Katherine Belessiotis, Nikolaos Diamantis, Uma Mukherjee, Fanny Pommeret, Annabelle Stoclin, Clara Martinez-Vila, Riccardo Bruna, Gianluca Gaidano, Francesca D'Avanzo, Alessandra Gennari, Janhavi Athale, Peter Eichacker, David J. Pinato, Parizad Torabi-Parizi, Alessio Cortellini, OnCovid study group.
International Journal of Infectious Diseases, 27.11.2023
Tilføjet 27.11.2023
Immune checkpoint inhibitor (ICI) use steadily increased since early reports describing marked efficacy [1]. They are now a mainstay treatment of several cancer types. Since the start of the SARS-CoV-2 pandemic, questions persisted of whether and how immune enhancing properties of ICIs impact outcomes in cancer patients with Coronavirus Disease 2019 (COVID-19) [2-4]. In particular, considering the cytokine-release syndrome (CRS) as the major event driving the deranged immune response underlying severe COVID-19, the major concerns were related to the possible exacerbating effect of cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed death-1 / programmed death ligand-1 (PD-1/PD-L1) checkpoint inhibitors [5].
Læs mere Tjek på PubMedClaudia Tandler, Jonas S. Heitmann, Tanja M. Michel, Maddalena Marconato, Simon U. Jaeger, Christian M. Tegeler, Monika Denk, Marion Richter, Melek Tutku Oezbek, Yacine Maringer, Sarah M. Schroeder, Nicole Schneiderhan-Marra, Karl-Heinz Wiesmüller, Michael Bitzer, Natalia Ruetalo, Michael Schindler, Christoph Meisner, Imma Fischer, Hans-Georg Rammensee, Helmut R. Salih, Juliane S. Walz
International Journal of Infectious Diseases, 26.11.2023
Tilføjet 26.11.2023
During the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), different vaccines have been successfully developed [1-3]. Although neutralizing antibodies provide the first line of antiviral defense [4, 5], spike-specific antibody titers tend to wane quickly and show limited neutralizing activity against newly arising variants of concern (VOCs) [6]. In contrast, T cells were shown to mediate long-term immunity that is largely conserved against VOCs after SARS-CoV-2 infection and vaccination [4, 7].
Læs mere Tjek på PubMedInfection, 26.11.2023
Tilføjet 26.11.2023
Abstract Purpose The COVID-19 pandemic caused by the novel Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) has put the world in a medical crisis for the past three years; nearly 6.3 million lives have been diminished due to the virus outbreak. This review aims to update the recent findings on COVID-19 infections from an epigenetic scenario and develop future perspectives of epi-drugs to treat the disease. Methods Original research articles and review studies related to COVID-19 were searched and analyzed from the Google Scholar/PubMed/Medline databases mainly between 2019 and 2022 to brief the recent work. Results Numerous in-depth studies of the mechanisms used by SARS-CoV-2 have been going on to minimize the consequences of the viral outburst. Angiotensin-Converting Enzyme 2 receptors and Transmembrane serine protease 2 facilitate viral entry to the host cells. Upon internalization, it uses the host machinery to replicate viral copies and alter the downstream regulation of the normal cells, causing infection-related morbidities and mortalities. In addition, several epigenetic regulations such as DNA methylation, acetylation, histone modifications, microRNA, and other factors (age, sex, etc.) are responsible for the regulations of viral entry, its immune evasion, and cytokine responses also play a major modulatory role in COVID-19 severity, which has been discussed in detail in this review. Conclusion Findings of epigenetic regulation of viral pathogenicity open a new window for epi-drugs as a possible therapeutical approach against COVID-19.
Læs mere Tjek på PubMedInfection, 26.11.2023
Tilføjet 26.11.2023
Abstract Purpose We aimed to assess symptoms in patients after SARS-CoV-2 infection and to identify factors predicting prolonged time to symptom-free. Methods COVIDOM/NAPKON-POP is a population-based prospective cohort of adults whose first on-site visits were scheduled ≥ 6 months after a positive SARS-CoV-2 PCR test. Retrospective data including self-reported symptoms and time to symptom-free were collected during the survey before a site visit. In the survival analyses, being symptom-free served as the event and time to be symptom-free as the time variable. Data were visualized with Kaplan–Meier curves, differences were tested with log-rank tests. A stratified Cox proportional hazard model was used to estimate adjusted hazard ratios (aHRs) of predictors, with aHR
Læs mere Tjek på PubMedBMC Infectious Diseases, 26.11.2023
Tilføjet 26.11.2023
Abstract Introduction COVID-19 induced cytokine storm is a well-documented phenomena that contributes significantly in the disease’s evolution and prognosis. Therefore, therapies such as therapeutic plasma exchange, constitute a mainstay of therapeutic management especially for critically-ill patients. Methods We conducted a monocentric retrospective cohort study in the Resuscitation Department of the Mohammed VI University Hospital of Oujda-Morocco, to evaluate the efficiency of therapeutic plasma exchange on critically-ill COVID-19 patients over a 6 months period. We divided our patients into two groups: patients who received TPE (Therapeutic Plasma Exchange) sessions (TPE group) and patients who only benefited from the standard protocol treatment (non TPE group). Results Our study included a total of 165 patients, 34.5% of which benefited from TPE sessions. We observed an improvement of oxygenation parameters (SpO2 and PaO2/FiO2 ratio) and a progressive respiratory weaning, as well as a significant decrease of biomarkers indicative of inflammation (lymphocyte count, CRP (C Reactive Protein), IL-6, Ferritin) and coagulopathy (d-dimers, fibrinogen) in the TPE group after 5 consecutive TPE sessions. In comparison with the non-TPE group, The TPE-group patients had a shorter ICU (Intensive Care Unit) length of stay, required less frequently mechanical ventilation, and we more likely to be extubated. Furthermore, the TPE group had a lower mortality rate. Discussion Multiple studies have reported the safety and efficiency of therapeutic plasma exchange in the COVID-19 induced cytokine storm. Given the urgent character of the pandemic at the time, each center followed its own protocol in implementing plasma exchange. Conclusion Similar to the results reported in the literature, our study reports positive results after using TPE specifically in terms of respiratory weaning and an improvement of the cytokine storm biomarkers, and more importantly a lower mortality rate.
Læs mere Tjek på PubMedBMC Infectious Diseases, 26.11.2023
Tilføjet 26.11.2023
Abstract With the SARS-CoV-2 pandemic, the impact of recent coronavirus, especially in children, cannot be ignored. In this study, we evaluated the SARS-CoV-2 infection rates and associated features in children less than 18 years of age in “Fars” and “Kohgiluyeh and Boyer Ahmad”, provinces, Iran. 5943 children who were suspected cases to SARS-CoV-2 infection were enrolled in this study. Demographic and clinical data of SARS-CoV-2 patients were collected from 16 February 2020 to 20 June 2021. Underlying conditions were considered in this study as well. Among 5943 patients suspected COVID 19 cases, 13.51% were confirmed by real-time PCR assay. The female/male ratio was 1:1.3 with a mean age of 5.71 years. 11.2% of confirmed patients were transferred and admitted in Pediatric ICU. COVID 19 was significantly higher in children with malignancy and diabetes rather than those with other underlying diseases. Children of all ages were susceptible to COVID 19, and there is no significant difference between both sexes. Most of the COVID 19 cases were in 10–18 years old group. Among a number of children with different underlying diseases, children with malignancy had the highest rate of SARS-CoV-2 infection, followed by those with diabetes.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
AbstractBackgroundHigh-risk patients, often immunocompromised and not responding to vaccine, continue to experience severe COVID-19 and death. Monoclonal antibodies (mAbs) were shown effective to prevent severe COVID-19 for these patients. Nevertheless, concerns about the emergence of resistance mutations were raised.MethodsWe conducted a multicentric prospective cohort study, including 264 patients with mild-to moderate COVID-19 at high risk for progression to severe COVID-19 and treated early with Casirivimab/Imdevimab, Sotrovimab or Tixagevimab/Cilgavimab. We sequenced the SARS-CoV-2 genome during follow-up and searched for emerging Spike mutations.ResultsImmunocompromised patients have a 6-fold increased risk of developing mutations, which are associated with a prolonged duration of viral clearance but no clinical worsening. Emerging P337S/R/L/H, E340D/K/A/Q/V/G and K356T/R substitutions in patients treated with Sotrovimab are associated with higher viral RNA loads for up to 14 days post-treatment initiation. Tixagevimab/Cilgavimab is associated with a 5-fold increased risk of developing mutations. R346K/I/T/S and K444R/N/M substitutions associated with Tixagevimab/Cilgavimab have been identified in multiple SARS-CoV-2 lineages, including BQ.1 and XBB.ConclusionsIn conclusion, the probability of emerging mutations arising in response to mAbs is significant, emphasizing the crucial need to investigate these mutations thoroughly and assess their impact on patients and the evolutionary trajectory of the SARS-CoV-2.
Læs mere Tjek på PubMedXueying Yang, Jiajia Zhang, Ziang Liu, Shujie Chen, Bankole Olatosi, Gregory A. Poland, Sharon Weissman, Xiaoming Li
International Journal of Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
The remarkable efficacy of COVID-19 vaccines was observed in both large, randomized-controlled US clinical trials and real-world settings,[1, 2] where four vaccines were found to be safe and efficacious in preventing symptomatic COVID-19. Despite the high level of vaccine efficacy, antibody waning occurs such that a small percentage of fully vaccinated persons (i.e., received all recommended doses of an FDA-authorized COVID-19 vaccine) will develop symptomatic or asymptomatic infection with SARS-CoV-2,[3] which are often referred to as COVID-19 vaccine breakthrough infections (hereafter as “breakthrough infections”).
Læs mere Tjek på PubMedAnnalan MD Navaratnam, Christopher O'Callaghan, Sarah Beale, Vincent Nguyen, Anna Aryee, Isobel Braithwaite, Thomas E Byrne, Wing Lam Erica Fong, Ellen Fragaszy, Cyril Geismar, Susan Hoskins, Jana Kovar, Parth Patel, Madhumita Shrotri, Sophie Weber, Alexei Yavlinsky, Robert W Aldridge, Andrew C Hayward, Virus Watch Collaborative
International Journal of Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
Respiratory viruses infect individuals via the nose, mouth and eyes, through contact with surfaces touched by the individual or via small and larger (i.e. droplet) aerosol particles.[1] Recommendations for the protection of the general public in most countries include social distancing, handwashing and face mask use but not eye protection. In the UK eye protection (including full face visors or goggles) is recommended in healthcare settings if blood or body fluid contamination to the eyes or face is anticipated or likely.
Læs mere Tjek på PubMedWu, J., Qiu, L., Xiong, W., Shen, Y., Li, J., Wu, J., Zhou, Q.
BMJ Open, 25.11.2023
Tilføjet 25.11.2023
ObjectivesTo explore the prevalence and associated factors of COVID-19 anxiety in patients with late-life depression (LLD) during the adjustment of epidemic prevention policies in China. DesignCross-sectional study. SettingThe data analysed in this study were collected from seven regions in China between November 2022 and January 2023. ParticipantsA total of 1205 patients with LLD (aged 60–78 years) participated in the survey. They completed a social demographic assessment and the Chinese version of the five-point Coronavirus Anxiety Scale (CAS). Primary outcome measuresThe primary outcome was the anxiety level of the participants. Patients were categorised into two groups based on their anxiety levels, one with anxiety and one without, according to CAS scores. ResultsThe prevalence of COVID-19 anxiety in depressed older adults was 47.3%. Regression analysis revealed that the average COVID-19 anxiety score was significantly higher among females (AOR: 2.177, 95% CI 1.201 to 3.947), widowed individuals (AOR: 3.015, 95% CI 1.379 to 6.591), patients residing at a distance from healthcare facilities (AOR: 3.765, 95% CI 1.906 to 7.438), and those who frequently experienced worry (AOR: 1.984, 95% CI 1.111 to 3.543). Conversely, the anxiety score was significantly lower among divorced individuals (AOR: 0.491, 95% CI 0.245 to 0.988), those aged 70 years and above (AOR: 0.117, 95% CI 0.064 to 0.213), patients without difficulty obtaining medication (AOR: 0.027, 95% CI 0.007 to 0.097), those living with family members (AOR: 0.080, 95% CI 0.022 to 0.282) or in nursing homes compared with those living alone (AOR: 0.019, 95% CI 0.004 to 0.087). ConclusionWomen with LLD who are widowed, live far from healthcare facilities, and are prone to excessive worry are more likely to experience anxiety. It is advisable to implement appropriate preventive measures and provide psychosocial support programmes for this vulnerable group during the COVID-19 pandemic.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
Abstract Introduction Severe forms of COVID-19 are more common in patients with abnormal fat distribution, particularly high visceral adiposity. The patient’s muscle strength may be reduced during the acute phase of the infection. Electrical bioimpedance (BIA) is a non-invasive method for measuring body compartments and estimating visceral fat area (VFA) that can be used at the bedside. Objective To assess the association between several body composition parameters, primarily high adipose tissue and high VFA, in patients with and without a diagnosis of COVID-19 infection, and whether it worsened the severity parameters. Methods This retrospective cohort study was conducted in a private hospital in the city of São Paulo from March 2020 to August 2021. The demographic and clinical data was collected from medical reports. Body composition is assessed using the InBODY® model S10 bioelectrical impedance device and a Jamar® digital hydraulic manual dynamometer with a scale from 0 to 90 kg is used to measure handgrip strength (HGS). Results A total of 96 patients with a mean age of 69.1 years (SD 15) were divided into two groups of 48 individuals, with and without COVID-19 infection. Body mass index (odds ratio [OR]: 4.47, 95% confidence interval [CI]: 1.69, 11.83), fat mass (OR: 2.03, 95% CI: 0.48, 8.55), and VFA (OR: 1.08, 95% CI: 0.33, 3.53) were all higher in the infection group. When COVID-19 patients were evaluated, those with higher VFA had longer hospital stays (OR: 0.99, 95% CI: 0.97, 1.01) and used more vasoactive drugs (p = 0.043). Patients with COVID-19 with poor handgrip strength were 3.29 times more likely to require a prolonged intensive care unit (ICU) stay. Conclusion The study concluded that excess weight and body fat are significantly associated with COVID-19 involvement, but the severity is primarily related to a greater area of visceral fat. The use of bioimpedance for visceral fat measurement was effective, as it is a simple method performed in the hospital setting that does not require the use of radiation.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
Abstract Introduction Severe forms of COVID-19 are more common in patients with abnormal fat distribution, particularly high visceral adiposity. The patient’s muscle strength may be reduced during the acute phase of the infection. Electrical bioimpedance (BIA) is a non-invasive method for measuring body compartments and estimating visceral fat area (VFA) that can be used at the bedside. Objective To assess the association between several body composition parameters, primarily high adipose tissue and high VFA, in patients with and without a diagnosis of COVID-19 infection, and whether it worsened the severity parameters. Methods This retrospective cohort study was conducted in a private hospital in the city of São Paulo from March 2020 to August 2021. The demographic and clinical data was collected from medical reports. Body composition is assessed using the InBODY® model S10 bioelectrical impedance device and a Jamar® digital hydraulic manual dynamometer with a scale from 0 to 90 kg is used to measure handgrip strength (HGS). Results A total of 96 patients with a mean age of 69.1 years (SD 15) were divided into two groups of 48 individuals, with and without COVID-19 infection. Body mass index (odds ratio [OR]: 4.47, 95% confidence interval [CI]: 1.69, 11.83), fat mass (OR: 2.03, 95% CI: 0.48, 8.55), and VFA (OR: 1.08, 95% CI: 0.33, 3.53) were all higher in the infection group. When COVID-19 patients were evaluated, those with higher VFA had longer hospital stays (OR: 0.99, 95% CI: 0.97, 1.01) and used more vasoactive drugs (p = 0.043). Patients with COVID-19 with poor handgrip strength were 3.29 times more likely to require a prolonged intensive care unit (ICU) stay. Conclusion The study concluded that excess weight and body fat are significantly associated with COVID-19 involvement, but the severity is primarily related to a greater area of visceral fat. The use of bioimpedance for visceral fat measurement was effective, as it is a simple method performed in the hospital setting that does not require the use of radiation.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
Abstract Background The declaration of SARS-CoV-2 as a public health emergency of international concern in January 2020 prompted the need to strengthen infection prevention and control (IPC) capacities within health care facilities (HCF). IPC guidelines, with standard and transmission-based precautions to be put in place to prevent the spread of SARS-CoV-2 at these HCFs were developed. Based on these IPC guidelines, a rapid assessment scorecard tool, with 14 components, to enhance assessment and improvement of IPC measures at HCFs was developed. This study assessed the level of implementation of the IPC measures in HCFs across the African Region during the COVID-19 pandemic. Method An observational study was conducted from April 2020 to November 2022 in 17 countries in the African Region to monitor the progress made in implementing IPC standard and transmission-based precautions in primary-, secondary- and tertiary-level HCFs. A total of 5168 primary, secondary and tertiary HCFs were assessed. The HCFs were assessed and scored each component of the tool. Statistical analyses were done using R (version 4.2.0). Results A total of 11 564 assessments were conducted in 5153 HCFs, giving an average of 2.2 assessments per HCF. The baseline median score for the facility assessments was 60.2%. Tertiary HCFs and those dedicated to COVID-19 patients had the highest IPC scores. Tertiary-level HCFs had a median score of 70%, secondary-level HCFs 62.3% and primary-level HCFs 56.8%. HCFs dedicated to COVID-19 patients had the highest scores, with a median of 68.2%, followed by the mixed facilities that attended to both COVID-19 and non-COVID-19 patients, with 64.84%. On the components, there was a strong correlation between high IPC assessment scores and the presence of IPC focal points in HCFs, the availability of IPC guidelines in HCFs and HCFs that had all their health workers trained in basic IPC. Conclusion In conclusion, a functional IPC programme with a dedicated focal person is a prerequisite for implementing improved IPC measures at the HCF level. In the absence of an epidemic, the general IPC standards in HCFs are low, as evidenced by the low scores in the non-COVID-19 treatment centres.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
Abstract Background The declaration of SARS-CoV-2 as a public health emergency of international concern in January 2020 prompted the need to strengthen infection prevention and control (IPC) capacities within health care facilities (HCF). IPC guidelines, with standard and transmission-based precautions to be put in place to prevent the spread of SARS-CoV-2 at these HCFs were developed. Based on these IPC guidelines, a rapid assessment scorecard tool, with 14 components, to enhance assessment and improvement of IPC measures at HCFs was developed. This study assessed the level of implementation of the IPC measures in HCFs across the African Region during the COVID-19 pandemic. Method An observational study was conducted from April 2020 to November 2022 in 17 countries in the African Region to monitor the progress made in implementing IPC standard and transmission-based precautions in primary-, secondary- and tertiary-level HCFs. A total of 5168 primary, secondary and tertiary HCFs were assessed. The HCFs were assessed and scored each component of the tool. Statistical analyses were done using R (version 4.2.0). Results A total of 11 564 assessments were conducted in 5153 HCFs, giving an average of 2.2 assessments per HCF. The baseline median score for the facility assessments was 60.2%. Tertiary HCFs and those dedicated to COVID-19 patients had the highest IPC scores. Tertiary-level HCFs had a median score of 70%, secondary-level HCFs 62.3% and primary-level HCFs 56.8%. HCFs dedicated to COVID-19 patients had the highest scores, with a median of 68.2%, followed by the mixed facilities that attended to both COVID-19 and non-COVID-19 patients, with 64.84%. On the components, there was a strong correlation between high IPC assessment scores and the presence of IPC focal points in HCFs, the availability of IPC guidelines in HCFs and HCFs that had all their health workers trained in basic IPC. Conclusion In conclusion, a functional IPC programme with a dedicated focal person is a prerequisite for implementing improved IPC measures at the HCF level. In the absence of an epidemic, the general IPC standards in HCFs are low, as evidenced by the low scores in the non-COVID-19 treatment centres.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
Abstract Background A test-based strategy against coronavirus disease 2019 (COVID-19) is one of the measures to assess the need for isolation and prevention of infection. However, testing with high sensitivity methods, such as quantitative RT-PCR, leads to unnecessary isolation, whereas the lateral flow antigen test shows low sensitivity and false negative results. The purpose of this study was to evaluate the performance of the LumiraDx SARS-CoV-2 Ag test (Lumira Ag), a rapid microfluidic immunofluorescence method, in assessing infectivity. Methods This study was performed from March 2022 to July 2022. A pair of nasopharyngeal swab samples were obtained from each patient with mild COVID-19. One swab was used for Lumira Ag testing, and the other for quantitative RT-PCR testing and virus culture. Results A total of 84 patients were included in the study. Among them, PCR, Lumira Ag test, and virus culture indicated positivity for 82, 66, and 24 patients, respectively. When comparing the Lumira Ag test to virus culture, its sensitivity was 100.0% (24/24), specificity, 30.0% (18/60); positive predictive value, 36.3% (24/66); and negative predictive value (NPV), 100.0% (18/18). The positive sample for virus culture was observed until the ninth day from the onset of symptoms, while the Lumira Ag test was observed until day 11. Conclusions The Lumira Ag test showed high sensitivity and NPV (100% each) compared to virus culture. A test-based strategy using the Lumira Ag test can effectively exclude COVID-19 infectiousness.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.11.2023
Tilføjet 25.11.2023
Abstract Background A test-based strategy against coronavirus disease 2019 (COVID-19) is one of the measures to assess the need for isolation and prevention of infection. However, testing with high sensitivity methods, such as quantitative RT-PCR, leads to unnecessary isolation, whereas the lateral flow antigen test shows low sensitivity and false negative results. The purpose of this study was to evaluate the performance of the LumiraDx SARS-CoV-2 Ag test (Lumira Ag), a rapid microfluidic immunofluorescence method, in assessing infectivity. Methods This study was performed from March 2022 to July 2022. A pair of nasopharyngeal swab samples were obtained from each patient with mild COVID-19. One swab was used for Lumira Ag testing, and the other for quantitative RT-PCR testing and virus culture. Results A total of 84 patients were included in the study. Among them, PCR, Lumira Ag test, and virus culture indicated positivity for 82, 66, and 24 patients, respectively. When comparing the Lumira Ag test to virus culture, its sensitivity was 100.0% (24/24), specificity, 30.0% (18/60); positive predictive value, 36.3% (24/66); and negative predictive value (NPV), 100.0% (18/18). The positive sample for virus culture was observed until the ninth day from the onset of symptoms, while the Lumira Ag test was observed until day 11. Conclusions The Lumira Ag test showed high sensitivity and NPV (100% each) compared to virus culture. A test-based strategy using the Lumira Ag test can effectively exclude COVID-19 infectiousness.
Læs mere Tjek på PubMedFilip, Iulia
AIDS, 24.11.2023
Tilføjet 24.11.2023
Tomkow, L., Prager, G., Drinkwater, J., Morris, R. L., Farrington, R.
BMJ Open, 24.11.2023
Tilføjet 24.11.2023
ObjectivesThe inadequate provision of language interpretation for people with limited English proficiency (LEP) is a determinant of poor health, yet interpreters are underused. This research explores the experiences of National Health Service (NHS) staff providing primary care for people seeking asylum, housed in contingency accommodation during COVID-19. This group often have LEP and face multiple additional barriers to healthcare access. Language discrimination is used as a theoretical framework. The potential utility of this concept is explored as a way of understanding and addressing inequities in care. DesignQualitative research using semistructured interviews and inductive thematic analysis. SettingAn NHS primary care service for people seeking asylum based in contingency accommodation during COVID-19 housing superdiverse residents speaking a wide spectrum of languages. ParticipantsTen staff including doctors, nurses, mental health practitioners, healthcare assistants and students participated in semistructured online interviews. Some staff were redeployed to this work due to the pandemic. ResultsAll interviewees described patients’ LEP as significant. Inadequate provision of interpretation services impacted the staff’s ability to provide care and compromised patient safety. Discrimination, such as that based on migration status, was recognised and challenged by staff. However, inequity based on language was not articulated as discrimination. Instead, insufficient and substandard interpretation was accepted as the status quo and workarounds used, such as gesticulating or translation phone apps. The theoretical lens of language discrimination shows how this propagates existing social hierarchies and further disadvantages those with LEP. ConclusionsThis research provides empirical evidence of how the inadequate provision of interpreters forces the hand of healthcare staff to use shortcuts. Although this innovative ‘tinkering’ allows staff to get the job done, it risks normalising structural gaps in care provision for people with LEP. Policy-makers must rethink their approach to interpretation provision which prioritises costs over quality. We assert that the concept of language discrimination is a valuable framework for clinicians to better identify and articulate unfair treatment on the grounds of LEP.
Læs mere Tjek på PubMedPius, R. E., Ajuluchukwu, J. N., Roberts, A. A.
BMJ Open, 24.11.2023
Tilføjet 24.11.2023
IntroductionPhysician burn-out was an issue before the pandemic. Medical personnel have faced several clinical and non-clinical challenges because of the novel coronavirus (SARS-CoV-2) pandemic, which predisposes them to burn-out. There is a paucity of studies that shed light on the level of burn-out and its association with work-related factors for Nigerian medical doctors. This study aims to examine the level of burn-out among Nigerian medical doctors during the COVID-19 pandemic and explore possible associations between burn-out and sociodemographic, work-related and COVID-19-related factors. MethodologyA cross-sectional study was conducted among 251 medical doctors in a tertiary hospital in Nigeria. A questionnaire was used to obtain sociodemographic history, work-associated factors, COVID-19-related parameters and burn-out history. Personal, work-related and patient-related burn-out were evaluated with the use of the Copenhagen Burnout Inventory. ResultsThe number of doctors enrolled in this study was 251 with a median age of 34; 51.4% were males. The percentage of doctors who had personal, work-related and patient-related burn-out were 62.2%, 52.2 % and 27.5%, respectively. The univariate analysis revealed a correlation between burn-out scores and cadre, age, sex, years of experience, marital status, weekly work hours and number of calls. After multiple regression, female gender (p=0.012), those with less than 6 years of work experience (p=0.004) and those working for at least 71 hours in a week (p=0.0001) remained correlated with higher burn-out scores. Additionally, physicians who had a person with COVID-19 in their immediate environment had an independent correlation with higher work-related burn-out scores (p=0.043). ConclusionThe prevalence of burn-out is high among Nigerian doctors and is linked to some sociodemographic, work-related and COVID-19-related factors. Due to the adverse effects of burn-out on physician well-being and patient care, strategies need to be put in place to identify and mitigate burn-out among Nigerian physicians.
Læs mere Tjek på PubMedBMC Infectious Diseases, 24.11.2023
Tilføjet 24.11.2023
BMC Infectious Diseases, 23.11.2023
Tilføjet 23.11.2023
Abstract Cross-reactive cellular and humoral immunity can substantially contribute to antiviral defense against SARS-CoV-2 variants of concern (VOC). While the adult SARS-CoV-2 cellular and humoral immunity and its cross-recognition potential against VOC is broadly analyzed, similar data regarding the pediatric population are missing. In this study, we perform an analysis of the humoral and cellular SARS-CoV-2 response immune of 32 convalescent COVID-19 children (children), 27 convalescent vaccinated adults(C + V+) and 7 unvaccinated convalescent adults (C + V-). Similarly to adults, a significant reduction of cross-reactive neutralizing capacity against delta and omicron VOC was observed 6 months after SARS-CoV-2 infection. While SAR-CoV-2 neutralizing capacity was comparable among children and C + V- against all VOC, children demonstrated as expected an inferior humoral response when compared to C + V+. Nevertheless, children generated SARS-CoV-2 reactive T cells with broad cross-recognition potential. When compared to V + C+, children presented even comparable frequencies of WT-reactive CD4 + and CD8 + T cells with high avidity and functionality. Taking into consideration the limitations of study - unknown disease onset for 53% of the asymptomatic pediatric subjects, serological detection of SARS-CoV-2 infection-, our results suggest that following SARS-CoV-2 infection children generate a humoral SARS-CoV-2 response with neutralizing potential comparable to unvaccinated COVID-19 convalescent adults as well a sustained SARS-CoV-2 cellular response cross-reactive to VOC.
Læs mere Tjek på PubMedXiaohong Fan, Xiahong Dai, Yun Ling, Lihua Wu, Lingling Tang, Chunxian Peng, Chaolin Huang, Hongyan Liu, Hongzhou Lu, Xinghua Shen, Wei Zhang, Furong Wang, Guangming Li, Ming Li, Yanming Huang, Hongying Zhang, Minghui Li, Fei Ren, Yuanyuan Li, Chenfan Liu, Zhiguo Zhou, Wei Sun, Yongxiang Yi, Daming Zhou, Hainv Gao, Qi Pan, Hongde Liu, Jiang Zhao, Zhen Ding, Yingmin Ma, Wei Li, Quanhong Wang, Xicheng Wang, Yichun Bai, Xiangao Jiang, Juan Ma, Bingying Xie, Kui Zhang, Lanjuan Li
Lancet Infectious Diseases, 23.11.2023
Tilføjet 23.11.2023
Among patients with mild-to-moderate COVID-19, VV116 significantly reduced the time to sustained clinical symptom resolution compared with placebo, with no observed safety concerns.
Læs mere Tjek på PubMedSamar Fatima, Madiha Ismail, Taymmia Ejaz, Zarnain Shah, Summaya Fatima, Mohammad Shahzaib, Hassan Masood Jafri
PLoS One Infectious Diseases, 22.11.2023
Tilføjet 22.11.2023
by Samar Fatima, Madiha Ismail, Taymmia Ejaz, Zarnain Shah, Summaya Fatima, Mohammad Shahzaib, Hassan Masood Jafri Objective There is a lack of estimates regarding the at-risk population associated with long COVID in Pakistan due to the absence of prospective longitudinal studies. This study aimed to determine the prevalence of long COVID and its association with disease severity and vaccination status of the patient. Design and data sources This prospective cohort study was conducted at the Aga Khan University Hospital and recruited patients aged > 18 years who were admitted between February 1 and June 7, 2021. During this time, 901 individuals were admitted, after excluding patients with missing data, a total of 481 confirmed cases were enrolled. Results The mean age of the study population was 56.9±14.3 years. Among patients with known vaccination status (n = 474), 19%(n = 90) and 19.2%(n = 91) were fully and partially vaccinated, respectively. Severe/critical disease was present in 64%(n = 312). The mortality rate following discharge was 4.58%(n = 22). Around 18.9%(n = 91) of the population required readmission to the hospital, with respiratory failure (31.8%, n = 29) as the leading cause. Long COVID symptoms were present in 29.9%(n = 144), and these symptoms were more prevalent in the severe/critical (35.5%, n = 111) and unvaccinated (37.9%, n = 105) cohort. The most prominent symptoms were fatigue (26.2%, n = 126) and shortness of breath (24.1%, n = 116), followed by cough (15.2%, n = 73). Vaccinated as compared to unvaccinated patients had lower readmissions (13.8% vs. 21.51%) and post-COVID pulmonary complications (15.4% vs. 24.2%). On multivariable analysis, after adjusting for age, gender, co-morbidity, and disease severity, lack of vaccination was found to be an independent predictor of long COVID with an Odds ratio of 2.42(95% CI 1.52–3.84). Fully and partially vaccinated patients had 62% and 56% reduced risk of developing long COVID respectively. Conclusions This study reports that the patients continued to have debilitating symptoms related to long COVID, one year after discharge, and most of its effects were observed in patients with severe/critical disease and unvaccinated patients.
Læs mere Tjek på PubMedNataliya Rybnikova, Dani Broitman, Murielle Mary-Krause, Maria Melchior, Yakov Ben-Haim
PLoS One Infectious Diseases, 22.11.2023
Tilføjet 22.11.2023
by Nataliya Rybnikova, Dani Broitman, Murielle Mary-Krause, Maria Melchior, Yakov Ben-Haim Questionnaires are among the most basic and widespread tools to assess the mental health of a population in epidemiological and public health studies. Their most obvious advantage (firsthand self-report) is also the source of their main problems: the raw data requires interpretation, and are a snapshot of the specific sample’s status at a given time. Efforts to deal with both issues created a bi-dimensional space defined by two orthogonal axes, in which most of the quantitative mental health research can be located. Methods aimed to assure that mental health diagnoses are solidly grounded on existing raw data are part of the individual validity axis. Tools allowing the generalization of the results across the entire population compose the collective validity axis. This paper raises a different question. Since one goal of mental health assessments is to obtain results that can be generalized to some extent, an important question is how robust is a questionnaire result when applied to a different population or to the same population at a different time. In this case, there is deep uncertainty, without any a priori probabilistic information. The main claim of this paper is that this task requires the development of a new robustness to deep uncertainty axis, defining a three-dimensional research space. We demonstrate the analysis of deep uncertainty using the concept of robustness in info-gap decision theory. Based on data from questionnaires collected before and during the Covid-19 pandemic, we first locate a mental health assessment in the space defined by the individual validity axis and the collective validity axis. Then we develop a model of info-gap robustness to uncertainty in mental health assessment, showing how the robustness to deep uncertainty axis interacts with the other two axes, highlighting the contributions and the limitations of this approach. The ability to measure robustness to deep uncertainty in the mental health realm is important particularly in troubled and changing times. In this paper, we provide the basic methodological building blocks of the suggested approach using the outbreak of Covid-19 as a recent example.
Læs mere Tjek på PubMedSara Belligoni, Kelly A. Stevens, Samiul Hasan, Haofei Yu
PLoS One Infectious Diseases, 22.11.2023
Tilføjet 22.11.2023
by Sara Belligoni, Kelly A. Stevens, Samiul Hasan, Haofei Yu People continue to use technology in new ways, and how governments harness digital information should consider privacy and security concerns. During COVID19, numerous countries deployed digital contact tracing that collect location data from user’s smartphones. However, these apps had low adoption rates and faced opposition. We launched an interdisciplinary study to evaluate smartphone location data concerns among college students in the US. Using interviews and a large survey, we find that college students have higher concerns regarding privacy, and place greater trust in local government with their location data. We discuss policy recommendations for implementing improved contact tracing efforts.
Læs mere Tjek på PubMedAndré Daher, Júlio Castro-Alves, Leandro Amparo, Natalia Pacheco de Moraes, Thaís Regina Araújo dos Santos, Karla Regina Gram dos Santos, Cristiane Siqueira do Valle, Maria Hermoso, Margareth Catoia Varela, Rodrigo Correa Oliveira
PLoS One Infectious Diseases, 22.11.2023
Tilføjet 22.11.2023
by André Daher, Júlio Castro-Alves, Leandro Amparo, Natalia Pacheco de Moraes, Thaís Regina Araújo dos Santos, Karla Regina Gram dos Santos, Cristiane Siqueira do Valle, Maria Hermoso, Margareth Catoia Varela, Rodrigo Correa Oliveira Monitoring of clinical trials is critical to the protection of human subjects and the conduct of high-quality research. Even though the adoption of risk-based monitoring (RBM) has been suggested for many years, the RBM approach has been less widespread than expected. Centralized monitoring is one of the RMB pillars, together with remote-site monitoring visits, reduced Source Data Verification (SDV) and Source Document Reviews (SDR). The COVID-19 pandemic promoted disruptions in the conduction of clinical trials, as on-site monitoring visits were adjourned. In this context, the transition to RBM by all actors involved in clinical trials has been encouraged. In order to ensure the highest quality of data within a COVID-19 clinical trial, a centralized monitoring tool alongside Case Report Forms (CRFs) and synchronous automated routines were developed at the clinical research platform, Fiocruz, Brazilian Ministry of Health. This paper describes how these tools were developed, their features, advantages, and limitations. The software codes, and the CRFs are available at the Fiocruz Data Repository for Research—Arca Dados, reaffirming Fiocruz’s commitment to Open Science practices.
Læs mere Tjek på PubMed