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47 ud af 47 tidsskrifter valgt, søgeord (covid) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
1289 emner vises.
BMC Infectious Diseases, 15.11.2023
Tilføjet 15.11.2023
Abstract Background In Turku, Finland, we introduced a home oxygen treatment and app-based monitoring program for hospitalized COVID-19 patients to facilitate an early discharge during the Omicron wave. In this case series we explore the clinical parameters of patients enrolled in the program and evaluate the cost–benefit and safety issues of the program. Methods Hospitalized COVID-19 patients with marked hypoxemia but otherwise in stable condition were screened from Turku City Hospital and Turku University Hospital by treating doctors for eligibility in the program. Peripheral oxygen saturation of > 92% and breathing frequency
Læs mere Tjek på PubMedWahome, Elizabeth; Otieno, Fredrick O.; Kimani, Joshua; Boyd, Anders; Okall, Duncan; Nzioka, Joseph; Gichuru, Evans; van der Elst, Elise; Mehta, Supriya D.; Bailey, Robert C.; Graham, Susan M.; Sanders, Eduard J.
AIDS, 15.11.2023
Tilføjet 15.11.2023
Introduction: Little is known about the impact that the COVID-19 pandemic had on risk of HIV acquisition in sub-Saharan Africa. We assessed the impact of COVID-19-related clinic closures on HIV incidence in a cohort of gay, bisexual, and other men who have sex with men (MSM) and transgender women (TW) in Kenya. Methods: MSM and TW enrolled in a prospective, multicenter cohort study were followed quarterly for HIV testing, behavior assessments, and risk. We estimated the HIV incidence rate (IR) and its 95% credible intervals (CrI) among participants who were HIV-negative before COVID-19-related clinic closure, comparing IR and risk factors associated with HIV acquisition before vs. after clinic reopening, using a Bayesian Poisson model with weakly-informative priors. Results: A total of 690 (87%) participants returned for follow-up after clinic reopening [total person-years (PY) 664.3 during clinic closure and 1013.3 after clinic reopening]. HIV IR declined from 2.05/100PY (95%CrI = 1.22–3.26, n = 14) during clinic closures to 0.96/100PY (95%CrI = 0.41–2.07, n = 10) after clinic reopening (IRR = 0.47, 95%CrI = 0.20–1.01). The proportion of participants reporting hazardous alcohol use and several sexual risk behaviors was higher during clinic closures than after clinic reopening. In multivariable analysis adjusting for study site and participant characteristics, HIV incidence was lower after clinic reopening (IRR 0.57, 95%CrI = 0.23–1.33). Independent risk factors for HIV acquisition included receptive anal intercourse (IRR 1.94, 95%CrI = 0.88–4.80) and perceived risk of HIV (IRR 3.03, 95%CRI = 1.40–6.24). Conclusions: HIV incidence during COVID-19-related clinic closures was moderately increased and reduced after COVID-19 restrictions were eased. Ensuring access to services for key populations is important during public health emergencies. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedMario Saviano, Annalisa Fierro, Antonella Liccardo
PLoS One Infectious Diseases, 15.11.2023
Tilføjet 15.11.2023
by Mario Saviano, Annalisa Fierro, Antonella Liccardo We propose a deterministic epidemic model to describe the transition between two variants of the same virus, through the combination of a series of realistic mechanisms such as partial cross immunity, waning immunity for vaccinated individuals and a novel data-based algorithm to describe the average immunological status of the population. The model is validated on the evolution of Covid-19 in Italy, during the period in which the transition between Delta and Omicron variant occurred, with very satisfactory agreement with the experimental data. According to our model, if the vaccine efficacy had been equal against Delta and Omicron variant infections, the transition would have been smoothed and the epidemic would have gone extinct. This circumstance confirms the fundamental role of vaccines in combating the epidemic, and the importance of identifying vaccines capable of intercepting new variants.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 15.11.2023
Tilføjet 15.11.2023
AbstractBackgroundPublished studies about mRNA COVID-19 vaccine effects focus on younger individuals comprising the majority of workforce. However, studies about elderly adults are sparse.Methods107 subjects (median 78 (IQR 58.5-90.5, range 35-105) yo) were recruited, and factors associated with antibody titer after the third mRNA COVID-19 vaccine were analyzed between 49 elderly (age ≥80, median 94 (IQR 86-97, range 80-105) yo) and 58 younger (≤79, median 61 (IQR 46-71, range 35-79) yo) adults.ResultsAmong BMI categories, the underweight group in elderly adults had a lower antibody titer compared to the normal weight group (p
Læs mere Tjek på PubMedJournal of the American Medical Association, 15.11.2023
Tilføjet 15.11.2023
A recent analysis found only a modest difference in outcomes after in-person medical visits compared with telemedicine during the COVID-19 pandemic, “suggesting that telephone or video telemedicine was still capable of addressing most patient clinical concern areas,” the researchers wrote.
Læs mere Tjek på PubMedJournal of the American Medical Association, 15.11.2023
Tilføjet 15.11.2023
Vitamin C is an essential nutrient, functioning as an antioxidant, immunomodulator, and cofactor for numerous enzymes. Vitamin C represents the definitive treatment for scurvy, which results from vitamin C deficiency. However, beyond this unequivocally beneficial indication, the history of vitamin C as a therapeutic is decidedly more checkered. Varying doses of vitamin C have been proposed to treat a large number of conditions and diseases ranging from cancer to cardiovascular disease to dementia to the common cold; however, despite numerous clinical trials, there is little evidence to support its routine use for any of these indications.
Læs mere Tjek på PubMedJournal of the American Medical Association, 15.11.2023
Tilføjet 15.11.2023
Two randomized clinical trials were harmonized to compare the effect of vitamin C vs control on outcomes in hospitalized patients with COVID-19 who were critically ill or who were not critically ill.
Læs mere Tjek på PubMedJournal of the American Medical Association, 15.11.2023
Tilføjet 15.11.2023
Staphylococcal infections among hospitalized patients, due to both methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus strains, are a substantial problem in the US. S aureus was the leading causative pathogen among health care–associated infections (HAIs) identified during the Centers for Disease Control and Prevention’s (CDC) 2015 national HAI prevalence survey (excluding Clostridioides difficile), accounting for 23% of all health care–associated bloodstream infections. Despite an overall 74% decline in the incidence of hospital-onset MRSA bloodstream infections from 2005 to 2016, these rates did not significantly change between 2013 and 2016. More sobering, strides made in the past 15 years in reducing HAIs in acute care settings, including those due to S aureus, markedly receded during the COVID-19 pandemic.
Læs mere Tjek på PubMedde Haan, L., ten Wolde, M., Beudel, M., Olde Engberink, R. H. G., Appelman, B., Haspels-Hogervorst, E. K., Rusch, D., Gritters van den Oever, N. C., Simsek, S., Paternotte, N., van den Bergh, J. P., Wyers, C. E., de Kruif, M. D., Dormans, T., Moeniralam, H., Bokhizzou, N., Brinkman, K., Douma, R., on behalf of The Dutch COVID-PREDICT study group, Beudel, Appelman, Douma, Rusch, Simsek, Brinkman, van den Oever, Bergh, Moeniralam, Bokhizzou, Kruif, Leavis, Pina-Fuentes, Thomas, Arts, Nurmohamed, Reeskamp, Hu, Herter, Vonk, Lopes, Ramos, Huberts, Wolfers, Schinkel, Kuij, Dormans, Noordzij, Bosch, Verhoef, Methorst, Darwesh, Egmond, Nasim, Ali, Boer, Nagel, Koenis, Bijlsma, Balvers, Ghauharali, Jongh, Emanuel, Aynaou, Ridder, Darraz, Darraz, Cinar, Roosen, Heideman, Leliveld, Ruijter, Rosenberg, Woutman, Vermeulen, de Joode, Berger, Ludden, Varan, Pinto, Sluis, Kuiper, Putten, Bosje, Sinyangwe, Rhijn, Kruif, Haan, Heijer, Kruijf, Hofhuis, Leliveld, Vermeulen, Telting, Boer, Ridder, Lei, Paassen, Veer, Opschoor, Breukhoven, Jiwa, Gooyer, Vrijdag, Gelder, Pannekoek, Dommershuijzen, Adang, Maren, Koop, Sanders, Wanten, Trommelen, Smeets, Heuvelings, Cox, Rademaekers, Hendrikx, Rooij, Heuts, Oudeman, Brans, Slot, Boerma-Argelo, Kok, Harmsen, Boerema, Pirson, Raafs, Smaal, Pop, Verkouteren, Waterink, Vrij, Willik, Hubers, Lems, Reitsma, Pieters, Logger, Sijben, Peeters, Teunissen, Blok-Hoos, Ketels, Henkens, Spanjers, Jacob-Dols, Hoogt, Houben, Goldhoorn, Gorp, Hinsenveld, Jansen
BMJ Open, 14.11.2023
Tilføjet 14.11.2023
ObjectivesTo evaluate the relationship among dysnatraemia at hospital presentation and duration of admission, risk of intensive care unit (ICU) admission and all-cause mortality and to assess the underlying pathophysiological mechanism of hyponatraemia in patients with COVID-19. Our hypothesis is that both hyponatraemia and hypernatraemia at presentation are associated with adverse outcomes. DesignObservational study. SettingSecondary care; 11 Dutch hospitals (2 university and 9 general hospitals). ParticipantsAn analysis was performed within the retrospective multicentre cohort study COVIDPredict. 7811 patients were included (60% men, 40% women) between 24 February 2020 and 9 August 2022. Patients who were ≥18 years with PCR-confirmed COVID-19 or CT with COVID-19 reporting and data system score≥4 and alternative diagnosis were included. Patients were excluded when serum sodium levels at presentation were not registered in the database or when they had been transferred from another participating hospital. Outcome measuresWe studied demographics, medical history, symptoms and outcomes. Patients were stratified according to serum sodium concentration and urinary sodium excretion. ResultsHyponatraemia was present in 2677 (34.2%) patients and hypernatraemia in 126 (1.6%) patients. Patients with hyponatraemia presented more frequently with diarrhoea, lower blood pressure and tachycardia. Hyponatraemia was, despite a higher risk for ICU admission (OR 1.27 (1.11–1.46; p
Læs mere Tjek på PubMedAdams, N., Stirrup, O., Blackstone, J., Krutikov, M., Cassell, J. A., Cadar, D., Henderson, C., Knapp, M., Gosce, L., Leiser, R., Regan, M., Cullen-Stephenson, I., Fenner, R., Verma, A., Gordon, A., Hopkins, S., Copas, A., Freemantle, N., Flowers, P., Shallcross, L.
BMJ Open, 14.11.2023
Tilføjet 14.11.2023
IntroductionCare home residents have experienced significant morbidity, mortality and disruption following outbreaks of SARS-CoV-2. Regular SARS-CoV-2 testing of care home staff was introduced to reduce transmission of infection, but it is unclear whether this remains beneficial. This trial aims to investigate whether use of regular asymptomatic staff testing, alongside funding to reimburse sick pay for those who test positive and meet costs of employing agency staff, is a feasible and effective strategy to reduce COVID-19 impact in care homes. Methods and analysisThe VIVALDI-Clinical Trial is a multicentre, open-label, cluster randomised controlled, phase III/IV superiority trial in up to 280 residential and/or nursing homes in England providing care to adults aged >65 years. All regular and agency staff will be enrolled, excepting those who opt out. Homes will be randomised to the intervention arm (twice weekly asymptomatic staff testing for SARS-CoV-2) or the control arm (current national testing guidance). Staff who test positive for SARS-CoV-2 will self-isolate and receive sick pay. Care providers will be reimbursed for costs associated with employing temporary staff to backfill for absence arising directly from the trial. The trial will be delivered by a multidisciplinary research team through a series of five work packages. The primary outcome is the incidence of COVID-19-related hospital admissions in residents. Secondary outcomes include the number and duration of outbreaks and home closures. Health economic and modelling analyses will investigate the cost-effectiveness and cost consequences of the testing intervention. A process evaluation using qualitative interviews will be conducted to understand intervention roll out and identify areas for optimisation to inform future intervention scale-up, should the testing approach prove effective and cost-effective. Stakeholder engagement will be undertaken to enable the sector to plan for results and their implications and to coproduce recommendations on the use of testing for policy-makers. Ethics and disseminationThe study has been approved by the London—Bromley Research Ethics Committee (reference number 22/LO/0846) and the Health Research Authority (22/CAG/0165). The results of the trial will be disseminated regardless of the direction of effect. The publication of the results will comply with a trial-specific publication policy and will include submission to open access journals. A lay summary of the results will also be produced to disseminate the results to participants. Trial registration numberISRCTN13296529.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.11.2023
Tilføjet 14.11.2023
Abstract Background A surge of more than 80 million Omicron variant infected cases was reported in China less than a month after the "zero COVID" strategy ended on December 7, 2022. In this circumstance, whether people living with HIV (PLWH) in China experience a similar risk is not clear. Methods A cross-sectional study was conducted in the Wuchang District of Wuhan between December 20, 2022, and January 18, 2023 through a self-administered online survey. PLWH and HIV-negative people aged ≥ 18 years old who volunteered for this survey were eligible. The prevalence of Omicron variant infection between PLWH and HIV-negative people was compared, and the factors associated with the Omicron variant infection among PLWH and HIV-negative people were further evaluated, respectively. Results In total, 890 PLWH and 1,364 HIV-negative adults from Wuchang District were enrolled. Among these participants, 690 PLWH (77.5%) and 1163 HIV-negative people (85.3%) reported SARS-CoV-2 infection. Gender, chronic disease conditions, and COVID-19 vaccination status significantly differed between the two groups. After adjusting gender, age, comorbidities, and COVID-19 vaccination status, the risk of SARS-CoV-2 infection among PLWH was significantly lower than among HIV-negative people (aOR 0.56, 95%CI 0.42–0.76). Multivariable logistic regression analysis showed that PLWH with older age and detectable HIV-viral load (HIV-VL) had decreased risk of SARS-CoV-2 infection (aOR 0.98, 95%CI 0.96–0.99; aOR 0.59, 95%CI 0.36–0.97). Compared with PLWH receiving one/two doses of COVID-19 vaccines, no significant differences in the risk of SARS-CoV-2 infection were observed among PLWH receiving three doses of inactivated vaccines and four doses of vaccines (three doses of inactivated vaccines plus one dose of inhaled recombinant adenovirus type 5 (AD5)-vectored vaccine). Among HIV-negative people, those receiving four doses of COVID-19 vaccines had a lower risk of SARS-CoV-2 infection than those receiving one/two doses (aOR 0.14, 95%CI 0.08–0.25). Conclusions Our study proves that PLWH have a lower risk of Omicron variant infection than HIV-negative people. However, even PLWH with younger age and virological suppression should strengthen the prevention against SARS-CoV-2 infection. Three doses of inactivated vaccines plus one dose of inhaled recombinant AD5-vectored COVID-19 vaccine may provide better protection for HIV-negative people.
Læs mere Tjek på PubMedJisu Kim, In-Whi Hwang, Jeong-Hui Park, Youngdeok Kim, Jung-Min Lee
PLoS One Infectious Diseases, 14.11.2023
Tilføjet 14.11.2023
by Jisu Kim, In-Whi Hwang, Jeong-Hui Park, Youngdeok Kim, Jung-Min Lee The current study is to examine the disparities in physical activity (PA), sedentary behavior (SB), and stress levels in Korean adolescents concerning changes in their perception of family economic status (ES) during COVID-19. Among a total of 6144 Korean adolescents aged 12 to 18, the participants were categorized into two groups based on their responses regarding changes in their family ES due to COVID-19: Declined ES (n = 3072) and Non-changed ES (n = 3072), with matching in terms of age, gender, and BMI. All variables were assessed using the 16th year (2020) of the Korean Youth Risk Behavior Survey. Statistical analyses were conducted using the SPSS 26.0 version, employing independent t-tests to examine anthropometrics’ differences and multinominal logistic regression to predict the impact of perception of family ES on PA, SB, and stress while comparing the two groups. The significance level was set at α = 0.05. Adolescents in the Declined ES group were 1.2 times more likely to engage in MVPA for less than 420 mins/wk (OR = 1.16, p = 0.039), 1.7 times more likely to meet recommended muscular strength activities (i.e., ≥ 3 days/wk) (OR = 1.70, p < 0.001), 37% less likely to not meet recommended recreational sitting time (i.e., ≥ 840 mins/wk) (OR = 0.63, p < 0.01), and were 2.1 times more likely to experience very severe stress level than the Non-changed ES group (p < 0.001). These results shed light on the importance of promoting mental health care in adolescents, regardless of PA levels, for their well-being during potential future pandemics. Understanding the impact of perceived ES changes on health behaviors can inform targeted interventions and support strategies to improve the mental health outcomes of adolescents during challenging times.
Læs mere Tjek på PubMedJaya M. Satagopan, Tina Dharamdasani, Shailja Mathur, Racquel E. Kohler, Elisa V. Bandera, Anita Y. Kinney
PLoS One Infectious Diseases, 14.11.2023
Tilføjet 14.11.2023
by Jaya M. Satagopan, Tina Dharamdasani, Shailja Mathur, Racquel E. Kohler, Elisa V. Bandera, Anita Y. Kinney Background South Asians are a rapidly growing population in the United States. Breast cancer is a major concern among South Asian American women, who are an understudied population. We established the South Asian Breast Cancer (SABCa) study in New Jersey during early 2020 to gain insights into their breast cancer-related health attitudes. Shortly after we started planning for the study, the COVID-19 disease spread throughout the world. In this paper, we describe our experiences and lessons learned from recruiting study participants by partnering with New Jersey’s community organizations during the COVID-19 pandemic. Methods We used a cross-sectional design. We contacted 12 community organizations and 7 (58%) disseminated our study information. However, these organizations became considerably busy with pandemic-related needs. Therefore, we had to pivot to alternative recruitment strategies through community radio, Rutgers Cancer Institute of New Jersey’s Community Outreach and Engagement Program, and Rutgers Cooperative Extension’s community health programs. We recruited participants through these alternative strategies, obtained written informed consent, and collected demographic information using a structured survey. Results Twenty five women expressed interest in the study, of which 22 (88%) participated. Nine (41%) participants learned about the study through the radio, 5 (23%) through these participants, 1 (4.5%) through a non-radio community organization, and 7 (32%) through community health programs. Two (9%) participants heard about the study from their spouse. All participants were born outside the US, their average age was 52.4 years (range: 39–72 years), and they have lived in the US for an average of 26 years (range: 5–51 years). Conclusion Pivoting to alternative strategies were crucial for successful recruitment. Findings suggest the significant potential of broadcast media for community-based recruitment. Family dynamics and the community’s trust in our partners also encouraged participation. Such strategies must be considered when working with understudied populations.
Læs mere Tjek på PubMedAmeeta Retzer, Janet Jones, Sarah Damery, Habib Ullah, Modupe Omonijo, Justin Varney, Kate Jolly
PLoS One Infectious Diseases, 14.11.2023
Tilføjet 14.11.2023
by Ameeta Retzer, Janet Jones, Sarah Damery, Habib Ullah, Modupe Omonijo, Justin Varney, Kate Jolly Objectives The COVID-19 pandemic has led to a change in people’s volunteering behaviours; participation has increased in informal volunteering (giving unpaid help to those who are not a relative) while decreasing in formal volunteering (unpaid help to groups or clubs). There is an interest from stakeholders who have experienced increased participation in maintaining the positive patterns of volunteering, aligning with National Health Service (NHS) objectives and realising benefits in a wider public health context. This research uses a local COVID-19 public health volunteering programme case study to explore the volunteer’s journey and perspective using volunteers’ reported experiences to consider the potential for volunteer retention and role expansion into other public health issues beyond the COVID-19 pandemic. Methods Recruitment was undertaken by Birmingham City Council Public Health Team via the COVID-19 Community Champions programme mailing list. Semi-structured focus group discussions, one-to-one interviews and email interviews were conducted with volunteers. Data were analysed through directed thematic analysis using an iteratively developed coding frame. Results Data were collected from three focus group discussions, four interviews, and one email interview involving a total of 16 participants. Six themes were identified: volunteer motivations and expectations; volunteer management; programme organisation; feeling valued; continued need for role, and interest in new responsibilities. Conclusion Our findings indicate that the factors which are conducive to volunteer recruitment, retention and re-purposing were: maintaining the original terms of engaging with the volunteering opportunity (including retaining the original brief and remit), adjusting these through consultative processes with an emphasis on seeking permission from the volunteers already involved and ensuring a reliable and consistent management and support structure. While some of the learning is specific to the local volunteer programme in question and the context of the COVID-19 pandemic, there are lessons that can be generalised to other scenarios and settings.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.11.2023
Tilføjet 14.11.2023
Abstract Background Pro–b-type natriuretic peptide (Pro-BNP) is an inflammatory marker that indicates cardiac damage and inflammation. The elevation of this marker in COVID-19 patients can be used as a predictive factor in the prognosis of these patients. Method Our cross-sectional study investigated the evaluation of cardiac diagnostic test findings based on pro-BNP levels in pregnant COVID-19 patients in Sayyad Shirazi Hospital, Gorgan, Iran, in 2020–2022. A hundred and ten pregnant patients diagnosed with COVID-19 infection were evaluated for cardiac diagnostic tests (electrocardiogram (ECG) and echocardiography (Echo)) and pro-BNP levels. Data were analyzed using SPSS 25 software. Chi-square and Student\'s t-test will be used to test and compare the relationship between variables and compare them. A P-value less than 0.05 is considered statistically significant. The chi-square test was used to compare the ratio of qualitative variables among the groups if the presuppositions of chi-square distribution were established. Otherwise, Fisher\'s exact test was used. Result The mean age of participants were 31.06 ± 5.533 years and 49.1% of patients had pro-BNP levels above the cut-off value for predicting an adverse outcome of COVID-19. The mean ± standard deviation of pro-BNP levels in the low group was 46.125 ± 17.523 pg/mL and in the high group was 878.814 ± 1038.060 pg/mL. This study revealed that patients with higher pro-BNP plasma levels had a significant relation between, myocardial infarction (MI), pericardial effusion (PE), urgent Caesarean section (C/S), and mortality. In addition, no significant relation between gravid, trimester, vaccination, arrhythmia, heart block, and valves diseases with high pro-BNP levels was found. Conclusion The current research showed that pro-BNP levels can be used as a diagnostic and valuable prognostic tool in pregnant women to diagnose cardiac complications by using ECG and Echo.
Læs mere Tjek på PubMedFederica Bellerba, Nils Bardeck, Michael Boehm, Oriana D'Ecclesiis, Sara Raimondi, Elisa Tomezzoli, Mafalda Silva Miranda, Inês Martins Alves, Daniela Alves, Ana Abecasis, Valeria Gabellone, Elisa Gabrielli, Giulia Vaglio, Elham Shamsara, Nico Pfeifer, Chiara Mommo, Francesca Incardona, Rolf Kaiser, Sara Gandini
International Journal of Infectious Diseases, 12.11.2023
Tilføjet 12.11.2023
As part of the global reaction to stop the spread of SARS-CoV-2 during the early months of the COVID-19 pandemic, primary and secondary schools were closed to on-site learning in many countries. This decision was based on data extrapolated from influenza transmission models, which suggested that closing schools could help reduce the spread of infections[1]. However, the effectiveness of this measure for SARS-CoV-2 was unclear. Several studies about the impact of school openings found conflicting results on community transmission, with some suggesting substantial increases in positivity rates[2], and others suggesting a small impact[3], [4] or no effect after adjusting for community incidence[5]–[7].
Læs mere Tjek på PubMedAsra Fazlollahi; Mahdi Zahmatyar; Ali Shamekh; Alireza Motamedi; Fatemeh Seyedi; Homa Seyedmirzaei; Seyed Ehsan Mousavi; Seyed Aria Nejadghaderi; Mark J. M. Sullman; Ali‐Asghar Kolahi; Shahnam Arshi; Saeid Safiri;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
A number of different neurological complications have been reported following vaccination against the coronavirus disease 2019 (COVID‐19). Electroencephalogram (EEG) is one of the modalities used to evaluate the neurological complications of diseases. The aim of the present study was to identify the EEG changes in participants vaccinated against COVID‐19. PubMed, Scopus, Web of Science, medRxiv, and Google Scholar were searched up to 1 September 2022, with terms related to COVID‐19 vaccines, EEG, neurological signs/symptoms, or neurological disorders. All case reports and case series were included if the participants had received at least one dose of a COVID‐19 vaccine and a post vaccination EEG report was also reported. We used the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for case reports and case series to appraise the methodological quality of the included studies. Thirty‐one studies were included, which were comprised of 24 case reports and seven case series and a total of 36 participants. Generalised slowing and non‐convulsive focal status epilepticus were the most common EEG findings post‐COVID‐19 vaccination. The most frequent symptoms were headache, fatigue, generalised weakness, and vomiting. In addition, the most common signs were encephalopathy, post‐ictal phases, and confusion. Encephalitis, acute disseminated encephalomyelitis, and post‐vaccinal encephalopathy were the most commonly diagnosed adverse events. Furthermore, most of the imaging studies appeared normal. The EEG reports mainly showed background slowing and epileptiform discharges, encephalitis, encephalopathies, and demyelinating disorders. Future studies with larger samples and more vaccine types may help to further unravel the potential neurological effects of COVID‐19 vaccinations on recipients.
Læs mere Tjek på PubMedBruno Azevedo Randi; Hermes Ryoiti Higashino; Vinícius Ponzio da Silva; Erick Menezes Xavier; Vanderson Rocha; Silvia Figueiredo Costa;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Patients who undergo hematopoietic stem‐cell transplantation (HSCT) are more susceptible to developing severe forms of COVID‐19 with an increased risk of mortality. The aim of this study was to analyze, by performing a systematic review and meta‐analysis, all studies that evaluated COVID‐19 in HSCT adult recipients and present clinical characteristics and outcomes. Studies were eligible for inclusion if they: (I) described the clinical characteristics of COVID‐19 in adult (aged 18 years old or above) HSCT recipients; (II) described outcomes of COVID‐19 in this population, mainly lethality; (III) were full‐text articles. We searched MedLine, Embase, SCOPUS, LILACS and Web of Science for full‐text studies that evaluated COVID‐19 in adult HSCT patients until 26 Apr 2023. Two independent reviewers screened the articles and extracted the data. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence Data was used to assess quality of the included studies. Meta‐analysis was performed and the pooled prevalence of severe/critical disease and of death with a 95% CI was calculated with the random‐effects model. Sixteen studies were included; seven (43.7%) were multicenter. Most of the studies were from Europe (37.5%). All of them had a low risk of bias using the JBI Checklist. A total of 1186 patients were included. Allogeneic HSCT patients were the majority in most studies, with a total of 861 patients (72.5%). The symptomatic rate was 79.4%. The pooled prevalence of severe/critical COVID‐19 was 24.0% (95% CI 0.13–0.36; = 94%; = 334/990). The pooled prevalence of death for the entire population was 17% (95% CI 0.13–0.22; = 76%; = 221/1117), 17% (95% CI 0.12–0.23; = 67%; = 152/822) for allogeneic‐HSCT and 14% (95% CI 0.08–0.22; = 65%; = 48/293) for autologous‐HSCT. In conclusion, frequently the infection of SARS‐CoV‐2 in HSCT was symptomatic and lethality is higher than in general population. Thus, it is essential to focus on the implementation of measures to mitigate the risk of SARS‐CoV‐2 infection in this population, as well as to carefully assess HSCT recipients who develop COVID‐19.
Læs mere Tjek på PubMedChang‐tai Zhu; Jian‐Yun Yin; Xiao‐hua Chen; Ming Liu; Shi‐gui Yang;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
This study aimed to clarify the beneficial effect and the clinical application value of Paxlovid in the treatment of coronavirus disease‐19 (COVID‐19) through a systematic review. Databases including PubMed, Cochrane Library, Chinese Clinical Trial Registry, and were systematically searched for interventional or observational studies on the efficacy and safety of Paxlovid in the treatment of SARS‐COV‐2. The relative and absolute effect sizes for the outcomes were calculated based on the data reported in the original intervention literature. The external applicability of the evidence was analysed in terms of clinical application scenarios, patient willingness, and cost utility. One interventional and three observational studies were conducted. Four studies published in 2022, had participation sample sizes ranging 1780–109,254. Based on the randomised controlled trial data, the risk of all‐cause mortality, all‐cause death, and hospitalisation was significantly reduced in the Paxlovid group. Serious adverse events were reduced during the study. Based on observational studies, Paxlovid can significantly reduce the risk of death and hospitalisation in older patients with COVID‐19 (moderate certainty) and improve in‐hospital disease progression, composite disease progression, and viral load (low certainty). Paxlovid did not improve the outcomes of death and hospitalisation (low certainty) in patients aged
Læs mere Tjek på PubMedShivani Malvankar; Anjali Singh; Y. S. Ravi Kumar; Swetangini Sahu; Megha Shah; Yamini Murghai; Mahendra Seervi; Rupesh K. Srivastava; Bhupendra Verma;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV2) emerged in December 2019, causing a range of respiratory infections from mild to severe. This resulted in the ongoing global COVID‐19 pandemic, which has had a significant impact on public health. The World Health Organization declared COVID‐19 as a global pandemic in March 2020. Viruses are intracellular pathogens that rely on the host\'s machinery to establish a successful infection. They exploit the gene expression machinery of host cells to facilitate their own replication. Gaining a better understanding of gene expression modulation in SARS‐CoV2 is crucial for designing and developing effective antiviral strategies. Efforts are currently underway to understand the molecular‐level interaction between the host and the pathogen. In this review, we describe how SARS‐CoV2 infection modulates gene expression by interfering with cellular processes, including transcription, post‐transcription, translation, post‐translation, epigenetic modifications as well as processing and degradation pathways. Additionally, we emphasise the therapeutic implications of these findings in the development of new therapies to treat SARS‐CoV2 infection.
Læs mere Tjek på PubMedRaphael Udeh; Alberto Utrero‐Rico; Xenia Dolja‐Gore; Masoud Rahmati; Mark McEVoy; Tony Kenna;
Reviews in Medical Virology, 11.11.2023
Tilføjet 11.11.2023
There\'s critical need for risk predictors in long COVID. This meta‐analysis evaluates the evidence for an association between plasma lactate dehydrogenase (LDH) and long COVID and explores the contribution of LDH to symptoms persistent across the distinct post‐acute sequelae of COVID‐19 (PASC) domains. PubMed, EMBASE, Web of Science, and Google Scholar were searched for articles published up to 20 March 2023 for studies that reported data on LDH levels in COVID‐19 survivors with and without PASC. Random‐effect meta‐analysis was employed to estimate the standardized mean difference (SMD) with corresponding 95% confidence interval of each outcome. There were a total of 8289 study participants (3338 PASC vs. 4951 controls) from 46 studies. Our meta‐analysis compared to the controls showed a significant association between LDH elevation and Resp‐PASC [SMD = 1.07, 95%CI = 0.72, 1.41, = 0.01] but not Cardio‐PASC [SMD = 1.79, 95%CI = −0.02, 3.61, = 0.05], Neuro‐PASC [SMD = 0.19, 95%CI = −0.24, 0.61, = 0.40], and Gastrointestinal‐PASC [SMD = 0.45, 95%CI = −1.08, 1.98, = 0.56]. This meta‐analysis suggests elevated LDH can be used for predicting Resp‐PASC, but not Cardio‐PASC, Neuro‐PASC or gastrointestinal‐PASC. Thus, elevated plasma LDH following COVID infection may be considered as a disease biomarker.
Læs mere Tjek på PubMedJournal of the American Medical Association, 11.11.2023
Tilføjet 11.11.2023
About 63% of COVID-19-related hospitalizations between January and August 2023 were among people aged 65 years or older, based on data collected by the US Centers for Disease Control and Prevention (CDC). The proportion had been declining through mid-July but increased again by the end of August.
Læs mere Tjek på PubMedJournal of the American Medical Association, 11.11.2023
Tilføjet 11.11.2023
Prior infection with COVID-19 was tied to a higher risk of autoimmune and autoinflammatory connective tissue disorders, according to results from 354 527 people with an average age of about 52 years. The chance of developing antineutrophil cytoplasmic antibody-associated vasculitis was the highest after infection, followed by alopecia totalis, Crohn disease, and sarcoidosis, among other conditions.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background The efficacy of antiviral drugs that neutralize antibody drugs and fight against SARS-COV-2 is reported to be attenuated by genetic mutations of the virus in vitro. When B-cell immunocompromised patients are infected with SARS-COV-2, the infection can be prolonged, and genetic mutations can occur during the course of treatment. Therefore, for refractory patients with persistent COVID-19 infection, genomic analysis was performed to obtain data on drug resistance mutations as a reference to determine which antiviral drugs and antibody therapies might be effective in their treatment. Methods This was a descriptive analysis with no controls. Patients were diagnosed as having COVID-19, examined, and treated in the Kansai Medical University General Medical Center between January 2022 and January 2023. The subjects of the study were B-cell immunocompromised patients in whom genome analysis of SARS-CoV-2 was performed. Results During the study period, 984 patients with COVID-19 were treated at our hospital. Of those, 17 refractory cases underwent genomic analysis. All 17 patients had factors related to immunodeficiency, such as malignant lymphoma or post-organ transplantation. Eleven patients started initial treatment for COVID-19 at our hospital, developed persistent infection, and underwent genomic analysis. Six patients who were initially treated for COVID-19 at other hospitals became persistently infected and were transferred to our hospital. Before COVID-19 treatment, genomic analysis showed no intrahost mutations in the NSP5, the NSP12, and the RBD regions. After COVID-19 treatment, mutations in these regions were found in 12 of 17 cases (71%). Sixteen patients survived the quarantine, but one died of sepsis. Conclusions In genomic analysis, more mutations were found to be drug-resistant after COVID-19 treatment than before COVID-19 treatment. Although it was not possible to demonstrate the usefulness of genome analysis for clinical application, the change of the treatment drug with reference to drug resistance indicated by genomic analysis may lead to good outcome of immunocompromised COVID-19 patients.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Infection prevention measures are the gold standard for preventing the spread of hospital-acquired infections (HAIs). COVID-19 pandemic caused major disruptions in infection prevention measures, and this has implications on the rate of HAIs. This study assessed the impact of COVID-19 pandemic on the rate and the types of HAIs at Sultan Ahmed Shah Hospital. Method This is a retrospective cohort study that compared the rate of HAIs from April to October 2019 (pre COVID period) and April to October 2020 (during COVID period). Data was collected through the review of patients’ electronic medical records. Results There were a total of 578 patients included in the selected wards during the pre- and during the pandemic. Thirty-nine episodes (12.1%) of HAIs were report in the pre COVID period and 29 (11.3%) during COVID-19. In both periods, hospital-acquired pneumonia (HAP) was the most frequent HAI among the patients. There was a rise in catheter-associated bloodstream infections (CLABSI) (0.8%) and ventilator associated pneumonia (VAP) (1.1%) during the COVID-19 period. The most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA) (28.2%) and Enterococcus faecalis (17.9%) in the Pre COVID-19 period, and Pseudomonas aeruginosa (27.6%) and Stenotrophomonas maltophilia (6.9%) during COVID-19. Conclusion Our research concluded that the rates of HAIs during the COVID-19 pandemic were not significantly impacted by the improved in-hospital infection prevention efforts to control the pandemic. There is need for further efforts to promote adherence to preventive practices.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background Clinical evidence suggests that pregnant women are more vulnerable to COVID-19, since they are at increased risk for disease progression and for obstetric complications, such as premature labor, miscarriage, preeclampsia, cesarean delivery, fetal growth restriction and perinatal death. Despite this evidence, pregnant women are often excluded from clinical trials, resulting in limited knowledge on COVID-19 management. The aim of this systematic review and meta-analysis is to provide better evidence on the efficacy and safety of available COVID-19 treatment in pregnant women. Methods Four authors searched major electronic databases from inception until 1 st November-2022 for controlled trials/observational studies, investigating outcomes after the administration of anti-SARS-CoV-2 treatments in pregnant women affected by COVID-19. The analyses investigated the cumulative incidence of delivery and maternal outcomes in pregnant women, comparing those taking active medication vs standard care. Risk ratios (RRs) with 95% confidence intervals were calculated. Statistical significance was assessed using the random effects model and inverse-variance method. This systematic review and meta-analysis was conducted in accordance with the updated 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol has been registered in Prospero (number registration: CRD42023397445). Results From initially 937 non duplicate records, we assessed the full texts of 40 articles, finally including ten studies. In six studies, including 1627 patients, the use of casirivimab/imdevimab (CAS/IMD), remdesivir, and IFN-alpha 2b significantly decreased the need of cesarean section ((RR = 0.665; 95%CI: 0.491–0.899; p = 0.008; I 2 = 19.5%;) (Table 1, (Fig. 1). Treatments did not decrease the risk of preterm delivery, admission to neonatal ICU, or stillbirth/perinatal loss (p-values > 0.50 for all these outcomes) and did not prevent the progression of disease towards severe degrees (k = 8; 2,374 pregnant women; RR = 0.778; 95%CI: 0.550–1.099; p = 0.15; I 2 = 0%). Moreover, the use of medications during pregnancy did not modify the incidence of maternal death in two studies (Table 2). Conclusions To our analysis, CAS/IMD, remdesivir, and IFN alpha 2b reduced the number of cesarean sections but demonstrated no effect on disease progression and other obstetric and COVID-19 related outcomes. The inability to evaluate the influence of viral load on illness development in pregnant women was attributed to lack of data. In our systematic review, no major side effects were reported. Though, it is essential for the medical community to focus more on clinical trials and less on episodic case reports and case series, with standardization of fetal and maternal outcomes.
Læs mere Tjek på PubMedBMC Infectious Diseases, 11.11.2023
Tilføjet 11.11.2023
Abstract Background While many studies on the determinants of post-COVID-19 conditions (PCC) have been conducted, little is known about the relationship between SARS-CoV-2 variants and PCC. This study aimed to assess the association between different SARS-CoV-2 variants and the probability of having PCC three months after the infection. Methods This study was a longitudinal cohort study conducted between April 2021 and September 2022 in Belgium. In total, 8,238 adults with a confirmed SARS-CoV-2 infection were followed up between the time of their infection and three months later. The primary outcomes were the PCC status three months post infection and seven PCC symptoms categories (neurocognitive, autonomic, gastrointestinal, respiratory, musculoskeletal, anosmia and/or dysgeusia, and other manifestations). The main exposure variable was the type of SARS-CoV-2 variants (i.e. Alpha, Delta, and Omicron), extracted from national surveillance data. The association between the different SARS-CoV-2 variants and PCC as well as PCC symptoms categories was assessed using multivariable logistic regression. Results The proportion of PCC among participants infected during the Alpha, Delta, and Omicron-dominant periods was significantly different and respectively 50%, 50%, and 37%. Participants infected during the Alpha- and Delta-dominant periods had a significantly higher odds of having PCC than those infected during the Omicron-dominant period (OR = 1.61, 95% confidence interval [CI] = 1.33–1.96 and OR = 1.73, 95%CI = 1.54–1.93, respectively). Participants infected during the Alpha and Delta-dominant periods were more likely to report neurocognitive, respiratory, and anosmia/dysgeusia symptoms of PCC. Conclusions People infected during the Alpha- and Delta-dominant periods had a higher probability of having PCC three months after infection than those infected during the Omicron-dominant period. The lower probability of PCC with the Omicron variant must also be interpreted in absolute figures. Indeed, the number of infections with the Omicron variant being higher than with the Alpha and Delta variants, it is possible that the overall prevalence of PCC in the population increases, even if the probability of having a PCC decreases.
Læs mere Tjek på PubMedAbeer Alharbi, Ranya S. Almana, Mohammed Aljuaid
PLoS One Infectious Diseases, 10.11.2023
Tilføjet 10.11.2023
Peng Wang, Jinliang Huang
PLoS One Infectious Diseases, 10.11.2023
Tilføjet 10.11.2023
by Peng Wang, Jinliang Huang The outbreak of the Coronavirus Disease 2019 (COVID-19) has profoundly influenced daily life, necessitating the understanding of the relationship between the epidemic’s progression and population dynamics. In this study, we present a data-driven framework that integrates GIS-based data mining technology and a Susceptible, Exposed, Infected and Recovered (SEIR) model. This approach helps delineate population dynamics at the grid and community scales and analyze the impacts of government policies, urban functional areas, and intercity flows on population dynamics during the pandemic. Xiamen Island was selected as a case study to validate the effectiveness of the data-driven framework. The results of the high/low cluster analysis provide 99% certainty (P < 0.01) that the population distribution between January 23 and March 16, 2020, was not random, a phenomenon referred to as high-value clustering. The SEIR model predicts that a ten-day delay in implementing a lockdown policy during an epidemic can lead to a significant increase in the number of individuals infected by the virus. Throughout the epidemic prevention and control period (January 23 to February 21, 2020), residential and transportation areas housed more residents. After the resumption of regular activities, the population was mainly concentrated in residential, industrial, and transportation, as well as road facility areas. Notably, the migration patterns into and out of Xiamen were primarily centered on neighboring cities both before and after the outbreak. However, migration indices from cities outside the affected province drastically decreased and approached zero following the COVID-19 outbreak. Our findings offer new insights into the interplay between the epidemic’s development and population dynamics, which enhances the prevention and control of the coronavirus epidemic.
Læs mere Tjek på PubMedWonderful T. Choga, Gobuiwang Khilly Kurusa (Gasenna), James Emmanuel San, Tidimalo Ookame, Irene Gobe, Mohammed Chand, Badisa Phafane, Kedumetse Seru, Patience Matshosi, Boitumelo Zuze, Nokuthula Ndlovu, Teko Matsuru, Dorcas Maruapula, Ontlametse T. Bareng, Kutlo Macheke, Lesego Kuate-Lere, Labapotswe Tlale, Onalethata Lesetedi, Modiri Tau, Mpaphi B. Mbulawa, Pamela Smith-Lawrence, Mogomotsi Matshaba, Roger Shapiro, Joseph Makhema, Darren P. Martin, Tulio de Oliveira, Richard J. Lessells, Shahin Lockman, Simani Gaseitsiwe, Sikhulile Moyo
International Journal of Infectious Diseases, 10.11.2023
Tilføjet 10.11.2023
Immune responses within the context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vary. Typically the virus is cleared within 2 weeks of infection but immunocompromised individuals can have prolonged infections[1, 2]. Weak immune systems increase infection risk and post-COVID-19 clinical sequelae, even post-vaccination[3]. Prolonged infections may facilitate viral evolution, including the evolution of immune-evasive viral variants. SARS-CoV-2 variants of concern (VOCs) such as Alpha, Beta and Gamma may have originated within the context of long-term infections in immunocompromised individuals[4-6].
Læs mere Tjek på PubMedVardar, U., Shaka, H., Kumi, D., Gajjar, R., Bess, O., Kanemo, P., Shaka, A., Baskaran, N.
BMJ Open, 10.11.2023
Tilføjet 10.11.2023
ObjectivesIn this study, we aimed to identify the causes, predictors and gender disparities of 30-day and 90-day cardiovascular readmissions after COVID-19-related hospitalisations using National Readmission Database (NRD) 2020. SettingWe used the NRD from 2020 to identify hospitalised adults with a principal diagnosis of COVID-19 infection. ParticipantsWe included subjects who were readmitted within 30 days and 90 days after index admission. We excluded subjects with elective and traumatic admissions. We used a multivariate Cox regression model to identify independent predictors of readmission. Primary and secondary outcomes measuresOur outcomes were inpatient mortality, 30-day and 90-day cardiovascular readmission rates following COVID-19 infection. ResultsDuring the study period, there were 1 024 492 index hospitalisations with a primary diagnosis of COVID-19 infection in the 2020 NRD database, 644 903 (62.9%) were included for 30-day readmission analysis, and 418 122 (40.8%) were included for 90-day readmission analysis. Of patients involved in the 30-day analysis, 7140 (1.1%) patients had a readmission within 30 days; of patients involved in the 90-day analysis, 8379 (2.0%) had a readmission within 90 days due to primarily cardiovascular causes. Cox regression analysis revealed that the female sex (aHR 0.89; 95% CI 0.82 to 0.95; p=0.001) was associated with a lower hazard of 30-day cardiovascular readmissions; however, congestive heart failure (aHR 2.45; 95% CI 2.2 to 2.72; p
Læs mere Tjek på PubMedStone, G., Sisk, A., Brown, M., Corder, A., Tea, K., Zu, Y., Shaffer, J., Kashyap, R., Qadir, N., Denson, J. L.
BMJ Open, 10.11.2023
Tilføjet 10.11.2023
IntroductionAcute respiratory distress syndrome (ARDS) is a life-threatening condition commonly seen in the intensive care unit. COVID-19 has dramatically increased the incidence of ARDS—with this rise in cases comes the ability to detect predisposing factors perhaps not recognised before, such as metabolic syndrome (MetS) and its associated conditions (hypertension, obesity, dyslipidaemia and type 2 diabetes mellitus). In this systematic review, we seek to describe the complex relationship between MetS, its associated conditions and ARDS (including COVID-19 ARDS). Methods and analysisA systematic search of PubMed, Embase, Cochrane Central Register of Controlled Trials, CINAHL and Web of Science will be conducted. The population of interest is adults with ARDS and MetS (as defined according to the study author recognising that MetS definitions vary) or any MetS-associated condition. The control group will be adult patients with ARDS without MetS or any individual MetS-associated condition. We will search studies published in English, with a date restriction from the year 2000 to June 2023 and employ the search phrases ‘metabolic syndrome’, ‘acute respiratory distress syndrome’ and related terms. Search terms including ‘dyslipidaemia’, ‘hypertension’, ‘diabetes mellitus’ and ‘obesity’ will also be utilised. Outcomes of interest will include mortality (in-hospital, ICU, 28-day, 60-day and 90-day), days requiring mechanical ventilation and hospital and/or ICU length of stay. Study bias will be assessed using the NIH Bias Scale. Ethics and disseminationEthical approval is not required because this study includes previously published and publicly accessible data. Findings from this review will be disseminated via publication in a peer-reviewed journal. PROSPERO registration numberCRD42023405816.
Læs mere Tjek på PubMedInfectious Disease Modelling, 10.11.2023
Tilføjet 10.11.2023
Publication date: Available online 10 November 2023 Source: Infectious Disease Modelling Author(s): Zhaobin Xu, Jian Song, Weidong Liu, Dongqing Wei
Læs mere Tjek på PubMedShankar Iyer
Trends in Microbiology, 10.11.2023
Tilføjet 10.11.2023
This year marks the 30th anniversary of Trends in Microbiology (TiM). Since the 25th anniversary milestone, the field of microbiology has undergone a tectonic shift brought about by the coronavirus disease 2019 (COVID-19) pandemic. The research, grant application, publication, and overall scientific communication landscapes have rapidly changed and adapted to new developments. The year 2022 saw the emergence of several cases of monkeypox in various countries where the disease is not endemic. Alongside this, the antimicrobial resistance (AMR) crisis remains a significant public threat calling for methods of surveillance and the need for urgent action.
Læs mere Tjek på PubMedClinical Infectious Diseases, 10.11.2023
Tilføjet 10.11.2023
AbstractThe goals of COVID-19 antiviral therapy early in the pandemic were to prevent severe disease, hospitalization, and death. As these outcomes have become infrequent in the age of widespread population immunity, the objectives have shifted. For the general population, COVID-19-directed antiviral therapy should decrease symptom severity and duration and minimize infectiousness and for immunocompromised individuals, antiviral therapy should reduce severe outcomes and persistent infection. The increased recognition of virologic rebound following ritonavir-boosted nirmatrelvir (NMV/r) and the lack of randomized controlled trial data showing benefit of antiviral therapy for SARS-CoV-2 infection for standard-risk, vaccinated individuals remain major knowledge gaps. Here, we review data for selected antiviral agents and immunomodulators currently available or in late-stage clinical trials for use in outpatients. We do not review antibody products, convalescent plasma, systemic corticosteroids, IL-6 inhibitors, Janus kinase inhibitors, or agents which lack FDA approval or emergency use authorization or are not appropriate for outpatients.
Læs mere Tjek på PubMedMelissa L. Boby, Daren Fearon, Matteo Ferla, Mihajlo Filep, Lizbé Koekemoer, Matthew C. Robinson, The COVID Moonshot Consortium‡, John D. Chodera, Alpha A. Lee, Nir London, Annette von Delft, Frank von Delft , Hagit Achdout, Anthony Aimon, Dominic S. Alonzi, Robert Arbon, Jasmin C. Aschenbrenner, Blake H. Balcomb, Elad Bar-David, Haim Barr, Amir Ben-Shmuel, James Bennett, Vitaliy A. Bilenko, Bruce Borden, Pascale Boulet, Gregory R. Bowman, Lennart Brewitz, Juliane Brun, Sarma BVNBS, Mark Calmiano, Anna Carbery, Daniel W. Carney, Emma Cattermole, Edcon Chang, Eugene Chernyshenko, Austin Clyde, Joseph E. Coffland, Galit Cohen, Jason C. Cole, Alessandro Contini, Lisa Cox, Tristan Ian Croll, Milan Cvitkovic, Steven De Jonghe, Alex Dias, Kim Donckers, David L. Dotson, Alice Douangamath, Shirly Duberstein, Tim Dudgeon, Louise E. Dunnett, Peter Eastman, Noam Erez, Charles J. Eyermann, Michael Fairhead, Gwen Fate, Oleg Fedorov, Rafaela S. Fernandes, Lori Ferrins, Richard Foster, Holly Foster, Laurent Fraisse, Ronen Gabizon, Adolfo García-Sastre, Victor O. Gawriljuk, Paul Gehrtz, Carina Gileadi, Charline Giroud, William G. Glass, Robert C. Glen, Itai Glinert, Andre S. Godoy, Marian Gorichko, Tyler Gorrie-Stone, Ed J. Griffen, Amna Haneef, Storm Hassell Hart, Jag Heer, Michael Henry, Michelle Hill, Sam Horrell, Qiu Yu Judy Huang, Victor D. Huliak, Matthew F. D. Hurley, Tomer Israely, Andrew Jajack, Jitske Jansen, Eric Jnoff, Dirk Jochmans, Tobias John, Benjamin Kaminow, Lulu Kang, Anastassia L. Kantsadi, Peter W. Kenny, J. L. Kiappes, Serhii O. Kinakh, Boris Kovar, Tobias Krojer, Van Ngoc Thuy La, Sophie Laghnimi-Hahn, Bruce A. Lefker, Haim Levy, Ryan M. Lithgo, Ivan G. Logvinenko, Petra Lukacik, Hannah Bruce Macdonald, Elizabeth M. MacLean, Laetitia L. Makower, Tika R. Malla, Peter G. Marples, Tatiana Matviiuk, Willam McCorkindale, Briana L. McGovern, Sharon Melamed, Kostiantyn P. Melnykov, Oleg Michurin, Pascal Miesen, Halina Mikolajek, Bruce F. Milne, David Minh, Aaron Morris, Garrett M. Morris, Melody Jane Morwitzer, Demetri Moustakas, Charles E. Mowbray, Aline M. Nakamura, Jose Brandao Neto, Johan Neyts, Luong Nguyen, Gabriela D. Noske, Vladas Oleinikovas, Glaucius Oliva, Gijs J. Overheul, C. David Owen, Ruby Pai, Jin Pan, Nir Paran, Alexander Matthew Payne, Benjamin Perry, Maneesh Pingle, Jakir Pinjari, Boaz Politi, Ailsa Powell, Vladimír Pšenák, Iván Pulido, Reut Puni, Victor L. Rangel, Rambabu N. Reddi, Paul Rees, St Patrick Reid, Lauren Reid, Efrat Resnick, Emily Grace Ripka, Ralph P. Robinson, Jaime Rodriguez-Guerra, Romel Rosales, Dominic A. Rufa, Kadi Saar, Kumar Singh Saikatendu, Eidarus Salah, David Schaller, Jenke Scheen, Celia A. Schiffer, Christopher J. Schofield, Mikhail Shafeev, Aarif Shaikh, Ala M. Shaqra, Jiye Shi, Khriesto Shurrush, Sukrit Singh, Assa Sittner, Peter Sjö, Rachael Skyner, Adam Smalley, Bart Smeets, Mihaela D. Smilova, Leonardo J. Solmesky, John Spencer, Claire Strain-Damerell, Vishwanath Swamy, Hadas Tamir, Jenny C. Taylor, Rachael E. Tennant, Warren Thompson, Andrew Thompson, Susana Tomásio, Charles W. E. Tomlinson, Igor S. Tsurupa, Anthony Tumber, Ioannis Vakonakis, Ronald P. van Rij, Laura Vangeel, Finny S. Varghese, Mariana Vaschetto, Einat B. Vitner, Vincent Voelz, Andrea Volkamer, Martin A. Walsh, Walter Ward, Charlie Weatherall, Shay Weiss, Kris M. White, Conor Francis Wild, Karolina D. Witt, Matthew Wittmann, Nathan Wright, Yfat Yahalom-Ronen, Nese Kurt Yilmaz, Daniel Zaidmann, Ivy Zhang, Hadeer Zidane, Nicole Zitzmann, Sarah N. Zvornicanin
Science, 10.11.2023
Tilføjet 10.11.2023
Roopa Farooki
Lancet, 10.11.2023
Tilføjet 10.11.2023
It\'s fair to say that the first floor of the Royal College of Physicians (RCP) is a safe space; it is light and airy, with high ceilings and stained-glass details in the windows. The RCP\'s new exhibition, Fortitude: Healthcare Workers’ Experiences of the COVID-19 Pandemic, arranged down a long wall, does not try to dominate. At first sight, it is a disparate and eclectic collection; glass cases with snapshots in candid moments, scraps of writing and small mementos, headphones promising voiced accounts, notwithstanding the short film and professional photographs of health-care workers that are prominently displayed.
Læs mere Tjek på PubMedErica Charters
Lancet, 10.11.2023
Tilføjet 10.11.2023
COVID-19 inquiries, reflections on the pandemic, and revised preparedness plans for the next outbreak signal that we have moved into the end stage of the COVID-19 pandemic, although infections and illness continue. The end of an epidemic is marked not by the disappearance of disease, but by looking back to make sense of what happened, identifying what went wrong, and transforming affliction into lessons learned, linking past frustrations to future optimism. Simon Schama\'s sweeping history of vaccines, Foreign Bodies: Pandemics, Vaccines, and the Health of Nations, fits neatly into this stage of epidemic trajectory.
Læs mere Tjek på PubMedThe PLOS ONE Editors
PLoS One Infectious Diseases, 10.11.2023
Tilføjet 10.11.2023
Chenhuan Kou, Xiuli Yang
PLoS One Infectious Diseases, 10.11.2023
Tilføjet 10.11.2023
by Chenhuan Kou, Xiuli Yang Social resilience is a key factor in disaster management, but compared to resilience in other fields, research on social resilience is still limited to assessment or evaluation, and there is still a lack of dynamic and procedural research, which is also a challenge. This article constructs a causal feedback model and a system dynamics model of social resilience during the COVID-19 epidemic, so as to analyze the dynamic characteristics and improvement path of social resilience. After verifying the effectiveness of the model, model simulation is conducted and the following important conclusions are drawn: social resilience dynamically changes during the research cycle and is influenced by social entity behavior and social mechanisms; The sensitivity factors for the two variables that measure social resilience, namely panic degree and damage degree, are the real-time information acquisition of public and the epidemic awareness of local government, respectively. Therefore, the path to enhancing social resilience should be pursued from both the public and government perspectives, including improving the public’s ability to access real-time information, increasing the timeline of government information disclosure, and enhancing local governments’ understanding and awareness of the epidemic.
Læs mere Tjek på PubMedInfection, 10.11.2023
Tilføjet 10.11.2023
Abstract We present a case of an ultimately fatal course of COVID-19 (coronavirus disease-19) in an 81-year-old female patient during the Omicron surge. The patient did not represent the typical patient at risk for severe COVID-19 with significant causes of immunodeficiency. However, she had been skeptical about the vaccination for severe acute respiratory syndrome virus-2 (SARS-CoV-2) and had refused it. Moreover, there had been no previous COVID-19 episodes. Our case report illustrates that with regard to SARS-CoV-2, immunologically naive patients are still at risk for severe and/or even fatal courses of COVID-19. We call to implement both, recommendations for SARS-CoV-2 vaccinations as well as for antiviral treatment.
Læs mere Tjek på PubMedLeonie K. Dallmeyer, Marit L. Schüz, Paraskevi C. Fragkou, Jimmy Omony, Hanna Krumbein, Dimitra Dimopoulou, Konstantina Dimopoulou, Chrysanthi Skevaki
International Journal of Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
On March 11, 2020, the World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) as a pandemic.[1] To prevent further spread of the virus many countries introduced public health measures such as closure of educational institutions, mandatory quarantine, stay-at-home restrictions and personal protective equipment like face masks.[2] Due to similar transmission routes, it seems plausible to assume that these measures also influenced the spread and distribution of other viruses.
Læs mere Tjek på PubMedBramwell, C., Carrieri, D., Melvin, A., Pearson, A., Scott, J., Hancock, J., Pearson, M., Papoutsi, C., Wong, G., Mattick, K.
BMJ Open, 9.11.2023
Tilføjet 9.11.2023
IntroductionThe growing incidence of mental ill health in doctors was a major issue in the UK and internationally, even prior to the COVID-19 pandemic. It has significant and far-reaching implications, including poor quality or inconsistent patient care, absenteeism, workforce attrition and retention issues, presenteeism, and increased risk of suicide. Existing approaches to workplace support do not take into account the individual, organisational and social factors contributing to mental ill health in doctors, nor how interventions/programmes might interact with each other within the workplace. The aim of this study is to work collaboratively with eight purposively selected National Health Service (NHS) trusts within England to develop an evidence-based implementation toolkit for all NHS trusts to reduce doctors’ mental ill health and its impacts on the workforce. Methods and analysisThe project will incorporate three phases. Phase 1 develops a typology of interventions to reduce doctors’ mental ill health. Phase 2 is a realist evaluation of the existing combinations of strategies being used by acute English healthcare trusts to reduce doctors’ mental ill health (including preventative promotion of well-being), based on 160 interviews with key stakeholders. Phase 3 synthesises the insights gained through phases 1 and 2, to create an implementation toolkit that all UK healthcare trusts can use to optimise their strategies to reduce doctors’ mental ill health and its impact on the workforce and patient care. Ethics and disseminationEthical approval has been granted for phase 2 of the project from the NHS Research Ethics Committee (REC reference number 22/WA/0352). As part of the conditions for our ethics approval, the sites included in our study will remain anonymous. To ensure the relevance of the study’s outputs, we have planned a wide range of dissemination strategies: an implementation toolkit for healthcare leaders, service managers and doctors; conventional academic outputs such as journal manuscripts and conference presentations; plain English summaries; cartoons and animations; and a media engagement campaign.
Læs mere Tjek på PubMedMacMartin, M., Zeng, A., Chelen, J., Barnato, A., Chuang, E.
BMJ Open, 9.11.2023
Tilføjet 9.11.2023
ObjectivesThe COVID-19 pandemic prompted planning for clinical surges and associated resource shortages, particularly of equipment such as ventilators. We sought to examine the experience of the healthcare professionals who created policies for crisis standards of care, and allocation of ventilators in the event of shortage. DesignTo that end, we conducted semistructured interviews with healthcare professionals in the USA involved in institutional planning for resource shortages in the setting of the COVID-19 pandemic. SettingUSA. ParticipantsWe conducted 25 interviews between May and July 2021. Half of the respondents were female (48%), many from Northeastern institutions (52%), and most practised in academic institutions (92%). ResultsMany (64%) respondents reported that their institution had an approved policy to guide ventilator allocation in the event of a shortage. We identified one overarching theme: the work of planning for resource shortages imposed a psychological burden on many planners. We identified four subthemes that influenced that burden: impact of leadership, institutional variation in process and policies, faith in the policies and future directions. ConclusionsImproved leadership strategies and cross-institutional collaboration can reduce the psychological burden of planning and facilitate updating plans in anticipation of future shortages.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Infection prevention measures are the gold standard for preventing the spread of hospital-acquired infections (HAIs). COVID-19 pandemic caused major disruptions in infection prevention measures, and this has implications on the rate of HAIs. This study assessed the impact of COVID-19 pandemic on the rate and the types of HAIs at Sultan Ahmed Shah Hospital. Method This is a retrospective cohort study that compared the rate of HAIs from April to October 2019 (pre COVID period) and April to October 2020 (during COVID period). Data was collected through the review of patients’ electronic medical records. Results There were a total of 578 patients included in the selected wards during the pre- and during the pandemic. Thirty-nine episodes (12.1%) of HAIs were report in the pre COVID period and 29 (11.3%) during COVID-19. In both periods, hospital-acquired pneumonia (HAP) was the most frequent HAI among the patients. There was a rise in catheter-associated bloodstream infections (CLABSI) (0.8%) and ventilator associated pneumonia (VAP) (1.1%) during the COVID-19 period. The most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA) (28.2%) and Enterococcus faecalis (17.9%) in the Pre COVID-19 period, and Pseudomonas aeruginosa (27.6%) and Stenotrophomonas maltophilia (6.9%) during COVID-19. Conclusion Our research concluded that the rates of HAIs during the COVID-19 pandemic were not significantly impacted by the improved in-hospital infection prevention efforts to control the pandemic. There is need for further efforts to promote adherence to preventive practices.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Infection prevention measures are the gold standard for preventing the spread of hospital-acquired infections (HAIs). COVID-19 pandemic caused major disruptions in infection prevention measures, and this has implications on the rate of HAIs. This study assessed the impact of COVID-19 pandemic on the rate and the types of HAIs at Sultan Ahmed Shah Hospital. Method This is a retrospective cohort study that compared the rate of HAIs from April to October 2019 (pre COVID period) and April to October 2020 (during COVID period). Data was collected through the review of patients’ electronic medical records. Results There were a total of 578 patients included in the selected wards during the pre- and during the pandemic. Thirty-nine episodes (12.1%) of HAIs were report in the pre COVID period and 29 (11.3%) during COVID-19. In both periods, hospital-acquired pneumonia (HAP) was the most frequent HAI among the patients. There was a rise in catheter-associated bloodstream infections (CLABSI) (0.8%) and ventilator associated pneumonia (VAP) (1.1%) during the COVID-19 period. The most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA) (28.2%) and Enterococcus faecalis (17.9%) in the Pre COVID-19 period, and Pseudomonas aeruginosa (27.6%) and Stenotrophomonas maltophilia (6.9%) during COVID-19. Conclusion Our research concluded that the rates of HAIs during the COVID-19 pandemic were not significantly impacted by the improved in-hospital infection prevention efforts to control the pandemic. There is need for further efforts to promote adherence to preventive practices.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Clinical evidence suggests that pregnant women are more vulnerable to COVID-19, since they are at increased risk for disease progression and for obstetric complications, such as premature labor, miscarriage, preeclampsia, cesarean delivery, fetal growth restriction and perinatal death. Despite this evidence, pregnant women are often excluded from clinical trials, resulting in limited knowledge on COVID-19 management. The aim of this systematic review and meta-analysis is to provide better evidence on the efficacy and safety of available COVID-19 treatment in pregnant women. Methods Four authors searched major electronic databases from inception until 1 st November-2022 for controlled trials/observational studies, investigating outcomes after the administration of anti-SARS-CoV-2 treatments in pregnant women affected by COVID-19. The analyses investigated the cumulative incidence of delivery and maternal outcomes in pregnant women, comparing those taking active medication vs standard care. Risk ratios (RRs) with 95% confidence intervals were calculated. Statistical significance was assessed using the random effects model and inverse-variance method. This systematic review and meta-analysis was conducted in accordance with the updated 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol has been registered in Prospero (number registration: CRD42023397445). Results From initially 937 non duplicate records, we assessed the full texts of 40 articles, finally including ten studies. In six studies, including 1627 patients, the use of casirivimab/imdevimab (CAS/IMD), remdesivir, and IFN-alpha 2b significantly decreased the need of cesarean section ((RR = 0.665; 95%CI: 0.491–0.899; p = 0.008; I 2 = 19.5%;) (Table 1, (Fig. 1). Treatments did not decrease the risk of preterm delivery, admission to neonatal ICU, or stillbirth/perinatal loss (p-values > 0.50 for all these outcomes) and did not prevent the progression of disease towards severe degrees (k = 8; 2,374 pregnant women; RR = 0.778; 95%CI: 0.550–1.099; p = 0.15; I 2 = 0%). Moreover, the use of medications during pregnancy did not modify the incidence of maternal death in two studies (Table 2). Conclusions To our analysis, CAS/IMD, remdesivir, and IFN alpha 2b reduced the number of cesarean sections but demonstrated no effect on disease progression and other obstetric and COVID-19 related outcomes. The inability to evaluate the influence of viral load on illness development in pregnant women was attributed to lack of data. In our systematic review, no major side effects were reported. Though, it is essential for the medical community to focus more on clinical trials and less on episodic case reports and case series, with standardization of fetal and maternal outcomes.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background Clinical evidence suggests that pregnant women are more vulnerable to COVID-19, since they are at increased risk for disease progression and for obstetric complications, such as premature labor, miscarriage, preeclampsia, cesarean delivery, fetal growth restriction and perinatal death. Despite this evidence, pregnant women are often excluded from clinical trials, resulting in limited knowledge on COVID-19 management. The aim of this systematic review and meta-analysis is to provide better evidence on the efficacy and safety of available COVID-19 treatment in pregnant women. Methods Four authors searched major electronic databases from inception until 1 st November-2022 for controlled trials/observational studies, investigating outcomes after the administration of anti-SARS-CoV-2 treatments in pregnant women affected by COVID-19. The analyses investigated the cumulative incidence of delivery and maternal outcomes in pregnant women, comparing those taking active medication vs standard care. Risk ratios (RRs) with 95% confidence intervals were calculated. Statistical significance was assessed using the random effects model and inverse-variance method. This systematic review and meta-analysis was conducted in accordance with the updated 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol has been registered in Prospero (number registration: CRD42023397445). Results From initially 937 non duplicate records, we assessed the full texts of 40 articles, finally including ten studies. In six studies, including 1627 patients, the use of casirivimab/imdevimab (CAS/IMD), remdesivir, and IFN-alpha 2b significantly decreased the need of cesarean section ((RR = 0.665; 95%CI: 0.491–0.899; p = 0.008; I 2 = 19.5%;) (Table 1, (Fig. 1). Treatments did not decrease the risk of preterm delivery, admission to neonatal ICU, or stillbirth/perinatal loss (p-values > 0.50 for all these outcomes) and did not prevent the progression of disease towards severe degrees (k = 8; 2,374 pregnant women; RR = 0.778; 95%CI: 0.550–1.099; p = 0.15; I 2 = 0%). Moreover, the use of medications during pregnancy did not modify the incidence of maternal death in two studies (Table 2). Conclusions To our analysis, CAS/IMD, remdesivir, and IFN alpha 2b reduced the number of cesarean sections but demonstrated no effect on disease progression and other obstetric and COVID-19 related outcomes. The inability to evaluate the influence of viral load on illness development in pregnant women was attributed to lack of data. In our systematic review, no major side effects were reported. Though, it is essential for the medical community to focus more on clinical trials and less on episodic case reports and case series, with standardization of fetal and maternal outcomes.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background While many studies on the determinants of post-COVID-19 conditions (PCC) have been conducted, little is known about the relationship between SARS-CoV-2 variants and PCC. This study aimed to assess the association between different SARS-CoV-2 variants and the probability of having PCC three months after the infection. Methods This study was a longitudinal cohort study conducted between April 2021 and September 2022 in Belgium. In total, 8,238 adults with a confirmed SARS-CoV-2 infection were followed up between the time of their infection and three months later. The primary outcomes were the PCC status three months post infection and seven PCC symptoms categories (neurocognitive, autonomic, gastrointestinal, respiratory, musculoskeletal, anosmia and/or dysgeusia, and other manifestations). The main exposure variable was the type of SARS-CoV-2 variants (i.e. Alpha, Delta, and Omicron), extracted from national surveillance data. The association between the different SARS-CoV-2 variants and PCC as well as PCC symptoms categories was assessed using multivariable logistic regression. Results The proportion of PCC among participants infected during the Alpha, Delta, and Omicron-dominant periods was significantly different and respectively 50%, 50%, and 37%. Participants infected during the Alpha- and Delta-dominant periods had a significantly higher odds of having PCC than those infected during the Omicron-dominant period (OR = 1.61, 95% confidence interval [CI] = 1.33–1.96 and OR = 1.73, 95%CI = 1.54–1.93, respectively). Participants infected during the Alpha and Delta-dominant periods were more likely to report neurocognitive, respiratory, and anosmia/dysgeusia symptoms of PCC. Conclusions People infected during the Alpha- and Delta-dominant periods had a higher probability of having PCC three months after infection than those infected during the Omicron-dominant period. The lower probability of PCC with the Omicron variant must also be interpreted in absolute figures. Indeed, the number of infections with the Omicron variant being higher than with the Alpha and Delta variants, it is possible that the overall prevalence of PCC in the population increases, even if the probability of having a PCC decreases.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.11.2023
Tilføjet 9.11.2023
Abstract Background While many studies on the determinants of post-COVID-19 conditions (PCC) have been conducted, little is known about the relationship between SARS-CoV-2 variants and PCC. This study aimed to assess the association between different SARS-CoV-2 variants and the probability of having PCC three months after the infection. Methods This study was a longitudinal cohort study conducted between April 2021 and September 2022 in Belgium. In total, 8,238 adults with a confirmed SARS-CoV-2 infection were followed up between the time of their infection and three months later. The primary outcomes were the PCC status three months post infection and seven PCC symptoms categories (neurocognitive, autonomic, gastrointestinal, respiratory, musculoskeletal, anosmia and/or dysgeusia, and other manifestations). The main exposure variable was the type of SARS-CoV-2 variants (i.e. Alpha, Delta, and Omicron), extracted from national surveillance data. The association between the different SARS-CoV-2 variants and PCC as well as PCC symptoms categories was assessed using multivariable logistic regression. Results The proportion of PCC among participants infected during the Alpha, Delta, and Omicron-dominant periods was significantly different and respectively 50%, 50%, and 37%. Participants infected during the Alpha- and Delta-dominant periods had a significantly higher odds of having PCC than those infected during the Omicron-dominant period (OR = 1.61, 95% confidence interval [CI] = 1.33–1.96 and OR = 1.73, 95%CI = 1.54–1.93, respectively). Participants infected during the Alpha and Delta-dominant periods were more likely to report neurocognitive, respiratory, and anosmia/dysgeusia symptoms of PCC. Conclusions People infected during the Alpha- and Delta-dominant periods had a higher probability of having PCC three months after infection than those infected during the Omicron-dominant period. The lower probability of PCC with the Omicron variant must also be interpreted in absolute figures. Indeed, the number of infections with the Omicron variant being higher than with the Alpha and Delta variants, it is possible that the overall prevalence of PCC in the population increases, even if the probability of having a PCC decreases.
Læs mere Tjek på PubMed