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47 ud af 47 tidsskrifter valgt, søgeord (covid) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
1285 emner vises.
Giorgia Minello, Carlo Romano Marcello Alessandro Santagiustina, Massimo Warglien
PLoS One Infectious Diseases, 4.04.2024
Tilføjet 4.04.2024
by Giorgia Minello, Carlo Romano Marcello Alessandro Santagiustina, Massimo Warglien During the COVID-19 pandemic, the scientific literature related to SARS-COV-2 has been growing dramatically. These literary items encompass a varied set of topics, ranging from vaccination to protective equipment efficacy as well as lockdown policy evaluations. As a result, the development of automatic methods that allow an in-depth exploration of this growing literature has become a relevant issue, both to identify the topical trends of COVID-related research and to zoom-in on its sub-themes. This work proposes a novel methodology, called LDA2Net, which combines topic modelling and network analysis, to investigate topics under their surface. More specifically, LDA2Net exploits the frequencies of consecutive words pairs (i.e. bigram) to build those network structures underlying the hidden topics extracted from large volumes of text by Latent Dirichlet Allocation (LDA). Results are promising and suggest that the topic model efficacy is magnified by the network-based representation. In particular, such enrichment is noticeable when it comes to displaying and exploring the topics at different levels of granularity.
Læs mere Tjek på PubMedMaduro, G., Li, W., Huynh, M., Bernard-Davila, B., Gould, L. H., Van Wye, G.
BMJ Open, 3.04.2024
Tilføjet 3.04.2024
ObjectiveAssessing excess deaths from benchmarks across causes of death during the first wave of the COVID-19 pandemic and identifying morbidities most frequently mentioned alongside COVID-19 deaths in the death record. MethodsDescriptive study of death records between 11 March 2020 and 27 July 2020, from the New York City Bureau of Vital Statistics. Mortality counts and percentages were compared with the average for the same calendar period of the previous 2 years. Distributions of morbidities from among forty categories of conditions were generated citywide and by sex, race/ethnicity and four age groups. Causes of death were assumed to follow Poisson processes for Z-score construction. ResultsWithin the study period, 46 563 all-cause deaths were reported; 132.9% higher than the average for the same period of the previous 2 years (19 989). Of those 46 563 records, 19 789 (42.5%) report COVID-19 as underlying cause of death. COVID-19 was the most prevalent cause across all demographics, with respiratory conditions (prominently pneumonia), hypertension and diabetes frequently mentioned morbidities. Black non-Hispanics had greater proportions of mentions of pneumonia, hypertension, and diabetes. Hispanics had the largest proportion of COVID-19 deaths (52.9%). Non-COVID-19 excess deaths relative to the previous 2-year averages were widely reported. ConclusionMortality directly due to COVID-19 was accompanied by significant increases across most other causes from their reference averages, potentially suggesting a sizable COVID-19 death undercount. Indirect effects due to COVID-19 may partially account for some increases, but findings are hardly dispositive. Unavailability of vaccines for the time period precludes any impact over excess deaths. Respiratory and cardiometabolic-related conditions were most frequently reported among COVID-19 deaths across demographic characteristics.
Læs mere Tjek på PubMedClohessy, S., Arvanitis, T. N., Rashid, U., Craddock, C., Evans, M., Toro, C. T., Elliott, M. T.
BMJ Open, 3.04.2024
Tilføjet 3.04.2024
ObjectiveThe COVID-19 pandemic accelerated changes to clinical research methodology, with clinical studies being carried out via online/remote means. This mixed-methods study aimed to identify which digital tools are currently used across all stages of clinical research by stakeholders in clinical, health and social care research and investigate their experience using digital tools. DesignTwo online surveys followed by semistructured interviews were conducted. Interviews were audiorecorded, transcribed and analysed thematically. Setting, participantsTo explore the digital tools used since the pandemic, survey participants (researchers and related staff (n=41), research and development staff (n=25)), needed to have worked on clinical, health or social care research studies over the past 2 years (2020–2022) in an employing organisation based in the West Midlands region of England (due to funding from a regional clinical research network (CRN)). Survey participants had the opportunity to participate in an online qualitative interview to explore their experiences of digital tools in greater depth (n=8). ResultsSix themes were identified in the qualitative interviews: ‘definition of a digital tool in clinical research’; ‘impact of the COVID-19 pandemic’; ‘perceived benefits/drawbacks of digital tools’; ‘selection of a digital tool’; ‘barriers and overcoming barriers’ and ‘future digital tool use’. The context of each theme is discussed, based on the interview results. ConclusionsFindings demonstrate how digital tools are becoming embedded in clinical research, as well as the breadth of tools used across different research stages. The majority of participants viewed the tools positively, noting their ability to enhance research efficiency. Several considerations were highlighted; concerns about digital exclusion; need for collaboration with digital expertise/clinical staff, research on tool effectiveness and recommendations to aid future tool selection. There is a need for the development of resources to help optimise the selection and use of appropriate digital tools for clinical research staff and participants.
Læs mere Tjek på PubMedTungsanga, S., Ghimire, A., Hariramani, V. K., Abdulrahman, A., Khan, A. S., Ye, F., Kung, J. Y., Klarenbach, S., Thompson, S., Collister, D., Srisawat, N., Okpechi, I. G., Bello, A. K.
BMJ Open, 3.04.2024
Tilføjet 3.04.2024
IntroductionIn recent decades, all-cause mortality has increased among individuals with chronic kidney disease (CKD), influenced by factors such as aetiology, standards of care and access to kidney replacement therapies (dialysis and transplantation). The recent COVID-19 pandemic also affected mortality over the past few years. Here, we outline the protocol for a systematic review to investigate global temporal trends in all-cause mortality among patients with CKD at any stage from 1990 to current. We also aim to assess temporal trends in the mortality rate associated with the COVID-19 pandemic. Methods and analysisWe will conduct a systematic review of studies reporting mortality for patients with CKD following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will search electronic databases, national and multiregional kidney registries and grey literature to identify observational studies that reported on mortality associated with any cause for patients with CKD of all ages with any stage of the disease. We will collect data between April and August 2023 to include all studies published from 1990 to August 2023. There will be no language restriction, and clinical trials will be excluded. Primary outcome will be temporal trends in CKD-related mortality. Secondary outcomes include assessing mortality differences before and during the COVID-19 pandemic, exploring causes of death and examining trends across CKD stages, country classifications, income levels and demographics. Ethics and disseminationA systematic review will analyse existing data from previously published studies and have no direct involvement with patient data. Thus, ethical approval is not required. Our findings will be published in an open-access peer-reviewed journal and presented at scientific conferences. PROSPERO registration numberCRD42023416084.
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 3.04.2024
Tilføjet 3.04.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 4 Pages: 741-748
Læs mere Tjek på PubMedPetrie, S., Laur, C., Rios, P., Suarez, A., Makanjuola, O., Burke, E., Bhattacharyya, O., Mukerji, G.
BMJ Open, 3.04.2024
Tilføjet 3.04.2024
ObjectivesDelivery of virtual care increased throughout the COVID-19 pandemic and persisted after physical distancing measures ended. However, little is known about how to measure the quality of virtual care, as current measures focus on in-person care and may not apply to a virtual context. This scoping review aims to understand the connections between virtual care modalities used with ambulatory patient populations and quality measures across the Quintuple Aim (provider experience, patient experience, per capita cost, population health and health equity). DesignVirtual care was considered any interaction between patients and/or their circle of care occurring remotely using any form of information technology. Five databases (MEDLINE, Embase, PsycInfo, Cochrane Library, JBI) and grey literature sources (11 websites, 3 search engines) were searched from 2015 to June 2021 and again in August 2022 for publications that analysed virtual care in ambulatory settings. Indicators were extracted, double-coded into the Quintuple Aim framework; patient and provider experience indicators were further categorised based on the National Academy of Medicine quality framework (safety, effectiveness, patient-centredness, timeliness, efficiency and equity). Sustainability was added to capture the potential for continued use of virtual care. Results13 504 citations were double-screened resulting in 631 full-text articles, 66 of which were included. Common modalities included video or audio visits (n=43), remote monitoring (n=11) and mobile applications (n=11). The most common quality indicators were related to patient experience (n=58 articles), followed by provider experience (n=25 articles), population health outcomes (n=23 articles) and health system costs (n=19 articles). ConclusionsThe connections between virtual care modalities and quality domains identified here can inform clinicians, administrators and other decision-makers how to monitor the quality of virtual care and provide insights into gaps in current quality measures. The next steps include the development of a balanced scorecard of virtual care quality indicators for ambulatory settings to inform quality improvement.
Læs mere Tjek på PubMedLee, J., Wong, K. K.-Y.
BMJ Open, 3.04.2024
Tilføjet 3.04.2024
ObjectivesThe impact of the COVID-19 pandemic on adolescent’s mental health and relationships has received growing attention, yet the challenges and support needs of adolescents living in existing deprivation are not well understood. The current qualitative study, part of a broader project cocreating mental health and life-skill workshops with young people, documents adolescents’ lived experience and support needs 4 years on from the COVID-19 pandemic. Design20 semi-structured interviews and 6 focus groups were transcribed and thematically analysed in NVivo V.12 to inform codesigned workshops to support adolescents’ needs. SettingIslington borough in North London, United Kingdom. Participants20 adolescents aged 14–25 years (mean=18.3; 60% female, 60% white) from Islington with a history of difficulties (eg, mental health, deprivation, court order) were referred by Islington local authority teams to our study. ResultsThematic analyses revealed eight themes on adolescents’ COVID-19 experiences and five associated suggestions on ‘support needs’: health challenges and support; relationships and support; routines and support; educational challenges and learning support; inequality and support; distrust; loss of opportunities and grief. ConclusionsIn our qualitative study, adolescents spoke of positive reflections, challenges, and need for support 4 years on from the COVID-19 pandemic. Many adolescents shared their lived experiences for the first time with someone else and wished they would have the space and time to acknowledge this period of loss. Adolescents living with existing inequality and deprivation before the pandemic have reported sustained and exacerbated impacts during the pandemic, hence coproduced support for adolescents should be a priority.
Læs mere Tjek på PubMedCélia Regina Malveste ItoMônica Oliveira SantosMarcos de Oliveira CunhaKelliane Martins de AraújoGuilherme Rocha Lino de SouzaGeovana Sôffa RézioPollyanna Neta de BritoAlana Parreira Costa RezendeJakeline Godinho FonsecaIsabela Jubé WastowskiJosé Daniel Gonçalves VieiraMelissa Ameloti Gomes AvelinoLilian Carla Carneiroa Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health, Federal University of Goiás– 235 St. Leste Universitário neighborhood, Goiânia, Goiás, Brazilb Biochemistry and Molecular Biology Laboratory, Biologic Science Institute, Federal University of Goiás, Samambaia Camp, Goiânia, Goiás, Brazilc State Emergency Hospital of the Northwest Region of Goiânia Governador Otávio Lage de Siqueira (HUGOL), Goiânia, Goiás, Brazild Molecular Immunology Laboratory of Goiás State University, Laranjeiras Unity Prof. Alfredo de Castro neighborhood, Goiânia, Goiás, Brazile Department of Pediatrics, Federal University of Goiás, Universitaria Avenue, Leste Universitário neighborhood, Goiânia, Goiás, Brazil
Virulence, 3.04.2024
Tilføjet 3.04.2024
Natalie M. KirkYuying LiangHinh LyDepartment of Veterinary & Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, Twin Cities, MN, USA
Virulence, 3.04.2024
Tilføjet 3.04.2024
Karina Leksy, Grzegorz Gawron, Rafaela Rosário
PLoS One Infectious Diseases, 3.04.2024
Tilføjet 3.04.2024
by Karina Leksy, Grzegorz Gawron, Rafaela Rosário The coronavirus pandemic has contributed to increasing the responsibility of school principals for the health of all school community members. Moreover, evidence confirms the significant role of school principals’ health literacy (HL) for health promotion in schools. Therefore, the presented study aims to evaluate the associations between Polish school principals HL and the implementation of the Health Promoting School (HPS) approach in Polish schools. The present study was conducted as part of an international survey on the global COVID-HL network (www.covid-hl.eu) between June 2021 and December 2021. Three subscales of the HPS were considered and an exploratory analysis were used in this study. Associations between the median split of each subscale of HPS (outcome) and health literacy (predictor) were performed using logistic regression. Research results showed that the highest level of HPS implementation was directed at pupils. Principals perceived themselves as having the highest HL on the ‘accessibility’ subscale and these respondents had significantly higher odds of implementing learning opportunities for students. The study suggests that principals with adequate HL may be more likely to effectively implement HPS strategies in schools. This research could provide insights into the complex interplay between HL and the HPS approach and inform the development of more effective strategies for promoting health and HL in schools.
Læs mere Tjek på PubMedYacheng Zhou, Feiyu Liu, Weidong Huo, Changjiang Peng
PLoS One Infectious Diseases, 3.04.2024
Tilføjet 3.04.2024
by Yacheng Zhou, Feiyu Liu, Weidong Huo, Changjiang Peng The expansion of the Belt and Road Initiative (BRI) has raised a wide range of concerns about its environmental impact. Therefore, from the perspective of environmental impacts, this study used the two-way fixed effect staggered differences in differences (TWFE Staggered DID) method to examine the impact of the BRI on the Environment Goods (EGs) intra-industry trade (IIT) between China and other Belt and Road (B&R) countries, including a sample of 191 countries, covering the period from 2010 to 2019 for eliminating the impact of COVID-19 and the financial crisis in 2008 and 2009. Because only 135 countries signed a Memorandum of Understanding between 2010 and 2019, this study treated these B&R countries as the study group, and the other 73 countries (non-B&R countries) as the control group. This study described EGs using the 54 6-digit code Environment Goods in Harmonized Commodity Description and Coding System listed in the “APEC LIST OF ENVIRONMENT GOODS” published by the Asia-Pacific Economic Cooperation in 2012, and used the intra-industry trade index proposed by Grubel and Lloyd in 1971 to measuring dependent variable. The research results indicated that the BRI has significantly promoted bilateral EGs IIT. The mechanism test implied that, in addition to direct impacts, the BRI also has indirect impacts by boosting the energy restructuring of B&R countries. These results prove that the BRI has positive impacts on the environment. The heterogeneity test showed that there is a heterogeneous impact depending on the type of IIT, product categorization, B&R countries’ income levels, and geographic environment. This study not only gives theoretical and empirical evidence of the positive environmental impacts of the BRI, but also provides practical guidance for the development of EGS IIT between China and B&R countries, thereby contributing to global carbon emissions reduction and environmental governance to some degree.
Læs mere Tjek på PubMedElisa Correcher-Martínez, Mónica López-Lacort, Cintia Muñoz-Quiles, Javier Díez-Domingo, Alejandro Orrico-Sánchez
International Journal of Infectious Diseases, 2.04.2024
Tilføjet 2.04.2024
Coronavirus disease (COVID-19), an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with very wide-ranging symptoms. Although the most common symptoms derive from infection of the respiratory tract, several cutaneous manifestations of COVID-19 exist [1,2]. Among these, cases of vesicular lesions and herpes zoster (HZ)-compatible cutaneous manifestations were reported in patients infected with SARS-CoV-2 during the first year of the COVID-19 pandemic [3–5].
Læs mere Tjek på PubMedJournal of the American Medical Association, 2.04.2024
Tilføjet 2.04.2024
New guidance from the US Centers for Disease Control and Prevention (CDC) provides updated measures to combat respiratory viruses such as SARS-CoV-2, influenza, and respiratory syncytial virus. The recommendations come at a time when deaths and hospitalizations from COVID-19 have decreased from the peak of the pandemic and the availability of tools to fight respiratory viruses is greater than ever, the agency noted.
Læs mere Tjek på PubMedJournal of the American Medical Association, 2.04.2024
Tilføjet 2.04.2024
From October 2023 to December 2023, older adults made up more than half of COVID-19 hospitalizations in the US. The Centers for Disease Control and Prevention (CDC) now recommends an additional updated 2023-2024 COVID-19 vaccine dose for adults aged 65 years or older.
Læs mere Tjek på PubMedJournal of the American Medical Association, 2.04.2024
Tilføjet 2.04.2024
New data support the idea that care for patients with COVID-19 early in the pandemic may have come at the cost of other services. A population-based study recently published in JAMA Oncology found an overall 13% reduction in all cancer diagnoses in the US from March through December 2020, amounting to approximately 134 000 missed cases, or 1 of every 9 diagnosed cancer cases, the researchers estimated.
Læs mere Tjek på PubMedClinical Infectious Diseases, 2.04.2024
Tilføjet 2.04.2024
Clinical Infectious Diseases, 2.04.2024
Tilføjet 2.04.2024
Abstract Background We aimed to evaluate the cardiac adverse events (AEs) in hospitalized patients with Coronavirus Disease 2019 (COVID-19) receiving remdesivir plus standard of care (SoC) compared to SoC alone (control), as an association was noted in some cohort studies and disproportionality analyses of safety databases.Methods This post-hoc safety analysis is based on data from the multicenter, randomized, open-label, controlled DisCoVeRy trial in hospitalized patients with COVID-19 (NCT04315948). Any first AE occurring between randomization and day 29 in the modified intention-to-treat (mITT) population randomized to either remdesivir or control group was considered. Analysis was performed using Kaplan-Meier survival curves and Kaplan-Meier estimates were calculated for event rates.Results Cardiac AEs were reported in 46 (11.2%) of 410 and 48 (11.3%) of 423 patients in the mITT population (n = 833) enrolled in the remdesivir and control groups, respectively. The difference between both groups was not significant (HR 1.0, 95% CI 0.7-1.5, p = 0.98), even when evaluating serious and non-serious cardiac AEs separately. The majority of reports in both groups were of arrhythmic nature (remdesivir, 84.8%; control, 83.3%) and were associated with a favorable outcome. There was no significant difference between remdesivir and control groups in the occurrence of different cardiac AE subclasses, including arrhythmic events (HR 1.1, 95% CI: 0.7-1.7, p = 0.68).Conclusions Remdesivir treatment was not associated with an increased risk of cardiac AEs, whether serious or not, and regardless of AE severity, compared to control, in patients hospitalized with moderate or severe COVID-19. This is consistent with the results of other randomized controlled trials and meta-analyses.
Læs mere Tjek på PubMedAstrid Juhl Andersen, Solène Wallez, Maria Melchior, Murielle Mary-Krause
PLoS One Infectious Diseases, 2.04.2024
Tilføjet 2.04.2024
by Astrid Juhl Andersen, Solène Wallez, Maria Melchior, Murielle Mary-Krause Introduction Results of the impact of lockdowns and stay-at-home orders during the COVID-19 pandemic on changes in cigarette smoking are mixed. Previous studies examining smoking changes during the early stages of the pandemic in 2020 have mainly focused on smoker’s perception of changes in cigarette consumption. Such measure has not been widely used in other contexts, and therefore we aim to compare the discrepancy between smokers’ perceived changes in cigarette smoking and the actual change in the number of cigarettes smoked, using repeated measurements. Methods We included 134 smokers from the French TEMPO cohort with repeated measurements of their perceived changes in smoking habits during the first phase of the COVID-19 pandemic and the number of cigarettes smoked repeatedly from March to May 2020. We used generalized estimation equations (GEE) to examine the association between changes in the number of cigarettes smoked and the odds of mismatched answers. Results The results suggest that at each study wave, 27–45% of participants provided mismatching answers between their perceived change in smoking habits and the actual change in the number of cigarettes smoked daily, measured repeatedly. Results from GEE analysis demonstrated that a mismatching assessment of smoking behavior was elevated among those who had an increase (OR = 2.52 [1.37;4.65]) or a decrease (OR = 5.73 [3.27;10.03]) in number of cigarettes smoked. Discussion Our findings highlight the possibility of obtaining different results depending on how changes in tobacco smoking are measured. This highlights the risk of underestimating the actual changes in cigarette smoking during the COVID-19 pandemic, but also more generally when validating public health interventions or smoking cessation programs. Therefore, objective measures such as the actual consumption of psychoactive substances should be utilized, preferably on a longitudinal basis, to mitigate recall bias.
Læs mere Tjek på PubMedNaman S. Shetty, Valentina Giammatteo, Mokshad Gaonkar, Peng Li, Oluwaseun Akeju, Garima Arora, Lorenzo Berra, Pankaj Arora
American Journal of Respiratory and Critical Care Medicine , 1.04.2024
Tilføjet 1.04.2024
American Journal of Respiratory and Critical Care Medicine, Volume 209, Issue 7, Page 887-890, April 1, 2024.
Læs mere Tjek på PubMedPedro David Wendel-Garcia, Benjamin Seeliger, Daniel Hofmaenner, Christian Bode, Klaus Stahl, Sascha David
American Journal of Respiratory and Critical Care Medicine , 1.04.2024
Tilføjet 1.04.2024
American Journal of Respiratory and Critical Care Medicine, Volume 209, Issue 7, Page 894-895, April 1, 2024.
Læs mere Tjek på PubMedMarco Giani, Matthieu Schmidt, Daniel Brodie, Roberto Lorusso, Antonio Arcadipane, Gennaro Martucci
American Journal of Respiratory and Critical Care Medicine , 1.04.2024
Tilføjet 1.04.2024
American Journal of Respiratory and Critical Care Medicine, Volume 209, Issue 7, Page 895-896, April 1, 2024.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 1.04.2024
Tilføjet 1.04.2024
Abstract Vγ9Vδ2 T-cells play a key role in the innate immune response to viral infections through butyrophilin (BTN)-3A. Here, we reported that blood Vγ9Vδ2 T-cells decreased in clinically mild COVID-19 compared to healthy volunteers (HV), and was maintained up to 28-days and in the recovery period. Terminally differentiated Vγ9Vδ2 T-cells tend to be enriched on the day of diagnosis, 28-days after and during the recovery period. These cells showed cytotoxic and inflammatory activities following anti-BTN3A activation. BTN3A upregulation and Vγ9Vδ2 T-cell infiltration were observed in a lung biopsy from a fatal SARS-CoV-2 infection. In vitro, SARS-CoV-2 infection increased BTN3A expression in macrophages and lung cells that enhanced the anti-SARS-CoV-2 Vγ9Vδ2 T-cells cytotoxicity and IFNγ and TNFα. Increasing concentrations of anti-BTN3A lead to viral replication inhibition. Altogether, we report that Vγ9Vδ2 T-cells are important in the immune response against SARS-CoV-2 infection and that activation by an anti-BTN3A antibody may enhance their response.
Læs mere Tjek på PubMedBMC Infectious Diseases, 31.03.2024
Tilføjet 31.03.2024
Abstract This comprehensive retrospective data-linkage study aimed at evaluating the impact of Direct-Acting Antivirals (DAAs) on Hepatitis C Virus (HCV) testing, treatment trends, and access to care in Tuscany over six years following their introduction. Utilizing administrative healthcare records, our work reveals a substantial increase in HCV tests in 2017, attributed to the decision to provide universal access to treatment. However, despite efforts to eradicate chronic HCV through a government-led plan, the target of treating 6,221 patients annually was not met, and services contracted after 2018, exacerbated by the COVID-19 pandemic. Key findings indicate a higher prevalence of HCV screening among females in the 33–53 age group, influenced by pregnancy-related recommendations, while diagnostic tests and treatment uptake were more common among males. Problematic substance users constituted a significant proportion of those tested and treated, emphasizing their priority in HCV screening. Our paper underscores the need for decentralized HCV models and alternative testing strategies, such as point-of-care assays, especially in populations accessing harm reduction services, communities, and prisons. The study acknowledges limitations in relying solely on administrative records, advocating for improved data access and timely linkages to accurately monitor HCV care cascades and inform regional plans. Despite challenges, the paper demonstrates the value of administrative record linkages in understanding the access to care pathway for hard-to-reach populations. The findings emphasize the importance of the national HCV elimination strategy and the need for enhanced data collection to assess progress accurately, providing insights for future regional and national interventions.
Læs mere Tjek på PubMedIván Sanz-Muñoz, Javier Sánchez-Martínez, Carla Rodríguez-Crespo, Irene Arroyo-Hernantes, Marta Domínguez-Gil, Silvia Rojo-Rello, Marta Hernández, José M Eiros
International Journal of Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Since the precise significance of viral load (VL) test for the management and treatment of patients with respiratory viruses remains unknown, it is not a commonly used tool. However, since the COVID-19 pandemic, VL evaluation has gained popularity in the scientific community and healthcare providers due to the possible application in daily clinical practice and research [1–3]. During the worst part of the pandemic, when hospitalization was overcrowded and a huge need for resources was the most important issue, the Ct value (Cycle threshold), a subrogate of the VL, was used as a criterion for discharging patients.
Læs mere Tjek på PubMedNicolas Salvadori, Gonzague Jourdain, Rungroj Krittayaphong, Taweegrit Siripongboonsitti, Subsai Kongsaengdao, Kriangsak Atipornwanich, Parichart Sakulkonkij, Nasikarn Angkasekwinai, Rujipas Sirijatuphat, Sarunyou Chusri, Tanavit Mekavuthikul, Anucha Apisarnthanarak, Sirawat Srichatrapimuk, Somnuek Sungkanuparph, Suppachok Kirdlarp, Thanyakamol Phongnarudech, Suraphan Sangsawang, Panuwat Napinkul, Jullapong Achalapong, Suwimon Khusuwan, Piyanut Pratipanawat, Pornboonya Nookeu, Namphol Danpipat, Pornvimol Leethong, Piya Hanvoravongchai, Pra-ornsuda Sukrakanchana, Prasert Auewarakul
International Journal of Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Evaluate and compare the efficacy and safety of molnupiravir and favipiravir in outpatients with mild to moderate COVID-19 and at risk of severe COVID-19.
Læs mere Tjek på PubMedNeupane, Maniraj; De Jonge, Nathaniel; Angelo, Sahil; Sarzynski, Sadia; Sun, Junfeng; Rochwerg, Bram; Hick, John; Mitchell, Steven H.; Warner, Sarah; Mancera, Alex; Cooper, Diane; Kadri, Sameer S.
Critical Care Medicine, 30.03.2024
Tilføjet 30.03.2024
Objectives: COVID-19 pandemic surges strained hospitals globally. We performed a systematic review to examine measures of pandemic caseload surge and its impact on mortality of hospitalized patients. Data Sources: PubMed, Embase, and Web of Science. Study Selection: English-language studies published between December 1, 2019, and November 22, 2023, which reported the association between pandemic “surge”-related measures and mortality in hospitalized patients. Data Extraction: Three authors independently screened studies, extracted data, and assessed individual study risk of bias. We assessed measures of surge qualitatively across included studies. Given multidomain heterogeneity, we semiquantitatively aggregated surge–mortality associations. Data Synthesis: Of 17,831 citations, we included 39 studies, 17 of which specifically described surge effects in ICU settings. The majority of studies were from high-income countries (n = 35 studies) and included patients with COVID-19 (n = 31). There were 37 different surge metrics which were mapped into four broad themes, incorporating caseloads either directly as unadjusted counts (n = 11), nested in occupancy (n = 14), including additional factors (e.g., resource needs, speed of occupancy; n = 10), or using indirect proxies (e.g., altered staffing ratios, alternative care settings; n = 4). Notwithstanding metric heterogeneity, 32 of 39 studies (82%) reported detrimental adjusted odds/hazard ratio for caseload surge–mortality outcomes, reporting point estimates of up to four-fold increased risk of mortality. This signal persisted among study subgroups categorized by publication year, patient types, clinical settings, and country income status. Conclusions: Pandemic caseload surge was associated with lower survival across most studies regardless of jurisdiction, timing, and population. Markedly variable surge strain measures precluded meta-analysis and findings have uncertain generalizability to lower-middle-income countries (LMICs). These findings underscore the need for establishing a consensus surge metric that is sensitive to capturing harms in everyday fluctuations and future pandemics and is scalable to LMICs.
Læs mere Tjek på PubMedKeene, C. M., Dickinson, S., Naidoo, R., Andersen-Waine, B., Ferguson-Lewis, A., Polner, A., Amswych, M., White, L., Molyneux, S., Wanat, M., EY-Oxford Health Analytics Consortium, Moldokmatova, Polner, Ferguson-Lewis, Andersen-Waine, Gao, Franco, Keene, Rowe, Norman, Stepniewska, Bimpong, Cantrell, White, Tsui, Amswych, Wanat, Mills, Voysey, Kasim, Dahal, Hounsell, Naidoo, Lewis, Shretta, Anye, Aguas, Creswell, Dittrich, Molyneux, Chen, Silal, Saralamba, Dickinson, Bajaj, Pokharel, Evans, Mahmood, Pan-ngum, Lambert
BMJ Open, 30.03.2024
Tilføjet 30.03.2024
ObjectiveTesting for COVID-19 was a key component of the UK’s response to the COVID-19 pandemic. This strategy relied on positive individuals self-isolating to reduce transmission, making isolation the lynchpin in the public health approach. Therefore, we scoped evidence to systematically identify and categorise barriers and facilitators to compliance with self-isolation guidance during the COVID-19 pandemic in the UK, to inform public health strategies in future pandemics. DesignA rapid scoping review was conducted. Search strategyKey terms were used to search literature databases (PubMed, Scopus and the WHO COVID-19 Research Database, on 7 November 2022), Google Scholar and stakeholder-identified manuscripts, ultimately including evidence published in English from UK-based studies conducted between 2020 and 2022. Data extraction and synthesisData were extracted and synthesised into themes, organised broadly into capability, opportunity and motivation, and reviewed with key stakeholders from the UK Health Security Agency (UKHSA). ResultsWe included 105 sources, with 63 identified from UKHSA and used to inform their decision-making during the pandemic. Influences on the decision to comply with isolation guidance were categorised into six themes: perceived ability to isolate; information and guidance; logistics; social influences, including trust; perceived value; and perceived consequences. Individuals continuously assessed these factors in deciding whether or not to comply with guidance and self-isolate. ConclusionsDecisions to self-isolate after a positive test were influenced by multiple factors, including individuals’ beliefs, concerns, priorities and personal circumstances. Future testing strategies must facilitate meaningful financial, practical and mental health support to allow individuals to overcome the perceived and actual negative consequences of isolating. Clear, consistent communication of the purpose and procedures of isolating will also be critical to support compliance with self-isolation guidance, and should leverage people’s perceived value in protecting others. Building public trust is also essential, but requires investment before the next pandemic starts.
Læs mere Tjek på PubMedPeter, D., Li, S.-X., Wang, Y., Zhang, J., Grady, J., McDowell, K., Norton, E., Lin, Z., Bernheim, S., Venkatesh, A. K., Fleisher, L. A., Schreiber, M., Suter, L. G., Triche, E. W.
BMJ Open, 30.03.2024
Tilføjet 30.03.2024
ObjectivesThe extent to which care quality influenced outcomes for patients hospitalised with COVID-19 is unknown. Our objective was to determine if prepandemic hospital quality is associated with mortality among Medicare patients hospitalised with COVID-19. DesignThis is a retrospective observational study. We calculated hospital-level risk-standardised in-hospital and 30-day mortality rates (risk-standardised mortality rates, RSMRs) for patients hospitalised with COVID-19, and correlation coefficients between RSMRs and pre-COVID-19 hospital quality, overall and stratified by hospital characteristics. SettingShort-term acute care hospitals and critical access hospitals in the USA. ParticipantsHospitalised Medicare beneficiaries (Fee-For-Service and Medicare Advantage) age 65 and older hospitalised with COVID-19, discharged between 1 April 2020 and 30 September 2021. Intervention/exposurePre-COVID-19 hospital quality. OutcomesRisk-standardised COVID-19 in-hospital and 30-day mortality rates (RSMRs). ResultsIn-hospital (n=4256) RSMRs for Medicare patients hospitalised with COVID-19 (April 2020–September 2021) ranged from 4.5% to 59.9% (median 18.2%; IQR 14.7%–23.7%); 30-day RSMRs ranged from 12.9% to 56.2% (IQR 24.6%–30.6%). COVID-19 RSMRs were negatively correlated with star rating summary scores (in-hospital correlation coefficient –0.41, p
Læs mere Tjek på PubMedMollons, M., Levasseur-Puhach, S., Kaur, J., Doyle, J., Giesbrecht, G., Lebel, C. A., Woods, L., Tomfohr-Madsen, L., Roos, L.
BMJ Open, 30.03.2024
Tilføjet 30.03.2024
ObjectivesThis study aimed to explore how the unprecedented stressors associated with the COVID-19 pandemic may have contributed to heightened levels of depression and anxiety among pregnant Indigenous persons, and identify protective individual-level factors. DesignThe current study used a mixed-methods design including standardised questionnaires and open-ended response questions. Using hierarchical regression models, we examined the extent to which COVID-19-related factors of service disruption (ie, changes to prenatal care, changes to birth plans and social support) were associated with mental well-being. Further, through qualitative analyses of open-ended questions, we examined the coping strategies used by pregnant Indigenous persons in response to the pandemic. SettingParticipants responded to an online questionnaire consisting of standardised measures from 2020 to 2021. ParticipantsThe study included 336 self-identifying Indigenous pregnant persons in Canada. ResultsDescriptive results revealed elevated rates of clinically relevant depression (52.7%) and anxiety (62.5%) symptoms among this population. 76.8% of participants reported prenatal care service disruptions, including appointment cancellations. Thematic analyses identified coping themes of staying informed, social and/or cultural connections and activities, and internal mental well-being strategies. Disruptions to services and decreased quality of prenatal care negatively impacted mental well-being of Indigenous pregnant persons during the COVID-19 pandemic. ConclusionsGiven the potential for mental well-being challenges to persist and long-term effects of perinatal distress, it is important to examine the quality of care that pregnant individuals receive. Service providers should advance policies and practices that promote relationship quality and health system engagement as key factors linked to well-being during the perinatal period for Indigenous persons.
Læs mere Tjek på PubMedGupta, R., Sharma, K., Khedar, R. S., Sharma, S. K., Makkar, J. S., Natani, V., Bana, A., Sharma, S.
BMJ Open, 30.03.2024
Tilføjet 30.03.2024
ObjectiveThe study examined the influence of the COVID-19 pandemic in India on variation in clinical features, management and in-hospital outcomes in patients undergoing percutaneous coronary intervention (PCI). DesignProspective registry-based observational study. SettingA tertiary care hospital in India participant in the American College of Cardiology CathPCI Registry. Participants7089 successive patients who underwent PCI from April 2018 to March 2023 were enrolled (men 5627, women 1462). Details of risk factors, clinical presentation, coronary angiography, coronary interventions, clinical management and in-hospital outcomes were recorded. Annual data were classified into specific COVID-19 periods according to Government of India guidelines as pre-COVID-19 (April 2018 to March 2019, n=1563; April 2019 to March 2020, n=1594), COVID-19 (April 2020 to March 2020, n=1206; April 2021 to March 2022, n=1223) and post-COVID-19 (April 2022 to March 2023, n=1503). ResultsCompared with the patients in pre-COVID-19 and post-COVID-19 periods, during the first COVID-19 year, patients had more hypertension, non-ST elevation myocardial infarction (NSTEMI), lower left ventricular ejection fraction (LVEF) and multivessel coronary artery disease (CAD). In the second COVID-19 year, patients had more STEMI, lower LVEF, multivessel CAD, primary PCI, multiple stents and more vasopressor and mechanical support. There were 99 (1.4%) in-hospital deaths which in the successive years were 1.2%, 1.4%, 0.8%, 2.4% and 1.3%, respectively (p=0.019). Compared with the baseline year, deaths were slightly lower in the first COVID-19-year (age-sex adjusted OR 0.68, 95% CI 0.31 to 1.47) but significantly more in the second COVID-19-year (OR 1.97, 95% CI 1.10 to 3.54). This variation attenuated following adjustment for clinical presentation, extent of CAD, in-hospital treatment and duration of hospitalisation. ConclusionsIn-hospital mortality among patients with CAD undergoing PCI was significantly higher in the second year of the COVID-19 pandemic in India and could be one of the reasons for excess deaths in the country. These patients had more severe CAD, lower LVEF, and more vasopressor and mechanical support and duration of hospitalisation.
Læs mere Tjek på PubMedGolden, B. N., Elrefaay, S., McLemore, M. R., Alspaugh, A., Baltzell, K., Franck, L. S.
BMJ Open, 30.03.2024
Tilføjet 30.03.2024
IntroductionIncreasing the midwifery workforce has been identified as an evidence-based approach to decrease maternal mortality and reproductive health disparities worldwide. Concurrently, the profession of midwifery, as with all healthcare professions, has undergone a significant shift in practice with acceleration of telehealth use to expand access. We conducted a systematic literature review to identify and synthesize the existing evidence regarding how midwives experience, perceive and accept providing sexual and reproductive healthcare services at a distance with telehealth. MethodsFive databases were searched, PubMed, CINHAL, PsychInfo, Embase and the Web of Science, using search terms related to ‘midwives’, ‘telehealth’ and ‘experience’. Peer-reviewed studies with quantitative, qualitative or mixed methods designs published in English were retrieved and screened. Studies meeting the inclusion criteria were subjected to full-text data extraction and appraisal of quality. Using a convergent approach, the findings were synthesized into major themes and subthemes. ResultsAfter applying the inclusion/exclusion criteria, 10 articles on midwives’ experience of telehealth were reviewed. The major themes that emerged were summarized as integrating telehealth into clinical practice; balancing increased connectivity; challenges with building relationships via telehealth; centring some patients while distancing others; and experiences of telehealth by age and professional experience. ConclusionsMost current studies suggest that midwives’ experience of telehealth is deeply intertwined with midwives’ experience of the response to COVID-19 pandemic in general. More research is needed to understand how sustained use of telehealth or newer hybrid models of telehealth and in-person care are perceived by midwives.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract This comprehensive retrospective data-linkage study aimed at evaluating the impact of Direct-Acting Antivirals (DAAs) on Hepatitis C Virus (HCV) testing, treatment trends, and access to care in Tuscany over six years following their introduction. Utilizing administrative healthcare records, our work reveals a substantial increase in HCV tests in 2017, attributed to the decision to provide universal access to treatment. However, despite efforts to eradicate chronic HCV through a government-led plan, the target of treating 6,221 patients annually was not met, and services contracted after 2018, exacerbated by the COVID-19 pandemic. Key findings indicate a higher prevalence of HCV screening among females in the 33–53 age group, influenced by pregnancy-related recommendations, while diagnostic tests and treatment uptake were more common among males. Problematic substance users constituted a significant proportion of those tested and treated, emphasizing their priority in HCV screening. Our paper underscores the need for decentralized HCV models and alternative testing strategies, such as point-of-care assays, especially in populations accessing harm reduction services, communities, and prisons. The study acknowledges limitations in relying solely on administrative records, advocating for improved data access and timely linkages to accurately monitor HCV care cascades and inform regional plans. Despite challenges, the paper demonstrates the value of administrative record linkages in understanding the access to care pathway for hard-to-reach populations. The findings emphasize the importance of the national HCV elimination strategy and the need for enhanced data collection to assess progress accurately, providing insights for future regional and national interventions.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background The COVID-19 pandemic has caused significant disruptions to everyday life and has had social, political, and financial consequences that will persist for years. Several initiatives with intensive use of technology were quickly developed in this scenario. However, technologies that enhance epidemiological surveillance in contexts with low testing capacity and healthcare resources are scarce. Therefore, this study aims to address this gap by developing a data science model that uses routinely generated healthcare encounter records to detect possible new outbreaks early in real-time. Methods We defined an epidemiological indicator that is a proxy for suspected cases of COVID-19 using the health records of Emergency Care Unit (ECU) patients and text mining techniques. The open-field dataset comprises 2,760,862 medical records from nine ECUs, where each record has information about the patient’s age, reported symptoms, and the time and date of admission. We also used a dataset where 1,026,804 cases of COVID-19 were officially confirmed. The records range from January 2020 to May 2022. Sample cross-correlation between two finite stochastic time series was used to evaluate the models. Results For patients with age 18 years, we find time-lag () = 72 days and cross-correlation () ~ 0.82, = 25 days and ~ 0.93, and = 17 days and ~ 0.88 for the first, second, and third waves, respectively. Conclusions In conclusion, the developed model can aid in the early detection of signs of possible new COVID-19 outbreaks, weeks before traditional surveillance systems, thereby anticipating in initiating preventive and control actions in public health with a higher likelihood of success.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background There are abundant studies on COVID-19 but few on its impact on hepatitis E. We aimed to assess the effect of the COVID-19 countermeasures on the pattern of hepatitis E incidence and explore the application of time series models in analyzing this pattern. Methods Our pivotal idea was to fit a pre-COVID-19 model with data from before the COVID-19 outbreak and use the deviation between forecast values and actual values to reflect the effect of COVID-19 countermeasures. We analyzed the pattern of hepatitis E incidence in China from 2013 to 2018. We evaluated the fitting and forecasting capability of 3 methods before the COVID-19 outbreak. Furthermore, we employed these methods to construct pre-COVID-19 incidence models and compare post-COVID-19 forecasts with reality. Results Before the COVID-19 outbreak, the Chinese hepatitis E incidence pattern was overall stationary and seasonal, with a peak in March, a trough in October, and higher levels in winter and spring than in summer and autumn, annually. Nevertheless, post-COVID-19 forecasts from pre-COVID-19 models were extremely different from reality in sectional periods but congruous in others. Conclusions Since the COVID-19 pandemic, the Chinese hepatitis E incidence pattern has altered substantially, and the incidence has greatly decreased. The effect of the COVID-19 countermeasures on the pattern of hepatitis E incidence was temporary. The incidence of hepatitis E was anticipated to gradually revert to its pre-COVID-19 pattern.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background Pakistan witnessed five waves of COVID-19 infections during the pandemic. Punjab, the largest province of Pakistan, remained the epicentre due to a high infection rate. Administrative data for five waves of the pandemic was analyzed to determine the rate of infections and the significance of pharmacological and non-pharmacological interventions on the severity and duration of infection. Methodology COVID-19 data from March 2020 to May 2023 was obtained from the Provincial Public Health Reference Laboratory (PPHRL), Punjab AIDS Control Program, Lahore. The data included samples from index cases, contacts, and recovered patients. A total of 36,252,48 cases were screened for COVID-19, and 90,923 (2.50%) were detected positive by RT-PCR, accounting for 5.69% of the cases reported positive throughout the country. Results Among the positive cases, 50.86% (n = 46,244) cases were new cases (registered for the first time), 40.41% (n = 36751) were the contact cases traced from the newly identified cases and 8.62% (n = 7842) repeated cases. The positivity rates among index cases were reported to be 2.37%, 2.34%, 4.61%, 2.09%, and 1.19%, respectively, for the five respective COVID-19 pandemic waves. Distribution by gender indicated that 64% of males and 35% of females were infected during the pandemic. The age factor demonstrated the most susceptibility to infection in women aged 19-29 years, whereas most males between the ages of 29-39 had an infection. Susceptibility to COVID-19 infection was observed to be equally likely between males and females; however, clinical outcomes indicated that infections in males were more severe and often resulted in fatalities as compared to those in females. This trend was also reflected in the viral titer as measured by the Ct values, where 40% of males had Ct values < 25 (an indicator of high viral titers) compared to 30% of females with Ct values < 25. Conclusion Overall, our data indicated that infection rates remained stable throughout the pandemic except for 3rd wave, which showed a higher incidence of infection rate of 4%. Additionally, data showed a positive impact of masking, social distancing, and immunization, as indicated by the shorter window of high infection rates.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background This study explores regional variations in COVID-19 hospitalization rates, in-hospital mortality, and acute kidney injury (AKI) in England. We investigated the influence of population demographic characteristics, viral strain changes, and therapeutic advances on clinical outcomes. Methods Using hospital episode statistics, we conducted a retrospective cohort study with 749,844 admissions in 337,029 adult patients with laboratory-confirmed COVID-19 infection (March 1, 2020, to March 31, 2021). Multivariable logistic regression identified factors predicting AKI and mortality in COVID-19 hospitalized patients. Results London had the highest number of COVID-19 admissions (131,338, 18%), followed by the North-west region (122,683, 16%). The North-west had the highest population incidence of COVID-19 hospital admissions (21,167 per million population, pmp), while the South-west had the lowest (9,292 admissions pmp). Patients in London were relatively younger (67.0 ± 17.7 years) than those in the East of England (72.2 ± 16.8 years). The shortest length of stay was in the North-east (12.2 ± 14.9 days), while the longest was in the North-west (15.2 ± 17.9 days). All eight regions had higher odds of death compared to London, ranging from OR 1.04 (95% CI 1.00, 1.07) in the South-west to OR 1.24 (95% CI 1.21, 1.28) in the North-west. Older age, Asian ethnicity, emergency admission, transfers from other hospitals, AKI presence, ITU admission, social deprivation, and comorbidity were associated with higher odds of death. AKI incidence was 30.3%, and all regions had lower odds of developing AKI compared to London. Increasing age, mixed and black ethnicity, emergency admission, transfers from other providers, ITU care, and different levels of comorbidity were associated with higher odds of developing AKI. Conclusions London exhibited higher hospital admission numbers and AKI incidence, but lower odds of death compared to other regions in England. Trial registration Registered on National Library of Medicine website (www.clinicaltrials.gov) with registration number NCT04579562 on 8/10/2020.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Introduction To answer to patients’ medical wandering, often due to “unexplained symptoms” of “unexplained diseases” and to misinformation, multidisciplinary care centers for suspected Lyme borreliosis (LB), such as the 5 Tick-Borne Diseases (TBDs) Reference Centers (TBD-RC), were created a few years ago in France, the Netherlands and Denmark. Our study consisted of a comprehensive analysis of the satisfaction of the patients managed at a TBD-RC for suspected LB in the context of scientific and social controversy. Methods We included all adults who were admitted to one of the TBD-RC from 2017 to 2020. A telephone satisfaction survey was conducted 12 months after their first consultation. It consisted of 5 domains, including 2 free-text items: “What points did you enjoy?” and “What would you like us to change or to improve?”. In the current study, the 2 free-items were analyzed with a qualitative method called reflexive thematic analysis within a semantic and latent approach. Results The answer rate was 61.3% (349/569) and 97 distinctive codes from the 2-free-text items were identified and classified into five themes: (1) multidisciplinarity makes it possible to set up quality time dedicated to patients; (2) multidisciplinarity enables seamless carepaths despite the public hospital crisis compounded by the COVID-19 pandemic; (3) multidisciplinarity is defined as trust in the team’s competences; (4) an ambivalent opinion and uncertainty are barriers to acceptance of the diagnosis, reflecting the strong influence of the controversy around LB; and (5) a lack of adapted communication about TBDs, their management, and ongoing research is present. Conclusion The multidisciplinary management for suspected LB seemed an answer to medical wandering for the majority of patients and helped avoid misinformation, enabling better patient-centered shared information and satisfaction, despite the context of controversy.
Læs mere Tjek på PubMedBate, Sebastian; Stokes, Victoria; Greenlee, Hannah; Goh, Kwee Yen; Whiting, Graham; Kitchen, Gareth; Martin, Glen P.; Parker, Alexander J.; Wilson, Anthony; on behalf of the MRI Critical Care Data Group
Critical Care Explorations, 30.03.2024
Tilføjet 30.03.2024
OBJECTIVES (BACKGROUND): To externally validate clinical prediction models that aim to predict progression to invasive ventilation or death on the ICU in patients admitted with confirmed COVID-19 pneumonitis. DESIGN: Single-center retrospective external validation study. DATA SOURCES: Routinely collected healthcare data in the ICU electronic patient record. Curated data recorded for each ICU admission for the purposes of the U.K. Intensive Care National Audit and Research Centre (ICNARC). SETTING: The ICU at Manchester Royal Infirmary, Manchester, United Kingdom. PATIENTS: Three hundred forty-nine patients admitted to ICU with confirmed COVID-19 Pneumonitis, older than 18 years, from March 1, 2020, to February 28, 2022. Three hundred two met the inclusion criteria for at least one model. Fifty-five of the 349 patients were admitted before the widespread adoption of dexamethasone for the treatment of severe COVID-19 (pre-dexamethasone patients). OUTCOMES: Ability to be externally validated, discriminate, and calibrate. METHODS: Articles meeting the inclusion criteria were identified, and those that gave sufficient details on predictors used and methods to generate predictions were tested in our cohort of patients, which matched the original publications’ inclusion/exclusion criteria and endpoint. RESULTS: Thirteen clinical prediction articles were identified. There was insufficient information available to validate models in five of the articles; a further three contained predictors that were not routinely measured in our ICU cohort and were not validated; three had performance that was substantially lower than previously published (range C-statistic = 0.483–0.605 in pre-dexamethasone patients and C = 0.494–0.564 among all patients). One model retained its discriminative ability in our cohort compared with previously published results (C = 0.672 and 0.686), and one retained performance among pre-dexamethasone patients but was poor in all patients (C = 0.793 and 0.596). One model could be calibrated but with poor performance. CONCLUSIONS: Our findings, albeit from a single center, suggest that the published performance of COVID-19 prediction models may not be replicated when translated to other institutions. In light of this, we would encourage bedside intensivists to reflect on the role of clinical prediction models in their own clinical decision-making.
Læs mere Tjek på PubMedSoheila Aghlmandi, Julia Bielicki, Heiner C. Bucher
Clinical Microbiology and Infection, 29.03.2024
Tilføjet 29.03.2024
There are fundamental differences between our cohort1 and the databases from Swiss primary care networks that are mentioned by Plüss-Suard C et al.2 In our study we used patient-level data covering roughly 50% of the Swiss population that was aggregated on a practice level, similar to our Benchmark II trial.3,4 We analyzed 2,945 general practices comprising 5,113 medium-to high-prescriber general practitioners (GPs) and pediatricians. Our study focused specifically on antibiotic prescriptions, and we considered any physician who had prescribed at least one antibiotic during a consultation in a specific year/month to construct the denominator for the calculation of antibiotic prescription rates.
Læs mere Tjek på PubMedHarrison, M., Rhodes, T., Lancaster, K.
BMJ Open, 29.03.2024
Tilføjet 29.03.2024
ObjectivesTo investigate the lived experiences of Long COVID. DesignCritical interpretive synthesis of qualitative research. Data sourcesPubMed and Web of Science databases were searched on 14 September 2023. Eligibility criteriaOriginal peer-reviewed qualitative studies describing the experiences of Long COVID were eligible for inclusion. Data extraction and synthesisWe used established qualitative synthesis methods to search, screen and manually code the included studies. Critical interpretation methods were used to analyse the data and develop synthetic constructs. Results68 articles were identified in the first phase of sampling, with 16 studies and 879 participants included in the final synthesis. The analysis of these studies was organised into three thematic constructions of Long COVID: (1) the illness, (2) the patient and (3) recovery. Long COVID was diversely characterised across study approaches, designs and findings but was underpinned by shared diagnostic logics, which shaped the identification and measurement of symptoms. The boundaries between different constitutions of Long COVID in qualitative accounts of illness experience were often imprecise. Slippages between different definitions of Long COVID had implications for patient experiences in relation to diagnosis, help-seeking and care, and expectations of recovery. ConclusionsLong COVID is a site of multiple and diverse qualitative interpretation. Accounts of lived experience emphasise the constitutions of illness, patienthood and recovery as situated and emergent. The ongoing context-based negotiation of Long COVID is a defining qualitative feature of the condition. Approaches to researching, diagnosing and developing health interventions must be as adaptive as the varieties of Long COVID lived experience.
Læs mere Tjek på PubMedMortensen, J. K., Blauenfeldt, R. A., Hedegaard, J. N., Morberg Wejse, C., Johnsen, S. P., Andersen, G., Simonsen, C. Z.
BMJ Open, 29.03.2024
Tilføjet 29.03.2024
ObjectivesAn increased risk of stroke has been reported among patients with COVID-19 caused by SARS-CoV-2. We aimed to investigate the nationwide prevalence of SARS-CoV-2 among patients with acute ischaemic stroke and to study the impact on stroke severity, quality of care and mortality on an individual patient level. DesignThis was a nationwide register-based cohort study. SettingWe used data from several Danish registers which were linked at an individual patient level using the unique civil registration number assigned to all Danish citizens. Patients were identified from the Danish Stroke Registry and information on SARS-CoV-2 infection status was collected from the Danish National COVID-19 Registry. Concurrent SARS-CoV-2 infection was defined as a positive PCR test within 31 days prior to, and 1 day after, stroke admission. Information on comorbidity was collected from the Danish National Patient Registry and information on vital status was collected from the Danish Civil Registration System. ParticipantsA total of 11 502 patients admitted with acute ischaemic stroke from 10 March 2020 to 31 May 2021 were included in the study. ResultsAmong the included patients, the majority (84.6%) were tested for SARS-CoV-2, but only 68 had a positive test. These patients were more prone to have atrial fibrillation and were more often treated with reperfusion therapy. They had a significantly increased risk of severe stroke (adjusted relative risk (aRR) 1.93, 95% CI: 1.22 to 3.04) and a significantly increased 30-day mortality risk (aRR 2.29, 95% CI: 1.19 to 4.39). There was no difference in the proportion of patients fulfilling relevant performance measures on quality of care. ConclusionIn this nationwide study, only 0.6% of patients with acute ischaemic stroke were tested positive for a concurrent SARS-CoV-2 infection. The patients with SARS-CoV-2 presented with more severe strokes.
Læs mere Tjek på PubMedBMC Infectious Diseases, 29.03.2024
Tilføjet 29.03.2024
Abstract Background The COVID-19 pandemic has caused significant disruptions to everyday life and has had social, political, and financial consequences that will persist for years. Several initiatives with intensive use of technology were quickly developed in this scenario. However, technologies that enhance epidemiological surveillance in contexts with low testing capacity and healthcare resources are scarce. Therefore, this study aims to address this gap by developing a data science model that uses routinely generated healthcare encounter records to detect possible new outbreaks early in real-time. Methods We defined an epidemiological indicator that is a proxy for suspected cases of COVID-19 using the health records of Emergency Care Unit (ECU) patients and text mining techniques. The open-field dataset comprises 2,760,862 medical records from nine ECUs, where each record has information about the patient’s age, reported symptoms, and the time and date of admission. We also used a dataset where 1,026,804 cases of COVID-19 were officially confirmed. The records range from January 2020 to May 2022. Sample cross-correlation between two finite stochastic time series was used to evaluate the models. Results For patients with age 18 years, we find time-lag () = 72 days and cross-correlation () ~ 0.82, = 25 days and ~ 0.93, and = 17 days and ~ 0.88 for the first, second, and third waves, respectively. Conclusions In conclusion, the developed model can aid in the early detection of signs of possible new COVID-19 outbreaks, weeks before traditional surveillance systems, thereby anticipating in initiating preventive and control actions in public health with a higher likelihood of success.
Læs mere Tjek på PubMedNoore Alam Siddiquee, Mohammad Hamiduzzaman, Helen McLaren, Emi Patmisari
PLoS One Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
by Noore Alam Siddiquee, Mohammad Hamiduzzaman, Helen McLaren, Emi Patmisari Background A global catastrophe–the COVID-19 pandemic–appears to have two-dimensional health consequences for older adults: high risk of being infected and psychological distress. There is limited evidence on how the pandemic has impacted the life and coping of older adults who are culturally and linguistically diverse (CALD), women in particular. This study explored the COVID-19 risk perception and coping strategies of older CALD women in South Australia. Methods A mixed-methods research design was employed, involving a 31-items coping and emergency preparation scale for survey and semi-structured interviews with participants. The older CALD women were approached through 11 multicultural NGOs. One hundred and nine women participants from 28 CALD communities completed the online surveys; 25 of them agreed to a telephone interview and provided their contact details. 15 older CALD women ultimately participated in interviews. Results Mean sum-score of dread risk, unknown risk, and fear (M: 43.5; SD: 4.9) indicated that the participants were somewhat anxious and worried. Mean sum-score of coping (M: 79.8; SD: 9.3) reported their compliance with expert advice and disinfection practices but accessing health information (M: 2.8; SD 1.4) and tendency to minimize anxiety (M: 2.1; SD: 1.2) were below neutral. Significant variations were found in coping in terms of age, meaning that the women aged 75 years and older were less likely to cope with the pandemic (P = 0.01). Emergency preparation differed based on the participants’ residence and occupation status. The deductive-inductive thematic analysis of interview data was framed around three priori themes: risks of being affected, emotional and behavioral coping, and emergency preparation and access to services. Conclusions Evidence shows a fear among the older CALD women with an endeavor to cope and prepare for emergency situations. This suggests the requirements for interventions that improve coping and reduce the risk of stress among them.
Læs mere Tjek på PubMedDaniel Azamar-Llamas, Josealberto Sebastiano Arenas-Martinez, Antonio Olivas-Martinez, Jose Victor Jimenez, Eric Kauffman-Ortega, Cristian J García-Carrera, Bruno Papacristofilou-Riebeling, Fabián E Rivera-López, Ignacio García-Juárez
PLoS One Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
by Daniel Azamar-Llamas, Josealberto Sebastiano Arenas-Martinez, Antonio Olivas-Martinez, Jose Victor Jimenez, Eric Kauffman-Ortega, Cristian J García-Carrera, Bruno Papacristofilou-Riebeling, Fabián E Rivera-López, Ignacio García-Juárez Background and aims COVID-19 vaccination has proved to be effective to prevent symptomatic infection and severe disease even in immunocompromised patients including liver transplant patients. We aim to assess the impact of COVID-19 vaccination on the mortality and development of severe and critical disease in our center. Methods A retrospective cohort study of LT patients in a reference center between March 2020 and February 2022. Demographic data, cirrhosis etiology, time on liver transplantation, immunosuppressive therapies, and vaccination status were recorded at the time of diagnosis. Primary outcome was death due to COVID-19, and secondary outcomes included the development of severe COVID-19 and intensive care unit (ICU) requirement. Results 153 of 324 LT recipients developed COVID-19, in whom the main causes of cirrhosis were HCV infection and metabolic-associated fatty liver disease. The vaccines used were BNT162b2 (48.6%), ChAdOx1 nCoV-19 (21.6%), mRNA-1273 vaccine (1.4%), Sputnik V (14.9%), Ad5-nCoV-S (4.1%) and CoronaVac (9.5%). Case fatality and ICU requirement risk were similar among vaccinated and unvaccinated LT patients (adjusted relative case fatality for vaccinated versus unvaccinated of 0.68, 95% CI 0.14–3.24, p = 0.62; adjusted relative risk [aRR] for ICU requirement of 0.45, 95% CI 0.11–1.88, p = 0.27). Nonetheless, vaccination was associated with a lower risk of severe disease (aRR for severe disease of 0.32, 95% CI 0.14–0.71, p = 0.005). Conclusions Vaccination reduces the risk of severe COVID-19 in LT patients, regardless of the scheme used. Vaccination should be encouraged for all.
Læs mere Tjek på PubMedYing LiuJiayou ZhangWen LiuYongbing PanShunan RuanXuanxuan NianWei ChenLina SunQiangling YinXin YueQingliang LiFang GuiCong WuShuzhen WangYunkai YangZhaofei JingFeiguang LongZejun WangZeyu ZhangChaolin HuangKai DuanMifang LiangXiaoming Yanga Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People’s Republic of Chinab Hubei Clinical Research Center for Infectious Diseases, Wuhan, People’s Republic of Chinac Hubei Public Health Clinical Center, Wuhan, People’s Republic of Chinad Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Wuhan, People’s Republic of Chinae National Engineering Technology Research Center for Combined Vaccines, Wuhan, People’s Republic of Chinaf Wuhan Institute of Biological Products Co. Ltd., Wuhan, People’s Republic of Chinag National Institute for Viral Disease Control and Prevention, Chinese CDC, Beijing, People’s Republic of Chinah Hubei Provincial Center for Disease Control and Prevention, Wuhan, People’s Republic of Chinai China National Biotec Group Company Limited, Beijing, People’s Republic of China
Emerg Microbes Infect, 28.03.2024
Tilføjet 28.03.2024
BMC Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
Abstract Background There are abundant studies on COVID-19 but few on its impact on hepatitis E. We aimed to assess the effect of the COVID-19 countermeasures on the pattern of hepatitis E incidence and explore the application of time series models in analyzing this pattern. Methods Our pivotal idea was to fit a pre-COVID-19 model with data from before the COVID-19 outbreak and use the deviation between forecast values and actual values to reflect the effect of COVID-19 countermeasures. We analyzed the pattern of hepatitis E incidence in China from 2013 to 2018. We evaluated the fitting and forecasting capability of 3 methods before the COVID-19 outbreak. Furthermore, we employed these methods to construct pre-COVID-19 incidence models and compare post-COVID-19 forecasts with reality. Results Before the COVID-19 outbreak, the Chinese hepatitis E incidence pattern was overall stationary and seasonal, with a peak in March, a trough in October, and higher levels in winter and spring than in summer and autumn, annually. Nevertheless, post-COVID-19 forecasts from pre-COVID-19 models were extremely different from reality in sectional periods but congruous in others. Conclusions Since the COVID-19 pandemic, the Chinese hepatitis E incidence pattern has altered substantially, and the incidence has greatly decreased. The effect of the COVID-19 countermeasures on the pattern of hepatitis E incidence was temporary. The incidence of hepatitis E was anticipated to gradually revert to its pre-COVID-19 pattern.
Læs mere Tjek på PubMedErika Renzi, Valentina Baccolini, Antonio Covelli, Leonardo Maria Siena, Antonio Sciurti, Giuseppe Migliara, Azzurra Massimi, Carolina Marzuillo, Corrado De Vito, Leandro Casini, Antonio Angeloni, Ombretta Turriziani, Guido Antonelli, Fabrizio D’Alba, Antonella Polimeni, Collaborating Group, Paolo Villari
PLoS One Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
by Erika Renzi, Valentina Baccolini, Antonio Covelli, Leonardo Maria Siena, Antonio Sciurti, Giuseppe Migliara, Azzurra Massimi, Carolina Marzuillo, Corrado De Vito, Leandro Casini, Antonio Angeloni, Ombretta Turriziani, Guido Antonelli, Fabrizio D’Alba, Antonella Polimeni, Collaborating Group , Paolo Villari Background During the SARS-CoV-2 testing program offered through the RT-PCR test by Sapienza University of Rome, we conducted a test-negative case-control study to identify risk factors for acquiring SARS-CoV-2 infection among university students. Methods Each SARS-CoV-2-positive case detected was matched to two controls randomly selected from students who tested negative on the same day. 122 positive students and 244 negative students were enrolled in the study. Multivariable conditional logistic regression models were built. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. A second model was limited to students who had attended campus. Results Out of 8223 tests for SARS-CoV-2, 173 students tested positive (2.1%), of whom 122 (71.5%) were included in the case-control study. In the first analysis, being a non-Italian student (aOR: 8.93, 95% CI: 2.71–29.41), having received only the primary vaccination course (aOR: 2.94, 95% CI: 1.24–6.96) compared to the booster dose, known exposure to a COVID-19 case or someone with signs/symptoms suggestive of COVID-19 (aOR: 6.51, 95% CI: 3.48–12.18), and visiting discos (aOR: 4.07, 95% CI: 1.52–10.90) in the two weeks before testing increased the likelihood of SARS-CoV-2 infection. Conversely, students attending in-person lectures on campus seemed less likely to become infected (aOR: 0.34, 95% CI: 0.15–0.77). No association was found with other variables. The results of the second model were comparable to the first analysis. Conclusions This study indicates that if universities adopt strict prevention measures, it is safe for students to attend, even in the case of an infectious disease epidemic.
Læs mere Tjek på PubMedLeann Blake, Patricia Tucker, Leigh M. Vanderloo
PLoS One Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
by Leann Blake, Patricia Tucker, Leigh M. Vanderloo Screen time for children under 5 is associated with various health risks. Amidst the COVID-19 pandemic, screen use among young children increased significantly. Mothers were more likely than fathers to be the primary caregivers and disproportionally assumed the responsibility of monitoring their children’s screen time. Several studies have examined children’s screen use throughout the pandemic; however, few have addressed mothers’ experiences. Therefore, the current study aimed to investigate mothers’ perceptions regarding the barriers and facilitators faced when trying to reduce their child’s pandemic screen time, as expressed on Reddit (a social media platform for anonymous discussion and information sharing). Two subreddit forums targeted toward mothers, \'mommit\' and \'beyondthebump,\' with 646,000 and 554,000 users, respectively, were examined. Posts were collected using related search terms and screened for inclusion by three independent researchers. Inductive thematic content analysis was leveraged to identify themes. In total, 582 posts were reviewed from March 14th, 2020, to August 31st, 2022. Qualitative analysis yielded 5 themes; 6 barriers and 2 facilitators were derived from themes and/or subthemes, where applicable. Results suggest that mothers faced barriers when trying to reduce their child’s screen time, including their competing work and in-home obligations, using screens to occupy their child during travel, child screen use with other caregivers, offering their child screen time while they needed rest, pandemic changes in routine, and using screens to encourage their child to engage in necessary behaviours. However, facilitating factors, including advice received from other mothers on how to reduce their child’s screen time and the sharing of non-screen alternatives supported mothers in lowering their children’s screen time. These results are important for future interventions, which may utilize the conclusions of this study to address what mothers perceive to be helping or hindering them, thus empowering mothers to successfully limit their children’s screen time.
Læs mere Tjek på PubMedJelena Dimnjaković, Tamara Buble, Pero Ivanko, Tamara Poljičanin, Sandra Karanović Štambuk, Hana Brborović, Ognjen Brborović
PLoS One Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
by Jelena Dimnjaković, Tamara Buble, Pero Ivanko, Tamara Poljičanin, Sandra Karanović Štambuk, Hana Brborović, Ognjen Brborović Introduction Patients with diabetes mellitus type 2 and chronic kidney disease (T2DM-CKD) have a 5 times higher risk of developing severe SARS-CoV-2 infection than those without these 2 diseases. The goal of this study is to provide information on T2DM-CKD and COVID-19 outcomes, with an emphasis on the association with anti-diabetic medications. Methodology Study is designed as a retrospective cohort analysis covering the years 2020 and 2021. Data from the National Diabetes Registry (CroDiab) were linked to hospital data, primary healthcare data, Causes of Death Registry data, the SARS-CoV-2 vaccination database, and the SARS-CoV-2 test results database. Study outcomes were cumulative incidence of SARS-CoV-2 positivity, COVID-19 hospitalizations, and COVID-19 deaths. For outcome predictors, logistic regression models were developed. Results Of 231 796 patients with diabetes mellitus type 2 in the database, 7 539 were T2DM-CKD (3.25%). The 2-year cumulative incidences of all three studies’ outcomes were higher in T2DM-CKD than in diabetes patients without CKD (positivity 18.1% vs. 14.4%; hospitalization 9.7% vs. 4.2%; death 3.3% vs. 1.1%, all p
Læs mere Tjek på PubMedLaura A. Bray, Lori L. Jervis, Amanda E. Janitz, Laura Ross, Gloria Tallbull, Timothy M. VanWagoner, the CATCH-UP Vaccines Team
PLoS One Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
by Laura A. Bray, Lori L. Jervis, Amanda E. Janitz, Laura Ross, Gloria Tallbull, Timothy M. VanWagoner, the CATCH-UP Vaccines Team Prior research identifies trust as critical to increase vaccine acceptance and uptake. However, few intervention studies have sought to develop or test strategies for bolstering vaccine-related trust. To address this gap, this exploratory study identifies features of COVID-19 vaccine hesitancy interventions that can promote or undermine trust across three interconnected domains: institutional, interpersonal, and product (the vaccine itself). We draw on focus groups (N = 27 participants) with community and university partners involved with hosting COVID-19 testing and vaccine events in underserved Oklahoma communities. Focus groups explored participants’ experiences serving community health needs and elicited feedback on proposed vaccine hesitancy interventions. Proposed interventions included two technology-based strategies (text message reminders and tablet-based testimonials and education) and one dialogue-based strategy (anti-body test interpretation). We find that community partners perceived local universities as trustworthy institutions because of their association with popular sports programs, academic credentials, and proximity, creating opportunities to address vaccine-related distrust through community-university partnerships. The most promising intervention strategies for building interpersonal trust included engaging in one-on-one dialogue and using autonomy enhancing approaches. Finally, interventions that successfully encouraged vaccine trust did so by incorporating personalized health information about individuals’ potential level of protection and susceptibility to the COVID-19 virus. These findings can inform future public health efforts to create trustworthy vaccine hesitancy interventions.
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