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47 ud af 47 tidsskrifter valgt, søgeord (covid) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
1277 emner vises.
Hashan, M. R., Smoll, N., Chapman, G., King, C., Walker, J., Kirk, M., Akbar, D., Booy, R., Khandaker, G.
BMJ Open, 15.03.2024
Tilføjet 15.03.2024
ObjectiveWe aimed to define the epidemiology of COVID-19 outbreaks in aged care facilities (ACFs) during the postvaccine period, including vaccine effectiveness (VE) for this high-risk group. DesignSystematic review and meta-analysis. Data sourcesOvid Medline, Ovid Embase, Scopus, Web of Science and Cochrane databases were searched through 1 September 2023. Eligibility criteriaAny original observational studies and trials reporting data on COVID-19 outbreaks among the partially/fully vaccinated residents from ACFs during or after the worldwide implementation of vaccine roll-out. Data extraction and synthesisWe estimated the attack rate, case fatality rate, mortality rate and VE during postvaccine period. Random effect model was adopted for meta-analysis. Quality assessment on all included studies was performed using the Meta Quality Appraisal Tool. Results38 articles were included from 12 countries reporting 79 outbreaks with 1708 confirmed cases of COVID-19 from 78 ACFs. The pooled attack rate was 28% (95% CI 20% to 37%) among the fully vaccinated residents. Two-thirds (62.5%) of the index cases were unvaccinated healthcare professionals (eg, physicians, nurses) and caregivers. Unvaccinated residents had a significantly higher rates (12%) (95% CI 7% to 19%) of mortality compared with the vaccinated residents (2%) (95% CI% 1 to 4%) and the post-COVID-19 vaccine estimates for case fatality rate (13% vs 23%) and hospitalisation rate (17% vs 37%) were substantially lower. VE in preventing disease among residents in ACFs was 73% (95% CI 49% to 86). Overall, the included studies were heterogeneous in nature, however, the risk of bias was low to moderate. ConclusionsOur study reaffirmed the impact of vaccination as a key public health measure to minimise the burden of COVID-19 in ACFs. Facilities with higher crowding indexes should be prioritised for vaccination and should advocate for higher vaccination targets among staff and residents as a critical intervention strategy to minimise disease burden in this vulnerable population.
Læs mere Tjek på PubMedPostill, G., Halpin, M., Zanin, C., Ritter, C.
BMJ Open, 15.03.2024
Tilføjet 15.03.2024
ObjectivesThis qualitative study aimed to explore how young adults experienced the COVID-19 pandemic in relation to extensive lockdowns, social isolation and psychosocial distress. Specifically, this research focused on how the pandemic impacted those who did not contract COVID-19 and lived in a low-risk geographical location. The focus was young adults given they have large social circles (high risk for disease transmission) and have an increased propensity to mental health conditions. These insights can inform planning for future pandemics. DesignThis paper draws on 30 in-depth semistructured interviews. Data were analysed inductively following the principles of a constructivist grounded theory approach. Setting and participants30 young adults living in Prince Edward Island during the COVID-19 pandemic, a Canadian province with a low number of COVID-19 cases at the time of data collection. ResultsWe developed four themes that describe the experience of young adults during the COVID-19 pandemic: (1) life course disruption, (2) fear and anxiety about the COVID-19 virus, (3) isolation and loss of hope and (4) strategies for managing adversity. Our findings highlight the areas of young adults’ lives that were affected by extensive social changes related to the COVID-19 pandemic. We demonstrate that even individuals who had not contracted the virus were considerably impacted. ConclusionWe provide a detailed description of the comprehensive impact of COVID-19 on low-risk young adults not previously infected with the COVID-19 virus. By reflecting on the biographical disruption experienced by young adults, we highlight the need and opportunity to direct healthcare resources towards identifying and addressing the secondary impacts of pandemics. Consequently, these findings can guide decisions relating to future pandemic restrictions to better account for the experiences of individuals living through them.
Læs mere Tjek på PubMedZheng, Z., Wang, L., Wang, S., Fan, Q., Zhang, H., Luo, G., Gao, B., Yang, X., Zhao, B., Wang, X., Dong, H., Nie, H., Lei, C.
BMJ Open, 15.03.2024
Tilføjet 15.03.2024
BackgroundA history of SARS-CoV-2 infection has been reported to be associated with an increased risk of postoperative pulmonary complications (PPCs). Even mild PPCs can elevate the rates of early postoperative mortality, intensive care unit (ICU) admission and prolong the length of ICU and/or hospital stays. Consequently, it is crucial to develop perioperative management strategies that can mitigate these increased risks in surgical patients who have recently been infected with SARS-CoV-2. Accumulating evidence suggests that nitric oxide (NO) inhalation might be effective in treating COVID-19. NO functions in COVID-19 by promoting vasodilation, anticoagulation, anti-inflammatory and antiviral effects. Therefore, our study hypothesises that the perioperative use of NO can effectively reduce PPCs in patients with recent SARS-CoV-2 infection. Method and analysisA prospective, double-blind, single-centre, randomised controlled trial is proposed. The trial aims to include participants who are planning to undergo surgery with general anaesthesia and have been recently infected with SARS-CoV-2 (within 7 weeks). Stratified allocation of eligible patients will be performed at a 1:1 ratio based on the predicted risk of PPCs using the Assess Respiratory Risk in Surgical Patients in Catalonia risk index and the time interval between infection and surgery. The primary outcome of the study will be the presence of PPCs within the first 7 days following surgery, including respiratory infection, respiratory failure, pleural effusion, atelectasis, pneumothorax, bronchospasm and aspiration pneumonitis. The primary outcome will be reported as counts (percentage) and will be compared using a two-proportion 2 test. The common effect across all primary components will be estimated using a multiple generalised linear model. Ethics and disseminationThe trial is approved by the Institutional Review Board of Xijing Hospital (KY20232058-F1). The findings, including positive, negative and inconclusive results, will be published in scientific journals with peer-review processes. Trial registration numberNCT05721144.
Læs mere Tjek på PubMedKitsios, G. D., Blacka, S., Jacobs, J. J., Mirza, T., Naqvi, A., Gentry, H., Murray, C., Wang, X., Golubykh, K., Qurashi, H., Dodia, A., Risbano, M., Benigno, M., Emir, B., Weinstein, E., Bramson, C., Jiang, L., Dai, F., Szigethy, E., Mellors, J. W., Methe, B., Sciurba, F. C., Nouraie, S. M., Morris, A.
BMJ Open, 15.03.2024
Tilføjet 15.03.2024
ObjectiveTo characterise subphenotypes of self-reported symptoms and outcomes (SRSOs) in postacute sequelae of COVID-19 (PASC). DesignProspective, observational cohort study of subjects with PASC. SettingAcademic tertiary centre from five clinical referral sources. ParticipantsAdults with COVID-19 ≥20 days before enrolment and presence of any new self-reported symptoms following COVID-19. ExposuresWe collected data on clinical variables and SRSOs via structured telephone interviews and performed standardised assessments with validated clinical numerical scales to capture psychological symptoms, neurocognitive functioning and cardiopulmonary function. We collected saliva and stool samples for quantification of SARS-CoV-2 RNA via quantitative PCR. Outcomes measuresDescription of PASC SRSOs burden and duration, derivation of distinct PASC subphenotypes via latent class analysis (LCA) and relationship with viral load. ResultsWe analysed baseline data for 214 individuals with a study visit at a median of 197.5 days after COVID-19 diagnosis. Participants reported ever having a median of 9/16 symptoms (IQR 6–11) after acute COVID-19, with muscle-aches, dyspnoea and headache being the most common. Fatigue, cognitive impairment and dyspnoea were experienced for a longer time. Participants had a lower burden of active symptoms (median 3 (1–6)) than those ever experienced (p
Læs mere Tjek på PubMedYang, Philip; Gregory, Ismail A.; Robichaux, Chad; Holder, Andre L.; Martin, Greg S.; Esper, Annette M.; Kamaleswaran, Rishikesan; Gichoya, Judy W.; Bhavani, Sivasubramanium V.
Critical Care Explorations, 15.03.2024
Tilføjet 15.03.2024
OBJECTIVES: To develop and validate machine learning (ML) models to predict high-flow nasal cannula (HFNC) failure in COVID-19, compare their performance to the respiratory rate-oxygenation (ROX) index, and evaluate model accuracy by self-reported race. DESIGN: Retrospective cohort study. SETTING: Four Emory University Hospitals in Atlanta, GA. PATIENTS: Adult patients hospitalized with COVID-19 between March 2020 and April 2022 who received HFNC therapy within 24 hours of ICU admission were included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Four types of supervised ML models were developed for predicting HFNC failure (defined as intubation or death within 7 d of HFNC initiation), using routine clinical variables from the first 24 hours of ICU admission. Models were trained on the first 60% (n = 594) of admissions and validated on the latter 40% (n = 390) of admissions to simulate prospective implementation. Among 984 patients included, 317 patients (32.2%) developed HFNC failure. eXtreme Gradient Boosting (XGB) model had the highest area under the receiver-operator characteristic curve (AUROC) for predicting HFNC failure (0.707), and was the only model with significantly better performance than the ROX index (AUROC 0.616). XGB model had significantly worse performance in Black patients compared with White patients (AUROC 0.663 vs. 0.808, p = 0.02). Racial differences in the XGB model were reduced and no longer statistically significant when restricted to patients with nonmissing arterial blood gas data, and when XGB model was developed to predict mortality (rather than the composite outcome of failure, which could be influenced by biased clinical decisions for intubation). CONCLUSIONS: Our XGB model had better discrimination for predicting HFNC failure in COVID-19 than the ROX index, but had racial differences in accuracy of predictions. Further studies are needed to understand and mitigate potential sources of biases in clinical ML models and to improve their equitability.
Læs mere Tjek på PubMedMark J. Panaggio, Mike Fang, Hyunseung Bang, Paige A. Armstrong, Alison M. Binder, Julian E. Grass, Jake Magid, Marc Papazian, Carrie K. Shapiro-Mendoza, Sharyn E. Parks
PLoS One Infectious Diseases, 15.03.2024
Tilføjet 15.03.2024
by Mark J. Panaggio, Mike Fang, Hyunseung Bang, Paige A. Armstrong, Alison M. Binder, Julian E. Grass, Jake Magid, Marc Papazian, Carrie K. Shapiro-Mendoza, Sharyn E. Parks
Læs mere Tjek på PubMedCharuai Suwanbamrung, Benchawan Srinam, Pakawan Promkool, Warissara Suwannakarn, Sangchom Siripanich, Md. Siddikur Rahman, Muhammad Haroon Stanikzai
PLoS One Infectious Diseases, 15.03.2024
Tilføjet 15.03.2024
by Charuai Suwanbamrung, Benchawan Srinam, Pakawan Promkool, Warissara Suwannakarn, Sangchom Siripanich, Md. Siddikur Rahman, Muhammad Haroon Stanikzai Background The COVID-19 pandemic has imposed unprecedented suffering on social and individual levels worldwide. Vaccines against COVID-19 have been prioritized as a crucial strategy for ending the pandemic as well as minimizing its consequences. Objectives This study aimed to determine the uptake of COVID-19 vaccine among high-risk urban populations in Southern Thailand using the Capability, Opportunity, Motivation, and Behavior (COM-B) model. Methods We conducted a web-based cross-sectional study in the Hat Yai district, Songkhla province in Southern Thailand, in September and October 2021. The questionnaire was composed of sections on sociodemographic characteristics, COVID-19 vaccination status, and COM-B constructs. We employed a multivariable logistic regression analysis to determine factors associated with the uptake of the COVID-19 vaccine. We set statistical significance at p < 0.05. Results In this study, females constituted 54.7% of the total participants (n = 358), and nearly half of the participants (45.8%) were in the younger age group (18–29). Of all the participants, 59.5% (95%CI: 54.2%-64.6%) received at least one dose of the COVID-19 vaccine. Factors associated with the uptake of COVID-19 vaccine and their adjusted OR (95% CI) were being married: 3.59 (2.06–6.24), having a graduate degree: 2.34 (1.38–3.96), gainfully employed: 3.30 (1.91–5.67), having a high level of opportunity: 2.90 (1.48–5.66), and having a high level of motivation: 2.87 (1.17–17.08). Conclusion The uptake of COVID-19 vaccines was moderate in this population. Moreover, the results showed that the COM-B model is useful in predicting COVID-19 vaccine uptake. The findings of this study could be used to aid future public health interventions in any event of outbreaks similar to COVID-19 disease in Thailand and beyond.
Læs mere Tjek på PubMedNeeltje de Vries, Laura Maniscalco, Domenica Matranga, José Bouman, J Peter de Winter
PLoS One Infectious Diseases, 15.03.2024
Tilføjet 15.03.2024
by Neeltje de Vries, Laura Maniscalco, Domenica Matranga, José Bouman, J Peter de Winter Background The global outbreak of COVID-19 has brought to light the profound impact that large-scale disease outbreaks can have on healthcare systems and the dedicated professionals who serve within them. It becomes increasingly important to explore strategies for retaining nurses and physicians within hospital settings during such challenging times. This paper aims to investigate the determinants of retention among nurses and physicians during the COVID-19 pandemic. Method A systematic review of other potential determinants impacting retention rates during the pandemic was carried out. Secondly, a meta-analysis on the prevalence of intention to leave for nurses and physicians during the COVID-19 pandemic. Findings A comprehensive search was performed within four electronic databases on March 17 2023. Fifty-five papers were included in the systematic review, whereas thirty-three papers fulfilled the eligibility criteria for the meta-analysis. The systematic review resulted in six themes of determinants impacting intention to leave: personal characteristics, job demands, employment services, working conditions, work relationships, and organisational culture. The main determinants impacting the intention to leave are the fear of COVID-19, age, experience, burnout symptoms and support. Meta-analysis showed a prevalence of intent to leave the current job of 38% for nurses (95% CI: 26%-51%) and 29% for physicians (95% CI: 21%-39%), whereas intention to leave the profession for nurses 28% (95% CI: 21%-34%) and 24% for physicians (95% CI: 23%-25%). Conclusion The findings of this paper showed the critical need for hospital managers to address the concerning increase in nurses’ and physicians’ intentions to leave during the COVID-19 pandemic. This intention to leave is affected by a complex conjunction of multiple determinants, including the fear of COVID-19 and the confidence in and availability of personal protective equipment. Moreover, individual factors like age, experience, burnout symptoms, and support are maintained in this review. Understanding the influence of determinants on retention during the COVID-19 pandemic offers an opportunity to formulate prospective strategies for retaining nurses and physicians within hospital settings.
Læs mere Tjek på PubMedKyung-Shin Lee, Min Jin Go, Youn Young Choi, Min-Kyung Kim, Jaehyun Seong, Ho Kyung Sung, Jaehyun Jeon, Hee-Chang Jang, Myoung-Hee Kim
PLoS One Infectious Diseases, 15.03.2024
Tilføjet 15.03.2024
by Kyung-Shin Lee, Min Jin Go, Youn Young Choi, Min-Kyung Kim, Jaehyun Seong, Ho Kyung Sung, Jaehyun Jeon, Hee-Chang Jang, Myoung-Hee Kim Background This study evaluated the clinical characteristics of patients with COVID-19 in Korea, and examined the relationship between severe COVID-19 cases and underlying health conditions during the Delta (September 20, 2021 to December 4, 2021) and the Omicron (February 20, 2022 to March 31, 2022) predominant period. Methods This study assessed the association between critical COVID-19 illness and various risk factors, including a variety of underlying health conditions, using multiple logistic regression models based on the K-COV-N cohort, a nationwide data of confirmed COVID-19 cases linked with COVID-19 vaccination status and the National Health Insurance claim information. Results We analyzed 137,532 and 8,294,249 cases of COVID-19 infection during the Delta and the Omicron variant dominant periods, respectively. During the Delta as well as the Omicron period, old age (≥80 years) showed the largest effect size among risk factors for critical COVID-19 illness (aOR = 18.08; 95% confidence interval [CI] = 14.71–22.23 for the Delta; aOR = 24.07; 95% CI = 19.03–30.44 for the Omicron period). We found that patients with solid organ transplant (SOT) recipients, unvaccinated, and interstitial lung disease had more than a two-fold increased risk of critical COVID-19 outcomes between the Delta and Omicron periods. However, risk factors such as urban residence, underweight, and underlying medical conditions, including chronic cardiac diseases, immunodeficiency, and mental disorders, had different effects on the development of critical COVID-19 illness between the Delta and Omicron periods. Conclusion We found that the severity of COVID-19 infection was much higher for the Delta variant than for the Omicron. Although the Delta and the Omicron variant shared many risk factors for critical illness, several risk factors were found to have different effects on the development of critical COVID-19 illness between those two variants. Close monitoring of a wide range of risk factors for critical illness is warranted as new variants continue to emerge during the pandemic.
Læs mere Tjek på PubMedInfection, 14.03.2024
Tilføjet 14.03.2024
BMC Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
Abstract Background Early during the COVID-19 pandemic, it was important to better understand transmission dynamics of SARS-CoV-2, the virus that causes COVID-19. Household contacts of infected individuals are particularly at risk for infection, but delays in contact tracing, delays in testing contacts, and isolation and quarantine posed challenges to accurately capturing secondary household cases. Methods In this study, 346 households in the Seattle region were provided with respiratory specimen collection kits and remotely monitored using web-based surveys for respiratory illness symptoms weekly between October 1, 2020, and June 20, 2021. Symptomatic participants collected respiratory specimens at symptom onset and mailed specimens to the central laboratory in Seattle. Specimens were tested for SARS-CoV-2 using RT-PCR with whole genome sequencing attempted when positive. SARS-CoV-2-infected individuals were notified, and their household contacts submitted specimens every 2 days for 14 days. Results In total, 1371 participants collected 2029 specimens that were tested; 16 individuals (1.2%) within 6 households tested positive for SARS-CoV-2 during the study period. Full genome sequences were generated from 11 individuals within 4 households. Very little genetic variation was found among SARS-CoV-2 viruses sequenced from different individuals in the same household, supporting transmission within the household. Conclusions This study indicates web-based surveillance of respiratory symptoms, combined with rapid and longitudinal specimen collection and remote contact tracing, provides a viable strategy to monitor households and detect household transmission of SARS-CoV-2. Trial registration identifier NCT04141930, Date of registration 28/10/2019.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
Abstract Background To effectively promote vaccine uptake, it is important to understand which people are most and least inclined to be vaccinated and why. In this study, we examined predictors of COVID-19 vaccine uptake and reasons for non-vaccination. Methods We conducted an online English-language survey study in December-2020, January-2021, and March-2021. A total of 930 US respondents completed all surveys. Multiple logistic regression models were run to test whether the early vaccine eligibility, demographic factors, and psychological factors predict getting at least one dose of a COVID-19 vaccination in January-2021 and in March-2021. Results The proportion of respondents who received ≥ 1-dose of a COVID-19 vaccine increased from 18% (January) to 67% (March). Older age predicted vaccine uptake in January (OR = 2.02[95%CI = 1.14–3.78], p
Læs mere Tjek på PubMedJournal of the American Medical Association, 14.03.2024
Tilføjet 14.03.2024
To the Editor The recently published REMAP-CAP and LOVIT-COVID studies tested the hypothesis that the administration of high-dose vitamin C (ascorbic acid) increases the number of days patients are alive and free from organ support. However, these studies were terminated early when statistical triggers for harm and futility were met. In addition, the earlier LOVIT study found harm from high-dose vitamin C and a higher risk of death or persistent organ dysfunction at 28 days. The dose of vitamin C given to the 1476 patients with critical illness in the 3 studies was 50 mg/kg of body weight administered 4 times daily. For a patient weighing 60 kg, this is 12 g of vitamin C daily.
Læs mere Tjek på PubMedJournal of the American Medical Association, 14.03.2024
Tilføjet 14.03.2024
In Reply Dr McKenzie and colleagues raise concerns regarding the safety of bundling thiamine with other vitamins into a product primarily prescribed for thiamine replacement in patients with or at risk of alcohol withdrawal. This formulation consists of 2 ampules (thiamine, riboflavin, and pyridoxine in ampule 1; ascorbic acid, nicotinamide, and glucose in ampule 2) that are intended to be diluted together in normal saline or 5% dextrose and infused. We are aware of a similar bundled injectable vitamin solution in other countries.
Læs mere Tjek på PubMedJournal of the American Medical Association, 14.03.2024
Tilføjet 14.03.2024
COVID-19 symptoms improved 24 hours sooner among patients with mild to moderate infection who received ensitrelvir, an investigational antiviral drug, than those who received a placebo, according to results from a randomized clinical trial involving more than 1000 patients from Japan, South Korea, and Vietnam.
Læs mere Tjek på PubMedJournal of the American Medical Association, 14.03.2024
Tilføjet 14.03.2024
A group exercise program delivered online in combination with psychological support sessions improved the health-related quality of life for people living with post–COVID-19 condition, also known as long COVID, compared with the usual care of 1 online support session. The results are based on randomized clinical trial data from 585 adults in England and Wales with ongoing physical and mental health symptoms after being hospitalized with SARS-CoV-2.
Læs mere Tjek på PubMedMovahedi Nia, Z., Prescod, C., Westin, M., Perkins, P., Goitom, M., Fevrier, K., Bawa, S., Kong, J.
BMJ Open, 14.03.2024
Tilføjet 14.03.2024
ObjectivesThe COVID-19 pandemic disrupted healthcare services, leading to the cancellation of non-urgent tests, screenings and procedures, a shift towards remote consultations, stalled childhood immunisations and clinic closures which had detrimental effects across the healthcare system. This study investigates the impact of the COVID-19 pandemic on clinical admissions and healthcare quality in the Peel, York and Toronto regions within the Greater Toronto Area (GTA). DesignIn a cross-sectional study, the negative impact of the pandemic on various healthcare sectors, including preventive and primary care (PPC), the emergency department (ED), alternative level of care (ALC) and imaging, procedures and surgeries is investigated. Study questions include assessing impairments caused by the COVID-19 pandemic and discovering hotspots and critical subregions that require special attention to recover. The measuring technique involves comparing the number of cases during the COVID-19 pandemic with before that, and determining the difference in percentage. Statistical analyses (Mann-Whitney U test, analysis of variance, Dunn’s test) is used to evaluate sector-specific changes and inter-relationships. SettingThis work uses primary data which were collected by the Black Creek Community Health Centre. The study population was from three regions of GTA, namely, the city of Toronto, York and Peel. For all health sectors, the sample size was large enough to have a statistical power of 0.95 to capture 1% variation in the number of cases during the COVID-19 pandemic compared with before that. ResultsAll sectors experienced a significant decline in patient volume during the pandemic. ALC admissions surged in some areas, while IPS patients faced delays. Surgery waitlists increased by an average of 9.75%, and completed IPS procedures decreased in several subregions. ConclusionsThe COVID-19 pandemic had a universally negative impact on healthcare sectors across various subregions. Identification of the hardest-hit subregions in each sector can assist health officials in crafting recovery policies.
Læs mere Tjek på PubMedYi Pang, Connor Robbs, Jingyun Wang
PLoS One Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
by Yi Pang, Connor Robbs, Jingyun Wang Background Our previous study revealed that the COVID-19 pandemic posed mental health challenges to eye care professionals and students. The intent of this study was to identify the longitudinal impact of the COVID-19 pandemic on mental health among ophthalmic personnel and students. Additionally, the potential risk factors for mental health problems were investigated. Methods A two-phase survey among eye care professionals and students in the USA and Canada was conducted. Phase 1 was administrated from June 23 to July 8, 2020, and has been published; Phase 2 was conducted from January 21 to February 2, 2021. A total of 824 eye care professionals and students participated in Phase 2, with a response rate of 44.1%. Symptoms of depression, anxiety, and stress were measured and calculated. Results Compared with Phase 1, stress scores in Phase 2 were significantly reduced (P
Læs mere Tjek på PubMedHuawei Li, Changying Wang
PLoS One Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
by Huawei Li, Changying Wang The accuracy of traditional CT image segmentation algorithms is hindered by issues such as low contrast and high noise in the images. While numerous scholars have introduced deep learning-based CT image segmentation algorithms, they still face challenges, particularly in achieving high edge accuracy and addressing pixel classification errors. To tackle these issues, this study proposes the MIS-Net (Medical Images Segment Net) model, a deep learning-based approach. The MIS-Net model incorporates multi-scale atrous convolution into the encoding and decoding structure with symmetry, enabling the comprehensive extraction of multi-scale features from CT images. This enhancement aims to improve the accuracy of lung and liver edge segmentation. In the evaluation using the COVID-19 CT Lung and Infection Segmentation dataset, the left and right lung segmentation results demonstrate that MIS-Net achieves a Dice Similarity Coefficient (DSC) of 97.61. Similarly, in the Liver Tumor Segmentation Challenge 2017 public dataset, the DSC of MIS-Net reaches 98.78.
Læs mere Tjek på PubMedMikael Rubin, Caitlin M. Fischer, Michael J. Telch
PLoS One Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
by Mikael Rubin, Caitlin M. Fischer, Michael J. Telch Loneliness, perceived stress, depression, and anxiety have increased during the COVID-19 pandemic. Many of existing mindfulness and compassion-based intervention are effective, but are time-intensive, decreasing overall accessibility and scalability. Single-session interventions (SSIs) serve as a promising alternative. The current pre-registered randomized clinical trial evaluated a newly developed, manualized, mindfulness-based single-session intervention. 91 adults were randomly assigned to one of three conditions: (1) one-hour mindfulness only telehealth intervention; (b) one-hour mindfulness and compassion telehealth intervention; or (c) one-week waitlist control (before randomization to an active intervention). Intervention sessions were conducted by graduate students in clinical psychology. The primary outcome was self-reported loneliness; secondary outcomes were self-reported perceived stress, depression, and anxiety. Using Bayesian multilevel models, we found that compared to the waitlist-control, the inclusion of a compassion component led to meaningful reductions in perceived stress b = -3.75, 95% HDI [-6.95, -0.59], anxiety b = -3.79, 95% HDI [-6.99, -0.53], and depression b = -3.01, 95% HDI [-5.22, -0.78], but not loneliness at the 1-week follow-up. Results suggest that a single-session mindfulness and compassion intervention may lead to meaningful reductions in perceived stress, symptoms of anxiety, and symptoms of depression, but not loneliness. Implications of these findings are discussed.
Læs mere Tjek på PubMedBMC Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
Abstract Background Early during the COVID-19 pandemic, it was important to better understand transmission dynamics of SARS-CoV-2, the virus that causes COVID-19. Household contacts of infected individuals are particularly at risk for infection, but delays in contact tracing, delays in testing contacts, and isolation and quarantine posed challenges to accurately capturing secondary household cases. Methods In this study, 346 households in the Seattle region were provided with respiratory specimen collection kits and remotely monitored using web-based surveys for respiratory illness symptoms weekly between October 1, 2020, and June 20, 2021. Symptomatic participants collected respiratory specimens at symptom onset and mailed specimens to the central laboratory in Seattle. Specimens were tested for SARS-CoV-2 using RT-PCR with whole genome sequencing attempted when positive. SARS-CoV-2-infected individuals were notified, and their household contacts submitted specimens every 2 days for 14 days. Results In total, 1371 participants collected 2029 specimens that were tested; 16 individuals (1.2%) within 6 households tested positive for SARS-CoV-2 during the study period. Full genome sequences were generated from 11 individuals within 4 households. Very little genetic variation was found among SARS-CoV-2 viruses sequenced from different individuals in the same household, supporting transmission within the household. Conclusions This study indicates web-based surveillance of respiratory symptoms, combined with rapid and longitudinal specimen collection and remote contact tracing, provides a viable strategy to monitor households and detect household transmission of SARS-CoV-2. Trial registration identifier NCT04141930, Date of registration 28/10/2019.
Læs mere Tjek på PubMedBMC Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
Abstract Background To effectively promote vaccine uptake, it is important to understand which people are most and least inclined to be vaccinated and why. In this study, we examined predictors of COVID-19 vaccine uptake and reasons for non-vaccination. Methods We conducted an online English-language survey study in December-2020, January-2021, and March-2021. A total of 930 US respondents completed all surveys. Multiple logistic regression models were run to test whether the early vaccine eligibility, demographic factors, and psychological factors predict getting at least one dose of a COVID-19 vaccination in January-2021 and in March-2021. Results The proportion of respondents who received ≥ 1-dose of a COVID-19 vaccine increased from 18% (January) to 67% (March). Older age predicted vaccine uptake in January (OR = 2.02[95%CI = 1.14–3.78], p
Læs mere Tjek på PubMedJournal of Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
Abstract Background We examined effects of single-nucleotide variants (SNVs) of IL1RN, the gene encoding the anti-inflammatory interleukin 1 receptor antagonist (IL-1Ra), on the cytokine release syndrome (CRS) and mortality in patients with acute severe respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.Methods IL1RN CTA haplotypes formed from 3 SNVs (rs419598, rs315952, rs9005) and the individual SNVs were assessed for association with laboratory markers of inflammation and mortality. We studied 2589 patients hospitalized with SARS-CoV-2 between March 2020 and March 2021.Results Mortality was 15.3% and lower in women than men (13.1% vs 17.3%, P = .0003). Carriers of the CTA-1/2 IL1RN haplotypes exhibited decreased inflammatory markers and increased plasma IL-1Ra. Evaluation of the individual SNVs of the IL1RN, carriers of the rs419598 C/C SNV exhibited significantly reduced inflammatory biomarker levels and numerically lower mortality compared to the C/T-T/T genotype (10.0% vs 17.8%, P = .052) in men, with the most pronounced association observed in male patients ≤74 years old, whose mortality was reduced by 80% (3.1% vs 14.0%, P = .030).Conclusions The IL1RN haplotype CTA and C/C variant of rs419598 are associated with attenuation of the CRS and decreased mortality in men with acute SARS-CoV-2 infection. The data suggest that the IL1RN pathway modulates the severity of coronavirus disease 2019 (COVID-19) via endogenous anti-inflammatory mechanisms.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
Abstract Serial blood and mucosal samples were characterized for 102 participants enrolled a median of 7.0 days post-COVID-19 diagnosis. Mucosal RNA was detectable a median 31.5 (95% CI 20.5 - 63.5) days, with persistence ≥1 month associated with obesity (BMI ≥30, OR 3.9, 95% CI 1.2 - 13.8) but not age, sex, or chronic conditions. Fifteen participants had likely reinfection; lower serum anti-S IgG levels were associated with reinfection risk. Nearly half of participants (47%) reported symptoms lasting ≥2-3 months; persistence ≥3 months was associated with BMI ≥30 (OR = 4.2 95% CI 1.1 - 12.8) and peak anti-S and anti-NC antibody levels.
Læs mere Tjek på PubMedReiter, J., Weibelzahl, S., Duden, G. S.
BMJ Open, 13.03.2024
Tilføjet 13.03.2024
ObjectivesMental health and well-being of healthcare staff were majorly impacted by the COVID-19 pandemic. Little attention has been devoted to the role employers could choose to play in mitigating long-term negative consequences and how effective organisational measures taken were perceived by the individual healthcare workers. This study aims to investigate (1) whether and how healthcare professionals’ mental health has changed from the second to the third pandemic year, (2) whether differences between professional groups (physicians, nurses, paramedics) identified in previous studies persisted and (3) how job demands and resources, for example, work culture and employers’ measures, impacted this situation. DesignThe study employs an observational, cross-sectional design, using an online survey. Setting and participantsThe study was conducted online from mid-June to mid-August 2022 among healthcare staff in state-run and private healthcare facilities, such as doctor’s practices, hospitals and paramedic organisations, in Germany and Austria (n=421). Outcome measuresWe measured psychological strain using an ICD-10-based symptom checklist, as well as subjective strain and importance of stressors using self-report questions. The ICD-10 was the 10th version of the International Statistical Classification of Diseases and Related Health Problems, a widely used standardized diagnostic manual. ResultsPsychological strain stayed relatively consistent, with nursing staff suffering the most. While the job demands participants felt most affected by were structural issues (eg, staff shortages), employers were far more likely to be perceived as taking action against pandemic-specific job demands (eg, lack of protective gear). Psychological strain was lowest when staff perceived employers’ actions as effective. Only 60% of those with severe enough symptoms to require psychological help had intentions of seeking such help, which is in line with past studies. This help-seeking hesitancy was also dependent on different facets of perceived work culture. ConclusionsHealthcare staff and nursing staff in particular continue to suffer in the aftermath of the COVID-19 pandemic. However, while employers were perceived as taking action against pandemic-specific job demands, pre-existing job demands causing stress and psychological strain for staff have remained uncombatted.
Læs mere Tjek på PubMedAndersson, C., Berman, A. H., Lindfors, P., Bendtsen, M.
BMJ Open, 13.03.2024
Tilføjet 13.03.2024
ObjectiveThis study used causal inference to estimate the longitudinal effects of contagion in cohabitants and family members on university students’ mental health and academic self-efficacy during the COVID-19 pandemic. DesignA prospective longitudinal study including a baseline online measurement in May 2020, and online follow-ups after 5 months and 10 months. Participants were recruited through open-access online advertising. SettingPublic universities and university colleges in Sweden. ParticipantsThe analytical sample included 2796 students. Outcome measuresContagion in cohabitants and in family members was assessed at baseline and at the 5-month follow-up. Mental health and academic self-efficacy were assessed at the 5-month and 10-month follow-ups. ResultsMild symptoms reported in cohabitants at baseline resulted in negative mental health effects at follow-up 5 months later, and mild baseline symptoms in family members resulted in negative effects on academic self-efficacy at follow-ups both 5 and 10 months later. ConclusionsNotwithstanding the lack of precision in estimated effects, the findings emphasise the importance of social relationships and the challenges of providing students with sufficient support in times of crisis.
Læs mere Tjek på PubMedZhu, T., Chen, C., Zhang, X., Yang, Q., Hu, Y., Liu, R., Zhang, X., Dong, Y.
BMJ Open, 13.03.2024
Tilføjet 13.03.2024
ObjectivesThis study measures the differences in inpatient performance after a points-counting payment policy based on diagnosis-related group (DRG) was implemented. The point value is dynamic; its change depends on the annual DRGs’ cost settlements and points of the current year, which are calculated at the beginning of the following year. DesignA longitudinal study using a robust multiple interrupted time series model to evaluate service performance following policy implementation. SettingTwenty-two public general hospitals (8 tertiary institutions and 14 secondary institutions) in Wenzhou, China. InterventionThe intervention was implemented in January 2020. Outcome measuresThe indicators were case mix index (CMI), cost per hospitalisation (CPH), average length of stay (ALOS), cost efficiency index (CEI) and time efficiency index (TEI). The study employed the means of these indicators. ResultsThe impact of COVID-19, which reached Zhejiang Province at the end of January 2020, was temporary given rapid containment following strict control measures. After the intervention, except for the ALOS mean, the change-points for the other outcomes (p
Læs mere Tjek på PubMedJulian Heidecke, Jan Fuhrmann, Maria Vittoria Barbarossa
PLoS One Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
by Julian Heidecke, Jan Fuhrmann, Maria Vittoria Barbarossa Diagnostic testing followed by isolation of identified cases with subsequent tracing and quarantine of close contacts—often referred to as test-trace-isolate-and-quarantine (TTIQ) strategy—is one of the cornerstone measures of infectious disease control. The COVID-19 pandemic has highlighted that an appropriate response to outbreaks of infectious diseases requires a firm understanding of the effectiveness of such containment strategies. To this end, mathematical models provide a promising tool. In this work, we present a delay differential equation model of TTIQ interventions for infectious disease control. Our model incorporates the assumption of limited TTIQ capacities, providing insights into the reduced effectiveness of testing and tracing in high prevalence scenarios. In addition, we account for potential transmission during the early phase of an infection, including presymptomatic transmission, which may be particularly adverse to a TTIQ based control. Our numerical experiments inspired by the early spread of COVID-19 in Germany demonstrate the effectiveness of TTIQ in a scenario where immunity within the population is low and pharmaceutical interventions are absent, which is representative of a typical situation during the (re-)emergence of infectious diseases for which therapeutic drugs or vaccines are not yet available. Stability and sensitivity analyses reveal both disease-dependent and disease-independent factors that impede or enhance the success of TTIQ. Studying the diminishing impact of TTIQ along simulations of an epidemic wave, we highlight consequences for intervention strategies.
Læs mere Tjek på PubMedDaniel Deuter, Katharina Hense, Kevin Kunkel, Johanna Vollmayr, Sebastian Schachinger, Christina Wendl, Andreas Schicho, Claudia Fellner, Bernd Salzberger, Florian Hitzenbichler, Judith Zeller, Veronika Vielsmeier, Frank Dodoo-Schittko, Nils Ole Schmidt, Katharina Rosengarth
PLoS One Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
by Daniel Deuter, Katharina Hense, Kevin Kunkel, Johanna Vollmayr, Sebastian Schachinger, Christina Wendl, Andreas Schicho, Claudia Fellner, Bernd Salzberger, Florian Hitzenbichler, Judith Zeller, Veronika Vielsmeier, Frank Dodoo-Schittko, Nils Ole Schmidt, Katharina Rosengarth Background Several research has underlined the multi-system character of COVID-19. Though effects on the Central Nervous System are mainly discussed as disease-specific affections due to the virus’ neurotropism, no comprehensive disease model of COVID-19 exists on a neurofunctional base by now. We aimed to investigate neuroplastic grey- and white matter changes related to COVID-19 and to link these changes to neurocognitive testings leading towards a multi-dimensional disease model. Methods Groups of acutely ill COVID-19 patients (n = 16), recovered COVID-19 patients (n = 21) and healthy controls (n = 13) were prospectively included into this study. MR-imaging included T1-weighted sequences for analysis of grey matter using voxel-based morphometry and diffusion-weighted sequences to investigate white matter tracts using probabilistic tractography. Comprehensive neurocognitive testing for verbal and non-verbal domains was performed. Results Alterations strongly focused on grey matter of the frontal—basal ganglia—thalamus network and temporal areas, as well as fiber tracts connecting these areas. In acute COVID-19 patients, a decline of grey matter volume was found with an accompanying diminution of white matter tracts. A decline in executive function and especially verbal fluency was found in acute patients, partially persisting in recovered. Conclusion Changes in gray matter volume and white matter tracts included mainly areas involved in networks of executive control and language. Deeper understanding of these alterations is necessary especially with respect to long-term impairments, often referred to as ‘Post-COVID’.
Læs mere Tjek på PubMedPrabhjot Kaur Juttla, Moses Ndiritu, Ferdinand Milliano, Alfred Owino Odongo, Magoma Mwancha-Kwasa
PLoS One Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
by Prabhjot Kaur Juttla, Moses Ndiritu, Ferdinand Milliano, Alfred Owino Odongo, Magoma Mwancha-Kwasa Background The knowledge possessed by healthcare workers (HCWs), along with their attitudes and practices play a vital role in effectively managing a pandemic. This is crucial considering that HCWs are exposed to great risk at the forefront of such crises. We aimed to describe the knowledge, attitude, and practices (KAP) of HCWs during the COVID-19 pandemic in Kiambu county, Kenya. Methods A cross-sectional study using a structured questionnaire was conducted from 11th March 2021 to 12th August 2021. Bloom’s cutoff points were used to determine KAP scores (>80%: good, 60–79%: medium and
Læs mere Tjek på PubMedMariko Hosozawa, Miyuki Hori, Mina Hayama-Terada, Iba Arisa, Yoko Mutou MPH, Akihiko Kitamura, Yoshihiro Takayama, Hiroyasu Iso
International Journal of Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
Coronavirus disease 2019 (COVID-19), with over 769 million confirmed cases worldwide as of July 2023, 1is increasingly prevalent among children and adolescents. Children and adolescents are more likely to experience asymptomatic or milder forms of acute severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection than adults. 2 The increasing number of infected children and adolescents raises concerns about the long-term impact of SARS-CoV-2 infection, known as post-COVID-19 condition (PPC).
Læs mere Tjek på PubMedLiang‐Tsai Yeh, Chi‐Ho Chan, Yu‐Hsun Wang, Chia‐Yi Lee, Shun‐Fa Yang, Chao‐Bin Yeh
Journal of Medical Virology, 12.03.2024
Tilføjet 12.03.2024
Infectious Disease Modelling, 12.03.2024
Tilføjet 12.03.2024
Publication date: Available online 12 March 2024 Source: Infectious Disease Modelling Author(s): Farhad Waseel, George Streftaris, Bhuvendhraa Rudrusamy, Sarat C. Dass
Læs mere Tjek på PubMedYao, A., Zhu, M., Li, L.
BMJ Open, 12.03.2024
Tilføjet 12.03.2024
ObjectiveTo explore the psychological experiences of university students in prolonged quarantine during the COVID-19 pandemic. DesignA qualitative descriptive study based on semistructured interviews; data were analysed using a thematic topic analysis approach. SettingInterviews were conducted via WeChat video. Participants20 full-time undergraduate students from seven districts in Shanghai Province who experienced prolonged quarantine were interviewed from June to August 2022. ResultsThe data analysis revealed three themes with corresponding subthemes related to the psychological experiences of university students during prolonged quarantine: (1) dynamic and complex psychological experiences, encompassing the feelings of relief, confusion, anxiety, insecurity, loneliness, craving for catharsis and emotional numbness; (2) desire for diverse support; and (3) self-reflection and growth, mainly including learning to be grateful, self-efficacy enhancement, reconsideration of the meaning of life and restructuring of future planning. ConclusionThis study explored the psychological experiences of university students in prolonged quarantine through qualitative interviews, which contributed to our understanding of their emotions, needs and conceptual changes during quarantine. Combined with the experiences of university students in quarantine, they reported complex emotional changes and diverse needs, as well as the impact of prolonged quarantine on their outlook on life. These findings can serve as a reference and basis for the development of future psychological intervention measures in line with national conditions.
Læs mere Tjek på PubMedNagappan, P. G., Brown, S., McManus, A., Sayers, S., Absar, S., Tan, S. R. X., Kuhn, I., Lau, E., Tulinius, C.
BMJ Open, 12.03.2024
Tilføjet 12.03.2024
IntroductionThe COVID-19 pandemic has had a significant impact on medical education, with many institutions shifting to online learning to ensure the safety of students and staff. However, there has been a decline in in-person attendance at medical schools across the UK and worldwide following the relaxation of social distancing rules and the reinstation of in-person teaching. Importantly, this trend has been observed prior to the pandemic. While reflected within the literature, there is currently no systematic review describing these changes. We aim to find out how medical students’ attendance is changing as documented within the literature and its impact on their educational outcomes. Methods and analysisThis systematic review will follow the guidelines of the Centre of Research and Dissemination, Meta-analyses of Observational Studies in Epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We will search the major databases of Medline via Ovid, Embase via Ovid, Scopus, Web of Science, British Education Index via EBSCOhost and ERIC via EBSCOhost. Two reviewers will independently screen each paper and extract data, with a third reviewer for dispute resolution. All studies reporting on medical students from various universities, both graduate and undergraduate and describing changes in attendance and/or students‘ educational outcomes will be included. Risk of bias in individual studies will be assessed using the Newcastle-Ottawa Scale and confidence in cumulative evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research approach. A narrative synthesis of the findings from all included studies will be reported. Ethics and disseminationEthical approval is not required for this systematic review of existing publicly available literature. We will subsequently aim to publish the results of this systematic review in a peer-reviewed journal.
Læs mere Tjek på PubMedJosé Luis Martínez-Sánchez, Carolina Zequeira Larios, Florisel Hernandez Ramirez
PLoS One Infectious Diseases, 12.03.2024
Tilføjet 12.03.2024
by José Luis Martínez-Sánchez, Carolina Zequeira Larios, Florisel Hernandez Ramirez Southern Mexico is particularly rich in natural resources, yet unemployment has risen to 8% during the COVID-19 pandemic. The effect of the pandemic on the use and abundance of Tabasco’s wild resources was examined through personal surveys. By using Microsoft Forms® with cell phones 1,963 surveys were collected. Cronbach’s alpha, Z-value, and chi2 were calculated using the MAXQDA Analytics Pro program. A higher abundance of wild resources before the pandemic than today (57% vs. 11%) was observed. During the pandemic, people referred more to a high use (28%) of resources than to a low use (20%). This caused the low abundance or scarcity of wild products to be greater during the pandemic than before the pandemic (43% vs. 4%). Wild foods and timber were the most used products. The pandemic has produced a greater use of natural resources probably due to the high unemployment rate in rural areas. Future studies of wild products should address the relevant products in the locality and their even sampling. Finding suitable respondents is highly recommended.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 12.03.2024
Tilføjet 12.03.2024
Abstract Background In addition to preventing pneumococcal disease, emerging evidence indicates that pneumococcal conjugate vaccines (PCVs) might indirectly reduce viral respiratory tract infections (RTI) by affecting pneumococcal-viral interactions.Methods We performed a systematic review of interventional and observational studies published during 2000-2022 on vaccine efficacy/adjusted effectiveness (VE) and overall effect of PCV7, PCV9, PCV10, or PCV13 against viral RTI.Results Sixteen of 1671 records identified were included. Thirteen publications described effects of PCVs against viral RTIs in children. VE against influenza ranged between 41-86% (n=4), except for the 2010-2011 influenza season. In a randomized controlled trial, PCV9 displayed efficacy against any viral RTI, human seasonal coronavirus, parainfluenza, and human metapneumovirus. Data in adults were limited (n=3). PCV13 VE ranged between 4-25% against viral lower RTI, 32-35% against COVID-19 outcomes, 24-51% against human seasonal coronavirus, and 13-36% against influenza A lower RTI, with some 95%CI spanning zero. No protection was found against adenovirus or rhinovirus in children or adults.Conclusions PCVs were associated with protection against some viral RTI, with the strongest evidence for influenza in children. Limited evidence for adults was generally consistent with pediatric data. Restricting public health evaluations to confirmed pneumococcal outcomes may underestimate the full impact of PCVs.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.03.2024
Tilføjet 12.03.2024
Abstract Background Symptoms of COVID-19 including fatigue and dyspnea, may persist for weeks to months after SARS-CoV-2 infection. This study compared self-reported disability among SARS-CoV-2-positive and negative persons with mild to moderate COVID-19-like illness who presented for outpatient care before widespread COVID-19 vaccination. Methods Unvaccinated adults with COVID-19-like illness enrolled within 10 days of illness onset at three US Flu Vaccine Effectiveness Network sites were tested for SARS-CoV-2 by molecular assay. Enrollees completed an enrollment questionnaire and two follow-up surveys (7–24 days and 2–7 months after illness onset) online or by phone to assess illness characteristics and health status. The second follow-up survey included questions measuring global health, physical function, fatigue, and dyspnea. Scores in the four domains were compared by participants’ SARS-CoV-2 test results in univariate analysis and multivariable Gamma regression. Results During September 22, 2020 – February 13, 2021, 2712 eligible adults were enrolled, 1541 completed the first follow-up survey, and 650 completed the second follow-up survey. SARS-CoV-2-positive participants were more likely to report fever at acute illness but were otherwise comparable to SARS-CoV-2-negative participants. At first follow-up, SARS-CoV-2-positive participants were less likely to have reported fully or mostly recovered from their illness compared to SARS-CoV-2-negative participants. At second follow-up, no differences by SARS-CoV-2 test results were detected in the four domains in the multivariable model. Conclusion Self-reported disability was similar among outpatient SARS-CoV-2-positive and -negative adults 2–7 months after illness onset.
Læs mere Tjek på PubMedEskild Petersen, Seif Al-Abri, Amina Al Jardani, Ziad A Memish, Eleni Aklillu, Francine Ntoumi, Peter Mwaba, Christian Wejse, Alimuddin Zumla, Fatma Al-Yaquobi
International Journal of Infectious Diseases, 11.03.2024
Tilføjet 11.03.2024
It has been previously estimated that the global prevalence of latent TB infection (LTBI) is 24% of the world\'s population [1;2]. The World Health Organization (WHO) estimated in 2023 that 1.8 billion people are infected with Mycobacterium tuberculosis, but without clinical symptoms of active tuberculosis, which is the definition of latent TB infection [3;4]. This represents a 4.5% increase from 2020. With the COVID-19 pandemic now over, TB is once again the leading cause of death from a single infectious agent, with 1.4 million deaths among HIV-negative people and 187,000 deaths among HIV-positive people estimated in 2021 [3].
Læs mere Tjek på PubMedInfection, 10.03.2024
Tilføjet 10.03.2024
Infection, 10.03.2024
Tilføjet 10.03.2024
Cassie Lee, Darren C. Greenwood, Harsha Master, Kumaran Balasundaram, Paul Williams, Janet T. Scott, Conor Wood, Rowena Cooper, Julie L. Darbyshire, Ana Espinosa Gonzalez, Helen E. Davies, Thomas Osborne, Joanna Corrado, Nafi Iftekhar, Natalie Rogers, Brendan Delaney, Trish Greenhalgh, Manoj Sivan, the LOCOMOTION Consortium, Adam Mosley, Amy Parkin, Amy Rebane, Ashliegh Lovett, Carlos Echevarria, Clare Rayner, Darren Winch, Ghazala Mir, Ian Tucker‐Bell, Juliet Harris, Karen Cook, Madeline Goodwin, Megan Ball, Nawar Bakerly, Nikki Smith, Rachael Evans, Ruairidh Milne, Samantha Jones, Sarah Elkin, Sophie Evans, Stephen Halpin, Zacchaeus Falope
Journal of Medical Virology, 9.03.2024
Tilføjet 9.03.2024
Plüss-Suard Catherine, Mueller Yolanda, Plate Andreas, Senn Oliver, Kronenberg Andreas
Clinical Microbiology and Infection, 9.03.2024
Tilføjet 9.03.2024
We have read with great interest the article published by Aghlmandi S. et al. regarding the \'Impact of the COVID-19 pandemic on antibiotic prescribing in high-prescribing primary care physicians in Switzerland\' [1]. This study presents the findings of a follow-up investigation following a national intervention trial on antibiotic prescription audit and feedback during the initial year of the SARS-CoV-2 pandemic, compared with the pre-pandemic years (2017-2019). The authors utilized claims data from 2945 physicians, representing the upper 75% of antibiotic prescribers, in an interrupted time series analysis.
Læs mere Tjek på PubMedChen, X., Norris, C., Whitten, T., Ho, C., Mann, B., Bakal, J.
BMJ Open, 9.03.2024
Tilføjet 9.03.2024
ObjectiveFatigue, headache, problems sleeping and numerous other symptoms have been reported to be associated with long COVID. However, many of these symptoms coincide with symptoms reported by the general population, possibly exacerbated by restrictions/precautions experienced during the COVID-19 pandemic. This study examines the symptoms reported by individuals who tested positive for COVID-19 compared with those who tested negative. DesignObservational study. SettingThe study was conducted on adult residents in Alberta, Canada, from October 2021 to February 2023. ParticipantsWe evaluated self-reported symptoms in 7623 adults with positive COVID-19 tests and 1520 adults who tested negative, using surveys adapted from the internationally standardised International Severe Acute Respiratory and emerging Infection Consortium (ISARIC)-developed COVID-19 long-term follow-up tools. These individuals had an index COVID-19 test date between 1 March 2020 and 31 December 2022 and were over 28 days post-COVID-19 testing. Primary outcome measuresThe primary outcomes were to identify the symptoms associated with COVID-19 positivity and risk factors for reporting symptoms. ResultsFatigue was the top reported symptom (42%) among COVID-19-positive respondents, while headache was the top reported symptom (32%) in respondents who tested negative. Compared with those who tested negative, COVID-19-positive individuals reported 1.5 times more symptoms and had higher odds of experiencing 31 out of the 40 listed symptoms during the postinfectious period. These symptoms included olfactory dysfunction, menstruation changes, cardiopulmonary and neurological symptoms. Female sex, middle age (41–55 years), Indigeneity, unemployment, hospital/intensive care unit (ICU) admission at the time of testing and pre-existing health conditions independently predicted a greater number and variety of symptoms. ConclusionsOur results provide evidence that COVID-19 survivors continue to experience a significant number and variety of symptoms. These findings can help inform targeted strategies for the unequally affected population. It is important to offer appropriate management for symptom relief to those who have survived the acute COVID-19 illness.
Læs mere Tjek på PubMedNelson, G., Kettaneh, H., Knox, B., Purkey, E., Chan-Nguyen, S., Jenkins, M., Bayoumi, I.
BMJ Open, 9.03.2024
Tilføjet 9.03.2024
IntroductionCommunity-based participatory research (CBPR) is a collaborative research approach that equally engages researchers and community stakeholders throughout all steps of the research process to facilitate social change and increase research relevance. Community advisory boards (CABs) are a CBPR tool in which individuals with lived experience and community organisations are integrated into the research process and ensure the work aligns with community priorities. We seek to (1) explore the best practices for the recruitment and engagement of people with lived experiences on CABs and (2) identify the scope of literature on minimising power dynamics between organisations and community members with lived experience who work on CABs together. Methods and analysisThis scoping review will follow the Arksey and O’Malley methodological framework, informed by Levac et al, and will be reported using a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram. Detailed and robust search strategies have been developed for Embase, Medline and PsychINFO. Grey literature references and reference lists of included articles published between 1 January 1990 and 30 March 2023 will be considered. Two reviewers will independently screen references in two successive stages of title/abstract and full-text screening. Conflicts will be decided by consensus or a third reviewer. Thematic analysis will be applied in three phases: open coding, axial coding and abstraction. Extracted data will be recorded and presented in a tabular format and/or graphical summaries, with a descriptive overview discussing how the research findings relate to the research questions. At this time, a preliminary search of peer-reviewed and grey literature has been conducted. Search results for peer-reviewed literature have been uploaded to Covidence for review and appraisal for relevance. Ethics and disseminationFormal ethics approval is not required for this review. Review findings will inform ongoing and future CBPR community advisory board dynamics. RegistrationThe protocol has been registered prospectively on the Open Science Framework (https://doi.org/10.17605/OSF.IO/QF5D3)
Læs mere Tjek på PubMedYuan, H.-Y., Wong, W. H., Khairunnasa, F., Ho, H. C., Chung, G. K.-K.
BMJ Open, 9.03.2024
Tilføjet 9.03.2024
ObjectiveTo estimate the impacts of demographic factors and income disparities on the case fatality rate (CFR) of COVID-19 in Hong Kong, taking into account the influence of reporting delays (ie, the duration between symptom onset and case confirmation). DesignRetrospective observational longitudinal study. ParticipantsA total of 7406 symptomatic patients with residence information reported between 23 January 2020 and 2 October 2021. Main outcome measuresThe study examined the disparity in COVID-19 deaths associated with the factors such as age (≥65 vs 0–64 years old groups), gender and the income level of districts (low income vs non-low income). The severe reporting delay (>10 days) was considered as the mediator for mediation analysis. A Cox proportional hazards regression model was constructed. ResultsWe found that CFR was 3.07% in the low-income region, twofold higher than 1.34% in the other regions. Although the severe reporting delay was associated with a hazard ratio (HR) of about 1.9, its mediation effect was only weakly present for age, but not for gender or income level. Hence, high CFR in Hong Kong was largely attributed to the direct effects of the elderly (HR 25.967; 95% CI 14.254 to 47.306) and low income (HR 1.558; 95% CI 1.122 to 2.164). ConclusionThe disparity in COVID-19 deaths between income regions is not due to reporting delays, but rather to health inequities in Hong Kong. These risks may persist after the discontinuation of test-and-trace measures and extend to other high-threat respiratory pathogens. Urgent actions are required to identify vulnerable groups in low-income regions and understand the underlying causes of health inequities.
Læs mere Tjek på PubMedReder, S. R., Herrlich, N., Grauhan, N. F., Othman, A. E., Müller-Eschner, M., Brockmann, C., Brockmann, M. A.
BMJ Open, 9.03.2024
Tilføjet 9.03.2024
ObjectivesA hard lockdown was presumed to lead to delayed diagnosis and treatment of serious diseases, resulting in higher acuity at admission. This should be elaborated based on the estimated acuity of the cases, changes in findings during hospitalisation, age structure and biological sex. DesignRetrospective monocentric cross-sectional study. SettingGerman Neuroradiology Department at a . ParticipantsIn 2019, n=1158 patients were admitted in contrast to n=884 during the first hard lockdown in 2020 (11th–13th week). Main outcome measuresThree radiologists evaluated the initial case acuity, classified them into three groups (not acute, subacute and acute), and evaluated if there was a relevant clinical deterioration. The data analysis was conducted using non-parametric methods and multivariate regression analysis. ResultsA 24% decrease in the number of examinations from 2019 to 2020 (p=0.025) was revealed. In women, the case acuity increased by 21% during the lockdown period (p=0.002). A 30% decrease in acute cases in men was observable (in women 5% decrease). Not acute cases decreased in both women and men (47%; 24%), while the subacute cases remained stable in men (0%) and decreased in women (28%). Regression analysis revealed the higher the age, the higher the acuity (p
Læs mere Tjek på PubMedGonzalez Bravo, C., Sabree, S. A., Dukes, K., Adeagbo, M. J., Edwards, S., Wainwright, K., Schaeffer, S. E., Villa, A., Wilks, A. D., Carvour, M. L.
BMJ Open, 9.03.2024
Tilføjet 9.03.2024
ObjectivesTo understand patients’ experiences with diabetes care during the COVID-19 pandemic, with an emphasis on rural, medically underserved, and/or minoritised racial and ethnic groups in the Midwestern USA. DesignCommunity-engaged, semi-structured interviews were conducted by medical student researchers trained in qualitative interviewing. Transcripts were prepared and coded in the language in which the interview was conducted (English or Spanish). Thematic analysis was conducted, and data saturation was achieved. SettingThe study was conducted in communities in Eastern and Western Iowa. ParticipantsAdults with diabetes (n=20) who were fluent in conversational English or Spanish were interviewed. One-third of participants were residents of areas designated as federal primary healthcare professional shortage areas and/or medically underserved areas, and more than half were recruited from medical clinics that offer care at no cost. ResultsThemes across both English and Spanish transcripts included: (1) perspectives of diabetes, care providers and care management; (2) challenges and barriers affecting diabetes care; and (3) participant feedback and recommendations. Participants reported major constraints related to provider availability, costs of care, access to nutrition counselling and mental health concerns associated with diabetes care during the pandemic. Participants also reported a lack of shared decision-making regarding some aspects of care, including amputation. Finally, participants recognised systems-level challenges that affected both patients and providers and expressed a preference for proactive collaboration with healthcare teams. ConclusionsThese findings support enhanced engagement of rural, medically underserved and minoritised groups as stakeholders in diabetes care, diabetes research and diabetes provider education.
Læs mere Tjek på PubMedCurtis, E., Jaung, R., Paine, S.-J., McLeod, M., Tamatea, J., Atkinson, J., Jiang, Y., Robson, B., Reid, P., Harris, R. B.
BMJ Open, 9.03.2024
Tilføjet 9.03.2024
IntroductionThe COVID-19 pandemic has had both direct and indirect impacts on the health of populations worldwide. While racial/ethnic health inequities in COVID-19 infection are now well known (and ongoing), knowledge about the impact of COVID-19 pandemic management on non-COVID-19-related outcomes for Indigenous peoples is less well understood. This article presents the study protocol for the Health Research Council of New Zealand funded project ‘Mā te Mōhio ka Mārama: Impact of COVID-19 on Māori:non-Māori inequities’. The study aims to explore changes in access to healthcare, quality of healthcare and health outcomes for Māori, the Indigenous peoples of Aotearoa New Zealand (NZ) and non-Māori during the COVID-19 outbreak period across NZ. Methods and analysisThis observational study is framed within a Kaupapa Māori research positioning that includes Kaupapa Māori epidemiology. National datasets will be used to report on access to healthcare, quality of healthcare and health outcomes between Māori and non-Māori during the COVID-19 pandemic in NZ. Study periods are defined as (a) prepandemic period (2015–2019), (b) first pandemic year without COVID-19 vaccines (2020) and (c) pandemic period with COVID-19 vaccines (2021 onwards). Regional and national differences between Māori and non-Māori will be explored in two phases focused on identified health priority areas for NZ including (1) mortality, cancer, long-term conditions, first 1000 days, mental health and (2) rheumatic fever. Ethics and disseminationThis study has ethical approval from the Auckland Health Research Ethics Committee (AHREC AH26253). An advisory group will work with the project team to disseminate the findings of this project via project-specific meetings, peer-reviewed publications and a project-specific website. The overall intention of the project is to highlight areas requiring health policy and practice interventions to address Indigenous inequities in health resulting from COVID-19 pandemic management (both historical and in the future).
Læs mere Tjek på PubMedPuoza Deo Gracious, Jerry Armah, Edward Appiah Boateng, Victoria Bam, Veronica Dzomeku, Joana Kyei-Dompim, Ampem Darko Oklodu-Abbey, Abigail Kusi Amponsah
PLoS One Infectious Diseases, 8.03.2024
Tilføjet 8.03.2024
by Puoza Deo Gracious, Jerry Armah, Edward Appiah Boateng, Victoria Bam, Veronica Dzomeku, Joana Kyei-Dompim, Ampem Darko Oklodu-Abbey, Abigail Kusi Amponsah Background The COVID-19 pandemic caused several higher educational institutions to switch from traditional face-to-face to virtual learning medium. This abrupt shift came with new expectations, experiences and challenges to nursing/ midwifery students, particularly new users, and even more so when preparation, orientation, and support were lacking or ineffective. The present study therefore aimed at exploring the expectations, experiences and challenges of nursing students using the virtual learning medium during the COVID-19 pandemic. Methods This was a descriptive phenomenological design using 12 purposively sampled nursing and midwifery students from a public university in Ghana. With the aid of a semi-structured guide, individual face-to-face interviews were audiotaped, transcribed verbatim at a later time and deductively analyzed into themes using the customer experience execution model. Results Participants were aged 22–36 years and involved equal number of males and females (n = 6), with majority being Christians (n = 11). Six themes were generated from the study: (1) “Initial thoughts and emotions” described participants initial reactions to the virtual educational medium during the pandemic; (2) \'Expectations with the virtual medium\' referred to the participants’ anticipations regarding the convenience offered by the virtual medium; (3) \'Experiences with the virtual medium\' depicted the participants’ recognition of both positive and negative encounters while using the virtual learning platform; (4) “Evaluation and recommendation” described participants’ reports of meeting expectations and recommendations they made to enhance virtual learning; (5) \'Challenges and limitations of the virtual medium\' typically represented the obstacles encountered by nursing/ midwifery students when they embraced the virtual medium; (6) “Prospects of the virtual medium” referred to participants’ views on the future of the virtual medium. Conclusion The study has brought to light that the virtual education environment comes with its own expectations, experiences and challenges to students. Provision of adequate support such as orientation and simulation laboratories by higher education institutions to satisfy students’ needs is necessary to enhance nursing education.
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