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47 ud af 47 tidsskrifter valgt, søgeord (covid-19) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
1115 emner vises.
LE Hermans, CM Centner, CM Morel, O Mbamalu, C Bonaconsa, C Ferreyra, O Lindahl, M Mendelson
International Journal of Infectious Diseases, 21.12.2023
Tilføjet 21.12.2023
Communicable diseases are the foremost cause of morbidity and mortality in sub-Saharan Africa (SSA).[1] This trend is mainly driven by the pandemics of HIV, tuberculosis, malaria, and COVID-19, neglected tropical diseases, and pneumonia and diarrhoeal disease in children.[2–4] The rising incidence of antimicrobial resistant (AMR) bacterial infections threatens to compound this already significant burden. A recent survey estimated that in 2019, the four global regions most heavily affected by AMR were all in SSA.[5]
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.12.2023
Tilføjet 21.12.2023
Abstract Background This work aimed to study natural humoral immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods Chemiluminescent immunoassay (CLIA) was used to detect the neutralizing antibody (Nabs) and IgG. Results Nabs peaked on days 57–96 after symptom onset and remained detected on days 97–132. The Nabs in the 32 patients who were dynamically monitored showed four changing patterns. The titers of Nabs and IgG were correlated, and three modes of relationship were found between them. Conclusions Nabs showed a regular change in the course of coronavirus disease 2019 (COVID-19). The detection of Nabs is very important for monitoring the course of COVID-19 and predicting the strength of antibody protection.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.12.2023
Tilføjet 21.12.2023
Abstract Background Currently, some meta-analyses on COVID-19 have suggested that glucocorticoids use can reduce the mortality rate of COVID-19 patients, utilization rate of invasive ventilation, and improve the prognosis of patients. However, optimal regimen and dosages of glucocorticoid remain unclear. Therefore, the purpose of this network meta-analysis is to analyze the efficacy and safety of glucocorticoids in treating COVID-19 at regimens. Methods This meta-analysis retrieved randomized controlled trials from the earliest records to December 30, 2022, published in PubMed, Embase, Cochrane Library, CNKI Database and Wanfang Database, which compared glucocorticoids with placebos for their efficacy and safety in the treatment of COVID-19, Effects of different treatment regimens, types and dosages (high-dose methylprednisolone, very high-dose methylprednisolone, Pulse therapy methylprednisolone, medium-dose hydrocortisone, high-dose hydrocortisone, high-dose dexamethasone, very high-dose dexamethasone and placebo) on 28-day all-caused hospitalization mortality, hospitalization duration, mechanical ventilation requirement, ICU admission and safety outcome were compared. Results In this network meta-analysis, a total of 10,544 patients from 19 randomized controlled trials were finally included, involving a total of 9 glucocorticoid treatment regimens of different types and dosages. According to the analysis results, the 28-day all-cause mortality rate was the lowest in the treatment with pulse therapy methylprednisolone (OR 0.08, 95% CI 0.02, 0.42), but the use of high-dose methylprednisolone (OR 0.85, 95% CI 0.59, 1.22), very high-dose dexamethasone (OR 0.95, 95% CI 0.67, 1.35), high-dose hydrocortisone (OR 0.64, 95% CI 0.34, 1.22), medium-dose hydrocortisone (OR 0.80, 95% CI 0.49, 1.31) showed no benefit in prolonging the 28-day survival of patient. Compared with placebo, the treatment with very high-dose methylprednisolone (MD = -3.09;95%CI: -4.10, -2.08) had the shortest length of hospital stay, while high-dose dexamethasone (MD = -1.55;95%CI: -3.13,0.03) and very high-dose dexamethasone (MD = -1.06;95%CI: -2.78,0.67) did not benefit patients in terms of length of stay. Conclusions Considering the available evidence, this network meta‑analysis suggests that the prognostic impact of glucocorticoids in patients with COVID-19 may depend on the regimens of glucocorticoids. It is suggested that pulse therapy methylprednisolone is associated with lower 28-day all-cause mortality, very high-dose methylprednisolone had the shortest length of hospital stay in patients with COVID-19. Trial registration PROSPERO CRD42022350407 (22/08/2022).
Læs mere Tjek på PubMedBrinkman, Sylvia; de Keizer, Nicolette F.; de Lange, Dylan W.; Dongelmans, Dave A.; Termorshuizen, Fabian; van Bussel, Bas C.T.
Critical Care Medicine, 21.12.2023
Tilføjet 21.12.2023
Objectives: Strain on ICUs during the COVID-19 pandemic required stringent triage at the ICU to distribute resources appropriately. This could have resulted in reduced patient volumes, patient selection, and worse outcome of non-COVID-19 patients, especially during the pandemic peaks when the strain on ICUs was extreme. We analyzed this potential impact on the non-COVID-19 patients. Design: A national cohort study. Setting: Data of 71 Dutch ICUs Participants: A total of 120,393 patients in the pandemic non-COVID-19 cohort (from March 1, 2020 to February 28, 2022) and 164,737 patients in the prepandemic cohort (from January 1, 2018 to December 31, 2019). Interventions: None. Measurements and Main Results: Volume, patient characteristics, and mortality were compared between the pandemic non-COVID-19 cohort and the prepandemic cohort, focusing on the pandemic period and its peaks, with attention to strata of specific admission types, diagnoses, and severity. The number of admitted non-COVID-19 patients during the pandemic period and its peaks were, respectively, 26.9% and 34.2% lower compared with the prepandemic cohort. The pandemic non-COVID-19 cohort consisted of fewer medical patients (48.1% vs. 50.7%), fewer patients with comorbidities (36.5% vs. 40.6%), and more patients on mechanical ventilation (45.3% vs. 42.4%) and vasoactive medication (44.7% vs. 38.4%) compared with the prepandemic cohort. Case-mix adjusted mortality during the pandemic period and its peaks was higher compared with the prepandemic period, odds ratios were, respectively, 1.08 (95% CI, 1.05–1.11) and 1.10 (95% CI, 1.07–1.13). Conclusions: In non-COVID-19 patients the strain on healthcare has driven lower patient volume, selection of fewer comorbid patients who required more intensive support, and a modest increase in the case-mix adjusted mortality.
Læs mere Tjek på PubMedEric A. Meyerowitz, Jake Scott, Aaron Richterman, Victoria Male, Muge Cevik
Nat Rev Microbiol, 20.12.2023
Tilføjet 20.12.2023
Byungkyu Lee, Kangsan Lee, Benjamin Hartmann
Science Advances, 20.12.2023
Tilføjet 20.12.2023
Sabir Meah, Xu Shi, Lars G. Fritsche, Maxwell Salvatore, Abram Wagner, Emily T. Martin, Bhramar Mukherjee
Science Advances, 20.12.2023
Tilføjet 20.12.2023
Journal of Infectious Diseases, 20.12.2023
Tilføjet 20.12.2023
Abstract Immunocompromised COVID-19 patients were prospectively enrolled from March to November 2022 to understand the association between antibody responses and SARS-CoV-2 shedding. A total of 62 patients were analyzed and the results indicated a faster decline in genomic and subgenomic viral RNA in patients with higher neutralizing and S1-specific IgG antibodies (both P
Læs mere Tjek på PubMedHawkes, A., Shields, R. C., Quenby, S., Bick, D., Parsons, J., Harris, B.
BMJ Open, 20.12.2023
Tilføjet 20.12.2023
ObjectiveThis study aims to describe the lived experiences of couples with a history of recurrent miscarriage in subsequent pregnancies and their perception of clinic support and cytogenetic investigations. DesignA qualitative interview study with a phenomenological approach. Semistructured interviews were conducted using video conferencing software. Two researchers coded the transcripts and developed themes. SettingA National Health Service (NHS) hospital in central England between May 2021 and July 2021, during the COVID-19 pandemic. ParticipantsPatients attending a specialist recurrent miscarriage clinic and their partners. This clinic accepts referrals from all over the UK for couples who have suffered two or more miscarriages. ResultsSeventeen participants were interviewed: 14 women and 3 male partners. Six main themes were identified from the data. Three related to the women’s lived experience of recurrent miscarriage (emotions in pregnancy, confidence in their bodies, expectations and coping strategies) and three related to the clinical support offered by the NHS service (impact of early pregnancy scanning, effect of the COVID-19 pandemic and cytogenetic investigations). ConclusionsPregnancy following recurrent miscarriage is extremely difficult. Recurrent miscarriage specialist services can provide couples with support and access to early pregnancy scanning, which can make the first trimester of pregnancy manageable. Partners should not be excluded from the clinic as it can result in a feeling of disconnect. Cytogenetic testing of pregnancy tissue can offer couples with recurrent miscarriage closure after pregnancy loss and is a desired investigation.
Læs mere Tjek på PubMedHenley, J., Brookes-Howell, L., Euden, J., Pallmann, P., Llewelyn, M., Howard, P., Powell, N., Dark, P., Szakmany, T., Hellyer, T. P., Albur, M., Hamilton, R., Prestwich, G., Ogden, M., Maboshe, W., Sandoe, J., Thomas-Jones, E., Carrol, E., on behalf of the PEACH study group (Procalcitonin Evaluation of Antibiotic use in COVID-19 Hospitalised patients), on behalf of the PEACH consortium (Procalcitonin Evaluation of Antibiotic use in COVID-19 Hospitalised patients), Albur, Bond, Gerver, Hopkins, McCullagh, Parsons, Partridge, Shaw, Shinkins, Todd, West
BMJ Open, 20.12.2023
Tilføjet 20.12.2023
ObjectiveTo explore and model factors affecting antibiotic prescribing decision-making early in the pandemic. DesignSemistructured qualitative interview study. SettingNational Health Service (NHS) trusts/health boards in England and Wales. ParticipantsClinicians from NHS trusts/health boards in England and Wales. MethodIndividual semistructured interviews were conducted with clinicians in six NHS trusts/health boards in England and Wales as part of the Procalcitonin Evaluation of Antibiotic use in COVID-19 Hospitalised patients study, a wider study that included statistical analysis of procalcitonin (PCT) use in hospitals during the first wave of the pandemic. Thematic analysis was used to identify key factors influencing antibiotic prescribing decisions for patients with COVID-19 pneumonia during the first wave of the pandemic (March to May 2020), including how much influence PCT test results had on these decisions. ResultsDuring the first wave of the pandemic, recommendations to prescribe antibiotics for patients with COVID-19 pneumonia were based on concerns about secondary bacterial infections. However, as clinicians gained more experience with COVID-19, they reported increasing confidence in their ability to distinguish between symptoms and signs caused by SARS-CoV-2 viral infection alone, and secondary bacterial infections. Antibiotic prescribing decisions were influenced by factors such as clinician experience, confidence, senior support, situational factors and organisational influences. A decision-making model was developed. ConclusionThis study provides insight into the decision-making process around antibiotic prescribing for patients with COVID-19 pneumonia during the first wave of the pandemic. The importance of clinician experience and of senior review of decisions as factors in optimising antibiotic stewardship is highlighted. In addition, situational and organisational factors were identified that could be optimised. The model presented in the study can be used as a tool to aid understanding of the complexity of the decision-making process around antibiotic prescribing and planning antimicrobial stewardship support in the context of a pandemic. Trial registration number ISRCTN66682918.
Læs mere Tjek på PubMedWolde, M., Wasihun, Y., Melesse, A., Tadesse, T., Sharma, R., Mon, H. S., Challa, A., Simireta, T., Addisu, H.
BMJ Open, 20.12.2023
Tilføjet 20.12.2023
ObjectiveThis research aimed to assess COVID-19 vaccine acceptance and the factors influencing it among the population of the Somali region in Ethiopia through a cross-sectional COVID-19 survey. DesignCommunity-based cross-sectional study. SettingThe survey was conducted in eight selected districts of the Somali region in Ethiopia from 20 October 2021 to 30 October 2021. ParticipantsParticipants were chosen using simple random sampling and data analysis used Stata V.14. Both bivariable and multivariable binary logistic regression methods were applied, with variables having a p value below 0.2 considered for inclusion in the final model, where statistically significant factors were identified at p
Læs mere Tjek på PubMedSamantha Young, Tara Gomes, Gillian Kolla, Daniel McCormack, Zoë Dodd, Janet Raboud, Ahmed M. Bayoumi
PLoS One Infectious Diseases, 19.12.2023
Tilføjet 19.12.2023
by Samantha Young, Tara Gomes, Gillian Kolla, Daniel McCormack, Zoë Dodd, Janet Raboud, Ahmed M. Bayoumi Aims Calls to prescribe safer supply hydromorphone (SSHM) as an alternative to the toxic drug supply increased during the COVID-19 pandemic but it is unknown whether prescribing behaviour was altered. We aimed to evaluate how the number of new SSHM dispensations changed during the pandemic in Ontario. Methods We conducted a retrospective interrupted time-series analysis using provincial administrative databases. We counted new SSHM dispensations in successive 28-day periods from March 22, 2016 to August 30, 2021. We used segmented Poisson regression methods to test for both a change in level and trend of new dispensations before and after March 17, 2020, the date Ontario’s pandemic-related emergency was declared. We adjusted the models to account for seasonality and assessed for over-dispersion and residual autocorrelation. We used counterfactual analysis methods to estimate the number of new dispensations attributable to the pandemic. Results We identified 1489 new SSHM dispensations during the study period (434 [mean of 8 per 28-day period] before and 1055 [mean of 56 per 28-day period] during the pandemic). Median age of individuals initiating SSHM was 40 (interquartile interval 33–48) with 61.7% (N = 919) male sex. Before the pandemic, there was a small trend of increased prescribing (incidence rate ratio [IRR] per period 1.002; 95% confidence interval [95CI] 1.001–1.002; p
Læs mere Tjek på PubMedCatherine E. Dubé, Natalia Nielsen, Emily McPhillips, J. Lee Hargraves, Carol Cosenza, Bill Jesdale, Kate L. Lapane
PLoS One Infectious Diseases, 19.12.2023
Tilføjet 19.12.2023
by Catherine E. Dubé, Natalia Nielsen, Emily McPhillips, J. Lee Hargraves, Carol Cosenza, Bill Jesdale, Kate L. Lapane Objectives To explore experiences of U.S. (United States) nursing home leadership during the COVID-19 pandemic in their efforts to address resident loneliness and social isolation and to elicit stories about personal and professional impacts on themselves and staff. Design Qualitative inquiry via three optional open-ended questions appended to a national self-administered survey of American nursing home leaders was employed. Textual data was analyzed using an iterative reflexive thematic approach. Setting and participants A stratified sample frame defined by facility size (beds: 30–99, 100+) and quality ratings (1, 2–4, 5) was employed. Web survey links and paper surveys were sent to 1,676 nursing home directors of nursing between February and May 2022. Results Open text responses were collected from 271 nursing homes. Broad themes included: 1) Addressing needs of residents & families; 2) Challenges; and 3) Personal experiences of nursing home leadership/staff. Respondents described trauma to residents, staff, and leadership. Resident loneliness was addressed using existing and newer technologies and innovative indoor and outdoor activities. Residents experienced fear, illness, loss, and sometimes death. Isolation from family and lack of touch were particularly difficult. Regulations were seen as punitive while ignoring emotional needs of residents. Staffing challenges and pressures to do more with less created additional stress. Leadership and staff made significant sacrifices resulting in physical, social, and emotional consequences. Beneficial outcomes included staff bonding, professional growth, and permanent implementation of new interventions. Conclusions and implications New and creative interventions were successfully implemented to address social isolation and loneliness. Improved Wi-Fi and other nursing home infrastructure upgrades are needed to maintain them. Reimagining often conflicting overlapping federal, state, and local regulations, grounding them in good clinical judgement, and incentivizing performance improvement should be considered. Trauma experienced by staff needs to be addressed to deal with current and future workforce needs.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 19.12.2023
Tilføjet 19.12.2023
Abstract Background Altered mediators of airway tissue remodeling such as matrix metalloproteinases (MMPs) in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may contribute to morbidity in coronavirus disease 2019 (COVID-19); however, the differential impact of SARS-CoV-2 variants of concern (VOCs) on MMPs is unknown.Methods Using both in vitro human airway cell culture model and in vivo transgenic mouse model of SARS-CoV-2 infection, we studied the differential effect of SARS-CoV-2 VOCs on expression of key MMPs and inflammatory mediators in airway cells and tissues.Results The most consistent findings with all SARS-CoV-2 variants in infected compared to uninfected human bronchial epithelial cell air–liquid interface cultures were the SARS-CoV-2–induced increases in MMP-12 and tissue inhibitor of MMPs. Infection with both SARS-CoV-2 wild type and SARS-CoV-2 Delta variant over 3 days postinfection (dpi) and with Beta variant over 7 dpi increased lung tissue levels of MMP-9 compared to uninfected mice. Overall, SARS-CoV-2 variants had differential dose-dependent impact on secretion of MMP-1, MMP-2, MMP-9, and MMP-12 that varied at the protein versus the gene level and in the early noninflammatory compared to late inflammatory phase of infection.Conclusions We provide novel mechanistic insight that the differential impact of SARS-CoV-2 variants on severity of COVID-19 may partially be attributed to unique changes in MMPs.
Læs mere Tjek på PubMedInfection, 19.12.2023
Tilføjet 19.12.2023
Abstract Purpose Preliminary evidence suggests a potential effect of antiviral medication used during the acute COVID-19 phase for preventing long-COVID. This review investigates if having received pharmacological treatment during acute SARS-CoV-2 infection may reduce the risk of long-COVID. Methods MEDLINE, CINAHL, PubMed, EMBASE, Web of Science databases, as well as medRxiv/bioRxiv preprint servers were searched up to July 15th, 2023. Articles comparing the presence of long-COVID symptoms between individuals who received or not a specific medication, particularly antivirals, during the acute phase of SARS-CoV-2 infection were included. Methodological quality was assessed using the Newcastle–Ottawa Scale or Cochrane’s Risk of Bias (Rob) tool. Results From 517 studies identified, 6 peer-reviewed studies and one preprint met all inclusion criteria. The sample included 2683 (n = 4) hospitalized COVID-19 survivors and 307,409 (n = 3) non-hospitalized patients. The methodological quality was high in 71% of studies (n = 5/7). Two studies investigating the effects of Nirmaltrevir/Ritonavir and three studies the effect of Remdesivir reported conflicting results on effectiveness for preventing long-COVID. Three studies investigating the effects of other medication such as Dexamethasone (n = 2) or Metformin (n = 1) found positive results of these medications for preventing long-COVID. Conclusion Available evidence about the effect of medication treatment with antivirals during acute COVID-19 and reduced risk of developing long-COVID is conflicting. Heterogeneous evidence suggests that Remdesivir or Nirmaltrevir/Ritonavir could have a potential protective effect for long-COVID. A limited number of studies demonstrated a potential benefit of other medications such as Dexamethasone or Metformin, but more studies are needed.
Læs mere Tjek på PubMedUluhan Sili, Aysun Tekin, Huseyin Bilgin, Syed Anjum Khan, Juan Pablo Domecq, Girish Vadgaonkar, Smitha S. Segu, Puneet Rijhwani, Umamaheswara Raju, Krishna Mohan Surapaneni, Igor Zabolotskikh, Dina Gomaa, Valerie M. Goodspeed, Pinar Ay
International Journal of Infectious Diseases, 19.12.2023
Tilføjet 19.12.2023
The Coronavirus disease 2019 (COVID-19) pandemic overwhelmed the healthcare systems around the world by increasing the hospitalization demand. A distal consequence of this phenomenon is worsening infections caused by antimicrobial resistant pathogens [1, 2]. Inappropriate antibiotic use was exacerbated during COVID-19, negating years of antimicrobial stewardship efforts [3, 4]. Previous studies reported confirmed bacterial co-infections in 1% to 8%, while 18.5% were clinically diagnosed with co-infection at admission [5-8].
Læs mere Tjek på PubMedJournal of the American Medical Association, 19.12.2023
Tilføjet 19.12.2023
Although the proportion of people vaccinated against measles grew to 86% worldwide between 2000 and 2019, that number fell to 81% during the COVID-19 pandemic and still has not returned to prepandemic levels. The decline has left millions vulnerable to the virus, which can cause complications including encephalitis and death, the US Centers for Disease Control and Prevention and World Health Organization wrote in a joint report.
Læs mere Tjek på PubMedJournal of the American Medical Association, 19.12.2023
Tilføjet 19.12.2023
Imagine if a new multicenter, randomized trial of a pharmaceutical drug found that for every 3 patients treated on presentation to the hospital with a common severe illness, one intubation and an intensive care unit (ICU) admission were prevented. This would be an instant blockbuster drug. Insurers would scramble to reimburse it, and guidelines and quality metrics would be established to facilitate implementation. In the setting of worsening hospital and ICU strain globally, health systems would work rapidly to implement pathways for using this new therapy. For reference, the RECOVERY trial testing the use of dexamethasone in hospitalized patients with COVID-19, cited more than 2500 times since publication 3 years ago, reduced the need for intubation for 1 in every 50 patients.
Læs mere Tjek på PubMedBMC Infectious Diseases, 19.12.2023
Tilføjet 19.12.2023
Abstract Objective To explore the effects of long-term oral ACEIs/ARBs on the incidence of exacerbation and in-hospital mortality in elderly COVID-19 Omicron BA.2 patients with hypertension, especially patients aged 80 years or older. Materials and methods In this retrospective study, patients suffering mild and rcommon COVID-19 with hypertension who were hospitalized in the Shanghai Fourth People’s Hospital between April 2022 and June 2022 were enrolled. Primary outcomes included the incidence of exacerbation and in-hospital mortality. Secondary outcomes included the incidence of respiratory failure of patients, use of mechanical ventilation, nucleic acid conversion time (NCT), hospitalization costs, and the temporal trend of the incidence of exacerbations and in-hospital mortality in different age groups. The data were analysed using propensity score weighting (PSW). Results In the entire cohort, there were 298 ACEI/ARB users and 465 non-ACEI/ARB users. The ACEI/ARB group showed a lower incidence of exacerbation (OR = 0.64, 95% CI for OR: 0.46–0.89, P = 0.0082) and lower in-hospital mortality (OR = 0.49, 95% CI for OR: 0.27–0.89, P = 0.0201) after PSW. Sensitivity analysis obtained the same results. The results of the subgroup of patients aged 80 years and older obtained a similar conclusion as the whole cohort. Most of the study indicators did not differ statistically significantly in the subgroup of patients aged 60 to 79 years except for rates of mechanical ventilation and respiratory failure. Conclusion Antihypertensive therapy with ACEIs/ARBs might reduce the incidence of exacerbation and in-hospital mortality. The findings of this study support the use of ACEIs/ARBs in COVID-19 patients infected by Omicron BA.2, especially in patients aged 80 years or older with hypertension.
Læs mere Tjek på PubMedClinical Infectious Diseases, 19.12.2023
Tilføjet 19.12.2023
Abstract Accurate molecular diagnostic tests are necessary for confirming a diagnosis of coronavirus disease 2019 (COVID-19) and for identifying asymptomatic carriage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The number of available SARS-CoV-2 nucleic acid detection tests continues to increase as does the COVID-19 diagnostic literature. Thus, the Infectious Diseases Society of America (IDSA) developed an evidence-based diagnostic guideline to assist clinicians, clinical laboratorians, patients, and policymakers in decisions related to the optimal use of SARS-CoV-2 nucleic acid amplification tests. In addition, we provide a conceptual framework for understanding molecular diagnostic test performance, discuss nuances of test result interpretation in a variety of practice settings, and highlight important unmet research needs related to COVID-19 diagnostic testing. IDSA convened a multidisciplinary panel of infectious diseases clinicians, clinical microbiologists, and experts in systematic literature review to identify and prioritize clinical questions and outcomes related to the use of SARS-CoV-2 molecular diagnostics. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess the certainty of evidence and make testing recommendations. The panel agreed on 12 diagnostic recommendations. Access to accurate SARS-CoV-2 nucleic acid testing is critical for patient care, hospital infection prevention, and the public health response to COVID-19 infection. Information on the clinical performance of available tests continues to grow, but the quality of evidence of the current literature to support this updated molecular diagnostic guideline remains moderate to very low. Recognizing these limitations, the IDSA panel weighed available diagnostic evidence and recommends nucleic acid testing for all symptomatic individuals suspected of having COVID-19. In addition, testing is suggested for asymptomatic individuals with known or suspected contact with a COVID-19 case when the results will impact isolation/quarantine/personal protective equipment (PPE) usage decisions. Evidence in support of rapid testing and testing of upper respiratory specimens other than nasopharyngeal swabs, which offer logistical advantages, is sufficient to warrant conditional recommendations in favor of these approaches.
Læs mere Tjek på PubMedArmbrust, K. R., Westanmo, A., Gravely, A., Chew, E. Y., van Kuijk, F. J.
BMJ Open, 19.12.2023
Tilføjet 19.12.2023
ObjectivesPrior studies suggest that patients with age-related macular degeneration (AMD) have poorer COVID-19 outcomes. This study aims to evaluate whether AMD is associated with adverse COVID-19 outcomes in a large clinical database. DesignCase–control study. SettingWe obtained demographic and clinical data from a national US Veterans Affairs (VA) database for all Veterans aged 50 years or older with positive COVID-19 testing prior to 2 May 2021. Primary and secondary outcome measuresThe primary outcome measure was hospitalisation. Secondary outcome measures were intensive care unit admission, mechanical ventilation and death. Potential associations between AMD and outcome measures occurring within 60 days of COVID-19 diagnosis were evaluated using multiple logistic regression analyses. ResultsOf the 171 325 patients in the study cohort, 7913 (5%) had AMD and 2152 (1%) had severe AMD, defined as advanced atrophic or exudative AMD disease coding. Multiple logistic regression adjusting for age, Charlson Comorbidity Index, sex, race, ethnicity and COVID-19 timing showed that an AMD diagnosis did not significantly increase the odds of hospitalisation (p=0.11). Using a Bonferroni-adjusted significance level of 0.006, AMD and severe AMD also were not significant predictors for the secondary outcomes, except for AMD being modestly protective for death (p=0.002). ConclusionsAfter adjusting for other variables, neither AMD nor severe AMD was a risk factor for adverse COVID-19 outcomes in the VA healthcare system. These findings indicate that an AMD diagnosis alone should not alter recommended ophthalmic management based on COVID-19 adverse outcome risk.
Læs mere Tjek på PubMedZhao, J., Li, X., Yang, J., Hao, X., Tian, J., Wang, X., Wang, X., Li, N., Li, Z.
BMJ Open, 19.12.2023
Tilføjet 19.12.2023
ObjectivesThis study aims to investigate the incidence of and factors associated with irritable bowel syndrome (IBS) among resident physicians in standardised training at eight traditional Chinese medicine (TCM) hospitals in China. DesignA cross-sectional survey was administered to resident physicians in their first to third years of standardised training at eight TCM hospitals. Participants and settingA total of 514 resident physicians in standardised training were included. MeasuresThe questionnaire consisted of two sections, namely: section A collected basic information, and section B included the four-item Perceived Stress Scale (PSS-4), the Patient Health Questionnaire-4 (PHQ-4), the Pittsburgh Sleep Quality Index (PSQI) and the Rome IV criteria for IBS. Univariate and multivariate logistic regression models were constructed to assess the associations of age, sex, body mass index, stress, depression, anxiety, sleep quality and IBS. ResultsOf the included resident doctors, 77.2% were female, 20.4% were obese or underweight and 8.6% had symptoms consistent with a diagnosis of IBS. There were no statistically significant differences in lifestyle factors (night shift work, overtime work or working efficiency during the COVID-19 pandemic) between patients with IBS and participants without IBS (hereafter, non-IBS participants) (p=0.429, p=0.572 or p=0.464, respectively). Notably, compared with non-IBS participants, patients with IBS had significantly higher mean scores on the PSS-4 and PHQ-4 (p=0.028 and p=0.012, respectively); however, there was not a significant difference in PSQI scores between these two groups (p=0.079). Depression symptoms were significantly associated with IBS (unadjusted OR 0.498, 95% CI 0.265 to 0.935, p=0.030). ConclusionThese findings suggest that IBS is common among resident physicians in standardised training. Future studies should investigate emotional distress, especially stress and depression, in the development of prevention or treatment of IBS.
Læs mere Tjek på PubMedRoshan Acharya, Dilli Poudel, Aakash Patel, Evan Schultz, Michael Bourgeois, Rishi Paswan, Scott Stockholm, Macylen Batten, Smita Kafle, Amanda Atkinson, Hafiz Sarwar
PLoS One Infectious Diseases, 18.12.2023
Tilføjet 18.12.2023
by Roshan Acharya, Dilli Poudel, Aakash Patel, Evan Schultz, Michael Bourgeois, Rishi Paswan, Scott Stockholm, Macylen Batten, Smita Kafle, Amanda Atkinson, Hafiz Sarwar
Læs mere Tjek på PubMedHeini Kari, Hanna Rättö, Leena Saastamoinen, Hanna Koskinen
PLoS One Infectious Diseases, 18.12.2023
Tilføjet 18.12.2023
by Heini Kari, Hanna Rättö, Leena Saastamoinen, Hanna Koskinen The COVID-19 pandemic has imposed an enormous burden on health care systems around the world. Simultaneously, many countries have reported a decrease in the incidence of other infectious diseases, such as acute respiratory infections, leading to a decline in outpatient antibiotic use. The aim of this study is to assess the impact of the COVID-19 pandemic on outpatient antibiotic prescribing in Finland during the first 2 years of the pandemic. We used nationwide register data, applied descriptive methods, and conducted an interrupted time series analysis (ITSA) using ARIMA modelling. Results from the ARIMA modelling showed that at the baseline, before the pandemic, the level of monthly number of antibiotic prescriptions was 248,560 (95% CI: 224,261 to 272,856; p
Læs mere Tjek på PubMedRobin Wollast, Éric Lacourse, Geneviève A. Mageau, Mathieu Pelletier-Dumas, Anna Dorfman, Véronique Dupéré, Jean-Marc Lina, Dietlind Stolle, Roxane de la Sablonnière
PLoS One Infectious Diseases, 18.12.2023
Tilføjet 18.12.2023
by Robin Wollast, Éric Lacourse, Geneviève A. Mageau, Mathieu Pelletier-Dumas, Anna Dorfman, Véronique Dupéré, Jean-Marc Lina, Dietlind Stolle, Roxane de la Sablonnière The COVID-19 pandemic has produced unprecedented changes in the lives of many people. Although research has documented associations between concerns related to COVID-19 and poor mental health indicators, fewer studies have focused on positive factors that could help people better cope with this stressful social context. To fill this gap, the present research investigated the trajectories of self-compassion facets in times of dramatic social change. Using a longitudinal research design, we described the trajectories of self-kindness, common humanity, and mindfulness during the first eight months of the COVID-19 pandemic, in a representative sample of Canadian adults (N = 3617). Relying on a multi-trajectory group-based approach, we identified clusters of individuals following persistently low (4.0%), moderate-low (39.3%), moderate-high (46.7%), and high (10.0%) levels of self-kindness, common humanity, and mindfulness. Interestingly, we found that compassionate self-responding trajectories were mainly stable over time with minor fluctuations for some groups of individuals, in line with the epidemiological situation. In terms of covariates, we observed that older women were more likely to follow trajectories of high compassionate self-responding, as compared to the other age and gender groups. In terms of mental health indicators, we demonstrated that trajectory groups with high levels of compassionate self-responding were associated with greater life satisfaction, more happiness, better sleep quality, higher sleep quantity, and fewer negative emotions, as compared to lower trajectory groups. The results supported the idea that self-compassion during the COVID-19 pandemic could have favored better mental health indicators and could possibly be promoted as a psychological intervention in the general population.
Læs mere Tjek på PubMedBMC Infectious Diseases, 18.12.2023
Tilføjet 18.12.2023
Abstract Objective To explore the effects of long-term oral ACEIs/ARBs on the incidence of exacerbation and in-hospital mortality in elderly COVID-19 Omicron BA.2 patients with hypertension, especially patients aged 80 years or older. Materials and methods In this retrospective study, patients suffering mild and rcommon COVID-19 with hypertension who were hospitalized in the Shanghai Fourth People’s Hospital between April 2022 and June 2022 were enrolled. Primary outcomes included the incidence of exacerbation and in-hospital mortality. Secondary outcomes included the incidence of respiratory failure of patients, use of mechanical ventilation, nucleic acid conversion time (NCT), hospitalization costs, and the temporal trend of the incidence of exacerbations and in-hospital mortality in different age groups. The data were analysed using propensity score weighting (PSW). Results In the entire cohort, there were 298 ACEI/ARB users and 465 non-ACEI/ARB users. The ACEI/ARB group showed a lower incidence of exacerbation (OR = 0.64, 95% CI for OR: 0.46–0.89, P = 0.0082) and lower in-hospital mortality (OR = 0.49, 95% CI for OR: 0.27–0.89, P = 0.0201) after PSW. Sensitivity analysis obtained the same results. The results of the subgroup of patients aged 80 years and older obtained a similar conclusion as the whole cohort. Most of the study indicators did not differ statistically significantly in the subgroup of patients aged 60 to 79 years except for rates of mechanical ventilation and respiratory failure. Conclusion Antihypertensive therapy with ACEIs/ARBs might reduce the incidence of exacerbation and in-hospital mortality. The findings of this study support the use of ACEIs/ARBs in COVID-19 patients infected by Omicron BA.2, especially in patients aged 80 years or older with hypertension.
Læs mere Tjek på PubMedFausta Michael, Mariam M. Mirambo, Gerald Misinzo, Omary Minzi, Medard Beyanga, Delphinus Mujuni, Florence S Kalabamu, Elias N Nyanda, Mary Mwanyika-Sando, Daniel Ndiyo, Richard Kasonogo, Abbas Ismail, Andrew Bahati, Farida Hassan, Elangiringa Kaale, John J Chai, Pricillah Kinyunyi, Furaha Kyesi, Florian Tinuga, Dhamira Mongi, Abdul Salehe, Bonaventura Muhindi, Joseph Mdachi, Richard Magodi, Mwendwa Mwenesi, Honest Nyaki, Betina Katembo, Kelvin Tenga, Magdalena Kasya, Willliam Mwengee, Stephen E. Mshana
International Journal of Infectious Diseases, 18.12.2023
Tilføjet 18.12.2023
Vaccines provide a safe and cost-effective solution to vaccine-preventable infectious diseases. However, vaccine-preventable infectious diseases still pose a serious public health threat especially in the world\'s poor regions[1]. In sub-Saharan Africa, this burden is further aggravated by the occurrence of concurrent epidemics such as Coronavirus Disease 2019 (COVID-19), Ebola virus disease, monkeypox, and measles overstretching the already weak public health system[2]. In addition to human conflicts, natural disasters, vaccine hesitancy, and the COVID-19 pandemic has disrupted routine immunisation services leaving millions of children under-vaccinated or unvaccinated against vaccine-preventable diseases as evidenced by the decline in the number of administered doses of diphtheria-pertussis-tetanus-containing vaccine and the first dose of measles virus-containing vaccine[3, 4].
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.12.2023
Tilføjet 17.12.2023
Abstract Background COVID-19 has caused millions of deaths globally, with vulnerable populations such as people experiencing homelessness (PEH) at higher risk. This systematic review and meta-analysis aims to identify the prevalence and key factors contributing to vaccine acceptance experienced by PEH. Methods The protocol of this study was registered in PROSPERO (CRD42023391659). We included studies that reported relevant information about vaccine acceptance or vaccine hesitant/refusal among PEH. Eight databases were systematically searched in January 2023. Meta-analysis was conducted for the prevalence of vaccine acceptance, vaccine uptake, and factors associated with vaccine acceptance. Attitudes toward vaccines were combined into bar charts. Result A total of 29 papers were included in this systematic review and 19 papers were included for meta-analysis. The pooled prevalence of COVID-19 vaccine acceptance among PEH was 66% (95%CI: 58%-73%). Our meta-regression showed vaccine acceptance was significantly increased over time. Moreover, subgroup meta-analysis showed that PEH were more likely to accept the COVID-19 vaccine after June 2021 (78%, 95%CI: 65%-86%) compared with earlier period (56%, 95%CI: 54%-59%). Subgroup meta-analysis also revealed that women and participants without underlying medical condition (chronic diseases) were significantly less likely to accept the COVID-19 vaccine, compared to men and those with medical conditions, respectively. Conclusion The study emphasizes the need for targeted public health interventions aimed at increasing vaccine acceptance among PEH, especially at the early stage of the pandemic, among females, those without underlying medical conditions, being Black (in Canada and the USA), and young people. These interventions should address the common concerns of vaccine safety, adverse effects, effectiveness, and distrust in health care systems. In addition to offering vaccinations in different areas convenient to them, education programs could be established to increase vaccine acceptance among PEH.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.12.2023
Tilføjet 17.12.2023
Abstract Background Persistent headache is a frequent symptom after coronavirus disease 2019 (COVID-19) and there is currently limited knowledge about its clinical spectrum and predisposing factors. A subset of patients may be experiencing new daily persistent headache (NDPH) after COVID-19, which is among the most treatment-refractory primary headache syndromes. Methods We conducted a cross-sectional study in Latin America to characterize individuals with persistent headache after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to identify factors associated with NDPH. Participants over 18 years old who tested positive for SARS-CoV-2 infection and reported persistent headache among their symptoms completed an online survey that included demographics, past medical history, persistent headache clinical characteristics, and COVID-19 vaccination status. Based on participants’ responses, NDPH diagnostic criteria were used to group participants into NDPH and non-NDPH groups. Participant data was summarized by descriptive statistics. Student’s t and Mann–Whitney U tests were used according to the distribution of quantitative variables. For categorical variables, Pearson’s chi-square and Fisher’s exact tests were used according to the size of expected frequencies. Binomial logistic regression using the backward stepwise selection method was performed to identify factors associated with NDPH. Results Four hundred and twenty-one participants from 11 Latin American countries met the inclusion criteria. One in four participants met the NDPH diagnostic criteria. The mean age was 40 years, with most participants being female (82%). Over 90% of the participants reported having had mild/moderate COVID-19. Most participants had a history of headache before developing COVID-19 (58%), mainly migraine type (32%). The most predominant clinical characteristics in the NDPH group were occipital location, severe/unbearable intensity, burning character, and radiating pain (p
Læs mere Tjek på PubMedHong ZhangJing ZhouHong ChenJohn MaoYanan TangWenhao YanTianxiang ZhangChuanjing LiShikui ChenGuoping LiGeorge ZhangYanhua DingLi Liu11 Phase I Clinical Research Center, The First Hospital of Jilin University, Changchun, Jilin, China2Fujian Akeylink Biotechnology Co., Ltd., Fuzhou, Fujian, China3Fujian Cosunter Pharmaceutical Co., Ltd., Fuzhou, Fujian, China4Department of Pediatrics, The First Hospital of Jilin University, Changchun, Jilin, China, Miguel Angel Martinez
Antimicrobial Agents And Chemotherapy, 16.12.2023
Tilføjet 16.12.2023
Seungeun Ryoo, Dae-Hyup Koh, Su-Yeon Yu, Miyoung Choi, Kyungmin Huh, Joon-Sup Yeom, Jung Yeon Heo
PLoS One Infectious Diseases, 16.12.2023
Tilføjet 16.12.2023
by Seungeun Ryoo, Dae-Hyup Koh, Su-Yeon Yu, Miyoung Choi, Kyungmin Huh, Joon-Sup Yeom, Jung Yeon Heo
Læs mere Tjek på PubMedYuichi Tatsukawa, Md. Rajib Arefin, Kazuki Kuga, Jun Tanimoto
PLoS One Infectious Diseases, 16.12.2023
Tilføjet 16.12.2023
by Yuichi Tatsukawa, Md. Rajib Arefin, Kazuki Kuga, Jun Tanimoto The COVID-19 pandemic has remarkably heightened concerns regarding the prediction of communicable disease spread. This study introduces an innovative agent-based modeling approach. In this model, the quantification of human-to-human transmission aligns with the dynamic variations in the viral load within an individual, termed “within-host” and adheres to the susceptible–infected–recovered (SIR) process, referred to as “between-host.” Variations in the viral load over time affect the infectivity between individual agents. This model diverges from the traditional SIR model, which employs a constant transmission probability, by incorporating a dynamic, time-dependent transmission probability influenced by the viral load in a host agent. The proposed model retains the time-integrated transmission probability characteristic of the conventional SIR model. As observed in this model, the overall epidemic size remains consistent with the predictions of the standard SIR model. Nonetheless, compared to predictions based on the classical SIR process, notable differences existed in the peak number of the infected individuals and the timing of this peak. These nontrivial differences are induced by the direct correlation between the time-evolving transmission probability and the viral load within a host agent. The developed model can inform targeted intervention strategies and public health policies by providing detailed insights into disease spread dynamics, crucial for effectively managing epidemics.
Læs mere Tjek på PubMedSarah Carbone, Whitney Berta, Susan Law, Kerry Kuluski
PLoS One Infectious Diseases, 16.12.2023
Tilføjet 16.12.2023
by Sarah Carbone, Whitney Berta, Susan Law, Kerry Kuluski The COVID-19 pandemic appears to have shifted the care trajectories of many residents and care partners in Ontario who considered leaving LTC to live in the community for a portion or the duration of the pandemic. This type of care transition–from LTC to home care–was highly uncommon prior to the pandemic, therefore we know relatively little about the planning and decision-making involved. The aim of this study was to describe who was involved in LTC to home care transitions in Ontario during the COVID-19 pandemic, to what extent, and the factors that guided their decision-making. A qualitative description study involving semi-structured interviews with 32 residents, care partners and health professionals was conducted. Transition decisions were largely made by care partners, with varied input from residents or health professionals. Stakeholders considered seven factors, previously identified in a scoping review, when making their transition decisions: (a) institutional priorities and requirements; (b) resources; (c) knowledge; (d) risk; (e) group structure and dynamic; (f) health and support needs; and (g) personality preferences and beliefs. Participants’ emotional responses to the pandemic also influenced the perceived need to pursue a care transition. The findings of this research provide insights towards the planning required to support LTC to home care transitions, and the many challenges that arise during decision-making.
Læs mere Tjek på PubMedAmos Lal, Mark T. Gladwin, Ognjen Gajic
American Journal of Respiratory and Critical Care Medicine , 15.12.2023
Tilføjet 15.12.2023
American Journal of Respiratory and Critical Care Medicine, Volume 208, Issue 12, Page 1259-1261, December 15, 2023.
Læs mere Tjek på PubMedRaffaele Di Fenza, Naman S. Shetty, Stefano Gianni, Vibhu Parcha, Valentina Giammatteo, Bijan Safaee Fakhr, Daniel Tornberg, Olof Wall, Piotr Harbut, Peggy S. Lai, Jonathan Z. Li, Sabrina Paganoni, Stefano Cenci, Ariel L. Mueller, Timothy T. Houle, Oluwaseun Akeju, Edward A. Bittner, Somnath Bose, Louie K. Scott, Ryan W. Carroll, Fumito Ichinose, Magnus Hedenstierna, Pankaj Arora, Lorenzo Berra
American Journal of Respiratory and Critical Care Medicine , 15.12.2023
Tilføjet 15.12.2023
American Journal of Respiratory and Critical Care Medicine, Volume 208, Issue 12, Page 1293-1304, December 15, 2023.
Læs mere Tjek på PubMedBMC Infectious Diseases, 15.12.2023
Tilføjet 15.12.2023
Abstract Background COVID-19 has caused millions of deaths globally, with vulnerable populations such as people experiencing homelessness (PEH) at higher risk. This systematic review and meta-analysis aims to identify the prevalence and key factors contributing to vaccine acceptance experienced by PEH. Methods The protocol of this study was registered in PROSPERO (CRD42023391659). We included studies that reported relevant information about vaccine acceptance or vaccine hesitant/refusal among PEH. Eight databases were systematically searched in January 2023. Meta-analysis was conducted for the prevalence of vaccine acceptance, vaccine uptake, and factors associated with vaccine acceptance. Attitudes toward vaccines were combined into bar charts. Result A total of 29 papers were included in this systematic review and 19 papers were included for meta-analysis. The pooled prevalence of COVID-19 vaccine acceptance among PEH was 66% (95%CI: 58%-73%). Our meta-regression showed vaccine acceptance was significantly increased over time. Moreover, subgroup meta-analysis showed that PEH were more likely to accept the COVID-19 vaccine after June 2021 (78%, 95%CI: 65%-86%) compared with earlier period (56%, 95%CI: 54%-59%). Subgroup meta-analysis also revealed that women and participants without underlying medical condition (chronic diseases) were significantly less likely to accept the COVID-19 vaccine, compared to men and those with medical conditions, respectively. Conclusion The study emphasizes the need for targeted public health interventions aimed at increasing vaccine acceptance among PEH, especially at the early stage of the pandemic, among females, those without underlying medical conditions, being Black (in Canada and the USA), and young people. These interventions should address the common concerns of vaccine safety, adverse effects, effectiveness, and distrust in health care systems. In addition to offering vaccinations in different areas convenient to them, education programs could be established to increase vaccine acceptance among PEH.
Læs mere Tjek på PubMedLee, J. J., Poon, C. Y., O'Connor, S., Wong, J. Y. H., Kwok, J. Y. Y., Choi, E. P. H., Tsang, W. N., Wang, M. P.
BMJ Open, 15.12.2023
Tilføjet 15.12.2023
ObjectivesTo compare the associations of COVID-19 preventive behaviours and depressive and anxiety symptoms with eHealth literacy and COVID-19 knowledge among Korean adults. DesignA cross-sectional online survey was conducted in April 2020. SettingSeoul metropolitan area in South Korea. Participants1057 Korean adults were recruited. Main outcome measuresAssociations between eHealth literacy, COVID-19 knowledge, COVID-19 preventive behaviours and psychological distress were computed using Pearson’s correlation and logistic regression analyses. eHealth literacy, COVID-19 knowledge, COVID-19 preventive behaviours and psychological distress were weighted by sex and age distribution of the general population in Seoul Metropolitan area. Results68.40% (n=723) perceived high eHealth literacy level (eHEALS ≥26), while 57.43% (n=605) had high levels of COVID-19 knowledge (score ≥25). No significant association between eHealth literacy and COVID-19 knowledge was identified (r=0.05, p=0.09). eHealth literacy and COVID-19 knowledge were significantly associated with COVID-19 preventive behaviours (aOR=1.99, 95% CI 1.51 to 2.62 L; aOR=1.81, 95% CI 1.40 to 2.34, respectively). High eHealth literacy was significantly associated with anxiety symptom (aOR=1.71, 95% CI 1.18 to 2.47) and depressive symptom (aOR=1.69, 95% CI 1.24 to 2.30). COVID-19 knowledge had negative and no associations with the symptoms (aOR=0.62, 95% CI 0.46 to 0.86; aOR=0.79, 95% CI 0.60 to 1.03, respectively). High eHealth literacy with low COVID-19 knowledge was positively and significantly associated with COVID-19 preventive behaviours (aOR=2.30, 95% CI 1.52 to 3.43), and anxiety (aOR=1.81, 95% CI 1.09 to 3.01) and depressive symptoms (aOR=2.24, 95% CI 1.41 to 3.55). High eHealth literacy with high COVID-19 knowledge were significantly associated with more preventive behaviours (aOR=3.66, 95% CI 2.47 to 5.42) but no significant associations with anxiety and depressive symptoms. ConclusionWe identified that eHealth literacy and COVID-19 knowledge were not associated each other, and differently associated with individuals’ COVID-19 preventive behaviours and psychological well-being. Public health strategies should pay attention to enhancing both eHealth literacy and COVID-19 knowledge levels in the public to maximise their COVID-19 preventive behaviours and mitigate their psychological distress during COVID-19 pandemic.
Læs mere Tjek på PubMedMettananda, C., Peiris, C., Abeyrathna, D., Gunasekara, A., Egodage, T., Dantanarayana, C., Pathmeswaran, A., Ranasinha, C.
BMJ Open, 15.12.2023
Tilføjet 15.12.2023
ObjectivesTo study if early initiation of inhaled beclomethasone 1200 mcg in patients with asymptomatic, mild or moderate COVID-19 reduces disease progression to severe COVID-19. DesignDouble-blinded, parallel-groups, randomised, placebo-controlled trial. SettingA hospital-based study in Sri Lanka. ParticipantsAdults with asymptomatic, mild or moderate COVID-19, presenting within the first 7 days of symptom onset or laboratory diagnosis of COVID-19, admitted to a COVID-19 intermediate treatment centre in Sri Lanka between July and November 2021. InterventionsAll participants received inhaled beclomethasone 600 mcg or placebo two times per day, for 10 days from onset of symptoms/COVID-19 test becoming positive if asymptomatic or until reaching primary endpoint, whichever is earlier. Primary outcome measureProgression of asymptomatic, mild or moderate COVID-19 to severe COVID-19. Secondary outcome measuresThe number of days with a temperature of 38°C or more and the time to self-reported clinical recovery. ResultsA total of 385 participants were randomised to receive beclomethasone(n=193) or placebo(n=192) stratified by age (≤60 or >60 years) and sex. One participant from each arm withdrew from the study. All participants were included in final analysis. Primary outcome occurred in 24 participants in the beclomethasone group and 26 participants in the placebo group (RR 0.90 ; p=0.763). The median time for self-reported clinical recovery in all participants was 5 days (95% CI 3 to 7) in the beclomethasone group and 5 days (95% CI 3 to 8) in the placebo group (p=0.5). The median time for self-reported clinical recovery in patients with moderate COVID-19 was 5 days (95% CI 3 to 7) in the beclomethasone group and 6 days (95% CI 4 to 9) in the placebo group (p=0.05). There were no adverse events. ConclusionsEarly initiation of inhaled beclomethasone in patients with asymptomatic, mild or moderate COVID-19 did not reduce disease progression to severe COVID-19. Trial registration numberSri Lanka Clinical Trials Registry; SLCTR/2021/017.
Læs mere Tjek på PubMedManlapaz, D., Vergara, J. A., Alpuerto, K. M. B., De Los Santos, I. K. S., Enriquez, M. U., Manicio, Z. Z., Mendres, J. E. F., Tolosa, C. G. S., Vilela, Z. G. D., Zabat, Z. E. G. A.
BMJ Open, 15.12.2023
Tilføjet 15.12.2023
BackgroundThe COVID-19 pandemic has taken a toll on both physical activity and fitness as several pursuits and activities have been restricted. Coupled with this, increased food intake and sedentary lifestyles have produced poor physical health outcomes. Online physical education classes have been more difficult to conduct given the limitations of the setup. As such, exergaming has been identified as a possible educational tool that could improve students’ motivation, participation and fitness levels and reduce negative behaviours in class while contributing to the current curriculum. ObjectivesThe study explores the perspectives of both the physical education academic staff and senior high school students from the University of Santo Tomas on the implementation of exergaming to determine the feasibility of exergaming as an educational tool in the Philippines’ physical education curriculum. MethodologyA descriptive qualitative design will be used and participants will be selected through criterion sampling. The authors will conduct a process of question development and pilot FGDs beforehand to ensure smooth proceedings. Once done, they will undergo FGDs conducted through Google Meet. Data will be coded and analysed via thematic analysis using manual coding and NVivo V.12 software to summarise central themes and perceptions. Ethics and disseminationThis study will abide by the Nuremberg Code, Declaration of Helsinki, Belmont Report, Data Privacy Act of 2012 and National Ethical Guidelines (for health-related research) of 2017. The study has received approval from the University of Santo Tomas (UST)-College of Rehabilitation Sciences (CRS) Ethics Review Committee. All participant data will be labelled according to random two-digit computer generated codes to preserve anonymity and stored in password-protected laptops and Google Drive folders to preserve confidentiality. Results will be made available to individual UST physical education academic staff and senior high school students prior to publication in peer-reviewed journal.
Læs mere Tjek på PubMedTsantila, F., Coppens, E., De Witte, H., Arensman, E., Aust, B., Pashoja, A. C., Corcoran, P., Cully, G., De Winter, L., Doukani, A., Dushaj, A., Fanaj, N., Griffin, E., Hogg, B., Holland, C., Leduc, C., Leduc, M., Mathieu, S., Maxwell, M., Ni Dhalaigh, D., O' Brien, C., Reich, H., Ditta Toth, M., van Weeghel, J., Van Audenhove, C., MENTUPP consortium members, Abula, Amann, Cox, Creswell-Smith, DAlessandro, Davey, Dooyoung, Greiner, Hackel, Hegerl, Hogg, Alcazar, Mulcahy, Connor, Orchard, Paterson, Purebl, Qirjako, Rapeli, Ross, Rugulies, Sanches, Szekely, Thompson, Wahlbeck, Zsak
BMJ Open, 15.12.2023
Tilføjet 15.12.2023
BackgroundAccording to the Medical Research Council (MRC) framework, the theorisation of how multilevel, multicomponent interventions work and the understanding of their interaction with their implementation context are necessary to be able to evaluate them beyond their complexity. More research is needed to provide good examples following this approach in order to produce evidence-based information on implementation practices. ObjectivesThis article reports on the results of the process evaluation of a complex mental health intervention in small and medium enterprises (SMEs) tested through a pilot study. The overarching aim is to contribute to the evidence base related to the recruitment, engagement and implementation strategies of applied mental health interventions in the workplace. MethodThe Mental Health Promotion and Intervention in Occupational Settings (MENTUPP) intervention was pilot tested in 25 SMEs in three work sectors and nine countries. The evaluation strategy of the pilot test relied on a mixed-methods approach combining qualitative and quantitative research methods. The process evaluation was inspired by the RE-AIM framework and the taxonomy of implementation outcomes suggested by Proctor and colleagues and focused on seven dimensions: reach, adoption, implementation, acceptability, appropriateness, feasibility and maintenance. ResultsFactors facilitating implementation included the variety of the provided materials, the support provided by the research officers (ROs) and the existence of a structured plan for implementation, among others. Main barriers to implementation were the difficulty of talking about mental health, familiarisation with technology, difficulty in fitting the intervention into the daily routine and restrictions caused by COVID-19. ConclusionsThe results will be used to optimise the MENTUPP intervention and the theoretical framework that we developed to evaluate the causal mechanisms underlying MENTUPP. Conducting this systematic and comprehensive process evaluation contributes to the enhancement of the evidence base related to mental health interventions in the workplace and it can be used as a guide to overcome their contextual complexity. Trial registration numberISRCTN14582090.
Læs mere Tjek på PubMedJeanne Rini Poespoprodjo, Nicholas M Douglas, Daniel Ansong, Steven Kho, Nicholas M Anstey
Lancet, 15.12.2023
Tilføjet 15.12.2023
Malaria is resurging in many African and South American countries, exacerbated by COVID-19-related health service disruption. In 2021, there were an estimated 247 million malaria cases and 619 000 deaths in 84 endemic countries. Plasmodium falciparum strains partly resistant to artemisinins are entrenched in the Greater Mekong region and have emerged in Africa, while Anopheles mosquito vectors continue to evolve physiological and behavioural resistance to insecticides. Elimination of Plasmodium vivax malaria is hindered by impractical and potentially toxic antirelapse regimens.
Læs mere Tjek på PubMedYan Xie, Taeyoung Choi, Ziyad Al-Aly
Lancet Infectious Diseases, 15.12.2023
Tilføjet 15.12.2023
Although rates of death and adverse health outcomes following hospital admission for either seasonal influenza or COVID-19 are high, this comparative analysis shows that hospital admission for COVID-19 was associated with higher long-term risks of death and adverse health outcomes in nearly every organ system (except for the pulmonary system) and significant cumulative excess DALYs than hospital admission for seasonal influenza. The substantial cumulative burden of health loss in both groups calls for greater prevention of hospital admission for these two viruses and for greater attention to the care needs of people with long-term health effects due to either seasonal influenza or SARS-CoV-2 infection.
Læs mere Tjek på PubMedLijun Zhang, Junwen Feng, Bo Feng
PLoS One Infectious Diseases, 15.12.2023
Tilføjet 15.12.2023
by Lijun Zhang, Junwen Feng, Bo Feng Asset-backed securitization (ABS) is currently used to refinance public-private partnership (PPP) projects in the infrastructure field. To stimulate the investors’ enthusiasm, this study evaluated the investment environment of PPP projects asset-backed securitization (PPP-ABS). Firstly, we established a PPP-ABS investment environment evaluation indicator system based on the literature review and the practice of PPP-ABS. Then, the optimal weights of each indicator were determined by the combined weighting of level difference maximization method, where the subjective weights were determined by the AHP method, and the objective weights were determined by the entropy method. Finally, we evaluated the PPP-ABS investment environment from 2015 to 2022 with the technique for order preference by similarity to ideal solution (TOPSIS) method. The final valuation results are consistent with the actual situation. The results showed that the PPP-ABS investment environment exhibits a stable and upward trend. Under the overall guidance of the government, the approval process, information disclosure and supervisory systems have continued to improve, the number of ABS products issued has continued to grow, and the overall market risk is controllable. However, some problems still need to be solved and improved, including inadequate accounting and tax systems, insufficient liquidity in the secondary market, and the recovery of economic development in the post-COVID-19 era. This study fills the research gap in PPP-ABS. It proves the rationality and feasibility of PPP-ABS and is expected to provide a reference for investors’ decision-making and promote the sustainable and healthy development of PPP-ABS.
Læs mere Tjek på PubMedMahadee Al Mobin, Md. Kamrujjaman
PLoS One Infectious Diseases, 15.12.2023
Tilføjet 15.12.2023
by Mahadee Al Mobin, Md. Kamrujjaman Data scarcity and discontinuity are common occurrences in the healthcare and epidemiological dataset and often is needed to form an educative decision and forecast the upcoming scenario. Often to avoid these problems, these data are processed as monthly/yearly aggregate where the prevalent forecasting tools like Autoregressive Integrated Moving Average (ARIMA), Seasonal Autoregressive Integrated Moving Average (SARIMA), and TBATS often fail to provide satisfactory results. Artificial data synthesis methods have been proven to be a powerful tool for tackling these challenges. The paper aims to propose a novel algorithm named Stochastic Bayesian Downscaling (SBD) algorithm based on the Bayesian approach that can regenerate downscaled time series of varying time lengths from aggregated data, preserving most of the statistical characteristics and the aggregated sum of the original data. The paper presents two epidemiological time series case studies of Bangladesh (Dengue, Covid-19) to showcase the workflow of the algorithm. The case studies illustrate that the synthesized data agrees with the original data regarding its statistical properties, trend, seasonality, and residuals. In the case of forecasting performance, using the last 12 years data of Dengue infection data in Bangladesh, we were able to decrease error terms up to 72.76% using synthetic data over actual aggregated data.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 15.12.2023
Tilføjet 15.12.2023
Abstract Background Solid organ transplant recipients (SOTRs) are at higher risk for severe infection. However, the risk for severe COVID-19 and vaccine effectiveness among SOTRs remain unclear.Methods This retrospective study used a nationwide health care claims database and COVID-19 registry from the Republic of Korea (2020 to 2022). Adult SOTRs diagnosed with COVID-19 were matched with up to 4 non-SOTR COVID-19 patients by propensity score. Severe COVID-19 was defined as treatment with high-flow nasal cannulae, mechanical ventilation, or extracorporeal membrane oxygenation.Results Among 6783 SOTRs with COVID-19, severe COVID-19 was reported with the highest rate in lung transplant recipients (13.16%), followed by the heart (6.30%), kidney (3.90%), and liver (2.40%). SOTRs had a higher risk of severe COVID-19 compared to non-SOTRs, and lung transplant recipients showed the highest risk (adjusted odds ratio, 18.14; 95% confidence interval [CI], 8.53–38.58). Vaccine effectiveness against severe disease among SOTRs was 47% (95% CI, 18%–65%), 64% (95% CI, 49%–75%), and 64% (95% CI, 29%–81%) for 2, 3, and 4 doses, respectively.Conclusions SOTRs are at significantly higher risk for severe COVID-19 compared to non-SOTRs. Vaccination is effective in preventing the progression to severe COVID-19. Efforts should be made to improve vaccine uptake among SOTRs, while additional protective measures should be developed.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.12.2023
Tilføjet 14.12.2023
Abstract Background Persistent headache is a frequent symptom after coronavirus disease 2019 (COVID-19) and there is currently limited knowledge about its clinical spectrum and predisposing factors. A subset of patients may be experiencing new daily persistent headache (NDPH) after COVID-19, which is among the most treatment-refractory primary headache syndromes. Methods We conducted a cross-sectional study in Latin America to characterize individuals with persistent headache after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to identify factors associated with NDPH. Participants over 18 years old who tested positive for SARS-CoV-2 infection and reported persistent headache among their symptoms completed an online survey that included demographics, past medical history, persistent headache clinical characteristics, and COVID-19 vaccination status. Based on participants’ responses, NDPH diagnostic criteria were used to group participants into NDPH and non-NDPH groups. Participant data was summarized by descriptive statistics. Student’s t and Mann–Whitney U tests were used according to the distribution of quantitative variables. For categorical variables, Pearson’s chi-square and Fisher’s exact tests were used according to the size of expected frequencies. Binomial logistic regression using the backward stepwise selection method was performed to identify factors associated with NDPH. Results Four hundred and twenty-one participants from 11 Latin American countries met the inclusion criteria. One in four participants met the NDPH diagnostic criteria. The mean age was 40 years, with most participants being female (82%). Over 90% of the participants reported having had mild/moderate COVID-19. Most participants had a history of headache before developing COVID-19 (58%), mainly migraine type (32%). The most predominant clinical characteristics in the NDPH group were occipital location, severe/unbearable intensity, burning character, and radiating pain (p
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.12.2023
Tilføjet 14.12.2023
Abstract Background Symptomatic COVID-19 and Long COVID, also referred to as post-acute sequelae of SARS-CoV-2 (PASC) or post-COVID conditions, have been widely reported in young, healthy people, but their prevalence has not yet been determined in student athletes. We sought to estimate the prevalence of reported COVID-19, symptomatic COVID-19, and Long COVID in college athletes in the United States attending 18 schools from spring 2020 to fall 2021. Methods We developed an online survey to measure the prevalence of student athletes who tested positive for COVID-19, developed Long COVID, and did not return to their sport during the relevant time period. We surveyed a convenience sample of 18 collegiate school administrators, representing about 7,000 student athletes. Of those schools surveyed, 16 responded regarding the spring 2020 semester, and 18 responded regarding the full academic year of fall 2020 to spring 2021 (both semesters). Results According to the survey responses, there were 9.8% of student athletes who tested positive for COVID-19 in spring 2020 and 25.4% who tested positive in the academic year of fall 2020 to spring 2021. About 4% of student athletes who tested positive from spring 2020 to spring 2021 developed Long COVID, defined as new, recurring, or ongoing physical or mental health consequences occurring 4 or more weeks after SARS-CoV-2 infection. Conclusions This study highlights that Long COVID occurs among young, healthy athletes and is a real consequence of COVID-19. Understanding the prevalence of Long COVID in this population requires longer follow-up and further study.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.12.2023
Tilføjet 14.12.2023
Abstract Background Coronavirus disease 2019 (COVID-19) surges, such as that which occurred when omicron variants emerged, may overwhelm healthcare systems. To function properly, such systems should balance detection and workloads by improving referrals using simple yet precise and sensitive diagnostic predictions. A symptom-based scoring system was developed using machine learning for the general population, but no validation has occurred in healthcare settings. We aimed to validate a COVID-19 scoring system using self-reported symptoms, including loss of smell and taste as major indicators. Methods A cross-sectional study was conducted to evaluate medical records of patients admitted to Dr. Sardjito Hospital, Yogyakarta, Indonesia, from March 2020 to December 2021. Outcomes were defined by a reverse-transcription polymerase chain reaction (RT-PCR). We compared the symptom-based scoring system, as the index test, with antigen tests, antibody tests, and clinical judgements by primary care physicians. To validate use of the index test to improve referral, we evaluated positive predictive value (PPV) and sensitivity. Results After clinical judgement with a PPV of 61% (n = 327/530, 95% confidence interval [CI]: 60% to 62%), confirmation with the index test resulted in the highest PPV of 85% (n = 30/35, 95% CI: 83% to 87%) but the lowest sensitivity (n = 30/180, 17%, 95% CI: 15% to 19%). If this confirmation was defined by either positive predictive scoring or antigen tests, the PPV was 92% (n = 55/60, 95% CI: 90% to 94%). Meanwhile, the sensitivity was 88% (n = 55/62, 95% CI: 87% to 89%), which was higher than that when using only antigen tests (n = 29/41, 71%, 95% CI: 69% to 73%). Conclusions The symptom-based COVID-19 predictive score was validated in healthcare settings for its precision and sensitivity. However, an impact study is needed to confirm if this can balance detection and workload for the next COVID-19 surge.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.12.2023
Tilføjet 14.12.2023
Journal of the American Medical Association, 14.12.2023
Tilføjet 14.12.2023
Recovery of sense of smell and taste following a mild SARS-CoV-2 infection continued over 3 years, results from 88 patients in Italy who tested positive for COVID-19 during 2020 suggest.
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