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47 ud af 47 tidsskrifter valgt, søgeord (covid-19) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
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Journal of the American Medical Association, 28.10.2023
Tilføjet 28.10.2023
The Original Investigation titled “Effect of Fluvoxamine vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19: A Randomized Clinical Trial,” published on January 12, 2023, was corrected to fix the description of how the medications were distributed and the name of the manufacturer. In the Methods section, under the Interventions subsection, the first sentence should have been “Participants received a 10-day supply of either fluvoxamine or placebo matching fluvoxamine in bottles provided by the manufacturer (Apotex) via direct home delivery from a central pharmacy.” This article was corrected online.
Læs mere Tjek på PubMedJournal of the American Medical Association, 28.10.2023
Tilføjet 28.10.2023
More than 3% of US adults had post–COVID-19 condition, or long COVID, at the time of a 2022 National Health Interview Survey, and about 7% reported ever having had the condition, the Centers for Disease Control and Prevention recently announced. A similar trend held for children, with 0.5% having long COVID at the time of the survey and 1.3% ever having had the condition.
Læs mere Tjek på PubMedJournal of the American Medical Association, 28.10.2023
Tilføjet 28.10.2023
In this Viewpoint, the authors summarize the therapeutic landscape for COVID-19, discuss who is most likely to benefit from treatment, provide an update on managing illness in immunocompromised individuals, and highlight how to improve COVID-19 treatment.
Læs mere Tjek på PubMedJournal of the American Medical Association, 28.10.2023
Tilføjet 28.10.2023
This Viewpoint addresses the state of COVID-19 as of fall 2023 in the US and summarizes key clinical information for health care professionals and patients.
Læs mere Tjek på PubMedGharaibeh, L., Alameri, M. A., Al-Kabariti, A. Y., Alsa'd, A. A., Abed, A., Karameh, N., Aldeeb, I. D.
BMJ Open, 27.10.2023
Tilføjet 27.10.2023
ObjectivesOnline purchasing, including drugs, increased dramatically in the last decade especially through the COVID-19 pandemic. The aim of this study was to investigate the frequency and attitudes of consumers concerning online drug purchasing and assess their perceptions regarding the benefits and disadvantages. DesignA web-based survey conducted through a self-administered questionnaire that was approved by the Institutional Review Board (IRB) committee, ethical approval number: IRB/Al-Ahliyya Amman University/3/13/2021-2022. Cronbach’s alpha for the attributes of benefits and disadvantages was 0.608 and 0.744, respectively. Primary outcome measures were extent of trust of the public in online drug purchasing using Likert scale. Multivariate linear regression was used to assess predictors of the trust score. SettingsHashemite Kingdom of Jordan. ParticipantsInclusion criteria; residents of the Hashemite Kingdom of Jordan 18 years or older. The questionnaire was distributed through snowball effect via different social media. ResultsA total of 428 participants filled the questionnaire, their average age was 29.7±11.2. Almost all participants, 419 (98.6%) use the internet daily but only 79 (18.6%) participants shop online regularly. Fifty participants (11.8%) purchased drugs online and they had higher benefits score of online purchasing compared with those who did not buy drugs online, 12.5±3.7 and 10.9±3.1, respectively, p=0.002. Participant who purchased drugs online had an increase in trust score of 0.847 compared with those who did not purchase drugs online, p
Læs mere Tjek på PubMedBMC Infectious Diseases, 27.10.2023
Tilføjet 27.10.2023
Abstract Background Infectious disease computational modeling studies have been widely published during the coronavirus disease 2019 (COVID-19) pandemic, yet they have limited reproducibility. Developed through an iterative testing process with multiple reviewers, the Infectious Disease Modeling Reproducibility Checklist (IDMRC) enumerates the minimal elements necessary to support reproducible infectious disease computational modeling publications. The primary objective of this study was to assess the reliability of the IDMRC and to identify which reproducibility elements were unreported in a sample of COVID-19 computational modeling publications. Methods Four reviewers used the IDMRC to assess 46 preprint and peer reviewed COVID-19 modeling studies published between March 13th, 2020, and July 30th, 2020. The inter-rater reliability was evaluated by mean percent agreement and Fleiss’ kappa coefficients (κ). Papers were ranked based on the average number of reported reproducibility elements, and average proportion of papers that reported each checklist item were tabulated. Results Questions related to the computational environment (mean κ = 0.90, range = 0.90–0.90), analytical software (mean κ = 0.74, range = 0.68–0.82), model description (mean κ = 0.71, range = 0.58–0.84), model implementation (mean κ = 0.68, range = 0.39–0.86), and experimental protocol (mean κ = 0.63, range = 0.58–0.69) had moderate or greater (κ > 0.41) inter-rater reliability. Questions related to data had the lowest values (mean κ = 0.37, range = 0.23–0.59). Reviewers ranked similar papers in the upper and lower quartiles based on the proportion of reproducibility elements each paper reported. While over 70% of the publications provided data used in their models, less than 30% provided the model implementation. Conclusions: The IDMRC is the first comprehensive, quality-assessed tool for guiding researchers in reporting reproducible infectious disease computational modeling studies. The inter-rater reliability assessment found that most scores were characterized by moderate or greater agreement. These results suggest that the IDMRC might be used to provide reliable assessments of the potential for reproducibility of published infectious disease modeling publications. Results of this evaluation identified opportunities for improvement to the model implementation and data questions that can further improve the reliability of the checklist.
Læs mere Tjek på PubMedBMC Infectious Diseases, 27.10.2023
Tilføjet 27.10.2023
Abstract Objective We aimed to compare the adaptive immune response in individuals with or without prior SARS-CoV-2 infections following the administration of mRNA-based COVID-19 vaccines. Methods A total of 54 participants with ages ranging from 37 to 56 years old, consisting of 23 individuals without a history of SARS-CoV-2 infection (uninfected group) and 31 individuals with prior infection of SARS-CoV-2 (infected group) who have received two doses of mRNA SARS-CoV-2 vaccines were enrolled in this study. We measured the IFN-γ level upon administration of BNT162b2 (PF) or mRNA-1273 (MO) by QuantiFERON SARS-CoV-2. The production of neutralizing antibodies was evaluated by a surrogate virus neutralization assay, and the neutralizing capacity was assessed by a plaque reduction neutralization test (PRNT50). The immune response was compared between the two groups. Results A significantly higher level of IFN-γ (p
Læs mere Tjek på PubMedClinical Infectious Diseases, 26.10.2023
Tilføjet 26.10.2023
AbstractEvaluating 100 adult COVID-19 patients from a Madrid hospital, we identified a mismatch between current clinical trial designs and the evolving profile of hospitalized patients. Most patients were ineligible for existing trials due to trial design constraints, suggesting a need to rethink trial criteria for a more accurate representation of the hospitalized COVID-19 population.
Læs mere Tjek på PubMedClinical Infectious Diseases, 26.10.2023
Tilføjet 26.10.2023
AbstractBackgroundNumerous prognostic scores have been published to support risk stratification for patients with Coronavirus disease 2019 (COVID-19).MethodsWe performed a systematic review to identify the scores for confirmed or clinically assumed COVID-19 cases. An in-depth assessment and risk of bias (ROB) analysis (Prediction model Risk Of Bias ASsessment Tool (PROBAST)) was conducted for scores fulfilling predefined criteria ((I) area under the curve (AUC) ≥ 0.75; (II) a separate validation cohort present; (III) training data from a multicenter setting (≥ 2 centers); (IV) point-scale scoring system).ResultsOut of 1,522 studies extracted from MEDLINE/Web of Science (20/02/2023), we identified 242 scores for COVID-19 outcome prognosis (mortality 109, severity 116, hospitalization 14, long-term sequelae 3). Most scores were developed using retrospective (75.2%) or single-center (57.1%) cohorts. Predictor analysis revealed the primary use of laboratory data and sociodemographic information in mortality and severity scores. Forty-nine scores were included in the in-depth analysis. The results indicated heterogeneous quality and predictor selection, with only five scores featuring low ROB. Among those, based on the number and heterogeneity of validation studies, only the 4C Mortality Score can be recommended for clinical application so far.ConclusionThe application and translation of most existing COVID scores appear unreliable. Guided development and predictor selection would have improved the generalizability of the scores and may enhance pandemic preparedness in the future.
Læs mere Tjek på PubMedClinical Infectious Diseases, 26.10.2023
Tilføjet 26.10.2023
Benoît Misset, Michael Piagnerelli, Eric Hoste, Nadia Dardenne, David Grimaldi, Isabelle Michaux, Elisabeth De Waele, Alexander Dumoulin, Philippe G. Jorens, Emmanuel van der Hauwaert, Frédéric Vallot, Stoffel Lamote, Walter Swinnen, Nicolas De Schryver, Vincent Fraipont, Nathalie de Mey, Nicolas Dauby, Nathalie Layios, Jean-Baptiste Mesland, Geert Meyfroidt, Michel Moutschen, Veerle Compernolle, André Gothot, Daniel Desmecht, Maria I. Taveira da Silva Pereira, Mutien Garigliany, Tome Najdovski, Axelle Bertrand, Anne-Françoise Donneau, Pierre-François Laterre
New England Journal of Medicine, 26.10.2023
Tilføjet 26.10.2023
New England Journal of Medicine, Volume 389, Issue 17, Page 1590-1600, October 2023.
Læs mere Tjek på PubMedNew England Journal of Medicine, 26.10.2023
Tilføjet 26.10.2023
Toal, Connor M.; Fowler, Alexander J.; Patel, Brijesh V.; Puthucheary, Zudin; Prowle, John R.
Critical Care Explorations, 26.10.2023
Tilføjet 26.10.2023
IMPORTANCE: Most studies on acute respiratory distress syndrome (ARDS) group patients by severity based on their initial degree of hypoxemia. However, this grouping has limitations, including inconsistent hypoxemia trajectories and outcomes. OBJECTIVES: This study explores the benefits of grouping patients by resolver status based on their hypoxemia progression over the first 7 days. DESIGN, SETTING, AND PARTICIPANTS: This is an observational study from a large single-center database. Medical Information Mart for Intensive Care (MIMIC)-IV and MIMIC Chest X-ray JPEG databases were used. Mechanically ventilated patients that met the Berlin ARDS criteria were included. MAIN OUTCOMES AND MEASURES: The primary outcome was the proportion of hypoxemia resolvers vs. nonresolvers in non-COVID-19 ARDS patients. Nonresolvers were defined as those whose hypoxemia worsened or remained moderate or severe over the first 7 days. Secondary outcomes included baseline admission characteristics, initial blood gases and ventilation settings, length of invasive mechanical ventilation, length of ICU stay, and ICU survival rates across resolver groups. RESULTS: A total of 894 ICU admissions were included in the study. Of these, 33.9% were hypoxemia nonresolvers. The resolver groups showed no significant difference in age, body mass index, comorbidities, or Charlson score. There was no significant difference in the percentage of those with initial severe hypoxemia between the two groups (8.1% vs. 9.2%; p = 0.126). The initial Pao2/Fio2 ratio did not significantly increase the odds ratio (OR) of being a nonresolver (OR, 0.84; 95% CI, 0.65–1.10). Nonresolver mortality was 61.4%, comparable to the survival rates seen in nonresolvers in a previous large COVID-19 ARDS study. CONCLUSIONS AND RELEVANCE: Our study shows that resolver status is a valuable grouping in ARDS. It has significant advantages over grouping by initial degree of hypoxemia, including better mapping of trajectory and comparable outcomes across other studies. While it may offer insights into disease-specific associations, future studies should include resolver status analysis for more definitive conclusions.
Læs mere Tjek på PubMedYiyuan Xu, Tian Xu, Shaoting Chen, Huakang Yao, Yuxiang Chen, Yanfen Zeng, Falin Chen, Guanbin Zhang
PLoS One Infectious Diseases, 26.10.2023
Tilføjet 26.10.2023
by Yiyuan Xu, Tian Xu, Shaoting Chen, Huakang Yao, Yuxiang Chen, Yanfen Zeng, Falin Chen, Guanbin Zhang The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has swept the world and poses a serious threat to human health. In the post-pandemic-era, we must remain vigilant against the co-infection of SARS-CoV-2 and other respiratory viruses. More accurate and convenient detection methods are required for the diagnosis of SARS-CoV-2 due to its prolonged existence. In this study, the application value of a novel lyophilized-pellet-based 2019-nCoV nucleic acid diagnostic kit (PCoV-Kit) was evaluated by comparing it with a conventional liquid diagnostic kit (LCoV-Kit). We assessed the sensitivity, precision, accuracy, specificity, and amplification efficiency of PCoV-Kit and LCoV-Kit using diluted SARS-CoV-2 RNA reference materials. The results showed that both kits had high sensitivity, precision, accuracy, and specificity. A total of 2,033 oropharyngeal swab specimens collected during mass screening in Fuzhou in December 2022 were applied for the consistency analysis of the two reagents. In the detection of clinical oropharyngeal swab specimens, although the positive rate of PCoV-Kit (19.28%) was slightly lower than that of LCoV-Kit (20.86%), statistical analysis demonstrated a high degree of consistency between the test results obtained using both kit (χ2 = 1.57, P>0.05; Kappa coefficient = 0.90, 95%CI: 0.88–0.93). In conclusion, the use of lyophilized PCoV-Kit provides a non-inferior assay for the diagnosis of COVID-19.
Læs mere Tjek på PubMedBMC Infectious Diseases, 26.10.2023
Tilføjet 26.10.2023
Abstract Background With Norwegian national registry data, we assessed the prevalence of post-COVID-19 symptoms at least 3 months after confirmed infection, and whether sociodemographic factors and pre-pandemic health problems were risk factors for these symptoms. Methods All persons with a positive SARS-CoV-2 PCR test from February 2020 to February 2021 (exposed) were compared to a group without a positive test (unexposed) matched on age, sex, and country of origin. We used Cox regression to estimate hazard ratios (HR) for 18 outcome symptoms commonly described as post-COVID-19 related, registered by GPs. We compared relative risks (RR) for fatigue, memory disturbance, or shortness of breath among exposed and unexposed using Poisson regression models, assessing sex, age, education, country of origin, and pre-pandemic presence of the same symptom and comorbidity as possible risk factors, with additional analyses to assess hospitalisation for COVID-19 as a risk factor among exposed. Results The exposed group (N = 53 846) had a higher prevalence of most outcome symptoms compared to the unexposed (N = 485 757), with the highest risk for shortness of breath (HR 2.75; 95%CI 2.59–2.93), fatigue (2.08; 2.00-2.16) and memory disturbance (1.41;1.26–1.59). High HRs were also found for disturbance of smell/taste and hair loss, but frequencies were low. Concerning risk factors, sociodemographic factors were at large similarly associated with outcome symptoms in both groups. Registration of the outcome symptom before the pandemic increased the risk for fatigue, memory disturbance and shortness of breath after COVID-19, but these associations were weaker among exposed. Comorbidity was not associated with fatigue and shortness of breath in the COVID-19 group. For memory disturbance, the RR was slightly increased with the higher comorbidity score both among exposed and unexposed. Conclusion COVID-19 was associated with a range of symptoms lasting more than three months after the infection.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 25.10.2023
Tilføjet 25.10.2023
AbstractMost COVID-19 patients requiring ICU care develop an acute respiratory distress syndrome (ARDS), characterised by severe hypoxemia, decreased lung compliance, and high vascular permeability. Activation of the complement system is a hallmark of moderate and severe COVID-19, with abundant deposition of complement proteins reported in inflamed tissue and on the endothelium during COVID-19. Using a transgenic mouse model of SARS-CoV-2 infection we assessed the therapeutic utility of an inhibitory antibody (HG4) targeting the lectin pathway key enzyme MASP-2. Treatment of infected mice with HG4 reduced the disease severity score and improved survival compared to mice that received an isotype control antibody. Administration of HG4 significantly reduced the lung injury score including alveolar inflammatory cell infiltration, alveolar oedema and alveolar haemorrhage. The overall ameliorating effect of MASP-2 inhibition on the severity of COVID-19 pathology is reflected by a significant reduction in the pro-inflammatory activation of brain microglia in HG4 treated mice.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 25.10.2023
Tilføjet 25.10.2023
AbstractBackgroundTo investigate evidence of residual viral infection, intrathecal immune activation, central nervous system (CNS) injury, and humoral responses in cerebrospinal fluid (CSF) and plasma in patients recovering from coronavirus disease 2019 (COVID-19), with or without neurocognitive post-COVID condition (PCC).MethodsThirty-one participants (25 with neurocognitive PCC) underwent clinical examination, lumbar puncture, and venipuncture ≥3 months after COVID-19 symptom onset. Healthy volunteers were included. CSF and plasma severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid and spike antigen (N-Ag, S-Ag), and CSF biomarkers of immune activation and neuronal injury were analyzed.ResultsSARS-CoV-2 N-Ag or S-Ag were undetectable in all samples and no participant had pleocytosis. We detected no significant differences in CSF and plasma cytokine concentrations, albumin ratio, IgG index, neopterin, β2M, or in CSF biomarkers of neuronal injury and astrocytic damage. Furthermore, principal component analysis (PCA1) analysis did not indicate any significant differences between the study groups in the marker sets cytokines, neuronal markers, or anti-cytokine autoantibodies.ConclusionsWe found no evidence of ongoing viral replication, immune activation, or CNS injury in plasma or CSF in patients with neurocognitive PCC compared with COVID-19 controls or healthy volunteers, suggesting that neurocognitive PCC is a consequence of events suffered during acute COVID-19 rather than persistent viral CNS infection or residual CNS inflammation.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.10.2023
Tilføjet 25.10.2023
Abstract Background Randomized clinical trials in non-critically ill COVID-19 patients showed that therapeutic-dose heparin increased survival with reduced organ support as compared with usual-care thromboprophylaxis, albeit with increased bleeding risk. The purpose of the study is to assess the safety of intermediate dose enoxaparin in hospitalized patients with moderate to severe COVID-19. Methods A phase II single-arm interventional prospective study including patients receiving intermediate dose enoxaparin once daily according to body weight: 60 mg for 45–60 kg, 80 mg for 61–100 kg or 100 mg for > 100 kg for 14 days, with dose adjustment according to anti-factor Xa activity (target range: 0.4–0.6 UI/ml); an observational cohort (OC) included patients receiving enoxaparin 40 mg day for comparison. Follow-up was 90 days. Primary outcome was major bleeding within 30 and 90 days after treatment onset. Secondary outcome was the composite of all-cause 30 and 90-day mortality rates, disease severity at the end of treatment, intensive care unit (ICU) admission and length of ICU stay, length of hospitalization. All outcomes were adjudicated by an independent committee and analyzed before and after propensity score matching (PSm). Results Major bleeding was similar in IC (1/98 1.02%) and in the OC (none), with only one event observed in a patient receiving concomitantly anti-platelet therapy. The composite outcome was observed in 53/98 patients (54%) in the IC and 132/203 (65%) patients in the OC (p = 0.07) before PSm, while it was observed in 50/90 patients (55.6%) in the IC and in 56/90 patients (62.2%) in the OC after PSm (p = 0.45). Length of hospitalization was lower in the IC than in OC [median 13 (IQR 8–16) vs 14 (11–21) days, p = 0.001], however it lost statistical significance after PSm (p = 0.08). At 30 days, two patients had venous thrombosis and two pulmonary embolism in the OC. Time to first negative RT-PCR were similar in the two groups. Conclusions Weight adjusted intermediate dose heparin with anti-FXa monitoring is safe with potential positive impact on clinical course in COVID-19 non-critically ill patients. Trial registration The study INHIXACOVID19 was registred on ClinicalTrials.gov with the trial registration number (TRN) NCT04427098 on 11/06/2020.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.10.2023
Tilføjet 25.10.2023
Abstract Background Randomized clinical trials in non-critically ill COVID-19 patients showed that therapeutic-dose heparin increased survival with reduced organ support as compared with usual-care thromboprophylaxis, albeit with increased bleeding risk. The purpose of the study is to assess the safety of intermediate dose enoxaparin in hospitalized patients with moderate to severe COVID-19. Methods A phase II single-arm interventional prospective study including patients receiving intermediate dose enoxaparin once daily according to body weight: 60 mg for 45–60 kg, 80 mg for 61–100 kg or 100 mg for > 100 kg for 14 days, with dose adjustment according to anti-factor Xa activity (target range: 0.4–0.6 UI/ml); an observational cohort (OC) included patients receiving enoxaparin 40 mg day for comparison. Follow-up was 90 days. Primary outcome was major bleeding within 30 and 90 days after treatment onset. Secondary outcome was the composite of all-cause 30 and 90-day mortality rates, disease severity at the end of treatment, intensive care unit (ICU) admission and length of ICU stay, length of hospitalization. All outcomes were adjudicated by an independent committee and analyzed before and after propensity score matching (PSm). Results Major bleeding was similar in IC (1/98 1.02%) and in the OC (none), with only one event observed in a patient receiving concomitantly anti-platelet therapy. The composite outcome was observed in 53/98 patients (54%) in the IC and 132/203 (65%) patients in the OC (p = 0.07) before PSm, while it was observed in 50/90 patients (55.6%) in the IC and in 56/90 patients (62.2%) in the OC after PSm (p = 0.45). Length of hospitalization was lower in the IC than in OC [median 13 (IQR 8–16) vs 14 (11–21) days, p = 0.001], however it lost statistical significance after PSm (p = 0.08). At 30 days, two patients had venous thrombosis and two pulmonary embolism in the OC. Time to first negative RT-PCR were similar in the two groups. Conclusions Weight adjusted intermediate dose heparin with anti-FXa monitoring is safe with potential positive impact on clinical course in COVID-19 non-critically ill patients. Trial registration The study INHIXACOVID19 was registred on ClinicalTrials.gov with the trial registration number (TRN) NCT04427098 on 11/06/2020.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.10.2023
Tilføjet 25.10.2023
Abstract Background Coronavirus disease 2019 (COVID-19) was first identified in South Korea during the 2019–2020 seasonal influenza epidemic. The social distancing measures, as effective non-pharmaceutical interventions (NPIs), adopted to mitigate the spread of COVID-19 might have influenced influenza activity. We evaluated IFV(influenza virus) activity during the COVID-19 pandemic and the effect of NPI intensity on influenza transmission. Methods IFV activity and epidemic duration during COVID-19 pandemic were predicted under a counterfactual scenario with no NPIs against COVID-19. The Seasonal Autoregressive Integrated Moving Average Model was used to quantify the effects of NPIs on the transmission of influenza virus. Influenza-like illness/1000 outpatients and IFV positivity rate from the 2011–2012 to 2021–2022 seasons were used in this study. Results Comparison of the 2020–2021 and 2021–2022 seasonal influenza activities with those in 2013–2019 showed that COVID-19 outbreaks and associated NPIs such as face mask use, school closures, and travel restrictions reduced the influenza incidence by 91%. Without NPIs against COVID-19, the rates of influenza-like illness and IFV positivity would have been high during the influenza epidemic season, as in previous seasons. NPI intensity decreased the transmission of influenza; the magnitude of the reduction increased as the intensity of social-distancing measures increased (weak social distancing; step-by-step daily recovery: 58.10%, strong social distancing; special quarantine measures: 95.12%). Conclusions Our results suggest that NPIs and personal hygiene can be used to suppress influenza transmission. NPIs against COVID-19 may be useful strategies for the prevention and control of influenza epidemics.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.10.2023
Tilføjet 25.10.2023
Abstract Background Coronavirus disease 2019 (COVID-19) was first identified in South Korea during the 2019–2020 seasonal influenza epidemic. The social distancing measures, as effective non-pharmaceutical interventions (NPIs), adopted to mitigate the spread of COVID-19 might have influenced influenza activity. We evaluated IFV(influenza virus) activity during the COVID-19 pandemic and the effect of NPI intensity on influenza transmission. Methods IFV activity and epidemic duration during COVID-19 pandemic were predicted under a counterfactual scenario with no NPIs against COVID-19. The Seasonal Autoregressive Integrated Moving Average Model was used to quantify the effects of NPIs on the transmission of influenza virus. Influenza-like illness/1000 outpatients and IFV positivity rate from the 2011–2012 to 2021–2022 seasons were used in this study. Results Comparison of the 2020–2021 and 2021–2022 seasonal influenza activities with those in 2013–2019 showed that COVID-19 outbreaks and associated NPIs such as face mask use, school closures, and travel restrictions reduced the influenza incidence by 91%. Without NPIs against COVID-19, the rates of influenza-like illness and IFV positivity would have been high during the influenza epidemic season, as in previous seasons. NPI intensity decreased the transmission of influenza; the magnitude of the reduction increased as the intensity of social-distancing measures increased (weak social distancing; step-by-step daily recovery: 58.10%, strong social distancing; special quarantine measures: 95.12%). Conclusions Our results suggest that NPIs and personal hygiene can be used to suppress influenza transmission. NPIs against COVID-19 may be useful strategies for the prevention and control of influenza epidemics.
Læs mere Tjek på PubMedJonathan J. Lau, Samuel M. S. Cheng, Kathy Leung, Cheuk Kwong Lee, Asmaa Hachim, Leo C. H. Tsang, Kenny W. H. Yam, Sara Chaothai, Kelvin K. H. Kwan, Zacary Y. H. Chai, Tiffany H. K. Lo, Masashi Mori, Chao Wu, Sophie A. Valkenburg, Gaya K. Amarasinghe, Eric H. Y. Lau, David S. C. Hui, Gabriel M. Leung, Malik Peiris, Joseph T. Wu
Nature, 25.10.2023
Tilføjet 25.10.2023
Phoomintara Longsompurana, Thanyada Rungrotmongkol, Nongluk Plongthongkum, Kittikhun Wangkanont, Peter Wolschann, Rungtiva P. Poo-arporn
PLoS One Infectious Diseases, 24.10.2023
Tilføjet 24.10.2023
by Phoomintara Longsompurana, Thanyada Rungrotmongkol, Nongluk Plongthongkum, Kittikhun Wangkanont, Peter Wolschann, Rungtiva P. Poo-arporn The COVID-19 pandemic has created an urgent need for effective therapeutic and diagnostic strategies to manage the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the emergence of numerous variants of concern (VOCs) has made it challenging to develop targeted therapies that are broadly specific in neutralizing the virus. In this study, we aimed to develop neutralizing nanobodies (Nbs) using computational techniques that can effectively neutralize the receptor-binding domain (RBD) of SARS-CoV-2 VOCs. We evaluated the performance of different protein-protein docking programs and identified HDOCK as the most suitable program for Nb/RBD docking with high accuracy. Using this approach, we designed 14 novel Nbs with high binding affinity to the VOC RBDs. The Nbs were engineered with mutated amino acids that interacted with key amino acids of the RBDs, resulting in higher binding affinity than human angiotensin-converting enzyme 2 (ACE2) and other viral RBDs or haemagglutinins (HAs). The successful development of these Nbs demonstrates the potential of molecular modeling as a low-cost and time-efficient method for engineering effective Nbs against SARS-CoV-2. The engineered Nbs have the potential to be employed in RBD-neutralizing assays, facilitating the identification of novel treatment, prevention, and diagnostic strategies against SARS-CoV-2.
Læs mere Tjek på PubMedAmanda Butler, Ruth Croxford, Katherine E. McLeod, Tara Gomes, Aaron M. Orkin, Susan J. Bondy, Fiona G. Kouyoumdjian
PLoS One Infectious Diseases, 24.10.2023
Tilføjet 24.10.2023
by Amanda Butler, Ruth Croxford, Katherine E. McLeod, Tara Gomes, Aaron M. Orkin, Susan J. Bondy, Fiona G. Kouyoumdjian Background To inform preparedness and population health action, we need to understand the effects of COVID-19 on health inequities. In this study, we assess the impact of COVID-19 on opioid toxicity deaths among people who experience incarceration compared to others in the general population in Ontario, Canada. Methods We conducted a retrospective cohort study for the period of January 1, 2015 to December 31, 2020. We accessed and linked coronial data on all opioid toxicity deaths in Ontario with correctional data for people aged 18 years and older who were incarcerated in a provincial correctional facility. We used data from the Statistics Canada Census to calculate whole population rates. We used an interrupted time series design and segmented regression to assess for change in the level or rate of increase in deaths due to opioid toxicity coinciding with the COVID-19 pandemic. We compared the impact of COVID-19 on the opioid toxicity death rates for people exposed and not exposed to incarceration. Results Rates of opioid toxicity death increased with a linear positive slope in both persons exposed to incarceration and those not exposed over the study period. The start of COVID-19 measures coincided with a marked upward shift in the trend lines with modification of the effect of COVID-19 by both sex and exposure to incarceration. For persons exposed to incarceration, the risk ratio (RR) was 1.50 (95%CI 1.35–1.69) for males and 1.21 (95%CI 1.06–1.42) for females, and for persons not exposed to incarceration, the RR was 1.25 (95%CI 1.13–1.38) for males and not significant for females. Conclusions COVID-19 substantially exacerbated the risk of opioid toxicity death, impacting males and females who experienced incarceration more than those who had not, with an immediate stepwise increase in risk but no change in the rate of increase of risk over time. Public health work, including pandemic preparedness, should consider the specific needs and circumstances of people who experience incarceration.
Læs mere Tjek på PubMedClaire Benny, Ambikaipakan Senthilselvan, Karen A. Patte, Brendan T. Smith, Paul J. Veugelers, Scott T. Leatherdale, Roman Pabayo
PLoS One Infectious Diseases, 24.10.2023
Tilføjet 24.10.2023
by Claire Benny, Ambikaipakan Senthilselvan, Karen A. Patte, Brendan T. Smith, Paul J. Veugelers, Scott T. Leatherdale, Roman Pabayo Introduction Understanding the inequitable impacts of the ongoing COVID-19 pandemic on youth mental health are leading priorities. Existing research has linked income inequality in schools to adolescent depression, however, it is unclear if the onset of the pandemic exacerbated the effects of income inequality on adolescent mental health. The current study aimed to quantify the association between income inequality and adolescent mental health during COVID-19. Material and methods Longitudinal data were taken from three waves (2018/19 to 2020/21) of the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) school-based study. Latent Growth Curve modelling was used to assess the association between Census District (CD)-level income inequality and depressive symptoms before and after the onset of COVID-19. Results The study sample included 29,722 students across 43 Census divisions in British Columbia, Alberta, Ontario, and Quebec. The average age of the sample at baseline was 14.9 years [standard deviation (SD) = 1.5] and ranged between 12 and 19 years of age. Most of the sample self-reported as white (76.3%) and female (54.4%). Students who completed the COMPASS survey after the onset of COVID reported 0.20-unit higher depressive scores (95% CI = 0.16, 0.24) compared to pre-COVID. The adjusted analyses indicated that the association between income inequality on anxiety scores was strengthened following the onset of COVID-19 (β = 0.02, 95% CI = 0.0004, 0.03), indicating that income inequality was associated with a greater increase in anxiety scores during COVID-19. Discussion The adjusted results indicate that the association between income inequality and adolescent anxiety persisted and was heightened at the onset of COVID-19. Future studies should use quasi-experimental methods to strengthen this finding. The current study can inform policy and program discussions regarding the effects of the COVID-19 pandemic and pandemic recovery for young Canadians and relevant social policies for improving adolescent mental health.
Læs mere Tjek på PubMedBMJ Open, 24.10.2023
Tilføjet 24.10.2023
Soomar SM, Soomar SM, Khan M, et al. COVID-19 vaccine acceptance and hesitancy among the general population of Pakistan: a population-based survey. BMJ Open 2022;12:e064096. doi: 10.1136/bmjopen-2022-064096. This article has been retracted by the journal and publisher at the request of the first author. The institution provided an investigational report that found the first author had stolen the data from a separate research group within the same institution, manipulated it and submitted it for publication under his own name with co-authors. The institution found that the co-authors neither engaged in nor were aware of the misconduct in the acquisition of the data.
Læs mere Tjek på PubMedBruno Kluwe-Schiavon, Lucas De Zorzi, Joana Meireles, Jorge Leite, Henrique Sequeira, Sandra Carvalho
PLoS One Infectious Diseases, 23.10.2023
Tilføjet 23.10.2023
by Bruno Kluwe-Schiavon, Lucas De Zorzi, Joana Meireles, Jorge Leite, Henrique Sequeira, Sandra Carvalho
Læs mere Tjek på PubMedSebastian Beyer, Sven Haufe, Dirks Meike, Michèle Scharbau, Viktoria Lampe, Alexandra Dopfer-Jablonka, Uwe Tegtbur, Isabell Pink, Nora Drick, Arno Kerling
PLoS One Infectious Diseases, 23.10.2023
Tilføjet 23.10.2023
by Sebastian Beyer, Sven Haufe, Dirks Meike, Michèle Scharbau, Viktoria Lampe, Alexandra Dopfer-Jablonka, Uwe Tegtbur, Isabell Pink, Nora Drick, Arno Kerling Purpose Post-Covid-19 syndrome is defined as the persistence of symptoms beyond 3 months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The most common symptoms include reduced exercise tolerance and capacity, fatigue, neurocognitive problems, muscle pain and dyspnea. The aim of our work was to investigate exercise capacity and markers of subjective wellbeing and their independent relation to post-COVID-19 syndrome. Patients and methods We examined a total of 69 patients with post-COVID-19 syndrome (23 male/46 female; age 46±12 years; BMI 28.9±6.6 kg/m2) with fatigue and a score ≥22 in the Fatigue Assessment Scale (FAS). We assessed exercise capacity on a cycle ergometer, a 6-minute walk test, the extent of fatigue (FAS), markers of health-related quality of life (SF-36 questionnaire) and mental health (HADS). Results On average the Fatigue Assessment Scale was 35.0±7.4 points. Compared with normative values the VO2max/kg was reduced by 8.6±5.8 ml/min/kg (27.7%), the 6MWT by 71±96 m (11.9%), the health-related quality of life physical component score by 15.0±9.0 points (29.9%) and the mental component score by 10.6±12.8 points (20.6%). Subdivided into mild fatigue (FAS score 22–34) and severe fatigue (FAS score ≥35), patients with severe fatigue showed a significant reduction of the 6-minute walk test by 64±165 m (p
Læs mere Tjek på PubMedMinako Suzuki, Yoshimi Fujii, Yurie Nishimura, Kazuma Yasui, Hidefumi Fujisawa
PLoS One Infectious Diseases, 23.10.2023
Tilføjet 23.10.2023
by Minako Suzuki, Yoshimi Fujii, Yurie Nishimura, Kazuma Yasui, Hidefumi Fujisawa This study aimed to determine the optimal conditions to measure the percentage of the area considered as pneumonia (pneumonia volume ratio [PVR]) and the computed tomography (CT) score due to coronavirus disease 2019 (COVID-19) using the Ziostation2 image analysis software (Z2; Ziosoft, Tokyo, Japan), which is popular in Japan, and to evaluate its usefulness for assessing the clinical severity. We included 53 patients (41 men and 12 women, mean age: 61.3 years) diagnosed with COVID-19 using polymerase chain reaction who had undergone chest CT and were hospitalized between January 2020 and January 2021. Based on the COVID-19 infection severity, the patients were classified as mild (n = 38) or severe (n = 15). For 10 randomly selected samples, the PVR and CT scores by Z2 under different conditions and the visual simple PVR and CT scores were compared. The conditions with the highest statistical agreement were determined. The usefulness of the clinical severity assessment based on the PVR and CT scores using Z2 under the determined conditions was statistically evaluated. The best agreement with the visual measurement was achieved by the Z2 measurement condition of ≥–600 HU. The areas under the receiver operating characteristic curves, Youden’s index, and the sensitivity, specificity, and p-values of the PVR and CT scores by Z2 were as follows: PVR: 0.881, 18.69, 66.7, 94.7, and
Læs mere Tjek på PubMedMichael Bergmann, Melanie Wagner
PLoS One Infectious Diseases, 23.10.2023
Tilføjet 23.10.2023
by Michael Bergmann, Melanie Wagner The COVID-19 pandemic began impacting Europe in early 2020, posing significant challenges for individuals requiring care. This group is particularly susceptible to severe COVID-19 infections and depends on regular health care services. In this article, we examine the situation of European care recipients aged 50 years and older 18 months after the pandemic outbreak and compare it to the initial phase of the pandemic. In the descriptive section, we illustrate the development of (unmet) care needs and access to health care throughout the pandemic. Additionally, we explore regional variations in health care receipt across Europe. In the analytical section, we shed light on the mid- and long-term health consequences of COVID-19-related restrictions on accessing health care services by making comparisons between care recipients and individuals without care needs. We conducted an analysis using data from the representative Corona Surveys of the Survey of Health, Ageing and Retirement in Europe (SHARE). Our study examines changes in approximately 3,400 care-dependent older Europeans (aged 50+) interviewed in 2020 and 2021, comparing them with more than 45,000 respondents not receiving care. The dataset provides a cross-national perspective on care recipients across 27 European countries and Israel. Our findings reveal that in 2021, compared to the previous year, difficulties in obtaining personal care from someone outside the household were significantly reduced in Western and Southern European countries. Access to health care services improved over the course of the pandemic, particularly with respect to medical treatments and appointments that had been canceled by health care institutions. However, even 18 months after the COVID-19 outbreak, a considerable number of treatments had been postponed either by respondents themselves or by health care institutions. These delayed medical treatments had adverse effects on the physical and mental health of both care receivers and individuals who did not rely on care.
Læs mere Tjek på PubMedGiovenco, Danielle; Pettifor, Audrey; Qayiya, Yamkela; Jones, Jeb; Bekker, Linda-Gail
Journal of Acquired Immune Deficiency Syndromes, 23.10.2023
Tilføjet 23.10.2023
ABSTRACT: Background: Young people living with HIV (YPLWH) experience poorer rates of virological suppression compared to adults. Differentiated service delivery models directed to YPLWH are urgently needed. Setting: Participants were recruited from an HIV treatment clinic near Cape Town, South Africa. Methods: We conducted a longitudinal pilot study to examine the acceptability, feasibility, and preliminary effectiveness of a courier ART delivery and SMS support intervention to retain YPLWH (13-24 years) in care during COVID-19. YPLWH had the option to enroll in the courier service and were randomized 1:1 to receive adherence support via a weekly SMS. Modified Poisson regression was used to estimate the preliminary effectiveness of the courier intervention on viral suppression (HIV-1 RNA
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.10.2023
Tilføjet 23.10.2023
Abstract Early case detection is critical to preventing onward transmission of COVID-19 by enabling prompt isolation of index infections, and identification and quarantining of contacts. Timeliness and completeness of ascertainment depend on the surveillance strategy employed. This paper presents modelling used to inform workplace testing strategies for the Australian government in early 2021. We use rapid prototype modelling to quickly investigate the effectiveness of testing strategies to aid decision making. Models are developed with a focus on providing relevant results to policy makers, and these models are continually updated and improved as new questions are posed. Developed to support the implementation of testing strategies in high risk workplace settings in Australia, our modelling explores the effects of test frequency and sensitivity on outbreak detection. We start with an exponential growth model, which demonstrates how outbreak detection changes depending on growth rate, test frequency and sensitivity. From the exponential model, we learn that low sensitivity tests can produce high probabilities of detection when testing occurs frequently. We then develop a more complex Agent Based Model, which was used to test the robustness of the results from the exponential model, and extend it to include intermittent workplace scheduling. These models help our fundamental understanding of disease detectability through routine surveillance in workplaces and evaluate the impact of testing strategies and workplace characteristics on the effectiveness of surveillance. This analysis highlights the risks of particular work patterns while also identifying key testing strategies to best improve outbreak detection in high risk workplaces.
Læs mere Tjek på PubMedCui, H., Chen, H., Gao, W., Shi, S., Li, Y., Li, H., Shen, B.
BMJ Open, 21.10.2023
Tilføjet 21.10.2023
BackgroundThis study investigated the experiences of front-line healthcare workers who had been in close contact with COVID-19 patients and had been quarantined in order to provide guidance on quarantine measures with more humanistic care when dealing with future public health emergencies. MethodsWe conducted a qualitative study using semistructured, qualitative, in-depth interviews between April and June 2022. The interviews were recorded and transcribed, followed by a thematic analysis. The study followed the Standards for Reporting Qualitative Research. ResultsThis study identified the following four themes: (1) personal psychological changes, (2) increased reflection on life and work during quarantine, (3) the important role of others’ support and (4) different types of demands during quarantine and isolation. Each theme is supported by several subthemes that further illustrate the participants’ experiences. ConclusionsQuarantine of close contacts is necessary to prevent outbreaks. Front-line doctors and nurses are at a greater risk of COVID-19 infection than others. The results showed the psychological reactions of ordinary close contacts, and the unique feelings and experiences of doctors and nurses during the epidemic. Therefore, future research should cooperate with multiple departments to assess their needs, provide them with individualised care and love and give them incentives in order to reduce their psychological burden, improve their quality of life and allow them to engage in healthcare with a healthy mind.
Læs mere Tjek på PubMedVan Pelt, A. E., Bilker, W. B., Nkwihorez, H., Ghadimi, F., Brady, K. A., Cidav, Z., Schriger, S. H., Beidas, R. S., Gross, R., Momplaisir, F.
BMJ Open, 21.10.2023
Tilføjet 21.10.2023
IntroductionTo end the HIV epidemic in Philadelphia, implementation of evidence-based practices (EBP) to increase viral suppression and retention in HIV care is critical. Managed problem solving (MAPS), an EBP for antiretroviral therapy adherence, follows a problem-solving approach to empower people living with HIV (PWH) to manage their health. To overcome barriers to care experienced by PWH in Philadelphia, the EBP was adapted to include a focus on care retention and delivery by community health workers (CHWs). The adapted intervention is MAPS+. To maximise the clinical impact and reach of the intervention, evaluation of the effectiveness and implementation of MAPS+ is necessary. Methods and analysisThis manuscript describes the protocol for a stepped-wedge cluster-randomised type 2 hybrid effectiveness-implementation trial in 10 clinics in Philadelphia. This research incorporates innovative approaches to accomplish three objectives: (1) to evaluate the effectiveness of the CHW-led MAPS+ intervention to improve viral suppression and retention in care 1 year after the individual implementation period (N=390 participants), (2) to examine the effect of the menu of implementation strategies on reach and implementation cost and (3) to examine processes, mechanisms, and sustainment of the implementation strategies for MAPS+ (N=56 participants). Due to various factors (eg, COVID-19), protocol modifications have occurred. Ethics and disseminationThe institutional review board (IRB) at the city of Philadelphia serves as the primary IRB; initial approval was granted on 21 December 2020. The University of Pennsylvania and Northwestern University executed reliance agreements. A safety monitoring committee comprised experts in implementation science, biostatistics and infectious diseases oversee this study. This research will offer insights into achieving the goals to end the HIV epidemic in Philadelphia as well as implementation efforts of MAPS+ and other behavioural interventions aimed at increasing medication adherence and retention in care. Dissemination will include deliverables (eg, peer-reviewed manuscripts and lay publications) to reach multiple constituents. Trial registration numberNCT04560621.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.10.2023
Tilføjet 21.10.2023
Abstract Background Nonpharmacological interventions for COVID-19 could reduce the incidence of children hospitalized in pediatric intensive care units (PICU) and the incidence of children with bacterial infections. This study aimed to evaluate changes in the bacterial profile of children in PICU before and during the COVID-19 pandemics. Methods This is a retrospective study, involving clinical data of children with positive bacterial cultures admitted to the PICU respectively in 2019 and 2021. Results In total 652 children were included in this study. The total number of hospitalized patients and the incidence of bacteria-positive children in 2021 were lower than those in 2019. There were no significant differences in the ratio of Gram-positive bacterial infection, Gram-negative bacteria infection or fungi infection between the two years. The rate of Streptococcus pneumoniae in 2021 was higher than that in 2019(p = 0.127). The incidence of Haemophilus influenzae in hospitalized patients decreased with a downward trend(p = 0.002). The distribution of previous underlying diseases in children admitted to PICU with different outcomes of bacterial infection between the two years were homogeneous (p > 0.05). Conclusion After the implementation of COVID-19 isolation, prevention and control measures, the number of hospitalizations and bacterial infections in PICU decreased, which may be due to changes in population’s behavior patterns. Meanwhile, the incidence of Haemophilus influenzae in hospitalized patients decreased with a downward trend.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.10.2023
Tilføjet 21.10.2023
Abstract Background A novel corona virus called SARS-CoV-2 was identified at the end of December 2019, and the illness induced by it was designated as coronavirus disease 2019 (COVID-19). Severity of the disease could vary significantly since most of the infected individuals experience mild to moderate respiratory symptoms and recover without specialized care. Genetic polymorphisms have implications in influencing the varying degrees of COVID-19 severity. This study aims to assess the potential association between the CXCL12 rs2839693 polymorphism and the severity of COVID-19 in Assiut University Quarantine Hospital during the period from May 2022 to August 2022. Methods The present study is a cross-sectional study and is applied to 300 COVID-19 patients confirmed by RT-PCR admitted to Assiut University Quarantine Hospital from May 2022 to August 2022. Based on the clinical symptoms, the recruited participants had been divided into two groups. Group I involved mild or moderate cases; Group II involved severe or critical conditions. The rs2839693 polymorphism was detected by real time PCR using TaqMan assay probe. Results The frequency of the T allele and the TT genotype was significantly higher in the severe or critical group compared with the mild or moderate group (p value
Læs mere Tjek på PubMedRuben D. Zapata, Shu Huang, Earl Morris, Chang Wang, Christopher Harle, Tanja Magoc, Mamoun Mardini, Tyler Loftus, François Modave
PLoS One Infectious Diseases, 21.10.2023
Tilføjet 21.10.2023
by Ruben D. Zapata, Shu Huang, Earl Morris, Chang Wang, Christopher Harle, Tanja Magoc, Mamoun Mardini, Tyler Loftus, François Modave Objective This study aimed to develop and validate predictive models using electronic health records (EHR) data to determine whether hospitalized COVID-19-positive patients would be admitted to alternative medical care or discharged home. Methods We conducted a retrospective cohort study using deidentified data from the University of Florida Health Integrated Data Repository. The study included 1,578 adult patients (≥18 years) who tested positive for COVID-19 while hospitalized, comprising 960 (60.8%) female patients with a mean (SD) age of 51.86 (18.49) years and 618 (39.2%) male patients with a mean (SD) age of 54.35 (18.48) years. Machine learning (ML) model training involved cross-validation to assess their performance in predicting patient disposition. Results We developed and validated six supervised ML-based prediction models (logistic regression, Gaussian Naïve Bayes, k-nearest neighbors, decision trees, random forest, and support vector machine classifier) to predict patient discharge status. The models were evaluated based on the area under the receiver operating characteristic curve (ROC-AUC), precision, accuracy, F1 score, and Brier score. The random forest classifier exhibited the highest performance, achieving an accuracy of 0.84 and an AUC of 0.72. Logistic regression (accuracy: 0.85, AUC: 0.71), k-nearest neighbor (accuracy: 0.84, AUC: 0.63), decision tree (accuracy: 0.84, AUC: 0.61), Gaussian Naïve Bayes (accuracy: 0.84, AUC: 0.66), and support vector machine classifier (accuracy: 0.84, AUC: 0.67) also demonstrated valuable predictive capabilities. Significance This study’s findings are crucial for efficiently allocating healthcare resources during pandemics like COVID-19. By harnessing ML techniques and EHR data, we can create predictive tools to identify patients at greater risk of severe symptoms based on their medical histories. The models developed here serve as a foundation for expanding the toolkit available to healthcare professionals and organizations. Additionally, explainable ML methods, such as Shapley Additive Explanations, aid in uncovering underlying data features that inform healthcare decision-making processes.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 21.10.2023
Tilføjet 21.10.2023
AbstractTuberculosis (TB) is the second leading infectious killer after COVID-19. Standard anti-tubercular drugs exhibit various limitations like toxicity, lengthy, and unresponsive to dormant and drug resistant organisms. Here, we report that all-trans-retinoic acid (ATRA) improves M.tb clearance in mice while treating with anti-tubercular drug isoniazid (INH). Interestingly, ATRA promoted activities of lysosomes, mitochondria, and production of various inflammatory mediators in macrophages. Furthermore, ATRA upregulated the expression of genes of lipid metabolic pathways in macrophages. Along this line, we registered that ATRA activated MEK/ERK pathway in macrophages in-vitro and MEK/ERK and p38 MAPK pathways in the mice. Finally, ATRA induced both Th1 and Th17 responses in lungs and spleens of M.tb-infected mice. Taken together, these data indicated that ATRA provides beneficial adjunct therapeutic value by modulating MEK/ERK and p38 MAPK pathways and thus warrants further testing for human use.
Læs mere Tjek på PubMedDe Luo, Bingjie Mei, Piao Wang, Xujia Li, Xinpei Chen, Gang Wei, Fei Kuang, Bo Li, Song Su
Clinical Microbiology and Infection, 20.10.2023
Tilføjet 20.10.2023
Long-term physical and mental persistent symptoms following COVID-19 represent a growing global public health concern. However, there remains a substantial knowledge gap regarding their prevalence and risk factors.
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.10.2023
Tilføjet 20.10.2023
Abstract Background Nonpharmacological interventions for COVID-19 could reduce the incidence of children hospitalized in pediatric intensive care units (PICU) and the incidence of children with bacterial infections. This study aimed to evaluate changes in the bacterial profile of children in PICU before and during the COVID-19 pandemics. Methods This is a retrospective study, involving clinical data of children with positive bacterial cultures admitted to the PICU respectively in 2019 and 2021. Results In total 652 children were included in this study. The total number of hospitalized patients and the incidence of bacteria-positive children in 2021 were lower than those in 2019. There were no significant differences in the ratio of Gram-positive bacterial infection, Gram-negative bacteria infection or fungi infection between the two years. The rate of Streptococcus pneumoniae in 2021 was higher than that in 2019(p = 0.127). The incidence of Haemophilus influenzae in hospitalized patients decreased with a downward trend(p = 0.002). The distribution of previous underlying diseases in children admitted to PICU with different outcomes of bacterial infection between the two years were homogeneous (p > 0.05). Conclusion After the implementation of COVID-19 isolation, prevention and control measures, the number of hospitalizations and bacterial infections in PICU decreased, which may be due to changes in population’s behavior patterns. Meanwhile, the incidence of Haemophilus influenzae in hospitalized patients decreased with a downward trend.
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.10.2023
Tilføjet 20.10.2023
Abstract Background A novel corona virus called SARS-CoV-2 was identified at the end of December 2019, and the illness induced by it was designated as coronavirus disease 2019 (COVID-19). Severity of the disease could vary significantly since most of the infected individuals experience mild to moderate respiratory symptoms and recover without specialized care. Genetic polymorphisms have implications in influencing the varying degrees of COVID-19 severity. This study aims to assess the potential association between the CXCL12 rs2839693 polymorphism and the severity of COVID-19 in Assiut University Quarantine Hospital during the period from May 2022 to August 2022. Methods The present study is a cross-sectional study and is applied to 300 COVID-19 patients confirmed by RT-PCR admitted to Assiut University Quarantine Hospital from May 2022 to August 2022. Based on the clinical symptoms, the recruited participants had been divided into two groups. Group I involved mild or moderate cases; Group II involved severe or critical conditions. The rs2839693 polymorphism was detected by real time PCR using TaqMan assay probe. Results The frequency of the T allele and the TT genotype was significantly higher in the severe or critical group compared with the mild or moderate group (p value
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.10.2023
Tilføjet 20.10.2023
Abstract Introduction The SARS-CoV-2 Omicron variant has decreased virulence and pathogenicity, yet the number of Omicron infections worldwide is unprecedentedly high, with rather high mortality and severe disease rate. Chronic kidney disease (CKD) patients are particularly vulnerable to the SARS-CoV-2 Omicron variant and have unique clinical outcomes. Methods We retrospectively collected data from 2140 hospitalized patients with SARS-CoV-2 Omicron variant infection from March 29, 2022, to May 17, 2022. Demographic characteristics, ancillary examination results, and clinical treatments were described. Occurrence of critical COVID-19 or death and time of positive-to-negative conversion was defined as primary outcomes. The presence of COVID-19 pneumonia and the usage of respiratory or circulatory support was defined as secondary outcomes. Univariate or multivariate logistic regression analyses were performed to identify risk factors for primary outcomes. Results 15.74% of CKD patients infected with the SARS-CoV-2 Omicron variant ended up with critical COVID-19 or death. Pre-existing CKD was a risk factor for critical COVID-19 or death and prolonged time of positive-to-negative conversion of SARS-CoV-2. Nirmatrelvir-ritonavir facilitated viral clearance among COVID-19 patients with non-severe CKD. Conclusion We found patients with CKD and COVID-19 due to Omicron experienced worse clinical outcomes and prolonged time of positive-to-negative conversion of SARS-CoV-2 compared to patients without CKD, which helps rationalize limited medical resources and offers guidance for appropriate clinical treatments.
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.10.2023
Tilføjet 20.10.2023
Abstract Background Pneumocystis jirovecii pneumonia (PCP) and SARS-CoV2 share some similarities in their effects on the respiratory system, clinical presentation, and management. The COVID-19 pandemic required rapid action to curb transmission and mitigate its lethiferous impact. Non-pharmaceutical interventions (NPIs) were globally adopted. We hypothesized that these measures reduced the transmission and acquisition of P. jirovecii in both hospital and community settings. Methods We conducted a retrospective observational study on 2950 respiratory specimens from patients with suspected pulmonary infection, analyzed at the Laboratory of Parasitology Unit of the Policlinico Tor Vergata of Rome, Italy, from January 2014 to December 2022. Results We show a significant reduction in the frequency of PCP in the COVID-19 pandemic era compared to the previous period. Among the four sequence types of P. jirovecii identified, genotype 1 was the most prevalent (37%). We observed a non-significant trend of decreasing cases with genotype 1 and increasing cases with genotype 3 over the study period. Conclusions The nationwide implementation of NPIs against COVID-19 may have changed the microbiological landscape of exposure, thereby decreasing the exposure to P. jirovecii and consequently reducing the incidence of PCP.
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.10.2023
Tilføjet 20.10.2023
Abstract Objective Hepatitis C presents a profound global health challenge. The impact of COVID-19 on hepatitis C, however, remain uncertain. This study aimed to ascertain the influence of COVID-19 on the hepatitis C epidemic trend in Henan Province. Methods We collated the number of monthly diagnosed cases in Henan Province from January 2013 to September 2022. Upon detailing the overarching epidemiological characteristics, the interrupted time series (ITS) analysis using autoregressive integrated moving average (ARIMA) models was employed to estimate the hepatitis C diagnosis rate pre and post the COVID-19 emergence. In addition, we also discussed the model selection process, test model fitting, and result interpretation. Results Between January 2013 and September 2022, a total of 267,968 hepatitis C cases were diagnosed. The yearly average diagnosis rate stood at 2.42/100,000 persons. While 2013 witnessed the peak diagnosis rate at 2.97/100,000 persons, 2020 reported the least at 1.7/100,000 persons. The monthly mean hepatitis C diagnosed numbers culminated in 2291 cases. The optimal ARIMA model chosen was ARIMA (0,1,1) (0,1,1)12 with AIC = 1459.58, AICc = 1460.19, and BIC = 1472.8; having coefficients MA1=-0.62 (t=-8.06, P
Læs mere Tjek på PubMedClay, Carson E.; Hoover, Karen W.; Le Guen, Yann; Bennett, Christopher L.
AIDS, 20.10.2023
Tilføjet 20.10.2023
Objectives: Emergency department (ED)-based HIV testing rates are historically low, but recent testing trends surrounding the COVID-19 pandemic and launch of the Ending the HIV Epidemic (EHE) initiative are unknown. The objective of the study is to estimate recent trends in the proportion of ED visits that included HIV testing. Methods: We performed a cross-sectional analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS), a weighted nationally representative survey of US EDs, from 2014 to 2020. Given EHE\'s focus on several rural Southern jurisdictions as well as populations disproportionately affected by HIV, we stratified by characteristics including US region and visit-listed race and ethnicity. Results: The proportion of ED visits that included HIV testing increased from 2014 (0.6%) to 2018 (1.1%) but was lower in 2019 and 2020 (0.8%). Compared to other regions the South had the lowest rates of testing in both 2019 (0.6%) and 2020 (0.5%); testing rates in the non-metropolitan South remained ≤0.1% across all years. Testing rates for ED visits by persons who identified as Hispanic/Latino were highest in 2018 (2.2%) but were sharply lower in 2019 and 2020 (0.8%). Conclusion: After a small but insufficient increase in ED-based HIV testing since 2014, rates decreased between 2018 and 2019 and were stable between 2019 and 2020. Overall, very few ED visits during our entire study period included an HIV test and there were persistently low rates of HIV testing for populations prioritized in national efforts and during visits in rural jurisdictions in the South. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedJanssen, Matthijs L.; Türk, Yasemin; Baart, Sara J.; Hanselaar, Wessel; Aga, Yaar; van der Steen Dieperink, Mariëlle; van der Wal, Floris J.; Versluijs, Vera J.; Hoek, Rogier A.S.; Endeman, Henrik; Boer, Dirk P.; Hoiting, Oscar; Hoelters, Jürgen; Achterberg, Sefanja; Stads, Susanne; Heller-Baan, Roxane; Dubois, Alain V.F.; Elderman, Jan H.; Wils, Evert-Jan; on behalf of the Dutch HFNO COVID-19 study group
Critical Care Medicine, 20.10.2023
Tilføjet 20.10.2023
OBJECTIVE: High-flow nasal oxygen (HFNO) therapy is frequently applied outside ICU setting in hypoxemic patients with COVID-19. However, safety concerns limit more widespread use. We aimed to assess the safety and clinical outcomes of initiation of HFNO therapy in COVID-19 on non-ICU wards. DESIGN: Prospective observational multicenter pragmatic study. SETTING: Respiratory wards and ICUs of 10 hospitals in the Netherlands. PATIENTS: Adult patients treated with HFNO for COVID-19-associated hypoxemia between December 2020 and July 2021 were included. Patients with treatment limitations were excluded from this analysis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Outcomes included intubation and mortality rate, duration of hospital and ICU stay, severity of respiratory failure, and complications. Using propensity-matched analysis, we compared patients who initiated HFNO on the wards versus those in ICU. Six hundred eight patients were included, of whom 379 started HFNO on the ward and 229 in the ICU. The intubation rate in the matched cohort (n = 214 patients) was 53% and 60% in ward and ICU starters, respectively (p = 0.41). Mortality rates were comparable between groups (28-d [8% vs 13%], p = 0.28). ICU-free days were significantly higher in ward starters (21 vs 17 d, p < 0.001). No patient died before endotracheal intubation, and the severity of respiratory failure surrounding invasive ventilation and clinical outcomes did not differ between intubated ward and ICU starters (respiratory rate-oxygenation index 3.20 vs 3.38; Pao2:Fio2 ratio 65 vs 64 mm Hg; prone positioning after intubation 81 vs 78%; mortality rate 17 vs 25% and ventilator-free days at 28 d 15 vs 13 d, all p values > 0.05). CONCLUSIONS: In this large cohort of hypoxemic patients with COVID-19, initiation of HFNO outside the ICU was safe, and clinical outcomes were similar to initiation in the ICU. Furthermore, the initiation of HFNO on wards saved time in ICU without excess mortality or complicated course. Our results indicate that HFNO initiation outside ICU should be further explored in other hypoxemic diseases and clinical settings aiming to preserve ICU capacity and healthcare costs.
Læs mere Tjek på PubMedBusico, Marina; Fuentes, Nora A.; Gallardo, Adrián; Vitali, Alejandra; Quintana, Jorgelina; Olmos, Matias; Burns, Karen E.A.; Esperatti, Mariano; Argentine Collaborative Group on High Flow and Prone Positioning
Critical Care Medicine, 20.10.2023
Tilføjet 20.10.2023
Objectives: The Berlin definition of acute respiratory distress syndrome (ARDS) was constructed for patients receiving invasive mechanical ventilation (IMV) with consideration given to issues related to reliability, feasibility, and validity. Notwithstanding, patients with acute respiratory failure (ARF) may be treated with high-flow nasal oxygen (HFNO) and may not fall within the scope of the original definition. We aimed to evaluate the predictive validity of the Berlin definition in HFNO-treated patients with COVID-19-related respiratory failure who otherwise met ARDS criteria. Design: Multicenter, prospective cohort study. Setting: Five ICUs of five centers in Argentina from March 2020 to September 2021. Patients: We consecutively included HFNO-treated patients older than 18 years with confirmed COVID-19-related ARF, a Pao2/Fio2 of less than 300 mm Hg, bilateral infiltrates on imaging, and worsening respiratory symptoms for less than 1 week. Interventions: None. Measurements and Main Results: We evaluated the predictive validity of mortality at day 28 using the area under the receiver operating characteristics curve (AUC), compared the predictive validity across subgroups, and characterized relevant clinical outcomes. We screened 1,231 patients and included 696 ARDS patients [30 (4%) mild, 380 (55%) moderate, and 286 (41%) severe]. For the study cohort, the AUC for mortality at day 28 was 0.606 (95% CI, 0.561–0.651) with the AUC for subgroups being similar to that of the overall cohort. Two hundred fifty-six patients (37%) received IMV. By day 28, 142 patients (21%) had died, of whom 81 (57%) had severe ARDS. Mortality occurred primarily in patients who were transitioned to IMV. Conclusions: The predictive validity of the Berlin ARDS definition was similar for HFNO-treated patients as compared with the original population of invasively ventilated patients. Our findings support the extension of the Berlin definition to HFNO-treated patients with ARDS.
Læs mere Tjek på PubMedMichael Reid, Yvan Jean Patrick Agbassi, Nimalan Arinaminpathy, Alyssa Bercasio, Anurag Bhargava, Madhavi Bhargava, Amy Bloom, Adithya Cattamanchi, Richard Chaisson, Daniel Chin, Gavin Churchyard, Helen Cox, Claudia M Denkinger, Lucica Ditiu, David Dowdy, Mark Dybul, Anthony Fauci, Endalkachew Fedaku, Mustapha Gidado, Mark Harrington, Janika Hauser, Petra Heitkamp, Nick Herbert, Ani Herna Sari, Philip Hopewell, Emily Kendall, Aamir Khan, Andrew Kim, Irene Koek, Sergiy Kondratyuk, Nalini Krishnan, Chu-Chang Ku, Erica Lessem, Erin V McConnell, Payam Nahid, Matt Oliver, Madhukar Pai, Mario Raviglione, Theresa Ryckman, Marco Schäferhoff, Sachin Silva, Peter Small, Guy Stallworthy, Zelalem Temesgen, Kitty van Weezenbeek, Anna Vassall, Gustavo E Velásquez, Nandita Venkatesan, Gavin Yamey, Armand Zimmerman, Dean Jamison, Soumya Swaminathan, Eric Goosby
Lancet, 20.10.2023
Tilføjet 20.10.2023
The 2019 Lancet Commission on Tuberculosis laid out an optimistic vision for how to build a tuberculosis-free world through smart investments based on sound science and shared responsibility.1 Since then, several major strides have been made towards ending tuberculosis, including substantive improvements in treatment outcomes for people with drug-resistant disease.2,3 Although COVID-19 has undermined global progress, many African countries have sustained declines in tuberculosis mortality rates.
Læs mere Tjek på PubMedValerie Leung, Suzanne Gill, Andrea Llanes, Armughan Khawaja, Amanda Stagg, Janine McCready, Mariana Jacubovich, Grace Ho, Jeff Powis, Christopher Kandel
PLoS One Infectious Diseases, 20.10.2023
Tilføjet 20.10.2023
by Valerie Leung, Suzanne Gill, Andrea Llanes, Armughan Khawaja, Amanda Stagg, Janine McCready, Mariana Jacubovich, Grace Ho, Jeff Powis, Christopher Kandel Background Large observational studies have demonstrated the real-world effectiveness of nirmatrelvir–ritonavir in preventing severe COVID-19 in higher risk individuals, but have provided limited information on other aspects of nirmatrelvir-ritonavir use. Our objective was to evaluate prescribing outcomes such as the prevalence of drug-drug interactions (DDI), adverse drug events (ADE) and treatment adherence in an outpatient community clinic setting. Methods We conducted a single-centre retrospective cohort study of adult outpatients prescribed nirmatrelvir–ritonavir in our community COVID-19 assessment clinic in Toronto, Ontario between March 3 and September 20, 2022. We performed a descriptive analysis of the patient population, DDIs, DDI interventions, treatment adherence, ADEs and clinical outcomes of patients prescribed nirmatrelvir–ritonavir. Results There were 637 individuals prescribed nirmatrelvir–ritonavir during the study period. The median age was 70, the median number of risk factors for severe disease were 2, 45% were immunocompromised and 82% had received 3 or more COVID-19 vaccine doses. 95% (542/572) completed the 5-day course of therapy with 68% (388/572) having complete symptom resolution by 28-day. Eleven percent (60/572) experienced recurrent symptoms following the completion of nirmatrelvir–ritonavir. Over 70% had one or more clinically significant DDIs requiring mitigation and 62% of patients experienced at least one ADE, which was most commonly dysgeusia or gastrointestinal-related. Ninety-five percent (542/572) of patients completed therapy as prescribed. Overall, hospitalization within 28 days was 3.3% with 1.2% attributed to COVID-19 and there were no deaths. Interpretation Nirmatrelvir–ritonavir was associated with a high prevalence of clinically significant DDIs, which required mitigation strategies and a high frequency of mild ADEs. Collaborative assessment to address medication alterations resulted in high treatment adherence.
Læs mere Tjek på PubMedJonathan W. Kunstman, Tade Ogungbadero, Jason C. Deska, Michael J. Bernstein, April R. Smith, Kurt Hugenberg
PLoS One Infectious Diseases, 20.10.2023
Tilføjet 20.10.2023
by Jonathan W. Kunstman, Tade Ogungbadero, Jason C. Deska, Michael J. Bernstein, April R. Smith, Kurt Hugenberg Racism creates and sustains mental health disparities between Black and White Americans and the COVID-19 pandemic and ongoing harassment directed at Black Americans has exacerbated these inequities. Yet, as the mental health needs of Black Americans rise, there is reason to believe the public paradoxically believes that psychopathology hurts Black individuals less than White individuals and these biased distress judgments affect beliefs about treatment needs. Four studies (two pre-registered) with participants from the American public and the field of mental health support this hypothesis. When presented with identical mental illnesses (e.g., depression, anxiety, schizophrenia), both laypeople and clinicians believed that psychopathology would be less distressing to Black relative to White individuals. These distress biases mediate downstream treatment judgments. Across numerous contexts, racially-biased judgments of psychological distress may negatively affect mental healthcare and social support for Black Americans.
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