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BMC Infectious Diseases, 25.07.2024
Tilføjet 25.07.2024
Abstract Background The global impact of the coronavirus disease 2019 (COVID-19) pandemic has resulted in significant morbidity and mortality. Immunocompromised patients, particularly those treated for B-cell lymphoma, have shown an increased risk of persistent infection with SARS-CoV-2 and severe outcomes and mortality. Multi-mutational SARS-CoV-2 variants can arise during the course of such persistent cases of COVID-19. No optimal, decisive strategy is currently available for patients with persistent infection that allows clinicians to sustain viral clearance, determine optimal timing to stop treatment, and prevent virus reactivation. We introduced a novel treatment combining antivirals, neutralizing antibodies, and genomic analysis with frequent monitoring of spike-specific antibody and viral load for immunocompromised patients with persistent COVID-19 infection. The aim of this retrospective study was to report and evaluate the efficacy of our novel treatment for immunocompromised B-cell lymphoma patients with persistent COVID-19 infection. Methods This retrospective descriptive analysis had no controls. Patients with B-cell lymphoma previously receiving immunotherapy including anti-CD20 antibodies, diagnosed as having COVID-19 infection, and treated in our hospital after January 2022 were included. We selected anti-SARS-CoV-2 monoclonal antibodies according to subvariants. Every 5 days, viral load was tested by RT-PCR, with antivirals continued until viral shedding was confirmed. Primary outcome was virus elimination. Independent predictors of prolonged viral shedding time were determined by multivariate Cox regression. Results Forty-four patients were included in this study. Thirty-five patients received rituximab, 19 obinutuzumab, and 26 bendamustine. Median treatment duration was 10 (IQR, 10–20) days; 22 patients received combination antiviral therapy. COVID-19 was severe in 16 patients, and critical in 2. All patients survived, with viral shedding confirmed at median 28 (IQR, 19–38) days. Bendamustine use or within 1 year of last treatment for B-cell lymphoma, and multiple treatment lines for B-cell lymphoma significantly prolonged time to viral shedding. Conclusions Among 44 consecutive patients treated, anti-SARS-CoV-2 monoclonal antibodies and long-term administration of antiviral drugs, switching, and combination therapy resulted in virus elimination and 100% survival. Bendamustine use, within 1 year of last treatment for B-cell lymphoma, and multiple treatment lines for B-cell lymphoma were the significant independent predictors of prolonged viral shedding time.
Læs mere Tjek på PubMedMukherjee, Vikramjit; Postelnicu, Radu; Parker, Chelsie; Rivers, Patrick S.; Anesi, George L.; Andrews, Adair; Ables, Erin; Morrell, Eric D.; Brett-Major, David M.; Broadhurst, M. Jana; Cobb, J. Perren; Irwin, Amy; Kratochvil, Christopher J.; Krolikowski, Kelsey; Kumar, Vishakha K.; Landsittel, Douglas P.; Lee, Richard A.; Liebler, Janice M.; Segal, Leopoldo N.; Sevransky, Jonathan E.; Srivastava, Avantika; Uyeki, Timothy M.; Wurfel, Mark M.; Wyles, David; Evans, Laura E.; Lutrick, Karen; Bhatraju, Pavan K.; on behalf of the Severe Acute Respiratory Infection-Preparedness (SARI-PREP) Study Group
Critical Care Explorations, 25.07.2024
Tilføjet 25.07.2024
IMPORTANCE: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has evolved through multiple phases in the United States, with significant differences in patient centered outcomes with improvements in hospital strain, medical countermeasures, and overall understanding of the disease. We describe how patient characteristics changed and care progressed over the various pandemic phases; we also emphasize the need for an ongoing clinical network to improve the understanding of known and novel respiratory viral diseases. OBJECTIVES: To describe how patient characteristics and care evolved across the various COVID-19 pandemic periods in those hospitalized with viral severe acute respiratory infection (SARI). DESIGN: Severe Acute Respiratory Infection-Preparedness (SARI-PREP) is a Centers for Disease Control and Prevention Foundation-funded, Society of Critical Care Medicine Discovery-housed, longitudinal multicenter cohort study of viral pneumonia. We defined SARI patients as those hospitalized with laboratory-confirmed respiratory viral infection and an acute syndrome of fever, cough, and radiographic infiltrates or hypoxemia. We collected patient-level data including demographic characteristics, comorbidities, acute physiologic measures, serum and respiratory specimens, therapeutics, and outcomes. Outcomes were described across four pandemic variant periods based on a SARS-CoV-2 sequenced subsample: pre-Delta, Delta, Omicron BA.1, and Omicron post-BA.1. SETTING: Multicenter cohort of adult patients admitted to an acute care ward or ICU from seven hospitals representing diverse geographic regions across the United States. PARTICIPANTS: Patients with SARI caused by infection with respiratory viruses. MAIN OUTCOMES AND RESULTS: Eight hundred seventy-four adult patients with SARI were enrolled at seven study hospitals between March 2020 and April 2023. Most patients (780, 89%) had SARS-CoV-2 infection. Across the COVID-19 cohort, median age was 60 years (interquartile range, 48.0–71.0 yr) and 66% were male. Almost half (430, 49%) of the study population belonged to underserved communities. Most patients (76.5%) were admitted to the ICU, 52.5% received mechanical ventilation, and observed hospital mortality was 25.5%. As the pandemic progressed, we observed decreases in ICU utilization (94% to 58%), hospital length of stay (median, 26.0 to 8.5 d), and hospital mortality (32% to 12%), while the number of comorbid conditions increased. CONCLUSIONS AND RELEVANCE: We describe increasing comorbidities but improved outcomes across pandemic variant periods, in the setting of multiple factors, including evolving care delivery, countermeasures, and viral variants. An understanding of patient-level factors may inform treatment options for subsequent variants and future novel pathogens.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.07.2024
Tilføjet 23.07.2024
Abstract Background The global impact of the coronavirus disease 2019 (COVID-19) pandemic has resulted in significant morbidity and mortality. Immunocompromised patients, particularly those treated for B-cell lymphoma, have shown an increased risk of persistent infection with SARS-CoV-2 and severe outcomes and mortality. Multi-mutational SARS-CoV-2 variants can arise during the course of such persistent cases of COVID-19. No optimal, decisive strategy is currently available for patients with persistent infection that allows clinicians to sustain viral clearance, determine optimal timing to stop treatment, and prevent virus reactivation. We introduced a novel treatment combining antivirals, neutralizing antibodies, and genomic analysis with frequent monitoring of spike-specific antibody and viral load for immunocompromised patients with persistent COVID-19 infection. The aim of this retrospective study was to report and evaluate the efficacy of our novel treatment for immunocompromised B-cell lymphoma patients with persistent COVID-19 infection. Methods This retrospective descriptive analysis had no controls. Patients with B-cell lymphoma previously receiving immunotherapy including anti-CD20 antibodies, diagnosed as having COVID-19 infection, and treated in our hospital after January 2022 were included. We selected anti-SARS-CoV-2 monoclonal antibodies according to subvariants. Every 5 days, viral load was tested by RT-PCR, with antivirals continued until viral shedding was confirmed. Primary outcome was virus elimination. Independent predictors of prolonged viral shedding time were determined by multivariate Cox regression. Results Forty-four patients were included in this study. Thirty-five patients received rituximab, 19 obinutuzumab, and 26 bendamustine. Median treatment duration was 10 (IQR, 10–20) days; 22 patients received combination antiviral therapy. COVID-19 was severe in 16 patients, and critical in 2. All patients survived, with viral shedding confirmed at median 28 (IQR, 19–38) days. Bendamustine use or within 1 year of last treatment for B-cell lymphoma, and multiple treatment lines for B-cell lymphoma significantly prolonged time to viral shedding. Conclusions Among 44 consecutive patients treated, anti-SARS-CoV-2 monoclonal antibodies and long-term administration of antiviral drugs, switching, and combination therapy resulted in virus elimination and 100% survival. Bendamustine use, within 1 year of last treatment for B-cell lymphoma, and multiple treatment lines for B-cell lymphoma were the significant independent predictors of prolonged viral shedding time.
Læs mere Tjek på PubMedBurcu Ünlütabak, Graciela Trujillo Hernandez, İlayda Velioğlu, David Menendez, Karl S. Rosengren
PLoS One Infectious Diseases, 22.07.2024
Tilføjet 22.07.2024
by Burcu Ünlütabak, Graciela Trujillo Hernandez, İlayda Velioğlu, David Menendez, Karl S. Rosengren Question-asking is a crucial tool for acquiring information about unseen entities, such as viruses; thus, examining children’s questions within the context of COVID-19 is particularly important for understanding children’s learning about the coronavirus. The study examined 3-12-year-old children’s questions and teachers’ responses about the COVID-19 pandemic in Türkiye, a non-Western developing context, and the United States, a Western cultural context. A total of 119 teachers from Türkiye and 95 teachers from the US participated in the study. Teachers completed an online survey consisting of a demographic form and a questionnaire asking them to report three questions about COVID-19 asked by children in their classrooms and their responses to these questions. We analyzed children’s questions and teachers’ responses for their type and content and examined demographic factors associated with children’s questions and teachers’ responses. Consistent with the literature, children from Türkiye asked fewer explanation-seeking (i.e., why/how) questions than children from the United States. Children asked questions about viruses and precautions. Teachers responded to children’s questions realistically in both countries. The findings have important implications for how children gain knowledge from teachers when discussing health, disease, and virus topics in two countries.
Læs mere Tjek på PubMedLaetitia Gay, Sandra Madariaga Zarza, Perla Abou Atmeh, Marie‐Sarah Rouvière, Jonatane Andrieu, Manon Richaud, Asma Boumaza, Laura Miquel, Aïssatou Bailo Diallo, Yassina Bechah, Myriem Otmani Idrissi, Bernard La Scola, Daniel Olive, Noémie Resseguier, Florence Bretelle, Soraya Mezouar, Jean‐Louis Mege
Journal of Medical Virology, 21.07.2024
Tilføjet 21.07.2024
Clinical & Experimental Immunology, 20.07.2024
Tilføjet 20.07.2024
Summary Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces pneumonia and acute respiratory failure in Coronavirus Disease 2019 (COVID-19) patients with inborn errors of immunity to type I interferon (IFN-I). The impact of SARS-CoV-2 infection varies widely, ranging from mild respiratory symptoms to life-threatening illness and organ failure, with a higher incidence in men than in women. Approximately 3 to 5% of critical COVID-19 patients under 60 and a smaller percentage of elderly patients exhibit genetic defects in IFN-I production, including X-chromosome-linked TLR7 and autosomal TLR3 deficiencies. Around 15 to 20% of cases over 70 years old, and a smaller percentage of younger patients, present with preexisting autoantibodies neutralizing type I interferons. Additionally, innate errors affecting the control of the response to type I interferon have been associated with pediatric multisystem inflammatory syndrome (MIS-C). Several studies have described rare errors of immunity, such as XIAP deficiency, CYBB, SOCS1, OAS1/2, and RNASEL, as underlying factors in MIS-C susceptibility. However, further investigations in expanded patient cohorts are needed to validate these findings and pave the way for new genetic approaches to MIS-C. This review aims to present recent evidence from the scientific literature on genetic and immunological abnormalities predisposing individuals to critical SARS-CoV-2 infection through IFN-I. We will also discuss multisystem inflammatory syndrome in children (MIS-C). Understanding the immunological mechanisms and pathogenesis of severe COVID-19 may inform personalized patient care and population protection strategies against future serious viral infections.
Læs mere Tjek på PubMedMahsa Karimi, Mohammad Reza Khami, Shabnam Varmazyari, Ahmad Reza Shamshiri, Mahmoud Hormozi, Nourhan M. Aly, Morẹ́nikẹ́ Oluwátóyìn Foláyan
PLoS One Infectious Diseases, 20.07.2024
Tilføjet 20.07.2024
by Mahsa Karimi, Mohammad Reza Khami, Shabnam Varmazyari, Ahmad Reza Shamshiri, Mahmoud Hormozi, Nourhan M. Aly, Morẹ́nikẹ́ Oluwátóyìn Foláyan Background The Coronavirus disease 2019 pandemic increased global psychological distress, emotional distress, and sleep disturbances, all known risk factors for compromised oral health. Despite this, there is limited understanding of the impacts of these psychological factors on oral health in certain populations, including Iranians. Thus, the present study investigates the associations between sociodemographic characteristics, emotional distress, sleep pattern changes, tooth brushing frequency, and oral ulcer reports in a sample of Iranian adults during the Coronavirus disease 2019 pandemic. Materials and methods This cross-sectional, web-based study collected data from Iranian adults between July and September 2022 using respondent-driven sampling. The Mental Health and Wellness questionnaire was used to gather information on sociodemographic characteristics, emotional distress, sleep pattern changes, toothbrushing frequency, and oral ulcer reports. Simple and multiple logistic regression served for statistical analysis. Results Among the 240 participants, comprising 164 females and 76 males, with a mean age of 35.3 years (±13.3), 28 individuals (11.7%) reported reduced tooth brushing frequency, and 35 individuals (14.6%) reported oral ulcers. Male gender (OR = 2.75, p = 0.016) and sleep patterns changes (OR = 2.93, p = 0.01) increased the likelihood of reduced tooth brushing frequency. Additionally, being younger than 30 (OR = 2.87, p = 0.025) and fearing coronavirus transmission (OR = 3.42, p = 0.009) increased the odds of oral ulcers. Conclusions Male gender and sleep pattern changes were risk factors for reduced tooth brushing frequency among the present sample of Iranian adults during the Coronavirus disease 2019 pandemic. Additionally, being under 30 and fearing coronavirus transmission were identified as risk factors for oral ulcers in this population. To preserve and promote adults’ oral health during public health crises, targeted educational initiatives, public health awareness campaigns, and integrated mental and oral healthcare approaches are encouraged.
Læs mere Tjek på PubMedKasim Abdulai, Abdul Rauf Alhassan, Safianu Osman Aleboko, Mohammed Doobia Ahmed, Awal Seidu Mohammed, Odei-Asare Fremah Adom, Rhoda Kumah
PLoS One Infectious Diseases, 20.07.2024
Tilføjet 20.07.2024
by Kasim Abdulai, Abdul Rauf Alhassan, Safianu Osman Aleboko, Mohammed Doobia Ahmed, Awal Seidu Mohammed, Odei-Asare Fremah Adom, Rhoda Kumah Background The coronavirus Disease 2019 (COVID-19) pandemic has brought about unique challenges in healthcare and nutrition, particularly for people living with HIV (PLHIV). Understanding their dietary patterns and nutritional status is crucial for developing targeted interventions and improving health outcomes. Therefore, this study assessed the dietary diversity and nutritional status of PLHIV during the COVID-19 era. Methods We adopted a facility-based cross-sectional study design to enroll 220 PLHIV from two hospitals in the Central Region of Ghana. Dietary intakes were assessed using 24-hour recall. Anthropometric and body composition data were collected with a stadiometer and a body composition monitor. Dietary diversity was evaluated using the FAO’s Individual Dietary Diversity Score (IDDS). Data analysis was conducted with SPSS version 20. Significance level was set p-value less than 0.05. Results A significant proportion (33.2%) of PLHIV had low dietary diversity, with the majority (55.5%) categorized as needing dietary improvement. Approximately 2 out of every 10 of the participants were identified as underweight. Participants aged 40 to 59 years were more likely to exhibit higher dietary diversity (adjusted odds ratio (AOR) = 1.966, 95% Confidence Interval (CI): 1.045–4.987). Participants who consumed meals at least three times daily were more likely to have a high IDDS (AOR = 1.641, 95% CI: 1.221, 8.879). Employed participants (public sector and private sector) were also more likely to have a high IDDS compared to unemployed participants (AOR = 1.448, 95% CI: 1.028–3.042; AOR = 1.165, 95% CI: 1.030–9.329, respectively). Factors associated with undernutrition included being female (AOR = 1.829, 95% CI: 1.294, 3.872) and first-line antiretroviral therapy ART (AOR = 1.683, 95% CI: 1.282–2.424). Conclusion The study emphasizes the need for nutritional interventions for PLHIV, particularly during crises. It advocates for a policy collaboration to address food insecurity and promote resilient health outcomes.
Læs mere Tjek på PubMedBMC Infectious Diseases, 19.07.2024
Tilføjet 19.07.2024
Abstract Objective To assess the evolution of the COVID-19 pandemic in Brazil and its macro-regions, considering disease incidence and mortality rates, as well as identifying territories with still rising disease indices and evaluating vaccine coverage and population adherence to COVID-19 immunization. Methods An ecological study conducted in Brazil with COVID-19 cases and deaths reported between February 2020 and April 2024, obtained through the Coronavirus Panel. Historical series were constructed from incidence and mortality rates to assess the pandemic’s evolution, and temporal trends were estimated using the Seasonal Trend Decomposition using Loess (STL) method. The Spatial Variation in Temporal Trends (SVTT) technique was employed to identify clusters with significant variations in temporal trends. Vaccination was analyzed considering the percentage of vaccinated and unvaccinated population in each municipality of the country. Results Brazil recorded a total of 38,795,966 cases and 712,038 deaths from COVID-19 during the study period. Incidence and mortality rates showed three waves of the disease, with a fourth wave of smaller amplitude. Four clusters with significant case growth and two with increased deaths were identified. Vaccine coverage varied among municipalities, with some regions showing low vaccination rates and others with high immunization adherence. Conclusion The study provided a comprehensive overview of coronavirus behavior in Brazil, and its results highlight the ongoing importance of vaccination and the need to direct efforts and resources to areas of higher risk.
Læs mere Tjek på PubMedClinical Infectious Diseases, 19.07.2024
Tilføjet 19.07.2024
Abstract Background Reliable biomarkers of coronavirus disease 2019 (COVID-19) outcomes are critically needed. We evaluated associations of spike antibody (Ab) and plasma nucleocapsid antigen (N Ag) with clinical outcomes in nonhospitalized persons with mild-to-moderate COVID-19.Methods Participants were nonhospitalized adults with mild-to-moderate COVID-19 enrolled in ACTIV-2 between January and July 2021 and randomized to placebo. We used quantitative assays for severe acute respiratory syndrome coronavirus 2 spike Ab and N Ag in blood and determined numbers of hospitalization/death events within 28 days and time to symptom improvement.Results Of 209 participants, 77 (37%) had quantifiable spike Ab and 139 (67%) quantifiable N Ag. Median age was 50 years; 111 (53%) were female, 182 (87%) White, and 105 (50%) Hispanic/Latino. Higher risk of hospitalization/death was seen with unquantifiable (22/132 [16.7%]) versus quantifiable (1/77 [1.3%]) spike Ab (risk ratio [RR], 12.83 [95% confidence interval {CI}, 1.76–93.34]) and quantifiable (22/139 [15.8%]) vs unquantifiable (1/70 [1.4%]) N Ag (RR, 11.08 [95% CI, 1.52–80.51]). Increasing risk of hospitalizations/deaths was seen with increasing N Ag levels. Time to symptom improvement was longer with unquantifiable versus quantifiable spike Ab (median, 14 [interquartile range {IQR}, 8 to >27] vs 8 [IQR, 4–22] days; adjusted hazard ratio [aHR], 0.66 [95% CI, .45–.96]) and with quantifiable versus unquantifiable N Ag (median, 12 [7 to >27] vs 10 [5–22] days; aHR, 0.79 [95% CI, .52–1.21]).Conclusions Absence of spike Ab and presence of plasma N Ag predicted hospitalization/death and delayed symptom improvement in COVID-19 outpatients.
Læs mere Tjek på PubMedAhd A. Mansour, Sarah M. Hussein, Shatha G. Felemban, Adib W. Mahamid
PLoS One Infectious Diseases, 19.07.2024
Tilføjet 19.07.2024
BMC Infectious Diseases, 17.07.2024
Tilføjet 17.07.2024
Abstract Background Corona virus disease 2019 (COVID-19) is an extremely contagious viral infection caused by the severe acute respiratory syndrome coronavirus 2. Understanding the willingness of the community to receive the COVID-19 vaccine will help in the development and implementation of effective COVID-19 vaccination promotion programs. Therefore, we aimed to assess the level of COVID-19 vaccine acceptance and associated factors among residents of Dire Dawa Administration, Eastern Ethiopia. Methods A community-based cross-sectional study was conducted among 840 residents in Dire Dawa Administration from May 18th to June 18th, 2021. Multistage cluster sampling followed by systematic random sampling was used to select respondents. A pretested interviewer-administered structured questionnaire was used to collect the data from respondents. Bivariable and multivariable logistic regression were used to identify predictors of COVID-19 vaccine acceptance. The odds ratio (OR), along with a 95% confidence interval (CI), was used to estimate the strength of the association. Results Out of 840 respondents recruited, the proportion of COVID-19 vaccine acceptance was found to be 54.4% (457/840); (95% CI: 51.0%, 57.7%) Being male [AOR = 1.85, 95% CI: (1.35, 2.54), P
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.07.2024
Tilføjet 17.07.2024
Abstract Background Coronavirus disease (COVID-19) may lead to serious complications and increased mortality. The outcomes of patients who survive the early disease period are burdened with persistent long-term symptoms and increased long-term morbidity and mortality. The aim of our study was to determine which baseline parameters may provide the best prediction of early and long-term outcomes. Methods The study group comprised 141 patients hospitalized for COVID-19. Demographic data, clinical data and laboratory parameters were collected. The main study endpoints were defined as in-hospital mortality and 1-year mortality. The associations between the baseline data and the study endpoints were evaluated. Prediction models were created. Results The in-hospital mortality rate was 20.5% (n = 29). Compared with survivors, nonsurvivors were significantly older (p = 0.001) and presented comorbidities, including diabetes (0.027) and atrial fibrillation (p = 0.006). Assessment of baseline laboratory markers and time to early death revealed negative correlations between time to early death and higher IL-6 levels (p = 0.032; Spearman rho − 0.398) and lower lymphocyte counts (p = 0.018; Pearson r -0.438). The one-year mortality rate was 35.5% (n = 50). The 1-year nonsurvivor subgroup was older (p
Læs mere Tjek på PubMedAgnieszka Fihel, Anna Janicka, Andrea Buschner, Rūta Ustinavičienė, Aurelija Trakienė
PLoS One Infectious Diseases, 17.07.2024
Tilføjet 17.07.2024
by Agnieszka Fihel, Anna Janicka, Andrea Buschner, Rūta Ustinavičienė, Aurelija Trakienė Objective In Central Europe, the increase in mortality during the COVID-19 pandemic exceeded the number of deaths registered due to coronavirus disease. Excess deaths reported to causes other than COVID-19 may have been due to unrecognised coronavirus disease, the interruptions in care in the overwhelmed health care facilities, or socioeconomic effects of the pandemic and lockdowns. Death certificates provide exhaustive medical information, allowing us to assess the extent of unrecognised COVID-19 deaths. Materials and methods Data from 187,300 death certificates with a COVID-19 mention from Austria, Bavaria (Germany), Czechia, Lithuania and Poland, 2020–2021, was used. The two step analysis uses Cause of Death Association Indicators (CDAIs) and Contributing CDAIs to identify and measure the statistical strength of associations between COVID-19 and all other medical mentions. Results 15,700 deaths were reported with COVID-19 only as a contributing condition (comorbidity). In three cases out of four, a typical, statistically significant coronavirus complication or pre-existing condition was registered as the underlying causes of death. In Austria, Bavaria, Czechia and Lithuania the scale of COVID-19 mortality would have been up to 18–27% higher had COVID-19 been coded as the underlying cause of death. Unrecognised coronavirus deaths were equivalent to the entire surplus of excess mortality beyond registered COVID-19 deaths in Austria and the Czech Republic, and its large proportion (25–31%) in Lithuania and Bavaria. Conclusions Death certificates with typical coronavirus complications or comorbidities as the underlying causes of death and contributing COVID-19 mentions were plausibly unrecognized coronavirus deaths.
Læs mere Tjek på PubMedLuying Chen, Lulu Dai, Jiawei Xu, Lian Duan, Xiaoxia Hou, Lu Zhang, Libo Song, Fangfang Zhao, Yuerong Jiang
PLoS One Infectious Diseases, 17.07.2024
Tilføjet 17.07.2024
by Luying Chen, Lulu Dai, Jiawei Xu, Lian Duan, Xiaoxia Hou, Lu Zhang, Libo Song, Fangfang Zhao, Yuerong Jiang Introduction Despite the available secondary preventive treatments, the management of stable coronary artery disease (SCAD) remains challenging. Intermediate coronary lesion (ICL), defined as luminal stenosis between 50% and 70%, is a key stage of SCAD. However, existing therapeutic strategies are limitated in delaying plaque progression and associated with various adverse effects and economic burdens. Qing-Xin-Jie-Yu Granules (QXJYG) with proven anti-platelet, anti-inflammatory, and lipid-lowering effects may compensate for the drawbacks of current treatments and can be tested as a complementary therapy. Therefore, this study aims to investigate the efficacy and safety of QXJYG in treating ICL, with a particular focus on its impact on myocardial ischemia and plaque progression. Materials and methods This is a multicenter, randomized, double-blind, placebo-controlled trial. A total of 120 participants with ICL will be randomly assigned to two groups in a 1:1 ratio. In addition to basic medications, the intervention group will receive QXJYG, while the control group will receive a placebo for over 6 months, followed by a 12-month follow-up. The primary efficacy outcome is computed tomography-derived fractional flow reserve. The secondary outcomes include the degree of coronary stenosis, coronary artery calcification score, Gensini score, Seattle Angina Questionnaire score, high-sensitivity C-reactive protein, matrix metalloproteinase-9, blood lipids, and carotid artery ultrasound parameters. Major adverse cardiovascular events are recorded as endpoints. The safety outcomes include composite events of bleeding, laboratory test results, and adverse events. Clinical visits are scheduled at baseline, every 2 months during the treatment, and after a 12-month follow-up. Discussion This trial is anticipated to yield reliable results to verify the efficacy and safety of QXJYG in the treatment of ICL, which will provide novel insights to help address the prevailing therapeutic dilemma of ICL, thereby facilitating for the management of SCAD. Trial registration Chinese Clinical Trial Registry, ChiCTR2200059262. Registered on April 27, 2022.
Læs mere Tjek på PubMedXingqi Mi, Xiaolong Zhang, Zhangyi Dai, Xi Yan, Yikai Xing, Jiandong Mei, Lin Ma, Chenglin Guo, Dong Tian, Xinmiao Du, Lunxu Liu, Qiang Pu
International Journal of Infectious Diseases, 16.07.2024
Tilføjet 16.07.2024
The coronavirus disease 2019 (COVID-19) would affect multiple systems with numerous complications, especially severe and irreversible lung parenchymal damage [1]. A significant proportion (6-10%) of patients with COVID-19 infection can progress to respiratory failure and require mechanical ventilation (MV) due to the development of acute respiratory distress syndrome (ARDS) [2,3], which is associated with high mortality exceeding 20% to 40% [4,5]. Additionally, some patients with COVID-19–associated ARDS develop pulmonary fibrosis (PF), which leads to prolonged MV or extracorporeal membrane oxygenation (ECMO) [6,7].
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.07.2024
Tilføjet 12.07.2024
Abstract Background Corona virus disease 2019 (COVID-19) is an extremely contagious viral infection caused by the severe acute respiratory syndrome coronavirus 2. Understanding the willingness of the community to receive the COVID-19 vaccine will help in the development and implementation of effective COVID-19 vaccination promotion programs. Therefore, we aimed to assess the level of COVID-19 vaccine acceptance and associated factors among residents of Dire Dawa Administration, Eastern Ethiopia. Methods A community-based cross-sectional study was conducted among 840 residents in Dire Dawa Administration from May 18th to June 18th, 2021. Multistage cluster sampling followed by systematic random sampling was used to select respondents. A pretested interviewer-administered structured questionnaire was used to collect the data from respondents. Bivariable and multivariable logistic regression were used to identify predictors of COVID-19 vaccine acceptance. The odds ratio (OR), along with a 95% confidence interval (CI), was used to estimate the strength of the association. Results Out of 840 respondents recruited, the proportion of COVID-19 vaccine acceptance was found to be 54.4% (457/840); (95% CI: 51.0%, 57.7%) Being male [AOR = 1.85, 95% CI: (1.35, 2.54), P
Læs mere Tjek på PubMedPilar Fuster-Parra, Aina Huguet-Torres, Enrique Castro-Sánchez, Miquel Bennasar-Veny, Aina M. Yañez
PLoS One Infectious Diseases, 12.07.2024
Tilføjet 12.07.2024
by Pilar Fuster-Parra, Aina Huguet-Torres, Enrique Castro-Sánchez, Miquel Bennasar-Veny, Aina M. Yañez Contact tracing played a crucial role in minimizing the onward dissemination of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) in the recent pandemic. Previous studies had also shown the effectiveness of preventive measures such as mask-wearing, physical distancing, and exposure duration in reducing SARS-CoV-2 transmission. However, there is still a lack of understanding regarding the impact of various exposure settings on the spread of SARS-CoV-2 within the community, as well as the most effective preventive measures, considering the preventive measures adherence in different daily scenarios. We aimed to evaluate the effect of individual protective measures and exposure settings on the community transmission of SARS-CoV-2. Additionally, we aimed to investigate the interaction between different exposure settings and preventive measures in relation to such SARS-CoV-2 transmission. Routine SARS-CoV-2 contact tracing information was supplemented with additional data on individual measures and exposure settings collected from index patients and their close contacts. We used a case-control study design, where close contacts with a positive test for SARS-CoV-2 were classified as cases, and those with negative results classified as controls. We used the data collected from the case-control study to construct a Bayesian network (BN). BNs enable predictions for new scenarios when hypothetical information is introduced, making them particularly valuable in epidemiological studies. Our results showed that ventilation and time of exposure were the main factors for SARS-CoV-2 transmission. In long time exposure, ventilation was the most effective factor in reducing SARS-CoV-2, while masks and physical distance had on the other hand a minimal effect in this ventilation spaces. However, face masks and physical distance did reduce the risk in enclosed and unventilated spaces. Distance did not reduce the risk of infection when close contacts wore a mask. Home exposure presented a higher risk of SARS-CoV-2 transmission, and any preventive measures posed a similar risk across all exposure settings analyzed. Bayesian network analysis can assist decision-makers in refining public health campaigns, prioritizing resources for individuals at higher risk, and offering personalized guidance on specific protective measures tailored to different settings or environments.
Læs mere Tjek på PubMedClinical Infectious Diseases, 11.07.2024
Tilføjet 11.07.2024
Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) down-regulates angiotensin-converting enzyme 2, potentially increasing angiotensin II. We hypothesized that losartan compared to usual care decreases mortality and is safe in patients hospitalized with coronavirus disease 2019 (COVID-19). We aimed to evaluate the effect of losartan versus usual care on 28-day mortality in patients hospitalized for acute COVID-19.Methods Eligibility criteria included adults admitted for acute COVID-19. Exclusion criteria were hypotension, hyperkalemia, acute kidney injury, and use of angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors within 7 days. Participants were randomized to losartan 25–100 mg/day orally for the hospital duration or 3 months or the control arm (usual care) in 29 hospitals in Canada and France. The primary outcome was 28-day mortality. Secondary outcomes were hospital mortality, organ support, and serious adverse events (SAEs).Results The trial was stopped early because of a serious safety concern with losartan. In 341 patients, any SAE and hypotension were significantly higher in the losartan versus usual care groups (any SAE: 39.8% vs 27.2%, respectively, P = .01; hypotension: 30.4% vs 15.3%, respectively, P < .001) in both ward and intensive care patients. The 28-day mortality did not differ between losartan (6.5%) versus usual care (5.9%) (odds ratio, 1.11 [95% confidence interval, .47–2.64]; P = .81), nor did organ dysfunction or secondary outcomes.Conclusions Caution is needed in deciding which patients to start or continue using ARBs in patients hospitalized with pneumonia to mitigate risk of hypotension, acute kidney injury, and other side effects. ARBs should not be added to care of patients hospitalized for acute COVID-19.Clinical Trials Registration NCT04606563.
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.07.2024
Tilføjet 10.07.2024
Abstract Background Coronavirus disease (COVID-19) may lead to serious complications and increased mortality. The outcomes of patients who survive the early disease period are burdened with persistent long-term symptoms and increased long-term morbidity and mortality. The aim of our study was to determine which baseline parameters may provide the best prediction of early and long-term outcomes. Methods The study group comprised 141 patients hospitalized for COVID-19. Demographic data, clinical data and laboratory parameters were collected. The main study endpoints were defined as in-hospital mortality and 1-year mortality. The associations between the baseline data and the study endpoints were evaluated. Prediction models were created. Results The in-hospital mortality rate was 20.5% (n = 29). Compared with survivors, nonsurvivors were significantly older (p = 0.001) and presented comorbidities, including diabetes (0.027) and atrial fibrillation (p = 0.006). Assessment of baseline laboratory markers and time to early death revealed negative correlations between time to early death and higher IL-6 levels (p = 0.032; Spearman rho − 0.398) and lower lymphocyte counts (p = 0.018; Pearson r -0.438). The one-year mortality rate was 35.5% (n = 50). The 1-year nonsurvivor subgroup was older (p
Læs mere Tjek på PubMedFumito Morisawa, Yuji Nishizaki, Shuko Nojiri, Hiroyuki Daida, Tohru Minamino, Tetsuya Takahashi
PLoS One Infectious Diseases, 10.07.2024
Tilføjet 10.07.2024
by Fumito Morisawa, Yuji Nishizaki, Shuko Nojiri, Hiroyuki Daida, Tohru Minamino, Tetsuya Takahashi Studies have reported that health care professionals experienced a lack of sleep during the coronavirus disease 2019 (COVID-19) pandemic and that such lack of sleep and working environment affect their performance. However, to the authors’ knowledge, no study has yet investigated the relationship between sleep duration and working environment among Japanese physiotherapists during the COVID-19 pandemic. This study retrospectively investigated the sleep duration of physiotherapists directly providing physiotherapy to patients with COVID-19 within the red zone and analyzed the association between sleep duration and working environment using logistic regression analysis. Among the 565 physiotherapists studied, the average sleep duration was 6 (6–7) h, and 381 (67.4%) had an average sleep duration of ≤6 h. Less experienced physiotherapists were 1.03 times more likely to sleep ≤6 h, and those in charge of patients with COVID-19 as the supervisor ordered were 0.64 times more likely to sleep ≤6 h. Moreover, physiotherapists with a significant increase in the frequency of internal online meetings and those who had been providing physiotherapy to patients with COVID-19 for >6 months were 2.34 and 2.05 times more likely to sleep ≤6 h, respectively. During the COVID-19 pandemic in Japan, two-thirds of the physiotherapists directly providing physiotherapy to patients with COVID-19 slept less than the recommended duration. This study highlights the need for appropriate workload and work hour management for physiotherapists according to their experience and workload, as well as establishing a medical care system that includes work rotation to ensure that the recommended sleep duration is satisfied.
Læs mere Tjek på PubMedNadin Younes, Hiam Chemaitelly, Parveen Banu Nizamuddin, Tasneem Al-Hamad, Marah Abdallah, Hadi M. Yassine, Laith J. Abu-Raddad, Gheyath K. Nasrallah
PLoS One Infectious Diseases, 10.07.2024
Tilføjet 10.07.2024
by Nadin Younes, Hiam Chemaitelly, Parveen Banu Nizamuddin, Tasneem Al-Hamad, Marah Abdallah, Hadi M. Yassine, Laith J. Abu-Raddad, Gheyath K. Nasrallah Background Hepatitis A virus (HAV) is the predominant cause of acute viral hepatitis worldwide; however, data on HAV antibody prevalence (seroprevalence) among migrant populations are limited. This study aimed to investigate HAV seroprevalence among Qatar’s migrant craft and manual workers (CMWs), constituting approximately 60% of the country’s population. Methods HAV antibody testing was conducted on stored serum specimens obtained from CMWs during a nationwide severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) population-based cross-sectional survey between July 26 and September 9, 2020. Associations with HAV infection were investigated through regression analyses. Results Of the 2,607 specimens with HAV antibody test results, 2,393 were positive, and 214 were negative. The estimated HAV seroprevalence among CMWs was 92.0% (95% CI: 90.9–93.1%). HAV seroprevalence was generally high but exhibited some variation, ranging from 70.9% (95% CI: 62.4–78.2%) among Sri Lankans to 99.8% (95% CI: 98.2–99.9%) among Pakistanis. The multivariable regression analysis identified age, nationality, and educational attainment as statistically significant factors associated with HAV infection. Relative to CMWs aged ≤29 years, the adjusted relative risk (ARR) was 1.06 (95% CI: 1.03–1.10) in CMWs aged 30–39 years and reached 1.15 (95% CI: 1.10–1.19) in those aged ≥50 years. In comparison to Indians, the ARR was lower among Sri Lankans, assessed at 0.81 (95% CI: 0.72–0.91), but higher among Nepalese at 1.07 (95% CI: 1.04–1.11), Bangladeshis at 1.10 (95% CI: 1.07–1.13), Pakistanis at 1.12 (95% CI: 1.09–1.15), and Egyptians at 1.15 (95% CI: 1.08–1.23). No evidence for differences was found by geographic location or occupation. Conclusions HAV seroprevalence among Qatar’s CMW population is very high, with over nine out of every ten individuals having been exposed to this infection, likely during childhood.
Læs mere Tjek på PubMedJannik Stemler, Lusine Yeghiazaryan, Christoph Stephan, Kristin Greve-Isdahl Mohn, Antonio-José Carcas-Sansuan, Esperanza Romero Rodriguez, José Moltó, Itziar Vergara Mitxeltorena, Tobias Welte, Birutė Zablockienė, Murat Akova, Ullrich Bethe, Sarah Heringer, Jon Salmanton-García, Julia Jeck, Lea Tischmann, Marouan Zarrouk, Arnd Cüppers, Lena M. Biehl, Jan Grothe, Sibylle C. Mellinghoff, Julia A. Nacov, Julia M. Neuhann, Rosanne Sprute, Jesús Frías-Iniesta, Riya Negi, Colette Gaillard, Gurvin Saini, Alejandro García León, Patrick W.G. Mallon, Christine Lammens, An Hotterbeekx, Katherine Loens, Surbhi Malhotra-Kumar, Herman Goossens, Samir Kumar-Singh, Franz König, Martin Posch, Philipp Koehler, Oliver A. Cornely, EU-COVAT-1 AGED study group on behalf of the VACCELERATE consortium
International Journal of Infectious Diseases, 9.07.2024
Tilføjet 9.07.2024
Despite successful primary vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), booster vaccinations are required to maintain vaccine-induced protection[1].
Læs mere Tjek på PubMedJournal of Infectious Diseases, 8.07.2024
Tilføjet 8.07.2024
Abstract We investigated the mutation profiles of severe acute respiratory syndrome coronavirus 2 in samples collected from a molnupiravir and nirmatrelvir/ritonavir combination therapy in macaques. We found that molnupiravir induced several nirmatrelvir resistance mutations at low abundance that were not further selected in combination therapy. Coadministration of nirmatrelvir/ritonavir lowered the magnitude of the mutagenetic effect of molnupiravir.
Læs mere Tjek på PubMedAna Paula Serafini Poeta Silva, Guilherme Arruda Cezar, Edison Sousa Magalhães, Kinath Rupasinghe, Srijita Chandra, Gustavo S. Silva, Marcelo Almeida, Bret Crim, Eric Burrough, Phillip Gauger, Christopher Siepker, Marta Mainenti, Michael Zeller, Rodger G. Main, Mary Thurn, Paulo Fioravante, Cesar Corzo, Albert Rovira, Hemant Naikare, Rob McGaughey, Franco Matias Ferreyra, Jamie Retallick, Jordan Gebhardt, Angela Pillatzki, Jon Greseth, Darren Kersey, Travis Clement, Jane Christopher-Hennings, Melanie Prarat, Ashley Johnson, Dennis Summers, Craig Bowen, Kenitra Hendrix, Joseph Boyle, Daniel Correia Lima Linhares, Giovani Trevisan
PLoS One Infectious Diseases, 6.07.2024
Tilføjet 6.07.2024
by Ana Paula Serafini Poeta Silva, Guilherme Arruda Cezar, Edison Sousa Magalhães, Kinath Rupasinghe, Srijita Chandra, Gustavo S. Silva, Marcelo Almeida, Bret Crim, Eric Burrough, Phillip Gauger, Christopher Siepker, Marta Mainenti, Michael Zeller, Rodger G. Main, Mary Thurn, Paulo Fioravante, Cesar Corzo, Albert Rovira, Hemant Naikare, Rob McGaughey, Franco Matias Ferreyra, Jamie Retallick, Jordan Gebhardt, Angela Pillatzki, Jon Greseth, Darren Kersey, Travis Clement, Jane Christopher-Hennings, Melanie Prarat, Ashley Johnson, Dennis Summers, Craig Bowen, Kenitra Hendrix, Joseph Boyle, Daniel Correia Lima Linhares, Giovani Trevisan This study evaluated the use of endemic enteric coronaviruses polymerase chain reaction (PCR)-negative testing results as an alternative approach to detect the emergence of animal health threats with similar clinical diseases presentation. This retrospective study, conducted in the United States, used PCR-negative testing results from porcine samples tested at six veterinary diagnostic laboratories. As a proof of concept, the database was first searched for transmissible gastroenteritis virus (TGEV) negative submissions between January 1st, 2010, through April 29th, 2013, when the first porcine epidemic diarrhea virus (PEDV) case was diagnosed. Secondly, TGEV- and PEDV-negative submissions were used to detect the porcine delta coronavirus (PDCoV) emergence in 2014. Lastly, encountered best detection algorithms were implemented to prospectively monitor the 2023 enteric coronavirus-negative submissions. Time series (weekly TGEV-negative counts) and Seasonal Autoregressive-Integrated Moving-Average (SARIMA) were used to control for outliers, trends, and seasonality. The SARIMA’s fitted and residuals were then subjected to anomaly detection algorithms (EARS, EWMA, CUSUM, Farrington) to identify alarms, defined as weeks of higher TGEV-negativity than what was predicted by models preceding the PEDV emergence. The best-performing detection algorithms had the lowest false alarms (number of alarms detected during the baseline) and highest time to detect (number of weeks between the first alarm and PEDV emergence). The best-performing detection algorithms were CUSUM, EWMA, and Farrington flexible using SARIMA fitted values, having a lower false alarm rate and identified alarms 4 to 17 weeks before PEDV and PDCoV emergences. No alarms were identified in the 2023 enteric negative testing results. The negative-based monitoring system functioned in the case of PEDV propagating epidemic and in the presence of a concurrent propagating epidemic with the PDCoV emergence. It demonstrated its applicability as an additional tool for diagnostic data monitoring of emergent pathogens having similar clinical disease as the monitored endemic pathogens.
Læs mere Tjek på PubMedBMC Infectious Diseases, 5.07.2024
Tilføjet 5.07.2024
Abstract Background The clinical benefit of coronavirus disease 2019 (COVID-19) treatments against new circulating variants remains unclear. We sought to describe characteristics and clinical outcomes of highest risk patients with COVID-19 receiving early COVID-19 treatments in Scotland. Methods Retrospective cohort study of non-hospitalized patients diagnosed with COVID-19 from December 1, 2021–October 25, 2022, using Scottish administrative health data. We included adult patients who met ≥ 1 of the National Health Service highest risk criteria for early COVID-19 treatment and received outpatient treatment with sotrovimab, nirmatrelvir/ritonavir or molnupiravir, or no early COVID-19 treatment. Index date was defined as the earliest of COVID-19 diagnosis or early COVID-19 treatment. Baseline characteristics and acute clinical outcomes in the 28 days following index were reported. Values of ≤ 5 were suppressed. Results In total, 2548 patients were included (492: sotrovimab, 276: nirmatrelvir/ritonavir, 71: molnupiravir, and 1709: eligible highest risk untreated). Patients aged ≥ 75 years accounted for 6.9% (n = 34/492), 21.0% (n = 58/276), 16.9% (n = 12/71) and 13.2% (n = 225/1709) of the cohorts, respectively. Advanced renal disease was reported in 6.7% (n = 33/492) of sotrovimab-treated and 4.7% (n = 81/1709) of untreated patients, and ≤ 5 nirmatrelvir/ritonavir-treated and molnupiravir-treated patients. All-cause hospitalizations were experienced by 5.3% (n = 25/476) of sotrovimab-treated patients, 6.9% (n = 12/175) of nirmatrelvir/ritonavir-treated patients, ≤ 5 (suppressed number) molnupiravir-treated patients and 13.3% (n = 216/1622) of untreated patients. There were no deaths in the treated cohorts; mortality was 4.3% (n = 70/1622) among untreated patients. Conclusions Sotrovimab was often used by patients who were aged
Læs mere Tjek på PubMedSchaffer, A. L., Park, R. Y., Tazare, J., Bhaskaran, K., MacKenna, B., Denaxas, S., Dillingham, I., Bacon, S. C. J., Mehrkar, A., Bates, C., Goldacre, B., Greaves, F., Macleod, J., The OpenSAFELY Collaborative, National Core Studies Collaborative, Tomlinson, L. A., Walker, A., Bacon, Bridges, Butler-Cole, Davy, Dillingham, Evans, Ben Goldacre, Hickman, Inglesby, Maude, Morley, Mehrkar, ODwyer, Smith, Ward, Massey, Wiedemann, Bates, Cockburn, Harper, Hester, Parry, Chaturvedi, Park, Carnemolla, Williams, Knueppel, Boyd, Turner, Evans, Thomas, Berman, McLachlan, Crane, Whitehorn, Oakley, Foster, Woodward, Campbell, Timpson, Kwong, Soares, Griffith, Toms, Jones, Herbert, Mitchell, Palmer, Sterne, Walker, Huntley, Fox, Denholm, Knight, Kate, Arun, Horne, Forbes, North, Taylor, Arab, Walker, Coronado, Karthikeyan, George, Moltrecht, Booth, Parsons, Wielgoszewska, Bridger-Staatz, Steves, Thompson, Garcia, Cheetham, Bowyer, Freydin, Roberts, Ben Goldacre, Morley, Hulme, Nab, Fisher, MacKenna, Andrews, Curtis, Hopcroft, Green, Patalay, Maddock, Patel, Stafford, Jacques, Tilling, Macleod, McElroy, Silverwood, Denaxas, Flaig, McCartney, Campbell, Tomlinson, Tazare, Zheng, Smeeth, Herrett, Cowling, Mansfield, Costello, Wang, Mansfield, Mahalingasivam, Douglas, Langan, Brophy, Parker, Kennedy, McEachan, Wright, Willan, Badrick, Santorelli, Yang, Hou, Steptoe, Gessa, Zhu, Zaninotto, Wood, Cezard, Ip, Bolton, Sampri, Rafeti, Almaghrabi, Sheikh, Shah, Katikireddi, Shaw, Hamilton, Green, Kromydas, Kopasker, Greaves, Willans, Glen, Sharp, Hughes, Wong, Howes, Rapala, Nigrelli, McArdle, Beckford, Raman, Dobson, Folarin, Stewart, Ranjan, Carpentieri, Sheard, Fang, Baz, Gibson, Kellas, Neubauer, Piechnik, Lukaschuk, Saunders, Wild, Smith, Jezzard, Tunnicliffe, Sanders, Finnigan, Ferreira, Green, Rhead, Kibble, Wei, Lemanska, Perez-Reche, Piehlmaier, Teece, Parker
BMJ Open, 3.07.2024
Tilføjet 3.07.2024
ObjectivesLong-term sickness absence from employment has negative consequences for the economy and can lead to widened health inequalities. Sick notes (also called ‘fit notes’) are issued by general practitioners when a person cannot work for health reasons for more than 7 days. We quantified the sick note rate in people with evidence of COVID-19 in 2020, 2021 and 2022, as an indication of the burden for people recovering from COVID-19. DesignCohort study. SettingWith National Health Service (NHS) England approval, we used routine clinical data (primary care, hospital and COVID-19 testing records) within the OpenSAFELY-TPP database. ParticipantsPeople 18–64 years with a recorded positive test or diagnosis of COVID-19 in 2020 (n=365 421), 2021 (n=1 206 555) or 2022 (n=1 321 313); general population matched in age, sex and region in 2019 (n=3 140 326), 2020 (n=3 439 534), 2021 (n=4 571 469) and 2022 (n=4 818 870); people hospitalised with pneumonia in 2019 (n=29 673). Primary outcome measureReceipt of a sick note in primary care. ResultsAmong people with a positive SARS-CoV-2 test or COVID-19 diagnosis, the sick note rate was 4.88 per 100 person-months (95% CI 4.83 to 4.93) in 2020, 2.66 (95% CI 2.64 to 2.67) in 2021 and 1.73 (95% CI 1.72 to 1.73) in 2022. Compared with the age, sex and region-matched general population, the adjusted HR for receipt of a sick note over the entire follow-up period (up to 10 months) was 4.07 (95% CI 4.02 to 4.12) in 2020 decreasing to 1.57 (95% CI 1.56 to 1.58) in 2022. The HR was highest in the first 30 days postdiagnosis in all years. Among people hospitalised with COVID-19, after adjustment, the sick note rate was lower than in people hospitalised with pneumonia. ConclusionsGiven the under-recording of postacute COVID-19-related symptoms, these findings contribute a valuable perspective on the long-term effects of COVID-19. Despite likely underestimation of the sick note rate, sick notes were issued more frequently to people with COVID-19 compared with those without, even in an era when most people are vaccinated. Most sick notes occurred in the first 30 days postdiagnosis, but the increased risk several months postdiagnosis may provide further evidence of the long-term impact.
Læs mere Tjek på PubMedAbinash Mallick, Soumi Sukla, Abhishek De, Subhajit Biswas
Journal of Medical Virology, 28.06.2024
Tilføjet 28.06.2024
BMC Infectious Diseases, 28.06.2024
Tilføjet 28.06.2024
Abstract Introduction When COVID-19 hit the world in 2019, an enhanced focus on diagnostic testing for SARS-CoV-2 was essential for a successful pandemic response. Testing laboratories stretched their capabilities for the new coronavirus by adopting different test methods. The necessity of having external quality assurance (EQA) mechanisms was even more critical due to this rapid expansion. However, there was a lack of experience in providing the necessary SARS-CoV-2 EQA materials, especially in locations with constrained resources. Objective We aimed to create a PT (Proficiency testing) programme based on the Dried Tube Specimens (DTS) method that would be a practical option for molecular based SARS-CoV-2 EQA in Low- and Middle-Income Countries. Methods Based on previous ISO/IEC 17043:2010 accreditation experiences and with assistance from the US Centers for Disease Control and Prevention, The Supranational Reference Laboratory of Uganda (adapted the DTS sample preparation method and completed a pilot EQA program between 2020 and 2021. Stability and panel validation testing was conducted on the designed materials before shipping to pilot participants in six African countries. Participants received a panel containing five SARS-CoV-2 DTS samples, transported at ambient conditions. Results submitted by participants were compared to validation results. Participants were graded as satisfactory (≥ 80%) or unsatisfactory (
Læs mere Tjek på PubMedYu Jung Choi, Han-Na Kim, Jiyeon Lee, Eliel Nham, Hye Seong, Jin Gu Yoon, Ji Yun Noh, Joon Young Song, Hee Jin Cheong, Woo Joo Kim
International Journal of Infectious Diseases, 26.06.2024
Tilføjet 26.06.2024
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has emerged as a global public health concern over the past four years, manifesting with diverse symptoms affecting different organs. Several reports detail various skin complications associated with the coronavirus disease-19 (COVID-19). A systematic review of the literature published until December 31, 2022, revealed that the most common skin manifestations of COVID-19 are maculopapular rash, chilblain-like lesions, and urticarial lesions.
Læs mere Tjek på PubMedSophia Werdin, Julia Neufeind
PLoS One Infectious Diseases, 25.06.2024
Tilføjet 25.06.2024
by Sophia Werdin, Julia Neufeind Background Measles is a highly contagious disease with the potential for severe complications. Despite the availability of effective vaccines, there have been recurrent measles outbreaks in Germany over the past decades. In response, a new measles vaccine mandate was introduced on March 1, 2020, aimed at closing vaccination gaps in high-risk populations. This study evaluates the mandate’s implementation, identifies operational challenges, assesses the impact of the Coronavirus disease 2019 pandemic, and investigates expert attitudes towards the new policy. Methods Semi-structured expert interviews were conducted with staff members of 16 different local health departments in Germany. The interviews, carried out in April and May 2021, were electronically recorded, transcribed verbatim, and analyzed using the Framework method. Results The implementation of the measles vaccine mandate in local health departments varied substantially. Challenges in implementing the mandate primarily arose from uncertainties regarding procedural specifics, such as handling fraudulent medical certificates and imposing sanctions, leading to a call from many interviewees for uniform guidelines to ensure coherent implementation. At the time the measles vaccine mandate came into force, managing the Coronavirus disease 2019 pandemic was a priority in most local health departments, often delaying the implementation of the mandate. Despite the difficulties encountered, most experts considered the mandate to be an effective step towards measles elimination. Conclusions The measles vaccine mandate has imposed a new responsibility on staff in German local health departments, which is associated with implementation challenges such as procedural uncertainties and vaccine hesitancy, but also the Coronavirus disease 2019 pandemic as a contextual impediment. Significant differences in the implementation approach underscore the need for harmonization to enhance implementation efficiency and public acceptance of the mandate. Despite the mandate’s potential to increase vaccination rates, our findings advocate for a comprehensive approach, incorporating public education, accessible vaccination, and measures to address social disparities.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 25.06.2024
Tilføjet 25.06.2024
Abstract Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic disrupted respiratory syncytial virus (RSV) seasonality. To optimize the use and evaluation of RSV infant immunization strategies, monitoring changes in RSV epidemiology is essential.Methods Hospitalizations for acute respiratory infections (ARIs) and RSV-coded ARI in children
Læs mere Tjek på PubMedBethany F. Ferris, Suganthi Balasubramanian, Anuradha Rajamanickam, Saravanan Munisankar, Bindu Dasan, Pradeep A. Menon, P'ng Loke, Subash Babu, Goylette F. Chami
PLoS One Infectious Diseases, 24.06.2024
Tilføjet 24.06.2024
by Bethany F. Ferris, Suganthi Balasubramanian, Anuradha Rajamanickam, Saravanan Munisankar, Bindu Dasan, Pradeep A. Menon, P\'ng Loke, Subash Babu, Goylette F. Chami Background In the first year of roll-out, vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevented almost 20 million deaths from coronavirus disease 2019 (COVID-19). Yet, little is known about the factors influencing access to vaccination at the individual level within rural poor settings of low-income countries. The aim of this study was to examine determinants of vaccine receipt in rural India. Methods A census of a rural village in Tamil Nadu was undertaken from June 2021 to September 2022. We surveyed 775 participants from 262 households. Household-level data on socioeconomic status (SES), water, sanitation, and hygiene practices, and individual-level demographic information, travel history, and biomedical data, including anthropometry, vital signs, and comorbidities, were collected. Logistic regression models with 5-fold cross-validation were used to identify the biomedical, demographic, and socioeconomic determinants of vaccine receipt and the timing of receipt within the first 30 days of eligibility. Vaccine ineligible participants were excluded leaving 659 eligible participants. There were 650 eligible participants with complete biomedical, demographic, and socioeconomic data. Results There were 68.0% and 34.0% of individuals (N = 650) who had received one and two vaccine doses, respectively. Participants with household ownership of a permanent account number (PAN) or ration card were 2.15 (95% CI:1.32–3.52) or 3.02 (95% CI:1.72–5.29) times more likely to receive at least one vaccine dose compared to households with no ownership of such cards. Participants employed as housewives or self-employed non-agricultural workers were 65% (95% CI:0.19–0.67) or 59% (95% CI:0.22–0.76) less likely to receive at least one vaccine dose compared to salaried workers. Household PAN card ownership, occupation and age were linked to the timing of vaccine receipt. Participants aged ≤18 and 45–60 years were 17.74 (95% CI:5.07–62.03) and 5.51 (95% CI:2.74–11.10) times more likely to receive a vaccine within 30 days of eligibility compared to 19-44-year-olds. Biomedical factors including BMI, vital signs, comorbidities, and COVID-19 specific symptoms were not consistently associated with vaccine receipt or timing of receipt. No support was found that travel history, contact with COVID-19 cases, and hospital admissions influenced vaccine receipt or timing of receipt. Conclusion Factors linked to SES were linked to vaccine receipt, more so than biomedical factors which were targeted by vaccine policies. Future research should explore if government interventions including vaccine mandates, barriers to vaccine access, or peer influence linked to workplace or targeted vaccine promotion campaigns underpin these findings.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.06.2024
Tilføjet 22.06.2024
Abstract Background Planned behaviors and self-care against the coronavirus are two important factor in controlling its spread and self-care behaviors depend on the level of health literacy. This research was conducted to determine the mediating role of health literacy in the relationship between elements of planned behavior and self-care in dealing with the Covid-19. Methods In this descriptive-analytical quantitative study, the sample size was calculated using Cochrane’s formula and considering a p-value of 0.51, α = 0.05, and d = 0.05, and 313 students were selected based on stratified and random method. To gather data and assess various aspects of variables, a questionnaires were utilized, focusing on health literacy, self-car and planned behavior. The relationship between the variables was examined by SPSS version 26 and via descriptive statistics, including the mean and standard deviation, and inferential statistics such as Pearson’s correlation coefficient (P = 0.05), path analysis, and determining the standard coefficients between self-care and planned behavior, mediated by the indicators of the health literacy. Results A significant difference was found between the level of health literacy of women and men. The comparison of the mean health literacy and self-care behavior in terms of other variables did not show any significant difference. Meanwhile, the comparison of health status control behaviors, hand washing, and mask use did not show any significant difference between the two groups. A positive and significant correlation was found between self-care behaviors, attitude, subjective norms, perceived behavioral control, and behavioral intention. The relationship of health literacy and psychological variables of attitude, subjective norms, and perceived behavioral control with self-care against COVID-19 was significant. Conclusion The direct and significant impact of health literacy on individuals’ self-care behaviors against the coronavirus was not observed. However, health literacy did have a significant effect on subjective norms. This finding is important because subjective norms significantly influenced individuals’ behavioral intention, which in turn had a significant effect on self-care behaviors against the coronavirus. Thus, health literacy played a mediating role in this relationship. Furthermore, attitude emerged as the strongest predictor of behavioral intention, exerting a direct effect. Conversely, perceived behavioral control did not directly and significantly affect students’ self-care behaviors.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.06.2024
Tilføjet 22.06.2024
Abstract Background Predictors of the outcome of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection remain to be fully determined. We evaluated selected viral characteristics and immunological responses that might predict and/or correlate to the clinical outcome of COVID-19. Methods For individuals developing divergent clinical outcomes, the magnitude and breadth of T cell-mediated responses were measured within 36 h of symptom onset. Peripheral Blood Mononuclear Cells (PBMCs) were subjected to in vitro stimulation with SARS-CoV-2-based peptides. In addition, SARS-CoV-2 sequences were generated by metagenome, and HLA typing was performed using Luminex technology. Findings CD4+ T cell activation was negatively correlated with SARS-CoV-2 basal viral load in patients with severe COVID-19 (p = 0·043). The overall cellular immune response, as inferred by the IFN-γ signal, was higher at baseline for patients who progressed to mild disease compared to patients who progressed to severe disease (p = 0·0044). Subjects with milder disease developed higher T cell responses for MHC class I and II-restricted peptides (p = 0·033). Interpretation Mounting specific cellular immune responses in the first days after symptom onset, as inferred by IFN-γ magnitude in the ELISPOT assay, may efficiently favor a positive outcome. In contrast, progression to severe COVID-19 was accompanied by stronger cellular immune responses, higher CD4 + T cell activation, and a higher number of in silico predicted high-affinity class I HLA alleles.
Læs mere Tjek på PubMedGiovanni Almanzar, Kimia Koosha, Tim Vogt, Astrid Stein, Lars Ziegler, Claudia Asam, Manuela Weps, Valeria Schwägerl, Lorena Richter, Nicola Hepp, Andre Fuchs, Isabell Wagenhäuser, Julia Reusch, Manuel Krone, Christof Geldmacher, Ulrike Protzer, Philipp Steininger, Klaus Überla, Ralf Wagner, Johannes Liese, Martina Prelog
Journal of Medical Virology, 21.06.2024
Tilføjet 21.06.2024
Eric Yuk Fai Wan, Boyuan Wang, Amanda Lauren Lee, Jiayi Zhou, Celine Sze Ling Chui, Francisco Tsz Tsun Lai, Xue Li, Carlos King Ho Wong, Ivan Fan Ngai Hung, Chak Sing Lau, Esther Wai Yin Chan, Ian Chi Kei Wong
International Journal of Infectious Diseases, 21.06.2024
Tilføjet 21.06.2024
During the COVID-19 pandemic, several vaccines have been developed and demonstrated effective against SARS-CoV-2 infection, COVID-19 severity, and related mortality. Among the various vaccines available to date, modified-nucleotide messenger ribonucleic acid (mRNA) and inactivated whole virus vaccines account for at least 90.3% of the global market [1]. Both types of vaccines have shown promise as prevention options in several studies [2-8]. However, direct evidence comparing their effectiveness and safety was limited.
Læs mere Tjek på PubMedKoen M. F. Gorgels, Suhreta Mujakovic, Eline Stallenberg, Volker H. Hackert, Christian J. P. A. Hoebe
PLoS One Infectious Diseases, 18.06.2024
Tilføjet 18.06.2024
by Koen M. F. Gorgels, Suhreta Mujakovic, Eline Stallenberg, Volker H. Hackert, Christian J. P. A. Hoebe There has been a lot of discussion about the role of schools in the transmission of severe acute respiratory coronavirus 2 (SARS-CoV-2) during the coronavirus 2019 (COVID-19) pandemic, where many countries responded with school closures in 2020. Reopening of primary schools in the Netherlands in February 2021 was sustained by various non-pharmaceutical interventions (NPIs) following national recommendations. Our study attempted to assess the degree of regional implementation and effectiveness of these NPIs in South Limburg, Netherlands. We approached 150 primary schools with a structured questionnaire containing items on the implementation of NPIs, including items on ventilation. Based on our registry of cases, we determined the number of COVID-19 cases linked to each school, classifying cases by their source of transmission. We calculated a crude secondary attack rate by dividing the number of cases of within-school transmission by the total number of children and staff members. Two-sample proportion tests were performed to compare these rates between schools stratified by the presence of a ventilation system and mask mandates for staff members. A total of 69 schools responded. Most implemented NPIs were aimed at students, except for masking mandates, which preferentially targeted teachers over students (63% versus 22%). We observed lower crude secondary attack rates in schools with a ventilation system compared to schools without a ventilation system (1.2% versus 2.8%, p
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.06.2024
Tilføjet 17.06.2024
Abstract Background As an emerging infectious disease with a heterogenous and uncertain transmission pattern, coronavirus disease 2019 (COVID-19) has created a catastrophe in healthcare-associated infections (HAIs) and posed a significant challenge to infection control practices (ICPs) in healthcare settings. While the unique characteristics of psychiatric patients and clinical settings may make the implementation of ICPs difficult, evidence is lacking for compliance with ICPs among healthcare workers (HCWs) in a psychiatric setting during the COVID-19 pandemic. Methods A cross-sectional multi-method study based on participant unobtrusive observation coupled with the completion of a self-administered ICP survey was conducted to assess compliance with ICPs among HCWs in a psychiatric inpatient ward in a regional hospital. An online checklist, called eRub, was used to record the performance of HCWs in hand hygiene (HH) and other essential ICPs. Furthermore, a well-validated questionnaire (i.e., Compliance with Standard Precautions Scale, CSPS) was used to collect the participants’ self-reported ICP compliance for later comparison. Results A total of 2,670 ICP opportunities were observed from January to April 2020. The overall compliance rate was 42.6%. HCWs exhibited satisfactory compliance to the wearing of mask (91.2%) and the handling of clinical waste (87.5%); suboptimal compliance to the handling of sharp objects (67.7%) and linen (72.7%); and poor compliance to HH (3.3%), use of gloves (40.9%), use of personal protective equipment (20%), and disinfection of used surface/area (0.4%). The compliance rates of the nurses and support staff to HH were significantly different (χ2 = 123.25, p
Læs mere Tjek på PubMedClinical Infectious Diseases, 15.06.2024
Tilføjet 15.06.2024
Abstract Background Nirmatrelvir-ritonavir is recommended for persons at risk for severe coronavirus disease 2019 (COVID-19) but remains underutilized. Information on which eligible groups are likely to benefit from treatment is needed.Methods We conducted a target trial emulation study in the Veterans Health Administration comparing nirmatrelvir–ritonavir treated versus matched untreated veterans at risk for severe COVID-19 who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from April 2022 through March 2023. We measured incidence of any hospitalization or all-cause mortality at 30 days. Outcomes were measured for the entire cohort, as well as among subgroups defined by 30-day risk of death or hospitalization, estimated using an ensemble risk prediction model.Results Participants were 87% male with median age 66 years and 16% unvaccinated. Compared with matched untreated participants, those treated with nirmatrelvir-ritonavir (n = 24 205) had a lower 30-day risk for hospitalization (1.80% vs 2.30%; risk difference [RD], −0.50% points [95% confidence interval {CI}: −.69 to −.35]) and death (0.11% vs 0.30%; RD, −0.20 [95% CI: −.24 to −.13]). The greatest reductions in combined hospitalization or death were observed in the highest risk quartile (RD −2.85 [95% CI: −3.94 to −1.76]), immunocompromised persons (RD −1.91 [95% CI: −3.09 to −.74]), and persons aged ≥75 years (RD −1.16 [95% CI: −1.73 to −.59]). No reductions were observed in the 2 lowest risk quartiles or persons younger than 65 years.Conclusions Nirmatrelvir-ritonavir was effective in reducing 30-day hospitalization and death in older veterans, those at highest predicted risk for severe outcomes, and immunocompromised groups. Benefit was not observed in younger veterans or groups at lower predicted risk for hospitalization and death.
Læs mere Tjek på PubMedLaura P. Chen, Kristina Singh-Verdeflor, Michelle M. Kelly, Daniel J. Sklansky, Kristin A. Shadman, M. Bruce Edmonson, Qianqian Zhao, Gregory P. DeMuri, Ryan J. Coller
PLoS One Infectious Diseases, 15.06.2024
Tilføjet 15.06.2024
by Laura P. Chen, Kristina Singh-Verdeflor, Michelle M. Kelly, Daniel J. Sklansky, Kristin A. Shadman, M. Bruce Edmonson, Qianqian Zhao, Gregory P. DeMuri, Ryan J. Coller Objectives Children with medical complexity experienced health disparities during the coronavirus disease 2019 (COVID-19) pandemic. Language may compound these disparities since people speaking languages other than English (LOE) also experienced worse COVID-19 outcomes. Our objective was to investigate associations between household language for children with medical complexity and caregiver COVID-19 vaccine intentions, testing knowledge, and trusted sources of information. Methods This cross-sectional survey of caregivers of children with medical complexity ages 5 to 17 years was conducted from April-June 2022. Children with medical complexity had at least 1 Complex Chronic Condition. Households were considered LOE if they reported speaking any language other than English. Multivariable logistic regression examined associations between LOE and COVID-19 vaccine intentions, interpretation of COVID-19 test results, and trusted sources of information. Results We included 1,338 caregivers of children with medical complexity (49% response rate), of which 133 (10%) had household LOE (31 total languages, 58% being Spanish). There was no association between household LOE and caregiver COVID-19 vaccine intentions. Caregivers in households with LOE had similar interpretations of positive COVID-19 test results, but significantly different interpretations of negative results. Odds of interpreting a negative test as expected (meaning the child does not have COVID-19 now or can still get the virus from others) were lower in LOE households (aOR [95% CI]: 0.56 [0.34–0.95]). Households with LOE were more likely to report trusting the US government to provide COVID-19 information (aOR [95% CI]: 1.86 [1.24–2.81]). Conclusion Differences in COVID-19 test interpretations based on household language for children with medical complexity were observed and could contribute to disparities in outcomes. Opportunities for more inclusive public health messaging likely exist.
Læs mere Tjek på PubMedKenneth Chan, Elizabeth Wahome, Apostolos Tsiachristas, Alexios S Antonopoulos, Parijat Patel, Maria Lyasheva, Lucy Kingham, Henry West, Evangelos K Oikonomou, Lucrezia Volpe, Michail C Mavrogiannis, Edward Nicol, Tarun K Mittal, Thomas Halborg, Rafail A Kotronias, David Adlam, Bhavik Modi, Jonathan Rodrigues, Nicholas Screaton, Attila Kardos, John P Greenwood, Nikant Sabharwal, Giovanni Luigi De Maria, Shahzad Munir, Elisa McAlindon, Yogesh Sohan, Pete Tomlins, Muhammad Siddique, Andrew Kelion, Cheerag Shirodaria, Francesca Pugliese, Steffen E Petersen, Ron Blankstein, Milind Desai, Bernard J Gersh, Stephan Achenbach, Peter Libby, Stefan Neubauer, Keith M Channon, John Deanfield, Charalambos Antoniades, ORFAN Consortium
Lancet, 14.06.2024
Tilføjet 14.06.2024
The FAI Score captures inflammatory risk beyond the current clinical risk stratification and CCTA interpretation, particularly among patients without obstructive CAD. The AI-Risk integrates this information in a prognostic algorithm, which could be used as an alternative to traditional risk factor-based risk calculators.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.06.2024
Tilføjet 12.06.2024
Abstract It is aimed to examine the frequency of COVID-19 disease, the rates of COVID-19 vaccination and the vaccine effectiveness (VE) among Syrian refugees. It is a retrospective cohort study. Syrian refugees aged 18 years and above registered to a family health center in Sultanbeyli district in Istanbul were included. Vaccine effectiveness were calculated for both Pfizer BioN-Tech and CoronaVac (Sinovac) vaccines. The data of 2586 Syrian people was evaluated in the study. The median age of the participants was 34.0 years (min:18.0; max: 90.0). Of the participants 58.4% (n = 1510) were female, 41.6% (n = 1076) were male. In our study of the refugees 15.7% had history of COVID-19 infection. Refugees having full vaccination with Biontech and Sinovac have a significantly lower COVID-19 infection rate than those without vaccination (HR = 8.687; p
Læs mere Tjek på PubMedYuan-Ting GuoJi-Bin JiangGuan-Rong QiaoRong-Hua LuoXin ZhouRong HuaChang-Bo ZhengZhen LiuaCollege of Life Sciences, Northwest University, Xi’an 710127, ChinabState Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650201, ChinacUniversity of Chinese Academy of Sciences, Beijing 100049, ChinadSchool of Pharmaceutical Science and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming 650500, ChinaeKey Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650201, ChinafYunnan Key Laboratory of Biodiversity Information, Kunming 650201, ChinagKey Laboratory of Genetic Evolution and Animal Models, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650201, China
Proceedings of the National Academy of Sciences, 12.06.2024
Tilføjet 12.06.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 24, June 2024.
Læs mere Tjek på PubMedMehboodi, F., Zamanzadeh, V., Rahmani, A., Dianat, I., Shabanloie, R.
BMJ Open, 11.06.2024
Tilføjet 11.06.2024
ObjectiveThis study explored the consequences of COVID-19 on the occupational safety and health of nurses. DesignQualitative conventional content analysis. Participants14 nurses selected by purposeful sampling method. SettingFive educational and non-educational hospitals in the Northwest of Iran. Data collection and analysisSemistructured interviews were used for data collection and analysed using conventional content analysis. ResultsTwo main categories have emerged from the data: reduced quality of professional life and post-traumatic growth. Reduced quality of professional life, which has two subcategories including job dissatisfaction and burnout, has a negative nature, and has had many negative effects on the physical, mental and well-being of nursing personnel during the coronavirus era. On the other hand, post-traumatic growth, with two subcategories that include promoting safe behaviour and gaining a positive self-concept, has a positive nature. ConclusionsMaintaining the occupational health and safety of nurses plays an important role in providing quality services to patients. Therefore, it is necessary for managers and policymakers to use the experiences related to the COVID-19 crisis, to prevent negative factors and strengthen positive factors, to maintain the safety and occupational health of nurses, and increase the quality of care.
Læs mere Tjek på PubMedBMC Infectious Diseases, 8.06.2024
Tilføjet 8.06.2024
Abstract It is aimed to examine the frequency of COVID-19 disease, the rates of COVID-19 vaccination and the vaccine effectiveness (VE) among Syrian refugees. It is a retrospective cohort study. Syrian refugees aged 18 years and above registered to a family health center in Sultanbeyli district in Istanbul were included. Vaccine effectiveness were calculated for both Pfizer BioN-Tech and CoronaVac (Sinovac) vaccines. The data of 2586 Syrian people was evaluated in the study. The median age of the participants was 34.0 years (min:18.0; max: 90.0). Of the participants 58.4% (n = 1510) were female, 41.6% (n = 1076) were male. In our study of the refugees 15.7% had history of COVID-19 infection. Refugees having full vaccination with Biontech and Sinovac have a significantly lower COVID-19 infection rate than those without vaccination (HR = 8.687; p
Læs mere Tjek på PubMedBennett, J. C., OHanlon, J., Acker, Z., Han, P. D., McDonald, D., Wright, T., Luiten, K. G., Regelbrugge, L., McCaffrey, K. M., Pfau, B., Wolf, C. R., Gottlieb, G. S., Hughes, J. P., Carone, M., Starita, L. M., Chu, H. Y., Weil, A. A.
BMJ Open, 5.06.2024
Tilføjet 5.06.2024
ObjectiveWe aimed to evaluate the feasibility and utility of an unsupervised testing mechanism, in which participants pick up a swab kit, self-test (unsupervised) and return the kit to an on-campus drop box, as compared with supervised self-testing at staffed locations. DesignUniversity SARS-CoV-2 testing cohort. SettingHusky Coronavirus Testing provided voluntary SARS-CoV-2 testing at a university in Seattle, USA. Outcome measuresWe computed descriptive statistics to describe the characteristics of the study sample. Adjusted logistic regression implemented via generalised estimating equations was used to estimate the odds of a self-swab being conducted through unsupervised versus supervised testing mechanisms by participant characteristics, including year of study enrolment, pre-Omicron versus post-Omicron time period, age, sex, race, ethnicity, affiliation and symptom status. ResultsFrom September 2021 to July 2022, we received 92 499 supervised and 26 800 unsupervised self-swabs. Among swabs received by the laboratory, the overall error rate for supervised versus unsupervised swabs was 0.3% vs 4%, although this declined to 2% for unsupervised swabs by the spring of the academic year. Results were returned for 92 407 supervised (5% positive) and 25 836 unsupervised (4%) swabs from 26 359 participants. The majority were students (79%), 61% were female and most identified as white (49%) or Asian (34%). The use of unsupervised testing increased during the Omicron wave when testing demand was high and stayed constant in spring 2022 even when testing demand fell. We estimated the odds of using unsupervised versus supervised testing to be significantly greater among those
Læs mere Tjek på PubMedInfection, 4.06.2024
Tilføjet 4.06.2024
Abstract Purpose Prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been observed in immunocompromised hosts. Early monotherapy with direct-acting antivirals or monoclonal antibodies, as recommended by the international guidelines, does not prevent this with certainty. Dual therapies may therefore have a synergistic effect. Methods This retrospective, multicentre study compared treatment strategies for corona virus disease-19 (COVID-19) with combinations of nirmatrelvir/ritonavir, remdesivir, molnupiravir, and/ or mABs during the Omicron surge. Co-primary endpoints were prolonged viral shedding (≥ 106 copies/ml at day 21 after treatment initiation) and days with SARS-CoV-2 viral load ≥ 106 copies/ml. Therapeutic strategies and risk groups were compared using odds ratios and Fisher’s tests or Kaplan−Meier analysis and long-rank tests. Multivariable regression analysis was performed. Results 144 patients were included with a median duration of SARS-CoV-2 viral load ≥ 106 copies/ml of 8.0 days (IQR 6.0–15.3). Underlying haematological malignancies (HM) (p = 0.03) and treatment initiation later than five days after diagnosis (p
Læs mere Tjek på PubMedBesnier, E., Moussa, M. D., Thill, C., Vallin, F., Donnadieu, N., Ruault, S., Lorne, E., Scherrer, V., Lanoiselee, J., Lefebvre, T., Sentenac, P., Abou-Arab, O.
BMJ Open, 4.06.2024
Tilføjet 4.06.2024
IntroductionIntraoperative opioids have been used for decades to reduce negative responses to nociception. However, opioids may have several, and sometimes serious, adverse effects. Cardiac surgery exposes patients to a high risk of postoperative complications, some of which are common to those caused by opioids: acute respiratory failure, postoperative cognitive dysfunction, postoperative ileus (POI) or death. An opioid-free anaesthesia (OFA) strategy, based on the use of dexmedetomidine and lidocaine, may limit these adverse effects, but no randomised trials on this issue have been published in cardiac surgery. We hypothesised that OFA versus opioid-based anaesthesia (OBA) may reduce the incidence of major opioid-related complications after cardiac surgery. Methods and analysisMulticentre, randomised, parallel and single-blinded clinical trial in four cardiac surgical centres in France, including 268 patients scheduled for coronary artery bypass grafting under cardiac bypass, with or without aortic valve replacement. Patients will be randomised to either a control OBA protocol using remifentanil or an OFA protocol using dexmedetomidine/lidocaine. The primary composite endpoint is the occurrence of at least one of the following: (1) postoperative cognitive disorder evaluated by the Confusion Assessment Method for the Intensive Care Unit test, (2) POI, (3) acute respiratory distress or (4) death within the first 48 postoperative hours. Secondary endpoints are postoperative pain, morphine consumption, nausea–vomiting, shock, acute kidney injury, atrioventricular block, pneumonia and length of hospital stay. Ethics and disseminationThis trial has been approved by an independent ethics committee (Comité de Protection des Personnes Ouest III–Angers on 23 February 2021). Results will be submitted in international journals for peer reviewing. Trial registration number NCT04940689, EudraCT 2020-002126-90.
Læs mere Tjek på PubMedBMC Infectious Diseases, 4.06.2024
Tilføjet 4.06.2024
Abstract Background The emergence of coronavirus disease 2019 (COVID-19) as a global health emergency necessitates continued investigation of the disease progression. This study investigated the relationship between eosinophilia and the severity of COVID-19 in chronic obstructive pulmonary disease (COPD) patients. Methods This cross-sectional study was conducted on 73 COPD patients infected by COVID-19 in Afzalipour Hospital, Iran. Peripheral blood samples were collected for hematological parameter testing, including eosinophil percentage, using Giemsa staining. Eosinophilia was defined as≥ 2% and non-eosinophilia as< 2%. The severity of pulmonary involvement was determined based on chest CT severity score (CT-SS) (based on the degree of involvement of the lung lobes, 0%: 0 points, 1–25%: 1 point, 26–50%: 2 points, 51–75%: 3 points, and 76–100%: 4 points). The CT-SS was the sum of the scores of the five lobes (range 0–20). Results The average age of patients was 67.90±13.71 years, and most were male (54.8%). Non-eosinophilic COPD patients were associated with more severe COVID-19 (P= 0.01) and lower oxygen saturation (P= 0.001). In addition, the study revealed a significant difference in the chest CT severity score (CT-SS) between non-eosinophilic (9.76±0.7) and eosinophilic COPD patients (6.26±0.63) (P< 0.001). Although non-eosinophilic COPD patients had a higher mortality rate, this difference was not statistically significant (P= 0.16). Conclusions Our study demonstrated that reduced peripheral blood eosinophil levels in COPD patients with COVID-19 correlate with unfavorable outcomes. Understanding this association can help us identify high-risk COPD patients and take appropriate management strategies to improve their prognosis.
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