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BMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Cat scratch disease (CSD) is caused by Bartonella henselae (B. henselae) and presents as lymphadenopathy following close contact with cats. However, in context of the global COVID-19 pandemic, clinical manifestations of CSD may vary, posing new challenges for healthcare professionals. Here we describe a case of a 54-year-old male with painful left upper arm mass, which gradually resolved until he was infected with COVID-19. The mass then rapidly progressed before admission. Meanwhile, pulmonary symptoms including pleural effusion emerged simultaneously. The cause was undetermined with routine blood culture and pathological test until the next generation sequencing (NGS) confirmed the presence of B. henselae. We believe this case is the first to report localized aggravation of CSD after COVID-19 infection and hopefully, offers treatment experience for clinicians worldwide.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious virus that uses angiotensin converting enzyme 2 (ACE2), a pivotal member of the renin–angiotensin system (RAS), as its cell-entry receptor. Another member of the RAS, angiotensin II (Ang II), is the major biologically active component in this system. There is growing evidence suggesting that serum miRNAs could serve as prognostic biomarkers for SARS-CoV-2 infection and regulate ACE2 expression. Therefore, the aim of this study is to evaluate the changes in the serum levels of sACE2 and Ang II, as well as the expression level of miR-141-3p and miR-421 in SARS-CoV-2 positive and negative subjects. Methods In the present study, the serum levels of sACE2 and Ang II were measured in 94 SARS-CoV-2 positive patients and 94 SARS-CoV-2 negative subjects with some symptoms similar to those of SARS-CoV-2 positive patients using the ELISA method. In addition, the expression level of miR-141-3p and miR-421 as ACE2 regulators and biomarkers was evaluated using quantitative real-time PCR (qRT-PCR) method. Results The mean serum sACE2 concentration in the SARS-CoV-2-positive group was 3.268 ± 0.410 ng/ml, whereas in the SARS-CoV-2 negative group, it was 3.564 ± 0.437 ng/ml. Additionally, the mean serum Ang II level in the SARS-CoV-2 positive and negative groups were 60.67 ± 6.192 ng/L and 67.97 ± 6.837 ng/L, respectively. However, there was no significant difference in the serum levels of sACE2 (P value: 0.516) and Ang II (P value: 0.134) between the SARS-CoV-2 positive and negative groups. Meanwhile, our findings indicated that the expression levels of miR-141-3p and miR-421 in SARS-CoV-2 positive group were significantly lower and higher than SARS-CoV-2 negative group, respectively (P value
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background Mental health (MH) is extremely relevant when referring to people living with a chronic disease, such as people living with HIV (PLWH). In fact – although life expectancy and quality have increased since the advent of antiretroviral therapy (ART) – PLWH carry a high incidence of mental disorders, and this burden has been exacerbated during the COVID-19 pandemic. In this scenario, UNAIDS has set new objectives for 2025, such as the linkage of at least 90% of PLWH to people-centered, context-specific MH services. Aim of this study was to determine the prevalence of MD in PLWH followed at the Clinic of Infectious Diseases of the University of Bari, Italy. Methods From January 10th to September 10th, 2022, all PLWH patients accessing our outpatient clinic were offered the following standardized tools: HAM-A for anxiety, BDI-II for depression, PC-PTSD-5 for post-traumatic stress disorder, CAGE-AID for alcohol-drug abuse. Factors associated with testing positive to the four MD were explored with a multivariable logistic regression model. Results 578 out of 1110 HIV-patients agreed to receive MH screening, with 141 (24.4%) people resulting positive to at least one MH disorder. HAM-A was positive in 15.8% (n = 91), BDI-II in 18% (n = 104), PC-PTSD-5 in 5% (n = 29) and CAGE in 6.1% (n = 35). The multivariable logistic regression showed a higher probability of being diagnosed with anxiety, depression and post-traumatic stress disorder for PLWH who reported severe stigma, social isolation, psychological deterioration during the COVID-19 pandemic and for those receiving a dolutegravir (DTG)-based regimen. Moreover, history of drug use (OR 1.13; [95% CE 1.06–4.35]), family stigma (2.42 [1.65–3.94]) and social isolation (2.72 [1.55;4.84]) were found to be associated to higher risk for substance use disorder. Conclusions In this study, stigma was a strong predictor for being diagnosed of a MH disorder among PLWH. Also, the possible role of dolutegravir as a risk factor for the onset of MH disorders should be considered in clinical practice, and MH of patients receiving DTG-containing regimens should be constantly monitored.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Objective To compare the similarities and differences between patients with Coronavirus Disease 2019 (COVID-19) and those with other community-acquired pneumonia (CAP) admitted to the intensive care unit (ICU), utilizing propensity score matching (PSM), regarding hospitalization expenses, treatment options, and prognostic outcomes, aiming to inform the diagnosis and treatment of COVID-19. Methods Patients admitted to the ICU of the Third People’s Hospital of Datong City, diagnosed with COVID-19 from December 2022 to February 2023, constituted the observation group, while those with other CAP admitted from January to November 2022 formed the control group. Basic information, clinical data at admission, and time from symptom onset to admission were matched using PSM. Results A total of 70 patients were included in the COVID-19 group and 119 in the CAP group. The patients were matched by the propensity matching method, and 37 patients were included in each of the last two groups. After matching, COVID-19 had a higher failure rate than CAP, but the difference was not statistically significant (73% vs. 51%, p = 0.055). The utilization rate of antiviral drugs (40% vs. 11%, p = 0.003), γ-globulin (19% vs. 0%, p = 0.011) and prone position ventilation (PPV) (27% vs. 0%, p
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background The impact of the constantly evolving severe acute respiratory syndrome coronavirus 2 on the effectiveness of early coronavirus disease 2019 (COVID-19) treatments is unclear. Here, we report characteristics and acute clinical outcomes of patients with COVID-19 treated with a monoclonal antibody (mAb; presumed to be sotrovimab) across six distinct periods covering the emergence and predominance of Omicron subvariants (BA.1, BA.2, and BA.5) in England. Methods Retrospective cohort study using data from the Hospital Episode Statistics database from January 1–July 31, 2022. Included patients received a mAb delivered by a National Health Service (NHS) hospital as a day-case, for which the primary diagnosis was COVID-19. Patients were presumed to have received sotrovimab based on NHS data showing that 99.98% of COVID-19-mAb-treated individuals received sotrovimab during the study period. COVID-19-attributable hospitalizations were reported overall and across six distinct periods of Omicron subvariant prevalence. Subgroup analyses were conducted in patients with severe renal disease and active cancer. Results Among a total of 10,096 patients, 1.0% (n = 96) had a COVID-19-attributable hospitalization, 4.6% (n = 465) had a hospital visit due to any cause, and 0.3% (n = 27) died due to any cause during the acute period. COVID-19-attributable hospitalization rates were consistent among subgroups, and no significant differences were observed across periods of Omicron subvariant predominance. Conclusions Levels of COVID-19-attributable hospitalizations and deaths were low in mAb-treated patients and among subgroups. Similar hospitalization rates were observed whilst Omicron BA.1, BA.2, and BA.5 were predominant, despite reported reductions in in vitro neutralization activity of sotrovimab against BA.2 and BA.5.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background COVID-19 has been shown to increase the risk of extracorporeal coagulation during hemodialysis in patients, but the underlying mechanism remains unclear. This study aimed to investigate the effect and mechanism of COVID-19 on the risk of extracorporeal coagulation in patients with chronic kidney disease undergoing hemodialysis. Methods A retrospective analysis of the extracorporeal coagulation status of 339 hemodialysis patients at our center before and after COVID-19 infection was performed, including subgroup analyses. Post-infection blood composition was analyzed by protein spectrometry and ELISA. Results Compared to the pre-COVID-19 infection period, COVID-19-induced extracorporeal coagulation predominantly occurred in patients with severe/critical symptoms. Further proteomic analysis demonstrated that in patients with severe/critical symptoms, the coagulation cascade reaction, platelet activation, inflammation, and oxidative stress-related pathways were significantly amplified compared to those in patients with no/mild symptoms. Notably, the vWF/FBLN5 pathway, which is associated with inflammation, vascular injury, and coagulation, was significantly upregulated. Conclusions Patients with severe/critical COVID-19 symptoms are at a higher risk of extracorporeal coagulation during hemodialysis, which is associated with the upregulation of the vWF/FBLN5 signaling pathway. These findings highlight the importance of early anticoagulant therapy initiation in COVID-19 patients with severe/critical symptoms, particularly those undergoing hemodialysis. Additionally, vWF/FBLN5 upregulation may be a novel mechanism for virus-associated thrombosis/coagulation.
Læs mere Tjek på PubMedWenting Zuo, Di He, Chaoyang Liang, Shiyu Du, Zhan Hua, Qiangqiang Nie, Xiaofeng Zhou, Meng Yang, Haidong Tan, Jiuyang Xu, Yanbing Yu, Yuliang Zhan, Ying Zhang, Xiaoying Gu, Weijie Zhu, Hui Zhang, Hongyan Li, Weiliang Sun, Mingzhi Sun, Xiaolei Liu, Liguo Liu, Chuanzhen Cao, Rui Li, Jing Li, Yun Zhang, Yuting Zhang, Jing Guo, Ling Zhao, Chuan-Peng Zhang, Hongyu Liu, Shiyao Wang, Fei Xiao, Yeming Wang, Zai Wang, Haibo Li, Bin Cao
Lancet Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Our findings suggest that residual SARS-CoV-2 can persist in patients who have recovered from mild COVID-19 and that there is a significant association between viral persistence and long COVID symptoms. Further research is needed to verify a mechanistic link and identify potential targets to improve long COVID symptoms.
Læs mere Tjek på PubMedXinyi Zhou, Tengda Huang, Hongyuan Pan, Ao Du, Tian Wu, Jiang Lan, Yujia Song, Yue Lv, Fang He, Kefei Yuan
PLoS One Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
by Xinyi Zhou, Tengda Huang, Hongyuan Pan, Ao Du, Tian Wu, Jiang Lan, Yujia Song, Yue Lv, Fang He, Kefei Yuan Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causal agent of coronavirus disease 2019 (COVID-19), has infected millions of individuals worldwide, which poses a severe threat to human health. COVID-19 is a systemic ailment affecting various tissues and organs, including the lungs and liver. Intrahepatic cholangiocarcinoma (ICC) is one of the most common liver cancer, and cancer patients are particularly at high risk of SARS-CoV-2 infection. Nonetheless, few studies have investigated the impact of COVID-19 on ICC patients. Methods With the methods of systems biology and bioinformatics, this study explored the link between COVID-19 and ICC, and searched for potential therapeutic drugs. Results This study identified a total of 70 common differentially expressed genes (DEGs) shared by both diseases, shedding light on their shared functionalities. Enrichment analysis pinpointed metabolism and immunity as the primary areas influenced by these common genes. Subsequently, through protein-protein interaction (PPI) network analysis, we identified SCD, ACSL5, ACAT2, HSD17B4, ALDOA, ACSS1, ACADSB, CYP51A1, PSAT1, and HKDC1 as hub genes. Additionally, 44 transcription factors (TFs) and 112 microRNAs (miRNAs) were forecasted to regulate the hub genes. Most importantly, several drug candidates (Periodate-oxidized adenosine, Desipramine, Quercetin, Perfluoroheptanoic acid, Tetrandrine, Pentadecafluorooctanoic acid, Benzo[a]pyrene, SARIN, Dorzolamide, 8-Bromo-cAMP) may prove effective in treating ICC and COVID-19. Conclusion This study is expected to provide valuable references and potential drugs for future research and treatment of COVID-19 and ICC.
Læs mere Tjek på PubMedPatricia Martins, Richardson Warley Siqueira Luzia, Jair Alves Pereira Filho, Kelly Silva Welsh, Cíntia Fuzikawa, Rodrigo Nicolato, Márcia Mascarenhas Alemão, Márcio Augusto Gonçalves, José Carlos Cavalheiro, Ianny Dumont Ávila, Ricardo Teixeira Veiga
PLoS One Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
by Patricia Martins, Richardson Warley Siqueira Luzia, Jair Alves Pereira Filho, Kelly Silva Welsh, Cíntia Fuzikawa, Rodrigo Nicolato, Márcia Mascarenhas Alemão, Márcio Augusto Gonçalves, José Carlos Cavalheiro, Ianny Dumont Ávila, Ricardo Teixeira Veiga Burnout is most commonly defined as a syndrome characterized by emotional exhaustion, cynicism, and ineffectiveness, which occurs in response to chronic stressors at work. It can adversely affect health workers’ physical and mental health, and the quality of care provided. The COVID-19 pandemic increased stressors and could impact burnout prevalence in this group. There is a lack of information regarding the prevalence of burnout among hospital health workers in Brazil. A newer definition of burnout has been proposed that considers three different clinical profiles: the frenetic, underchallenged and worn-out subtypes. This differentiation could lead to interventions tailored for each subtype. The present study aimed to estimate the prevalence of burnout, its subtypes, and associated factors in workers of a public hospital network in Brazil, during the pandemic. A total of 143 randomly selected participants answered an online form that included sociodemographic and occupational items, and the Burnout Clinical Subtypes Questionnaire, a summarized version. This questionnaire evaluates three burnout dimensions (overload, lack of development, neglect) that can be used to discriminate the three burnout subtypes (frenetic, underchallenged, worn-out, respectively); higher scores indicate higher burnout levels. The prevalence of burnout was high (53.85%), similar to other studies during the pandemic. The most common subtypes were ‘frenetic’ (34.97%), characterized by increased efforts to meet work demands, to the point of neglecting personal needs, and ‘lack of development’ (23.78%), characterized by a sense that work is uninteresting and does not contribute to personal development, and a perfunctory behavior towards tasks. Age was associated with burnout: workers with less than 51 years presented higher levels of burnout. These findings indicate the need for effective interventions to prevent and/or treat burnout. The assessment of burnout subtypes can allow managers to better understand the processes affecting employees, and inform actions to improve workforce health.
Læs mere Tjek på PubMedTseng, Ashley S.; Mugwanya, Kenneth K.; Szpiro, Adam A.; van Heerden, Alastair; Ntinga, Xolani; Schaafsma, Torin T.; Barnabas, Ruanne V.
Journal of Acquired Immune Deficiency Syndromes, 22.04.2024
Tilføjet 22.04.2024
Background: People living with HIV require reliable access to and adequate supply of antiretroviral therapy (ART) for viral suppression. The Deliver Health Study, a randomized trial conducted during the COVID-19 pandemic, found that home-delivered ART significantly increased viral suppression compared to clinic-based care. The effect of changing COVID-19 alert levels on self-reported ART use has not been quantified. Setting: KwaZulu-Natal, South Africa. Methods: Adults living with HIV were followed in the Deliver Health Study during October 2019-December 2020. We used difference-in-differences (DiD) to estimate the effect of changing COVID-19 alert levels during three distinct periods on self-reported missed ART doses (missed 0 vs. 1 doses in past week) for participants receiving home-delivered vs. clinic-based refills. We additionally estimated the effect of changing COVID-19 alert levels on late clinic ART refill visits (late vs. on-time). We used relative risk regression for both binary outcomes. Results: Of 155 participants, 46% were women and median age was 36 years. The mean number of missed weekly doses was 0.11, 0, and 0.12 in the home-delivery group and 0.09, 0.08, and 0.18 in the clinic group during periods 1, 2, and 3, respectively. There were no differences in relative risk (RR) of self-reported daily ART use between refill groups when comparing across periods (DiDperiod 2 vs. 1=1.05; 95% confidence interval [CI]: 0.97, 1.13 and DiDperiod 3 vs. 2=0.99; 95% CI: 0.91, 1.08). In the clinic group, the risk of late refill visits was significantly higher during COVID-19 restrictions (vs. before alert level 5 implementation) and even after the COVID-19 alert level was downgraded to level 1 (RRperiod 2 vs. 1=1.83, 95% CI: 1.34, 2.51 and RRperiod 3 vs. 2=1.71; 95% CI: 1.43, 2.04). Conclusion: The COVID-19 pandemic did not differentially impact self-reported ART adherence by method of ART refills, but the risk of late clinic refill visits was significantly higher during COVID-19 restrictions and sustained after restrictions were loosened. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedOyuga, Roseline; Amadi, Emmanuel; Blanco, Natalia; Ndaga, Angela; Abuya, Kepha; Oneya, Daniel; Ng'eno, Caroline; Koech, Emily; Lavoie, Marie-Claude C.
Journal of Acquired Immune Deficiency Syndromes, 22.04.2024
Tilføjet 22.04.2024
Background: In Kenya, of the 82,000 children living with HIV; only 59% of these children are receiving ART, and 67% of these are virally suppressed. Early in the COVID-19 pandemic, the Ministry of Health recommended three multi-month dispensing (3MMD) of ART to all people living with HIV, including children. This study assess the association between 3MMD and clinical outcomes among children in Western Kenya. Settings and Methods: We conducted a retrospective cohort study using routinely collected de-identified patient-level data from 43 facilities in Kisii and Migori counties. The study included children 2-9 years old who had been previously initiated on ART and sought HIV services between March 01, 2020, and March 30, 2021. We used generalized linear models with Poisson regression models to assess the association of MMD on retention at 6 months and viral suppression (
Læs mere Tjek på PubMedJournal of the American Medical Association, 21.04.2024
Tilføjet 21.04.2024
People who were infected with SARS-CoV-2 tended to score slightly worse on cognitive assessments—particularly in memory, reasoning, and tasks that require executive function—than those who were not infected, according to data from about 113 000 participants in England. The score was the equivalent of a 3-point loss on an IQ scale, the researchers reported in the New England Journal of Medicine.
Læs mere Tjek på PubMedJournal of the American Medical Association, 21.04.2024
Tilføjet 21.04.2024
People who were infected with SARS-CoV-2 had a 25% higher risk of later being diagnosed with an autoimmune inflammatory rheumatic disease (AIRD) after infection than those who weren’t infected, according to a large cohort study that included more than 22 million participants in Japan and South Korea. They also had a 30% greater risk of developing AIRD, such as systemic lupus erythematosus or rheumatoid arthritis, compared with people who had influenza, the researchers reported in the Annals of Internal Medicine.
Læs mere Tjek på PubMedJournal of the American Medical Association, 21.04.2024
Tilføjet 21.04.2024
The rate of antidepressant prescriptions for teens and young adults increased by about two-thirds between 2016 and 2022, an analysis of information from a national database involving participants aged 12 to 25 years found. But the rate of increase wasn’t constant, with prescriptions surging by about 64% per month after the start of the COVID-19 pandemic compared with a 17% increase per month before March 2020.
Læs mere Tjek på PubMedJournal of the American Medical Association, 21.04.2024
Tilføjet 21.04.2024
To the Editor A recent Viewpoint elucidated the potential of IHL in protecting the sacredness of health care. But, they also highlighted the difficulties in implementing its lofty principles. Throughout most modern wars, protection of the right to health embodied in these humanitarian principles has been violated, by targeting civilians and their living spaces. The brutal October 7 Hamas attack that included rapes, burning of infants, torching individuals while still alive, and killing of parents in front of their children, as well as hostage-taking, unfortunately continues this horrific pattern of modern terrorist warfare. Given the importance of health, even in war, Israel has struggled—putting its own soldiers at risk—to protect civilians within Gazan hospitals that are used as command and control centers and weapons depots and to provide humanitarian aid corridors when few, if any, of its neighbors will aid (or resettle) fleeing Gazans. Yet, beyond the current conflict, how could a right to health contribute to a peaceful Gaza? Under international human rights law, states are required to maintain a functioning health care system as part of their obligation to fulfill the right to health. Within existing international law and a stable Gaza, Israel could work collaboratively with multiple sectors across Gazan communities, and a revised Ministry of Health, to coordinate tailored community-based health care resources. As during the height of the COVID-19 pandemic, Coordination of Government Activities in the Territories trained Gazan nurses, Israel provided aid to Gaza, and Hebrew University of Jerusalem has continued to train Gazan and other Arab medical residents. These efforts could be reestablished with international cooperation. And, with a focus on the right to health, perhaps enduring peace would be a secondary outcome.
Læs mere Tjek på PubMedGray, Raluca; Pradhan, Prajwal Mani; Hoffmeister, Jesse; Misono, Stephanie; Cho, Roy; Tignanelli, Christopher
Critical Care Explorations, 21.04.2024
Tilføjet 21.04.2024
OBJECTIVES: Occurrence of post-intubation laryngotracheal stenosis (LTS) with respect to COVID-19 status. DESIGN: Retrospective cross-sectional inpatient database. SETTING: Eleven Midwest academic and community hospitals, United States. PATIENTS: Adults, mechanically ventilated, from January 2020 to August 2022, who were subsequently readmitted within 6 months with a new diagnosis of LTS. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Six thousand eight hundred fifty-one COVID-19 negative and 1316 COVID-19 positive patients were intubated and had similar distribution by age (median 63.77 vs. 63.16 yr old), sex (male, 60.8%; n = 4173 vs. 60%; n = 789), endotracheal tube size (≥ 7.5, 75.8%; n = 5192 vs. 75.5%; n = 994), and comorbidities. The ICU length of stay (median [interquartile range (IQR)], 7.23 d [2.13–16.67 d] vs. 3.95 d [1.91–8.88 d]) and mechanical ventilation days (median [IQR], 5.57 d [1.01–14.18 d] vs. 1.37 d [0.35–4.72 d]) were longer in the COVID-19 positive group. The occurrence of LTS was double in the COVID-19 positive group (12.7%, n = 168 vs. 6.4%, n = 440; p < 0.001) and was most commonly diagnosed within 60 days of intubation. In multivariate analysis, the risk of LTS increased by 2% with each additional ICU day (hazard ratio [HR], 1.02; 95% CI, 1.02–1.03; p < 0.001), by 3% with each additional day of ventilation (HR, 1.03; 95% CI, 1.02–1.04; p < 0.001), and by 52% for each additional reintubation (HR, 1.52; 95% CI, 1.36–1.71; p < 0.001). We observed no significant association COVID-19 status and risk of LTS. CONCLUSIONS: The occurrence of post-intubation LTS was double in a COVID-19 positive cohort, with higher risk with increasing number of days intubated, days in the ICU and especially with the number of reintubations. COVID-19 status was not an independent risk factor for LTS.
Læs mere Tjek på PubMedClinical & Experimental Immunology, 21.04.2024
Tilføjet 21.04.2024
Abstract Obesity and type 2 diabetes (DM) are risk factors for severe COVID-19 outcomes, which disproportionately affect South Asian populations. This study aims to investigate the humoral and cellular immune responses to SARS-CoV-2 in adult COVID-19 survivors with obesity and DM in Bangladesh. In this cross-sectional study, SARS-CoV-2-specific antibody and T cell responses were investigated in 63 healthy and 75 PCR-confirmed COVID-19 recovered individuals in Bangladesh, during the pre-vaccination first wave of the COVID-19 pandemic in 2020. In COVID-19 survivors, SARS-CoV-2 infection induced robust antibody and T cell responses, which correlated with disease severity. After adjusting for age, sex, DM status, disease severity, and time since onset of symptoms, obesity was associated with decreased neutralising antibody titers, and increased SARS-CoV-2 spike-specific IFN-γ response along with increased proliferation and IL-2 production by CD8+ T cells. In contrast, DM was not associated with SARS-CoV-2-specific antibody and T cell responses after adjustment for obesity and other confounders. Obesity is associated with lower neutralising antibody levels and higher T cell responses to SARS-CoV-2 post COVID-19 recovery, while antibody or T cell responses remain unaltered in DM.
Læs mere Tjek på PubMedHuicui Meng, Yin Wang, Yanmei Zhai, Wanyu Luo, Yuanyuan Wang, Yunqi Hu, Sizhe Liu, Weimin Xiao, Guowu Yang, Feng Ye, Shifeng Chen, Yusheng Jie, Yao‐Qing Chen
Journal of Medical Virology, 20.04.2024
Tilføjet 20.04.2024
Ranjeet Singh Mahla, Lynn B. Dustin
Journal of Medical Virology, 20.04.2024
Tilføjet 20.04.2024
Zheng, Q., Zeng, Z., Tang, X., Ma, L.
BMJ Open, 20.04.2024
Tilføjet 20.04.2024
ObjectivesFollowing the implementation of China’s open policy with respect to COVID-19 on 7 December 2022, the influx of patients with infectious diseases has surged rapidly, necessitating hospitals to adopt temporary requisition and modification of ward beds to optimise hospital bed capacity and alleviate the burden of overcrowded patients. This study aims to investigate the effect of an intensive care unit (ICU) bed capacity optimisation method on the average length of stay (ALS) and average cost of hospitalisation (ACH) after the open policy of COVID-19 in China. Design and settingA difference-in-differences (DID) approach is employed to analyse and compare the ALS and ACH of patients in four modified ICUs and eight non-modified ICUs within a tertiary hospital located in southwest China. The analysis spans 2 months before and after the open policy, specifically from 5 October 2022 to 6 December 2022, and 7 December 2022 to 6 February 2023. ParticipantsWe used the daily data extracted from the hospital’s information management system for a total of 5944 patients admitted by the outpatient and emergency access during the 2-month periods before and after the release of the open policy in China. ResultsThe findings indicate that the ICU bed optimisation method implemented by the tertiary hospital led to a significant reduction in ALS (HR –0.6764, 95% CI –1.0328 to –0.3201, p=0.000) and ACH (HR –0.2336, 95% CI –0.4741 to –0.0068, p=0.057) among ICU patients after implementation of the open policy. These results were robust across various sensitivity analyses. However, the effect of the optimisation method exhibits heterogeneity among patients admitted through the outpatient and emergency channels. ConclusionsThis study corroborates a significant positive impact of ICU bed optimisation in mitigating the shortage of medical resources following an epidemic outbreak. The findings hold theoretical and practical implications for identifying effective emergency coordination strategies in managing hospital bed resources during sudden public health emergency events. These insights contribute to the advancement of resource management practices and the promotion of experiences in dealing with public health emergencies.
Læs mere Tjek på PubMedFitzPatrick, K. M., Brown, S. J., Hegarty, K., Mensah, F. K., Gartland, D.
BMJ Open, 20.04.2024
Tilføjet 20.04.2024
ObjectiveThere is a lack of longitudinal population-based research comparing women’s experiences of intimate partner violence (IPV) prior to and during the COVID-19 pandemic. Using data from the Mothers’ and Young People’s Study, the prevalence of physical and emotional IPV in the first year of the pandemic is compared with earlier waves of data. DesignA prospective pregnancy cohort of first-time mothers in Melbourne, Australia was followed up over the first decade of motherhood, with a quick response study conducted during the COVID-19 pandemic. 422 women completed the primary exposure measure (IPV; Composite Abuse Scale) in the 1st, 4th and 10th year postpartum and the additional pandemic survey (June 2020–April 2021). Outcome measuresDepressive symptoms; anxiety symptoms; IPV disclosure to a doctor, friends or family, or someone else. ResultsMaternal report of emotional IPV alone was higher during the pandemic (14.4%, 95% CI 11.4% to 18.2%) than in the 10th (9.5%, 95% CI 7.0% to 12.7%), 4th (9.2%, 95% CI 6.8% to 12.4%) and 1st year after the birth of their first child (5.9%, 95% CI 4.0% to 8.6%). Conversely, physical IPV was lowest during the pandemic (3.1%, 95% CI 1.8% to 5.0%). Of women experiencing IPV during the pandemic: 29.7% were reporting IPV for the first time, 52.7% reported concurrent depressive symptoms and just 6.8% had told their doctor. ConclusionsFindings suggest that the spike in IPV-related crime statistics following the onset of the pandemic (typically incidents of physical violence) is the tip of the iceberg for women’s IPV experiences. There is a need to increase the capacity of health practitioners to recognise emotional as well as physical IPV, and IPV ought to be considered where women present with mental health problems.
Læs mere Tjek på PubMedCiaccio, L., Donnan, P. T., Parcell, B. J., Marwick, C. A.
BMJ Open, 20.04.2024
Tilføjet 20.04.2024
ObjectivesThis study aims to examine community antibiotic prescribing across a complete geographical area for people with a positive COVID-19 test across three pandemic waves, and to examine health and demographic factors associated with antibiotic prescribing. DesignA population-based study using administrative data. SettingA complete geographical region within Scotland, UK. ParticipantsResidents of two National Health Service Scotland health boards with SARS-CoV-2 virus test results from 1 February 2020 to 31 March 2022 (n=184 954). Individuals with a positive test result (n=16 025) had data linked to prescription and hospital admission data ±28 days of the test, general practice data for high-risk comorbidities and demographic data. Outcome measuresThe associations between patient factors and the odds of antibiotic prescription in COVID-19 episodes across three pandemic waves from multivariate binary logistic regression. ResultsData included 768 206 tests for 184 954 individuals, identifying 16 240 COVID-19 episodes involving 16 025 individuals. There were 3263 antibiotic prescriptions ±28 days for 2395 episodes. 35.6% of episodes had a prescription only before the test date, 52.3% of episodes after and 12.1% before and after. Antibiotic prescribing reduced over time: 20.4% of episodes in wave 1, 17.7% in wave 2 and 12.0% in wave 3. In multivariate logistic regression, being female (OR 1.31, 95% CI 1.19 to 1.45), older (OR 3.02, 95% CI 2.50 to 3.68 75+ vs
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.04.2024
Tilføjet 20.04.2024
Abstract Considering that neutralizing antibody levels induced by two doses of the inactivated vaccine decreased over time and had fallen to low levels by 6 months, and homologous and heterologous booster immunization programs have been implemented in adults in China. The booster immunization of recombinant COVID-19 vaccine (ZF2001) after priming with inactivated vaccine in healthy children and adolescents has not been reported. We performed an open-labeled, single-arm clinical trial to evaluate the safety and immunogenicity of heterologous booster immunization with ZF2001 after priming with inactivated vaccine among 240 population aged 3-17 years in China. The primary outcome was immunogenicity, including geometric mean titers (GMTs), geometric mean ratios (GMRs) and seroconversion rates of SARS-CoV-2 neutralizing antibodies against prototype SARS-CoV-2 and Omicron BA.2 variant at 14 days after vaccination booster. On day 14 post-booster, a third dose booster of the ZF2001 provided a substantial increase in antibody responses in minors, and the overall occurrence rate of adverse reactions after heterologous vaccination was low and all adverse reactions were mild or moderate. The results showed that the ZF2001 heterologous booster had high immunogenicity and good safety profile in children and adolescents, and can elicit a certain level of neutralizing antibodies against Omicron. Trial registration NCT05895110 (Retrospectively registered, First posted in ClinicalTrials.gov date: 08/06/2023)
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.04.2024
Tilføjet 20.04.2024
Abstract Considering that neutralizing antibody levels induced by two doses of the inactivated vaccine decreased over time and had fallen to low levels by 6 months, and homologous and heterologous booster immunization programs have been implemented in adults in China. The booster immunization of recombinant COVID-19 vaccine (ZF2001) after priming with inactivated vaccine in healthy children and adolescents has not been reported. We performed an open-labeled, single-arm clinical trial to evaluate the safety and immunogenicity of heterologous booster immunization with ZF2001 after priming with inactivated vaccine among 240 population aged 3-17 years in China. The primary outcome was immunogenicity, including geometric mean titers (GMTs), geometric mean ratios (GMRs) and seroconversion rates of SARS-CoV-2 neutralizing antibodies against prototype SARS-CoV-2 and Omicron BA.2 variant at 14 days after vaccination booster. On day 14 post-booster, a third dose booster of the ZF2001 provided a substantial increase in antibody responses in minors, and the overall occurrence rate of adverse reactions after heterologous vaccination was low and all adverse reactions were mild or moderate. The results showed that the ZF2001 heterologous booster had high immunogenicity and good safety profile in children and adolescents, and can elicit a certain level of neutralizing antibodies against Omicron. Trial registration NCT05895110 (Retrospectively registered, First posted in ClinicalTrials.gov date: 08/06/2023)
Læs mere Tjek på PubMedSabrina L Jin, Jessica Kolis, Jessica Parker, Dylan A Proctor, Dimitri Prybylski, Claire Wardle, Neetu Abad, Kathryn A Brookmeyer, Christopher Voegeli, Howard Chiou
Lancet Infectious Diseases, 20.04.2024
Tilføjet 20.04.2024
Recognition of misinformation as a public health threat and interest in infodemics, defined as an inundation of information accompanying an epidemic or acute health event, have increased worldwide. However, scientists have no consensus on how to best define and identify misinformation and other essential characteristics of infodemics. We conducted a narrative review of secondary historical sources to examine previous infodemics in relation to four infectious diseases associated with pandemics (ie, smallpox, cholera, 1918 influenza, and HIV) and challenge the assumption that misinformation is a new phenomenon associated with increased use of social media or with the COVID-19 pandemic.
Læs mere Tjek på PubMedMilhan Chaze, Laurent Mériade, Corinne Rochette, Mélina Bailly, Rea Bingula, Christelle Blavignac, Martine Duclos, Bertrand Evrard, Anne Cécile Fournier, Lena Pelissier, David Thivel, on behalf of CAUVIM-19 Group
PLoS One Infectious Diseases, 20.04.2024
Tilføjet 20.04.2024
by Milhan Chaze, Laurent Mériade, Corinne Rochette, Mélina Bailly, Rea Bingula, Christelle Blavignac, Martine Duclos, Bertrand Evrard, Anne Cécile Fournier, Lena Pelissier, David Thivel, on behalf of CAUVIM-19 Group Background Work on long COVID-19 has mainly focused on clinical care in hospitals. Thermal spa therapies represent a therapeutic offer outside of health care institutions that are nationally or even internationally attractive. Unlike local care (hospital care, general medicine, para-medical care), their integration in the care pathways of long COVID-19 patients seems little studied. The aim of this article is to determine what place french thermal spa therapies can take in the care pathway of long COVID-19 patients. Methods Based on the case of France, we carry out a geographic mapping analysis of the potential care pathways for long COVID-19 patients by cross-referencing, over the period 2020–2022, the available official data on COVID-19 contamination, hospitalisations in intensive care units and the national offer of spa treatments. This first analysis allows us, by using the method for evaluating the attractiveness of an area defined by David Huff, to evaluate the accessibility of each French department to thermal spas. Results Using dynamic geographical mapping, this study describes two essential criteria for the integration of the thermal spa therapies offer in the care pathways of long COVID-19 patients (attractiveness of spa areas and accessibility to thermal spas) and three fundamental elements for the success of these pathways (continuity of the care pathways; clinical collaborations; adaptation of the financing modalities to each patient). Using a spatial attractiveness method, we make this type of geographical analysis more dynamic by showing the extent to which a thermal spa is accessible to long COVID-19 patients. Conclusion Based on the example of the French spa offer, this study makes it possible to place the care pathways of long COVID-19 patients in a wider area (at least national), rather than limiting them to clinical and local management in a hospital setting. The identification and operationalization of two geographical criteria for integrating a type of treatment such as a spa cure into a care pathway contributes to a finer conceptualization of the construction of healthcare pathways.
Læs mere Tjek på PubMedLuiza Mesesan-Schmitz, Claudiu Coman, Carmen Stanciu, Venera Bucur, Laurentiu Gabriel Tiru, Maria Cristina Bularca
PLoS One Infectious Diseases, 20.04.2024
Tilføjet 20.04.2024
by Luiza Mesesan-Schmitz, Claudiu Coman, Carmen Stanciu, Venera Bucur, Laurentiu Gabriel Tiru, Maria Cristina Bularca This study was designed to explore mothers’ perceptions about changes in parenting behavior in the middle of the pandemic COVID 19 period. Based on the convergent mixed-method design and Parental Stress model, we illustrated these changes by taking into account the impact of the pandemic perceived by mothers and the resources they had available. Research on parenting changes was important in the Romanian context because, in that challenging period, there were no regulations to safeguard parents, especially single parents as mothers. Mothers experienced increased levels of stress, some of them having to leave their jobs to stay at home with their children. Other mothers needed to work from home and in the meantime to take care of their children. In this context we wanted to illustrate the possible changes that occurred in their parenting behavior during the pandemic period. Results from the quantitative survey showed that there is a moderate correlation between the negative impact felt by mothers and the negative changes in their parenting behavior, and this correlation was diminished by a series of resources such as: social support, parenting alliance, or high income. Qualitative data provided better understanding of mothers’ parenting behavior by showing that mothers shared both positive and negative experiences during the pandemic, regardless of the general trend mentioned. As shown by the quantitative data, the qualitative data also showed that mothers who felt more strongly the impact of the pandemic reported more negative changes in their parenting behavior. The positive changes most frequently stated involved expressing affection and communicating more often on various topics, carrying out leisure activities or activities meant to help with the personal development of the child, and involving children in domestic activities. Mothers mostly described negative aspects such as too much involvement in school life, increased control and surveillance of children, especially when it comes to school related activities and to the time children were allowed to spend on their digital devices. These changes led to conflicts and sometimes, mothers resorted to discipline practices. In addition to the resources identified in quantitative research, mothers with higher education and medium–high income also turned to specialized resources (psychologists, online courses, support groups) in order to manage conflicts, them being able to see the challenges of the pandemic as an opportunity to develop and improve the relationship with their children.
Læs mere Tjek på PubMedMohammad M. Hamasha, Areen Jihad Alomari, Ala H. Bani-Irshid
PLoS One Infectious Diseases, 20.04.2024
Tilføjet 20.04.2024
by Mohammad M. Hamasha, Areen Jihad Alomari, Ala H. Bani-Irshid This study investigates the impact of COVID-19 pandemic-induced E-learning in Jordanian higher education. Through a quantitative survey, the study analyzes the independent variables of system use and user satisfaction, finding that information quality and service quality significantly affect these variables and that user satisfaction notably impacts E-learning. System usage moderates these effects. This research comprehensively analyzes the effects of the COVID-19 epidemic on Jordanian higher education, focusing on E-learning. It shows how information, system, and service quality affect system use and user satisfaction. The study also emphasizes these aspects’ importance in E-learning platform effectiveness. The study offers actionable insights and recommendations to help Jordan establish more resilient and effective educational policies and practices that can adjust to higher education shocks. The study recommends establishing a specialized department to modify student intention to use E-learning systems, not only during the pandemic crisis but also after-ward, to improve familiarity with E-learning tools. This study provides insights into the pandemic’s impact on Jordan’s higher education system and suggests future approaches to enhance E-learning platforms. It contributes to the development of effective E-learning systems that can improve higher education standards by pinpointing the key effects of the pandemic on the independent variables and offering workable solutions. The study emphasizes the importance of information and service quality in improving user satisfaction and system usage in E-learning.
Læs mere Tjek på PubMedMakam, Anil N.; Burnfield, Judith; Prettyman, Ed; Nguyen, Oanh Kieu; Wu, Nancy; Espejo, Edie; Blat, Cinthia; Boscardin, W. John; Ely, E. Wesley; Jackson, James C.; Covinsky, Kenneth E; Votto, John; for the Recovery After Transfer to an LTACH for COVID-19 (RAFT COVID) Study
Critical Care Medicine, 19.04.2024
Tilføjet 19.04.2024
Objectives: Understanding the long-term effects of severe COVID-19 illness on survivors is essential for effective pandemic recovery planning. Therefore, we investigated impairments among hospitalized adults discharged to long-term acute care hospitals (LTACHs) for prolonged severe COVID-19 illness who survived 1 year. Design: The Recovery After Transfer to an LTACH for COVID-19 (RAFT COVID) study was a national, multicenter, prospective longitudinal cohort study. Setting and Patients: We included hospitalized English-speaking adults transferred to one of nine LTACHs in the United States between March 2020 and February 2021 and completed a survey. Interventions: None. Measurements and Main Results: Validated instruments for impairments and free response questions about recovering. Among 282 potentially eligible participants who provided permission to be contacted, 156 (55.3%) participated (median age, 65; 38.5% female; 61.3% in good prior health; median length of stay of 57 d; 77% mechanically ventilated for a median of 26 d; 42% had a tracheostomy). Approximately two-thirds (64%) had a persistent impairment, including physical (57%), respiratory (49%; 19% on supplemental oxygen), psychiatric (24%), and cognitive impairments (15%). Nearly half (47%) had two or more impairment types. Participants also experienced persistent debility from hospital-acquired complications, including mononeuropathies and pressure ulcers. Participants described protracted recovery, attributing improvements to exercise/rehabilitation, support, and time. While considered life-altering with 78.7% not returning to their usual health, participants expressed gratitude for recovering; 99% returned home and 60% of previously employed individuals returned to work. Conclusions: Nearly two-thirds of survivors of among the most prolonged severe COVID-19 illness had persistent impairments at 1 year that resembled post-intensive care syndrome after critical illness plus debility from hospital-acquired complications.
Læs mere Tjek på PubMedMuyun Wei, Shuangshuang Li, Xinhua Lu, Kaiming Hu, Zhilan Li, Min Li
Journal of Medical Virology, 19.04.2024
Tilføjet 19.04.2024
BMC Infectious Diseases, 19.04.2024
Tilføjet 19.04.2024
Abstract Background and purpose The COVID-19 pandemic has presented unprecedented public health challenges worldwide. Understanding the factors contributing to COVID-19 mortality is critical for effective management and intervention strategies. This study aims to unlock the predictive power of data collected from personal, clinical, preclinical, and laboratory variables through machine learning (ML) analyses. Methods A retrospective study was conducted in 2022 in a large hospital in Abadan, Iran. Data were collected and categorized into demographic, clinical, comorbid, treatment, initial vital signs, symptoms, and laboratory test groups. The collected data were subjected to ML analysis to identify predictive factors associated with COVID-19 mortality. Five algorithms were used to analyze the data set and derive the latent predictive power of the variables by the shapely additive explanation values. Results Results highlight key factors associated with COVID-19 mortality, including age, comorbidities (hypertension, diabetes), specific treatments (antibiotics, remdesivir, favipiravir, vitamin zinc), and clinical indicators (heart rate, respiratory rate, temperature). Notably, specific symptoms (productive cough, dyspnea, delirium) and laboratory values (D-dimer, ESR) also play a critical role in predicting outcomes. This study highlights the importance of feature selection and the impact of data quantity and quality on model performance. Conclusion This study highlights the potential of ML analysis to improve the accuracy of COVID-19 mortality prediction and emphasizes the need for a comprehensive approach that considers multiple feature categories. It highlights the critical role of data quality and quantity in improving model performance and contributes to our understanding of the multifaceted factors that influence COVID-19 outcomes.
Læs mere Tjek på PubMedAmit Saraf, Rohan Gurjar, Swarnendu Kaviraj, Aishwarya Kulkarni, Durgesh Kumar, Ruta Kulkarni, Rashmi Virkar, Jayashri Krishnan, Anjali Yadav, Ekta Baranwal, Ajay Singh, Arjun Raghuwanshi, Praveen Agarwal, Laxman Savergave, Sanjay Singh, Himanshu Pophale, Prakash Shende, Ravindra Baban Shinde, Vikram Vikhe, Abhishek Karmalkar, Bhaskar Deshmukh, Krishna Giri, Shrikant Deshpande, Ajay Bulle, Md. Sabah Siddiqui, Swapnav Borthakur, V. Reddy Tummuru, A. Venkateshwar Rao, Dhaiwat Shukla, Manish Kumar Jain, Pankaj Bhardwaj, Pravin Dinkar Supe, Manoja Kumar Das, Manoj Lahoti, Vijaykumar Barge
Nature, 18.04.2024
Tilføjet 18.04.2024
Suzy E. Meijer, Yael Paran, Ana Belkin, Ronen Ben-Ami, Yasmin Maor, Lior Nesher, Khetam Hussein, Galia Rahav, Tal Brosh-Nissimov
Clinical Microbiology and Infection, 18.04.2024
Tilføjet 18.04.2024
Immunocompromised patients with impaired humoral immunity are at risk for persistent COVID-19 (pCOVID), a protracted symptomatic disease with active viral replication.
Læs mere Tjek på PubMedCheema, H. A., Jafar, U., Shahid, A., Masood, W., Usman, M., Hermis, A. H., Naseem, M. A., Sahra, S., Sah, R., Lee, K. Y.
BMJ Open, 18.04.2024
Tilføjet 18.04.2024
ObjectivesWe conducted an updated systematic review and meta-analysis to investigate the effect of colchicine treatment on clinical outcomes in patients with COVID-19. DesignSystematic review and meta-analysis. Data sourcesWe searched PubMed, Embase, the Cochrane Library, medRxiv and ClinicalTrials.gov from inception to January 2023. Eligibility criteriaAll randomised controlled trials (RCTs) that investigated the efficacy of colchicine treatment in patients with COVID-19 as compared with placebo or standard of care were included. There were no language restrictions. Studies that used colchicine prophylactically were excluded. Data extraction and synthesisWe extracted all information relating to the study characteristics, such as author names, location, study population, details of intervention and comparator groups, and our outcomes of interest. We conducted our meta-analysis by using RevMan V.5.4 with risk ratio (RR) and mean difference as the effect measures. ResultsWe included 23 RCTs (28 249 participants) in this systematic review. Colchicine did not decrease the risk of mortality (RR 0.99; 95% CI 0.93 to 1.05; I2=0%; 20 RCTs, 25 824 participants), with the results being consistent among both hospitalised and non-hospitalised patients. There were no significant differences between the colchicine and control groups in other relevant clinical outcomes, including the incidence of mechanical ventilation (RR 0.75; 95% CI 0.48 to 1.18; p=0.22; I2=40%; 8 RCTs, 13 262 participants), intensive care unit admission (RR 0.77; 95% CI 0.49 to 1.22; p=0.27; I2=0%; 6 RCTs, 961 participants) and hospital admission (RR 0.74; 95% CI 0.48 to 1.16; p=0.19; I2=70%; 3 RCTs, 8572 participants). ConclusionsThe results of this meta-analysis do not support the use of colchicine as a treatment for reducing the risk of mortality or improving other relevant clinical outcomes in patients with COVID-19. However, RCTs investigating early treatment with colchicine (within 5 days of symptom onset or in patients with early-stage disease) are needed to fully elucidate the potential benefits of colchicine in this patient population. PROSPERO registration numberCRD42022369850.
Læs mere Tjek på PubMedRockwell, M. S., Oyese, E. G., Singh, E., Vinson, M., Yim, I., Turner, J. K., Epling, J. W.
BMJ Open, 18.04.2024
Tilføjet 18.04.2024
ObjectivesPotentially harmful non-steroidal anti-inflammatory drugs (NSAIDs) utilisation persists at undesirable rates worldwide. The purpose of this paper is to review the literature on interventions to de-implement potentially harmful NSAIDs in healthcare settings and to suggest directions for future research. DesignScoping review. Data sourcesPubMed, CINAHL, Embase, Cochrane Central and Google Scholar (1 January 2000 to 31 May 2022). Study selectionStudies reporting on the effectiveness of interventions to systematically reduce potentially harmful NSAID utilisation in healthcare settings. Data extractionUsing Covidence systematic review software, we extracted study and intervention characteristics, including the effectiveness of interventions in reducing NSAID utilisation. ResultsFrom 7818 articles initially identified, 68 were included in the review. Most studies took place in European countries (45.6%) or the USA (35.3%), with randomised controlled trial as the most common design (55.9%). Interventions were largely clinician-facing (76.2%) and delivered in primary care (60.2%) but were rarely (14.9%) guided by an implementation model, framework or theory. Academic detailing, clinical decision support or electronic medical record interventions, performance reports and pharmacist review were frequent approaches employed. NSAID use was most commonly classified as potentially harmful based on patients’ age (55.8%), history of gastrointestinal disorders (47.1%), or history of kidney disease (38.2%). Only 7.4% of interventions focused on over-the-counter (OTC) NSAIDs in addition to prescription. The majority of studies (76.2%) reported a reduction in the utilisation of potentially harmful NSAIDs. Few studies (5.9%) evaluated pain or quality of life following NSAIDs discontinuation. ConclusionMany varied interventions to de-implement potentially harmful NSAIDs have been applied in healthcare settings worldwide. Based on these findings and identified knowledge gaps, further efforts to comprehensively evaluate the effectiveness of interventions and the combination of intervention characteristics associated with effective de-implementation are needed. In addition, future work should be guided by de-implementation theory, focus on OTC NSAIDs and incorporate patient-focused strategies and outcomes, including the evaluation of unintended consequences of the intervention.
Læs mere Tjek på PubMedHansen, M. A., Lekodeba, N. A., Chevalier, J. M., Ockhuisen, T., del Rey-Puech, P., Marban-Castro, E., Martinez-Perez, G. Z., Shilton, S., Radzi Abu Hassan, M., Getia, V., Weinert-Mizuschima, C., Tenorio Bezerra, M. I., Chala, L., Leong, R., Peregino, R., Keller, S., Spruijt, I., Johnson, C. C., Girdwood, S. J., Nichols, B. E.
BMJ Open, 18.04.2024
Tilføjet 18.04.2024
ObjectiveDiagnostic testing is an important tool to combat the COVID-19 pandemic, yet access to and uptake of testing vary widely 3 years into the pandemic. The WHO recommends the use of COVID-19 self-testing as an option to help expand testing access. We aimed to calculate the cost of providing COVID-19 self-testing across countries and distribution modalities. DesignWe estimated economic costs from the provider perspective to calculate the total cost and the cost per self-test kit distributed for three scenarios that differed by costing period (pilot, annual), the number of tests distributed (actual, planned, scaled assuming an epidemic peak) and self-test kit costs (pilot purchase price, 50% reduction). SettingWe used data collected between August and December 2022 in Brazil, Georgia, Malaysia, Ethiopia and the Philippines from pilot implementation studies designed to provide COVID-19 self-tests in a variety of settings—namely, workplace and healthcare facilities. ResultsAcross all five countries, 173 000 kits were distributed during pilot implementation with the cost/test distributed ranging from $2.44 to $12.78. The cost/self-test kit distributed was lowest in the scenario that assumed implementation over a longer period (year), with higher test demand (peak) and a test kit price reduction of 50% ($1.04–3.07). Across all countries and scenarios, test procurement occupied the greatest proportion of costs: 58–87% for countries with off-site self-testing (outside the workplace, for example, home) and 15–50% for countries with on-site self-testing (at the workplace). Staffing was the next key cost driver, particularly for distribution modalities that had on-site self-testing (29–35%) versus off-site self-testing (7–27%). ConclusionsOur results indicate that it is likely to cost between $2.44 and $12.78 per test to distribute COVID-19 self-tests across common settings in five heterogeneous countries. Cost-effectiveness analyses using these results will allow policymakers to make informed decisions on optimally scaling up COVID-19 self-test distribution programmes across diverse settings and evolving needs.
Læs mere Tjek på PubMedGonzalez-Jaramillo, N., Abbühl, D., Roa-Diaz, Z. M., Kobler-Betancourt, C., Frahsa, A.
BMJ Open, 18.04.2024
Tilføjet 18.04.2024
ObjectiveTo compare vaccination willingness before rollout and 1 year post-rollout uptake among the general population and under-resourced communities in high-income countries. DesignA realist review. Data sourcesEmbase, PubMed, Dimensions ai and Google Scholar. SettingHigh-income countries. DefinitionsWe defined vaccination willingness as the proportion of participants willing or intending to receive vaccines prior to availability. We defined vaccine uptake as the real proportion of the population with complete vaccination as reported by each country until November 2021. ResultsWe included data from 62 studies and 18 high-income countries. For studies conducted among general populations, the proportion of vaccination willingness was 67% (95% CI 62% to 72%). In real-world settings, the overall proportion of vaccine uptake among those countries was 73% (95% CI 69% to 76%). 17 studies reported pre-rollout willingness for under-resourced communities. The summary proportion of vaccination willingness from studies reporting results among people from under-resourced communities was 52% (95% CI 0.46% to 0.57%). Real-world evidence about vaccine uptake after rollout among under-resourced communities was limited. ConclusionOur review emphasises the importance of realist reviews for assessing vaccine acceptance. Limited real-world evidence about vaccine uptake among under-resourced communities in high-income countries is a call to context-specific actions and reporting.
Læs mere Tjek på PubMedSiti Nur Aisyah Zaid, Azidah Abdul Kadir, Norhayati Mohd Noor, Basaruddin Ahmad, Muhamad Saiful Bahri Yusoff, Anis Safura Ramli, Jasy Liew Suet Yan
PLoS One Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
by Siti Nur Aisyah Zaid, Azidah Abdul Kadir, Norhayati Mohd Noor, Basaruddin Ahmad, Muhamad Saiful Bahri Yusoff, Anis Safura Ramli, Jasy Liew Suet Yan Introduction Healthcare workers play a crucial role in supporting COVID-19 vaccination as they are the most trusted source of information to the public population. Assessing the healthcare workers’ hesitancy towards COVID-19 vaccination is pertinent, however, there are limited validated tools to measure their hesitancy on COVID-19 vaccines. This study aims to adapt and validate the first COVID-19 hesitancy scale among healthcare workers in Malaysia. Materials and methods This study adapted and translated the Vaccine Hesitancy Scale (VHS) developed by the WHO SAGE Working Group. The scale underwent a sequential validation process, including back-back translation, content, face, and construct validity for Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). The reliability was tested using internal consistency (Cronbach’s alpha composite reliability (CR) and average variance extracted (AVE)). Results The data for EFA and CFA were completed by a separate sample of 125 and 300 HCWs, respectively. The EFA analysis of the C19-VHS-M scale was unidimensional with 10 items. A further CFA analysis revealed a uniform set of nine items with acceptable goodness fit indices (comparative fit index = 0.997, Tucker-Lewis index = 0.995, incremental fit index = 0.997, chi-squared/degree of freedom = 1.352, and root mean square error of approximation = 0.034). The Cronbach’s alpha, CR and AVE results were 0.953, 0.95 and 0.70, respectively. Conclusions The questionnaire was valid and reliable for use in the Malay language.
Læs mere Tjek på PubMedKarolina Pawlak, Agata Malak-Rawlikowska, Mariusz Hamulczuk, Marta Skrzypczyk
PLoS One Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
by Karolina Pawlak, Agata Malak-Rawlikowska, Mariusz Hamulczuk, Marta Skrzypczyk The aim of the paper is to provide an ex-post assessment of the impact of the COVID-19 pandemic on food insecurity in the EU-27 countries expressed by physical and economic food access. We analysed trade and price effects, together with food insecurity and malnutrition indicators. Actual levels of the indicators were compared with their pre-pandemic magnitudes and/or with counterfactual levels derived from predictive models. We also aimed to compare the objective statistics with the subjective consumers’ perception of their households’ food security. Our research indicates that the EU food trade was more resilient to COVID-19 impacts than the trade in non-food products, while food trade decreases were of a temporary nature. This did not affect the trade balance significantly; however, the import reduction threatened the physical food access in most EU countries. Regarding economic food access, the results indicate that the increase in food prices was offset by the increase in disposable income. It may suggest that the COVID-19 pandemic did not significantly affect the deterioration of economic access to food in the EU countries. However, the prevalence of severe food insecurity in the total population or the proportion of households reporting inability to afford a meal with meat, chicken, fish, or a vegetarian equivalent increased in 2020–2021 compared to 2019. This means that the comparative analysis of the real data on prices and households’ income, as well as consumer financial situation and food consumption affordability, does not offer a clear answer concerning the impact of the COVID-19 pandemic on the food security of EU households.
Læs mere Tjek på PubMedMariko I. Ito, Yudai Honma, Takaaki Ohnishi, Tsutomu Watanabe, Kazuyuki Aihara
PLoS One Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
by Mariko I. Ito, Yudai Honma, Takaaki Ohnishi, Tsutomu Watanabe, Kazuyuki Aihara Transactions in financial markets are not evenly spaced but can be concentrated within a short period of time. In this study, we investigated the factors that determine the transaction frequency in financial markets. Specifically, we employed the Hawkes process model to identify exogenous and endogenous forces governing transactions of individual stocks in the Tokyo Stock Exchange during the COVID-19 pandemic. To enhance the accuracy of our analysis, we introduced a novel EM algorithm for the estimation of exogenous and endogenous factors that specifically addresses the interdependence of the values of these factors over time. We detected a substantial change in the transaction frequency in response to policy change announcements. Moreover, there is significant heterogeneity in the transaction frequency among individual stocks. We also found a tendency where stocks with high market capitalization tend to significantly respond to external news, while their excitation relationship between transactions is weak. This suggests the capability of quantifying the market state from the viewpoint of the exogenous and endogenous factors generating transactions for various stocks.
Læs mere Tjek på PubMedMark Griffiths, Dunia Hatabah, Patrick Sullivan, Grace Mantus, Travis Sanchez, Maria Zlotorzynska, Stacy Heilman, Andres Camacho-Gonzalez, Deborah Leake, Rawan Korman, Mimi Le, Mehul Suthara, Jens Wrammert, Miriam B. Vos, Claudia R. Morris
International Journal of Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
Understanding the prevalence and incidence of SARS-CoV-2 infection among frontline healthcare workers is important to inform health policy and strategy. In the early stages of the COVID-19 pandemic, children were thought to be at low risk for infection, suggesting minimal risk of work-acquired SARS-CoV-2 infection in pediatric healthcare workers (pHCWs). This is due to early hypotheses that children were not affected by and did not spread SARS-CoV-2 to the degree that was seen among adult patients and their caregivers [1].
Læs mere Tjek på PubMedGiulia Matusali, Alessandra Vergori, Eleonora Cimini, Davide Mariotti, Valentina Mazzotta, Alessandro Cozzi Lepri, Francesca Colavita, Roberta Gagliardini, Stefania Notari, Silvia Meschi, Marisa Fusto, Eleonora Tartaglia, Enrico Girardi, Fabrizio Maggi, Andrea Antinori, the HIV‐VAC Study Group
Journal of Medical Virology, 17.04.2024
Tilføjet 17.04.2024
Marco Del Riccio, Saverio Caini, Guglielmo Bonaccorsi, Chiara Lorini, John Paget, Koos van der Velden, Adam Meijer, Mendel Haag, Ian McGovern, Patrizio Zanobini
International Journal of Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
The emergence of the COVID-19 pandemic, caused by SARS-CoV-2, has undeniably reshaped life on a global scale. As infection rates and fatalities surged to historic proportions, initial strategies to combat the crisis revolved around non-pharmaceutical interventions (NPIs) such as the use of facemasks, physical distancing, travel bans, and lockdowns, considering the absence of available vaccines or targeted therapeutics. Characterized by a spectrum of actions spanning individual precautions to broader societal measures, NPIs aimed to curtail the rapid dissemination of the virus [1].
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
Abstract Background Since the emergence of SARS-CoV-2 (COVID-19), there have been multiple waves of infection and multiple rounds of vaccination rollouts. Both prior infection and vaccination can prevent future infection and reduce severity of outcomes, combining to form hybrid immunity against COVID-19 at the individual and population level. Here, we explore how different combinations of hybrid immunity affect the size and severity of near-future Omicron waves. Methods To investigate the role of hybrid immunity, we use an agent-based model of COVID-19 transmission with waning immunity to simulate outbreaks in populations with varied past attack rates and past vaccine coverages, basing the demographics and past histories on the World Health Organization Western Pacific Region. Results We find that if the past infection immunity is high but vaccination levels are low, then the secondary outbreak with the same variant can occur within a few months after the first outbreak; meanwhile, high vaccination levels can suppress near-term outbreaks and delay the second wave. Additionally, hybrid immunity has limited impact on future COVID-19 waves with immune-escape variants. Conclusions Enhanced understanding of the interplay between infection and vaccine exposure can aid anticipation of future epidemic activity due to current and emergent variants, including the likely impact of responsive vaccine interventions.
Læs mere Tjek på PubMedReem Hoteit, Imad Bou-Hamad, Sahar Hijazi, Dinah Ayna, Maya Romani, Christo El Morr
PLoS One Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
by Reem Hoteit, Imad Bou-Hamad, Sahar Hijazi, Dinah Ayna, Maya Romani, Christo El Morr Objectives University students are regarded as the backbone of society, and their mental health during a pandemic may have a substantial impact on their performance and life outcomes. The purpose of this study was to assess university students’ mental health, specifically depression, anxiety, and stress, during Lebanon’s extended COVID-19 pandemic, as well as the sociodemographic factors and lifestyle practices associated with it. Methods An online anonymous survey assessed the rates of mental health problems during COVID-19, controlling for socio-demographics and other lifestyle practices, in 329 undergraduate and graduate university students. Instruments utilized were the Patient Health Questionnaire (PHQ-9) for depression, the Beck Anxiety Inventory (21-BAI) for anxiety, and the Perceived Stress Scale (PSS-10) for stress. The study employed descriptive statistics and multiple logistic regression models to analyze the association between depression, anxiety, and stress with sociodemographic and lifestyle factors. Results were evaluated using adjusted odds ratios and confidence intervals, with a significance level of 0.05. Results Moderate to severe rates of depression, anxiety and stress among students were reported by 75.9%, 72.2%, and 89.3%, respectively. The odds of anxiety and stress were higher among women compared to men. Students who used private counseling services had higher odds of anxiety and stress than those who did not. Overall rated health was a major predictor of depression and anxiety, with the \'poor\' and \'fair\' overall-reported health groups having higher odds than the \'Excellent\' group. When compared to those who did not smoke, students who increased their smoking intake had higher odds of depression, anxiety and stress. Students who reduced their alcohol consumption had lower odds of anxiety compared to those who did not consume alcohol. Students who reduced their physical activity had higher odds than those who increased it. Finally, students who slept fewer than seven hours daily had higher odds of depression than those who slept seven to nine hours. Conclusion Our findings indicate a national student mental health crisis, with exceptionally high rates of moderate to severe depression, anxiety, and stress. Factors such as gender, university program, overall rated health, importance of religion in daily decisions, private counseling, smoking cigarettes, alcohol consumption, physical activity, and sleeping, were all found to have an impact on mental health outcomes. Our study highlights the need for university administrators and mental health professionals to consider targeted mental health programming for students, particularly for women and those with poor or fair overall perceived health.
Læs mere Tjek på PubMedHao Tan, Jiayan Liu, Yingli Zhang
PLoS One Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
by Hao Tan, Jiayan Liu, Yingli Zhang As a major concern shared by parents globally, COVID-19 vaccine safety is typically being messaged to the public in a negative frame in many countries. However, whether the COVID-19 vaccine safety framing have an effect on parents when vaccinating their children is unclear. Here we implement an online survey with a convenience sample of 3,861 parents living in mainland China, all over 18 years old and with at least one child under 18. The parents were randomly assigned to receive information about COVID-19 vaccine safety in either a negative frame (incidence of side effects) or a positive frame (the inverse incidence of side effects), to compare parental reactions to a range of questions about communication, risk perception, trust, involvement and behavioral intention. We found that parents were more likely to regard vaccine safety as relevant to policy support and as a higher priority for government when receiving positively framed information (p = 0.002). For some specific subgroups, parents in positive framing group showed lower risk perception and higher trust (p
Læs mere Tjek på PubMedR. Constance Wiener, Eric W. Lundstrom
PLoS One Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
by R. Constance Wiener, Eric W. Lundstrom Background A large proportion of United States (U.S.) youth play basketball, baseball, softball, or T-ball. Each of the activities poses a documented risk of craniofacial and neck injuries. However, few studies have assessed the national prevalence of pediatric craniofacial and neck injuries in this population, particularly following the COVID-19 pandemic. Methods The National Electronic Injury Surveillance System (NEISS) dataset was used to identify pediatric craniofacial and neck injuries associated with basketball, baseball, softball, or T-ball from 2003–2022 in a cross-sectional study. The annual number of injuries before and after the onset of the COVID-19 pandemic with 95% confidence intervals were calculated. Interrupted time series analysis (ITSA) was used to estimate the pandemic’s impact on the monthly number of injuries incurred nationally. Results Both overall and stratified by sport involvement, the annual number and rate of injuries identified in NEISS decreased significantly after the COVID-19 pandemic. ITSA demonstrated that the monthly number of injuries decreased -4094.4 (95% CI = -5100, -3088.7) immediately after the beginning of the pandemic. The number of injuries began increasing towards pre-pandemic levels at a rate of 110.6 (95% CI = 64, 157.2) injuries per month after the initial plunge. Conclusion Prior to the-pandemic, there was a steady decline in craniofacial and neck injuries due to basketball, baseball, softball and T-ball among children, aged
Læs mere Tjek på PubMedMeghan Weissflog, Soyeon Kim, Natalie Rajack, Nathan J. Kolla
PLoS One Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
by Meghan Weissflog, Soyeon Kim, Natalie Rajack, Nathan J. Kolla While COVID-19 impacted all aspects of health care and patient treatment, particularly for patients with mental health/substance use (MH/SU) concerns, research has suggested a concerning increase in the use of restraint and seclusion (R/S) interventions, although results vary depending on facility type and patient population. Thus, the present study sought to explore COVID-related changes in the use of R/S interventions among patients presenting to Ontario emergency departments (EDs) with MH/SU complaints. To determine whether temporal and clinical factors were associated with changes in R/S use during COVID, binary logistic regression models were computed using data from the National Ambulatory Care Reporting System database. We then compared both prevalence rates and probability of an R/S event occurring during an ED visit in Ontario before and after the onset of COVID. The number of ED visits during which an R/S event occurred for patients presenting with MH/SU concerns increased by 9.5%, while their odds of an R/S event occurring during an ED visit increased by 23% in Ontario after COVID onset. Similarly, R/S event probability increased for patients presenting with MH/SU concerns after COVID onset (0.7% - 21.3% increase), particularly during the first wave, with the greatest increases observed for concerns associated with increased restraint risk pre-COVID. R/S intervention use increased substantially for patients presenting to Ontario EDs with MH/SU concerns during the first wave of COVID when the strain on healthcare system and uncertainty about the virus was arguably greatest. Patients with concerns already associated with increased R/S risk also showed the largest increases in R/S probability, suggesting increased behavioural issues during treatment among this population after COVID onset. These results have the potential to inform existing policies to mitigate risks associated with R/S intervention use during future public health emergencies and in general practice.
Læs mere Tjek på PubMedD'souza, B., Glover, A., Bavor, C., Brown, B., Dodd, R. H., Lee, J. C., Millar, J., Miller, J. A., Zalcberg, J. R., Serpell, J., Ioannou, L. J., Nickel, B.
BMJ Open, 16.04.2024
Tilføjet 16.04.2024
ObjectivesThe study aims to investigate the perceptions of patients with thyroid cancer on the potential impact of diagnosis and treatment delays during the COVID-19 pandemic. DesignThis study involved qualitative semi-structured telephone interviews. The interviews were transcribed verbatim, analysed using the thematic framework analysis method and reported using the Consolidated Criteria for Reporting Qualitative Research. SettingParticipants in the study were treated and/or managed at hospital sites across New South Wales and Victoria, Australia. Participants17 patients with thyroid cancer were interviewed and included in the analysis (14 females and 3 males). ResultsThe delays experienced by patients ranged from 12 months. The patients reported about delays to diagnostic tests, delays to surgery and radioactive iodine treatment, perceived disease progression and, for some, the financial burden of choosing to go through private treatment to minimise the delay. Most patients also reported not wanting to experience delays any longer than they did, due to unease and anxiety. ConclusionsThis study highlights an increased psychological burden in patients with thyroid cancer who experienced delayed diagnosis and/or treatment during COVID-19. The impacts experienced by patients during this time may be similar in the case of other unexpected delays and highlight the need for regular clinical review during delays to diagnosis or treatment.
Læs mere Tjek på PubMedQingyuan Sun, Jinyang Gao, Ran An, Menggeer Wang, Yanqing Wang
Journal of Medical Virology, 16.04.2024
Tilføjet 16.04.2024