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Søgeord (covid-19) valgt.
2048 emner vises.
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 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 PubMedMarco 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 PubMedGBD 2021 Lower Respiratory Infections and Antimicrobial Resistance Collaborators
Lancet Infectious Diseases, 16.04.2024
Tilføjet 16.04.2024
Substantial progress has been made in reducing LRI mortality, but the burden remains high, especially in low-income and middle-income countries. During the COVID-19 pandemic, with its associated non-pharmaceutical interventions, global incident LRI cases and mortality attributable to influenza and RSV declined substantially. Expanding access to health-care services and vaccines, including S pneumoniae, H influenzae type B, and novel RSV vaccines, along with new low-cost interventions against S aureus, could mitigate the LRI burden and prevent transmission of LRI-causing pathogens.
Læs mere Tjek på PubMedClinical Infectious Diseases, 16.04.2024
Tilføjet 16.04.2024
Abstract Background In 2020, the Council of State and Territorial Epidemiologists (CSTE) pertussis case definition was modified; the main change was classifying PCR-positive cases as confirmed, regardless of cough duration. Pertussis data reported through Enhanced Pertussis Surveillance (EPS) in seven sites and the National Notifiable Diseases Surveillance System (NNDSS) were used to evaluate the impact of the new case definition.Methods We compared the number of EPS cases with cough onset in 2020 to the number that would have been reported based on the prior (2014) CSTE case definition. To assess the impact of the change nationally, the proportion of EPS cases newly reportable under the 2020 CSTE case definition was applied to 2020 NNDSS data to estimate how many additional cases were captured nationally.Results Among 442 confirmed and probable cases reported to EPS states in 2020, 42 (9.5%) were newly reportable according to the 2020 case definition. Applying this proportion to the 6,124 confirmed and probable cases reported nationally in 2020, we estimated that the new definition added 582 cases. Had the case definition not changed, reported cases in 2020 would have decreased by 70% from 2019; the observed decrease was 67%.Conclusions Despite a substantial decrease in reported pertussis cases in the setting of COVID-19, our data show that the 2020 pertussis case definition change resulted in additional case reporting compared with the previous case definition, providing greater opportunities for public health interventions such as prophylaxis of close contacts.
Læs mere Tjek på PubMedJasper Fuk-Woo Chan, Shuofeng Yuan, Hin Chu, Siddharth Sridhar, Kwok-Yung Yuen
Nat Rev Microbiol, 15.04.2024
Tilføjet 15.04.2024
Infection, 13.04.2024
Tilføjet 13.04.2024
Abstract Purpose To evaluate clinical outcomes associated with sotrovimab use during Omicron BA.2 and BA.5 predominance. Methods Electronic databases were searched for observational studies published in peer-reviewed journals, preprint articles and conference abstracts from January 1, 2022 to February 27, 2023. Results The 14 studies identified were heterogeneous in terms of study design, population, endpoints and definitions. They included > 1.7 million high-risk patients with COVID-19, of whom approximately 41,000 received sotrovimab (range n = 20–5979 during BA.2 and n = 76–1383 during BA.5 predominance). Four studies compared the effectiveness of sotrovimab with untreated or no monoclonal antibody treatment controls, two compared sotrovimab with other treatments, and three single-arm studies compared outcomes during BA.2 and/or BA.5 versus BA.1. Five studies descriptively reported rates of clinical outcomes in patients treated with sotrovimab. Rates of COVID-19-related hospitalization or mortality (0.95–4.0% during BA.2; 0.5–2.0% during BA.5) and all-cause mortality (1.7–2.0% during BA.2; 3.4% during combined BA.2 and BA.5 periods) among sotrovimab-treated patients were consistently low. During BA.2, a lower risk of all-cause hospitalization or mortality was reported across studies with sotrovimab versus untreated cohorts. Compared with other treatments, sotrovimab was associated with a lower (molnupiravir) or similar (nirmatrelvir/ritonavir) risk of COVID-19-related hospitalization or mortality during BA.2 and BA.5. There was no significant difference in outcomes between the BA.1, BA.2 and BA.5 periods. Conclusions This systematic literature review suggests continued effectiveness of sotrovimab in preventing severe clinical outcomes during BA.2 and BA.5 predominance, both against active/untreated comparators and compared with BA.1 predominance.
Læs mere Tjek på PubMedGemma Lladós, Marta Massanella, Roger Paredes, Lourdes Mateu
Clinical Microbiology and Infection, 13.04.2024
Tilføjet 13.04.2024
Remigius Gröning, Jonatan Walde, Clas Ahlm, Mattias NE Forsell, Johan Normark, Johan Rasmuson
International Journal of Infectious Diseases, 12.04.2024
Tilføjet 12.04.2024
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been a major public health concern since the start of the 2019 pandemic. Although current vaccines protect the general public, individuals with severe immunodeficiencies often exhibit a poor vaccine response and a higher risk of severe and/or persistent disease [1,2]. There are no treatment recommendations for persistent infection in immunocompromised individuals. Attempts with repeated antiviral mono or combination therapy has been described [3].
Læs mere Tjek på PubMedGondhalekar, Vikram B.; Gandomi, Amir; Gilman, Sarah L.; Hajizadeh, Negin; Hasan, Zubair M.; Bank, Matthew A.; Rolston, Daniel M.; Cohen, Allison; Li, Timmy; Nishikimi, Mitsuaki; Narasimhan, Mangala; Becker, Lance; Jafari, Daniel
Critical Care Medicine, 12.04.2024
Tilføjet 12.04.2024
Objectives: Nonconventional ventilators (NCVs), defined here as transport ventilators and certain noninvasive positive pressure devices, were used extensively as crisis-time ventilators for intubated patients with COVID-19. We assessed whether there was an association between the use of NCV and higher mortality, independent of other factors. Design: This is a multicenter retrospective observational study. Setting: The sample was recruited from a single healthcare system in New York. The recruitment period spanned from March 1, 2020, to April 30, 2020. Patients: The sample includes patients who were intubated for COVID-19 acute respiratory distress syndrome (ARDS). Interventions: None. Measurements and Main Results: The primary outcome was 28-day in-hospital mortality. Multivariable logistic regression was used to derive the odds of mortality among patients managed exclusively with NCV throughout their ventilation period compared with the remainder of the sample while adjusting for other factors. A secondary analysis was also done, in which the mortality of a subset of the sample exclusively ventilated with NCV was compared with that of a propensity score-matched subset of the control group. Exclusive use of NCV was associated with a higher 28-day in-hospital mortality while adjusting for confounders in the regression analysis (odds ratio, 1.41; 95% CI [1.07–1.86]). In the propensity score matching analysis, the mortality of patients exclusively ventilated with NCV was 68.9%, and that of the control was 60.7% (p = 0.02). Conclusions: Use of NCV was associated with increased mortality among patients with COVID-19 ARDS. More lives may be saved during future ventilator shortages if more full-feature ICU ventilators, rather than NCVs, are reserved in national and local stockpiles.
Læs mere Tjek på PubMedClare Wenham, Liam Stout
Lancet, 12.04.2024
Tilføjet 12.04.2024
WHO has determined a public health emergency of international concern (PHEIC) seven times, and beyond this nomenclature declared COVID-19 to be a pandemic. Under the International Health Regulations (IHR), and through their operationalisation in the joint external evaluation (JEE), governments are urged to create suitable legislation to be able to enact a response to a public health emergency. Whether the pandemic declaration had a greater effect than a PHEIC in encouraging goverments to act, however, remains conjecture, as there is no systemic analysis of what each term means in practice and whether either has meaningful legal implications at the national level.
Læs mere Tjek på PubMedThe PLOS One Staff
PLoS One Infectious Diseases, 12.04.2024
Tilføjet 12.04.2024
Anna Zhilkova, Laila Alsabahi, Donald Olson, Duncan Maru, Tsu-Yu Tsao, Michelle E. Morse
PLoS One Infectious Diseases, 12.04.2024
Tilføjet 12.04.2024
by Anna Zhilkova, Laila Alsabahi, Donald Olson, Duncan Maru, Tsu-Yu Tsao, Michelle E. Morse Background Hospital segregation by race, ethnicity, and health insurance coverage is prevalent, with some hospitals providing a disproportionate share of undercompensated care. We assessed whether New York City (NYC) hospitals serving a higher proportion of Medicaid and uninsured patients pre-pandemic experienced greater critical care strain during the first wave of the COVID-19 pandemic, and whether this greater strain was associated with higher rates of in-hospital mortality. Methods In a retrospective analysis of all-payer NYC hospital discharge data, we examined changes in admissions, stratified by use of intensive care unit (ICU), from the baseline period in early 2020 to the first COVID-19 wave across hospital quartiles (265,329 admissions), and crude and risk-adjusted inpatient mortality rates, also stratified by ICU use, in the first COVID wave across hospital quartiles (23,032 inpatient deaths), based on the proportion of Medicaid or uninsured admissions from 2017–2019 (quartile 1 lowest to 4 highest). Logistic regressions were used to assess the cross-sectional association between ICU strain, defined as ICU volume in excess of the baseline average, and patient-level mortality. Results ICU admissions in the first COVID-19 wave were 84%, 97%, 108%, and 123% of the baseline levels by hospital quartile 1–4, respectively. The risk-adjusted mortality rates for ICU admissions were 36.4 (CI = 34.7,38.2), 43.6 (CI = 41.5,45.8), 45.9 (CI = 43.8,48.1), and 45.7 (CI = 43.6,48.0) per 100 admissions, and those for non-ICU admissions were 8.6 (CI = 8.3,9.0), 10.9 (CI = 10.6,11.3), 12.6 (CI = 12.1,13.0), and 12.1 (CI = 11.6,12.7) per 100 admissions by hospital quartile 1–4, respectively. Compared with the reference group of 100% or less of the baseline weekly average, ICU admissions on a day for which the ICU volume was 101–150%, 151–200%, and > 200% of the baseline weekly average had odds ratios of 1.17 (95% CI = 1.10, 1.26), 2.63 (95% CI = 2.31, 3.00), and 3.26 (95% CI = 2.82, 3.78) for inpatient mortality, and non-ICU admissions on a day for which the ICU volume was 101–150%, 151–200%, and > 200% of the baseline weekly average had odds ratios of 1.28 (95% CI = 1.22, 1.34), 2.60 (95% CI = 2.40, 2.82), and 3.44 (95% CI = 3.11, 3.63) for inpatient mortality. Conclusions Our findings are consistent with hospital segregation as a potential driver of COVID-related mortality inequities and highlight the need to desegregate health care to address structural racism, advance health equity, and improve pandemic resiliency.
Læs mere Tjek på PubMedHan Chen, Longgang Yu, Lin Wang, Jisheng Zhang, Xudong Yan, Yan Jiang
International Journal of Infectious Diseases, 12.04.2024
Tilføjet 12.04.2024
Invasive fungal sinusitis (IFS) is a rare, life-threatening, and the most aggressive form of fungal infection. It is characterized by extensive tissue necrosis through vascular invasion and thrombosis, following by rapid progression and invasion into the orbit and brain from the nasal and sinus mucosa [1]. The leading pathogens are Aspergillus and mucor [2]. If not detected and treated early, the condition rapidly deteriorates, with the mortality rates as high as 50% to 80% due to intracranial extension, orbital involvement, and irreversible immunosuppression [3].
Læs mere Tjek på PubMedAlessandra Vergori, Alessandro Cozzi Lepri, Marta Chiuchiarelli, Valentina Mazzotta, Elisabetta Metafuni, Giulia Matusali, Valentina Siciliano, Jessica Paulicelli, Eleonora Alma, Agostina Siniscalchi, Simona Sica, Elisabetta Abruzzese, Massimo Fantoni, Andrea Antinori, Antonella Cingolani
International Journal of Infectious Diseases, 12.04.2024
Tilføjet 12.04.2024
Although the overall mortality during SARS-CoV-2 Omicron variants of concern (VoC) wave might be lower than that seen with other previous VoCs immunocompromised individuals remain at increased the risk of hospitalization and prolonged duration of the infection compared to the general population [1]. Moreover, persons with immunosuppression may experience reduced vaccine immune response with an impaired seroconversion and effectiveness [2]. To address the need to protect these individuals from breakthrough infections and possibly from long-lasting SARS-CoV-2 infections, in December 2021 the combination tixagevimab/cilgavimab (EvusheldTM, AstraZeneca; T/C) received the emergency use authorization (EUA) from the United States Food and Drug Administration (FDA) as pre-exposure prophylaxis (PrEP) at the dosage of 150/150 mg in moderate to severely immunocompromised individuals (aged 12 years or older and weighing >40 kg) who could not be vaccinated against COVID-19 or who may have had an inadequate response to SARS-CoV-2 vaccination.
Læs mere Tjek på PubMedGhosh, R., Gutierrez, J. P., de Jesus Ascencio-Montiel, I., Juarez-Flores, A., Bertozzi, S. M.
BMJ Open, 12.04.2024
Tilføjet 12.04.2024
ObjectiveConflicting evidence for the association between COVID-19 and adverse perinatal outcomes exists. This study examined the associations between maternal COVID-19 during pregnancy and adverse perinatal outcomes including preterm birth (PTB), low birth weight (LBW), small-for-gestational age (SGA), large-for-gestational age (LGA) and fetal death; as well as whether the associations differ by trimester of infection. Design and settingThe study used a retrospective Mexican birth cohort from the Instituto Mexicano del Seguro Social (IMSS), Mexico, between January 2020 and November 2021. ParticipantsWe used the social security administrative dataset from IMSS that had COVID-19 information and linked it with the IMSS routine hospitalisation dataset, to identify deliveries in the study period with a test for SARS-CoV-2 during pregnancy. Outcome measuresPTB, LBW, SGA, LGA and fetal death. We used targeted maximum likelihood estimators, to quantify associations (risk ratio, RR) and CIs. We fit models for the overall COVID-19 sample, and separately for those with mild or severe disease, and by trimester of infection. Additionally, we investigated potential bias induced by missing non-tested pregnancies. ResultsThe overall sample comprised 17 340 singleton pregnancies, of which 30% tested positive. We found that those with mild COVID-19 had an RR of 0.89 (95% CI 0.80 to 0.99) for PTB and those with severe COVID-19 had an RR of 1.53 (95% CI 1.07 to 2.19) for LGA. COVID-19 in the first trimester was associated with fetal death, RR=2.36 (95% CI 1.04, 5.36). Results also demonstrate that missing non-tested pregnancies might induce bias in the associations. ConclusionsIn the overall sample, there was no evidence of an association between COVID-19 and adverse perinatal outcomes. However, the findings suggest that severe COVID-19 may increase the risk of some perinatal outcomes, with the first trimester potentially being a high-risk period.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.04.2024
Tilføjet 12.04.2024
BMC Infectious Diseases, 12.04.2024
Tilføjet 12.04.2024
Abstract Background Respiratory syncytial virus (RSV) infection in children under 5 years have a significant clinical burden, also in primary care settings. This study investigates the epidemiology and burden of RSV in Italian children during the 2019/20 pre-pandemic winter season. Methods A prospective cohort study was conducted in two Italian regions. Children with Acute Respiratory Infection (ARI) visiting pediatricians were eligible. Nasopharyngeal swabs were collected and analyzed via multiplex PCR for RSV detection. A follow-up questionnaire after 14 days assessed disease burden, encompassing healthcare utilization and illness duration. Statistical analyses, including regression models, explored associations between variables such as RSV subtype and regional variations. Results Of 293 children with ARI, 41% (119) tested positive for RSV. Median illness duration for RSV-positive cases was 7 days; 6% required hospitalization (median stay: 7 days). Medication was prescribed to 95% (110/116) of RSV cases, with 31% (34/116) receiving antibiotics. RSV subtype B and regional factors predicted increased healthcare utilization. Children with shortness of breath experienced a 36% longer illness duration. Conclusions This study highlights a significant clinical burden and healthcare utilization associated with RSV in pre-pandemic Italian primary care settings. Identified predictors, including RSV subtype and symptomatology, indicate the need for targeted interventions and resource allocation strategies. RSV epidemiology can guide public health strategies for the implementation of preventive measures.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.04.2024
Tilføjet 12.04.2024
Abstract Background Vaccination has been recommended as one of the approaches for the control of COVID-19 pandemic. However, adequate vaccine coverage is critical to the effectiveness of the vaccine at population level. Data on acceptability of the vaccine in Ugandan urban areas are limited. This study examined the prevalence, factors associated with willingness to accept COVID-19 vaccine including reasons for not taking COVID-19 vaccine in a predominantly urban population of Wakiso, central Uganda. Methods Data were obtained from a cross-sectional study conducted between March 1st, 2021 and September 30th, 2021 in the urban population-based cohort of the Africa Medical and behavioral Sciences Organization (AMBSO). A Multivariable modified Poisson regression analysis was used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals of willingness to accept the COVID-19 vaccine. Results A total of 1,903 participants were enrolled in this study; 61% of whom were females. About 63% of participants indicated their willingness to accept the COVID-19 vaccine. Persons aged 13–19 years (aPR = 0.79; [95% CI: 0.74, 0.84]) or 20-29years (aPR = 0.93; [95% CI: 0.88, 0.98]) were less likely to accept the vaccine compared to persons aged 40–49 years. Persons with post-primary level of education (aPR = 1.05; [95% CI: 1.02, 1.09]) were more likely to accept the vaccine compared to persons with primary level of education. Additionally, students or individuals working in government (aPR = 1.13; [95% CI: 1.04, 1.23]) were more likely to accept the vaccine compared to individuals doing construction and Mechanic work as their main occupation. Reported reasons for not taking a COVID-19 vaccine included; concerns about side effects of the vaccine 154(57.0%), 64(23.7%) did not think the vaccines were effective, while 32(11.9%) did not like the vaccines. Conclusion A substantial proportion of individuals were not willing to accept the COVID-19 vaccine. Health education campaigns on vaccination within urban communities could help reduce COVID-19 vaccine misconceptions in the urban populations more especially the young and persons with low levels of formal education.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.04.2024
Tilføjet 12.04.2024
Abstract Background COVID-19-associated pulmonary aspergillosis (CAPA) is burdened by high mortality. Data are lacking about non-ICU patients. Aims of this study were to: (i) assess the incidence and prevalence of CAPA in a respiratory sub-intensive care unit, (ii) evaluate its risk factors and (iii) impact on in-hospital mortality. Secondary aims were to: (i) assess factors associated to mortality, and (ii) evaluate significant features in hematological patients. Materials and methods This was a single-center, retrospective study of COVID-19 patients with acute respiratory failure. A cohort of CAPA patients was compared to a non-CAPA cohort. Among patients with CAPA, a cohort of hematological patients was further compared to another of non-hematological patients. Results Three hundred fifty patients were included in the study. Median P/F ratio at the admission to sub-intensive unit was 225 mmHg (IQR 155–314). 55 (15.7%) developed CAPA (incidence of 5.5%). Eighteen had probable CAPA (37.3%), 37 (67.3%) possible CAPA and none proven CAPA. Diagnosis of CAPA occurred at a median of 17 days (IQR 12–31) from SARS-CoV-2 infection. Independent risk factors for CAPA were hematological malignancy [OR 1.74 (95%CI 0.75–4.37), p = 0.0003], lymphocytopenia [OR 2.29 (95%CI 1.12–4.86), p = 0.02], and COPD [OR 2.74 (95%CI 1.19–5.08), p = 0.014]. Mortality rate was higher in CAPA cohort (61.8% vs 22.7%, p 65 years resulted a predictor of mortality [OR 5.09 (95% CI 1.20–26.92), p = 0.035]. No differences were observed in hematological cohort. Conclusion CAPA is a life-threatening condition with high mortality rates. It should be promptly suspected, especially in case of hematological malignancy, COPD and lymphocytopenia.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.04.2024
Tilføjet 12.04.2024
Abstract Background Practicing hand hygiene is recommended as one of the key preventive measures for reducing the transmission of COVID-19 and other infectious agents. However, it is often not practiced frequently enough or correctly by the public. We aimed to identify barriers to and facilitators of hand hygiene in the Zimbabwean population during the COVID-19 pandemic. Methods A qualitative study was conducted with a purposive sample of health workers, village health workers, church leaders, traditional healers, teachers, youth leaders and the general population selected from ten districts across the country from September to October 2022. Semistructured interviews were conducted with 3 key informant interviews per site. In addition, one homogenous focus group discussion was also conducted per site using a focus group discussion guide. The data were recorded on audiotapes, transcribed verbatim, and translated into English. All the analyses were performed manually using thematic analysis. Results Two themes were identified as facilitators of hand hygiene. These include individual factors (knowledge of hand hygiene practices and how they are performed) and access-related factors (access to hand washing infrastructure, soap, and sanitizers). Among the barriers to hand hygiene, four themes were identified: individual factors (knowledge gaps in proper hand washing, lack of conviction about hand hygiene, and habitual behaviour), access-related factors (lack of access to hand washing infrastructure, soap, and sanitizers), safety concerns (concern about the side effects of sanitizers), and sociocultural and religious factors (social customs, cultural beliefs, values, and religious practices). Conclusion During public health emergencies, there is a need for people to access uninterrupted, on-premises water supplies to promote compliance with hand hygiene. The provision of clean water and hand washing facilities is critical for vulnerable communities to afford them the opportunity to improve quality of life and facilitate resilience in the event of future pandemics. Community engagement is important for identifying vulnerability factors to provide appropriate mitigatory measures.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.04.2024
Tilføjet 12.04.2024
Abstract Background Since December 2019, COVID-19 has spread rapidly around the world, and studies have shown that measures to prevent COVID-19 can largely reduce the spread of other infectious diseases. This study explored the impact of the COVID-19 outbreak and interventions on the incidence of HFMD. Methods We gathered data on the prevalence of HFMD from the Children’s Hospital Affiliated to Zhengzhou University. An autoregressive integrated moving average model was constructed using HFMD incidence data from 2014 to 2019, the number of cases predicted from 2020 to 2022 was predicted, and the predicted values were compared with the actual measurements. Results From January 2014 to October 2022, the Children’s Hospital of Zhengzhou University admitted 103,995 children with HFMD. The average number of cases of HFMD from 2020 to 2022 was 4,946, a significant decrease from 14,859 cases from 2014 to 2019. We confirmed the best ARIMA (2,0,0) (1,1,0)12 model. From 2020 to 2022, the yearly number of cases decreased by 46.58%, 75.54%, and 66.16%, respectively, compared with the forecasted incidence. Trends in incidence across sexes and ages displayed patterns similar to those overall. Conclusions The COVID-19 outbreak and interventions reduced the incidence of HFMD compared to that before the outbreak. Strengthening public health interventions remains a priority in the prevention of HFMD.
Læs mere Tjek på PubMedClinical Infectious Diseases, 11.04.2024
Tilføjet 11.04.2024
Abstract Background Respiratory syncytial virus (RSV) circulation dropped markedly early in the COVID-19 pandemic, followed by a resurgence with heightened case counts. The “immunity debt” hypothesis proposes that the RSV-naїve pediatric population increased during the period of low transmission. However, the evidence supporting this hypothesis is limited, and the role of changing testing practices in the perceived surge has not been comprehensively evaluated.Methods We conducted a multicenter, retrospective analysis of 342 530 RSV encounters and 980 546 RSV diagnostic tests occurring at 32 US pediatric hospitals in 2013–2023. We used interrupted time series analysis to estimate pandemic-associated changes in RSV patient and test volume and to quantify changes in the proportions of patients requiring hospitalization, intensive care, or mechanical ventilation. We quantified the fraction of the shifts in case counts and in the age of diagnosed patients attributable to changes in testing.Results RSV patient volume increased 2.4-fold (95% confidence interval [CI]: 1.7, 3.5) in 2021–2023 relative to the pre-pandemic phase and was accompanied by an 18.9-fold increase (95% CI: 15.0, 23.9) in RSV test volume. Shifts in patient volume and in patient age were largely attributable to increased testing. The proportions of patients with RSV that required hospitalization, intensive care, or mechanical ventilation declined significantly across all patient age groups.Conclusions A surge in RSV testing, rather than in viral circulation, likely underlies the increased case counts observed in 2021–2023. These findings warrant a critical assessment of the immunity debt hypothesis and highlight the importance of considering the testing denominator when surveillance strategies are dynamic.
Læs mere Tjek på PubMedClinical Infectious Diseases, 11.04.2024
Tilføjet 11.04.2024
Abstract Background Although the SARS-CoV-2 vaccines are highly efficacious at preventing severe disease in the general population, current data are lacking regarding vaccine efficacy (VE) for individuals with mild immunocompromising conditions.Methods A post-hoc, cross-protocol analysis of participant-level data from the blinded phase of four randomized, placebo-controlled, COVID-19 vaccine phase 3 trials (Moderna, AstraZeneca, Janssen, and Novavax) was performed. We defined a “tempered immune system” (TIS) variable via a consensus panel based on medical history and medications to determine VE against symptomatic and severe COVID-19 cases in TIS participants versus non-TIS (NTIS) individuals starting at 14 days after completion of the primary series through the blinded phase for each of the four trials. An analysis of participants living with well-controlled HIV was conducted using the same methods.Results 3,852/30,351 (12.7%) Moderna participants, 3,088/29,868 (10.3%) Novavax participants, 3,549/32,380 (11.0%) AstraZeneca participants, and 5,047/43,788 (11.5%) Janssen participants were identified as having a TIS. Most TIS conditions (73.9%) were due to metabolism and nutritional disorders. Vaccination (versus placebo) significantly reduced the likelihood of symptomatic and severe COVID-19 for all participants for each trial. VE was not significantly different for TIS participants vs NTIS for either symptomatic or severe COVID-19 for each trial, nor was VE significantly different in the symptomatic endpoint for participants with HIV.Conclusions For individuals with mildly immunocompromising conditions, there is no evidence of differences in VE against symptomatic or severe COVID-19 compared to those with non-tempered immune systems in the four COVID-19 vaccine randomized controlled efficacy trials.
Læs mere Tjek på PubMedInfection, 11.04.2024
Tilføjet 11.04.2024
Abstract Purpose To evaluate clinical outcomes associated with sotrovimab use during Omicron BA.2 and BA.5 predominance. Methods Electronic databases were searched for observational studies published in peer-reviewed journals, preprint articles and conference abstracts from January 1, 2022 to February 27, 2023. Results The 14 studies identified were heterogeneous in terms of study design, population, endpoints and definitions. They included > 1.7 million high-risk patients with COVID-19, of whom approximately 41,000 received sotrovimab (range n = 20–5979 during BA.2 and n = 76–1383 during BA.5 predominance). Four studies compared the effectiveness of sotrovimab with untreated or no monoclonal antibody treatment controls, two compared sotrovimab with other treatments, and three single-arm studies compared outcomes during BA.2 and/or BA.5 versus BA.1. Five studies descriptively reported rates of clinical outcomes in patients treated with sotrovimab. Rates of COVID-19-related hospitalization or mortality (0.95–4.0% during BA.2; 0.5–2.0% during BA.5) and all-cause mortality (1.7–2.0% during BA.2; 3.4% during combined BA.2 and BA.5 periods) among sotrovimab-treated patients were consistently low. During BA.2, a lower risk of all-cause hospitalization or mortality was reported across studies with sotrovimab versus untreated cohorts. Compared with other treatments, sotrovimab was associated with a lower (molnupiravir) or similar (nirmatrelvir/ritonavir) risk of COVID-19-related hospitalization or mortality during BA.2 and BA.5. There was no significant difference in outcomes between the BA.1, BA.2 and BA.5 periods. Conclusions This systematic literature review suggests continued effectiveness of sotrovimab in preventing severe clinical outcomes during BA.2 and BA.5 predominance, both against active/untreated comparators and compared with BA.1 predominance.
Læs mere Tjek på PubMedInfection, 10.04.2024
Tilføjet 10.04.2024
Abstract In the context of the evolving global health landscape shaped by the COVID-19 pandemic, tuberculosis (TB) is gaining renewed attention as a reemerging threat even in low-endemic countries. Immunological tests such as the tuberculin skin test (TST) and interferon-gamma release assay (IGRA) are pivotal in identifying tuberculosis infection (TBI). However, their inability to distinguish between past and ongoing infection poses a diagnostic challenge, possibly leading to the unnecessary treatment of a significant portion of the population with potential side effects. This review delves into the concept of incipient tuberculosis (ITB), a dynamic, presymptomatic stage characterized by heightened Mycobacterium tuberculosis complex (MTC) metabolic activity and replication that result in minimal radiological changes, signifying a transitional state between TBI and TB. Key focus areas include epidemiological factors, underlying pathogenesis, imaging findings, and the ongoing challenges in the identification of individuals with ITB through the development of new biomarkers and the use of whole-genome sequencing-based analyses to implement early treatment strategies.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 10.04.2024
Tilføjet 10.04.2024
To the editor—We would like to thank our colleagues Mattiuzzi and Lippi for confirming our conclusion [1] on Spanish flu being deadlier than coronavirus disease 2019 (COVID-19) by Italian figures [2]. Italy was the first European country hit by the COVID-19 pandemic and it was hit very hard. A reflection on death toll puts the events in a historical perspective. The conclusion of our Italian colleagues is based on a comparison of crude death rates. However, when comparing both pandemics, the difference of population structure should be taken into account. Therefore, we compared not only crude death rates, but also age-standardized death rates. As there is no gold standard in this case, we projected both the age-specific Spanish flu figures of 1918–1920 on the (average) 2020–2022 population, and conversely, we projected the age-specific COVID-19 figures of 2020–2022 on the (average) 1918–1920 population. The first projection resulted in a Spanish flu:COVID-19 ratio of 2.2, the second in a Spanish flu:COVID-19 ratio of 6.9. The outcome of the second projection is close to the estimate of our Italian colleagues.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 10.04.2024
Tilføjet 10.04.2024
To the Editor—We read with great interest the results of the analysis by Harteloh et al [1], who concluded that the death rate in The Netherlands from the 1918–1920 Spanish flu was more than twice as high as the death rate for coronavirus disease 2019 (COVID-19) in 2020–2022 (ie, 214 vs 98 per 100 000 per year exposure). This is not surprising as the pathogen responsible for the Spanish flu pandemic (ie, influenza virus A/H1N1) was very aggressive, hit a nearly naive population with no prior immunity, and evolved at a time when healthcare and economic resources were extremely limited compared to recent times. To determine whether similar evidence could be replicated in other countries, we used statistics on the total resident population and the number of deaths from the Spanish flu in 1918–1920 [2] and from COVID-19 in 2020 [3] (ie, before the introduction of COVID-19 vaccination at the end of December 2020) in Italy.
Læs mere Tjek på PubMedIsabel A.L. Slurink, Sophie C.M. van den Houdt, Gaëtan Mertens
International Journal of Infectious Diseases, 10.04.2024
Tilføjet 10.04.2024
Even though most people infected with severe acute respiratory syndrome coronavirus 2 (i.e., SARS-CoV-2), resulting in Coronavirus disease 2019 (COVID-19) fully recover [1,2], a considerable number of patients continues to experience prolonged symptoms, such as fatigue, neurocognitive problems, and smell and taste impairment [2]. This syndrome of lingering symptoms following COVID-19 is referred to as long COVID or post-COVID syndrome.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.04.2024
Tilføjet 10.04.2024
Humans are aerobic animals; we need oxygen to support metabolism and generate energy. Simply put, breathing oxygen is necessary for life. Consequently, it would make sense that diseases that inhibit the transfer of oxygen from the lung to the blood should be treated with supplementary oxygen to overcome problems associated with hypoxemia, and one should strive to achieve “normal” levels of arterial oxygen (Pao2). But is that reasoning supported by the understanding of physiology and the weight of clinical evidence?
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.04.2024
Tilføjet 10.04.2024
This randomized clinical trial assesses the effect of targeting a lower vs higher oxygenation level on 90-day survival without need for life support among intensive care unit patients with COVID-19 and severe hypoxemia.
Læs mere Tjek på PubMedJiafei Yu, Kai Zhang, Tianqi Chen, Ronghai Lin, Qijiang Chen, Chensong Chen, Minfeng Tong, Jianping Chen, Jianhua Yu, Yuhang Lou, Panpan Xu, Chao Zhong, Qianfeng Chen, Kangwei Sun, Liyuan Liu, Lanxin Cao, Cheng Zheng, Ping Wang, Qitao Chen, Qianqian Yang, Weiting Chen, Xiaofang Wang, Zuxi Yan, Xuefeng Zhang, Wei Cui, Lin Chen, Zhongheng Zhang, Gensheng Zhang
International Journal of Infectious Diseases, 10.04.2024
Tilføjet 10.04.2024
Since 2019, there has been a global pandemic of patients infected with severe acute respiratory syndrome coronaviruses (SARS-CoV-2), with more than 700 million confirmed cases and more than 6 million deaths in more than 200 countries worldwide as of October 2023, according to the World Health Organization (WHO) [1]. SARS-CoV-2 acts on angiotensin-converting enzyme 2 (ACE2), which is widely expressed in a variety of tissues, such as the lung, kidney, and cardiovascular system [2], resulting in respiratory dysfunction (RD) and nonpulmonary organ dysfunction (nPOD).
Læs mere Tjek på PubMedFreitas, C. L., Sarmento, A. C. A., Serquiz, N., Nobre, M. L., Costa, A. P. F., Medeiros, K. S., Goncalves, A. K.
BMJ Open, 10.04.2024
Tilføjet 10.04.2024
IntroductionThe paediatric population represents a quarter of the world’s population, and like adult patients, they have also suffered immeasurably from the SARS-CoV-2 pandemic. Immunisation is an effective strategy for reducing the number of COVID-19 cases. With the advancements in vaccination for younger age groups, parents or guardians have raised doubts and questions about adverse effects and the number of doses required. Therefore, systematic reviews focusing on this population are needed to consolidate evidence that can help in decision-making and clinical practice. This protocol aims to assess the safety of COVID-19 vaccines in paediatric patients and evaluate the correlation between the number of vaccine doses and side effects. Methods and analysisWe will search the PubMed, ClinicalTrials.gov, Web of Science, Embase, CINAHL, Latin American and Caribbean Health Sciences Literature, Scopus and Cochrane databases for randomised and quasi-randomised clinical trials that list the adverse effects of the COVID-19 vaccine and assess its correlation with the number of doses, without any language restrictions. Two reviewers will select the studies according to the inclusion and exclusion criteria, extract data and asses for risk of bias using the Cochrane risk-of-bias tool. The Review Software Manager (RevMan V.5.4.1) will be used to synthesise the data. We will use the Working Group’s Grading of Recommendations Assessment, Development and Evaluations to grade the strength of the evidence of the results. Ethics and disseminationFormal ethical approval is not required as no primary data are collected. This systematic review will be disseminated through a peer-reviewed publication. PROSPERO registration numberCRD42023390077.
Læs mere Tjek på PubMedHarris, J., Ramirez, P., Arnold, F., Redgrave, P.
BMJ Open, 10.04.2024
Tilføjet 10.04.2024
ObjectivesGovernment guidance to manage COVID-19 was challenged by low levels of health and digital literacy and lack of information in different languages. ‘Covid Confidence’ sessions (CC-sessions) were evaluated to assess their effectiveness in counteracting misinformation and provide an alternative source of information about the pandemic. DesignWe worked with community anchor organisations to co-ordinate online CC-sessions serving three economically deprived, ethnically mixed, neighbourhoods. We conducted a qualitative, participatory process evaluation, in tandem with the CC-sessions to explore whether a popular opinion leader/local champion model of health promotion could mobilise pandemic responses. Group discussions were supplemented by final interviews to assess changes in community capacity to mobilise. SettingSheffield, England, September 2020 to November 2021. ParticipantsCommunity leaders, workers and volunteers representing a variety of local organisations resulted in 314 attendances at CC-sessions. A group of local health experts helped organisations make sense of government information. ResultsCC-sessions fostered cross-organisational relationships, which enabled rapid community responses. Community champions successfully adapted information to different groups. Listening, identifying individual concerns and providing practical support enabled people to make informed decisions on managing exposure and getting vaccinated. Some people were unable to comply with self-isolation due to overcrowded housing and the need to work. Communities drew on existing resources and networks. ConclusionsCC-sessions promoted stronger links between community organisations which reduced mistrust of government information. In future, government efforts to manage pandemics should partner with communities to codesign and implement prevention and control measures.
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.04.2024
Tilføjet 10.04.2024
Abstract Background Practicing hand hygiene is recommended as one of the key preventive measures for reducing the transmission of COVID-19 and other infectious agents. However, it is often not practiced frequently enough or correctly by the public. We aimed to identify barriers to and facilitators of hand hygiene in the Zimbabwean population during the COVID-19 pandemic. Methods A qualitative study was conducted with a purposive sample of health workers, village health workers, church leaders, traditional healers, teachers, youth leaders and the general population selected from ten districts across the country from September to October 2022. Semistructured interviews were conducted with 3 key informant interviews per site. In addition, one homogenous focus group discussion was also conducted per site using a focus group discussion guide. The data were recorded on audiotapes, transcribed verbatim, and translated into English. All the analyses were performed manually using thematic analysis. Results Two themes were identified as facilitators of hand hygiene. These include individual factors (knowledge of hand hygiene practices and how they are performed) and access-related factors (access to hand washing infrastructure, soap, and sanitizers). Among the barriers to hand hygiene, four themes were identified: individual factors (knowledge gaps in proper hand washing, lack of conviction about hand hygiene, and habitual behaviour), access-related factors (lack of access to hand washing infrastructure, soap, and sanitizers), safety concerns (concern about the side effects of sanitizers), and sociocultural and religious factors (social customs, cultural beliefs, values, and religious practices). Conclusion During public health emergencies, there is a need for people to access uninterrupted, on-premises water supplies to promote compliance with hand hygiene. The provision of clean water and hand washing facilities is critical for vulnerable communities to afford them the opportunity to improve quality of life and facilitate resilience in the event of future pandemics. Community engagement is important for identifying vulnerability factors to provide appropriate mitigatory measures.
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.04.2024
Tilføjet 10.04.2024
Abstract Background Since December 2019, COVID-19 has spread rapidly around the world, and studies have shown that measures to prevent COVID-19 can largely reduce the spread of other infectious diseases. This study explored the impact of the COVID-19 outbreak and interventions on the incidence of HFMD. Methods We gathered data on the prevalence of HFMD from the Children’s Hospital Affiliated to Zhengzhou University. An autoregressive integrated moving average model was constructed using HFMD incidence data from 2014 to 2019, the number of cases predicted from 2020 to 2022 was predicted, and the predicted values were compared with the actual measurements. Results From January 2014 to October 2022, the Children’s Hospital of Zhengzhou University admitted 103,995 children with HFMD. The average number of cases of HFMD from 2020 to 2022 was 4,946, a significant decrease from 14,859 cases from 2014 to 2019. We confirmed the best ARIMA (2,0,0) (1,1,0)12 model. From 2020 to 2022, the yearly number of cases decreased by 46.58%, 75.54%, and 66.16%, respectively, compared with the forecasted incidence. Trends in incidence across sexes and ages displayed patterns similar to those overall. Conclusions The COVID-19 outbreak and interventions reduced the incidence of HFMD compared to that before the outbreak. Strengthening public health interventions remains a priority in the prevention of HFMD.
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