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Williams DM, Lu M, Weber AM, Cook DM, Wang L, Yang W. Smoking and Risks Contributing to COVID-19 Hospitalization in Washoe County, Nevada, 2020-2021. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2025; 31:E205-E213. [PMID: 39837289 DOI: 10.1097/phh.0000000000002119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2025]
Abstract
OBJECTIVES To investigate the association between smoking behavior and COVID-19 hospitalization, integrating individual and regional factors such as community resilience and social determinants of health (SDOH), addressing gaps in existing research. DESIGN Retrospective cohort study utilizing multilevel analytical methods to evaluate the effects of individual smoking status and regional SDOH on COVID-19 hospitalization. SETTING Washoe County, Nevada, during the first year of the COVID-19 pandemic (March 5, 2020, to April 30, 2021). PARTICIPANTS All reported laboratory-positive COVID-19-infected adult residents of Washoe County collected by the Washoe County Health District through mandated disease surveillance for which smoking status was recorded, totaling 10,215 cases after data cleaning. MAIN OUTCOME MEASURE Hospitalization among those with COVID-19 was the primary outcome measure, analyzed in relation to individual smoking status and zip code tabulation area (ZCTA)-level SDOH variables. RESULTS The analysis found that individuals infected with COVID-19 who currently and formerly smoked had significantly higher odds of hospitalization compared to those who never had smoked, with odds ratios adjusted for demographics and comorbidities. An increased odds of hospitalization among those with COVID-19 were associated with higher local unemployment, a significant ZCTA-level factor. CONCLUSIONS Smoking may have increased the odds of hospitalization among those infected with COVID-19, as well as the socioeconomic factor of unemployment. The integration of SDOH into the assessment of health outcomes underscores the need for targeted public health interventions that address both individual behaviors and community-level factors. Future research should continue to explore these factors to inform more effective public health strategies and policy decisions.
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Affiliation(s)
- Danika M Williams
- Author Affiliations: Interdisciplinary Environmental Sciences and Health (Ms Williams and Dr Yang) and School of Public Health (Dr Lu, Dr Weber, Dr Cook, Mr Wang, and Dr Yang), University of Nevada Reno, Reno, Nevada
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Ayala IN, Garcia-Mendez JP, Tekin A, Malinchoc M, Barwise AK. Association Between Ethnicity and Mortality Outcomes in Patients with COVID-19: A Mayo Clinic VIRUS Registry Cohort Study. J Racial Ethn Health Disparities 2025; 12:1423-1431. [PMID: 38546947 DOI: 10.1007/s40615-024-01975-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 02/29/2024] [Accepted: 03/11/2024] [Indexed: 05/13/2025]
Abstract
Hispanic populations face significant disparities in health and healthcare. The COVID-19 pandemic highlighted and sometimes further exacerbated these disparities. We conducted a multisite, retrospective cohort study of 6494 hospitalized adult patients admitted between March 2020 and January 2022 with a diagnosis of COVID-19 from five sites including academic hospitals in MN, AZ, and FL and community hospitals in MN and WI. This is an ancillary project of the Viral Infection and Respiratory illness Universal Study (VIRUS) registry, supplemented by electronic health record data. We compared in-hospital mortality and length of stay outcomes between Hispanic and non-Hispanic populations admitted with COVID-19 using propensity matched scores to account for imbalances in demographic and clinical covariables. Among a total of 6494 patients, 512 (7.9%) patients were reported deceased and 5982 (92.1%) alive at discharge. We did not find a statistically significant difference between in-hospital mortality nor length of stay between the two groups.
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Affiliation(s)
- Ivan N Ayala
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Juan P Garcia-Mendez
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Aysun Tekin
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Amelia K Barwise
- Division of Pulmonary and Critical Care Medicine, Rochester, MN, USA
- Biomedical Ethics Research Program, Rochester, MN, USA
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Wolday D, Gebrehiwot AG, Le Minh AN, Rameto MA, Abdella S, Gebreegziabxier A, Amogne W, Rinke de Wit TF, Hailu M, Tollera G, Tasew G, Tessema M, Miller M, Gillgrass A, Bowdish DME, Kaushic C, Verschoor CP. Distinct proteomic signatures in Ethiopians predict acute and long-term sequelae of COVID-19. Front Immunol 2025; 16:1575135. [PMID: 40475767 PMCID: PMC12137110 DOI: 10.3389/fimmu.2025.1575135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2025] [Accepted: 04/21/2025] [Indexed: 06/11/2025] Open
Abstract
Introduction Little is known about the acute and long-term sequelae of COVID-19 and its pathophysiology in African patients, who are known to have a distinct immunological profile compared to Caucasian populations. Here, we established protein signatures to define severe outcomes of acute COVID-19 and determined whether unique protein signatures during the first week of acute illness predict the risk of post-acute sequelae of COVID-19 (Long COVID) in a low-income country (LIC) setting. Method Using the Olink inflammatory panel, we measured the abundance of 92 proteins in the plasma of COVID-19 patients (n=55) and non-COVID-19 individuals (n=23). We investigated distinct inflammatory protein signatures in acute severe COVID-19 individuals (n=22) compared to asymptomatic or mild/moderate COVID-19 cases (n=33), and non-COVID-19 controls. Results Levels of SLAMF1, CCL25, IL2RB, IL10RA, IL15RA, IL18 and CST5 were significantly upregulated in patients with critical COVID-19 illness compared to individuals negative for COVID-19. The cohort was followed for an average of 20 months, and 23 individuals developed Long COVID, based on the WHO's case definition, while 32 COVID-19 patients recovered fully. Whereas upregulated levels of SLAMF1, TNF, TSLP, IL15RA, IL18, ADA, CXCL9, CXCL10, IL17C, and NT3 at the acute phase of the illness were associated with increased Long COVID risk, upregulated TRANCE was associated with a reduced risk of developing Long COVID. Protein levels of SLAMF1, IL15RA, and IL18 associated with critical illness during the acute phase of COVID-19 also predicted Long COVID risk. Discussion Patients with severe COVID-19 and Long COVID outcomes exhibited distinct proteomic signatures. Unravelling the pathophysiology of severe acute COVID-19 and Long COVID before its advent may contribute to designing novel interventions for diagnosing, treating, and monitoring of SARS-CoV-2 infection and its associated acute and long-term consequences.
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Affiliation(s)
- Dawit Wolday
- Department of Biochemistry and Biomedical Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- McMaster Immunology Research Centre, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote Institute for Infectious, Diseases, McMaster University, Hamilton, ON, Canada
- Infectious Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abrha G. Gebrehiwot
- Department of Biochemistry and Biomedical Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - An Nguyen Le Minh
- Department of Biochemistry and Biomedical Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Muhammed Ahmed Rameto
- Infectious Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Saro Abdella
- Infectious Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Atsbeha Gebreegziabxier
- Infectious Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wondwossen Amogne
- Department of Infectious Diseases, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tobias F. Rinke de Wit
- Amsterdam Institute for Global Health and Development, Academic Medical Center – Amsterdam University, Amsterdam, Netherlands
| | - Messay Hailu
- Infectious Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Getachew Tollera
- Infectious Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Infectious Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Masresha Tessema
- Infectious Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Matthew Miller
- Department of Biochemistry and Biomedical Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote Institute for Infectious, Diseases, McMaster University, Hamilton, ON, Canada
- Infectious Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Amy Gillgrass
- McMaster Immunology Research Centre, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote Institute for Infectious, Diseases, McMaster University, Hamilton, ON, Canada
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Dawn M. E. Bowdish
- McMaster Immunology Research Centre, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote Institute for Infectious, Diseases, McMaster University, Hamilton, ON, Canada
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Firestone Institute for Respiratory Health, The Research Institute of St Joe’s, St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Charu Kaushic
- McMaster Immunology Research Centre, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote Institute for Infectious, Diseases, McMaster University, Hamilton, ON, Canada
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Chris P. Verschoor
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Health Sciences North Research Institute, Northern Ontario School of Medicine University, Sudbury, ON, Canada
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Zhang J, Zhu W, Jiang P, Ma F, Li Y, Cao Y, Li J, Zhang Z, Zhang X, Zou W, Chen J. In-depth analysis of the risk factors for persistent severe acute respiratory syndrome coronavirus 2 infection and construction of predictive models: an exploratory research study. BMC Infect Dis 2025; 25:699. [PMID: 40369416 PMCID: PMC12080215 DOI: 10.1186/s12879-025-11083-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2025] [Accepted: 05/05/2025] [Indexed: 05/16/2025] Open
Abstract
BACKGROUND Persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection differs from long coronavirus disease (COVID-19) (acute symptoms ≥ 12 weeks post-clearance). The Omicron BA.5 variant has a shorter median clearance time (10-14 days) than the Delta variant, suggesting that the traditional 20-day diagnostic threshold may delay interventions in high-risk populations. This study integrated multi-threshold analysis (14/20/30 days), whole-genome sequencing, and machine learning to investigate diagnostic thresholds for persistent SARS-CoV-2 infection and developed a generalizable risk prediction model. METHODS This retrospective study analyzed data from 1,216 patients with COVID-19 hospitalized at Aerospace Center Hospital between January 2021 and October 2024. We used whole-genome sequencing to genotype all COVID-19 cases and to identify major variants (such as Omicron BA. 5, Delta). The outcome, "persistent SARS-CoV-2 infection," was defined as viral nucleic acid positivity ≥ 14 days. Risk factors associated with persistent infection were identified through subgroup analysis with multiple logistic regression (adjusted for age, comorbidities, vaccination status, and virus strain) and machine learning models (70% training, 30% testing dataset). RESULTS Persistent SARS-CoV-2 infection was identified in 15.5% (188/1,216) of hospitalized COVID-19 patients. Key predictors included comorbidities-hypertension, diabetes, and active malignancy-and immune dysfunction, marked by reduced B-cell and CD4 + T-cell counts. Unvaccinated patients exhibited an 82% higher risk of persistent infection. Elevated inflammatory markers (C-reactive protein and interleukin-6) and bilateral lung infiltrates on computed tomography further distinguished persistent cases. The predictive model demonstrated strong discrimination with an area under the curve (AUC) of 0.847 (95% confidence interval: 0.815-0.879) and an AUC of 0.81 externally in external validation, underscoring its clinical utility for risk stratification. CONCLUSIONS Hypertension, diabetes, malignancy, immunosuppression (low B/CD4 + cells), and non-vaccination are independent risk factors for persistent SARS-CoV-2 infection. Integrating these factors into clinical risk stratification may optimize management of high-risk populations.
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Affiliation(s)
- Jia Zhang
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Beijing, 100049, China
| | - Weihua Zhu
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Beijing, 100049, China
| | - Piping Jiang
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Beijing, 100049, China
| | - Feng Ma
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Beijing, 100049, China
| | - Yulin Li
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Beijing, 100049, China
| | - Yuwei Cao
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Beijing, 100049, China
| | - Jiaxin Li
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Beijing, 100049, China
| | - Zhe Zhang
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Beijing, 100049, China
| | - Xin Zhang
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Beijing, 100049, China
| | - Wailong Zou
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Beijing, 100049, China.
| | - Jichao Chen
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Beijing, 100049, China.
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Ishmatov A. Age, gender, and race differences in nasal morphology: Linking air conditioning and filtration efficiency to disparities in air pollution health outcomes and COVID-19 mortality. CHEMOSPHERE 2025; 377:144358. [PMID: 40153988 DOI: 10.1016/j.chemosphere.2025.144358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Revised: 03/17/2025] [Accepted: 03/22/2025] [Indexed: 04/01/2025]
Abstract
COVID-19 mortality disparities underscore the critical role of environmental factors, age, sex, and racial demographics. This study investigates how individual variations in nasal morphology - specifically its air conditioning (temperature and humidity regulation) and filtration functions - may influence respiratory health and contribute to differential COVID-19 outcomes. Analysis reveals significant differences in nasal structure and function across racial, sex, and age groups, demonstrating associations with disparities in respiratory vulnerability to environmental stressors such as air pollution, infectious aerosols, and climatic conditions. Specifically, wider nasal cavities (more common in certain populations), larger male nasal passages, and age-related changes like mucosal atrophy and increased endonasal volume impair air conditioning and filtration efficiency. These morphological variations influence the nose's protective capacity, which is critical for shielding the middle and lower airways from environmental exposures. Populations with inherently reduced nasal filtration and conditioning efficiency demonstrate higher vulnerability, aligning with U.S. mortality patterns for both COVID-19 and air pollution across demographic groups. This suggests a direct link between nasal anatomy and population-level health disparities. These findings provide novel insights into the role of nasal anatomy in mediating respiratory health disparities by modulating individual responses to environmental exposures, air pollution, and pathogens. They highlight the need to address critical gaps in understanding how airway characteristics influence susceptibility to environmental stressors and to develop targeted interventions aimed at reducing health disparities.
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Affiliation(s)
- Alexander Ishmatov
- Institute for Engineering and Environmental Safety, Togliatti State University, Belorusskaya St, 14, Togliatti, 445020, Russia.
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Kostrzewa D, Milewska AJ, Iltchev P, Kaszubowski M, Dorobek A, Marczak M, Rębas E, Sierocka A, Kozlowski R. The Conditions of Survival of Patients with a SARS-CoV-2 Infection Burdened by Cardiovascular Pathologies in a Temporary Hospital in Gdańsk in 2021 and 2022. J Clin Med 2025; 14:2806. [PMID: 40283636 PMCID: PMC12027972 DOI: 10.3390/jcm14082806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2025] [Revised: 04/09/2025] [Accepted: 04/15/2025] [Indexed: 04/29/2025] Open
Abstract
A detailed analysis was carried out on the impact of cardiovascular disease on the risk of death of patients hospitalized at a temporary hospital in Gdańsk during the third and fifth waves of the COVID-19 pandemic (in 2021 and 2022, respectively). Background/Objectives: The documentation of 1244 patients was analyzed, of which 701 were hospitalized in 2021 (the Delta variant) and 543 in 2022 (the Omicron variant). The aim of this study was to assess the risk of death of patients with COVID-19 depending on the co-existence of cardiovascular diseases. Methods: A model of logistic regression was used to identify the impact of the patients' age, the coexistence of cardiovascular disease, and the length of hospitalization on the risk of death. Results: In 2021, patients were younger (median of 66 years) than in 2022 (median of 74 years), the length of hospitalization was shorter in 2022 (9 days) than in 2021 (11 days), and there was a higher proportion of patients with cardiovascular and respiratory diseases and a medical history of cancer in 2022. The odds of death were also observed to be higher in older patients with cardiovascular disease, particularly those under 73 years of age. In older patients (over 73 years), the odds were paradoxically reduced. Conclusions: The age of the patient, cardiovascular disease, and duration of hospitalization affect the risk of death. The Delta variant (2021) was more virulent than Omicron (2022). Cardiovascular disease significantly increases the risk of death in patients with COVID-19. The comprehensive diagnosis and treatment of patients with these conditions may reduce mortality. Further studies are needed on the long-term effects of COVID-19 on the cardiovascular system.
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Affiliation(s)
- Dariusz Kostrzewa
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-419 Lodz, Poland; (D.K.); (P.I.); (A.S.); (R.K.)
- Copernicus Podmiot Leczniczy Sp. z o.o., 80-803 Gdansk, Poland;
| | - Anna Justyna Milewska
- Department of Biostatistics and Medical Informatics, Medical University of Bialystok, 15-295 Bialystok, Poland
| | - Petre Iltchev
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-419 Lodz, Poland; (D.K.); (P.I.); (A.S.); (R.K.)
| | - Mariusz Kaszubowski
- Professor Tadeusz Bilikiewicz Provincial Psychiatric Hospital, 80-282 Gdansk, Poland;
| | | | - Michał Marczak
- Department of Innovation, Merito University in Poznan, 61-895 Poznan, Poland;
| | - Elżbieta Rębas
- Department of Molecular Neurochemistry, Medical University of Lodz, 90-419 Lodz, Poland;
| | - Aleksandra Sierocka
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-419 Lodz, Poland; (D.K.); (P.I.); (A.S.); (R.K.)
| | - Remigiusz Kozlowski
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-419 Lodz, Poland; (D.K.); (P.I.); (A.S.); (R.K.)
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Wu Y, Serna R, Gan W, Fan Z. Different patterns of leukocyte immune responses to infection of ancestral SARS-CoV-2 and its variants. Front Cell Infect Microbiol 2025; 15:1508120. [PMID: 40313462 PMCID: PMC12043629 DOI: 10.3389/fcimb.2025.1508120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 03/27/2025] [Indexed: 05/03/2025] Open
Abstract
Background Contributions of leukocytes to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) defense have been reported extensively. However, it remains unclear whether there are different leukocyte responses to ancestral SARS-CoV-2 and its variants. Methods We analyzed peripheral blood leukocyte and subtype concentrations from 575 COVID-19 patients and 950 non-COVID-19 subjects registered at the University of Connecticut John Dempsey Hospital between 2020 and 2022, which covers the ancestral strain, Delta, and Omicron variants. Results We found that neutrophils, immature granulocytes, and monocytes were elevated, and lymphocytes were reduced after infection. These hyperactive neutrophils/immature granulocytes and suppressed lymphocytes/monocytes were associated with poorer prognosis in ancestral strain infection. Different from the ancestral strain, hyperactive immature granulocytes were not shown in the decedents of Delta infection, and immature granulocyte concentration was not observed to be associated with mortality. In Omicron infection, suppressed lymphocytes and monocytes were not shown in the decedents, and lymphocyte/monocyte concentrations were not associated with mortality. Conclusions Our findings provided insights into different leukocyte immune responses to ancestral SARS-CoV-2, Delta, and Omicron variants.
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Affiliation(s)
- Yuanyuan Wu
- Department of Immunology, University of Connecticut School of Medicine, Farmington, CT, United States
| | - Raphael Serna
- Department of Immunology, University of Connecticut School of Medicine, Farmington, CT, United States
| | - Wenqi Gan
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, United States
| | - Zhichao Fan
- Department of Immunology, University of Connecticut School of Medicine, Farmington, CT, United States
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Rohde J, Bundschuh R, Kaußner Y, Simmenroth A. Lingering symptoms in non-hospitalized patients with COVID-19 - a prospective survey study of symptom expression and effects on mental health in Germany. BMC PRIMARY CARE 2025; 26:94. [PMID: 40175915 PMCID: PMC11963417 DOI: 10.1186/s12875-025-02784-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/10/2025] [Indexed: 04/04/2025]
Abstract
BACKGROUND The infection rates with SARS-CoV 2 virus, known since 2019, are currently significantly weakened in their dynamics. Nevertheless, COVID 19 is still a common disease, which in most cases is overcome quite well and can be treated by the general practitioner. Despite an initially uncomplicated disease progression, the long-term consequences can be considerable. Symptoms persisting over a period of more than 12 weeks after infection are summarized as Post-COVID (PC) syndrome. The aim of this study is to document the symptom expression in PC patients in the outpatient setting, with a major focus on limitations in daily life and consequences for mental health. METHODS This survey is part of a prospective European collaborative study with the German cohort having been slightly extended and evaluated separately. Data collection was performed by telephone interviews of adult SARS CoV 2 positive patients using standardized questionnaires (38 open and 6 closed questions). After an inclusion interview, follow-up interviews were conducted every 4 weeks over a period of 6 months. Participants were recruited in collaboration with the local health department (Wuerzburg, Germany). RESULTS Sixty participants were recruited in April and May 2021. After 12 weeks (PC cutoff), 48.3% still reported symptoms related to SARS-CoV-2 infection. The most commonly reported symptoms were fatigue/tiredness (33.3%), reduced concentration (26.7%), and shortness of breath (23.3%). One-quarter of respondents reported impaired functioning, with the most common daily limitations being sports (28.3%), work (25.0%), and social life (15.0%). At 6 months, 21.6% of respondents experienced anxiety and 11.6% reported depressive symptoms. Overall, 40.0% of respondents were concerned that their health would deteriorate again or not fully normalize because of COVID-19. Over two-thirds (70.0%) visited a physician during the course of the study because of COVID-19, 73.8% of whom visited their general practitioner. CONCLUSION PC in outpatient care appears to be a complex and multifaceted condition that not only presents with physical symptoms, but also has a significant impact on mental health and daily life. Although the complexity of the condition is not yet fully understood, our findings suggest that it presents long-term challenges, particularly in outpatient care. Further research, particularly in larger and more diverse cohorts, is needed to confirm these observations. Routine screening for psychosocial comorbidities could be a valuable approach to identify supportive interventions that may help to reduce the risk of chronification and/or somatization.
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Affiliation(s)
- Jörn Rohde
- Department of General Practice, University Hospital Wuerzburg, Würzburg, Germany.
| | - René Bundschuh
- Department of General Practice, University Hospital Wuerzburg, Würzburg, Germany
| | - Yvonne Kaußner
- Counseling Center for Employees, University Hospital Wuerzburg, Würzburg, Germany
| | - Anne Simmenroth
- Department of General Practice, University Hospital Wuerzburg, Würzburg, Germany
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Neves CAM, Dorneles GP, Teixeira PC, Santana Filho PC, Peres A, Boeck CR, Rotta LN, Thompson CE, Romão PRT. Neuroinflammation in Severe COVID-19: The Dynamics of Inflammatory and Brain Injury Markers During Hospitalization. Mol Neurobiol 2025; 62:4264-4273. [PMID: 39433647 DOI: 10.1007/s12035-024-04551-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 10/11/2024] [Indexed: 10/23/2024]
Abstract
Patients with COVID-19 can develop excessive inflammation in the brain and consequent neurological complications. The aim of this study was to evaluate the inflammatory, endothelial and brain injury markers in hospitalized COVID-19 patients and compare those with or without neurological symptoms. A total of 30 intensive care unit (ICU) COVID-19 patients were allocated into COVID-19 (without neurological symptoms) or neuro-COVID-19 (with neurological symptoms) groups. Patients with respiratory infection symptoms but negative for COVID-19 were included as a control group. Peripheral blood samples were collected at hospital admission (T1) (controls and ICU patients) and during hospitalization (T2: last 72 h before hospital discharge or in-hospital death) (ICU COVID-19 patients) to analyze inflammatory markers. Higher ICAM-1, CCL26 and VEGF at T1 were identified in both COVID-19 groups compared with control. Neuro-COVID-19 patients presented lower systemic BDNF levels compared with the control group and increased S100B compared with the control and COVID-19 groups. BDNF levels in survivors were lower in the neuro-COVID-19 group compared to the COVID-19 group, while S100B were higher, regardless of the outcome. In addition, all COVID-19 patients presented increased ICAM-1 and CCL26 levels over the hospitalization period (T2 > T1). Furthermore, S100B, ICAM-1, CCL26 and VEGF levels increased in relation to T1 in neuro-COVID-19 patients, with S100B and CCL26 being significantly higher in relation to the COVID-19 group. In conclusion, high levels of brain injury biomarkers were found in patients with neuro-COVID-19, indicating neuroinflammatory and consequent brain injury in the last 72 h of hospitalization.
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Affiliation(s)
- Carla Andretta Moreira Neves
- Laboratory of Cellular and Molecular Immunology, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Gilson P Dorneles
- Laboratory of Cellular and Molecular Immunology, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil.
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
| | - Paula C Teixeira
- Laboratory of Cellular and Molecular Immunology, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Paulo C Santana Filho
- Laboratory of Cellular and Molecular Immunology, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Alessandra Peres
- Laboratory of Cellular and Molecular Immunology, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil
- Graduate Program in Biosciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | | | - Liane N Rotta
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Claudia E Thompson
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Pedro R T Romão
- Laboratory of Cellular and Molecular Immunology, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil.
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
- Graduate Program in Biosciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
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Weirauch T, Schüttfort G, Vehreschild MJGT. Syncopes, paresis and loss of vision after COVID-19 mRNA-based vaccination and SARS-CoV-2 infection. Infection 2025; 53:741-746. [PMID: 39621236 PMCID: PMC11971158 DOI: 10.1007/s15010-024-02439-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 11/06/2024] [Indexed: 04/05/2025]
Abstract
mRNA-based vaccines played a key role in fighting the global COVID-19 pandemic by saving millions of lives. In rare cases, however, the BNT162b2 vaccine has been associated with severe adverse reactions e.g. myocarditis (OE ratio 2.78; 95% CI 2.61; 2.95) [Faksova in Vaccine 42(9):2200-2211, 2024, https://doi.org/10.1016/j.vaccine.2024.01.100 , Schwab in Clin Res Cardiol 112(3):431-440, 2022, https://doi.org/10.1007/s00392-022-02129-5 ]. Here, we describe the case of a 38-year-old man who developed a wide variety of long-term symptoms (fatigue, dizziness, palpitations with recurrent syncopes, paresthesia, paresis and fasciculations) following his first mRNA-based BNT162b2 COVID-19 vaccination. 143 days after vaccination, a subsequent COVID-19 infection was associated with exacerbation of paresis and a temporary loss of vision. After ruling out other causes and due to the immediate temporal association, an adverse reaction to vaccination appears likely. The fact that these symptoms worsened after a subsequent acute COVID 19 infection hints at the possibility of a common underlying pathophysiology. This case combines two clinical phenomena that have emerged during the COVID 19 pandemic, side effects associated with novel vaccines and Post-COVID Syndrome.
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Affiliation(s)
- Tobias Weirauch
- Goethe University Frankfurt, University Hospital Frankfurt, Department II of Internal Medicine, Infectious Diseases, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| | - Gundolf Schüttfort
- Goethe University Frankfurt, University Hospital Frankfurt, Department II of Internal Medicine, Infectious Diseases, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Maria J G T Vehreschild
- Goethe University Frankfurt, University Hospital Frankfurt, Department II of Internal Medicine, Infectious Diseases, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
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11
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Marquez E, Haboush-Deloye A, Kim J, López EB, Mangla AT, Adhikari B, Shen JJ. Factors Associated with Hospital Length of Stay and Intensive Care Utilization Among Pediatric COVID-19 Patients in Southern Nevada: A Multivariate Analysis. CHILDREN (BASEL, SWITZERLAND) 2025; 12:332. [PMID: 40150614 PMCID: PMC11941629 DOI: 10.3390/children12030332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2025] [Revised: 03/02/2025] [Accepted: 03/04/2025] [Indexed: 03/29/2025]
Abstract
The COVID-19 pandemic has revealed significant disparities in health outcomes across various populations, with children being no exception. Objective: This study aimed to identify factors associated with hospital length of stay and intensive care unit (ICU) utilization among children hospitalized with COVID-19. Methods: The project evaluated inpatient COVID-19 hospitalization data of children aged 0 to 17 years between 2020 and 2021 with a positive PCR COVID-19 test 14 days prior to or during hospitalization. Using a multivariate linear regression model, hospital length of stay and ICU utilization were evaluated by sociodemographic factors, including age, gender, race/ethnicity, primary payer status, comorbidities, CDC Social Vulnerability Index (SVI), and clinical factors. Results: Among 376 hospitalized pediatric patients, 62.2% were non-White minorities, 4.3% had at least one comorbidity, and 58.5% were covered by public insurance. Additionally, 67.6% scored high on the SVI. The average hospital stay was 3.89 days (standard deviation (SD) = 4.8), and 25% of children utilized the ICU during their hospitalization (SD = 0.43). After adjusting for sociodemographic and clinical characteristics, minority patients were more likely to have a longer length of stay by 1.09 days compared to White patients. Minority patients were also 72% more likely to use the ICU than White patients. Conclusions: These findings demonstrate that non-White children experience more severe outcomes related to COVID-19, supporting the need for culturally specific mitigation and intervention strategies for children and families during a pandemic.
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Affiliation(s)
- Erika Marquez
- School of Public Health, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | | | - Jihye Kim
- School of Public Health, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - Erick B López
- Office of Disease Surveillance and Control, Southern Nevada Health District, Las Vegas, NV 89107, USA
| | - Anil T. Mangla
- Office of Disease Surveillance and Control, Southern Nevada Health District, Las Vegas, NV 89107, USA
| | - Binita Adhikari
- School of Public Health, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - Jay J. Shen
- School of Public Health, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
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12
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Yu B, Wang H, Li G, Sun J, Luo H, Yang M, Zhang Y, Liu R, Cheng M, Zhang S, Li G, Wang L, Qian G, Zhang D, Li S, Kan Q, Jiang J, Ren Z. A retrospective cohort study of the efficacy and safety of oral azvudine versus nirmatrelvir/ritonavir in elderly hospitalized COVID-19 patients aged over 60 years. Acta Pharm Sin B 2025; 15:1333-1343. [PMID: 40370553 PMCID: PMC12069234 DOI: 10.1016/j.apsb.2024.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 11/15/2024] [Accepted: 12/12/2024] [Indexed: 03/04/2025] Open
Abstract
Azvudine and nirmatrelvir/ritonavir (Paxlovid) are recommended for COVID-19 treatment in China, but their safety and efficacy in the elderly population are not fully known. In this multicenter, retrospective, cohort study, we identified 5131 elderly hospitalized COVID-19 patients from 32,864 COVID-19 patients admitted to nine hospitals in Henan Province, China, from December 5, 2022, to January 31, 2023. The primary outcome was all-cause death, and the secondary outcome was composite disease progression. Propensity score matching (PSM) was performed to control for confounding factors, including demographics, vaccination status, comorbidities, and laboratory tests. After 2:1 PSM, 1786 elderly patients receiving azvudine and 893 elderly patients receiving Paxlovid were included. Kaplan-Meier and Cox regression analyses revealed that compared with Paxlovid group, azvudine could significantly reduce the risk of all-cause death (log-rank P = 0.002; HR: 0.71, 95% CI: 0.573-0.883, P = 0.002), but there was no difference in composite disease progression (log-rank P = 0.52; HR: 1.05, 95% CI: 0.877-1.260, P = 0.588). Four sensitivity analyses verified the robustness of above results. Subgroup analysis suggested that a greater benefit of azvudine over Paxlovid was observed in elderly patients with primary malignant tumors (P for interaction = 0.005, HR: 0.32, 95% CI: 0.18-0.57) compared to patients without primary malignant tumors. Safety analysis revealed that azvudine treatment had a lower incidence of adverse events and higher lymphocyte levels than Paxlovid treatment. In conclusion, azvudine treatment is not inferior to Paxlovid treatment in terms of all-cause death, composite disease progression and adverse events in elderly hospitalized COVID-19 patients.
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Affiliation(s)
- Bo Yu
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Haiyu Wang
- Department of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Guangming Li
- Department of Liver Disease, the Affiliated Infectious Disease Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Junyi Sun
- Department of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Hong Luo
- Guangshan County People's Hospital, Guangshan County, Xinyang 465450, China
| | - Mengzhao Yang
- Department of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yanyang Zhang
- Henan Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - Ruihan Liu
- Xiangya Medical College, Central South University, Changsha 410028, China
| | - Ming Cheng
- Department of Medical Information, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Shixi Zhang
- Department of Infectious Diseases, Shangqiu Municipal Hospital, Shangqiu 476000, China
| | - Guotao Li
- Department of Infectious Diseases, Luoyang Central Hospital Affiliated of Zhengzhou University, Luoyang 471000, China
| | - Ling Wang
- Department of Clinical Laboratory, Henan Provincial Chest Hospital Affiliated of Zhengzhou University, Zhengzhou 450008, China
| | - Guowu Qian
- Department of Gastrointestinal Surgery, Nanyang Central Hospital, Nanyang 473009, China
| | - Donghua Zhang
- Department of Infectious Diseases, Anyang City Fifth People's Hospital, Anyang 455000, China
| | - Silin Li
- Department of Respiratory and Critical Care Medicine, Fengqiu County People's Hospital, Xinxiang 453300, China
| | - Quancheng Kan
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou 450052, China
| | - Jiandong Jiang
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100050, China
| | - Zhigang Ren
- Department of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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13
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Li J, Tao L, Zhou Y, Zhu Y, Li C, Pan Y, Yao P, Qian X, Liu J. Identification of biomarkers in Alzheimer's disease and COVID-19 by bioinformatics combining single-cell data analysis and machine learning algorithms. PLoS One 2025; 20:e0317915. [PMID: 39965013 PMCID: PMC11835241 DOI: 10.1371/journal.pone.0317915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Accepted: 01/07/2025] [Indexed: 02/20/2025] Open
Abstract
BACKGROUND Since its emergence in 2019, COVID-19 has become a global epidemic. Several studies have suggested a link between Alzheimer's disease (AD) and COVID-19. However, there is little research into the mechanisms underlying these phenomena. Therefore, we conducted this study to identify key genes in COVID-19 associated with AD, and evaluate their correlation with immune cells characteristics and metabolic pathways. METHODS Transcriptome analyses were used to identify common biomolecular markers of AD and COVID-19. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were performed on gene chip datasets (GSE213313, GSE5281, and GSE63060) from AD and COVID-19 patients to identify genes associated with both conditions. Gene ontology (GO) enrichment analysis identified common molecular mechanisms. The core genes were identified using machine learning. Subsequently, we evaluated the relationship between these core genes and immune cells and metabolic pathways. Finally, our findings were validated through single-cell analysis. RESULTS The study identified 484 common differentially expressed genes (DEGs) by taking the intersection of genes between AD and COVID-19. The black module, containing 132 genes, showed the highest association between the two diseases according to WGCNA. GO enrichment analysis revealed that these genes mainly affect inflammation, cytokines, immune-related functions, and signaling pathways related to metal ions. Additionally, a machine learning approach identified eight core genes. We identified links between these genes and immune cells and also found a association between EIF3H and oxidative phosphorylation. CONCLUSION This study identifies shared genes, pathways, immune alterations, and metabolic changes potentially contributing to the pathogenesis of both COVID-19 and AD.
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Affiliation(s)
- Juntu Li
- Department of Critical Care Medicine and Emergency, The Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Gusu School, Nanjing Medical University, Suzhou Clinical Medical Center of Critical Care Medicine, Suzhou, Jiangsu, China
| | - Linfeng Tao
- Department of Critical Care Medicine and Emergency, The Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Gusu School, Nanjing Medical University, Suzhou Clinical Medical Center of Critical Care Medicine, Suzhou, Jiangsu, China
| | - Yanyou Zhou
- Department of Critical Care Medicine and Emergency, The Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Gusu School, Nanjing Medical University, Suzhou Clinical Medical Center of Critical Care Medicine, Suzhou, Jiangsu, China
| | - Yue Zhu
- Department of Breast and Thyroid Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Chao Li
- Department of Critical Care Medicine and Emergency, The Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Gusu School, Nanjing Medical University, Suzhou Clinical Medical Center of Critical Care Medicine, Suzhou, Jiangsu, China
| | - Yiyuan Pan
- Department of Critical Care Medicine and Emergency, The Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Gusu School, Nanjing Medical University, Suzhou Clinical Medical Center of Critical Care Medicine, Suzhou, Jiangsu, China
| | - Ping Yao
- Department of Critical Care Medicine and Emergency, The Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Gusu School, Nanjing Medical University, Suzhou Clinical Medical Center of Critical Care Medicine, Suzhou, Jiangsu, China
| | - Xuefeng Qian
- Department of Critical Care Medicine and Emergency, The Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Gusu School, Nanjing Medical University, Suzhou Clinical Medical Center of Critical Care Medicine, Suzhou, Jiangsu, China
| | - Jun Liu
- Department of Critical Care Medicine and Emergency, The Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Gusu School, Nanjing Medical University, Suzhou Clinical Medical Center of Critical Care Medicine, Suzhou, Jiangsu, China
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14
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Gómez de Cedrón M, Moreno-Rubio J, de la O Pascual V, Alvarez B, Villarino M, Sereno M, Gómez-Raposo C, Roa S, López Gómez M, Merino-Salvador M, Jiménez-Gordo A, Falagán S, Aguayo C, Zambrana F, Tabarés B, Garrido B, Cruz-Gil S, Fernández Díaz CM, Fernández LP, Molina S, Crespo MC, Ouahid Y, Montoya JJ, Ramos Ruíz R, Reglero G, Ramírez de Molina A, Casado E. Randomized clinical trial in cancer patients shows immune metabolic effects exerted by formulated bioactive phenolic diterpenes with potential clinical benefits. Front Immunol 2025; 16:1519978. [PMID: 40034703 PMCID: PMC11872936 DOI: 10.3389/fimmu.2025.1519978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Accepted: 01/31/2025] [Indexed: 03/05/2025] Open
Abstract
Background Nutrients, including bioactive natural compounds, have been demonstrated to affect key metabolic processes implicated in tumor growth and progression, both in preclinical and clinical trials. Although the application of precision nutrition as a complementary approach to improve cancer treatments is still incipient in clinical practice, the development of powerful "omics" techniques has opened new possibilities for delivering nutritional advice to cancer patients. Precision nutrition may contribute to improving the plasticity and function of antitumor immune responses. Objectives Herein, we present the results of a randomized, prospective, longitudinal, double-blind, and parallel clinical trial (NCT05080920) in cancer patients to explore the immune-metabolic effects of a bioactive formula based on diterpenic phenols from rosemary, formulated with bioactive alkylglycerols (Lipchronic© WO/2017/187000). The trial involved cancer patients, including those with lung cancer (LC), colorectal cancer (CRC), and breast cancer (BC), undergoing chemotherapy, targeted biological therapy, and/or immunotherapy. The main readouts of the study were the analysis of Lip on systemic inflammation, hemogram profile, anthropometry, lipid and glucose profiles, and tolerability. Additionally, a deep immune phenotyping of peripheral blood mononuclear cells (PBMCs) was performed to identify the functional effects of Lip on key mediators of the immune system. Results Lip was well tolerated. The lung cancer subgroup of patients showed a reduction in biomarkers of systemic inflammation, including the neutrophil-to-lymphocyte ratio (NLR). Furthermore, modulation of key players in the immune system associated with the experimental treatment Lip compared to the control placebo (Pla) treatment was revealed, with particularities among the distinct subgroups of patients. Our results encourage further research to apply molecular nutrition-based strategies as a complementary tool in the clinical management of cancer patients, particularly in the current era of novel immunotherapies. Clinical trial registration ClinicalTrials.gov, identifier NCT05080920.
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Affiliation(s)
| | - Juan Moreno-Rubio
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
- Clinical Oncology Group, IMDEA Food, CEI UAM+CSIC, Madrid, Spain
| | - Victor de la O Pascual
- Precision Nutrition and Cardiometabolic Health, IMDEA Food, CEI UAM+CSIC, Madrid, Spain
- Faculty of Health Sciences, International University of La Rioja (UNIR), Logroño, Spain
| | - Beatriz Alvarez
- Centro Nacional de Investigaciones Cardiovasculares CarlosIII (CNIC Carlos III), Madrid, Spain
| | - Marta Villarino
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
| | - María Sereno
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
- Clinical Oncology Group, IMDEA Food, CEI UAM+CSIC, Madrid, Spain
| | - César Gómez-Raposo
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
- Clinical Oncology Group, IMDEA Food, CEI UAM+CSIC, Madrid, Spain
| | - Silvia Roa
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
| | - Miriam López Gómez
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
| | - María Merino-Salvador
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
| | - Ana Jiménez-Gordo
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
- Clinical Oncology Group, IMDEA Food, CEI UAM+CSIC, Madrid, Spain
| | - Sandra Falagán
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
| | - Cristina Aguayo
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
| | - Francisco Zambrana
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
| | - Beatriz Tabarés
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
| | - Beatriz Garrido
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
| | - Silvia Cruz-Gil
- Molecular Oncology Group, IMDEA Food, CEI UAM+CSIC, Madrid, Spain
| | | | | | - Susana Molina
- Molecular Oncology Group, IMDEA Food, CEI UAM+CSIC, Madrid, Spain
| | | | - Youness Ouahid
- MiRNAX Biosens Research & Development Unit (MBR&DU), Madrid, Spain
| | - Juan José Montoya
- MiRNAX Biosens Research & Development Unit (MBR&DU), Madrid, Spain
- Faculty of Medicine, School of Sport Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Guillermo Reglero
- Institute of Food Science Research CIAL CSIC-UAM, Madrid, Spain
- Production and Development of Foods for Health, IMDEA Food, CEI UAM+CSIC, Madrid, Spain
| | | | - Enrique Casado
- Medical Oncology Department, Infanta Sofia University Hospital-Henares University Hospital-Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain
- Clinical Oncology Group, IMDEA Food, CEI UAM+CSIC, Madrid, Spain
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15
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Yousaf AR, Mak J, Gwynn L, Lutrick K, Bloodworth RF, Rai RP, Jeddy Z, LeClair LB, Edwards LJ, Olsho LE, Newes-Adeyi G, Dalton AF, Caban-Martinez AJ, Gaglani M, Yoon SK, Hegmann KT, Phillips AL, Burgess JL, Ellingson KD, Rivers P, Meece JK, Feldstein LR, Tyner HL, Naleway A, Campbell AP, Britton A, Saydah S. COVID-19 Vaccination and Odds of Post-COVID-19 Condition Symptoms in Children Aged 5 to 17 Years. JAMA Netw Open 2025; 8:e2459672. [PMID: 39992656 PMCID: PMC11851240 DOI: 10.1001/jamanetworkopen.2024.59672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Accepted: 11/21/2024] [Indexed: 02/26/2025] Open
Abstract
Importance An estimated 1% to 3% of children with SARS-CoV-2 infection will develop post-COVID-19 condition (PCC). Objective To evaluate the odds of PCC among children with COVID-19 vaccination prior to SARS-CoV-2 infection compared with odds among unvaccinated children. Design, Setting, and Participants In this case-control study, children were enrolled in a multisite longitudinal pediatric cohort from July 27, 2021, to September 1, 2022, and followed up through May 2023. Analysis used a case (PCC reported)-control (no PCC reported) design and included children aged 5 to 17 years whose first real time-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infection occurred during the study period, who were COVID-19 vaccine age-eligible at the time of infection, and who completed a PCC survey at least 60 days after infection. From December 1, 2022, to May 31, 2023, children had weekly SARS-CoV-2 testing and were surveyed regarding PCC (≥1 new or ongoing symptom lasting ≥1 month after infection). Exposures COVID-19 mRNA vaccination status at time of infection was the exposure of interest; participants were categorized as vaccinated (≥2-dose series completed ≥14 days before infection) or unvaccinated. Vaccination status was verified through vaccination cards or vaccine registry and/or medical records when available. Main Outcome and Measures Main outcomes were estimates of the odds of PCC symptoms. Multivariate logistic regression was performed to estimate the odds of PCC among vaccinated children compared with odds of PCC among unvaccinated children. Results A total of 622 participants were included, with 28 (5%) case participants and 594 (95%) control participants. Median (IQR) age was 10.0 (7.0-11.9) years for case participants and 10.3 (7.8-12.7) years for control participants (P = .37). Approximately half of both groups reported female sex (13 case participants [46%] and 287 control participants [48%]). Overall, 57% of case participants (16 children) and 77% of control participants (458 children) were vaccinated (P = .05). After adjusting for demographic characteristics, number of acute COVID-19 symptoms, and baseline health, COVID-19 vaccination was associated with decreased odds of 1 or more PCC symptom (adjusted odds ratio [aOR], 0.43; 95% CI, 0.19-0.98) and 2 or more PCC symptoms (aOR, 0.27; 95% CI, 0.10-0.69). Conclusions and Relevance In this study, mRNA COVID-19 vaccination was associated with reduced odds of PCC in children. The aORs correspond to an estimated 57% and 73% reduced likelihood of 1 or more and 2 or more PCC symptoms, respectively, among vaccinated vs unvaccinated children. These findings suggest benefits of COVID-19 vaccination beyond those associated with protection against acute COVID-19 and may encourage increased pediatric uptake.
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Affiliation(s)
- Anna R. Yousaf
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Georgia
| | - Josephine Mak
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Georgia
| | - Lisa Gwynn
- Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, Florida
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
| | - Karen Lutrick
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson
| | | | | | | | | | | | | | | | - Alexandra F. Dalton
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Georgia
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
| | - Manjusha Gaglani
- Section of Pediatric Infectious Diseases, Department of Pediatrics, Baylor Scott & White Health and Baylor College of Medicine, Department of Medical Education, Texas A&M University College of Medicine, Temple
| | - Sarang K. Yoon
- Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City
| | - Kurt T. Hegmann
- Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City
| | - Andrew L. Phillips
- Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah Health, Salt Lake City
| | - Jefferey L. Burgess
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson
| | - Katherine D. Ellingson
- Department of Epidemiology and Biostatistics Department, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson
| | - Patrick Rivers
- Department of Epidemiology and Biostatistics Department, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson
| | | | - Leora R. Feldstein
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Georgia
| | - Harmony L. Tyner
- St Luke’s Regional Health Care System Infectious Disease Associates, Duluth, Minnesota
| | - Allison Naleway
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Angela P. Campbell
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Georgia
| | - Amadea Britton
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Georgia
| | - Sharon Saydah
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Georgia
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16
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Chew D, Shiau S, Sudharshan S, Alankar A, Desilva M, Kodali S, Raquepo TM, Meilad N, Sudyn A, Swaminathan S. Outcomes Among Patients Hospitalized for COVID-19 Treated with Remdesivir in an Urban Center Pre-COVID-19 Vaccination. J Racial Ethn Health Disparities 2025; 12:173-180. [PMID: 38012432 PMCID: PMC11753339 DOI: 10.1007/s40615-023-01861-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE Data on treatment outcomes among minority populations treated with remdesivir are limited. We sought to evaluate outcomes among patients hospitalized with COVID-19 and treated with remdesivir among a predominantly Black and LatinX population. METHODS This was a retrospective cohort study of adult patients hospitalized with COVID-19 and treated with remdesivir at an urban hospital in Newark, NJ, between May 1, 2020, and April 30, 2021, prior to widespread COVID-19 vaccination uptake. We describe 28-day mortality by demographic, socio-economic, and clinical factors, including clinical status by World Health Organization's (WHO) 8-point Ordinal Scale for Clinical Improvement. RESULTS A total of 206 patients met study inclusion criteria (52% were male, 41% non-Hispanic Black and 42% Hispanic). Overall mortality at 28 days was 11%. Eighty-one percent of patients with baseline WHO status of 4 or greater recovered by day 14. Mortality was higher among those who were older (p = 0.01), those with underlying diabetes mellitus (p = 0.047), those with more severe illness on admission by WHO Ordinal Scale (WHO status ≥ 4), and those on concomitant tociluzimab or convalescent plasma use. CONCLUSIONS We found that remdesivir was effective in treating most COVID-19 patients in our study. Traditional risk factors, such as advanced age and underlying co-morbidities, were associated with worse clinical outcomes and deaths.
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Affiliation(s)
- Debra Chew
- Division of Infectious Diseases, Rutgers New Jersey Medical School, 185 South Orange Avenue, MSB I-689, Newark, NJ, 07101, USA.
| | - Stephanie Shiau
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Sree Sudharshan
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Aparna Alankar
- Division of Infectious Diseases, Rutgers New Jersey Medical School, 185 South Orange Avenue, MSB I-689, Newark, NJ, 07101, USA
| | - Malithi Desilva
- Division of Infectious Diseases, Rutgers New Jersey Medical School, 185 South Orange Avenue, MSB I-689, Newark, NJ, 07101, USA
| | - Swetha Kodali
- Division of Infectious Diseases, Rutgers New Jersey Medical School, 185 South Orange Avenue, MSB I-689, Newark, NJ, 07101, USA
| | - Tricia Mae Raquepo
- Division of Infectious Diseases, Rutgers New Jersey Medical School, 185 South Orange Avenue, MSB I-689, Newark, NJ, 07101, USA
| | - Naema Meilad
- Division of Infectious Diseases, Rutgers New Jersey Medical School, 185 South Orange Avenue, MSB I-689, Newark, NJ, 07101, USA
| | - Alexander Sudyn
- Division of Infectious Diseases, Rutgers New Jersey Medical School, 185 South Orange Avenue, MSB I-689, Newark, NJ, 07101, USA
| | - Shobha Swaminathan
- Division of Infectious Diseases, Rutgers New Jersey Medical School, 185 South Orange Avenue, MSB I-689, Newark, NJ, 07101, USA
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17
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Haj Husin A, Ahrari H, Keep J. Predicting COVID-19 Patient Disposition Using the National Early Warning Score 2: A Retrospective Cohort Study. Cureus 2025; 17:e79610. [PMID: 40151731 PMCID: PMC11948155 DOI: 10.7759/cureus.79610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2025] [Indexed: 03/29/2025] Open
Abstract
Objectives To evaluate the effectiveness of the National Early Warning Score 2 (NEWS2) in predicting the need for hospital admission and close monitoring of suspected patients with COVID-19 presenting to the Emergency Department (ED). This study aims to determine whether NEWS2 can aid in identifying high-risk patients with COVID-19 requiring urgent care and admission. Methodology Retrospective data from electronic health records of 300 patients with COVID-19 who presented to Mediclinic Parkview Hospital ED between January 1, 2021, and June 30, 2021, were analyzed. Collected variables included age, gender, body mass index (BMI), vital signs, and patient disposition. Statistical analysis was conducted to assess the ability of NEWS2 to predict COVID-19 patient disposition. Results A total of 300 patients were included, and their NEWS2 scores were analyzed to predict clinical deterioration. NEWS2, with a cutoff value of 2, predicted hospital admission with 86% sensitivity and 75% specificity. It achieved an average area under the curve (AUC) of 0.86 for predicting outcomes at 24 to 72 hours from the time of initial presentation to the ED. Conclusions NEWS2 demonstrates high sensitivity in predicting the disposition of patients with COVID-19. Our findings support the use of NEWS2 as a useful tool for the initial assessment of patients with COVID-19 presenting to the ED, assisting in identifying patients at risk of deterioration.
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Affiliation(s)
- Asmaa Haj Husin
- Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE
| | - Hind Ahrari
- Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE
| | - Jeffrey Keep
- Emergency, Mediclinic Parkview Hospital, Dubai, ARE
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18
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Ashmawy R, Hamouda EA, Zeina S, Sharaf S, Erfan S, Redwan EM. Impact of COVID-19 on preexisting comorbidities. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2025; 213:215-258. [PMID: 40246345 DOI: 10.1016/bs.pmbts.2024.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2025]
Abstract
COVID-19 is a highly contagious viral disease caused by SARS-CoV-2, leading to a tragic global pandemic, where it was ranked in 2020 as the third leading cause of death in the USA, causing approximately 375,000 deaths, following heart disease and cancer. The CDC reports that the risk of death increases with age and preexisting comorbidities such as such as hypertension, diabetes, respiratory system disease, and cardiovascular disease. this report will delineate and analyze the paramount comorbidities and their repercussions on individuals infected with SARS-CoV-2.
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Affiliation(s)
- Rasha Ashmawy
- Ministry of Health and Population, Alexandria, Egypt
| | | | - Sally Zeina
- Ministry of Health and Population, Alexandria, Egypt
| | - Sandy Sharaf
- Ministry of Health and Population, Alexandria, Egypt
| | - Sara Erfan
- Ministry of Health and Population, Alexandria, Egypt
| | - Elrashdy M Redwan
- Biological Science Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.
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19
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Rowley EA, Mitchell PK, Yang DH, Lewis N, Dixon BE, Vazquez-Benitez G, Fadel WF, Essien IJ, Naleway AL, Stenehjem E, Ong TC, Gaglani M, Natarajan K, Embi P, Wiegand RE, Link-Gelles R, Tenforde MW, Fireman B. Methods to Adjust for Confounding in Test-Negative Design COVID-19 Effectiveness Studies: Simulation Study. JMIR Form Res 2025; 9:e58981. [PMID: 39869907 PMCID: PMC11811671 DOI: 10.2196/58981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 10/22/2024] [Accepted: 11/10/2024] [Indexed: 01/29/2025] Open
Abstract
BACKGROUND Real-world COVID-19 vaccine effectiveness (VE) studies are investigating exposures of increasing complexity accounting for time since vaccination. These studies require methods that adjust for the confounding that arises when morbidities and demographics are associated with vaccination and the risk of outcome events. Methods based on propensity scores (PS) are well-suited to this when the exposure is dichotomous, but present challenges when the exposure is multinomial. OBJECTIVE This simulation study aimed to investigate alternative methods to adjust for confounding in VE studies that have a test-negative design. METHODS Adjustment for a disease risk score (DRS) is compared with multivariable logistic regression. Both stratification on the DRS and direct covariate adjustment of the DRS are examined. Multivariable logistic regression with all the covariates and with a limited subset of key covariates is considered. The performance of VE estimators is evaluated across a multinomial vaccination exposure in simulated datasets. RESULTS Bias in VE estimates from multivariable models ranged from -5.3% to 6.1% across 4 levels of vaccination. Standard errors of VE estimates were unbiased, and 95% coverage probabilities were attained in most scenarios. The lowest coverage in the multivariable scenarios was 93.7% (95% CI 92.2%-95.2%) and occurred in the multivariable model with key covariates, while the highest coverage in the multivariable scenarios was 95.3% (95% CI 94.0%-96.6%) and occurred in the multivariable model with all covariates. Bias in VE estimates from DRS-adjusted models was low, ranging from -2.2% to 4.2%. However, the DRS-adjusted models underestimated the standard errors of VE estimates, with coverage sometimes below the 95% level. The lowest coverage in the DRS scenarios was 87.8% (95% CI 85.8%-89.8%) and occurred in the direct adjustment for the DRS model. The highest coverage in the DRS scenarios was 94.8% (95% CI 93.4%-96.2%) and occurred in the model that stratified on DRS. Although variation in the performance of VE estimates occurred across modeling strategies, variation in performance was also present across exposure groups. CONCLUSIONS Overall, models using a DRS to adjust for confounding performed adequately but not as well as the multivariable models that adjusted for covariates individually.
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Affiliation(s)
| | | | | | - Ned Lewis
- Vaccine Study Center, Northern California Division of Research, Kaiser Permanente, Oakland, CA, United States
| | - Brian E Dixon
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, United States
- Fairbanks School of Public Health, Indiana University, Indianapolis, IN, United States
| | | | - William F Fadel
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, United States
- Fairbanks School of Public Health, Indiana University, Indianapolis, IN, United States
| | - Inih J Essien
- HealthPartners Institute, Minneapolis, MN, United States
| | - Allison L Naleway
- Center for Health Research, Kaiser Permanente, Portland, OR, United States
| | - Edward Stenehjem
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, UT, United States
| | - Toan C Ong
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Manjusha Gaglani
- Department of Pediatrics, Section of Pediatric Infectious Diseases, Baylor Scott & White Health, Temple, TX, United States
- Department of Medical Education, Texas A&M University College of Medicine, Killeen, TX, United States
| | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
- New York Presbyterian Hospital, New York, NY, United States
| | - Peter Embi
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, United States
- Vanderbilt University Medical Center, Nashville, TN, United States
| | - Ryan E Wiegand
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Ruth Link-Gelles
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Mark W Tenforde
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Bruce Fireman
- Vaccine Study Center, Northern California Division of Research, Kaiser Permanente, Oakland, CA, United States
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20
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Oboho IK, Hanna J, Silva-Rodriguez D, Christie-Smith A, Psenicka A, Khongmongkhon A, Kouma MA, Reid S, Bedimo R. Management of a COVID-19 outbreak using a multidisciplinary approach and infection prevention control practices at a community living center in Veterans Administration Hospital, North Texas. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2025; 5:e12. [PMID: 39839361 PMCID: PMC11748011 DOI: 10.1017/ash.2024.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 11/22/2024] [Accepted: 11/25/2024] [Indexed: 01/23/2025]
Abstract
Background The increase in severe acute respiratory coronavirus virus 2 (SARS-CoV-2) cases due to the omicron strain led to reduced acute care hospital beds at the Veterans Administration (VA) Hospital, North Texas; veterans with non-severe coronavirus disease 2019 (COVID-19) disease were managed at a community living center (CLC), a VA nursing home. The management of non-severe COVID-19 in VA nursing homes has not been extensively described. Methods We describe resident characteristics and outcomes, and infection control practices implemented during 2 COVID-19 outbreak periods (January 12-February 15, 2022, June 28-July 14, 2023). Serial testing of all CLC residents was conducted, and residents with polymerase chain reaction-confirmed SARS-CoV-2 (COVID-19) infection were included in the analysis. Resident data were ascertained from the COVID-19 facility dashboard and medical record system. Results From January 12 to February 15, 2022, and June 28-July 14, 2023, 62 adults residing at the CLC were diagnosed with COVID-19. Overall, the median age was 75 years [interquartile range, 71-80], and 57 (91.9%) were men. Residents were cohorted by COVID-19 test results. A multidisciplinary team was convened, and staff were fit tested for appropriate personal protective equipment (PPE) and received refresher training on hand hygiene, donning, and doffing of PPE. Thirty-seven (59.7%) residents were symptomatic. Overall, 55 (88.7%) residents were documented to have received the SARS-CoV-2 primary vaccination series. Most residents were managed at the CLC, while 12 (19.3%) were hospitalized in acute care. Conclusions It is feasible to manage high-risk residents with non-severe COVID-19 disease in a CLC utilizing a multidisciplinary approach and implementing Infection Prevention and Control strategies.
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Affiliation(s)
- Ikwo K. Oboho
- Division of Infectious Diseases & Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Veterans Affairs North Texas Health Care System, Dallas, TX, USA
| | - John Hanna
- Division of Infectious Diseases & Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- East Carolina University (ECU) Health, Greenville, NC, USA
- Brody School of Medicine, ECU, Greenville, NC, USA
| | | | | | - Andrew Psenicka
- Veterans Affairs North Texas Health Care System, Dallas, TX, USA
| | | | - Marcus A. Kouma
- Veterans Affairs North Texas Health Care System, Dallas, TX, USA
| | - Sherry Reid
- Veterans Affairs North Texas Health Care System, Dallas, TX, USA
| | - Roger Bedimo
- Division of Infectious Diseases & Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Veterans Affairs North Texas Health Care System, Dallas, TX, USA
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21
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Navuluri N, Bhavsar NA, Chen V, Falkovic M, Fish LJ, Gray L, Makarushka C, Mkumba L, Lwin HT, Stiefer A, Ashana DC. Role of Social Determinants of Health in COVID-19 Recovery: A Qualitative Study. JAMA Netw Open 2025; 8:e2453261. [PMID: 39761047 PMCID: PMC11704979 DOI: 10.1001/jamanetworkopen.2024.53261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 11/04/2024] [Indexed: 01/07/2025] Open
Abstract
Importance Health systems are increasingly required to conduct health-related social needs screening. However, how social resources negatively and positively affect recovery from acute illnesses, such as COVID-19, is incompletely understood. Objective To examine how social determinants of health (SDOH) influence recovery from COVID-19. Design, Setting, and Participants In this qualitative study, patients were recruited for semistructured interviews from a post-COVID-19 pulmonary clinic at a southeastern US academic medical center between November 2022 and March 2023. Caregivers were included in dyadic interviews when available. Interviews queried participants about SDOH domains, as defined by the US Centers for Disease Control and Prevention, and their relationship with COVID-19 recovery. Main Outcome and Measures Phenomenologic analysis identified themes characterizing participant perspectives on the influence of SDOH on COVID-19 recovery. Results A total of 24 interviews were conducted: 10 (42%) with patient-caregiver dyads, 13 (54%) with patients alone, and 1 (4%) with 2 patients who also served as each other's caregiver. Most participants were female (18 patients [72%] and 6 caregivers [60%]). The median age of patients was 57 years (IQR, 44-61 years) and of caregivers was 47 years (IQR, 39-62 years). Three cross-cutting themes that overlapped SDOH domains were identified. Participants noted that innovative mobilization of social resources (eg, policies to secure income during time away from work) supported recovery from COVID-19 illness, but destabilization and change introduced by illness (eg, disrupted social support networks) and mistrust of previously established institutions (eg, public health misinformation) hindered recovery. Conclusions and Relevance Participants identified 3 distinct SDOH domains positively and negatively influencing recovery from COVID-19 illness. The findings suggest that longitudinal, multidomain data on SDOH are needed to best address barriers and identify resources for patients recovering from acute illness and may help determine opportunities for system- and policy-level interventions that can mitigate the influence of long-standing structural inequities on health.
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Affiliation(s)
- Neelima Navuluri
- Department of Medicine, Duke University, Durham, North Carolina
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Nrupen A. Bhavsar
- Department of Surgery, Duke University, Durham, North Carolina
- Department of Biostatistics & Bioinformatics, Duke University, Durham, North Carolina
| | - Vivian Chen
- Duke University School of Medicine, Durham, North Carolina
| | | | - Laura J. Fish
- Department of Family Medicine & Community Health, Duke University, Durham, North Carolina
| | - Lauren Gray
- Duke University School of Medicine, Durham, North Carolina
| | - Christina Makarushka
- Duke Global Health Institute, Duke University, Durham, North Carolina
- Duke Cancer Institute, Duke University, Durham, North Carolina
| | - Laura Mkumba
- Department of Population Health Sciences, Duke University, Durham, North Carolina
| | - Hnin Thuzar Lwin
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Auston Stiefer
- Department of Medicine, Duke University, Durham, North Carolina
| | - Deepshikha Charan Ashana
- Department of Medicine, Duke University, Durham, North Carolina
- Department of Population Health Sciences, Duke University, Durham, North Carolina
- Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina
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22
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Tseng KH, Chiou JY, Wang SI. Real-world assessment of reinfection with SARS-CoV-2: Implications for vaccines. J Infect Public Health 2025; 18:102599. [PMID: 39612547 DOI: 10.1016/j.jiph.2024.102599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 11/13/2024] [Accepted: 11/14/2024] [Indexed: 12/01/2024] Open
Abstract
BACKGROUND There have been over 670 million confirmed cases of SARS-CoV-2 infection globally, resulting in over 6.87 million deaths. With approximately 0.1 %-6.8 % experiencing reinfection. This retrospective cohort study aimed to compare the risk of short-term circulatory and respiratory sequelae between SARS-CoV-2 reinfection and initial infection, and assess the impact of vaccination. METHOD Data from the TriNetX US Collaborative network (2020-2022) were used to create two cohorts based on reinfection status. The main outcome assessed were medical utilization, circulatory and respiratory symptoms, and circulatory and respiratory diseases. The Kaplan-Meier method was used to compare the risks between two cohorts. Four subgroup analyses (vaccination status, age, sex, race) and six sensitivity analyses (rigorous definition, modified exclusion criteria, treatment, different COVID-19 variants timeline, address survivorship bias, and E-value calculation) were also conducted. RESULTS The reinfection cohort showed a significant reduction in medical utilization [ Hazard ratio, HR: 0.867, (95 % confidence interval, CI:0.839-0.896) for hospitalization, 0.488 (0.418-0.570) for critical care services, and 0.476 (0.360-0.629) for mechanical ventilation], lower risk of circulatory diseases [ HR: 0.701 (95 % CI:0.637-0.772), 0.695 (0.583-0.829), 0.660 (0.605-0.719), 0.741 (0.644-0.854), 0.614 (0.535-0.705), and 0.758 (0.656-0.876) for ischemic heart disease, inflammatory heart disease, dysrhythmias, venous thromboembolism, other cardiac disorders, and cerebrovascular diseases, respectively], and lower risk of respiratory diseases such as pneumonia, other acute lower respiratory infections, asthma, and hypoxemia [HR: 0.302 (95 % CI: 0.273-0.333), 0.811 (0.686-0.958), 0.791 (0.735-0.850), and 0.392 (0.338-0.455), respectively]. The vaccinated reinfection cohort showed no significant differences in medical utilization, circulatory diseases, or respiratory conditions but had a higher risk of breathing abnormalities. breathing abnormalities [HR: 1.195 (95 % CI:1.087-1.313)]. CONCLUSIONS The individuals who experienced reinfection exhibited milder short-term sequelae in the circulatory and respiratory systems. Vaccine administration protects against cardiovascular or respiratory systems.
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Affiliation(s)
- Kuang-Hung Tseng
- In-service Master Program of International Health Industry Management, College of Health Care and Management, Chung Shan Medical University, Taichung, Taiwan; Director of Sheng-kuang Pediatric Clinic, Puli Township, Nantou County, Taiwan.
| | - Jeng-Yuan Chiou
- Department of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan.
| | - Shiow-Ing Wang
- Department of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan; Center for Health Data Science, Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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23
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Alqahtani L, Kano S, Bokhary H, Bahamdan S, Ghazi R, Abdu S, Almutiri S, Alhejaili F. Association Between Severities of Obstructive Sleep Apnea and COVID-19 Outcomes. Cureus 2025; 17:e77626. [PMID: 39834670 PMCID: PMC11743573 DOI: 10.7759/cureus.77626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2025] [Indexed: 01/22/2025] Open
Abstract
Introduction Obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse resulting in episodes of apnea and hypopnea. Studies have shown worsened coronavirus disease 2019 (COVID-19) severity due to coexisting respiratory conditions and suggest increased severity of COVID-19 in patients with or at high risk of OSA. However, the extent of this correlation is unclear. This retrospective study aimed to evaluate the association between OSA severity and COVID-19 severity and assess the impact of continuous positive airway pressure (CPAP) compliance. Methods This single-center retrospective study was conducted at King Abdulaziz University Hospital (KAUH), a tertiary care center in Jeddah, Saudi Arabia. Data were collected from 62 adult patients with OSA who were diagnosed via polysomnography (PSG) and had a positive documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test result. COVID-19 severity was categorized into mild, moderate, and severe. Results There was no significant correlation between OSA severity as measured by the apnea-hypopnea index (AHI), low oxyhemoglobin desaturation (LSAT), arousal index (AI), respiratory disturbance index (RDI), or the type of treatment used, including adherence to CPAP, and the outcomes of COVID-19. However, higher arousal with respiratory index (ARI) and a lower percentage of time with SpO2 < 90% (T90) values were linked to moderate COVID-19 severity with significant p-values of 0.046 and 0.007, respectively. Conclusion There was no significant correlation between the severity or types of OSA treatment and the severity of COVID-19. Further research including multicenter studies with bigger populations and extensive sleep study data is warranted. Understanding the OSA-COVID-19 link may improve risk stratification and patient management.
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Affiliation(s)
- Lamis Alqahtani
- Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Suzana Kano
- Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Hanaa Bokhary
- Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Sulafah Bahamdan
- Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Rafah Ghazi
- Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Shahad Abdu
- Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Sarah Almutiri
- Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
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24
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Bhatia A, Preiss AJ, Xiao X, Brannock MD, Alexander GC, Chew RF, Davis H, Fitzgerald M, Hill E, Kelly EP, Mehta HB, Madlock-Brown C, Wilkins KJ, Chute CG, Haendel M, Moffitt R, Pfaff ER, the N3C Consortium. Effect of nirmatrelvir/ritonavir (Paxlovid) on hospitalization among adults with COVID-19: An electronic health record-based target trial emulation from N3C. PLoS Med 2025; 22:e1004493. [PMID: 39823513 PMCID: PMC11790232 DOI: 10.1371/journal.pmed.1004493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 02/03/2025] [Accepted: 10/21/2024] [Indexed: 01/19/2025] Open
Abstract
BACKGROUND Nirmatrelvir with ritonavir (Paxlovid) is indicated for patients with Coronavirus Disease 2019 (COVID-19) who are at risk for progression to severe disease due to the presence of one or more risk factors. Millions of treatment courses have been prescribed in the United States alone. Paxlovid was highly effective at preventing hospitalization and death in clinical trials. Several studies have found a protective association in real-world data, but they variously used less recent study periods, correlational methods, and small, local cohorts. Their estimates also varied widely. The real-world effectiveness of Paxlovid remains uncertain, and it is unknown whether its effect is homogeneous across demographic strata. This study leverages electronic health record data in the National COVID Cohort Collaborative's (N3C) repository to investigate disparities in Paxlovid treatment and to emulate a target trial assessing its effectiveness in reducing severe COVID-19 outcomes. METHODS AND FINDINGS This target trial emulation used a cohort of 703,647 patients with COVID-19 seen at 34 clinical sites across the United States between April 1, 2022 and August 28, 2023. Treatment was defined as receipt of a Paxlovid prescription within 5 days of the patient's COVID-19 index date (positive test or diagnosis). To emulate randomization, we used the clone-censor-weight technique with inverse probability of censoring weights to balance a set of covariates including sex, age, race and ethnicity, comorbidities, community well-being index (CWBI), prior healthcare utilization, month of COVID-19 index, and site of care provision. The primary outcome was hospitalization; death was a secondary outcome. We estimated that Paxlovid reduced the risk of hospitalization by 39% (95% confidence interval (CI) [36%, 41%]; p < 0.001), with an absolute risk reduction of 0.9 percentage points (95% CI [0.9, 1.0]; p < 0.001), and reduced the risk of death by 61% (95% CI [55%, 67%]; p < 0.001), with an absolute risk reduction of 0.2 percentage points (95% CI [0.1, 0.2]; p < 0.001). We also conducted stratified analyses by vaccination status and age group. Absolute risk reduction for hospitalization was similar among patients that were vaccinated and unvaccinate, but was much greater among patients aged 65+ years than among younger patients. We observed disparities in Paxlovid treatment, with lower rates among black and Hispanic or Latino patients, and within socially vulnerable communities. This study's main limitation is that it estimates causal effects using observational data and could be biased by unmeasured confounding. CONCLUSIONS In this study of Paxlovid's real-world effectiveness, we observed that Paxlovid is effective at preventing hospitalization and death, including among vaccinated patients, and particularly among older patients. This remains true in the era of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron subvariants. However, disparities in Paxlovid treatment rates imply that the benefit of Paxlovid's effectiveness is not equitably distributed.
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Affiliation(s)
- Abhishek Bhatia
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | | | - Xuya Xiao
- School of Medicine, Public Health, and Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | | | - G. Caleb Alexander
- School of Medicine, Public Health, and Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Robert F. Chew
- RTI International, Durham, North Carolina, United States of America
| | - Hannah Davis
- Patient-Led Research Collaborative, New York, New York State, United States of America
| | - Megan Fitzgerald
- Patient-Led Research Collaborative, New York, New York State, United States of America
| | - Elaine Hill
- University of Rochester, Department of Public Health Sciences and Department of Economics, Rochester, New York State, United States of America
| | - Elizabeth P. Kelly
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Hemalkumar B. Mehta
- School of Medicine, Public Health, and Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Charisse Madlock-Brown
- University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Kenneth J. Wilkins
- National Institute of Diabetes & Digestive & Kidney Diseases, Office of the Director, National Institutes of Health, Bethesda, Maryland, United States of America
- F. Edward Hébert School of Medicine, Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Christopher G. Chute
- School of Medicine, Public Health, and Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Melissa Haendel
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Richard Moffitt
- Emory University, Atlanta, Georgia, United States of America
| | - Emily R. Pfaff
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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25
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Al-Rawi MBA, Khan AHI, Sheikh Ghadzi SM. The Severity of the COVID-19 Among Chronic Disease Patients in the Selected Hospitals in Riyadh, Saudi Arabia - A Retrospective Study. Risk Manag Healthc Policy 2024; 17:3327-3339. [PMID: 39742076 PMCID: PMC11687317 DOI: 10.2147/rmhp.s456155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 10/18/2024] [Indexed: 01/03/2025] Open
Abstract
Background and Aims Chronic disease is a lifelong disorder that necessitates continuing medical care and is more prone to infections such as COVID-19, compared to healthy individuals. Therefore, this study aimed to assess the severity of COVID-19 among chronic disease patients in the Kingdom of Saudi Arabia. Methods and Materials A cross-sectional study was conducted in selected hospitals in the Riyadh region in Saudi Arabia, over 6 months in 2022. All participants' records were reviewed for socio-demographic data including age, gender, residence, marital status, level of education, occupation, and special habits such as smoking or addiction. In addition to this main complaint and present history, history of chronic illnesses, drug intake, surgical interference, general examination findings including vital signs, state of consciousness, general condition at admission and discharge, and outcome of cases were recorded. Results The mean age of the patient was 54.46 ± 15.85 (median of 53.67 years). In this study, the severity of COVID-19 was significantly associated with chronic diseases. For instance, 22.31% of the patients with diabetes reported mild symptoms, compared with 77.69% of the patients without diabetes. The current findings reported 2.18% of COVID-19 patients with respiratory diseases and 97.82% of the patients without respiratory diseases reported mild symptoms of COVID-19 infection. In comparison, 97.75% of COVID-19 patients without respiratory diseases and 2.25% of patients with respiratory diseases reported moderately severe COVID-19 infection. Conclusion The current findings revealed that 66.2% of the COVID-19 patients with chronic diseases were free of symptoms, 5.3% of them died and 0.9% of the patients were in a worse situation. The severity of COVID-19 was significantly associated with the presence of chronic diseases. Additionally, medical practitioners must be more knowledgeable about the long-term illnesses that put patients at risk for serious COVID-19 challenges and mortality.
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Affiliation(s)
- Mahmood Basil A Al-Rawi
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Amer Hayat Ibrahim Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Feltner FJ, Baker WM, Bowling B, Massey B, Howard S, Hahn EJ. Exploratory Pilot Study Engages Community Health Workers to Test Drone-Based Package Delivery System for Personal Protective Equipment in High-Risk Appalachia Population. Health Promot Pract 2024:15248399241300577. [PMID: 39707708 DOI: 10.1177/15248399241300577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2024]
Abstract
During the COVID-19 pandemic, high-risk clients' and caregivers' access to essential personal protective equipment (PPE) was limited especially in many remote areas of Appalachia. A multidisciplinary team of community and university partners explored how to coordinate the use of community health workers (CHWs) and drone technologies to increase access to PPE in rural and remote Appalachian regions. CHWs recruited 10 Homeplace clients in an exploratory study of drone-based package delivery of PPE to assess importance and effectiveness of PPE self-efficacy related to PPE use, use of PPE, and ease and acceptability of drone delivery (following delivery only). CHWs educated each participant via in-person and Zoom meetings on the reasons for using PPE and proper use of PPE using Centers for Disease Control and Prevention guidelines. Most participants found the drone delivery of PPE easy and 80% were extremely satisfied with the drone delivery process. The frequency of mask-wearing increased from 60% at baseline to 90% at follow-up. On average, participants rated all types of PPE as effective in preventing the spread of disease. Drone officials used the findings of this pilot study to develop a waiver application to the U.S. Federal Aviation Administration to request permission to fly beyond visual line of sight in remote areas. Aerial drone technology could be a cutting-edge approach to health promotion in remote areas. The study results provide the proof of concept to assist investigators in designing future projects to promote healthy homes by collecting air and water samples and testing novel interventions deploying drone technology in remote Appalachian regions.
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Affiliation(s)
- Frances J Feltner
- University of Kentucky Center of Excellence in Rural Health, Hazard, KY, USA
| | - William Mace Baker
- University of Kentucky Center of Excellence in Rural Health, Hazard, KY, USA
| | - Beth Bowling
- University of Kentucky Center of Excellence in Rural Health, Hazard, KY, USA
| | | | - Sydney Howard
- University of Kentucky Center of Excellence in Rural Health, Hazard, KY, USA
| | - Ellen J Hahn
- University of Kentucky College of Nursing, Lexington, KY, USA
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Shahrbabaki PM, Zeidabadinejad S, Abolghaseminejad P, Dehghan M, Asadilari M, Zakeri MA, Shahrour G, Lari LA. The relationship between COVID-19 anxiety and self-efficacy among adolescent students: A cross-sectional study. PLoS One 2024; 19:e0310434. [PMID: 39637160 PMCID: PMC11620552 DOI: 10.1371/journal.pone.0310434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 08/30/2024] [Indexed: 12/07/2024] Open
Abstract
BACKGROUND The spread of the COVID-19 epidemic, as well as its high contagiousness, increased students' anxiety and stress. Anxiety may affect individuals' functioning and undermine their self-efficacy. Therefore, the present study aimed to determine the relationship between COVID-19 anxiety and self-efficacy among adolescent students. METHOD This cross-sectional descriptive correlational study was conducted on 306 adolescent students in southern Iran. The research tools were the Corona Disease Anxiety Scale consisting of physical and psychological dimensions of anxiety and the Self-Efficacy Scale composed of three subscales: academic, social, and emotional self-efficacy. Data were analyzed using SPSS 25. Pearson correlation was used to investigate the relationship between COVID-19 anxiety and self-efficacy using the total score of both scales and their dimensions as well. T-Test and one-way ANOVA were used to see whether sociodemographic variables of participants significantly varied in self-efficacy and COVID-19 anxiety. RESULTS The mean score of COVID-19 anxiety was 11.70 ± 9.25, representing mild anxiety, and the mean score of the psychological dimension was higher than that of the physical dimension. The mean self-efficacy score was 81.29 ± 12.98 indicating high level of self-efficacy. In addition, the mean score of academic self-efficacy was higher than that of social and emotional self-efficacy. There was an inverse, significant, and mild to moderate relationship between COVID-19 anxiety and the total score of self-efficacy (r = -.28, p < .001) and all its dimensions (r = -. 18, p = .002 for social and academic self-efficacy; r = -.32, p <. 001 for emotional self-efficacy). While the physical dimension of COVID-19 anxiety correlated significantly and negatively with self-efficacy total and subscale scores, the mental subscale of COVID-19 anxiety only correlated with the self-efficacy total score (r = -.20, p < .001) and emotional self-efficacy (r = -.28, p < .001). CONCLUSION The study results revealed that the higher the COVID-19 anxiety, the lower the self-efficacy among adolescents. It is important to prioritize the enhancement of self-efficacy among adolescents to ensure their success across various life domains including managing stressors brought about by pandemics like COVID-19. This requires a collaborative effort from parents and teachers as they are a primary source of reassurance and information. Parents and teachers can also serve as role models in showcasing resilience and positive coping with the pandemic and allow adolescent students to master adaptive coping and provide positive reinforcement for effective behaviors.
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Affiliation(s)
| | - Somayeh Zeidabadinejad
- M.Sc in Critical Care Nursing, Nursing Research Center, Sirjan University of Medical Sciences, Sirjan, Iran
| | | | - Mahlagha Dehghan
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Marzieh Asadilari
- Department of Nursing, M.Sc Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran
| | - Mohammad Ali Zakeri
- MSc in Nursing, Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ghada Shahrour
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
- College of Nursing, RAK Medical and Health Sciences University, Ras Al-Khaimah, UAE
| | - Leyla Ahmadi Lari
- Department of Anesthesiology, M.Sc in Critical Care Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran
- Hazrat Zeinab Faculty of Nursing and Midwifery, Larestan University of Medical Sciences, Dr. Dadman Highway, Larestan, Iran
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Kim T, Kim JS, So MW, Yeo HJ, Jang JH, Park O, Cho WH. Treatment outcomes and healthcare resource utilization in critically ill COVID-19 patients in Korea: A nationwide multicenter cohort study. Medicine (Baltimore) 2024; 103:e40505. [PMID: 39560591 PMCID: PMC11575975 DOI: 10.1097/md.0000000000040505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 10/24/2024] [Indexed: 11/20/2024] Open
Abstract
COVID-19 pandemic was accompanied by many healthcare-related issues. Concrete national data regarding the care performance of critical ill cases of COVID-19 does not exist in Korea. The current study aimed to describe the treatment outcome and healthcare resource utilization of critically ill COVID-19 patients. Our multicenter retrospective cohort study enrolled critically ill COVID-19 patients from 22 tertiary care hospitals in Korea. Inclusion criteria: (1) patients aged 19 years or older, (2) patients with laboratory-confirmed SARS-CoV-2 infection who received at least one of following initial treatments such as high-flow oxygen therapy (HFOT) or noninvasive ventilation (NIV) or invasive mechanical ventilation (IMV) or extracorporeal membrane oxygenation. During the study wave, a total of 1358 eligible participants were enrolled, with 21 institutions participating in the study. Among them, data from 1113 patients were available and analyzed. Of 921 (82.7%), 621 (55.8%) were supported by IMV. Of the 921 patients supported by HFOT or NIV, 438 (47.6%) recovered without IMV, 429 (46.6%) required IMV, and 54 died who DNR after NIV was applied. Prone position ventilation was administered to 163 (33.1%) patients with IMV and 25 (6.2%) patients with HFOT. Extracorporeal membrane oxygenation was administered to 128 (20.6%) patients treated with IMV. The overall mortality rate was 26.4%. In South Korea, mortality rates for patients with severe COVID-19 pneumonia have been shown substantial fatality, with the highest mortality rates observed in wave 3. The increased mortality rate in wave 3 could be associated with the rapid escalation of critically ill COVID-19 patients and the consequent saturation of intensive care unit capacities. Patients received NIV therapy and prone position ventilation more frequently in wave 3 as the number of cases increased.
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Affiliation(s)
- Taehwa Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Yangsan, Republic of Korea
- Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Jeong Su Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
- Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Min Wook So
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
- Division of Rheumatology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Hye Ju Yeo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Yangsan, Republic of Korea
- Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Jin Ho Jang
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Yangsan, Republic of Korea
- Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Onyu Park
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan, Republic of Korea
| | - Woo Hyun Cho
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Yangsan, Republic of Korea
- Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
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Baltrus P, Li C, Douglas M, Josiah Willock R, Daniel A, Mack D, Gaglioti A. Neighborhood Ecologies, Cases, and Deaths during the Beginning of the COVID-19 Pandemic: Lessons for Current and Future Epidemics? South Med J 2024; 117:640-645. [PMID: 39486448 PMCID: PMC11534281 DOI: 10.14423/smj.0000000000001757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2024]
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected Black and Latinx communities. Ecologic analyses have shown that counties with a higher percentage of Latinx and Black people have worse COVID-19 outcome rates. Few ecologic analyses have been published at the neighborhood (census tract) level. We sought to determine whether certain sociodemographic neighborhood ecologies were associated with COVID-19 case and death rates in metropolitan Atlanta, Georgia. METHODS We used census data and principal-component analysis to identify unique neighborhood ecologies. We then estimated correlation coefficients to determine whether the neighborhood profiles produced by a principal-component analysis were correlated with COVID-19 case and death rates. We conducted geographically weighted regression models to assess how correlation coefficients varied spatially for neighborhood ecologies and COVID-19 outcomes. RESULTS We identified two unique neighborhood profiles: (1) high percentage of residents, Hispanic ethnicity, without a high school diploma, without health insurance, living in crowded households, and lower percentage older than 65 years; and (2) high percentage of residents, Black race, living in poverty, unemployed, and households receiving Supplemental Nutrition Assistance Program benefits. Profile 1 was associated with COVID-19 case rate (Pearson r = 0.462, P < 0.001) and profile 2 was associated with COVID-19 death rate (Spearman r = 0.279, P < 0.001). Correlations between neighborhood profiles and COVID-19 outcomes varied spatially. CONCLUSIONS Neighborhoods were differentially at risk of COVID-19 cases or deaths depending on their sociodemographic ecology at the beginning of the COVID-19 pandemic. Prevention methods and interventions may need to consider different social determinants of health when addressing potential cases and deaths during future emergent epidemics.
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Affiliation(s)
| | - Chaohua Li
- Morehouse School of Medicine, Atlanta, Georgia
| | | | | | | | | | - Anne Gaglioti
- Case Western Reserve Medical School, Cleveland, Ohio
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Naquin A, O’Halloran A, Ujamaa D, Sundaresan D, Masalovich S, Cummings CN, Noah K, Jain S, Kirley PD, Alden NB, Austin E, Meek J, Yousey-Hindes K, Openo K, Witt L, Monroe ML, Henderson J, Nunez VT, Lynfield R, McMahon M, Shaw YP, McCahon C, Spina N, Engesser K, Tesini BL, Gaitan MA, Shiltz E, Lung K, Sutton M, Hendrick MA, Schaffner W, Talbot HK, George A, Zahid H, Reed C, Garg S, Bozio CH. Laboratory-Confirmed Influenza-Associated Hospitalizations Among Children and Adults - Influenza Hospitalization Surveillance Network, United States, 2010-2023. MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES (WASHINGTON, D.C. : 2002) 2024; 73:1-18. [PMID: 39471107 PMCID: PMC11537671 DOI: 10.15585/mmwr.ss7706a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2024]
Abstract
Problem/Condition Seasonal influenza accounts for 9.3 million-41 million illnesses, 100,000-710,000 hospitalizations, and 4,900-51,000 deaths annually in the United States. Since 2003, the Influenza Hospitalization Surveillance Network (FluSurv-NET) has been conducting population-based surveillance for laboratory-confirmed influenza-associated hospitalizations in the United States, including weekly rate estimations and descriptions of clinical characteristics and outcomes for hospitalized patients. However, a comprehensive summary of trends in hospitalization rates and clinical data collected from the surveillance platform has not been available. Reporting Period 2010-11 through 2022-23 influenza seasons. Description of System FluSurv-NET conducts population-based surveillance for laboratory-confirmed influenza-associated hospitalizations among children and adults. During the reporting period, the surveillance network included 13-16 participating sites each influenza season, with prespecified geographic catchment areas that covered 27 million-29 million persons and included an estimated 8.8%-9.5% of the U.S. population. A case was defined as a person residing in the catchment area within one of the participating states who had a positive influenza laboratory test result within 14 days before or at any time during their hospitalization. Each site abstracted case data from hospital medical records into a standardized case report form, with selected variables submitted to CDC on a weekly basis for rate estimations. Weekly and cumulative laboratory-confirmed influenza-associated hospitalization rates per 100,000 population were calculated for each season from 2010-11 through 2022-23 and stratified by patient age (0-4 years, 5-17 years, 18-49 years, 50-64 years, and ≥65 years), sex, race and ethnicity, influenza type, and influenza A subtype. During the 2020-21 season, only the overall influenza hospitalization rate was reported because case counts were insufficient to estimate stratified rates. Results During the 2010-11 to 2022-23 influenza seasons, laboratory-confirmed influenza-associated hospitalization rates varied significantly across seasons. Before the COVID-19 pandemic, hospitalization rates per 100,000 population ranged from 8.7 (2011-12) to 102.9 (2017-18) and had consistent seasonality. After SARS-CoV-2 emerged, the hospitalization rate for 2020-21 was 0.8, and the rate did not return to recent prepandemic levels until 2022-23. Inconsistent seasonality also was observed during 2020-21 through 2022-23, with influenza activity being very low during 2020-21, extending later than usual during 2021-22, and occurring early during 2022-23. Molecular assays, particularly multiplex standard molecular assays, were the most common influenza test type in recent seasons, increasing from 12% during 2017-18 for both pediatric and adult cases to 43% and 55% during 2022-23 for pediatric and adult cases, respectively. During each season, adults aged ≥65 years consistently had the highest influenza-associated hospitalization rate across all age groups, followed in most seasons by children aged 0-4 years. Black or African American and American Indian or Alaska Native persons had the highest age-adjusted influenza-associated hospitalization rates across these seasons. Among patients hospitalized with influenza, the prevalence of at least one underlying medical condition increased with increasing age, ranging from 36.9% among children aged 0-4 years to 95.4% among adults aged ≥65 years. Consistently across each season, the most common underlying medical conditions among children and adolescents were asthma, neurologic disorders, and obesity. The most common underlying medical conditions among adults were hypertension, obesity, chronic metabolic disease, chronic lung disease, and cardiovascular disease. The proportion of FluSurv-NET patients with acute respiratory signs and symptoms at hospital admission decreased from 90.6% during 2018-19 to 83.2% during 2022-23. Although influenza antiviral use increased during the 2010-11 through the 2017-18 influenza seasons, it decreased from 90.2% during 2018-19 to 79.1% during 2022-23, particularly among children and adolescents. Admission to the intensive care unit, need for invasive mechanical ventilation, and in-hospital death ranged from 14.1% to 22.3%, 4.9% to 11.1%, and 2.2% to 3.5% of patients hospitalized with influenza, respectively, during the reported surveillance period. Interpretations Influenza continues to cause severe morbidity and mortality, particularly in older adults, and disparities have persisted in racial and ethnic minority groups. Persons with underlying medical conditions represented a large proportion of patients hospitalized with influenza. Increased use of multiplex tests and other potential changes in facility-level influenza testing practices (e.g., influenza screening at all hospital admissions) could have implications for the detection of influenza infections among hospitalized patients. Antiviral use decreased in recent seasons, and explanations for the decrease should be further evaluated. Public Health Action Continued robust influenza surveillance is critical to monitor progress in efforts to encourage antiviral treatment and improve clinical outcomes for persons hospitalized with influenza. In addition, robust influenza surveillance can potentially reduce disparities by informing efforts to increase access to preventive measures for influenza and monitoring any subsequent changes in hospitalization rates.
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Koh LP, Chia TRT, Wang SSY, Chavatte JM, Hawkins R, Ting Y, Sim JZT, Chen WX, Tan KB, Tan CH, Lye DC, Young BE. Utility of ISARIC 4C Mortality Score, Vaccination History, and Anti-S Antibody Titre in Predicting Risk of Severe COVID-19. Viruses 2024; 16:1604. [PMID: 39459939 PMCID: PMC11512353 DOI: 10.3390/v16101604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Revised: 10/08/2024] [Accepted: 10/10/2024] [Indexed: 10/28/2024] Open
Abstract
The ISARIC 4C Mortality score was developed to predict mortality risk among patients with COVID-19. Its performance among vaccinated individuals is understudied. This is a retrospective study of all patients with SARS-CoV-2 infection admitted to the National Centre for Infectious Diseases, Singapore, from January-2020 to December-2021. Demographic, clinical, and laboratory data were extracted, and multiple logistic regression (MLR) models were developed to predict the relationship between ISARIC score, vaccination status, anti-S antibody titre, and severe COVID-19. A total of 6377 patients were identified, of which 5329 met the study eligibility criteria. The median age of the patients was 47 years (IQR 35-71), 1264 (23.7%) were female, and 1239 (25.7%) were vaccinated. Severe disease occurred in 499 (9.4%) patients, including 133 (2.5%) deaths. After stratification, 3.0% of patients with low (0-4), 17.8% of patients with moderate (5-9), and 36.2% of patients with high (≥10) ISARIC scores developed severe COVID-19. Vaccination was associated with a reduced risk of progression to severe COVID-19 in the MLR model: aOR 0.88 (95% CI: 0.86-0.90), and the risk of severe COVID-19 decreased inversely to anti-S antibody titres. The anti-S antibody titre should be further investigated as an adjunct to the ISARIC score to triage COVID-19 patients for hospital admission and antiviral therapy.
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Affiliation(s)
- Lin Pin Koh
- National Centre for Infectious Diseases, Singapore 308442, Singapore; (L.P.K.); (T.R.T.C.); (S.S.Y.W.); (J.-M.C.); (C.H.T.); (D.C.L.)
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Travis Ren Teen Chia
- National Centre for Infectious Diseases, Singapore 308442, Singapore; (L.P.K.); (T.R.T.C.); (S.S.Y.W.); (J.-M.C.); (C.H.T.); (D.C.L.)
| | - Samuel Sherng Young Wang
- National Centre for Infectious Diseases, Singapore 308442, Singapore; (L.P.K.); (T.R.T.C.); (S.S.Y.W.); (J.-M.C.); (C.H.T.); (D.C.L.)
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Jean-Marc Chavatte
- National Centre for Infectious Diseases, Singapore 308442, Singapore; (L.P.K.); (T.R.T.C.); (S.S.Y.W.); (J.-M.C.); (C.H.T.); (D.C.L.)
| | - Robert Hawkins
- Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore;
| | - Yonghan Ting
- Department of Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore; (Y.T.); (J.Z.T.S.); (W.X.C.)
| | - Jordan Zheng Ting Sim
- Department of Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore; (Y.T.); (J.Z.T.S.); (W.X.C.)
| | - Wen Xiang Chen
- Department of Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore; (Y.T.); (J.Z.T.S.); (W.X.C.)
| | - Kelvin Bryan Tan
- Ministry of Health, 16 College Road, College of Medicine Building, Singapore 169854, Singapore;
| | - Cher Heng Tan
- National Centre for Infectious Diseases, Singapore 308442, Singapore; (L.P.K.); (T.R.T.C.); (S.S.Y.W.); (J.-M.C.); (C.H.T.); (D.C.L.)
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Department of Radiology, Tan Tock Seng Hospital, Singapore 308433, Singapore; (Y.T.); (J.Z.T.S.); (W.X.C.)
| | - David Chien Lye
- National Centre for Infectious Diseases, Singapore 308442, Singapore; (L.P.K.); (T.R.T.C.); (S.S.Y.W.); (J.-M.C.); (C.H.T.); (D.C.L.)
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore 308433, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Barnaby E. Young
- National Centre for Infectious Diseases, Singapore 308442, Singapore; (L.P.K.); (T.R.T.C.); (S.S.Y.W.); (J.-M.C.); (C.H.T.); (D.C.L.)
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore 308433, Singapore
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Ye M, Vena JE, Shen-Tu G, Johnson JA, Eurich DT. Impact of COVID-19 Pandemic on Healthcare Utilization in People with Diabetes: A Time-Segmented Longitudinal Study of Alberta's Tomorrow Project. Healthcare (Basel) 2024; 12:2009. [PMID: 39408189 PMCID: PMC11476217 DOI: 10.3390/healthcare12192009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Revised: 10/01/2024] [Accepted: 10/05/2024] [Indexed: 10/20/2024] Open
Abstract
OBJECTIVE The objective is to characterize the impact of COVID-19 on major healthcare for diabetes, including hospitalization, emergency department (ED) visits and primary care visits in Alberta, Canada. METHODS Participants from Alberta's Tomorrow Project (ATP) with pre-existing diabetes prior to 1 April 2018 were included and followed up to 31 March 2021. A time-segmented regression model was used to characterize the impact of COVID-19 on healthcare utilization after adjusting for seasonality, socio-demographic factors, lifestyle behaviors and comorbidity profile of patients. RESULTS Among 6099 participants (53.5% females, age at diagnosis 56.1 ± 9.9 y), the overall rate of hospitalization, ED visits and primary care visits was 151.5, 525.9 and 8826.9 per 1000 person-year during the COVID-19 pandemic (up to 31 March 2021), which means they reduced by 12% and 22% and increased by 6%, compared to pre-pandemic rates, respectively. Specifically, the first COVID-19 state of emergency (first wave of the outbreak) was associated with reduced rates of hospitalization, ED visits and primary care visits, by 79.4% (95% CI: 61.3-89.0%), 93.2% (95% CI: 74.6-98.2%) and 65.7% (95% CI: 47.3-77.7%), respectively. During the second state of emergency, healthcare utilization continued to decrease; however, a rebound (increase) of ED visits was observed during the period when the public health state of emergency was relaxed. CONCLUSION The declared COVID-19 states of emergency had a negative impact on healthcare utilization for people with diabetes, especially for hospital and ED services, which suggests the importance of enhancing the capacity of these two healthcare sectors during future COVID-19-like public health emergencies.
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Affiliation(s)
- Ming Ye
- School of Public Health, University of Alberta, Edmonton, AB T6G 2G4, Canada
| | - Jennifer E. Vena
- Alberta’s Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2T 5C7, Canada
| | - Grace Shen-Tu
- Alberta’s Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2T 5C7, Canada
| | - Jeffrey A. Johnson
- School of Public Health, University of Alberta, Edmonton, AB T6G 2G4, Canada
| | - Dean T. Eurich
- School of Public Health, University of Alberta, Edmonton, AB T6G 2G4, Canada
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Soto RA, Vahey GM, Marshall KE, McDonald E, Herlihy R, Chun HM, Killerby ME, Kawasaki B, Midgley CM, Alden NB, Tate JE, Staples JE, Team CI. The role and limitations of electronic medical records versus patient interviews for determining symptoms of, underlying comorbidities of, and medication use by patients with COVID-19. Am J Epidemiol 2024; 193:1442-1450. [PMID: 38775290 DOI: 10.1093/aje/kwae079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/07/2024] [Accepted: 05/17/2024] [Indexed: 10/09/2024] Open
Abstract
Electronic medical records (EMRs) are important for rapidly compiling information to determine disease characteristics (eg, symptoms) and risk factors (eg, underlying comorbidities, medications) for disease-related outcomes. To assess EMR data accuracy, agreement between EMR abstractions and patient interviews was evaluated. Symptoms, medical history, and medication use among patients with COVID-19 collected from EMRs and patient interviews were compared using overall agreement (ie, same answer in EMR and interview), reported agreement (yes answer in both EMR and interview among those who reported yes in either), and κ statistics. Overall, patients reported more symptoms in interviews than in EMR abstractions. Overall agreement was high (≥50% for 20 of 23 symptoms), but only subjective fever and dyspnea had reported agreement of ≥50%. The κ statistics for symptoms were generally low. Reported medical conditions had greater agreement with all condition categories (n = 10 of 10) having ≥50% overall agreement and half (n = 5 of 10) having ≥50% reported agreement. More nonprescription medications were reported in interviews than in EMR abstractions, leading to low reported agreement (28%). Discordance was observed for symptoms, medical history, and medication use between EMR abstractions and patient interviews. Investigations using EMRs to describe clinical characteristics and identify risk factors should consider the potential for incomplete data, particularly for symptoms and medications.
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Affiliation(s)
- Raymond A Soto
- Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, Centers for Disease Control and Prevention, Atlanta, GA 30345, United States
- COVID-19 Emergency Response, Division of Emergency Operations, Centers for Disease Control and Prevention, Atlanta, GA 30329, and Fort Collins, CO 80521, United States
| | - Grace M Vahey
- Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, Centers for Disease Control and Prevention, Atlanta, GA 30345, United States
- COVID-19 Emergency Response, Division of Emergency Operations, Centers for Disease Control and Prevention, Atlanta, GA 30329, and Fort Collins, CO 80521, United States
| | - Kristen E Marshall
- Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, Centers for Disease Control and Prevention, Atlanta, GA 30345, United States
- COVID-19 Emergency Response, Division of Emergency Operations, Centers for Disease Control and Prevention, Atlanta, GA 30329, and Fort Collins, CO 80521, United States
| | - Emily McDonald
- Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, Centers for Disease Control and Prevention, Atlanta, GA 30345, United States
- COVID-19 Emergency Response, Division of Emergency Operations, Centers for Disease Control and Prevention, Atlanta, GA 30329, and Fort Collins, CO 80521, United States
| | - Rachel Herlihy
- Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment, Denver, CO 80426, United States
| | - Helen M Chun
- COVID-19 Emergency Response, Division of Emergency Operations, Centers for Disease Control and Prevention, Atlanta, GA 30329, and Fort Collins, CO 80521, United States
| | - Marie E Killerby
- COVID-19 Emergency Response, Division of Emergency Operations, Centers for Disease Control and Prevention, Atlanta, GA 30329, and Fort Collins, CO 80521, United States
| | - Breanna Kawasaki
- Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment, Denver, CO 80426, United States
| | - Claire M Midgley
- COVID-19 Emergency Response, Division of Emergency Operations, Centers for Disease Control and Prevention, Atlanta, GA 30329, and Fort Collins, CO 80521, United States
| | - Nisha B Alden
- Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment, Denver, CO 80426, United States
| | - Jacqueline E Tate
- COVID-19 Emergency Response, Division of Emergency Operations, Centers for Disease Control and Prevention, Atlanta, GA 30329, and Fort Collins, CO 80521, United States
| | - J Erin Staples
- COVID-19 Emergency Response, Division of Emergency Operations, Centers for Disease Control and Prevention, Atlanta, GA 30329, and Fort Collins, CO 80521, United States
| | - Colorado Investigation Team
- Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment, Denver, CO 80426, United States
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Hall EW, Sarwary S, Reynolds A, Przedworski J, Newby-Kew A, Camp K, Ku JH, Snowden JM. Development of a University-Government Partnership for Public Health Response and Workforce Development in the State of Oregon. J Community Health 2024; 49:779-784. [PMID: 38491319 DOI: 10.1007/s10900-024-01352-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
The COVID-19 pandemic exposed and exacerbated a public health workforce shortage and national strategies have called for the development of clear occupational pathways for students to enter the public health workforce and meaningful public health careers. In response to the immediate need for public health workers during the pandemic, several universities and academic hospitals rapidly mobilized students and employees and partnered with local or state health departments. However, many of those partnerships were based on short-term volunteer effort to support critical COVID-19 public health efforts. In this article, we document the development of Oregon's Public Health Practice Team, a student, staff, and faculty workforce developed at the Oregon Health & Science University-Portland State University (OHSU-PSU) School of Public Health in close collaboration with the Oregon Health Authority (OHA). This project contributed significant effort to several phases of Oregon's statewide public health response to COVID-19, and over time developed into a lasting, multi-purpose, inter-agency collaborative public health practice program. Health equity has been centered at every stage of this work. We describe the phases of the partnership development, the current team structure and operations, and highlight key challenges and lessons learned. This provides a case-study of how an innovative and flexible university-government partnership can contribute to immediate pandemic response needs, and also support ongoing public health responses to emerging needs, while contributing to the development of a skilled and diverse public health workforce.
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Affiliation(s)
- Eric W Hall
- School of Public Health, Oregon Health & Science University-Portland State University School of Public Health, 1810 SW 5th Avenue, Suite 510, Portland, OR, 97201, USA.
| | - Shabir Sarwary
- School of Public Health, Oregon Health & Science University-Portland State University School of Public Health, 1810 SW 5th Avenue, Suite 510, Portland, OR, 97201, USA
| | - Amelia Reynolds
- Health Security, Preparedness and Response Program, Public Health Division, Oregon Health Authority, Portland, OR, USA
| | | | - Abigail Newby-Kew
- School of Public Health, Oregon Health & Science University-Portland State University School of Public Health, 1810 SW 5th Avenue, Suite 510, Portland, OR, 97201, USA
| | - Karen Camp
- School of Public Health, Oregon Health & Science University-Portland State University School of Public Health, 1810 SW 5th Avenue, Suite 510, Portland, OR, 97201, USA
| | - Jennifer H Ku
- Department of Research & Evaluation, Kaiser Permanente Southern California, California, USA
| | - Jonathan M Snowden
- School of Public Health, Oregon Health & Science University-Portland State University School of Public Health, 1810 SW 5th Avenue, Suite 510, Portland, OR, 97201, USA
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Abad N, Bonner KE, Kolis J, Brookmeyer KA, Voegeli C, Lee JT, Singleton JA, Quartarone R, Black C, Yee D, Ramakrishnan A, Rodriguez L, Clay K, Hummer S, Holmes K, Manns BJ, Donovan J, Humbert-Rico T, Flores SA, Griswold S, Meyer S, Cohn A. Strengthening COVID-19 vaccine confidence & demand during the US COVID-19 emergency response. Vaccine 2024; 42 Suppl 3:125604. [PMID: 38267329 DOI: 10.1016/j.vaccine.2024.01.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/14/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
In October 2020, the CDC's Vaccinate with Confidence strategy specific to COVID-19 vaccines rollout was published. Adapted from an existing vaccine confidence framework for childhood immunization, the Vaccinate with Confidence strategy for COVID-19 aimed to improve vaccine confidence, demand, and uptake of COVID-19 vaccines in the US. The objectives for COVID-19 were to 1. build trust, 2. empower healthcare personnel, and 3. engage communities and individuals. This strategy was implemented through a dedicated unit, the Vaccine Confidence and Demand (VCD) team, which collected behavioral insights; developed and disseminated toolkits and best practices in collaboration with partners; and collaborated with health departments and community-based organizations to engage communities and individuals in behavioral interventions to strengthen vaccine demand and increase COVID-19 vaccine uptake. The VCD team collected and used social and behavioral data through establishing the Insights Unit, implementing rapid community assessments, and conducting national surveys. To strengthen capacity at state and local levels, the VCD utilized "Bootcamps," a rapid training of trainers on vaccine confidence and demand, "Confidence Consults", where local leaders could request tailored advice to address local vaccine confidence challenges from subject matter experts, and utilized surge staffing to embed "Vaccine Demand Strategists" in state and local public health agencies. In addition, collaborations with Prevention Research Centers, the Institute of Museum and Library Services, and the American Psychological Association furthered work in behavioral science, community engagement, and health equity. The VCD team operationalized CDC's COVID-19 Vaccine with Confidence strategy through behavioral insights, capacity building opportunities, and collaborations to improve COVID-19 vaccine confidence, demand, and uptake in the US. The inclusion of applied behavioral science approaches were a critical component of the COVID-19 vaccination program and provides lessons learned for how behavioral science can be integrated in future emergency responses.
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Affiliation(s)
- Neetu Abad
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA.
| | - Kimberly E Bonner
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Jessica Kolis
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Kathryn A Brookmeyer
- Office of the Director, National Center for HIV, Viral Hepatitis, STD and TB Prevention, USA
| | - Chris Voegeli
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - James T Lee
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - James A Singleton
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Richard Quartarone
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Carla Black
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Daiva Yee
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | | | | | - Kelly Clay
- Karna LLC, CDC Contractor, Atlanta, GA, USA
| | - Sarah Hummer
- Tanaq Support Services, CDC Contractor, Atlanta, GA, USA
| | - Kathleen Holmes
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Brian J Manns
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - John Donovan
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Tiffany Humbert-Rico
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Stephen A Flores
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Stephanie Griswold
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Sarah Meyer
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Amanda Cohn
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
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Rostamzadeh S, Allafasghari A, Allafasghari A, Abouhossein A. Handgrip strength as a prognostic factor for COVID-19 mortality among older adult patients admitted to the intensive care unit (ICU): a comparison Alpha (B.1.1.7) and Delta (B.1.617.2) variants. Sci Rep 2024; 14:19927. [PMID: 39198687 PMCID: PMC11358457 DOI: 10.1038/s41598-024-71034-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 08/23/2024] [Indexed: 09/01/2024] Open
Abstract
Handgrip strength (HGS) is a non-invasive and reliable biomarker of overall health, physical function, mobility, and mortality. This study aimed to investigate the possible relationship between HGS and mortality in older adult patients hospitalized with COVID-19 in the intensive care unit (ICU) by Alpha (B.1.1.7) and Delta (B.1.617.2) variants. This retrospective cohort study was conducted on 472 COVID-19 patients (222 female and 250 male) aged 60-85 years admitted to the ICU. Demographic data, underlying comorbidities, COVID-19-related symptoms, as well as laboratory and computed tomography (CT) findings were obtained from the patient's medical records. Using a JAMAR® hydraulic dynamometer, the average grip strength value (kg) after three measurements on the dominant side was recorded for subsequent analysis. Low grip strength (LGS) was defined as an arbitrary cut-off of two standard deviations below the gender-specific peak mean value of normative HGS in Iranian healthy population, i.e. < 26 kg in males and < 14 kg in females. The findings showed lower mean grip strength and high frequency of LGS in the non-survivors patients versus survivors group and in the Delta (B.1.617.2) variant vs. Alpha (B.1.1.7) variant, respectively (both p < 0.01). The binary logistic regression analysis showed that chronic obstructive pulmonary disease (COPD) (adjusted odds ratio [OR] 5.125, 95% CI 1.425-25.330), LGS (OR 4.805, 95% CI 1.624-10.776), SaO2 (OR - 3.501, 95% CI 2.452-1.268), C-reactive protein (CRP) level (OR 2.625, 95% CI 1.256-7.356), and age (OR 1.118, 95% CI 1.045-1.092) were found to be independent predictors for mortality of patients with Alpha (B.1.1.7) variant (all p < 0.05). However, only four independent predictors including COPD (OR 6.728, 95% CI 1.683-28.635), LGS (OR 5.405, 95% CI 1.461-11.768), SaO2 (OR - 4.120, 95% CI 2.924-1.428), and CRP level (OR 1.893, 95% CI 1.127-8.692) can be predicted the mortality of patients with Delta (B.1.617.2) variant (p < 0.05). Along with the well-known and common risk factors (i.e. COPD, CRP, and SaO2), handgrip strength can be a quick and low-cost prognostic tool in predicting chances of mortality in older adults who are afflicted with COVID-19 variants.
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Affiliation(s)
- Sajjad Rostamzadeh
- Department of Ergonomics, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atabak Allafasghari
- Department of Health, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Amin Allafasghari
- Department of Health, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Abouhossein
- Department of Ergonomics, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Quan SF, Weaver MD, Czeisler MÉ, Barger LK, Booker LA, Howard ME, Jackson ML, McDonald CF, Ridgers A, Robbins R, Varma P, Rajaratnam SMW, Czeisler CA. Obstructive Sleep Apnea is a Risk Factor for Incident COVID-19 Infection. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.15.24312067. [PMID: 39185535 PMCID: PMC11343271 DOI: 10.1101/2024.08.15.24312067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Cross-sectional studies suggest that obstructive sleep apnea (OSA) is a potential risk factor for incident COVID-19 infection, but longitudinal studies are lacking. In this study, two surveys from a large general population cohort, the COVID-19 Outbreak Public Evaluation (COPE) Initiative, undertaken 147 ± 58 days apart were analyzed to determine whether the pre-existing OSA was a risk factor for the incidence of COVID-19. Of the 24,803 respondents completing the initial survey, 14,950 were negative for COVID-19; data from the follow-up survey were available for 2,325 respondents. Those with incident COVID-19 infection had a slightly higher prevalence of OSA (14.3 vs. 11.5%, p=0.068). Stratification by treatment status revealed that those untreated for their OSA were at greater risk for developing COVID-19 infection (OSA Untreated, 14.2 vs. 7.4%, p≤0.05). In a logistic regression model adjusted for comorbidities, demographic and socioeconomic factors and the interaction between vaccination status and OSA, incident COVID-19 infection was 2.15 times more likely in those with untreated OSA (aOR: 2.15, 95% CI: 1.18-3.92, p≤0.05). Stratification by treatment status revealed only untreated OSA participants were at greater risk for COVID-19 (aOR: 3.21, 95% CI: 1.25-8.23, p≤0.05). The evidence from this study confirms untreated OSA as a risk factor for acquiring COVID-19 infection and highlights the importance of actively treating and managing OSA as a preventative mechanism against COVID-19 disease.
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Pham D, Lomeli A, Goldhaber NH, Valentine HD, Knight R, Longhurst CA, Laurent LC, Jacobs MB. Longitudinal assessment of the impact of COVID-19 infection on mask-wearing behaviors. BMC Public Health 2024; 24:2230. [PMID: 39152377 PMCID: PMC11328381 DOI: 10.1186/s12889-024-19776-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 08/12/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Wearing a mask was a crucial component in slowing the COVID-19 pandemic. However, little is known about the intersectionality between mask usage, risk perception, and infection. The purpose of this study was to investigate whether risk perceptions and masking behaviors are associated with contracting SARS-CoV-2 and how contracting SARS-CoV-2 subsequently changes masking behaviors in specific situations. METHODS This cohort study utilized survey data from the UC San Diego ZAP COVID-19 study (n = 1,230) to evaluate the risk of contracting SARS-CoV-2 in relation to baseline risk perceptions and masking behaviors in various situations and how contracting SARS-CoV-2 affects subsequent masking behavior. RESULTS We found that more consistent self-reported mask use in indoor public spaces (p = 0.03) and in other people's houses (p = 0.002) was associated with remaining free of SARS-CoV-2 infection. We also found that contracting SARS-CoV-2 was associated with a subsequent increase in mask use in other people's houses (p = 0.01). CONCLUSIONS Our findings suggest that consistent mask use is correlated with decreased infection and that contracting SARS-CoV-2 may modify mask use behaviors in high-risk situations. These findings may help inform future public health messaging for infectious disease prevention. TRIAL REGISTRATION This study has not been previously registered as it is an observational study. There was no pre-registration of the analytic plan for the present study.
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Affiliation(s)
- Danielle Pham
- University of California, San Diego Herbert Wertheim School of Public Health and Human Longevity Science, La Jolla, USA
| | - Angel Lomeli
- University of California, San Diego Herbert Wertheim School of Public Health and Human Longevity Science, La Jolla, USA
- San Diego School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal Fetal Medicine, University of California, 9300 Campus Point Dr., MC 7433, , La Jolla, USA
| | - Nicole H Goldhaber
- San Diego School of Medicine, Department of Surgery, University of California, La Jolla, USA
| | - Holly D Valentine
- San Diego School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal Fetal Medicine, University of California, 9300 Campus Point Dr., MC 7433, , La Jolla, USA
| | - Rob Knight
- San Diego EXCITE Laboratory, University of California, La Jolla, USA
- San Diego School of Medicine, Department of Pediatrics, University of California, La Jolla, USA
- Department of Computer Science and Engineering, University of California, San Diego Jacobs School of Engineering, La Jolla, USA
| | - Christopher A Longhurst
- San Diego School of Medicine, Department of Pediatrics, University of California, La Jolla, USA
- San Diego School of Medicine, Department of Medicine, University of California, La Jolla, USA
| | - Louise C Laurent
- San Diego School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal Fetal Medicine, University of California, 9300 Campus Point Dr., MC 7433, , La Jolla, USA
- San Diego EXCITE Laboratory, University of California, La Jolla, USA
| | - Marni B Jacobs
- San Diego School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal Fetal Medicine, University of California, 9300 Campus Point Dr., MC 7433, , La Jolla, USA.
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Fisher KA, Epstein MM, Nguyen N, Fouayzi H, Crawford S, Linas BP, Mazor KM. COVID-19 clinical trials: who is likely to participate and why? J Comp Eff Res 2024; 13:e230181. [PMID: 39045844 PMCID: PMC11287768 DOI: 10.57264/cer-2023-0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 06/28/2024] [Indexed: 07/25/2024] Open
Abstract
Aim: To identify factors associated with willingness to participate in a COVID-19 clinical trial and reasons for and against participating. Materials & methods: We surveyed Massachusetts (MA, USA) residents online using the Dynata survey platform and via phone using random digit dialing between October and November 2021. Respondents were asked to imagine they were hospitalized with COVID-19 and invited to participate in a treatment trial. We assessed willingness to participate by asking, "Which way are you leaning" and why. We used multivariate logistic regression to model factors associated with leaning toward participation. Open-ended responses were analyzed using conventional content analysis. Results: Of 1071 respondents, 65.6% leaned toward participating. Multivariable analyses revealed college-education (OR: 1.59; 95% CI: 1.11, 2.27), trust in the healthcare system (OR: 1.32; 95% CI: 1.10, 1.58) and relying on doctors (OR: 1.77; 95% CI: 1.45, 2.17) and family or friends (OR: 1.31; 95% CI: 1.11, 1.54) to make health decisions were significantly associated with leaning toward participating. Respondents with lower health literacy (OR: 0.57; 95% CI: 0.36, 0.91) and who identify as Black (OR: 0.40; 95% CI: 0.24, 0.68), Hispanic (OR: 0.61; 95% CI: 0.38, 0.98), or republican (OR: 0.61; 95% CI: 0.38, 0.97) were significantly less likely to lean toward participating. Common reasons for participating included helping others, benefitting oneself and deeming the study low risk. Common reasons for leaning against were deeming the study high risk, disliking experimental treatments and not wanting to be a guinea pig. Conclusion: Our finding that vulnerable individuals and those with lower levels of trust in the healthcare system are less likely to be receptive to participating in a COVID-19 clinical trial highlights that work is needed to achieve a healthcare system that provides confidence to historically disadvantaged groups that their participation in research will benefit their community.
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Affiliation(s)
- Kimberly A Fisher
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA
| | - Mara M Epstein
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA
| | - Ngoc Nguyen
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA
| | - Hassan Fouayzi
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA
| | - Sybil Crawford
- Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, MA 01655, USA
| | - Benjamin P Linas
- Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, & Boston University School of Public Health, Boston, MA 02118, USA
| | - Kathleen M Mazor
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA 01655, USA
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Dahlstrand A, Farrokhnia N. Socioeconomic, medical and demographic characteristics of early adopters of digital primary care. Scand J Public Health 2024; 52:547-555. [PMID: 37089003 DOI: 10.1177/14034948221119640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
AIMS In this paper, we investigated which socioeconomic and demographic groups first adopted digital primary care video consultations when they became accessible to the entire population in Sweden. METHODS We analysed data on all patients (378,000) who had a consultation with the largest provider of digital healthcare in Sweden - Kry - in the first years of national availability of the service, 2016-2018. We studied their income, education, demographics, and diagnosis backgrounds using matched registry data. Moreover, to compare users and non-users of digital primary care, we used data on all physical primary care users in one Swedish region: Skåne. RESULTS We found that this digital primary care was first used by young and higher-income adults, but not far from half of adult users had incomes below the national median. Digital care patients were more educated than the general population, reflecting that urban inhabitants were more likely than rural inhabitants to be users. First-generation immigrants were less represented among digital care users than in the population. However, second-generation immigrants with two foreign parents were slightly over-represented. The prevalence of some chronic diseases in pre-digital secondary (specialist and hospital) healthcare data among digital care users was similar to the population adjusted for age. Studying all physical primary care users in Skåne region, young digital care users had more primary care diagnoses and previous in-person primary care appointments than non-users, while the pattern was reversed for older users. CONCLUSIONS When digital primary care became nationally available, younger, urban and more educated patients were the first to adopt the new technology. Regarding medical history, young users of digital care had a higher previous disease burden than young non-users, suggesting that these digital services were first adopted by young people with high primary care needs.
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Affiliation(s)
| | - Nasim Farrokhnia
- Department of Clinical Science and Education, Karolinska Institutet and Microsoft (previously Mindler and Kry), Sweden
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Simpson EL, Silverberg JI, Nosbaum A, Winthrop K, Guttman-Yassky E, Hoffmeister KM, Egeberg A, Valdez H, Fan H, Farooqui SA, Chan G, Alderfer J, Romero W, Chittuluru K. Integrated Safety Update of Abrocitinib in 3802 Patients with Moderate-to-Severe Atopic Dermatitis: Data from More than 5200 Patient-Years with Up to 4 Years of Exposure. Am J Clin Dermatol 2024; 25:639-654. [PMID: 38888681 PMCID: PMC11193687 DOI: 10.1007/s40257-024-00869-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Abrocitinib, an oral, once-daily, Janus kinase 1-selective inhibitor, is efficacious in moderate-to-severe atopic dermatitis with a manageable long-term safety profile. OBJECTIVE We aimed to provide updated integrated long-term safety results for abrocitinib from available data accrued up to a maximum of almost 4 years in patients with moderate-to-severe atopic dermatitis from the JADE clinical development program. METHODS Analysis included 3802 patients (exposure: 5213.9 patient-years) from the phase II monotherapy study (NCT02780167) and the phase III studies JADE MONO-1 (NCT03349060), JADE MONO-2 (NCT03575871), JADE TEEN (NCT03796676), JADE COMPARE (NCT03720470), JADE DARE (NCT04345367; 200 mg only), JADE REGIMEN (NCT03627767), and JADE EXTEND (NCT03422822; data cutoff 25 September, 2021). Data from patients receiving one or more doses of abrocitinib 200 mg or 100 mg were pooled in a consistent-dose cohort (patients were allocated to receive the same abrocitinib dose throughout exposure in the qualifying parent study and/or long-term study) or a variable-dose cohort (patients received open-label abrocitinib 200 mg; responders were randomized to abrocitinib 200 mg, 100 mg, or placebo, and could then receive abrocitinib 200 mg plus topical corticosteroids as rescue therapy). Incidence rates of adverse events of special interest were assessed. Cox regression analysis of risk factors for herpes zoster and serious infections was performed. RESULTS Overall, this safety analysis of long-term data up to a maximum of ~ 4 years of abrocitinib exposure does not indicate any changes from the previously reported risk profile. The most frequent serious infections (per Medical Dictionary for Regulatory Activities preferred term) with consistent-dose abrocitinib 200 mg and 100 mg were herpes zoster (0.5% and 0.2%), pneumonia (0.2% with either dose), and herpes simplex (0.1% with either dose). Risk factors for herpes zoster were a history of herpes zoster, abrocitinib 200-mg dose, age ≥ 65 years, absolute lymphocyte count < 1 × 103/mm3 before the event, and residing in Asia. For serious infections, > 100 kg body weight was a risk factor. Incidence rate/100 patient-years (95% confidence interval) with the consistent abrocitinib 200-mg and 100-mg dose combined was higher in older (aged ≥ 65 years) patients versus younger (aged 18 to < 65 years) patients for serious adverse events (17.6 [11.7‒25.4] vs 6.7 [5.8‒7.8]), malignancy excluding non-melanoma skin cancer (2.4 [0.6‒6.0] vs 0.1 [0.0‒0.4]), non-melanoma skin cancer (2.4 [0.6‒6.1] vs 0.2 [0.1‒0.4]), lymphopenia (3.5 [1.3‒7.6] vs 0.1 [0.0‒0.3]), and venous thromboembolism (1.7 [0.4‒5.1] vs 0.1 [0.0‒0.3]). Incident rate/100 patient-years (95% confidence interval) of non-melanoma skin cancer with the consistent abrocitinib 200-mg and 100-mg dose combined was higher in current/former smokers (0.9 [0.4‒1.6]) vs never-smokers (0.0 [0.0‒0.1]). CONCLUSIONS This safety update showed a consistent profile for abrocitinib with no new safety signals and continues to support that abrocitinib has a manageable long-term safety profile in patients with moderate-to-severe atopic dermatitis. Risk of specific adverse events was higher in certain patient populations, especially those aged ≥ 65 years. [Video abstract available.] CLINICAL TRIAL REGISTRATION: NCT02780167; study start date: April, 2016; primary completion date: March, 2017; study completion date: April, 2017. NCT03349060; study start date: 7 December, 2017; study completion date: 26 March, 2019. NCT03575871; study start date: 29 June, 2018; study completion date: 13 August, 2019. NCT03720470; study start date: 29 October, 2018; primary completion date: 27 December, 2019; study completion date: 6 March, 2020. NCT03796676; study start date: 18 February, 2019; study completion date: 8 April, 2020. NCT03627767; study start date: 11 June, 2018; primary completion date: 2 September, 2020; study completion date: 7 October, 2020. NCT04345367; study start date: 11 June, 2020; primary completion date: 16 December, 2020; study completion date: 13 July, 2021. NCT03422822; study start date: 8 March, 2018; study completion date: ongoing (estimated completion date: 31 January, 2026).
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Affiliation(s)
- Eric L Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Audrey Nosbaum
- Hospices Civils de Lyon, Allergologie et Immunologie Clinique, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - Kevin Winthrop
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
| | | | - Karin M Hoffmeister
- Versiti, Translational Glycomics Center, Blood Research Institute, Milwaukee, WI, USA
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alexander Egeberg
- Bispebjerg University Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Gopalakrishnan S, Rana MM, Curry MA, Krishnakumar A, Rahimi R. Sticker-Type Remote Monitoring System for Early Risk Detection of Catheter Associated Urinary Tract Infections. IEEE Trans Biomed Eng 2024; 71:2070-2079. [PMID: 38335074 DOI: 10.1109/tbme.2024.3361439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
A substantial number of critically ill patients in intensive care units (ICUs) rely on indwelling urinary catheters (IDCs), demanding regular monitoring of urine bags. This process increases the workload for healthcare providers and elevates the risk of exposure to contagious diseases. Moreover, IDCs are a primary cause of catheter-associated urinary tract infections (UTIs) in ICU patients whose delayed detection can have life-threatening complications. To address this, we have developed a Sticker Type Antenna for Remote Sensing (STARS) system capable of measuring urine flow rate and conductivity as early-risk markers for UTIs, alongside tracking patients' urine bag status to facilitate medical automation for healthcare providers. STARS comprises a simple, low-cost, disposable antenna module for contactless measurements of urine volume and conductivity, and a reusable wireless module for real-time data transmission. Systematic studies on STARS revealed its stable performance within physiologically relevant ranges of urine volume (0 to 2000 ml) and conductivity (5 to 40 mS/cm) in urine bags. As a proof-of-concept, STARS was tested in artificially created healthy and infected urine specimens to validate its non-contact sensing performance in detecting the onset of UTIs in catheterized patients within a hospital-like environment. STARS represents the first application of a real-time, contactless, wireless monitoring platform for simultaneous urine bag management and early risk detection of UTIs.
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Üsküp DK, Castellon-Lopez YM, Jolayemi O, Branch CA, Adeyiga O, Shoptaw S. Racial (In)Equity in South Los Angeles-Community Centered Experiences with COVID-19 Syndemics. Health Equity 2024; 8:446-454. [PMID: 39011070 PMCID: PMC11249122 DOI: 10.1089/heq.2023.0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2024] [Indexed: 07/17/2024] Open
Abstract
Objectives To analyze community experiences involving COVID-19 vaccination access and equity in Black and Latina/o/x communities within South Los Angeles, using a socioecological framework. Methods We conducted four virtual focus groups (n = 33 total participants) in 2021, with Black and Latina/o/x community members, community leaders, and community-based providers in South Los Angeles, a region highly impacted by the COVID-19 pandemic. We used a grounded theory approach to guide the analysis and generate data shaped by participant perspectives. Results Participants across groups consistently emphasized medical mistrust, fear/skepticism, misinformation, accessibility, and feelings of pressure and blame as factors influencing COVID-19 vaccination decisions. The need to address pandemic-related socioeconomic hardships in underresourced communities was equally highlighted. Conclusions Findings show that building trust, providing tailored information, and continued investment into diversity and equity initiatives can support Black and Latino/a/x communities in making informed health decisions. Community-centered support services should address the economic, social, and structural impact of the pandemic on vulnerable communities. Furthermore, public health and policy efforts must prioritize funding to equip social and health care systems with infrastructure investment in racial and ethnic minority communities.
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Affiliation(s)
- Dilara K. Üsküp
- Department of Family Medicine, UCLA David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Department of Internal Medicine, Charles R. Drew University of Medicine, and Science, Los Angeles, California, USA
| | | | - Oluwadamilola Jolayemi
- Department of Family Medicine, UCLA David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Cheryl A. Branch
- The Community Response System of South Los Angeles (CRSSLA), Los Angeles, California, USA
| | - Oladunni Adeyiga
- Department of Medicine, Division of Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - Steve Shoptaw
- Department of Family Medicine, UCLA David Geffen School of Medicine, University of California, Los Angeles, California, USA
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Moreira de Barros GA, Silva DICD, Barbosa MLA, Soares RA, Alves RL, Miranda CL, Costa PDLD, Nascimento Júnior PD, Módolo NSP. Chronic pain after hospital discharge on patients hospitalized for COVID-19: an observational study. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ELSEVIER) 2024; 74:744457. [PMID: 37562649 PMCID: PMC11281913 DOI: 10.1016/j.bjane.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND There are few studies related to Coronavirus Disease 2019 (COVID-19) on the prevalence and nature of pain symptoms after hospital discharge, especially in individuals who develop moderate to severe disease forms. Therefore, this study aimed to evaluate the presence of chronic pain in patients discharged after hospitalization for COVID-19, and the relationship between the presence of chronic pain and intensive care stay, demographics, and risk factors for the worst Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outcome. METHODS A cross-sectional observational study was carried out on patients with COVID-19 who recovered after hospitalization. Patients were recruited at the least 3 months after discharge and their hospital's health files were prospected. The variables evaluated were demographics, the severity of SARS-CoV-2 infection (considering the need for intensive care), and the presence of chronic pain. The results were shown in a descriptive manner, and multivariate analysis expressed as Odds Ratios (ORs) and respective Confidence Intervals (CIs) for the outcomes studied. Statistical significance was set at p < 0.05. RESULTS Of 242 individuals included, 77 (31.8%) reported chronic pain related to COVID-19, with no correlation with the severity of infection. Female sex and obesity were associated with a higher risk for chronic pain with ORs of 2.69 (Confidence Interval [95% CI 1.4 to 5.0]) and 3.02 (95% CI 1.5 to 5.9). The limbs were the most affected areas of the body. CONCLUSION Chronic pain is common among COVID-19 survivors treated in hospital environments. Female sex and obesity are risk factors for its occurrence.
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Affiliation(s)
| | | | - Mariana Lopes Amaral Barbosa
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Departamento de Anestesiologia, Botucatu, SP, Brazil
| | - Rafael Abbud Soares
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Departamento de Anestesiologia, Botucatu, SP, Brazil
| | - Rodrigo Leal Alves
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Departamento de Anestesiologia, Botucatu, SP, Brazil
| | - Claudio Lucas Miranda
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Departamento de Anestesiologia, Botucatu, SP, Brazil
| | - Paula Danieli Lopes da Costa
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Departamento de Anestesiologia, Botucatu, SP, Brazil
| | - Paulo do Nascimento Júnior
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Departamento de Anestesiologia, Botucatu, SP, Brazil
| | - Norma Sueli Pinheiro Módolo
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Departamento de Anestesiologia, Botucatu, SP, Brazil
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Aminsobahni E, Hosseini M, Gholizadeh N, Soltani-Zangbar MS, Savari G, Motlagh Asghari K, Pourlak T, Zolfaghari M, Chakari-Khiavi F, Motavalli R, Chakari-Khiavi A, Shekarchi AA, Mahmoodpoor A, Ahmadian Heris J, Pouya K, Mehdizadeh A, Babalou Z, Yousefi M. T Lymphocyte Characteristic Changes Under Serum Cytokine Deviations and Prognostic Factors of COVID-19 in Pregnant Women. Appl Biochem Biotechnol 2024; 196:4366-4381. [PMID: 37947946 DOI: 10.1007/s12010-023-04775-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 11/12/2023]
Abstract
Physiological changes during pregnancy make the individuals more susceptible to severe respiratory diseases. Hence, pregnant women with coronavirus disease 2019 (COVID-19) are likely at a higher risk. We investigated the effects of COVID-19 on T cell response and serum cytokine profile in pregnant patients. Peripheral blood mononuclear cells (PBMCs) of women with COVID-19 were collected during the first trimester of pregnancy, and the percentage of total lymphocytes, as well as CD4 + and CD8 + T cells, was assessed using flow cytometry. The expression of the programmed death-1 (PD-1) marker for exhausted T cells was evaluated. Additionally, the serum samples were provided to evaluate the levels of antiviral and proinflammatory cytokines, as well as laboratory serological tests. Pregnant women with COVID-19 presented lymphopenia with diminished CD4 + and CD8 + T cells. Besides, high expression levels of the PD-1 gene and protein were observed on PBMCs and T cells, respectively, when compared with normal pregnant individuals. Moreover, serum levels of TNF-α, IL-6, IL-1β, and IL-2 receptor were notably enhanced, while IFN-I α/β values were significantly decreased in the patients when compared with controls. Furthermore, hyperlipidemia, hyperglycemia, and hypertension were directly correlated with the disease although serum albumin and vitamin D3 levels adversely affected the viral infection. Our study showed extreme lymphopenia and poor T cell response while elevated values of serum inflammatory cytokines in infected pregnant women. Moreover, a hypertension background or metabolic changes, including hyperlipidemia, hyperglycemia, and vitamin D3 or albumin deficiency, might be promising prognostic factors in pregnant women with COVID-19.
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Affiliation(s)
- Ehsan Aminsobahni
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Hosseini
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasim Gholizadeh
- Department of Dermatology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Sadegh Soltani-Zangbar
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Golaleh Savari
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Tannaz Pourlak
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammadali Zolfaghari
- Department of Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Roza Motavalli
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Aref Chakari-Khiavi
- Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Akbar Shekarchi
- Department of Pathology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ata Mahmoodpoor
- Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javad Ahmadian Heris
- Department of Allergy and Clinical Immunology, Pediatric Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Khadijeh Pouya
- Department of Obstetrics and Gynecology, Faculty of Medicine, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Amir Mehdizadeh
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zohreh Babalou
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Yousefi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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Quan SF, Weaver MD, Czeisler MÉ, Barger LK, Booker LA, Howard ME, Jackson ML, Lane RI, McDonald CF, Ridgers A, Robbins R, Varma P, Rajaratnam SM, Czeisler CA. Association of Chronotype and Shiftwork With COVID-19 Infection. J Occup Environ Med 2024; 66:548-555. [PMID: 38595269 PMCID: PMC11230841 DOI: 10.1097/jom.0000000000003103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This study assesses whether chronotype is related to COVID-19 infection and whether there is an interaction with shift work. Methods: This study used a cross-sectional survey of 19,821 U.S. adults. Results: COVID-19 infection occurred in 40% of participants, 32.6% morning and 17.2% evening chronotypes. After adjusting for demographic and socioeconomic factors, shift/remote work, sleep duration, and comorbidities, morning chronotype was associated with a higher (adjusted odds ratio [aOR]: 1.15, 95% CI: 1.10-1.21) and evening chronotype with a lower (aOR: 0.82, 95% CI: 0.78-0.87) prevalence of COVID-19 infection in comparison to an intermediate chronotype. Working exclusively night shifts was not associated with higher prevalence of COVID-19. Morning chronotype and working some evening shifts was associated with the highest prevalence of previous COVID-19 infection (aOR: 1.87, 95% CI: 1.28-2.74). Conclusion: Morning chronotype and working a mixture of shifts increase risk of COVID-19 infection.
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Affiliation(s)
- Stuart F. Quan
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Matthew D. Weaver
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Mark É. Czeisler
- Francis Weld Peabody Society, Harvard Medical School, Boston, MA, USA
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Laura K. Barger
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Lauren A. Booker
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- University Department of Rural Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Mark E. Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melinda L. Jackson
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Rashon I. Lane
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Christine F. McDonald
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- Faculty of Medicine, Monash University, Melbourne Australia
| | - Anna Ridgers
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Rebecca Robbins
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Prerna Varma
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Shantha M.W. Rajaratnam
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Charles A. Czeisler
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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Mederos-Torres CV, Díaz-Burke Y, Muñoz-Almaguer ML, García-Zapién AG, Uvalle-Navarro RL, González-Sandoval CE. Triglyceride/high-density cholesterol ratio as a predictor of cardiometabolic risk in young population. J Med Life 2024; 17:722-727. [PMID: 39440341 PMCID: PMC11493158 DOI: 10.25122/jml-2024-0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/30/2024] [Indexed: 10/25/2024] Open
Abstract
Cardiovascular disease remains a leading cause of morbidity and mortality worldwide. Understanding and detecting risk factors are crucial for early diagnosis and prevention strategies. Obesity, dyslipidemia, hypertension, and insulin resistance, among others, have been described as modifiable risk factors. Among these, the triglycerides-to-HDL cholesterol (TG/HDL) ratio has been described as a marker of insulin resistance and a predictor of cardiovascular disease. Our objective was to investigate the association between the TG/HDL ratio and various cardiometabolic risk factors. A total of 239 young adults aged 18-24 years were recruited. We assessed anthropometric measurements, lipid profiles, glucose levels, insulin, the HOMA index, and the TG/HDL ratio. Participants were stratified based on their BMI and TG/HDL ratio. Our findings revealed that individuals with an elevated TG/HDL ratio had higher blood pressure, BMI, waist circumference, cholesterol, and triglyceride levels compared to those with a normal ratio. Specifically, the TG/HDL ratio was associated with an odds ratio (OR) of 9.3 for overweight, 27.5 for obesity, and 4.41 for abdominal obesity. Additionally, the HOMA index, which measures insulin resistance, was higher in those with an elevated TG/HDL ratio, with a prevalence of 45.6%. In conclusion, the TG/HDL ratio is a predictive marker of insulin resistance in young individuals and is associated with modifiable risk factors for cardiometabolic disease.
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Affiliation(s)
- Claudia Veronica Mederos-Torres
- Department of Pharmacobiology, University Center for Exact Sciences and Engineering, University of Guadalajara, Guadalajara, Mexico
| | - Yolanda Díaz-Burke
- Department of Pharmacobiology, University Center for Exact Sciences and Engineering, University of Guadalajara, Guadalajara, Mexico
- Academic Body UDG-CA-156 Biomedical Science and Toxicology, University of Guadalajara, Guadalajara, Mexico
| | - María Luisa Muñoz-Almaguer
- Department of Pharmacobiology, University Center for Exact Sciences and Engineering, University of Guadalajara, Guadalajara, Mexico
- Academic Body UDG-CA-156 Biomedical Science and Toxicology, University of Guadalajara, Guadalajara, Mexico
| | | | - Rosario Lizette Uvalle-Navarro
- Department of Pharmacobiology, University Center for Exact Sciences and Engineering, University of Guadalajara, Guadalajara, Mexico
| | - Claudia Elena González-Sandoval
- Department of Pharmacobiology, University Center for Exact Sciences and Engineering, University of Guadalajara, Guadalajara, Mexico
- Academic Body UDG-CA-156 Biomedical Science and Toxicology, University of Guadalajara, Guadalajara, Mexico
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Brown HE, Begay RL, Sanderson PR, Chief C, Lameman B, Harris RB. Healthcare access, attitudes and behaviours among Navajo adults during the COVID-19 pandemic: a cross-sectional study. BMJ PUBLIC HEALTH 2024; 2:e000061. [PMID: 39669294 PMCID: PMC11636652 DOI: 10.1136/bmjph-2023-000061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2024]
Abstract
Objective To assess factors associated with positive COVID-19 tests, perspectives on health-related care delivery during pandemic, and factors supporting resilience among members of the Navajo Nation. Methods and Analysis From May through October 2021, a multi-institutional team recruited participants (n=154) to complete a 49-item questionnaire or participate in focus group (n=14) about their experience with COVID-19 and the effects on their use and access to allopathic and traditional health care. A multi-investigator, phenomenological approach summarized focus group experiences. Results While 72% had been tested for COVID-19, only 27.5% reported a positive test. Positive tests were not associated with household size or multigenerational homes, though time to grocery store was (p=0.04). There were no significant differences in allopathic or traditional medical care experiences from before and during the pandemic. Despite limited internet access, 28.8% chose a telehealth appointment and 42% expressed satisfaction with their experience. Discussion themes revealed perceived disruptions of healthcare needs with acknowledgement that healthcare providers were supportive throughout the Navajo Nation quarantine. Conclusion Presence of co-morbidities and living in multigenerational homes do not explain the disproportionate effects of COVID-19 among American Indian communities. Strengthening family and community bonds supported resilience in these communities.
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Affiliation(s)
- Heidi E Brown
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave, Tucson, AZ 85724
| | - Rachelle L Begay
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave, Tucson, AZ 85724
| | - Priscilla R Sanderson
- Department of Health Sciences, College of Health and Human Services, Northern Arizona University, SAS (Bldg 60), 1100 South Beaver Street, PO Box 15095, Flagstaff, AZ 86011
| | - Carmenlita Chief
- Center for Health Equity Research, Northern Arizona University, 1395 Knoles Drive, PO Box 4065, Flagstaff, AZ 86011
| | - Breanna Lameman
- Graduate Program, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave, Tucson, AZ 85724
| | - Robin B Harris
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave, Tucson, AZ 85724
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Costantino V, MacIntyre CR. Impact of vaccine coverage and disruption to health services on COVID-19 in Ukraine. Sci Rep 2024; 14:14729. [PMID: 38926448 PMCID: PMC11208616 DOI: 10.1038/s41598-024-57447-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/18/2024] [Indexed: 06/28/2024] Open
Abstract
COVID-19 surveillance in Ukraine ceased after the Russian invasion of the country in 2022, on a background of low vaccination rates of 34.5% for two doses at this time. We conducted a modelling study to estimate the epidemic trajectory of SARS-COV-2 in Ukraine after the start of the war. We use a COVID-19 deterministic Susceptible-Exposed-Infected-Recovered (SEIR) model for Ukraine to estimate the impact of increased vaccination coverage and masking as public health interventions. We fit the model output to case notification data between 6 January and 25 February 2022, then we forecast the COVID-19 epidemic trajectory in different scenarios of mask use and vaccine coverage. In the best-case scenario, 69% of the Ukrainian population would have been infected in the first half of 2022. Increasing mask use from 50 to 80% reduces cases and deaths by 17% and 30% respectively, while increasing vaccination rates to 60% and 9.6% for two and three doses respectively results in a 3% reduction in cases and 28% in deaths. However, if vaccination is increased to a higher coverage of 80% with two doses and 12.8% with three, or mask effectiveness is reduced to 40%, increasing vaccination coverage is more effective. The loss of health services, displacement, and destruction of infrastructure will amplify the risk of COVID-19 in Ukraine and make vaccine programs less feasible. Masks do not need the health infrastructure or cold-chain logistics required for vaccines and are more feasible for rapid epidemic control during war. However, increasing vaccine coverage will save more lives. Vaccination of refugees who have fled to other countries can be more feasibly achieved.
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Affiliation(s)
- Valentina Costantino
- The Biosecurity Program, The Kirby Institute, University of New South Wales, High street, Kensington, Sydney, Australia.
| | - Chandini R MacIntyre
- The Biosecurity Program, The Kirby Institute, University of New South Wales, High street, Kensington, Sydney, Australia
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
- Watts College of Public Affairs and Community Solutions, Arizona State University, Tempe, AZ, USA
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Musbat S, Reuveni I, Magnezi R. Improvements in mental health associated with increased electronic communication and deterioration in physical health in adults aged 50+ during the COVID-19 pandemic. Front Public Health 2024; 12:1369707. [PMID: 38975353 PMCID: PMC11224488 DOI: 10.3389/fpubh.2024.1369707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/04/2024] [Indexed: 07/09/2024] Open
Abstract
Background Previous studies have documented changes in physical health, mental health and social parameters during COVID-19. At the same time, there are no comprehensive analyses of these parameters designed as longitudinal studies on large-scale older populations before and during the pandemic. Objective This longitudinal study aims to provide a quantitative analysis of the COVID-19 impact on the physical, mental, and social parameters in adults aged 50 and older before, in the early stages, and during the COVID-19 pandemic. Methods The data for this study were collected from three waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), a supranational longitudinal database: pre-COVID (October 2019-March 2020), early-COVID (June-September 2020), and during-COVID (June-August 2021). The sample included 31,526 individuals, compared across the three-time points through nonparametric group comparison tests. Results Physical health was subjectively rated as poorer in the during-COVID wave compared to the pre-COVID wave. Additionally, the number of illnesses or health conditions reported in the during-COVID wave was significantly higher than in the pre-COVID wave, with the biggest increases registered for cardiovascular diseases. The results also show that employment and overall social contact decreased while loneliness increased over time. Unexpectedly, mental health issues, such as sadness or depression and trouble sleeping, decreased significantly in the COVID waves compared to the pre-COVID wave. The analysis of two additional pre-COVID waves (2015, 2017) revealed that poorer pre-COVID mental health reflected in high values of sadness or depression and trouble sleeping was not an isolated peak but represented a typical baseline. The positive influence on the individuals' mental health during COVID-19 was found to be electronic communication, which showed higher values than face-to-face communication and lowered the odds of sadness or depression. Conclusion Future policies should thus consider the positive impact of electronic contacts on mental health to promote overall health in adults aged 50 and older.
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Affiliation(s)
- Shay Musbat
- Department of Management, Health Systems Management Program, Bar-Ilan University, Ramat Gan, Israel
| | - Inbal Reuveni
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
| | - Racheli Magnezi
- Department of Management, Health Systems Management Program, Bar-Ilan University, Ramat Gan, Israel
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