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1.
Int J Public Health ; 69: 1607063, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38835806

RESUMO

Objectives: This study investigates gender and sex disparities in COVID-19 epidemiology in the Canton of Vaud, Switzerland, focusing on the interplay with socioeconomic position (SEP) and age. Methods: We analyzed COVID-19 surveillance data from March 2020 to June 2021, using an intersectional approach. Negative binomial regression models assessed disparities between women and men, across SEP quintiles and age groups, in testing, positivity, hospitalizations, ICU admissions, and mortality (Incidence Rate Ratios [IRR], with 95% Confidence Intervals [CI]). Results: Women had higher testing and positivity rates than men, while men experienced more hospitalizations, ICU admissions, and deaths. The higher positivity in women under 50 was mitigated when accounting for their higher testing rates. Within SEP quintiles, gender/sex differences in testing and positivity were not significant. In the lowest quintile, women's mortality risk was 68% lower (Q1: IRR 0.32, CI 0.20-0.52), with decreasing disparities with increasing SEP quintiles (Q5: IRR 0.66, CI 0.41-1.06). Conclusion: Our findings underscore the complex epidemiological patterns of COVID-19, shaped by the interactions of gender/sex, SEP, and age, highlighting the need for intersectional perspectives in both epidemiological research and public health strategy development.


Assuntos
COVID-19 , Fatores Socioeconômicos , Humanos , COVID-19/mortalidade , COVID-19/epidemiologia , Suíça/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Idoso , Fatores Sexuais , Hospitalização/estatística & dados numéricos , Disparidades nos Níveis de Saúde , SARS-CoV-2 , Adulto Jovem , Adolescente , Fatores Etários , Teste para COVID-19/estatística & dados numéricos
2.
Front Endocrinol (Lausanne) ; 15: 1304436, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38836223

RESUMO

Introduction: The Coronavirus Disease - 2019 (COVID-19) pandemic significantly impacted healthcare service provision and put diabetic patients at increased risk of adverse health outcomes. We aimed to assess the impact of the COVID-19 pandemic on the incidence and demographic shift of major lower-limb amputation in diabetic patients. Methods: We performed a retrospective analysis of diabetic patient records undergoing major lower-limb amputation between 01/03/2019 and 01/03/2021 at the Royal Sussex County Hospital, the regional arterial hub for Sussex. Primary outcomes were amputation incidence rates and patient demographics compared between the prepandemic and pandemic cohorts. Results: The incidence rate ratio of major lower-limb amputations shows a drop in amputations during the pandemic compared to pre-pandemic (IRR 0.82; 95% CI 0.57-1.18). Data suggests a shift in the social deprivation background of patients receiving amputations to disproportionately affect those in the more deprived 50% of the population (p=0.038). Younger patients received more amputations during the pandemic compared to prepandemic levels (p=0.001). Conclusion: Results suggest that during the COVID-19 pandemic there was a paradoxical reduction in amputations compared to prepandemic levels. However, changes to the demographic makeup of patient's receiving amputations are alarming as younger, and more deprived patients have been disproportionately affected by the pandemic.


Assuntos
Amputação Cirúrgica , COVID-19 , Humanos , COVID-19/epidemiologia , Amputação Cirúrgica/estatística & dados numéricos , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso , Privação Social , Pé Diabético/cirurgia , Pé Diabético/epidemiologia , Incidência , Pandemias , SARS-CoV-2 , Idoso de 80 Anos ou mais
3.
Influenza Other Respir Viruses ; 18(6): e13312, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38837866

RESUMO

BACKGROUND: To inform future response planning we aimed to assess SARS-CoV-2 trends in infection- and/or vaccine-induced immunity, including breakthrough infections, among (sub)groups, professions and regions in the Dutch population during the Variant of Concern (VOC)-era. METHODS: In this prospective population-based cohort, randomly selected participants (n = 9985) aged 1-92 years (recruited early-2020) donated home-collected fingerstick-blood samples at six timepoints in 2021/2022, covering waves dominated by Alpha, Delta, and multiple Omicron (sub-)variants. IgG antibody assessment against Spike-S1 and Nucleoprotein was combined with vaccination- and testing data to estimate infection-induced (inf) and total (infection- and vaccination-induced) seroprevalence. RESULTS: Nationwide inf-seroprevalence rose modestly from 12% (95% CI 11-13) since Alpha to 26% (95% CI 24-28) amidst Delta, while total seroprevalence increased rapidly to 87% (95% CI 85-88), particularly in elderly and those with comorbidities (i.e., vulnerable groups). Interestingly, highest infection rates were noticeable among low/middle educated elderly, non-Western, those in contact professions, adolescents and young adults, and in low-vaccination coverage regions. Following Omicron emergence, inf-seroprevalence elevated sharply to 62% (95% CI 59-65) and further to 86% (95% CI 83-90) in late-2022, with frequent breakthrough infections and decreasing seroprevalence dissimilarities between most groups. Whereas > 90% of < 60-year-olds had been infected at least once, 30% of vaccinated vulnerable individuals had still not acquired hybrid immunity. CONCLUSIONS: Groups identified to have been infected disproportionally during the acute phase of the pandemic require specific attention in evaluation of control measures and future response planning worldwide. Furthermore, ongoing tailored vaccination efforts and (sero-)monitoring of vulnerable groups may remain important.


Assuntos
Anticorpos Antivirais , COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/imunologia , Estudos Soroepidemiológicos , Países Baixos/epidemiologia , Pessoa de Meia-Idade , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , SARS-CoV-2/imunologia , Adulto Jovem , Masculino , Feminino , Idoso de 80 Anos ou mais , Lactente , Anticorpos Antivirais/sangue , Estudos Prospectivos , Vacinas contra COVID-19/imunologia , Vacinas contra COVID-19/administração & dosagem , Imunoglobulina G/sangue , Vacinação/estatística & dados numéricos
4.
PLoS One ; 19(6): e0300191, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38838042

RESUMO

Asymptomatic and underreported individuals remain a source of coronafig disease 2019 (COVID-19) transmission to others. Data on the prevalence and epidemiological factors influencing transmission are fundamental for establishing control measures, especially in vulnerable regions such as the Amazon. This study aimed to determine the point prevalence and active infection of COVID-19 among the population in Araguaína, a Brazilian city located in the Amazon region, analyzed the socioeconomic and behavioral variables of a statistically representative sample of this population using an epidemiological survey, and identify the viral genomic diversity in the region. During the sixth epidemiological week of 2021 (February 8 to 12), samples of 497 inhabitants of the municipality asymptomatic for respiratory syndromes underwent reverse transcription-quantitative polymerase chain reaction and serological tests (immunoglobulin M and immunoglobulin G). A questionnaire collated data on socioeconomic factors, prevention measures, and health status history. The active infection rate was 6.2%, and the prevalence was 13.5% of the study population. Active infection cases were under-reported; each reported positive case represented 14-28 under-reported cases. Lineages P.2, P.1, and B.1.1 were detected. Working from home was a protective factor against the infection, and clinical signs of fever, dry cough, and loss of taste or smell were associated with testing positive (p <0.05). A descriptive analysis of the indicators revealed that the entire population was susceptible to the disease. Intensified vaccination strategies are required regardless of socioeconomic factors, health conditions, and preventive measures. Implementation of objective, comprehensive, and efficient management tools to minimize the spread of COVID-19 in this municipality can serve as a model for other regions of Brazil.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Brasil/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , COVID-19/transmissão , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Prevalência , Adolescente , Adulto Jovem , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/genética , Idoso , Criança , Pré-Escolar , Monitoramento Epidemiológico , Lactente , Idoso de 80 Anos ou mais
5.
Influenza Other Respir Viruses ; 18(6): e13332, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38838093

RESUMO

BACKGROUND: Mozambique was one of many African countries with limited testing capacity for SARS-CoV-2. Serosurveys, an alternative to estimate the real exposure to understand the epidemiology and transmission dynamics, have been scarce in Mozambique. Herein, we aimed to estimate the age-specific seroprevalence of SARS-CoV-2 in the general population of the Manhiça District, at four time points, for evaluating dynamics of exposure and the impact of vaccination. METHODS: We conducted four community-based seroepidemiological surveys separated by 3 months between May 2021 and June 2022 to assess the prevalence of SARS-CoV-2 antibodies. An age-stratified (0-19, 20-39, 40-59, and ≥ 60 years) sample of 4810 individuals was randomly selected from demographic surveillance database, and their blood samples were analyzed using WANTAI SARS-CoV-2 IgG + IgM ELISA. Nasopharyngeal swabs from a subsample of 2209 participants were also assessed for active infection by RT-qPCR. RESULTS: SARS-CoV-2 seroprevalence increased from 27.6% in the first survey (May 2021) to 63.6%, 91.2%, and 91.1% in the second (October 2021), third (January 2022), and fourth (May 2022) surveys, respectively. Seroprevalence in individuals < 18 years, who were not eligible for vaccination, increased from 23.1% in the first survey to 87.1% in the fourth. The prevalence of active infection was below 10.1% in all surveys. CONCLUSIONS: A high seroprevalence to SARS-CoV-2 was observed in the study population, including individuals not eligible for vaccination at that time, particularly after circulation of the highly transmissible Delta variant. These data are important to inform decision making on the vaccination strategies in the context of pandemic slowdown in Mozambique.


Assuntos
Anticorpos Antivirais , COVID-19 , População Rural , SARS-CoV-2 , Humanos , Moçambique/epidemiologia , COVID-19/epidemiologia , COVID-19/transmissão , COVID-19/prevenção & controle , Estudos Soroepidemiológicos , Adulto , Adolescente , Pré-Escolar , Pessoa de Meia-Idade , Adulto Jovem , Criança , SARS-CoV-2/imunologia , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/genética , Feminino , Masculino , Lactente , Anticorpos Antivirais/sangue , Recém-Nascido , Idoso , Imunoglobulina G/sangue , Imunoglobulina M/sangue
6.
Sci Adv ; 10(23): eadn0671, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38838157

RESUMO

Government responses to COVID-19 are among the most globally impactful events of the 21st century. The extent to which responses-such as school closures-were associated with changes in COVID-19 outcomes remains unsettled. Multiverse analyses offer a systematic approach to testing a large range of models. We used daily data on 16 government responses in 181 countries in 2020-2021, and 4 outcomes-cases, infections, COVID-19 deaths, and all-cause excess deaths-to construct 99,736 analytic models. Among those, 42% suggest outcomes improved following more stringent responses ("helpful"). No subanalysis (e.g. limited to cases as outcome) demonstrated a preponderance of helpful or unhelpful associations. Among the 14 associations with P values < 1 × 10-30, 5 were helpful and 9 unhelpful. In summary, we find no patterns in the overall set of models that suggests a clear relationship between COVID-19 government responses and outcomes. Strong claims about government responses' impacts on COVID-19 may lack empirical support.


Assuntos
COVID-19 , Governo , SARS-CoV-2 , COVID-19/epidemiologia , COVID-19/mortalidade , COVID-19/virologia , Humanos , Modelos Teóricos , Pandemias
7.
Int J Public Health ; 69: 1606626, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38841538

RESUMO

Objectives: This study aimed to describe the impact of COVID-19 on maternal and child health service utilization in the Eastern part of Ethiopia. Methods: Comparative analysis was used to examine 2 years of maternal and child health service utilization. Data were extracted from client registers. A traditional Expert Modeler and one-way Analysis of Variance were used to compare service utilization before and during the COVID-19 pandemic. Results: A total of 34,576 client records were reviewed, of which 17,100 (49.5%) and 17,476 (50.5%) had visited the MCH service before and during the COVID-19 pandemic, respectively. The total client visit has shown a 2% percentage point increase. However, postnatal care and child immunization services showed a decrease. Moreover, there was a significant difference between service visits before and during COVID-19 (f = 4.6, p < 0.04). Conclusion: Mothers and children have missed or unattended facility appointments due to protective impositions or fear of getting infected with COVID-19, which might suggest a higher proportion of MCH issues were not addressed during the pandemic. The health system should therefore improve its resilience and strengthen its access at the lowest health care inlets.


Assuntos
COVID-19 , Aceitação pelo Paciente de Cuidados de Saúde , Humanos , COVID-19/epidemiologia , Etiópia/epidemiologia , Feminino , Criança , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , SARS-CoV-2 , Pré-Escolar , Lactente , Serviços de Saúde da Criança/estatística & dados numéricos , Serviços de Saúde Materno-Infantil/estatística & dados numéricos , Gravidez , Serviços de Saúde Materna/estatística & dados numéricos , Masculino , Pandemias
9.
JMIR Aging ; 7: e55471, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38842915

RESUMO

BACKGROUND: There is growing evidence that telemedicine can improve the access to and quality of health care for nursing home residents. However, it is still unclear how to best manage and guide the implementation process to ensure long-term adoption, especially in the context of a decline in telemedicine use after the COVID-19 crisis. OBJECTIVE: This study aims to identify and address major challenges for the implementation of televisits among residents in a nursing home, their caring nurses, and their treating general practitioners (GPs). It also evaluated the impact of televisits on the nurses' workload and their nursing practice. METHODS: A telemedical system with integrated medical devices was introduced in 2 nursing homes and their cooperating GP offices in rural Germany. The implementation process was closely monitored from the initial decision to introduce telemedicine in November 2019 to its long-term routine use until March 2023. Regular evaluation was based on a mixed methods approach combining rigorous qualitative approaches with quantitative measurements. RESULTS: In the first phase during the COVID-19 pandemic, both nursing homes achieved short-term adoption. In the postpandemic phase, an action-oriented approach made it possible to identify barriers and take control actions for long-term adoption. The implementation of asynchronous visits, strong leadership, and sustained training of the nurses were critical elements in achieving long-term implementation in 1 nursing home. The implementation led to enhanced clinical skills, higher professional recognition, and less psychological distress among the nursing staff. Televisits resulted in a modest increase in time demands for the nursing staff compared to organizing in-person home visits with the GPs. CONCLUSIONS: Focusing on health care workflow and change management aspects depending on the individual setting is of utmost importance to achieve successful long-term implementation of telemedicine.


Assuntos
COVID-19 , Casas de Saúde , Telemedicina , Humanos , Casas de Saúde/organização & administração , COVID-19/epidemiologia , Telemedicina/organização & administração , Alemanha/epidemiologia , Feminino , Masculino , Idoso , Pandemias , Televisão
10.
JMIR Res Protoc ; 13: e56271, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38842925

RESUMO

BACKGROUND: Globally, there are marked inconsistencies in how immunosuppression is characterized and subdivided into clinical risk groups. This is detrimental to the precision and comparability of disease surveillance efforts-which has negative implications for the care of those who are immunosuppressed and their health outcomes. This was particularly apparent during the COVID-19 pandemic; despite collective motivation to protect these patients, conflicting clinical definitions created international rifts in how those who were immunosuppressed were monitored and managed during this period. We propose that international clinical consensus be built around the conditions that lead to immunosuppression and their gradations of severity concerning COVID-19. Such information can then be formalized into a digital phenotype to enhance disease surveillance and provide much-needed intelligence on risk-prioritizing these patients. OBJECTIVE: We aim to demonstrate how electronic Delphi objectives, methodology, and statistical approaches will help address this lack of consensus internationally and deliver a COVID-19 risk-stratified phenotype for "adult immunosuppression." METHODS: Leveraging existing evidence for heterogeneous COVID-19 outcomes in adults who are immunosuppressed, this work will recruit over 50 world-leading clinical, research, or policy experts in the area of immunology or clinical risk prioritization. After 2 rounds of clinical consensus building and 1 round of concluding debate, these panelists will confirm the medical conditions that should be classed as immunosuppressed and their differential vulnerability to COVID-19. Consensus statements on the time and dose dependencies of these risks will also be presented. This work will be conducted iteratively, with opportunities for panelists to ask clarifying questions between rounds and provide ongoing feedback to improve questionnaire items. Statistical analysis will focus on levels of agreement between responses. RESULTS: This protocol outlines a robust method for improving consensus on the definition and meaningful subdivision of adult immunosuppression concerning COVID-19. Panelist recruitment took place between April and May of 2024; the target set for over 50 panelists was achieved. The study launched at the end of May and data collection is projected to end in July 2024. CONCLUSIONS: This protocol, if fully implemented, will deliver a universally acceptable, clinically relevant, and electronic health record-compatible phenotype for adult immunosuppression. As well as having immediate value for COVID-19 resource prioritization, this exercise and its output hold prospective value for clinical decision-making across all diseases that disproportionately affect those who are immunosuppressed. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/56271.


Assuntos
COVID-19 , Técnica Delphi , Terapia de Imunossupressão , Humanos , COVID-19/imunologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Terapia de Imunossupressão/métodos , Hospedeiro Imunocomprometido/imunologia , Consenso , Medição de Risco/métodos , SARS-CoV-2/imunologia , Adulto , Projetos de Pesquisa/normas
12.
J Med Internet Res ; 26: e48491, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38843521

RESUMO

BACKGROUND: Social media has become an increasingly popular and critical tool for users to digest diverse information and express their perceptions and attitudes. While most studies endeavor to delineate the emotional responses of social media users, there is limited research exploring the factors associated with the emergence of emotions, particularly negative ones, during news consumption. OBJECTIVE: We aim to first depict the web coverage by news organizations on social media and then explore the crucial elements of news coverage that trigger the public's negative emotions. Our findings can act as a reference for responsible parties and news organizations in times of crisis. METHODS: We collected 23,705 Facebook posts with 1,019,317 comments from the public pages of representative news organizations in Hong Kong. We used text mining techniques, such as topic models and Bidirectional Encoder Representations from Transformers, to analyze news components and public reactions. Beyond descriptive analysis, we used regression models to shed light on how news coverage on social media is associated with the public's negative emotional responses. RESULTS: Our results suggest that occurrences of issues regarding pandemic situations, antipandemic measures, and supportive actions are likely to reduce the public's negative emotions, while comments on the posts mentioning the central government and the Government of Hong Kong reveal more negativeness. Negative and neutral media tones can alleviate the rage and interact with the subjects and issues in the news to affect users' negative emotions. Post length is found to have a curvilinear relationship with users' negative emotions. CONCLUSIONS: This study sheds light on the impacts of various components of news coverage (issues, subjects, media tone, and length) on social media on the public's negative emotions (anger, fear, and sadness). Our comprehensive analysis provides a reference framework for efficient crisis communication for similar pandemics at present or in the future. This research, although first extending the analysis between the components of news coverage and negative user emotions to the scenario of social media, echoes previous studies drawn from traditional media and its derivatives, such as web newspapers. Although the era of COVID-19 pandemic gradually brings down the curtain, the commonality of this research and previous studies also contributes to establishing a clearer territory in the field of health crises.


Assuntos
COVID-19 , Emoções , Mídias Sociais , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Hong Kong , Pandemias , Meios de Comunicação de Massa/estatística & dados numéricos , SARS-CoV-2 , Mineração de Dados/métodos
14.
BMJ ; 385: q1221, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38843903
16.
Dan Med J ; 71(6)2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38847410

RESUMO

INTRODUCTION: We aimed to investigate the prevalence of SARS-CoV-2 infection and SARS-CoV-2 antibodies in parturient women and their newborns during the first Danish COVID-19 wave and to identify associations with maternal background characteristics, self-reported symptoms, and pregnancy outcomes. METHODS: In a single-centre, prospective cohort study from Denmark, we invited 1,883 women with singleton pregnancies giving live birth from 25 May 2020 to 2 November 2020. Hereof, 953 (50.6%) women were included. Nasopharyngeal swabs, maternal and umbilical cord blood samples, and questionnaires were collected. Medical records were available for participants and non-participants. RESULTS: SARS-CoV-2 antibodies were found in 1.3% of the women. All newborns of seropositive women had SARS-CoV-2 antibodies in cord blood. No association was found between SARS-CoV-2 antibodies and pregnancy outcomes. Self-reported loss of smell correlated with seropositivity (p less-than 0.001). No women were hospitalised due to COVID-19 during pregnancy or had a positive nasopharyngeal swab intrapartum. CONCLUSIONS: The prevalence of COVID-19 in pregnancy was low during the first wave. Maternal SARS-CoV-2 antibodies were associated with antibodies in cord blood, loss of smell and positive SARS-CoV-2 swab during pregnancy, but not with any adverse pregnancy outcomes. FUNDING: Ferring Pharmaceuticals funded part of the study. TRIAL REGISTRATION: The study was approved by the Regional Committee on Health Research Ethics (H-20028002) and the Danish Data Protection Agency (P-2020-264).


Assuntos
Anticorpos Antivirais , COVID-19 , Complicações Infecciosas na Gravidez , Resultado da Gravidez , SARS-CoV-2 , Humanos , Gravidez , Feminino , COVID-19/epidemiologia , COVID-19/imunologia , Dinamarca/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Estudos Prospectivos , Anticorpos Antivirais/sangue , SARS-CoV-2/imunologia , Recém-Nascido , Sangue Fetal/imunologia , Prevalência
17.
Gastroenterol Nurs ; 47(3): 203-212, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38847430

RESUMO

The aim of this study was to determine the nutritional experiences of patients who underwent total gastrectomy surgery. This qualitative study was conducted using the phenomenological research design. The sample consisted of 18 individuals who underwent total gastrectomy surgery. The research data were collected using the semistructured in-depth interview method. Interviews were conducted and recorded using audio/visual tools during the COVID-19 pandemic. Data analysis was carried out by two researchers according to the hermeneutic phenomenological approach. The nutritional experiences of the informants were organized under three themes, namely, First Feeding Experiences may remain, Gastrointestinal Problems, and Coping Methods. It was determined that individuals face various problems after total gastrectomy, both physical and psychological. They have developed coping methods to deal with the nutritional problems they experience. Development of a patient-specific nutrition program is recommended to support adaptation to new eating habits after total gastrectomy.


Assuntos
Adaptação Psicológica , Gastrectomia , Pesquisa Qualitativa , Humanos , Gastrectomia/psicologia , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , COVID-19/prevenção & controle , COVID-19/epidemiologia , Adulto , Estado Nutricional , Neoplasias Gástricas/cirurgia , SARS-CoV-2
19.
Indian J Public Health ; 68(1): 60-65, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38847635

RESUMO

INTRODUCTION: Analysis of the coronavirus disease 2019 (COVID-19) surveillance system in the first wave indicated that the data-driven approach helped in resource allocation and public health interventions. OBJECTIVES: We described the epidemiology of COVID-19 cases in Chennai, Tamil Nadu, India, from February 2021 to February 2022. MATERIALS AND METHODS: We analyzed the COVID-19 surveillance data from Chennai City, Tamil Nadu, India's Greater Chennai Corporation. We described the deidentified line list of COVID-19 cases and deaths by months, zones, age, and gender. We estimated the incidence of COVID-19 cases per million population, test positivity rate (TPR), and case fatality ratio (CFR). RESULTS: Of the 434,040 cases reported in Chennai from February 1, 2021, to February 28, 2022, 53% were male. The incidence per million peaked in May 2021 (19,210) and January 2022 (15,881). Age groups more than 60 years reported maximum incidence. Southern region zones reported higher incidence. Overall TPR was 5.8%, peaked in May 2021 (17.5%) and January 2022 (15.1%). Over half of the 4929 reported deaths were in May 2021 (56%). Almost half of the deaths were 61-80 years (52%), followed by 41-60 years (26%). Overall CFR was 1%, which peaked in June 2021 (4%). CONCLUSION: We conclude that Chennai city experienced a surge in COVID-19 due to delta and omicron variants. Understanding descriptive epidemiology is vital for planning the public health response, resource allocation, vaccination policies, and risk communication to the community.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Índia/epidemiologia , COVID-19/epidemiologia , COVID-19/mortalidade , Masculino , Feminino , Pessoa de Meia-Idade , Incidência , Adulto , Idoso , Adolescente , Criança , Pré-Escolar , Adulto Jovem , Lactente
20.
Minerva Surg ; 79(3): 273-285, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38847766

RESUMO

BACKGROUND: Colorectal (CRC) cancer is becoming a disease of the elderly. Ageing is the most significant risk factor for presenting CRC. Early diagnosis of CRC and management is the best way in achieving good outcomes and longer survival but patients aged ≥75 years are usually not screened for CRC. This group of patients is often required to be managed when they are symptomatic in the emergency setting with high morbidity and mortality rates. Our main aim is to provide clinical data about the management of elderly patients presenting complicated colorectal cancer who required emergency surgical management to improve their care. METHODS: The management of complicated COlorectal cancer in OLDER patients (CO-OLDER; ClinicalTrials.gov ID: NCT05788224; evaluated by the local ethical committee CPP EST III-France with the national number 2023-A01094-41) in the emergency setting project provides carrying out an observational multicenter international cohort study aimed to collect data about patients aged ≥75 years to assess modifiable risk factors for negative outcomes and mortality correlated to the emergency surgical management of this group of patients at risk admitted with a complicated (obstructed and perforated) CRC. The CO-OLDER protocol was approved by Institutional Review Board and released. Each CO-OLDER collaborator is asked to enroll ≥25 patients over a study period from 1st January 2018 to 30th October 2023. Data will be analyzed comparing two periods of study: before and after the COVID-19 pandemic. A sample size of 240 prospectively enrolled patients with obstructed colorectal cancer in a 5-month period was calculated. The secured database for entering anonymized data will be available for the period necessary to achieve the highest possible participation. RESULTS: One hundred eighty hospitals asked to be a CO-OLDER collaborator, with 36 potentially involved countries over the world. CONCLUSIONS: The CO-OLDER project aims to improve the management of elderly people presenting with a complicated colorectal cancer in the emergency setting. Our observational global study can provide valuable data on the effectiveness of different management strategies in improving primary assessment, management and outcomes for elderly patients with obstructed or perforated colorectal cancer in the emergency setting, guiding clinical decision-making. This information can help healthcare providers make informed decisions about the best course of action for these patients.


Assuntos
COVID-19 , Neoplasias Colorretais , Humanos , COVID-19/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Masculino , Feminino , Fatores de Risco , Saúde Global , Obstrução Intestinal/cirurgia , Obstrução Intestinal/epidemiologia
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