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PurposeGovernments around the world have shown poor capabilities in responding effectively to the COVID-19 health emergency outbreaks. After the declaration of COVID-19 as an international pandemic by the World Health Organization on January 31, 2020, three countries experienced the greatest initial impact in Europe. Sequentially Italy, Spain and the United Kingdom (UK) were hit by the highest numbers of contagion and death in the first few months in Europe. The aim of this paper is to assess how information channels and sources influenced the public's evaluation of the three government's communication response strategies.Design/methodology/approachAn online survey was conducted between March 14 and April 14, 2020, during the first wave of lockdowns and declarations of States of Emergency in the three countries.FindingsFindings show particularities for the different countries, but also similarities in response and reactions of the public in the three scenarios. The response strategy of the UK Government was the most untrusted and criticized by citizens. In contrast, the Italian and Spanish Governments, which both chose to respond with the severest restrictions, attracted more support from citizens, especially in Italy, which was the first to close borders and impose lockdowns for the population.Research limitations/implicationsDespite the national differences in the preference of information channels and sources, overall, an empirical relationship between government communication assessment and media use were found in all the scenarios.Practical implicationsThis empirical study has theoretical and practical implications. Theoretically, findings will add evidence of implications of the Channel Complementary Theory to the field of risk, crisis and emergency communication. The results also provide insights for communication practitioners in the public sector on how forms of information and trust in sources influence the public's assessment of authorities' communication.Originality/valueImplications for theory and empirical research about communication during a health pandemic are identified and discussed.
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The crisis caused by COVID-19 forced public and private actors to deploy various strategies on social media to communicate effectively with their public. This research analyses the institutional communication of the World Health Organization's Twitter account during the first quarter of 2021, with the aim of shedding light on their strategy and analyzing both its strengths and the areas with room for improvement in a crisis like the one studied. For this purpose, an ethnographic content analysis was run on the tweets published by the institutional account of the WHO and the responses issued by the public. A computer-assisted analysis was undertaken through two software programs (SPSS 27 and NVivo 11), and an online tool, Onodo - that helped us develop a sociogram with the different relationships between the actors involved in the crisis and risk communication of the WHO around the subject of vaccination. The main results show, on the one hand, that vaccination is not the focal point of the WHO's discourse at a time when the public's interest was centered on said thematic axis, and on the other, that the or-ganization was not able to create an effective dialogic space. Considering these findings, a reflection is encouraged to optimize professional praxis in future risk and crisis communication strategies in digital environments, expanding the scope of this study towards other organizations and/or time frames.
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Intro: Several rodents, including mice and the brown rat, are synanthropic animals usually found in rural and urban environments in contact with other animals and humans. Rodents are natural reservoirs of infectious agents and could harbour a plethora of zoonotic pathogens of public health importance. Taking advantage of a parallel study on presence and distribution of Hantaviruses, we aimed to investigate the occurrence in mice of other viruses with zoonotic or economic impact. Method(s): From May to July 2022, 41 mice (Mus domesticus) were captured and killed by using baited snap traps in 13 selected cattle, goat and poultry farms located in the Piedmont region. Gut and lung samples were homogenised and tested by PCR methods for pan-Coronavirus (CoV) and SARS-CoV-2, pan-Pestivirus, Mammalian orthoreoviruses, Canine Distemper virus (CDV), Flaviviruses, Influenza A (IAV) and D (IDV) viruses. Finding(s): All captured animals did not present at necropsy lesions related to infectious diseases. Virological investigations detected the presence of CoV in six mice. By sequencing Rodent CoVs was identified in two samples (four more pending). Mammalian orthoreovirus was detected in nine animals and typing and characterization are in progress. One mouse, captured in a bovine farm, tested slightly positive for IDV and confirmation of positivity is in progress by complete sequencing with NGS approach. All samples were negative for Flaviviruses, IAV, CDV, pan-Pestivirus and SARS-CoV-2. Conclusion(s): Rodents are well adapted to a wide range of habitats, including peri-urban and rural environments, where they benefit from human activities. These results, although preliminary, underline the importance of enhancing surveillance in rodents in anthropized areas to better assess the presence of zoonotic agents and the potential risk of transmission.Copyright © 2023
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Intro: Coronaviruses infect humans and a wide range of wild and domestic animals. Some CoVs could be zoonotic, being able to mutate, crossing the species barrier and infecting humans (e.g. SARS-CoV and MERS-CoV). Since the emergence of SARS-CoV-2, several studies were carried out to ascertain the susceptibility of both domestic and wild animals to SARS-CoV-2. However, information on some species is lacking, and for others only RDB-ACE receptor affinity studies have been carried out. Considering the high densities of Marmota marmota in the alpine environment, where livestock and recreational activities are commonly present, this study aims to investigate the presence and characterization of CoVs in this species. Method(s): During provincial relocation plan carried out in 2021 and 2022, 170 alpine marmots were captured in municipality of Livigno in Sondrio province (North-Italy) for decreasing animal density and, after a quarantine period, they were released in other alpine places. Faecal samples were collected from each animal and then subjected to RNA extraction and nested RT-PCR pan-Coronavirus and real time RT-PCR for SARS-CoV-2. PCR positive samples for pan-CoV were then sequenced. Finding(s): The pan-Coronavirus RT-PCR detected CoVs in seven marmots. The CoV sequence originating from one marmot sampled in 2021 had 97% affinity to strains isolated in lagomorphs. The other six sequences from 2022 were highly correlate with Bovine Beta-CoVs. This could be explained by the fact that marmots share alpine pastures with these species;in fact, the trapping area in 2022 represented grazing and forage production areas. All samples tested for SARS-CoV-2 resulted negative. Conclusion(s): Despite the absence of zoonotic coronaviruses, marmots show high plasticity in harbouring CoVs of sympatric species. For this reason, and considering the affinity of their ACE-receptor demonstrated for SARS-CoV, it would be worthwhile to increase surveillance for CoVs in this species.Copyright © 2023
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Background: During the COVID - 19 pandemic in Colombia in the year 2021, changes have been reported in the number of meals consumed per day in households, which merited an analysis of the relationship between this situation with territorial socioeconomic variables and mortality due to nutritional deficiencies and anemias. Method(s): A multiple-group descriptive study was carried out. Result(s): From the analyses, a moderate negative and significant correlation was identified between the consumption of at least three meals a day and mortality due to nutritional deficiencies and anemias, as well as for a higher level of multidimensional poverty at territorial level. Conclusion(s): Population risk factors were identified, such as higher levels of multidimensional poverty that may lead to the use of survival strategies such as the consumption of fewer meals per day by the population, which may have an impact on higher mortality rates due to nutritional deficiencies and anemias during the COVID- 19 pandemic in Colombia.Copyright © 2022 Sociedad Espanola de Nutricion Comunitaria. All rights reserved.
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Background: Delayed post-hypoxic leukoencephalopathy (DPHL) with associated microbleeds is a clinical entity presenting with cognitive impairment days or weeks after an episode of acute hypoxic brain injury. Case report: We describe a 68-year-old male with SARS-CoV2 infection who had cardiac arrest, required sedation and mechanical ventilation for 17 days, and after sedation was discontinued, he became unresponsive. Brain MRI showed diffuse confluent hyperintense signals in the subcortical white matter and multiple subcortical white matter microhemorrhages. EEG revealed diffuse attenuation of brain electrical activity with isolated polymorphic delta waves in the frontal region without epileptiform activity. Conclusion(s): Clinicians need to be aware that patients with Covid-19 can develop delayed post-hypoxic leukoencephalopathy.Copyright © 2022 The Authors
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Introduction: Patients with chronic kidney disease (CKD) have a higher risk for infection caused by the new coronavirus (COVID-19). The COVID-19 pandemic and social isolation contributed to the adaptation to new health promotion and education tools, including virtual methods. The aim of this study is to analyze the guidelines made through the Renal Health profile on Instagram during the COVID-19 pandemic to patients with CKD. Method(s): This is a quantitative, descriptive study, with the analysis of posts, comments and likes, carried out on the Renal Health (@renal_health) Instagram profile, an educational project based in Brazil, initiated as part of an ISN Clinical Research Program Project, which addresses kidney health, from February 2020 to May 2022, during the COVID-19 pandemic. Result(s): Currently, the Renal Health Instagram profile (https://www.instagram.com/renal_health/) has 1333 publications and more than 10,000 followers. It is a profile administered by a nurse, a nephrologist and a team of public health researchers at the University of Fortaleza, Brazil. A total of 106 posts about COVID-19 were analyzed, covering news about the pandemic, guidelines on prevention and vaccination, association between COVID-19, CKD and transplantation, among others. There were 13,815 likes and 1,068 comments. The most liked post (n = 696) was a photo with a news item: "InCor discharges Covid patient with transplanted lung". Among the comments, it was possible to observe several compliments, reports of patients with CKD and kidney transplants, as well as doubts, which were answered by the team that maintains the profile. The most commented post was also a news item: "Hospital denies transplant to unvaccinated patients", with 146 comments. Conclusion(s): The general population's interest in the association between COVID-19 and kidney disease is evident. It is important to point out the role of the profile as an online educational tool that helps in clarifying doubts about the new coronavirus, in addition to acting as an easy and practical way to acquire knowledge from reliable sources, regarding the risks that patients with kidney diseases have when contracting the virus, as well as many other relevant subjects, always emphasizing the relevance of preventive measures, including vaccination. From the study, it is noticeable that, during the pandemic, there were a large number of clarified doubts, as well as positive feedbacks about the platform. Therefore, the Renal Health profile proved to be an important health education mechanism during the pandemic. No conflict of interestCopyright © 2023
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Aim: The aim of this study was to determine severity in patients who have had SARS-CoV2 pneumonia. Method(s): A cohort of 802 patients from our post-COVID multidisciplinary unit treated at least 30 days after being discharged from hospital was analyzed. Patients were divided into three groups: group 1 (admission to the Intensive Care Unit or Intermediate Respiratory Care Unit), group 2 (admission to conventional hospitalization), and group 3 (outpatient management without hospitalization). Symptoms, quality of life, daily physical activity, emotional state, biomarkers of systemic inflammation and KL-6 levels were evaluated. Result(s): A total of 802 patients with a median (interquartile range) age 59 (48-70 years) at diagnosis were reviewed, of whom 439 (54.8%) were women. Dyspnea was reported by 351 (66.%) patients and 142 (36.4%) had a grade more than 2 on the mMRC scale. Likewise, 106 (20.1%) presented dry cough and 233 (44.5%) asthenia. There were significant differences between groups 2 and 3 in: dyspnea (p=0.04), myalgia (p=0.04) and asthenia (p=0.01). Group 1 had a higher score in the TTO and VAS rates of the EuroQuoL scale compared to group 2. Finally, the KL6 levels in groups 1, 2 and 3 were: 381.50 (304 - 511.75) U/ml, 372 (249 - 483) U/ml and 298 (231.5 - 398) U/ml, respectively. Statistically significant differences were observed between the 3 groups (p=0.001) and in the post-hoc analysis, lower levels of KL-6 were observed in group 3 compared to the other two groups. Conclusion(s): There is evidence to affirm that KL6 levels in post-COVID patients are related to the severity of the acute episode.
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Objectives: To evaluate the impact of combined non-invasive support strategies in critically ill COVID-19 patients [high-flow nasal cannula (HFNC), non-invasive ventilation (NIV) or both]. Method(s): Prospective observational multicenter study in 73 Spanish ICU with data obtained from the SEMICYUC registry. All confirmed COVID-19 patients admitted due to respiratory failure were included. They were classified according to the ventilatory strategy used on admission and subsequently according to success, failure, or strategy change. Demographic data, comorbidities, severity at admission, respiratory, biomarkers, failure, length of stay and mortality were evaluated. Result(s): We analyzed 3,889 patients, 33% receiving HFNC, and 11% NIV at ICU admission. NIV group compared to HFNC were more severely ill with more shock on admission. When NIV was received as a first-choice higher failure rates and mortality were shown vs HFNC (68% vs 61%, p=0.016 and 27% vs 20%, p=0.003). Among patients who initially received HFNC, 57% failed and 7.4% switched to NIV, with no change in mortality. Among patients who were switched to NIV, 66% failed presenting a higher mortality trend than the intubated patients after the HFNC starting (40% vs 30%, p=0.098). Among patients who initially received NIV, 60% failed and 20% switched to HFNC. Patients in whom NIV was switched to HFNC, had lower mortality than patients who initially failed (18% vs 40%, p<0.001). Among patients who were switched to HFNC, 43% failed, presenting the same mortality as the intubated patients after the NIV starting (38% vs 38%, p=0.934). Conclusion(s): Patients receiving NIV at admission have worse outcomes than those receiving HFNC. Changing the strategy in patients who received HFNC as a first choice without success can worsen the prognosis.
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Access to safe water, sanitation, and hygiene (WASH) are human rights and play a fundamental role in protecting health, which has been particularly evident during the SARS-CoV2 (COVID-19) pandemic. People experiencing homelessness face frequent violations of their human rights to water and sanitation, negatively affecting their health and dignity and ability to protect themselves from COVID-19. This research aimed to identify barriers to safe water, sanitation and hygiene access for people experiencing homelessness in Mexico City during the COVID-19 pandemic. A survey of 101 respondents experiencing homelessness was conducted using mobile data collection tools in collaboration with El Caracol A.C., an NGO that contributes to the visibility and social inclusion of homeless people in Mexico. We report findings according to the following themes: general economic impacts of COVID-19;experiences with reduced access to WASH services due to COVID-19, challenges in accessing hand washing to follow COVID-19 public health advice;and coping mechanisms used to deal with reductions in access to WASH. We discuss the broader implications of the findings in terms of realization of the human rights to water and sanitation (HRtWS), and how people experiencing homelessness are left behind by the existing approaches to ensure universal access to water and sanitation under SDG 6. Copyright © 2023 Liera, Dickin, Rishworth, Bisung, Moreno and Elliott.
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Background: Gas exchange abnormalities in COVID-19 survivors might involve impairment of the transfer through alveolar-capillary membrane and/or loss of capillary bed. Membrane diffusing capacity (Dm) and capillary volume (Vc) can be calculated from combined DLCO-DLNO. Aim(s): To investigate the values of Dm and Vc after COVID-19. Method(s): We retrospectively included all the patients (Pts) having performed DLCO-DLNO after COVID-19 in 4 French centres between 2020/04/20 and 2021/12/16. We excluded Pts with known history of COPD, severe asthma, interstitial lung disease, pulmonary hypertension, and congestive heart failure. We collected data from clinical records, pulmonary function test (PFT), and CT-scan when performed +/-1.5 months from PFT. Result(s): Data from 132 Pts have been analysed yet (over a total of about 500): 72 men (55%), mean age 57.7+/-13 years, mean BMI 30+/-5.7. 25 Pts (19%) were grade 1-4 on COVID-19 WHO scale (no oxygen), 45 (34%) were grade 5 (oxygen), 44 (33%) were grade 6 (NIV or high-flow oxygen), and 18 (14%) were grade 7-9 (mechanical ventilation). Median time between COVID-19 and PFT was 4.4 months [3.1-6.1]. 58 Pts (44%) had DLCO < lower limit of normal (LLN), with a significant correlation between initial COVID-19 severity and later DLCO. Mean Dm and Vc were 48.7% +/-15.1 and 80.2% +/-21. The most frequent pattern was Dm < LLN and normal Vc, in 78 Pts (59%). Only 1 (1%) had isolated Vc < LLN with normal Dm. Among the 37 (28%) with both Dm and Vc < LLN, 36 performed a CT-scan that showed fibrosing sequellae in 26 (72%). Conclusion(s): Dm was the most decreased variable, suggesting delayed healing after COVID-19. Decreased Vc was frequently associated with pulmonary fibrosis.
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Introduction: Gattinoni et al. have recently introduced a new parameter: the "alactic base excess"(ABE). ABE is equivalent to the number of strong acids, other than lactate, which are present in the plasma in abnormal concentrations, negative ABE being associated with higher mortality in sepsis. Hemoperfusion (HPF) is an extracorporeal procedure that involves the passage of blood through an adsorption cartridge, where solutes are removed by direct binding to the sorbent material. Then, it was decided to explore the influence of HPF on negative ABE value in sepsis. Material(s) and Method(s): Basal values of ABE, standard base excess (SBE), and lactate (mean, standard deviation [SD]) were obtained. The difference between these parameter values before and after four sessions of HPF (HA330) (delta value) was evaluated. Student's t-test and Wilcoxon test were applied. Result(s): From 32 patients (age: 57+/-13) suffering from respiratory insufficiency secondary to COVID-19 who were treated with HPF in the critical care unit of Clinica de la Mujer, Bogota (Colombia), 6 patients presented with metabolic acidosis with negative ABE value (-2.7+/-1) with negative SBE (-4.7+/-1) and high lactate serum value (2+/-0.7 mmol/L). Delta ABE, SBE, and lactate were: 7.7 (p = 0.005), 6.1 (p = 0.003), and 1.6 (p = NS), respectively. Thus, negative ABE was significantly reversed by HPF, since SBE value turned positive without significant change in lactate. Conclusion(s): Negative alactic parameter was significantly reversed by HPF in septic patients. It is necessary to carry out evaluations in larger groups to estimate their impact on clinical outcomes. Copyright © 2022 The Authors.
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On March 11, 2020, the World Health Organization (WHO) declared SARS-CoV-2 a pandemic. Within weeks, the virus infected thousands, paralyzing the global economy. Countries rolled out urgent measures to stem the spread of coronavirus and limit the strain on their healthcare systems.This paper reports on a lexicometric analysis of a corpus comprised of four comparable subcorpora (in English, French and Spanish). It analyzes speeches concerning pandemic management delivered by the leaders of the WHO, European Commission (EC), Government of Spain (ES), and Presidency of the French Republic (FR) between January 1, 2020, and September 30, 2021.Drawing on corpus-based linguistics, discourse analysis and lexicometrics, the study considers the vocabulary used in WHO speeches, qualitatively analyzing the most frequently used units and comparing these to the subcorpus as a whole. Terms described relate to a range of emergency measures, war imagery, and vocabulary related to values, qualities and abilities.
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The prevalence of follicular cell-derived thyroid carcinoma with an unusual pattern in its metastatic spread is relatively unknown, and therefore its clinicopathological characteristics are not well defined and represent uncertainty in diagnosis and treatment. In this report, two cases of metastasis in the paranasal sinuses and one of metastasis in the parapharyngeal space are described. In the first case, given the extension of the lesion to the cavernous sinus, surgical resection was not possible and external radiotherapy management was determined. However, the patient died of COVID-19. In the second case, the patient underwent endoscopic release of the left maxillary nerve and partial resection of the tumor as a palliative measure, clinical improvement was observed, and he subsequently received 30Gy external radiotherapy. The third case was managed surgically using a minimally invasive approach using robotic transoral surgery, which was successful. Metastasis in the paranasal sinuses and parapharyngeal space due to differentiated thyroid carcinoma represents an unusual scenario. Its characterization and management will always be a challenge, but new minimally invasive techniques play an increasingly promising role. © 2022 EDIZIONI MINERVA MEDICA.
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More than ever before, the COVID-19 crisis and the need to spend longer periods of time in our places of residence, have highlighted the need to improve indoor air quality (IAQ) and ventilation to reduce the risks of airborne virus transmission. Added to the need to progressively improve the energy performance of our buildings to achieve carbon neutrality is this completely contrary new requirement, which forces reconsidering the ventilation issue, its standards, and technological solutions to improve IAQ and limit the risks of contagion inside our homes, without losing sight of the goals that climate change imposes on us. Chile is seeking strategies to generate sustainable, energy-efficient, and comfortable housing, which must be reconsidered in light of Covid-19. Greater permanence inside the home revealed the precariousness of the lifestyles the most vulnerable families face;sometimes exposing them to environments that are risky for their health. The objective of this research was to estimate the impact of Covid-19 on CO2 indoor air concentrations, as a result of the intensity of use (occupation) of the home, considering envelopes with different levels of airtightness. Using an experimental methodology, based on simulations with the DesignBuilder software, the CO2 concentrations of four types of social housing, located in the commune of Coronel, Biobío, Chile, were quantified. The results showed that confinement increased CO2 levels by 16.4%, while the change from the original condition of the envelope to more airtight levels generated an increase of more than 83% in normal use and 97% for periods of confinement. © 2022, Universidad del Bío Bío. All rights reserved.
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BACKGROUND: To compare the severity of pulmonary embolism (PE) and the long-term complications between patients with and without COVID-19, and to investigate whether the tools for risk stratification of death are valid in this population. METHODS: We retrospectively included hospitalized patients with PE from 1 January 2016 to 31 December 2022. Comparisons for acute episode characteristics, risk stratification of the PE, outcomes, and long-term complications were made between COVID and non-COVID patients. RESULTS: We analyzed 116 (27.5%) COVID patients and 305 (72.4%) non-COVID patients. In patients with COVID-19, the traditional risk factors for PE were absent, and the incidence of deep vein thrombosis was lower. COVID patients showed significantly higher lymphocyte count, lactate dehydrogenase, lactic acid, and D-dimer levels. COVID patients had PE of smaller size (12.3% vs. 25.5% main pulmonary artery, 29.8% vs. 37.1% lobar, 44.7% vs. 29.5% segmental and 13.2% vs. 7.9% subsegmental, respectively; p < 0.001), less right ventricular dysfunction (7.7% vs. 17.7%; p = 0.007) and higher sPESI score (1.66 vs. 1.11; p < 0.001). The need for mechanical ventilation was significantly higher in COVID patients (8.6% vs. 1.3%; p < 0.001); However, the in-hospital death was less (5.2% vs. 10.8%; p = 0.074). The incidence of long-term complications was lower in COVID cohort (p < 0.001). PE severity assessed by high sPESI and intermediate and high-risk categories were independently associated with in-hospital mortality in COVID patients. CONCLUSION: The risk of in-hospital mortality and the incidence of long-term complications were lower in COVID-19. The usual tools for risk stratification of PE are valid in COVID patients.
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COVID-19 , Pulmonary Embolism , Humans , Hospital Mortality , COVID-19/complications , Retrospective Studies , Pulmonary Embolism/complications , Pulmonary Artery , Risk AssessmentABSTRACT
Background. Although COVID-19 vaccination has shown to be clearly beneficial in children and adolescents to reduce hospitalization and potentially transmission, there is still a lot of hesitation among parents due to concerns about vaccine safety and efficacy, especially in children under 12 years of age. Methods. We conducted a comparative study in Peru to evaluate the trends in parents' intention to vaccinate their children under 12 years of age against COVID-19, for which an online survey was administered. The survey was distributed through social networks (Facebook, Twitter, etc.), and was applied during two periods: 11/25/2021 to 12/06/2022 (Period 1) and 01/16/2022 to 01/24/2022 (Period 2). We also assessed the factors associated with the intention to vaccinate in each period through crude (cPR) and adjusted prevalence rates (aPR). Results. During period 1, there were 673 participants (69.7% women). In period 2, we had 1139 respondents (77.7% women). Regarding intention to vaccinate, 83.5% of parents intended to vaccinate their children under 12 years of age during period 1. This percentage was almost the same during period 2 (83.3%). During period 1, the factors associated with a decrease in this intention were to believe that the vaccine was not necessary (aPR 0.65;95% CI 0.44 - 0.94, p=0.022), that it would not protect (aPR: 0.14;95% CI 0.03 - 0.63, p=0.011), that it would not be safe (aPR: 0.80;95% CI 0.70 - 0.92, p=0.001), that it could cause long-termside effects (aPR: 0.92;95% CI 0.85 - 1.00, p=0.037), and to think it should not be mandatory (aPR: 0.89;95% CI 0.80-0.99, p=0.038). During period 2, besides the factors identified in period 1, not knowing about COVID-19 infection risk in children (aPR: 0.92;95% CI 0.85-1.00, p=0.042) was also associated with a decrease in the intention. Living on the highlands or jungle was associated with an increase in the intention in both periods. Conclusion. A high rate of intention to vaccinate children under 12 years of age was noted among parents in Peru, which was maintained until the end of January of 2022, right before COVID-19 vaccination started for this age group. There was a perception in some parents that the vaccine might not be necessary or safe, leading to a lower intention to vaccinate their children.
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Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets. Copyright © 2022