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1.
Euro Surveill ; 27(20)2022 05.
Article in English | MEDLINE | ID: covidwho-1862541

ABSTRACT

For the period of predominance of SARS-CoV-2 Omicron variant in Slovenia, February to March 2022, we estimated mRNA vaccine effectiveness (VE) against severe acute respiratory infection (SARI) COVID-19 using surveillance data. In the most vulnerable age group comprising individuals aged 65 years and more, VE against SARI COVID-19 was 95% (95% CI: 95-96%) for those vaccinated with three doses, in comparison to 82% (95% CI: 79-84%) for those vaccinated with two doses. Such levels of protection were maintained for at least 6 months.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/prevention & control , COVID-19 Vaccines , Hospitalization , Humans , RNA, Messenger , SARS-CoV-2/genetics , Slovenia/epidemiology , Vaccines, Synthetic
2.
Influenza Other Respir Viruses ; 2022 Apr 29.
Article in English | MEDLINE | ID: covidwho-1822050

ABSTRACT

Based on our national outpatient sentinel surveillance, we have developed a novel approach to determine respiratory syncytial virus (RSV) epidemic seasons in Germany by using RSV positivity rate and its lower limit of 95% confidence interval. This method was evaluated retrospectively on nine RSV seasons, and it is also well-suited to describe off-season circulation of RSV in near real time as observed for seasons 2020/21 and 2021/22 during the COVID-19 pandemic. Prospective application is of crucial importance to enable timely actions for health service delivery and prevention.

3.
Clin Infect Dis ; 2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1758700

ABSTRACT

BACKGROUND: To combat the COVID-19 pandemic, nonpharmaceutical interventions (NPI) were implemented worldwide, which impacted a broad spectrum of acute respiratory infections (ARI). METHODS: Etiologically diagnostic data from 142 559 cases with ARIs, who were tested for eight viral pathogens (influenza virus, IFV; respiratory syncytial virus, RSV; human parainfluenza virus, HPIV; human adenovirus; human metapneumovirus; human coronavirus, HCoV; human bocavirus, HBoV, and human rhinovirus, HRV) between 2012 and 2021, were analyzed to assess the changes of respiratory infections in China during the first COVID-19 pandemic year compared to pre-pandemic years. RESULTS: Test positive rates of all respiratory viruses decreased during 2020, compared to the average levels during 2012-2019, with changes ranging from -17·2% for RSV to -87·6% for IFV. Sharp decreases mostly occurred between February and August when massive NPIs remained active, although HRV rebounded to the historical level during the summer. While IFV and HMPV were consistently suppressed year round, RSV, HPIV, HCoV, HRV HBov resurged and went beyond historical levels during September, 2020-January, 2021, after NPIs were largely relaxed and schools reopened. Resurgence was more prominent among children younger than 18 years and in Northern China. These observations remain valid after accounting for seasonality and long-term trend of each virus. CONCLUSIONS: Activities of respiratory viral infections were reduced substantially in the early phases of the COVID-19 pandemic, and massive NPIs were likely the main driver. Lifting of NPIs can lead to resurgence of viral infections, particularly in children.

4.
8th Colombian Congress and International Conference on Air Quality and Public Health, CASAP 2021 ; 2021.
Article in Spanish | Scopus | ID: covidwho-1746121

ABSTRACT

This study was carried out in order to determine the presence of potentially pathogenic microorganisms in the air of a home located in the municipality of Tausa and its possible relationship with ARIs (Acute Respiratory Infections), for which a microbiological analysis was carried out in order to identify bacteria that are possibly causing respiratory illnesses in the household. The sampling consisted of the use of a suction equipment (MAS100 Eco), during different time bands and spaces inside and outside the house. Later the respective analysis was carried out in the laboratory and 6 different mesophilic microorganisms were identified, which were: Salmonella tiphy, Bacillus subtilis, Acinetobacter baumannii, Escherichia coli, Staphylococcus aureus, and Kingella kingae. In addition, each of these bacteria were individually analyzed to understand the dynamics of the pollutant load in the home. Finally, the identified mesophilic microorganisms correspond to bacteria with some degree of pathogenicity and/or health effects, in the same way the morbidity data from the Tausa medical center were analyzed. Here we found that the population under 13 years old is the most affected by ARI, and that the bacteria present more easily affect this type of population, generating a wider perspective on the possibilities of having more patients diagnosed with ARI, as found in the home. The data presented here were affected and biased due to the health emergency caused by COVID19. © 2021 IEEE.

5.
Viruses ; 12(6)2020 06 10.
Article in English | MEDLINE | ID: covidwho-1726022

ABSTRACT

There is currently debate about human coronavirus (HCoV) seasonality and pathogenicity, as epidemiological data are scarce. Here, we provide epidemiological and clinical features of HCoV patients with acute respiratory infection (ARI) examined in primary care general practice. We also describe HCoV seasonality over six influenza surveillance seasons (week 40 to 15 of each season) from the period 2014/2015 to 2019/2020 in Corsica (France). A sample of patients of all ages presenting for consultation for influenza-like illness (ILI) or ARI was included by physicians of the French Sentinelles Network during this period. Nasopharyngeal samples were tested for the presence of 21 respiratory pathogens by real-time RT-PCR. Among the 1389 ILI/ARI patients, 105 were positive for at least one HCoV (7.5%). On an annual basis, HCoVs circulated from week 48 (November) to weeks 14-15 (May) and peaked in week 6 (February). Overall, among the HCoV-positive patients detected in this study, HCoV-OC43 was the most commonly detected virus, followed by HCoV-NL63, HCoV-HKU1, and HCoV-229E. The HCoV detection rates varied significantly with age (p = 0.00005), with the age group 0-14 years accounting for 28.6% (n = 30) of HCoV-positive patients. Fever and malaise were less frequent in HCoV patients than in influenza patients, while sore throat, dyspnoea, rhinorrhoea, and conjunctivitis were more associated with HCoV positivity. In conclusion, this study demonstrates that HCoV subtypes appear in ARI/ILI patients seen in general practice, with characteristic outbreak patterns primarily in winter. This study also identified symptoms associated with HCoVs in patients with ARI/ILI. Further studies with representative samples should be conducted to provide additional insights into the epidemiology and clinical features of HCoVs.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus 229E, Human/isolation & purification , Coronavirus Infections/epidemiology , Coronavirus NL63, Human/isolation & purification , Coronavirus OC43, Human/isolation & purification , Respiratory Tract Infections/epidemiology , Adolescent , Adult , Aged , Child , Child, Preschool , Coronavirus Infections/diagnosis , Disease Outbreaks , Female , Humans , Infant , Infant, Newborn , Influenza, Human/epidemiology , Male , Middle Aged , Nasopharynx/virology , Primary Health Care , Real-Time Polymerase Chain Reaction , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/virology , SARS-CoV-2 , Seasons , Young Adult
6.
Matern Child Nutr ; 18(3): e13328, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1673239

ABSTRACT

Early initiation of breastfeeding, within 1 h of birth, is vital for the health of newborns and reduces morbidity and mortality. Secondary analysis of the 2016 Nepal Demographic and Health Survey (DHS) showed that early initiation of breastfeeding significantly reduced the risk of acute respiratory infection (ARI) in children under 2 years. Early initiation of breastfeeding requires maternal proximity. Separation of infant and mother inhibits early initiation of breastfeeding and increases the risk that infants will suffer from ARIs. However, during the COVID-19 pandemic, guidance varied, with some recommending that infants and mothers with SARS-CoV-2 be isolated from one another. Nepal's Ministry of Health and Population recommended nonseparation, but the adherence to this guidance was inconsistent. Maternal proximity, nonseparation and early initiation of breastfeeding should be promoted in all birthing facilities.


Subject(s)
COVID-19 , Respiratory Tract Infections , Breast Feeding , Child , Female , Humans , Infant , Infant, Newborn , Mothers , Pandemics/prevention & control , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/prevention & control , SARS-CoV-2
7.
Clinical Laboratory ; : 9, 2021.
Article in English | Web of Science | ID: covidwho-1667675

ABSTRACT

Background: Acute respiratory infection (ARI) is the most common infectious disease in all ages and genders worldwide. Respiratory microorganisms such as respiratory viruses, are commonly responsible for causing ARI. COVID-19 is still prevalent in Korea. The implementation of lockdown and strict control measures, the mandatory wearing of masks, and social distancing are critical steps for controlling the risk of COVID-19 spread. This study was conducted to find out how these changes in daily lives impacted the distribution of respiratory microorganisms. Methods: A retrospective study was conducted to identify the incidence and distribution patterns of ARI-causing respiratory microorganisms before (Period.) and during the COVID-19 pandemic (Period.) in terms of detection method, age, month, and season. In particular, data in Periods. and. were compared for eight major kinds of respiratory microorganisms: adenovirus (AdV), human metapneumovirus (HMPV), human rhinovirus/enterovirus (Rhino/Entero), influenza virus (Flu) A, Flu B, human parainfluenza virus (HPIV) 3, respiratory syncytial virus, and Mycoplasma pneumoniae. Results: A total of 27,191 respiratory specimens were tested, of which 5,513 were obtained from children and adolescents (age groups 1. 5) and 21,678 from adults (age group 6). The overall positive rates for at least one respiratory microorganism in Periods. and. were 23.1% (1,199/5,193) and 4.9% (1,070/21,998), respectively (p < 0.001). The overall positive rates in male and female patients were significantly different (8.7% vs. 7.9%;p = 0.016). On the FilmArray (TM) RP assay, positive rates in all age groups decreased significantly in Period. compared with Period.. AdV, Rhino/Entero, and Flu A were detected in all four seasons, but HMPV and HPIV3 were not detected. The overall positive rates on FilmArray and the Flu antigen test in Period. were significantly decreased. In the COVID-19 test, the positive rates were high in March and April 2020, and decreased thereafter, but these increased again in the winter of 2020/2021. Conclusions: Life changes due to COVID-19 pandemic have had a significant impact on the distribution of respiratory microorganisms;our study results might provide useful information on respiratory virus epidemiology.

8.
JMIR Form Res ; 6(1): e29889, 2022 Jan 17.
Article in English | MEDLINE | ID: covidwho-1662505

ABSTRACT

BACKGROUND: Acute respiratory infection (ARI) in childhood is common, but more knowledge on the burden and natural history of ARI in the community is required. A better understanding of ARI risk factors, treatment, and outcomes will help support parents to manage their sick child at home. Digital health tools are becoming more widely adopted in clinical care and research and may assist in understanding and managing common pediatric diseases, including ARI, in hospitals and in the community. We integrated 2 digital tools-a web-based discharge communication system and the REDCap (Research Electronic Data Capture) platform-into the Pragmatic Adaptive Trial for Acute Respiratory Infection in Children to enhance parent and physician engagement around ARI discharge communication and our patient registry. OBJECTIVE: The objective of this study is to determine the efficacy and usability of digital tools integrated into a pediatric patient registry for ARI. METHODS: Semistructured interviews and software interface usability testing were conducted with 11 parents and 8 emergency department physicians working at a tertiary pediatric hospital and research center in Perth, Western Australia, in 2019. Questions focused on experiences of discharge communication and clinical trial engagement. Responses were analyzed using the qualitative Framework Method. Participants were directly observed using digital interfaces as they attempted predetermined tasks that were then classified as success, failure, software failure, or not observed. Participants rated the interfaces using the System Usability Scale (SUS). RESULTS: Most parents (9/11, 82%) indicated that they usually received verbal discharge advice, with some (5/11, 45%) recalling receiving preprinted resources from their physician. Most (8/11, 73%) would also like to receive discharge advice electronically. Most of the physicians (7/8, 88%) described their usual practice as verbal discharge instructions, with some (3/8, 38%) reporting time pressures associated with providing discharge instructions. The digital technology option was preferred for engaging in research by most parents (8/11, 73%). For the discharge communication digital tool, parents gave a mean SUS score of 94/100 (SD 4.3; A grade) for the mobile interface and physicians gave a mean usability score of 93/100 (SD 4.7; A grade) for the desktop interface. For the research data management tool (REDCap), parents gave a mean usability score of 78/100 (SD 11.0; C grade) for the mobile interface. CONCLUSIONS: Semistructured interviews allowed us to better understand parent and physician experiences of discharge communication and clinical research engagement. Software interface usability testing methods and use of the SUS helped us gauge the efficacy of our digital tools with both parent and physician users. This study demonstrates the feasibility of combining qualitative research methods with software industry interface usability testing methods to help determine the efficacy of digital tools in a pediatric clinical research setting.

9.
Prehosp Disaster Med ; 37(1): 142-144, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1616894

ABSTRACT

INTRODUCTION: Japan recently experienced two major heavy rain disasters: the West Japan heavy rain disaster in July 2018 and the Kumamoto heavy rain disaster in July 2020. Between the occurrences of these two disasters, Japan began experiencing the wave of the coronavirus disease 2019 (COVID-19) pandemic, providing a unique opportunity to compare the incidence of acute respiratory infection (ARI) between the two disaster responses under distinct conditions. SOURCES FOR INFORMATION: The data were collected by using the standard disaster medical reporting system used in Japan, so-called the Japan-Surveillance in Post-Extreme Emergencies and Disasters (J-SPEED), which reports number and types of patients treated by Emergency Medical Teams (EMTs). Data for ARI were extracted from daily aggregated data on the J-SPEED form and the frequency of ARI in two disasters was compared. OBSERVATION: Acute respiratory infection in the West Japan heavy rain that occurred in the absence of COVID-19 and in the Kumamoto heavy rain that occurred in the presence of COVID-19 were responsible for 5.4% and 1.2% of the total consultation, respectively (P <.001). ANALYSIS OF OBSERVATION AND CONCLUSION: Between the occurrence of these two disasters, Japan implemented COVID-19 preventive measures on a personal and organizational level, such as wearing masks, disinfecting hands, maintaining social distance, improving room ventilation, and screening people who entered evacuation centers by using hygiene management checklists. By following the basic prevention measures stated above, ARI can be significantly reduced during a disaster.


Subject(s)
COVID-19 , Disasters , Respiratory Tract Infections , Humans , Incidence , Japan/epidemiology , Pandemics , Respiratory Tract Infections/epidemiology , SARS-CoV-2
10.
Euro Surveill ; 27(1)2022 01.
Article in English | MEDLINE | ID: covidwho-1613511

ABSTRACT

We estimated vaccine effectiveness (VE) against severe COVID-19 during October 2021, using Slovenian surveillance data. For people fully vaccinated with any vaccine in age groups 18-49, 50-64, ≥ 65 years, VE was 86% (95% CI: 79-90), 89% (85-91), and 77% (74-81). Among ≥ 65 year-olds fully vaccinated with mRNA vaccines, VE decreased from 93% (95% CI: 88-96) in those vaccinated ≤ 3 months ago to 43% (95% CI: 30-54) in those vaccinated ≥ 6 months ago, suggesting the need for early boosters.


Subject(s)
COVID-19 , Aged , Hospitalization , Humans , SARS-CoV-2 , Slovenia/epidemiology
11.
Int J Infect Dis ; 113: 344-346, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1555515

ABSTRACT

Over the course of the second pandemic wave in late 2020, new infections with severe acute respiratory syndrome coronavirus-2 shifted from the most affluent to the most deprived regions of Germany. This study investigated how this trend in infections played out for deaths due to coronavirus disease 2019 (COVID-19) by examining area-level socio-economic disparities in COVID-19-related mortality during the second pandemic wave in Germany. The analysis was based on nationwide data on notified deaths, which were linked to an area-based index of socio-economic deprivation. In the autumn and winter of 2020/2021, COVID-19-related deaths increased faster among residents in Germany's more deprived districts. From late 2020 onwards, the mortality risks of men and women in the most deprived districts were 1.52 (95% confidence interval [CI] 1.27-1.82] and 1.44 (95% CI 1.19-1.73) times higher than among those in the most affluent districts, respectively, after adjustment for age, urbanization and population density. To promote health equity in the pandemic and beyond, deprived populations should receive increased attention in pandemic planning, infection control and disease prevention.


Subject(s)
COVID-19 , Female , Germany/epidemiology , Health Promotion , Humans , Male , Pandemics , Poverty , SARS-CoV-2
12.
Clin Infect Dis ; 2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1522157

ABSTRACT

BACKGROUND: To combat the COVID-19 pandemic, nonpharmaceutical interventions (NPI) were implemented worldwide, which impacted a broad spectrum of acute respiratory infections (ARI). METHODS: Etiologically diagnostic data from 142 559 cases with ARIs, who were tested for eight viral pathogens (influenza virus, IFV; respiratory syncytial virus, RSV; human parainfluenza virus, HPIV; human adenovirus; human metapneumovirus; human coronavirus, HCoV; human bocavirus, HBoV, and human rhinovirus, HRV) between 2012 and 2021, were analyzed to assess the changes of respiratory infections in China during the first COVID-19 pandemic year compared to pre-pandemic years. RESULTS: Test positive rates of all respiratory viruses decreased during 2020, compared to the average levels during 2012-2019, with changes ranging from -17·2% for RSV to -87·6% for IFV. Sharp decreases mostly occurred between February and August when massive NPIs remained active, although HRV rebounded to the historical level during the summer. While IFV and HMPV were consistently suppressed year round, RSV, HPIV, HCoV, HRV HBov resurged and went beyond historical levels during September, 2020-January, 2021, after NPIs were largely relaxed and schools reopened. Resurgence was more prominent among children younger than 18 years and in Northern China. These observations remain valid after accounting for seasonality and long-term trend of each virus. CONCLUSIONS: Activities of respiratory viral infections were reduced substantially in the early phases of the COVID-19 pandemic, and massive NPIs were likely the main driver. Lifting of NPIs can lead to resurgence of viral infections, particularly in children.

13.
Influenza Other Respir Viruses ; 15(1): 34-44, 2021 01.
Article in English | MEDLINE | ID: covidwho-1452865

ABSTRACT

BACKGROUND: Severe acute respiratory infection (SARI) accounts for a large burden of illness in Indonesia. However, epidemiology of SARI in tertiary hospitals in Indonesia is unknown. This study sought to assess the burden, clinical characteristics, and etiologies of SARI and concordance of clinical diagnosis with confirmed etiology. METHODS: Data and samples were collected from subjects presenting with SARI as part of the acute febrile Illness requiring hospitalization study (AFIRE). In tertiary hospitals, clinical diagnosis was ascertained from chart review. Samples were analyzed to determine the "true" etiology of SARI at hospitals and Indonesia Research Partnership on Infectious Diseases (INA-RESPOND) laboratory. Distribution and characteristics of SARI by true etiology and accuracy of clinical diagnosis were assessed. RESULTS: Four hundred and twenty of 1464 AFIRE subjects presented with SARI; etiology was identified in 242 (57.6%), including 121 (28.8%) viruses and bacteria associated with systemic infections, 70 (16.7%) respiratory bacteria and viruses other than influenza virus, and 51 (12.1%) influenza virus cases. None of these influenza patients were accurately diagnosed as having influenza during hospitalization. CONCLUSIONS: Influenza was misdiagnosed among all patients presenting with SARI to Indonesian tertiary hospitals in the AFIRE study. Diagnostic approaches and empiric management should be guided by known epidemiology. Public health strategies to address the high burden of influenza should include broad implementation of SARI screening, vaccination programs, clinician education and awareness campaigns, improved diagnostic capacity, and support for effective point-of-care tests.


Subject(s)
Influenza, Human , Orthomyxoviridae , Respiratory Tract Infections , Diagnostic Errors , Hospitalization , Humans , Indonesia/epidemiology , Infant , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/epidemiology
14.
Euro Surveill ; 26(42)2021 10.
Article in English | MEDLINE | ID: covidwho-1485003

ABSTRACT

We monitored trends of severe COVID-19 morbidity in Slovenia during weeks 13 to 37 2021. National weekly rates of severe acute respiratory infections (SARI) cases testing positive for SARS-CoV-2 at admission in all hospitals varied between 0.2 and 16.3 cases per 100,000 population. Of those without previous COVID-19 diagnosis, SARI COVID-19 admission rates ranged between 0.3 and 17.5 per 100,000 unvaccinated, and 0.0 and 7.3 per 100,000 fully vaccinated individuals. National SARI COVID-19 surveillance is essential in informing COVID-19 response.


Subject(s)
COVID-19 , Influenza, Human , Respiratory Tract Infections , COVID-19 Testing , Hospitalization , Humans , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/epidemiology , SARS-CoV-2 , Slovenia/epidemiology
15.
Orv Hetil ; 162(43): 1710-1716, 2021 10 24.
Article in Hungarian | MEDLINE | ID: covidwho-1484906

ABSTRACT

Összefoglaló. Bevezetés: A koronavírus-2 által okozott fertozések igen gyakran súlyos, akut légzoszervi károsodás kialakulásához vezetnek, melynek következtében légzési elégtelenség manifesztálódik. A pneumoniák kialakulásának kezdete (2019. december) óta igen sok beteg szorult kórházi kezelésre. A súlyos tüdogyulladások ellátása során igazolódott, hogy a légzoszervi gyulladásos folyamatok során a betegek jelentos részében vénás, ritkábban artériás thrombosisok alakulnak ki, tovább súlyosbítva a klinikai állapotot. Célkituzés: A 2020. szeptember és 2021. március közötti idoszakban 1590, koronavírus-2 által megfertozött, tüdogyulladással szövodött beteget láttunk el osztályunkon. Betegeinkben azt vizsgáltuk, hogy milyen jellegu és arányú a thromboemboliás szövodmények elofordulása. Módszer: Az 1590, koronavírus-2 által fertozött beteg mindegyikében meghatároztuk a pneumonia súlyosságát; klinikai gyanú eseteiben alsó végtagi Doppler-ultrahangvizsgálatot, valamint komputertomográfiával végzett tüdoangiográfiát végeztünk. Eredmények: A képalkotó vizsgálatok eredményei azt igazolták, hogy a koronavírus-2 által okozott tüdogyulladással kezeltekben 13%-os gyakorisággal fordult elo mélyvénás thrombosis; akut tüdoemboliát a betegek 17%-ában kórisméztünk. Következtetés: A koronavírus-2 által okozott fertozésekben elsosorban a tüdoben, de egyéb szervekben is (szív, vese, máj) súlyos gyulladással járó kórfolyamatok alakulhatnak ki, amelyek hatására fokozott thrombosiskészség jelentkezik a gyulladásos és koagulációs rendszer interakciója következtében. A fokozott thrombosishajlam végeredményeként vénás és ritkábban artériás thrombosisok kialakulása súlyosbítja a betegek klinikai állapotát, s kedvezotlen hatást gyakorol az életkilátásra. Orv Hetil. 2021; 162(43): 1710-1716. INTRODUCTION: The infections caused by coronavirus-2 very often lead to severe, acute respiratory damages, because of which respiratory insufficiency is manifested. As a result, since the development of pneumonias (December, 2019), many patients have required hospitalization. When treating the severe pneumonia cases, it was proved that in a significant number of patients with respiratory inflammatory processes, venous, less often arterial thrombosis occured, making the clinical state even more severe. OBJECTIVE: We treated 1590 coronavirus-2 infected, pneumonia-connected patients between September, 2020 and March, 2021 at our department. We examined the nature and the proportion of the thromboembolic complications. METHOD: We determined the severity of pneumonia in the 1950 coronavirus-2 infected patients; when clinically suspected, they had lower limb Doppler ultrasound examination and angiography carried out with computer tomograph. RESULTS: The result of imaging examinations proved that in 13% of cases deep vein thrombosis occured; in 17% of cases acute pulmonary embolia occured with pneumonia caused by coronavirus-2. CONCLUSION: In coronavirus-2 infected cases, mainly in the lung, but also in other organs (heart, kidney, liver), severe inflammatory disease-processes may occur, as a result of which increased thrombosis tendency shows because of the ineraction of the inflammatory and coagulatory system. As a result of the increased thrombosis tendency, venous and less often arterial thrombosis worsen the clinical state of patients, and have unfavourable effect on life expectancy. Orv Hetil. 2021; 162(43): 1710-1716.


Subject(s)
COVID-19 , Acute Disease , Humans , SARS-CoV-2
16.
J Family Med Prim Care ; 10(9): 3240-3246, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1478272

ABSTRACT

BACKGROUND: In March 2020, the Indian Council of Medical Research (ICMR) issued guidelines that all patients presenting with severe acute respiratory infections (SARI) should be investigated for coronavirus disease 2019 (COVID-19). Following the same protocol, in our institute, all patients with SARI were transferred to the COVID-19 suspect intensive care unit (ICU) and investigated for COVID-19. METHODS: This study was planned to examine the demographical, clinical features, and outcomes of the first 500 suspected patients of COVID-19 with SARI admitted in the COVID-19 suspect ICU at a tertiary care center. Between March 7 and July 20, 2020, 500 patients were admitted to the COVID-19 suspect ICU. We analyzed the demographical, clinical features, and outcomes between COVID-19 positive and negative SARI cases. The records of all the patients were reviewed until July 31, 2020. RESULTS: Of the 500 suspected patients admitted to the hospital, 88 patients showed positive results for COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR) of the nasopharyngeal swabs. The mean age in the positive group was higher (55.31 ± 16.16 years) than in the negative group (40.46 ± 17.49 years) (P < 0.001). Forty-seven (53.4%) of these patients in the COVID-19 positive group and 217 (52.7%) from the negative group suffered from previously known comorbidities. The common symptoms included fever, cough, sore throat, and dyspnea. Eighty-five (20.6%) patients died in the COVID-19 negative group, and 30 (34.1%) died in the COVID-19 positive group (P = 0.006). Deaths among the COVID-19 positive group had a significantly higher age than deaths in the COVID-19 negative group (P < 0.001). Among the patients who died with positive COVID-19 status had substantially higher neutrophilia and lymphopenia (P < 0.001). X-ray chest abnormalities were almost three times more likely in COVID-19 deaths (P < 0.001). CONCLUSION: In the present article, 17.6% of SARI were due to COVID-19 infection with significantly higher mortality (34.1%) in COVID-19 positive patients with SARI. Although all patients presenting as SARI have considerable mortality rates, the COVID-19-associated SARI cases thus had an almost one-third risk of mortality.

17.
J Infect Public Health ; 14(11): 1635-1641, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1446868

ABSTRACT

BACKGROUND: The COVID-19 pandemic has strained ICUs worldwide. To learn from our experience, we described the critical care response to the outbreak. METHODS: This is a case study of the response of the Intensive Care Department (75-bed capacity) at a tertiary-care hospital to COVID-19 pandemic, which resulted in a high number of critically ill patients. RESULTS: Between March 1 and July 31, 2020, 822 patients were admitted to the adult non-cardiac ICUs with suspected (72%)/confirmed (38%) COVID-19. At the peak of the surge, 125 critically ill patients with COVID-19 were managed on single day. To accommodate these numbers, the bed capacity of 4 ICUs was increased internally from 58 to 71 beds (+40%) by cohorting 2 patients/room in selected rooms; forty additional ICUs beds were created in 2 general wards; one cardiac ICU was converted to managed non-COVID-19 general ICU patients and one ward was used as a stepdown for COVID-19 patients. To manage respiratory failure, 53 new ICU ventilators, 90 helmets for non-invasive ventilation and 47 high-flow nasal cannula machines were added to the existing capacity. Dedicated medical teams cared for the COVID-19 patients to prevent cross-contamination. The nurse-to-patient and RT-to-patient ratio remained mostly 1:1 and 1:6, respectively. One-hundred-ten ward nurses were up-skilled to care for COVID-19 and other ICU patients using tiered staffing model. Daily executive rounds were conducted to identify patients for transfer and at least 10 beds were made available for new COVID-19 admissions/day. The consumption of PPE increased multiple fold compared with the period preceding the pandemic. Regular family visits were not allowed and families were updated daily by videoconferencing and phone calls. CONCLUSIONS: Our ICU response to the COVID-19 pandemic required almost doubling ICU bed capacity and changing multiple aspects of ICU workflow to be able to care for high numbers of affected patients.


Subject(s)
COVID-19 , Pandemics , Adult , Critical Care , Humans , Intensive Care Units , SARS-CoV-2 , Tertiary Care Centers
18.
J Infect ; 83(2): e1-e3, 2021 08.
Article in English | MEDLINE | ID: covidwho-1386044

ABSTRACT

AIM: to compare clinical features and outcome of children with severe acute lower respiratory infection (ALRI) with or without SARS-CoV-2 infection admitted to Paediatric Intensive Care Unit (PICU). METHODS: for this retrospective cohort study, all children aged<17 years admitted with severe ALRI at a PICU, in Salvador, Brazil were evaluated. Investigation of SARS-CoV-2 infection was performed by real-time reverse-transcription PCR. Clinical data, physical findings upon admission and outcome were registered. Patients were categorized by with or without SARS-Cov-2 infection. Outcomes were death and invasive mechanical ventilation (IMV). RESULTS: we enrolled 210 patients, whose median age was 2.8 years (IQR: 7.1 months-6.2 years). IMV was used in 33 (15.7%; 95%CI 11.3%-21.1%) patients. Eight (3.8%; 95%CI 1.8%-7.1%) cases died. 62 patients (29.5%) tested positive for SARS-CoV-2. Male gender (67.7% vs. 52.7%, P = 0.045) and sickle cell disease (6.5% vs. 0%, P = 0.007) were associated with SARS-CoV-2 infection. Wheezing upon admission was more common in patients without SARS-CoV-2 infection (38.5% vs. 21.0%, P = 0.01). IMV was more frequent among patients with SARS-CoV-2 infection (25.8% vs. 11.5%, P = 0.009) as well as death (8.1% vs. 2.0%, P = 0.05). CONCLUSION: children with severe ALRI infection with SARS-CoV-2 need IMV more frequently than those without it.


Subject(s)
COVID-19 , SARS-CoV-2 , Brazil/epidemiology , Child , Child, Preschool , Humans , Male , Respiration, Artificial , Retrospective Studies
19.
Indian J Crit Care Med ; 25(8): 853-859, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1355123

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) pandemic has caused a huge burden on healthcare services worldwide, severely affecting the management of non-COVID-19 patients as well. The Government of India has updated guidelines for the clinical management of COVID-19 illness, including severe acute respiratory infections (SARI) definition for triaging suspected COVID-19 cases in an isolated intensive care unit (ICU). The aim of this study was to estimate the adherence of clinicians in triaging COVID-19 suspects as per SARI definition to SARI ICU. This study also observed the impact of such triaging on admission, diagnosis, and treatment process of non-COVID-19 patients admitted to SARI ICU. Patients and methods: This cross-sectional study was conducted in a designated SARI ICU of two tertiary care medical college hospitals involving 78 patients from the month of June to July 2020. Data related to demographics, the severity of illness, advanced life supports, delay in diagnosis, intervention, and treatment of patients in SARI ICU due to suspected COVID-19 status were documented. Results: Adherence to SARI definition for triaging COVID-19-suspect cases was 19.2%. Despite hindrance in diagnosis (17.9%) and treatment (12.8%), mortality among patients in SARI ICU was limited to 14.10%. Results were insignificant when checked for various factors associated with mortality. Conclusion: Nonadherence to SARI definition may lead to undue delay in diagnosis, intervention, and treatment of non-COVID-19 cases. This may result in increased morbidity, mortality, and economic burden on patients and the healthcare system. key message: A rationale and just utilization of healthcare resources are need of the hour in the face of an enormous volume of SARI cases during COVID-19 pandemic. SARI criteria as implemented by the Ministry of Health and Family Welfare (MOHFW), Government of India, are a very important tool in triaging of COVID-19-suspect cases. Adequate measures should be in place in order to mitigate the inadequacies and deficiencies in the treatment of non-COVID-19 cases, which have occurred as a result of COVID-19 pandemic. How to cite this article: Arunachala S, Venkatesh BT, Bhatt MT, Puranik A, Rao S, Ravindranath S. COVID-19 Pandemic: Impact on Admission, Diagnosis, and Treatment of Non-COVID-19 Patients Admitted to SARI ICU. Indian J Crit Care Med 2021;25(8):853-859.

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Indian J Pediatr ; 89(1): 45-51, 2022 01.
Article in English | MEDLINE | ID: covidwho-1326855

ABSTRACT

OBJECTIVE: To detail clinical profile and outcome in children infected with SARS-CoV-2. METHODS: This retrospective study was undertaken at a tertiary care pediatric teaching hospital in Northern India. The data on clinical characteristics and outcome of children (< 18 y) with COVID-19 illness from April 2020-October 2020 were reviewed and analyzed. RESULTS: A total of 2919 children with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) illness were tested for novel COVID-19 virus in the flu emergency (n = 1744), severe acute respiratory infection (SARI) ward (n = 825), and non-COVID area (n = 350) of the hospital. 8.73% (255/2919) children tested positive for SARS-CoV-2 infection. Of the 255 positive cases, 144 (56.47%) were managed on an outpatient basis and 100 (59 boys) required admission in COVID ward. The mortality rate of patients with SARS-CoV-2 was 11.4% (29/255). Majority of children admitted with COVID-19 had severe to critical illness due to the presence of malnutrition and underlying comorbidities. CONCLUSIONS: Children of all age groups were susceptible to COVID-19 illness with a slight male preponderance. Amongst infected, two-third were asymptomatic or had mild symptoms that required outpatient management and home isolation. The adverse outcomes were more commonly seen in infants and children > 10 y of age with malnutrition and comorbid illness.


Subject(s)
COVID-19 , Child , Hospitalization , Humans , Male , Retrospective Studies , SARS-CoV-2 , Tertiary Care Centers
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