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1.
PLoS One ; 16(4): e0250815, 2021.
Article in English | MEDLINE | ID: covidwho-1833533

ABSTRACT

BACKGROUND: COVID-19 is a respiratory infectious disease caused by SARS-CoV-2, and cardiovascular damage is commonly observed in affected patients. We sought to investigate the effect of SARS-CoV-2 infection on cardiac injury and hypertension during the current coronavirus pandemic. STUDY DESIGN AND METHODS: The clinical data of 366 hospitalized COVID-19-confirmed patients were analyzed. The clinical signs and laboratory findings were extracted from electronic medical records. Two independent, experienced clinicians reviewed and analyzed the data. RESULTS: Cardiac injury was found in 11.19% (30/268) of enrolled patients. 93.33% (28/30) of cardiac injury cases were in the severe group. The laboratory findings indicated that white blood cells, neutrophils, procalcitonin, C-reactive protein, lactate, and lactic dehydrogenase were positively associated with cardiac injury marker. Compared with healthy controls, the 190 patients without prior hypertension have higher AngⅡ level, of which 16 (8.42%) patients had a rise in blood pressure to the diagnostic criteria of hypertension during hospitalization, with a significantly increased level of the cTnI, procalcitonin, angiotensin-II (AngⅡ) than those normal blood pressure ones. Multivariate analysis indicated that elevated age, cTnI, the history of hypertension, and diabetes were independent predictors for illness severity. The predictive model, based on the four parameters and gender, has a good ability to identify the clinical severity of COVID-19 in hospitalized patients (area under the curve: 0.932, sensitivity: 98.67%, specificity: 75.68%). CONCLUSION: Hypertension, sometimes accompanied by elevated cTnI, may occur in COVID-19 patients and become a sequela. Enhancing Ang II signaling, driven by SARS-CoV-2 infection, might play an important role in the renin-angiotensin system, and consequently lead to the development of hypertension in COVID-19.


Subject(s)
COVID-19/complications , Heart Injuries/epidemiology , Hypertension/epidemiology , Adult , Aged , Aged, 80 and over , COVID-19/metabolism , COVID-19/physiopathology , Comorbidity , Disease Progression , Female , Heart Injuries/virology , Hospitalization , Humans , Hypertension/physiopathology , Hypertension/virology , Male , Medical Records , Middle Aged , Pandemics , Renin-Angiotensin System , SARS-CoV-2/pathogenicity
2.
PLoS One ; 16(4): e0250651, 2021.
Article in English | MEDLINE | ID: covidwho-1833527

ABSTRACT

In recent times, many alarm bells have begun to sound: the metaphorical presentation of the COVID-19 emergency as a war might be dangerous, because it could affect the way people conceptualize the pandemic and react to it, leading citizens to endorse authoritarianism and limitations to civil liberties. The idea that conceptual metaphors actually influence reasoning has been corroborated by Thibodeau and Boroditsky, who showed that, when crime is metaphorically presented as a beast, readers become more enforcement-oriented than when crime is metaphorically framed as a virus. Recently, Steen, Reijnierse and Burgers replied that this metaphorical framing effect does not seem to occur and suggested that the question should be rephrased about the conditions under which metaphors do or do not influence reasoning. In this paper, we investigate whether presenting the COVID-19 pandemic as a war affects people's reasoning about the pandemic. Data collected suggest that the metaphorical framing effect does not occur by default. Rather, socio-political individual variables such as speakers' political orientation and source of information favor the acceptance of metaphor congruent entailments: right-wing participants and participants relying on independent sources of information are those more conditioned by the COVID-19 war metaphor, thus more inclined to prefer bellicose options.


Subject(s)
COVID-19/psychology , Social Behavior , Thinking/physiology , Adult , Armed Conflicts/psychology , Female , Humans , Italy , Language , Male , Metaphor , Pandemics/prevention & control , Problem Solving , SARS-CoV-2/pathogenicity
3.
PLoS One ; 16(4): e0250319, 2021.
Article in English | MEDLINE | ID: covidwho-1833525

ABSTRACT

Projections of the stage of the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) pandemic and local, regional and national public health policies to limit coronavirus spread as well as "reopen" cities and states, are best informed by serum neutralizing antibody titers measured by reproducible, high throughput, and statically credible antibody (Ab) assays. To date, a myriad of Ab tests, both available and FDA authorized for emergency, has led to confusion rather than insight per se. The present study reports the results of a rapid, point-in-time 1,000-person cohort study using serial blood donors in the New York City metropolitan area (NYC) using multiple serological tests, including enzyme-linked immunosorbent assays (ELISAs) and high throughput serological assays (HTSAs). These were then tested and associated with assays for neutralizing Ab (NAb). Of the 1,000 NYC blood donor samples in late June and early July 2020, 12.1% and 10.9% were seropositive using the Ortho Total Ig and the Abbott IgG HTSA assays, respectively. These serological assays correlated with neutralization activity specific to SARS-CoV-2. The data reported herein suggest that seroconversion in this population occurred in approximately 1 in 8 blood donors from the beginning of the pandemic in NYC (considered March 1, 2020). These findings deviate with an earlier seroprevalence study in NYC showing 13.7% positivity. Collectively however, these data demonstrate that a low number of individuals have serologic evidence of infection during this "first wave" and suggest that the notion of "herd immunity" at rates of ~60% or higher are not near. Furthermore, the data presented herein show that the nature of the Ab-based immunity is not invariably associated with the development of NAb. While the blood donor population may not mimic precisely the NYC population as a whole, rapid assessment of seroprevalence in this cohort and serial reassessment could aid public health decision making.


Subject(s)
COVID-19/epidemiology , SARS-CoV-2/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Antibodies, Neutralizing/blood , Antibodies, Viral/immunology , Blood Donors , COVID-19/immunology , Cohort Studies , Enzyme-Linked Immunosorbent Assay/methods , Female , Humans , Immunoglobulin G/blood , Male , Middle Aged , New York City/epidemiology , SARS-CoV-2/pathogenicity , Sensitivity and Specificity , Seroconversion/physiology , Seroepidemiologic Studies , Serologic Tests/methods , Spike Glycoprotein, Coronavirus/immunology
4.
BMC Cancer ; 21(1): 1148, 2021 Oct 26.
Article in English | MEDLINE | ID: covidwho-1833290

ABSTRACT

BACKGROUND: Studies have shown that the skeletal muscle index at the third lumbar vertebra (L3 SMI) had reasonable specificity and sensitivity in nutritional assessment and prognostic prediction in digestive system cancers, but its performance in lung cancer needs further investigation. METHODS: A retrospective study was performed on 110 patients with advanced lung cancer. The L3 SMI, the Patient-Generated Subjective Global Assessment score (PG-SGA score), body mass index (BMI), and serological indicators were analyzed. According to PG-SGA scores, patients were divided into severe malnutrition (≥9 points), mild to moderate malnutrition (≥3 points and ≤ 8 points), and no malnutrition (≤2 points) groups. Pearson correlation and logistic regression analysis were adopted to find factors related to malnutrition, and a forest plot was drawn. The receiver operating characteristic (ROC) curve was performed to compare the diagnostic values of malnutrition among factors, which were expressed by the area under curve (AUC). RESULTS: 1. The age of patients in the severe malnutrition group, the mild to moderate malnutrition group, and the no malnutrition group significantly differed, with mean ages of 63.46 ± 10.01 years, 60.42 ± 8.76 years, and 55.03 ± 10.40 years, respectively (OR = 1.062, 95%CI: 1.008 ~ 1.118, P = 0.024; OR = 1.100, 95%CI: 1.034 ~ 1.170, P = 0.002). Furthermore, the neutrophil to lymphocyte ratio (NLR) of the severe malnutrition group was significantly higher than that of the no malnutrition group, with statistical significance. The difference between the mild to moderate malnutrition group and the no malnutrition group were not statistically significant, with NLR of 4.07 ± 3.34 and 2.47 ± 0.92, respectively (OR = 1.657,95%CI: 1.036 ~ 2.649, P = 0.035). The L3 SMI of patients in the severe malnutrition and mild to moderate malnutrition groups were significantly lower than that of the patients in the no malnutrition group, with statistical significance. The L3 SMI of patients in the severe malnutrition group, mild to moderate malnutrition group, and no malnutrition group were 27.40 ± 4.25 cm2/m2, 38.19 ± 6.17 cm2/m2, and 47.96 ± 5.02 cm2/m2, respectively (OR = 0.600, 95%CI: 0.462 ~ 0.777, P < 0.001; OR = 0.431, 95%CI: 0.320 ~ 0.581, P < 0.001). 2. The Pearson correlation analysis showed that the PG-SGA score positively correlated with age (r = 0.296, P < 0.05) but negatively correlated with L3 SMI (r = - 0.857, P < 0.05). The L3 SMI was also negatively correlated with age (r = - 0.240, P < 0.05). 3. The multivariate analysis showed that the L3 SMI was an independent risk factor for malnutrition (OR = 0.446, 95%CI: 0.258 ~ 0.773, P = 0.004; OR = 0.289, 95%CI: 0.159 ~ 0.524, P < 0.001). CONCLUSION: 1. The differences in the L3 SMI was statistically significant among advanced lung cancer patients with different nutritional statuses. 2. In the nutritional assessment of patients with lung cancer, the L3 SMI was consistent with the PG-SGA. 3. The L3 SMI is an independent predictor of malnutrition in patients with advanced lung cancer.


Subject(s)
Lung Neoplasms/complications , Malnutrition/etiology , Muscle, Skeletal/physiology , Vertebral Body/physiology , Female , Humans , Male , Malnutrition/physiopathology , Middle Aged , Nutrition Assessment , Prognosis , Retrospective Studies , Risk Factors
5.
BMJ Open ; 11(1): e045889, 2021 01 17.
Article in English | MEDLINE | ID: covidwho-1832434

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had a major impact on delivery of social support services. This might be expected to particularly affect older adults and people living with dementia (PLWD), and to reduce their well-being. AIMS: To explore how social support service use by older adults, carers and PLWD, and their mental well-being changed over the first 3 months since the pandemic outbreak. METHODS: Unpaid dementia carers, PLWD and older adults took part in a longitudinal online or telephone survey collected between April and May 2020, and at two subsequent timepoints 6 and 12 weeks after baseline. Participants were asked about their social support service usage in a typical week prior to the pandemic (at baseline), and in the past week at each of the three timepoints. They also completed measures of levels of depression, anxiety and mental well-being. RESULTS: 377 participants had complete data at all three timepoints. Social support service usage dropped shortly after lockdown measures were imposed at timepoint 1 (T1), to then increase again by T3. The access to paid care was least affected by COVID-19. Cases of anxiety dropped significantly across the study period, while cases of depression rose. Well-being increased significantly for older adults and PLWD from T1 to T3. CONCLUSIONS: Access to social support services has been significantly affected by the pandemic, which is starting to recover slowly. With mental well-being differently affected across groups, support needs to be put in place to maintain better well-being across those vulnerable groups during the ongoing pandemic.


Subject(s)
COVID-19/psychology , Caregivers/psychology , Dementia/psychology , Health Facility Closure , Social Work , Adult , Aged , Aged, 80 and over , Anxiety/epidemiology , COVID-19/prevention & control , Depression/epidemiology , Female , Humans , Longitudinal Studies , Male , Mental Health , Middle Aged , Social Support , United Kingdom/epidemiology , Young Adult
8.
PLoS One ; 15(11): e0237799, 2020.
Article in English | MEDLINE | ID: covidwho-1833518

ABSTRACT

OBJECTIVE: The occurrence of pneumonia separates severe cases of COVID-19 from the majority of cases with mild disease. However, the factors determining whether or not pneumonia develops remain to be fully uncovered. We therefore explored the associations of several lifestyle factors with signs of pneumonia in COVID-19. METHODS: Between May and July 2020, we conducted an online survey of 201 adults in Germany who had recently gone through COVID-19, predominantly as outpatients. Of these, 165 had a PCR-based diagnosis and 36 had a retrospective diagnosis by antibody testing. The survey covered demographic information, eight lifestyle factors, comorbidities and medication use. We defined the main outcome as the presence vs. the absence of signs of pneumonia, represented by dyspnea, the requirement for oxygen therapy or intubation. RESULTS: Signs of pneumonia occurred in 39 of the 165 individuals with a PCR-based diagnosis of COVID-19 (23.6%). Among the lifestyle factors examined, only overweight/obesity was associated with signs of pneumonia (odds ratio 2.68 (1.29-5.59) p = 0.008). The observed association remained significant after multivariate adjustment, with BMI as a metric variable, and also after including the antibody-positive individuals into the analysis. CONCLUSIONS: This exploratory study finds an association of overweight/obesity with signs of pneumonia in COVID-19. This finding suggests that a signal proportional to body fat mass, such as the hormone leptin, impairs the body's ability to clear SARS-CoV-2 before pneumonia develops. This hypothesis concurs with previous work and should be investigated further to possibly reduce the proportion of severe cases of COVID-19.


Subject(s)
COVID-19/complications , Life Style , Obesity/complications , Pneumonia/complications , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Comorbidity , Female , Humans , Male , Middle Aged , Pandemics , Surveys and Questionnaires , Young Adult
9.
Surgery ; 171(5): 1422-1426, 2022 May.
Article in English | MEDLINE | ID: covidwho-1829571

ABSTRACT

BACKGROUND: To determine the impact of COVID-19 infection in patients with chronic limb-threatening ischemia, mainly the limb salvage estimates rate and the overall survival. METHODS: This was a retrospective, consecutive cohort study of chronic limb-threatening ischemia in patients with COVID-19 infection. RESULTS: Overall, 35 patients with chronic limb-threatening ischemia and COVID-19 infection were evaluated. The mean age of the patients was 72.51 years, and most of them were male (60%), with arterial hypertension (85.7%), followed by diabetes mellitus (80%) and tobacco user (71.4%). There was a higher prevalence of wound, ischemia and foot infection (WIfI) classification 4 with 58.8% and Rutherford grade 5 (74.3%). The factors related to overall mortality rate were: D-dimer >1,000 mg/dL (hazard ratio = 22.7, P < .001, confidence interval = 10.49-26.52), respiratory symptoms (hazard ratio = 16.6, P < .001, confidence interval = 9.87-20.90), chest computed tomography compromising higher than 50% of the pulmonary tract (hazard ratio = 16,0, P < .001, confidence interval = 10.41-20.55), acute kidney failure (hazard ratio = 21.58, P < .001, confidence interval = 16.5-30.5), chronic kidney disease (hazard ratio = 4.4, P = .036, confidence interval = 1.45-10.1), therapeutic anticoagulation (hazard ratio = 8.37, P = .004, confidence interval = 1.35-8.45), and WIfI classification (hazard ratio = 5.28, P = .022, confidence interval = 1.34-10.01). The following were related to limb loss: D-dimer >1,000 mg/mL (hazard ratio = 5.47, P = .02, confidence interval = 1.94-10.52), respiratory symptoms (hazard ratio = 5.42, P = .02, confidence interval = 1.87-10.90), and WIfI classification (hazard ratio = 4.44, P = .035, confidence interval = 1.34-8.01). CONCLUSION: This study concluded that COVID-19 has a catastrophic impact among patients with chronic limb-threatening ischemia. The main factors related to overall mortality were D-dimer >1,000 mg/dL, respiratory symptoms, chest computed tomography compromising higher than 50% of the pulmonary tract, acute kidney failure, chronic kidney disease, therapeutic anticoagulation, and WIfI classification. The factors related to limb loss were WIfI classification, D-dimer >1,000 mg/mL and respiratory symptoms.


Subject(s)
COVID-19 , Peripheral Arterial Disease , Wound Infection , Aged , Amputation , Anticoagulants , COVID-19/complications , Cohort Studies , Female , Humans , Ischemia/surgery , Kaplan-Meier Estimate , Limb Salvage , Male , Peripheral Arterial Disease/surgery , Predictive Value of Tests , Retrospective Studies , Risk Factors , Time Factors , Treatment Outcome , Wound Healing , Wound Infection/diagnosis , Wound Infection/surgery
10.
Nutr Metab Cardiovasc Dis ; 31(9): 2612-2618, 2021 08 26.
Article in English | MEDLINE | ID: covidwho-1829287

ABSTRACT

BACKGROUND AND AIMS: Diabetes conveys an increased risk of infectious diseases and related mortality. We investigated risk of ascertained SARS-CoV-2 infection in diabetes subjects from the Veneto Region, Northeastern Italy, as well as the risk of being admitted to hospital or intensive care unit (ICU), or mortality for COVID-19. METHODS AND RESULTS: Diabetic subjects were identified by linkage of multiple health archives. The rest of the population served as reference. Information on ascertained infection by SARS-CoV-2, admission to hospital, admission to ICU and mortality in the period from February 21 to July 31, 2020 were retrieved from the regional registry of COVID-19. Subjects with ascertained diabetes were 269,830 (55.2% men; median age 72 years). Reference subjects were 4,681,239 (men 48.6%, median age 46 years). Ratios of age- and gender-standardized rates (RR) [95% CI] for ascertained infection, admission to hospital, admission to ICU and disease-related death in diabetic subjects were 1.31 [1.19-1.45], 2.11 [1.83-2.44], 2.45 [1.96-3.07], 1.87 [1.68-2.09], all p < 0.001. The highest RR of ascertained infection was observed in diabetic men aged 20-39 years: 1.90 [1.04-3.21]. The highest RR of ICU admission and death were observed in diabetic men aged 40-59 years: 3.47 [2.00-5.70] and 5.54 [2.23-12.1], respectively. CONCLUSIONS: These data, observed in a large population of ∼5 million people of whom ∼250,000 with diabetes, show that diabetes not only conveys a poorer outcome in COVID-19 but also confers an increased risk of ascertained infection from SARS-CoV-2. Men of young or mature age have the highest relative risks.


Subject(s)
COVID-19/etiology , Diabetes Complications/etiology , SARS-CoV-2 , Adult , Age Factors , Aged , Female , Hospitalization , Humans , Intensive Care Units , Male , Middle Aged , Young Adult
11.
Heart Lung Circ ; 31(2): 292-298, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1828537

ABSTRACT

BACKGROUND: Patients with Coronavirus disease 2019 (COVID-19)-related acute respiratory disease (ARDS) increasingly receive extracorporeal membrane oxygenation (ECMO) support. While ECMO has been shown to increase risk of stroke, few studies have examined this association in COVID-19 patients. OBJECTIVE: We conducted a systematic review to characterise neurological events during ECMO support in COVID-19 patients. DESIGN: Systematic review of cohort and large case series of COVID-19 patients who received ECMO support. DATA SOURCES: Studies retrieved from PubMed, EMBASE, Cochrane, Cochrane COVID-19 Study Register, Web of Science, Scopus, Clinicaltrials.gov, and medRχiv from inception to November 11, 2020. ELIGIBILITY CRITERIA: Inclusion criteria were a) Adult population (>18 year old); b) Positive PCR test for SARS-CoV-2 with active COVID-19 disease; c) ECMO therapy due to COVID-19 ARDS; and d) Neurological events and outcome described while on ECMO support. We excluded articles when no details of neurologic events were available. RESULTS: 1,322 patients from 12 case series and retrospective cohort studies were included in our study. The median age was 49.2, and 75% (n=985) of the patients were male. Diabetes mellitus and dyslipidaemia were the most common comorbidities (24% and 20%, respectively). Most (95%, n=1,241) patients were on venovenous ECMO with a median P:F ratio at the time of ECMO cannulation of 69.1. The prevalence of intracranial haemorrhage (ICH), ischaemic stroke, and hypoxic ischaemic brain injury (HIBI) was 5.9% (n=78), 1.1% (n=15), and 0.3% (n=4), respectively. The overall mortality of the 1,296 ECMO patients in the 10 studies that reported death was 36% (n=477), and the mortality of the subset of patients who had a neurological event was 92%. CONCLUSIONS: Neurological injury is a concern for COVID-19 patients who receive ECMO. Further research is required to explore how neuromonitoring protocols can inform tailored anticoagulation management and improve survival in COVID-19 patients with ECMO support.


Subject(s)
Brain Ischemia , COVID-19 , Extracorporeal Membrane Oxygenation , Stroke , Adolescent , Adult , Extracorporeal Membrane Oxygenation/adverse effects , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , Stroke/epidemiology , Stroke/etiology
12.
Am J Surg ; 221(2): 277-284, 2021 02.
Article in English | MEDLINE | ID: covidwho-1827840

ABSTRACT

BACKGROUND: The global COVID-19 pandemic has placed tremendous physical and mental strain on the US healthcare system. Studies examining the effects of outbreaks have demonstrated both an increased prevalence and long-term development of Post-Traumatic Stress Disorder (PTSD) symptoms in healthcare providers. We sought to assess the impact of the COVID-19 pandemic on the psychological well-being of medical providers, medical trainees, and administrators at a large academic center to identify stressors and moderators to guide future mental health and hospital-system interventions. METHODS: A 42-item survey examining specific stressors, grit, and resilience was widely distributed to physicians, residents, fellows, and administrators a large academic institution for departmental distribution. Survey results were analyzed using descriptive statistics, ANOVA, and multivariate linear regressions. A p-value <0.05 was considered statistically significant. RESULTS: A total of 785 participants completed the survey. The majority of respondents rated their stress to be significantly increased during the pandemic. Respondents' fear of transmitting the virus to their family members was a significant stressor. Higher resilience was associated with lower stress, anxiety, fatigue, and sleep disturbances. Overall, respondents felt supported by their departments and institution and felt contingency plans and personal protective equipment were adequate. CONCLUSIONS: Healthcare workers have increased resilience in the face of heightened stress during a pandemic. Higher resilience and grit were protective factors in managing personal and system-level stressors at the peak of the COVID-19 pandemic in our institution. Implementing an intervention designed to enhance healthcare workers' resilience in response to the COVID-19 pandemic is warranted.


Subject(s)
COVID-19/therapy , Health Personnel/psychology , Pneumonia, Viral/therapy , Resilience, Psychological , Stress Disorders, Post-Traumatic/prevention & control , Stress Disorders, Post-Traumatic/psychology , Adult , COVID-19/epidemiology , Female , Humans , Male , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Surveys and Questionnaires , United States/epidemiology
13.
Am J Emerg Med ; 51: 262-266, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1827781

ABSTRACT

IMPORTANCE: Considering the resurgence of COVID19 and the rapid spread of new and deadlier strains across the globe understanding the incidence and pattern of violence and self harm tendencies during this period might help in formulating better contingency plans for future lockdowns. A deeper look at the available data shows that there is a significant dearth of research into self-harm & violence during the COVID-19 pandemic. OBJECTIVE: To identify the incidence and sociodemographic characteristics of self-harm and violence during the COVID19 lockdown and compare with a control group from the previous year. DESIGN: A cross-sectional retrospective observational study. SETTING: Tertiary care teaching hospital. PARTICIPANTS: All patients presenting to the emergency department (ED) with self harm and violence during the COVID-19 lockdown period between March 24-June 30, 2020 and March 24-June 30, 2019. EXPOSURE: The COVID-19 lockdown period. MAIN OUTCOME (S) AND MEASURE (S): The hypothesis being tested was formulated before the study. The null hypothesis tested was a decline in number of self-harm and violence cases during the lockdown. RESULTS: A total of 828 patients were analysed over both the time periods, out of which 30% (248) were females while 70% (580) were males. Increases in self-harm and violence were 12.71% and 95.32% respectively per 1000 ED admissions. A significant correlation was found between the COVID-19 lockdown and the increased incidence (X2 (1, N = 828) = 9.2, p < .05). An increase of violence by known individuals and between partners was seen. Intimate partner violence also increased to 7%. X2 (3, N = 662) = 21.03, p < .05. In the self harm dataset an increase in mortality, ICU admissions and decision to leave against medical advice was noted (X2 (4, N = 166) = 24.49, p < .05). Increase in the use of alcohol prior to acts of self harm and violence was noted. CONCLUSIONS: Increase in the incidence of cases of self-harm and violence reported to the ED was noted during the lockdown period. Upgradation of health-care and law enforcement infrastructure maybe needed to deal with similar circumstances in a more efficient manner. TRIAL REGISTRATION: N/A.


Subject(s)
COVID-19/epidemiology , Self-Injurious Behavior/epidemiology , Violence/statistics & numerical data , Adult , Communicable Disease Control , Cross-Sectional Studies , Emergency Service, Hospital/statistics & numerical data , Female , Hospitalization , Humans , Incidence , India/epidemiology , Intimate Partner Violence , Male , Middle Aged , Pandemics , Retrospective Studies , Young Adult
14.
Nat Rev Immunol ; 20(7): 442-447, 2020 07.
Article in English | MEDLINE | ID: covidwho-1830064

ABSTRACT

A male bias in mortality has emerged in the COVID-19 pandemic, which is consistent with the pathogenesis of other viral infections. Biological sex differences may manifest themselves in susceptibility to infection, early pathogenesis, innate viral control, adaptive immune responses or the balance of inflammation and tissue repair in the resolution of infection. We discuss available sex-disaggregated epidemiological data from the COVID-19 pandemic, introduce sex-differential features of immunity and highlight potential sex differences underlying COVID-19 severity. We propose that sex differences in immunopathogenesis will inform mechanisms of COVID-19, identify points for therapeutic intervention and improve vaccine design and increase vaccine efficacy.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Adaptive Immunity , Age Factors , Betacoronavirus/physiology , COVID-19 , Coronavirus Infections/immunology , Coronavirus Infections/pathology , Coronavirus Infections/physiopathology , Female , Humans , Interferons/immunology , Male , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/pathology , Pneumonia, Viral/physiopathology , SARS-CoV-2 , Severity of Illness Index , Sex Factors , Sociological Factors
15.
Knee Surg Sports Traumatol Arthrosc ; 28(6): 1712-1719, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1826408

ABSTRACT

PURPOSE: The aim of the present study was to evaluate the impact of the coronavirus (COVID-19) pandemic on joint arthroplasty service in Europe by conducting an online survey of arthroplasty surgeons. METHODS: The survey was conducted in the European Hip Society (EHS) and the European Knee Associates (EKA). The survey consisted of 20 questions (single, multiple choice, ranked). Four topics were addressed: (1) origin and surgical experience of the participant (four questions); (2) potential disruption of arthroplasty surgeries (12 questions); (3) influence of the COVID-19 pandemic on the particular arthroplasty surgeon (four questions); (4) a matrix provided 14 different arthroplasty surgeries and the participant was asked to state whether dedicated surgery was stopped, delayed or cancelled. RESULTS: Two-hundred and seventy-two surgeons (217 EHS, 55 EKA) from 40 different countries participated. Of the respondents, 25.7% stated that all surgeries were cancelled in their departments, while 68.4% responded that elective inpatient procedures were no longer being performed. With regard to the specific surgical procedures, nearly all primary TJA were cancelled (92.6%) as well as aseptic revisions (94.7%). In most hospitals, periprosthetic fractures (87.2%), hip arthroplasty for femoral neck fractures and septic revisions for acute infections (75.8%) were still being performed. CONCLUSION: During the current 2020 COVID-19 pandemic, we are experiencing a near-total shutdown of TJA. A massive cutback was observed for primary TJA and revision TJA, even in massively failed TJA with collapse, dislocation, component failure or imminent dislocation. Only life-threatening pathologies like periprosthetic fractures and acute septic TJA are currently undergoing surgical treatment. LEVEL OF EVIDENCE: V.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Delivery of Health Care/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Orthopedic Procedures/statistics & numerical data , Pandemics , Pneumonia, Viral/epidemiology , COVID-19 , Europe/epidemiology , Health Care Surveys , Humans , Internet , Male , Prospective Studies , SARS-CoV-2
16.
Knee Surg Sports Traumatol Arthrosc ; 28(6): 1705-1711, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1826407

ABSTRACT

PURPOSE: Due to the lack of evidence, it was the aim of the study to investigate current possible cutbacks in orthopaedic healthcare due to the coronavirus disease 2019 pandemic (COVID-19). METHODS: An online survey was performed of orthopaedic surgeons in the German-speaking Arthroscopy Society (Gesellschaft für Arthroskopie und Gelenkchirurgie, AGA). The survey consisted of 20 questions concerning four topics: four questions addressed the origin and surgical experience of the participant, 12 questions dealt with potential cutbacks in orthopaedic healthcare and 4 questions addressed the influence of the pandemic on the particular surgeon. RESULTS: Of 4234 contacted orthopaedic surgeons, 1399 responded. Regarding arthroscopic procedures between 10 and 30% of the participants stated that these were still being performed-with actual percentages depending on the specific joint and procedure. Only 6.2% of the participants stated that elective total joint arthroplasty was still being performed at their centre. In addition, physical rehabilitation and surgeons' postoperative follow-ups were severely affected. CONCLUSION: Orthopaedic healthcare services in Austria, Germany, and Switzerland are suffering a drastic cutback due to COVID-19. A drastic reduction in arthroscopic procedures like rotator cuff repair and cruciate ligament reconstruction and an almost total shutdown of elective total joint arthroplasty were reported. Long-term consequences cannot be predicted yet. The described disruption in orthopaedic healthcare services has to be viewed as historic. LEVEL OF EVIDENCE: V.


Subject(s)
Coronavirus Infections/epidemiology , Delivery of Health Care/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Orthopedic Procedures/statistics & numerical data , Orthopedics/statistics & numerical data , Pneumonia, Viral/epidemiology , Aftercare/statistics & numerical data , Arthroplasty/statistics & numerical data , Arthroscopy/statistics & numerical data , Austria/epidemiology , Betacoronavirus , COVID-19 , Coronavirus Infections/virology , Germany/epidemiology , Health Care Surveys , Humans , Internet , Male , Pandemics/statistics & numerical data , Pneumonia, Viral/virology , Rehabilitation/statistics & numerical data , SARS-CoV-2 , Switzerland/epidemiology
17.
Monaldi Arch Chest Dis ; 92(1)2021 Aug 12.
Article in English | MEDLINE | ID: covidwho-1822487

ABSTRACT

A pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 was declared in 2020. Severe cases were characterized by the development of acute hypoxemic respiratory failure (AHRF) requiring advanced respiratory support. However, intensive care units (ICU) were saturated, and many patients had to be treated out of ICU. This case describes a 75-year-old man affected by AHRF due to Coronavirus Disease 2019 (COVID-19), hospitalized in a high-dependency unit, with PaO2/FiO2 <100 for 28 consecutive days. An experienced team with respiratory physiotherapists was in charge of the noninvasive ventilatory support (NIVS). The patient required permanent NIVS with continuous positive airway pressure, non-invasive ventilation, high flow nasal oxygen and body positioning. He was weaned from NIVS after 37 days and started exercise training afterwards. The patient was discharged at home with low-flow oxygen therapy. This case represents an example of a successful treatment of AHRF with the still controversial noninvasive respiratory support in one patient with COVID-19.


Subject(s)
COVID-19 , Noninvasive Ventilation , Respiratory Insufficiency , Aged , Humans , Male , Oxygen Inhalation Therapy , Pandemics , Respiratory Insufficiency/etiology , Respiratory Insufficiency/therapy
19.
Rev. saúde pública (Online) ; 55: 01, 2021. tab
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1818706

ABSTRACT

ABSTRACT This study describes body weight changes among participants of the NutriNet Brasil cohort (n = 14,259) during the covid-19 pandemic. We analyzed data reported before the pandemic onset (01/26/2020 to 03/18/2020) and about six months after (09/14/2020 to 10/19/2020). Our results show that 19.7% of the participants gained ≥ 2 kg. Weight gain was directly associated with male gender, lower education, and previous presence of overweight, and inversely associated with age. In turn, 15.2% lost ≥ 2kg, being directly associated with male gender and previous presence of overweight and inversely associated with age.


RESUMO Este estudo descreve modificações no peso corporal de participantes da coorte NutriNet Brasil (n = 14.259) ocorridas durante a pandemia de covid-19. Foram analisados dados informados em período anterior ao início da pandemia (26/01/2020 a 18/03/2020) e cerca de 6 meses após (14/09/2020 a 19/10/2020). O ganho de peso ≥ 2 kg alcançou 19,7% dos participantes, mostrando-se diretamente associado ao sexo masculino, à menor escolaridade e à presença prévia de excesso de peso, sendo inversamente associado à idade. A perda de peso ≥ 2kg alcançou 15,2% dos participantes, mostrando-se diretamente associada ao sexo masculino e à presença prévia de excesso de peso, sendo inversamente associada à idade.


Subject(s)
Humans , Male , Female , Body Weight , Pandemics , COVID-19 , Brazil/epidemiology , Weight Gain , Cohort Studies , Age Factors , Overweight
20.
Saúde Soc ; 31(1): e210294, 2022.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1817578

ABSTRACT

Resumo Este texto apresenta uma atividade grupal desenvolvida durante a epidemia de covid-19 em espaço virtual, com 13 participantes, estudantes e professores universitários. O objetivo foi oferecer um espaço de escuta protegido e criar estratégias para enfrentar a angústia e o medo decorrentes da epidemia. A ferramenta metodológica utilizada foi a intervenção grupal, realizada entre maio e agosto de 2020, que operou como uma rede de conversação. No grupo, produziu-se um diálogo horizontal com temas escolhidos conjuntamente e buscando soluções compartilhadas para diversos problemas. Este artigo analisa o diálogo ocorrido nos encontros em que se falou sobre o medo. Neles, os(as) participantes identificaram o medo da morte e da perda de pessoas amadas como aquele que desperta maior sofrimento, acentuado quando as pessoas estão distantes geograficamente. A avaliação mostrou que os encontros e os diálogos produziram alívio e bem-estar, e que trabalhar em plataforma virtual não constituiu empecilho à comunicação. Grupos de intervenção desenvolvidos em espaço virtual compõem metodologias de baixo custo, porém potentes, fáceis de operar e possíveis de serem nucleadas nos mais diversos coletivos.


Abstract This paper describes a virtual group activity developed during the covid-19 pandemic with 13 university students and professors. Based on a group intervention operating as a conversation network, carried out between May and August 2020, the goal was to offer a safe listening space and to create strategies to cope with the anguish and fear resulting from the pandemic. The group engaged in horizontal dialogue on topics chosen jointly, seeking shared solutions to various problems. This article analyzes the dialogue that took place during meetings where fear was discussed. In these meetings, participants identified the fear of death and loss of loved ones as the feelings that arouse the most suffering, heightened when people are geographically distant. The analysis showed that such meetings and dialogues produced relief and well-being, and that working on a virtual platform did not hinder communication. Intervention groups developed virtually are low-cost yet powerful methodologies, easy to operate and possible to be implemented in the most diverse collectives.


Subject(s)
Humans , Male , Female , Adaptation, Psychological , Mental Health , Death , Fear , Internet-Based Intervention , COVID-19
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