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1.
Int J Environ Res Public Health ; 19(22)2022 Nov 10.
Статья в английский | MEDLINE | ID: covidwho-2110080

Реферат

This paper elucidates the relationship between possible changes in volunteering experienced by older people during the COVID-19 pandemic, and their motivation to volunteer, as well as the direct or indirect experience of COVID-19 symptoms. Given the well-known positive benefits of volunteering in older age both for individuals (in terms of improved health and wellbeing) and society at large, there is a paucity of studies on older volunteers in the time of COVID-19. In this context, older people's volunteering was highly challenged due to age-based physical and social restrictions put in place by national governments, which have been considered as ageist by a large part of the gerontological scientific community. This study was carried out on a sample of 240 Italian older volunteers. The results suggest that during the COVID-19 pandemic, especially older volunteers driven by social goals (e.g., opportunities to have relationships with others) were able to continue volunteer activities without needing to change them. The study also clarified that having directly or indirectly experienced COVID-19 symptoms did not influence changes in voluntary activities of older people. These results have important policy implications, given the indication that through volunteering, older individuals may try to counter the undesired calls by the governments for self-isolation and physical distancing. It is important that in emergency situations involving older people, policy makers should not treat them as only recipients of health and social care, but also as useful providers of help in the community.


Тема - темы
COVID-19 , Motivation , Humans , Aged , COVID-19/epidemiology , Pandemics , Personal Satisfaction , Volunteers
2.
Int J Environ Res Public Health ; 19(22)2022 Nov 08.
Статья в английский | MEDLINE | ID: covidwho-2110065

Реферат

The COVID-19 pandemic has made evident the exclusion to which older people may be subjected for reasons of age. This study delves into the cultural image of older adults during the pandemic from the perspective of people between 60 and 81 years of age. Through a qualitative methodology, the voices of 37 people have been collected through in-depth interviews. Two main themes are derived from the inductive analysis: on the one hand, the devaluation of older people, and on the other hand, the positive image of the older population as older and valid. We conclude that people over 60 years of age in the Basque Country denounce the stigma of low capacity attributed to the older population during the pandemic. They reject the signs of age-based overprotection manifested during the pandemic and highlight the vital experience by which older people could be considered referents in situations of social crisis. They reflect on the initiatives necessary to improve the cultural image of the older population and point out the opportunities for active ageing, education based on values and intergenerational relationships.


Тема - темы
COVID-19 , Voice , Humans , Middle Aged , Aged , COVID-19/epidemiology , Pandemics , Social Stigma , Educational Status
3.
Curr Oncol ; 29(11): 8565-8578, 2022 Nov 11.
Статья в английский | MEDLINE | ID: covidwho-2109972

Реферат

Since the beginning of the COVID-19 pandemic, the use of telehealth was rapidly implemented without previous evidence. The ONCOTELEMD study aimed to evaluate the opinion of patients attended via telemedicine during this period and to study factors that condition patient preferences on its use. Included patients had a confirmed cancer diagnosis and were contacted by telephone between 13 March and 30 April 2020, in the Medical Oncology Service of Hospital Parc Taulí, Sabadell. A 12-question survey was presented to them between 4 February and 19 April 2021. Statistical analysis was carried out using chi-square and multivariable logistic regression tests. Six hundred forty-six patients were included; 487 responded to the survey. The median age was 68 years (27-90), 55.2% were female. Most patients had a surveillance visit (65.3%) and were diagnosed with colorectal or breast cancer (43% and 26.5%, respectively); 91.8% of patients were satisfied, and 60% would accept the use of telemedicine beyond the pandemic. Patients aged more than 50 years (OR 0.40; 95% CI, 0.19-0.81; p = 0.01) and diagnosed with breast cancer (OR 0.45; 95% CI, 0.26-0.69; p < 0.001) were less predisposed to adopt telehealth in the future. Patients agreed to be informed via telehealth of scan or lab results (62% and 84%, respectively) but not of new oral or endovenous treatments (52% and 33.5%, respectively). Additionally, 75% of patients had a medium or low-null technologic ability, and 51.3% would only use the telephone or video call to contact health professionals. However, differences were found according to age groups (p < 0.0001). In total, patients surveyed were satisfied with telemedicine and believed telehealth could have a role following the COVID-19 pandemic. Moreover, our results remark on the importance of individualizing the use of telehealth, showing relevant data on patient preferences and digital literacy.


Тема - темы
Breast Neoplasms , COVID-19 , Telemedicine , Humans , Female , Aged , Male , COVID-19/epidemiology , Pandemics , Telemedicine/methods , Health Personnel
4.
Front Public Health ; 10: 966606, 2022.
Статья в английский | MEDLINE | ID: covidwho-2109877

Реферат

With the rapid development of digital technology, mobile Internet use is increasing in popularity in China. Previous studies have shown that mobile Internet use has a positive or negative effect on mental distress. Using CFPS2020 data, this paper finds that mobile Internet use significantly alleviates mental distress in Chinese adults. Heterogeneity analysis indicates that mobile Internet use can significantly alleviate mental distress among adults between the ages of 30 and 70, without a bachelor's degree or residing outside the province of Hubei. Furthermore, mobile Internet use significantly reduces mental distress through two mediators: trust and happiness. It also shows that watching short videos or learning online is associated with reduced mental distress, as opposed to online shopping, chatting, or playing games. However, the mental distress of new mobile Internet users in 2020 has not been alleviated. This paper enriches the relevant theoretical research and provides a practical reference for using the mobile Internet to ease mental distress during epidemics.


Тема - темы
COVID-19 , Mental Disorders , Adult , Humans , Middle Aged , Aged , COVID-19/epidemiology , Pandemics , Internet Use , Mental Disorders/epidemiology , China/epidemiology
6.
Euro Surveill ; 27(44)2022 11.
Статья в английский | MEDLINE | ID: covidwho-2109635

Реферат

BackgroundSince the roll-out of COVID-19 vaccines in late 2020 and throughout 2021, European governments have relied on mathematical modelling to inform policy decisions about COVID-19 vaccination.AimWe present a scenario-based modelling analysis in the Netherlands during summer 2021, to inform whether to extend vaccination to adolescents (12-17-year-olds) and children (5-11-year-olds).MethodsWe developed a deterministic, age-structured susceptible-exposed-infectious-recovered (SEIR) model and compared modelled incidences of infections, hospital and intensive care admissions, and deaths per 100,000 people across vaccination scenarios, before the emergence of the Omicron variant.ResultsOur model projections showed that, on average, upon the release of all non-pharmaceutical control measures on 1 November 2021, a large COVID-19 wave may occur in winter 2021/22, followed by a smaller, second wave in spring 2022, regardless of the vaccination scenario. The model projected reductions in infections/severe disease outcomes when vaccination was extended to adolescents and further reductions when vaccination was extended to all people over 5 years-old. When examining projected disease outcomes by age group, individuals benefitting most from extending vaccination were adolescents and children themselves. We also observed reductions in disease outcomes in older age groups, particularly of parent age (30-49 years), when children and adolescents were vaccinated, suggesting some prevention of onward transmission from younger to older age groups.ConclusionsWhile our scenarios could not anticipate the emergence/consequences of SARS-CoV-2 Omicron variant, we illustrate how our approach can assist decision making. This could be useful when considering to provide booster doses or intervening against future infection waves.


Тема - темы
COVID-19 , SARS-CoV-2 , Child , Adolescent , Humans , Aged , Adult , Middle Aged , Child, Preschool , Netherlands/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Vaccination
7.
Intern Med ; 61(21): 3197-3204, 2022 Nov 01.
Статья в английский | MEDLINE | ID: covidwho-2109498

Реферат

Objective Among treatment options for coronavirus infectious disease 2019 (COVID-19), well-studied oral medications are limited. We conducted a multicenter non-randomized, uncontrolled single-arm prospective study to assess the efficacy and safety of favipiravir for patients with COVID-19. Methods One hundred participants were sequentially recruited to 2 cohorts: cohort 1 (Day 1: 1,600 mg/day, Day 2 to 14: 600 mg/day, n=50) and cohort 2 (Day 1: 1,800 mg/day, Day 2 to 14: 800 mg/day, n=50). The efficacy endpoint was the negative conversion rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the odds ratio (OR) of cohort 2 to cohort 1 for negative conversion on Day 10 was calculated. Characteristics of all participants and profiles of adverse events (AEs) were collected and analyzed. Results The mean age of participants was 62.8±17.6 years old. Thirty-four patients (34.0%) experienced worsening pneumonia, 7 (7.0%) were intubated, and 4 (4.0%) died during the observation period. Cohort 2 showed a higher negative conversion rate than cohort 1 [adjusted OR 3.32 (95% confidence interval (CI), 1.17 to 9.38), p=0.024], and this association was maintained after adjusting for the age, sex, body mass index, and baseline C-reactive protein level. Regarding adverse events, hyperuricemia was most frequently observed followed by an elevation of the liver enzyme levels (all-grade: 49.0%, Grade ≥3: 12.0%), and cohort 2 tended to have a higher incidence than cohort 1. However, no remarkable association of adverse events was observed between patients <65 and ≥65 years old. Conclusion The antiviral efficacy of favipiravir was difficult to interpret due to the limitation of the study design. However, no remarkable issues with safety or tolerability associated with favipiravir were observed, even in elderly patients with COVID-19.


Тема - темы
COVID-19 , Humans , Aged , Middle Aged , Aged, 80 and over , COVID-19/drug therapy , SARS-CoV-2 , Prospective Studies , Treatment Outcome , Antiviral Agents/adverse effects
8.
Rev Inst Med Trop Sao Paulo ; 64: e62, 2022.
Статья в английский | MEDLINE | ID: covidwho-2109457

Реферат

This study aimed to evaluate the COVID-19 hospitalizations in a tertiary hospital by age group and month, considering the introduction and the advance of the vaccination against the disease. The laboratory-confirmed COVID-19-associated hospitalizations among people aged 20 years or older, that occurred between March 2020 and June 2021, were distributed by month of symptom onset and age group. The proportion of hospitalizations by age group was calculated for the year 2021. The proportions were compared using the chi-square test for trends. The marks of vaccination advances among different age groups were taken from the official website LocalizaSUS. In 2020, hospitalizations among people aged 60-80 years old were the most frequent (39.1%). From January-June 2021, when the vaccination commenced, while hospitalizations of patients aged 20 to < 40 and 40 to 60 years old showed an increasing trend, the older age groups and those with vaccination recommendations (from 60 to < 80 and from 80 or over) showed a downward trend. As of June 2021, with widespread vaccination, a drop in hospitalizations was observed in > 60 years old. At 20 to <40 and 40 to < 60, an increase in hospitalizations was observed. It demonstrates the important role of vaccination in combating the COVID-19 pandemic.


Тема - темы
COVID-19 , Aged , Aged, 80 and over , Brazil/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Hospitalization , Humans , Middle Aged , Pandemics , Tertiary Care Centers , Vaccination
9.
PLoS One ; 17(11): e0277340, 2022.
Статья в английский | MEDLINE | ID: covidwho-2109331

Реферат

Due to the high prevalence of patients attending with urinary tract infection (UTI) symptoms, the use of flow-cytometry as a rapid screening tool to avoid unnecessary cultures is becoming a widely used system in clinical practice. However, the recommended cut-points applied in flow-cytometry systems differ substantially among authors, making it difficult to obtain reliable conclusions. Here, we present FlowUTI, a shiny web-application created to establish optimal cut-off values in flow-cytometry for different UTI markers, such as bacterial or leukocyte counts, in urine from patients with UTI symptoms. This application provides a user-friendly graphical interface to perform robust statistical analysis without a specific training. Two datasets are analyzed in this manuscript: one composed of 204 urine samples from neonates and infants (≤3 months old) attended in the emergency department with suspected UTI; and the second dataset including 1174 urines samples from an elderly population attended at the primary care level. The source code is available on GitHub (https://github.com/GuillermoMG-HUVR/Microbiology-applications/tree/FlowUTI/FlowUTI). The web application can be executed locally from the R console. Alternatively, it can be freely accessed at https://covidiario.shinyapps.io/flowuti/. FlowUTI provides an easy-to-use environment for evaluating the efficiency of the urinary screening process with flow-cytometry, reducing the computational burden associated with this kind of analysis.


Тема - темы
Urinary Tract Infections , Aged , Infant , Infant, Newborn , Humans , Flow Cytometry , Urinary Tract Infections/microbiology , Urinalysis , Leukocyte Count , Software
10.
PLoS One ; 17(11): e0277247, 2022.
Статья в английский | MEDLINE | ID: covidwho-2109329

Реферат

AIMS: Worldwide, loneliness is one of the most common psychological phenomena among older adults, adversely affecting their physical and mental health conditions during the COVID-19 pandemic. This study aims to assess changes in the prevalence of loneliness in the two timeframes (first and second waves of COVID-19 in Bangladesh) and identify its correlates in pooled data. METHODS: This repeated cross-sectional study was conducted on two successive occasions (October 2020 and September 2021), overlapping with the first and second waves of the COVID-19 pandemic in Bangladesh. The survey was conducted remotely through telephone interviews among 2077 (1032 in the 2020-survey and 1045 in the 2021-survey) older Bangladeshi adults aged 60 years and above. Loneliness was measured using the 3-item UCLA Loneliness scale. The binary logistic regression model was used to identify the factors associated with loneliness in pooled data. RESULTS: We found a decline in the loneliness prevalence among the participants in two survey rounds (51.5% in 2021 versus 45.7% in 2020; P = 0.008), corresponding to 33% lower odds in the 2021-survey (AOR 0.67, 95% CI 0.54-0.84). Still, nearly half of the participants were found to be lonely in the latest survey. We also found that, compared to their respective counterparts, the odds of loneliness were significantly higher among the participants without a partner (AOR 1.58, 95% CI 1.20-2.08), with a monthly family income less than 5000 BDT (AOR 2.34, 95% CI 1.58-3.47), who lived alone (AOR 2.17, 95% CI 1.34-3.51), with poor memory or concentration (AOR 1.58, 95% CI 1.23-2.03), and suffering from non-communicable chronic conditions (AOR 1.55, 95% CI 1.23-1.95). Various COVID-19-related characteristics, such as concern about COVID-19 (AOR 1.28, 95% CI 0.94-1.73), overwhelm by COVID-19 (AOR 1.53, 95% CI 1.14-2.06), difficulty earning (AOR 2.00, 95% CI 1.54-2.59), and receiving routine medical care during COVID-19 (AOR 2.08, 95% CI 1.61-2.68), and perception that the participants required additional care during the pandemic (AOR 2.93, 95% CI 2.27-3.79) were also associated with significantly higher odds of loneliness. However, the odds of loneliness were significantly lower among the participants with formal schooling (AOR 0.71, 95% CI 0.57-0.89) and with a family of more than four members (AOR 0.76, 95% CI 0.60-0.96). CONCLUSIONS: The current study found a decreased prevalence of loneliness among Bangladeshi older adults during the ongoing pandemic. However, the prevalence is still very high. The findings suggest the need for mental health interventions that may include improving social interactions increasing opportunities for meaningful social connections with family and community members and providing psychosocial support to the vulnerable population including older adults during the pandemic. It also suggests that policymakers and public health practitioners should emphasise providing mental health services at the peripheral level where the majority of older adults reside.


Тема - темы
COVID-19 , Humans , Aged , COVID-19/epidemiology , Loneliness/psychology , Pandemics , Prevalence , Cross-Sectional Studies
11.
Environ Health Prev Med ; 27: 45, 2022.
Статья в английский | MEDLINE | ID: covidwho-2109258

Реферат

BACKGROUND: People's preventive behavior is crucial for reducing the infection and transmission of a novel coronavirus, especially in aging societies. Moreover, since behavioral restrictions may lead to high risks of secondary health impacts among older people, health-promoting behaviors, including proper nutrition intake and regular exercise, should also be encouraged. Although various studies have reported the positive association between social participation and health among older people, whether their social participation relates to preventive and health-promoting behaviors during the COVID-19 pandemic was uncertain. This study examined the relationships between social participation before the COVID-19 pandemic and preventive and health-promoting behaviors during the pandemic among older people in Japan. METHODS: We obtained longitudinal data from the Japan Gerontological Evaluation Study (JAGES), which conducted baseline and follow-up surveys from November 2019 to January 2020 (pre-pandemic) and from November 2020 to February 2021 (during the pandemic) in ten municipalities. In total, 10,523 responses were analyzed. Preventive and health-promoting behaviors were measured by nine actions (e.g., wash/disinfect hands, wear masks, do exercise), and the total of these actions was divided into two (highly implemented ≥7 or not highly implemented <7). Social participation was assessed by nine activities (e.g., participating in volunteering, sports clubs, had paid work). Adjusted for covariates, we examined the relationships between each social participation and preventive and health-promoting behavior by the logistic regression analysis or the Poisson regression analysis. RESULTS: Older people who participated in social activities pre-pandemic showed a tendency to implement preventive and health-promoting behaviors during the pandemic. Especially, participations in "sports" and "Kayoi-no-ba" were positively related to "do exercise." Only "had paid work" was negatively related to highly implemented preventive and health-promoting behaviors. CONCLUSIONS: There were the positive relationships between social participation and preventive and health-promoting behavior. This study also indicated that older people who did not participate in social activities or had paid work before the COVID-19 pandemic may have higher risks of infection and secondary health impacts. Taking into account such old people's lifestyles as well as their workplace conditions, promoting appropriate behaviors need to be considered.


Тема - темы
COVID-19 , Pandemics , Humans , Aged , Pandemics/prevention & control , COVID-19/epidemiology , COVID-19/prevention & control , Social Participation , Longitudinal Studies , Japan/epidemiology , Surveys and Questionnaires
12.
Neurology ; 99(14): e1486-e1498, 2022 Oct 04.
Статья в английский | MEDLINE | ID: covidwho-2109249

Реферат

BACKGROUND AND OBJECTIVES: Increased anxious-depressive symptomatology is observed in the preclinical stage of Alzheimer disease (AD), which may accelerate disease progression. We investigated whether ß-amyloid, cortical thickness in medial temporal lobe structures, neuroinflammation, and sociodemographic factors were associated with greater anxious-depressive symptoms during the COVID-19 confinement. METHODS: This retrospective observational study included cognitively unimpaired older adults from the Alzheimer's and Families cohort, the majority with a family history of sporadic AD. Participants performed the Hospital Anxiety and Depression Scale (HADS) during the COVID-19 confinement. A subset had available retrospective (on average: 2.4 years before) HADS assessment, amyloid [18F] flutemetamol PET and structural MRI scans, and CSF markers of neuroinflammation (interleukin-6 [IL-6], triggering receptor expressed on myeloid cells 2, and glial fibrillary acidic protein levels). We performed multivariable linear regression models to investigate the associations of prepandemic AD-related biomarkers and sociodemographic factors with HADS scores during the confinement. We further performed an analysis of covariance to adjust by participants' prepandemic anxiety-depression levels. Finally, we explored the role of stress and lifestyle changes (sleep patterns, eating, drinking, smoking habits, and medication use) on the tested associations and performed sex-stratified analyses. RESULTS: We included 921 (254 with AD biomarkers) participants. ß-amyloid positivity (B = 3.73; 95% CI = 1.1 to 6.36; p = 0.006), caregiving (B = 1.37; 95% CI 0.24-2.5; p = 0.018), sex (women: B = 1.95; 95% CI 1.1-2.79; p < 0.001), younger age (B = -0.12; 95% CI -0.18 to -0.052; p < 0.001), and lower education (B = -0.16; 95% CI -0.28 to -0.042; p = 0.008) were associated with greater anxious-depressive symptoms during the confinement. Considering prepandemic anxiety-depression levels, we further observed an association between lower levels of CSF IL-6 (B = -5.11; 95% CI -10.1 to -0.13; p = 0.044) and greater HADS scores. The results were independent of stress-related variables and lifestyle changes. Stratified analysis revealed that the associations were mainly driven by women. DISCUSSION: Our results link AD-related pathophysiology and neuroinflammation with greater anxious-depressive symptomatology during the COVID-19-related confinement, notably in women. AD pathophysiology may increase neuropsychiatric symptomatology in response to stressors. This association may imply a worse clinical prognosis in people at risk for AD after the pandemic and thus deserves to be considered by clinicians. TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov Identifier NCT02485730.


Тема - темы
Alzheimer Disease , COVID-19 , Aged , Alzheimer Disease/metabolism , Amyloid beta-Peptides/metabolism , Anxiety , Biomarkers , Depression , Female , Glial Fibrillary Acidic Protein , Humans , Interleukin-6 , Male , Positron-Emission Tomography , Retrospective Studies , tau Proteins/metabolism
13.
Cogn Res Princ Implic ; 7(1): 84, 2022 09 06.
Статья в английский | MEDLINE | ID: covidwho-2109076

Реферат

The widespread use of face masks in the era of the Covid-19 pandemic has promoted research on their effect on the perception and recognition of faces. There is growing evidence that masks hinder the recognition of identity and expression, as well as the interpretation of speech from facial cues. It is less clear whether and in what manner masks affect the perception of age from facial cues. Recent research has emphasized the role of the upper region of the face, a part not covered by a mask, in the evaluation of age. For example, smile-related wrinkles in the region of the eyes make smiling faces appear older than neutral faces of the same individuals (the aging effect of smiling, AES). In two experiments, we tested the effect of face masks on age evaluations of neutral and smiling faces in a range of different age groups from 20 to 80 years. The results showed that smiling faces were perceived as older than neutral faces even when individuals were wearing a face mask-and there was no effect of masks on bias in age evaluations. Additional analyses showed reduced accuracy in age evaluations for smiling compared to neutral faces and for masked compared to unmasked faces. The results converge on previous studies emphasizing the importance of the upper region of the face in evaluations of age.


Тема - темы
COVID-19 , Smiling , Adult , Aged , Aged, 80 and over , COVID-19/prevention & control , Humans , Masks , Middle Aged , Pandemics , Perception , Young Adult
14.
Trials ; 23(1): 923, 2022 Nov 04.
Статья в английский | MEDLINE | ID: covidwho-2108881

Реферат

BACKGROUND: Considering the confinement recommended by the World Health Organization due to the pandemic caused by COVID-19, many community physical exercise programmes for older adults have had their activities cancelled. In this context, proposing strategies to recover the possible adverse effects of the confinement period is pertinent. The use of self-management strategies associated with regular physical activity reduces sedentary behaviour and improves physical capacity in older adults. Thus, the purpose of this study was to describe a multicomponent training programme combined with a self-management strategy protocol to mitigate the effects of interruptions in physical exercise programmes on functionality, physical capacity, mental health, body composition and quality of life in older adults. METHODS: This will be a blinded, randomized and controlled clinical trial performed in São Carlos, SP, Brazil. Eighty older adults will be divided into two groups: multicomponent training (Multi) and multicomponent training + self-management strategies (Multi+SM). The intervention will be performed over 16 weeks on three alternate days of every week, with 50-min sessions. The assessment of physical capacity will be performed before the interruption of physical exercise programmes (T0: initial assessment, March 2020), preintervention (T1: immediately after the return of the exercise programme) and postintervention (T2). The assessments of physical activity level, quality of life, mental health, functionality and body composition will be performed at T1 and T2. DISCUSSION: The results from this MC+SM protocol will allow us to contribute clinical support to evaluate the variables analysed and to guide future public health policies with the aim of minimizing the possible deleterious effects arising from the physical exercise interruption periods caused by epidemics and pandemics. TRIAL REGISTRATION: RBR-10zs97gk . Prospectively registered in Brazilian Registry of Clinical Trials (ReBEC) on 17 June 2021. Registry name: Use of self-management strategies combined with multicomponent training to mitigate the effects of social distancing due to COVID-19 on capacity, physical capacity, mental health and quality of life in older adults - A blind, randomized and controlled clinical trial.


Тема - темы
COVID-19 , Self-Management , Humans , Aged , Sedentary Behavior , Quality of Life/psychology , Pandemics/prevention & control , Self-Management/methods , Mental Health , Exercise , Exercise Therapy/methods , Body Composition , Randomized Controlled Trials as Topic
15.
BMC Med ; 20(1): 425, 2022 11 07.
Статья в английский | MEDLINE | ID: covidwho-2108771

Реферат

BACKGROUND: The COVID-19 pandemic has highlighted the importance of evidence-based clinical decision-making. Clinical management guidelines (CMGs) may help reduce morbidity and mortality by improving the quality of clinical decisions. This systematic review aims to evaluate the availability, inclusivity, and quality of pandemic influenza CMGs, to identify gaps that can be addressed to strengthen pandemic preparedness in this area. METHODS: Ovid Medline, Ovid Embase, TRIP (Turning Research Into Practice), and Guideline Central were searched systematically from January 2008 to 23rd June 2022, complemented by a grey literature search till 16th June 2022. Pandemic influenza CMGs including supportive care or empirical treatment recommendations were included. Two reviewers independently extracted data from the included studies and assessed their quality using AGREE II (Appraisal of Guidelines for Research & Evaluation). The findings are presented narratively. RESULTS: Forty-eight CMGs were included. They were produced in high- (42%, 20/48), upper-middle- (40%, 19/48), and lower-middle (8%, 4/48) income countries, or by international organisations (10%, 5/48). Most CMGs (81%, 39/48) were over 5 years old. Guidelines included treatment recommendations for children (75%, 36/48), pregnant women (54%, 26/48), people with immunosuppression (33%, 16/48), and older adults (29%, 14/48). Many CMGs were of low quality (median overall score: 3 out of 7 (range 1-7). All recommended oseltamivir; recommendations for other neuraminidase inhibitors and supportive care were limited and at times contradictory. Only 56% (27/48) and 27% (13/48) addressed oxygen and fluid therapy, respectively. CONCLUSIONS: Our data highlights the limited availability of up-to-date pandemic influenza CMGs globally. Of those identified, many were limited in scope and quality and several lacked recommendations for specific at-risk populations. Recommendations on supportive care, the mainstay of treatment, were limited and heterogeneous. The most recent guideline highlighted that the evidence-base to support antiviral treatment recommendations is still limited. There is an urgent need for trials into treatment and supportive care strategies including for different risk populations. New evidence should be incorporated into globally accessible guidelines, to benefit patient outcomes. A 'living guideline' framework is recommended and further research into guideline implementation in different resourced settings, particularly low- and middle-income countries.


Тема - темы
COVID-19 , Influenza, Human , Child , Female , Humans , Pregnancy , Aged , Child, Preschool , Pandemics , Influenza, Human/drug therapy , Influenza, Human/epidemiology , Oseltamivir , Antiviral Agents/therapeutic use
16.
BMC Oral Health ; 22(1): 475, 2022 11 08.
Статья в английский | MEDLINE | ID: covidwho-2108765

Реферат

BACKGROUND: To evaluate the relationship between pandemic events and dental emergency service frequentation. Utilization patterns in the scope of the COVID-19 pandemic were analyzed and considered in regard of seasonal parameters. METHODS: All outpatients seeking treatment in a university hospital's dental emergency service were analyzed in the years 2019, 2019 and 2020 according to demographic data and emergencies were subdivided into "absolute" and "relative". The years 2018 and 2019 were used to compare COVID-19 and non-COVID-19 phases. Defined waves of the pandemic were compared with equivalent prior-year periods. RESULTS: Our study includes 11,219 dental emergency patients over a period of three years with a slight surplus of male patients. Comparing the pre-COVID-19 years and 2020 as a year of pandemic, the total count of cases decreased by more than 25%. The share of absolute emergencies in 2020 was higher than in the years before (p < 0.0001). The under-utilization during the waves was more pronounced during the first wave compared to the second waves. CONCLUSIONS: Additionally to the clear decrease by more than 25% in 2020, we found an inverse dependency of 7-day-incidence of COVID-19 and number of visits. This effect was more distinct for relative emergencies, while the number of patients with absolute emergencies remains rather constant. Probably, there is an acclimatization effect regarding the waves. Patients older than 60 years who suffered from relative emergencies showed an under-utilzation during 2020. During a pandemic such as COVID-19, the effect of under-utilization is more pronounced among elderly patients. However, a pandemic acclimatization effect seems to occur. This can be taken into account in the administration of this kind of circumstances in the future.


Тема - темы
COVID-19 , Pandemics , Humans , Male , Aged , COVID-19/epidemiology , Emergencies , SARS-CoV-2 , Seasons , Emergency Service, Hospital , Retrospective Studies
17.
BMC Public Health ; 22(1): 2017, 2022 11 04.
Статья в английский | MEDLINE | ID: covidwho-2108757

Реферат

BACKGROUND: The COVID-19 pandemic continues to generate an unprecedented impact on all aspects of everyday life across the world. However, those with historically and currently marginalized identities (i.e., gender or ethnicity) who already experience a wide range of structural inequities have been disproportionally impacted. LTNB are a particularly at-risk population as they lie at the intersection of race/ethnicity, gender identity, language, migration status, geographical location, among others, which could further increase their COVID-19 and other health-related risks and disparities. The objective of this study was to examine the impact of key social determinants of health (i.e., gender identity, country, health insurance, employment) among a sample of LTNB individuals. METHODS: The team implemented a cross-sectional exploratory design with an online survey technique using the secure web platforms REDcap and SurveyMonkey. A total of 133 participants completed the online survey. Most of the sample self-identified as transwomen (38.8%), transmen (26.3%), and non-binary (21.8%) between the ages of 21 to 72. All participants were Latinx living in either Puerto Rico (47.7%) or mainland United States (52.3%). Descriptive statistics, reliability tests, Mann-Whitney and rapid thematic analysis test were conducted. RESULTS: Findings show that most participants were always (38.1%) or almost always (33.3%) worried about contracting COVID-19. Individuals living in Puerto Rico reported more difficulties than those residing in the mainland US regarding COVID-19 impact on psychosocial, emotional, and COVID-related thinking. Most participants' answers for the COVID-19 open-ended questions focused on three main domains: income, access to trans-affirmative health care, and coping strategies. DISCUSSION: Findings evidence that although most of LTNB participants were negatively impacted by the COVID-19 pandemic in multiple aspects of their lives, those living in Puerto Rico experienced these differently when compared to those in mainland US. More research is needed to understand better the mechanisms and pathways through which this context specifically impacts LTNB health and wellbeing, particularly in Puerto Rico. This study could help shape the public health response taking into account the geographical location and other intersectional identities that play critical roles in the production and reproduction of inequities.


Тема - темы
COVID-19 , Transgender Persons , United States/epidemiology , Humans , Female , Male , Young Adult , Adult , Middle Aged , Aged , Puerto Rico/epidemiology , COVID-19/epidemiology , Cross-Sectional Studies , Pandemics , Reproducibility of Results , Gender Identity
18.
BMC Infect Dis ; 22(1): 818, 2022 Nov 07.
Статья в английский | MEDLINE | ID: covidwho-2108748

Реферат

BACKGROUND: Neutralizing monoclonal antibodies (mAbs) are highly effective in reducing hospitalization and mortality among early symptomatic COVID-19 patients in clinical trials and real-world data. While resistance to some mAbs has since emerged among new variants, characteristics associated with treatment failure of mAbs remain unknown. METHODS: This multicenter, observational cohort study included patients with COVID-19 who received mAb treatment between November 20, 2020, and December 9, 2021. We utilized electronic health records from a statewide health system plus state-level vaccine and mortality data. The primary outcome was mAb treatment failure, defined as hospitalization or death within 28 days of a positive SARS-CoV-2 test. RESULTS: COVID-19 mAb was administered to 7406 patients. Hospitalization within 28 days of positive SARS-CoV-2 test occurred in 258 (3.5%) of all patients who received mAb treatment. Ten patients (0.1%) died within 28 days, and all but one were hospitalized prior to death. Characteristics associated with treatment failure included having two or more comorbidities excluding obesity and immunocompromised status (adjusted odds ratio [OR] 3.71, 95% confidence interval [CI] 2.52-5.56), lack of SARS-CoV-2 vaccination (OR 2.73, 95% CI 2.01-3.77), non-Hispanic black race/ethnicity (OR 2.21, 95% CI 1.20-3.82), obesity (OR 1.79, 95% CI 1.36-2.34), one comorbidity (OR 1.68, 95% CI 1.11-2.57), age ≥ 65 years (OR 1.62, 95% CI 1.13-2.35), and male sex (OR 1.56, 95% CI 1.21-2.02). Immunocompromised status (none, mild, or moderate/severe), pandemic phase, and type of mAb received were not associated with treatment failure (all p > 0.05). CONCLUSIONS: Comorbidities, lack of prior SARS-CoV-2 vaccination, non-Hispanic black race/ethnicity, obesity, age ≥ 65 years, and male sex are associated with treatment failure of mAbs.


Тема - темы
COVID-19 , Humans , Male , Aged , SARS-CoV-2 , Antibodies, Neutralizing , Outpatients , COVID-19 Vaccines , Hospitalization , Obesity , Treatment Failure , Antibodies, Monoclonal/therapeutic use
19.
BMC Infect Dis ; 22(1): 816, 2022 Nov 05.
Статья в английский | MEDLINE | ID: covidwho-2108747

Реферат

BACKGROUND: The elderly are highly vulnerable to severe COVID-19. Waning immunity and emergence of Omicron have caused concerns about reduced effectiveness of COVID-19 vaccines. The objective was to estimate vaccine effectiveness (VE) against severe COVID-19 among the elderly. METHODS: This nationwide, register-based cohort analysis included all residents aged 70 years and over in Finland. The follow-up started on December 27, 2020, and ended on March 31, 2022. The outcomes of interest were COVID-19-related hospitalization and intensive care unit (ICU) admission timely associated with SARS-CoV-2 infection. VE was estimated as one minus the hazard ratio comparing the vaccinated and unvaccinated and taking into account time since vaccination. Omicron-specific VE was evaluated as the effectiveness observed since January 1, 2022. RESULTS: The cohort included 896,220 individuals. Comirnaty (BioNTech/Pfizer) VE against COVID-19-related hospitalization was 93% (95% CI 89-95%) and 85% (95% CI 82-87%) 14-90 and 91-180 days after the second dose; VE increased to 95% (95% CI 94-96%) 14-60 days after the third dose. VE of other homologous and heterologous three dose series was similar. Protection against severe COVID-19 requiring ICU treatment was even better. Since January 1, 2022, Comirnaty VE was 98% (95% CI 92-99%) and 92% (95% CI 87-95%) 14-90 and 91-180 days after the second and 98% (95% CI 95-99%) 14-60 days after the third dose. CONCLUSIONS: VE against severe COVID-19 is high among the elderly. It waned slightly after two doses, but a third restored the protection. VE against severe COVID-19 remained high even after the emergence of Omicron.


Тема - темы
COVID-19 , Aged , Humans , Aged, 80 and over , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Finland/epidemiology , Vaccine Efficacy , SARS-CoV-2
20.
J Int Med Res ; 50(11): 3000605221133147, 2022 Nov.
Статья в английский | MEDLINE | ID: covidwho-2108537

Реферат

OBJECTIVE: The primary goals of this research were to analyze the relationship between ABO blood types and the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and investigate the effect of vaccination in Iraq. METHODS: Data and outcomes were gathered from the medical records of 200 patients. Patients were categorized by blood group and vaccination status in the analysis. RESULTS: In total, 200 hospitalized patients (125 men and 75 women) with confirmed SARS-CoV-2 infection and blood group (ABO) and clinical data were enrolled. Of the 200 patients, 155 (77.5%) were vaccinated against SARS-CoV-2. The results illustrated that 25 patients died, which might have been attributable to a lack of vaccination or older age. Our analysis revealed that blood group O individuals were much less likely to be infected by SARS-CoV-2 than non-O subjects, whereas blood group A individuals carried a higher risk of infection. CONCLUSIONS: Our findings illustrated that immunization significantly reduces COVID-19 risk across all age groups, but there has been an increase in the number of cases because of decreased vaccine efficacy in older patients and persons with comorbidities. However, 45% vaccination coverage lowered the outbreak's peak.


Тема - темы
COVID-19 , SARS-CoV-2 , Male , Humans , Female , Aged , ABO Blood-Group System , COVID-19/epidemiology , Iraq/epidemiology , Vaccination
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