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1.
Vaccine ; 40(45): 6512-6519, 2022 Oct 26.
Статья в английский | MEDLINE | ID: covidwho-2106121

Реферат

BACKGROUND: Studies have reported evidence about the effectiveness of a third dose with BNT162b2 for preventing hospitalization and death by COVID-19. However, there is little evidence regarding other primary vaccine schedules such as BBIBP-CorV and ChAdOx1-S. We estimated the relative vaccine effectiveness (RVE) of the booster dose versus the primary regimens of COVID-19 vaccines based on BBIBP-CorV, ChAdOx1-S, or BNT162b2 for preventing death during the Omicron wave in Peruvian adult people. METHODS: We carried out a nested case-control study with a risk set sampling of controls using data from Peru between December 20, 2021, and February 20, 2022 (during the Omicron wave). Data on vaccination, COVID-19 tests and deaths were collected from national surveillance databases. We performed conditional logistic regression models to estimate the RVE on the adult population. In addition, we executed sub-group analysis per age group (18 to 59 years, and 60 years or more) and per primary regime (based on BNT162b2, BBIBP-CorV, or ChAdOx1-S). RESULTS: Of the 11,188,332 people eligible to enter the study 1,974 met the case definition (death from COVID-19) and were matched to 9,183 controls. The overall RVE of a third dose to prevent death was 87.2% (84.2%-89.7%), which varied according to the primary regime (87.3% for BNT162b2, 82.0% for BBIPB-CorV-2, and 79.5% for ChAdOx-S). In older adults, the RVE was 87.1%, without significant variations according to the primary regime (86.1% for BNT162b2, 86.1 for BBIBP-CorV, and 82% for ChAdOx-S). CONCLUSIONS: The booster) dose of vaccine against COVID-19 had a high RVE for preventing death by COVID-19 in the Peruvian population in all primary regimes of vaccines during the Omicron wave. This effect was consistent in people over 60 years of age, the group most vulnerable to die from this infection.


Тема - темы
COVID-19 , Influenza Vaccines , Influenza, Human , Humans , Middle Aged , Aged , Adolescent , Young Adult , Adult , COVID-19 Vaccines , BNT162 Vaccine , Peru/epidemiology , Case-Control Studies , COVID-19/prevention & control , Vaccine Efficacy , Influenza, Human/prevention & control
2.
Psychiatr Danub ; 32(3-4): 491-498, 2020.
Статья в английский | MEDLINE | ID: covidwho-2100770

Реферат

BACKGROUND: Individuals with certain pre-existing chronic health conditions have been identified as a high-risk group for fatalities of COVID-19. Therefore, it is likely that individuals with chronic diseases may worry during this pandemic to the detriment of their mental health. This study compares the mental health of Bangladeshi adults affected by chronic disease to a healthy, matched control group during the COVID-19 pandemic. SUBJECTS AND METHODS: A matched case-control analysis was performed with data collected from 395 respondents with chronic diseases and 395 controls matched for age, gender, and residence. Inclusion criteria for cases were respondents who self-reported having asthma, cardiovascular disease symptoms and/or diabetes. Respondents were recruited using an online survey, which included the DASS-21 measure to assess symptoms of stress, anxiety, and depression. Chi-square test, t-test, Fisher's exact test and a conditional logistic regression were performed to examine associations among variables. RESULTS: The prevalence of anxiety symptoms and depression symptoms and the level of stress were significantly higher among cases (59%; 71.6%; 73.7%, respectively) than among controls (25.6%; 31.1%; 43.3%, respectively). Chi-square and t-test showed significant associations and differences between having chronic diseases and mental health outcomes. A conditional logistic regression showed that respondents with asthma, diabetes, cardiovascular disease symptoms, or any combination of these diseases had higher odds of exhibiting symptoms of stress, anxiety, and depression than healthy individuals. CONCLUSION: These results underscore a subpopulation vulnerable to mental health consequences during this pandemic and indicate the need for additional mental health resources to be available to those with chronic diseases.


Тема - темы
COVID-19 , Adult , Anxiety , Case-Control Studies , Chronic Disease , Comorbidity , Depression , Humans , Outcome Assessment, Health Care , Pandemics , SARS-CoV-2
3.
Acta Med Acad ; 51(2): 134-146, 2022 Aug.
Статья в английский | MEDLINE | ID: covidwho-2093996

Реферат

Herein, we present a bird's eye view of common observational study designs utilized for measurement of vaccine effectiveness. Assessing vaccines effectiveness is an integral part of vaccine research, particularly for the newly developed vaccines. A cohort study is prospective, directing from an exposure to one or more outcomes. The design is the best method to ascertain the attack rate of an infectious disease. A traditional case-control study is retrospective, directing from a given outcome to one or more exposures. The design cannot provide the relative risk, but it can provide the odds ratio, which is a good estimation of the relative risk when the attack rate is low. Critically depending on laboratory test results and performance, the test-negative case-control study design is another type of observational study commonly used nowadays for the evaluation of the vaccine effectiveness. Comparing to cohort and traditional case-control designs, conducting a test-negative case-control study is relatively cheaper and faster. Herein, we describe each of the above-mentioned study designs through examples generated by a Monte-Carlo simulation program assuming real-world conditions. CONCLUSION: The simulation shows that regardless of the study design employed, the diagnostic test specificity is of utmost importance in providing a valid estimate of the vaccine effectiveness.


Тема - темы
Vaccine Efficacy , Vaccines , Humans , Case-Control Studies , Cohort Studies , Retrospective Studies , Prospective Studies
4.
Int J Clin Pract ; 2022: 4761631, 2022.
Статья в английский | MEDLINE | ID: covidwho-2098045

Реферат

Background: Th-17 cells, a proinflammatory subset of CD4 T lymphocytes, have been suggested as a possible cause of coronavirus disease-19 (COVID-19)-related immunological injuries. The aim of this study was to investigate the relationship between IL-17F (rs763780) polymorphism and the susceptibility to and outcomes of COVID-19 infection and to determine the clinical and laboratory predictors of COVID-19 death. Methods: This case-control study included 132 COVID-19 patients and 135 healthy age- and sex-matched controls. The participants were tested for IL-17F rs763780 polymorphism via TaqMan-based genotyping and for the expression of IL-17 by enzyme-linked immunosorbent assay. This study also investigated the predictors for COVID-19 mortality. Results: A non-statistically significant association was observed between IL-17F alleles and genotypes with COVID-19 (P=0.309, P=0.138, respectively). Moreover, no significant difference in the IL-17F genotypes was observed between non-survivors and survivors (P=0.482). In the multivariate analysis, the participants with the following characteristics had 17.7-, 11.2-, 8-, and 17.9-fold higher odds of exhibiting in-hospital mortality, respectively: (1) hypertension, (2) age of >57 years, (3) WBC count of >12.6 × 103/mm3, and (4) D-dimer of >0.9 ng/ml. The ROC curve analysis showed that IL-17 at a cutoff point of >46 pg/ml was a perfect discriminator of COVID-19 patients from control subjects (AUC = 1.0). Conclusion: The findings indicate that the IL-17F H161R variant does not influence the risk of COVID-19. However, the IL-17 level is a perfect discriminator of COVID-19 infection. Hypertension, age of >57 years, white blood cell count of >12.6 × 103/mm3, and D-dimer of >0.9 ng/ml are the independent predictors for death among COVID-19 patients.


Тема - темы
COVID-19 , Hypertension , Humans , Middle Aged , Interleukin-17/genetics , COVID-19/genetics , Genetic Predisposition to Disease , Case-Control Studies , Genotype , Polymorphism, Single Nucleotide
5.
Georgian Med News ; (328-329): 100-107, 2022.
Статья в английский | MEDLINE | ID: covidwho-2092168

Реферат

Currently, in relation to the effect of this pandemic on pregnancy, there are more questions than certainties about the real impact of COVID-19 on pregnant women. Studies are updated and often contradict each other. There is no evidence to suggest that pregnant women with COVID-19 have higher morbidity than affected non-pregnant women. We aimed to know whether maternal morbidities were more frequent in pregnant woman with COVID-19 compared to non-infected pregnant women. A retrospective case control study was conducted during a period of 6 months. Medical records were reviewed. A 120 files of COVID-19 infected women from Mosul city, and 95 files of non-infected pregnant women were reviewed and analyzed. We found that Infection with COVID-19 had a significant effect on pregnancy outcome, infected women were more likely to have higher incidence rates of adverse perinatal outcomes in both mothers and the newborns. Also, higher odds of complications associated with severe disease form Findings of our study came in line with previous studies in other countries, however, more medical care and support should be provided to pregnant women infected with COVID-19, particularly severe cases. Further studies with larger sample size are still needed for good understanding of the effect of virus on pregnancy outcomes.


Тема - темы
COVID-19 , Pregnancy Complications, Infectious , Infant, Newborn , Female , Pregnancy , Humans , Pregnancy Trimester, Third , Case-Control Studies , Retrospective Studies , Pregnancy Outcome
7.
Vaccine ; 40(48): 6979-6986, 2022 Nov 15.
Статья в английский | MEDLINE | ID: covidwho-2082297

Реферат

BACKGROUND: Test-negative design (TND) studies have produced validated estimates of vaccine effectiveness (VE) for influenza vaccine studies. However, syndrome-negative controls have been proposed for differentiating bias and true estimates in VE evaluations for COVID-19. To understand the use of alternative control groups, we compared characteristics and VE estimates of syndrome-negative and test-negative VE controls. METHODS: Adults hospitalized at 21 medical centers in 18 states March 11-August 31, 2021 were eligible for analysis. Case patients had symptomatic acute respiratory infection (ARI) and tested positive for SARS-CoV-2. Control groups were test-negative patients with ARI but negative SARS-CoV-2 testing, and syndrome-negative controls were without ARI and negative SARS-CoV-2 testing. Chi square and Wilcoxon rank sum tests were used to detect differences in baseline characteristics. VE against COVID-19 hospitalization was calculated using logistic regression comparing adjusted odds of prior mRNA vaccination between cases hospitalized with COVID-19 and each control group. RESULTS: 5811 adults (2726 cases, 1696 test-negative controls, and 1389 syndrome-negative controls) were included. Control groups differed across characteristics including age, race/ethnicity, employment, previous hospitalizations, medical conditions, and immunosuppression. However, control-group-specific VE estimates were very similar. Among immunocompetent patients aged 18-64 years, VE was 93 % (95 % CI: 90-94) using syndrome-negative controls and 91 % (95 % CI: 88-93) using test-negative controls. CONCLUSIONS: Despite demographic and clinical differences between control groups, the use of either control group produced similar VE estimates across age groups and immunosuppression status. These findings support the use of test-negative controls and increase confidence in COVID-19 VE estimates produced by test-negative design studies.


Тема - темы
COVID-19 , Influenza Vaccines , Influenza, Human , Humans , Adult , United States/epidemiology , Influenza, Human/prevention & control , COVID-19 Vaccines , SARS-CoV-2 , COVID-19/prevention & control , COVID-19 Testing , Vaccine Efficacy , Case-Control Studies , Hospitalization , Syndrome
8.
PLoS One ; 17(10): e0276384, 2022.
Статья в английский | MEDLINE | ID: covidwho-2079766

Реферат

INTRODUCTION: Real-world data on COVID-19 vaccine effectiveness are needed to validate evidence from randomized clinical trials. Accordingly, this study aims to evaluate, in a real-world setting in Brazil, the effectiveness of Pfizer-BioNTech BNT162b2 against symptomatic COVID-19 and COVID-19-related complications across diverse populations. MATERIALS AND METHODS: A test-negative case-control study with follow-up of cases is currently being conducted in Toledo, a city in southern Brazil, following a mass COVID-19 vaccination campaign with BNT162b2. The study is being conducted among patients aged 12 years or older seeking care in the public health system with acute respiratory symptoms and tested for SARS-CoV-2 on reverse transcription polymerase chain reaction (RT-PCR). Cases are RT-PCR positive and controls RT-PCR negative. Test-positive cases are prospectively followed through structured telephone interviews performed at 15 days post-enrollment, and at 1, 3, 6, 9 and 12 months. Baseline demographic, clinical, and vaccination data are being collected by means of structured interviews and medical registry records reviews at the time of enrollment. All RT-PCR-positive samples are screened for mutations to identify SARS-CoV-2 variants. ETHICS AND DISSEMINATION: The study protocol has been approved by the research ethics committee of all participant sites. Study findings will be disseminated through peer-reviewed publications and conference presentations. TRAIL REGISTRATION: Clinicatrials.gov: NCT05052307.


Тема - темы
COVID-19 , SARS-CoV-2 , Humans , BNT162 Vaccine , Brazil/epidemiology , Case-Control Studies , COVID-19/epidemiology , COVID-19 Vaccines , SARS-CoV-2/genetics , Randomized Controlled Trials as Topic
9.
PLoS One ; 17(8): e0272042, 2022.
Статья в английский | MEDLINE | ID: covidwho-2079710

Реферат

BACKGROUND: In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India. METHODS: We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model. RESULTS: Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM. CONCLUSIONS: Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.


Тема - темы
COVID-19 , Diabetes Mellitus , Hyperglycemia , Mucormycosis , Orbital Diseases , Antifungal Agents/therapeutic use , Blood Glucose , Blood Glucose Self-Monitoring , COVID-19/epidemiology , Case-Control Studies , Diabetes Mellitus/drug therapy , Diabetes Mellitus/epidemiology , Hospitalization , Humans , Hyperglycemia/complications , Hyperglycemia/drug therapy , Hyperglycemia/epidemiology , India/epidemiology , Middle Aged , Mucormycosis/drug therapy , Mucormycosis/epidemiology , Orbital Diseases/drug therapy , Pandemics
10.
BMC Med ; 20(1): 400, 2022 10 20.
Статья в английский | MEDLINE | ID: covidwho-2079421

Реферат

BACKGROUND: Limited data are available on the effectiveness of inactivated and Ad5-nCoV COVID-19 vaccines in real-world use-especially against Omicron variants in SARS-CoV-2 infection-naïve population. METHODS: A matched case-control study was conducted among people aged ≥ 3 years between 2 December 2021 and 13 May 2022. Cases were SARS-CoV-2-infected individuals, individuals with severe/critical COVID-19, or COVID-19-related deaths. Controls were selected from consecutively test-negative individuals at the same time as cases were diagnosed and were exact-matched on year-of-age, gender, birthplace, illness onset date, and residential district in ratios of 1:1 with infected individuals and 4:1 with severe/critical COVID-19 and COVID-19-related death. Additionally, two subsets were constructed to analyze separate vaccine effectiveness (VE) of inactivated vaccines (subset 1) and Ad5-vectored vaccine (subset 2) against each of the three outcomes. RESULTS: Our study included 612,597 documented SARS-CoV-2 infections, among which 1485 progressed to severe or critical illness and 568 died. Administering COVID-19 vaccines provided limited protection against SARS-CoV-2 infection across all age groups (overall VE: 16.0%, 95% CI: 15.1-17.0%) but high protection against severe/critical illness (88.6%, 85.8-90.8%) and COVID-19-related death (91.6%, 86.8-94.6%). In subset 1, inactivated vaccine showed 16.3% (15.4-17.2%) effective against infection, 88.6% (85.8-90.9%) effective against severe/critical COVIID-19, and 91.7% (86.9-94.7%) against COVID-19 death. Booster vaccination with inactivated vaccines enhanced protection against severe COVID-19 (92.7%, 90.1-94.6%) and COVID-19 death (95.9%, 91.4-98.1%). Inactivated VE against infection began to wane 12 weeks after the last dose, but two and three doses sustained high protection levels (> 80%) against severe/critical illness and death, while subset 2 showed Ad5-vectored vaccine was 13.2% (10.9-15.5%) effective against infection and 77.9% (15.6-94.2%) effective against severe/critical COVIID-19. CONCLUSIONS: Our real-world study found high and durable two- and three-dose inactivated VE against Omicron-associated severe/critical illness and death across all age groups, but lower effectiveness against Omicron infection, which reinforces the critical importance of full-series vaccination and timely booster dose administration for all eligible individuals.


Тема - темы
COVID-19 , Viral Vaccines , Humans , Antibodies, Viral , Case-Control Studies , COVID-19/prevention & control , COVID-19 Vaccines , Critical Illness , SARS-CoV-2 , Vaccines, Inactivated , Severity of Illness Index
11.
J Int Med Res ; 50(10): 3000605221129154, 2022 Oct.
Статья в английский | MEDLINE | ID: covidwho-2079248

Реферат

OBJECTIVE: To identify carbapenem-resistant Enterobacteriaceae (CRE) in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19) and to determine whether they had different risk factors for the acquisition of CRE than patients without COVID-19. METHODS: This retrospective single-centre, case-control study enrolled patients with and without COVID-19. The demographic, clinical, infection, colonization and mortality data were compared between the two groups. RESULTS: A total of 38 patients with COVID-19 and 26 patients without COVID-19 were enrolled. The majority of isolates detected in COVID-19 patients were Klebsiella spp. Leukopenia at admission (odds ratio [OR] 4.70; 95% confidence interval [CI] 1.37, 16.10), invasive mechanical ventilation (OR 5.74; 95% CI 1.07, 30.63), carbapenem treatment (OR 5.09; 95% CI 1.21, 21.27) and corticosteroid treatment (OR 7.06; 95% CI 1.53, 32.39) were independent risk factors for CRE acquisition in COVID-19 patients. Intensive care unit (ICU) mortality was significantly higher in COVID-19 patients compared with patients without COVID-19 (OR 20.62; 95% CI 5.50, 77.23). Length of ICU stay increased the risk of death in patients with COVID-19 (subdistribution hazard ratio 3.81; 95% CI 1.33, 10.92). CONCLUSION: CRE strains were more common in patients with COVID-19 and they had different risks for CRE compared with patients without COVID-19.


Тема - темы
COVID-19 , Carbapenem-Resistant Enterobacteriaceae , Enterobacteriaceae Infections , Humans , Enterobacteriaceae Infections/drug therapy , Enterobacteriaceae Infections/epidemiology , Case-Control Studies , Retrospective Studies , Anti-Bacterial Agents/therapeutic use , SARS-CoV-2 , Carbapenems/pharmacology , Carbapenems/therapeutic use , Intensive Care Units , Risk Factors
13.
Ital J Pediatr ; 47(1): 193, 2021 Sep 27.
Статья в английский | MEDLINE | ID: covidwho-2079517

Реферат

BACKGROUND: The locations where children get exposed to SARS-CoV-2 infection and their contribution in spreading the infection are still not fully understood. Aim of the article is to verify the most frequent reasons for SARS-CoV-2 infection in children and their role in the secondary transmission of the infection. METHODS: A case-control study was performed in all SARS-CoV-2 positive children (n = 81) and an equal number of age- and sex- matched controls who were referred to the S. Camillo-Forlanini Pediatric Walk-in Center of Rome. The results of all SARS-CoV-2 nasopharyngeal swabs performed in children aged < 18 years from October 16 to December 19, 2020 were analyzed. RESULTS: School contacts were more frequent in controls than in cases (OR 0.49; 95% CI: 0.3-0.9), while household contacts were higher in cases (OR 5.09; 95% CI: 2.2-12.0). In both cases and controls, school contacts were significantly less frequent, while on the contrary household contacts seemed to be more frequent in nursery school children compared to primary school or middle/high school children. A multivariate logistic regression showed that the probability of being positive to SARS-CoV-2 was significantly lower in children who had school contacts or who had flu symptoms compared to children who had household contacts. Results showed a 30.6% secondary attack rate for household contacts. CONCLUSION: In our study population, the two most frequent reasons for SARS-CoV-2 infection were school and home contacts. The risk of being positive was 5 times lower in children who had school contacts than in children who had household contacts.


Тема - темы
COVID-19/transmission , Pneumonia, Viral/transmission , Adolescent , Age Factors , Case-Control Studies , Child , Child, Preschool , Female , Humans , Incidence , Infant , Infant, Newborn , Italy , Male , Pandemics , Pneumonia, Viral/virology , SARS-CoV-2 , Surveys and Questionnaires
14.
J Occup Environ Med ; 64(9): e559-e566, 2022 09 01.
Статья в английский | MEDLINE | ID: covidwho-2077941

Реферат

OBJECTIVE: The aims of this study were to investigate occupational and non-work-related risk factors of coronavirus disease 2019 among health care workers (HCWs) in Vancouver Coastal Health, British Columbia, Canada, and to examine how HCWs described their experiences. METHODS: This was a matched case-control study using data from online and phone questionnaires with optional open-ended questions completed by HCWs who sought severe acute respiratory syndrome coronavirus 2 testing between March 2020 and March 2021. Conditional logistic regression and thematic analysis were utilized. RESULTS: Providing direct care to coronavirus disease 2019 patients during the intermediate cohort period (adjusted odds ratio, 1.90; 95% confidence interval, 1.04 to 3.46) and community exposure to a known case in the late cohort period (adjusted odds ratio, 3.595%; confidence interval, 1.86 to 6.83) were associated with higher infection odds. Suboptimal communication, mental stress, and situations perceived as unsafe were common sources of dissatisfaction. CONCLUSIONS: Varying levels of risk between occupational groups call for wider targeting of infection prevention measures. Strategies for mitigating community exposure and supporting HCW resilience are required.


Тема - темы
COVID-19 , British Columbia/epidemiology , COVID-19/epidemiology , COVID-19 Testing , Case-Control Studies , Health Personnel , Humans , Risk Factors , SARS-CoV-2
15.
Crit Care Med ; 50(11): 1638-1643, 2022 Nov 01.
Статья в английский | MEDLINE | ID: covidwho-2077907

Реферат

OBJECTIVES: Cerebrovascular injury associated with COVID-19 has been recognized, but the mechanisms remain uncertain. Acute respiratory distress syndrome (ARDS) is a severe pulmonary injury, which is associated with both ischemic and hemorrhagic stroke. It remains unclear if cerebrovascular injuries associated with severe COVID-19 are unique to COVID-19 or a consequence of severe respiratory disease or its treatment. The frequency and patterns of cerebrovascular injury on brain MRI were compared among patients with COVID-19 ARDS and non-COVID-19 ARDS. DESIGN: A case-control study. SETTING: A tertiary academic hospital system. PATIENTS: Adult patients (>18 yr) with COVID-19 ARDS (March 2020 to July 2021) and non-COVID-19 ARDS (January 2010-October 2018) who underwent brain MRI during their index hospitalization. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Cerebrovascular injury on MRI included cerebral ischemia (ischemic infarct or hypoxic ischemic brain injury) and intracranial hemorrhage (intraparenchymal, subarachnoid, or subdural, and cerebral microbleed [CMB]).Twenty-six patients with COVID-19 ARDS and sixty-six patients with non-COVID ARDS underwent brain MRI during the index hospitalization, resulting in 23 age- and sex-matched pairs. The frequency of overall cerebrovascular injury (57% vs 61%), cerebral ischemia (35% vs 43%), intracranial hemorrhage (43% vs 48%), and CMB (52% vs 41%) between COVID-19 ARDS and non-COVID-19 ARDS patients was similar (all p values >0.05). However, four of 26 patients (15%) with COVID-19 and no patients with non-COVID-19 ARDS had disseminated leukoencephalopathy with underlying CMBs, an imaging pattern that has previously been reported in patients with COVID-19. CONCLUSIONS: In a case-control study of selected ARDS patients with brain MRI, the frequencies of ischemic and hemorrhagic cerebrovascular injuries were similar between COVID-19 versus non-COVID-19 ARDS patients. However, the MRI pattern of disseminated hemorrhagic leukoencephalopathy was unique to the COVID-19 ARDS patients in this cohort.


Тема - темы
Brain Ischemia , COVID-19 , Leukoencephalopathies , Respiratory Distress Syndrome , Adult , Brain Ischemia/diagnostic imaging , Brain Ischemia/epidemiology , COVID-19/complications , Case-Control Studies , Humans , Intracranial Hemorrhages , Magnetic Resonance Imaging , Respiratory Distress Syndrome/diagnostic imaging , Respiratory Distress Syndrome/epidemiology , Respiratory Distress Syndrome/etiology
16.
JAMA Netw Open ; 5(10): e2236670, 2022 10 03.
Статья в английский | MEDLINE | ID: covidwho-2074855

Реферат

Importance: The Omicron variant is phylogenetically and antigenically distinct from earlier SARS-CoV-2 variants and the original vaccine strain. Protection conferred by prior SARS-CoV-2 infection against Omicron reinfection, with and without vaccination, requires quantification. Objective: To estimate the protection against Omicron reinfection and hospitalization conferred by prior heterologous non-Omicron SARS-CoV-2 infection and/or up to 3 doses of an ancestral, Wuhan-like messenger RNA (mRNA) vaccine. Design, Setting, and Participants: This test-negative, population-based case-control study was conducted between December 26, 2021, and March 12, 2022, and included community-dwelling individuals aged 12 years or older who were tested for SARS-CoV-2 infection in the province of Quebec, Canada. Exposures: Prior laboratory-confirmed SARS-CoV-2 infection with or without mRNA vaccination. Main Outcomes and Measures: The main outcome was laboratory-confirmed SARS-CoV-2 reinfection and associated hospitalization, presumed to be associated with the Omicron variant according to genomic surveillance. The odds of prior infection with or without vaccination were compared for case participants with Omicron infection and associated hospitalizations vs test-negative control participants. Estimated protection was derived as 1 - the odds ratio, adjusted for age, sex, testing indication, and epidemiologic week. Analyses were stratified by severity and time since last non-Omicron infection or vaccine dose. Results: This study included 696 439 individuals (224 007 case participants and 472 432 control participants); 62.2% and 63.9% were female and 87.4% and 75.5% were aged 18 to 69 years, respectively. Prior non-Omicron SARS-CoV-2 infection was detected for 9505 case participants (4.2%) and 29 712 control participants (6.3%). Among nonvaccinated individuals, prior non-Omicron infection was associated with a 44% reduction (95% CI, 38%-48%) in Omicron reinfection risk, which decreased from 66% (95% CI, 57%-73%) at 3 to 5 months to 35% (95% CI, 21%-47%) at 9 to 11 months postinfection and was below 30% thereafter. The more severe the prior infection, the greater the risk reduction. Estimated protection (95% CI) against Omicron infection was consistently significantly higher among vaccinated individuals with prior infection compared with vaccinated infection-naive individuals, with 65% (63%-67%) vs 20% (16%-24%) for 1 dose, 68% (67%-70%) vs 42% (41%-44%) for 2 doses, and 83% (81%-84%) vs 73% (72%-73%) for 3 doses. For individuals with prior infection, estimated protection (95% CI) against Omicron-associated hospitalization was 81% (66%-89%) and increased to 86% (77%-99%) with 1, 94% (91%-96%) with 2, and 97% (94%-99%) with 3 mRNA vaccine doses, without signs of waning. Conclusions and Relevance: The findings of this study suggest that vaccination with 2 or 3 mRNA vaccine doses among individuals with prior heterologous SARS-CoV-2 infection provided the greatest protection against Omicron-associated hospitalization. In the context of program goals to prevent severe outcomes and preserve health care system capacity, a third mRNA vaccine dose may add limited protection in twice-vaccinated individuals with prior SARS-CoV-2 infection.


Тема - темы
COVID-19 , Viral Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , Case-Control Studies , Female , Humans , Male , Quebec/epidemiology , RNA, Messenger , Reinfection/epidemiology , Reinfection/prevention & control , SARS-CoV-2/genetics , Vaccines, Synthetic , mRNA Vaccines
17.
Clinics (Sao Paulo) ; 77: 100130, 2022.
Статья в английский | MEDLINE | ID: covidwho-2068802

Реферат

BACKGROUND: The relationship between Multidrug Resistant-Gram Negative Bacteria (MDR-GNB) infection and colonization in critically ill COVID-19 patients has been observed, however, it is still poorly understood. This study evaluated the risk factors for acquiring MDR-GNB in patients with severe COVID-19 in Intensive Care Units (ICU). METHODS: This is a nested case-control study in a cohort of 400 adult patients (≥ 18 years old) with COVID-19, hospitalized in the ICU of 4 hospitals in the city of Curitiba, Brazil. Cases were critical COVID-19 patients with one or more MDR GNB from any surveillance and/or clinical cultures were taken during their ICU stay. Controls were patients from the same units with negative cultures for MDR-GNB. Bivariate and multivariate analyses were done. RESULTS: Sixty-seven cases and 143 controls were included. Independent risk factors for MDR bacteria were: male gender (OR = 2.6; 95% CI 1.28‒5.33; p = 0.008); the hospital of admission (OR = 3.24; 95% CI 1.39‒7.57; p = 0.006); mechanical ventilation (OR = 25.7; 95% CI 7.26‒91; p < 0.0001); and desaturation on admission (OR = 2.6; 95% CI 1.27‒5.74; p = 0.009). CONCLUSIONS: Male gender, desaturation, mechanical ventilation, and the hospital of admission were the independent factors associated with MDR-GNB in patients in the ICU with COVID-19. The only modifiable factor was the hospital of admission, where a newly opened hospital posed a higher risk. Therefore, coordinated actions toward a better quality of care for critically ill COVID-19 patients are essential.


Тема - темы
COVID-19 , Cross Infection , Gram-Negative Bacterial Infections , Adult , Humans , Male , Adolescent , Gram-Negative Bacteria , Critical Illness , Case-Control Studies , Cross Infection/drug therapy , Cross Infection/epidemiology , Cross Infection/microbiology , Drug Resistance, Multiple, Bacterial , Gram-Negative Bacterial Infections/microbiology , Risk Factors , Intensive Care Units , Anti-Bacterial Agents/pharmacology
18.
Ital J Dermatol Venerol ; 157(5): 419-423, 2022 Oct.
Статья в английский | MEDLINE | ID: covidwho-2067532

Реферат

BACKGROUND: Wearing masks is an optimal preventive strategy during COVID-19 pandemic, but it may increase facial sebum production. However, few case reports have described seborrheic dermatitis (SeBD) and psoriasis (PsO) flares due to masks. Hence, we conducted a multicenter study to clarify the possibility of increased SeBD and PsO flares in association with mask wearing during the COVID-19 pandemic. METHODS: This multicenter study enrolled patients with a diagnosis of facial SeBD and PsO. All dermatological consultations were conducted in teledermatology at baseline (T0) and after 1 month (T1) Of >6 hours/day wearing mask. PsO patients were assessed using PsO Area and Severity Index (PASI) and self-administered PASI (SAPASI), whilst SeBD patients with symptom scale of seborrheic dermatitis' (SSSD) and seborrheic dermatitis area and severity index (SEDASI). RESULTS: A total of 33 (20 males, 13 females, average age 43.61±9.86) patients with PsO and 33 (20 males, 13 females, average age 44.00±8.58) with SeBD were enrolled. After 1 month, PsO patients displayed higher values of both PASI and SAPASI (P<0.0001), while SeBD patients experienced a flare, as testified by the increment of both SSSD and SEDASI (P<0.0001). Mask type did not seem to influence the flare severity. CONCLUSIONS: Masks remain an optimal preventive strategy during COVID-19 pandemic, but patients with PsO and SeBD may experience facial flares. Thus, therapeutic approach should be more aggressive in these groups of patients to counteract the triggering effect of masks.


Тема - темы
COVID-19 , Dermatitis, Seborrheic , Psoriasis , Adult , COVID-19/epidemiology , Case-Control Studies , Dermatitis, Seborrheic/epidemiology , Female , Humans , Male , Masks/adverse effects , Middle Aged , Pandemics/prevention & control , Psoriasis/epidemiology
20.
Viruses ; 14(10)2022 09 30.
Статья в английский | MEDLINE | ID: covidwho-2066553

Реферат

Interferon gamma (IFN-γ) may be potential adjuvant immunotherapy for COVID-19 patients. In this work, we assessed gene expression profiles associated with the IFN-γ pathway in response to SARS-CoV-2 infection. Employing a case-control study from SARS-CoV-2-positive and -negative patients, we identified IFN-γ-associated pathways to be enriched in positive patients. Bioinformatics analyses showed upregulation of MAP2K6, CBL, RUNX3, STAT1, and JAK2 in COVID-19-positive vs. -negative patients. A positive correlation was observed between STAT1/JAK2, which varied alongside the patient's viral load. Expression of MX1, MX2, ISG15, and OAS1 (four well-known IFN-stimulated genes (ISGs)) displayed upregulation in COVID-19-positive vs. -negative patients. Integrative analyses showcased higher levels of ISGs, which were associated with increased viral load and STAT1/JAK2 expression. Confirmation of ISGs up-regulation was performed in vitro using the A549 lung cell line treated with Poly (I:C), a synthetic analog of viral double-stranded RNA; and in different pulmonary human cell lines and ferret tracheal biopsies infected with SARS-CoV-2. A pre-clinical murine model of Coronavirus infection confirmed findings displaying increased ISGs in the liver and lungs from infected mice. Altogether, these results demonstrate the role of IFN-γ and ISGs in response to SARS-CoV-2 infection, highlighting alternative druggable targets that can boost the host response.


Тема - темы
COVID-19 , Humans , Animals , Mice , Interferon-gamma/genetics , SARS-CoV-2 , Case-Control Studies , RNA, Double-Stranded , Ferrets , MAP Kinase Kinase 6/genetics
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