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1.
Neurocomputing ; 468: 335-344, 2022 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-34690432

RESUMO

COVID-19 was declared a global pandemic by the World Health Organisation (WHO) on 11th March 2020. Many researchers have, in the past, attempted to predict a COVID outbreak and its effect. Some have regarded time-series variables as primary factors which can affect the onset of infectious diseases like influenza and severe acute respiratory syndrome (SARS). In this study, we have used public datasets provided by the European Centre for Disease Prevention and Control for developing a prediction model for the spread of the COVID-19 outbreak to and throughout Malaysia, Morocco and Saudi Arabia. We have made use of certain effective deep learning (DL) models for this purpose. We assessed some specific major features for predicting the trend of the existing COVID-19 outbreak in these three countries. In this study, we also proposed a DL approach that includes recurrent neural network (RNN) and long short-term memory (LSTM) networks for predicting the probable numbers of COVID-19 cases. The LSTM models showed a 98.58% precision accuracy while the RNN models showed a 93.45% precision accuracy. Also, this study compared the number of coronavirus cases and the number of resulting deaths in Malaysia, Morocco and Saudi Arabia. Thereafter, we predicted the number of confirmed COVID-19 cases and deaths for a subsequent seven days. In this study, we presented their predictions using the data that was available up to December 3rd, 2020.

2.
Pers Individ Dif ; 184: 111188, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34393312

RESUMO

Today, we witness the progress toward global COVID-19 vaccinations organized by countries worldwide. Experts say a mass vaccination plan is the only effective antidote against the spread of SARS-COV-2. However, a part of the world population refuses vaccination. The present study aimed to understand the impact of some individual variables on the intention to get vaccinated. Through a serial mediation model, we tested the influence of fear of COVID-19 on the intention to get vaccinated and the serial mediating effect of existential anxiety and conspiracy beliefs. Via a cross-sectional design this research was conducted with the participation of 223 French adults (Female: 69.5%; Male: 30.5%; M age = 30.26, SD = 13.24; range: 18-75 years) who responded to an online survey. The results showed a positive relationship between fear of COVID-19 and intention to get vaccinated; however, when this fear was associated with high levels of existential anxiety through conspiracy beliefs, the intention to get vaccinated decreased. Our findings were in line with Terror Management Health Model, which states that, in facing health threats, humans may strive to reduce their own perceived vulnerability not only by engaging in healthy behaviors but also denying or avoiding death anxiety, as anti-vaxxers do.

4.
Rob Auton Syst ; 148: 103917, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34720413

RESUMO

The coronavirus disease 2019 (COVID-19) outbreak has increased mortality and morbidity world-wide. Oropharyngeal swabbing is a well-known and commonly used sampling technique for COVID-19 diagnose around the world. We developed a robot to assist with COVID-19 oropharyngeal swabbing to prevent frontline clinical staff from being infected. The robot integrates a UR5 manipulator, rigid-flexible coupling (RFC) manipulator, force-sensing and control subsystem, visual subsystem and haptic device. The robot has strength in intrinsically safe and high repeat positioning accuracy. In addition, we also achieve one-dimensional constant force control in the automatic scheme (AS). Compared with the rigid sampling robot, the developed robot can perform the oropharyngeal swabbing procedure more safely and gently, reducing risk. Alternatively, a novel robot control schemes called collaborative manipulation scheme (CMS) which combines a automatic phase and teleoperation phase is proposed. At last, comparative experiments of three schemes were conducted, including CMS, AS, and teleoperation scheme (TS). The experimental results shows that CMS obtained the highest score according to the evaluation equation. CMS has the excellent performance in quality, experience and adaption. Therefore, the proposal of CMS is meaningful which is more suitable for robot-sampling.

5.
J King Saud Univ Sci ; 34(1): 101687, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34744393

RESUMO

Objectives: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has developed a challenging situation worldwide. In India, the SARS-CoV-2 cases and deaths have markedly increased. This study aims to evaluate the impact of environmental pollutants "particulate matter (PM 2.5 µm), carbon monoxide (CO), Ozone (O3), and Nitrogen Dioxide (NO2) on daily cases and deaths due to SARS-CoV-2 infection" in Delhi, Mumbai, and Kolkata, India. Methods: The day-to-day air pollutants PM2.5, CO, O3, and NO2 were recorded from the metrological web "Real-time Air Quality Index (AQI)." SARS-COV-2 everyday cases and deaths were obtained from the "Coronavirus outbreak in India Web". The PM 2.5, CO, O3, NO2, and daily cases, deaths were documented for more than one year, from March 2, 2020, to March 15, 2021. Results: Environmental pollutants CO, O3, and NO2, were positively related to SARS-COV-2 cases and deaths. The findings further described that for each one-unit increase in CO, O3, and NO2 levels, the number of cases was significantly augmented by 0.77%, 0.45%, and 4.33%. Conclusions: Environmental pollution is a risk factor to SARS-CoV-2 daily cases and deaths. The regional and international authorities must implement the policies to reduce air pollution and the COVID-19 pandemic. The findings can inform health policymakers' verdicts about battling the COVID-19 pandemic in India and globally by minimizing environmental pollution.

6.
Philos Trans A Math Phys Eng Sci ; 380(2214): 20210122, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-34802275

RESUMO

The COVID-19 pandemic has posed unprecedented challenges to public health world-wide. To make decisions about mitigation strategies and to understand the disease dynamics, policy makers and epidemiologists must know how the disease is spreading in their communities. Here we analyse confirmed infections and deaths over multiple geographic scales to show that COVID-19's impact is highly unequal: many regions have nearly zero infections, while others are hot spots. We attribute the effect to a Reed-Hughes-like mechanism in which the disease arrives to regions at different times and grows exponentially at different rates. Faster growing regions correspond to hot spots that dominate spatially aggregated statistics, thereby skewing growth rates at larger spatial scales. Finally, we use these analyses to show that, across multiple spatial scales, the growth rate of COVID-19 has slowed down with each surge. These results demonstrate a trade-off when estimating growth rates: while spatial aggregation lowers noise, it can increase bias. Public policy and epidemic modelling should be aware of, and aim to address, this distortion. This article is part of the theme issue 'Data science approaches to infectious disease surveillance'.


Assuntos
COVID-19 , Pandemias , Viés , Humanos , SARS-CoV-2
7.
Exp Ther Med ; 23(1): 10, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34815762

RESUMO

According to the Centre for Disease Control and Prevention in 2020, a cluster of pneumonia cases of unknown etiology caused by the severe acute respiratory syndrome (SARS)-coronavirus 2 was reported in Wuhan, China. The present review examined the literature to reveal the incidence of novel coronavirus-2019 disease (COVID-19) infections, underlying comorbidities, workplace infections and case fatality rates. A review was performed to identify the relevant publications available up to May 15, 2020. Since the early stages of the COVID-19 outbreak, the case fatality rate among healthcare workers (HCWs) has stood at 0.69% worldwide and 0.4% in Italy. Based on the current information, most patients have exhibited good prognoses in terms of after-effects or sequelae and low mortality rate. Patients that became critically ill were primarily in the elderly population or had chronic underlying diseases, including diabetes and hypertension. Among all working sectors, HCWs, since they are front-line caregivers for patients with COVID-19, are considered to be in the high-risk population. Increased age and a number of comorbidity factors have been associated with increased risk of mortality in patients with COVID-19. The most frequent complications of COVID-19 reported that can cause fatality in patients were SARS, cardiac arrest, secondary infections and septic shock, in addition to acute kidney failure and liver failure. Overcoming the COVID-19 pandemic is an ongoing challenge, which poses a threat to global health that requires close surveillance and prompt diagnosis, in coordination with research efforts to understand this pathogen and develop effective countermeasures.

8.
Int J Health Serv ; 52(1): 23-29, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34672836

RESUMO

The impact of public health measures on the coronavirus-2019 pandemic was analyzed by comparing mandatory versus voluntary nonpharmaceutical interventions between 2 comparable European countries and among 3 U.S. states. Using an ecological retrospective cohort study design, we examine differences in mortality, economic impact, and equity. Compared to voluntary policies, mandatory shelter-in-place policies were associated with a 3- to 5-fold lower population-adjusted mortality in the U.S. model and between 11- to 12-fold lower in the European one. Voluntary shelter-in-place measures were associated with overall increased mortality cost, as measured by value of a statistical life; somewhat greater decreases in gross domestic product; and substantial negative impacts on minority communities, who experienced markedly increased mortality rates (the percentage of minority deaths was 2.3 and 4 times greater in the U.S. model and 14.5 times higher in the European one) and mortality cost (2.7- and 4.5-fold higher in the U.S. model and 11.1-fold higher in the European one). We conclude that voluntary policies are less effective than mandatory ones, based on historical precedent and the current analysis. Negative effects on health equity mirrored the increased mortality outcomes of voluntary policies, and there was no apparent economic benefit associated with voluntary measures.


Assuntos
Coronavirus , Equidade em Saúde , Humanos , Políticas , Saúde Pública , Estudos Retrospectivos
9.
J Public Health Manag Pract ; 28(1): 50-59, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34797241

RESUMO

CONTEXT: Coronavirus disease 2019 (COVID-19) incidence rates are 2- to 5-fold higher among persons incarcerated in the United States than in the general population. PROGRAM OR POLICY: We describe an outbreak investigation of COVID-19 at a jail (jail A) in Alameda County during March 2020-March 2021. IMPLEMENTATION: To prevent COVID-19 cases among incarcerated persons and employees, staff at jail A and the county public health department worked to develop and recommend infection control measures implemented by jail A including, but not limited to, face covering use among incarcerated persons and staff; cohorting incarcerated persons at a higher risk of severe COVID-19 in dedicated housing units; quarantining all newly detained individuals for 14 days; and offering testing for all symptomatic incarcerated persons, newly incarcerated persons at day 2 and day 10, and all persons who resided in a housing unit where a COVID-19 case was detected. EVALUATION: A total of 571 COVID-19 cases were detected among incarcerated persons at jail A during March 2020-March 2021, which represented a total incidence of 280 per 1000 population, 5 times higher than the rate in Alameda County. Of the 571 cases among incarcerated persons, 557 (98%) were male; 415 (73%) were aged 18 to 40 years; 249 (44%) were Latino; and 180 (32%) were African American; 354 (62%) were not symptomatic; and 220 (39%) had no comorbidities. Less than 2% of infected incarcerated persons were hospitalized, and no deaths were reported. DISCUSSION: COVID-19 disproportionately impacted persons incarcerated at jail A, with higher numbers among Latinos and African Americans. Implementation of COVID-19 infection control and testing measures, and collaboration between public health, law enforcement, and health care providers may have, in part, led to reductions in morbidity and mortality associated with COVID-19 at jail A.

10.
J Med Virol ; 94(1): 407-412, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34491572

RESUMO

The ChAdOx1 nCoV-19 vaccine (Oxford University-Astra Zeneca) has demonstrated nearly 70% efficacy against symptomatic COVID-19 in trials and some real-world studies. The vaccine was the first to be approved in India in early January 2021 and is manufactured by the Serum Institute of India. Favorable short-term safety data of the vaccine in India in a real-world setting has been recently demonstrated. Here, we report secondary objective (COVID-19 occurrence) measures of the same ongoing prospective observational study in prioritized recipients of the vaccine. The findings are based on participants who could complete at least 2 months of follow-up (n = 1500; female/male: 472/1028; mean age: 38.8 years). Laboratory confirmed SARS-CoV-2 infection was observed in 27/65 participants (41%) who received a single dose and 271/1435 (19%) who received both doses. Specifically, among doctors, 18/27 (66.7%) one dose recipients and 131/377 (34.7%) fully vaccinated developed SARS-CoV-2 infection. The majority of the cases were mild in all groups, and most were breakthrough infections. The occurrence of "severe" COVID-19 was 7.7 times lower (0.4%) in fully vaccinated participants compared to partially vaccinated (3.1%). Four deaths were observed in the study. One of the four deaths was due to sepsis, two due to unspecified cardiac events, and one due to unspecified post-COVID-19 complications. The results of this preliminary analysis necessitate vigorous research on the performance of vaccines against variants, optimal timing of vaccination, and also optimal timings of effectiveness studies to guide future vaccination policy.


Assuntos
Vacinas contra COVID-19/imunologia , COVID-19/prevenção & controle , Imunogenicidade da Vacina/imunologia , SARS-CoV-2/imunologia , Adulto , COVID-19/epidemiologia , COVID-19/mortalidade , Comorbidade , Feminino , Humanos , Imunização Secundária/estatística & dados numéricos , Índia/epidemiologia , Masculino , Estudos Prospectivos , Índice de Gravidade de Doença , Vacinação
11.
J Med Virol ; 94(1): 7-10, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34506635

RESUMO

Hepatitis, a significant cause of mortality worldwide, results in around 1.34 million deaths each year globally. Africa is not exempt from the plague of Hepatitis. Around 100 million estimated individuals are infected with Hepatitis B or C. Egypt has the highest prevalence of cases of Hepatitis followed by Cameroon and Burundi. The continent is severely affected by the onset of the COVID-19 pandemic, as the virus has added an additional burden on the already fragile continent. With the pandemic, it is presumable that Hepatitis like other viral diseases will pose a threat to collapsing healthcare system. Therefore, for Africa to become more resilient in the face of such menaces, including Hepatitis, further prevention policies are required to be implemented.


Assuntos
COVID-19/epidemiologia , Acesso aos Serviços de Saúde , Hepatite B Crônica/epidemiologia , Hepatite C Crônica/epidemiologia , Países em Desenvolvimento , Egito/epidemiologia , Hepacivirus/patogenicidade , Vírus da Hepatite B/patogenicidade , Hepatite B Crônica/prevenção & controle , Hepatite B Crônica/terapia , Hepatite C Crônica/prevenção & controle , Hepatite C Crônica/terapia , Humanos , Fígado/lesões , Fígado/patologia , Fígado/virologia , Prevalência , SARS-CoV-2
12.
J Intensive Care Med ; 37(1): 12-20, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34515571

RESUMO

Background: Since the beginning of the ongoing Coronavirus Disease 2019 (COVID-19) pandemic, pneumomediastinum has been reported in patients with COVID-19 pneumonia and acute respiratory distress syndrome. It has been suggested that pneumomediastinum may portend a worse outcome in such patients although no investigation has established this association definitively. Research Question: We hypothesized that the finding of pneumomediastinum in the setting of COVID-19 disease may be associated with a worse clinical outcome. The purpose of this study was to determine if the presence of pneumomediastinum was predictive of increased mortality in patients with COVID-19. Study Design and Methods: A retrospective case-control study utilizing clinical data and imaging for COVID-19 patients seen at our institution from 3/7/2020 to 5/20/2020 was performed. 87 COVID-19 positive patients with pneumomediastinum were compared to 87 COVID-19 positive patients without pneumomediastinum and to a historical group of patients with pneumomediastinum during the same time frame in 2019. Results: The incidence of pneumomediastinum was increased more than 6-fold during the COVID-19 pandemic compared to 2019 (P = <.001). 1.5% of all COVID-19 patients and 11% of mechanically ventilated COVID-19 patients at our institution developed pneumomediastinum. Patients who developed pneumomediastinum had a significantly higher PEEP and lower P/F ratio than those who did not (P = .002 and .033, respectively). Pneumomediastinum was not found to be associated with increased mortality (P = .16, confidence interval [CI]: 0.89-2.09, 1.37). The presence of concurrent pneumothorax at the time of pneumomediastinum diagnosis was associated with increased mortality (P = .013 CI: 1.15-3.17, 1.91). Conclusion: Pneumomediastinum is not independently associated with a worse clinical prognosis in COVID-19 positive patients. The presence of concurrent pneumothorax was associated with increased mortality.


Assuntos
COVID-19 , Enfisema Mediastínico , Estudos de Casos e Controles , Humanos , Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/epidemiologia , Enfisema Mediastínico/etiologia , Pandemias , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
13.
J Med Virol ; 94(1): 318-326, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34516010

RESUMO

When hospitals first encountered coronavirus disease 2019 (COVID-19), there was a dearth of therapeutic options and nearly 1 in 3 patients died from the disease. By the summer of 2020, as deaths from the disease declined nationally, multiple single-center studies began to report declining mortality of patients with COVID-19. To evaluate the effect of COVID-19 on hospital-based mortality, we searched the Vizient Clinical Data Base for outcomes data from approximately 600 participating hospitals, including 130 academic medical centers, from January 2017 through December 2020. More than 32 million hospital admissions were included in the analysis. After an initial spike, mortality from COVID-19 declined in all regions of the country to under 10% by June 2020 and remained constant for the remainder of the year. Despite this, inpatient, all-cause mortality has increased since the beginning of the pandemic, even those without respiratory failure. Inpatient mortality has particularly increased in elderly patients and in those requiring intubation for respiratory failure. Since June 2020, COVID-19 kills one in every 10 patients admitted to the hospital with this diagnosis. The addition of this new disease has raised overall hospital mortality especially those who require intubation for respiratory failure.


Assuntos
COVID-19/mortalidade , Mortalidade Hospitalar/tendências , Insuficiência Respiratória/mortalidade , Hospitalização/estatística & dados numéricos , Humanos , Pacientes Internados/estatística & dados numéricos , Intubação/estatística & dados numéricos , Respiração Artificial/mortalidade , SARS-CoV-2
14.
J Med Virol ; 94(1): 349-356, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34542192

RESUMO

Corticosteroid dosing in the range of 0.5-2 mg/kg/day of methylprednisolone equivalents has become a standard part of the management of intensive care unit (ICU) patients with COVID-19 pneumonia based on positive results of randomized trials and a meta-analysis. Alongside such conventional dosing, administration of 1 gm of methylprednisolone daily (pulse dosing) has also been reported in the literature with claims of favorable outcomes. Comparisons between such disparate approaches to corticosteroids for Coronavirus disease 2019 (COVID-19) pneumonia are lacking. In this retrospective study of patients admitted to the ICU with COVID-19 pneumonia, we compared patients treated with 0.5-2 mg/kg/day in methylprednisolone equivalents (high-dose corticosteroids) and patients treated with 1 gm of methylprednisolone (pulse-dose corticosteroids) to those who did not receive any corticosteroids. The endpoints of interest were hospital mortality, ICU-free days at Day 28, and complications potentially attributable to corticosteroids. Pulse-dose corticosteroid therapy was associated with a significant increase in ICU-free days at Day 28 compared to no receipt: adjusted relative risk (aRR): 1.45 (95% confidence interval [CI]: 1.05-2.02; p = 0.03) and compared with high-dose corticosteroid administration (p = 0.003). Nonetheless, receipt of high-dose corticosteroids-but not of pulse-dose corticosteroids-significantly reduced the odds of hospital mortality compared to no receipt: adjusted Odds ratio (aOR) 0.31 (95% CI: 0.12-0.77; p = 0.01). High-dose corticosteroids reduced mortality compared to pulse-dose corticosteroids (p = 0.04). Pulse-dose corticosteroids-but not high-dose corticosteroids-significantly increased the odds of acute kidney injury requiring renal replacement therapy compared to no receipt: aOR 3.53 (95% CI: 1.27-9.82; p = 0.02). The odds of this complication were also significantly higher in the pulse-dose group when compared to the high-dose group (p = 0.05 for the comparison). In this single-center study, pulse-dose corticosteroid therapy for COVID-19 pneumonia in the ICU was associated with an increase in ICU-free days but failed to impact hospital mortality, perhaps because of its association with development of severe renal failure. In line with existing trial data, the effect of high-dose corticosteroids on mortality was favorable.


Assuntos
Injúria Renal Aguda/induzido quimicamente , Corticosteroides/uso terapêutico , COVID-19/tratamento farmacológico , COVID-19/mortalidade , Metilprednisolona/uso terapêutico , Pulsoterapia/efeitos adversos , Injúria Renal Aguda/epidemiologia , Corticosteroides/administração & dosagem , Corticosteroides/efeitos adversos , Cuidados Críticos/métodos , Mortalidade Hospitalar , Humanos , Metilprednisolona/administração & dosagem , Metilprednisolona/efeitos adversos , Pulsoterapia/métodos , Estudos Retrospectivos , SARS-CoV-2/efeitos dos fármacos
15.
J Med Virol ; 94(1): 372-379, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34559436

RESUMO

Coronavirus disease 2019 (COVID-19) is characterized by dysregulated hyperimmune response and steroids have been shown to decrease mortality. However, whether higher dosing of steroids results in better outcomes has been debated. This was a retrospective observation of COVID-19 admissions between March 1, 2020, and March 10, 2021. Adult patients (≥18 years) who received more than 10 mg daily methylprednisolone equivalent dosing (MED) within the first 14 days were included. We excluded patients who were discharged or died within 7 days of admission. We compared the standard dose of steroids (<40 mg MED) versus the high dose of steroids (>40 mg MED). Inverse probability weighted regression adjustment (IPWRA) was used to examine whether higher dose steroids resulted in improved outcomes. The outcomes studied were in-hospital mortality, rate of acute kidney injury (AKI) requiring hemodialysis, invasive mechanical ventilation (IMV), hospital-associated infections (HAI), and readmissions. Of the 1379 patients meeting study criteria, 506 received less than 40 mg of MED (median dose 30 mg MED) and 873 received more than or equal to 40 mg of MED (median dose 78 mg MED). Unadjusted in-hospital mortality was higher in patients who received high-dose corticosteroids (40.7% vs. 18.6%, p < 0.001). On IPWRA, the use of high-dose corticosteroids was associated with higher odds of death (odds ratio [OR] 2.14; 95% confidence interval [CI] 1.45-3.14, p < 0.001) but not with the development of HAI, readmissions, or requirement of IMV. High-dose corticosteroids were associated with lower rates of AKI requiring hemodialysis (OR 0.33; 95% CI 0.18-0.63). In COVID-19, corticosteroids more than or equal to 40 mg MED were associated with higher in-hospital mortality.


Assuntos
Injúria Renal Aguda/epidemiologia , Corticosteroides/uso terapêutico , COVID-19/tratamento farmacológico , COVID-19/mortalidade , Metilprednisolona/uso terapêutico , Corticosteroides/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Infecção Hospitalar/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Respiração Artificial/estatística & dados numéricos , Estudos Retrospectivos , SARS-CoV-2/efeitos dos fármacos
16.
Environ Pollut ; 292(Pt A): 118224, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34600065

RESUMO

The consequence of the lockdowns implemented to address the COVID-19 pandemic on human health damage due to air pollution and other environmental issues must be better understood. This paper analyses the effect of reducing energy demand on the evolution of environmental impacts during the occurrence of 2020-lockdown periods in Italy, with a specific focus on life expectancy. An energy metabolism analysis is conducted based on the life cycle assessment (LCA) of all monthly energy consumptions, by sector, category and province area in Italy between January 2015 to December 2020. Results show a general decrease (by ∼5% on average) of the LCA midpoint impact categories (global warming, stratospheric ozone depletion, fine particulate matter formation, etc.) over the entire year 2020 when compared to past years. These avoided impacts, mainly due to reductions in fossil energy consumptions, are meaningful during the first lockdown phase between March and May 2020 (by ∼21% on average). Regarding the LCA endpoint damage on human health, ∼66 Disability Adjusted Life Years (DALYs) per 100,000 inhabitants are estimated to be saved. The analysis shows that the magnitude of the officially recorded casualties is substantially larger than the estimated gains in human lives due to the environmental impact reductions. Future research could therefore investigate the complex cause-effect relationships between the deaths occurred in 2020 imputed to COVID-19 disease and co-factors other than the SARS-CoV-2 virus.

17.
Environ Res ; 203: 111678, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34280421

RESUMO

The Coronavirus Disease 2019 (COVID-19) continues to generate a constant pandemic threat with new mutations of the viral agent (SARS-CoV-2) that create socioeconomic issues. One of the fundamental problems is the evaluation of the preparedness of countries to cope with COVID-19 pandemic crisis to detect and support factors associated with the reduction of mortality and the growth of vaccinations in society. The study here confronts this problem by developing two basic indexes, which measure the performance of countries to face pandemic threats. In particular, the Index r (as resilience) detects the countries having the best performance in the reduction of the negative impact of mortality related to COVID-19 pandemic and the Index p (as preparedness and prevention) assesses best-performer countries to support COVID-19 vaccinations in order to constrain future pandemic threats and support the recovery of socioeconomic systems. Index of resilience is a composite measure based on three indicators associated with COVID-19, given by average mortality, hospital occupancy and Intensive Care Units occupancy per 100 000 people, producing an overall score; Index of preparedness/prevention is a composite measure of two indicators related to COVID-19 vaccinations (i.e., doses of vaccines administered and total vaccinates per 100 000 people), producing also an overall score of performance. The application of these indexes on a case study of European countries, having a homogenous socioeconomic area, shows the strategic positioning of countries to cope with a major pandemic threat. Findings reveal that all countries have some weaknesses and no country has a high preparedness to cope with a major epidemic or pandemic. Moreover, results suggest that best-performer countries to cope with COVID-19 pandemic crisis have a smaller size of population and/or better public governance, associated with high expenditures in health system. These indexes can help policymakers for designing effective strategies to improve preparedness and prevention of countries to face future pandemic threats.

18.
J Palliat Care ; 37(1): 3-7, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34397284

RESUMO

With coronavirus disease 2019, the risk of death has increased in the general population. In these unprecedented times and even otherwise, it is important for the health care professionals caring for Hindu patients to be aware of the end of life practices in Hinduism. There is limited information in the medical literature about traditions and practices followed in Hinduism which is observed by 15% of the world population. Hinduism is currently the third largest religion following Christianity and Islam. Based on Hindu beliefs about life, death, and reincarnation, we propose 10 end of life best practices for Hindu patients.

19.
J Palliat Care ; 37(1): 18-25, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34402330

RESUMO

BACKGROUND: End-of-life care has become an important public health issue in recent years. Place of death is a major component of end-of-life care. Despite attempts to improve end-of-life care, there has not been published any data about place of deaths in Turkey. Aim: This retrospective, cross-sectional study investigates the place of death and trends over the years in geriatric age groups in Turkey. Methods: Patients who were admitted to geriatric outpatient clinic of a university hospital during a 7-year period were included. Place and date of death information were received from the death notification system and recorded as hospital or out-of-hospital death. Demographic and clinical data were collected from the hospital information system. Deaths occurring after March 1, 2020 were not included to eliminate the effect of coronavirus disease-2019 pandemic. Results: A total of 4025 (20.7%) patients were determined to be dead. Approximately three-quarters of deaths (73.0%) occurred in hospital. The number of deaths reported from nursing homes was only 13 (3.0%). Patients with dementia less frequently died in hospital, however, it was not statistically significant (12.4% vs 14.7%, P = .05). The prevalence of death in hospital was significantly higher in patients with chronic renal failure (3.1% vs 1.7%, P = .02). The presence of comorbid conditions such as heart failure, cerebrovascular disease, Parkinson's disease, chronic obstructive pulmonary disease/asthma, and cancer did not affect the place of death (P = .24, .21, .24, .51, and .18). Out-of-hospital mortality increased with advanced age (P < .001). No significant difference was found in the place of death over the years (P = .41). Conclusion: To the best of our knowledge, this is the first study examining the place of death in Turkey, an aging country. Our results may help to establish policies about end-of-life care in elderly people to improve quality of life by using resources effectively.

20.
J Med Virol ; 94(1): 384-387, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34406670

RESUMO

The antiviral remdesivir has been shown to decrease the length of hospital stay in coronavirus disease 2019 (COVID-19) patients requiring supplemental oxygen. However many patients decompensate despite being treated with remdesivir. To identify potential prognostic factors in remdesivir-treated patients, we performed a retrospective cohort study of patients hospitalized at NewYork-Presbyterian Hospital/Weill Cornell Medical Center between March 23, 2020 and May 27, 2020. We identified 55 patients who were treated with remdesivir for COVID-19 and analyzed inflammatory markers and clinical outcomes. C-reactive protein (CRP), d-dimer, and lactate dehydrogenase levels were significantly higher in patients who progressed to intubation or death by 14 days compared to those who remained stable. CRP levels decreased significantly after remdesivir administration in patients who remained nonintubated over the study period. To our knowledge, this is the largest study to date examining inflammatory markers before and after remdesivir administration. Our findings support further investigation into COVID-19 treatment strategies that modify the inflammatory response.


Assuntos
Monofosfato de Adenosina/análogos & derivados , Alanina/análogos & derivados , Antivirais/uso terapêutico , COVID-19/tratamento farmacológico , COVID-19/mortalidade , SARS-CoV-2/efeitos dos fármacos , Monofosfato de Adenosina/uso terapêutico , Idoso , Alanina/uso terapêutico , Biomarcadores/sangue , Proteína C-Reativa/análise , COVID-19/patologia , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Humanos , Inflamação/tratamento farmacológico , L-Lactato Desidrogenase/sangue , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , SARS-CoV-2/imunologia
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