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1.
Pediatr Infect Dis J ; 40(7): e272-e274, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34097664

RESUMO

The estimated severe acute respiratory syndrome coronavirus 2 seroprevalence in children was found to be 9.46% for the Washington Metropolitan area. Hispanic/Latinx individuals were found to have higher odds of seropositivity. While chronic medical conditions were not associated with having antibodies, previous fever and body aches were predictive symptoms.


Assuntos
Anticorpos Antivirais/sangue , Teste Sorológico para COVID-19 , COVID-19/epidemiologia , Adolescente , COVID-19/etnologia , Criança , Pré-Escolar , Doença Crônica/epidemiologia , District of Columbia/epidemiologia , Feminino , Voluntários Saudáveis , Hispano-Americanos , Humanos , Imunoglobulina G/sangue , Lactente , Recém-Nascido , Masculino , Maryland/epidemiologia , Estudos Soroepidemiológicos , Virginia/epidemiologia , West Virginia/epidemiologia , Adulto Jovem
2.
Pan Afr Med J ; 39: 1, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34178229

RESUMO

Introduction: Non-Communicable Diseases (NCD) are becoming a public health problem in Mozambique and wider sub-Saharan Africa, and are driving changes to guaranty lifelong follow up of patients within the health systems. Patient-Held Medical Records (PHMR) are an option for this follow-up in under-resourced health systems. We designed a study to assess the rate of retention and quality of conservation of the PHMR. Methods: we conducted a prospective observational study from November 2016 to October 2018 in a peri-urban hospital from in Mozambique. Consecutive newly diagnosed patients with cardiovascular disease were given PHMR. Data was collected after their first consultation and one year after. The retention and quality of conservation were assessed after 12 months. Results: overall 134 PHMR were given to patients (24;17.9% children and 77;57.5% female), of which 121 (90.3%) retained at 12 months (90.9% in good conservation state). Most patients had on average four visits to health facilities during the study, all registered in the PHMR. Retention could not be confirmed in 13 patients who did not return the PHMR. Conclusion: PHMR retention rates were high in an urban low-income setting in Africa, with high quality of conservation, thus supporting its use to replace hospital paper-based medical files. Specific research is recommended on acceptability, quality of information registered and patient´s perception.


Assuntos
Doenças Cardiovasculares/epidemiologia , Registros Médicos/estatística & dados numéricos , Doenças não Transmissíveis/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Doença Crônica/epidemiologia , Feminino , Humanos , Lactente , Masculino , Registros Médicos/normas , Pessoa de Meia-Idade , Moçambique , Estudos Prospectivos , Fatores de Tempo , População Urbana , Adulto Jovem
5.
Pediatr Infect Dis J ; 40(7): e272-e274, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: covidwho-1258811

RESUMO

The estimated severe acute respiratory syndrome coronavirus 2 seroprevalence in children was found to be 9.46% for the Washington Metropolitan area. Hispanic/Latinx individuals were found to have higher odds of seropositivity. While chronic medical conditions were not associated with having antibodies, previous fever and body aches were predictive symptoms.


Assuntos
Anticorpos Antivirais/sangue , Teste Sorológico para COVID-19 , COVID-19/epidemiologia , Adolescente , COVID-19/etnologia , Criança , Pré-Escolar , Doença Crônica/epidemiologia , District of Columbia/epidemiologia , Feminino , Voluntários Saudáveis , Hispano-Americanos , Humanos , Imunoglobulina G/sangue , Lactente , Recém-Nascido , Masculino , Maryland/epidemiologia , Estudos Soroepidemiológicos , Virginia/epidemiologia , West Virginia/epidemiologia , Adulto Jovem
6.
Arq. ciências saúde UNIPAR ; 25(2): 125-131, maio-ago. 2021.
Artigo em Português | LILACS | ID: biblio-1252370

RESUMO

A doença crítica crônica (DCC) descreve pacientes que sobreviveram ao episódio inicial de doença crítica, mas que permanecem dependentes da unidade de terapia intensiva (UTI) por períodos prolongados ou pelo resto de suas vidas. O presente estudo objetivou caracterizar pacientes traumatizados e hospitalizados na Unidade de Terapia Intensiva com Doença Crítica Crônica. Foram coletados dados de internações por trauma UTI no interior do Paraná de 2013 a 2016, dessa maneira, foi traçado o perfil epidemiológico e realizado associações e comparação dos grupos analisados (total de pacientes traumatizados hospitalizados em UTI em comparação com os pacientes traumatizados que desenvolveram DCC). Notou-se que dos 417 indivíduos traumatizados investigados, 41 (9,8%) foram classificados com DCC. Além disso, o sexo masculino, menor índice de comorbidades, maior gravidade do trauma e ferimentos contusos estiveram relacionados ao desenvolvimento da DCC. Os pacientes com DCC apresentaram complicações cirúrgicas (87,8%), e 41,5% evoluíram a óbito. Portanto, os pacientes com DCC permanecem por longo período na UTI (com uma média de 19,88 dias), os quais necessitam de cuidados intensivos de enfermagem e da equipe multiprofissional.(AU)


Chronic critical illness (CCI) describes patients who survived the initial episode of critical illness, but who remain dependent of the intensive care unit (ICU) for extended periods or for the rest of their lives. This study aimed at characterizing traumatized patients hospitalized in the Intensive Care Unit with Chronic Critical Illness. Data from ICU trauma hospitalizations in the interior of the state of Paraná were collected from 2013 to 2016, and with them, the epidemiological profile was drawn up, associations were made, and the analyzed groups were compared (total traumatized patients hospitalized in the ICU compared to traumatized patients who developed CCI). It was observed that from the 417 traumatized individuals investigated, 41 (9.8%) were classified as having CCI. In addition, it was observed that gender (male), a lower rate of comorbidities, greater severity of trauma, and blunt injuries were related to the development of CCI. Patients with CCI had surgical complications (87.8%), and 41.5% died. Therefore, CCI remain in the ICU for a long period (with an average of 19.88 days), which require intensive nursing care and the use of a multidisciplinary team.(AU)


Assuntos
Humanos , Ferimentos e Lesões/complicações , Doença Crônica/epidemiologia , Unidades de Terapia Intensiva/tendências , Epidemiologia Descritiva , Estudos Retrospectivos , Pacientes Internados/estatística & dados numéricos
7.
BMC Infect Dis ; 21(1): 474, 2021 May 25.
Artigo em Inglês | MEDLINE | ID: covidwho-1243805

RESUMO

BACKGROUND: Defining socio-demographic factors, clinical presentations and underlying diseases associated with COVID-19 severity could be helpful in its management. This study aimed to further clarify the determinants and clinical risk factors of the disease severity in patients infected with COVID-19. METHODS: A multi-centre descriptive study on all patients who have been diagnosed with COVID-19 in the province of Tehran from March 2020 up to Dec 2020 was conducted. Data on socio-demographic characteristics, clinical presentations, comorbidities, and the health outcomes of 205,654 patients were examined. Characteristics of the study population were described. To assess the association of study variables with the disease severity, the Chi-Squared test and Multiple Logistic Regression model were applied. RESULTS: The mean age of the study population was 52.8 years and 93,612 (45.5%) were women. About half of the patients have presented with low levels of blood oxygen saturation. The ICU admission rate was 17.8% and the overall mortality rate was 10.0%. Older age, male sex, comorbidities including hypertension, cancer, chronic respiratory diseases other than asthma, chronic liver diseases, chronic kidney diseases, chronic neurological disorders, and HIV/AIDS infection were risk markers of poor health outcome. Clinical presentations related with worse prognosis included fever, difficulty breathing, impaired consciousness, and cutaneous manifestations. CONCLUSION: These results might alert physicians to pay attention to determinants and risk factors associated with poor prognosis in patients with COVID-19. In addition, our findings aid decision makers to emphasise on vulnerable groups in the public health strategies that aim at preventing the spread of the disease and its mortalities.


Assuntos
COVID-19/epidemiologia , SARS-CoV-2 , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/mortalidade , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Doença Crônica/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Hipertensão/epidemiologia , Lactente , Irã (Geográfico)/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Prognóstico , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
8.
Diabetes Metab Syndr ; 15(3): 993-999, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1226283

RESUMO

BACKGROUND AND AIMS: In India, COVID-19 case fatality rates (CFRs) have consistently been very high in states like Punjab and Maharashtra and very low in Kerala and Assam. To investigate the discrepancy in state-wise CFRs, datasets on various factors related to demography, socio-economy, public health, and healthcare capacity have been collected to study their association with CFR. METHODS: State-wise COVID-19 data was collected till April 22, 2021. The latest data on the various factors have been collected from reliable sources. Pearson correlation, two-tailed P test, Spearman rank correlation, and Artificial Neural Network (ANN) structures have been used to assess the association between various factors and CFR. RESULTS: Life expectancies, prevalence of overweight, COVID-19 test positive rates, and H1N1 fatality rates show a significant positive association with CFR. Human Development Index, per capita GDP, public affairs index, health expenditure per capita, availability of govt. doctors & hospital beds, prevalence of certain diseases, and comorbidities like diabetes and hypertension show insignificant association with CFR. Sex ratio, health expenditure as a percent of GSDP, and availability of govt. hospitals show a significant negative correlation with CFR. CONCLUSION: The study indicates that older people, males of younger age groups, and overweight people are at more fatality risk from COVID-19. Certain diseases and common comorbidities like diabetes and hypertension do not seem to have any significant effect on CFR. States with better COVID-19 testing rates, health expenditure, and healthcare capacity seem to perform better with regard to COVID-19 fatality rates.


Assuntos
COVID-19/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Inteligência Artificial , COVID-19/complicações , COVID-19/diagnóstico , Criança , Pré-Escolar , Doença Crônica/epidemiologia , Doença Crônica/mortalidade , Comorbidade , Correlação de Dados , Fatores Epidemiológicos , Feminino , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Expectativa de Vida , Masculino , Pessoa de Meia-Idade , Mortalidade , Redes Neurais de Computação , Fatores de Risco , SARS-CoV-2/fisiologia , Fatores Socioeconômicos , Adulto Jovem
9.
Respirology ; 26(6): 552-565, 2021 06.
Artigo em Inglês | MEDLINE | ID: covidwho-1218177

RESUMO

Coronavirus disease 2019 (COVID-19) caused by infection with severe acute respiratory syndrome coronavirus 2 was first detected in Wuhan, China, in late 2019 and continues to spread worldwide. Persistent questions remain about the relationship between the severity of COVID-19 and comorbid diseases, as well as other chronic pulmonary conditions. In this systematic review and meta-analysis, we aimed to examine in detail whether the underlying chronic obstructive pulmonary diseases (COPD), asthma and chronic respiratory diseases (CRDs) were associated with an increased risk of more severe COVID-19. A comprehensive literature search was performed using five international search engines. In the initial search, 722 articles were identified. After eliminating duplicate records and further consideration of eligibility criteria, 53 studies with 658,073 patients were included in the final analysis. COPD was present in 5.2% (2191/42,373) of patients with severe COVID-19 and in 1.4% (4203/306,151) of patients with non-severe COVID-19 (random-effects model; OR = 2.58, 95% CI = 1.99-3.34, Z = 7.15, p < 0.001). CRD was present in 8.6% (3780/44,041) of patients with severe COVID-19 and in 5.7% (16,057/280,447) of patients with non-severe COVID-19 (random-effects model; OR = 2.14, 95% CI = 1.74-2.64, Z = 7.1, p < 0.001). Asthma was present in 2.3% (1873/81,319) of patients with severe COVID-19 and in 2.2% (11,796/538,737) of patients with non-severe COVID-19 (random-effects model; OR = 1.13, 95% CI = 0.79-1.60, Z = 0.66, p = 0.50). In conclusion, comorbid COPD and CRD were clearly associated with a higher severity of COVID-19; however, no association between asthma and severe COVID-19 was identified.


Assuntos
Asma/epidemiologia , COVID-19/epidemiologia , Gravidade do Paciente , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Asma/fisiopatologia , Doença Crônica/epidemiologia , Comorbidade , Humanos , SARS-CoV-2
10.
BMC Infect Dis ; 21(1): 474, 2021 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-34034649

RESUMO

BACKGROUND: Defining socio-demographic factors, clinical presentations and underlying diseases associated with COVID-19 severity could be helpful in its management. This study aimed to further clarify the determinants and clinical risk factors of the disease severity in patients infected with COVID-19. METHODS: A multi-centre descriptive study on all patients who have been diagnosed with COVID-19 in the province of Tehran from March 2020 up to Dec 2020 was conducted. Data on socio-demographic characteristics, clinical presentations, comorbidities, and the health outcomes of 205,654 patients were examined. Characteristics of the study population were described. To assess the association of study variables with the disease severity, the Chi-Squared test and Multiple Logistic Regression model were applied. RESULTS: The mean age of the study population was 52.8 years and 93,612 (45.5%) were women. About half of the patients have presented with low levels of blood oxygen saturation. The ICU admission rate was 17.8% and the overall mortality rate was 10.0%. Older age, male sex, comorbidities including hypertension, cancer, chronic respiratory diseases other than asthma, chronic liver diseases, chronic kidney diseases, chronic neurological disorders, and HIV/AIDS infection were risk markers of poor health outcome. Clinical presentations related with worse prognosis included fever, difficulty breathing, impaired consciousness, and cutaneous manifestations. CONCLUSION: These results might alert physicians to pay attention to determinants and risk factors associated with poor prognosis in patients with COVID-19. In addition, our findings aid decision makers to emphasise on vulnerable groups in the public health strategies that aim at preventing the spread of the disease and its mortalities.


Assuntos
COVID-19/epidemiologia , SARS-CoV-2 , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/mortalidade , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Doença Crônica/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Hipertensão/epidemiologia , Lactente , Irã (Geográfico)/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Prognóstico , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
11.
Respirology ; 26(6): 552-565, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33955623

RESUMO

Coronavirus disease 2019 (COVID-19) caused by infection with severe acute respiratory syndrome coronavirus 2 was first detected in Wuhan, China, in late 2019 and continues to spread worldwide. Persistent questions remain about the relationship between the severity of COVID-19 and comorbid diseases, as well as other chronic pulmonary conditions. In this systematic review and meta-analysis, we aimed to examine in detail whether the underlying chronic obstructive pulmonary diseases (COPD), asthma and chronic respiratory diseases (CRDs) were associated with an increased risk of more severe COVID-19. A comprehensive literature search was performed using five international search engines. In the initial search, 722 articles were identified. After eliminating duplicate records and further consideration of eligibility criteria, 53 studies with 658,073 patients were included in the final analysis. COPD was present in 5.2% (2191/42,373) of patients with severe COVID-19 and in 1.4% (4203/306,151) of patients with non-severe COVID-19 (random-effects model; OR = 2.58, 95% CI = 1.99-3.34, Z = 7.15, p < 0.001). CRD was present in 8.6% (3780/44,041) of patients with severe COVID-19 and in 5.7% (16,057/280,447) of patients with non-severe COVID-19 (random-effects model; OR = 2.14, 95% CI = 1.74-2.64, Z = 7.1, p < 0.001). Asthma was present in 2.3% (1873/81,319) of patients with severe COVID-19 and in 2.2% (11,796/538,737) of patients with non-severe COVID-19 (random-effects model; OR = 1.13, 95% CI = 0.79-1.60, Z = 0.66, p = 0.50). In conclusion, comorbid COPD and CRD were clearly associated with a higher severity of COVID-19; however, no association between asthma and severe COVID-19 was identified.


Assuntos
Asma/epidemiologia , COVID-19/epidemiologia , Gravidade do Paciente , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Asma/fisiopatologia , Doença Crônica/epidemiologia , Comorbidade , Humanos , SARS-CoV-2
12.
Diabetes Metab Syndr ; 15(3): 993-999, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33984819

RESUMO

BACKGROUND AND AIMS: In India, COVID-19 case fatality rates (CFRs) have consistently been very high in states like Punjab and Maharashtra and very low in Kerala and Assam. To investigate the discrepancy in state-wise CFRs, datasets on various factors related to demography, socio-economy, public health, and healthcare capacity have been collected to study their association with CFR. METHODS: State-wise COVID-19 data was collected till April 22, 2021. The latest data on the various factors have been collected from reliable sources. Pearson correlation, two-tailed P test, Spearman rank correlation, and Artificial Neural Network (ANN) structures have been used to assess the association between various factors and CFR. RESULTS: Life expectancies, prevalence of overweight, COVID-19 test positive rates, and H1N1 fatality rates show a significant positive association with CFR. Human Development Index, per capita GDP, public affairs index, health expenditure per capita, availability of govt. doctors & hospital beds, prevalence of certain diseases, and comorbidities like diabetes and hypertension show insignificant association with CFR. Sex ratio, health expenditure as a percent of GSDP, and availability of govt. hospitals show a significant negative correlation with CFR. CONCLUSION: The study indicates that older people, males of younger age groups, and overweight people are at more fatality risk from COVID-19. Certain diseases and common comorbidities like diabetes and hypertension do not seem to have any significant effect on CFR. States with better COVID-19 testing rates, health expenditure, and healthcare capacity seem to perform better with regard to COVID-19 fatality rates.


Assuntos
COVID-19/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Inteligência Artificial , COVID-19/complicações , COVID-19/diagnóstico , Criança , Pré-Escolar , Doença Crônica/epidemiologia , Doença Crônica/mortalidade , Comorbidade , Correlação de Dados , Fatores Epidemiológicos , Feminino , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Expectativa de Vida , Masculino , Pessoa de Meia-Idade , Mortalidade , Redes Neurais de Computação , Fatores de Risco , SARS-CoV-2/fisiologia , Fatores Socioeconômicos , Adulto Jovem
14.
J Infect Dev Ctries ; 15(3): 360-365, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: covidwho-1175612

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that causes coronavirus diseases 2019 (COVID-19). The SARS-CoV-2 is very contagious and nobody is known to be immune to it. The post-infected lung would leave a scar known as fibrosis, a scar tissue. A study from Wuhan, China suggested the development of fibrosis, though it was too early to label these lung changes as irreversible fibrosis in a time range of 3 weeks. The occurrence of fibrosis indicates a chronic infection which greatly contributes to the hallmark symptom of COVID-19 induced ARDS such as shortness of breath and chest pain. However, many of those studies have not yet explained the condition of the patient's lung after total recovery from the COVID-19. This report demonstrates the clinical symptoms, chest CT scan, spirometry, and blood gas analysis of patient after total recovery from the COVID-19 with appearance lung fibrosis.


Assuntos
COVID-19/complicações , Pulmão/patologia , Pulmão/virologia , Fibrose Pulmonar/virologia , Gasometria , COVID-19/epidemiologia , COVID-19/fisiopatologia , China/epidemiologia , Doença Crônica/epidemiologia , Progressão da Doença , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Fibrose Pulmonar/diagnóstico por imagem , Fibrose Pulmonar/epidemiologia , Espirometria , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X
15.
BMC Public Health ; 21(1): 685, 2021 04 08.
Artigo em Inglês | MEDLINE | ID: covidwho-1175313

RESUMO

BACKGROUND: People with chronic conditions are disproportionately prone to be affected by the COVID-19 pandemic but there are limited data documenting this. We aimed to assess the health, psychosocial and economic impacts of the COVID-19 pandemic on people with chronic conditions in India. METHODS: Between July 29, to September 12, 2020, we telephonically surveyed adults (n = 2335) with chronic conditions across four sites in India. Data on participants' demographic, socio-economic status, comorbidities, access to health care, treatment satisfaction, self-care behaviors, employment, and income were collected using pre-tested questionnaires. We performed multivariable logistic regression analysis to examine the factors associated with difficulty in accessing medicines and worsening of diabetes or hypertension symptoms. Further, a diverse sample of 40 participants completed qualitative interviews that focused on eliciting patient's experiences during the COVID-19 lockdowns and data analyzed using thematic analysis. RESULTS: One thousand seven hundred thirty-four individuals completed the survey (response rate = 74%). The mean (SD) age of respondents was 57.8 years (11.3) and 50% were men. During the COVID-19 lockdowns in India, 83% of participants reported difficulty in accessing healthcare, 17% faced difficulties in accessing medicines, 59% reported loss of income, 38% lost jobs, and 28% reduced fruit and vegetable consumption. In the final-adjusted regression model, rural residence (OR, 95%CI: 4.01,2.90-5.53), having diabetes (2.42, 1.81-3.25) and hypertension (1.70,1.27-2.27), and loss of income (2.30,1.62-3.26) were significantly associated with difficulty in accessing medicines. Further, difficulties in accessing medicines (3.67,2.52-5.35), and job loss (1.90,1.25-2.89) were associated with worsening of diabetes or hypertension symptoms. Qualitative data suggest most participants experienced psychosocial distress due to loss of job or income and had difficulties in accessing in-patient services. CONCLUSION: People with chronic conditions, particularly among poor, rural, and marginalized populations, have experienced difficulties in accessing healthcare and been severely affected both socially and financially by the COVID-19 pandemic.


Assuntos
COVID-19 , Doença Crônica , Pandemias , Idoso , COVID-19/economia , COVID-19/epidemiologia , COVID-19/psicologia , Doença Crônica/epidemiologia , Doença Crônica/terapia , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Quarentena , Fatores Socioeconômicos , Inquéritos e Questionários
16.
BMC Fam Pract ; 22(1): 69, 2021 04 08.
Artigo em Inglês | MEDLINE | ID: covidwho-1175289

RESUMO

BACKGROUND: The emergence of the COVID-19 pandemic has raised concerns about the potential decrease in access and utilisation of general practice services and its impact on patient care. In March 2020, the Australian Government introduced telehealth services to ensure that people more vulnerable to COVID-19 do not delay routine care from their general practitioners. Evidence about patients' experience of telehealth and its impact on patient care is scarce. This study aimed to investigate the experience with telehealth by Australian general practice patients at high risk of poor health outcomes during the COVID-19 pandemic. METHODS: Semi-structured telephone interviews were conducted with 30 patients from nine general practices in metropolitan Adelaide (May-June 2020). Participants were identified by their regular doctor as being at high risk of poor health outcomes. Interviews sought participants' perspectives and experiences about telehealth services in the general practice setting during COVID-19, and the value of offering continued telehealth services post pandemic. Interviews were recorded and transcribed verbatim. Data were analysed using a coding structure developed based on deductive codes derived from the research questions and any additional concepts that emerged inductively from interviews. RESULTS: Participants expressed satisfaction with telehealth including convenient and timely access to general practice services. Yet, participants identified challenges including difficulties in expressing themselves and accessing physical exams. Prescription renewal, discussing test results and simple follow-ups were the most common reasons that telehealth was used. Telehealth was mainly via phone that better suited those with low digital literacy. Participants indicated that an existing doctor-patient relationship was important for telehealth services to be effective. Subjects believed that telehealth services should be continued but needed to be combined with opportunities for face-to-face consultations after the COVID-19 pandemic was over. CONCLUSIONS: The expansion of telehealth supported access to general practice including chronic disease management during the COVID-19 pandemic. In the future, telehealth in Australia is likely to have a stronger place in primary healthcare policy and practice and an increased acceptance amongst patients.


Assuntos
COVID-19 , Doença Crônica , Medicina Geral , Relações Médico-Paciente , Medição de Risco/métodos , Telemedicina , Austrália/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Doença Crônica/epidemiologia , Doença Crônica/terapia , Controle de Doenças Transmissíveis/métodos , Feminino , Medicina Geral/métodos , Medicina Geral/tendências , Acesso aos Serviços de Saúde/organização & administração , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Pesquisa Qualitativa , SARS-CoV-2 , Telemedicina/métodos , Telemedicina/organização & administração
18.
Prev Chronic Dis ; 18: E33, 2021 04 08.
Artigo em Inglês | MEDLINE | ID: covidwho-1173046

RESUMO

The Centers for Disease Control and Prevention (CDC) define chronic diseases as conditions that last 1 year or more and that require ongoing medical attention or limit activities of daily living, or both (1). Chronic diseases may be influenced by a combination of genetics, lifestyle and social behaviors, health care system factors, community influences, and environmental determinants of health (2). These risk factors often coexist and interact with each other. Therefore, a better understanding of determinants of chronic diseases such as tobacco use, unhealthy eating, and physical inactivity stands to benefit from effective strategies for improving primary, secondary, and tertiary disease prevention and management in diverse global settings (3). Strategies to prevent and manage chronic disease outcomes such as diabetes and cardiovascular diseases (CVDs) have global commonalities (4-7). The impact of chronic diseases is disproportionately evident in Black and Brown communities (8,9). Chronic disease prevention and management typically focus on behavioral interventions such as healthy eating, increased physical activity, and cessation of unhealthy practices such as tobacco and alcohol use (10-15). In 2020, the COVID-19 pandemic added to the fact that chronic diseases disproportionately affect low-resource communities, where many Black and Brown populations live (16,17). COVID-19 demonstrated that chronic disease disparities actually present as preexisting conditions in Black and Brown communities, who are disproportionately affected by COVID-19 outcomes. Although most of the articles in this Preventing Chronic Disease (PCD) collection were published before the pandemic, the insights they present, combined with the racial and ethnic data on the burden of COVID-19 thus far, support this reality. Many researchers and public health practitioners often consider the need to sufficiently address the relationships between chronic diseases and social, behavioral, and community factors (18). Global lessons in the prevention and management of chronic diseases, therefore, can help researchers and practitioners benefit from the shared lessons and experience derived from research and interventions conducted in different parts of the world. There are more than 7 billion people worldwide, who speak diverse languages and who have different nationalities, identities, and health systems. Yet, if we share challenges and opportunities for chronic disease prevention and management, many of the global adversities to improving health and well-being can be ameliorated, which is the purpose of this collection. The authors in this collection share lessons that represent experiences in diverse contexts across countries and regions of the world.


Assuntos
COVID-19/epidemiologia , Doença Crônica , Saúde Global , Saúde Pública , Determinantes Sociais da Saúde , Causalidade , Doença Crônica/epidemiologia , Doença Crônica/prevenção & controle , Doença Crônica/terapia , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Disseminação de Informação , Estilo de Vida , Psicologia , Saúde Pública/normas , Saúde Pública/tendências , SARS-CoV-2 , Determinantes Sociais da Saúde/etnologia , Determinantes Sociais da Saúde/estatística & dados numéricos
19.
Diabetes Metab Syndr ; 15(3): 847-856, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1191539

RESUMO

BACKGROUND AND AIMS: Corona virus disease-19 first detected in China, December 2019. The government of Ethiopia takes preventive measures but the number of peoples infected with COVID-19 has been increased. Control of the pandemic requires changing of knowledge, attitude and practice of people. Hence, the objective of this study was to assess chronic disease patients' knowledge, attitude and practice towards COVID-19 pandemic. METHODS: Institution based cross-sectional study was done among 413 chronic disease patients from July 20 to August 5, 2020 in Dessie town hospitals. Multinomial logistic regression analysis was used and significant association declared at p-value of <0.05. RESULTS: From the total participants 34.6%, 81.4% and 40.7% had good knowledge, attitude and practice while 35.1%, 12.1% and 24.7% had moderate knowledge, attitude and practice towards COVID-19 pandemic, respectively. In multinomial logistic regression young age, urban residency, attainment of secondary education and presence of additional co-morbidity were predictors of moderate knowledge whereas urban residency, not attended formal education and presence of additional co-morbidity were predictors of good knowledge about COVID-19. Household family size and presence of additional co-morbidity were factors significantly associated with moderate practice of COVID-19 prevention methods. Furthermore, male sex, household family size, knowledge of COVID-19 and attitude towards COVID-19 were factors significantly associated with good practice of COVID-19 prevention methods. CONCLUSION: Significant number of chronic disease patients had poor knowledge and practice towards COVID-19. Therefore, government, health professionals, Medias, researchers and health institution should do to improve the gaps of chronic diseases patients.


Assuntos
COVID-19 , Doença Crônica/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Doença Crônica/psicologia , Comorbidade , Estudos Transversais , Etiópia/epidemiologia , Feminino , Hospitais Urbanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , SARS-CoV-2/fisiologia , Adulto Jovem
20.
Med Sci Monit ; 27: e930278, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: covidwho-1148370

RESUMO

The high infectivity and severity of SARS-CoV-2 infection (COVID-19), and our limited understanding of the biology of the novel coronavirus, as well as the lack of an effective treatment for COVID-19, have created a global pandemic. Those most likely to become seriously ill with COVID-19 are adults, especially the elderly and those who are already weak or sick. At present, a specific drug for treatment of COVID-19 has not been developed. This, combined with the typical coexistence of a variety of chronic diseases in elderly patients, makes treatment challenging at present. In addition, for elderly patients, COVID-19 isolation measures during the epidemic can easily lead to psychological problems. Thus, how to manage elderly patients has become a focus of social attention in the current circumstances. This article reviews the effects of COVID-19 and makes management suggestions for elderly patients during this epidemic period. In addition to the elderly, critically ill people are also highly susceptible to this novel coronavirus. For elderly COVID-19 patients, antiviral therapy, immune regulation, and even auxiliary respiratory therapy can be given after a comprehensive evaluation of the disease. With the approval and use of COVID-19 vaccines, it is reasonable to expect that we can conquer SARS-CoV-2.


Assuntos
Antivirais/uso terapêutico , COVID-19/terapia , Doença Crônica/epidemiologia , Terapia Respiratória/métodos , Fatores Etários , Idoso , Envelhecimento/imunologia , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/imunologia , Vacinas contra COVID-19/administração & dosagem , Terapia Combinada/métodos , Comorbidade , Estado Terminal/epidemiologia , Suscetibilidade a Doenças , Humanos , Fatores de Risco , SARS-CoV-2/efeitos dos fármacos , SARS-CoV-2/imunologia , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de Doença
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