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1.
Pan Afr Med J ; 38: 247, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104295

RESUMO

Introduction: a significant proportion of pregnancy related deaths result from delay in decision to seek care and this often stems from failure to identify obstetric danger signs earlier. Early identification of these danger signs will therefore reduce maternal mortality. However, studies on obstetric danger signs awareness are lacking in Cameroon. The objective of this study was to assess the determinants of obstetric danger signs awareness of women at immediate postpartum period. This will inform ANC providers´ practice. Methods: between June and September 2019, women who delivered at the Buea Regional Hospital were interviewed within 24 hours following their delivery using a researcher-administered questionnaire that covered socio-demographic and obstetric variables. Data were entered into EpiData and analysis done using SPSS 16 and OpenEpi. Statistical significance was set at p-value < 0.05. Results: of the 532 participants, majority (230/532: 43.2%) were those aged 26-35; danger signs awareness rate was 73.3%. There was a statistically significant relation between age and awareness of obstetric danger signs which showed that older women were more aware than their younger counterparts (p=0.00). Other statistically significant determinants of danger sign awareness included occupation, level of education, parity, trimester of onset of antenatal visits and the number of visits before delivery (p<0.05). Multiparity (370/490: 75.5%) and grand multiparity (14/22: 63.6%) were more likely to be aware of obstetric danger signs than primiparous women (6/20: 30%). Similarly, those who started antenatal visits earlier (first or second trimester) and those who attended more visits were more likely to be aware of obstetric danger signs than their counterparts who started later or had lesser antenatal visits before delivery. The most reported danger signs were severe vaginal bleed (71.4%), fever (62.0%) and reduced fetal movement. Conclusion: conclusively, more focus should be placed on the sensitisation about obstetric danger signs when in contact with primiparous and younger parturient during ANC visits.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Complicações do Trabalho de Parto/epidemiologia , Período Pós-Parto , Cuidado Pré-Natal/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Camarões , Estudos Transversais , Escolaridade , Feminino , Humanos , Mortalidade Materna , Pessoa de Meia-Idade , Paridade , Gravidez , Inquéritos e Questionários , Adulto Jovem
2.
Nutrients ; 13(5)2021 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-34064534

RESUMO

Coronaviruses are a large family of viruses that are known to cause respiratory tract infections ranging from colds to more severe diseases, such as Middle East Respiratory Syndrome (MERS) and the Severe Acute Respiratory Syndrome (SARS). New Coronavirus Disease 2019 (COVID-19), which led to deaths as well as social and economic disruptions, is an ongoing worldwide pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Currently, there is no approved treatment for COVID-19. Hence, only supportive care has been approved by the World Health Organization (WHO) for now. Pharmacological agents used for the adjunctive treatment of COVID-19 following the current literature and clinical experiences include antiviral, anti-inflammatory, and anti-malaria drugs, and other traditional or untraditional treatments. However, it has been reported that the use of these drugs may have some negative effects and comorbidities. Moreover, the current data have indicated that the risk of drug-drug interactions may also be high in polypharmacy cases, especially in elderly people, some comorbidity situations, and intensive care unit (ICU) patients. It is highly possible that these situations can not only increase the risk of drug-drug interactions but also increase the risk of food/nutrition-drug interactions and affect the nutritional status. However, this issue has not yet been entirely discussed in the literature. In this review, current information on the possible mechanisms as well as pharmacokinetic and pharmacodynamic effects of some pharmacological agents used in the treatment of COVID-19 and/or their secondary interactions with nutrition were evaluated and some future directions were given.


Assuntos
Antivirais , COVID-19/tratamento farmacológico , Interações Alimento-Droga , SARS-CoV-2 , Fatores Etários , Antivirais/farmacocinética , Antivirais/uso terapêutico , COVID-19/epidemiologia , Humanos
3.
Nutrients ; 13(5)2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-34064715

RESUMO

Lockdowns to contain the spread of the SARS-CoV-2 have disrupted routines and behaviors, which could lead to a worsening of lifestyle and an increase in the burden of non-communicable diseases. This study aimed to describe the changes in physical activity, diet, alcohol drinking, and cigarette smoking during lockdown. A self-administered online survey addressing adults living in a province in northern Italy was advertised through websites and social media. Citizens could access the survey in anonymity from 4 May until 15 June 2020. A total of 1826 adults completed the survey, with a worsening of physical activity (35.1%), diet (17.6%), alcohol drinking (12.5%), and cigarette smoking (7.7%) reported. In contrast, 33.5% reported an improvement in diet, 12.6% in alcohol drinking, 5.3% in physical activity and 4.1% in cigarette smoking. Female sex, young adult age, suspension of work activity, and symptoms of psychological distress were the factors associated with a greater likelihood of change, which was frequently for the worse. Lockdown had an impact on lifestyle, with some net beneficial effects on diet and mostly negative effects on physical activity. Public health measures should be implemented to avoid long-term negative effects of the lockdown, supporting individuals more prone to change for the worse.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , COVID-19 , Fumar Cigarros/epidemiologia , Exercício Físico , Comportamento Alimentar , Pandemias , Quarentena , SARS-CoV-2 , Adolescente , Adulto , Fatores Etários , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública , Fatores Sexuais
4.
S Afr Fam Pract (2004) ; 63(1): e1-e5, 2021 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-34082556

RESUMO

Clinicians notify positive results of the severe acute respiratory syndrome coronavirus-2 polymerase chain reaction to patients and/or relatives, whilst short message service (SMS) has been adopted as a means of disseminating negative results. Therefore, clinicians should be adequately equipped to provide telephonic consultation whilst delivering a positive test result to patients. The news of the coronavirus disease 2019 (COVID-19) test result often invokes fear of impending death in patients, especially the elderlies and those with comorbidities. In addition, several survivors have reported persistent symptoms and COVID-19-related stigma, which precludes them from immediate re-integration into their workplaces. Consequently, COVID-19 results are perceived as bad news by the members of the public. This article justifies why COVID-19 test results are bad news and also discusses the notification steps to follow when delivering COVID-19 results, whilst also addressing patients' immediate concerns. The article concludes by highlighting an important safety net for COVID-19 patients and the attending clinician.


Assuntos
COVID-19/diagnóstico , Comunicação , Papel do Médico , Revelação da Verdade , Fatores Etários , COVID-19/psicologia , Competência Clínica , Comorbidade , Medo , Humanos , Estigma Social
5.
Nutrients ; 13(5)2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34069656

RESUMO

The aim of this observational study was investigating the possible correlation between adherence to the Mediterranean diet (MeD) and SARS-COV-2 infection rates and severity among healthcare professionals (HCPs). An online self-administrated questionnaire (evaluating both MeD adherence and dietary habits) was filled out by HCPs working in Piedmont (Northern Italy) from 15 January to 28 February 2021. Out of the 1206 questionnaires collected, 900 were considered reliable and analyzed. Individuals who reported the SARS-COV-2 infection (n = 148) showed a significantly lower MeD score, with a lower adherence in fruit, vegetables, cereals, and olive oil consumption. In a logistic regression model, the risk of infection was inversely associated with the MeD score (OR = 0.88; 95% CI 0.81-0.97) and the consumption of cereals (OR = 0.64; 0.45-0.90). Asymptomatic individuals with SARS-COV-2 infection reported a lower intake of saturated fats than symptomatic; individuals requiring hospitalization were significantly older and reported worse dietary habits than both asymptomatic and symptomatic individuals. After combining all symptomatic individuals together, age (OR = 1.05; 1.01-1.09) and saturated fats intake (OR = 1.09; 1.01-1.17) were associated with the infection severity. HCPs who reported a SARS-COV-2 infection showed a significantly lower MeD score and cereal consumption. The infection severity was directly associated with higher age and saturated fat intake.


Assuntos
COVID-19/epidemiologia , Dieta Mediterrânea , SARS-CoV-2 , Inquéritos e Questionários , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudo de Prova de Conceito , Estudos Retrospectivos , Fatores de Risco
6.
J Aging Stud ; 57: 100929, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34082999

RESUMO

Early reports of COVID-19 often inaccurately presented the virus as a serious concern only among older adults. On the social media platform of Twitter, #BoomerRemover originated as a hashtag intended to express the age-related disparities of COVID-19. This study used a content analysis to examine tweets over a two-week period in March 2020 that used #BoomerRemover to discuss COVID-19 among older adults. A total of 1875 tweets were analyzed. Salient themes include: (1) There's a Real Intergenerational Divide, (2) Young People are Affected Too, (3) It's Being Used for Political Gain, and (4) #BoomerRemover is Simply Disrespectful. Findings suggest that many of the tweets employing #BoomerRemover were grounded in either personal or political ageism. In addition, a significant portion of tweeters used #BoomerRemover to defend older adults and speak out against ageism. This study highlights the importance of recognizing and addressing the growing intergenerational divide on social media, particularly during the COVID-19 pandemic.


Assuntos
Ageismo/psicologia , Ageismo/estatística & dados numéricos , COVID-19/psicologia , Mídias Sociais/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Humanos , Pessoa de Meia-Idade , SARS-CoV-2 , Adulto Jovem
7.
Rev Esc Enferm USP ; 55: e03735, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34105686

RESUMO

OBJECTIVE: To evaluate the practice of using masks by the population of the Brazilian state of Paraíba during the COVID-19 pandemic. METHOD: Cross-sectional, descriptive-analytical study conducted with adults living in the state of Paraíba through an online instrument from April to May 2020, through the Face Mask Use Scale of Faculdades Metropolitanas Unidas da Paraíba. RESULTS: The participants amounted to 1,307 (100.0%) individuals, who were predominantly female (78.0%), aged 35 to 45 (32.3%), married (53.3%) and post-graduates (46.9%). The mean score for the practice of using masks was 18.7 (SD = 8.0; minimum 6.00; maximum 30). The use of masks for self-protection scored 9.8 (DP = 3.9; minimum 3.0; maximum 15.0), whereas the score for protection of others was 8.9 (SD = 4.5; minimum 3.0; maximum 15.0). In the comparison between the scores of the practice of using masks, there was a significant statistical difference for gender, education, age group, and income (p ≤ 0.01). The practice of using masks was more frequent in health environments, 7.3 (DP = 3.2). CONCLUSION: The practice of using masks was predominant among women, people over 35, married, with an income higher than seven minimum wages, and post-graduation. The use of masks for self-protection was higher than for the protection of others and its use in health environments was higher than in the others.


Assuntos
COVID-19/prevenção & controle , Máscaras/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Brasil , Estudos Transversais , Escolaridade , Feminino , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Inquéritos e Questionários , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-34064703

RESUMO

In South Korea, a country with a high coronavirus disease 19 (COVID-19) testing rate, a total of 87,324 COVID-19 cases, including 1562 deaths, have been recorded as of 23 February 2021. This study assessed the delay-adjusted COVID-19 case fatality risk (CFR), including data from the second and third waves. A statistical method was applied to the data from 20 February 2021 through 23 February 2021 to minimize bias in the crude CFR, accounting for the survival interval as the lag time between disease onset and death. The resulting overall delay-adjusted CFR was 1.97% (95% credible interval: 1.94-2.00%). The delay-adjusted CFR was highest among adults aged ≥80 years and 70-79 years (22.88% and 7.09%, respectively). The cumulative incidence rate was highest among individuals aged ≥80 years and 60-69 years. The cumulative mortality rate was highest among individuals aged ≥80 years and 70-79 years (47 and 12 per million, respectively). In South Korea, older adults are being disproportionately affected by COVID-19 with a high death rate, although the incidence rate among younger individuals is relatively high. Interventions to prevent COVID-19 should target older adults to minimize the number of deaths.


Assuntos
COVID-19 , Fatores Etários , Idoso , Humanos , Incidência , República da Coreia/epidemiologia , SARS-CoV-2
10.
N Engl J Med ; 384(23): 2219-2228, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34107181

RESUMO

BACKGROUND: Documenting current trends in diabetes treatment and risk-factor control may inform public health policy and planning. METHODS: We conducted a cross-sectional analysis of data from adults with diabetes in the United States participating in the National Health and Nutrition Examination Survey (NHANES) to assess national trends in diabetes treatment and risk-factor control from 1999 through 2018. RESULTS: Diabetes control improved from 1999 to the early 2010s among the participants but subsequently stalled and declined. Between the 2007-2010 period and the 2015-2018 period, the percentage of adult NHANES participants with diabetes in whom glycemic control (glycated hemoglobin level, <7%) was achieved declined from 57.4% (95% confidence interval [CI], 52.9 to 61.8) to 50.5% (95% CI, 45.8 to 55.3). After major improvements in lipid control (non-high-density lipoprotein cholesterol level, <130 mg per deciliter) in the early 2000s, minimal improvement was seen from 2007-2010 (52.3%; 95% CI, 49.2 to 55.3) to 2015-2018 (55.7%; 95% CI, 50.8 to 60.5). From 2011-2014 to 2015-2018, the percentage of participants in whom blood-pressure control (<140/90 mm Hg) was achieved decreased from 74.2% (95% CI, 70.7 to 77.4) to 70.4% (95% CI, 66.7 to 73.8). The percentage of participants in whom all three targets were simultaneously achieved plateaued after 2010 and was 22.2% (95% CI, 17.9 to 27.3) in 2015-2018. The percentages of participants who used any glucose-lowering medication or any blood-pressure-lowering medication were unchanged after 2010, and the percentage who used statins plateaued after 2014. After 2010, the use of combination therapy declined in participants with uncontrolled blood pressure and plateaued for those with poor glycemic control. CONCLUSIONS: After more than a decade of progress from 1999 to the early 2010s, glycemic and blood-pressure control declined in adult NHANES participants with diabetes, while lipid control leveled off. (Funded by the National Heart, Lung, and Blood Institute.).


Assuntos
Anti-Hipertensivos/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipoglicemiantes/uso terapêutico , Adulto , Fatores Etários , Idoso , Peso Corporal , Colesterol/sangue , Estudos Transversais , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Quimioterapia Combinada/tendências , Uso de Medicamentos/tendências , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
11.
Afr J Reprod Health ; 25(1): 101-113, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34077116

RESUMO

Sex at an early age can have later life negative health outcomes. Insights on early sexual activity may help in the development of future health-promotion products and interventions related to pregnancy and sexually transmitted infections (STIs) prevention. Among Kenyan women participating in a contraceptive vaginal ring study, we determined: (1) the proportion with first sex at ≤15 years (early sex) and (2) factors associated with early sex. Baseline data collection and testing for pregnancy, STIs, and HIV were undertaken. A log-binomial or a modified Poisson regression was used to estimate univariable prevalence ratios and multivariable adjusted prevalence ratios (aPRs). Among 332 women aged 18-34 years, the median age of first sex was 16 years, with 40.1% experiencing early sex. Overall, 29.8% reported an older first sex partner (≥5 years); 83.9% indicated lack of readiness or intentions at first sex; and 56.2% received money, gifts, or favors as part of first sex. Early sex was more prevalent among inherited widows (a Luo cultural practice, aPR 1.49), gift recipients (aPR 1.38), women with a forced/unwanted sex history (aPR 1.42), or those with a partner of unknown or positive HIV status in the past 3 months (aPR 1.45). Sex before or at the age 15 may be associated with higher sexual risk behaviors. Complex power and gender relations may additionally influence exposure to sexual risk in our research setting.


Assuntos
Dispositivos Anticoncepcionais Femininos , Comportamento Sexual , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Programas de Rastreamento , Gravidez , Adulto Jovem
12.
Sci Rep ; 11(1): 11563, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078968

RESUMO

Adolescence is a formative period for socio-emotional development which is threatened by the COVID-19 pandemic. The current longitudinal study examined two aims: (1) the short- and long-term effects of the pandemic on young people's mood (i.e. vigor, tension, and depression levels) and emotional reactivity (i.e. fluctuations in daily mood), and (2) the impact of stressors on mood, emotional reactivity, self-oriented (i.e. maladaptive behavior towards COVID-19 rules) and other-benefitting behaviors (i.e. behavior aimed at helping and comforting others). We conducted an online two-week daily diary study among 462 Dutch adolescents (Mage = 15.27 years, 64% females) and 371 young adults (Mage = 21.49 years, 81% females) in May 2020, with a follow-up in November 2020 (N = 238 and 231, respectively adolescents and young adults). In May 2020, young adults and older relative to younger adolescents showed higher levels and more fluctuations in tension and depression and lower levels of vigor. Vigor levels decreased and tension and depression levels increased between May 2020 and November 2020, especially for younger adolescents. There were positive associations between instability of negative emotions (i.e. tension and depression fluctuations) and the exposure to stressors (i.e. family stress and inequality of online homeschooling) in the adolescent sample. Together, this study demonstrates vulnerability regarding young people's mood and emotional reactivity during the COVID-19 pandemic, especially for adolescents who experience more stressors.


Assuntos
Comportamento do Adolescente/psicologia , Afeto , COVID-19 , Emoções , Estresse Psicológico/psicologia , Adolescente , Adulto , Fatores Etários , COVID-19/psicologia , Criança , Depressão/psicologia , Família , Feminino , Humanos , Masculino , Países Baixos , Fatores Socioeconômicos , Adulto Jovem
13.
Sci Rep ; 11(1): 11555, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078992

RESUMO

Black, Asian and Minority Ethnic (BAME) populations are at an increased risk of developing COVID-19 and consequentially more severe outcomes compared to White populations. The aim of this study was to quantify how much of the disproportionate disease burden can be attributed to ethnicity and deprivation as well as its interaction. An ecological study was conducted using data derived from the Office for National Statistics data at a Local Authority District (LAD) level in England between 1st March and 17th April 2020. The primary analysis examined how age adjusted COVID-19 mortality depends on ethnicity, deprivation, and the interaction between the two using linear regression. The secondary analysis using spatial regression methods allowed for the quantification of the extent of LAD spillover effect of COVID-19 mortality. We find that in LADs with the highest deprivation quartile, where there is a 1 percentage point increase in "Black-African (regression coefficient 2.86; 95% CI 1.08-4.64)", "Black-Caribbean (9.66: 95% CI 5.25-14.06)" and "Bangladeshi (1.95: 95% CI 1.14-2.76)" communities, there is a significantly higher age-adjusted COVID-19 mortality compared to respective control populations. In addition, the spatial regression results indicated positive significant correlation between the age-adjusted mortality in one LAD and the age-adjusted mortality in a neighbouring LAD, suggesting a spillover effect. Our results suggest targeted public health measures to support those who are deprived and belong to BAME communities as well as to encourage restricted movement between different localities to limit disease propagation.


Assuntos
COVID-19/etnologia , COVID-19/mortalidade , Grupo com Ancestrais do Continente Africano , Fatores Etários , Estudos Transversais , Inglaterra/epidemiologia , Humanos , Grupos Minoritários/estatística & dados numéricos , Análise de Regressão , Fatores Socioeconômicos
14.
BMC Emerg Med ; 21(1): 67, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078273

RESUMO

BACKGROUND: Coronavirus disease highly contagious, is prevalent in all age and sex groups infecting the respiratory system. The present study seeks to investigate the epidemiology and effective factors in mortality of patients with COVID-19 in Ardabil province, northwestern Iran. METHODS: In a retrospective study, the hospitalized patients with laboratory-diagnosed COVID-19 between February to August 2020 were enrolled. The data registration portal was designated according to Iranian Ministry of Health and Medical Education guidelines. In this portal, demographic information, clinical presentation, laboratory and imaging data were registered for patients in all hospitals in the same format. The Hosmer-Lemeshow strategy was used for variable selection in a multiple model. RESULTS: Of the patients involved 2812(50.3%) were male and 150 (2.7%) had contact with a confirmed case of COVID-19 in the last 14 days. Pre-existing comorbidity was reported in 1310 (23.4%) patients. Of all patients, 477(8.5%) died due to COVID-19. the result of the multiple logistic regression model indicated that after adjusting for other factors, higher age (OR = 3.11), fever or chills (OR = 1.61), shortness of breath (OR = 1.82), fatigue (OR = 0.71), headache (OR = 0.64), runny nose (OR = 1.54), Skeletal muscle pain (OR = 1.53), hospitalization (OR = 5.66), and hospitalization in ICU (OR = 5.12) were associated with death. CONCLUSIONS: Hospitalization had the strongest effect on mortality followed by hospitalization in ICU, and higher age. This study showed that having some extra-pulmonary symptoms in contrast with pulmonary symptoms can predict as good prognostic factors.


Assuntos
COVID-19/mortalidade , Hospitalização/estatística & dados numéricos , Pneumonia Viral/mortalidade , Adulto , Distribuição por Idade , Fatores Etários , Idoso , COVID-19/terapia , Comorbidade , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/terapia , Estudos Retrospectivos , Fatores de Risco
15.
Infez Med ; 29(2): 209-215, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34061785

RESUMO

Information regarding predictors of a worse COVID-19 prognosis in the South American population is scarce. We aimed to determine whether the blockade of the renin-angiotensin system is associated with a worse clinical course of COVID-19, and to evaluate what clinical variables are associated with COVID severity in our population. We included adult subjects with rtPCR-confirmed COVID-19. The use of renin system inhibitors was defined according to its registration in the electronic medical record or the hospital pharmacy registry during the previous three months. Our endpoint was a composite of death or mechanical ventilation requirement. Patients were followed up until discharge or death. A multiple logistic regression model was used to determine the predictors of the composite endpoint. In all, we included 4930 COVID+ patients, the median age was 52 years, and 48.1% were male. The endpoint occurred in 488 patients (9.9%). In adjusted analysis, neither angiotensin converting enzyme inhibitors nor angiotensin receptor blockers were associated with the outcome. Independent predictors of mortality and/or mechanical ventilation requirement were age, male sex, a history of diabetes and/or chronic kidney disease, smoking and dementia. To conclude, renin system inhibitors seem to be unrelated to COVID-19 severity, whereas prognosis is independently associated with age, male sex and comorbidities.


Assuntos
Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , COVID-19/tratamento farmacológico , Respiração Artificial/estatística & dados numéricos , Índice de Gravidade de Doença , Adulto , Fatores Etários , Idoso , Argentina/epidemiologia , COVID-19/epidemiologia , COVID-19/mortalidade , Cidades/epidemiologia , Comorbidade , Demência/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pandemias , Prognóstico , Insuficiência Renal Crônica/epidemiologia , Fatores Sexuais , Fumar/epidemiologia , Centros de Atenção Terciária
16.
Open Biol ; 11(6): 200288, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34062097

RESUMO

We describe the epidemiological characteristics and associated risk factors of those presenting at a large testing centre for SARS-CoV-2 infection. This is a retrospective record review of individuals who underwent SARS-CoV-2 testing by reverse transcription-polymerase chain reaction (RT-PCR) at a high-throughput national-level government facility located in the north of India. Samples collected from 6 April to 31 December 2020 are included in this work and represent four highly populous regions. Additionally, there was a prospective follow-up of 1729 cases through telephone interviews from 25 May 2020 to 20 June 2020. Descriptive analysis has been performed for profiling clinic-epidemiological aspects of suspect cases. Multivariable logistic regression analysis was undertaken to determine risk factors that are associated with SARS-CoV-2 test positivity and symptom status. A total of 125 600 participants' details have been included in this report. The mean (s.d.) age of the participants was 33.1 (±15.3) years and 66% were male. Among these tested, 9515 (7.6%) were positive for COVID-19. A large proportion of positive cases were asymptomatic. In symptomatic positive cases, the commonest symptoms were cough and fever. Increasing age (groups 20-59 and ≥60 years compared to age group less than 5 years), male sex, history of international travel, symptoms for SARS-CoV-2, and participants from Delhi and Madhya Pradesh were positively associated with SARS-CoV-2 test positivity. Having co-morbidity, risk behaviours and intra-familial positivity were associated with a positive odds ratio for exhibiting SARS-CoV-2 symptoms. Intensified testing and isolation of cases, identification of both asymptomatic and symptomatic individuals and additional care of those with co-morbidities and risk behaviours will all be collectively important for disease containment in India. Reasons for differentials in testing between men and women remain an important area for in-depth study. The increased deployment of vaccines is likely to impact the trajectory of COVID-19 in the coming time, and therefore our data will serve as a comparative resource as India experiences the second wave of infection in light of newer variants that are likely to accelerate disease spread.


Assuntos
Teste de Ácido Nucleico para COVID-19/estatística & dados numéricos , COVID-19/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Comorbidade , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Viagem/estatística & dados numéricos
17.
Endocrinol Diabetes Nutr ; 68(2): 123-129, 2021 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-34085003

RESUMO

Obesity is a chronic disease that leads to an increased risk of mortality and morbidity, and the impact of the COVID-19 pandemic may create a new health challenge. There is clear evidence showing that some biological and social factors associated with obesity involve an increased risk of COVID-19 infection, hospitalization, and greater severity compared to people with normal weight. Undoubtedly, obesity involves a low-grade proinflammatory state that produces a dysregulation of the immune system that compromises its ability to respond to respiratory infection by COVID-19 and so produces a worsening of the disease. In this review, the main epidemiological and pathophysiological data that associate obesity with COVID-19 are described.


Assuntos
COVID-19/epidemiologia , Saúde Global , Hospitalização , Obesidade/complicações , Pandemias , Fatores Etários , Índice de Massa Corporal , Previsões , Humanos , Estado Nutricional , Obesidade/epidemiologia , Obesidade/imunologia , Espanha/epidemiologia , Deficiência de Vitamina D/complicações , Populações Vulneráveis
18.
Biomed Environ Sci ; 34(5): 337-347, 2021 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-34059170

RESUMO

Objective: Nutrition is closely related to the health of the elderly population. This study aimed to provide a comprehensive picture of the nutrition status of elderly Chinese and its related dietary, geographical, and socioeconomic factors. Methods: A total of 13,987 ≥ 60-year-old persons from the 2010-2013 Chinese National Nutrition and Health Survey were included to evaluate various aspects of malnutrition, including underweight, overweight or obesity, and micronutrient inadequacy. Results: Overall, the prevalence of obesity, overweight, and underweight was 12.4%, 34.8%, and 5.7%, respectively, with disparities both geographically and socioeconomically. The prevalence of underweight was higher among the older old (≥ 75 years), rural residents and those with low income, with low education status, and residing in undeveloped West areas. More than 75% of the elderly do not meet the Dietary Reference Intakes for vitamins A, B 1, B 2, and E, folate, calcium, selenium, potassium, biotin, and choline, with the prevalence of inadequate intake increasing with age for most nutrients. At the population level, the mean intakes of numerous food groups did not meet the recommendations by the Chinese Dietary Guideline. Conclusions: Obesity epidemic, inadequacy of micronutrient intake, and high prevalence of underweight and anemia in susceptible older people are the major nutrition challenges for the rapidly aging population in China.


Assuntos
Desnutrição/epidemiologia , Sobrepeso/epidemiologia , Magreza/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Dieta/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Desnutrição/diagnóstico , Desnutrição/etiologia , Micronutrientes/deficiência , Pessoa de Meia-Idade , Estado Nutricional , Sobrepeso/diagnóstico , Sobrepeso/etiologia , Fatores de Risco , Fatores Socioeconômicos , Magreza/diagnóstico , Magreza/etiologia
19.
Biomed Environ Sci ; 34(5): 348-355, 2021 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-34059171

RESUMO

Objective: To examine increases in average height among Chinese children and adolescents. Methods: The data were obtained from the China Health and Nutrition Survey conducted during the period 1989-2015. A stratified multistage cluster sampling method was utilized to select participants aged 2-22 years in each province. Linear regression was used to examine the effects of age, birth cohort, and survey period on height. Results: A total of 15,227 males and 13,737 females were included in the final analysis. Age (A) showed a continuous effect on height. The average heights of the investigated groups increased continuously during the investigation period. By 2015, the average height of the overall group increased by 7.87 cm compared to the average height during the 1989 survey. Moreover, birth year (cohort, C) also had a stable effect on height. Using the height of individuals born in or before 1975 as a reference, the average height of each birth cohort increased in comparison to the previous birth cohort. Conclusions: The height of Chinese children and adolescents was affected by age, period, and cohort effects, and this effect is governed by certain rules. The age-period-cohort model can be used to analyze the trends of children's and adolescent's heights. The findings provide a scientific basis for the formulation of children's and adolescents' growth and development policies in China.


Assuntos
Desenvolvimento do Adolescente , Estatura , Desenvolvimento Infantil , Indicadores Básicos de Saúde , Adolescente , Saúde do Adolescente , Fatores Etários , Criança , Saúde da Criança , Pré-Escolar , China , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Lineares , Masculino , Fatores Sexuais , Adulto Jovem
20.
NPJ Prim Care Respir Med ; 31(1): 33, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34083541

RESUMO

Accurate prediction of the risk of progression of coronavirus disease (COVID-19) is needed at the time of hospitalization. Logistic regression analyses are used to interrogate clinical and laboratory co-variates from every hospital admission from an area of 2 million people with sporadic cases. From a total of 98 subjects, 3 were severe COVID-19 on admission. From the remaining subjects, 24 developed severe/critical symptoms. The predictive model includes four co-variates: age (>60 years; odds ratio [OR] = 12 [2.3, 62]); blood oxygen saturation (<97%; OR = 10.4 [2.04, 53]); C-reactive protein (>5.75 mg/L; OR = 9.3 [1.5, 58]); and prothrombin time (>12.3 s; OR = 6.7 [1.1, 41]). Cutoff value is two factors, and the sensitivity and specificity are 96% and 78% respectively. The area under the receiver-operator characteristic curve is 0.937. This model is suitable in predicting which unselected newly hospitalized persons are at-risk to develop severe/critical COVID-19.


Assuntos
COVID-19/diagnóstico , Hospitalização/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/análise , COVID-19/patologia , Criança , Pré-Escolar , Progressão da Doença , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Prognóstico , Tempo de Protrombina , Curva ROC , Medição de Risco , Sensibilidade e Especificidade , Adulto Jovem
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