Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 457.980
Filtrar
1.
Rev. enferm. UERJ ; 28: e39729, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1116093

RESUMO

Objetivo: identificar as principais causas de óbito entre adolescentes de 10 a 19 anos em um município no interior do estado do Rio de Janeiro. Método: estudo descritivo, exploratório de abordagem quantitativa, a partir do levantamento de dados em registros de óbitos do município de Rio das Ostras. O desfecho foi causa básica do óbito. Os dados foram processados no Programa R. Resultados: foram observados 84 (100%) óbitos, com maior prevalência entre adolescentes de 17 a 19 anos, 49 (58,3%), do sexo masculino, 71 (84,5%) e de cor parda, 38 (45,2%). As principais causas de óbitos foram homicídio/perfuração por arma de fogo, 35 (41,7%), e acidentes, 32 (38,1%). Conclusão: o reconhecimento dessa vulnerabilidade configura importante caminho para o enfrentamento e resolução desse grave problema, sobretudo municípios localizados longe de centros urbanos, parece muitas vezes esquecido, no que tange o cumprimento de estatutos e políticas públicas a favor desse grupo etário.


Objective: to identify the main causes of death among adolescents aged 10 to 19 years in a municipality in the state of Rio de Janeiro. Method: in this exploratory, descriptive, quantitative study, based on data collected from death records in the municipality of Rio das Ostras, the basic cause of death was the outcome. The data were processed in the statistics software, R. Results: of the 84 (100%) deaths observed, prevalence was higher among adolescents aged 17 to 19 years (49; 58.3%), males (71; 84.5%), and pardos (38; 45.2%). The main causes of deaths were firearm Injury / homicide (35; 41.7%) and accidents (32; 38.1%). Conclusion: one important step towards confronting and solving this serious problem is to acknowledge this vulnerability, especially in municipalities distant from urban centers, which often seem neglected as regards compliance with statutes and public policies in favor of this age group.


Objetivo: identificar las principales causas de muerte entre adolescentes de 10 a 19 años en un municipio del estado de Río de Janeiro. Método: en este estudio exploratorio, descriptivo, cuantitativo, basado en los datos recopilados de los registros de defunciones en el municipio de Rio das Ostras, la causa básica de la muerte fue el resultado. Los datos se procesaron en el programa estadístico R. Resultados: de las 84 (100%) muertes observadas, la prevalencia fue mayor entre los adolescentes de 17 a 19 años (49; 58.3%), varones (71; 84.5%) y pardos (38; 45,2%). Las principales causas de muerte fueron lesiones por arma de fuego / homicidio (35; 41.7%) y accidentes (32; 38.1%). Conclusión: un paso importante para enfrentar y resolver este grave problema es reconocer esta vulnerabilidad, especialmente en municipios alejados de los centros urbanos, que a menudo parecen descuidados en cuanto al cumplimiento de los estatutos y las políticas públicas a favor de este grupo de edad.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Acidentes/estatística & dados numéricos , Causas de Morte , Populações Vulneráveis/estatística & dados numéricos , Homicídio/estatística & dados numéricos , Brasil , Epidemiologia Descritiva , Fatores Etários , Vulnerabilidade Social , Mortalidade Prematura
2.
Allergol. immunopatol ; 48(5): 500-506, sept.-oct. 2020. graf
Artigo em Inglês | IBECS | ID: ibc-192549

RESUMO

The reasons for the relative resistance of children to certain infections such as that caused by coronavirus SARS-CoV2 are not yet fully clear. Deciphering these differences can provide important information about the pathogenesis of the disease. Regarding the SARS-CoV2 virus, children are at the same risk of infection as the general population of all ages, with the most serious cases being found in infants. However, it has been reported that the disease is much less frequent than in adults and that most cases are benign or moderate (even with high viral loads), provided there are no other risk factors or underlying diseases. It is not clear why they have lower morbidity and virtually no mortality. A series of findings, relationships and behavioral patterns between the infectious agent and the child host may account for the lower incidence and a greatly attenuated clinical presentation of the disease in children


No disponible


Assuntos
Humanos , Criança , Índice de Gravidade de Doença , Infecções por Coronavirus/imunologia , Pneumonia Viral/imunologia , Betacoronavirus/imunologia , Betacoronavirus/patogenicidade , Fatores Etários
3.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(5): 272-278, sept.-oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193032

RESUMO

OBJETIVOS: Analizar si existen diferencias en función de la edad en ansiedad, tristeza, soledad y comorbilidad ansioso-depresiva en personas jóvenes, de mediana edad y mayores confinadas debido a la pandemia de la COVID-19, y explorar la relación entre la autopercepción negativa del envejecimiento y nivel de sintomatología psicológica en función del grupo de edad. MÉTODO: Participan 1.501 personas (rango de edad: 18 a 88 años). Se evaluaron el grado de ansiedad, tristeza y soledad, y la autopercepción del envejecimiento. Se dividió a la muestra en función del grupo de edad y por cuartiles (bajo, intermedios y alto) en ansiedad, tristeza, soledad y autopercepción del envejecimiento. RESULTADOS: Las personas mayores informan de menor ansiedad y tristeza que los de mediana edad y jóvenes, y los de mediana edad de menores niveles que los jóvenes. Los de mediana edad informan de menor soledad, seguidos de los mayores y los jóvenes. Para cada grupo de edad, aquellos con una alta autopercepción negativa del envejecimiento informan de mayor ansiedad, tristeza y soledad. Hay más comorbilidad ansioso-depresiva en jóvenes y menos en mayores; más personas deprimidas en mediana edad, menos mayores con ansiedad, y más mayores y menos jóvenes sin sintomatología ansiosa y depresiva. Para todos los grupos de edad, las personas con comorbilidad ansioso-depresiva son las que tienen puntuaciones altas en autopercepción negativa del envejecimiento. CONCLUSIONES: Las personas mayores informan de menos malestar psicológico que otros grupos de edad. Tener una alta autopercepción negativa del envejecimiento perjudica a la salud psicológica, independientemente de la edad


OBJECTIVES: To analyze differences by age group in anxiety, depression, loneliness and comorbid anxiety and depression in young people, middle aged adults and older adults during the lock-down period at home due to the COVID-19 pandemic, and to explore the association between negative self-perceptions of aging and psychological symptoms controlling by age group. METHOD: Participants are 1501 people (age range 18 to 88 years). Anxiety, sadness, loneliness and self-perceptions of aging were assessed. The sample was divided according to the age group and quartiles (lower, intermediate levels, and higher) of anxiety, sadness, loneliness and self-perceptions of aging. RESULTS: Older adults reported lower levels of anxiety and sadness than middle aged adults, and middle aged adults reported lower levels than younger participants. Middle aged adults reported the lowest loneliness, followed by older adults and younger participants. For each age group, those with more negative self-perceptions of aging reported higher anxiety, sadness and loneliness. More comorbid anxiety and sadness was found in younger adults and less in older adults; more depressed participants in the middle aged group, and more older adults and less younger participants were found in the group with the lowest levels of anxiety and sadness. For all the age groups, participants with high levels of comorbid anxiety and sadness are those who report the highest scores in negative self-perceptions of aging. CONCLUSIONS: Older adults reported lower psychological anxiety, sadness and loneliness than the other age groups. Having negative self-perceptions of aging damage psychological health irrespective of the chronological age


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/epidemiologia , Quarentena/psicologia , Envelhecimento/psicologia , Autoimagem , Solidão/psicologia , Depressão/psicologia , Ansiedade/epidemiologia , Adaptação Psicológica , Inquéritos de Morbidade , Pandemias , Fatores Etários , Questionário de Saúde do Paciente/estatística & dados numéricos , Transtornos de Adaptação/epidemiologia
4.
Sci Rep ; 10(1): 16384, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: covidwho-811563

RESUMO

The COVID-19 outbreak is becoming a public health emergency. Data are limited on the clinical characteristics and causes of death. A retrospective analysis of COVID-19 deaths were performed for patients' clinical characteristics, laboratory results, and causes of death. In total, 56 patients (72.7%) of the decedents (male-female ratio 51:26, mean age 71 ± 13, mean survival time 17.4 ± 8.4 days) had comorbidities. Acute respiratory failure (ARF) and sepsis were the main causes of death. Increases in C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer and lactic acid and decreases in lymphocytes were common laboratory results. Intergroup analysis showed that (1) most female decedents had cough and diabetes. (2) The proportion of young- and middle-aged deaths was higher than elderly deaths for males, while elderly decedents were more prone to myocardial injury and elevated CRP. (3) CRP and LDH increased and cluster of differentiation (CD) 4+ and CD8+ cells decreased significantly in patients with hypertension. The majority of COVID-19 decedents are male, especially elderly people with comorbidities. The main causes of death are ARF and sepsis. Most female decedents have cough and diabetes. Myocardial injury is common in elderly decedents. Patients with hypertension are prone to an increased inflammatory index, tissue hypoxia and cellular immune injury.


Assuntos
Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Sepse/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/análise , Causas de Morte , China , Comorbidade , Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Infecções por Coronavirus/patologia , Diabetes Mellitus/epidemiologia , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Cardiopatias/epidemiologia , Humanos , L-Lactato Desidrogenase/sangue , Ácido Láctico/sangue , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Pneumonia Viral/patologia , Sepse/etiologia , Síndrome Respiratória Aguda Grave/etiologia
5.
MMWR Morb Mortal Wkly Rep ; 69(41): 1485-1491, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: covidwho-874994

RESUMO

Frequent hand hygiene, including handwashing with soap and water or using a hand sanitizer containing ≥60% alcohol when soap and water are not readily available, is one of several critical prevention measures recommended to reduce the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19).* Previous studies identified demographic factors associated with handwashing among U.S. adults during the COVID-19 pandemic (1,2); however, demographic factors associated with hand sanitizing and experiences and beliefs associated with hand hygiene have not been well characterized. To evaluate these factors, an Internet-based survey was conducted among U.S. adults aged ≥18 years during June 24-30, 2020. Overall, 85.2% of respondents reported always or often engaging in hand hygiene following contact with high-touch public surfaces such as shopping carts, gas pumps, and automatic teller machines (ATMs).† Respondents who were male (versus female) and of younger age reported lower handwashing and hand sanitizing rates, as did respondents who reported lower concern about their own infection with SARS-CoV-2§ and respondents without personal experience with COVID-19. Focused health promotion efforts to increase hand hygiene adherence should include increasing visibility and accessibility of handwashing and hand sanitizing materials in public settings, along with targeted communication to males and younger adults with focused messages that address COVID-19 risk perception.


Assuntos
Infecções por Coronavirus/prevenção & controle , Higiene das Mãos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adolescente , Adulto , Fatores Etários , Idoso , Grupos de Populações Continentais/psicologia , Grupos de Populações Continentais/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/etnologia , Grupos Étnicos/psicologia , Grupos Étnicos/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/etnologia , Fatores Sexuais , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
7.
Cien Saude Colet ; 25(suppl 2): 4131-4140, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33027349

RESUMO

We investigated the predictors of delay in the diagnosis and mortality of patients with COVID-19 in Rio de Janeiro, Brazil. A cohort of 3,656 patients were evaluated (Feb-Apr 2020) and patients' sociodemographic characteristics, and social development index (SDI) were used as determinant factors of diagnosis delays and mortality. Kaplan-Meier survival analyses, time-dependent Cox regression models, and multivariate logistic regression analyses were conducted. The median time from symptoms onset to diagnosis was eight days (interquartile range [IQR] 7.23-8.99 days). Half of the patients recovered during the evaluated period, and 8.3% died. Mortality rates were higher in men. Delays in diagnosis were associated with male gender (p = 0.015) and patients living in low SDI areas (p < 0.001). The age groups statistically associated with death were: 70-79 years, 80-89 years, and 90-99 years. Delays to diagnosis greater than eight days were also risk factors for death. Delays in diagnosis and risk factors for death from COVID-19 were associated with male gender, age under 60 years, and patients living in regions with lower SDI. Delays superior to eight days to diagnosis increased mortality rates.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Diagnóstico Tardio , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Técnicas de Laboratório Clínico , Estudos de Coortes , Feminino , Humanos , Masculino , Pandemias , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Fatores de Tempo
8.
PLoS One ; 15(10): e0240400, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33031439

RESUMO

BACKGROUND & AIMS: Although metabolic risk factors are associated with more severe COVID-19, there is little evidence on outcomes in patients with non-alcoholic fatty liver disease (NAFLD). We here describe the clinical characteristics and outcomes of NAFLD patients in a cohort hospitalised for COVID-19. METHODS: This study included all consecutive patients admitted for COVID-19 between February and April 2020 at Imperial College Healthcare NHS Trust, with either imaging of the liver available dated within one year from the admission or a known diagnosis of NAFLD. Clinical data and early weaning score (EWS) were recorded. NAFLD diagnosis was based on imaging or past medical history and patients were stratified for Fibrosis-4 (FIB-4) index. Clinical endpoints were admission to intensive care unit (ICU)and in-hospital mortality. RESULTS: 561 patients were admitted. Overall, 193 patients were included in the study. Fifty nine patients (30%) died, 9 (5%) were still in hospital, and 125 (65%) were discharged. The NAFLD cohort (n = 61) was significantly younger (60 vs 70.5 years, p = 0.046) at presentation compared to the non-NAFLD (n = 132). NAFLD diagnosis was not associated with adverse outcomes. However, the NAFLD group had higher C reactive protein (CRP) (107 vs 91.2 mg/L, p = 0.05) compared to non-NAFLD(n = 132). Among NAFLD patients, male gender (p = 0.01), ferritin (p = 0.003) and EWS (p = 0.047) were associated with in-hospital mortality, while the presence of intermediate/high risk FIB-4 or liver cirrhosis was not. CONCLUSION: The presence of NAFLD per se was not associated with worse outcomes in patients hospitalised for COVID-19. Though NAFLD patients were younger on admission, disease stage was not associated with clinical outcomes. Yet, mortality was associated with gender and a pronounced inflammatory response in the NAFLD group.


Assuntos
Infecções por Coronavirus/imunologia , Infecções por Coronavirus/mortalidade , Hepatopatia Gordurosa não Alcoólica/imunologia , Pneumonia Viral/imunologia , Pneumonia Viral/mortalidade , Fatores Etários , Idoso , Betacoronavirus , Estudos de Coortes , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Fígado/patologia , Londres/epidemiologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/mortalidade , Hepatopatia Gordurosa não Alcoólica/patologia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Fatores Sexuais
9.
PLoS One ; 15(10): e0240394, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33031467

RESUMO

BACKGROUND: The SARS-CoV-2 pandemic compounds Mexico's pre-existing challenges: very high levels of both non-communicable diseases (NCD) and social inequity. METHODS AND FINDINGS: Using data from national reporting of SARS-CoV-2 tested individuals, we estimated odds of hospitalization, intubation, and death based on pre-existing non-communicable diseases and socioeconomic indicators. We found that obesity, diabetes, and hypertension are positively associated with the three outcomes in a synergistic manner. The municipal poverty level is also positively associated with hospitalization and death. CONCLUSIONS: Mexico's response to COVID-19 is complicated by a synergistic double challenge: raging NCDs and extreme social inequity. The response to the current pandemic must take both into account both to be effective and to ensure that the burden of COVID-19 not falls disproportionately on those who are already disadvantaged.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , Fatores Etários , Betacoronavirus/fisiologia , Comorbidade , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Complicações do Diabetes , Diabetes Mellitus/fisiopatologia , Feminino , Hospitalização , Humanos , Hipertensão/fisiopatologia , Intubação , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Pandemias , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Pobreza , Fatores Sexuais , Fatores Socioeconômicos
10.
Skinmed ; 18(4): 218-220, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33032685

RESUMO

Coronavirus disease of 2019 (COVID-19) is a viral infection caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). In addition to affecting mainly the respiratory tract, there have been many reported cutaneous manifestations of the disease. A retrospective case series based on history and clinical findings was performed across six hospitals in the UAE, including two field hospitals. A total of 324 patients with COVID-19 were identified and divided into three groups based on the severity of the disease. Forty-five (12.5%) patients had clearly identifiable cutaneous manifestation of COVID-19. Two patients each with alopecia areata and sclerosis of the extremities, respectively, were identified in the second group. Cutaneous manifestations of COVID-19 have been well reported across the literature. The experience in the UAE is similar to that of published reports. The occurrence of other cutaneous manifestations with an underlying autoimmune pathogenesis should raise the possibility of such conditions in those with COVID-19. (SKINmed. 2020;18:218-220).


Assuntos
Infecções por Coronavirus/epidemiologia , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Dermatopatias Virais/epidemiologia , Dermatopatias Virais/fisiopatologia , Adulto , Fatores Etários , Estudos de Coortes , Infecções por Coronavirus/prevenção & controle , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Prevalência , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Emirados Árabes Unidos/epidemiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-33036351

RESUMO

The new corona virus infection SARS-CoV2 which was later renamed COVID-19 is a pandemic affecting public health. The fear and the constraints imposed to control the pandemic may correspondingly influence leisure activities, such as birding, which is the practice of observing birds based on visual and acoustic cues. Birders are people who carry out birding observations around the globe and contribute to the massive data collection in citizen science projects. Contrasting to earlier COVID-19 studies, which have concentrated on clinical, pathological, and virological topics, this study focused on the behavioral changes of birders. A total of 4484 questionnaire survey responses from 97 countries were received. The questionnaire had an open-ended style. About 85% of respondents reported that COVID-19 has changed their birding behavior. The most significant change in birdwatchers' behavior was related to the geographic coverage of birding activities, which became more local. People focused mostly on yard birding. In total, 12% of respondents (n = 542 cases) reported having more time for birding, whereas 8% (n = 356 cases) reported having less time for birding. Social interactions decreased since respondents, especially older people, changed their birding behavior toward birding alone or with their spouse. Women reported more often than men that they changed to birding alone or with their spouse, and women also reported more often about canceled fieldtrips or society meetings. Respondents from higher developed countries reported that they spend currently more time for birding, especially for birding alone or with their spouse, and birding at local hotspots. Our study suggests that long lockdowns with strict regulations may severely impact on leisure activities. In addition, a temporal and spatial shift in birding due to the pandemic may influence data quality in citizen science projects. As nature-based recreation will be directed more toward nearby sites, environmental management resources and actions need to be directed to sites that are located near the users, e.g., in urban and suburban areas. The results can be applied with caution to other nature-based recreational activities.


Assuntos
Ciência do Cidadão , Infecções por Coronavirus/psicologia , Coronavirus , Atividades de Lazer , Pneumonia Viral/psicologia , Quarentena/psicologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Animais , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Masculino , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Saúde Pública , Fatores Sexuais , Comportamento Social , Inquéritos e Questionários
13.
MMWR Morb Mortal Wkly Rep ; 69(41): 1485-1491, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33056951

RESUMO

Frequent hand hygiene, including handwashing with soap and water or using a hand sanitizer containing ≥60% alcohol when soap and water are not readily available, is one of several critical prevention measures recommended to reduce the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19).* Previous studies identified demographic factors associated with handwashing among U.S. adults during the COVID-19 pandemic (1,2); however, demographic factors associated with hand sanitizing and experiences and beliefs associated with hand hygiene have not been well characterized. To evaluate these factors, an Internet-based survey was conducted among U.S. adults aged ≥18 years during June 24-30, 2020. Overall, 85.2% of respondents reported always or often engaging in hand hygiene following contact with high-touch public surfaces such as shopping carts, gas pumps, and automatic teller machines (ATMs).† Respondents who were male (versus female) and of younger age reported lower handwashing and hand sanitizing rates, as did respondents who reported lower concern about their own infection with SARS-CoV-2§ and respondents without personal experience with COVID-19. Focused health promotion efforts to increase hand hygiene adherence should include increasing visibility and accessibility of handwashing and hand sanitizing materials in public settings, along with targeted communication to males and younger adults with focused messages that address COVID-19 risk perception.


Assuntos
Infecções por Coronavirus/prevenção & controle , Higiene das Mãos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adolescente , Adulto , Fatores Etários , Idoso , Grupos de Populações Continentais/psicologia , Grupos de Populações Continentais/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/etnologia , Grupos Étnicos/psicologia , Grupos Étnicos/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/etnologia , Fatores Sexuais , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
14.
Mayo Clin Proc ; 95(10): 2110-2124, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33012342

RESUMO

OBJECTIVE: To address the issue of limited national data on the prevalence and distribution of underlying conditions among COVID-19 deaths between sexes and across age groups. PATIENTS AND METHODS: All adult (≥18 years) deaths recorded in England and Wales (March 1, 2020, to May 12, 2020) were analyzed retrospectively. We compared the prevalence of underlying health conditions between COVID and non-COVID-related deaths during the COVID-19 pandemic and the age-standardized mortality rate (ASMR) of COVID-19 compared with other primary causes of death, stratified by sex and age group. RESULTS: Of 144,279 adult deaths recorded during the study period, 36,438 (25.3%) were confirmed COVID deaths. Women represented 43.2% (n=15,731) of COVID deaths compared with 51.9% (n=55,980) in non-COVID deaths. Overall, COVID deaths were younger than non-COVID deaths (82 vs 83 years). ASMR of COVID-19 was higher than all other common primary causes of death, across age groups and sexes, except for cancers in women between the ages of 30 and 79 years. A linear relationship was observed between ASMR and age among COVID-19 deaths, with persistently higher rates in men than women across all age groups. The most prevalent reported conditions were hypertension, dementia, chronic lung disease, and diabetes, and these were higher among COVID deaths. Pre-existing ischemic heart disease was similar in COVID (11.4%) and non-COVID (12%) deaths. CONCLUSION: In a nationwide analysis, COVID-19 infection was associated with higher age-standardized mortality than other primary causes of death, except cancer in women of select age groups. COVID-19 mortality was persistently higher in men and increased with advanced age.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Disparidades em Assistência à Saúde/estatística & dados numéricos , Mortalidade Hospitalar/tendências , Pneumonia Viral/mortalidade , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Causas de Morte , Inglaterra/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Distribuição por Sexo , Fatores Socioeconômicos , País de Gales/epidemiologia
16.
Eur Rev Med Pharmacol Sci ; 24(18): 9698-9704, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33015815

RESUMO

OBJECTIVE: To investigate patient characteristics and factors that increase the risk of being admitted to intensive care and that influence survival in cases of SARS-CoV-2 pneumonia. PATIENTS AND METHODS: One-hundred and ninety-one SARS-CoV-2 patients were admitted to the "Fondazione Poliambulanza di Brescia" Hospital (Brescia, Lombardy, Italy) in the period 1st March 2020 to 11th April 2020. Data on demographics, clinical presentation at admission, co-morbidities, pharmacological treatment, admission to intensive care and death was recorded. Logistic regression and survival analysis were carried out to investigate the risk of being admitted to intensive care and the risk of death. RESULTS: The mean age of the study cohort was 64.6±9.9 years (range 20-88). Median BMI was 28.5±5 kg/m2. Fever (81%) and dyspnea (65%) were the most common symptoms on admission. Most of patients (63%) had at least one co-existing disease. The 157 (82%) patients admitted to intensive care were more likely to be of intermediate age (60-69 years; OR 3.23, 95% CI 1.32-8.38), overweight (OR 2.66, 95% CI 1.02-7.07) or obese (OR 5.63, 95% CI 1.73-21.09) and with lymphocytopenia (OR 2.75, 95% CI 1.17-6.89) than the 34 patients admitted to the ordinary ward. During intensive care, 50% of patients died and their death was associated with older age (HR 2.06, 95% CI 1.07-3.97), obesity (HR 2.23, 95% CI 1.15-4.35) and male gender (HR 1.9, 95% CI 1.02-3.57). CONCLUSIONS: We found that admission to intensive care and poor survival were associated with advanced age and higher body mass index, albeit with differences in statistical significance. Pre-existing diseases and symptoms on admission were not associated with different clinical outcomes. Interestingly, male gender was more prevalent among SARS-CoV-2 patients and was related negatively to survival, but it was not associated with more frequent admission to intensive care.


Assuntos
Infecções por Coronavirus/mortalidade , Hospitalização/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Pneumonia Viral/mortalidade , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores de Risco , Fatores Sexuais , Adulto Jovem
17.
Medicine (Baltimore) ; 99(40): e22422, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019420

RESUMO

Infectious aortitis (IA) is a rare and severe disease. The treatment classically associates open surgery with prolonged antibiotic therapy. This study aimed to describe clinical characteristics, medical and surgical supports in a large and current series of IA.We conducted a retrospective multicenter study of native aorta IA, between 2000 and 2019. Inclusion criteria were the presence of a microorganism on blood culture, aortic sample or any other validated technique and structural anomaly in imaging.We included 55 patients (85% men), with a median age of 65. Microbiology data substantially differed from previous studies with 12 Gram-negative rods IA, of which only 3 due to Salmonella spp., 24 Gram-positive cocci IA of which 12 Streptococcus spp., and 18 IA due to intracellular growth and/or fastidious microorganisms, of which 8 Coxiella burnetii, 3 Treponema pallidum, and 5 tuberculosis suspicious cases. Fifteen patients (27%) presented with thoracic IA, 31 (56%) with abdominal IA, and 9 (16%) with thoraco-abdominal IA. Eight patients had no surgery, 41 underwent open surgery, only 4 endovascular aneurysm repair, and 2 a combination of these 2 techniques. Nine patients died before 1-month follow-up. There was no difference in the mortality rate between the different types of germ or localization of IA.The variety of germs involved in IA increases. Positron emission tomography-computed tomography scan is a very useful tool for diagnosis. Surgery is still mainly done in open approach and a prospective multicenter study seems necessary to better determine the place of endovascular aneurysm repair versus open surgery.


Assuntos
Aortite/terapia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Aortite/microbiologia , Aortite/mortalidade , Aortite/fisiopatologia , Feminino , Humanos , Imunossupressão/efeitos adversos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Estudos Retrospectivos , Fatores Sexuais
18.
Nat Commun ; 11(1): 5009, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33024121

RESUMO

Comorbid conditions appear to be common among individuals hospitalised with coronavirus disease 2019 (COVID-19) but estimates of prevalence vary and little is known about the prior medication use of patients. Here, we describe the characteristics of adults hospitalised with COVID-19 and compare them with influenza patients. We include 34,128 (US: 8362, South Korea: 7341, Spain: 18,425) COVID-19 patients, summarising between 4811 and 11,643 unique aggregate characteristics. COVID-19 patients have been majority male in the US and Spain, but predominantly female in South Korea. Age profiles vary across data sources. Compared to 84,585 individuals hospitalised with influenza in 2014-19, COVID-19 patients have more typically been male, younger, and with fewer comorbidities and lower medication use. While protecting groups vulnerable to influenza is likely a useful starting point in the response to COVID-19, strategies will likely need to be broadened to reflect the particular characteristics of individuals being hospitalised with COVID-19.


Assuntos
Infecções por Coronavirus/epidemiologia , Hospitalização , Influenza Humana/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Comorbidade , Infecções por Coronavirus/tratamento farmacológico , Feminino , Humanos , Influenza Humana/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/tratamento farmacológico , Prevalência , República da Coreia/epidemiologia , Fatores Sexuais , Espanha/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
19.
Can Respir J ; 2020: 2045341, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33005276

RESUMO

Objective: Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus SARS-CoV-2, was first identified in December 2019 in Wuhan, China, and has since spread globally, resulting in an ongoing pandemic. However, the study of asymptomatic patients is still rare, and the understanding of its potential transmission risk is still insufficient. In this study, epidemiological investigations were conducted in the Zhejiang province to understand the epidemiology and clinical characteristics of asymptomatic patients with COVID-19. Methods: This retrospective study was carried out on 22 asymptomatic patients and 234 symptomatic patients with COVID-19 who were hospitalized in Zhejiang Duodi Hospital from January 21 to March 16, 2020. The characteristics of epidemiology, demography, clinical manifestations, and laboratory data of mild patients were compared and analyzed. Results: The median age was 28 years in asymptomatic patients and 48 years in symptomatic patients. The proportion who were female was 77.3% in asymptomatic patients and 36.3% in symptomatic patients (p < 0.001). The proportion of patients with coexisting diseases was 4.5% in asymptomatic patients and 38.0% in symptomatic patients (p=0.002). The proportion of patients with increased CRP was 13.6% in the asymptomatic group and 61.1% in the symptomatic group (p < 0.001). The proportion of patients received antiviral therapy was 45.5% in the asymptomatic group and 97.9% in the symptomatic group (p < 0.001). The proportion of patients received oxygen therapy was 22.7% in the asymptomatic group and 99.1% in symptomatic patients (p < 0.001). By March 16, 2020, all patients were discharged from the hospital, and no symptoms had appeared in the asymptomatic patients during hospitalization. The median course of infection to discharge was 21.5 days in asymptomatic patients and 22 days in symptomatic patients. Conclusions: Asymptomatic patients are also infectious; relying only on clinical symptoms, blood cell tests, and radiology examination will lead to misdiagnosis of most patients, leading to the spread of the virus. Investigation of medical history is the best strategy for screening asymptomatic patients, especially young people, women, and people without coexisting disease, who are more likely to be asymptomatic when infected. Although the prognosis is good, isolation is critical for asymptomatic patients, and it is important not to end isolation early before a nucleic acid test turns negative.


Assuntos
Doenças Assintomáticas , Infecções por Coronavirus , Transmissão de Doença Infecciosa/prevenção & controle , Pandemias , Pneumonia Viral , Medição de Risco/métodos , Adulto , Fatores Etários , Doenças Assintomáticas/epidemiologia , Doenças Assintomáticas/terapia , Betacoronavirus/isolamento & purificação , China/epidemiologia , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Erros de Diagnóstico/prevenção & controle , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Oxigenoterapia/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Prognóstico , Fatores Sexuais
20.
Colomb Med (Cali) ; 51(2): e4270, 2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-33012885

RESUMO

Introduction: The COVID-19 disease pandemic is a health emergency. Older people and those with chronic noncommunicable diseases are more likely to develop serious illnesses, require ventilatory support, and die from complications. Objective: To establish deaths from respiratory infections and some chronic non-communicable diseases that occurred in Cali, before the SARS-CoV-2 disease pandemic. Methods: During the 2003-2019 period, 207,261 deaths were registered according to the general mortality database of the Municipal Secretary of Health of Cali. Deaths were coded with the International Classification of Diseases and causes of death were grouped according to WHO guidelines. Rates were standardized by age and are expressed per 100,000 people-year. Results: A direct relationship was observed between aging and mortality from respiratory infections and chronic non-communicable diseases. Age-specific mortality rates were highest in those older than 80 years for all diseases evaluated. Seasonal variation was evident in respiratory diseases in the elderly. Comments: Estimates of mortality rates from respiratory infections and chronic non-communicable diseases in Cali provide the baseline that will serve as a comparison to estimate the excess mortality caused by the COVID-19 pandemic. Health authorities and decision makers should be guided by reliable estimates of mortality and of the proportion of infected people who die from SARS-CoV-2 virus infection.


Assuntos
Causas de Morte/tendências , Doenças não Transmissíveis/epidemiologia , Infecções Respiratórias/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Colômbia/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Humanos , Doenças não Transmissíveis/mortalidade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Infecções Respiratórias/mortalidade , Fatores de Risco , Estações do Ano
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA