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1.
J Med Virol ; 94(1): 366-371, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34546584

RESUMO

Co-epidemics happening simultaneously can generate a burden on healthcare systems. The co-occurrence of SARS-CoV-2 with vector-borne diseases (VBD), such as malaria and dengue in resource-limited settings represents an additional challenge to the healthcare systems. Herein, we assessed the coinfection rate between SARS-CoV-2 and VBD to highlight the need to carry out an accurate diagnosis and promote timely measures for these infections in Luanda, the capital city of Angola. This was a cross-sectional study conducted with 105 subjects tested for the SARS-CoV-2 and VBD with a rapid detection test in April 2021. The participants tested positive for SARS-CoV-2 (3.80%), malaria (13.3%), and dengue (27.6%). Low odds related to testing positivity to SARS-CoV-2 or VBD were observed in participants above or equal to 40 years (odds ratio [OR]: 0.60, p = 0.536), while higher odds were observed in male (OR: 1.44, p = 0.392) and urbanized areas (OR: 3.78, p = 0.223). The overall co-infection rate between SARS-CoV-2 and VBD was 11.4%. Our findings showed a coinfection between SARS-CoV-2 with malaria and dengue, which could indicate the need to integrate the screening for VBD in the SARS-CoV-2 testing algorithm and the adjustment of treatment protocols. Further studies are warranted to better elucidate the relationship between COVID-19 and VBD in Angola.


Assuntos
COVID-19/epidemiologia , Coinfecção/epidemiologia , Dengue/epidemiologia , Malária/epidemiologia , Doenças Transmitidas por Vetores/epidemiologia , Adolescente , Adulto , Fatores Etários , Angola/epidemiologia , Anticorpos Antiprotozoários/sangue , Anticorpos Antivirais/sangue , Teste para COVID-19 , Febre de Chikungunya/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , RNA Viral/sangue , SARS-CoV-2/isolamento & purificação , Fatores Sexuais , Adulto Jovem , Infecção por Zika virus/epidemiologia
2.
Philos Trans A Math Phys Eng Sci ; 380(2214): 20210121, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-34802274

RESUMO

We develop a statistical model for the testing of disease prevalence in a population. The model assumes a binary test result, positive or negative, but allows for biases in sample selection and both type I (false positive) and type II (false negative) testing errors. Our model also incorporates multiple test types and is able to distinguish between retesting and exclusion after testing. Our quantitative framework allows us to directly interpret testing results as a function of errors and biases. By applying our testing model to COVID-19 testing data and actual case data from specific jurisdictions, we are able to estimate and provide uncertainty quantification of indices that are crucial in a pandemic, such as disease prevalence and fatality ratios. This article is part of the theme issue 'Data science approach to infectious disease surveillance'.


Assuntos
Teste para COVID-19 , COVID-19 , Viés , Reações Falso-Positivas , Humanos , Modelos Estatísticos , SARS-CoV-2 , Viés de Seleção , Sensibilidade e Especificidade
3.
J Public Health Manag Pract ; 28(Suppl 1): S101-S110, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34797267

RESUMO

CONTEXT: The New York City (NYC) Test & Trace Corps (Test & Trace), under New York City Health + Hospitals (NYC H+H), set out to provide universal access to COVID-19 testing. Test & Trace partnered with numerous organizations to direct mobile COVID-19 testing from concept through implementation to reduce COVID-19-related health inequities. PROGRAM: Test & Trace employs a community-informed mobile COVID-19 testing model to deliver testing to the hardest-hit, underserved communities. Community partners, uniquely knowledgeable of the residents they serve, are engaged as decision makers and operational partners in mobile COVID-19 testing delivery. IMPLEMENTATION: Through several mobile testing methods, community partners choose testing locations and tailor outreach to their community. Test & Trace assumes logistical responsibility for mobile testing but defers critical programmatic decisions and community engagement to partners. Integral to the success of this program is responsive, bidirectional communication. EVALUATION: During the reporting period of December 1, 2020, to April 30, 2021, Test & Trace's community-informed mobile COVID-19 testing model provided testing to 150351 unique patients and processed 274083 tests in total. The available outcomes data and qualitative feedback provided by community partners illustrate that this intervention, combined with robust governmental investment, successfully ensured that NYC-identified, low-resource neighborhoods had greater access to COVID-19 testing. DISCUSSION: Making community partners decision makers reduced inequities in access to testing for communities of color. In addition, the model has served as the framework for Test & Trace's community-informed mobile COVID-19 vaccination program, operated in concert with NYC's Vaccine Command Center, and is a foundation for addressing health inequities at scale, including during public health crises.


Assuntos
COVID-19 , Teste para COVID-19 , Vacinas contra COVID-19 , Humanos , Características de Residência , SARS-CoV-2
4.
Methods Mol Biol ; 2392: 185-197, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34773624

RESUMO

Real-time quantitative PCR is currently the most widely used method for the human pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) identification. Due to the rapid evolution of the SARS-CoV-2 genome, novel mutations on the primer binding sites will cause the failure of PCR. Therefore, in addition to a well-designed primer set, these primers need to be updated and evaluated regularly to ensure that the rapidly evolving genome primers can be amplified. In this protocol, (1) we firstly use assembled genome sequences in the SARS-CoV-2 database to identify and characterize indels and point mutations; (2) design primers skipping the sites of mutations; (3) check the coverage of the primers with the daily update SARS-CoV-2 database; (4) redesign them if novel mutations found in the primer binding sites. Although this protocol takes SARS-CoV-2 as an example, it is suitable for other species that have genomes accumulating mutations over time.


Assuntos
COVID-19 , Genoma Viral , Reação em Cadeia da Polimerase em Tempo Real , SARS-CoV-2 , COVID-19/diagnóstico , Teste para COVID-19 , Humanos , SARS-CoV-2/genética
5.
Biosens Bioelectron ; 195: 113656, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34600203

RESUMO

Serological tests play an important role in the fight against Coronavirus Disease 2019 (COVID-19), including monitoring the dynamic immune response after vaccination, identifying past infection and determining community infection rate. Conventional methods for serological testing, such as enzyme-linked immunosorbent assays and chemiluminescence immunoassays, provide reliable and sensitive antibody detection but require sophisticated laboratory infrastructure and/or lengthy assay time. Conversely, lateral flow immunoassays are suitable for rapid point-of-care tests but have limited sensitivity. Here, we describe the development of a rapid and sensitive magnetofluidic immuno-PCR platform that can address the current gap in point-of-care serological testing for COVID-19. Our magnetofluidic immuno-PCR platform automates a magnetic bead-based, single-binding, and one-wash immuno-PCR assay in a palm-sized magnetofluidic device and delivers results in ∼30 min. In the device, a programmable magnetic arm attracts and transports magnetically-captured antibodies through assay reagents pre-loaded in a companion plastic cartridge, and a miniaturized thermocycler and a fluorescence detector perform immuno-PCR to detect the antibodies. We evaluated our magnetofluidic immuno-PCR with 108 clinical serum/plasma samples and achieved 93.8% (45/48) sensitivity and 98.3% (59/60) specificity, demonstrating its potential as a rapid and sensitive point-of-care serological test for COVID-19.


Assuntos
Técnicas Biossensoriais , COVID-19 , Anticorpos Antivirais , Teste Sorológico para COVID-19 , Teste para COVID-19 , Humanos , Sistemas Automatizados de Assistência Junto ao Leito , Testes Imediatos , SARS-CoV-2 , Sensibilidade e Especificidade
7.
Multimedia | Recursos Multimídia | ID: multimedia-9323

RESUMO

The COVID-19 pandemic brought to light the shortcomings of health systems worldwide and the need to address the factors underpinning these flaws. In this webinar, we discuss the role of private sector and commercial determinants of health (#CDoH) in this global health crisis. Through their different perspectives, the panelists explore the role of private sector in the pandemic, the relationship between CDoH and COVID-19 on national and global levels and discuss the implications for global health. TIMESTAMPS: 00:00 | Welcome and Objective 02:35 | Opening Remarks 07:00 | COVID-19 as Commercial Determinant of Health 19:58 | Unhealthy Commodity Industries' Response to COVID-19 38:00 | Moderated Discussion and Q&A


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/economia , Sistemas Públicos de Saúde , Política de Saúde , Estratégias de Saúde Globais , Capitalismo , Marketing de Serviços de Saúde , Racismo , Equidade em Saúde , Distanciamento Físico , Quarentena , Grupos de Risco , Teste para COVID-19 , Equipamento de Proteção Individual , Promoção da Saúde , Setor Privado/economia , Indústria do Tabaco
8.
Porto Alegre; CEVS/RS; nov. 2021. 1-29 p. ilus., graf., tab., mapas.
Não convencional em Português | Coleciona SUS, CONASS, SES-RS | ID: biblio-1348396

RESUMO

Neste boletim são apresentados: situação mundial, ocorrência de hospitalizações confirmadas para sars-cov-2, perfil das pessoas, distribuição espacial, Síndrome Inflamatória Multissistêmica Pediátrica (SIM-P), povos indígenas, descrição de surtos, trabalhadores da saúde, Vigilância sentinela de síndrome gripal e tabelas de descrição do surto. (AU)


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Perfil de Saúde , Mortalidade Hospitalar , Pessoal de Saúde/estatística & dados numéricos , Vigilância de Evento Sentinela , Grupos Populacionais/estatística & dados numéricos , Saúde de Populações Indígenas , Teste para COVID-19 , Teste de Ácido Nucleico para COVID-19 , COVID-19/epidemiologia , Hospitalização/estatística & dados numéricos , Saúde da Criança/estatística & dados numéricos , Surtos de Doenças , Saúde do Adolescente/estatística & dados numéricos , COVID-19/complicações , COVID-19/mortalidade
9.
Washington, D.C.; PAHO; 2021-11-09. (PAHO/PHE/IMS/COVID-19/21-0016).
Não convencional em Inglês | PAHO-IRIS | ID: phr-55124

RESUMO

This report documents PAHO’s efforts in the first six months of 2021, period in which the Organization continued responding to emerging needs in the Americas Region to detect, track, treat and slow the spread of COVID-19; acted promptly to facilitate vaccine procurement; and supported countries during each step of the vaccine introduction process.


Assuntos
COVID-19 , Coronavirus , Infecções por Coronavirus , Teste para COVID-19 , Teste Sorológico para COVID-19 , Teste de Ácido Nucleico para COVID-19 , Vacinas contra COVID-19 , Vacinação , Vacinas , Doenças Preveníveis por Vacina , SARS-CoV-2 , Pandemias , Epidemias , Organização Pan-Americana da Saúde , América , Região do Caribe
10.
Sci Rep ; 11(1): 22013, 2021 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-34759300

RESUMO

To meet the unprecedented requirement of diagnostic testing for SARS-CoV-2, a large number of diagnostic kits were authorized by concerned authorities for diagnostic use within a short period of time during the initial phases of the ongoing pandemic. We undertook this study to evaluate the inter-test agreement and other key operational features of 5 such commercial kits that have been extensively used in India for routine diagnostic testing for COVID-19. The five commercial kits were evaluated, using a panel of positive and negative respiratory samples, considering the kit provided by National Institute of Virology, Indian Council of Medical Research (2019-nCoV Kit) as the reference. The positive panel comprised of individuals who fulfilled the 3 criteria of being clinically symptomatic, having history of contact with diagnosed cases and testing positive in the reference kit. The negative panel included both healthy and disease controls, the latter being drawn from individuals diagnosed with other respiratory viral infections. The same protocol of sample collection, same RNA extraction kit and same RT-PCR instrument were used for all the kits. Clinical samples were collected from a panel of 92 cases and 60 control patients, who fulfilled our inclusion criteria. The control group included equal number of healthy individuals and patients infected with other respiratory viruses (n = 30, in each group). We observed varying sensitivity and specificity among the evaluated kits, with LabGun COVID-19 RT-PCR kit showing the highest sensitivity and specificity (94% and 100% respectively), followed by TaqPath COVID-19 Combo and Allplex 2019-nCoV assays. The extent of inter-test agreement was not associated with viral loads of the samples. Poor correlation was observed between Ct values of the same genes amplified using different kits. Our findings reveal the presence of wide heterogeneity and sub-optimal inter-test agreement in the diagnostic performance of the evaluated kits and hint at the need of adopting stringent standards for fulfilling the quality assurance requirements of the COVID-19 diagnostic process.


Assuntos
Teste para COVID-19 , COVID-19 , Humanos , Pandemias , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sensibilidade e Especificidade
11.
Artigo em Inglês | MEDLINE | ID: mdl-34769600

RESUMO

In the recent pandemic, accurate and rapid testing of patients remained a critical task in the diagnosis and control of COVID-19 disease spread in the healthcare industry. Because of the sudden increase in cases, most countries have faced scarcity and a low rate of testing. Chest X-rays have been shown in the literature to be a potential source of testing for COVID-19 patients, but manually checking X-ray reports is time-consuming and error-prone. Considering these limitations and the advancements in data science, we proposed a Vision Transformer-based deep learning pipeline for COVID-19 detection from chest X-ray-based imaging. Due to the lack of large data sets, we collected data from three open-source data sets of chest X-ray images and aggregated them to form a 30 K image data set, which is the largest publicly available collection of chest X-ray images in this domain to our knowledge. Our proposed transformer model effectively differentiates COVID-19 from normal chest X-rays with an accuracy of 98% along with an AUC score of 99% in the binary classification task. It distinguishes COVID-19, normal, and pneumonia patient's X-rays with an accuracy of 92% and AUC score of 98% in the Multi-class classification task. For evaluation on our data set, we fine-tuned some of the widely used models in literature, namely, EfficientNetB0, InceptionV3, Resnet50, MobileNetV3, Xception, and DenseNet-121, as baselines. Our proposed transformer model outperformed them in terms of all metrics. In addition, a Grad-CAM based visualization is created which makes our approach interpretable by radiologists and can be used to monitor the progression of the disease in the affected lungs, assisting healthcare.


Assuntos
COVID-19 , Aprendizado Profundo , Teste para COVID-19 , Atenção à Saúde , Humanos , SARS-CoV-2
12.
Artigo em Inglês | MEDLINE | ID: mdl-34769597

RESUMO

High testing rates limit COVID-19 transmission. Attempting to increase testing rates, Stovner District in Oslo, Norway, combined door-to-door campaigns with easy access testing facilities. We studied the intervention's impact on COVID-19 testing rates. The Stovner District administration executed three door-to-door campaigns promoting COVID-19 testing accompanied by drop-in mobile COVID-19 testing facilities in different areas at 2-week intervals. We calculated testing rates pre- and post-campaigns using data from the Norwegian emergency preparedness register for COVID-19 (Beredt C19). We applied a difference-in-difference approach using ordinary least square regression models and robust standard errors to estimate changes in COVID-19 testing rates. Door-to-door visits reached around one of three households. Intervention and comparison areas had identical testing rates before the intervention, and we observed an increase in intervention areas after the campaigns. We estimate a 43% increase in testing rates over the first three days following the door-to-door campaigns (p = 0.28), corresponding to an additional 79 (95% confidence interval, -54 to 175) people tested. Considering the shape of the time series curves and the large effect estimate, we find it highly likely that the campaigns had a substantial positive impact on COVID-19 testing rates, despite a p-value above the conventional levels for statistical significance. The results and the feasibility of the intervention suggest that it may be worth implementing in similar settings.


Assuntos
COVID-19 , Teste para COVID-19 , Humanos , Noruega , SARS-CoV-2
13.
Artigo em Inglês | MEDLINE | ID: mdl-34769659

RESUMO

Background: The ongoing COVID-19 pandemic has created numerous stressful conditions, especially for vulnerable populations such as pregnant women. Pandemic-related pregnancy stress consists of two dimensions: stress associated with feeling unprepared for birth due to the pandemic (Preparedness Stress), and stress related to fears of perinatal COVID-19 infection (Perinatal Infection Stress). The purpose of our study was to elucidate the association between various factors-sociodemographic, obstetric, pandemic-related, and situational-and pandemic stress in its two dimensions during the second wave of the COVID-19 pandemic in Polish pregnant women. Methods: A cross-sectional study with a total of 1119 pregnant women recruited during the second wave of the COVID-19 pandemic in Poland (between November 2020 and January 2021). Participants were recruited via social media to complete an online study questionnaire that included sociodemographic, obstetric, situational, and COVID-19 pandemic factors, as well as the Pandemic-Related Pregnancy Stress Scale (PREPS). Results: Nearly 38.5% of participants reported high Preparedness Stress; 26% reported high Perinatal Infection Stress. Multivariate analyses indicated that lack of COVID-19 diagnosis, higher compliance with safety rules and restrictions, and limited access to outdoor space were independently associated with moderate to severe levels of Infection Stress. Current emotional or psychiatric problems, nulliparity, limited access to outdoor space, and alterations to obstetric visits were independently associated with moderate to severe Preparedness Stress. Conclusion: Study findings suggest that particular attention should be focused on the groups of pregnant women who are most vulnerable to pandemic-related stress and therefore may be more prone to adverse outcomes associated with prenatal stress.


Assuntos
COVID-19 , Pandemias , Ansiedade , Teste para COVID-19 , Estudos Transversais , Feminino , Humanos , Parto , Polônia/epidemiologia , Gravidez , Gestantes , SARS-CoV-2 , Estresse Psicológico/epidemiologia , Inquéritos e Questionários
14.
Acad Radiol ; 28(12): 1645-1653, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34740527

RESUMO

RATIONALE AND OBJECTIVES: Asymptomatic COVID-19 carriers and insufficient testing make containment of the virus difficult. The purpose of this study was to determine if unexpected lung base findings on abdominopelvic CTs concerning for COVID-19 infection could serve as a surrogate for the diagnosis of COVID-19 in the community. MATERIALS AND METHODS: A database search of abdominopelvic CT reports from March 1,2020 to May 2,2020 was performed for keywords suggesting COVID-19 infection by lung base findings. COVID-19 status, respiratory symptoms, laboratory parameters and patient outcomes (hospitalization, ICU admission and/or intubation, and death) were recorded. The trend in cases of unexpected concerning lung base findings on abdominopelvic CT at our institution was compared to the total number of confirmed new cases in NYC over the same time period. RESULTS: The trend in abnormal lung base findings on abdominopelvic CT at our institution correlated with the citywide number of confirmed new cases, including rise and subsequent fall in total cases. The trend was not mediated by COVID-19 testing status or number of tests performed. Patients with respiratory symptoms had significantly higher ferritin (median = 995ng/ml vs 500ng/ml, p = 0.027) and death rate (8/24, 33% vs 4/54, 9%, p = 0.018) compared to those without. CONCLUSION: The rise and fall of unexpected lung base findings suggestive of COVID-19 infection on abdominopelvic CT in patients without COVID-19 symptoms correlated with the number of confirmed new cases throughout NYC from the same time period. A model using abdominopelvic CT lung base findings can serve as a surrogate for future COVID-19 outbreaks.


Assuntos
COVID-19 , Teste para COVID-19 , Surtos de Doenças , Humanos , Pulmão , Cidade de Nova Iorque/epidemiologia , SARS-CoV-2
15.
West J Emerg Med ; 22(6): 1253-1256, 2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34787547

RESUMO

INTRODUCTION: Emergency medical services (EMS) dispatchers have made efforts to determine whether patients are high risk for coronavirus disease 2019 (COVID-19) so that appropriate personal protective equipment (PPE) can be donned. A screening tool is valuable as the healthcare community balances protection of medical personnel and conservation of PPE. There is little existing literature on the efficacy of prehospital COVID-19 screening tools. The objective of this study was to determine the positive and negative predictive value of an emergency infectious disease surveillance tool for detecting COVID-19 patients and the impact of positive screening on PPE usage. METHODS: This study was a retrospective chart review of prehospital care reports and hospital electronic health records. We abstracted records for all 911 calls to an urban EMS from March 1-July 31, 2020 that had a documented positive screen for COVID-19 and/or had a positive COVID-19 test. The dispatch screen solicited information regarding travel, sick contacts, and high-risk symptoms. We reviewed charts to determine dispatch-screening results, the outcome of patients' COVID-19 testing, and documentation of crew fidelity to PPE guidelines. RESULTS: The sample size was 263. The rate of positive COVID-19 tests for all-comers in the state of Massachusetts was 2.0%. The dispatch screen had a sensitivity of 74.9% (confidence interval [CI], 69.21-80.03) and a specificity of 67.7% (CI, 66.91-68.50). The positive predictive value was 4.5% (CI, 4.17-4.80), and the negative predictive value was 99.3% (CI, 99.09-99.40). The most common symptom that triggered a positive screen was shortness of breath (51.5% of calls). The most common high-risk population identified was skilled nursing facility patients (19.5%), but most positive tests did not belong to a high-risk population (58.1%). The EMS personnel were documented as wearing full PPE for the patient in 55.7% of encounters, not wearing PPE in 8.0% of encounters, and not documented in 27.9% of encounters. CONCLUSION: This dispatch-screening questionnaire has a high negative predictive value but moderate sensitivity and therefore should be used with some caution to guide EMS crews in their PPE usage. Clinical judgment is still essential and may supersede screening status.


Assuntos
COVID-19/diagnóstico , Serviços Médicos de Emergência , Programas de Rastreamento/instrumentação , Gravidade do Paciente , Triagem , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Teste de Ácido Nucleico para COVID-19 , Teste para COVID-19 , Registros Eletrônicos de Saúde , Humanos , Corpo Clínico Hospitalar , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , SARS-CoV-2
16.
Kobe J Med Sci ; 67(2): E55-E60, 2021 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-34795156

RESUMO

COVID-19 patients reveal various clinical manifestations; however, the specific mechanisms and factors contributing to rapid recovery remain unclear. We performed serum cytokine profiling using a bead-based immunoassay in six COVID-19 patients with mild symptoms who experienced rapid recovery. All patients had fever that resolved within 4 days. During the study, the interferon gamma-related protein 10 (IP-10) level rapidly increased initially, and then rapidly decreased in all six patients. Similarly, the interferon (IFN)-λ 2/3 levels rapidly increased initially, and then decreased in five of the six patients. IP-10 and IFN-λ2/3 may play a key role in the rapid recovery of mild COVID-19.


Assuntos
COVID-19/diagnóstico , COVID-19/imunologia , Citocinas/sangue , Imunidade Inata , Adulto , Biomarcadores , COVID-19/sangue , Teste para COVID-19 , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Índice de Gravidade de Doença
17.
JMIR Public Health Surveill ; 7(11): e28956, 2021 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-34783673

RESUMO

BACKGROUND: Digital contact tracing apps have been deployed worldwide to limit the spread of COVID-19 during this pandemic and to facilitate the lifting of public health restrictions. However, due to privacy-, trust-, and design-related issues, the apps are yet to be widely adopted. This calls for an intervention to enable a critical mass of users to adopt them. OBJECTIVE: The aim of this paper is to provide guidelines to design contact tracing apps as persuasive technologies to make them more appealing and effective. METHODS: We identified the limitations of the current contact tracing apps on the market using the Government of Canada's official exposure notification app (COVID Alert) as a case study. Particularly, we identified three interfaces in the COVID Alert app where the design can be improved. The interfaces include the no exposure status interface, exposure interface, and diagnosis report interface. We propose persuasive technology design guidelines to make them more motivational and effective in eliciting the desired behavior change. RESULTS: Apart from trust and privacy concerns, we identified the minimalist and nonmotivational design of exposure notification apps as the key design-related factors that contribute to the current low uptake. We proposed persuasive strategies such as self-monitoring of daily contacts and exposure time to make the no exposure and exposure interfaces visually appealing and motivational. Moreover, we proposed social learning, praise, and reward to increase the diagnosis report interface's effectiveness. CONCLUSIONS: We demonstrated that exposure notification apps can be designed as persuasive technologies by incorporating key persuasive features, which have the potential to improve uptake, use, COVID-19 diagnosis reporting, and compliance with social distancing guidelines.


Assuntos
COVID-19 , Aplicativos Móveis , Teste para COVID-19 , Notificação de Doenças , Humanos , SARS-CoV-2
18.
West J Emerg Med ; 22(6): 1257-1261, 2021 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-34787548

RESUMO

INTRODUCTION: Patients diagnosed with coronavirus disease 2019 (COVID-19) require significant healthcare resources. While published research has shown clinical characteristics associated with severe illness from COVID-19, there is limited data focused on the emergency department (ED) discharge population. METHODS: We performed a retrospective chart review of all ED-discharged patients from Wake Forest Baptist Health and Wake Forest Baptist Health Davie Medical Center between April 25-August 9, 2020, who tested positive for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) from a nasopharyngeal swab using real-time reverse transcription polymerase chain reaction (rRT-PCR) tests. We compared the clinical characteristics of patients who were discharged and had return visits within 30 days to those patients who did not return to the ED within 30 days. RESULTS: Our study included 235 adult patients who had an ED-performed SARS-CoV-2 rRT-PCR positive test and were subsequently discharged on their first ED visit. Of these patients, 57 (24.3%) had return visits to the ED within 30 days for symptoms related to COVID-19. Of these 57 patients, on return ED visits 27 were admitted to the hospital and 30 were not admitted. Of the 235 adult patients who were discharged, 11.5% (27) eventually required admission for COVID-19-related symptoms. With 24.3% patients having a return ED visit after a positive SARS-CoV-2 test and 11.5% requiring eventual admission, it is important to understand clinical characteristics associated with return ED visits. We performed multivariate logistic regression analysis of the clinical characteristics with independent association resulting in a return ED visit, which demonstrated the following: diabetes (odds ratio [OR] 2.990, 95% confidence interval [CI, 1.21-7.40, P = 0.0179); transaminitis (OR 8.973, 95% CI, 2.65-30.33, P = 0.004); increased pulse at triage (OR 1.04, 95% CI, 1.02-1.07, P = 0.0002); and myalgia (OR 4.43, 95% CI, 2.03-9.66, P = 0.0002). CONCLUSION: As EDs across the country continue to treat COVID-19 patients, it is important to understand the clinical factors associated with ED return visits related to SARS-CoV-2 infection. We identified key clinical characteristics associated with return ED visits for patients initially diagnosed with SARS-CoV-2 infection: diabetes mellitus; increased pulse at triage; transaminitis; and complaint of myalgias.


Assuntos
COVID-19/diagnóstico , Serviço Hospitalar de Emergência/estatística & dados numéricos , Alta do Paciente , Readmissão do Paciente , SARS-CoV-2/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Teste de Ácido Nucleico para COVID-19 , Teste para COVID-19 , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , SARS-CoV-2/genética
19.
BMC Med Inform Decis Mak ; 21(Suppl 9): 271, 2021 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-34789243

RESUMO

BACKGROUND: 2019-nCoV has been spreading around the world and becoming a global concern. To prevent further widespread of 2019-nCoV, confirmed and suspected cases of COVID-19 infection are suggested to be kept in quarantine. However, the diagnose of COVID-19 infection is quite time-consuming and labor-intensive. To alleviate the burden on the medical staff, we have done some research on the intelligent diagnosis of COVID-19. METHODS: In this paper, we constructed a COVID-19 Diagnosis Ontology (CDO) by utilizing Protégé, which includes the basic knowledge graph of COVID-19 as well as diagnostic rules translated from Chinese government documents. Besides, SWRL rules were added into the ontology to infer intimate relationships between people, thus facilitating the efficient diagnosis of the suspected cases of COVID-19 infection. We downloaded real-case data and extracted patients' syndromes from the descriptive text, so as to verify the accuracy of this experiment. RESULTS: After importing those real instances into Protégé, we demonstrated that the COVID-19 Diagnosis Ontology showed good performances to diagnose cases of COVID-19 infection automatically. CONCLUSIONS: In conclusion, the COVID-19 Diagnosis Ontology will not only significantly reduce the manual input in the diagnosis process of COVID-19, but also uncover hidden cases and help prevent the widespread of this epidemic.


Assuntos
COVID-19 , Teste para COVID-19 , Humanos , SARS-CoV-2
20.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 29(Special Issue): 1343-1349, 2021 Aug.
Artigo em Russo | MEDLINE | ID: mdl-34792888

RESUMO

The article presents an analysis of the work of the largest children's COVID-19 center in Moscow, organized on the basis of the Children's City Clinical Hospital named after Z. A. Bashlyaeva of the Moscow City Health Department. From March to November 2020 at the COVID-19 Center were hospitalized 2,837 patients with suspected/confirmed diagnosis of COVID-19, in total in 2020 1,876 children with a confirmed diagnosis of COVID-19 were treated, 58 (3%) children were in serious condition in the intensive care unit, of which children 11-18 years old were 25%. At the 2020 neonatal COVID-19 center, 215 newborns were observed with suspected COVID-19 diagnosis. The diagnosis of COVID-19 was confirmed in 18 children, while 8 newborns came from the home of COVID-19. In the Center for rehabilitation, where children aged 0 to 3 years old who were born with very low and extremely low body weight are observed, dispensary observation for children who have undergone COVID-19 is organized. 45 children who were observed fell ill with the new coronavirus infection. There were no deaths among children with COVID-19.


Assuntos
Teste para COVID-19 , COVID-19 , Adolescente , Criança , Pré-Escolar , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Estudos Retrospectivos , SARS-CoV-2
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