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PURPOSE: The study aimed to investigate the potential influence of COVID-19 infection on embryo implantation and early development in women undergoing frozen embryo transfer (FET), with a specific focus on infections occurring at different periods around FET. METHODS: A retrospective analysis was performed on women who had undergone FET during a period marked by a significant surge in COVID-19 infection in Shanghai. All enrolled women experienced their first documented COVID-19 infection around the time of FET, ensuring that infections did not occur prior to oocyte retrieval. Participants were categorized into six groups based on the timing of infection: uninfected, ≥ 60 days, < 60 days before FET, 0-14 days, 15-28 days, and 29-70 days after FET. Clinical outcomes were compared across these groups. RESULTS: The infection rate among the total of 709 cases was 78.28%. Infected individuals exhibited either asymptomatic or mild symptoms. The ongoing pregnancy rates for the first four groups were 40.7%, 44.4%, 40.5%, and 34.2% (P = 0.709) respectively, biochemical pregnancy rates (59.1% vs. 61.1% vs. 67.6% vs. 55.7%, P = 0.471) and clinical pregnancy rates (49.6% vs. 55.6% vs. 55.4% vs. 48.1%, P = 0.749), all showed no significant differences. Early spontaneous abortion rates across all six groups were 18.3%, 20.0%, 25.0%, 28.9%, 5.4%, and 19.0% respectively, with no significant differences (P = 0.113). Multivariable logistic analysis revealed no significant correlation between the infection and ongoing pregnancy. CONCLUSION: Asymptomatic or mild COVID-19 infections occurring around FET do not appear to have a significant adverse impact on early pregnancy outcomes.
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COVID-19 , Transferência Embrionária , Resultado da Gravidez , Taxa de Gravidez , Humanos , Feminino , Gravidez , COVID-19/epidemiologia , Transferência Embrionária/métodos , Transferência Embrionária/estatística & dados numéricos , Estudos Retrospectivos , Adulto , China/epidemiologia , Resultado da Gravidez/epidemiologia , SARS-CoV-2 , Criopreservação , Implantação do Embrião , Fatores de Tempo , Aborto Espontâneo/epidemiologia , Aborto Espontâneo/etiologiaRESUMO
BACKGROUND: Data on mixed mould infection with COVID-19-associated pulmonary aspergillosis (CAPA) and COVID-19-associated pulmonary mucormycosis (CAPM) are sparse. OBJECTIVES: To ascertain the prevalence of co-existent CAPA in CAPM (mixed mould infection) and whether mixed mould infection is associated with early mortality (≤7 days of diagnosis). METHODS: We retrospectively analysed the data collected from 25 centres across India on COVID-19-associated mucormycosis. We included only CAPM and excluded subjects with disseminated or rhino-orbital mucormycosis. We defined co-existent CAPA if a respiratory specimen showed septate hyphae on smear, histopathology or culture grew Aspergillus spp. We also compare the demography, predisposing factors, severity of COVID-19, and management of CAPM patients with and without CAPA. Using a case-control design, we assess whether mixed mould infection (primary exposure) were associated with early mortality in CAPM. RESULTS: We included 105 patients with CAPM. The prevalence of mixed mould infection was 20% (21/105). Patients with mixed mould infection experienced early mortality (9/21 [42.9%] vs. 15/84 [17.9%]; p = 0.02) and poorer survival at 6 weeks (7/21 [33.3] vs. 46/77 [59.7%]; p = 0.03) than CAPM alone. On imaging, consolidation was more commonly encountered with mixed mould infections than CAPM. Co-existent CAPA (odds ratio [95% confidence interval], 19.1 [2.62-139.1]) was independently associated with early mortality in CAPM after adjusting for hypoxemia during COVID-19 and other factors. CONCLUSION: Coinfection of CAPA and CAPM was not uncommon in our CAPM patients and portends a worse prognosis. Prospective studies from different countries are required to know the impact of mixed mould infection.
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COVID-19 , Coinfecção , Mucormicose , Humanos , COVID-19/complicações , COVID-19/mortalidade , Mucormicose/mortalidade , Mucormicose/epidemiologia , Mucormicose/complicações , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Prevalência , Coinfecção/mortalidade , Coinfecção/epidemiologia , Coinfecção/microbiologia , Índia/epidemiologia , Adulto , Aspergilose Pulmonar/complicações , Aspergilose Pulmonar/mortalidade , Aspergilose Pulmonar/epidemiologia , SARS-CoV-2 , Idoso , Estudos de Casos e Controles , Pneumopatias Fúngicas/mortalidade , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/epidemiologiaRESUMO
BACKGROUND: The COVID-19 pandemic engendered numerous societal and economic challenges in addition to health-related concerns. Maintenance of healthcare utilization assumed immense significance during this period. However, few studies have examined the association between loneliness and cancelled medical appointments during the COVID-19 pandemic. This study aimed to examine whether medical appointments are less likely to be cancelled with increased loneliness during a pandemic. We analyzed the association between loneliness and both patient- and provider-initiated appointment cancellations. METHODS: Cross-sectional data from the Hamburg City Health Study (HCHS) were collected during April 2020-November 2021. The analytical sample included 1,840 participants with an average age of 55.1 years (standard deviation: 6.5, range 45-76 years). Medical appointments cancelled by individuals-medical appointments in general, and GP, specialist, and dentist appointments-and appointments cancelled by healthcare providers served as outcome measures. Loneliness was quantified using a single item ranging from 0 to 10. Accordingly, we created empirical loneliness tertiles. Covariates were selected based on the Andersen model. Several penalized maximum likelihood logistic regressions were utilized to examine the association between loneliness and cancellation of medical appointments during the COVID-19 pandemic. RESULTS: The penalized maximum likelihood logistic regressions showed that, compared to individuals in the lowest loneliness tertiles, individuals in the other two tertiles reported a higher chance of medical appointments cancellation by individuals, particularly driven by cancelled GP appointments. Except for age and sex, none of the covariates were comparably associated with the outcomes. When appointments cancelled by healthcare providers served as outcomes, only a higher number of chronic conditions was significantly positively associated with it. CONCLUSIONS: Individuals scoring higher in loneliness had a greater chance of cancelling medical (particularly GP) appointments. This may contribute to a potential cascade of loneliness and skipped medical appointments in the future, resulting in adverse health outcomes over the medium-to-long term. Future research should examine whether lonely people are more likely to lack the social motivation to visit the doctor.
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COVID-19 , Humanos , Pessoa de Meia-Idade , Idoso , COVID-19/epidemiologia , Solidão , Pandemias , Estudos Transversais , Aceitação pelo Paciente de Cuidados de SaúdeRESUMO
Ocular involvement is not uncommon in patients with COVID-19. However, the incidence of COVID-19 ophthalmopathy in COVID-19 patients is still not clear. In this prospective case series study, we recruited 2445 consecutive cases presenting at Neuro-ophthalmology clinic of our Eye Center during the last resurgence of SARS-CoV-2 infection from 8 December 2022 to 15 March 2023 in China, 149 cases were diagnosed as COVID-19 ophthalmopathy, 87 cases were female, with a mean age of 43.2 years, and the mean follow-up time was 15.4 weeks. One hundred and twenty of 149 cases suffered from systemic symptoms mostly manifesting as fever, cough and muscle pain prior to or soon after ocular involvement. The most common COVID-19 ophthalmopathy was optic neuritis (51/149), followed by acute zonal occult outer retinopathy complex disease (31/149), uveitis (17/149), ocular mobility disorder-related (third, fourth, or sixth) cranial nerve neuritis (15/149), anterior ischaemic optic neuropathy (9/149), retinal artery occlusion (8/149), retinal microangiopathy including retinal haemorrhage and cotton wool spot (8/149), viral conjunctivitis (7/149), retinal vein occlusion (3/149), viral keratitis (2/149), ptosis (2/149), and other rare ocular diseases. Except 5 cases with central retinal artery occlusion, other 144 COVID-19 ophthalmopathy cases showed good response to steroid therapy. Our study revealed an incidence of 6.09% for COVID-19 ophthalmopathy in outpatients at our Neuro-ophthalmology clinic during last resurgence of COVID-19 in China, and demonstrated that SARS-CoV-2 infection could induce an initial onset or a relapse of ophthalmic diseases, and that ocular involvement might manifest as the initial or even the only presentation of COVID-19.
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How to cite this article: Finsterer J, Scorza FA. Calibration of Prediction Models of In-hospital Mortality in SARS-CoV-2 Patients Depends also on Data Quality. Indian J Crit Care Med 2024;28(2):181-182.
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Purpose: Few studies examined variables that might explain the link between perceived COVID-19 stress and suicidal ideation. The present study tested a multiple-sequence mediation model with family cohesion, thwarted belongingness, and perceived burdensomeness as mediators. Methods: The current study surveyed 1098 college students in China using questionnaires concerning perceived COVID-19 stress, family cohesion, unmet interpersonal needs, and suicide ideation. Results: Perceived COVID-19 stress was significantly associated with family cohesion, thwarted belongingness, perceived burdensomeness, and suicidal ideation. Family cohesion, thwarted belongingness, and perceived burdensomeness mediated the relationship between perceived COVID-19 stress and suicidal ideation separately. These factors also had multiple sequence-mediated effects between perceived COVID-19 stress and suicidal ideation. Conclusion: The study revealed pathways from perceived COVID-19 stress to suicidal ideation and suggested that interventions to increase family cohesion and reduce one's unmet interpersonal needs were beneficial in decreasing individuals' suicidal ideation.
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We have established considerable expertise in studying the role of platelets in cancer biology. From this expertise, we were keen to recognize the numerous venous-, arterial-, microvascular-, and macrovascular thrombotic events and immunologic disorders are caused by severe, acute-respiratory-syndrome coronavirus 2 (SARS-CoV-2) infections. With this offering, we explore the evolutionary connections that place platelets at the center of hemostasis, immunity, and adaptive phylogeny. Coevolutionary changes have also occurred in vertebrate viruses and their vertebrate hosts that reflect their respective evolutionary interactions. As mammals adapted from aquatic to terrestrial life and the heavy blood loss associated with placentalization-based live birth, platelets evolved phylogenetically from thrombocytes toward higher megakaryocyte-blebbing-based production rates and the lack of nuclei. With no nuclei and robust RNA synthesis, this adaptation may have influenced viral replication to become less efficient after virus particles are engulfed. Human platelets express numerous receptors that bind viral particles, which developed from archetypal origins to initiate aggregation and exocytic-release of thrombo-, immuno-, angiogenic-, growth-, and repair-stimulatory granule contents. Whether by direct, evolutionary, selective pressure, or not, these responses may help to contain virus spread, attract immune cells for eradication, and stimulate angiogenesis, growth, and wound repair after viral damage. Because mammalian and marsupial platelets became smaller and more plate-like their biophysical properties improved in function, which facilitated distribution near vessel walls in fluid-shear fields. This adaptation increased the probability that platelets could then interact with and engulf shedding virus particles. Platelets also generate circulating microvesicles that increase membrane surface-area encounters and mark viral targets. In order to match virus-production rates, billions of platelets are generated and turned over per day to continually provide active defenses and adaptation to suppress the spectrum of evolving threats like SARS-CoV-2.
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COVID-19 , Neoplasias , Animais , Biologia , Plaquetas/metabolismo , Hemostasia , Humanos , Mamíferos , Neoplasias/metabolismo , SARS-CoV-2RESUMO
Due to the COVID-19 pandemic, a series of sequelae, such as fatigue, tachypnea, and ageusia, appeared in long COVID patients, but the pathological basis was still uncertain. The targeted radiopharmaceuticals were of potential to systemically and dynamically trace the pathological changes. For the key ACE2 protein in the virus-host interaction, 68 Ga-cyc-DX600 was developed on the basis of DX600 as a PET tracer of ACE2 fluctuation and maintained the ability in differentiating ACE and ACE2. In the temporary infection model inhaled with the radio-traceable pseudovirus in the upper respiratory tract of male humanized ACE2 (hACE2) mice, organ-specific ACE2 dysfunction in acute period and the following ACE2 recovery in a relatively long period was visualized and quantified by ACE2 PET, revealing a complex pattern of virus concentration-dependent degree and time period-dependent tendency of ACE2 recovery, mainly a sudden decrease of apparent ACE2 in the heart, liver, kidneys, lungs, and so on, but the liver was of a quick functional compensation on ACE2 expression after a temporary decrease. ACE2 expression of most organs has recovered to a normal level at 15 days post inhalation, with brain and genitals still of a decreased SUVACE2 ; meanwhile, kidneys were of an increased SUVACE2 . These findings on ACE2 PET were further verified by western blot. When compared with high-resolution computed tomography on structural changes and FDG PET on glycometabolism, ACE2 PET was superior in an earlier diagnostic window during infection and more comprehensive understanding of functional dysfunction post-infection. In the respective ACE2 PET/CT and ACE2 PET/MR scans of a volunteer, the repeatability of SUVACE2 and the ACE2 specificity were further confirmed. In conclusion, 68 Ga-cyc-DX600 was developed as an ACE2-specific tracer, and the corresponding ACE2 PET revealed the dynamic patterns of functional ACE2 recovery and provided a reference and approach to explore the ACE2-related pathological basis of sequelae in long COVID.
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COVID-19 , Masculino , Humanos , Camundongos , Animais , Peptidil Dipeptidase A/metabolismo , SARS-CoV-2/metabolismo , Enzima de Conversão de Angiotensina 2 , Síndrome de COVID-19 Pós-Aguda , Pandemias , Tomografia por Emissão de Pósitrons combinada à Tomografia ComputadorizadaRESUMO
INTRODUCTION: The surge in novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leading to coronavirus disease-2019 (COVID-19) has overwhelmed the health system. To help health-care workers and policy makers prioritize treatment and to decrease the burden on health systems caused by COVID-19, clinical severity along with various clinico-biochemical parameters was evaluated by designing a cross-sectional study comprising 236 SARS-CoV-2-infected individuals from Kashmir Valley, India. METHODS: Briefly, real-time polymerase chain reaction (RT-PCR) was used for the confirmation of SARS-CoV-2 infection. The principles of spectrophotometry and chemiluminescent microparticle immunoassay (CMIA) were employed to estimate the levels of glucose, TSH, and 25-hydroxy vitamin D levels in serum of infected patients. RESULTS: A total of 236 patients infected with SARS-CoV-2 were taken for this cross-sectional study. Patients with COVID-19 had a male predominance (72.9 vs. 27.1%) and a higher prevalence of 25-hydroxy vitamin D deficiency (72.0 vs. 28.0%) with a mean 25-hydroxy vitamin D levels of 24.0 ± 13.9 in ng/mL. We observed a varied clinical spectrum of SARS-CoV-2 infection with 36.4%, 23.7%, and 29.7% patients having mild, moderate, and severe disease, respectively. We observed that severity of SARS-CoV-2 infection was significantly associated with older age group, hypertension, low TSH levels, and 25-hydroxy vitamin D deficiency. CONCLUSION: We conclude that not only old age but also hypertension and low levels of TSH and 25-hydroxy vitamin D levels could significantly lead to clinical severity of SARS-CoV-2 infection.
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COVID-19 , Hipertensão , Deficiência de Vitamina D , Humanos , Masculino , Idoso , Feminino , COVID-19/diagnóstico , SARS-CoV-2 , Estudos Transversais , Vitamina D , TireotropinaRESUMO
Early diagnosis and treatment of diseases are crucial research areas of human health. For early diagnosis, one method that has proven efficient is the detection of biomarkers which can provide real-time and accurate biological information. Most biomarker detection is currently carried out at localised dedicated laboratories using large and automated analysers, increasing waiting time and costs. Smaller, faster, and cheaper devices could potentially replace these time-consuming laboratory analyses and make analytical results available as point-of-care diagnostics. Innovative biosensor-based strategies could allow biomarkers to be tested reliably in a decentralised setting. Early diagnosis of COVID-19 patients has a key role in order to use quarantine and treatment strategies in a timely manner. Raised levels of several biomarkers in COVID-19 patients are associated with respiratory infections or dysfunction of various organs. Through clinical studies of COVID-19 patient biomarkers such as ferritin, Interleukins, albumin and are found to reveals significant differences in their excretion ranges from healthy patients and patients with SARS-CoV-2, in addition to the development of biomarkers based biosensor such as stated biomarkers can be used and to investigate more specific biomarkers further proteomic analysis can be performed. This review presents several biomarker alterations in COVID-19 patients such as salivary, circulatory, coagulation, cardiovascular, renal, liver, C-reactive protein (CRP), immunological and inflammatory biomarkers. Also, biomarker sensors based on electrochemical, optical, and lateral flow characteristics which have potential applications for SARS-COV-2 in the recent COVID-19 pandemic, will be discussed.
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Técnicas Biossensoriais , COVID-19 , Biomarcadores/análise , Técnicas Biossensoriais/métodos , COVID-19/diagnóstico , Teste para COVID-19 , Humanos , Pandemias , Proteômica , SARS-CoV-2RESUMO
COVID-19 pneumonia causes acute respiratory distress syndrome (ARDS). Prone positioning (PP) is beneficial to pulmonary physiology and improves oxygenation in patients with ARDS. We aimed to investigate the effect of the PP on oxygenation, respiratory rate (RR) and ROX index in non-intubated patients with COVID-19 associated respiratory failure and to determine whether ROX index predicts intubation. Awake critically-ill patients with confirmed diagnosis of COVID-19 who underwent PP were enrolled in the retrospective, single-center study. Oxygenation parameters were recorded 1â h before PP, during PP and 1â h after return to supine position (after PP). Intubation was defined as the endpoint. Seventy-one patients with a median age of 64 [55-73] years were enrolled in the study. PaO2/FiO2 and SpO2/FiO2 improved during PP, this improvement did not persist after PP. RR improved during and after PP in both intubated and non-intubated patients (for all P < .001). ROX index improved only in non-intubated patients (P < .001) but not in intubated patients (P = .07). Area under the curve (AUC) of ROX index for intubation before PP, during PP and after PP were 0.74 [0.61-0.88] (P = .002), 0.76 [0.62-0.91] (P = .001), and 0.76 [0.64-0.89] (P = .001), respectively. ROX index >6.83 before PP had a negative predictive value (NPV) of 0.85; ROX index >8.28 during PP had a NPV of 0.88 and ROX index >7.48 after PP had a NPV of 0.85. In logistic regression adjusted for APACHE II score, ROX index ≤6.83 before PP had an odds ratio (OR) 4.47 [1.39-14.38], ROX index ≤8.28 during PP had an OR 7.96 [2.29-27.64] and ROX index ≤7.48 had an OR 3.98 [1.25-12.61] for prediction of intubation. In conclusion, awake PP improves oxygenation and decreases RR. ROX index improved only in non- intubated patients and a higher ROX index predicts lower risk of progressing to mechanical ventilation with intubation.
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COVID-19 , Síndrome do Desconforto Respiratório , Insuficiência Respiratória , Humanos , Pessoa de Meia-Idade , Idoso , COVID-19/complicações , COVID-19/terapia , Estudos Retrospectivos , Vigília , Decúbito Ventral/fisiologia , Estado Terminal/terapia , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapiaRESUMO
PURPOSE: During the first SARS-CoV-2-infection wave, a deterioration in emotional well-being and increased need for mental health care were observed among patients treated or being treated for breast cancer. In this follow-up study, we assessed patient-reported quality of life (QoL), physical functioning, and psychosocial well-being during the second SARS-CoV-2-infection wave in a large, representative cohort. METHODS: This longitudinal cohort study was conducted within the prospective, multicenter UMBRELLA breast cancer cohort. To assess patient-reported QoL, physical functioning and psychosocial well-being, COVID-19-specific surveys were completed by patients during the first and second SARS-CoV-2-infection waves (April and November 2020, respectively). An identical survey was completed by a comparable reference population during the second SARS-CoV-2-infection waves. All surveys included the validated EORTC-QLQ-C30/BR23, HADS and "De Jong-Gierveld Loneliness" questionnaires. Pre-COVID-19 EORTC-QLQ-C30/BR23 and HADS outcomes were available from UMBRELLA. Response rates were 69.3% (n = 1106/1595) during the first SARS-CoV-2-infection wave and 50.9% (n = 822/1614) during the second wave. A total of 696 patients responded during both SARS-CoV-2-infection waves and were included in the analysis comparing patient-reported outcomes (PROs) during the second SARS-CoV-2-infection wave to PROs during the first wave. Moreover, PROs reported by all patients during the second SARS-CoV-2-infection wave (n = 822) were compared to PROs of a similar non-cancer reference population (n = 241) and to their pre-COVID-19 PROs. RESULTS: Patient-reported QoL, physical functioning, and psychosocial well-being of patients treated or being treated for breast cancer remained stable or improved from the first to the second SARS-CoV-2-infection wave. The proportion of emotional loneliness reduced from 37.6 to 29.9% of patients. Compared to a similar non-cancer reference population, physical, emotional, and cognitive functioning, future perspectives and symptoms of dyspnea and insomnia were worse in patients treated or being treated for breast cancer during the second SARS-CoV-2-infection wave. PROs in the second wave were similar to pre-COVID-19 PROs. CONCLUSION: Although patients scored overall worse than individuals without breast cancer, QoL, physical functioning, and psychosocial well-being did not deteriorate between the first and second wave. During the second wave, PROs were similar to pre-COVID-19 values. Overall, current findings are cautiously reassuring for future mental health of patients treated or being treated for breast cancer.
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Neoplasias da Mama , COVID-19 , Humanos , Feminino , Neoplasias da Mama/psicologia , Qualidade de Vida/psicologia , SARS-CoV-2 , Saúde Mental , Estudos Longitudinais , Seguimentos , COVID-19/epidemiologia , Estudos Prospectivos , Sobreviventes/psicologiaRESUMO
COVID-19, the global pandemic of twenty-first century, has caused major challenges and setbacks for researchers and medical infrastructure worldwide. The CoVID-19 influences on the patients respiratory system cause flooding of airways in the lungs. Multiple techniques have been proposed since the outbreak each of which is interdepended on features and larger training datasets. It is challenging scenario to consolidate larger datasets for accurate and reliable decision support. This research article proposes a chest X-Ray images classification approach based on feature thresholding in categorizing the CoVID-19 samples. The proposed approach uses the threshold value-based Feature Extraction (TVFx) technique and has been validated on 661-CoVID-19 X-Ray datasets in providing decision support for medical experts. The model has three layers of training datasets to attain a sequential pattern based on various learning features. The aligned feature-set of the proposed technique has successfully categorized CoVID-19 active samples into mild, serious, and extreme categories as per medical standards. The proposed technique has achieved an accuracy of 97.42% in categorizing and classifying given samples sets.
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COVID-19 , Humanos , COVID-19/diagnóstico por imagem , Raios X , Redes Neurais de Computação , Pandemias , TóraxRESUMO
BACKGROUND AND AIMS: Nutritional status is essential for the maintenance of the immune system, with malnutrition suppressing immunity. The aims of the current study were to assess the immune status of a group of Jordanian adults and to evaluate the association between vitamin C, vitamin D, and zinc consumption and the Immune Status during the COVID-19 pandemic. METHODS: A total of 615 adults Jordanian participants were enrolled in this study, an online- based cross sectional survey was used as a tool for this study. Data was collected by distributing the questionnaire form link through social media platforms. The association between ISQ score and the supplement intake pattern (daily, weekly, monthly and rarely) was assessed using multinomial logistic regression analysis, described as Odds ratio and 95% CI. RESULTS: Data have indicated that the majority of the participants did not take Vitamin D supplements during the pandemic (46.3%). Also, there was a significant association between the frequency of Vitamin D supplement intake and ISQ (r = 12.777; P < 0.05). Data showed that the majority of participants used vitamin C supplementation (49.4%). Also, there was a significant association between the frequency of Vitamin C supplement intake and ISQ (r = 12.797; P < 0.05). Data also have indicated that the majority of the participants did not increase their consumption of Zinc during the COVID-19 pandemic (55.6%). CONCLUSIONS: The findings of this study suggest a significant association between the frequency of Vitamin D, and vitamin C supplement intake and ISQ. Nutritional status is essential for the maintenance of the immune system, with malnutrition suppressing immunity.
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COVID-19 , Desnutrição , Adulto , Humanos , Vitamina D/uso terapêutico , Estudos Transversais , Zinco/uso terapêutico , Ácido Ascórbico/uso terapêutico , Jordânia/epidemiologia , Pandemias , COVID-19/epidemiologia , Vitaminas/uso terapêutico , Suplementos NutricionaisRESUMO
BACKGROUND AND AIMS: Stroke associated with COVID-19 has been characterised in several multicentre retrospective studies and meta-analyses. However, they did not distinguish first-ever ischemic strokes (F-AIS). Therefore, we aimed to study the incidence, clinical characteristics, and outcomes of a cohort of F-AIS associated with COVID-19 during the first wave of the pandemic and compare this cohort with those of F-AIS without COVID-19, COVID-19 without stroke. We also sought to compare the stroke admissions and mechanisms during the pandemic and immediate prepandemic periods.
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COVID-19 , AVC Isquêmico , Acidente Vascular Cerebral , Humanos , AVC Isquêmico/epidemiologia , AVC Isquêmico/etiologia , Estudos Retrospectivos , COVID-19/complicações , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Índia/epidemiologia , Sistema de RegistrosRESUMO
The Corona Virus Disease 2019 (COVID-19) outbreak took a heavy toll on the global tourism industry in 2020, and affected the value realization of coastal recreational ecosystem service. From the micro perspective, this paper combines travel cost method with contingent behaviour method to obtain residents' actual behaviour and contingent behaviour data, and discusses the impact of the outbreak of COVID-19 on the value realization of coastal recreational resources from the perspective of the change in residents' recreational behaviour in Qingdao, China. Residents are observed to significantly reduce their outdoor activities in response to the COVID-19. The number of visits to the beach decreases by 25.2% when there is an outbreak, and decreases by 0.064% for every 1% increase in the number of confirmed cases, which is used to represent the severity of the epidemic. The asymmetries effects of epidemic situation on residents' recreational behaviour show that the improvements lead to larger and more significant impacts than the deteriorations. The disappearance of the pandemic crisis will provide considerable welfare for the citizens in Qingdao, which reaches to 1.9323 billion CNY/year. If the number of confirmed cases deteriorates to 900, the environmental welfare loss will be 0.3366 billion CNY/year. Additionally, we test the effects of residents' cognitive variables, and find that risk perception can strengthen the negative impacts of COVID-19 cases. Furthermore, the deteriorations in the environmental attributes are found to have stronger impacts on the number of visits than the improvements. This paper provides empirical-support results about the change of coastal recreational value through the evaluation of recreational behaviours in the post-epidemic period, which will give important implications for government's marine ecosystem restoration and coastal management work.
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The outbreak of Corona Virus Disease 2019 (COVID-19) makes people more concerned about the validity and timeliness of emergency decision making. When an emergency occurs, it is difficult for decision makers (DMs) to give accurate assessment information in the early stage due to the urgency of time, the incompleteness of information, and the limitations of DMs' cognition and knowledge. Hence, we use interval-valued intuitionistic hesitant fuzzy sets rather than exact numbers to better characterize the fuzziness and uncertainty of emergencies. In addition, the Internet has become a major platform for the public to express their opinions or concerns, so we can collect the user-generated content on social media to help DMs determine appropriate emergency decision-making criteria which are the premise and basis of scientific decisions. However, there is likely to be some correlation between the obtained criteria. To this end, we first extend the Bonferroni mean (BM) operator to the interval-valued intuitionistic hesitant fuzzy environment, and propose three interval-valued intuitionistic hesitant fuzzy BM operators to capture the interrelation of fuzzy input variables, including an interval-valued intuitionistic hesitant fuzzy BM operator, a simplified interval-valued intuitionistic hesitant fuzzy BM operator, and a simplified interval-valued intuitionistic hesitant fuzzy weighted BM (SIVIHFWBM) operator. Then, a new group emergency decision-making method based on the SIVIHFWBM operator and social media data is proposed, and the specific steps of ranking all emergency plans are put forward. Moreover, our method is applied to evaluate emergency plans for the prevention and control of COVID-19. Finally, the effectiveness and feasibility of the method are verified by the sensitivity analysis, validity test, and comparative analysis.
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OBJECTIVE: To explore the impacts of delayed ureteral stent removal on the quality of life (QoL) and mental health of urinary calculi postoperative patients due to the corona virus disease 2019(COVID-19) pandemic. METHODS: The demographic and clinical data of patients with ureteral stent placement after urinary endoscopic lithotripsy and returned to Peking University People's Hospital for stent removal from December 2019 to June 2020 were collected. Ureteral stent symptoms questionnaire (USSQ) score and the outcome 20-item self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were collected to estimate the QoL and mental status. The USSQ consisted of 44 questions in 6 domains (including urinary symptom, physical pain, general health, work performance, sexual function, and ureteral stent related infection). For most questions in each domain, its score was a five-point Likert-type scale from 1 to 5, and a small proportion of questions was quantified by 1 to 4 or 1 to 7 scale. SAS and SDS both contained 20 questions used to assess a patient's level of anxiety and depression. Its scoring for each item was on a four-point Likert-type scale from 1 to 4. A total score (ranging from 20 to 80) was the main statistical indicator. The level of clinical anxiety and depression was quantified by using standard scores (total score multiplied by 1.25 to produce integers). And the multi-group structural equation model was constructed by analysis of moment structure (AMOS) analysis. RESULTS: Overall, 71 patients were enrolled for analysis. It was found that the median duration of ureteral stent time differed significantly between the control and delayed groups for 32 (30, 33) d and 94.5 (88, 103) d, respectively. The delayed group resulted in higher scores in the USSQ multidimensional, which included urinary symptoms, general health, work performance and ureteral stent related infections. Anxiety and depression were also significantly serious in the delayed group than in the control group. A longer indwelling time of a ureteral stent could exacerbate the effects of urinary symptoms and physical pain on work performance (P=0.029 < 0.05). Among them, the patients with severe urinary symptoms leading to poor work performance were most significantly affected by prolonged ureteral stent duration time (CR=2.619>1.96). CONCLUSION: Patients with delayed ureteral stent removal due to the COVID-19 had resulted in worse QoL and mental status. Stents related symptoms are more severe in patients with higher anxiety and depression degree during COVID-19. To improve the QoL and mental health of patients after urinary calculi surgery during COVID-19, it is still not recommended to prolong the stent duration time or corresponding intervention measures should be taken.
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COVID-19 , Ureter , Cálculos Ureterais , Doenças Ureterais , Cálculos Urinários , Humanos , Qualidade de Vida , Pandemias , COVID-19/epidemiologia , Ureter/cirurgia , Dor , Stents , Inquéritos e QuestionáriosRESUMO
The "Middle East Respiratory" (MERS-Cov) is among the world's dangerous diseases that still exist. Presently it is a threat to Arab countries, but it is a horrible prediction that it may propagate like COVID-19. In this article, a stochastic version of the epidemic model, MERS-Cov, is presented. Initially, a mathematical form is given to the dynamics of the disease while incorporating some unpredictable factors. The study of the underlying model shows the existence of positive global solution. Formulating appropriate Lyapunov functionals, the paper will also explore parametric conditions which will lead to the extinction of the disease from a community. Moreover, to reveal that the infection will persist, ergodic stationary distribution will be carried out. It will also be shown that a threshold quantity exists, which will determine some essential parameters for exploring other dynamical aspects of the main model. With the addition of some examples, the underlying stochastic model of MERS-Cov will be studied graphically for more illustration.
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Based on the online and membrane sampling data of Yuncheng from January 1st to February 12th, 2020, the formation mechanism of haze under the dual influence of Spring Festival and COVID-19 (Corona Virus Disease) was analyzed. Atmospheric capacity, chemical composition, secondary transformation, source apportionment, backward trajectory, pollution space and enterprise distribution were studied. Low wind speed, high humidity and small atmospheric capacity inhibited the diffusion of air pollutants. Four severe pollution processes occurred during the period, and the pollution degree was the highest around the Spring Festival. In light, medium and heavy pollution periods, the proportion of SNA (SO42-, NO3- and NH4+) was 59.6%, 56.0% and 54.9%, respectively, which was the largest components of PM2.5; the [NO3-]/[SO42-] ratio was 2.1, 1.5 and 1.7, respectively, indicating that coal source had a great influence; the changes of NOR (nitrogen oxidation ratio, 0.44, 0.45, 0.61) and SOR (sulphur oxidation ratio, 0.40, 0.49, 0.65) indicated the accumulation of secondary aerosols with increasing pollution. The coal combustion, motor vehicle, secondary inorganic sources and industrial sources contributed 36.8%, 26.59%, 11.84% and 8.02% to PM2.5 masses, respectively. Backward trajectory showed that the influence from the east was greater during the Spring Festival, and the pollutants from the eastern air mass were higher, which would aggravate the pollution. Meteorological and Spring Festival had a great impact on heavy pollution weather. Although some work could not operate due to the impact of the COVID-19 epidemic, the emission of pollutants did not reduce much.