back to the search page

Query Topic: Covid-19

Query Date:

intensive care unit(55)

Toward Using Twitter Data to Monitor Covid-19 Vaccine Safety in Pregnancy: A Proof-of-Concept Study of Cohort Identification.
Coronavirus Disease 2019 (Covid-19) during pregnancy is associated with an increased risk of maternal death, intensive care unit (ICU) admission, and preterm birth; however, many people who are pregnant refuse to receive Covid-19 vaccination because of a lack of safety data. The objective of this preliminary study was to assess whether Twitter data could be used to identify a cohort for epidemiologic studies of Covid-19 vaccination in pregnancy-in particular, whether we could identify users who have reported (1) that they received Covid-19 vaccination during pregnancy or the periconception period, and (2) their pregnancy outcomes. We developed regular expressions to search for reports of Covid-19 vaccination in a large collection of tweets posted, through the beginning of July 2021, by users who have announced their pregnancy on Twitter. To help determine if users were vaccinated during pregnancy, we drew upon a natural language processing (NLP) tool that estimates the timeframe of the prenatal period. For users who posted tweets with a timestamp indicating they were vaccinated during pregnancy, we drew upon additional NLP tools to help identify tweets that report their pregnancy outcomes. We manually verified the content of tweets detected automatically, identifying 150 users who reported on Twitter that they received at least one dose of Covid-19 vaccination during pregnancy or the periconception period. Among the 60 completed pregnancies, we manually verified at least one reported outcome for 45 (75%) of them. Given the limited availability of data on Covid-19 vaccine safety in pregnancy, Twitter can be a complementary resource for potentially increasing the acceptance of Covid-19 vaccination in pregnant populations. The results of this preliminary study justify the development of scalable methods to identify a larger cohort for epidemiologic studies.
Publication Date: 2021-12-07
Journal: JMIR formative research

covid-19 vaccine(237)

Efficacy and safety of heterologous booster vaccination with Ad26.COV2.S after BNT162b2 mRNA COVID-19 vaccine in haemato-oncological patients with no antibody response.
Patients with haemato-oncological malignancies are one of the high-risk groups for a severe course in case of COVID-19 infections. Furthermore, vaccination results in significantly lower response rates in haematological malignancies and lower antibody levels in patients with solid cancer. We investigated efficacy and safety of a heterologous booster vaccination with Ad26.COV2.S DNA vector vaccine in haemato-oncological patients without antibody response after double-dose BNT162b2 messenger (m-)RNA COVID-19 vaccine. A total of 32 haemato-oncological non-responders to double-dose BNT162b2 received a heterologous booster vaccination with Ad26.COV2.S. Blood samples were assessed directly before the vaccination (T0) and four weeks after (T1). Safety assessment was performed using a standardised questionnaire. The overall response rate was 31%, with a mean (SD) antibody titre of 693·79 (1 096·99) binding activity units (BAU)/ml. Patients with chronic lymphocytic leukaemia or lymphoma showed a significantly lower response rate (P = 0·048). Adverse events were reported in 29·6% of patients, of which 7·1% were graded as severe, including grade III and IV events following the Common Terminology Criteria of Adverse Events (CTCAE). The heterologous booster vaccination with Ad26.COV2.S led to a serological response in nine out of 29 patients without response after double-dose BNT162b2. Furthermore, the vaccination was safe in our cohort, leading to mainly mild local and systemic reactions. Overall, this vaccination regimen should be further evaluated to increase the response rate in the highly vulnerable population of haemato-oncological patients.
Publication Date: 2021-12-07
Journal: British journal of haematology

acute respiratory(219)

SARS-CoV-2 infection presenting as rhabdomyolysis: case report and review.
Coronavirus disease 2019 (COVID-19) is the health crisis of our time and a great challenge we face, requiring the implementation of worldwide general containment. The symptoms and complications of COVID-19 are diverse, and rhabdomyolysis is an atypical manifestation. We report a case of a 63-year-old patient, admitted to the emergency room for myalgia and fever evolving over 5 days, in whom laboratory and other examinations indicated rhabdomyolysis complicated by renal insufficiency. During the diagnostic workup, the real-time polymerase chain reaction (RT-PCR) test result for COVID-19 was positive, revealing infection with sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the severity of COVID-19 infection relates mainly to acute respiratory syndrome, other complications can be prognostic, and these complications make the management of this disease difficult. Rhabdomyolysis is one of the fatal complications; first, because the pathophysiological mechanism is not yet understood, and second, because rhabdomyolysis, itself, is usually complicated by acute renal failure. This complication makes the disease management difficult, especially in patients with SARS. Rhabdomyolysis during COVID-19 infection represents a significant challenge, given the few reported cases, and further research is required to develop a therapeutic consensus.
Publication Date: 2021-12-07
Journal: The Journal of international medical research

covid-19 pandemic(198)

Determinants of COVID-19 Vaccination Willingness among Health Care Workers: A Quick Online Survey in India.
The coronavirus disease 2019 (COVID-19) pandemic has caused a large number of deaths along with severe socio-economic effects. The vaccine is considered to be the last hope to control viral transmission. This study aimed to explore the determinants of health care workers' (HCWs) willingness to take the COVID-19 vaccination. A structured, pre-validated, and pre-tested questionnaire was administered online to 599 HCWs including physicians, residents, and nurses from different types of healthcare set-ups across India. Information was collected regarding vaccine acceptability, attitude toward vaccination, and reasons for hesitancy. The chi-square test, followed by multinomial regression analysis, was applied to determine the factors associated with HCWs' vaccination willingness. It was found that 73 % (n=437) of HCWs were willing to accept the vaccines, while 10.85% (n=65) refused and 16.2% (n=96) needed more time to decide. Gender (P<0.001), occupation (P=0.040), working as front-line workers (P=0.008), vaccine manufacturing country preferences (P<0.001), and perceived risk of catching COVID-19 in the next 6 months (P=0.005) had a significant association with intent to receive vaccination (the response were "yes" vs. "no" and "not sure"). The reasons for vaccine hesitancy were vaccine safety and efficacy concerns, antivaccine attitude and beliefs, personal choice, and not wanting to take a vaccine before others. The majority of HCWs agreed to take COVID-19 vaccines once available. Nevertheless, providing support to manage evolving vaccine environments will help change the perception of HCWs who refuse or are reluctant to take the vaccines.
Publication Date: 2021-12-07
Journal: Korean journal of family medicine

covid-19 vaccination(187)

Cellular and humoral Immune response to mRNA COVID-19 vaccination in subjects with chronic lymphocytic leukemia.
Publication Date: 2021-12-07
Journal: Blood advances

mental health(167)

Gender in mental health: Gender-based violence, suffering, recovery, and the greater responsibility of society during the COVID-19 pandemic.
Publication Date: 2021-12-07
Journal: Asian journal of psychiatry

public health(162)

The Interplay Between Strictness of Policies and Individuals' Self-Regulatory Efforts: Associations with Handwashing During the COVID-19 Pandemic.
Patterns of protective health behaviors, such as handwashing and sanitizing during the COVID-19 pandemic, may be predicted by macro-level variables, such as regulations specified by public health policies. Health behavior patterns may also be predicted by micro-level variables, such as self-regulatory cognitions specified by health behavior models, including the Health Action Process Approach (HAPA). This study explored whether strictness of containment and health policies was related to handwashing adherence and whether such associations were mediated by HAPA-specified self-regulatory cognitions. The study (NCT04367337) was conducted among 1,256 adults from Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Self-report data on cross-situational handwashing adherence were collected using an online survey at two time points, 4 weeks apart. Values of the index of strictness of containment and health policies, obtained from the Oxford COVID-19 Government Response Tracker database, were retrieved twice for each country (1 week prior to individual data collection). Across countries and time, levels of handwashing adherence and strictness of policies were high. Path analysis indicated that stricter containment and health policies were indirectly related to lower handwashing adherence via lower self-efficacy and self-monitoring. Less strict policies were indirectly related to higher handwashing adherence via higher self-efficacy and self-monitoring. When policies are less strict, exposure to the SARS-CoV-2 virus might be higher, triggering more self-regulation and, consequently, more handwashing adherence. Very strict policies may need to be accompanied by enhanced information dissemination or psychosocial interventions to ensure appropriate levels of self-regulation.
Publication Date: 2021-12-07
Journal: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine

2 sars-cov-2(132)

A Tale of Two Institutions: COVID-19 Positive Rates in Asymptomatic Patients Pre-Screened for Spine Procedures and Surgeries in Los Angeles, California.
Retrospective cohort study. The coronavirus disease (COVID-19), caused by the severe respiratory syndrome coronavirus 2 (SARS-CoV-2), has created an unprecedented global public health emergency. The aim of the current study was to report on COVID-19 rates in an asymptomatic population prior to undergoing spine procedures or surgeries at two large Los Angeles healthcare systems. Elective spine procedures and surgeries from May 1, 2020 to January 31, 2021 were included. Results from SARS-CoV-2 virus RT-PCR nasopharyngeal testing within 72 hours prior to elective spine procedures were recorded. Los Angeles County COVID-19 rates were calculated using data sets from Los Angeles County Department of Public Health. Chi-squared test and Stata/IC were used for statistical analysis. A total of 4,062 spine procedures and surgeries were scheduled during this time period. Of these, 4,043 procedures and surgeries were performed, with a total of 19 patients testing positive. Nine positive patients were from UCLA, and 10 from USC. The overall rate of positive tests was low at .47% and reflected similarities with Los Angeles County COVID-19 rates over time. The current study shows that pre-procedure COVID-19 testing rates remains very low, and follows similar patterns of community rates. While pre-procedure testing increases the safety of elective procedures, universal COVID-19 pre-screening adds an additional barrier to receiving care for patients and increases cost of delivering care. A combination of pre-screening, pre-procedure self-quarantine, and consideration of overall community COVID-19 positivity rates should be further studied.
Publication Date: 2021-12-07
Journal: Global spine journal

study aimed(128)

Direct and Indirect Associations of Media Use with COVID-19 Vaccine Hesitancy: Cross-sectional Web-Based Survey in South Korea.
Background: The battle against the 2019 novel coronavirus (COVID-19) has not concluded. Although vaccines are available, the high prevalence of vaccine hesitancy represents a significant challenge to public health and raising vaccine acceptance among the public is critical. While media has become an increasingly popular source of COVID-19 vaccine-related information, the question of whether and how media use is related to the public's vaccine hesitancy warrants exploration. This study aimed to (1) examine the level of COVID-19 vaccine hesitancy, (2) identify factors associated with COVID-19 vaccine hesitancy, and (3) explore the direct and indirect relationship between media use and vaccine hesitancy through psychological factors. A cross-sectional online survey took place over six days (January 20-25, 2021), a month ago before COVID-19 vaccination was initiated in South Korea. This study included 1016 subjects, and a logit model for regression analyzed associations between socio-demographic factors, health-related factors, psychological factors, and media use toward one's COVID-19 vaccine hesitancy. Additionally, path analysis to examine the indirect effects of media use on vaccine hesitancy via psychological factors (i.e., perceived risk of COVID-19 infection, perceived benefits, and perceived barriers of COVID-19 vaccination) were conducted. Among the respondents (n=1,016), 53.3% hesitated COVID-19 vaccination, while 46.7% of the respondents would accept the vaccine. Out of the socio-demographic factors, female (OR, 1.967; 95% CI, 1.36-2.86; P < .001), age in 50s (OR, .47; 95% CI, .23-.96; P= .004), and over 60s (OR, .49; 95% CI, .24 - 0.99; P= .04) were significant individual predictors of COVID-19 vaccine hesitancy. Perceived susceptibility of infection (OR, .69; 95% CI, .52 - .91; P= .01) and perceived benefits of vaccination (OR, .69; 95% CI, .52 - .91; P= .01) were associated with lower vaccine hesitancy. Perceived barriers of vaccination (OR, 1.63; 95% CI, 1.29 - 2.07; P < .001) and lower trust in government (OR, .72; 95% CI, .53 - 0.98; P= .04) were related to vaccine hesitancy. The use of offline and online media was associated with vaccine hesitancy through perceived benefits of vaccination, resulting in a lower vaccine hesitancy. Moreover, perceived susceptibility of the disease and perceived barriers of vaccination mediated the association between social media use and vaccine hesitancy. Findings revealed a considerable level of COVID-19 vaccine hesitancy in South Korea. Gender-based and generation-based public health policies and communication are recommended. Efforts to lower the perceived risk of vaccine side effects and heighten perceived benefits of the vaccine are required. While the use of media has a positive or negative effect on the population's vaccine hesitancy, efforts should be made to disseminate reliable and timely information on media while confront misinformation or disinformation for successive implementation of vaccine programs during pandemics.
Publication Date: 2021-12-07
Journal: Journal of medical Internet research

covid-19 outbreak(87)

Poor walking ability outcome and activities of daily living improvement in patients undergoing cardiac rehabilitation during COVID-19 pandemic.
The COVID-19 pandemic has had wide-ranging impacts across international healthcare systems and direct impacts on rehabilitation professionals. Few outcome data for cardiac patients undergoing rehabilitation programs during the COVID-19 pandemic are available. We conducted a study to compare the effect of modified rehabilitation therapies mainly performed in wards versus conventional therapies mainly performed in rehabilitation units in which exercise on a treadmill and cardiopulmonary exercise testing were available. The observational study involved 55 consecutive inpatients who were admitted to a university hospital and underwent a cardiac rehabilitation program from August 2019 to June 2020. The patients were divided into two groups: those admitted during the COVID-19 outbreak (Group A, n = 28) and those admitted before the COVID-19 outbreak (Group B, n = 27). The evaluation included age, sex, duration of the rehabilitation intervention program, days before initiation of the rehabilitation program, functional status, and functional independence measure (FIM) score. A higher proportion of patients in Group A than B underwent a cardiac rehabilitation program provided in wards (88.5% vs. 48.8%, respectively). Group A showed a significantly lower 6-minute walking distance and walking speed than Group B at discharge (P = 0.031 and 0.014, respectively). Group A showed a significantly shorter exercise time using an ergometer than Group B (P = 0.028). The difference in the cardiac rehabilitation location during the COVID-19 pandemic may affect the rehabilitation contents and lead to less improvement in physical function. A cardiac rehabilitation program was performed mainly in wards instead of in rehabilitation units during the COVID-19 pandemic. Walking abilities were adversely affected by the modified cardiac rehabilitation program.
Publication Date: 2021-12-07
Journal: European journal of physical and rehabilitation medicine

first wave(73)

Cardiac inflammation and microvascular procoagulant changes are decreased in second wave compared to first wave deceased COVID-19 patients.
Compelling evidence has shown cardiac involvement in COVID-19 patients. However, the overall majority of these studies use data obtained during the first wave of the pandemic, while recently differences have been reported in disease course and mortality between first- and second wave COVID-19 patients. The aim of this study was to analyze and compare cardiac pathology between first- and second wave COVID-19 patients. Autopsied hearts from first- (n = 15) and second wave (n = 10) COVID-19 patients and from 18 non-COVID-19 control patients were (immuno)histochemically analyzed. CD45+ leukocyte, CD68+ macrophage and CD3+ T lymphocyte infiltration, cardiomyocyte necrosis and microvascular thrombosis were quantified. In addition, the procoagulant factors Tissue Factor (TF), Factor VII (FVII), Factor XII (FXII), the anticoagulant protein Dipeptidyl Peptidase 4 (DPP4) and the advanced glycation end-product N( Cardiac inflammation was significantly decreased in second wave compared to first wave COVID-19 patients, predominantly related to a decrease in infiltrated lymphocytes and the occurrence of lymphocytic myocarditis. This was accompanied by significant decreases in cardiomyocyte injury and microvascular thrombosis. Moreover, microvascular deposits of FVII and CML were significantly lower in second wave compared to first wave COVID-19 patients. These results show that in our cohort of fatal COVID-19 cases cardiac inflammation, cardiomyocyte injury and microvascular thrombogenicity were markedly decreased in second wave compared to first wave patients. This may reflect advances in COVID-19 treatment related to an increased use of steroids in the second COVID-19 wave.
Publication Date: 2021-12-07
Journal: International journal of cardiology

healthcare workers(58)

Digital Interventions to Reduce Distress Among Health Care Providers at the Frontline: Protocol for a Feasibility Trial.
Stress, anxiety, distress, and depression are high among healthcare workers during the COVID-19 pandemic, and they have reported acting in ways that are contrary to their moral values and professional commitments that degrade their integrity. This creates moral distress and injury due to constraints they have encountered, such as limited resources. The purpose of this study is to develop and show the feasibility of digital platforms (a virtual reality (VR) and a mobile platform) to understand the causes and ultimately reduce the moral distress of healthcare providers during the COVID-19 pandemic. This project is a proof-of-concept integration of concepts/applications to demonstrate viability over six months and guide future studies to develop these state-of-the-art technologies to help frontline healthcare workers work in complex moral contexts. In addition, the project will develop innovations that can be used for future pandemics and in other contexts prone to producing moral distress and injury. This will be a prospective, single cohort, pre- and post-test study examining the effect of a brief informative video describing moral distress on perceptual, psychological, and physiological indicators of stress and decision-making during the scenario known to potentially elicit moral distress. To accomplish this, we have developed a VR simulation scenario that will be used before and after the digital intervention for monitoring short-term impacts. The simulation involves an ICU setting during the COVID-19 pandemic, and participants will be placed in a morally challenging situation. The participants will be engaged in an educational intervention at the individual, team, and organizational levels. During each test, data will be collected for a) physiological measures of stress and after each test, data will be collected regarding b) thoughts, feelings and behaviours during a morally challenging situation, and c) perceptual estimates of psychological stress. We aim to create an effective compound intervention composed of the VR-based simulation educational intervention that is examined through the data collected from mental health questionnaires. In addition, participants will continue to be monitored for moral distress and other psychological stresses for eight weeks through our Digital intervention/intelligence Group mobile (DiiG) platform for a longer-term impact. Finally, a comparison will be conducted using machine learning and biostatistical techniques to analyze the short- and long-term impacts of the VR intervention. Funded in (November, 2020), approved by REB in (March, 2021), the study is ongoing. This project aims to demonstrate the feasibility of using digital platforms to understand the continuum of moral distress that can lead to moral injury. Demonstration of feasibility will lead to future studies to examine the efficacy of digital platforms to reduce moral distress. Trial registry name:, registration/identifier number: NCT05001542, URL:, Unity Health Toronto protocol record: 21-066.
Publication Date: 2021-12-07
Journal: JMIR research protocols

covid-19 pneumonia(50)

[Pneumomediastinum in Severe COVID-19-disease: a Case Series of Eight Patients].
The most common cause of pneumomediastinum is trauma. However, in the context of COVID-19 pneumonia, this clinical picture is more often found in patients without underlying exogenous injury. Pathophysiologically, a cause analogous to the Macklin effect is suspected here, in which tears at the alveolar level lead to emphysema along the tracheobronchial tree with concentrating in the mediastinum. Here we present a case series of eight patients who were treated in our intensive care unit. In all patients, mediastinal emphysema could already be seen in the chest X-ray. Five patients also received a computed tomography scan of the thorax. Six patients had invasive ventilation. All patients received corticosteroids, anticoagulation and antibiotics. Pleural drainage was applied only in patients with an additional pneumothorax (n = 5). Bronchoscopy was performed only if there was a suspicion of iatrogenic injury to the tracheobronchial tree in relation to the appearance of the pneumomediastinum (n = 2). Three patients died during intensive care as part of the COVID-19 disease. A prognostic relationship between the occurrence of a pneumomediastinum and a fatal course of the disease is discussed. Die häufigste Ursache für ein Pneumomediastinum sind Traumata. Im Rahmen von COVID-19-Pneumonien wird dieses Krankheitsbild jedoch häufiger bei Patienten ohne zugrunde liegende exogene Verletzung gefunden. Pathophysiologisch wird hier eine Ursache analog zum Macklin-Effekt vermutet, bei dem Einrisse auf Alveolarebene zu Emphysemen entlang des Tracheobronchialbaums mit Betonung im Mediastinum führen. Wir stellen hier eine Fallserie von 8 Patienten vor, die auf unserer Intensivstation behandelt wurden. Bei allen Patienten konnte das Mediastinalemphysem bereits im Röntgenbild des Thorax gesehen werden. Fünf Patienten erhielten zusätzlich eine Computertomografie des Thorax. Sechs Patienten waren invasiv beatmet. Alle Patienten erhielten Kortikosteroide, Antikoagulation und Antibiose. Nur bei Patienten mit einem zusätzlichen Pneumothorax (n = 5) wurde eine Pleuradrainage angelegt. Eine Bronchoskopie wurde nur durchgeführt, falls im Zusammenhang mit dem Auftreten des Pneumomediastinums der Verdacht auf eine iatrogene Verletzung des Tracheobronchialbaums bestand (n = 2). Drei Patienten verstarben im Verlauf der Intensivbehandlung im Rahmen der COVID-19-Erkrankung. Ein prognostischer Zusammenhang zwischen dem Auftreten eines Pneumomediastinums und einem fatalen Krankheitsverlauf wird diskutiert.
Publication Date: 2021-12-07
Journal: Zentralblatt fur Chirurgie

covid-19 severity(47)

SARS-CoV-2 genetic variations associated with COVID-19 pathogenicity.
In this study, we performed genome-wide association analyses on SARS-CoV-2 genomes to identify genetic mutations associated with pre-symptomatic/asymptomatic COVID-19 cases. Various potential covariates and confounding factors of COVID-19 severity, including patient age, gender and country, as well as virus phylogenetic relatedness were adjusted for. In total, 3021 full-length genomes of SARS-CoV-2 generated from original clinical samples and whose patient status could be determined conclusively as either 'pre-symptomatic/asymptomatic' or 'symptomatic' were retrieved from the GISAID database. We found that the mutation 11 083G>T, located in the coding region of non-structural protein 6, is significantly associated with asymptomatic COVID-19. Patient age is positively correlated with symptomatic infection, while gender is not significantly correlated with the development of the disease. We also found that the effects of the mutation, patient age and gender do not vary significantly among countries, although each country appears to have varying baseline chances of COVID-19 symptom development.
Publication Date: 2021-12-07
Journal: Microbial genomics

physical activity(40)

Gender-related differences in the impact of COVID-19 pandemic in cardiometabolic patients in Latin America: The CorCOVID LATAM Gender sub-study.
COVID-19 pandemic and lockdown measures have disrupted lifestyle habits and self-care. Gender differences in health behavior during the pandemic have not yet been fully elucidated. To evaluate gender-related differences in the impact of COVID-19 pandemic on patients with cardiometabolic diseases. A cross-sectional survey was administered to cardiometabolic patients in 13 Latin American countries between June 15 The study included 4,216 participants, of which 2,147 (50.9%) were women. Women reported healthier eating habits as well as lower tobacco and alcohol consumption than men but exercised less and reported increased symptoms of depression. Low income and symptoms of depression were associated with sedentarism in women. Women presented better dietary habits during COVID-19 pandemic but reported lower levels of physical activity and more frequent symptoms of depression. The interplay between psychological factors and sedentarism could increase the risk of cardiovascular events in this population.
Publication Date: 2021-12-07
Journal: Current problems in cardiology

disease-2019 covid-19(39)

Association between clinical characteristics and CT findings in patients with coronavirus disease-2019.
This retrospective study was to investigate the association between clinical characteristics and computerized tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19). The clinical data of COVID-19 patients were retrospectively analyzed. Spearman correlation analysis was used to identify the correlation. Totally 209 consecutive COVID-19 patients were eligible for the study, with the mean age of 47.53 ± 13.52 years. At onset of the disease, the most common symptoms were fever (85.65%) and cough (61.24%). The CT features of COVID-19 included pulmonary, bronchial, and pleural changes, with the significant pulmonary presentation of ground-glass opacification (93.30%), consolidation (48.80%), ground-glass opacification plus a reticular pattern (54.07%), telangiectasia (84.21%), and pulmonary fibrotic streaks (49.76%). Spearman analysis showed that the CT findings had significantly inverse associations with the platelets, lymphocyte counts, and sodium levels, but were positively related to the age, erythrocyte sedimentation rate, D-dimer, lactic dehydrogenase, α-hydroxybutyrate dehydrogenase, and C-reactive protein levels (P < .05). In conclusion, the severity of lung abnormalities on CT in COVID-19 patients is inversely associated with the platelets, lymphocyte count, and sodium levels, whereas positively with the age, erythrocyte sedimentation rate, D-dimer, lactic dehydrogenase, hydroxybutyrate dehydrogenase, and C-reactive protein levels.
Publication Date: 2021-12-07
Journal: Medicine

covid-19 mortality(39)

Fire association with respiratory disease and COVID-19 complications in the State of Pará, Brazil.
Brazil has faced two simultaneous problems related to respiratory health: forest fires and the high mortality rate due to COVID-19 pandemics. The Amazon rain forest is one of the Brazilian biomes that suffers the most with fires caused by droughts and illegal deforestation. These fires can bring respiratory diseases associated with air pollution, and the State of Pará in Brazil is the most affected. COVID-19 pandemics associated with air pollution can potentially increase hospitalizations and deaths related to respiratory diseases. Here, we aimed to evaluate the association of fire occurrences with the COVID-19 mortality rates and general respiratory diseases hospitalizations in the State of Pará, Brazil. We employed machine learning technique for clustering k-means accompanied with the elbow method used to identify the ideal quantity of clusters for the k-means algorithm, clustering 10 groups of cities in the State of Pará where we selected the clusters with the highest and lowest fires occurrence from the 2015 to 2019. Next, an Auto-regressive Integrated Moving Average Exogenous (ARIMAX) model was proposed to study the serial correlation of respiratory diseases hospitalizations and their associations with fire occurrences. Regarding the COVID-19 analysis, we computed the mortality risk and its confidence level considering the quarterly incidence rate ratio in clusters with high and low exposure to fires. Using the k-means algorithm we identified two clusters with similar DHI (Development Human Index) and GDP (Gross Domestic Product) from a group of ten clusters that divided the State of Pará but with diverse behavior considering the hospitalizations and forest fires in the Amazon biome. From the auto-regressive and moving average model (ARIMAX), it was possible to show that besides the serial correlation, the fires occurrences contribute to the respiratory diseases increase, with an observed lag of six months after the fires for the case with high exposure to fires. A highlight that deserves attention concerns the relationship between fire occurrences and deaths. Historically, the risk of mortality by respiratory diseases is higher (about the double) in regions and periods with high exposure to fires than the ones with low exposure to fires. The same pattern remains in the period of the COVID-19 pandemic, where the risk of mortality for COVID-19 was 80% higher in the region and period with high exposure to fires. Regarding the SARS-COV-2 analysis, the risk of mortality related to COVID-19 is higher in the period with high exposure to fires than in the period with low exposure to fires. Another highlight concerns the relationship between fire occurrences and COVID-19 deaths. The results show that regions with high fire occurrences are associated with more cases of COVID deaths. The decision-make process is a critical problem mainly when it involves environmental and health control policies. Environmental policies are often more cost-effective as health measures than the use of public health services. This highlight the importance of data analyses to support the decision making and to identify population in need of better infrastructure due to historical environmental factors and the knowledge of associated health risk. The results suggest that The fires occurrences contribute to the increase of the respiratory diseases hospitalization. The mortality rate related to COVID-19 was higher for the period with high exposure to fires than the period with low exposure to fires. The regions with high fire occurrences is associated with more COVID-19 deaths, mainly in the months with high number of fires. No additional funding source was required for this study.
Publication Date: 2021-12-07
Journal: Lancet Regional Health. Americas

coronavirus covid-19(33)

A Cross-Cultural Analysis of the COVID-19 Pandemic's Impact on Antenatal Healthcare-Seeking Behaviors in Ghana and the United States.
The coronavirus (COVID-19) pandemic impacted healthcare systems worldwide. In this study, we conducted qualitative interviews with pregnant women in Ghana and the United States (US) to understand their antenatal care (ANC) experience. Adapting to the virtual nature of the pandemic, social media platforms Facebook and WhatsApp were used to recruit, consent, enroll, and interview women. Interviewers used a semi-structured guide with content validated by the US and Ghanaian collaborators. Audio recordings of the interviews were transcribed, coded using Dedoose (v8.0.35, Dedoose) and grounded theory, and analyzed for recurring themes. Between May and July 2020, 32 women (15 Ghanaians, 17 Americans), aged 25-40 years were interviewed. Major themes emerged: (i) apprehension about ANC services; (ii) disruptions to planned healthcare provider use; and (iii) changes in social support. Although the women strove to retain their ANC as planned, the pandemic universally caused several unanticipated changes. Given associations between higher maternal mortality and poor outcomes with inadequate ANC, specific policies and resources for telehealth education and intra- and postpartum support should be implemented to reduce disruptions to ANC imposed by COVID-19.
Publication Date: 2021-12-07
Journal: Journal of patient experience

unit icu(28)

[Multicenter validation of Early Warning Scores for detection of clinical deterioration in COVID-19 hospitalized patients].
investigate the predictive value of NEWS2, NEWS-C, and COVID-19 Severity Index for predicting intensive care unit (ICU) transfer in the next 24 hours. retrospective multicenter studySetting: two third-level hospitals in ArgentinaPatients: all adult patients with confirmed COVID-19, admitted on general wards, excluding patients with non-intubated orders. Patients were divided between those who were admitted to ICU and non-admitted. We calculated the three scores for each day of hospitalization. we evaluate the calibration and discrimination of the three scores for the outcome ICU admission within 24, 48 h, and at hospital admission. we evaluate 13,768 days of hospitalizations on general medical wards of 1318 patients. Among these, 126 (9.5%) were transferred to ICU. The AUROC of NEWS2 was 0.73 (95%CI 0.68-0.78) 24 hours before ICU admission, and 0.52 (95%CI 0.47-0.57) at hospital admission. The AUROC of NEWS-C was 0.73 (95%CI 0.68-0.78) and 0.52 (95%CI 0.47-0.57) respectively, and the AUROC of COVID-19 Severity Index was 0.80 (95%CI 0.77-0.84) and 0.61 (95%CI 0.58-0.66) respectively. COVID-19 Severity Index presented better calibration than NEWS2 and NEWS-C. COVID-19 Severity index has better calibration and discrimination than NEWS2 and NEWS-C to predict ICU transfer during hospitalization.
Publication Date: 2021-12-07
Journal: Medicina intensiva

95 confidence(27)

SARS-CoV-2 incidence, testing rates, and severe COVID-19 outcomes among people with and without HIV.
To assess SARS-CoV-2 outcomes, we matched a municipal COVID-19 registry and clinic rosters from a municipal primary care network containing a large HIV clinic and assessed clinical outcomes by HIV status. The risk of severe COVID-19 was higher among people with HIV (PWH, adjusted relative risk = 1.84, 95% confidence interval = 1.05-3.25), while SARS-CoV-2 incidence was lower despite higher testing rates. SARS-CoV-2 vaccination campaigns should prioritize PWH to prevent severe COVID-19 disease given potentially higher risk.
Publication Date: 2021-12-07
Journal: AIDS (London, England)

workers hcws(23)

Perception, Willingness, Barriers, and Hesitancy Towards COVID-19 Vaccine in Pakistan: Comparison Between Healthcare Workers and General Population.
Background Vaccine hesitancy has been a huge challenge in controlling preventable diseases. With the emergence of coronavirus disease 2019 (COVID-19) vaccines, it is vital to know their acceptance rates among the masses. No comparative data is available on the current subject from Pakistan yet. Therefore, this study aimed to evaluate the acceptance of a potential COVID-19 vaccine among the general population and healthcare workers (HCWs) of Pakistan, along with their perceptions and barriers to acceptance. Methods An online cross-sectional study was carried out in Pakistan from December 19, 2020, to January 10, 2021, using convenience sampling. A self-administered questionnaire consisting of 31 items was distributed after informed consent. Inclusion criteria consisted of HCWs and non-HCWs (general population) aged 18 years and above, residing in Pakistan. All analyses were done using Statistical Package for Social Sciences (SPSS) version 23.0 (IBM Corp., Armonk, NY, USA). Chi-square and T-test were used and a p-value of less than 0.05 was considered significant for all cases. Results Of the 404 respondents (n=196 general population and n=208 HCWs), 73.5% were willing to get a proven, safe, and effective COVID-19 vaccine if it was free of cost. This was reduced to only 64.3% if the vaccine was not free and had to be paid for. A total of 168 (41.6%) participants agreed to get vaccinated immediately, while 149 (36.9%) participants concurred to get it on a delayed basis. Eighty-seven (21.5%) participants refused to receive the COVID-19 vaccine, amongst which a significant majority (p<0.001) of the participants were from the general population. Doctors or scientists/scholarly journals were found to be the most trusted source of information (67.6%; n=273), while fear of unknown side effects (45.5%; n=184) was found to be the most common barrier towards COVID-19 vaccination. More than half (53.5%) participants believed that the vaccine is safe, effective, and has minimal side effects, amongst which a significantly large fraction (p<0.001) belonged to the HCWs. Conclusion The acceptance rate of a safe, effective, proven, and free COVID-19 vaccine was 73.5%. The fear of unknown side effects was the most common barrier to COVID-19 vaccine uptake. The general population demonstrated less knowledge, more false perceptions, and barriers to COVID-19 vaccine. Adequate measures should be taken to educate the masses about the COVID-19 vaccine, and its safety, and further studies are required.
Publication Date: 2021-12-07
Journal: Cureus


Conducting and critically appraising a high-quality systematic review and meta-analysis pertaining to COVID-19.
With constantly emerging new information regarding the epidemiology, pathogenesis, diagnosis and management of Coronavirus Disease 2019 (COVID-19), reviewing literature related to it has become increasingly complicated and resource-intensive. In the setting of this global pandemic, clinical decisions are being guided by the results of multiple pertinent studies; however, it has been observed that these studies are often heterogenous in design and population characteristics and results of initial trials may not be replicated in subsequent studies. The resulting clinical conundrum can be resolved by high-quality systematic review and meta-analysis with a robust and reliable methodology, encapsulating and critically appraising all the available literature relevant to the clinical scenario under scrutiny. It can condense the large volume of scientific information available and can also identify the cause of differences in the degree of effect under consideration across different studies. It can identify optimal diagnostic algorithms, assess efficacy of treatment strategies, and analyze inherent factors influencing the efficacy of treatment for COVID-19.The current review aims to provide a basic guide to plan and conduct a high-quality systematic review and meta-analysis pertaining to COVID-19, describing the main steps and addressing the pitfalls commonly encountered at each step. Knowledge of the basic steps would also allow the reader to critically appraise published systematic review and meta-analysis and the quality of evidence provided therein.
Publication Date: 2021-12-07
Journal: Current medical research and opinion


[Surgery for Thoracic Malignancies during the COVID-19 Pandemic: a Case-control Study Investigating the Risk for Postoperative Complications].
The COVID-19 pandemic led to a major disturbance in the health care system. Many elective operations were postponed, including surgical oncology cases. Besides the need to contain hospital resources, this was also due to concerns about the safety to perform surgery during the pandemic and the impact of perioperative infections on postoperative outcomes. In this study we investigate the safety of surgery for thoracic malignancies during the COVID-19 pandemic. We retrospectively analysed the outcome of surgery for thoracic malignancies during the first, second and third waves of the COVID-19 pandemic (from 01.01. to 30.04.2020 and from 01.01. to 30.04.2021). As a control group we included the patients who received thoracic oncology surgeries during the same period in the last 2 years before the onset of the pandemic. The primary outcome was the rate of postoperative complications. 236 operations were included in the pandemic group and 227 operations in the control group. There was no statistically significant difference in the rate of postoperative minor complications (16.1% vs. 18.5%, p = 0.5395) or major complications (12.2% vs. 10.13 %, p = 0.5563). The risk to develop postoperative pulmonary complications was not higher in the pandemic group (odds ratio 1.193, 95% CI 0.6515-2.203, p = 0.8232). There were 5 cases with COVID-19 infection after the operation in the pandemic group. There was no difference in the rate of postoperative mortalities (2 (0.85%) vs. 1 (0.44%), p > 0.9999) There was no COVID-19 related mortality. Maintaining oncologic thoracic surgery during the COVID-19 pandemic is safe, feasible and not associated with increased risks of postoperative complications or mortalities. Die COVID-19-Pandemie hatte, neben der offensichtlichen Bedeutung als eigenständige Erkrankung, einen schwerwiegenden Einfluss auf alle Aspekte der medizinischen Versorgung. In der onkologischen Chirurgie mussten Operationen verschoben werden oder es kam zu verzögerten Diagnosen onkologischer Erkrankungen, was neben der Sorge um unzureichende Ressourcen auch in der Unsicherheit bezüglich der perioperativen Risiken begründet lag. In dieser Studie untersuchen wir die Sicherheit der Durchführung onkologischer thoraxchirurgischer Eingriffe während der COVID-19-Pandemie. Es wurden retrospektiv die Ergebnisse der thoraxchirurgischen Operationen bei onkologischen Patienten am Universitätsklinikum Freiburg während der 1., 2. und 3. Welle der COVID-19-Pandemie (vom 01.01. bis 30.04.2020 sowie vom 01.01. bis 30.04.2021) untersucht. Als Kontrollgruppe wurden die im gleichen Zeitraum vor der Pandemie (2018 und 2019) durchgeführten Operationen gewählt. Der primäre Endpunkt war das Auftreten postoperativer Komplikationen. 236 Operationen in der Pandemiekohorte und 227 Operationen in der Kontrollkohorte wurden in die Studie eingeschlossen. Es gab keinen Unterschied in der Inzidenzrate von postoperativen Minor-Komplikationen (16,1% vs. 18,5%, p = 0,5395) oder Major-Komplikationen (12,2% vs. 10,13%, p = 0,5563) zwischen der Pandemiekohorte und der Kontrollkohorte. Es zeigte sich kein erhöhtes Risiko für postoperative pulmonale Komplikationen in der Pandemiekohorte (Odds Ratio = 1,193, 95%-KI= 0,6515–2,203, p = 0,8232). Eine COVID-19-Infektion nach der Operation trat bei 5 Patienten der Pandemiekohorte auf (2,29%). Die postoperative Motilität innerhalb von 30 Tagen waren vergleichbar zwischen der Pandemiekohorte und der Kontrollkohorte (2 (0,85%) vs. 1 (0,44%), p > 0,9999). Es gab keine COVID-19-infektionsbedingte Mortalität. Die Durchführung von onkologischen thoraxchirurgischen Operationen während der COVID-19-Pandemie ist, unter Einhaltung der entsprechenden Sicherheitsmaßnahmen, sicher und weder mit einer erhöhten Komplikationsrate noch einer erhöhten Mortalität verbunden.
Publication Date: 2021-12-07
Journal: Zentralblatt fur Chirurgie


Dyspnea and COVID-19: A Review of Confounding Diagnoses during the Postpartum Period.
The puerperium is a complex period that begins with placental delivery and lasts for 6 weeks, during which readaptation of the female organism and redistribution of blood volume occur. This period is conducive to the occurrence of thromboembolic events. In the context of the SARS-CoV-2 pandemic, the virus responsible for COVID-19, the attention of the scientific community and health professionals has been focused on obtaining insights on different aspects of this disease, including etiology, transmission, diagnosis, and treatment. Regarding the pregnancy-postpartum cycle, it is opportune to review the clinical conditions that can occur during this period and to investigate dyspnea as a postpartum symptom in order to avoid its immediate association with COVID-19 without further investigation, which can lead to overlooking the diagnosis of other important and occasionally fatal conditions. O puerpério é um período complexo que se inicia com a dequitação placentária e dura por 6 semanas, no qual a readaptação do organismo materno e a redistribuição do volume sanguíneo ocorrem, além de ser também um cenário propício para eventos pró-trombóticos. No contexto da pandemia de SARS-CoV-2, vírus responsável pela COVID-19, a atenção da comunidade científica e dos profissionais da saúde está voltada a elucidar os aspectos da doença, como a etiologia, a transmissão, o diagnóstico e o tratamento. Considerando o ciclo gravídico-puerperal, é oportuna a revisão de condições clínicas que ocorrem durante este período e que apresentam a dispneia como sintoma, a fim de evitar que ela seja automaticamente associada à COVID-19 sem investigações aprofundadas, o que pode levar à negligência do diagnóstico de outras condições importantes e que podem ser, por vezes, fatais.
Publication Date: 2021-12-07
Journal: Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia


Prevalence of Urinary Incontinence in CrossFit Practitioners before and during the COVID-19 Quarantine and its Relationship with Training Level: An Observational Study.
 To compare the prevalence of urinary incontinence (UI) before and during the COVID-19 quarantine in CrossFit women and their relationship with training level.  A cross-sectional study was performed among 197 women practicing CrossFit. The inclusion criteria were nulliparous women, between 18 and 45 years old, who had trained, before quarantine, in accredited gyms. The exclusion criteria were not following the COVID-19 prevention protocols and having UI on other occasions than just sport. An online questionnaire was emailed containing questions about frequency, duration, and intensity of training and data related to the COVID-19 pandemic. The participants were invited to answer whether they were infected with COVID-19 and what treatment/recommendation they have followed. Whether UI stopped among participants, they were asked about the possible reasons why this happened. The training intensity was categorized as "the same," "decreased" or "increased."  The mean age of the participants was 32 years old and most (98.5%) could practice CrossFit during the pandemic. There was a decrease in training intensity in 64% of the respondents. Exercises with their own body weight, such as air squat (98.2%), were the most performed. Urinary incontinence was reported by 32% of the participants before the COVID-19 pandemic, and by only 14% of them during the pandemic (odds ratio [OR] = 0.32 [0.19-0.53];  The reduction in the intensity of CrossFit training during the COVID-19 quarantine decreased the prevalence of UI among female athletes.  Comparar a prevalência de incontinência urinária (IU) no CrossFit, antes e durante a quarentena por COVID-19, e sua relação com a intensidade do treinamento. MéTODOS:  Estudo observacional com 197 atletas de CrossFit. Os critérios de inclusão foram: nulíparas, 18 a 45 anos, treinando antes da quarentena em academias credenciadas. Os critérios de exclusão foram: não seguir os protocolos de prevenção da COVID-19 e ter IU em outras ocasiões que não apenas no esporte. Utilizou-se um questionário online com perguntas sobre frequência, duração e intensidade do treinamento e dados relacionados à pandemia, além de caso tivessem tido infecção pelo SARS-COV2, qual tratamento/recomendação seguiram. Caso a IU tenha parado entre as participantes, elas foram perguntadas quanto quais as possíveis razões pelas quais isso aconteceu. A intensidade do treinamento foi categorizada como “igual,” “diminuída” ou “aumentada “.  A média de idade foi de 32 anos e a maioria (98,5%) conseguiu praticar CrossFit durante a pandemia. Houve uma diminuição na intensidade do treinamento em 64% das entrevistadas. Exercícios com o próprio peso corporal, como agachamento no ar (98,2%), foram os mais realizados. Incontinência urinária foi relatada por 32% das participantes antes da pandemia e por apenas 14% durante a pandemia (odds ratio [OR] = 0,32 [0,19–0,53];
Publication Date: 2021-12-07
Journal: Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia


Lipopeptides against COVID-19 RNA-dependent RNA polymerase using molecular docking.
Coronavirus disease 2019 (COVID-19) is caused by a novel virus that is responsible for the largest pandemic in recent times. Although numerous studies have explored methods to cope with COVID-19 and targeted drugs and vaccines have been developed, the spread of disease remains rapid due to the high infectivity and mutation capability of SARS-CoV-2, the causative virus of COVID-19. Therefore, there is an urgent necessity to seek more efficient treatments and approaches to combat the disease. In this study, molecular docking was used to predict the binding of different lipopeptides, which exhibit significant biological functions, to the RNA-dependent RNA polymerase (also known as nsp12) of SARS-CoV-2, the central component of coronaviral replication and transcription machinery. The results showed that seven lipopeptides bound to nsp12 at the same location as the FDA-approved drug remdesivir, with higher affinities. Notably, iron-chelating ferrocin A (ferrocin A-iron complex [FAC]) bound to nsp12 most tightly, releasing up to 9.1 kcal mol Our findings suggest that the abovementioned lipopeptides can tightly bind to nsp12, and thus represent promising drug candidates for anti-coronaviral treatments with the potential to fight SARS-CoV-2.
Publication Date: 2021-12-07
Journal: Biomedical journal


The role of a socially assistive robot in enabling older adults with mild cognitive impairment to cope with the measures of the COVID-19 lockdown: A qualitative study.
During the COVID-19 pandemic, mandatory containment measures led to lockdowns and severely diminished social interaction, with older adults being one vulnerable group. Socially assistive robots (SARs) could prove to be an effective intervention. To explore the experiences of older adults with mild cognitive impairment (MCI) with a SAR during the first lockdown in Belgium. Inductive thematic analysis was used. After a two-week interaction period with robot James®, semi-structured interviews were conducted. Four people were interviewed (median: 86 years; range: 70-90 years; 2 men, 2 women). Four themes were identified. The first theme described the robot as a companion, alleviating feelings of loneliness and social isolation. The second theme explored the robot in light of meaningful activity. The third theme detailed the technical aspects of the robot and the fourth theme described notable barriers and areas of improvement. The study demonstrated the potential of SARs during the first lockdown period in Belgium. The robot proved to be promising in terms of alleviating feelings of loneliness and social isolation. It was found to be both motivating and facilitating in terms of meaningful activity. The study provided valuable insights for the care of lonely and occupationally deprived older adults.
Publication Date: 2021-12-07
Journal: Scandinavian journal of occupational therapy


Kidney Recovery and Death in Critically Ill Patients With COVID-19-Associated Acute Kidney Injury Treated With Dialysis: The STOP-COVID Cohort Study.
Acute kidney injury treated with kidney replacement therapy (AKI-KRT) occurs frequently in critically ill patients with COVID-19. We examined the clinical factors that determine kidney recovery in this population. Multicenter cohort study. 4221 adults with COVID-19 not receiving kidney replacement therapy who were admitted to intensive care units at 68 US hospitals with COVID-19 from March 1 to June 22, 2020 (the "ICU cohort"). Among these, 876 developed AKI-KRT after admission to the ICU (the "AKI-KRT subcohort"). The ICU cohort was analyzed using AKI severity as the exposure. For the AKI-KRT subcohort, exposures included demographics, comorbidities, initial mode of KRT, and markers of illness severity at the time of dialysis initiation. The outcome for the ICU cohort was estimated glomerular filtration rate (GFR) at hospital discharge. A three-level outcome including death, kidney nonrecovery, and kidney recovery at discharge, was analyzed for the AKI-KRT subcohort. The ICU cohort was characterized using descriptive analyses. The AKI-KRT subcohort was characterized with both descriptive analyses and multinomial logistic regression to assess factors associated with kidney nonrecovery while accounting for death. Among a total of 4221 patients in the ICU cohort, 2361 (56%) developed AKI, including 876 (21%) who received KRT. More severe AKI was associated with higher mortality. Among survivors, more severe AKI was associated with an increased rate of kidney nonrecovery and lower kidney function at discharge. Among the 876 patients with AKI-KRT, 588 (67%) died, 95 (11%) had kidney nonrecovery, and 193 (22%) had kidney recovery by the time of discharge. The odds of kidney nonrecovery was greater for lower estimated GFR with odds ratios (ORs) of 2.09 (95% CI, 1.09-4.04), 4.27 (95% CI, 1.99-9.17), and 8.69 (95% CI, 3.07-24.55) for CKD GFR categories 3, 4, and 5, respectively, compared to estimated GFR > 60 mL/min/1.73 m2. Oliguria at the time of KRT initiation was also associated with nonrecovery (OR 2.10 [95% CI, 1.14-3.88] and 4.02 [95% CI, 1.72-9.39] for patients with 50-499 and <50 mL urine/day respectively, compared to ≥500 mL urine/day). Later recovery events may not have been captured due to lack of post-discharge follow-up. Lower baseline eGFR and reduced urine output at the time of KRT initiation are each strongly and independently associated with kidney nonrecovery among critically ill patients with COVID-19.
Publication Date: 2021-12-07
Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation


Prognostication using SpO
The SpO This was a post-hoc analysis of a national multicenter cohort study in invasively ventilated patients with ARDS due to COVID-19. The primary endpoint was 28-day mortality. In 869 invasively ventilated patients, 28-day mortality was 30.1%. The SpO In this cohort of patients with ARDS due to COVID-19, the SpO
Publication Date: 2021-12-07
Journal: Journal of critical care


Severity of respiratory failure and computed chest tomography in acute COVID-19 correlates with pulmonary function and respiratory symptoms after infection with SARS-CoV-2: An observational longitudinal study over 12 months.
Prospective and longitudinal data on pulmonary injury over one year after acute coronavirus disease 2019 (COVID-19) are sparse. We aim to determine reductions in pulmonary function and respiratory related quality of life up to 12 months after acute COVID-19. Patients with acute COVID-19 were enrolled into an ongoing single-centre, prospective observational study and prospectively examined 6 weeks, 3, 6 and 12 months after onset of COVID-19 symptoms. Chest CT-scans, pulmonary function and symptoms assessed by St. Georges Respiratory Questionnaire were used to evaluate respiratory limitations. Patients were stratified according to severity of acute COVID-19. Median age of all patients was 57 years, 37.8% were female. Higher age, male sex and higher BMI were associated with acute-COVID-19 severity (p < 0.0001, 0.001 and 0.004 respectively). Also, pulmonary restriction and reduced carbon monoxide diffusion capacity was associated with disease severity. In patients with restriction and impaired diffusion capacity, FVC improved over 12 months from 61.32 to 71.82, TLC from 68.92 to 76.95, D Severity of respiratory failure during COVID-19 correlates with the degree of pulmonary function impairment and respiratory quality of life in the year after acute infection.
Publication Date: 2021-12-07
Journal: Respiratory medicine


The effects of organizational climate on adherence to guidelines for COVID-19 prevention.
During the current pandemic, it is essential that individuals follow the COVID-19 guidelines (e.g., physical distancing) to slow down the spread of the new coronavirus. Organizations generally affect their employees' behavior in a wide range of areas, but can they also affect how strictly employees adhere to COVID-19 guidelines? To answer this question, the present study examined the impact of an organizational climate for preventing infectious diseases (OCID) on employees' adherence to COVID-19 guidelines both at work and in their private life. We used a two-wave longitudinal online survey with a final sample of N = 304 UK employees. Our results show that OCID during the first lockdown in the UK in April 2020 (T1) was positively linked to adherence to COVID-19 guidelines at work one month later (T2). We also found a relationship between OCID (T1) and adherence to guidelines in one's private life (T2) that was mediated through adherence to guidelines at work (T2). These results highlight the pivotal role organizations play in mitigating the COVID-19 pandemic.
Publication Date: 2021-12-07
Journal: Social science & medicine (1982)


Randomized, double-blind, controlled trial of human anti-LIGHT monoclonal antibody in COVID-19 acute respiratory distress syndrome.
Severe coronavirus disease 2019 (COVID-19) infection is associated with a dysregulated immune response, which can result in cytokine release syndrome and acute respiratory distress syndrome (ARDS). Patients with COVID-19-associated ARDS have elevated free serum levels of the cytokine lymphotoxin-like inducible protein that competes with glycoprotein D for herpesvirus entry on T cells (LIGHT; also known as TNFSF14). Such patients may benefit from LIGHT neutralization therapy. This randomized, double-blind, multicenter, proof-of-concept trial enrolled adults hospitalized with COVID-19-associated pneumonia and mild to moderate ARDS. Patients received standard of care plus a single dose of CERC-002 or placebo. The primary endpoint was the proportion of patients receiving CERC-002 who remained alive and free of respiratory failure through day 28. Safety was assessed via adverse event monitoring. For most of the 83 enrolled patients, standard of care included systemic corticosteroids (88.0%) or remdesivir (57.8%). A higher proportion of patients remained alive and free of respiratory failure through day 28 after receiving CERC-002 (83.9%) versus placebo (64.5%; P = .044), including in patients ≥60 years (76.5% vs 47.1%, respectively; P = .042). Mortality rates were 7.7% (CERC-002) and 14.3% (placebo) at day 28 and 10.8% and 22.5%, respectively, at day 60. Treatment-emergent adverse events were less frequent with CERC-002 than placebo. For patients with COVID-19-associated ARDS, adding CERC-002 to standard of care treatment reduces LIGHT levels and might reduce the risk of respiratory failure and death. NCT04412057. Avalo Therapeutics (formerly Cerecor, Inc.).
Publication Date: 2021-12-07
Journal: The Journal of clinical investigation


The association between COVID-19 related food insecurity and weight promoting eating behaviours: The mediating role of distress and eating to cope.
Food insecurity (a lack of stable access to nutritious food) is reliably associated with obesity, although the underlying mechanisms are unclear. Past research indicates that this relationship may, in part, be explained by the distress of being food insecure and using food as a coping mechanism. While previous work has focused on long-term food insecurity, the first COVID-19 national lockdown presented a unique opportunity to establish if the same relationships existed for individuals experiencing pandemic related food insecurity. Adults in the United Kingdom (N = 211) were recruited three months after the first UK lockdown via social media. They completed questionnaires on COVID-19 related food insecurity, physical stress, psychological distress, eating to cope, drinking to cope, diet quality, and changes in weight promoting eating behaviours (e.g. consuming larger portions, increased snacking) since the start of the lockdown. A structural equation model revealed that food insecurity was indirectly associated with changes in weight promoting eating behaviours. As predicted, the more instances of pandemic related food insecurity, the more distress individuals reported. Distress was then associated with eating as a way of coping, which in turn was associated with increases in weight promoting eating behaviours. Food insecurity was also indirectly associated with diet quality, but this was via distress only. These results reflect similar pathways observed in individuals reporting chronic food insecurity and strengthens the evidence that distress and eating to cope are generic mediators of food insecurity and eating behaviour.
Publication Date: 2021-12-07
Journal: Appetite


Employees' reactions toward COVID-19 information exposure: Insights from terror management theory and generativity theory.
As the coronavirus disease (COVID-19) has imposed significant risks to our health and affected our social and economic order, information on COVID-19 becomes readily accessible via various mass media and social media. In the current research, we aim to understand the impacts of employees' exposure to COVID-19 information on their workplace behaviors. Integrating Terror Management Theory (TMT; Becker, 1973; Greenberg et al., 1986) with Generativity Theory (Erikson, 1963, 1982), we proposed and investigated two psychological mechanisms (i.e., death anxiety and generativity-based death reflection) that account for the effects of employees' COVID-19 information exposure on their work withdrawal and helping behaviors toward coworkers. We also examined organizational actions [internal and external corporate social responsibility (CSR) activities] that served as a context for employees to make sense of their COVID-19 information exposure. We conducted two studies with samples of full-time employees (N1 = 278; N2 = 382) to test our predictions. Results in both studies showed that employees' exposure to COVID-19 information was positively related to their death anxiety and generativity-based death reflection, which in turn predicted their work withdrawal and helping behaviors, respectively. Further, employees' perceived internal CSR of their organization mitigated the positive association between COVID-19 information exposure and their death anxiety, weakening the positive indirect effect of COVID-19 information exposure on their work withdrawal. Our study offers new insights to the understanding of work and employment in the COVID-19 pandemic and sheds light on how individuals' death-related experiences shape work-related behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Publication Date: 2021-12-07
Journal: The Journal of applied psychology


Pushing the boundaries: A qualitative study of how stem women adapted to disrupted work-nonwork boundaries during the COVID-19 pandemic.
National reports widely publicized that the coronavirus disease (COVID-19) pandemic's disruption of work-nonwork boundaries impacted women's careers negatively, as many exited their jobs to manage nonwork demands. We know less about the adaptations made by highly career-invested women to remain in the workforce in occupations where they are extremely under-represented. Based on qualitative data from 763 academic Science, Technology, Engineering, Mathematics (STEM) women at 202 universities, we examined adaptation to disrupted work-nonwork boundaries and identified workplace contextual features associated with these adaptations. Results show that STEM women varied in their adaptation. Many women adapted their professional image management approaches: From concealing nonwork roles-particularly when in less supportive contexts, to revealing them-often to challenge existing ideal worker norms and advocate for change. Also, women adapted through varying forms of role sacrifice; trading off one role's execution for another, mental detachment through psychological role withdrawal, or abandoning role duties through behavioral role exit. Notably, some sacrificed their nonwork roles, although the dominant media narrative highlights women sacrificing work roles. Work contextual features associated with boundary management adaptation include structural support (e.g., flexibility) and social support (e.g., empathy). Results illuminate the complex decisions faced by STEM women when they lose the scaffolding supporting their work-nonwork interface. Moreover, the results have practical and theoretical implications for advancing workforce gender equity, and for supporting all employees' work-nonwork boundary management. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Publication Date: 2021-12-07
Journal: The Journal of applied psychology


["COVID-19" and "Anxiety and Virtual Reality"].
Das Thema COVID-19 und neurologische Erkrankungen lässt uns so schnell nicht los. Nach unserem Themenheft im Juni dieses Jahres greifen Gülke und Gerloff das Thema im aktuellen Heft noch einmal auf, mit einem instruktiven Fallbeispiel, und setzten den Fokus auf die Auswirkungen einer COVID-19 Erkrankung bei Patienten mit neurologischen Vorerkrankungen 1. Die neurologischen Symptome bei COVID-19 Erkrankung werden derzeit durch verschiedene Pathomechanismen erklärt: a) Direkte Bindung an ACE2-Rezeptoren und somit Funktionsstörung von Neuronen, die solche Rezeptoren exprimieren, b) Hyperkoagulabilität und c) der Zytokinsturm, der auch für die schwere Lungenbeteiligung verantwortlich gemacht wird 2. Anosmie und Ageusie, Schlaganfälle und Enzephalopathie sind somit pathophysiologisch plausible und inzwischen in der internationalen Literatur gut beschriebene Komplikationen der COVID-19 Erkrankung. Im peripheren Nervensystem kommen noch einige Erkrankungen dazu. Eine Critical-illness Neuropathie ist eine häufige Komplikation bei allen intensivmedizinisch behandelten Patienten, insbesondere, wenn auch eine Sepsis vorliegt 3, und somit auch bei COVID-19 erkrankten Intensivpatienten. Ob das Guillain-Barré-Syndrom (GBS, oder akute inflammatorische demyelinisierende Polyradikuloneuropathie (AIDP)) im Zusammenhang mit COVID-19 Erkrankungen häufiger vorkommt als sonst, wird in der Literatur kontrovers diskutiert, während z. B. der Anstieg von GBS-Fällen in endemischen Gebieten der ZIKA-Erkrankung vor einigen Jahren eindeutig war 4. Im Zusammenhang mit COVID-19 Erkrankung wurde in Großbritannien sogar ein Rückgang der GBS-Fälle beobachtet 5, während eine rezente Metaanalyse ein erhöhtes GBS-Risiko nach COVID-19 Erkrankung fand 6. Auch Fälle von neuaufgetretenen neuropathisch oder myogen verursachten Schmerzen nach COVID-19 Erkrankung sind beschrieben worden 7. Ein interessantes Phänomen ist die vorübergehende Hyp- oder Analgesie unter und nach COVID-19 Erkrankung, für die man einen ähnlichen Mechanismus annimmt wie für die Anosmie. Hierzu wurde kürzlich eine Fallserie publiziert 8, und auch wir konnten einen solchen Fall beobachten 9. Aus den vielfältigen Wirkungen von SARS-CoV-2 und der COVID-19 Erkrankung auf das Nervensystem werden wir also noch viele pathophysiologische Erkenntnisse ziehen können. Ein großes Rätsel sind weiterhin die Symptome des Post-COVID-19-Syndroms, insbesondere Fatigue und die kognitiven Störungen 1.
Publication Date: 2021-12-07
Journal: Fortschritte der Neurologie-Psychiatrie


Impact of non-pharmaceutical interventions during the COVID-19 pandemic on common childhood respiratory viruses - A epidemiological study based on hospital data.
Considering common childhood respiratory viruses and SARS-CoV-2 share similar transmission routes, non-pharmaceutical interventions (NPIs) to prevent SARS-CoV-2 may affect the epidemiology of respiratory viruses. Therefore, our study aimed to observe the epidemiologic characteristics of common childhood respiratory viruses in 2020 (after the pandemic) compared with 2019 (before the pandemic) in Hangzhou, China. The data were compared between 2019 and 2020 based on age and month, respectively. One or more viruses were detected in 3135/21452 (14.61%) specimens in 2019, which was significantly lower in 1110/8202 (13.53%) specimens in 2020. Respiratory syncytial virus (RSV) was the most commonly detected virus in 2019 and 2020. The positive rate of adenovirus (ADV), parainfluenza virus (PIV)1, PIV2, and PIV3 in 2020 was significantly decreased in 2019. In 2020, RSV replaced ADV as the most predominant virus in children aged 1-6 years, and the positive rate of influenza virus A (FluA), influenza virus B (FluB), PIV1, and PIV2 was not correlated to age. FluA, FluB, and PIV2 were not almost detected from February 2020. The positive rates of ADV and PIV1 were uncorrelated to the month in 2020. By strict NPIs, besides controlling the COVID-19 pandemic, incredible progress has been made to reduce the prevalence of common childhood respiratory viruses.
Publication Date: 2021-12-07
Journal: Microbes and infection


The First GAEN-Based COVID-19 Contact Tracing App in Norway Identifies 80% of Close Contacts in "Real Life" Scenarios.
The coronavirus disease 2019 (COVID-19) response in most countries has relied on testing, isolation, contact tracing, and quarantine (TITQ), which is labor- and time-consuming. Therefore, several countries worldwide launched Bluetooth-based apps as supplementary tools. The aim of using contact tracing apps is to rapidly notify people about their possible exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and thus make the process of TITQ more efficient, especially upon exposure in public places. We evaluated the Norwegian Google Apple exposure notification (GAEN)-based contact tracing app Smittestopp v2 under relevant "real-life" test scenarios. We used a total of 40 devices, representing six different brands, and compared two different exposure configurations, experimented with different time thresholds and weights of the Bluetooth attenuation levels (buckets), and calculated the true notification rates among close contacts (≤2 m and ≥15 min) and false notification of sporadic contacts. In addition, we assessed the impact of using different operating systems and locations of the phone (hand/pocket). The best configuration tested to trigger exposure notification resulted in the correct notification of 80% of the true close contacts and incorrect notification of 34% of the sporadic contacts. Among those who incorrectly received notifications, most (67%) were within 2 m but the duration of contact was <15 min and thus they were not,
Publication Date: 2021-12-07
Journal: Frontiers in digital health


Staphylococcus aureus costochondritis and chest wall abscess in a COVID-19 patient treated with tocilizumab.
Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, causing a global health threat. Up to 15% of the confirmed cases develop severe disease, requiring hospitalization or intensive care unit (ICU) admission. Tocilizumab, an IL-6 receptor antagonist, is a promising treatment of severe pneumonia with acute respiratory distress syndrome (ARDS) or cytokine release syndrome (CRS) in the course of COVID-19. We report a suppurative costochondritis and chest wall abscess in a severe COVID-19 patient treated with tocilizumab.
Publication Date: 2021-12-07
Journal: Turkish journal of physical medicine and rehabilitation


Associations between COVID-19 risk perceptions and smoking and quitting behavior among U.S. adults.
The COVID-19 pandemic may impact cigarette smokers' behaviors. Among smokers, perceptions about the risks of contracting COVID-19 and the severity of COVID-19 illness likely vary, and perceptions may be associated with individual smoking behavior. Our study measured smokers' perceptions of COVID-19 risks and their association with smoking and quitting outcomes. A sample of 1,223 U.S. adult cigarette smokers participated in an online survey in October-November 2020 to assess their COVID-19-related risk perceptions and changes in smoking, readiness to quit, and quit attempts during the COVID-19 pandemic. More smokers believed smoking could increase the severity of COVID-19 (43.6%, 95% CI: 40.1, 47.3) than believed smoking makes them more susceptible to COVID-19 (20.0%, 95% CI: 17.2, 23.0.). While there were no associations between perceptions of COVID-19 susceptibility and smoking behaviors or intentions, perceptions of greater smoking-related COVID-19 severity were associated with both higher likelihood of smoking increases (aOR: 2.16, 95% CI: 1.19, 3.93) and greater readiness to quit smoking (aOR: 1.65, 95% CI: 1.18, 2.30). Greater perceptions of general COVID-19 severity were associated with higher likelihood of smoking reductions (aOR: 1.12, 95% CI: 1.02, 1.22), greater readiness to quit smoking (aOR: 1.14, 95% CI: 1.07, 1.22), and higher likelihood of making a quit attempt (aOR: 1.12, 95% CI: 1.04, 1.22). Smokers' perceptions about COVID-19 severity are related to their smoking behavior and likelihood of making a quit attempt. Providing smokers with accurate information on the relationship between smoking and the severity of COVID-19 may alter smoking behaviors.
Publication Date: 2021-12-07
Journal: Addictive behaviors reports