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Shamim L, Musharaf I, Nashwan AJ. Dexamethasone in coronavirus disease 2019 care: Dosage and utilization insights. World J Virol 2025; 14:98765. [PMID: 40134846 PMCID: PMC11612875 DOI: 10.5501/wjv.v14.i1.98765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 11/04/2024] [Accepted: 11/19/2024] [Indexed: 11/28/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2. It was declared a global pandemic on March 11, 2020, by the World Health Organization. An excessive inflammatory response is a severe respiratory manifestation of COVID-19, which becomes predominant in later stages. Due to its immunosuppressive and anti-inflammatory properties, dexamethasone is the first systemic glucocorticoid to treat severe COVID-19 patients. This editorial reviews the efficacy and safety of high-dose vs low-dose dexamethasone in patients with COVID-19. Findings indicate that using low-dose dexamethasone is beneficial and emphasize the need for additional research on the use of high-dose dexamethasone. While the study provides a robust evidence base, it is limited by the lack of long-term data, focus on specific outcomes and heterogeneity of the included studies. Future research should focus on the long-term effects of dexamethasone and its impact across varying disease severities and patient populations to refine treatment strategies and improve patient care.
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Affiliation(s)
- Laiba Shamim
- Department of Clinical Medicine, Jinnah Sindh Medical University, Karachi 75510, Sindh, Pakistan
| | - Imshaal Musharaf
- Department of Medicine, Jinnah Sindh Medical University, Karachi 75510, Sindh, Pakistan
| | - Abdulqadir J Nashwan
- Department of Nursing and Midwifery Research, Hamad Medical Corporation, Doha 3050, Qatar
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Salazar AP, Lecours S, Engel L, Gignac MAM, Rotenberg S, Zarshenas S, McDonald M, Nalder E, Bottari C. Responding to the ongoing pandemic-related challenges of individuals with brain injury through the perspective of community-service in Canada: A qualitative study. Brain Inj 2025; 39:267-276. [PMID: 39550618 DOI: 10.1080/02699052.2024.2426683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 10/30/2024] [Accepted: 11/02/2024] [Indexed: 11/18/2024]
Abstract
OBJECTIVE To investigate brain injury (BI) associations' perspectives regarding the impacts of the second year of the COVID-19 pandemic on individuals with BI and BI associations services across Canada. METHODS This qualitative descriptive study included 26 representatives of Canadian BI associations that participated in six online focus groups to discuss the effects of the second year of the pandemic on clients living with BI and on the provision of community services. RESULTS Findings revealed three main themes: 1) ongoing pandemic-related challenges faced by clients living with BI, including worsening mental health and basic needs insecurities, difficulties faced by clients in adhering to safety measures, and ongoing technological issues; 2) ongoing adaptations to accommodate clients' needs, including offering tailored services, ensuring consistent and transparent safety measures, and providing hybrid services; and 3) developing a sustainable 'new normal' aligned with association mandates and resources by expanding networks and building resilience. CONCLUSION The unfolding of the pandemic has brought increased challenges for people with BI and reinforced the need for adapted, clear, and accessible public health information to ensure the safety of vulnerable populations in times of crisis. It is essential to bolster community-based associations that provide direct care to people with BI.
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Affiliation(s)
- Ana Paula Salazar
- School of Rehabilitation, Université de Montréal, Montréal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada
| | - Sophie Lecours
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada
| | - Lisa Engel
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Institute for Work & Health, Toronto, Ontario, Canada
| | - Monique A M Gignac
- Institute for Work & Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Shlomit Rotenberg
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Sareh Zarshenas
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Emily Nalder
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Carolina Bottari
- School of Rehabilitation, Université de Montréal, Montréal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada
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Murray A, Conroy I, Kirrane F, Cullen L, Worlikar H, O'Keeffe DT. User Experience of a Bespoke Videoconferencing System for Web-Based Family Visitation for Patients in an Intensive Care Unit: 1-Year Cross-Sectional Survey of Nursing Staff. JMIR Hum Factors 2025; 12:e54560. [PMID: 40116766 DOI: 10.2196/54560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 07/31/2024] [Accepted: 08/12/2024] [Indexed: 03/23/2025] Open
Abstract
Background During the COVID-19 pandemic, in-person visitation within hospitals was restricted and sometimes eliminated to reduce the risk of transmission of SARS-CoV-2. Many health care professionals created novel strategies that were deployed to maintain a patient-centered approach. Although pandemic-related restrictions have eased, these systems, including videoconferencing or web-based bedside visits, remain relevant for visitors who cannot be present due to other reasons (lack of access to transport, socioeconomic restraints, geographical distance, etc). Objective The aims of this study were (1) to report the experience of intensive care nursing staff using a bespoke videoconferencing system called ICU FamilyLink; (2) to examine the scenarios in which the nursing staff used the system; and (3) to assess the future use of videoconferencing systems to enhance communication with families. Methods A modified Telehealth Usability questionnaire was administered to the nursing staff (N=22) of an intensive care unit in a model 4 tertiary hospital in Ireland 1 year after implementing the bespoke videoconferencing system. Results In total, 22 nurses working in the intensive care department at University Hospital Galway, Ireland, responded to the survey. A total of 23% (n=5) of participants were between the ages of 25 and 34 years, 54% (n=12) were between 35 and 44 years, and 23% (n=5) were between 45 and 54 years. Most (n=15, 68%) of the participants reported never using videoconferencing in the intensive care setting to communicate with family members before March 2020. The modified Telehealth Usability Questionnaire showed overall satisfaction scores for each subcategory of ease of use and learnability, interface quality, interaction quality, reliability, satisfaction and future use, and usefulness. In total, 21 (95%) participants agreed or strongly agreed with the statement, "I would use the ICU FamilyLink system in future circumstances in which family members cannot be physically present (ie, pandemics, abroad, inability to travel, etc)," and 1 participant responded neutrally. One participant highlighted a common scenario in intensive care settings in which a videoconferencing system can be used "Even without COVID, web-based communication is important when patients become unexpectedly ill and when families are abroad." Conclusions This study provides valuable insights into health care professionals' experience using a videoconferencing system to facilitate web-based visits for families. We conclude that videoconferencing systems when appropriately tailored to the environment with the users in mind can be an acceptable solution to maintain communication with family members who cannot be physically present at the bedside. The bespoke videoconferencing system had an overall positive response from 22 nursing staff who interacted with the system at varying frequency levels.
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Affiliation(s)
- Aoife Murray
- Health Innovation Via Engineering Laboratory, School of Medicine, University of Galway, University Road, Galway, H91TK33, Ireland, 353 091492147
- School of Medicine, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Irial Conroy
- Health Innovation Via Engineering Laboratory, School of Medicine, University of Galway, University Road, Galway, H91TK33, Ireland, 353 091492147
| | - Frank Kirrane
- Department of Medical Physics and Clinical Engineering, University Hospital Galway, Galway, Ireland
| | - Leonie Cullen
- Critical Care Department, University Hospital Galway, Galway, Ireland
| | - Hemendra Worlikar
- Health Innovation Via Engineering Laboratory, School of Medicine, University of Galway, University Road, Galway, H91TK33, Ireland, 353 091492147
| | - Derek T O'Keeffe
- School of Medicine, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
- Lero Science Foundation Ireland Centre for Software Research, University of Galway, Galway, Ireland
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Gomillia CE, Arnold T, Dobbs TE, Monger ML, Nunn A, Ward LM. Access and Utilization of HIV/STI Testing Services among Men Who have Sex with Men During the COVID-19 Pandemic: A Systematic Review. J Racial Ethn Health Disparities 2025:10.1007/s40615-024-02103-z. [PMID: 40102349 DOI: 10.1007/s40615-024-02103-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/26/2024] [Accepted: 07/21/2024] [Indexed: 03/20/2025]
Abstract
BACKGROUND Men who have sex with men (MSM) continue to bear the disproportionate burden of HIV and other sexually transmitted infections (STIs). The public health response to the COVID-19 pandemic coupled with the public's fear of the virus may have exacerbated this burden by hindering access to and utilization of HIV/STI testing services. METHODS We completed a systematic literature review to evaluate the impact of the COVID-19 pandemic on MSM's access and utilization of HIV/STI testing services. Online databases (PubMed, EMBASE, LGBTQ + Source, CINAHL, and the WHO COVID database) and reference lists were searched until October 8, 2023 to identify literature meeting the following criteria: primary data collection; peer-reviewed publication in the English language; included MSM ≥ 18 years of age; examined access to and utilization of HIV and/or STI testing in the United States. RESULTS We identified 1,013 articles, of which 88 were eligible for full text review. Nineteen articles met full inclusion criteria and were included in the qualitative synthesis. Twelve were cross-sectional studies, 4 were prospective cohort studies, and 3 were retrospective chart reviews. Sixteen of the 19 studies reported perceived interruptions or decreases in HIV/STI testing among MSM during the COVID-19 pandemic. However, two cross-sectional studies reported increases in STI prevalence during the pandemic and one cross-sectional study reported that access to HIV testing was unaffected. CONCLUSION This systematic review summarized the existing literature that suggests that the COVID-19 pandemic largely impacted access to and utilization of HIV/STI testing among MSM in the U.S.
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Affiliation(s)
- Courtney E Gomillia
- Department of Population Health Science, University of Mississippi Medical Center, 2500 N State Street, TR202, Jackson, MS, 39216, USA.
| | - Trisha Arnold
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Thomas E Dobbs
- Department of Population Health Science, University of Mississippi Medical Center, 2500 N State Street, TR202, Jackson, MS, 39216, USA
| | - Mauda L Monger
- Department of Population Health Science, University of Mississippi Medical Center, 2500 N State Street, TR202, Jackson, MS, 39216, USA
| | - Amy Nunn
- Department of Medicine, Division of Infectious Diseases, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Social and Behavioral Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Lori M Ward
- Department of Population Health Science, University of Mississippi Medical Center, 2500 N State Street, TR202, Jackson, MS, 39216, USA
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Estadilla CDS, Cicolani C, Blasco-Aguado R, Saldaña F, Borri A, Mar J, Van-Dierdonck JB, Ibarrondo O, Stollenwerk N, Aguiar M. The impact of non-pharmaceutical interventions on COVID-19 transmission and its effect on life expectancy in two European regions. BMC Public Health 2025; 25:1004. [PMID: 40087626 PMCID: PMC11907853 DOI: 10.1186/s12889-025-22239-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/07/2025] [Indexed: 03/17/2025] Open
Abstract
BACKGROUND In response to the rapid global transmission of COVID-19, governments worldwide enacted lockdowns and other non-pharmaceutical interventions (NPI) to control the disease. In this study, we aim to quantify the influence of NPIs on the transmission of COVID-19 within selected European regions, specifically Spain (including the Basque Country) and Italy (including Tuscany), during the period of February to December 2020, which predates the initiation of COVID-19 vaccinations. We investigate potential correlations and associations between the implementation of NPIs, changes in COVID-19 transmission rates, and alterations in life expectancy across different age and sex categories from the year 2019 to 2020. METHODS We use a Susceptible-Hospitalized-Asymptomatic/Mild-Recovered-Deceased (SHARD) ordinary differential equations model to analyze COVID-19 dynamics in the studied regions. The model calibration process was performed with empirical data on hospitalization and death to estimate the weekly transmission and death rates. To quantify reductions in life expectancy, we used established survival analysis techniques. RESULTS The SHARD model effectively captures multiple waves of COVID-19, accurately representing peaks and aligning with the instantaneous reproduction number. Our analysis reveals a 66-78% reduction in transmission rates during the initial set of NPIs in March 2020, followed by a 34-55% reduction during the subsequent NPIs in October 2020. Additionally, the elderly and individuals with comorbidities experienced the most pronounced reductions in life expectancy. CONCLUSIONS Our model calibration approach provides a valuable tool for evaluating the effectiveness of interventions across multiple waves of an epidemic. By applying this method to COVID-19 dynamics, we have demonstrated the capacity to quantify the impact of non-pharmaceutical interventions (NPIs) on transmission rates. These findings offer practical insights into the effectiveness of NPIs in mitigating COVID-19 spread and contribute to the broader understanding of epidemic control strategies.
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Affiliation(s)
- Carlo Delfin S Estadilla
- BCAM-Basque Center for Applied Mathematics, Bilbao, Basque Country, Spain
- Preventive Medicine and Public Health Department, University of the Basque Country (UPV/EHU), Leioa, Basque Country, Spain
| | - Chiara Cicolani
- BCAM-Basque Center for Applied Mathematics, Bilbao, Basque Country, Spain
- Università degli studi dell'Aquila, L'Aquila, Italy
| | | | - Fernando Saldaña
- BCAM-Basque Center for Applied Mathematics, Bilbao, Basque Country, Spain
| | - Alessandro Borri
- Università degli studi dell'Aquila, L'Aquila, Italy
- IASI-Institute for System Analysis and Computer Science, Rome, Italy
| | - Javier Mar
- Osakidetza Basque Health Service, Arrasate-Mondragón, Basque Country, Spain
- Biodonostia Health Research Institute, Donostia-San Sebastián, Basque Country, Spain
| | | | - Oliver Ibarrondo
- Osakidetza Basque Health Service, Arrasate-Mondragón, Basque Country, Spain
| | - Nico Stollenwerk
- BCAM-Basque Center for Applied Mathematics, Bilbao, Basque Country, Spain
| | - Maíra Aguiar
- BCAM-Basque Center for Applied Mathematics, Bilbao, Basque Country, Spain.
- Ikerbasque, Basque Foundation for Science, Bilbao, Basque Country, Spain.
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Sculco C, Bano B, Prina E, Tedeschi F, Bartucz MB, Barbui C, Purgato M, Albanese E. Access and use of general and mental health services before and during the COVID-19 pandemic: a systematic review and meta-analysis. BMJ Open 2025; 15:e091342. [PMID: 40074252 PMCID: PMC11904334 DOI: 10.1136/bmjopen-2024-091342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2025] Open
Abstract
OBJECTIVES To quantify access to health services during the COVID-19 pandemic and measure the change in use between the prepandemic and the pandemic periods in a population with assessment of psychological distress or diagnosis of mental disorders. DATA SOURCES We developed and piloted a search syntax and adapted it to enter the following databases from 1 January 2020 to 31 March 2023: PubMed/MEDLINE, PsycINFO, Web of Science, Epistemonikos and the WHO International Clinical Trials Registry Platform. We reran the searches from the end of the original search to 3 December 2024. DESIGN We systematically screened titles, abstracts and full texts of retrieved records. ELIGIBILITY CRITERIA We included observational studies on any populations and regions, covering health services such as doctor visits, hospital admissions, diagnostic examinations, pharmaceutical therapies and mental health (MH) services. Only studies using validated scales to assess psychological distress or mental disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders were included. DATA EXTRACTION AND SYNTHESIS We extracted data using a purposefully designed form and evaluated the studies' quality with the Newcastle-Ottawa Scale. We measured the incidence rate (IR) of access to health services and the IR ratio (IRR) between the prepandemic and the pandemic periods. We calculated contacts days and catchment areas in the different periods. We used the random effects DerSimonian-Laird inverse-variance model and calculated heterogeneity with statistics I² and τ². We computed pooled IR and pooled IRR and tested the hypothesis of no variation (IRR=1). RESULTS We retrieved 10 014 records and examined the full text of 580 articles. We included 136 primary studies of which 44 were meta-analysed. The IR of access to services during the pandemic was 2.59 contact months per 10 000 inhabitants (IR=2.592; 95% CI: 1.301 to 5.164). We observed a reduction of 28.5% in the use of services with negligible differences by age group and type of services (IRR=0.715; 95% CI: 0.651 to 0.785). We observed significant differences in effect sizes across studies (τ2=5.44; p<0.001 and τ2=0.090; p<0.001). CONCLUSION By considering MH, our study provides consolidated evidence and quantifies the reduction in the use of health services during the COVID-19 pandemic. PROSPERO REGISTRATION NUMBER CRD42023403778.
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Affiliation(s)
- Camilla Sculco
- Institute of Public Health, Universita della Svizzera italiana, Lugano, Ticino, Switzerland
| | - Beatrice Bano
- Institute of Public Health, Universita della Svizzera italiana, Lugano, Ticino, Switzerland
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Tedeschi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Monica Bianca Bartucz
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Emiliano Albanese
- Institute of Public Health, Universita della Svizzera italiana, Lugano, Ticino, Switzerland
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Yoo J, Seo JW, Ock M, Jun JY. Screening and monitoring patients at high risk for mental health issues in COVID-19: a multicenter pre-post assessment study. BMC Psychol 2025; 13:226. [PMID: 40069877 PMCID: PMC11895362 DOI: 10.1186/s40359-025-02514-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 02/20/2025] [Indexed: 03/15/2025] Open
Abstract
PURPOSE This study aimed to present the methods for screening, monitoring, and intervening with patients at high risk for mental health issues with COVID-19 at residential treatment centers, which are isolation treatment facilities for COVID-19 patients. METHODS We evaluated the mental health status of COVID-19 patients in three residential treatment centers. At admission and one day before discharge, patients received via their mobile a questionnaire containing one question each on anxiety, subjective psychological distress, post-traumatic stress symptoms, depression and suicidal ideation to identify those at high risk for mental health issues. High-risk patients and normal-risk participants who requested consultation were referred for psychological counseling. We evaluated the participants' clinical and mental health characteristics and performed a logistic regression analysis to identify factors associated with worsened depression and suicide risk at discharge. RESULTS Of 5,163 qualifying patients, 1,941 patients (37.6%) had their mental health assessed both at admission and discharge. In total, 661 persons (34.1%) required mental health support at admission and 648 persons (33.4%) at discharge. The patients at high risk for mental health issues at admission had an odds ratio of 5.31 (95% CI: 4.23-6.66) for depression at discharge, compared to those with normal mental health status at admission. The group that requested professional psychological counseling at admission showed an odds ratio of 2.33 (95% CI: 1.31-4.13) for depression at discharge. CONCLUSIONS Repeated mental health monitoring is crucial for COVID-19 patients. Additionally, a flexible intervention strategy should be developed to implement different screening methods for patients at high risk for mental health issues, depending on the status of the COVID-19 epidemic and available resources.
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Affiliation(s)
- Jeonga Yoo
- Ulsan Center for Infectious Disease Control & Prevention, Ulsan, Republic of Korea
| | - Jeong-Wook Seo
- Public Health and Medical Services Team, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Minsu Ock
- Task Forces to Support Public Health and Medical Services in Ulsan Metropolitan City, Ulsan, Republic of Korea.
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea.
- Ulsan University Hospital, University of Ulsan College of Medicine, Daehagbyeongwon-ro 25, Dong-gu, Ulsan, 44033, Republic of Korea.
| | - Jin Yong Jun
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
- Ulsan University Hospital, University of Ulsan College of Medicine, Daehagbyeongwon-ro 25, Dong-gu, Ulsan, 44033, Republic of Korea.
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Vadi S, Sanwalka N, Thaker P. Healthcare providers’ perspectives on factors influencing their critical care decision-making during the COVID-19 pandemic: An international pilot survey. World J Crit Care Med 2025; 14:97006. [DOI: 10.5492/wjccm.v14.i1.97006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 10/24/2024] [Accepted: 11/19/2024] [Indexed: 12/11/2024] Open
Abstract
BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making. One analytical technique that can be helpful in uncertain situations is clinical judgment. Clinicians must deal with contradictory information, lack of time to make decisions, and long-term factors when emergencies occur.
AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019 (COVID-19) pandemic and the factors affecting clinical decision-making.
METHODS This pilot study, which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19. The survey focused on topics related to their professional roles and personal relationships. We examined five core areas influencing critical care decision-making: Patients' personal factors, family-related factors, informed consent, communication and media, and hospital administrative policies on clinical decision-making. The collected data were analyzed using the χ2 test for categorical variables.
RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey. Age was a significant factor in treatment planning (n = 88) and ventilator access (n = 78). Sex had no bearing on how decisions were made. Most doctors reported maintaining patient confidentiality regarding privacy and informed consent. Approximately 50% of clinicians reported a moderate influence of clinical work, with many citing it as one of the most important factors affecting their health and relationships. Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries. Regarding personal experiences, some respondents noted that treatment plans and preferences changed from wave to wave, and that there was a rapid turnover of studies and evidence. Hospital and government policies also played a role in critical decision-making. Rather than assessing the appropriateness of treatment, some doctors observed that hospital policies regarding medications were driven by patient demand.
CONCLUSION Factors other than medical considerations frequently affect management choices. The disparity in treatment choices, became more apparent during the pandemic. We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency. False information, large patient populations, and limited resources caused problems for clinicians. These factors impacted decision-making, which, in turn, affected patient care and healthcare staff well-being.
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Affiliation(s)
- Sonali Vadi
- Department of Critical Care Medicine, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai 400053, Mahārāshtra, India
| | - Neha Sanwalka
- Department of Statistics, HCJMRI, Jehangir Hospital, Pune 411001, Mahārāshtra, India
| | - Pramod Thaker
- Medical Ethics Fellowship, Harvard Medical School, Boston, MA 02138, United States
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Soleimani M, Jalilvand A. Spatial analysis of COVID-19 incidence and mortality rates in northwest iran for future epidemic preparedness. Sci Rep 2025; 15:7450. [PMID: 40032988 DOI: 10.1038/s41598-025-91246-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Accepted: 02/19/2025] [Indexed: 03/05/2025] Open
Abstract
The COVID-19 pandemic has underscored the critical need for effective public health strategies to combat infectious diseases. This study examines the epidemiological characteristics and spatial distribution of COVID-19 incidence and mortality in Zanjan Province, northwest Iran, to inform future epidemic preparedness. Using data from 39,739 hospitalized COVID-19 cases recorded between February 2020 and September 2021, sourced from the Medical Care Monitoring Center, we conducted descriptive and geospatial analyses. Demographic, clinical, and spatial variables were analyzed using logistic regression and advanced spatial techniques, including Kernel Density Estimation and Local Moran's I, to identify risk factors and disease hotspots. Results revealed that women accounted for 52% of cases, with higher incidence rates, while men exhibited higher mortality rates (7.86% vs. 7.80%). Urban areas, particularly the provincial capital, were identified as hotspots, with the highest patient density (20,384 cases per 10 km²). Comorbidities such as HIV/AIDS (OR: 4.85), chronic liver disease (OR: 3.6), chronic blood diseases (OR: 2.8), and cancer (OR: 2.5) significantly increased mortality risk, with ventilator use showing the highest odds ratio for death (OR = 91). Vaccination significantly reduced mortality, with fully vaccinated individuals experiencing a 6.3% mortality rate compared to 8.1% in unvaccinated individuals. Spatial analysis highlighted population density and mobility as key drivers of disease spread. These findings emphasize the importance of integrating spatial and epidemiological data to enhance pandemic preparedness. Targeted interventions in urban hotspots, early detection systems, and prioritizing vaccination for high-risk populations are critical for mitigating future outbreaks. This study provides a foundation for evidence-based public health strategies to strengthen global epidemic response and improve preparedness for future health crises.
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Affiliation(s)
- Mohsen Soleimani
- Assistant Professor of Medical Informatics, Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Ahmad Jalilvand
- Associate Professor of Pathology, Department of Pathology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
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Tack J, Bruyneel A, Taccone F, Thys F, Mélot C, Van Wilder P, Pirson M. Analysis of admissions to intensive care units that could be supported on an intermediate care unit. Nurs Crit Care 2025; 30:e13043. [PMID: 38351617 DOI: 10.1111/nicc.13043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/28/2025]
Abstract
BACKGROUND Only one third of European countries use intermediate care units (IMCs). An IMC makes it possible to manage patients who do not require intensive care but who need a higher level of nursing care that cannot be provided on the general ward. In Belgium, there are no national criteria for ICU admission or discharge, and no policies regarding IMC care or for differentiating ICU intensity levels. AIM The aim of our study was to analyse the profile of ICU patients in Belgium on the basis of registered nursing activity in order to quantify the number of ICU days potentially transferable to an IMC. STUDY DESIGN The study was conducted on 310 ICU beds. Patients admitted to the study were recruited during two different one-month periods in 2018 and were included into a prospective database that evaluated nursing workload carried out in 15 hospitals in the French-speaking part of Belgium. The number of ICU days that could be supported on an IMC was defined according to the Nursing Activities Score (NAS) items. RESULTS A total of 3279 ICU patients for a total of 13 942 ICU days were included. 4987 days (35.8%) were considered as "transferable" to an IMC. The proportion of ICU days transferable to an IMC was highly variable among hospitals, ranging from 20.4% to 59.5% of all ICU days. On the day of ICU admission, 665/2142 (31.0%) of the patients were already identified as transferable to an IMC; this percentage significantly increased on day 2 (972/2066, 47.1%) and day 3 (650/1390, 46.7%). CONCLUSIONS In Belgian ICUs, 35.8% of ICU hospital days, as per recorded NAS, do not necessitate intensive monitoring. These 35.8% of days of ICU hospitalization could be supported on an IMC. RELEVANCE FOR CLINICAL PRACTICE In this study, a significant number of days spent in the ICU could be supported on an IMC, this could alleviate the workload of nurses and reduce the occupancy rate of intensive care units.
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Affiliation(s)
- Jérôme Tack
- Research Center in Health Economics, Management of Health Care Institutions and Nursing Sciences, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
- Clinical Research and Translational Unit, Grand Hôpital de Charleroi (GHdC), Charleroi, Belgium
| | - Arnaud Bruyneel
- Research Center in Health Economics, Management of Health Care Institutions and Nursing Sciences, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Fabio Taccone
- Soins intensifs - Hôpitaux Universitaire Bruxellois - Hôpital Erasme, Anderlecht, Belgium
| | - Fréderic Thys
- Clinical Research and Translational Unit, Grand Hôpital de Charleroi (GHdC), Charleroi, Belgium
- Continuing Education Unit UCLouvain Woluwe, Université Catholique de Louvain, Woluwe-Saint-Lambert, France
- Department of Acute and Emergency Medicine, Grand Hôpital de Charleroi (GHdC), Charleroi, Belgium
| | - Christian Mélot
- Research Center in Health Economics, Management of Health Care Institutions and Nursing Sciences, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Phillipe Van Wilder
- Ecole de Santé Publique, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Magali Pirson
- Research Center in Health Economics, Management of Health Care Institutions and Nursing Sciences, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
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11
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Aston ER, Benz MB, Souza R, Berey BL, Metrik J. Using prospective mixed methods to investigate the effect of the COVID-19 pandemic on cannabis demand. J Exp Anal Behav 2025; 123:297-311. [PMID: 39996464 DOI: 10.1002/jeab.70001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 01/29/2025] [Indexed: 02/26/2025]
Abstract
Following the COVID-19 pandemic, it is vital to understand how major global stressors influence substance use, including cannabis-related outcomes. The Marijuana Purchase Task assesses hypothetical cannabis demand (i.e., relative reinforcing value) and can detect contextual alterations. This study paired prospective cannabis demand assessment with qualitative inquiry to explore how COVID-19 impacted cannabis use behavior. Individuals previously enrolled in a laboratory cannabis administration study opted in to a remote follow-up survey (n = 41, 46% female). Participants were categorized as those who did or did not increase use based on self-reported changes in cannabis flower use and provided contextual explanations regarding pandemic-related influences on cannabis outcomes. General linear models with repeated measures examined mean differences in demand by occasion (i.e., before/during COVID-19), group (i.e., those who did/did not increase use), and their interaction. Those who increased use exhibited significantly higher demand during the pandemic; those who did not increase use exhibited similar demand across time revealing a Group × Time interaction. Thematic analysis contextualized quantitative findings, explaining external influences that affect use and demand (e.g., changes in cost, access, environment). COVID-19 differentially impacted cannabis use and demand, with prepandemic use affecting trajectories. Contextual influences (i.e., availability, free time, income) facilitate the escalation of use under conditions of extreme global stress.
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Affiliation(s)
- Elizabeth R Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Madeline B Benz
- Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA
| | | | - Benjamin L Berey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- Providence VA Medical Center, Providence, RI, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- Providence VA Medical Center, Providence, RI, USA
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12
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Mehedi ST, Abdulrazak LF, Ahmed K, Uddin MS, Bui FM, Chen L, Moni MA, Al-Zahrani FA. A privacy-preserving dependable deep federated learning model for identifying new infections from genome sequences. Sci Rep 2025; 15:7291. [PMID: 40025035 PMCID: PMC11873272 DOI: 10.1038/s41598-025-89612-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Accepted: 02/06/2025] [Indexed: 03/04/2025] Open
Abstract
The traditional molecular-based identification (TMID) technique of new infections from genome sequences (GSs) has made significant contributions so far. However, due to the sensitive nature of the medical data, the TMID technique of transferring the patient's data to the central machine or server may create severe privacy and security issues. In recent years, the progression of deep federated learning (DFL) and its remarkable success in many domains has guided as a potential solution in this field. Therefore, we proposed a dependable and privacy-preserving DFL-based identification model of new infections from GSs. The unique contributions include automatic effective feature selection, which is best suited for identifying new infections, designing a dependable and privacy-preserving DFL-based LeNet model, and evaluating real-world data. To this end, a comprehensive experimental performance evaluation has been conducted. Our proposed model has an overall accuracy of 99.12% after independently and identically distributing the dataset among six clients. Moreover, the proposed model has a precision of 98.23%, recall of 98.04%, f1-score of 96.24%, Cohen's kappa of 83.94%, and ROC AUC of 98.24% for the same configuration, which is a noticeable improvement when compared to the other benchmark models. The proposed dependable model, along with empirical results, is encouraging enough to recognize as an alternative for identifying new infections from other virus strains by ensuring proper privacy and security of patients' data.
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Affiliation(s)
- Sk Tanzir Mehedi
- Department of Information and Communication Technology, Mawlana Bhashani Science and Technology University, Santosh, Tangail, 1902, Bangladesh
| | - Lway Faisal Abdulrazak
- Electrical Engineering Technical College, Middle Technical University, Baghdad, Iraq
- Department of Computer Science, Cihan University Sulaimaniya, Sulaimaniya, Kurdistan Region, 46001, Iraq
| | - Kawsar Ahmed
- Department of Electrical and Computer Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada.
- Health Informatics Research Lab, Department of Computer Science and Engineering, Daffodil International University, Daffodil Smart City, Birulia, Dhaka, 1216, Bangladesh.
- Group of Bio-Photomatiχ, Information and Communication Technology, Mawlana Bhashani Science and Technology University, Santosh, Tangail, 1902, Bangladesh.
| | - Muhammad Shahin Uddin
- Department of Information and Communication Technology, Mawlana Bhashani Science and Technology University, Santosh, Tangail, 1902, Bangladesh
| | - Francis M Bui
- Department of Electrical and Computer Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
| | - Li Chen
- Department of Electrical and Computer Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
| | - Mohammad Ali Moni
- AI and Digital Health Technology, Artificial Intelligence and Cyber Future Institute, Charles Sturt University, Bathurst, NSW, 2795, Australia
- AI and Digital Health Technology, Rural Health Research Institute, Charles Sturt University, Orange, NSW, 2800, Australia
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13
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Cao C, Xie H, Guo R, Dou C, Tang J. First insight into eosinophils as a biomarker for the early distinction of COVID-19 from influenza A in outpatients. Exp Ther Med 2025; 29:56. [PMID: 39885908 PMCID: PMC11775767 DOI: 10.3892/etm.2025.12806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 11/13/2024] [Indexed: 02/01/2025] Open
Abstract
Coronavirus disease 2019 (COVID-19) and influenza A outbreaks have spread rapidly in China. It is difficult to accurately differentiate these two different respiratory tract infections on the basis of their similar early-stage symptoms and lymphocytopenia. In the present study, the age, sex and white blood cell, neutrophil, lymphocyte, monocyte and eosinophil counts, as well as the neutrophil-to-lymphocyte ratio (NLR) of 201 outpatients with confirmed COVID-19 and 246 outpatients with influenza A were investigated and compared. A receiver operating characteristic curve was drawn to determine the thresholds in distinguishing COVID-19 from influenza A Our study found that the monocyte count and NLR were significantly elevated, while the eosinophil count/percentage was higher in outpatients with COVID-19 than in those with influenza A (0.06±0.07 vs. 0.04±0.09, P=0.002; 0.95±1.12 vs. 0.56±0.95, P<0.001, respectively). Logit(P)=-1.11 + 1.29 x eosinophil percentage -12.07 x eosinophil count +1.10 x monocyte count, deduced from the eosinophil count/percentage and monocyte count, had the largest area under the curve at 0.67, with high specificity (80.1%) and a sensitivity of 47.3%. The present study demonstrated that a higher eosinophil count/percentage may be a potential biomarker to significantly differentiate early COVID-19 from influenza A.
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Affiliation(s)
- Chuangjie Cao
- Department of Pathology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Haitao Xie
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Ruohan Guo
- Department of Infectious Diseases, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Chengyun Dou
- Department of Infectious Diseases, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Jian Tang
- Department of Infectious Diseases, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
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14
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Tuttle JB, Allais C, Allerton CMN, Anderson AS, Arcari JT, Aschenbrenner LM, Avery M, Bellenger J, Berritt S, Boras B, Boscoe BP, Buzon LM, Cardin RD, Carlo AA, Coffman KJ, Dantonio A, Di L, Eng H, Farley KA, Ferre RA, Gajiwala KS, Gibson SA, Greasley SE, Hurst BL, Kadar EP, Kalgutkar AS, Lachapelle EA, Lanyon LF, Lee J, Lee J, Lian Y, Liu W, Martínez-Alsina LA, Mason SW, Noell S, Novak J, Obach RS, Ogilvie K, O'Neil SV, Ostner G, Owen DR, Patel NC, Pettersson M, Singh RS, Rai DK, Reese MR, Sakata S, Sammons MF, Sathish JG, Sharma R, Steppan CM, Stewart A, Updyke L, Verhoest PR, Wei L, Wright SW, Yang E, Yang Q, Zhu Y. Discovery of Nirmatrelvir (PF-07321332): A Potent, Orally Active Inhibitor of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) Main Protease. J Med Chem 2025. [PMID: 40019854 DOI: 10.1021/acs.jmedchem.4c02561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2025]
Abstract
In early 2020, severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infections leading to COVID-19 disease reached a global level leading to the World Health Organization (WHO) declaration of a pandemic. Scientists around the globe rapidly responded to try and discover novel therapeutics and repurpose extant drugs to treat the disease. This work describes the preclinical discovery efforts that led to the invention of PF-07321332 (nirmatrelvir, 14), a potent and orally active inhibitor of the SARS CoV-2 main protease (Mpro) enzyme. At the outset we focused on modifying PF-00835231 (1) discovered in 2004 as a potent inhibitor of the SARS CoV-1 Mpro with poor systemic exposure. Our effort was focused on modifying 1 with the goal of engineering in oral bioavailability by design, while maintaining cellular potency and low metabolic clearance. Modifications of 1 ultimately led to the invention of nirmatrelvir 14, the Mpro inhibitor component in PAXLOVID.
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Affiliation(s)
- Jamison B Tuttle
- Pfizer Research & Development, Cambridge, Massachusetts 02139, United States
| | - Christophe Allais
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | | | | | - Joel T Arcari
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | | | - Melissa Avery
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Justin Bellenger
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Simon Berritt
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Britton Boras
- Pfizer Research & Development, La Jolla, California 92121, United States
| | - Brian P Boscoe
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Leanne M Buzon
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Rhonda D Cardin
- Pfizer Research & Development, Pearl River, New York 10965, United States
| | - Anthony A Carlo
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Karen J Coffman
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Alyssa Dantonio
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Li Di
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Heather Eng
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Kathleen A Farley
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Rose Ann Ferre
- Pfizer Research & Development, La Jolla, California 92121, United States
| | - Ketan S Gajiwala
- Pfizer Research & Development, La Jolla, California 92121, United States
| | - Scott A Gibson
- Institute of Antiviral Research, Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, Utah 84322, United States
| | | | - Brett L Hurst
- Institute of Antiviral Research, Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, Utah 84322, United States
| | - Eugene P Kadar
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Amit S Kalgutkar
- Pfizer Research & Development, Cambridge, Massachusetts 02139, United States
| | - Erik A Lachapelle
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Lorraine F Lanyon
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Jisun Lee
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Jack Lee
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Yajing Lian
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Wei Liu
- Pfizer Research & Development, La Jolla, California 92121, United States
| | | | - Stephen W Mason
- Pfizer Research & Development, Pearl River, New York 10965, United States
| | - Stephen Noell
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Jonathan Novak
- Pfizer Research & Development, Cambridge, Massachusetts 02139, United States
| | - R Scott Obach
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Kevin Ogilvie
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Steven V O'Neil
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Gregory Ostner
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Dafydd R Owen
- Pfizer Research & Development, Cambridge, Massachusetts 02139, United States
| | - Nandini C Patel
- Pfizer Research & Development, Cambridge, Massachusetts 02139, United States
| | - Martin Pettersson
- Pfizer Research & Development, Cambridge, Massachusetts 02139, United States
| | - Ravi Shankar Singh
- Pfizer Research & Development, Cambridge, Massachusetts 02139, United States
| | - Devendra K Rai
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Matthew R Reese
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Sylvie Sakata
- Pfizer Research & Development, La Jolla, California 92121, United States
| | - Matthew F Sammons
- Pfizer Research & Development, Cambridge, Massachusetts 02139, United States
| | - Jean G Sathish
- Pfizer Research & Development, Pearl River, New York 10965, United States
| | - Raman Sharma
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Claire M Steppan
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Al Stewart
- Pfizer Research & Development, La Jolla, California 92121, United States
| | - Lawrence Updyke
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Patrick R Verhoest
- Pfizer Research & Development, Cambridge, Massachusetts 02139, United States
| | - Liuqing Wei
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Stephen W Wright
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Eddie Yang
- Pfizer Research & Development, Groton, Connecticut 06340, United States
| | - Qingyi Yang
- Pfizer Research & Development, Cambridge, Massachusetts 02139, United States
| | - Yuao Zhu
- Pfizer Research & Development, Pearl River, New York 10965, United States
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15
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Darwazah H, Hammond JB, Aita SL, Moncrief GG, Thompson RC, Lichtenstein JD, Roth RM. Coronavirus anxiety and its relationship to mood and cognition in post-acute sequelae of COVID-19. APPLIED NEUROPSYCHOLOGY. ADULT 2025:1-9. [PMID: 39991928 DOI: 10.1080/23279095.2025.2469247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2025]
Abstract
Background: Subjective and objective cognitive dysfunction may be observed in patients with post-acute sequelae of COVID-19 (PASC), and are associated with depression and general anxiety. Coronavirus anxiety (CA) is associated with subjective cognition, depression, and general anxiety in community samples. We determined the base rate of CA in patients with PASC and its relation to mood, subjective and objective cognition. Design and Methods: Participants were 79 patients with PASC referred for clinical neuropsychological evaluation, who completed the Coronavirus Anxiety Scale (CAS), BDI-II, BAI, BRIEF-A, and cognitive tests. Results: Base rate of clinically elevated CAS was low (5.1%), whereas BDI-II (78.6%), BAI (80%), and BRIEF-A Global Executive Composite (GEC; 60.3%) were high. Objective dysfunction was most common for Color-Word Interference (20.8%) and Trail Making Test (TMT) Part-B (23.1%). Greater CA was associated with worse depression, general anxiety, BRIEF-A GEC, and TMT Part-A. Higher GAI accounted for the CAS and BRIEF-A GEC association. Longer time since pandemic onset was only associated with decreasing CA. Exploratory factor analysis supported a unidimensional structure for the CAS. Conclusions: Clinically elevated CA is rare in patients with PASC seen for neuropsychological evaluation. Higher CA is associated with worse mood and subjective executive dysfunction, though the latter was accounted for by general anxiety. Patients with PASC who endorse a high level of CA would likely benefit from interventions to reduce emotional distress.
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Affiliation(s)
- Hannah Darwazah
- Department of Psychiatry, Dartmouth Health/Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Jared B Hammond
- Department of Psychiatry, Dartmouth Health/Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Stephen L Aita
- Department of Mental Health, VA Maine Healthcare System, Augusta, ME, USA
- Department of Psychology, University of Maine, Orono, ME, USA
| | - Grant G Moncrief
- Department of Psychiatry, Dartmouth Health/Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Ryan C Thompson
- Department of Psychiatry, Dartmouth Health/Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Jonathan D Lichtenstein
- Department of Psychiatry, Dartmouth Health/Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Robert M Roth
- Department of Psychiatry, Dartmouth Health/Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
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16
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Gao LP, Zheng CJ, Tian TT, Brima Tia A, Abdulai MK, Xiao K, Chen C, Liang DL, Shi Q, Liu ZG, Dong XP. Spatiotemporal prevalence of COVID-19 and SARS-CoV-2 variants in Africa. Front Public Health 2025; 13:1526727. [PMID: 40051513 PMCID: PMC11882590 DOI: 10.3389/fpubh.2025.1526727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Accepted: 02/03/2025] [Indexed: 03/09/2025] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic has caused significant public health and socioeconomic crises across Africa; however, the prevalent patterns of COVID-19 and the circulating characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants in the continent remain insufficiently documented. Methods In this study, national data on case numbers, infection incidences, mortality rates, the circulation of SARS-CoV-2 variants, and key health indexes were collected from various official and professional sources between January 2020 and December 2023 were analyzed with SaTScan and geographically weighted regression (GWR). Results The prevalent profiles and circulating features of SARS-CoV-2 across the African continent, including its five regions and all African countries, were analyzed. Four major waves of the epidemic were observed. The first wave was closely associated with the introduction of the early SARS-CoV-2 strain while the subsequent waves were linked to the emergence of specific variants, including variants of concern (VOCs) Alpha, Beta, variants of interest (VOIs) Eta (second wave), VOC Delta (third wave), and VOC Omicron (fourth wave). SaTScan analysis identified four large spatiotemporal clusters that affected various countries. A significant number of countries (50 out of 56) reported their first cases during February 2020 and March 2020, predominantly involving individuals with confirmed cross-continental travel histories, mainly from Europe. In total, 12 distinct SARS-CoV-2 VOCs and VOIs were identified, with the most prevalent being VOCs Omicron, Delta, Beta, Alpha, and VOI Eta. Unlike the dominance of VOC Delta during the third wave and Omicron during the fourth wave, VOC Alpha was relatively rare in the Southern regions but more common in the other four regions. At the same time, Beta predominated in the Southern region and Eta in the Western region during the second wave. Additionally, relatively higher COVID-19 case incidences and mortalities were reported in the Southern and Northern African regions. Spearman rank correlation and geographically weighted regression (GWR) analyses of COVID-19 incidences against health indexes in 52 African countries indicate that countries with higher national health expenditures and better personnel indexes tended to report higher case incidences. Discussion This study offers a detailed overview of the COVID-19 pandemic in Africa. Strengthening the capacity of health institutions across African countries is essential for the timely detection of new SARS-CoV-2 variants and, consequently, for preparedness against future COVID-19 pandemics and other potentially infectious disease outbreaks.
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Affiliation(s)
- Li-Ping Gao
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Can-Jun Zheng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ting-Ting Tian
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Alie Brima Tia
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Michael K. Abdulai
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Kang Xiao
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cao Chen
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dong-Lin Liang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qi Shi
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhi-Guo Liu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-Ping Dong
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Shanghai Institute of Infectious Disease and Biosafety, Shanghai, China
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17
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Moser LJ, Lisi C, Gutberlet M, Boccalini S, Budde RPJ, Francone M, Hrabak Paar M, Loewe C, Muscogiuri G, Natale L, Nikolaou K, Pirnat M, Salgado R, Vliegenthart R, Williams MC, Eberhard M, Alkadhi H. Impact of the COVID-19 pandemic on cardiac magnetic resonance imaging practices: insights from the MRCT registry. Eur Radiol 2025:10.1007/s00330-025-11464-w. [PMID: 39969555 DOI: 10.1007/s00330-025-11464-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Revised: 01/14/2025] [Accepted: 02/05/2025] [Indexed: 02/20/2025]
Abstract
PURPOSE To assess the relationship between the COVID-19 pandemic and the spectrum of indications for cardiac magnetic resonance imaging (MRI) with a focus on myocarditis. MATERIALS AND METHODS This was a retrospective analysis of data from the MRCT registry of the European Society of Cardiovascular Radiology (ESCR). Data regarding indications and diagnoses of myocarditis between January 1, 2018, and April 30, 2024, were extracted. Data was analyzed for the periods before and after the beginning (i.e., March 11, 2020) of the COVID-19 pandemic. RESULTS Data from 112,361 cardiac MRI examinations was analyzed (63.5% male, median age 58 [IQR 44-69]). Over the entire period, assessment of myocarditis was the most common indication for cardiac MRI (31%, n = 34,906/112,361). Before the pandemic, this indication comprised 28% of examinations and increased to a maximum of 41% in 2022 after the onset of the pandemic. Simultaneously, the positivity rate of these examinations decreased from 21% before the pandemic to 14% in 2022. Male patients had a higher positivity rate than female patients both before and during the pandemic, with mirroring trends between sexes. The proportion of cardiac MRI examinations performed for suspected and known coronary artery disease showed an inverse relationship with those performed for myocarditis and decreased from 24% and 17% pre-pandemic to a minimum of 21% and 13% during the pandemic. CONCLUSION The COVID-19 pandemic considerably influenced the pattern of referrals for cardiac MRI examinations in Europe, leading to a higher proportion of examinations for suspected myocarditis but a reduced positivity rate, suggesting a lower referral threshold for this indication. At the same time, proportionally fewer examinations were performed for suspected and known coronary artery disease. KEY POINTS Question The COVID-19 pandemic may have influenced the spectrum and positivity rates of indications for cardiac MRI, especially examinations for myocarditis. Findings The COVID-19 pandemic led to a higher proportion of cardiac MRI examinations for suspected myocarditis but a reduced positivity rate. Clinical relevance The spectrum and proportions of indications for cardiac MRI give important information on the historical and current trends in cardiac imaging and provide insight into resource deployment.
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Affiliation(s)
- Lukas J Moser
- Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Costanza Lisi
- Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - Matthias Gutberlet
- Department of Diagnostic and Interventional Radiology, University of Leipzig-Heart Centre, Leipzig, Germany
| | - Sara Boccalini
- Department of Cardiovascular Radiology, Hôpital Pradel, Hospices Civils de Lyon, Lyon, France
| | - Ricardo P J Budde
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marco Francone
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - Maja Hrabak Paar
- Department of Diagnostic and Interventional Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Christian Loewe
- Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria
| | - Giuseppe Muscogiuri
- Department of Radiology, ASST Papa Giovanni XXIII, Bergamo, University Milano Bicocca, Milan, Italy
| | - Luigi Natale
- Department of Radiological Sciences-Institute of Radiology, Catholic University of Rome, A. Gemelli University Hospital, Rome, Italy
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Maja Pirnat
- Radiology Department, University Medical Centre Maribor, Maribor, Slovenia
| | - Rodrigo Salgado
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium
- Department of Medicine & Health Sciences, University of Antwerp, Wilrijk, Belgium
- Department of Radiology, Holy Heart Hospital, Lier, Belgium
| | - Rozemarijn Vliegenthart
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Michelle C Williams
- British Heart Foundation Centre of Research Excellence, University of Edinburgh, Edinburgh, UK
| | - Matthias Eberhard
- Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hatem Alkadhi
- Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
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18
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Lal ZZ, Gogoi M, Qureshi I, Al-Oraibi A, Chaloner J, Papineni P, Lagrata S, Nellums LB, Martin CA, Woolf K, Pareek M. Redeployment and changes in working patterns of healthcare workers during COVID-19 in the UK: a qualitative study. BMC Health Serv Res 2025; 25:267. [PMID: 39966930 PMCID: PMC11834651 DOI: 10.1186/s12913-025-12389-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Accepted: 02/06/2025] [Indexed: 02/20/2025] Open
Abstract
BACKGROUND Redeployment was critical in addressing the increased demands of COVID-19 on the healthcare system. Previous research indicates that ethnic minority healthcare workers (HCWs), those on visas, and in junior roles, were more likely to be redeployed to COVID-19 duties compared to White UK-born HCWs. There is limited evidence on how redeployment was practically organized, preparedness of HCWs and the NHS for rapid changes, and the decision-making processes involved. This paper discusses HCWs' redeployment experiences, their alignment with NHS policy for deploying staff safely, and potential links to staff attrition. METHODS As part of the United Kingdom Research study into Ethnicity And COVID-19 outcomes among Healthcare workers, we conducted a qualitative sub-study, between December 2020 and July 2021, consisting of interviews and focus groups with 164 HCWs from different ethnicities, genders, job roles, migration statuses, and UK regions. Sessions were conducted online or by telephone, recorded, transcribed and analysed with participants' consent. We utilised the breadth-and-depth approach, initially identifying transcripts mentioning redeployment or changes in work patterns, followed by an in-depth thematic analysis. RESULTS Of the 164 HCWs, 22 (13.4%) reported redeployment to a new role, while 42 (26.8%) reported changes in their working patterns. Redeployment experiences varied based on HCWs' workplaces, skillsets, input into decisions, and perceived risks. Four themes were identified: 1. redeployment and the changing nature of work, 2. pandemic (un)preparedness, 3. redeployment decision-making, and 4. risk assessments in the context of redeployment. Our data revealed the practical realities of redeployment, including discrepancies between the NHS policy and actual practices, particularly early deployment without adequate training and supervision. The lack of planning and preparedness had an operational and emotional impact on HCWs, affecting their morale. Lastly, some HCWs felt disempowered and undervalued due to a lack of agency in redeployment decisions. CONCLUSION This study highlights HCWs' redeployment experiences during COVID-19, the conditions under which it occurred, and its impacts. The findings, although rooted in the pandemic, remain relevant for addressing staffing challenges in the healthcare workforce. We recommend future redeployment strategies prioritise HCWs' training and supervision, ensure strategic planning with clear communication and support for all staff, foster a sense of value among HCWs, and integrate an intersectional equity lens into workforce planning to improve staff retention and morale.
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Affiliation(s)
- Zainab Zuzer Lal
- Department of Respiratory Sciences, University of Leicester, University Road, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
| | - Mayuri Gogoi
- Department of Respiratory Sciences, University of Leicester, University Road, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
| | - Irtiza Qureshi
- Department of Respiratory Sciences, University of Leicester, University Road, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
- The Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
| | - Amani Al-Oraibi
- Department of Respiratory Sciences, University of Leicester, University Road, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jonathan Chaloner
- Department of Respiratory Sciences, University of Leicester, University Road, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Padmasayee Papineni
- Ealing Hospital, London North West University Healthcare NHS Trust, Southall, UK
| | - Susie Lagrata
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Laura B Nellums
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
- College of Population Health, University of New Mexico, Albuquerque, NM, USA
| | - Christopher A Martin
- Department of Respiratory Sciences, University of Leicester, University Road, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
- National Institute of Health Research (NIHR) Leicester Biomedical Research Centre (BRC), Leicester, UK
| | | | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, University Road, Leicester, UK.
- Development Centre for Population Health, University of Leicester, Leicester, UK.
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
- National Institute of Health Research (NIHR) Leicester Biomedical Research Centre (BRC), Leicester, UK.
- National Institute of Health Research (NIHR) Applied Health Collaboration (ARC) East Midlands, Leicester, UK.
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19
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Cárdenas-Marín PA, Cordoba-Melo BD, Carrillo-Gómez DC, León-Giraldo H, Mendoza I, Flórez N, Larrea Gómez RE, Mercedes JM, Herrera CJ, Lugo-Peña J, Cárdenas-Aldaz LP, Rossel V, Ramírez Ramírez R, Fernández HF, Retana AU, Sierra-Lara Martinez JD, Figueiredo EL, Yabar Galindo WG, Quintana Da Silva MA, Romero A, Silva P, Alvarado A, Valencia A, Gomez-Mesa JE. Impact of myocardial injury on cardiovascular complications in hospitalized patients with COVID-19: insights from Latin America. Front Cardiovasc Med 2025; 12:1545142. [PMID: 40034989 PMCID: PMC11872895 DOI: 10.3389/fcvm.2025.1545142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Accepted: 01/26/2025] [Indexed: 03/05/2025] Open
Abstract
Introduction Viral infection by SARS-CoV2 is a pandemic affecting over 600 million people worldwide. One of five hospitalized patients may present myocardial injury, strongly associated with disease severity and mortality. Methodology Retrospective cross-sectional study of hospitalized COVID-19 patients diagnosed between May 01, 2020, and June 30, 2021, from the database of the Registro Latinoamericano de Enfermedad Cardiovascular y COVID-19 (CARDIO COVID 19-20) with a troponin value recorded during hospitalization. A descriptive analysis of sociodemographic and clinical characteristics was performed. Bivariate analysis was conducted according to the presence or absence of myocardial injury. Survival analysis was made using Kaplan-Meier curves, by the presence of myocardial injury. A multivariate Poisson regression model was performed to determine factors associated with mortality. Statistical analyses were performed using the RStudio V.1.4.1717 package. Results A total of 2,134 patients were included, 64.2% were male, and 911 patients had myocardial injury. The median age of the total population was 61 years. Individuals with myocardial injury had a higher prevalence of hypertension, diabetes, and dyslipidemia. Survival probability was lower in this subgroup. Patients with myocardial injury had a 1.95 times higher risk of death. Age, male sex, chronic kidney disease, arrhythmias, decompensated heart failure, requirement of inotropic/vasopressor, and invasive mechanical ventilation were related to higher mortality risk in patients with myocardial injury. Conclusion Patients with COVID-19 and myocardial injury exhibit a broad spectrum of cardiac abnormalities. Myocardial injury is associated with a higher disease severity and risk of in-hospital mortality. This multicenter study uniquely represents data from 13 Latin American countries, offering regional insights into the impact of myocardial injury during the COVID-19 pandemic.
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Affiliation(s)
- Paula Andrea Cárdenas-Marín
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
- Servicio de Cardiología, Departamento de Medicina Interna, Fundación Valle del Lili, Cali, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - Brayan Daniel Cordoba-Melo
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
- Servicio de Cardiología, Departamento de Medicina Interna, Fundación Valle del Lili, Cali, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | | | - Hoover León-Giraldo
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - Iván Mendoza
- Instituto de Medicina Tropical, Universidad Central de Venezuela, Caracas, Venezuela
| | - Noel Flórez
- Servicio de Cardiología, Departamento de Medicina Interna, Fundación Valle del Lili, Cali, Colombia
| | | | | | - Cesar J. Herrera
- Departamento de Cardiología, Centro de Diagnóstico y Medicina Avanzada y de Conferencias Médicas y Telemedicina (CEDIMAT), Santo Domingo, Dominican Republic
| | - Julián Lugo-Peña
- Departamento de Cardiología, Clínica del Occidente, Bogotá, Colombia
| | | | - Victor Rossel
- Sección de Cardiología, Hospital del Salvador, Facultad de Medicina Universidad de Chile, Santiago, Chile
| | | | | | | | - J. Daniel Sierra-Lara Martinez
- Unidad de Cuidados Críticos Cardiovasculares, Instituto Nacional de Cardiología “Ignacio Chávez”, Ciudad de Mexico, Mexico
| | | | | | | | - Alexander Romero
- Departamento de Cardiología, Hospital Santo Tomas, Ciudad de Panamá, Panama
| | - Paula Silva
- Departamento de Cardiología, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - Armando Alvarado
- Servicio de Terapia Intensiva, Hospital Especializado de Villa Nueva, Villa Nueva, Guatemala
| | - Andrea Valencia
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| | - Juan Esteban Gomez-Mesa
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
- Servicio de Cardiología, Departamento de Medicina Interna, Fundación Valle del Lili, Cali, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
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20
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Behnke G, Mata D, Meneses V, Strickland EC, Gray TR. Trends in central/peripheral ratio of fentanyl in Harris County, TX, and Orange County, CA, from 2009 to 2020. J Anal Toxicol 2025; 49:115-121. [PMID: 39605304 DOI: 10.1093/jat/bkae093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 11/08/2024] [Accepted: 11/27/2024] [Indexed: 11/29/2024] Open
Abstract
Since the opioid epidemic was declared in 2017, postmortem fentanyl cases and the need for interpretation of their results have increased. Postmortem redistribution (PMR) is one of the factors to consider when interpreting cases. There have been several previous studies regarding fentanyl PMR; however, these studies either have small sample sizes or were conducted prior to the declaration of the opioid epidemic, which may cause conflicting results and not be reflective of current trends. This study includes fentanyl central/peripheral (C/P) blood ratios from 748 cases from both Harris County, TX, and Orange County, TX, spanning from January 2009 to June 2022. Because the data set was determined to be non-normally distributed, a Kruskal-Wallis test was used for statistical comparisons. There were statistically significant differences between epidemic cases from the Harris County Institute of Forensic Sciences and the Orange County Crime Laboratory, C/P ratios from pre-epidemic to epidemic years, and in cases where medically related administration of fentanyl was documented when compared to cases where there was no documentation of licit fentanyl use. Various factors that could impact PMR were evaluated (age, gender, polydrug use, etc.), and no clear trend or observation was made from the data. Based on the results of this study, there is still no clear indication as to what caused the increase in C/P ratios, but it may be related to an increase in illicit fentanyl use.
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Affiliation(s)
- Grayce Behnke
- Forensic Toxicology, Harris County Institute of Forensic Sciences, 1861 Old Spanish Trail, Houston, TX 77954, United States
| | - Dani Mata
- Toxicology, Orange County Crime Lab, 320 N Flower Street, Santa Ana, CA 92703, United States
| | - Vanessa Meneses
- Toxicology, Orange County Crime Lab, 320 N Flower Street, Santa Ana, CA 92703, United States
| | - Erin C Strickland
- Forensic Toxicology, Harris County Institute of Forensic Sciences, 1861 Old Spanish Trail, Houston, TX 77954, United States
| | - Teresa R Gray
- Toxicology, Orange County Crime Lab, 320 N Flower Street, Santa Ana, CA 92703, United States
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21
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Naiditch H, Betts MR, Larman HB, Levi M, Rosenberg AZ. Immunologic and inflammatory consequences of SARS-CoV-2 infection and its implications in renal disease. Front Immunol 2025; 15:1376654. [PMID: 40012912 PMCID: PMC11861071 DOI: 10.3389/fimmu.2024.1376654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 12/23/2024] [Indexed: 02/28/2025] Open
Abstract
The emergence of the COVID-19 pandemic made it critical to understand the immune and inflammatory responses to the SARS-CoV-2 virus. It became increasingly recognized that the immune response was a key mediator of illness severity and that its mechanisms needed to be better understood. Early infection of both tissue and immune cells, such as macrophages, leading to pyroptosis-mediated inflammasome production in an organ system critical for systemic oxygenation likely plays a central role in the morbidity wrought by SARS-CoV-2. Delayed transcription of Type I and Type III interferons by SARS-CoV-2 may lead to early disinhibition of viral replication. Cytokines such as interleukin-1 (IL-1), IL-6, IL-12, and tumor necrosis factor α (TNFα), some of which may be produced through mechanisms involving nuclear factor kappa B (NF-κB), likely contribute to the hyperinflammatory state in patients with severe COVID-19. Lymphopenia, more apparent among natural killer (NK) cells, CD8+ T-cells, and B-cells, can contribute to disease severity and may reflect direct cytopathic effects of SARS-CoV-2 or end-organ sequestration. Direct infection and immune activation of endothelial cells by SARS-CoV-2 may be a critical mechanism through which end-organ systems are impacted. In this context, endovascular neutrophil extracellular trap (NET) formation and microthrombi development can be seen in the lungs and other critical organs throughout the body, such as the heart, gut, and brain. The kidney may be among the most impacted extrapulmonary organ by SARS-CoV-2 infection owing to a high concentration of ACE2 and exposure to systemic SARS-CoV-2. In the kidney, acute tubular injury, early myofibroblast activation, and collapsing glomerulopathy in select populations likely account for COVID-19-related AKI and CKD development. The development of COVID-19-associated nephropathy (COVAN), in particular, may be mediated through IL-6 and signal transducer and activator of transcription 3 (STAT3) signaling, suggesting a direct connection between the COVID-19-related immune response and the development of chronic disease. Chronic manifestations of COVID-19 also include systemic conditions like Multisystem Inflammatory Syndrome in Children (MIS-C) and Adults (MIS-A) and post-acute sequelae of COVID-19 (PASC), which may reflect a spectrum of clinical presentations of persistent immune dysregulation. The lessons learned and those undergoing continued study likely have broad implications for understanding viral infections' immunologic and inflammatory consequences beyond coronaviruses.
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Affiliation(s)
- Hiam Naiditch
- Department of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Michael R. Betts
- Department of Microbiology and Institute of Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - H. Benjamin Larman
- Institute for Cell Engineering, Division of Immunology, Department of Pathology, Johns Hopkins University, Baltimore, MD, United States
| | - Moshe Levi
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University, Washington, DC, United States
| | - Avi Z. Rosenberg
- Department of Pathology, Johns Hopkins University, Baltimore, MD, United States
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22
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Saputra A, Wichaidit W, Kesuma ZM, Chongsuvivatwong V. Spatio-temporal distribution of COVID-19 cases and tuberculosis in four provinces of Sumatra Islands, Indonesia. BMC Public Health 2025; 25:529. [PMID: 39930380 PMCID: PMC11809051 DOI: 10.1186/s12889-025-21754-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Accepted: 02/03/2025] [Indexed: 02/14/2025] Open
Abstract
BACKGROUND The COVID-19 pandemic disrupted national tuberculosis programs in high-burden countries. We hypothesize that COVID-19 occurrence had a delayed effect on tuberculosis case reports from the Indonesia Ministry of Health, also known as the tuberculosis case notification. The objectives of this study are: (1) to describe the potential effect of the reported COVID-19 cases on the spatial distribution of tuberculosis in four provinces of Sumatra Islands (Aceh, North Sumatra, West Sumatra, and Riau Provinces), Indonesia; (2) to estimate the temporal lag effect of the occurrence of COVID-19 on tuberculosis case notifications. METHODS We retrieved data from the Indonesian Ministry of Health and the Indonesia COVID-19 Task Force. We also examined the monthly tuberculosis and COVID-19 case notifications. We identified time series clusters of tuberculosis case notifications and used lag non-linear model to assess the delayed effect of the occurrence of COVID-19 cases on tuberculosis case notifications. RESULTS The secondary data included 217,593 tuberculosis case notifications (January 2019 to December 2022) and 373,671 reported COVID-19 cases (January 2020 to December 2022). Time series cluster analysis revealed 5 clusters each for monthly tuberculosis case notifications and monthly reported COVID-19 cases. There was a negative association with a 0-month lag in more than 10,000 reported COVID-19 cases (RR = 0.95, 95%CI: 0.91-0.98). CONCLUSIONS The findings suggested that Indonesia's national tuberculosis program in four provinces of Sumatra Island was disrupted during the COVID-19 pandemic. Lag analysis showed that COVID-19 case occurrence had an immediate effect on tuberculosis case notifications. CLINICAL TRIAL Not applicable.
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Affiliation(s)
- Arif Saputra
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Thailand
| | - Wit Wichaidit
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Thailand
| | - Zurnila Marli Kesuma
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, 24415, Indonesia
| | - Virasakdi Chongsuvivatwong
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Thailand.
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23
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Ezenwaka U, Mbachu C, Onwujekwe O. A scoping review of the roles of stakeholders and coordination mechanisms for enhanced multi-sectoral and multi-level interventions in COVID-19 response in Nigeria. Health Res Policy Syst 2025; 23:18. [PMID: 39930477 PMCID: PMC11808979 DOI: 10.1186/s12961-024-01276-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/09/2024] [Indexed: 02/14/2025] Open
Abstract
BACKGROUND Collaboration among multiple stakeholders from different sectors requires a coherent coordination mechanism in implementing responses to public health emergencies such as coronavirus disease 2019 (COVID-19) to improve the effectiveness and efficiency of countermeasures against the pandemic. The paper describes multi-stakeholder roles and the coordination mechanisms that were used at different levels of government in the COVID-19 response in Nigeria. METHODS A scoping review of documents on COVID-19 was undertaken between March 2021 and October 2022. Databases including Google Scholar, PubMed, Medline and Google were searched using "COVID-19", "Nigeria", "response" and "government" as the keywords. We included articles published from 30 January 2020 to 1 October 2022. The literature was extracted into Excel spreadsheets and analysed using the adapted WHO framework for multi-stakeholder preparedness coordination. RESULTS A total of 173 documents were reviewed. The review revealed that various stakeholders (state and non-state actors) at national and sub-national levels played complementary roles in the implementation of different countermeasures to COVID-19 in Nigeria. The multi-sectoral response to COVID-19 in Nigeria was coordinated through the Presidential and State Task Force Teams. However, there were very weak linkages between and across different task forces. In addition, the expert and advisory committees at national and sub-national levels apparently functioned independently without lines of communication amongst them to encourage information sharing and learning. More so, the processes of coordination of different actors and their activities were fragmented and constrained by poor communication of policies among stakeholders, poor planning and contextualization of response strategies, lack of data for evidence-informed planning and lack of accountability. CONCLUSIONS The coordination of multi-stakeholders and multi-sectoral response to COVID-19 at national and sub-national levels in Nigeria was weak. A systematic coordination framework involving multiple stakeholders working at varying capacities is needed for effective and efficient response during pandemics such as COVID-19, to reduce duplication of efforts, inequitable resource allocation and wastage of resources and time. It is recommended that a future systematic coordination framework and guidelines involve multiple stakeholders, including the private and non-health public sectors, working at varying capacities and levels, to ensure an effective and efficient response during pandemics.
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Affiliation(s)
- Uchenna Ezenwaka
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria Enugu-Campus, Enugu, Nigeria.
- Department of Health Administration and Management, Faculty of Health Science and Technology, College of Medicine, University of Nigeria Enugu-Campus, Enugu, Nigeria.
| | - Chinyere Mbachu
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria Enugu-Campus, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria Enugu-Campus, Enugu, Nigeria
- Department of Health Administration and Management, Faculty of Health Science and Technology, College of Medicine, University of Nigeria Enugu-Campus, Enugu, Nigeria
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24
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Tabrizi JS, Letaief M, Mashhadi Abdolahi H, Rezapour R, Alboksmaty A, Farahbakhsh M. Safety of health workers during the COVID-19 pandemic and beyond: piloting WHO framework in Iran. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2025; 44:29. [PMID: 39920792 PMCID: PMC11806829 DOI: 10.1186/s41043-025-00749-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 01/10/2025] [Indexed: 02/09/2025]
Abstract
BACKGROUND Health Workers Safety (HWS) is a global health priority and essential at all times, in stable situations, in emergencies, in disease epidemics or pandemics. This study aimed to assess HWS during the COVID-19 Pandemic. METHODS This cross-sectional study was conducted in 2022 in east Azerbaijan province, Iran. HWS was assessed based on 22 indicators suggested by WHO EMRO. We selected 15 PHC facilities and six wards from two hospitals randomly. Data collected (qualitative and quantitative) using national digital health records, staff records, and indicator-specific tools. In addition to measuring the indicator's value, the indicators' feasibility was also assessed. Descriptive and inferential statistics with SPSS-16 were used for data analysis. RESULTS Totally, 325 Health Workers (HWs) (218 from PHC facilities and 107 from hospitals) participated in the study. Most of the participants in PHC facilities and hospitals were Community Health Workers (CHWs) (Moragheb Salamat) (45.4%) and nurses (37.38%), respectively. Most of HWs had completed the full vaccination schedule for Hepatitis B and COVID-19. Personal Protective Equipment (PPE) safety protocols were adhered by most of HWs within a healthcare facility. None of managers had attended nationally certified training for mental health support for health and care workers. Less than 20% of HWs participated in the work burnout prevention courses and most of HWs complained about work overload, or burnout. The job satisfaction level of hospital HWs (60.20%) was significantly higher than that of HWs from PHC facilities (57.18%) (P < 0.001). CONCLUSION Even though the mental health of HWs was not as expected, the indicators related to physical health and occupational health were at a suitable level. Also, there is not a system in PHC to audit the application of safety measures to mitigate the risk of contracting COVID-19. We recommend creating a specific system (precise and detailed) for HWs' safety and applying safety measures in the PHC routine programs.
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Affiliation(s)
- Jafar Sadegh Tabrizi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mondher Letaief
- Department of Universal Health Coverage and Health Systems, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Hossein Mashhadi Abdolahi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Ramin Rezapour
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmed Alboksmaty
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Mostafa Farahbakhsh
- Research center of psychiatry and behavioral sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
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25
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Nash C. An Initial Scoping Review of Dysregulation of Mood, Energy, and Social Rhythms Syndrome (DYMERS) Regarding Burnout in Healthcare Professionals During COVID-19. J Clin Med 2025; 14:1035. [PMID: 39941704 PMCID: PMC11818672 DOI: 10.3390/jcm14031035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2025] [Revised: 02/04/2025] [Accepted: 02/05/2025] [Indexed: 02/16/2025] Open
Abstract
Background/Objectives: Dysregulation of Mood, Energy, and Social Rhythms Syndrome (DYMERS) characterizes the poor regulation of biological (sleep/waking), social, and behavioral rhythms that affected the level of burnout in healthcare professionals during the pandemic in particular. The aim is to provide an initial scoping review of publications on this topic. Methods: The keywords "Stress Rhythms Dysregulation Bipolar Disorder Burnout DYMERS Healthcare professionals COVID-19" were searched on 9 December 2024 following PRISMA 2020 guidelines, using five primary databases (OVID, ProQuest, PubMed, Scopus, Web of Science), one register (Cochrane COVID-19 register), and one supplementary database (Google Scholar). Included were peer-reviewed publications. Excluded were duplicates, reports lacking either a research study or any keywords, or including irrelevant information regarding them. Results: The returns for all the databases were (n = 0) except for ProQuest (n = 4) and Google Scholar (n = 14). Of these, three ProQuest returns were duplicates of the Google Scholar search. The remaining report contained irrelevant information on healthcare professionals. The Google Scholar search results produced two relevant reports-neither duplicated with ProQuest. The excluded contained a duplicate in the search itself, three that did not mention healthcare professionals, two that contained irrelevant information concerning them, four returns that were not a research study, and three that were not peer-reviewed. Conclusions: The two studies published on this topic are by various members of the same investigating institution. DYMERS has provided valuable insights regarding burnout in healthcare professionals. The suggestion is for further DYMERS research by this team and others, anticipating future pandemics.
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Affiliation(s)
- Carol Nash
- History of Medicine Program, Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
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26
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Barozi V, Tastan Bishop Ö. Impact of African-Specific ACE2 Polymorphisms on Omicron BA.4/5 RBD Binding and Allosteric Communication Within the ACE2-RBD Protein Complex. Int J Mol Sci 2025; 26:1367. [PMID: 39941135 PMCID: PMC11818624 DOI: 10.3390/ijms26031367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Revised: 01/27/2025] [Accepted: 02/01/2025] [Indexed: 02/16/2025] Open
Abstract
Severe acute respiratory symptom coronavirus 2 (SARS-CoV-2) infection occurs via the attachment of the spike (S) protein's receptor binding domain (RBD) to human ACE2 (hACE2). Natural polymorphisms in hACE2, particularly at the interface, may alter RBD-hACE2 interactions, potentially affecting viral infectivity across populations. This study identified the effects of six naturally occurring hACE2 polymorphisms with high allele frequency in the African population (S19P, K26R, M82I, K341R, N546D and D597Q) on the interaction with the S protein RBD of the BA.4/5 Omicron sub-lineage through post-molecular dynamics (MD), inter-protein interaction and dynamic residue network (DRN) analyses. Inter-protein interaction analysis suggested that the K26R variation, with the highest interactions, aligns with reports of enhanced RBD binding and increased SARS-CoV-2 susceptibility. Conversely, S19P, showing the fewest interactions and largest inter-protein distances, agrees with studies indicating it hinders RBD binding. The hACE2 M82I substitution destabilized RBD-hACE2 interactions, reducing contact frequency from 92 (WT) to 27. The K341R hACE2 variant, located distally, had allosteric effects that increased RBD-hACE2 contacts compared to WThACE2. This polymorphism has been linked to enhanced affinity for Alpha, Beta and Delta lineages. DRN analyses revealed that hACE2 polymorphisms may alter the interaction networks, especially in key residues involved in enzyme activity and RBD binding. Notably, S19P may weaken hACE2-RBD interactions, while M82I showed reduced centrality of zinc and chloride-coordinating residues, hinting at impaired communication pathways. Overall, our findings show that hACE2 polymorphisms affect S BA.4/5 RBD stability and modulate spike RBD-hACE2 interactions, potentially influencing SARS-CoV-2 infectivity-key insights for vaccine and therapeutic development.
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Affiliation(s)
- Victor Barozi
- Research Unit in Bioinformatics (RUBi), Department of Biochemistry, Microbiology and Bioinformatics, Rhodes University, Makhanda 6139, South Africa;
| | - Özlem Tastan Bishop
- Research Unit in Bioinformatics (RUBi), Department of Biochemistry, Microbiology and Bioinformatics, Rhodes University, Makhanda 6139, South Africa;
- National Institute for Theoretical and Computational Sciences (NITheCS), Matieland 7602, South Africa
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27
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Murphy B, Rohrbeck CA, Wirtz PW, Hoffert F, DeArcangelis N. Optimism and emergency preparedness self-efficacy: Moderators of the relationship between perceived threat of disasters and COVID-19 anxiety symptoms. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2025:1-9. [PMID: 39908328 DOI: 10.1080/07448481.2025.2455629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 11/02/2024] [Accepted: 01/13/2025] [Indexed: 02/07/2025]
Abstract
Objectives: Despite research showing the impact of the threat of COVID-19 on mental health, scholars have failed to examine the relationship between perceived disaster threat and COVID-19 anxiety. Factors that buffer that positive relationship (e.g., optimism and emergency preparedness self-efficacy or EPSE) are also understudied. Thus, we examined the relationship between the perceived threat of disasters and COVID-19-related anxiety, as well as potential moderating factors of this relationship, including optimism and EPSE. Participants and methods: Participants were a representative sample of U.S. college students (N = 392) recruited through Prolific.co who completed measures in an online Qualtrics survey. Results: Both optimism and EPSE were significant moderators of the relationship between perceived threat and symptoms of anxiety related to COVID-19. When both moderators were included in a double moderation model analysis, only EPSE remained a significant moderator. Conclusions: These findings reflect the importance of cultivating protective psychological resources to protect college students' well-being during disasters.
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Affiliation(s)
- Blakely Murphy
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | - Cynthia A Rohrbeck
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | - Philip W Wirtz
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
- Department of Decision Sciences, George Washington University, Washington, District of Columbia, USA
| | - Felicity Hoffert
- Department of Psychology, La Salle University, Philadelphia, Pennsylvania, USA
| | - Nicolas DeArcangelis
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
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28
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Shehab S, Anouti L, Boutros CF, Radi C, Baasiri SE, Badih A, Korman R, Masri ME, Alwan J, Monzer M, Bitar Y, Kassem M, Naser M, Salameh Y, Khafaja S, Ghosn MB, Al Hamod D, Ghadban S, Ghanem S, Dbaibo GS. End of Pandemic Parental Hesitancy Towards Pediatric COVID-19 Vaccination: A Cross-sectional Survey at Two Lebanese Tertiary Hospitals. J Epidemiol Glob Health 2025; 15:15. [PMID: 39910010 PMCID: PMC11799484 DOI: 10.1007/s44197-025-00364-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 11/14/2024] [Indexed: 02/07/2025] Open
Abstract
BACKGROUND This observational prospective cross-sectional study was conducted during the last 4 months of the COVID-19 pandemic to determine whether parental hesitancy to vaccinate their children against COVID-19 had improved compared to earlier studies in other countries showing high levels of hesitancy. METHODS Parents were surveyed from January 4 until May 16, 2023, at two tertiary medical centers in Beirut, the American University of Beirut Medical Center (AUBMC) and the Saint George Hospital University Medical Center (SGHUMC). RESULTS The study enrolled 950 participants, predominantly mothers (79.6%) aged 30-49 (79%), highly educated parents (69.8% of mothers and 62.2% of fathers were university graduates). Although routine childhood vaccinations received remarkable acceptance (98.3%), there was considerable hesitancy towards pediatric COVID-19 (56.4%). Only 9.4% had vaccinated all eligible children. The main parental concern was the vaccine's safety and perceived lack of testing (p < 0.001). Other factors were parental gender, vaccination status, and children's age. In the adjusted model, mothers had a higher rate of vaccine acceptance (AOR: 1.746 [1.059-2.878], p = 0.029). Similarly, parents vaccinated against COVID-19 vaccine (AOR: 2.703, p < 0.001) and parents of children aged 12-17 (AOR: 4.450, p < 0.001) had more vaccine acceptance. CONCLUSION This study's findings indicate a persistently high level of hesitancy for pediatric COVID-19 vaccination despite more than two years of positive global experience with the vaccine. Raising awareness about the safety and effectiveness of pediatric COVID-19 vaccination would address this hesitancy and mitigate the impact of COVID-19 on children's health and well-being.
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Affiliation(s)
- Sabine Shehab
- Faculty of Medicine, American University of Beirut, Hamra, Beirut, Lebanon
| | - Lina Anouti
- Faculty of Health Sciences, American University of Beirut, Hamra, Beirut, Lebanon
| | - Celina F Boutros
- Center for Infectious Diseases Research, American University of Beirut, Hamra, Beirut, Lebanon
| | - Christelle Radi
- Faculty of Medicine, American University of Beirut, Hamra, Beirut, Lebanon
| | - Silma El Baasiri
- Faculty of Medicine, American University of Beirut, Hamra, Beirut, Lebanon
- Center for Infectious Diseases Research, American University of Beirut, Hamra, Beirut, Lebanon
| | - Arabia Badih
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra, Beirut, Lebanon
| | - Rawan Korman
- Center for Infectious Diseases Research, American University of Beirut, Hamra, Beirut, Lebanon
| | - Marwa El Masri
- Department of Pediatrics, Saint George Hospital University Medical Center, Achrafieh, Beirut, Lebanon
| | - Joudie Alwan
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra, Beirut, Lebanon
| | - Maha Monzer
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra, Beirut, Lebanon
| | - Yara Bitar
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra, Beirut, Lebanon
| | - Mona Kassem
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra, Beirut, Lebanon
| | - Mayse Naser
- Center for Infectious Diseases Research, American University of Beirut, Hamra, Beirut, Lebanon
| | - Yara Salameh
- Center for Infectious Diseases Research, American University of Beirut, Hamra, Beirut, Lebanon
| | - Sarah Khafaja
- Center for Infectious Diseases Research, American University of Beirut, Hamra, Beirut, Lebanon
- Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra, Beirut, 1107, Lebanon
| | - Murielle Bou Ghosn
- Faculty of Medicine, University of Balamand, Dekwaneh, Metn, Mount Lebanon, Lebanon
| | - Dany Al Hamod
- Department of Pediatrics, Saint George Hospital University Medical Center, Achrafieh, Beirut, Lebanon
| | - Sarah Ghadban
- Department of Pediatrics, Saint George Hospital University Medical Center, Achrafieh, Beirut, Lebanon
| | - Soha Ghanem
- Department of Pediatrics, Saint George Hospital University Medical Center, Achrafieh, Beirut, Lebanon
| | - Ghassan S Dbaibo
- Center for Infectious Diseases Research, American University of Beirut, Hamra, Beirut, Lebanon.
- Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Hamra, Beirut, 1107, Lebanon.
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29
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Liu F, Ge A, Wang X, Wu F, Xu J, Ma B. A Contracted Channel Droplet Reinjection Chip-Based Simple Integrated ddpcr System for SARS-CoV-2 and H1N1 Detection. Anal Chem 2025; 97:2195-2203. [PMID: 39846371 DOI: 10.1021/acs.analchem.4c05201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2025]
Abstract
Droplet microfluidics is a powerful method for digital droplet polymerase chain reaction (ddPCR) applications. However, precise droplet control, bulky peripherals, and multistep operation usually required in droplet detection process hinder the broad application of ddPCR. Here, a contracted channel droplet reinjection chip is presented, where droplets can be self-separated and detected one by one at intervals. Based on that, a Simple Integrated ddPCR (SI-ddPCR) system is established, including surface-wetting-based droplet generation, tube heating, and droplet signal detection. To assess the system's performance, we quantified SARS-CoV-2 and H1N1 simultaneously using duplex-ddPCR. The results exhibited a good linearity (R2 = 0.999) at concentrations ranging from 101 to 104 copies/μL. By employing the SI-ddPCR system, we detected SARS-CoV-2 and H1N1 in clinical samples isolated from 20 swab specimens with an accuracy of 97.5%. Thus, the developed SI-ddPCR system offers simple droplet detection, eliminates complicated peripherals and multistep operations, and promises to be a portable, low-cost, and easy-to-deploy toolbox for high-accuracy ddPCR.
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Affiliation(s)
- Fengyi Liu
- CAS Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, Shandong 266101, China
- Shandong Energy Institute, Qingdao, Shandong 266101, China
- Qingdao New Energy Shandong Laboratory, Qingdao, Shandong 266101, China
- College of Life Science, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Anle Ge
- CAS Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, Shandong 266101, China
- Shandong Energy Institute, Qingdao, Shandong 266101, China
- Qingdao New Energy Shandong Laboratory, Qingdao, Shandong 266101, China
- College of Life Science, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xixian Wang
- CAS Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, Shandong 266101, China
- Shandong Energy Institute, Qingdao, Shandong 266101, China
- Qingdao New Energy Shandong Laboratory, Qingdao, Shandong 266101, China
- College of Life Science, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Fei Wu
- CAS Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, Shandong 266101, China
- Shandong Energy Institute, Qingdao, Shandong 266101, China
- Qingdao New Energy Shandong Laboratory, Qingdao, Shandong 266101, China
| | - Jian Xu
- CAS Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, Shandong 266101, China
- Shandong Energy Institute, Qingdao, Shandong 266101, China
- Qingdao New Energy Shandong Laboratory, Qingdao, Shandong 266101, China
- College of Life Science, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Bo Ma
- CAS Key Laboratory of Biofuels, Shandong Key Laboratory of Energy Genetics, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, Shandong 266101, China
- Shandong Energy Institute, Qingdao, Shandong 266101, China
- Qingdao New Energy Shandong Laboratory, Qingdao, Shandong 266101, China
- College of Life Science, University of Chinese Academy of Sciences, Beijing 100049, China
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30
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Chen H, Li Y, Yuan L, Liu F, Sun Q, Luo Q, Lei Y, Hou Y, Li J, Cai L, Tang S. Age-related immune response disparities between adults and children with severe COVID-19: a case-control study in China. Front Microbiol 2025; 16:1525051. [PMID: 39967737 PMCID: PMC11832681 DOI: 10.3389/fmicb.2025.1525051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Accepted: 01/13/2025] [Indexed: 02/20/2025] Open
Abstract
Background Elucidation of immune response differences is critical for uncovering underlying mechanisms and developing potential intervention measures among adults and children with COVID-19. Methods In this retrospective study, we analyzed serum biochemical markers and cytokine profiles among adults and children with COVID-19 in the First People's Hospital of Chenzhou in Hunan, China from 1 December 2022 to 13 February 2023. A case-control study was conducted using propensity score matching (PSM) to mitigate possible confounding factors. Results The significant differences observed included lymphocyte exhaustion, an increased neutrophil-to-lymphocyte (NEU/LYM) ratio, high levels of C-reactive protein (CRP), and a cytokine storm, characterized by high levels of Th1 proinflammatory cytokines, including interleukin 1β (IL-1β), IL-6, IL-8, interferon type I (IFN-γ), and tumor necrosis factor (TNF-α) in the lung among severe adult COVID-19 patients. Additionally, systemic immune responses were observed in children with COVID-19. Conclusion Significant differences in immune responses between adults and children with COVID-19 highlight the different mechanisms and potential intervention measures of COVID-19.
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Affiliation(s)
- Hongliang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Clinical Microbiology Laboratory, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Yuan Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Liping Yuan
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Fen Liu
- Department of Clinical Microbiology Laboratory, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Qian Sun
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, China
| | - Qingkai Luo
- Department of Clinical Microbiology Laboratory, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Yefei Lei
- Department of Clinical Microbiology Laboratory, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Yinglan Hou
- Department of Clinical Microbiology Laboratory, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Jiayan Li
- Department of Clinical Microbiology Laboratory, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Liang Cai
- Hunan Provincial Center for Disease Control and Prevention, Hunan, China
| | - Shixing Tang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
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31
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Non AL, Clausing ES, Lara-Cinisomo S, D'Anna Hernandez KL. COVID-19-Related Risk, Resilience, and Mental Health Among Mexican American Mothers Across the First Year of the Pandemic. J Racial Ethn Health Disparities 2025; 12:49-58. [PMID: 37940768 PMCID: PMC11753345 DOI: 10.1007/s40615-023-01849-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Latina mothers have been especially affected by the pandemic and historically exhibit high rates of depression and anxiety. However, few longitudinal studies have assessed the effect of the pandemic on this vulnerable population. We hypothesized that COVID-19-related stressors would associate with psychological distress among Latina mothers across the first year of the pandemic. METHODS We investigated COVID-19-related impact, stigma, and fears across two critical time points and changes in these measures in relation to changes in maternal anxiety and depression among mothers of Mexican descent living in Southern California (n=152). Surveys were administered within 5-16 weeks of the March 19, 2020 stay-at-home COVID-19 order in California and again between June to December 2021. RESULTS High proportions of women reported moderate to severe impacts of COVID-19 early in the pandemic, which reduced modestly a year later, e.g., reduced family incomes (55.9% 2020 Lockdown vs 32.7% 1-year follow-up). Anticipatory stigma was high across the first year, e.g., worrying at least some of the time that a family member will be deported (33.1% 2020 Lockdown vs. 14.1% 1-year follow-up), or they would not be able to care for their children (88.5% 2020 lockdown vs 82.2% 1-year follow-up). COVID-19 stigma, impact, and fears were significantly associated with higher levels of anxiety and depressive symptoms at both time points (p<0.003), and changes in COVID-19 impact were associated with changes in depression (p=0.0004). CONCLUSION Findings emphasize the adverse socioeconomic and psychological effects of the pandemic for Latina mothers.
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Affiliation(s)
- Amy L Non
- Department of Anthropology, University of California San Diego, La Jolla, CA, USA.
| | - Elizabeth S Clausing
- Department of Anthropology, School of Global Integrative Studies, University of Nebraska, Lincoln, NE, USA
- Center for Brain, Biology, and Behavior, University of Nebraska, Lincoln, NE, USA
| | - Sandraluz Lara-Cinisomo
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
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32
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Schowe AM, Godara M, Czamara D, Adli M, Singer T, Binder EB. Genetic predisposition for negative affect predicts mental health burden during the COVID-19 pandemic. Eur Arch Psychiatry Clin Neurosci 2025; 275:61-73. [PMID: 38587666 PMCID: PMC11799032 DOI: 10.1007/s00406-024-01795-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/09/2024] [Indexed: 04/09/2024]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic was accompanied by an increase in mental health challenges including depression, stress, loneliness, and anxiety. Common genetic variants can contribute to the risk for psychiatric disorders and may present a risk factor in times of crises. However, it is unclear to what extent polygenic risk played a role in the mental health response to the COVID-19 pandemic. In this study, we investigate whether polygenic scores (PGSs) for mental health-related traits can distinguish between four resilience-vulnerability trajectories identified during the COVID-19 pandemic and associated lockdowns in 2020/21. We used multinomial regression in a genotyped subsample (n = 1316) of the CovSocial project. The most resilient trajectory characterized by the lowest mental health burden and the highest recovery rates served as the reference group. Compared to this most resilient trajectory, a higher value on the PGS for the well-being spectrum decreased the odds for individuals to be in one of the more vulnerable trajectories (adjusted R-square = 0.3%). Conversely, a higher value on the PGS for neuroticism increased the odds for individuals to be in one of the more vulnerable trajectories (adjusted R-square = 0.2%). Latent change in mental health burden extracted from the resilience-vulnerability trajectories was not associated with any PGS. Although our findings support an influence of PGS on mental health during COVID-19, the small added explained variance suggests limited utility of such genetic markers for the identification of vulnerable individuals in the general population.
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Affiliation(s)
- Alicia M Schowe
- Department of Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany.
- Graduate School of Systemic Neuroscience, Ludwig Maximilian University, Munich, Germany.
| | - Malvika Godara
- Social Neuroscience Lab, Max Planck Society, 10557, Berlin, Germany.
| | - Darina Czamara
- Department of Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany
| | - Mazda Adli
- Department of Psychiatry and Neurosciences, CCM, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Center for Psychiatry, Psychotherapy and Psychosomatic Medicine, Fliedner Klinik Berlin, Berlin, Germany
| | - Tania Singer
- Social Neuroscience Lab, Max Planck Society, 10557, Berlin, Germany
| | - Elisabeth B Binder
- Department of Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany
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33
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Singh N, Pati SK, Bodhey NK, De S, Behera AK. A Retrospective Analysis of Chest Radiographic Patterns in Patients With COVID-19. Cureus 2025; 17:e78942. [PMID: 40091990 PMCID: PMC11910160 DOI: 10.7759/cureus.78942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2025] [Indexed: 03/19/2025] Open
Abstract
BACKGROUND Chest radiography is often the most utilized and primary investigation for patients with COVID-19 pneumonia, however, only limited studies are available evaluating its essence. Therefore, we retrospectively analyzed various chest radiographic patterns in patients with COVID-19 and correlated the radiographic severity index with clinical severity and laboratory parameters. METHODS In this retrospective study, radiographs of 512 COVID-19 patients diagnosed with pneumonia were assessed, out of which 289 patients satisfying inclusion and exclusion criteria were recruited for the study. The spectrum of radiographic findings was compared with the contemporary clinical and laboratory records. RESULTS Ground glass opacities (GGOs; 250/289, 86.5%) and consolidations (166/289, 57.4%) were the most common findings seen in radiographs, with the most common distributions being "basal and peripheral" (92/289, 31.9%), followed by "non-specific pattern" (73/289, 25.3%), "basal" (60/289, 20.8%), and "peripheral" (48/289, 16.6%) patterns. A statistically significant association was seen between the clinical and radiographic severity scores and in-hospital mortality and radiographic severity scores. Also, a statistically significant association was seen between the radiographic severity score and various laboratory parameters (i.e., white blood cell (WBC) count, lactate dehydrogenase (LDH), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR)). CONCLUSION With this study, we concluded that specific patterns of lung involvement were seen in patients with COVID-19 and that radiographic severity scores correlated well with the clinical severity and laboratory parameters. Hence, in our opinion, chest radiography could be a useful tool for stratifying disease severity and differentiating between severe and non-severe COVID-19 pneumonia.
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Affiliation(s)
- Narender Singh
- Radiodiagnosis, All India Institute of Medical Sciences, Raipur, IND
| | - Saroj Kumar Pati
- Radiodiagnosis, All India Institute of Medical Sciences, Raipur, IND
| | | | - Sajal De
- Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences, Raipur, IND
| | - Ajoy K Behera
- Pulmonary Medicine and Tuberculosis, All India Institute of Medical Sciences, Raipur, IND
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Billah SMB, Sayef SA, Nur SMM, Rahman MM, Chowa SK, Yasmin A, Akter MS, Shajnin S, Zaman AA, Banna MH. Fear of COVID-19 and mental health status among the medical students of a selected medical college in Bangladesh. Ir J Med Sci 2025; 194:225-231. [PMID: 39527180 DOI: 10.1007/s11845-024-03833-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Accepted: 10/25/2024] [Indexed: 11/16/2024]
Abstract
BACKGROUND COVID-19 pandemic and mental health of people are related to each other. AIMS To assess the relationship between fear of COVID-19 (FCOV) and the psychological status of medical students of Bangladesh. METHODS A total of 967 medical students and intern doctors of Sher-E-Bangla Medical College participated in this cross-sectional study. FCOV was measured using the Fear of COVID-19 Scale (FCV-19S). Mental health status was assessed using the Depression Anxiety Stress Scale (DASS-21). Correlation between these two variables was done followed by general linear model to assess the relationship of other covariates with mental health. RESULTS FCOV had a highly significant relationship with mental health (DASS-21 and all its components, p < 0.001 for all). Females suffered more from fear than males except the interns. Clinical students, students with middle income groups, students residing with the families, and students having family members in health services exhibited more FCOV compared to their counterparts. When we looked at the DASS-21 and its components, females suffered more from stress. Having family members in health services was related to higher anxiety and stress with higher DASS-21 scores as well. Students who expressed their lives to be affected by COVID-19 had higher DASS-21 and its components compared to those whose lives were not affected as such. Students residing with their families revealed increased stress. FCOV and life affected by COVID-19 were constantly related to DASS-21 and its components (p < 0.001), adjusted for other variables. CONCLUSIONS Fear of COVID-19 is associated with poor mental health of medical students.
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Affiliation(s)
| | | | | | | | | | - Abida Yasmin
- Sher-E-Bangla Medical College, Barishal, Bangladesh
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Lue C, Petrie TA, Moore EWG. NCAA international student-athletes' psychological wellbeing during COVID-19: Gender and academic year. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2025:1-9. [PMID: 39889208 DOI: 10.1080/07448481.2025.2459739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 11/07/2024] [Accepted: 01/21/2025] [Indexed: 02/02/2025]
Abstract
Objective: To examine international student-athletes' (ISAs) rates of depression, perceived stress, problematic drinking, and sleep disturbance. Participants: 509 ISAs (Mage = 20.39 years, women = 63.1%) from over 80 NCAA institutions. Methods: Survey data were collected in April/May 2020. Results: Overall, 27.9% and 9.2% endorsed clinical and high levels of depression and stress, respectively; 2.4% (n = 12) reported severe sleep disturbances and 12.4% (n = 63) problematic drinking. Except problematic drinking, being a woman ISA was associated with significantly higher levels of disturbance. Year in school interacted with gender for perceived stress; men ISAs in their 2nd year or higher reported the lowest levels. Conclusions: Large numbers of ISAs endorsed clinical/severe levels of psychological concerns at onset of COVID-19, likely due to the unique stressors experienced by this international college population. Athletic departments, like universities in general, must provide culturally-sensitive mental health services for their ISAs.
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Affiliation(s)
- Cachet Lue
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Trent A Petrie
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - E Whitney G Moore
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
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Maison DP, Tasissa H, Deitchman A, Peluso MJ, Deng Y, Miller FD, Henrich TJ, Gerschenson M. COVID-19 clinical presentation, management, and epidemiology: a concise compendium. Front Public Health 2025; 13:1498445. [PMID: 39957982 PMCID: PMC11826932 DOI: 10.3389/fpubh.2025.1498445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2024] [Accepted: 01/21/2025] [Indexed: 02/18/2025] Open
Abstract
Coronavirus Disease 2019, caused by severe acute respiratory coronavirus 2, has been an ever-evolving disease and pandemic, profoundly impacting clinical care, drug treatments, and understanding. In response to this global health crisis, there has been an unprecedented increase in research exploring new and repurposed drugs and advancing available clinical interventions and treatments. Given the widespread interest in this topic, this review aims to provide a current summary-for interested professionals not specializing in COVID-19-of the clinical characteristics, recommended treatments, vaccines, prevention strategies, and epidemiology of COVID-19. The review also offers a historical perspective on the pandemic to enhance understanding.
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Affiliation(s)
- David P. Maison
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Hawi Tasissa
- Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, United States
| | - Amelia Deitchman
- Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, United States
| | - Michael J. Peluso
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Youping Deng
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - F. DeWolfe Miller
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Timothy J. Henrich
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Mariana Gerschenson
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
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Salo JLM, Marcelo LJN, Sanchez ACA, Marcelino CP, Hazel Anne LC, Miranda KJA, Carandang RRZ. Effectiveness of Tocilizumab in COVID-19 Patients with Pneumonia: A Systematic Review. ACTA MEDICA PHILIPPINA 2025; 59:72-80. [PMID: 39967711 PMCID: PMC11831086 DOI: 10.47895/amp.vi0.8188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/20/2025]
Abstract
Background and Objective COVID-19 contributes significantly to global morbidity and mortality. Age-related comorbidities elevate the risk of severe cases. Studies have recently demonstrated that widely available medications, including tocilizumab (TCZ), can manage severe symptoms. However, its effectiveness is unclear, particularly among the older population. Therefore, this review aimed to evaluate TCZ's efficacy in managing severe pneumonia in individuals aged 50 and older. Methods We systematically search several databases and gray literature including Web of Science, CINAHL, Academic Search Complete, PsycINFO, PsycArticles, SocINDEX, CENTRAL/Cochrane Library, PubMed/MEDLINE for original research articles in English across several study designs published in the year 2020-2022. A narrative synthesis was conducted to summarize the evidence. We employed the NIH quality assessment tool for observational cohort studies to evaluate risk of bias. Additionally, we utilized GRADE to appraise the certainty of evidence. Results Among 539 screened articles, only five studies met the selection criteria. Tocilizumab's impact on severe COVID-19 pneumonia revealed a diverse effect on mortality rate, with 29% in the TCZ group, and 40% in the controls died within 30 days of intubation (OR 0.61; 95% CI, 0.27-1.36). It is also reported that TCZ was not associated with mortality, despite faster decline in pulmonary function and prolonged fever. Hospital mortality in the TCZ group was significantly lower than in the controls, and age over 60 was the only significant risk factor. Moreover, administering TCZ reduced mechanical ventilation needs, with 82% extubated compared to 53% in controls. However, 45% in TCZ group was associated with a higher ventilator-associated pneumonia rate than in the untreated group which was 20% (P < 0.001). Despite this, TCZ-treated patients had shorter hospital stays. Conclusions The effects of tocilizumab on reducing mortality risk and improving the survival rate of COVID-19 patients with pneumonia remained inconclusive. Yet, the majority of results suggested that giving tocilizumab leads to shorter hospital stays, lowers the requirement for mechanical ventilation, and decreases the likelihood of ICU transfer. Tocilizumab is linked to the incidence of secondary infections; hence, this medication should be closely monitored for side effects.
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Affiliation(s)
| | | | | | | | | | | | - Rogie Royce Z Carandang
- College of Pharmacy, Adamson University, Manila, Philippines
- Department of Public Health Sciences, University of Connecticut School of Medicine, Connecticut, USA
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Espiritu AI, Leochico CFD, Supnet IE, Villanueva EQ, Sy MCC, Anlacan VMM, Jamora RDG. Risk of COVID-19 Outcomes among Healthcare Workers: Findings from the Philippine CORONA Retrospective Cohort Study. ACTA MEDICA PHILIPPINA 2025; 59:25-32. [PMID: 39967703 PMCID: PMC11831081 DOI: 10.47895/amp.vi0.9316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/20/2025]
Abstract
Objectives While many healthcare workers (HCWs) contracted COVID-19 during the pandemic, more information is needed to fully understand the potential for adverse health effects in this population segment. The aim of the present study is to examine the association between healthcare worker status and neurologic and clinical outcomes in COVID-19 infected inpatients. Methods Using the nationwide database provided by the retrospective cohort Philippine CORONA study, we extracted relevant data and performed a secondary analysis primarily focusing on the presentation and outcomes of healthcare workers. Propensity score matching in a 3:1 ratio was performed to match HCWs and non-HCWs. We performed multiple logistic and Cox regression analyses to determine the relationship between HCWs and COVID-19 clinical outcomes. Results We included 3,362 patients infected with COVID-19; of which, 854 were HCWs. Among the HCWs, a total of 31 (3.63%) and 45 (5.27%) had the primary outcomes of in-hospital mortality and respiratory failure, respectively. For both overall and 3:1 propensity-matched cohorts, being an HCW significantly decreased the odds of the following outcomes: severe/critical COVID-19 at nadir; in-hospital mortality; respiratory failure; intensive care unit admission; and hospital stay >14 days. Conclusion We found that being an HCW is not associated with worse neurologic and clinical outcomes among patients hospitalized for COVID-19.
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Affiliation(s)
- Adrian I. Espiritu
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Division of Neurology (Department of Medicine) and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Carl Froilan D. Leochico
- Division of Neurology (Department of Medicine) and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Department of Physical Medicine and Rehabilitation, St. Luke’s Medical Center, Global City and Quezon City, Philippines
| | - Isabella E. Supnet
- Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Emilio Q. Villanueva
- Department of Pathology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Marie Charmaine C. Sy
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Veeda Michelle M. Anlacan
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Roland Dominic G. Jamora
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
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Batool S, Chokkakula S, Jeong JH, Baek YH, Song MS. SARS-CoV-2 drug resistance and therapeutic approaches. Heliyon 2025; 11:e41980. [PMID: 39897928 PMCID: PMC11786845 DOI: 10.1016/j.heliyon.2025.e41980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 12/30/2024] [Accepted: 01/14/2025] [Indexed: 02/04/2025] Open
Abstract
In light of the transition of COVID-19 from a pandemic to an endemic phase, there is still a dire need to address challenges associated with drug resistance, particularly among immunocompromised and high-risk populations. This review explores the current state of research on SARS-CoV-2 drug resistance and underscores the ongoing need for effective therapeutic strategies. It critically evaluates existing knowledge on resistance mechanisms and therapeutic options, aiming to consolidate information and highlight areas for future research. By examining the complex interactions between the virus and its host, the review advocates for a multifaceted approach, including combination therapies, targeted drug development, and continuous surveillance of viral mutations. It also emphasizes the impact of evolving viral variants on antiviral efficacy and suggests adaptive treatment protocols. This review aims to enhance our understanding of SARS-CoV-2 drug resistance and contribute to more effective management of COVID-19 through a discussion of promising strategies such as drug repurposing and combination therapies.
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Affiliation(s)
- Sania Batool
- Department of Microbiology, Chungbuk National University, College of Medicine and Medical Research Institute, Cheongju 28644, Chungbuk, Republic of Korea
| | - Santosh Chokkakula
- Department of Microbiology, Chungbuk National University, College of Medicine and Medical Research Institute, Cheongju 28644, Chungbuk, Republic of Korea
| | - Ju Hwan Jeong
- Department of Microbiology, Chungbuk National University, College of Medicine and Medical Research Institute, Cheongju 28644, Chungbuk, Republic of Korea
| | - Yun Hee Baek
- Department of Microbiology, Chungbuk National University, College of Medicine and Medical Research Institute, Cheongju 28644, Chungbuk, Republic of Korea
| | - Min-Suk Song
- Department of Microbiology, Chungbuk National University, College of Medicine and Medical Research Institute, Cheongju 28644, Chungbuk, Republic of Korea
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Mamashela TA, Ntuli ST. The impact of the COVID-19 pandemic on forensic pathology services in Limpopo province, South Africa. S Afr Fam Pract (2004) 2025; 67:e1-e4. [PMID: 39935159 PMCID: PMC11830830 DOI: 10.4102/safp.v67i1.6038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Revised: 10/24/2024] [Accepted: 10/24/2024] [Indexed: 02/13/2025] Open
Abstract
BACKGROUND To evaluate the effects of coronavirus disease 2019 (COVID-19) and the preventative measures taken, especially how they affect forensic pathology services in rural South Africa. METHODS This retrospective analysis includes referred post-mortem cases from all forensic pathology services in Limpopo province, comparing the period before the COVID-19 pandemic (01 January 2019 to 31 December 2019) with the pandemic period (01 January 2020 to 31 December 2020). Data analysis was performed using STATA 16.0 software (StataCorp; College Station, TX). Chi-square test was employed for comparison, with a p-value 0.05 deemed statistically significant. RESULTS Approximately 9319 cases were submitted for post-mortem examinations, with 4857 occurring before the pandemic and 4462 during it, marking an 8.1% decrease. There was a decrease in the number of unnatural death cases, while the instances of natural deaths rose. Cases under investigation saw a notable increase. There was a marked decrease in referrals for forensic examinations across all districts. In addition, except for one facility, there was a decline in the number of cases sent for autopsies at all facilities. CONCLUSION In conclusion, forensic pathology services in this province had been severely disrupted by the COVID-19 outbreak and the lockdown that followed, especially in the tertiary hospital. It has led to new challenges for case management and necessitated changes to operating procedures.Contribution: It has required modifications to operational procedures and has introduced various challenges in case management.
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Affiliation(s)
- Thakadu A Mamashela
- Department of Forensic Pathology, School of Medicine, University of Limpopo, Limpopo.
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Cătană RT, Nechifor-Boila A, Zăhan A, Militaru AD, Radu GN, Borda A. A 6-Year Retrospective Study in Surgery Patients with Thyroid Diseases in Mureș County, Romania, Before and During the COVID-19 Pandemic. Diagnostics (Basel) 2025; 15:287. [PMID: 39941217 PMCID: PMC11816865 DOI: 10.3390/diagnostics15030287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Revised: 01/20/2025] [Accepted: 01/24/2025] [Indexed: 02/16/2025] Open
Abstract
Background/Objectives: In this study, we aimed to assess the impact of the COVID-19 (Coronavirus Disease 2019) pandemic period on the time trend prevalence of thyroid pathology in a university hospital in Romania. Methods: We performed a 6-year retrospective study (2017-2022) including all patients who underwent thyroid surgery, registered in the Pathology Department, Emergency County Hospital, Târgu-Mureș, Romania (n = 971). Thyroid lesions were grouped into three major categories: (1) benign, non-tumoral; (2) benign, tumoral; and (3) malignant, tumoral. To assess the impact of the COVID-19 pandemic on the annual rate of thyroid surgeries and thyroid pathology, data were analyzed in comparison: before COVID-19 (2017-2019) versus the COVID-19 (2020-2022) period. Results: A significant decrease in the mean number of thyroid specimens per year was observed in the COVID-19 period compared to the previous period (131 versus 192 cases, p = 0.0023). Thyroid benign lesions were the most frequent, but their prevalence was significantly lower during the pandemic period (50.8%) compared to the previous period (58.6%) (p = 0.017). Benign tumors were rare, revealing similar occurrence rates in both periods. By contrast, the annual rate of malignant tumors increased significantly during the COVID-19 period (26.3% versus 35.4%, p = 0.002), the most common histopathological type being papillary thyroid carcinoma. Conclusions: Along with the COVID-19 pandemic (starting in the year 2020), due to reduced access to medical investigations, many thyroid cancers remained unoperated in our hospital. Consequently, this has led to an increased prevalence of malignant cases in the years that came after.
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Affiliation(s)
- Ramona Teodora Cătană
- Department of Histology, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Târgu-Mureş, 38th Gh. Marinescu Street, 540139 Târgu-Mureş, Romania; (R.T.C.)
- Department of Endocrinology, Târgu-Mureş Emergency County Hospital, 50th Gh. Marinescu Street, 540139 Târgu-Mureş, Romania
| | - Adela Nechifor-Boila
- Department of Histology, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Târgu-Mureş, 38th Gh. Marinescu Street, 540139 Târgu-Mureş, Romania; (R.T.C.)
- Department of Pathology, Târgu-Mureş County Hospital, 28th 1 December 1918 Street, 540061 Târgu-Mureş, Romania;
| | - Ancuța Zăhan
- Department of Histology, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Târgu-Mureş, 38th Gh. Marinescu Street, 540139 Târgu-Mureş, Romania; (R.T.C.)
| | - Andreea Deborah Militaru
- Department of Histology, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Târgu-Mureş, 38th Gh. Marinescu Street, 540139 Târgu-Mureş, Romania; (R.T.C.)
| | - Georgian-Nicolae Radu
- Department of Pathology, Târgu-Mureş County Hospital, 28th 1 December 1918 Street, 540061 Târgu-Mureş, Romania;
| | - Angela Borda
- Department of Histology, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Târgu-Mureş, 38th Gh. Marinescu Street, 540139 Târgu-Mureş, Romania; (R.T.C.)
- Department of Pathology, Târgu-Mureş Emergency County Hospital, 50th Gh. Marinescu Street, 540139 Târgu-Mureş, Romania
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Traore AM, Toure MK, Coulibaly YI, Keita M, Diarra B, Sanafo S, Dabo G, Kodio M, Traore B, Diarra A, Dicko A, Traore HA, Faye O, Minta DK. Factors of progression to severity and death in COVID-19 patients at two health care sites in Bamako, Mali. BMC Infect Dis 2025; 25:77. [PMID: 39825241 PMCID: PMC11742798 DOI: 10.1186/s12879-025-10456-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/07/2025] [Indexed: 01/20/2025] Open
Abstract
OBJECTIVES To analyze the clinical and biological characteristics and to evaluate the risk factors associated with the mortality of patients with COVID-19 in Commune IV of the District of Bamako. METHODS The cohort consisted of COVID-19 patients managed from March 2020 to June 2022 at the Bamako Dermatology Hospital and the Pasteur Polyclinic in Commune IV in Bamako. The studied variables were sociodemographic, clinical, and biological. For the analysis of deaths, explanatory variables were grouped into sociodemographic factors, comorbidities and symptoms. Binomial logistic regression models were used to identify mortality associated risk factors. RESULTS Among the 1319 included patients, 38.4% were asymptomatic, 46% and 15.5% developed moderate or severe COVID-19 respectively. The predominant signs were cough (48.5%), respiratory difficulty (24.6%) and headache (19.7%). Male were more common (58.2%). High blood pressure (19.9%) and diabetes (10%) were the main comorbidities. D-dimers < 0.5 μg/l was found in 53.3% of cases and the mean hemoglobin level was 12.9 ± 1.7 g/l. The case fatality rate was 3.71% in our series. In bivariate analysis, age > 60 years, high blood pressure, diabetes, clinical severity, D-dimers < 0.5 μg/l were associated with death. Using binomial logistic regression method, age > 60 years, increased heart rate, disease severity level and mainly acute respiratory distress syndrome (polypnea, difficulty breathing) were the factors found associated with death. After adjusting for all the assessed factors, age < 60 years [aHR = 0.15 (0.06-0.35)] and administration of azithromycin [aHR = 0.31 (0.1-0.97)] were protective factors while higher respiratory rate [aHR = 1.14 (1.07-1.22)] and difficulty breathing [aHR = 3.06 (1.03-9.13)] were risk factors associated with death. CONCLUSION These main findings elucidate the factors associated with severity and lethality external of health care system constraints. Advanced age, higher heart rate and the development of respiratory distress were the factors significantly associated with increased fatalities.
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Affiliation(s)
- Abdoulaye Mamadou Traore
- Centre Hospitalier Universitaire du Point G (Point G University Hospital), Bamako, Mali.
- Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali.
| | - Mamadou Karim Toure
- Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital), Bamako, Mali
- Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Yaya Ibrahim Coulibaly
- Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital), Bamako, Mali
- Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Modibo Keita
- Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital), Bamako, Mali
| | - Bakary Diarra
- Polyclinique Pasteur (Pasteur Polyclinic), Bamako, Mali
| | - Salif Sanafo
- Polyclinique Pasteur (Pasteur Polyclinic), Bamako, Mali
| | - Garan Dabo
- Hopital du Mali (Mali Hospital, Bamako, Mali
- Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Mamoudou Kodio
- Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital), Bamako, Mali
- Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Bourama Traore
- Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital), Bamako, Mali
- Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Aminata Diarra
- Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital), Bamako, Mali
- Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Adama Dicko
- Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital), Bamako, Mali
- Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Hamar A Traore
- Polyclinique Pasteur (Pasteur Polyclinic), Bamako, Mali
- Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Ousmane Faye
- Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital), Bamako, Mali
- Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Daouda K Minta
- Centre Hospitalier Universitaire du Point G (Point G University Hospital), Bamako, Mali
- Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
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Amiri M, Hashemi Z, Chekin F. Zinc oxide nanoparticles decorated nitrogen doped porous reduced graphene oxide-based hybrid to sensitive detection of hydroxychloroquine in plasma and urine. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2025; 36:4. [PMID: 39775200 PMCID: PMC11706907 DOI: 10.1007/s10856-024-06847-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 11/26/2024] [Indexed: 01/11/2025]
Abstract
The antimalarial hydroxychloroquine (HCQ) has considered for the treatment of systemic lupus erythematosus. Moreover, HCQ has been used as a drug to treat Coronavirus disease (COVID-19). In this work, nitrogen doped porous reduced graphene oxide (NprGO) has been prepared via environmentally friendly process using Fummaria Parviflora extract. A catalyst based on ZnO nanoparticles-nitrogen doped porous reduced graphene oxide (ZnO-NprGO) was prepared by hydrothermal method and characterized. The diameter of ZnO nanoparticles was ~22-37 nm, which were inserted between the NprGO sheets effectively prevented their aggregation. The ZnO-NprGO hybrid had high surface area and good electro-catalytic property, suiting for determination of HCQ. The ZnO-NprGO modified carbon paste electrode (CPE)-based sensor operated in a wide concentration range of 0.07-5.5 μmol L-1 with low limit of detection of 57 nmol L-1 and sensitivity of 14.175 μA μmol-1 L. Remarkably, the ZnO-NprGO/CPE sensor indicated acceptable accuracy, reproducibility, and stability. In addition, the proposed sensor was applied to detection of HCQ in biological samples and the recoveries were 92.0-102.5%, with relative standard deviations of 1.9-4.3%. The unique physical structure of ZnO-NprGO, as well as its chemical and electrical properties, make it promising interface for use in sensors and nanoelectronic applications.
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Affiliation(s)
- Mohammad Amiri
- Department of Pharmacy, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran
| | - Zahra Hashemi
- Department of Pharmacy, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran
| | - Fereshteh Chekin
- Department of Chemistry, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran.
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Al-Mana NM, Zareef TA, Albathi FA, Awney HA, Baeshen F, Abdullah R. Exploring lifestyle and dietary pattern shifts among Saudi adults during COVID-19 pandemic: insights from a cross-sectional examination. Front Nutr 2025; 11:1489160. [PMID: 39834457 PMCID: PMC11743356 DOI: 10.3389/fnut.2024.1489160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Accepted: 12/11/2024] [Indexed: 01/22/2025] Open
Abstract
Background Since the emergence of COVID-19 and the subsequent imposition of lockdown and movement restrictions, the world has witnessed fundamental lifestyle changes including alterations in dietary patterns and food consumption habits. Here, we investigated how the COVID-19 lockdown impacted dietary patterns and eating behaviors in the Saudi population. Methodology This cross-sectional study enrolled 427 participants aged 18 years or more, with 258 of them completing the survey. The survey included questions about demographic and dietary patterns during the COVID-19 lockdown. Data were collected and dietary behaviors before and during the lockdown in Jeddah, Saudi Arabia, were analyzed. Results The number of participants who considered lunch as their primary meal significantly decreased (p < 0.001) during the COVID-19 lockdown (74%), compared to before it (86%). By contrast, the number of participants who considered dinner as their primary meal remained almost unchanged (p = 0.079) during (79.1%) and before (84.1%) the lockdown. However, snack consumption significantly increased (p < 0.001) while fast-food consumption significantly decreased (p < 0.01) during the lockdown period. Our results also revealed a significant increase (p < 0.01) in water and coffee intake during the lockdown, with a significant rise in dessert consumption (p < 0.01). Conclusion Our results demonstrate that the COVID-19 lockdown caused a marked shift in dietary patterns and eating behaviors among the Saudi population. Notable changes were observed in overall food preferences after the lockdowns were imposed, with reduced consumption of fast foods and increased fluid intake.
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Affiliation(s)
- Najlaa M. Al-Mana
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Tahani A. Zareef
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Jeddah, Saudi Arabia
| | - Fatmah A. Albathi
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Hala A. Awney
- Department of Environmental Studies, Institute of Graduate Studies and Research, Alexandria University, Alexandria, Egypt
| | - Farah Baeshen
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Renad Abdullah
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Shah R, Hanna NM, Loo CE, David M, Mafra A, Fink H, McFerran E, Garcia M, Ghodssighassemabadi R, Acharya S, Niyibaga J, Langselius O, Frick C, Lasebikan N, Vignat J, Steinberg J, Hughes S, Kircher CE, Goldie CL, Egger S, Sullivan R, Ginsburg O, Bray F, Caruana M, Hui H, Ilbawi AM, Canfell K, Soerjomataram I. The global impact of the COVID-19 pandemic on delays and disruptions in cancer care services: a systematic review and meta-analysis. NATURE CANCER 2025; 6:194-204. [PMID: 39747650 DOI: 10.1038/s43018-024-00880-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 11/13/2024] [Indexed: 01/04/2025]
Abstract
The coronavirus disease 2019 pandemic substantially impacted the delivery of cancer services and programs. Here we reviewed and synthesized the global scale and impact of pandemic-related delays and disruptions on cancer services, including diagnosis, diagnostic procedures, screening, treatment and supportive and palliative care. Based on data from 245 articles in 46 countries, we observed declines in the number of cancer screening participation (39.0%), diagnoses (23.0%), diagnostic procedures (24.0%) and treatment (28.0%), ranging from a 15.0% decline for radiotherapy to a 35.0% decline for systemic treatment during the pandemic compared to during the prepandemic period. Medium-human development index (HDI) category countries experienced greater reductions than high- and very-high-HDI countries. Missing data from low-HDI countries emphasize the need for increased investments in cancer surveillance and research in these settings. PROSPERO registration: CRD42022301816.
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Affiliation(s)
- Richa Shah
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
| | | | - Ching Ee Loo
- Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Michael David
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Allini Mafra
- Cancer Epidemiology and Prevention Team, Public Health Expertise, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Registre National du Cancer, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Hanna Fink
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Montse Garcia
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), Early Detection of Cancer Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | | | | | - Jean Niyibaga
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Oliver Langselius
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Clara Frick
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Nwamaka Lasebikan
- Oncology Center, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Jerome Vignat
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Suzanne Hughes
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | | | | | - Sam Egger
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Richard Sullivan
- King's College London, Institute of Cancer Policy, Guy's Hospital, London, UK
| | - Ophira Ginsburg
- Center for Global Health, National Cancer Institute, Bethesda, MD, USA
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Michael Caruana
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Harriet Hui
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - André Michel Ilbawi
- Department of Non-Communicable Diseases, World Health Organization, Geneva, Switzerland
| | - Karen Canfell
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Gupte A, Sriram S, Gunasekaran V, Chaudhari K, Kamat D. The Triad of COVID-19 in Children: Acute COVID-19, Multisystem Inflammatory Syndrome, and Long COVID-Part II. Pediatr Ann 2025; 54:e40-e44. [PMID: 39760348 DOI: 10.3928/19382359-20241106-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2025]
Abstract
Coronavirus disease 2019 (COVID-19), which is now known to be caused by severe acute respiratory syndrome coronavirus 2, has been a public health threat since early 2020 and has affected millions of people worldwide. Many studies have now shown that this virus exhibits a milder infection in children compared to adults. Acute COVID-19 infection, multisystem inflammatory syndrome in children (MIS-C), and long COVID have been recently well-established in the pediatric population with a myriad of systemic manifestations. This section of the review will focus on the following systems-neurology, psychiatry, endocrinology, hematology, and oncology-under three broad lenses, such as acute COVID-19, MIS-C, and long COVID. [Pediatr Ann. 2025;54(1):e40-e44.].
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Xu X, Meng L, Li J, Zhang Y, Liu B, Jiang W, Hao C. Analysis of the potentially pathogenic bacteria of lower respiratory tract infections in children per-, during and post-COVID-19: a retrospective study. Eur J Clin Microbiol Infect Dis 2025; 44:167-180. [PMID: 39556174 DOI: 10.1007/s10096-024-04991-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Accepted: 11/07/2024] [Indexed: 11/19/2024]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has caused significant changes in lower respiratory tract infections (LRTIs). This study aimed to characterize potentially pathogenic bacterial infections in paediatric patients hospitalized for LRTIs per-, during and post-COVID-19. METHODS Sputum culture data from 85,659 children with LRTIs at the Children's Hospital of Soochow University from January 2016 to May 2024 were analyzed for eight bacteria: Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Moraxella catarrhalis, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii. The data during the pandemic (2020-2022, during COVID-19) and after the pandemic (January 2023-May 2024, post-COVID-19) were compared with those before the pandemic (2016-2019). RESULTS Overall, 85,659 children with LRTIs were enrolled. Of these, 42,567 cases (49.7%) were diagnosed in the pre-COVID-19 period, 22,531 cases (26.3%) during the COVID-19 period and 20,561 cases (24.0%) in the post-COVID-19 period. The overall positive rate for pathogenic bacteria was 37.1%, with the top three being S. pneumoniae (14.5%), H. influenzae (12.1%) and S. aureus (6.5%). Compared to the average pre-COVID-19 levels, the bacterial pathogen positive rate decreased by 3.5% during the COVID-19 period (OR: 0.94, 95% CI: 0.91-0.98) and by 23.4% in the post-COVID-19 period (OR: 0.66, 95% CI: 0.64-0.69). During the COVID-19 period, the positive rates for S. pneumoniae, H. influenzae, E. coli, K. pneumoniae and mixed infections decreased by 11.7%, 35.3%, 22.2%, 33.3% and 45.7% respectively, while the positive rates for S. aureus, M. catarrhalis and P. aeruginosa increased by 21.7%, 44.7% and 25% respectively. In the post-COVID-19 period, the positive rates for S. pneumoniae, H. influenzae, E. coli, P. aeruginosa, K. pneumoniae, A. baumannii and mixed infections decreased by 50.0%, 7.4%, 22.2%, 50.0%, 44.4%, 60.0% and 32.6% respectively, while there was no statistical change in the positive rates for S. aureus and M. catarrhalis. Bacteria case detection decreases in 2020 (67.0%), 2021 (60.5%), 2022 (76.3%) and 2023 (72.7%) compared to predicted cases. CONCLUSIONS Measures to restrict COVID-19 as a driver of declining bacterial positive rates. Respiratory bacteria in children are change across COVID-19 phases, age groups and seasons. After COVID-19, clinicians should continue to increase surveillance for pathogenic bacteria, especially drug-resistant flora.
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Affiliation(s)
- Xuena Xu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Lingjian Meng
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
- Department of Pediatrics, Xuzhou Medical University Affiliated Hospital, Xuzhou, China
| | - Jiaoyang Li
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yizhu Zhang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Bingjie Liu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wujun Jiang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.
| | - Chuangli Hao
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.
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Kern M, Jansen G, Strickmann B, Kerner T. Advancements in Public First Responder Programs for Out-of-Hospital Cardiac Arrest: An Updated Literature Review. Rev Cardiovasc Med 2025; 26:26140. [PMID: 39867188 PMCID: PMC11760550 DOI: 10.31083/rcm26140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Revised: 10/31/2024] [Accepted: 11/04/2024] [Indexed: 01/28/2025] Open
Abstract
Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide, with a low survival rate of around 7% globally. Key factors for improving survival include witnessed arrest, bystander cardiopulmonary resuscitation (CPR), and early defibrillation. Despite guidelines advocating for the "chain of survival", bystander CPR and defibrillation rates remain suboptimal. Innovative approaches, such as dispatcher-assisted CPR (DA-CPR) and smartphone-based alerts, have emerged to address these challenges. DA-CPR effectively transforms emergency callers into lay rescuers, and smartphone apps are increasingly being used to alert volunteer first responders to OHCA incidents, enhancing response times and increasing survival rates. Smartphone-based systems offer advantages over traditional text messaging by providing real-time guidance and automated external defibrillator (AED) locations. Studies show improved outcomes with app-based alerts, including higher rates of early CPR, increased survival rates and improved neurological outcomes. Additionally, the potential of unmanned aerial vehicles (drones) to deliver AEDs rapidly to OHCA sites has been demonstrated, particularly in rural areas with extended emergency medical services response times. Despite technological advancements, challenges such as ensuring responder training, effective dispatching, and maintaining responder well-being, particularly during the coronavirus disease 19 (COVID-19) pandemic, remain. During the pandemic, some community first responder programs were suspended or modified due to shortages of personal protective equipment (PPE) and increased risks of infection. However, systems that adapted by using PPE and revising protocols generally maintained responder participation and effectiveness. Moving forward, integrating new technology within robust responder systems and support mechanisms will be essential to improving OHCA outcomes and sustaining effective response networks.
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Affiliation(s)
- Michael Kern
- Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine, Pain and Palliative Therapy, Asklepios Klinikum Harburg, 21075 Hamburg, Germany
- Asklepios Campus Hamburg Asklepios Medical School GmbH, 20099 Hamburg, Germany
| | - Gerrit Jansen
- University Department of Anesthesiology, Intensive Care Medicine and Emergency Medicine, Johannes Wesling Klinikum Minden, Ruhr University Bochum, 32423 Minden, Germany
- Medical School and University Medical Center East Westphalia-Lippe, University of Bielefeld, 33615 Bielefeld, Germany
- Department of Medical and Emergency Services, Study Institute Westfalen-Lippe, 33602 Bielefeld, Germany
| | - Bernd Strickmann
- Bevoelkerungsschutz, District of Guetersloh, 33334 Guetersloh, Germany
| | - Thoralf Kerner
- Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine, Pain and Palliative Therapy, Asklepios Klinikum Harburg, 21075 Hamburg, Germany
- Asklepios Campus Hamburg Asklepios Medical School GmbH, 20099 Hamburg, Germany
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49
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Güler A, Bush HM, Schill K, Kussainov N, Coker AL. Association Between Lifetime Interpersonal Violence and Post-COVID-19 Condition Among Women in Kentucky, 2020-2022. Public Health Rep 2025; 140:9S-19S. [PMID: 38785343 PMCID: PMC11556550 DOI: 10.1177/00333549241236638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE The COVID-19 pandemic increased the risk of interpersonal violence. We investigated the association between lifetime interpersonal violence experience and risk of post-COVID-19 condition (the persistence of symptoms of COVID-19 and severity of health problems associated with COVID-19 that last a few weeks, months, or years) among women with lifetime interpersonal violence experience. METHODS Women participants aged ≥18 years in Kentucky's Wellness, Health & You-COVID-19 study completed online quantitative surveys about the impacts of the pandemic, developing COVID-19, and symptoms of post-COVID-19 condition. We conducted cross-sectional analyses estimating rate ratios of developing COVID-19 and symptoms of post-COVID-19 condition during the pandemic (October 13, 2020-February 28, 2022). RESULTS Of the analytic sample (N = 938), 342 (36.5%) disclosed a history of lifetime interpersonal violence. Compared with women with no lifetime interpersonal violence experience, women with lifetime interpersonal violence experience had significantly more distress because of the pandemic, defined as family financial challenges (P = .001), symptoms of mental health challenges (P < .001), and negative coping behaviors (P < .001). While experiencing lifetime interpersonal violence was not significantly associated with either receiving COVID-19 vaccinations (adjusted rate ratio [aRR] = 1.10; 95% CI, 0.75-1.61) or developing COVID-19 (aRR = 1.15; 95% CI, 0.92-1.44), experiencing lifetime interpersonal violence was associated with an increased rate of developing symptoms of post-COVID-19 condition (aRR = 2.09; 95% CI, 1.19-3.65). CONCLUSION Symptoms of post-COVID-19 condition may be linked to lifetime interpersonal violence experience, possibly through stress or violence-associated trauma. Future research is needed to assess the negative effects of the pandemic, prioritizing people with lifetime interpersonal violence experience.
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Affiliation(s)
- Ayşe Güler
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
- Center for Research on Violence Against Women, University of Kentucky, Lexington, KY, USA
| | - Heather M Bush
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
- Center for Research on Violence Against Women, University of Kentucky, Lexington, KY, USA
| | - Katie Schill
- Center for Clinical and Translational Science, University of Kentucky, Lexington, KY, USA
| | - Nurlan Kussainov
- The Southeast Center for Agricultural Health & Injury Prevention, College of Agriculture, Food, and the Environment, University of Kentucky, Lexington, KY, USA
| | - Ann L Coker
- Center for Research on Violence Against Women, University of Kentucky, Lexington, KY, USA
- Department of Obstetrics and Gynecology, College of Medicine, University of Kentucky, Lexington, KY, USA
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50
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Sohmer JS, Fridman S, Peters D, Jacomino M, Luck G. Winning the Lottery: A Simulation Study Comparing Scarce Resource Allocation Protocols in Crisis Scenarios. Cureus 2025; 17:e76977. [PMID: 39912038 PMCID: PMC11798620 DOI: 10.7759/cureus.76977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Accepted: 01/04/2025] [Indexed: 02/07/2025] Open
Abstract
Introduction In times of crisis, such as natural disasters, pandemics, or other emergencies, healthcare facilities often experience an unprecedented surge in critically ill or severely injured patients. When the demand for life-saving resources surpasses the available supply, healthcare leaders must implement scarce resource allocation (SRA) protocols, which are defined by state governments or hospital committees. Due to the lack of federal standardization and the wide variations in these protocols across states and healthcare systems, researchers aimed to investigate the disparities in SRA protocols and their impact on patient outcomes in preparation for future emergencies. -- Methods Researchers created a simulation involving mock patients admitted to a hospital with limited ventilator availability, where they were required to implement an SRA protocol. Nine mock adult patient profiles were generated, each varying in age, biological sex, past medical history, social history, and illness acuity and severity. Researchers also comprehensively reviewed SRA protocols implemented across the United States during the COVID-19 pandemic. Six protocols were selected and applied to the mock patient population. Variations in the methodology of allocation and outcomes of resource stewardship were observed. Results Significant differences were found among the six SRA protocols, including differences in objective scoring categories, exclusion criteria, considerations for age and pregnancy, tie-breaking methods, and the use of lottery systems. These protocol differences influenced the outcomes of life-saving treatments received by different patients. In this simulation, no two state algorithms provided the same ventilator allocation results for the nine patients. Conclusion SRA protocols either emphasized scoring systems or employed an ambiguous lottery system, placing an unnecessary burden on physicians and patients. As a result, the researchers advocate for federal standardization of SRA protocols, to ensure equal access to critical medical care for all individuals, regardless of location, and to eliminate the element of chance that currently varies by state.
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Affiliation(s)
- Joshua S Sohmer
- Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
| | - Sabina Fridman
- Pediatrics, Memorial Healthcare, Pembroke Pines, USA
- Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
| | - Darian Peters
- Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
| | - Mario Jacomino
- Women's and Children's Health, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
| | - George Luck
- Integrated Medical Science, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
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