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Gasmi A, Kassym L, Menzel A, Anzar W, Dadar M, Semenova Y, Arshad M, Bihunyak T, Meguid NA, Peana M, Bekbergenova Z, Bjørklund G. Genetic and Epigenetic Determinants of COVID-19 Susceptibility: A Systematic Review. Curr Med Chem 2025; 32:753-770. [PMID: 38251695 DOI: 10.2174/0109298673267890231221100659] [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: 06/18/2023] [Revised: 08/04/2023] [Accepted: 11/14/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND The molecular mechanisms regulating coronavirus pathogenesis are complex, including virus-host interactions associated with replication and innate immune control. However, some genetic and epigenetic conditions associated with comorbidities increase the risk of hospitalization and can prove fatal in infected patients. This systematic review will provide insight into host genetic and epigenetic factors that interfere with COVID-19 expression in light of available evidence. METHODS This study conducted a systematic review to examine the genetic and epigenetic susceptibility to COVID-19 using a comprehensive approach. Through systematic searches and applying relevant keywords across prominent online databases, including Scopus, PubMed, Web of Science, and Science Direct, we compiled all pertinent papers and reports published in English between December 2019 and June 2023. RESULTS The findings reveal that the host's HLA genotype plays a substantial role in determining how viral protein antigens are showcased and the subsequent immune system reaction to these antigens. Within females, genes responsible for immune system regulation are found on the X chromosome, resulting in reduced viral load and inflammation levels when contrasted with males. Possessing blood group A may contribute to an increased susceptibility to contracting COVID-19 as well as a heightened risk of mortality associated with the disease. The capacity of SARS-CoV-2 involves inhibiting the antiviral interferon (IFN) reactions, resulting in uncontrolled viral multiplication. CONCLUSION There is a notable absence of research into the gender-related predisposition to infection, necessitating a thorough examination. According to the available literature, a significant portion of individuals affected by the ailment or displaying severe ramifications already had suppressed immune systems, categorizing them as a group with elevated risk.
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Affiliation(s)
- Amin Gasmi
- Department of Research, Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
| | - Laura Kassym
- Department of Research, Astana Medical University, Astana, Kazakhstan
| | - Alain Menzel
- Department of Research, Laboratoires Réunis, Junglinster, Luxembourg
| | - Wajiha Anzar
- Department of Research, Dow University of Health Sciences, Karachi, Pakistan
| | - Maryam Dadar
- Department of Research, CONEM Iran Microbiology Research Group, Tehran, Iran
| | - Yuliya Semenova
- Department of Research, Nazarbayev University School of Medicine, Astana, Kazakhstan
| | - Mehreen Arshad
- Department of Research, National University of Sciences and Technology, Islamabad, Pakistan
| | - Tetyana Bihunyak
- Department of Research, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Nagwa Abdel Meguid
- Research on Children with Special Needs Department, National Research Centre, Giza, Egypt
- CONEM Egypt Child Brain Research Group, National Research Center, Giza, Egypt
| | - Massimiliano Peana
- Department of Chemical, Physical, Mathematical and Natural Sciences, University of Sassari, Sassari, Italy
| | | | - Geir Bjørklund
- Department of Research, Council for Nutritional and Environmental Medicine (CONEM), Mo i Rana, Norway
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Branche A, Ramesh M, Francis B. A Narrative Review of Key Risk Factors for Severe Illness Following SARS-CoV-2, Influenza Virus, and Respiratory Syncytial Virus Infection. Infect Dis Ther 2025; 14:39-61. [PMID: 39739198 PMCID: PMC11724830 DOI: 10.1007/s40121-024-01081-3] [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: 06/03/2024] [Accepted: 11/06/2024] [Indexed: 01/02/2025] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza, and respiratory syncytial virus (RSV) are highly infectious respiratory viruses that affect people of all ages and are typically associated with mild symptoms and few complications in immunocompetent individuals. However, the risk of severe outcomes (e.g., hospitalization and death) following infection with these respiratory viruses is higher in certain populations, including older adults and individuals of certain race/ethnic and sociodemographic groups. Additionally, immunocompromising conditions and pre-existing comorbidities, including underlying cardiovascular (e.g., congestive heart failure) and respiratory diseases (e.g., chronic obstructive pulmonary disease), diabetes, chronic kidney disease, and obesity, are key factors that predispose individuals to SARS-CoV-2-, influenza-, and RSV-related severe outcomes. Increased risk for severe outcomes associated with advancing age and comorbidities is compounded by residence in long-term care facilities due to the enhanced spread of respiratory infections in congregate living environments. In this narrative review, risk factors associated with severe outcomes following infection with SARS-CoV-2, influenza, and RSV in adult populations are explored. Additionally, distinct clinical outcomes based on underlying comorbidities following infection are discussed in the context of high-risk populations. Factors unique to each virus that underpin distinct risk profiles are described and suggest the potential for tailored surveillance and healthcare approaches to target and ultimately mitigate SARS-CoV-2-, influenza-, and RSV-associated disease burden in vulnerable populations. Mutual risk factors for severe outcomes are also highlighted; these similarities indicate that cohesive risk reduction strategies may also be feasible, particularly since vaccines are available for each of these respiratory viruses. Ultimately, a more thorough understanding of the risk factors that predispose individuals to develop SARS-CoV-2-, influenza-, and RSV-related severe outcomes may improve risk reduction strategies, inform healthcare policy, and contribute to the expansion and refinement of existing surveillance approaches to ultimately mitigate disease burden in vulnerable populations.
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Leal KNDS, Santos da Silva AB, Fonseca EKB, Moreira OBDO, de Lemos LM, Leal de Oliveira MA, Stewart AJ, Arruda MAZ. Metallomic analysis of urine from individuals with and without Covid-19 infection reveals extensive alterations in metal homeostasis. J Trace Elem Med Biol 2024; 86:127557. [PMID: 39500269 DOI: 10.1016/j.jtemb.2024.127557] [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] [Received: 08/26/2024] [Revised: 10/14/2024] [Accepted: 10/25/2024] [Indexed: 12/08/2024]
Abstract
BACKGROUND Metal ions perform important functions in the body and their concentrations in cells and tissues are tightly controlled. Alterations in metal homeostasis can occur in certain disease states including infection. In this study urinary excretion of several metals including calcium, cadmium, cobalt, copper, iron, magnesium, nickel, selenium, and zinc in Covid-19 patients (n=35) and control (n=60) individuals, spanning ages and sexes. METHODS Urinary samples were analysed using ICP-MS and the differences in metal concentrations between the Covid-19-infected and control groups were assessed using multivariate data analysis and univariate data analysis employing Student's t-test and Pearson's correlation, with significance set at p<0.05. RESULTS The urinary concentrations of all metals analysed were significantly higher in the Covid-infected group (compared to controls), with the exception of copper, which was markedly reduced. The increase in calcium excretion was lower and magnesium excretion greater in Covid-19-positive individuals aged 41 or over compared to those aged 40 or lower. Whilst the increase in iron excretion was lower, and cobalt excretion greater in Covid-19-positive males compared to females. CONCLUSIONS The study highlights significant alterations in the handling of a range of metals in the body during Covid-19 infection. It also highlights both age and sex-specific differences in metal homeostasis. The results suggest an important role for copper in the body during Covid-19 infection and suggests that urinary concentrations of copper and other metals may serve as markers to predict progression of the disease.
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Affiliation(s)
- Ketolly Natanne da Silva Leal
- Institute of Chemistry, University of Campinas - Unicamp, PO Box 6154, Campinas, SP 13083-970, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, University of Campinas - Unicamp, PO Box 6154, Campinas, SP 13083-970, Brazil; School of Medicine, Medical and Biological Sciences Building, University of St Andrews, North Haugh, St Andrews, KY16 9TF, United Kingdom
| | - Ana Beatriz Santos da Silva
- Institute of Chemistry, University of Campinas - Unicamp, PO Box 6154, Campinas, SP 13083-970, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, University of Campinas - Unicamp, PO Box 6154, Campinas, SP 13083-970, Brazil
| | - Elisânia Kelly Barbosa Fonseca
- Institute of Chemistry, University of Campinas - Unicamp, PO Box 6154, Campinas, SP 13083-970, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, University of Campinas - Unicamp, PO Box 6154, Campinas, SP 13083-970, Brazil
| | - Olívia Brito de Oliveira Moreira
- Analytical Chemistry and Chemometrics Group (GQAQ), Institute of Exact Sciences, Juiz de Fora Federal University - UFJF, Juiz de Fora, MG 36036-90, Brazil
| | | | - Marcone Augusto Leal de Oliveira
- National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, University of Campinas - Unicamp, PO Box 6154, Campinas, SP 13083-970, Brazil; Analytical Chemistry and Chemometrics Group (GQAQ), Institute of Exact Sciences, Juiz de Fora Federal University - UFJF, Juiz de Fora, MG 36036-90, Brazil
| | - Alan J Stewart
- School of Medicine, Medical and Biological Sciences Building, University of St Andrews, North Haugh, St Andrews, KY16 9TF, United Kingdom
| | - Marco Aurélio Zezzi Arruda
- Institute of Chemistry, University of Campinas - Unicamp, PO Box 6154, Campinas, SP 13083-970, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, University of Campinas - Unicamp, PO Box 6154, Campinas, SP 13083-970, Brazil.
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Ghanchi NK, Masood KI, Qazi MF, Shahid S, Nasir A, Mahmood SF, Ansar Z, Nisar MI, Hasan Z. Disparities in age and gender-specific SARS-CoV-2 diagnostic testing trends: a retrospective study from Pakistan. BMC Public Health 2024; 24:2629. [PMID: 39333938 PMCID: PMC11438081 DOI: 10.1186/s12889-024-19958-w] [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: 12/28/2023] [Accepted: 09/02/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Pakistan reported 1.57 million COVID-19 cases between 2020 and 2022, based on approximately 30.6 million SARS-CoV-2 RT-PCR (reverse-transcription polymerase chain reaction) tests conducted. This study utilized data from one of the largest in-country testing facilities, Aga Khan University Hospital (AKUH) in Karachi, Pakistan, to explore gender and age-related in RT-PCR testing patterns. METHODS We conducted a retrospective review of SARS-CoV-2 RT-PCR test data extracted from AKUH clinical laboratory records between February 2020 and February 2022. Gender and age distributions were examined in the context of testing patterns across the period. Multivariate regression models assessed independent associations between COVID-19 positivity and key variables. RESULTS We reviewed 470,249 RT-PCR tests, finding that most tests were in those aged 21-40 years (48.1%). Overall, COVID-19 test positivity was 20.6%. In all, 57.7% were performed for males, predominant amongst those tested across all age groups and waves. Females had significantly lower odds of testing positive for COVID-19 (OR: 0.9; 95% CI: 0.9-1.0). However, when adjusted for gender, age and pandemic phases, the positivity rates between males and females were the same. The odds of a positive result increased significantly with age; individuals aged > 80 years had 2.5 times higher odds of testing positive than those aged 0-10 years (aOR 2.5, 95% CI 2.3-2.7). CONCLUSIONS The analysis indicates a consistent male dominance in COVID-19 testing, with higher positivity rates in older age groups. Our study highlight the importance of examining demographic characteristics in disease associated data especially, representation of females amongst cohorts.
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Affiliation(s)
- Najia Karim Ghanchi
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Kiran Iqbal Masood
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | | | - Shahira Shahid
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Asghar Nasir
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | | | - Zeeshan Ansar
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Muhammad Imran Nisar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Zahra Hasan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan.
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Kirui BK, Santosa A, Li H, Vanfleteren LEGW, Stridsman C, Nyberg F. Key Characteristics of Asthma Patients with COVID-19 Vary Substantially by Age. J Asthma Allergy 2024; 17:589-600. [PMID: 38932752 PMCID: PMC11203787 DOI: 10.2147/jaa.s456145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
Introduction Assessing COVID-19 risk in asthma patients is challenging due to disease heterogeneity and complexity. We hypothesized that potential risk factors for COVID-19 may differ among asthma age groups, hindering important insights when studied together. Methods We included a population-based cohort of asthma patients from the Swedish National Airway Register (SNAR) and linked to data from several national health registers. COVID-19 outcomes included infection, hospitalization, and death from Jan 2020 until Feb 2021. Asthma patients were grouped by ages 12-17, 18-39, 40-64, and ≥65 years. Characteristics of asthma patients with different COVID-19 outcomes were compared with those in their age-corresponding respective source population. Results Among 201,140 asthma patients studied, 11.2% were aged 12-17 years, 26.4% 18-39, 37.6% 40-64, and 24.9% ≥65 years. We observed 18,048 (9.0%) COVID-19 infections, 2172 (1.1%) hospitalizations, and 336 (0.2%) COVID-19 deaths. Deaths occurred only among patients aged ≥40. When comparing COVID-19 cases to source asthma populations by age, large differences in potential risk factors emerged, mostly for COVID-19 hospitalizations and deaths. For ages 12-17, these included education, employment, autoimmune, psychiatric, and depressive conditions, and use of short-acting β-agonists (SABA) and inhaled corticosteroids (ICS). In the 18-39 age group, largest differences were for age, marital status, respiratory failure, anxiety, and body mass index. Ages 40-64 displayed notable differences for sex, birth region, cancer, oral corticosteroids, antihistamines, and smoking. For those aged ≥65, largest differences were observed for cardiovascular comorbidities, type 1 diabetes, chronic obstructive pulmonary disease, allergic conditions, and specific asthma treatments (ICS-SABA, ICS-long-acting bronchodilators (LABA)). Asthma control and lung function were important across all age groups. Conclusion We identify distinct differences in COVID-19-related risk factors among asthma patients of different ages. This information is essential for assessing COVID-19 risk in asthma patients and for tailoring patient care and public health strategies accordingly.
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Affiliation(s)
- Brian K Kirui
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ailiana Santosa
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Huiqi Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lowie E G W Vanfleteren
- COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Caroline Stridsman
- Department of Public Health and Clinical Medicine/The OLIN-Unit, Umeå University, Umeå, Sweden
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Nechita L, Niculet E, Baroiu L, Balta AAS, Nechita A, Voinescu DC, Manole C, Busila C, Debita M, Tatu AL. Acute Myocardial Infarction in COVID-19 Patients-A Review of Literature Data and Two-Case Report Series. J Clin Med 2024; 13:2936. [PMID: 38792477 PMCID: PMC11121956 DOI: 10.3390/jcm13102936] [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: 04/23/2024] [Revised: 05/12/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objectives: The newly emergent COVID-19 pandemic involved primarily the respiratory system and had also major cardiovascular system (CVS) implications, revealed by acute myocardial infarction (AMI), arrhythmias, myocardial injury, and thromboembolism. CVS involvement is done through main mechanisms-direct and indirect heart muscle injury, with high mortality rates, worse short-term outcomes, and severe complications. AMI is the echo of myocardial injury (revealed by increases in CK, CK-MB, and troponin serum markers-which are taken into consideration as possible COVID-19 risk stratification markers). When studying myocardial injury, physicians can make use of imaging studies, such as cardiac MRI, transthoracic (or transesophageal) echocardiography, coronary angiography, cardiac computed tomography, and nuclear imaging (which have been used in cases where angiography was not possible), or even endomyocardial biopsy (which is not always available or feasible). Two-case-series presentations: We present the cases of two COVID-19 positive male patients who were admitted into the Clinical Department of Cardiology in "Sfântul Apostol Andrei" Emergency Clinical Hospital of Galați (Romania), who presented with acute cardiac distress symptoms and have been diagnosed with ST elevation AMI. The patients were 82 and 57 years old, respectively, with moderate and severe forms of COVID-19, and were diagnosed with anteroseptal left ventricular AMI and extensive anterior transmural left ventricular AMI (with ventricular fibrillation at presentation), respectively. The first patient was a non-smoker and non-drinker with no associated comorbidities, and was later discharged, while the second one died due to AMI complications. Conclusions: From this two-case series, we extract the following: old age alone is not a significant risk factor for adverse outcomes in COVID-19-related CVS events, and that the cumulative effects of several patient-associated risk factors (be it either for severe forms of COVID-19 and/or acute cardiac injury) will most probably lead to poor patient prognosis (death). At the same time, serum cardiac enzymes, dynamic ECG changes, along with newly developed echocardiographic modifications are indicators for poor prognosis in acute cardiac injury in COVID-19 patients with acute myocardial injury, regardless of the presence of right ventricular dysfunction (due to pulmonary hypertension).
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Affiliation(s)
- Luiza Nechita
- Doctoral School of Biomedical Sciences, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.N.); (A.A.S.B.)
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 800008 Galați, Romania
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (C.M.)
| | - Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
| | | | - Aurel Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Doina Carina Voinescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (C.M.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
| | - Corina Manole
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (C.M.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
| | - Camelia Busila
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Mihaela Debita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
| | - Alin Laurentiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
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Jiang Z, Fang C, Peng F, Fan W. Comparison of clinical characteristics and disease burden of febrile seizures in children with and without COVID-19. BMC Pediatr 2024; 24:329. [PMID: 38741083 DOI: 10.1186/s12887-024-04821-z] [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] [Received: 11/06/2023] [Accepted: 05/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Febrile seizures (FS) are the most common seizure disorder in children and a common neurologic complication in children with coronavirus disease 2019 (COVID-19). This study aimed to identify differences in clinical characteristics and disease burden between FS with and without COVID-19. MATERIALS AND METHODS We conducted a retrospective analysis of medical data at our hospital from December 2019 to July 2023, focusing on hospitalized patients under the age of 14 diagnosed with FS who underwent COVID-19 polymerase chain reaction (PCR) testing. Descriptive statistics and analysis of variance were employed to compare the COVID-19 and non-COVID-19 groups in terms of clinical characteristics and disease burden. RESULTS A total of 514 patients were included, with 106 testing positive for COVID-19 and 408 testing negative. Patients with COVID-19 were older (34.87 ± 6.16 vs. 28.61 ± 11.35 months, P < 0.001) and had a higher proportion of males (79.2% vs. 62.3%, P = 0.001). The COVID-19 group had longer seizure durations (4.57 ± 4.38 vs. 3.22 ± 2.91 min, P = 0.006) and more complex FS (25.5% vs. 15.9%, P = 0.022). Laboratory tests showed lower lymphocyte counts in the COVID-19 group (1.87 ± 1.48 vs. 2.75 ± 1.51 × 103/µL, P < 0.001) and higher creatine kinase levels (158.49 ± 82.89 vs. 110.89 ± 56.11 U/L, P < 0.001). No significant differences were found in hospital costs, length of hospitalization, and intensive care unit admissions. CONCLUSION Clinicians should be knowledgeable about the distinct clinical characteristics of FS in children with COVID-19. Despite distinct features, the prognosis remains favorable and does not require excessive intervention. Ongoing monitoring and research are needed to fully understand the impact of COVID-19 on FS and optimize management strategies.
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Affiliation(s)
- Zhongli Jiang
- Department of Pediatrics, Liyang People's Hospital, Liyang, China
| | - Cuiyun Fang
- Department of Nursing, Liyang People's Hospital, Liyang, China
| | - Fengyimei Peng
- Department of Pediatrics, Liyang People's Hospital, Liyang, China
| | - Wei Fan
- Department of Pediatrics, Liyang People's Hospital, Liyang, China.
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Żak K, Starek E, Korga-Plewko A, Rasoul-Pelińska K, Abramiuk M, Michalczuk M, Rajtak A, Kotarski J, Frankowska K, Bis L, Ostrowska-Leśko M, Bobiński M. Assessment of the Impact of SARS-CoV-2 Infection on the Sexual Function of Women, Levels of Oxytocin and Prolactin: A Prospective Cohort Study. J Clin Med 2024; 13:2230. [PMID: 38673504 PMCID: PMC11051359 DOI: 10.3390/jcm13082230] [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: 02/23/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
(1) Background: There is a lack of direct evidence on whether SARS-CoV-2 affects women's sexual function through a biological-organic mechanism. Existing studies on the topic are few and have produced contradictory results. This study aims to explore the possible relationship between sex hormones and sexual function in patients who have been infected with SARS-CoV-2. Moreover, we aimed to determine whether these changes are related to the clinical course of COVID-19 and whether they are temporary or long-lasting. (2) Methods: A study was conducted on 104 women, including 64 women infected with COVID-19 and a control group of 40 healthy women, between January 2021 and August 2022. Blood samples were collected to measure prolactin and oxytocin levels, and a clinical assessment was performed 3 and 6 months later. Sexual function self-assessment was captured based on the FSFI scale. (3) Results: Our study found that patients with severe COVID-19 had better sexual satisfaction scores one month after recovery but no discernible difference after six months. High levels of serum prolactin were observed in patients with active COVID-19 but became similar to a control group after one month and remained stable over time. Higher prolactin levels were significantly associated with increased arousal and hydration. Individuals with severe COVID-19 had notably low levels of plasma oxytocin, but there was no correlation between oxytocin levels and sexual satisfaction. (4) Conclusions: The gynecologic symptoms, as well as disturbances in oxytocin and prolactin levels, might be observed in a short time after infection. However, SARS-CoV-2 infection has no lasting effect on sexual function, oxytocin, and prolactin levels among women.
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Affiliation(s)
- Klaudia Żak
- Department of Medical Chemistry, Medical University of Lublin, 20-059 Lublin, Poland
| | - Ernest Starek
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
| | - Agnieszka Korga-Plewko
- Independent Medical Biology Unit, Medical University of Lublin, 20-090 Lublin, Poland; (A.K.-P.); (M.M.)
| | - Karolina Rasoul-Pelińska
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
| | - Monika Abramiuk
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
- Independent Laboratory of Minimally Invasive Gynecology and Gynecological Endocrinology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Mariola Michalczuk
- Independent Medical Biology Unit, Medical University of Lublin, 20-090 Lublin, Poland; (A.K.-P.); (M.M.)
| | - Alicja Rajtak
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
| | - Jan Kotarski
- Independent Laboratory of Cancer Diagnostics and Immunology, Medical University in Lublin, 20-081 Lublin, Poland;
| | - Karolina Frankowska
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
| | - Liliana Bis
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
| | - Marta Ostrowska-Leśko
- Chair and Department of Toxicology, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Marcin Bobiński
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
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Schwartz CE, Borowiec K, Li Y, Rapkin BD. Individual differences in the long-term impact of the pandemic: moderators of COVID-related hardship, worry, and social support. Qual Life Res 2024; 33:927-939. [PMID: 38183562 DOI: 10.1007/s11136-023-03573-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 01/08/2024]
Abstract
PURPOSE Understanding people's response to the pandemic needs to consider individual differences in priorities and concerns. The present study sought to understand how individual differences in cognitive-appraisal processes might moderate the impact of three COVID-specific factors-hardship, worry, and social support-on reported depression. METHODS This longitudinal study of the psychosocial impact of the COVID-19 pandemic included 771 people with data at three timepoints over 15.5 months. Participants were recruited from panels of chronically ill or general population samples. Depression was measured by an item response theory validated depression index created using items from existing measures that reflected similar content to the Patient Health Questionnaire-8. COVID-specific factors of hardship, worry, and social support were assessed with items compiled by the National Institutes of Health. The Quality of Life Appraisal Profilev2 Short-Form assessed cognitive appraisal processes. A series of random effects models examined whether appraisal moderated the effects of hardship, worry, and social support on depression over time. RESULTS Over time the association between low social support and depression was greater (p = 0.0181). Emphasizing the negative was associated with exacerbated depression, in particular for those with low social support (p = 0.0007). Focusing on demands and habituation was associated with exacerbated depression unless one experienced greater hardship (p = 0.0074). There was a stronger positive connection between recent changes and depression for those people with higher worry scores early in the pandemic as compared to later, but a stronger positive correlation for those with lower worry scores later in the pandemic (p = 0.0015). Increased endorsement of standards of comparison, emphasizing the negative, problem goals, and health goals was associated with worse depression scores (all p < 0.0001). People who were younger, disabled, or had greater difficulty paying bills also reported worse depression (p < 0.0001, 0.0001, and 0.002, respectively). CONCLUSION At the aggregate level, COVID-specific stressors changed over the course of the pandemic, whereas depression and social-support resources seemed stable. However, deeper analysis revealed substantial individual differences. Cognitive-appraisal processes showed considerable variability across individuals and moderated the impact of COVID-specific stressors and resources over time. Future work is needed to investigate whether coaching individuals away from maladaptive cognitive-appraisal processes can reduce depression and lead to better overall well-being.
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Affiliation(s)
- Carolyn E Schwartz
- DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, USA.
- Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USA.
| | - Katrina Borowiec
- DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, USA
- Department of Measurement, Evaluation, Statistics, & Assessment, Boston College Lynch School of Education and Human Development, Chestnut Hill, MA, USA
| | - Yuelin Li
- Department of Psychiatry & Behavioral Sciences and the Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bruce D Rapkin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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10
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Lidenge SJ, Yalcin D, Bennett SJ, Ngalamika O, Kweyamba BB, Mwita CJ, Tso FY, Mwaiselage J, West JT, Wood C. Viral Epitope Scanning Reveals Correlation between Seasonal HCoVs and SARS-CoV-2 Antibody Responses among Cancer and Non-Cancer Patients. Viruses 2024; 16:448. [PMID: 38543814 PMCID: PMC10975915 DOI: 10.3390/v16030448] [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: 01/27/2024] [Revised: 02/23/2024] [Accepted: 03/09/2024] [Indexed: 04/01/2024] Open
Abstract
Seasonal coronaviruses (HCoVs) are known to contribute to cross-reactive antibody (Ab) responses against SARS-CoV-2. While these responses are predictable due to the high homology between SARS-CoV-2 and other CoVs, the impact of these responses on susceptibility to SARS-CoV-2 infection in cancer patients is unclear. To investigate the influence of prior HCoV infection on anti-SARS-CoV-2 Ab responses among COVID-19 asymptomatic individuals with cancer and controls without cancers, we utilized the VirScan technology in which phage immunoprecipitation and sequencing (PhIP-seq) of longitudinal plasma samples was performed to investigate high-resolution (i.e., epitope level) humoral CoV responses. Despite testing positive for anti-SARS-CoV-2 Ab in the plasma, a majority of the participants were asymptomatic for COVID-19 with no prior history of COVID-19 diagnosis. Although the magnitudes of the anti-SARS-CoV-2 Ab responses were lower in individuals with Kaposi sarcoma (KS) compared to non-KS cancer individuals and those without cancer, the HCoV Ab repertoire was similar between individuals with and without cancer independent of age, sex, HIV status, and chemotherapy. The magnitudes of the anti-spike HCoV responses showed a strong positive association with those of the anti-SARS-CoV-2 spike in cancer patients, and only a weak association in non-cancer patients, suggesting that prior infection with HCoVs might play a role in limiting SARS-CoV-2 infection and COVID-19 disease severity.
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Affiliation(s)
- Salum J. Lidenge
- Department of Clinical Research, Training, and Consultancy, Ocean Road Cancer Institute, Dar es Salaam P.O. Box 3592, Tanzania; (S.J.L.); (B.B.K.); (J.M.)
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
| | - Dicle Yalcin
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA; (D.Y.); (S.J.B.); (F.Y.T.); (J.T.W.)
| | - Sydney J. Bennett
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA; (D.Y.); (S.J.B.); (F.Y.T.); (J.T.W.)
- School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE 68516, USA
| | - Owen Ngalamika
- Dermatology and Venereology Division, University Teaching Hospital, University of Zambia School of Medicine, Lusaka P.O. Box 50001, Zambia;
| | - Brenda B. Kweyamba
- Department of Clinical Research, Training, and Consultancy, Ocean Road Cancer Institute, Dar es Salaam P.O. Box 3592, Tanzania; (S.J.L.); (B.B.K.); (J.M.)
| | - Chacha J. Mwita
- Department of Clinical Research, Training, and Consultancy, Ocean Road Cancer Institute, Dar es Salaam P.O. Box 3592, Tanzania; (S.J.L.); (B.B.K.); (J.M.)
| | - For Yue Tso
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA; (D.Y.); (S.J.B.); (F.Y.T.); (J.T.W.)
| | - Julius Mwaiselage
- Department of Clinical Research, Training, and Consultancy, Ocean Road Cancer Institute, Dar es Salaam P.O. Box 3592, Tanzania; (S.J.L.); (B.B.K.); (J.M.)
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
| | - John T. West
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA; (D.Y.); (S.J.B.); (F.Y.T.); (J.T.W.)
| | - Charles Wood
- Department of Interdisciplinary Oncology, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA; (D.Y.); (S.J.B.); (F.Y.T.); (J.T.W.)
- School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE 68516, USA
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11
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Andersson C, Berman AH, Lindfors P, Bendtsen M. Effects of COVID-19 contagion in cohabitants and family members on mental health and academic self-efficacy among university students in Sweden: a prospective longitudinal study. BMJ Open 2024; 14:e077396. [PMID: 38479749 PMCID: PMC10936505 DOI: 10.1136/bmjopen-2023-077396] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 03/01/2024] [Indexed: 12/28/2024] Open
Abstract
OBJECTIVE This study used causal inference to estimate the longitudinal effects of contagion in cohabitants and family members on university students' mental health and academic self-efficacy during the COVID-19 pandemic. DESIGN A prospective longitudinal study including a baseline online measurement in May 2020, and online follow-ups after 5 months and 10 months. Participants were recruited through open-access online advertising. SETTING Public universities and university colleges in Sweden. PARTICIPANTS The analytical sample included 2796 students. OUTCOME MEASURES Contagion in cohabitants and in family members was assessed at baseline and at the 5-month follow-up. Mental health and academic self-efficacy were assessed at the 5-month and 10-month follow-ups. RESULTS Mild symptoms reported in cohabitants at baseline resulted in negative mental health effects at follow-up 5 months later, and mild baseline symptoms in family members resulted in negative effects on academic self-efficacy at follow-ups both 5 and 10 months later. CONCLUSIONS Notwithstanding the lack of precision in estimated effects, the findings emphasise the importance of social relationships and the challenges of providing students with sufficient support in times of crisis.
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Affiliation(s)
| | - Anne H Berman
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Petra Lindfors
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
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12
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Ghanbari‐Jahromi M, Kharazmi E, Bastani P, Shams M, Marzaleh MA, Amin Bahrami M. Factors disrupting the continuity of care for patients with chronic disease during the pandemics: A systematic review. Health Sci Rep 2024; 7:e1881. [PMID: 38384975 PMCID: PMC10879648 DOI: 10.1002/hsr2.1881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/21/2023] [Accepted: 01/16/2024] [Indexed: 02/23/2024] Open
Abstract
Background and Aims Continuous routine care is necessary to prevent long-term complications of chronic diseases and improve patients' health conditions. This review study was conducted to determine the factors disrupting continuity of care for patients with chronic diseases during the pandemic. Methods All original articles published on factors disrupting continuity of care for patients with chronic disease during a pandemic between December 2019 and June 28, 2023, in PubMed, Web of Science, Scopus, and ProQuest databases were searched. Selection of articles, data extraction, and qualitative evaluation of articles (through STROBE and COREQ checklist) were done by two researchers separately. Data graphing form was used to extract the data of each study and then the data were classified by thematic analysis method. Results Out of 1708 articles reviewed from the databases, 22 were included. The factors disrupting the continuity of care for patients with chronic diseases during the epidemics were classified into two main categories: patient-side factors and health system-side factors. Patient-side factors including psychological, individual and social, disease-related, and health system-side factors including provider access, health system institutional, and infrastructural and financial problems were among the subcategories disrupting the continuity of care for patients with chronic diseases during the pandemic. Based on the studies, psychological factors and access to the provider were among the most frequent factors affecting the continuity of care for patients with chronic diseases in the pandemic. Conclusion Considering the factors disrupting the continuity of care and applying appropriate interventions based on them, can guarantee the continuity of providing services to chronic patients in health crises.
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Affiliation(s)
- Mohadeseh Ghanbari‐Jahromi
- Department of Healthcare Management, Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Erfan Kharazmi
- Department of Healthcare Management, Health Human Resources Research Center, School of Health Management and Information SciencesShiraz University of Medical SciencesShirazIran
| | - Peivand Bastani
- College of Business, Government and LawFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Mesbah Shams
- Department of Internal Medicine, Endocrinology and Metabolism Research CenterShiraz University of Medical SciencesShirazIran
| | - Milad Ahmadi Marzaleh
- Department of Health in Disasters and Emergencies, School of Health Management and Information SciencesShiraz University of Medical SciencesShirazIran
| | - Mohammad Amin Bahrami
- Department of Healthcare Management, Health Human Resources Research Center, School of Health Management and Information SciencesShiraz University of Medical SciencesShirazIran
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13
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Hokstad A, Thommessen B, Ihle-Hansen H, Indredavik B, Døhl Ø, Askim T. Reduced physical activity level was associated with poorer quality of life during the early phase of the COVID-19 pandemic: a sub-study of the last-long trial. J Rehabil Med 2023; 55:jrm12352. [PMID: 38058014 PMCID: PMC10719864 DOI: 10.2340/jrm.v55.12352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/20/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVES To assess how physical activity levels changed in a stroke cohort during the COVID-19 (SARS-CoV-2) pandemic, and how these changes were associated with quality of life (QoL). METHODS Between March and July 2021, 150 patients with stroke already included in the Life after Stroke (LAST-long) trial in Norway were invited to participate in this cross-sectional survey. Participants were asked to complete a questionnaire assessing changes in physical activity and self-reported health following the pandemic. Univariate and multivariate logistic regression analyses were used to explore the association between physical activity, loneliness, mental health, social activity and QoL. RESULTS In all, 118 (79%) participants completed the questionnaire. A total of 80 (68%) reported less physical activity, 46 (39%) felt lonelier, and 43 (37%) reported worse mental health, while 50 (42%) reported reduced QoL compared with before the lockdown. In the univariate analyses less physical activity, feeling lonelier and changes in mental health were associated with reduced QoL. In the multivariate analysis only less physical activity odds ratio (OR) = 4.04 (95% confidence interval (95% CI) 1.44-11.34, p = 0.008) was significantly associated with reduced QoL. CONCLUSION More than two-thirds of patients with stroke reported reduced physical activity during the COVID-19 pandemic, and less physical activity was strongly associated with reduced QoL.
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Affiliation(s)
- Anne Hokstad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
| | - Bente Thommessen
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Håkon Ihle-Hansen
- Stroke Unit, Medical Department, Bærum Hospital, Vestre Viken Hospital Trust
| | - Bent Indredavik
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Stroke, Clinic of Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department Department of Medical Quality Registries, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Øystein Døhl
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Finance, City of Trondheim, Norway
| | - Torunn Askim
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
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14
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Shaikh AA, Mubasher TA, Makkawi MH, Alasmari SZ. Predictive value of ferritin, glucose, urea, and creatinine for COVID-19 severity and mortality in patients from Asir, Saudi Arabia. Saudi Med J 2023; 44:773-781. [PMID: 37582571 PMCID: PMC10425619 DOI: 10.15537/smj.2023.44.8.20230162] [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: 03/04/2023] [Accepted: 07/11/2023] [Indexed: 08/17/2023] Open
Abstract
OBJECTIVES To correlate demographics, blood groupings, and laboratory characteristics of hospitalized COVID-19 patients with disease severity and outcomes. METHODS This study included 294 COVID-19 patients. Data on patient age, gender, laboratory results, clinical severity, mortality, comorbidities, and blood group were obtained from medical records retrospectively. RESULTS High levels of ferritin (p<0.01), urea (p<0.0001), and creatinine (p<0.05) were detected in intensive care unit (ICU)-admitted patients. Ferritin (p<0.05), glucose (p<0.0001), urea (p<0.0001), and creatinine (p<0.0001) were significantly higher in non-survivor compared to survivor COVID-19 patients. Predictors for ICU admission among patients were ferritin (odd ratio [OR]=0.999, p=0.0055) and urea (OR=0.991, p=0.0001). Predictors for mortality were: age (OR=0.963, p=0.0001), ferritin (OR=0.999, p=0.0149), glucose (OR=0.993, p=0.0001), urea (OR=0.976, p=0.0001), and creatinine (OR=0.556, p=0.0001). The most reliable laboratory parameters in predicting mortality were: age (area under the curve [AUC]=0.685, p<0.0001), ferritin (AUC=0.610, p<0.05), glucose (AUC=0.681, p<0.0001), urea (AUC=0.856, p<0.0001), and creatinine (AUC=0.823, p<0.0001). CONCLUSION High ferritin, glucose, urea, and creatinine levels may predict poor outcomes in COVID-19 patients. These findings could help predict admissions to the ICU and mortality among such patients.
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Affiliation(s)
- Ahmad A. Shaikh
- From the the Department of Clinical Laboratory Sciences (Shaikh, Makkawi, Alasmari), Faculty of Applied Medical Sciences, King Khalid University, and from the Department of Clinical Laboratory (Mubasher), Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
| | - Turki A. Mubasher
- From the the Department of Clinical Laboratory Sciences (Shaikh, Makkawi, Alasmari), Faculty of Applied Medical Sciences, King Khalid University, and from the Department of Clinical Laboratory (Mubasher), Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
| | - Mohammed H. Makkawi
- From the the Department of Clinical Laboratory Sciences (Shaikh, Makkawi, Alasmari), Faculty of Applied Medical Sciences, King Khalid University, and from the Department of Clinical Laboratory (Mubasher), Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
| | - Sultan Z. Alasmari
- From the the Department of Clinical Laboratory Sciences (Shaikh, Makkawi, Alasmari), Faculty of Applied Medical Sciences, King Khalid University, and from the Department of Clinical Laboratory (Mubasher), Asir Central Hospital, Abha, Kingdom of Saudi Arabia.
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15
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Valero-Bover D, Monterde D, Carot-Sans G, Cainzos-Achirica M, Comin-Colet J, Vela E, Clèries M, Folguera J, Abilleira S, Arrufat M, Lejardi Y, Solans Ò, Dedeu T, Coca M, Pérez-Sust P, Pontes C, Piera-Jiménez J. Is Age the Most Important Risk Factor in COVID-19 Patients? The Relevance of Comorbidity Burden: A Retrospective Analysis of 10,551 Hospitalizations. Clin Epidemiol 2023; 15:811-825. [PMID: 37408865 PMCID: PMC10319286 DOI: 10.2147/clep.s408510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/26/2023] [Indexed: 07/07/2023] Open
Abstract
Purpose To assess the contribution of age and comorbidity to the risk of critical illness in hospitalized COVID-19 patients using increasingly exhaustive tools for measuring comorbidity burden. Patients and Methods We assessed the effect of age and comorbidity burden in a retrospective, multicenter cohort of patients hospitalized due to COVID-19 in Catalonia (North-East Spain) between March 1, 2020, and January 31, 2022. Vaccinated individuals and those admitted within the first of the six COVID-19 epidemic waves were excluded from the primary analysis but were included in secondary analyses. The primary outcome was critical illness, defined as the need for invasive mechanical ventilation, transfer to the intensive care unit (ICU), or in-hospital death. Explanatory variables included age, sex, and four summary measures of comorbidity burden on admission extracted from three indices: the Charlson index (17 diagnostic group codes), the Elixhauser index and count (31 diagnostic group codes), and the Queralt DxS index (3145 diagnostic group codes). All models were adjusted by wave and center. The proportion of the effect of age attributable to comorbidity burden was assessed using a causal mediation analysis. Results The primary analysis included 10,551 hospitalizations due to COVID-19; of them, 3632 (34.4%) experienced critical illness. The frequency of critical illness increased with age and comorbidity burden on admission, irrespective of the measure used. In multivariate analyses, the effect size of age decreased with the number of diagnoses considered to estimate comorbidity burden. When adjusting for the Queralt DxS index, age showed a minimal contribution to critical illness; according to the causal mediation analysis, comorbidity burden on admission explained the 98.2% (95% CI 84.1-117.1%) of the observed effect of age on critical illness. Conclusion Comorbidity burden (when measured exhaustively) explains better than chronological age the increased risk of critical illness observed in patients hospitalized with COVID-19.
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Affiliation(s)
- Damià Valero-Bover
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
| | - David Monterde
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
- Catalan Institute of Health, Barcelona, Spain
| | - Gerard Carot-Sans
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
| | - Miguel Cainzos-Achirica
- Center for Outcomes Research, Houston Methodist, Houston, TX, USA
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Josep Comin-Colet
- Cardiology Department, Bellvitge University Hospital (IDIBELL), Barcelona, Spain
- Department of Medicine, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain
- CIBER Cardiovascular (CIBERCV), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Emili Vela
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
| | - Montse Clèries
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
| | - Júlia Folguera
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
| | - Sònia Abilleira
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | | | - Òscar Solans
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
- Health Department, eHealth Unit, Barcelona, Spain
| | - Toni Dedeu
- WHO European Centre for Primary Health Care, Almaty, Kazakhstan
| | - Marc Coca
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
| | | | - Caridad Pontes
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
- Department of Pharmacology, Autonomous University of Barcelona, Barcelona, Spain
| | - Jordi Piera-Jiménez
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
- Faculty of Informatics, Telecommunications and Multimedia, Universitat Oberta de Catalunya, Barcelona, Spain
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16
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Vulnerability in context; hard numbers, tricky words and grey areas for gerontology. J Aging Stud 2023; 65. [PMCID: PMC10036039 DOI: 10.1016/j.jaging.2023.101131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
At the start of the COVID-19 pandemic, the Portuguese government identified those aged 70 or more as a risk group, placing a special duty of protection on them to shelter-at-home. This paper asks how Portuguese municipalities, using Facebook posts, communicated the risk to older adults and to what extent ageist stereotypes were found in the language and frames employed. Over 3800 Facebook posts made by Portuguese municipalities concerning older adults and COVID-19 published between March and July 2020 were analyzed. Language counts for age-related words were used in a first round of content analysis followed by a process of thematic analysis. Findings indicate that the language used to address Portuguese older adults could be understood as ageist in terms of homogenizing older people as a fixed group. The communication of risk was often conflated with the vulnerability narrative already observed in the extant literature. However, context- and culture-specific themes of ‘solidarity’, ‘inter-relatedness’, ‘duty of care’ and ‘support for those living in isolation’ were also found. The study highlights the extent to which language, culture and context are intertwined with our understanding of age, aging and ageism. It provides a culturally-specific case study, which challenges both gerontological interpretations of vulnerability and neoliberal frames which focus responsibility on the individual regardless of age. We argue that these alternative frames echo the emerging discourse of mutual aid and solidarity, providing a wider context for addressing vulnerability in a health crisis.
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Bakakos A, Koukaki E, Ampelioti S, Ioannidou I, Papaioannou AI, Loverdos K, Koutsoukou A, Rovina N. The Real Impact of Age on Mortality in Critically Ill COVID-19 Patients. J Pers Med 2023; 13:908. [PMID: 37373897 DOI: 10.3390/jpm13060908] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/26/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE The impact of severe infection from COVID-19 and the resulting need for life support in an ICU environment is a fact that caused immense pressure in healthcare systems around the globe. Accordingly, elderly people faced multiple challenges, especially after admission to the ICU. On this basis, we performed this study to assess the impact of age on COVID-19 mortality in critically ill patients. MATERIALS AND METHODS In this retrospective study, we collected data from 300 patients who were hospitalized in the ICU of a Greek respiratory hospital. We split patients into two age groups using a threshold of 65 years old. The primary objective of the study was the survival of patients in a follow up period of 60 days after their admission to the ICU. Secondary objectives were to determine whether mortality is affected by other factors, including sepsis and clinical and laboratory factors, Charlson Comorbidity Index (CCI), APACHE II and d-dimers, CRP, etc. Results: The survival of all patients in the ICU was 75.7%. Those in the <65 years old age group expressed a survival rate of 89.3%, whereas those in the ≥65 years old age group had a survival rate of 58% (p-value < 0.001). In the multivariate Cox regression, the presence of sepsis and an increased CCI were independent predictors of mortality in 60 days (p-value < 0.001), while the age group did not maintain its statistical significance (p-value = 0.320). CONCLUSIONS Age alone as a simple number is not capable of predicting mortality in patients with severe COVID-19 in the ICU. We must use more composite clinical markers that may better reflect the biological age of patients, such as CCI. Moreover, the effective control of infections in the ICU is of utmost importance for the survival of patients, since avoiding septic complications can drastically improve the prognosis of all patients, regardless of age.
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Affiliation(s)
- Agamemnon Bakakos
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Evangelia Koukaki
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Sevasti Ampelioti
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Iliana Ioannidou
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Andriana I Papaioannou
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Konstantinos Loverdos
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Antonia Koutsoukou
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikoleta Rovina
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
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18
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Ciski M, Rząsa K. Multiscale Geographically Weighted Regression in the Investigation of Local COVID-19 Anomalies Based on Population Age Structure in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105875. [PMID: 37239602 DOI: 10.3390/ijerph20105875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
A growing number of various studies focusing on different aspects of the COVID-19 pandemic are emerging as the pandemic continues. Three variables that are most commonly used to describe the course of the COVID-19 pandemic worldwide are the number of confirmed SARS-CoV-2 cases, the number of confirmed COVID-19 deaths, and the number of COVID-19 vaccine doses administered. In this paper, using the multiscale geographically weighted regression, an analysis of the interrelationships between the number of confirmed SARS-CoV-2 cases, the number of confirmed COVID-19 deaths, and the number of COVID-19 vaccine doses administered were conducted. Furthermore, using maps of the local R2 estimates, it was possible to visualize how the relations between the explanatory variables and the dependent variables vary across the study area. Thus, analysis of the influence of demographic factors described by the age structure and gender breakdown of the population over the course of the COVID-19 pandemic was performed. This allowed the identification of local anomalies in the course of the COVID-19 pandemic. Analyses were carried out for the area of Poland. The results obtained may be useful for local authorities in developing strategies to further counter the pandemic.
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Affiliation(s)
- Mateusz Ciski
- Faculty of Geoengineering, Institute of Spatial Management and Geography, Department of Socio-Economic Geography, University of Warmia and Mazury in Olsztyn, 10-720 Olsztyn, Poland
| | - Krzysztof Rząsa
- Faculty of Geoengineering, Institute of Spatial Management and Geography, Department of Socio-Economic Geography, University of Warmia and Mazury in Olsztyn, 10-720 Olsztyn, Poland
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19
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Topuz K, Davazdahemami B, Delen D. A Bayesian belief network-based analytics methodology for early-stage risk detection of novel diseases. ANNALS OF OPERATIONS RESEARCH 2023:1-25. [PMID: 37361089 PMCID: PMC10189691 DOI: 10.1007/s10479-023-05377-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 06/28/2023]
Abstract
During a pandemic, medical specialists have substantial challenges in discovering and validating new disease risk factors and designing effective treatment strategies. Traditionally, this approach entails several clinical studies and trials that might last several years, during which strict preventive measures are enforced to manage the outbreak and limit the death toll. Advanced data analytics technologies, on the other hand, could be utilized to monitor and expedite the procedure. This research integrates evolutionary search algorithms, Bayesian belief networks, and innovative interpretation techniques to provide a comprehensive exploratory-descriptive-explanatory machine learning methodology to assist clinical decision-makers in responding promptly to pandemic scenarios. The proposed approach is illustrated through a case study in which the survival of COVID-19 patients is determined using inpatient and emergency department (ED) encounters from a real-world electronic health record database. Following an exploratory phase in which genetic algorithms are used to identify a set of the most critical chronic risk factors and their validation using descriptive tools based on the concept of Bayesian Belief Nets, the framework develops and trains a probabilistic graphical model to explain and predict patient survival (with an AUC of 0.92). Finally, a publicly available online, probabilistic decision support inference simulator was constructed to facilitate what-if analysis and aid general users and healthcare professionals in interpreting model findings. The results widely corroborate intensive and expensive clinical trial research assessments.
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Affiliation(s)
- Kazim Topuz
- Collins College of Business, School of Finance and Operations Management, The University of Tulsa, Tulsa, USA
| | - Behrooz Davazdahemami
- Department of IT and Supply Chain Management, University of Wisconsin-Whitewater, 809 W. Starin Rd., Hyland Hall 1222, Whitewater, USA
| | - Dursun Delen
- Center for Health Systems Innovation, Spears School of Business, Oklahoma State University, Stillwater, USA
- Faculty of Engineering and Natural Sciences, Istinye University, Istanbul, Turkey
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20
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Snooks H, Watkins A, Lyons J, Akbari A, Bailey R, Bethell L, Carson-Stevens A, Edwards A, Emery H, Evans BA, Jolles S, John A, Kingston M, Porter A, Sewell B, Williams V, Lyons RA. Did the UK's public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in Wales? Results of EVITE Immunity, a linked data retrospective study. Public Health 2023; 218:12-20. [PMID: 36933354 PMCID: PMC9928733 DOI: 10.1016/j.puhe.2023.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION The UK shielding policy intended to protect people at the highest risk of harm from COVID-19 infection. We aimed to describe intervention effects in Wales at 1 year. METHODS Retrospective comparison of linked demographic and clinical data for cohorts comprising people identified for shielding from 23 March to 21 May 2020; and the rest of the population. Health records were extracted with event dates between 23 March 2020 and 22 March 2021 for the comparator cohort and from the date of inclusion until 1 year later for the shielded cohort. RESULTS The shielded cohort included 117,415 people, with 3,086,385 in the comparator cohort. The largest clinical categories in the shielded cohort were severe respiratory condition (35.5%), immunosuppressive therapy (25.9%) and cancer (18.6%). People in the shielded cohort were more likely to be female, aged ≥50 years, living in relatively deprived areas, care home residents and frail. The proportion of people tested for COVID-19 was higher in the shielded cohort (odds ratio [OR] 1.616; 95% confidence interval [CI] 1.597-1.637), with lower positivity rate incident rate ratios 0.716 (95% CI 0.697-0.736). The known infection rate was higher in the shielded cohort (5.9% vs 5.7%). People in the shielded cohort were more likely to die (OR 3.683; 95% CI: 3.583-3.786), have a critical care admission (OR 3.339; 95% CI: 3.111-3.583), hospital emergency admission (OR 2.883; 95% CI: 2.837-2.930), emergency department attendance (OR 1.893; 95% CI: 1.867-1.919) and common mental disorder (OR 1.762; 95% CI: 1.735-1.789). CONCLUSION Deaths and healthcare utilisation were higher amongst shielded people than the general population, as would be expected in the sicker population. Differences in testing rates, deprivation and pre-existing health are potential confounders; however, lack of clear impact on infection rates raises questions about the success of shielding and indicates that further research is required to fully evaluate this national policy intervention.
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Affiliation(s)
- H Snooks
- Swansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK.
| | - A Watkins
- Swansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK.
| | - J Lyons
- Population Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, Swansea, SA2 8PP, UK.
| | - A Akbari
- Population Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, Swansea, SA2 8PP, UK.
| | - R Bailey
- Population Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, Swansea, SA2 8PP, UK.
| | - L Bethell
- Swansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK.
| | - A Carson-Stevens
- Cardiff University, Division of Population Medicine, Neuadd Meirionnydd, University Hospital of Wales, Heath Park, Cardiff, CF14 4YS, UK.
| | - A Edwards
- Cardiff University, Division of Population Medicine, Neuadd Meirionnydd, University Hospital of Wales, Heath Park, Cardiff, CF14 4YS, UK.
| | - H Emery
- Swansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK.
| | - B A Evans
- Swansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK.
| | - S Jolles
- Immunodeficiency Centre for Wales, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK.
| | - A John
- Population Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, Swansea, SA2 8PP, UK.
| | - M Kingston
- Swansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK.
| | - A Porter
- Swansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK.
| | - B Sewell
- Swansea University, School of Health and Social Care, Vivian Tower, Singleton Park, Swansea, SA2 8PP, UK.
| | - V Williams
- Swansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK.
| | - R A Lyons
- Population Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, Swansea, SA2 8PP, UK.
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21
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Laatifi M, Douzi S, Ezzine H, Asry CE, Naya A, Bouklouze A, Zaid Y, Naciri M. Explanatory predictive model for COVID-19 severity risk employing machine learning, shapley addition, and LIME. Sci Rep 2023; 13:5481. [PMID: 37015978 PMCID: PMC10071246 DOI: 10.1038/s41598-023-31542-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/14/2023] [Indexed: 04/06/2023] Open
Abstract
The rapid spread of SARS-CoV-2 threatens global public health and impedes the operation of healthcare systems. Several studies have been conducted to confirm SARS-CoV-2 infection and examine its risk factors. To produce more effective treatment options and vaccines, it is still necessary to investigate biomarkers and immune responses in order to gain a deeper understanding of disease pathophysiology. This study aims to determine how cytokines influence the severity of SARS-CoV-2 infection. We measured the plasma levels of 48 cytokines in the blood of 87 participants in the COVID-19 study. Several Classifiers were trained and evaluated using Machine Learning and Deep Learning to complete missing data, generate synthetic data, and fill in any gaps. To examine the relationship between cytokine storm and COVID-19 severity in patients, the Shapley additive explanation (SHAP) and the LIME (Local Interpretable Model-agnostic Explanations) model were applied. Individuals with severe SARS-CoV-2 infection had elevated plasma levels of VEGF-A, MIP-1b, and IL-17. RANTES and TNF were associated with healthy individuals, whereas IL-27, IL-9, IL-12p40, and MCP-3 were associated with non-Severity. These findings suggest that these cytokines may promote the development of novel preventive and therapeutic pathways for disease management. In this study, the use of artificial intelligence is intended to support clinical diagnoses of patients to determine how each cytokine may be responsible for the severity of COVID-19, which could lead to the identification of several cytokines that could aid in treatment decision-making and vaccine development.
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Affiliation(s)
- Mariam Laatifi
- Laboratory of Biodiversity, Ecology and Genome, Department of Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Samira Douzi
- IPSS Laboratory, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
- Laboratory of Pharmacology and Toxicology, Pharmaceutical and Toxicological Analysis Research Team, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
| | - Hind Ezzine
- Laboratory of Biodiversity, Ecology and Genome, Department of Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
- Public Health International Consultant, Rabat, Morocco
| | - Chadia El Asry
- Faculty of Sciences, IPSS Laboratory, Mohammed V University, Rabat, Morocco
| | - Abdellah Naya
- Department of Biology, Immunology, and Biodiversity Laboratory, Faculty of Sciences Ain Chock, Hassan II University, Casablanca, Morocco
| | - Abdelaziz Bouklouze
- Laboratory of Pharmacology and Toxicology, Pharmaceutical and Toxicological Analysis Research Team, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Younes Zaid
- Laboratory of Biodiversity, Ecology and Genome, Department of Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
- Department of Biology, Immunology, and Biodiversity Laboratory, Faculty of Sciences Ain Chock, Hassan II University, Casablanca, Morocco
- Research Center of Abulcasis, University of Health Sciences, Rabat, Morocco
| | - Mariam Naciri
- Laboratory of Biodiversity, Ecology and Genome, Department of Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
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22
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Navarro-Soria I, Costa-López B, Collado-Valero JA, de Mier RJR, Lavigne-Cervan R. Anxiety, sleep habits and executive function during the COVID-19 pandemic through parents’ perception: a longitudinal study. PSICOLOGIA-REFLEXAO E CRITICA 2023; 36:8. [PMID: 36988724 PMCID: PMC10050808 DOI: 10.1186/s41155-023-00251-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
AbstractThe present study therefore aims to examine trait and state anxiety, sleep habits and executive functioning during 1 year and a half of the COVID-19 pandemic in children and adolescents through the lens of parents. Assessments were conducted at three different times: April 2020 (T1), October 2020 (T2) and October 2021 (T3). The main sample included 953 children and adolescents aged 6 to 18 years, and scales were used to assess anxiety (STAIC), sleep habits (BEARS) and executive functioning (BRIEF-2). The results showed that 6 months after the outbreak of the pandemic, state and trait anxiety, sleep disturbances and executive dysfunctions increased significantly. One and a half year later, trait anxiety and sleep disturbances have been maintained, while state anxiety and executive dysfunction have decreased their scores obtaining scores similar to those of April 2020. In conclusion, there has been a further decrease in children and adolescents’ mental health since the beginning of the pandemic, and it seems to remain at the present time, such as trait anxiety as a part of the personality.
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23
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Johnson BB, Kim B. Cross-temporal relations of conditional risk perception measures with protective actions against COVID-19. Soc Sci Med 2023; 324:115867. [PMID: 37040680 PMCID: PMC10029334 DOI: 10.1016/j.socscimed.2023.115867] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/21/2023] [Accepted: 03/20/2023] [Indexed: 03/24/2023]
Abstract
Two decades ago a research team clarified that cross-sectional associations of risk perceptions and protective behavior can only test an “accuracy” hypothesis: e.g., people with higher risk perceptions at Ti should also exhibit low protective behavior and/or high risky behavior at Ti. They argued that these associations are too often interpreted wrongly as testing two other hypotheses, only testable longitudinally: the “behavioral motivation” hypothesis, that high risk perception at Ti increases protective behavior at Ti+1, and the “risk reappraisal” hypothesis, that protective behavior at Ti reduces risk perception at Ti+1. Further, this team argued that risk perception measures should be conditional (e.g., personal risk perception if one's behavior does not change). Yet these theses have garnered relatively little empirical testing. An online longitudinal panel study of U.S. residents' COVID-19 views across six survey waves over 14 months in 2020–2021 tested these hypotheses for six behaviors (hand washing, mask wearing, avoiding travel to infected areas, avoiding large public gatherings, vaccination, and [for five waves] social isolation at home). Accuracy and behavioral motivation hypotheses were supported for both behaviors and intentions, excluding a few waves (particularly in February–April 2020, when the pandemic was new in the U.S.) and behaviors. The risk reappraisal hypothesis was contradicted—protective behavior at one wave increased risk perception later—perhaps reflecting continuing uncertainty about efficacy of COVID-19 protective behaviors and/or that dynamic infectious diseases may yield different patterns than chronic diseases dominating such hypothesis-testing. These findings raise intriguing questions for both perception-behavior theory and behavior change practice.
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Affiliation(s)
| | - Byungdoo Kim
- Department of Psychology, Norwegian University of Science and Technology, Norway
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24
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Muehlenbein M, Gassen J, Nowak T, Henderson A, Morris B, Weaver S, Baker E. Age-Dependent Relationships Between Disease Risk and Testosterone Levels: Relevance to COVID-19 Disease. Am J Mens Health 2023; 17:15579883221130195. [PMID: 36935555 PMCID: PMC10028446 DOI: 10.1177/15579883221130195] [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] [Indexed: 03/21/2023] Open
Abstract
Testosterone levels in men appear to be prognostic of a number of disease outcomes, including severe COVID-19 disease. Testosterone levels naturally decline with age and are lower in individuals with a number of comorbidities and chronic conditions. Low testosterone may therefore be both a cause and a consequence of illness, including COVID-19 disease. The present project examines whether preexisting conditions for severe COVID-19 disease were themselves related to serum-free testosterone levels in men who had not been infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. A clinical risk score for severe COVID-19 disease was computed based on the results of previously published meta-analyses and cohort studies, and relationships between this score and testosterone levels were tested in 142 men ages 19 to 82 years. Greater burden of preexisting conditions for severe COVID-19 disease was related to lower testosterone levels among men younger than 40 years of age. In older men, the decrease in testosterone that accompanies aging attenuated the effect of the clinical risk score on free testosterone levels. Given that older age itself is a predictor of COVID-19 disease severity, these results together suggest that the presence of preexisting conditions may confound the relationship between testosterone levels and COVID-19 disease outcomes in men. Future research examining relationships among testosterone and outcomes related to infectious and chronic diseases should consider potential confounds, such as the role of preexisting conditions.
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25
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Sahin AT, Yurtseven A, Dadmand S, Ozcan G, Akarlar BA, Kucuk NEO, Senturk A, Ergonul O, Can F, Tuncbag N, Ozlu N. Plasma proteomics identify potential severity biomarkers from COVID-19 associated network. Proteomics Clin Appl 2023; 17:e2200070. [PMID: 36217943 PMCID: PMC9874836 DOI: 10.1002/prca.202200070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/27/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Coronavirus disease 2019 (COVID-19) continues to threaten public health globally. Severe acute respiratory coronavirus type 2 (SARS-CoV-2) infection-dependent alterations in the host cell signaling network may unveil potential target proteins and pathways for therapeutic strategies. In this study, we aim to define early severity biomarkers and monitor altered pathways in the course of SARS-CoV-2 infection. EXPERIMENTAL DESIGN We systematically analyzed plasma proteomes of COVID-19 patients from Turkey by using mass spectrometry. Different severity grades (moderate, severe, and critical) and periods of disease (early, inflammatory, and recovery) are monitored. Significant alterations in protein expressions are used to reconstruct the COVID-19 associated network that was further extended to connect viral and host proteins. RESULTS Across all COVID-19 patients, 111 differentially expressed proteins were found, of which 28 proteins were unique to our study mainly enriching in immunoglobulin production. By monitoring different severity grades and periods of disease, CLEC3B, MST1, and ITIH2 were identified as potential early predictors of COVID-19 severity. Most importantly, we extended the COVID-19 associated network with viral proteins and showed the connectedness of viral proteins with human proteins. The most connected viral protein ORF8, which has a role in immune evasion, targets many host proteins tightly connected to the deregulated human plasma proteins. CONCLUSIONS AND CLINICAL RELEVANCE Plasma proteomes from critical patients are intrinsically clustered in a distinct group than severe and moderate patients. Importantly, we did not recover any grouping based on the infection period, suggesting their distinct proteome even in the recovery phase. The new potential early severity markers can be further studied for their value in the clinics to monitor COVID-19 prognosis. Beyond the list of plasma proteins, our disease-associated network unravels altered pathways, and the possible therapeutic targets in SARS-CoV-2 infection by connecting human and viral proteins. Follow-up studies on the disease associated network that we propose here will be useful to determine molecular details of viral perturbation and to address how the infection affects human physiology.
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Affiliation(s)
- Ayse Tugce Sahin
- Department of Molecular Biology and Genetics, Koc University, Istanbul, Turkey.,Graduate School of Science and Engineering, Koc University, Istanbul, Turkey
| | - Ali Yurtseven
- Department of Molecular Biology and Genetics, Koc University, Istanbul, Turkey.,Graduate School of Science and Engineering, Koc University, Istanbul, Turkey
| | - Sina Dadmand
- Graduate School of Science and Engineering, Koc University, Istanbul, Turkey.,Department of Chemical and Biological Engineering, Koc University, Istanbul, Turkey
| | - Gulin Ozcan
- Koc University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey.,Graduate School of Health Sciences, Koc University, Istanbul, Turkey
| | - Busra A Akarlar
- Department of Molecular Biology and Genetics, Koc University, Istanbul, Turkey.,Department of Chemical and Biological Engineering, Koc University, Istanbul, Turkey
| | - Nazli Ezgi Ozkan Kucuk
- Department of Molecular Biology and Genetics, Koc University, Istanbul, Turkey.,Department of Chemical and Biological Engineering, Koc University, Istanbul, Turkey
| | - Aydanur Senturk
- Department of Molecular Biology and Genetics, Koc University, Istanbul, Turkey
| | - Onder Ergonul
- Graduate School of Health Sciences, Koc University, Istanbul, Turkey.,Koc University Is Bank Research Center for Infectious Diseases (KUISCID), Istanbul, Turkey
| | - Fusun Can
- Graduate School of Health Sciences, Koc University, Istanbul, Turkey.,Department of Infectious Diseases, School of Medicine, Koc University, Istanbul, Turkey
| | - Nurcan Tuncbag
- Department of Chemical and Biological Engineering, Koc University, Istanbul, Turkey.,Department of Medical Microbiology, School of Medicine, Koc University, Istanbul, Turkey.,Department of Medical Biology, School of Medicine, Koc University, Istanbul, Turkey
| | - Nurhan Ozlu
- Department of Molecular Biology and Genetics, Koc University, Istanbul, Turkey.,Department of Chemical and Biological Engineering, Koc University, Istanbul, Turkey.,Department of Medical Biology, School of Medicine, Koc University, Istanbul, Turkey
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26
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Ismail M, Morden E, Hussey H, Paleker M, Jacobs T, Laenen I, Hunter M, Moodley M, Smith M, Mutemaringa T, Bam JL, Dane P, Heekes A, Boulle A, Davies MA. Evaluation of a public COVID-19 dashboard in the Western Cape, South Africa: a tool for communication, trust, and transparency. BMC Public Health 2022; 22:2453. [PMID: 36581823 PMCID: PMC9797888 DOI: 10.1186/s12889-022-14657-w] [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: 05/24/2022] [Accepted: 11/17/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Public health dashboards have been used in the past to communicate and guide local responses to outbreaks, epidemics, and a host of various health conditions. During the first year of the COVID-19 pandemic, dashboards proliferated but the availability and quality differed across the world. This study aimed to evaluate the quality, access, and end-user experience of one such dashboard in the Western Cape province, South Africa. METHODS We analysed retrospective aggregate data on viewership over time for the first year since launch of the dashboard (30 April 2020 - 29 April 2021) and conducted a cross-sectional survey targeting adult users of the dashboard at one year post the initial launch. The self-administered, anonymous questionnaire with a total of 13 questions was made available via an online digital survey tool for a 2-week period (6 May 2021 - 21 May 2021). RESULTS After significant communication by senior provincial political leaders, adequate media coverage and two waves of COVID-19 the Western Cape public COVID-19 dashboard attracted a total of 2,248,456 views during its first year. The majority of these views came from Africa/South Africa with higher median daily views during COVID-19 wave periods. A total of 794 participants responded to the survey questionnaire. Reported devices used to access the dashboard differed statistically between occupational status groups with students tending toward using mobile devices whilst employed and retired participants tending toward using desktop computers/laptops. Frequency of use increases with increasing age with 65.1% of those > 70 years old viewing it daily. Overall, 76.4% of respondents reported that the dashboard influenced their personal planning and behaviour. High Likert score ratings were given for clarity, ease of use and overall end-user experience, with no differences seen across the various age groups surveyed. CONCLUSION The study demonstrated that both the availability of data and an understanding of end-user need is critical when developing and delivering public health tools that may ultimately garner public trust and influence individual behaviour.
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Affiliation(s)
- Muzzammil Ismail
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa.
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Cape Town, South Africa.
| | - Erna Morden
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Cape Town, South Africa
| | - Hannah Hussey
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Cape Town, South Africa
| | - Masudah Paleker
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
- Division of Health Systems and Public Health, Stellenbosch University, Stellenbosch, South Africa
| | - Theuns Jacobs
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
| | - Inneke Laenen
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
- Division of Health Systems and Public Health, Stellenbosch University, Stellenbosch, South Africa
| | - Mehreen Hunter
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Cape Town, South Africa
| | - Melvin Moodley
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
| | - Mariette Smith
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Cape Town, South Africa
| | - Themba Mutemaringa
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Cape Town, South Africa
- Computational Biology Division, Integrative Biomedical Sciences Department, University of Cape Town, Cape Town, South Africa
| | - Jamy-Lee Bam
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
| | - Pierre Dane
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
- Centre for Infectious Disease Epidemiology and Research, Cape Town, South Africa
| | - Alexa Heekes
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
- Centre for Infectious Disease Epidemiology and Research, Cape Town, South Africa
| | - Andrew Boulle
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Cape Town, South Africa
- Centre for Infectious Disease Epidemiology and Research, Cape Town, South Africa
| | - Mary-Ann Davies
- Health Intelligence Directorate, Western Cape Government: Department of Health, Cape Town, South Africa
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Cape Town, South Africa
- Centre for Infectious Disease Epidemiology and Research, Cape Town, South Africa
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27
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Karuniawati A, Syam AF, Achmadsyah A, Ibrahim F, Rosa Y, Sudarmono P, Fadilah F, Rasmin M. Case series in Indonesia: B.1.617.2 (delta) variant of SARS-CoV-2 infection after a second dose of vaccine. World J Clin Cases 2022; 10:13216-13226. [PMID: 36683635 PMCID: PMC9851004 DOI: 10.12998/wjcc.v10.i36.13216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/09/2022] [Accepted: 07/31/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The B.1.617.2 (delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first discovered in Maharashtra in late 2020 and has rapidly expanded across India and worldwide. It took only 2 mo for this variant to spread in Indonesia, making the country the new epicenter of the delta variant as of July 2021. Despite efforts made by accelerating massive rollouts of current vaccines to protect against infection, cases of fully-vaccinated people infected with the delta variant have been reported.
AIM To describe the demographic statistics and clinical presentation of the delta variant infection after the second dose of vaccine in Indonesia.
METHODS A retrospective, single-centre case series of the general consecutive population that worked or studied at Faculty of Medicine, Universitas Indonesia with confirmed Delta Variant Infection after a second dose of vaccine from 24 June and 25 June 2021. Cases were collected retrospectively based on a combination of author recall, reverse transcription-polymerase chain reaction (RT-PCR), and whole genome sequencing results from the Clinical Microbiology Laboratory, Faculty of Medicine, Universitas Indonesia.
RESULTS Between 24 June and 25 June 2021, 15 subjects were confirmed with the B.1.617.2 (delta) variant infection after a second dose of the vaccine. Fourteen subjects were vaccinated with CoronaVac (Sinovac) and one subject with ChAdOx1 nCoV-19 (Oxford-AstraZeneca). All of the subjects remained in home isolation, with fever being the most common symptom at the onset of illness (n = 10, 66.67%). The mean duration of symptoms was 7.73 d (± 5.444). The mean time that elapsed from the first positive swab to a negative RT-PCR test for SARS-CoV-2 was 17.93 d (± 6.3464). The median time that elapsed from the second dose of vaccine to the first positive swab was 87 d (interquartile range: 86-128).
CONCLUSION Although this case shows that after two doses of vaccine, subjects are still susceptible to the delta variant infection, currently available vaccines remain the most effective protection. They reduce clinical manifestations of COVID-19, decrease recovery time from the first positive swab to negative swab, and lower the probability of hospitalization and mortality rate compared to unvaccinated individuals.
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Affiliation(s)
- Anis Karuniawati
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Jakarta Indonesia, Jakarta 10430, DKI Jaya, Indonesia
| | - Ari F Syam
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Jakarta Indonesia, Jakarta PUsat 10430, DKI Jaya, Indonesia
| | - Armand Achmadsyah
- Faculty of Medicine, Universits Indonesia, Jakarta Pusat 10430, DKI Jaya, Indonesia
| | - Fera Ibrahim
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Jakarta Indonesia, Jakarta 10430, DKI Jaya, Indonesia
| | - Yulia Rosa
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Jakarta Indonesia, Jakarta 10430, DKI Jaya, Indonesia
| | - Pratiwi Sudarmono
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Jakarta Indonesia, Jakarta 10430, DKI Jaya, Indonesia
| | - Fadilah Fadilah
- Department of Medical Chemistry, Faculty of Medicine, Universitas Indonesia, Jakarta Indonesia , Faculty of Medicine, Universitas Indonesia, Jakarta 10430, DKI Jaya, Indonesia
| | - Menaldi Rasmin
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia/Persahabatan Hospital, Jakarta Indonesia, Jakarta Pusat 10430, DKI Jaya, Indonesia
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Bentley SA, Ahmad S, Kobeissy FH, Toklu HZ. Concomitant Guillain-Barré Syndrome and COVID-19: A Meta-Analysis of Cases. Medicina (B Aires) 2022; 58:medicina58121835. [PMID: 36557036 PMCID: PMC9788175 DOI: 10.3390/medicina58121835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/03/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Background and Objectives: Recent findings demonstrate that the transmigration of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) to the nervous system implicates severe neurotropic pathologies, including the onset of the rare disease called Guillain-Barré syndrome (GBS) which is characterized by immune-mediated polyneuropathy. This study aimed to identify the predisposing factors and the clinical features of coronavirus disease 2019 (COVID-19)-induced GBS. Materials and Methods: We have performed an analysis of 147 cases. A systematic review of the published research work was performed per the PRISMA statement to obtain individual participant data (IPD) for the meta-analysis. The search was conducted through PubMed, using the combined search terms "Guillain-Barré syndrome" and "COVID-19". All case reports and series in the English language with accessed full text were included in the search. Results: A systematic database search led to the retrieval of 112 peer-reviewed articles published between 1 April 2020, and 8 February 2022. The articles comprised 16 case series and 96 case reports containing IPD for 147 patients. Our findings showed that 77.6% of all cases were 40 years or older. Males comprised most of the cases (65.3%; n = 96). The intensive care unit (ICU) admission was 44.9%, and the need for mechanical ventilation (MV) was 38.1%. The patients presented with hyporeflexia or areflexia (84.4%; n = 124), lower limb strength and sensation impairment (93.2%; n = 138), upper limb strength and sensation impairment (85.7; n = 126), and somatic sensation impairment (72.8%; n = 107). The patients presented with increased cerebral spinal fluid (CSF) protein levels (92%; n = 92) and the presence of CSF albuminocytological dissociation (83.5%; n = 71). The most common variant of GBS observed was acute inflammatory demyelinating polyneuropathy (AIDP). We found that predisposing factors concomitant with COVID-19 and GBS were male gender and older age. Among the cases, patient mortality was 10.9%. Conclusions: A gap of knowledge exists regarding the complete spectrum of clinical characteristics of COVID-19-related GBS. Recent findings suggest that SARS-CoV-2 triggers GBS, as it follows a similar para-infectious pattern as the other viral agents contributing to the onset of GBS.
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Affiliation(s)
- Skylar A. Bentley
- College of Health Sciences, University of Central Florida, Orlando, FL 32816, USA
- Burnette Honors College, University of Central Florida, Orlando, FL 32816, USA
| | - Sarfraz Ahmad
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA
- Advent Health Cancer Institute, Orlando, FL 32804, USA
| | - Firas H. Kobeissy
- Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, FL 32608, USA
- Correspondence: (F.H.K.); (H.Z.T.); Tel.: +1-352-328-4617 (F.H.K.); +1-352-562-2220 (H.Z.T.)
| | - Hale Z. Toklu
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA
- Correspondence: (F.H.K.); (H.Z.T.); Tel.: +1-352-328-4617 (F.H.K.); +1-352-562-2220 (H.Z.T.)
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Mohan AA, Olson LB, Naqvi IA, Morrison SA, Kraft BD, Chen L, Que LG, Ma Q, Barkauskas CE, Kirk A, Nair SK, Sullenger BA, Kasotakis G. Age and Comorbidities Predict COVID-19 Outcome, Regardless of Innate Immune Response Severity: A Single Institutional Cohort Study. Crit Care Explor 2022; 4:e0799. [PMID: 36506827 PMCID: PMC9726311 DOI: 10.1097/cce.0000000000000799] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic has claimed over eight hundred thousand lives in the United States alone, with older individuals and those with comorbidities being at higher risk of severe disease and death. Although severe acute respiratory syndrome coronavirus 2-induced hyperinflammation is one of the mechanisms underlying the high mortality, the association between age and innate immune responses in COVID-19 mortality remains unclear. DESIGN Flow cytometry of fresh blood and multiplexed inflammatory chemokine measurements of sera were performed on samples collected longitudinally from our cohort. Aggregate impact of comorbid conditions was calculated with the Charlson Comorbidity Index, and association between patient factors and outcomes was calculated via Cox proportional hazard analysis and repeated measures analysis of variance. SETTING A cohort of severely ill COVID-19 patients requiring ICU admission was followed prospectively. PATIENTS In total, 67 patients (46 male, age 59 ± 14 yr) were included in the study. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Mortality in our cohort was 41.8%. We identified older age (hazard ratio [HR] 1.09 [95% CI 1.07-1.11]; p = 0.001), higher comorbidity index (HR 1.24 [95% CI 1.14-1.35]; p = 0.039), and hyponatremia (HR 0.90 [95% CI 0.82-0.99]; p = 0.026) to each independently increase risk for death in COVID-19. We also found that neutrophilia (R = 0.2; p = 0.017), chemokine C-C motif ligand (CCL) 2 (R = 0.3; p = 0.043), and C-X-C motif chemokine ligand 9 (CXCL9) (R = 0.3; p = 0.050) were weakly but significantly correlated with mortality. Older age was associated with lower monocyte (R = -0.2; p = 0.006) and cluster of differentiation (CD) 16+ cell counts (R = -0.2; p = 0.002) and increased CCL11 concentration (R = 0.3; p = 0.050). Similarly, younger patients (< 65 yr) demonstrated a rise in CD4 (b-coefficient = 0.02; p = 0.036) and CD8 (0.01; p = 0.001) counts, as well as CCL20 (b-coefficient = 6.8; p = 0.036) during their ICU stay. This CD8 count rise was also associated with survival (b-coefficient = 0.01; p = 0.023). CONCLUSIONS Age, comorbidities, and hyponatremia independently predict mortality in severe COVID-19. Neutrophilia and higher CCL2 and CXCL9 levels are also associated with higher mortality, while independent of age.
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Affiliation(s)
| | - Lyra B Olson
- Department of Surgery, Duke University, Durham, NC
| | | | | | | | - Lingye Chen
- Department of Surgery, Duke University, Durham, NC
| | | | - Qing Ma
- Department of Surgery, Duke University, Durham, NC
| | | | - Allan Kirk
- Department of Surgery, Duke University, Durham, NC
| | - Smita K Nair
- Department of Surgery, Duke University, Durham, NC
- Departments of Neurosurgery and Pathology, Duke University, Durham, NC
| | - Bruce A Sullenger
- Department of Surgery, Duke University, Durham, NC
- Departments of Neurosurgery and Pathology, Duke University, Durham, NC
- Departments of Neurosurgery, Pharmacology, and Cancer Biology, Duke University, Durham, NC
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Chen Y, Song H, Liu S. Evaluations of COVID-19 epidemic models with multiple susceptible compartments using exponential and non-exponential distribution for disease stages. Infect Dis Model 2022; 7:795-810. [PMID: 36439948 PMCID: PMC9681122 DOI: 10.1016/j.idm.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
Mathematical models have wide applications in studying COVID-19 epidemic transmission dynamics, however, most mathematical models do not take into account the heterogeneity of susceptible populations and the non-exponential distribution infectious period. This paper attempts to investigate whether non-exponentially distributed infectious period can better characterize the transmission process in heterogeneous susceptible populations and how it impacts the control strategies. For this purpose, we establish two COVID-19 epidemic models with heterogeneous susceptible populations based on different assumptions for infectious period: the first one is an exponential distribution model (EDM), and the other one is a gamma distribution model (GDM); explicit formula of peak time of the EDM is presented via our analytical approach. By data fitting with the COVID-19 (Omicron) epidemic in Spain and Norway, it seems that Spain is more suitable for EDM while Norway is more suitable for GDM. Finally, we use EDM and GDM to evaluate the impaction of control strategies such as reduction of transmission rates, and increase of primary course rate (PCR) and booster dose rate (BDR).
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Affiliation(s)
- Yan Chen
- School of Mathematical Sciences, Tiangong University, Tianjin, 300387, China
| | - Haitao Song
- Complex Systems Research Center, Shanxi University, Taiyuan, 030006, China
| | - Shengqiang Liu
- School of Mathematical Sciences, Tiangong University, Tianjin, 300387, China
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Davazdahemami B, Zolbanin HM, Delen D. An explanatory analytics framework for early detection of chronic risk factors in pandemics. HEALTHCARE ANALYTICS (NEW YORK, N.Y.) 2022; 2:100020. [PMID: 37520623 PMCID: PMC8744302 DOI: 10.1016/j.health.2022.100020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/29/2021] [Accepted: 01/03/2022] [Indexed: 06/28/2023]
Abstract
Timely decision-making in national and global health emergencies such as pandemics is critically important from various aspects. Especially, early identification of risk factors of contagious viral diseases can lead to efficient management of limited healthcare resources and saving lives by prioritizing at-risk patients. In this study, we propose a hybrid artificial intelligence (AI) framework to identify major chronic risk factors of novel, contagious diseases as early as possible at the time of pandemics. The proposed framework combines evolutionary search algorithms with machine learning and the novel explanatory AI (XAI) methods to detect the most critical risk factors, use them to predict patients at high risk of mortality, and analyze the risk factors at the individual level for each high-risk patient. The proposed framework was validated using data from a repository of electronic health records of early COVID-19 patients in the US. A chronological analysis of the chronic risk factors identified using our proposed approach revealed that those factors could have been identified months before they were determined by clinical studies and/or announced by the United States health officials.
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Affiliation(s)
- Behrooz Davazdahemami
- Department of IT & Supply Chain Management, University of Wisconsin-Whitewater, United States
| | - Hamed M Zolbanin
- Department of MIS, Operations & Supply Chain Management, Business Analytics, University of Dayton, United States
| | - Dursun Delen
- Department of Management Science and Information Systems, Oklahoma State University, United States
- Center for Health Systems Innovation, Spears School of Business, Oklahoma State University, United States
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Yaseen ASA. Impact of social determinants on COVID-19 infections: a comprehensive study from Saudi Arabia governorates. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2022; 9:355. [PMID: 36249903 PMCID: PMC9540145 DOI: 10.1057/s41599-022-01208-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/19/2022] [Indexed: 06/16/2023]
Abstract
The last two years have been marked by the emergence of Coronavirus. The pandemic has spread in most countries, causing substantial changes all over the world. Many studies sought to analyze phenomena related to the pandemic from different perspectives. This study analyzes data from the governorates of the Kingdom of Saudi Arabia (the KSA), proposing a broad analysis that addresses three different research objectives. The first is to identify the main factors affecting the variations between KSA governorates in the cumulative number of COVID-19 infections. The study uses principal component regression. Results highlight the significant positive effects of the number of schools in each governorate, and classroom density within each school on the number of infections in the KSA. The second aim of this study is to use the number of COVID-19 infections, in addition to its significant predictors, to classify KSA governorates using the K-mean cluster method. Findings show that all KSA governorates can be grouped into two clusters. The first cluster includes 31 governorates that can be considered at greater risk of Covid infections as they have higher values in all the significant determinants of Covid infections. The last objective is to compare between traditional statistical methods and artificial intelligence techniques in predicting the future number of COVID-19 infections, with the aim of determining the method that provides the highest accuracy. Results also show that multilayer perceptron neural network outperforms others in forecasting the future number of COVID-19. Finally, the future number of infections for each cluster is predicted using multilayer perceptron neural network method.
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Heusler A, Osiander C, Schmidtke J. Essential for society but not equally deserving of preferential treatment? A discrete-choice experiment regarding COVID-19 healthcare. Soc Sci Med 2022; 311:115304. [PMID: 36063591 PMCID: PMC9398555 DOI: 10.1016/j.socscimed.2022.115304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/23/2022] [Accepted: 08/17/2022] [Indexed: 11/21/2022]
Abstract
Workers' risks of contracting COVID-19 vary according to individual behaviors, occupations and job characteristics. Therefore, persons may consider different groups of workers more or less deserving of COVID-19 healthcare. To evaluate such preferences, we conducted an online conjoint experiment on the precedence of ICU treatment and COVID-19 vaccination. Our results demonstrate that working in essential occupations increases the likelihood of being considered deserving of vaccination and ICU treatment. We also find differences in how essential workers are prioritized, yet these differences cannot be clearly attributed to risk exposure or occupational prestige. Furthermore, we show that age, asthma, household context and compliance with COVID-19 measures significantly affect respondents' choices, while weight matters only for vaccination priority. Our results therefore contribute to research regarding the characteristics that are salient to fair distributions of scarce resources among workers during a health crisis.
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Affiliation(s)
- Anna Heusler
- Institute for Employment Research (IAB), Regensburger Strasse 104, 90478, Nuremberg, Germany.
| | - Christopher Osiander
- Institute for Employment Research (IAB), Regensburger Strasse 104, 90478, Nuremberg, Germany.
| | - Julia Schmidtke
- Institute for Employment Research (IAB), Regensburger Strasse 104, 90478, Nuremberg, Germany.
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Rizvi S, Rizvi SM, Raza ST, Abbas M, Fatima K, Zaidi ZH, Mahdi F. Implication of single nucleotide polymorphisms in Interleukin-10 gene ( rs1800896 and rs1800872) with severity of COVID-19. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022; 23:145. [PMID: 37521849 PMCID: PMC9526386 DOI: 10.1186/s43042-022-00344-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/18/2022] [Indexed: 11/21/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) is an ongoing pandemic which has emerged as a new challenge for the medical sciences. Severity of COVID-19 is mostly determined with overexpressed proinflammatory cytokines eventually leading to endothelial dysfunction causing vital organ injury, especially in the lungs. It has been postulated that various genetic mutations might be associated with an increased risk of disease severity in COVID-19. This study was thus carried out to determine the association of rs1800896 and rs1800872 genetic polymorphism in IL-10 gene in determining COVID-19 severity. Methods The study included 160 RT-PCR confirmed COVID-19 patients with mild (n = 85) and severe (n = 75) conditions. All subjects were genotyped for Interleukin-10 (rs1800896 and rs1800872) gene polymorphisms using PCR-RFLP technique followed by statistical analysis. Results This study found a significant gender and age-based discrepancy in COVID-19 severity with 1.85-and 3.81-fold increased risk of COVID-19 in males of mild and severe groups as compared to females (p = 0.046 and p < 0.001) and 4.35-fold high risk in subjects ≥ 50 (p < 0.001). Genotyping analysis showed that IL-10 (rs1800872) gene polymorphism was strongly associated with COVID-19 severity (p = 0.01) whereas, IL-10 rs1800896 polymorphism was not found to confer the risk of COVID-19 severity in our population. Conclusion In this regard, the present study provided an evidence that IL-10 (rs1800872) gene polymorphism is strongly associated with COVID-19 severity and CC genotype confer a protective role in preventing severe disease progression. More detailed studies with a larger sample size on the genetic variations are required to establish the role of studied IL-10 gene polymorphisms with COVID-19 severity.
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Affiliation(s)
- Saliha Rizvi
- Department of Biotechnology, Era’s Lucknow Medical College and Hospital, Era University, Lucknow, Uttar Pradesh 226003 India
- Department of Personalized and Molecular Medicine, Era University, Lucknow, Uttar Pradesh 226003 India
| | - S. Mohd.Shiraz Rizvi
- Department of Biochemistry, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh 226003 India
| | - Syed Tasleem Raza
- Department of Biotechnology, Era’s Lucknow Medical College and Hospital, Era University, Lucknow, Uttar Pradesh 226003 India
- Department of Biochemistry, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh 226003 India
| | - Mohd. Abbas
- Department of Personalized and Molecular Medicine, Era University, Lucknow, Uttar Pradesh 226003 India
| | - Kaynat Fatima
- Department of Biotechnology, Era’s Lucknow Medical College and Hospital, Era University, Lucknow, Uttar Pradesh 226003 India
| | - Zeashan H. Zaidi
- Department of Community Medicine, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh 226003 India
| | - Farzana Mahdi
- Department of Biotechnology, Era’s Lucknow Medical College and Hospital, Era University, Lucknow, Uttar Pradesh 226003 India
- Department of Personalized and Molecular Medicine, Era University, Lucknow, Uttar Pradesh 226003 India
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Length of hospital stay and survival of hospitalized COVID-19 patients during the second wave of the pandemic: A single centre retrospective study from Slovenia. Zdr Varst 2022; 61:201-208. [DOI: 10.2478/sjph-2022-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 07/28/2022] [Indexed: 11/05/2022] Open
Abstract
Abstract
Background
As of writing, there are no publications pertaining to the prediction of COVID-19-related outcomes and length of stay in patients from Slovene hospitals.
Objectives
To evaluate the length of regular ward and ICU stays and assess the survival of COVID-19 patients to develop better prediction models to forecast hospital capacity and staffing demands in possible further pandemic peaks.
Methods
In this retrospective, single-site study we analysed the length of stay and survival of all patients, hospitalized due to the novel coronavirus (COVID-19) at the peak of the second wave, between November 18th 2020 and January 27th 2021 at the University Clinic Golnik, Slovenia.
Results
Out of 407 included patients, 59% were male. The median length of stay on regular wards was 7.5 (IQR 5–13) days, and the median ICU length of stay was 6 (IQR 4–11) days. Age, male sex, and ICU stay were significantly associated with a higher risk of death. The probability of dying in 21 days at the regular ward was 14.4% (95% CI [10.9–18%]) and at the ICU it was 43.6% (95% CI [19.3-51.8%]).
Conclusion
The survival of COVID-19 is strongly affected by age, sex, and the fact that a patient had to be admitted to ICU, while the length of hospital bed occupancy is very similar across different demographic groups. Knowing the length of stay and admission rate to ICU is important for proper planning of resources during an epidemic.
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Pharmacometric Modeling of the Impact of Azelastine Nasal Spray on SARS-CoV-2 Viral Load and Related Symptoms in COVID-19 Patients. Pharmaceutics 2022; 14:pharmaceutics14102059. [PMID: 36297492 PMCID: PMC9609097 DOI: 10.3390/pharmaceutics14102059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
The histamine-1 receptor antagonist azelastine was recently found to impact SARS-CoV-2 viral kinetics in a Phase 2 clinical trial (CARVIN). Thus, we investigated the relationship between intranasal azelastine administrations and viral load, as well as symptom severity in COVID-19 patients and analyzed the impact of covariates using non-linear mixed-effects modeling. For this, we developed a pharmacokinetic (PK) model for the oral and intranasal administration of azelastine. A one-compartment model with parallel absorption after intranasal administration described the PK best, covering both the intranasal and the gastro-intestinal absorption pathways. For virus kinetic and symptoms modeling, viral load and symptom records were gathered from the CARVIN study that included data of 82 COVID-19 patients receiving placebo or intranasal azelastine. The effect of azelastine on viral load was described by a dose–effect model targeting the virus elimination rate. An extension of the model revealed a relationship between COVID-19 symptoms severity and the number of infected cells. The analysis revealed that the intranasal administration of azelastine led to a faster decline in viral load and symptoms severity compared to placebo. Moreover, older patients showed a slower decline in viral load compared to younger patients and male patients experienced higher peak viral loads than females.
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Dings C, Götz KM, Och K, Sihinevich I, Werthner Q, Smola S, Bliem M, Mahfoud F, Volk T, Kreuer S, Rissland J, Selzer D, Lehr T. Model-Based Analysis of SARS-CoV-2 Infections, Hospitalization and Outcome in Germany, the Federal States and Districts. Viruses 2022; 14:2114. [PMID: 36298669 PMCID: PMC9607468 DOI: 10.3390/v14102114] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 11/01/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic challenged many national health care systems, with hospitals reaching capacity limits of intensive care units (ICU). Thus, the estimation of acute local burden of ICUs is critical for appropriate management of health care resources. In this work, we applied non-linear mixed effects modeling to develop an epidemiological SARS-CoV-2 infection model for Germany, with its 16 federal states and 400 districts, that describes infections as well as COVID-19 inpatients, ICU patients with and without mechanical ventilation, recoveries, and fatalities during the first two waves of the pandemic until April 2021. Based on model analyses, covariates influencing the relation between infections and outcomes were explored. Non-pharmaceutical interventions imposed by governments were found to have a major impact on the spreading of SARS-CoV-2. Patient age and sex, the spread of variant B.1.1.7, and the testing strategy (number of tests performed weekly, rate of positive tests) affected the severity and outcome of recorded cases and could reduce the observed unexplained variability between the states. Modeling could reasonably link the discrepancies between fine-grained model simulations of the 400 German districts and the reported number of available ICU beds to coarse-grained COVID-19 patient distribution patterns within German regions.
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Affiliation(s)
- Christiane Dings
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | | | - Katharina Och
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | - Iryna Sihinevich
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | - Quirin Werthner
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), 66123 Saarbrücken, Germany
| | - Marc Bliem
- CompuGroup Medical (CGM), 56070 Koblenz, Germany
| | - Felix Mahfoud
- Department of Internal Medicine III (Cardiology, Angiology, Intensive Care Medicine), Saarland University Medical Center and Saarland University Faculty of Medicine, 66421 Homburg, Germany
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Thomas Volk
- Department of Anesthesiology, University Hospital of the Saarland, 66421 Homburg, Germany
| | - Sascha Kreuer
- Department of Anesthesiology, University Hospital of the Saarland, 66421 Homburg, Germany
| | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Dominik Selzer
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
| | - Thorsten Lehr
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany
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Chahin A, Dhabaan G, Buhaish A, Shorman M. Medications and Supplements Prescription Patterns during COVID 19 Pandemic in Yemen: A Questionnaire-Based Study. FORTUNE JOURNAL OF HEALTH SCIENCES 2022; 5:522-528. [PMID: 36644208 PMCID: PMC9835554 DOI: 10.26502/fjhs.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Introduction the study aims to better understand the COVID-19 prescription treatments and over the counter regimens in Yemen in view of limited published data and limited availability of COVID-19 testing. Methods A 34 question web-based survey was distributed on social media outlets targeting people in Yemen. Data aggregation, analysis, and visualization were performed using Tableau and Microsoft Excel. Results 2341 individuals reported symptoms concerning for COVID-19 infection, with 25.4% reporting a chronic medical condition. Female patients were less likely to receive medications for treatment in all age groups examined. Azithromycin was the most prescription medication prescribed (32.8%) and vitamin C being the most supplement used (62%). Around 5.5% were on Hydroxychloroquine prophylaxis prior to their diagnosis and only 12.9% of them continued using after diagnosis. Conclusions This study provides some important information about the commonly observed treatments and prescription patterns during the COVID-19 pandemic in Yemen during May- July of 2020. The study reflects the influence of global trends in medication prescription even in resource-limited countries.
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Affiliation(s)
- Abdullah Chahin
- Division of Infectious Disease, Loyola University Medical Center and the Stitch School of Medicine at Loyola University, Maywood, Illinois, USA
| | - Ghulam Dhabaan
- Department of Microbiology, Mount Sinai Hospital/University Health Network, University of Toronto, Toronto, oN, Canada
| | | | - Mahmoud Shorman
- Division of Infectious Diseases, University of Tennessee Medical Center, Knoxville, TN, United States
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Islam KR, Kumar J, Tan TL, Reaz MBI, Rahman T, Khandakar A, Abbas T, Hossain MSA, Zughaier SM, Chowdhury MEH. Prognostic Model of ICU Admission Risk in Patients with COVID-19 Infection Using Machine Learning. Diagnostics (Basel) 2022; 12:2144. [PMID: 36140545 PMCID: PMC9498213 DOI: 10.3390/diagnostics12092144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 11/18/2022] Open
Abstract
With the onset of the COVID-19 pandemic, the number of critically sick patients in intensive care units (ICUs) has increased worldwide, putting a burden on ICUs. Early prediction of ICU requirement is crucial for efficient resource management and distribution. Early-prediction scoring systems for critically ill patients using mathematical models are available, but are not generalized for COVID-19 and Non-COVID patients. This study aims to develop a generalized and reliable prognostic model for ICU admission for both COVID-19 and non-COVID-19 patients using best feature combination from the patient data at admission. A retrospective cohort study was conducted on a dataset collected from the pulmonology department of Moscow City State Hospital between 20 April 2020 and 5 June 2020. The dataset contains ten clinical features for 231 patients, of whom 100 patients were transferred to ICU and 131 were stable (non-ICU) patients. There were 156 COVID positive patients and 75 non-COVID patients. Different feature selection techniques were investigated, and a stacking machine learning model was proposed and compared with eight different classification algorithms to detect risk of need for ICU admission for both COVID-19 and non-COVID patients combined and COVID patients alone. C-reactive protein (CRP), chest computed tomography (CT), lung tissue affected (%), age, admission to hospital, and fibrinogen parameters at hospital admission were found to be important features for ICU-requirement risk prediction. The best performance was produced by the stacking approach, with weighted precision, sensitivity, F1-score, specificity, and overall accuracy of 84.45%, 84.48%, 83.64%, 84.47%, and 84.48%, respectively, for both types of patients, and 85.34%, 85.35%, 85.11%, 85.34%, and 85.35%, respectively, for COVID-19 patients only. The proposed work can help doctors to improve management through early prediction of the risk of need for ICU admission of patients during the COVID-19 pandemic, as the model can be used for both types of patients.
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Affiliation(s)
- Khandaker Reajul Islam
- Department of Physiology, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Jaya Kumar
- Department of Physiology, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Toh Leong Tan
- Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Mamun Bin Ibne Reaz
- Department of Electrical, Electronics and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Tawsifur Rahman
- Department of Electrical Engineering, Qatar University, Doha P.O. Box 2713, Qatar
| | - Amith Khandakar
- Department of Electrical Engineering, Qatar University, Doha P.O. Box 2713, Qatar
| | - Tariq Abbas
- Urology Division, Surgery Department, Sidra Medicine, Doha P.O. Box 26999, Qatar
| | | | - Susu M. Zughaier
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
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Tarnas MC, Desai AN, Parker DM, Almhawish N, Zakieh O, Rayes D, Whalen-Browne M, Abbara A. Syndromic surveillance of respiratory infections during protracted conflict: experiences from northern Syria 2016-2021. Int J Infect Dis 2022; 122:337-344. [PMID: 35688310 DOI: 10.1016/j.ijid.2022.06.003] [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: 03/15/2022] [Revised: 05/30/2022] [Accepted: 06/03/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Northern Syria faces a large burden of influenza-like illness (ILI) and severe acute respiratory illness (SARI). This study aimed to investigate the trends of Early Warning and Response Network (EWARN) reported ILI and SARI in northern Syria between 2016 and 2021 and the potential impact of SARS-CoV-2. METHODS We extracted weekly EWARN data on ILI/ SARI and aggregated cases and consultations into 4-week intervals to calculate case positivity. We conducted a seasonal-trend decomposition to assess case trends in the presence of seasonal fluctuations. RESULTS It was observed that 4-week aggregates of ILI cases (n = 5,942,012), SARI cases (n = 114,939), ILI case positivity, and SARI case positivity exhibited seasonal fluctuations with peaks in the winter months. ILI and SARI cases in individuals aged ≥5 years surpassed those in individuals aged <5 years in late 2019. ILI cases clustered primarily in Aleppo and Idlib, whereas SARI cases clustered in Aleppo, Idlib, Deir Ezzor, and Hassakeh. SARI cases increased sharply in 2021, corresponding with a severe SARS-CoV-2 wave, compared with the steady increase in ILI cases over time. CONCLUSION Respiratory infections cause widespread morbidity and mortality throughout northern Syria, particularly with the emergence of SARS-CoV-2. Strengthened surveillance and access to testing and treatment are critical to manage outbreaks among conflict-affected populations.
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Affiliation(s)
- Maia C Tarnas
- University of California, Population Health and Disease Prevention, Irvine, CA, USA.
| | - Angel N Desai
- University of California, Davis Medical Center, Sacramento, CA, USA
| | - Daniel M Parker
- University of California, Population Health and Disease Prevention, Irvine, CA, USA
| | | | - Omar Zakieh
- Imperial College, Department of Infection, London, UK
| | - Diana Rayes
- Syria Public Health Network, London, UK; Johns Hopkins University, Department of International Health, Baltimore, MD, USA
| | | | - Aula Abbara
- Imperial College, Department of Infection, London, UK; Syria Public Health Network, London, UK
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Power N, Perreault M, Ferrari M, Boudreau P, Boivin DB. Sleep of Healthcare Workers During the COVID-19 Pandemic and the Role of Atypical Work Schedules: A Scoping Review. J Biol Rhythms 2022; 37:358-384. [PMID: 35773789 DOI: 10.1177/07487304221103376] [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] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has negatively impacted the well-being of healthcare workers (HCWs). HCWs are highly exposed to shift work and their work schedules have been subject to increasing unpredictability since the start of the pandemic. This review aims to: (1) map the studies providing information about factors associated with sleep characteristics in HCWs working in the context of the COVID-19 pandemic during the first and second waves and (2) examine the state of the evidence base in terms of the availability of information on the influence of atypical work schedules. A literature search was performed in PubMed. Studies containing information about factors (demographic; psychological; occupational; COVID-19-specific; work schedule; lifestyle; medical; or other) associated with various sleep characteristics among HCWs working in the context of the COVID-19 pandemic were included. Particular attention was paid to the availability of information on the role of atypical work schedules on HCW sleep. Fifty-seven articles met the inclusion criteria. Most studies were reports of quantitative cross-sectional surveys using self-report measures. Associations between female sex, frontline HCW status, psychological factors, and poorer sleep were observed. Six studies included a measure of shift work in their analyses, 5 of which reported an association between shift work status and sleep. A wide range of factors were investigated, with female sex, frontline HCW status, and psychological factors repeatedly demonstrating associations with poorer sleep. Sleep was predominantly measured in terms of self-reported sleep quality or insomnia symptoms. Few studies investigated the influence of atypical work schedules on HCW sleep in the context of the COVID-19 pandemic. Research on this topic is lacking in terms of reliable and consistent measurements of sleep outcomes, longitudinal data, and knowledge about the influence of covariates such atypical work schedules, comorbidity, and medical history on HCW sleep.
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Affiliation(s)
- Niamh Power
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Michel Perreault
- Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal QC, Canada
| | - Manuela Ferrari
- Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal QC, Canada
| | - Philippe Boudreau
- Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal QC, Canada
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Diane B Boivin
- Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal QC, Canada
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Montreal, QC, Canada
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Fadda WA, Al‐Batanony MA, Aboukhalil REE, Khader HF, Al Rugaie O. Comparison between clinical characteristics and laboratory findings among patients with complicated and noncomplicated SARS-CoV-2 infection: A single-center experience from Shebin Al-Kom, Egypt. Immun Inflamm Dis 2022; 10:e671. [PMID: 35894709 PMCID: PMC9274799 DOI: 10.1002/iid3.671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) infection is considered a serious highly infectious disease caused by severe acute respiratory syndrome coronavirus 2, resulting in more than 6.27 million deaths worldwide. AIM OF THE STUDY The study aimed to compare clinical characteristics and laboratory findings of COVID-19 patients with complications and without complications and discriminate the important risk factors for the complications and deaths. SUBJECTS AND METHODS This cross-sectional study included 75 confirmed COVID-19 positive patients; out of which 49 were severely-ill cases. Analysis of all patients' clinical and laboratory information on admission including serum ferritin, thrombotic activity (d-dimer), lactate dehydrogenase (LDH), C-reactive protein (CRP), creatinine, aspartate aminotransferase, and alanine aminotransferase were done. RESULTS Lymphopenia, tachycardia, tachypnea, elevated CRP, d-dimer, serum ferritin, LDH, and decreased SpO2 were significantly associated with complicated cases (p < .05 for all). By using multivariate logistic regression analysis models, elevated serum ferritin and tachycardia were significantly correlated with the increased odds of complicated COVID-19 cases (odds ratio [confidence interval 95%] = 10.42 [2.32-46.89] and 8.01 [1.17-55.99]; respectively) (p = .002 and .007, respectively). CONCLUSION Lymphocytopenia, d-dimer, LDH, and CRP levels, which were significantly linked to the severity of COVID-19, were the prognostic biomarkers to predict the disease severity.
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Affiliation(s)
- Walaa A. Fadda
- Department of Basic Medical Sciences, Unaizah College of Medicine and Medical SciencesQassim UniversityUnaizahKingdom of Saudi Arabia
- Department of Human Anatomy and Embryology, Menoufia Faculty of MedicineMenoufia UniversityShebin Al‐KomEgypt
| | - Manal A. Al‐Batanony
- Department of Family and Community Medicine, Unaizah College of Medicine and Medical SciencesQassim UniversityUnaizahKingdom of Saudi Arabia
- Department of Public Health and Community Medicine, Menoufia Faculty of MedicineMenoufia UniversityShebin Al‐KomEgypt
| | - Reham E. E. Aboukhalil
- Department of Basic Medical Sciences, Unaizah College of Medicine and Medical SciencesQassim UniversityUnaizahKingdom of Saudi Arabia
| | - Heba F. Khader
- Department of Basic Medical Sciences, Unaizah College of Medicine and Medical SciencesQassim UniversityUnaizahKingdom of Saudi Arabia
- Department of Medical Biochemistry, Menoufia Faculty of MedicineMenoufia UniversityShebin Al‐KomEgypt
| | - Osamah Al Rugaie
- Department of Basic Medical Sciences, Unaizah College of Medicine and Medical SciencesQassim UniversityUnaizahKingdom of Saudi Arabia
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Van der Sluis RM, Holm CK, Jakobsen MR. Plasmacytoid dendritic cells during COVID-19: Ally or adversary? Cell Rep 2022; 40:111148. [PMID: 35858624 PMCID: PMC9279298 DOI: 10.1016/j.celrep.2022.111148] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/10/2022] [Accepted: 07/07/2022] [Indexed: 12/12/2022] Open
Abstract
Plasmacytoid dendritic cells (pDCs) are specialized cells of the immune system that are thought to be the main cellular source of type I interferon alpha (IFNα) in response to viral infections. IFNs are powerful antivirals, whereas defects in their function or induction lead to impaired resistance to virus infections, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. IFN production needs to be controlled, because sustained IFN production can also have detrimental effects on disease outcome. As such, pDCs are likely important for acute antiviral protection against SARS-CoV-2 infection but could potentially also contribute to chronic IFN levels. Here, we provide a historical overview of pDC biology and summarize existing literature addressing their involvement and importance during viral infections of the airways. Furthermore, we outline recent reports focused on the potential role of pDCs during SARS-CoV-2 infection, as well as the potential for this cellular subset to impact COVID-19 disease outcome.
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The Willingness of the Healthcare Professionals Working in Healthcare Institutions to Accept the First Dose of COVID-19 Vaccine in Jordan: A National Survey. Vaccines (Basel) 2022; 10:vaccines10071138. [PMID: 35891302 PMCID: PMC9322749 DOI: 10.3390/vaccines10071138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022] Open
Abstract
Health workers play an important part as role models, advocates for vaccination, vaccinators and educators in a community. Furthermore, they are at high risk of being infected with COVID-19 as they are on the frontlines. Thus, this study purposed to determine the willingness of the healthcare professionals working in healthcare institutions to accept the first dose of COVID-19 vaccine in Jordan. A cross-sectional design and a convenience-sampling method were used to recruit the study population from different healthcare sectors. A web-based survey was used to collect data. Findings showed that 1594 healthcare professionals responded and 74% of them were aged less than 45 years. Almost 65% of the respondents were registered nurses and 68.4% of them were married. A total of 94.9% of the participants heard about the COVID-19 vaccine, but only 56.5% of them had had the opportunity to attend lectures/discussions about COVID-19 vaccine. Official government websites were the primary source of obtaining information about COVID-19 (36.3%). The willingness of acceptance rate of COVID-19 vaccine was 63%. There were positive correlations between vaccine acceptance and compliance toward COVID-19 infection control precautions (r = 0.119, p < 0.01), knowledge about COVID-19 (r = 0.256, p < 0.01), age (r = 0.170, p < 0.01), and years of experience (r = 0.105, p < 0.01). Furthermore, age, knowledge, and compliance were significant predictors of the acceptance of the COVID-19 vaccine. Thus, it is necessary to develop specific interventions for healthcare professionals with low acceptance rates and take into consideration the predictors of COVID-19 vaccine acceptance. Further research is needed to explore the factors influencing the refusal of the COVID-19 vaccine by healthcare professionals.
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Vezzoli M, Inciardi RM, Oriecuia C, Paris S, Murillo NH, Agostoni P, Ameri P, Bellasi A, Camporotondo R, Canale C, Carubelli V, Carugo S, Catagnano F, Danzi G, Dalla Vecchia L, Giovinazzo S, Gnecchi M, Guazzi M, Iorio A, La Rovere MT, Leonardi S, Maccagni G, Mapelli M, Margonato D, Merlo M, Monzo L, Mortara A, Nuzzi V, Pagnesi M, Piepoli M, Porto I, Pozzi A, Provenzale G, Sarullo F, Senni M, Sinagra G, Tomasoni D, Adamo M, Volterrani M, Maroldi R, Metra M, Lombardi CM, Specchia C. Machine learning for prediction of in-hospital mortality in coronavirus disease 2019 patients: results from an Italian multicenter study. J Cardiovasc Med (Hagerstown) 2022; 23:439-446. [PMID: 35763764 DOI: 10.2459/jcm.0000000000001329] [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: 12/15/2022]
Abstract
BACKGROUND Several risk factors have been identified to predict worse outcomes in patients affected by SARS-CoV-2 infection. Machine learning algorithms represent a novel approach to identifying a prediction model with a good discriminatory capacity to be easily used in clinical practice. The aim of this study was to obtain a risk score for in-hospital mortality in patients with coronavirus disease infection (COVID-19) based on a limited number of features collected at hospital admission. METHODS AND RESULTS We studied an Italian cohort of consecutive adult Caucasian patients with laboratory-confirmed COVID-19 who were hospitalized in 13 cardiology units during Spring 2020. The Lasso procedure was used to select the most relevant covariates. The dataset was randomly divided into a training set containing 80% of the data, used for estimating the model, and a test set with the remaining 20%. A Random Forest modeled in-hospital mortality with the selected set of covariates: its accuracy was measured by means of the ROC curve, obtaining AUC, sensitivity, specificity and related 95% confidence interval (CI). This model was then compared with the one obtained by the Gradient Boosting Machine (GBM) and with logistic regression. Finally, to understand if each model has the same performance in the training and test set, the two AUCs were compared using the DeLong's test. Among 701 patients enrolled (mean age 67.2 ± 13.2 years, 69.5% male individuals), 165 (23.5%) died during a median hospitalization of 15 (IQR, 9-24) days. Variables selected by the Lasso procedure were: age, oxygen saturation, PaO2/FiO2, creatinine clearance and elevated troponin. Compared with those who survived, deceased patients were older, had a lower blood oxygenation, lower creatinine clearance levels and higher prevalence of elevated troponin (all P < 0.001). The best performance out of the samples was provided by Random Forest with an AUC of 0.78 (95% CI: 0.68-0.88) and a sensitivity of 0.88 (95% CI: 0.58-1.00). Moreover, Random Forest was the unique model that provided similar performance in sample and out of sample (DeLong test P = 0.78). CONCLUSION In a large COVID-19 population, we showed that a customizable machine learning-based score derived from clinical variables is feasible and effective for the prediction of in-hospital mortality.
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Affiliation(s)
- Marika Vezzoli
- Department of Molecular and Translational Medicine, University of Brescia, Italy
| | - Riccardo Maria Inciardi
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Chiara Oriecuia
- Department of Molecular and Translational Medicine, University of Brescia, Italy
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Sara Paris
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Natalia Herrera Murillo
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, Department of Clinical Sciences and Community Health, University of Milano, Milan
- Department of Clinical Sciences and Community Health, University of Milano, Milan
| | - Pietro Ameri
- IRCCS Ospedale Policlinico San Martino and Department of Internal Medicine, University of Genova, Genova
| | - Antonio Bellasi
- Innovation and Brand Reputation Unit, Papa Giovanni XXIII Hospital, Bergamo
| | - Rita Camporotondo
- Fondazione IRCCS Policlinico S. Matteo and University of Pavia, Pavia
| | - Claudia Canale
- IRCCS Ospedale Policlinico San Martino and Department of Internal Medicine, University of Genova, Genova
| | - Valentina Carubelli
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Stefano Carugo
- Division of Cardiology, Ospedale San Paolo, ASST Santi Paolo E Carlo, University of Milano, Milan
| | - Francesco Catagnano
- Fondazione IRCCS Policlinico S. Matteo and University of Pavia, Pavia
- Cardiology Department, Policlinico Di Monza, Monza
| | | | - Laura Dalla Vecchia
- Department of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Istituto Scientifico Di Milano, Milan
| | - Stefano Giovinazzo
- IRCCS Ospedale Policlinico San Martino and Department of Internal Medicine, University of Genova, Genova
| | | | - Marco Guazzi
- Heart Failure Unit, Cardiology Department, IRCCS San Donato Hospital, University of Milan, Milan
| | - Anita Iorio
- Cardiovascular Department and Cardiology Unit, Papa Giovanni XXIII Hospital-Bergamo, Bergamo
| | - Maria Teresa La Rovere
- Department of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Istituto Scientifico Di Pavia, Pavia
| | - Sergio Leonardi
- Fondazione IRCCS Policlinico S. Matteo and University of Pavia, Pavia
| | - Gloria Maccagni
- Heart Failure Unit, Cardiology Department, IRCCS San Donato Hospital, University of Milan, Milan
| | - Massimo Mapelli
- Centro Cardiologico Monzino, IRCCS, Department of Clinical Sciences and Community Health, University of Milano, Milan
- Department of Clinical Sciences and Community Health, University of Milano, Milan
| | - Davide Margonato
- Fondazione IRCCS Policlinico S. Matteo and University of Pavia, Pavia
- Cardiology Department, Policlinico Di Monza, Monza
| | - Marco Merlo
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata, Trieste
| | - Luca Monzo
- Istituto Clinico Casal Palocco, Rome
- Policlinico Casilino, Rome
| | | | - Vincenzo Nuzzi
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata, Trieste
| | - Matteo Pagnesi
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Massimo Piepoli
- Heart Failure Unit, G da Saliceto Hospital, AUSL Piacenza, Piacenza
- Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa
| | - Italo Porto
- IRCCS Ospedale Policlinico San Martino and Department of Internal Medicine, University of Genova, Genova
| | - Andrea Pozzi
- Cardiovascular Department and Cardiology Unit, Papa Giovanni XXIII Hospital-Bergamo, Bergamo
| | - Giovanni Provenzale
- Division of Cardiology, Ospedale San Paolo, ASST Santi Paolo E Carlo, University of Milano, Milan
| | - Filippo Sarullo
- Cardiovascular Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, Palermo
| | - Michele Senni
- Cardiovascular Department and Cardiology Unit, Papa Giovanni XXIII Hospital-Bergamo, Bergamo
| | - Gianfranco Sinagra
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata, Trieste
| | - Daniela Tomasoni
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Marianna Adamo
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Maurizio Volterrani
- Department of Medical Sciences, Istituto Di Ricovero E Cura a Carattere Scientifico (IRCCS) San Raffaele Pisana
| | - Roberto Maroldi
- Radiology ASST Spedali Civili di Brescia and Department of Medical and Surgical, Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Marco Metra
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Carlo Mario Lombardi
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Claudia Specchia
- Department of Molecular and Translational Medicine, University of Brescia, Italy
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Ramírez-del Real T, Martínez-García M, Márquez MF, López-Trejo L, Gutiérrez-Esparza G, Hernández-Lemus E. Individual Factors Associated With COVID-19 Infection: A Machine Learning Study. Front Public Health 2022; 10:912099. [PMID: 35844896 PMCID: PMC9279686 DOI: 10.3389/fpubh.2022.912099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
The fast, exponential increase of COVID-19 infections and their catastrophic effects on patients' health have required the development of tools that support health systems in the quick and efficient diagnosis and prognosis of this disease. In this context, the present study aims to identify the potential factors associated with COVID-19 infections, applying machine learning techniques, particularly random forest, chi-squared, xgboost, and rpart for feature selection; ROSE and SMOTE were used as resampling methods due to the existence of class imbalance. Similarly, machine and deep learning algorithms such as support vector machines, C4.5, random forest, rpart, and deep neural networks were explored during the train/test phase to select the best prediction model. The dataset used in this study contains clinical data, anthropometric measurements, and other health parameters related to smoking habits, alcohol consumption, quality of sleep, physical activity, and health status during confinement due to the pandemic associated with COVID-19. The results showed that the XGBoost model got the best features associated with COVID-19 infection, and random forest approximated the best predictive model with a balanced accuracy of 90.41% using SMOTE as a resampling technique. The model with the best performance provides a tool to help prevent contracting SARS-CoV-2 since the variables with the highest risk factor are detected, and some of them are, to a certain extent controllable.
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Affiliation(s)
- Tania Ramírez-del Real
- Cátedras Conacyt, National Council on Science and Technology, Mexico City, Mexico
- Center for Research in Geospatial Information Sciences, Mexico City, Mexico
| | - Mireya Martínez-García
- Clinical Research Division, National Institute of Cardiology “Ignacio Chávez”, Mexico City, Mexico
| | - Manlio F. Márquez
- Clinical Research Division, National Institute of Cardiology “Ignacio Chávez”, Mexico City, Mexico
| | - Laura López-Trejo
- Institute for Security and Social Services of State Workers, Mexico City, Mexico
| | - Guadalupe Gutiérrez-Esparza
- Cátedras Conacyt, National Council on Science and Technology, Mexico City, Mexico
- Clinical Research Division, National Institute of Cardiology “Ignacio Chávez”, Mexico City, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Division, National Institute of Genomic Medicine, Mexico City, Mexico
- Center for Complexity Sciences, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Benavides FG, Vives A, Zimmerman M, Silva-Peñaherrera M. [Excess mortality in 2020 in the working-age population of nine Latin American countriesExcesso de mortalidade na população em idade ativa em nove países da América Latina no ano de 2020]. Rev Panam Salud Publica 2022; 46:e75. [PMID: 35747472 PMCID: PMC9211029 DOI: 10.26633/rpsp.2022.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/05/2022] [Indexed: 11/24/2022] Open
Abstract
Objetivo. Estimar el impacto de la pandemia de la COVID-19 durante el año 2020, a través del exceso de mortalidad por todas las causas y los años potenciales de vida laboral perdidos en la población en edad de trabajar, de una selección de países latinoamericanos y el Caribe. Métodos. Estudio basado en datos de defunciones por todas las causas entre 15 y 69 años, procedentes principalmente de los Institutos Nacionales de Estadísticas. Se estimaron defunciones esperadas a partir de las registradas entre 2015 y 2019. El exceso de mortalidad fue estimado a través del indicador P, la razón de mortalidad estandarizada (RME) y los años potenciales de vida laboral perdidos (AVLP) hasta los 70 años. Resultados. El exceso de defunciones en Brasil, Bolivia, Chile, Colombia, Costa Rica, Cuba, México, Perú y República Dominicana sumó 426 978 (279 591 en hombres y 147 438 en mujeres), lo que representó una pérdida de 5 710 048 (3 738 775 en hombres y 1 971 273 en mujeres) de APVLP. La mortalidad observada fue significativamente superior a la esperada en todos los países, menos República Dominicana. Conclusiones. El impacto de la COVID-19 en la población en edad de trabajar tendrá un impacto profundo en la situación socioeconómica. El recuento oportuno del exceso de muertes resulta útil y puede ser usado como un sistema de alerta temprana para monitorizar la magnitud de los brotes de COVID-19. La monitorización del exceso de mortalidad en personas en edad de trabajar, realizada por el Observatorio Iberoamericano de Seguridad y Salud en el Trabajo permite evaluar con mayor exactitud la carga social y económica de la COVID-19.
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Affiliation(s)
- Fernando G Benavides
- Observatorio Iberoamericano de Seguridad y Salud en el Trabajo Centro de Investigación en Salud Laboral Universitat Pompeu Fabra IMIM (Instituto Hospital del Mar de Investigaciones Médicas) CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona España Observatorio Iberoamericano de Seguridad y Salud en el Trabajo, Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, IMIM (Instituto Hospital del Mar de Investigaciones Médicas) CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España
| | - Alejandra Vives
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile CEDEUS Santiago Chile Departamento de Salud Pública, Pontificia Universidad Católica de Chile. CEDEUS. Santiago, Chile
| | - Marta Zimmerman
- Instituto Nacional de Seguridad y Salud en el Trabajo Ministerio de Trabajo y Economía Social España Instituto Nacional de Seguridad y Salud en el Trabajo, Ministerio de Trabajo y Economía Social, España
| | - Michael Silva-Peñaherrera
- Observatorio Iberoamericano de Seguridad y Salud en el Trabajo Centro de Investigación en Salud Laboral Universitat Pompeu Fabra IMIM (Instituto Hospital del Mar de Investigaciones Médicas) CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona España Observatorio Iberoamericano de Seguridad y Salud en el Trabajo, Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, IMIM (Instituto Hospital del Mar de Investigaciones Médicas) CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España
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Yuan Y, Thierry JM, Bull-Otterson L, Yeargin-Allsopp M, Clark KEN, Rice C, Ritchey M, Ryerson AB. COVID-19 Cases and Hospitalizations Among Medicare Beneficiaries With and Without Disabilities - United States, January 1, 2020-November 20, 2021. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:791-796. [PMID: 35709015 DOI: 10.15585/mmwr.mm7124a3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Approximately 27% of adults in the United States live with a disability,* some of whom qualify for Medicare benefits. Persons with disabilities are at increased risk for severe COVID-19-associated outcomes compared with the general population (1); however, existing studies have limited generalizability† or only pertain to a specific disability (e.g., intellectual) (2). Older age is also associated with COVID-19-associated hospitalization and death, but the extent to which age might contribute to increased risk for severe COVID-19-associated outcomes among persons with disabilities is unknown (3). To describe the impact of COVID-19 on persons with disabilities and whether and how age contributes to disease rates, CDC assessed COVID-19 cases and hospitalizations during January 2020-November 2021, among Centers for Medicare & Medicaid Services (CMS) Medicare beneficiaries aged ≥18 years who were either eligible because of a disability (disability-eligible§) or only eligible because of age ≥65 years (age-eligible). COVID-19 incidence and hospitalization rates were higher in the disability-eligible group (10,978 and 3,148 per 100,000 population, respectively) throughout the study period compared with the age-eligible group (8,102 and 2,129 per 100,000 population, respectively). Both COVID-19 incidence and hospitalization rates increased with age in both disability- and age-eligible beneficiaries. American Indian or Alaska Native (AI/AN) persons had the highest disability-eligible (4,962 per 100,000) and age-eligible (5,024 per 100,000) hospitalization rates. Among all other racial and ethnic groups, hospitalization rates were higher among disability-eligible than among age-eligible patients. COVID-19 incidence and hospitalization rates among disability-eligible Medicare beneficiaries were disproportionally higher than rates among age-eligible beneficiaries. Collection of disability status as a core demographic variable in public health surveillance data and identification, as well as the addition of disability questions in other existing data sources can guide research and development of interventions for persons with disabilities. Efforts to increase access to and use of COVID-19 prevention and treatment strategies, including activities that support equitable vaccine access regardless of the substantial challenges that older adults and persons with disability face, are critical to reducing severe COVID-19-associated outcomes among these groups.
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Dinç HÖ, Demirci M, Özdemir YE, Sirekbasan S, Aktaş AN, Karaali R, Tok YT, Özbey D, Akçin R, Gareayaghi N, Kuşkucu MA, Midilli K, Aygün G, Sarıbaş S, Kocazeybek B. Anti-SARS-CoV-2 IgG and Neutralizing Antibody Levels in Patients with Past COVID-19 Infection: A Longitudinal Study. Balkan Med J 2022; 39:172-177. [PMID: 35378574 PMCID: PMC9136548 DOI: 10.4274/balkanmedj.galenos.2022.2021-8-131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/08/2022] [Indexed: 12/01/2022] Open
Abstract
Background Monitoring the longevity of immunoglobulin G (IgG) responses following severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections is vital to understanding the role of antibodies in preventing infection. Aims To determine the quantitative IgG responses specific to the Spike-S1 (S1) receptor-binding domain (S1/RBD) region of the virus in serum samples taken between 4 weeks and 7 months after polymerase chain reaction (PCR) positivity in patients who are diagnosed with coronavirus disease-2019 (COVID-19). Study Design A longitudinal study. Methods This study included 113 patients with a clinical and molecular diagnosis of COVID-19. The first and second serum samples were taken 1 and 7 months, respectively, after the PCR positivity. S1/RBD-specific IgG antibody response was assayed using anti-SARS-CoV- 2 QuantiVac ELISA (IgG) kit (Euroimmun, Lübeck, Germany). The neutralizing antibodies were investigated in 57 patients whose IgG test results were above the cut-off value. Results In 57 patients with SARS-CoV-2 IgG, the anti-SARS-CoV-2 IgG quantitative antibody levels significantly decreased after 7 months (Z = −2.197, p = 0.028). A correlation was detected between the anti-SARS-CoV-2 IgG and nAb percent inhibition (IH%) levels detected in 1 month (rs = 0.496, p < 0.001), but without significant correlation in serum samples taken on 7 months. The nAb IH% levels of the first and second were compared for COVID-19 severity and revealed no statistical difference (p = 0.256). In the second serum sample, the nAb IH%s of patients with moderate COVID-19 showed a statistically significant difference from patients with mild COVID-19 (p = 0.018), but without significant differences between severe and moderate or mild COVID-19. Conclusion SARS-CoV-2 quantitative IgG antibody titers are significantly reduced at long-term follow-up (> 6 months). Due to the limited information on seroconversion, comprehensive studies should be conducted for long-term follow-up of the immune response against SARS-CoV-2.
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Affiliation(s)
- Harika Öykü Dinç
- Department of Pharmaceutical Microbiology, Pharmacy Faculty, Bezmialem Vakıf University, İstanbul, Turkey
| | - Mehmet Demirci
- Department of Medical Microbiology Faculty, of Medicine, Kırklareli University, Kırklareli, Turkey
| | - Yusuf Emre Özdemir
- Specialist of Infectious Diseases and Clinical Microbiology, University of Health Sciences Turkey Bakırköy Sadi Konuk Training Research Hospital, İstanbul, Turkey
| | - Serhat Sirekbasan
- Department of Medical Laboratory, Techniques Çankırı Karatekin University, Eldivan Vocational School of Health Services, Çankırı, Turkey
| | - Ayse Nur Aktaş
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Rıdvan Karaali
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Yeşim Tuyji Tok
- Department of Medical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Doğukan Özbey
- Department of Medical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Rüveyda Akçin
- Department of Medical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Nesrin Gareayaghi
- Blood Center İstanbul Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Mert Ahmet Kuşkucu
- Blood Center İstanbul Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Kenan Midilli
- Department of Medical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Gökhan Aygün
- Department of Medical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Suat Sarıbaş
- Department of Medical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Bekir Kocazeybek
- Department of Medical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
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Mohamed ME, Farouk K, Mohamed GA, Ahmed A, Mohamed AS, Sameh ST, Amr H, Motaz ME. Does Tocilizumab Influence the Outcome of Patients with COVID-19 Pneumonia Compared to the Standard Therapy? Retrospective Analysis of Data Obtained during Phase I COVID Pandemic. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: No gold standard therapy was approved globally for COVID-19 pneumonia to the date of this study. The pathophysiology of SARS-CoV-2 infection displayed the predominance of hyperinflammation and immune dysregulation in inducing multiorgan damage. Therefore, the potential benefits of both immune modulation and suppression in COVID-19 have been extensively discussed as a modality to control cytokine release syndrome (CRS). Abnormally high levels of interleukin-6 (IL-6) are a common finding in COVID-19 patients with pneumonia and acute respiratory distress syndrome, so the use of IL-6 antagonist was tested as a therapeutic option in controlling the disease. Tocilizumab is a recombinant humanized anti-human IL-6 receptor monoclonal antibody that can specifically bind the membrane-bound IL-6 receptor and soluble IL-6 receptor, thereby inhibiting signal transduction. Tocilizumab is currently FDA approved for the management of rheumatoid arthritis, giant cell arthritis, polyarticular juvenile idiopathic arthritis, and systemic juvenile idiopathic arthritis. This study is a retrospective analysis of data polled during Phase I of COVID pandemic, adopted by the isolation hospital of Kasr Al-Ainy Medical School, Cairo University, during the period from May to September 2020.
AIM: The aim of this study is to evaluate tocilizumab influence in the outcome; in terms of reducing the hospital stay, risk and duration of mechanical ventilation (invasive and noninvasive), mortality, and the incidence of complications related to drugs use (secondary bacterial infection and GIT bleeding) in patients with moderate-to-severe COVID-19.
METHODS: This retrospective, observational cohort study included adults (between 18 and 80 years) with moderate-to-severe COVID-19 pneumonia, who were admitted to isolation hospital of Kasr Al-Ainy Medical School, Cairo University, between May and September 2020. We segregated the patients into two groups: Group A: In addition to the standard care protocol according to the local guidelines of the Egyptian Ministry of Health and Population in that period (supplemental oxygen, steroids in a dose of 1–2 mg/kg methylprednisolone for 5–10 days, broad-spectrum antibiotics, vitamins, and prophylactic dose of anticoagulation with low-molecular-weight heparin, proton-pump inhibitor, and poly-vitamins), they received tocilizumab intravenously in a dose of 8 mg/kg bodyweight (up to a maximum of 800 mg per dose), divided in two shots 12–24 h apart. Group B: Those received the standard care protocol alone, noting that guidelines were adjusted later on according to the updated scientific publications and WHO recommendations. The primary endpoint was to evaluate the effect of different regimens in controlling the disease, the need for mechanical ventilation and its duration (either invasive or non-invasive), length of ICU stay, hospital stay, and in-hospital mortality. Comparisons between quantitative variables were done using the non-parametric Mann–Whitney U-test. For comparison of serial measurements within each patient, the non-parametric Wilcoxon signed-rank test was used. For comparing categorical data, Chi-square (2) test was performed. Exact test was used instead when the expected frequency was <5. Correlations between quantitative variables were done using Spearman correlation coefficient.
RESULTS: During this period, 166 patients were admitted to ICU, suffering from severe hypoxemia with moderate to severe COVID-19 pneumonia, 10 of them were excluded (three were over 80 years old, other three had advanced stages of malignancy, two were on steroids therapy and non-invasive home ventilation due to chronic chest condition, and two were presented with MODs and deceased in <48 h from admission), thus, 156 were included in the study. Group A: Seventy-six patients (49%) received tocilizumab in addition to standard therapy, Group B: Eighty patients (51%) received standard therapy only. In Group A, the mean length of ICU stay was 8.96 days with mean length of hospital stay 13.76, compared to mean length of ICU stay 9 days in Group B (p = 0.57) and mean length of hospital stay 12.46 days (p = 0.117). In Group A, 35 patients (46%) needed non-invasive mechanical ventilation (MV),12 patients of the 35 needed invasive MV in later stage, compared to 26 patients (32%) in Group B, 14 patients of the 26 needed invasive MV in later stage (p = 0.16). In Group A, 14 patients (18.4%) needed invasive mechanical ventilation, compared to 19 patients (23.7%) in Group B (p = 0.213). In Group A, 6 (7.9%) of 76 patients died, compared to 13 (16.3%) of 80 in Group B p = 0.11. The incidence of secondary bacterial infection in Group A was 16 patients (21%) compared to 21 (26%) in Group B (p = 0.44).
CONCLUSION: In this study, we did not detect statistical difference in both groups of patients coming during CRS-associated COVID-19 pneumonia, regarding (ICU stay, need for and length of MV, the incidence of secondary bacterial infection, and in-hospital mortality) for COVID-19 moderate-to-severe pneumonia.
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