ABSTRACT
The main objective of this randomized controlled trial was to analyze the acute effects of a nitrate-based nutritional formula on peripheral oxygen saturation (SpO(2)), patient-reported outcomes, and safety indices in patients with acute COVID-19 infection. The participants completing the protocol for the trial (n = 71) were allocated in a double-blind design to receive either a multicomponent nutritional formula (containing 1200 mg of potassium nitrate, 200 mg of magnesium, 50 mg of zinc, and 1000 mg of citric acid), or a placebo (2.5 g of inulin) during a 72-h monitoring period. All participants were requested to take an intervention (four capsules;weight of each capsule was similar to 2.5 g) every 4 h during the intervention period. A two-way mixed model ANOVA with repeated measures revealed a significant difference in SpO(2) between interventions (P = 0.007). As many as 30 out of 38 patients (78.9%) receiving nitrate-based nutritional formula, who all started the treatment with SpO(2) <= 95%, finished the intervention with SpO(2) of at least 95% at 72-h follow-up, whereas in the placebo group, 13 patients out of 33 (39.4%) finished the trial with SpO(2) of at least 95% (P < 0.05). The hospital admission rate after the 72-h follow-up was 21.1% in patients receiving nitrate-based formula compared to 33.3% in the placebo group (P = 0.25). The nitrate-based formula might be recognized as a potent strategy to tackle hypoxemia and concomitant features of the COVID-19 pandemic. In conclusion, it appears that the novel nitrated-based nutritional formulation described here was able to improve oxygen saturation and clinical outcomes in COVID-19 patients. Although the exact mechanism of action remains unknown, the nitrate-based formula might be recognized as a potent, safe, and convenient strategy to tackle hypoxemia and concomitant features of the COVID-19 pandemic.
ABSTRACT
Background: The COVID-19 pandemic has once again raised awareness of the potential of telemedicine as a cost-effective and, given the human resource constraints, tremendous opportunity to reach out to patients. However, the adoption of virtual technologies as well as advanced practice nurses (APN) behind such services may not fully be supported by healthcare providers and patients. The aim of our study was to assess the attitudes of general practitioners (GPs) and lay people towards telemedicine and to explore the openness of the Hungarian population and primary care physicians towards virtual healthcare and the extended scope of university registered nurses. Methods: Non-random, purposive sampling was performed. Data were collected by means of a questionnaire, separately for physicians and laypersons, which included socio-demographic, telemedicine-related and APN preference questions. Data analyses were performed using SPSS 25.0 statistical software, descriptive statistics and Mann-Whitney test were used for comparisons (p<0.05). Results: The public was more open to accept the use of smart devices than GPs (p<0.001), but doctors preferred internet contact more compared to laypersons (p<0.001). If doctors and APNs were believed to have the same level of competency, lay people would equally choose to see a doctor or an APN nurse (p>0.05). More than 50% (60.5%) of doctors would only approve APNs working independently if they did so under professional supervision. Conclusions: Telemedicine was generally welcome by GPs. Assuming equal service quality, laypersons did not reject nurse consultation. The provision of telemedicine health services in GP practices should also be part of the APN competence. Development of a legal framework for independent APN services and designing telemedicine protocols are warranted.
ABSTRACT
Objectives: The occurrence of coronavirus disease 2019 (COVID-19) showed different patterns in different countries. The aim of our study is to analyse the geographical inequalities in the occurrence of COVID-19 caused by SARS-CoV-2 virus in member states of the European Union (EU). Methods: Data derived from the European Centre for Disease Prevention and Control (ECDC) of European Union. Member states of the European Union were classified according to their geographical location: Western-European (Austria, Belgium, France, Germany, Luxembourg, Netherlands), Eastern-European (Bulgaria, Croatia, Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, Slovenia), Mediterranean (Cyprus, Greece, Italy, Malta, Portugal, Spain) and Nordic (Denmark, Finland, Ireland, Sweden) countries. Total number of COVID-19 cases per 1 million population and standard deviation (SD) was calculated with weighted averages. Period up to 7 July 2020 was covered. Single factor analysis of variance (ANOVA) was performed. Results: Up to 07.07.2020 in the European Union 1,313,317 COVID-19 cases were identified resulting in an incidence of 2.950 cases/1 million population. We found the highest occurrence in Luxembourg (7,352 cases/1 million population), Sweden (7,262), Spain (6,400), Belgium (5,354), Ireland (5,171), while the lowest occurrence was observed in Lithuania (678), Latvia (601), Hungary (435), Greece (344), Slovakia (324). We found 19.8-fold differences in the incidence of COVID-19 cases among EU countries with the lowest (Slovakia: 324) and highest (Luxembourg: 7,352) occurrence. Mediterranean countries had the highest incidence 4,563 (SD:+/-2,378), followed by Nordic: 4,514 (SD:+/-2,732), Western-European: 2.683 (SD:+/-2,114) and Eastern-European: 986 (SD:+/-395) countries. The relative risk of COVID-19 occurrence was 4.63-times higher in Mediterranean, 4.58-times higher in Nordic and 2.72-times higher in Western-European countries compared to Eastern-European countries. Single factor analysis of variance (ANOVA) showed significant differences among country groups (P<0.008). Conclusions: Eastern-European countries had significantly lower incidence of COVID-19 cases compared to Western-European, Mediterranean and Nordic countries in the European Union.
ABSTRACT
Objectives: The first patient with coronavirus disease 2019 (COVID-19) was diagnosed on the 4th of March 2020 in Hungary. The aim of our study is to analyse the regional inequalities in the occurrence of the coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 virus in Hungary. Methods: Data derived from the National Surveillance System (OSZIR) of the National Public Health Center (Nemzeti Népegészségügyi Központ) of Hungary. Patients diagnosed with coronavirus disease 2019 were confirmed by reverse transcription polymerase chain reaction (RT-PCR) in highly specialised laboratories designated for SARS-CoV-2 virus diagnostic. Data of laboratory confirmed cases were reported to the National Surveillance System. The period from the onset of first COVID-19 case up to 7th July 2020 was covered. Data were analysed according to 20 counties of Hungary. Results: Altogether 4,205 laboratory confirmed COVID-19 cases were identified in Hungary resulting in an incidence of 4.35 cases per 10,000 population. The number of novel coronavirus daily cases reached its peak in Hungary between 10-23 April with higher than 100 novel cases per day (0.102 new cases per 10,000 population). There was a 28.88 times higher incidence of COVID-19 in the county with the lowest (Békés 0.39) and with the highest (Budapest 11.36) occurrence. We found 4 counties with very high COVID-19 incidence (cases per 10,000 population): Budapest (11.36), Komárom-Esztergom county (10.20), Zala county (9.8) and Fejér county (9.05). The lowest frequency of COVID-19 was observed in the following counties (cases per 10,000 population): Jász-Nagykun-Szolnok (0.46), Hajdú-Bihar (0.44), Bács-Kiskun (0.42) and Békés (0.39). Conclusions: We found 28.88-fold differences in the incidence of COVID-19 cases among Hungarian counties with the lowest and highest occurrence. The highest incidence was observed in the capital city (Budapest) and in counties characterized by either nosocomial infections or cumulative cases in social institutions.