ABSTRACT
Older people in nursing homes (NH) have been hit particularly hard by the COVID-19 pandemic. We conducted a retrospective study of three outbreaks of COVID-19, occurring during the waves of the initial pre-Alpha, Delta and Omicron SARS-CoV-2 variants, in one NH in suburban Belgrade, Serbia. All staff and 95% residents were vaccinated in February 2021, mostly with BBIBP-CorV, and two thirds were boosted with a third dose in August 2021. COVID-19 was diagnosed by positive PCR and/or antigen test. After the first outbreak, 80 affected individuals were tested for SARS-CoV-2 specific antibodies. The first outbreak involved 64/126 (50.8%) residents and 45/64 (70.3%) staff, the second 22/75 (29.3%) residents and 3/40 (7.5%) staff, and the third involved 36/110 (32.7%) residents and 19/56 (33.9%) staff. Clinical presentation ranged from asymptomatic to severe, with severe cases referred to hospital ICUs. Deaths occurred only in residents, and the case fatality rate was 31.2%, 9.1% and 0%, respectively in outbreaks 1, 2 and 3. Specific IgG antibodies were detected in all 35 residents and 44 of the 45 staff, and higher IgG levels were detected in the residents (417.3±273.5) than in the staff (201.9±192.9, p<0.0001) despite a double difference in age (79.0±7.4 vs. 40.1±11.5 years). Outbreaks 2 and 3 involved four and 23 breakthrough infections, respectively. Older individuals mounted a good immunological response to SARS-CoV-2 infection and vaccination, which prevented significant mortality and severe morbidity in the subsequent outbreaks, despite a significant number of breakthrough infections.
ABSTRACT
The COVID-19 pandemic has had a strong impact on people's quality of life (QoL), which is affected by social and economic changes as well as by mental and physical health. The aim of this study was to determine QoL in post-COVID-19 patients who had required hospitalization, and to identify relevant sociodemographic data. We used questionnaires which considered demographic and socioeconomic data, health and vaccination status, the pandemic situation, and EQ-5D scoring. The interactions of all data and the scores of EQ-5D were analyzed. Multivariate logistic regression analysis was applied to the five dimensions of EQ-5D. In this single-hospital-cohort study, the average times elapsed since initial diagnosis and hospital admission were 2.5 (76.3 ± 18.1 days) and 5 months (155.4 ± 33.9 days), respectively. Post-COVID-19 females were 3-5 times more likely to be affected in terms of anxiety/depression, and in negative impact upon their usual activities, at 5 months after diagnosis. At the same time, reductions in mobility were 3-4 times more likely in elderly post-COVID-19 patients, whose levels of pain and discomfort increased. Single patients, those with low incomes, and those with severe clinical outcomes were 2-4 times more likely to experience a reduction in their usual activities, while the presence of co-morbidities and lower levels of education were associated with increased pain and discomfort. Aging-induced pain/discomfort and anxiety/depression were significantly exacerbated in elderly patients with widespread vaccination. Our study revealed effects of demographic and socioeconomic factors upon lower QoL in post-COVID-19 patients in four dimensions of EQ-5D: mobility, usual activity, pain/discomfort, and anxiety/depression, 5 months after first diagnosis and hospitalization.
ABSTRACT
With the wake of the COVID-19 pandemic, the question of society’s capability to deal with an acute health crisis is, once again, brought to the forefront. In the core is the need to broaden the perspective on the determinants of a country’s ability to cope with the spread of the virus. This paper is about bringing together diverse aspects of readiness and initial reaction to a COVID-19 outbreak. We proposed an integrated evaluation framework which encapsulates six dimensions of readiness and initial reaction. Using a specific multi-level outranking method, we analysed how these dimensions affect the relative positioning of European countries in the early stages of the COVID-19 outbreak. The results revealed that the order of countries based on our six-dimensional assessment framework is significantly reminiscent of the actual positioning of countries in terms of COVID-19 morbidity and mortality in the initial phase of the pandemic. Our findings confirm that only when a country’s readiness is complemented by an appropriate societal reaction we can expect a less severe outcome. Moreover, our study revealed different patterns of performance between former communist Eastern European and Western European countries.
ABSTRACT
With the wake of the COVID-19 pandemic, the question of society's capability to deal with an acute health crisis is, once again, brought to the forefront. In the core is the need to broaden the perspective on the determinants of a country's ability to cope with the spread of the virus. This paper is about bringing together diverse aspects of readiness and initial reaction to a COVID-19 outbreak. We proposed an integrated evaluation framework which encapsulates six dimensions of readiness and initial reaction. Using a specific multi-level outranking method, we analysed how these dimensions affect the relative positioning of European countries in the early stages of the COVID-19 outbreak. The results revealed that the order of countries based on our six-dimensional assessment framework is significantly reminiscent of the actual positioning of countries in terms of COVID-19 morbidity and mortality in the initial phase of the pandemic. Our findings confirm that only when a country's readiness is complemented by an appropriate societal reaction we can expect a less severe outcome. Moreover, our study revealed different patterns of performance between former communist Eastern European and Western European countries.