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The severity of the SARS-CoV-2 virus that causes the infectious disease of Covid-19, affected the traditional face-to-face educational system;which has been forced to rethink teaching through technological elements in various careers of Higher Education Institutions (IES) in areas such as: social, economic, administrative, arts, etc., being the area of industrial engineering and logistics, the most complicated to rethink, for which, it has had to enhance the ability, to favor the teaching-learning of logistical problem solving, through the use of open-source programs such as the R programming language, evidencing its accessibility, reliability and flexibility to modify its code, by personnel who do not need to be specialists in the area of programming or software development;in addition to allowing the effective management and storage of data, as well as the analysis of large volumes and also provides tools that add to the presentation of high quality graphics. © 2023 Universidad de La Habana. All rights reserved.
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PurposeThis study aims to present a framework for automatically collecting, cleaning and analyzing text (news articles, in this case) to provide valuable decision-making information to destination management organizations. Keeping a record of certain aspects of the projected destination image of an attraction (Cancun in this study) will grant the design of better strategies for the promotion and administration of destinations without the time-consuming effort of manually evaluating high quantities of textual information. Design/methodology/approachUsing Web scraping, news articles were collected from the USA, Mexico and Canada over an interval of one year. The documents were analyzed using an automatic topic modeling method known as Latent Dirichlet Allocation and a coherence analysis to determine the number of themes present in each collection. With the data provided, the authors were able to extract valuable information to understand how Cancun is presented to the countries. FindingsIt was found that in all countries, Cancun is an important destination to travel and vacation;however, given the period defined for this study (from July 2021 to July 2022), an important part of the articles analyzed was concerned with the sanitary measures derived from the COVID-19 pandemic. Besides, given the rise of violence and the threat of organized crime, many articles from the three countries are focused on warning potential tourists about the risks of traveling to Cancun. Originality/valueThe examination of the relevant literature revealed that similar analyses are manually performed by the experts on a set of predefined categories. Although those approaches are methodologically sound, the logistic effort and the time used could become prohibitively expensive, precluding carrying out this analysis frequently. Additionally, the preestablished categories to be studied in press articles may distort the results. For these reasons, the proposed framework automatically allows for gathering valuable information for decision-making in an unbiased manner.
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Intro The concept of training immunity originally developed for other diseases has gained attraction during the epidemic. Several clinical trials and epidemiological analyses of populations previously immunized with BCG and other vaccines were the focus of scientific discussions. Here we show the activation of innate immunity markers both at mucosal and systemic levels with a mucosal vaccine CIGB2020 (HeberNasvacTM) containing virus-like particles (HBsAg) and nucleocapsid particle (HBcAg) of the hepatitis B virus. Moreover, the immune potentiating capacity of the HBcAg combined with RBD protein was used to formulate a specific mucosal vaccine candidate against SARS-CoV-2 (MambisaTM). Methods With CIGB 2020 (100µg HBsAg and 100 µg HBcAg) were conducted two proof of concept trials in human volunteers and a Phase I-II open, randomized, and controlled trial in 46 volunteers older than 60 years, symptomatic or close contact of COVID-19 patients. The volunteers were randomly assigned to the treatment group or not treated group. The nasal spray was administered to the treatment group on days 0, 7, and 14 together with daily sublingual administrations. Mucosal and serum samples were collected on days 0, 4, and 8. With MambisaTM vaccine (50µg RBD and 40 µg HBcAg) was conducted one proof of concept trial and a Phase I-II open and randomized trial in 1131 volunteers 19 to 60 years old, evaluating three different devices for nasal administration. All the volunteers gave written informed consent. Findings CIGB2020 activates interferon-induced genes and TLR 3, 7, and 8 at the level of oropharyngeal mucosa and PBMC. Monocyte and lymphocyte populations were also activated. One dose of the MambisaTM vaccine induces high levels of specific IgG. The serum and mucosal antibodies show RBD-ACE2 binding inhibition capacity and neutralization activity. Conclusion Nasal immunization exhibits advantages in inducing immunity at the level of the nasopharyngeal mucosa in addition to the systemic response.
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Intro: With the first case of COVID-19 in Cuba on March 11, 2020, the Center for Genetic Engineering and Biotechnology in Havana began an extensive vaccine program. Two vaccines based on RBD recombinant protein were developed, one for systemic administration "Abdala" and one mucosal vaccine "Mambisa". Abdala received the EUA in July 2021 and "Mambisa" completed its clinical development as a booster dose for convalescent subjects. Method(s): Two doses (25 and 50 microg) and two schedules (0-14-28 and 1-28-56 days) were evaluated in phase I clinical trials with volunteers 19 to 54 years old. The phase II and III clinical trials were also double-blind, randomized, and placebo-controlled, and included respectively 660 and 48,000 volunteers from 19 to 80 years. The anti-RBD titers were evaluated using a quantitative ELISA system developed at the Center for Immunoassay, Havana Cuba, and ELECSYS system from Roche. The RBD to ACE2 plate-based binding competitive ELISA was performed to determine the inhibitory activity of the anti-RBD polyclonal sera on the binding of the hFc-ACE2 coated plates. The neutralization antibody titers were detected by a traditional virus microneutralization assay (MN50). Finding(s): The Abdala vaccine reached 92.28% efficacy. The epidemic was frankly under control in Cuba after the vaccine introduction having reached the highest levels of cases and mortality in July 2021 with the dominance of the Delta strain. The peak of the Omicron wave, unlike other countries, did not reach half of the cases of the Delta wave with a significant reduction in mortality. The mucosal vaccine candidate "Mambisa" completed its clinical development as a booster dose for convalescent subjects reaching the trial end-point. Conclusion(s): Vaccine composition based on RBD recombinant antigen alone is sufficient to achieve high vaccine efficacy comparable to mRNA and live vaccine platforms. The vaccine also protects against different viral variants including Delta and Omicron strains.Copyright © 2023
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Purpose of Study: Previous Osteopathic manipulative treatment (OMT) research has shown evidence of increased lymphatic movement resulting in increased leukocyte and cytokine flow. One study even showed increased antibody titer response in patients when used in conjunction with the Hepatitis B vaccine. Given previous studies, our group conducted a year-long longitudinal randomized controlled clinical trial to evaluate the ability of OMT to improve the COVID-19 vaccine immune response. Methods Used: Subjects were randomized into either the control arm or OMT intervention arm. OMT consisted of myofascial release of the thoracic inlet, pectoral traction, diaphragm release with MFR, splenic pump, and thoracic pump applied the day of and the day following each vaccination session. All subjects in each group received the Pfizer mRNA COVID-19 vaccine. All subjects had blood drawn on day 0 (1st vaccine), day 7, day 21 (2nd vaccine), days 28, 90, 210, and 365. Anti-spike IgG immunoglobulin titers (AS IgG) were measured at all time points for all subjects. Side effects, adverse events, and medication usage in response to the vaccines or OMT was documented. Breakthrough cases with symptomology and medication usage was documented for both groups. The study was approved by the WesternU IRB committee, protocol #FB21/IRB026. Summary of Results: Data for 91 subjects were analyzed with 41 male (45.1%) and 50 female (54.9%). Age distribution was comparable between the two groups. Side effects and medication usage reported by the subjects was similar between groups (p>0.1). AS IgG measured at baseline distinguished between previously infected individuals and those naive to COVID-19, regardless of OMT treatment. For all time points measured, the average AS IgG in subjects trended higher in OMT group than control group. Two-way ANOVA analysis showed statistical significance at 1 week after 2nd injection (p<0.001) in the COVID-19 naive population. 13 symptomatic breakthrough infections were reported in the control group and 12 in the OMT group. Length of symptoms were reported as 8.36 +/- 4.60 days (control) and 4.62 +/- 2.60 days (OMT) (p<0.05). Length of medication usage was 3.64 +/- 3.58 days (control) and 1.23 +/- 1.24 days (OMT) (p<0.1). Conclusion(s): Both groups had comparable side effects after COVID-19 vaccination with no adverse events linked to OMT, indicating that OMT is a safe adjunct that can be used with COVID-19 vaccination. The data showed an enhanced immune response by OMT, as evidenced by increased levels of AS IgG in previously naive subjects. Although both control and OMT groups had similar rates of symptomatic breakthrough infection, the OMT data shows reduced length of symptoms and medication duration in this population when compared to control breakthrough infections. This study is underpowered for statistical significance at each time point and future vaccination studies should recruit more patients to confirm the trends seen here.
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The objective of the present research was to evaluate the level of motor coordination in 9-year-old infants belonging to sports training schools in Bogotá and Chía-Cundinamarca in a post-confinement context by means of the 3JS test in relation to gender, sociodemographic context, sport, confinement training and days of training. The study included 307 infants, of which: 187 were male and 120 were female. Likewise, they were grouped by sport: soccer n:113, skating n:91, basketball n:52 and tennis n:51 and, finally, by sociodemographic context 102 were evaluated in Chia-Cundinamarca and 205 in Bogotá. The study has a quantitative approach, descriptive-transversal type and with a non-probabilistic sampling. The statistical treatment was carried out using the statistical software ® version 4.1.0. The results indicate that the significant differences were established in response to gender p=0.00 better in male infants, sociodemographic context p=0.04 better in Bogotá, days of training p=0.006 better in equal or greater than four days of weekly training, training in confinement during Covid-19 p=0.02 better in those who trained and sport p=0.00 evidencing significant differences between them, having as reference soccer as the highest and tennis the lowest level correspondingly. These findings show that normal levels of motor coordination were found for all the infants evaluated according to the intervals proposed by the 3JS test, likewise, the differences were established in turn, between locomotor coordination and object control coordination according to the variables object of this study. © Federación Española de Asociaciones de Docentes de Educación Física (FEADEF).
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Objective To identify adverse events related to prone positioning in COVID-19 patients with severe disease and acute respiratory distress syndrome, to analyze the risk factors associated with the development of anterior pressure ulcers, to determine whether the recommendation of prone positioning is associated with improved clinical outcomes. Methods Retrospective study performed in 63 consecutive patients with COVID-19 pneumonia admitted to intensive care unit on invasive mechanical ventilation and treated with prone positioning between March and April 2020. Association between prone-related pressure ulcers and selected variables was explored by the means of logistic regression. Results A total of 139 proning cycles were performed. The mean number of cycles were 2 [1–3] and the mean duration per cycle was of 22 h [15–24]. The prevalence of adverse events this population was 84.9 %, being the physiologic ones (i.e., hypo/hypertension) the most prevalent. 29 out of 63 patients (46%) developed prone-related pressure ulcers. The risk factors for prone-related pressure ulcers were older age, hypertension, levels of pre-albumin <21 mg/dl, the number of proning cycles and severe disease. We observed a significant increase in the PaO2/FiO2 at different time points during the prone positioning, and a significant decrease after it. Conclusions There is a high incidence of adverse events due to PD, with the physiological type being the most frequent. The identification of the main risk factors for the development of prone-related pressure ulcers will help to prevent the occurrence of these lesions during the prone positioning. Prone positioning offered an improvement in the oxygenation in these patients.
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BACKGROUND: An outbreak is defined as an increase in epidemiologically-associated cases greater than expected, during the 2019 Coronavirus pandemic 10.1% of cases are reported in healthcare workers in Mexico, however the circulation of the new Omicron variant with greater transmissibility is a risk for the occurrence of outbreaks. OBJECTIVE: Describes an outbreak of SARS-CoV-2 infection in health personnel of a pediatric hospital during the pandemic. METHODS: An outbreak study is carried out in health personnel diagnosed with SARSCoV- 2 infection, in a tertiary pediatric hospital, from January 1, 2021 to January 30, 2022. The increase in laboratory confirmed cases in January, higher than cases reported in the previous period indicated an outbreak and the need to strengthen prevention measures in the population. RESULTS: An outbreak with 508 cases in health personnel in January 2022 was confirmed, identifying 27.5% as in-hospital. The circulation of a new variant with high transmissibility, together with the relaxation of prevention measures due to the state of vaccination and the perception of a lower risk from COVID 19, are factors for the presence of the outbreak. CONCLUSIONS: It is important to continuously strengthen prevention measures and make staff adopt them as a daily behavior to avoid outbreaks. © 2022 Instituto Nacional de Pediatria. All rights reserved.
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OBJECTIVE: To identify adverse events related to prone positioning in COVID-19 patients with severe disease and acute respiratory distress syndrome, to analyze the risk factors associated with the development of anterior pressure ulcers, to determine whether the recommendation of prone positioning is associated with improved clinical outcomes. METHODS: Retrospective study performed in 63 consecutive patients with COVID-19 pneumonia admitted to intensive care unit on invasive mechanical ventilation and treated with prone positioning between March and April 2020. Association between prone-related pressure ulcers and selected variables was explored by the means of logistic regression. RESULTS: A total of 139 proning cycles were performed. The mean number of cycles were 2 [1-3] and the mean duration per cycle was of 22h [15-24]. The prevalence of adverse events this population was 84.9 %, being the physiologic ones (i.e., hypo/hypertension) the most prevalent. 29 out of 63 patients (46%) developed prone-related pressure ulcers. The risk factors for prone-related pressure ulcers were older age, hypertension, levels of pre-albumin <21mg/dl, the number of proning cycles and severe disease. We observed a significant increase in the PaO2/FiO2 at different time points during the prone positioning, and a significant decrease after it. CONCLUSIONS: There is a high incidence of adverse events due to PD, with the physiological type being the most frequent. The identification of the main risk factors for the development of prone-related pressure ulcers will help to prevent the occurrence of these lesions during the prone positioning. Prone positioning offered an improvement in the oxygenation in these patients.
Subject(s)
COVID-19 , Hypertension , Pressure Ulcer , Respiratory Distress Syndrome , Humans , Respiration, Artificial/adverse effects , COVID-19/complications , Prone Position/physiology , Pressure Ulcer/epidemiology , Pressure Ulcer/etiology , Retrospective Studies , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , Hypertension/complicationsABSTRACT
The appearance of fake news in Ecuador, during the period of confinement generated by the pandemic related to COVID-19, evidenced the various dimensions of this phenomenon. This paper analyzes the spread of fake news about Covid in the Ecuadorian technological scene, in order to promote an understanding and subsequent debate that contributes to the generation of prevention strategies and even reduction of its impact on the Internet and social networks, for the benefit of communication and democracy. One of the serious problems caused by disinformation is the appearance of rumors, which in the context of a health emergency cause anguish and despair among the population. This is where a social environment is needed in which the State shields the production of fake news and the destruction of disinformation from official communication, through transparent and precise communication, with clear and detailed messages on the form of prevention and attention, that it arrives by truthful technological means. Much better if these are disseminated through official spokespersons from different professional branches: scientific community, authorities with responsibilities in health matters and civil society organizations with an aligned and coherent discursive line, to share certainties with the public and appease the anguish of the situation, and communication technology professionals. In the context of political information and technological strategic communication, it is worrying that social networks are the strategic field to attack the adversary by creating rumors that are spread as fake news. A similar case occurs with the false information that circulates on social networks in relation to the health emergency, and that puts people's lives at risk. As evidenced, information technology is a weapon on an unprecedented scale. This is precisely because the technological and communicational advances of the information society have facilitated the fabrication and manipulation of content that, when disseminated through social networks, dramatically amplifies the lies produced by the States, by populist politicians and by dishonest corporations, among the population, that lacks criteria to assess these technological contents. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The objective of this study was to describe the health situation regarding the pandemic of COVID-19 and its coping strategies among residents of the Mario Lago Settlement, belonging to the Fazenda da Barra Sustainable Development Project (PDS) located in Ribeirao Preto, state of Sao Paulo. This is a cross-sectional, descriptive, survey-type study with stratified random sampling. A total of 158 residents, aged between 18 and 84 years, were interviewed between October 26, 2021, and January 28, 2022. The results obtained expose a situation of social vulnerability of its population, in which only 23.4% of the interviewees reached high school, and 95.6% have a family income of up to three minimum wages. Among the study participants, 17.1% tested positive for a COVID-19 test, and 42.4% reported that the pandemic significantly decreased household income, while 3.8% were left without income. In order for the settled populations to be better prepared for future crises such as the one caused by the COVID-19 pandemic, it is necessary to continue the actions already taken by the social and popular movements in the countryside and ensure the maintenance and development of social support networks.
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Background: Mono(ethylhexyl) phthalate (MEHP) is the main metabolite of Di(2-ethylhexyl) phthalate (DEHP), a chemical worldwide used as a plastic softener to increase the malleability, flexibility, and durability of several types of plastic, including those employed in bottled water, medical devices, and food wrapping, among others. Importantly, the consumption of these products has dramatically increased during the COVID-19 pandemic. MEHP has been classified as an endocrine disruptor chemical (EDC) and its involuntary intake has been associated with pregnancy complications such as preeclampsia and miscarriages. The placenta is a transitory organ that provides sustainability to the fetus, as well as the transportation of nutrients, hormones, and oxygen. Recent studies have proposed that MEHP may impair placental development and functionality. Nevertheless, little is known about its molecular mechanisms and effects on the placenta. Recent data has suggested that Sirtuin 1 (SIRT1) might be a molecular target. The aim of this study was to analyze the toxic and transcriptomic effects of MEHP in the human trophoblastic cell line HTR-8/svneo, focusing on the SIRT1-related pathways. Methods and Results: The HTR-8/svneo cell line was used as an extravillous trophoblast model to investigate MEHP effects. MEHP concentrations employed in this study were 0.5, 5, 50, 100, and 200 microM. Cell viability was evaluated by two methods: fixable viability staining, using eFluor 780, and MTT assay. Only the MTT assay suggested a significant decrease in cell viability at 48 hours with MEHP treatments of 5, 50, 100, and 200 microM. Mitochondrial biogenesis was analyzed by qPCR amplifying a region of the MT-ND1 mitochondrial gene. GAPDH promoter was used as a reference control. The results suggested a decrease in mitochondrial DNA at 48 hours. The transcriptomic analysis was performed in an Illumina Next-seq 500 with a coverage of 10 million reads. Doses of 5 and 200 microM of MEHP at 48 hours were analyzed. The results show that 41 and 341 genes were differentially expressed, respectively. These genes are involved in trophoblast function and pathophysiology and, according to previous reports, a portion of them are regulated by SIRT1. Finally, the effect of MEHP on SIRT1 was explored at both protein and mRNA levels by western blot and RT-qPCR, respectively. The results for mRNA levels exhibited a significant decline at 24 hours for all treatments, while protein levels were significantly reduced by 200 microM MEHP treatment at 48 hours. Conclusion(s): The present study demonstrates that MEHP treatments promote mitochondrial dysfunction in HTR-8/svneo cells. Moreover, the transcriptome analysis showed that MEHP modifies important signals for placental function and pathophysiology. The decline in SIRT1 levels correlates with the mitochondrial alterations as well as a portion of the transcriptomic changes, suggesting that SIRT1 may have an important role in MEHP effects in trophoblastic cells. Copyright © 2022 Elsevier B.V.
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In this paper we propose a method for using mobile network data to detect potential COVID-19 hospitalizations and derive corresponding epidemic risk maps. We apply our methods to a dataset from more than 2 million cellphones, collected by a mobile network provider located in London, UK. The approach yields a 98.6% agreement with released public records of patients admitted to NHS hospitals. Analyzing the mobility pattern of these individuals prior to their potential hospitalization, we present a series of risk maps. Compared with census-based maps, our risk maps indicate that the areas of highest risk are not necessarily the most densely populated ones and may change from day to day. Finally, we observe that hospitalized individuals tended to have a higher average mobility than non-hospitalized ones. © 2022 Owner/Author.
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Background. Currently, therapeutic options for outpatients with COVID-19 are limited, in Mexico Polymerized Collagen type I (PCTI) has been tested as a useful option. Methods. Double-blind, randomised, placebo-controlled clinical trial of PTIC vs placebo. To evaluate the safety, efficacy and effect of the intramuscular administration of polymerized type I collagen (PTIC) on hyperinflammation, oxygen saturation and symptom improvement in adult outpatients with symptomatic COVID-19. Eighty-nine adult participants with a confirmed COVID-19 diagnosis and symptom onset within the 7 days preceding recruitment were included from August 31, 2020 to November 7, 2020 and followed for 12 weeks. Final date of follow-up was February 4, 2021. Patients were randomly assigned to receive either 1.5 ml of PTIC intramuscularly every 12 h for 3 days and then every 24 h for 4 days (n=45), or matching placebo (n=44). Results. Of 89 patients who were randomised, 87 (97.8%) were included in an intention-to-treat analysis;37 (41.6%) were male and mean age was 48.5+/-14.0 years. The IP-10 levels decreased 75% in the PTIC group and 40% in the placebo group vs baseline. The comparison between treatment vs placebo was also statistically significant (P=0.0047). The IL-8 (44%, P=0.045), M-CSF (25%, P=0.041) and IL-1Ra (36%, P=0.05) levels were also decreased in the PTIC group vs baseline. Mean oxygen saturation >=92% was achieved by 40/44 (90%), 41/42 (98%) and 40/40 (100%) of participants that received PTIC at 8, 15 and 97 days of follow-up vs 29/43 (67%), 31/39 (80%) and 33/37 (89%) of patients treated with placebo (P=0.001). The unadjusted accelerated failure time model showed that patients treated with PTIC achieved the primary outcome 2.70-fold faster (P< 0.0001) than placebo. In terms of risk, the group of patients treated with PTIC had a 63% lower risk of having a mean oxygen saturation < 92% vs placebo (P< 0.0001). Symptom duration in patients treated with PTIC was reduced by 6.1+/-3.2 days vs placebo. No differences in adverse effects were observed between the groups at 8, 15 and 97 days of follow-up. Conclusion. Treatment with PTIC down-regulated IP-10, IL-8, M-CSF and IL-Ra levels, which could explain the PTIC effect on the higher proportion of patients with mean SaO2 >=92% and a shorter duration of symptoms as compared with placebo. Serum cytokine and chemokine levels of SARS-CoV2-infected symptomatic outpatients at baseline and day 8 post-treatment with PTIC or placebo. Data are expressed as median with 95% confidence. (A) IP-10, IFN-gamma inducible protein-10;(B) IL-8, Interleukin-8;(C) M-CSF, Macrophage colony-stimulating factor;(D) IL-1Ra, IL-1 receptor antagonist;(E) TRAIL, TNF-related apoptosis inducing ligand;and (F) Forest plot (95% confidence intervals). (A) Probability of oxygen saturation 92% or greater while breathing ambient air. (B) Accelerated time failure model for oxygen saturation 92% or greater while breathing ambient air among polymerised type I collagen and placebo.
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Background. The SARS-CoV-2 Omicron variant has been rapidly spreading worldwide. We aimed to characterize Omicron severity by assessing in-hospital deaths and intensive care admissions in a large healthcare system in South Florida during an Omicron predominant surge. Methods. Laboratory-confirmed COVID-19 adult patients hospitalized during January 1 -14, 2022 were retrospectively reviewed. Risks of in-hospital mortality and intensive care admission were estimated using logistic regression models. Analyses were stratified by age >= 65 years and vaccination status, and further adjusted for sex, comorbidities, and history of a previous COVID-19 infection. Results. 500 consecutively hospitalized COVID-19 Omicron patients were included. The median age was 69 (IQR, 53-80) years, and 271 (54.2%) were women. The most common comorbidities were hypertension (65.5%), diabetes (32%), and chronic kidney disease (24%). 260 (52%) patients were fully vaccinated (defined as a patient who received 2-dose vaccines), and 32 (6.4%) were previously infected with COVID-19. 252 (50.4%) patients required supplemental oxygen, 54 (10.8%) required intensive care unit (ICU) admission, and 44 (8.8%) patients required mechanical ventilation. At study closeout of March 7, 2022, case fatality rates among patients aged 18 -29 years, 30 -39 years, 40-49 years, 50-59 years, 60-69 years, 70-79 years, and >= 80 years were 0%, 2.2%, 6.4%, 5.3%, 8.0%, 5.7%, and 15.4% respectively ( p < 0.001), with the median time from hospital admission to death being 13 days (IQR, 6.5-20.5) (Figure 1). Patients aged >= 65 years had 2.6 times higher rates for in-hospital mortality (OR, 2.63;95% CI, 1.29-5.33;p =0.007) than those aged < 65 years, but were comparable for ICU admission (OR, 0.85;95% CI, 0.49-1.52;p =0.586). Past vaccination offered no protection against in-hospital mortality (OR, 1.18;95% CI, 0.64-2.19;p =0.599) or ICU admission (OR, 1.16;95% CI, 0.66-2.06;p =0.6) (Figure 2). In multivariable-adjusted models, patients aged >= 65 years had a higher in-hospital mortality than those aged < 65 years (Figure 2). Conclusion. This case series provides characteristics and outcomes of hospitalized adult patients with COVID-19 Omicron variant. Past COVID-19 vaccination did not impact ICU admission rate nor in-hospital mortality.
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Background. Patients infected with COVID-19 Omicron variant, may be hospitalized for reasons other than COVID-19 pneumonia. We describe the clinical presentations of hospitalized adult patients with COVID-19 Omicron variant in a large healthcare system in South Florida. Methods. Laboratory-confirmed COVID-19 adult patients hospitalized during January 1-14, 2022 were retrospectively reviewed. Clinical presentations were divided into one of three admission groups: COVID-19 pneumonia or respiratory infection (Group 1), severe extrapulmonary manifestations of COVID-19 (Group 2), and completely incidental diagnosis of COVID-19 (Group 3). Risks of in-hospital mortality and intensive care admission were estimated using logistic regression models. Results. Among 500 consecutively hospitalized COVID-19 Omicron patients, the median age was 69 (IQR, 53-80) years, and 271 (54.2%) were women. The most common comorbidities were hypertension (326;65.5%), diabetes (160;32%), and chronic kidney disease (120;24%). 260 (52%) patients were fully vaccinated (defined as a patient who received 2-dose vaccines), and 32 (6.4%) were previously infected with COVID-19. 257(51.4%) patients were classified as Group 1, 82 (16.4%) in Group 2, and 161 (32.2%) in Group 3 (Figure 1). Compared to Group 3, patients in Group 1 and Group 2 had a higher risk for ICU admission, with odds ratios (ORs) of 7.45 (95% CI, 2.62-21.23;p< 0.001) and 4.84 (95% CI, 1.44-16.23;p=0.011), and for in-hospital mortality, with ORs of 27.76 (95% CI, 3.78-204.3;p=0.001) and 12.63 (95% CI, 1.49-106.78;p=0.020), respectively (Figure 2). In multivariable-adjusted models, patients in Group 1 remained at higher risk for ICU admission and in-hospital mortality compared to Group 3, while patients in Group 2 remained at a higher risk for ICU admission, but with no difference in in-hospital mortality compared to Group 3 (Figure 2). Figure 1. Clinical characteristics of consecutively hospitalized patients stratified by clinical presentations at admission. Figure 2. Crude (Upper panel) and multivariable-adjusted (Lower panel) odds ratios for ICU admission and in-hospital mortality from logistic regression models. Group 3 represents patients with a completely incidental diagnosis of COVID-19. The variables included in the final multivariable models were age, gender, history of hypertension, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, coronary artery disease, malignancy, transplantation, HIV, vaccination status, and previous SARS-CoV-2 infection. Conclusion. This case series illustrates the clinical presentations of hospitalized adult patients infected with the COVID-19 Omicron variant. Significant differences in in-hospital mortality and ICU admission exist when comparing patients admitted for a COVID-19 related respiratory infection to those admitted with a completely incidental COVID-19 diagnosis.
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In this paper we propose a method for using mobile network data to detect potential COVID-19 hospitalizations and derive corresponding epidemic risk maps. We apply our methods to a dataset from more than 2 million cellphones, collected over the months of March and April in 2020 by a British mobile network provider. The method consists of different algorithms, including detection, filtering, validation and fine-tuning. The approach detected over 2,800 potentially hospitalized individuals, yielding a 98.6% agreement with released public records of patients admitted to NHS hospitals. Analyzing the mobility pattern of these individuals prior to their potential hospitalization, we present a series of risk maps. Compared with census-based maps, our risk maps indicate that the areas of highest risk are not necessarily the most densely populated ones. We also show that the areas of highest risk may change from day to day. Finally, we observe that hospitalized individuals tended to have a higher average mobility than non-hospitalized ones. Overall, we conclude that the rich spatio-temporal information extracted from mobile network data may benefit both the mobile-based technologies and the policies that are being developed against existing and future epidemics. © 2022 ACM.