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Background. Since the start of the COVID-19 pandemic, Chad has had 7,417 confirmed cases and 193 deaths, one of the lowest in Africa. Objective. This study assessed SARS-CoV-2 immunity in N'Djamena. Methods. In August-October 2021, eleven N'Djamena hospitals collected outpatient data and samples. IgG antibodies against SARSCoV- 2 nucleocapsid protein were identified using ELISA. "Bambino Gesu" Laboratory, Rome, Italy, performed external quality control with chemiluminescence assay. Results. 25-34-year-old (35.2%) made up the largest age group at 31.9 12.6 years. 56.4% were women, 1.3 women/men. The 7th district had 22.5% and the 1st 22.3%. Housewives and students dominated. Overall seroprevalence was 69.5% (95% CI: 67.7-71.3), females 68.2% (65.8-70.5) and males 71.2% (68.6-73.8). >44-year-old had 73.9% seroprevalence. Under-15s were 57.4% positive. Housewives (70.9%), civil servants (71.5%), and health workers (9.7%) had the highest antibody positivity. N'Djamena's 9th district had 73.1% optimism and the 3rd district had 52.5%. Seroprevalences were highest at Good Samaritan Hospital (75.4%) and National General Referral Hospital (74.7%). Conclusion. Our findings indicate a high circulation of SARS-CoV- 2 in N'Djamena, despite low mortality and morbidity after the first two COVID-19 pandemic waves. This high seroprevalence must be considered in Chad's vaccine policy.
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Background. Since the start of the COVID-19 pandemic, Chad has had 7,417 confirmed cases and 193 deaths, one of the lowest in Africa. Objective. This study assessed SARS-CoV-2 immunity in N'Djamena. Methods. In August-October 2021, eleven N'Djamena hospitals col-lected outpatient data and samples. IgG antibodies against SARS-CoV-2 nucleocapsid protein were identified using ELISA. "Bambino Gesu" Laboratory, Rome, Italy, performed external quality control with chemiluminescence assay. Results. 25-34-year-old (35.2%) made up the largest age group at 31.9+/-12.6 years. 56.4% were women, 1.3 women/men. The 7th district had 22.5% and the 1st 22.3%. Housewives and students dominated. Overall seroprevalence was 69.5% (95% CI: 67.7-71.3), females 68.2% (65.8-70.5) and males 71.2% (68.6-73.8). >44-year-old had 73.9% seroprevalence. Under-15s were 57.4% positive. Housewives (70.9%), civil servants (71.5%), and health workers (9.7%) had the highest antibody positivity. N'Djamena's 9th district had 73.1% optimism and the 3rd district had 52.5%. Seroprevalences were highest at Good Samaritan Hospital (75.4%) and National General Referral Hospital (74.7%). Conclusion. Our findings indicate a high circulation of SARS-CoV-2 in N'Djamena, despite low mortality and morbidity after the first two COVID-19 pandemic waves. This high seroprevalence must be considered in Chad's vaccine policy.Copyright © 2022 The Authors and PAGEPRESS PUBLICATIONS.
ABSTRACT
Background. Since the start of the COVID-19 pandemic, Chad has had 7,417 confirmed cases and 193 deaths, one of the lowest in Africa. Objective. This study assessed SARS-CoV-2 immunity in N'Djamena. Methods. In August-October 2021, eleven N'Djamena hospitals col-lected outpatient data and samples. IgG antibodies against SARS-CoV-2 nucleocapsid protein were identified using ELISA. "Bambino Gesu" Laboratory, Rome, Italy, performed external quality control with chemiluminescence assay. Results. 25-34-year-old (35.2%) made up the largest age group at 31.9+/-12.6 years. 56.4% were women, 1.3 women/men. The 7th district had 22.5% and the 1st 22.3%. Housewives and students dominated. Overall seroprevalence was 69.5% (95% CI: 67.7-71.3), females 68.2% (65.8-70.5) and males 71.2% (68.6-73.8). >44-year-old had 73.9% seroprevalence. Under-15s were 57.4% positive. Housewives (70.9%), civil servants (71.5%), and health workers (9.7%) had the highest antibody positivity. N'Djamena's 9th district had 73.1% optimism and the 3rd district had 52.5%. Seroprevalences were highest at Good Samaritan Hospital (75.4%) and National General Referral Hospital (74.7%). Conclusion. Our findings indicate a high circulation of SARS-CoV-2 in N'Djamena, despite low mortality and morbidity after the first two COVID-19 pandemic waves. This high seroprevalence must be considered in Chad's vaccine policy. Copyright © 2022 The Authors and PAGEPRESS PUBLICATIONS.
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Background: Older patients with cancer remain at high risk for negative outcomes from COVID-19 infection, particularly those who have multimorbidities and on immunosuppressive therapy. These patients have been excluded or underrepresented in pivotal COVID-19 vaccine clinical trials and there are ongoing concerns that they may not acquire the same level of protection from the available vaccines as the immunocompetent adults. Moreover, the level of protection wanes over time making them more susceptible to emerging COVID-19 novel variants of concern. Despite the implementation of global vaccination campaigns which have successfully reduced COVID-related hospitalisations and deaths in many parts of the world, there remains many unresolved issues and challenges to address as the pandemic ensues. With aging, concerns for age-related dysregulation and immune dysfunctions called immunosenescence may lead to potentially lower immunogenicity to vaccines. Despite receiving the primary vaccination, real-world evidence showed that both patients aged > 65 years and those with cancer have a higher risk of developing breakthrough COVID-19 infections and related complications. Subsequent booster doses are found to be effective at improving immune response, particularly against the novel variants, and the vulnerable population should be given the priority in booster campaigns. Method(s): Since the beginning of the pandemic in 2020, The International Society of Geriatric Oncology set up a COVID-19 Working Group comprised of multidisciplinary specialists by developing recommendations, advocacy, and action plans based on expert opinion and evidence related to older adults with cancer. Result(s): The table below summarises the updated recommendations from the SIOG COVID-19 Working Group. Conclusion(s): The SIOG COVID-19 Working Group supports ongoing public health interventions, continued mass immunisations, and booster campaigns targeting the most vulnerable members of the society, including older adults with cancer (Table Presented).
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Background. Clinical trial demonstrated that SARS-CoV-2 vaccines have the ability of reduce mortality and morbidity due to COVID-19. The aim of this study is to describe the effect of vaccination in term of mortality, type of ventilation and ICU admission among patients hospitalized for COVID-19 from May to December 2021 in a Ligurian Hospital. Methods. This is a retrospective, single-center study conducted in San Martino Hospital (Genoa, Italy), including patients >= 18 years hospitalized for COVID-19 in Infectious Disease and Emergency Units from 1st May to 31st December 2021. We collected demographical data, multimorbidity and disability score, vaccination time ("vaccinated" all patients hospitalized >= 14 days after first dose or >= 7 days after second/ third dose), therapy for COVID-19, mortality at 7 and 30 days, ICU admission, ventilation type. Characteristics of vaccinated (group A) versus non vaccinated (group B) patients were compared using Chi-squared/Fisher's exact test for categorical variables and t-test /Kruskal-Wallis test for the continuous ones. Cox proportional hazards models for death at 30 days were performed as univariate analysis as well as adjusting for age, Cumulative Illness Rating Scale [CIRS], gender, Remdesivir, Monoclonal antibodies, Tocilizumab use. Results. Overall, 405 patients SARS-CoV-2 infected were enrolled. Data about timing of vaccination were available for 360 patients (89%). We compared clinical characteristics and outcomes of group A (32%) versus group B (68%). In group A patients were older (p< 0.001) and frailer (higher CIRS score and lower Barthel index, p< 0.001) than in group B. Among patients requiring oxygen, 76 (31.5%) in group B vs 26 (22.41%) in group A needed high flow ventilation (p=0.036);33 (13.52%) vs 3 (2.59%) respectively were admitted to ICU (Figure 1). Mortality at 30 days after hospitalization was higher in group A at univariate analysis [HR(95%CI) 1.44(0.82;2.53), p=0.208], lower at multivariate analysis [0.57(0.31;1.02), p=0.059]. Conclusion. The results of this study confirm that SARS-CoV-2 vaccination reduces rate of admission to ICU and 30 days mortality among patients hospitalized for COVID-19. In our cohort mortality among vaccinated patients remains high and we hypothesized this is due to high frailty of evaluated population.
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This article deals with the passage from a merely summative evaluation to a continuous evaluation, based on the educational challenge posed by the COVID-19 pandemic. Likewise, it states that the adequacy of the pedagogical-didactic proposals and their organization in virtual classrooms provided teachers with a series of student monitoring tools. This motivated the teaching role of guide or educational facilitator, making the course administration methodology consistent with the evaluation methodology. © 2022 IEEE.
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The impact of restrictions on movement resulting from the SARS-CoV-2 pandemic may contribute to a disruption of mental health in young people during this era. In March 2021, lockdown restrictions were enforcing national policies of tackling the infectious disease across the globe. In the early stages of the vaccination rollout, public enquires on confidence to endure the virus pandemic have shown high levels of psychological distress. Under the above circumstances, 333 university students were asked to fill in an online-based survey on alcohol consumption, compulsive behavior as a loss of control over eating, fear of weight changes, excessive sleepiness and sleep deprivation. Text mining and multiple correspondence analysis were employed to analyze qualitative data on the lived experience against the occurrence of healthrelated behaviors. Data analyses have showed that the pandemic was associated with a mixed breakup of clustered lemmas based on sex, age, and relationship status. The extent to which the participants have reported a lower degree of satisfaction on living arrangements, intimate and family relationships were interpreted as meaningfully related with a more negative lived experience. Social confinement has resulted as an immediate action for mitigating a public health crisis from the SARS-CoV-2 disease. Incidentally, social measures to mitigate the virus transmission have sought to protect internal collapse of the health care systems by reducing the number of casualties. Conversely, these findings provide new evidence on the social determinants of health among youth and consequently highlight the potential interference from missing social interactions in the COVID-19 pandemic response. © Author (s).
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Despite SARS-CoV-2 transmission being a complex phenomenon, greater population density seems to be a risk factor. The aim of this study was to analyze through an epidemiologic urban health approach the relationship between population density and SARS-CoV-2 incidence using data which are comparable with regard to testing strategies. All 10,300 SARS-CoV-2 confirmed cases between October and December 2020 were included. We conducted separate analysis by gender standardizing and stratifying by age and month. In the Province Capital (p.d.=765 inhabitants/km2), standardized SARS-CoV-2 incidence rate was higher than the expected, both in men (SIR=1.17, 95%CI=1.12;1.22, p<0.0001) and women (SIR=1.20, 95%CI=1.15;1.25, p<0.0001). In municipalities with p.d. >200 inhabitants/km2, standardized SARS-CoV-2 incidence rate was similar to the expected (p>0.05). In municipalities with p.d. <200 inhabitants/km2, standardized SARS-CoV-2 incidence rate was lower than the expected, both in men (SIR=0.85, 95%CI=0.81;0.90, p<0.0001) and women (SIR=0.84, 95%CI=0.80;0.88, p<0.0001). Stratified analysis by months with likelihood ratio test showed heterogeneity of the p.d. effect in men and women (p<0.05). SARS-CoV-2 incidence rate seemed to be higher in most densely populated areas, both in men and women. Our results confirmed the great importance of restrictive measures as well as the importance of limiting the epidemic wave in the initial stages and could help guide pandemic management strategies according to urban context and population density.
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Background and Aim: This study aimed to understand and analyze the experiences and knowledge of various health professionals, the social area and an informal caregiver on the integration of care for the elderly in a pandemic context. Method: a qualitative investigation was carried out in which seven participants with distinct but complementary roles in the essence of care participated. Data collection was carried out through the communications of the participants of the seminar "The ping-pong of our elderly - (Re)think, (re)build and Integrate Care" promoted by the Portuguese Association of Integrated Care (PAFIC) within the scope of the VIII Value Conference of the Portuguese Association of Hospital Administrators (APAH). Results: From the participants' perspective, the integration of care in the person's path is fundamental, and for this, it is necessary to strengthen the articulation between the National Health Service and the social. As well as centering care on the person, allied to the community matrix that leads to the transformation of the current organizational model of care, to the change in management models that have remained unchanged for many years. The integration of people's care depends not only on the activity in the health area but is also conditioned by other sectors of activity, and therefore it is important to assess the role that civil society can play in providing care. Conclusions: The COVID-19 pandemic allowed the reflection on the care of the older people and how partnerships and articulation strategies between the different levels of care, health, social and community could be enhanced.
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Background: Long-term effects of Coronavirus Disease of 2019 (COVID- 19) and their sustainability are of the utmost relevance. For the chronic phase, the main concerns are the development of pulmonary interstitial disease and/or lingering cardiovascular involvement. How to intercept, assess, and treat these patients with long-term consequences of COVID-19 remains uncertain. Purpose: We aimed to determine: 1) functional capacity of COVID-19 survivors by cardiopulmonary exercise testing (CPET);2) those characteristics associated with CPET performance;3) safety and tolerability of CPET. Methods: We prospectively enrolled consecutive patients with laboratoryconfirmed COVID-19 discharged alive at a single hospital in northern Italy. At 3-month from hospital discharge, complete clinical evaluation, transthoracic echocardiography, cardiopulmonary exercise testing (CPET), pulmonary function test (PFT), and dominant leg extension (DLE) maximal strength evaluation were performed. Results: From 225 patients discharged from March to November 2020 we excluded 12 incomplete/missing cases, and 13 unable to perform CPET leading to a final population of 200 patients. At PFT all median parameters were within normality range. Median percent-predicted peak oxygen uptake (%pVO2) was 88% (78.3- 103.1). Ninety-nine (49.5%) patients had %pVO2 below, whereas 101 (50.5%) above the 85% predicted value (indicating normality). Sixteen (16.2%) patients had respiratory, 28 (28.9%) cardiac, 21 (21.2%) mixed-cardiopulmonary, and 34 (34.3%) non-cardiopulmonary limitation of exercise. One-hundred sixty (80.0%) patients complain at least one symptom, without relationship with peakVO2. Multivariate linear regression analysis showed percent-predicted forced expiratory volume in one-second (β=5.29, p=0.023), percent-predicted diffusing capacity of lungs for carbon monoxide (β=6.31, p=0.001), and DLE maximal strength (β=14.09, p=0.008) independently associated with peakVO2. At sensitivity analysis, the results of previous multivariate linear regression analysis were also similar among sub-groups of patients with no previous significant disease in anamnesis (cardiovascular disease except for arterial hypertension, respiratory disease, kidney disease, or cancer) and of those with a length of hospital stay ≤7 days. None major event was reported during/after CPET, whereas only two cases (1.0%) had a mild symptomatic hypotension post exercise. None of the involved health professionals developed COVID-19. Conclusions: CPET after COVID-19 is safe and about 1/3rd of COVID-19 survivors show functional capacity limitation mainly explained by muscular impairment, calling for future research to identify patients at higher risk of long-term effects that may benefit from careful surveillance and targeted rehabilitation. (Figure Presented).
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If Huntington disease (HD) may represent a risk factor for Covid-19 is debated. The aim of our work was to assess the impact of Covid-19 pandemic on HD disease progression, to evaluate patients vulnerability to Covid-19 infection and the incidence of severe manifestations compared to the general population. Methods After obtaining oral informed consent, we conducted a telephone interview directed to patients or care-givers, using an ad hoc developed semi-structured questionnaire. The questionnaire was composed of two sections and is shown in table 1. Section one: telephone interview to HD patients Section two: telephone interview to HD patients who tested positive for COVID19 Results We interviewed a total of 112 HD patients. Since the beginning of the pandemic, 72.3% of patients experienced a progression of the basal clinical condition (figure 1). Thirty-one-percent of patients changed their pre-existing psychiatric therapy or started a new one. Interestingly, 50% described the onset of a new sleep disorder. Analysis of the standards of care showed that 78% of the patients missed their scheduled medical visit and 64.7% stopped physiotherapy. Within the observed cohort 10.8% of patients tested positive for Covid-19 infection, 6 experienced symptoms and 5 of them had comorbidities. Despite resolution of the infection 3 patients underwent a rapid progressive and generalized clinical worsening. Conclusion Our study was among one of the first to investigate the impact of the Covid-19 pandemic on HD patients. Our results shown that most patients experienced a global clinical worsening since the beginning of the pandemic. Despite the more severe confinement measure adopted by HD patients, the incidence, and the morbidity of Covid-19 infection seemed to be higher than the general population (Buder, et al., 2021). Whether HD represents per se a risk factor for COVID-19 is unclear. However, a negative impact of HD on the immune system has been described, and difficulties in swallowing and clearing secretions may have negatively impacted the disease course.