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Background: "Long COVID" or "post-COVID conditions" describes prolonged symptoms after the acute phase of coronavirus disease 2019 (COVID-19). However, there is a paucity of published reports on its treatment. Method(s): This retrospective cohort study included adult, non-hospitalized patients with COVID-19 symptoms at least one month after the onset who had been examined at the isolation facility in Miyagi prefecture between October 2020 and September 2021. Result(s): In total, 70 patients with a median age of 46 (21-69) years were included, and 37 were women (52.9%). The median time from onset to the end of treatment was 46 (28-396) days. Thirty-eight patients (53.5%) showed improvement in all symptoms, while four (5.7%) did not recover within the study period. The symptoms at six months with high residual rates were dizziness (33.3%), fatigue (14.3%), myalgia (14.3%), abdominal discomfort (14.3%), and taste dysfunction (11.8%). For treatment of prolonged symptoms, formulae of Kampo medicine (Japanese traditional medicine) were used alone or in combination with Western medications in 76%, 66%, 53%, and 66% of patients at 1-2 months, 2-3 months, 3-6 months, and over 6 months respectively. Kampo formulae with anti-inflammatory effects were used in the early period;however, tonifying formulae and blood stasis-resolving formulae were used in the late period. Conclusion(s): Non-hospitalized patients with COVID-19 may suffer from persistent symptoms after the acute phase of infection. For the management of long COVID, a comprehensive and holistic approach is needed. Kampo medicine should be considered as a treatment option for long COVID.Copyright © 2023 The Authors. Traditional & Kampo Medicine published by John Wiley & Sons Australia, Ltd on behalf of Japan Society for Oriental Medicine and Japan Society of Medical and Pharmaceutical Sciences for Traditional Medicine.
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Background: There is evidence that secondhand smoke exposure, particularly indoor smoking exposure, increases the risk of asthma exacerbations. This relationship might be modified in the era of a pandemic of covid-19 when the overall spread of viral infection may decrease due to precaution. Method(s): In this public school-based longitudinal paper questionnaire study in 2019 and 2021, the students and parents of junior high schools were asked whether the student had ever been diagnosed as wheezy bronchitis or asthma by a doctor and whether they had wheezing or whistling in the chest in the last 12 months. The presence of smokers in the household and their location of smoking (outside only or indoor) were also asked. Student sex, parental age, household income, and the region of the school were employed as covariates. Result(s): Of 1926 students who registered in 2019, 1482 (76.9%) responded in 2021. A total of 351 (23.4%) ever had a doctor diagnosis of asthma. The rate of students who reported asthma symptoms decreased from 27.4% in 2019 to 8.6% in 2021. The rate of asthma symptoms significantly increased depending on the presence of smokers in the household and the location of smoking in 2019;22.1% (44/199) in the students with no smokers in the household, 29.2% (19/65) smokers with smokers who smoke only outside the home, and 39.1% (34/87) with indoor smokers. This association remained significant in 2021, although there were some improvements in the overall smoking status in the household;5.5% (12/217), 12.3% (7/50), and 14.3% (11/77), respectively. The adjusted odds ratio of asthma symptoms in the students with indoor smokers, as compared with no smokers in the household, was 1.92 (95% confidential intervals (CI), 1.06-3.48) in 2019 and 2.92 (95% CI, 1.03-8.21) in 2021. Conclusion(s): These results suggest that household indoor smoking exposure may have an adverse effect on asthma symptoms even in the era of the covid-19 pandemic.
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Objectives: Administration of the third dose of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine was initiated on December 1, 2021, in Japan. However, data on the long-term effects of this third vaccination remain scarce. Here, we examined the levels of SARS-CoV-2 antibodies in those who received the Pfizer BioNTech (BNT162b2) vaccine, 6 months after the third vaccination. Method(s): Samples from 40 healthy volunteers were used to measure SARS-CoV-2 antibodies with chemiluminescent assays against the receptor-binding domain (RBD) of the virus. Result(s): At 445 days after the first dose of BNT162b2, which is 180 days after the third vaccination, the mean anti-RBD IgG level was 159.4 AU/mL (SD 100.1 AU/mL), which was significantly higher than 144 days after the second vaccination, while mean anti-RBD IgM was baseline level (0.4 C.O.I.). The decline in IgG, 180 days after the third vaccination, was 74.1% (SD 16.1%), which was significantly lower than the 88.6% (SD 4.4%) decline observed 144 days after the second vaccination. Furthermore, we revealed that the reduction in IgG from 14 to 180 days after the third vaccination showed a significant inverse correlation with age, and the higher antibody response in younger participants at 14 days after the third vaccination disappeared at longer time points. Conclusion(s): The long-term durability of the IgG titer was significantly higher following the third vaccination compared with the second vaccination, and the reduction in IgG titer after the third vaccination inversely correlated with age.Copyright © 2022 the author(s), published by De Gruyter, Berlin/Boston.
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Background: Due, partially, to the COVID-19 pandemic, interest in remote clinical trials has grown rapidly. The convenience associated with remote trials, for both researchers and participants, can lead to improved recruitment, retention, and engagement. Advancements in digital technology have led to increased accessibility to remote healthcare and have made possible remote data collection and intervention delivery in clinical trials. However, remote clinical trials are not ''one-sizefits- all'' and present key challenges, particularly, when there are multi-component outcomes, for example, the metabolic syndrome (MetS). Motivated by an ongoing, in-person, national, multi-site clinical trial aimed at the remission of the MetS (ELM trial), the Virtual ELM pilot study assessed the plausibility of remote data collection and delivery of a lifestyle intervention to participants with the MetS. It focused on weight loss after a 3-month treatment, which was used as a surrogate measure for the MetS. Objective(s): To assess the feasibility and remediate challenges of a fully remote data collection and intervention delivery for translation into a large-scale remote clinical trial. Method(s): A treatment-only pilot study was conducted with 10 participants with the MetS. Participants were recruited via self-referral or medical records interrogation. They attended virtual group meetings via Zoom led by trained interventionists every week for three consecutive months to practice mindful exercise and eating. Intervention tools, such as participant selfmonitoring, included daily food intake, mindful habit logs and daily steps. All data collection was completed remotely including weight and components of the MetS (waist circumference, blood pressure, glucose, HDL, and triglycerides). Other outcomes included physical activity, diet, and mindfulness. Remote data collection was conducted using a variety of tools including Snap Surveys (web-based questionnaires), Actigraph/ CentrePoint (accelerometer-based physical activity), Fitabase (weight, steps, and food logs). Accelerometers, blood pressure monitors, Fitbit activity trackers, wireless scales, and waist measuring tapes were mailed to participants, along with instructions on how to use them. Participants visited Quest Diagnostics to complete blood draws. Result(s): There were several challenges such as remote recruitment, outcomes data collection, and intervention delivery. The most distinctive challenges were completion of the accelerometer and blood draw protocols. Despite the challenges, this pilot achieved 100% retention for both baseline and follow-up outcomes assessments and 95% remote session attendance. Thirty percent of the sample achieved remission of MetS and 40% achieved weight loss >=5%. The screening-toenrollment ratio was 2.0. Conclusion(s): The Virtual ELM pilot study showed promising results for the possibility of efficient execution of a remote, large-scale trial. The study helped identify challenges associated with its virtual nature, such as physical measures and physical activity protocol completion, and resourceful delivery of the intervention content. Proactively addressing challenges in the enrollment phase, for example, screening for smartphone technology awareness and refinement in the planning phase, for example, selecting effective data capture tools, is essential for a successful, remote trial.
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Background: Information regarding effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant strains on clinical manifestations and outcomes of coronavirus disease 2019 (COVID-19) in pregnant women is limited. Methods: A retrospective observational study was conducted using the data from the nationwide COVID-19 registry in Japan. We identified pregnant patients with symptomatic COVID-19 hospitalized during the study period. The Delta and Omicron variants of concern (VOC) predominant periods were defined as August 1 to December 31, 2021 and January 1 to May 31, 2022, respectively. Clinical characteristics were compared between the patients in the Delta and Omicron VOC periods. In addition, logistic regression analysis was performed to identify risk factors for developing moderate-to-severe COVID-19. Results: During the study period, 310 symptomatic COVID-19 cases of pregnant women were identified;111 and 199 patients were hospitalized during the Delta and Omicron VOC periods, respectively. Runny nose and sore throat were more common, and fatigue, dysgeusia, and olfactory dysfunction were less common manifestations observed in the Omicron VOC period. In the multivariable logistic regression analysis, onset during the later stage of pregnancy (OR: 2.08 [1.24–3.71]) and onset during the Delta VOC period (OR: 2.25 [1.08–4.90]) were independently associated with moderate-to-severe COVID-19, whereas two doses of SARS-CoV-2 vaccine were protective against developing moderate-to-severe COVID-19 (OR: 0.34 [0.13–0.84]). Conclusions: Clinical manifestations of COVID-19 in pregnant women differed between the Delta and Omicron VOC periods. SARS-CoV-2 vaccination was still effective in preventing severe COVID-19 throughout the Delta and Omicron VOC periods. © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
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Background: Information regarding effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant strains on clinical manifestations and outcomes of coronavirus disease 2019 (COVID-19) in pregnant women is limited. Methods: A retrospective observational study was conducted using the data from the nationwide COVID-19 registry in Japan. We identified pregnant patients with symptomatic COVID-19 hospitalized during the study period. The Delta and Omicron variants of concern (VOC) predominant periods were defined as August 1 to December 31, 2021 and January 1 to May 31, 2022, respectively. Clinical characteristics were compared between the patients in the Delta and Omicron VOC periods. In addition, logistic regression analysis was performed to identify risk factors for developing moderate-to-severe COVID-19. Results: During the study period, 310 symptomatic COVID-19 cases of pregnant women were identified;111 and 199 patients were hospitalized during the Delta and Omicron VOC periods, respectively. Runny nose and sore throat were more common, and fatigue, dysgeusia, and olfactory dysfunction were less common manifestations observed in the Omicron VOC period. In the multivariable logistic regression analysis, onset during the later stage of pregnancy (OR: 2.08 [1.24-3.71]) and onset during the Delta VOC period (OR: 2.25 [1.08-4.90]) were independently associated with moderate-to-severe COVID-19, whereas two doses of SARS-CoV-2 vaccine were protective against developing moderate-to-severe COVID-19 (OR: 0.34 [0.13-0.84]). Conclusions: Clinical manifestations of COVID-19 in pregnant women differed between the Delta and Omicron VOC periods. SARS-CoV-2 vaccination was still effective in preventing severe COVID-19 throughout the Delta and Omicron VOC periods.
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With the increasing improvement of quality of life (QOL), health has become an item of concern. However, owing to Covid-19, most organizations cannot do annual health check-ups because they require contact with people and it is difficult to maintain social distance. Consequently, in an era of increasing epidemics, non-contact methods are paramount. In this paper, we present a non-contact breathing and heart rate measurement system integrated into an application using 24 GHz medical radar to support the health check work. In this system, we solve the problem of imbalance between the two signal channels of the radar to increase the accuracy of the breathing and heart rate extraction. © 2022 IEEE.
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Background: Randomized phase III clinical trials suggest that the antibody cocktail containing casirivimab and imdevimab reduces the risk of hospitalization/death in high-risk COVID-19 patients. However, the efficacy of the cocktail in daily clinical practice remains unknown.
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Background. Black Americans have been disproportionately impacted by COVID-19, with systemic inequities contributing to increased incidence and mortality. In Chicago, access to COVID-19 testing was scarce in many predominantly Black neighborhoods early in the pandemic, exacerbating inequities. We aimed to assess uptake and yield of a COVID-19 testing campaign to increase access in high-risk, underserved Chicago communities. Methods. The Alive Church Network (ACN) is a community-driven coalition of Black pastors and public health researchers developed to address health inequities in Chicago. For this initiative, ACN implemented two strategies to improve access to COVID-19 testing in underserved neighborhoods: 1) church-based testing, with nurses and community health workers (CHWs) stationed in churches to perform PCR testing for community members and church staff (Dec 2020-Dec 2021) and 2) community site testing, with nurses and CHWs deployed to 8 local sites (e.g., Salvation Army) to conduct weekly PCR testing for employees and clients (May 2021-Mar 2022). We assessed characteristics of individuals undergoing testing;symptom and exposure history;and COVID-19 positivity. In addition, we compared positivity for ACN sites with Chicago citywide positivity over time. Results. A total of 3420 tests were performed for 1703 individuals. Of those tested, 931 (54.7%) were tested at churches and 772 (45.3%) were tested at community partner sites. Those presenting to churches were older (mean 44.8 vs. 39.1 years), more likely to be female (56.5% vs. 48.5%), and more likely to have a chronic medical condition (37.1% vs. 22.5%, Table). Prevalence of COVID-19 symptoms and exposure history were similar for those presenting to church and community sites (Table). Overall, ACN test positivity was similar to Chicago citywide positivity;however, ACN test positivity was much higher during the Omicron surge (24% vs. 11%, Figure). Characteristics of individuals tested for COVID-19 at church and community sites COVID-19 test positivity, ACN sites vs. Chicago citywide Conclusion. The ACN testing campaign increased access to COVID-19 testing in underserved neighborhoods in Chicago and had high yield during the Omicron surge. Church-based testing was successful for reaching older, medically vulnerable individuals. Ensuring widespread access to testing is essential for health equity and to reduce COVID-19 morbidity and mortality.
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BACKGROUND: Information regarding effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant strains on clinical manifestations and outcomes of coronavirus disease 2019 (COVID-19) in pregnant women is limited. METHODS: A retrospective observational study was conducted using the data from the nationwide COVID-19 registry in Japan. We identified pregnant patients with symptomatic COVID-19 hospitalized during the study period. The Delta and Omicron variants of concern (VOC) predominant periods were defined as August 1 to December 31, 2021 and January 1 to May 31, 2022, respectively. Clinical characteristics were compared between the patients in the Delta and Omicron VOC periods. In addition, logistic regression analysis was performed to identify risk factors for developing moderate-to-severe COVID-19. RESULTS: During the study period, 310 symptomatic COVID-19 cases of pregnant women were identified;111 and 199 patients were hospitalized during the Delta and Omicron VOC periods, respectively. Runny nose and sore throat were more common, and fever, fatigue, dysgeusia, and olfactory dysfunction were less common manifestations observed in the Omicron VOC period. In the multivariable logistic regression analysis, onset during the later stage of pregnancy (OR: 2.08 [1.24-3.71]) and onset during the Delta VOC period (OR: 2.25 [1.08-4.90]) were independently associated with moderate-to-severe COVID-19, whereas two doses of SARS-CoV-2 vaccine were protective against developing moderate-to-severe COVID-19 (OR: 0.34 [0.13-0.84]). CONCLUSIONS: Clinical manifestations of COVID-19 in pregnant women differed between the Delta and Omicron VOC periods. SARS-CoV-2 vaccination was still effective in preventing severe COVID-19 throughout the Delta and Omicron VOC periods.
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Rationale: In severe COVID-19 patients, decrease of ATP production caused by mitochondrial dysfunction thought to induce the lung injury. Febuxostat, which is a therapeutic medicine for hyperuricemia, is thought to have the effect of improving mitochondrial dysfunction and enhances the production of ATP. The purpose of this study is to investigate the effect of febuxostat in LPS induced lung injury mouse model. Methods: C57BL/6 WT mice (8-12 wk-old males) were exposed to lipopolysaccharide (LPS) intratracheally to develop the murine model of LPS-induced lung injury. For the treatment, 100 μg of febuxostat was administered twice a day from 2 days before the exposure of LPS. Bronchial lavage fluid (BALF) and lung tissue were collected 24 hours and 7 days after the LPS exposure. The BALF were analyzed for total and differential cell counts. The lung tissues were stained with Masson's trichrome staining and analyzed for lung fibrosis. Results: Twenty-four hours after the LPS exposure, the number of total cells and neutrophils in the BALF was increased. In the group receiving febuxostat, the number of total cells and neutrophils were significantly decreased at 24 hours after the LPS exposure. At 7 days after the LPS exposure, the number of total cells and neutrophils in both LPS and LPS + Febuxostat group returned to almost the same level as control group. Additionally, the percentage of collagen deposition area representing lung fibrosis in the entire lung field was enhanced in LPS group compared to control group at 7 days after the LPS exposure. Moreover, the treatment of febuxostat inhibited the fibrosis in LPS group. Conclusions: Administration of febuxostat inhibited the lung inflammation in the acute phase and improved the lung fibrosis in LPS-induced lung injury model. This study suggests that the treatment of febuxostat may inhibit the lung injury caused in severe COVID-19 patients.
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Coronavirus disease 2019 (COVID-19) was announced as an outbreak by the World Health Organization (WHO) in January 2020 and as a pandemic in March 2020. The majority of infected individuals have experienced no or only mild symptoms, ranging from fully asymptomatic cases to mild pneumonic disease. However, a minority of infected individuals develop severe respiratory symptoms. The objective of this study was to identify susceptible HLA alleles and clinical markers that can be used in risk prediction models for the early identification of severe COVID-19 among hospitalized COVID-19 patients. A total of 137 patients with mild COVID-19 (mCOVID-19) and 53 patients with severe COVID-19 (sCOVID-19) were recruited from the Center Hospital of the National Center for Global Health and Medicine (NCGM), Tokyo, Japan for the period of February-August 2020. High-resolution sequencing-based typing for eight HLA genes was performed using next-generation sequencing. In the HLA association studies, HLA-A∗11:01:01:01 [Pc = 0.013, OR = 2.26 (1.27-3.91)] and HLA-C∗12:02:02:01∼HLAB∗ 52:01:01:02 [Pc = 0.020, OR = 2.25 (1.24-3.92)] were found to be significantly associated with the severity of COVID-19. After multivariate analysis controlling for other confounding factors and comorbidities, HLAA∗ 11:01:01:01 [P = 3.34E-03, OR = 3.41 (1.50-7.73)], age at diagnosis [P = 1.29E-02, OR= 1.04 (1.01-1.07)] and sex at birth [P = 8.88E-03, OR= 2.92 (1.31-6.54)] remained significant. The area under the curve of the risk prediction model utilizing HLA-A∗11:01:01:01, age at diagnosis, and sex at birth was 0.772, with sensitivity of 0.715 and specificity of 0.717. To the best of our knowledge, this is the first article which describes associations of HLA alleles with COVID-19 at the 4-field (highest) resolution level. Early identification of potential COVID-19 could help clinicians prioritize medical utility and significantly decrease mortality from COVID-19.
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Introduction: On July 22, 2020, the Japanese government launched the "Go to Travel" campaign that subsidizes 50% of personal travel expenditure to support the tourism industry under the COVID-19 pandemic. This policy was controversial from the viewpoint of infection spread and was temporarily cancelled in December 2020, though there was no statistical evidence. Methods: This is the first study that measures the extent to which this campaign increased COVID-19 cases. This study regards the campaign as a natural experiment: although Tokyo and its commuting areas experienced the same time-series trends of COVID-19 cases before the "Go To Travel" campaign, this campaign was implemented in areas outside Tokyo, but not in Tokyo. Then, the comparison (difference-in-differences) yields the campaign's effect. Results: The estimation shows that the "Go To Travel" campaign significantly raised the increment rate of cases by 23.7%-34.4% during July 30-August 4. There is no significant effect after August 5. In addition, our simulation identified the number of campaign-related cases in each city. Conclusions: Although the campaign significantly spread COVID-19, the effect was not continuous to permanently change the time-series trend.
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Under the severe COVID-19 infection circumstance as rapidly spreading in JAPAN since March 2020, we conducted 2-D land seismic survey in residential area, Niigata, JAPAN from November to December 2020 with necessary infection prevention measures. We set the criteria for the survey start propriety in advance and discussed about the survey implementation with related parties. We also obtained the understanding about this survey from local governments and residents before the survey start. During seismic survey, we took two types of original infection prevention measures as “Enclosure” and “Separation”, in addition to basic measures indicated by guidelines of the Japanese government. “Enclosure” measures aimed to prevent coronavirus from entering inside of the survey site. “Separation” measures were risk diversification of spreading coronavirus in the survey site. By planning and thoroughly adhering original countermeasures that matched the survey area COVID-19 status, we were able to complete the survey in the planned duration without interrupted the survey. In this paper, we introduce our original on-site infection prevention measures “Enclosure” and “Separation” and discuss how to manage the risk of COVID-19 infection at the seismic survey site. © (2021) by the European Association of Geoscientists & Engineers (EAGE)All rights reserved.