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2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-316649

ABSTRACT

Purpose: The rapid spread of the SARS-CoV-2 pandemic around the world caused most healthcare services to turn substantial attention to treatment of these patients and also to alter the structure of healthcare systems to address an infectious disease. As a result, many cancer patients had their treatment deferred during the pandemic, increasing the time to treatment initiation, the number of untreated patients (which will alter the dynamics of healthcare delivery in the post-pandemic era) and increasing their risk of death. Hence, we analyzed the impact on global cancer mortality considering the decline in oncology care during the COVID-19 outbreak using head and neck cancer, a known time-dependent disease, as a model. Methods: : An online practical tool capable of predicting the risk of cancer patients dying due to the COVID-19 outbreak and also useful for mitigation strategies after the peak of the pandemic has been developed, based on a mathematical model. The scenarios were estimated by information of 15 oncological services worldwide, given a perspective from the five continents and also some simulations were conducted at world demographic data. Results: : The model demonstrates that the more that cancer care was maintained during the outbreak and also the more it is increased during the mitigation period, the shorter will be the recovery, lessening the additional risk of dying due to time to treatment initiation. Conclusions: : This impact of COVID-19 pandemic on cancer patients is inevitable, but it is possible to minimize it with an effort measured by the proposed model.

3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-308896

ABSTRACT

Aim: Implementation of a web-form based pharmacovigilance plan for the spontaneous notification of adverse events to the Comirnaty® COVID-19 vaccine during its administration to hospital healthcare professionals. Methods An electronic pharmacovigilance form was developed containing 8 pre-defined event options, an open answer option for the description of other events and/or symptoms, and a question about the overall intensity of symptoms. The adverse events reports were standardised according to physiological and pathological condition. Results A total of 4119 adverse events notifications were obtained with a 45% rate of electronic notification. The most clinically relevant events reported were: tachycardia (n=19), dyspnoea (n=7), chest pain (n=6), facial/labial oedema (n=6), lipothymia (n=5), bronchospasm (n=2), herpetic infection (n=2), vasculitis (n=2), arrhythmia (n=1), difficult to control arterial hypertension (n=1), gastritis (n=1) and spontaneous abortion (n=1). Regarding the intensity of symptoms (n=2928), 70.0% were reported as mild, 25.8% as moderate and 4.27% as severe, with higher intensity in the 2nd dose compared to 1st dose. The highest frequency of severe events were reported in the groups from 40 to 59 years in both vaccination periods. During the vaccination process, no hospitalisations and no deaths were notified and/or recorded. Conclusion In this real world study, comparing with Comirnaty clinical trials program, it was observed a higher frequency of adenomegaly and gastrointestinal disorders. Noteworthy, the notification of a case of miscarriage. The use of hospital pharmacy pharmacovigilance electronic forms, seemed to be relevant to notification adherence and to obtain a greater and faster knowledge of COVID-19 vaccine safety profile.

4.
PLoS Med ; 19(2): e1003904, 2022 02.
Article in English | MEDLINE | ID: covidwho-1686090

ABSTRACT

BACKGROUND: Deaths in the first year of the Coronavirus Disease 2019 (COVID-19) pandemic in England and Wales were unevenly distributed socioeconomically and geographically. However, the full scale of inequalities may have been underestimated to date, as most measures of excess mortality do not adequately account for varying age profiles of deaths between social groups. We measured years of life lost (YLL) attributable to the pandemic, directly or indirectly, comparing mortality across geographic and socioeconomic groups. METHODS AND FINDINGS: We used national mortality registers in England and Wales, from 27 December 2014 until 25 December 2020, covering 3,265,937 deaths. YLLs (main outcome) were calculated using 2019 single year sex-specific life tables for England and Wales. Interrupted time-series analyses, with panel time-series models, were used to estimate expected YLL by sex, geographical region, and deprivation quintile between 7 March 2020 and 25 December 2020 by cause: direct deaths (COVID-19 and other respiratory diseases), cardiovascular disease and diabetes, cancer, and other indirect deaths (all other causes). Excess YLL during the pandemic period were calculated by subtracting observed from expected values. Additional analyses focused on excess deaths for region and deprivation strata, by age-group. Between 7 March 2020 and 25 December 2020, there were an estimated 763,550 (95% CI: 696,826 to 830,273) excess YLL in England and Wales, equivalent to a 15% (95% CI: 14 to 16) increase in YLL compared to the equivalent time period in 2019. There was a strong deprivation gradient in all-cause excess YLL, with rates per 100,000 population ranging from 916 (95% CI: 820 to 1,012) for the least deprived quintile to 1,645 (95% CI: 1,472 to 1,819) for the most deprived. The differences in excess YLL between deprivation quintiles were greatest in younger age groups; for all-cause deaths, a mean of 9.1 years per death (95% CI: 8.2 to 10.0) were lost in the least deprived quintile, compared to 10.8 (95% CI: 10.0 to 11.6) in the most deprived; for COVID-19 and other respiratory deaths, a mean of 8.9 years per death (95% CI: 8.7 to 9.1) were lost in the least deprived quintile, compared to 11.2 (95% CI: 11.0 to 11.5) in the most deprived. For all-cause mortality, estimated deaths in the most deprived compared to the most affluent areas were much higher in younger age groups, but similar for those aged 85 or over. There was marked variability in both all-cause and direct excess YLL by region, with the highest rates in the North West. Limitations include the quasi-experimental nature of the research design and the requirement for accurate and timely recording. CONCLUSIONS: In this study, we observed strong socioeconomic and geographical health inequalities in YLL, during the first calendar year of the COVID-19 pandemic. These were in line with long-standing existing inequalities in England and Wales, with the most deprived areas reporting the largest numbers in potential YLL.


Subject(s)
COVID-19/mortality , Adult , Aged , Cardiovascular Diseases/mortality , Cause of Death , Diabetes Mellitus/mortality , England/epidemiology , Female , Health Status Disparities , Humans , Interrupted Time Series Analysis , Life Expectancy , Male , Middle Aged , Neoplasms/mortality , Residence Characteristics , Respiratory Tract Diseases/mortality , Socioeconomic Factors , Wales/epidemiology
5.
ACS Appl Mater Interfaces ; 14(2): 2522-2533, 2022 Jan 19.
Article in English | MEDLINE | ID: covidwho-1606881

ABSTRACT

Electrochemical detection in complex biofluids is a long-standing challenge as electrode biofouling hampers its sensing performance and commercial translation. To overcome this drawback, pyrolyzed paper as porous electrode coupled with the drop casting of an off-the-shelf polysorbate, that is, Tween 20 (T20), is described here by taking advantage of the in situ formation of a hydrophilic nanocoating (2 nm layer of T20). The latter prevents biofouling while providing the capillarity of samples through paper pores, leveraging redox reactions across both only partially fouled and fresh electrodic surfaces with increasing detection areas. The nanometric thickness of this blocking layer is also essential by not significantly impairing the electron-transfer kinetics. These phenomena behave synergistically to enhance the sensibility that further increases over long-term exposures (4 h) in biological fluids. While the state-of-the-art antibiofouling strategies compromise the sensibility, this approach leads to peak currents that are up to 12.5-fold higher than the original currents after 1 h exposure to unprocessed human plasma. Label-free impedimetric immunoassays through modular bioconjugation by directly anchoring spike protein on gold nanoparticles are also allowed, as demonstrated for the COVID-19 screening of patient sera. The scalability and simplicity of the platform combined with its unique ability to operate in biofluids with enhanced sensibility provide the generation of promising biosensing technologies toward real-world applications in point-of-care diagnostics, mass testing, and in-home monitoring of chronic diseases.


Subject(s)
Antibodies, Viral/immunology , Biosensing Techniques/methods , COVID-19 Serological Testing/methods , Diagnostic Tests, Routine/methods , Recombinant Proteins/immunology , Spike Glycoprotein, Coronavirus/immunology , Early Diagnosis , Humans , Sensitivity and Specificity
6.
Bioeng Transl Med ; 6(3): e10253, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1372699

ABSTRACT

The persistence of the global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has brought to the forefront the need for safe and effective vaccination strategies. In particular, the emergence of several variants with greater infectivity and resistance to current vaccines has motivated the development of a vaccine that elicits a broadly neutralizing immune response against all variants. In this study, we used a nanoparticle-based vaccine platform for the multivalent display of the receptor-binding domain (RBD) of the SARS-CoV-2 spike (S) protein, the primary target of neutralizing antibodies. Multiple copies of RBD were conjugated to the SpyCatcher-mi3 protein nanoparticle to produce a highly immunogenic nanoparticle-based vaccine. RBD-SpyCatcher-mi3 vaccines elicited broadly cross-reactive antibodies that recognized the spike proteins of not just an early isolate of SARS-CoV-2, but also three SARS-CoV-2 variants of concern as well as SARS-CoV-1. Moreover, immunization elicited high neutralizing antibody titers against an early isolate of SARS-CoV-2 as well as four variants of concern, including the delta variant. These results reveal the potential of RBD-SpyCatcher-mi3 as a broadly protective vaccination strategy.

7.
Rev. Soc. Bras. Med. Trop ; 54: e0174, 2021. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1299352

ABSTRACT

Abstract INTRODUCTION: We aimed to evaluate the impact of the new coronavirus disease 2019 on coronary hospitalizations in the Brazilian private health system. METHODS: Data on coronary admissions in 2020 and a 2-year historical series were collected from the UNIMED-BH insurance system. RESULTS: Admission rates in 2020 reduced by 26% (95%CI, 22-30) in comparison with 2018/2019, markedly from March to May (37%) compared to the peak of the pandemic (June-September, 19%). Mortality was higher in 2020 (5.4%, 95%CI 4.5-6.4) than in 2018/2019 (3.6%, 95%CI 3.2-4.1). CONCLUSIONS: There was a significant decrease in coronary admissions, with higher mortality during the COVID-19 pandemic.

8.
Lancet Reg Health Eur ; 7: 100144, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1260817

ABSTRACT

BACKGROUND: Excess deaths during the COVID-19 pandemic compared with those expected from historical trends have been unequally distributed, both geographically and socioeconomically. Not all excess deaths have been directly related to COVID-19 infection. We investigated geographical and socioeconomic patterns in excess deaths for major groups of underlying causes during the pandemic. METHODS: Weekly mortality data from 27/12/2014 to 2/10/2020 for England and Wales were obtained from the Office of National Statistics. Negative binomial regressions were used to model death counts based on pre-pandemic trends for deaths caused directly by COVID-19 (and other respiratory causes) and those caused indirectly by it (cardiovascular disease or diabetes, cancers, and all other indirect causes) over the first 30 weeks of the pandemic (7/3/2020-2/10/2020). FINDINGS: There were 62,321 (95% CI: 58,849 to 65,793) excess deaths in England and Wales in the first 30 weeks of the pandemic. Of these, 46,221 (95% CI: 45,439 to 47,003) were attributable to respiratory causes, including COVID-19, and 16,100 (95% CI: 13,410 to 18,790) to other causes. Rates of all-cause excess mortality ranged from 78 per 100,000 in the South West of England and in Wales to 130 per 100,000 in the West Midlands; and from 93 per 100,000 in the most affluent fifth of areas to 124 per 100,000 in the most deprived. The most deprived areas had the highest rates of death attributable to COVID-19 and other indirect deaths, but there was no socioeconomic gradient for excess deaths from cardiovascular disease/diabetes and cancer. INTERPRETATION: During the first 30 weeks of the COVID-19 pandemic there was significant geographic and socioeconomic variation in excess deaths for respiratory causes, but not for cardiovascular disease, diabetes and cancer. Pandemic recovery plans, including vaccination programmes, should take account of individual characteristics including health, socioeconomic status and place of residence. FUNDING: None.

10.
Cancer Causes Control ; 32(5): 459-471, 2021 May.
Article in English | MEDLINE | ID: covidwho-1126565

ABSTRACT

PURPOSE: The rapid spread of the SARS-CoV-2 pandemic around the world caused most healthcare services to turn substantial attention to treatment of these patients and also to alter the structure of healthcare systems to address an infectious disease. As a result, many cancer patients had their treatment deferred during the pandemic, increasing the time-to-treatment initiation, the number of untreated patients (which will alter the dynamics of healthcare delivery in the post-pandemic era) and increasing their risk of death. Hence, we analyzed the impact on global cancer mortality considering the decline in oncology care during the COVID-19 outbreak using head and neck cancer, a known time-dependent disease, as a model. METHODS: An online practical tool capable of predicting the risk of cancer patients dying due to the COVID-19 outbreak and also useful for mitigation strategies after the peak of the pandemic has been developed, based on a mathematical model. The scenarios were estimated by information of 15 oncological services worldwide, given a perspective from the five continents and also some simulations were conducted at world demographic data. RESULTS: The model demonstrates that the more that cancer care was maintained during the outbreak and also the more it is increased during the mitigation period, the shorter will be the recovery, lessening the additional risk of dying due to time-to-treatment initiation. CONCLUSIONS: This impact of COVID-19 pandemic on cancer patients is inevitable, but it is possible to minimize it with an effort measured by the proposed model.


Subject(s)
COVID-19 , Carcinoma, Squamous Cell/epidemiology , Delivery of Health Care , Head and Neck Neoplasms/epidemiology , SARS-CoV-2 , Time-to-Treatment , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/mortality , Global Health , Head and Neck Neoplasms/etiology , Head and Neck Neoplasms/mortality , Humans , Models, Theoretical , Risk Factors
12.
Saude Coletiva ; - (59):4425-4429, 2020.
Article in English | CINAHL | ID: covidwho-976748

ABSTRACT

The objective is to describe the epidemiological scenario of COVID-19 in northeastern Brazil. Method: This is a descriptive, cross-sectional, retrospective epidemiological study, carried out based on data collected from the COVID-19 epidemiological bulletins in Northeast Brazil, from March to July 2020. Results: In the Northeast, 585,831 cases were confirmed of COVID-19, in seven states the percentage of cases in females is higher than in males, the number of deaths in the period was 22,187, of these 56% (12,187) occurred in males, the highest mortality rate was observed in Ceará (73.8). The number of cases recovered in the region exceeds 400 thousand. Conclusion: The northeast region has a high number of cases of COVID-19, and Ceará stands out for presenting a higher mortality and incidence rate. The spread of the pathology was more intense in females, however the number of deaths was higher in males in the nine northeastern states. El objetivo es describir el escenario epidemiológico del COVID-19 en el noreste de Brasil. Método: Se trata de un estudio epidemiológico descriptivo, transversal, retrospectivo, realizado con base en los datos recolectados de los boletines epidemiológicos COVID-19 en el Nordeste de Brasil, de marzo a julio de 2020. Resultados: En el Nordeste se confirmaron 585.831 casos. de COVID- 19, en siete estados el porcentaje de casos en mujeres es mayor que en hombres, el número de muertes en el período fue de 22,187, de estos 56% (12,187) ocurrieron en hombres, la mayor tasa de mortalidad se observó en Ceará (73,8). El número de casos recuperados en la región supera los 400 mil. Conclusión: La región noreste tiene un alto número de casos de COVID-19, y Ceará se destaca por presentar una mayor tasa de mortalidad e incidencia. La extensión de la patología fue más intensa en las mujeres, sin embargo, el número de muertes fue mayor en los hombres en los nueve estados del noreste. Objetiva-se descrever o cenário epidemiológico da covid-19 no nordeste brasileiro. Método: Trata-se de um estudo epidemiológico descritivo, transversal, retrospectivo, realizado a partir de dados coletados dos boletins epidemiológicos da COVID-19 no Nordeste do Brasil, no período de março a julho de 2020. Resultados: No Nordeste foram confirmados 585.831 casos da COVID- 19, em sete estados o percentual de casos no sexo feminino é superior ao masculino, o número de óbitos no período foi de 22.187, destes 56% (12.187) ocorreram no sexo masculino, a maior taxa de mortalidade foi observada no Ceará (73,8). O número de casos recuperados na região ultrapassa 400 mil. Conclusão: A região nordeste apresenta elevado quantitativo de casos da COVID-19, sendo que o Ceará se destaca por apresentar maior índice de mortalidade e incidência. A disseminação da patologia foi mais intensa no sexo feminino, contudo o quantitativo de óbitos foi maior no sexo masculino nos nove estados nordestinos.

13.
J Telemed Telecare ; : 1357633X20969529, 2020 Oct 25.
Article in English | MEDLINE | ID: covidwho-890016

ABSTRACT

INTRODUCTION: Triage by on-demand telemedicine is a strategy for healthcare surge control in the COVID-19 pandemic. We aimed to assess the impact of a large-scale COVID-19 telemedicine system on emergency department (ED) visits and all-cause and cardiovascular hospital admissions in Brazil. METHODS: From March 18-May 18, 2020 we evaluated the database of a cooperative private health insurance, with 1.28 million clients. The COVID-19 telemedicine system consisted of: a) mobile app, which redirects to teleconsultations if indicated; b) telemonitoring system, with regular phone calls to suspected/confirmed COVID-19 cases to monitor progression; c) emergency ambulance system (EAS), with internet phone triage and counselling. ED visits and hospital admissions were recorded, with diagnoses assessed by the Diagnosis Related Groups method. COVID-19 diagnosis and deaths were identified from the patients' registries, and outcomes assessed until June 1st. RESULTS: In 60 days, 24,354 patients accessed one of the telemedicine systems. The most frequently utilized was telemonitoring (16,717, 69%), followed by teleconsultation (13,357, 55%) and EAS (687, 3%). The rates of ED and hospital admissions were: telemonitoring 19.7% (3,296) and 4.7% (782); teleconsultation 17.3% (2,313) and 2.4% (318) and EAS: 55.9% (384) and 56.5% (388) patients. At total 4.1% (1,010) had hospital admissions, 36% (363) with respiratory diseases (44 requiring mechanical ventilation) and 4.4% (44) with cardiovascular diagnoses. Overall, 277 (1.1%) patients had confirmed COVID-19 diagnosis, and 160 (0.7%) died, 9 with COVID-19. CONCLUSION: Telemedicine resulted in low rates of ED visits and hospital admissions, suggesting positive impacts on healthcare utilization. Cardiovascular admissions were remarkably rare.

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