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1.
Frontiers in pediatrics ; 10, 2022.
Article in English | EuropePMC | ID: covidwho-1823827

ABSTRACT

Background Out-of-hospital cardiac arrest (OHCA) in children is a critical condition with a poor prognosis. After the coronavirus disease 2019 (COVID-19) pandemic developed, the epidemiology and clinical characteristics of the pediatric emergency department (PED) visits have changed. This study aimed to analyze the impact of the COVID-19 pandemic on pediatric OHCA in the PED. Methods From January 2018 to September 2021, we retrospectively collected data of children (18 years or younger) with a definite diagnosis of OHCA admitted to the PED. Patient data studied included demographics, pre-/in-hospital information, treatment modalities;and outcomes of interest included sustained return of spontaneous circulation (SROSC) and survival to hospital-discharge (STHD). These were analyzed and compared between the periods before and after the COVID-19 pandemic. Results A total of 97 patients with OHCA (68 boys and 29 girls) sent to the PED were enrolled in our study. Sixty cases (61.9%) occurred in the pre-pandemic period and 37 during the pandemic. The most common age group was infants (40.2%) (p = 0.018). Asystole was the most predominant cardiac rhythm (72.2%, P = 0.048). Eighty patients (82.5%) were transferred by the emergency medical services, 62 (63.9%) gained SROSC, and 25 (25.8%) were STHD. During the COVID-19 pandemic, children with non-trauma OHCA had significantly shorter survival duration and prolonged EMS scene intervals (both p < 0.05). Conclusion During the COVID-19 pandemic, children with OHCA had a significantly lower rate of SROSC and STHD than that in the pre-pandemic period. The COVID-19 pandemic has changed the nature of PED visits and has affected factors related to ROSC and STHD in pediatric OHCA.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308167

ABSTRACT

Background: Better understanding of incidence and clinical outcomes of COVID-19 infection in hemodialysis (HD) patients could assist healthcare providers to develop proper preventive strategies and optimal management. However, no published systematic review summarizes current epidemiological evidence regarding COVID-19 infection in HD patients. Methods: : This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We systematically searched PUBMED and EMBASE for articles published on incidence or mortality of COVID-19 infection in maintenance HD patients until September 2020, and conducted meta-analysis of proportions for incidence and mortality rate. Heterogeneity was measured by Cochran’s Q and I 2 statistic. Publication bias was evaluated by Egger’s test. The study protocol was registered in the PROSPERO database (CRD42020209134). Results: : In total, 29 articles with 3,261 confirmed COVID-19 cases from pooled 396,062 HD patients were identified. Overall COVID-19 incidence in these HD patients was 7.7% (95% CI: 5.0-10.9%), with significant heterogeneity among the studies (I 2 = 99.7%, p<0.001) and risk of publication bias (Egger’s test, p<0.001). Overall mortality rate was 22.4% (95% CI: 17.9-27.1%) in HD patients with COVID-19, with significant heterogeneity among the studies (I 2 = 87.1%, p<0.001). Reported incidence and mortality varied by geographic area, being higher in non-Asian- than Asian countries. Conclusions: : Both incidence and mortality of COVID-19 infection were higher in HD patients. Available data may underestimate the real incidence of infection because screening and diagnosis differ between countries. International collaboration and standardized reporting of future epidemiologic studies is encouraged to improve clinical outcomes of COVID-19 infection in HD patients.

3.
J Pers Med ; 12(1)2022 Jan 07.
Article in English | MEDLINE | ID: covidwho-1613865

ABSTRACT

BACKGROUND: Data are lacking regarding predictors of quantification of neutralizing antibodies (nAbs) based on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 50% neutralization titer (NT50) after a single dose of COVID-19 vaccine in hemodialysis (HD) patients. METHODS: This prospective single-center study enrolled 200 HD patients and 82 healthy subjects to estimate antibodies against the SARS-CoV-2 viral spike protein 1 and receptor-binding domain after a first dose of a COVID-19 vaccine (ChAdOx1 or mRNA-1273), measured by enzyme-linked immunosorbent assay and applied spline-based generalized additive model regression analysis to predict NT50 converted to international units. RESULTS: After the first dose of ChAdOx1, multiple linear regression showed that age (p = 0.011) and cardiothoracic ratio (p = 0.002) were negatively associated with NT50. Older age (OR = 0.958, p = 0.052) and higher cardiothoracic ratio (OR < 0.001, p = 0.037) could predict negative humoral response (NT50 < 35.13 IU/mL). NT50 was lower in HD patients compared with healthy controls receiving ChAdOx1 (10.68 vs. 43.01 IU/m, p < 0.001) or mRNA-1273 (36.39 vs. 262.2 IU/mL, p < 0.001). ChAdOx1 elicited lower GMTs than mRNA-1273 in the HD cohort (10.68 vs. 36.39 IU/mL, p < 0.001) and in healthy controls (43.01 vs. 262.22 IU/mL, p < 0.001). CONCLUSION: High cardiothoracic ratio and old age could independently predict a decline in nAb titers in an HD cohort vaccinated with a single dose of ChAdOx1.

4.
Nutrients ; 13(10)2021 Oct 19.
Article in English | MEDLINE | ID: covidwho-1477978

ABSTRACT

BACKGROUND: Lockdown is an effective nonpharmaceutical intervention to reduce coronavirus disease 2019 (COVID-19) transmission, but it restricts daily activity. We aimed to investigate the impact of lockdown on pediatric body weight and body mass index (BMI). METHODS: The systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Four online databases (EMBASE, Medline, the Cochrane Library and CINAHL) were searched. RESULTS: The pooled results showed that lockdown was associated with significant body weight gain (MD 2.67, 95% CI 2.12-3.23; p < 0.00001). The BMI of children with comorbidities or obesity did not change significantly. The BMI of general population was significantly higher during lockdown than before the pandemic (MD 0.94, 95% CI 0.32-1.56; p = 0.003). However, heterogeneity was high (I2 = 84%). Among changes in weight classification, increases in the rates of obesity (OR 1.23, 95% CI 1.10-1.37; p = 0.0002) and overweight (OR 1.17, 95% CI 1.06-1.29; p = 0.001) were reported. CONCLUSIONS: Our meta-analysis showed significant increases in body weight and BMI during lockdown among school-age children and adolescents. The prevalence of obesity and overweight also increased. The COVID-19 pandemic worsened the burden of childhood obesity.


Subject(s)
Body Mass Index , COVID-19/prevention & control , Pediatric Obesity/epidemiology , Quarantine/methods , Social Isolation , Weight Gain , Adolescent , Child , Humans , Pandemics , SARS-CoV-2
5.
Healthcare (Basel) ; 9(9)2021 Sep 07.
Article in English | MEDLINE | ID: covidwho-1430831

ABSTRACT

BACKGROUND: Dialyzed patients are vulnerable to coronavirus infection disease 2019 (COVID-19). The incidence and outcome of COVID-19 in hemodialysis (HD) patients in Taiwan remain unclear. A series of preventive measures were executed to combat COVID-19 transmission among HD patients. METHODS: We carried out a series of forward-looking and practical preventive strategies of COVID-19 control in our HD center. Incidences of COVID-19 of our HD unit were compared with those of national and local estimates from a community outbreak from 15 May to 30 June 2021. Prognostic factors associated with mortality were analyzed. RESULTS: The national incidence of COVID-19 was 0.062%; being highest in Taipei City (0.173%), followed by New Taipei City (0.161%) and Keelung (0.083%). The overall incidence in Keelung HD patients was 0.666%. One patient of our HD center contracted COVID-19 from the household; however, we have contained secondary transmission in our HD center by implementing strict preventive measures. The mortality rate of HD patients in Keelung was 66.6%. The median Ct value of HD patients was 17.53 (11.75-27.90) upon diagnosis. The deceased patients had a higher cardiac/thoracic ratio than alive (0.61 vs. 0.55, p = 0.036). CONCLUSIONS: Taking aggressive and proactive infection preventive measures impedes the secondary transmission of COVID-19 in HD facilities. COVID-19-associated mortality was high in HD patients, being the high cardiac-thoracic ratio, an important prognostic factor for clinical outcome of infected HD patients.

6.
Healthcare (Basel) ; 9(1)2021 Jan 05.
Article in English | MEDLINE | ID: covidwho-1011454

ABSTRACT

Hemodialysis (HD) patients are highly susceptible to COVID-19 infection. However, comprehensive assessments of current evidence regarding COVID-19 in HD patients remain incomplete. We systematically searched PUBMED and EMBASE for articles published on incidence or mortality of COVID-19 infection in HD patients until September 2020. Two independent researchers extracted data and study-level risk of bias across studies. We conducted meta-analysis of proportions for incidence and mortality rate. Study heterogeneity and publication bias were assessed. A total of 29 articles with 3261 confirmed COVID-19 cases from a pool of 396,062 HD patients were identified. Incidence of COVID-19 in these HD patients was 7.7% (95% CI: 5.0-10.9%; study heterogeneity: I2 = 99.7%, p < 0.001; risk of publication bias, Egger's test, p < 0.001). Overall mortality rate was 22.4% (95% CI: 17.9-27.1%; study heterogeneity: I2 = 87.1%, p < 0.001; risk of publication bias, Egger's test: p = 0.197) in HD patients with COVID-19. Reported estimates were higher in non-Asian than Asian countries. Quality of study may affect the reported incidence but not the mortality among studies. Both incidence and mortality of COVID-19 infection were higher in HD patients. Available data may underestimate the real incidence of infection. International collaboration and standardized reporting of epidemiological data should be needed for further studies.

7.
CAplus; 2020.
Preprint | CAplus | ID: ppcovidwho-2063

ABSTRACT

A review. Aromatic Chinese herbs has been used to prevent plague since ancient times, and traditional Chinese medicine has unique advantages in the prevention and treatment of epidemic disease. Corona virus disease 2019 (COVID-19) is rampant, and the National Health Commission of the People's Republic of China issued guidelines recommends treatment plans with integrated traditional Chinese and Western medicine. According to the traditional Chinese medicine treatment plan in the National COVID-19 Diagnosis and Treatment Plan (Trial Seventh Edition) of the National Health Commission, Chinese patent medicines or prescriptions containing more aromatic Chinese herbs are selected for prevention and treatment during the period of medical observation, clin. treatment and recovery of confirmed patients. Some local health committees or traditional Chinese medicine administrations also recommend a variety of other ways to use aromatic traditional Chinese herbs (external fumigation, moxibustion, wearing sachet, etc.) to prevent and cure COVID-19. The efficacy of "fragrance repels filth and reinforces vital qi" of aromatic Chinese herbs plays a pos. role in the prevention and treatment of COVID-19. It has become a consensus to use aromatic Chinese herbs to interfere with the occurrence and development of COVID-19. The unique properties, chem. composition and action mechanism of aromatic Chinese herbs are worthy of extensive and in-depth exptl. and clin. research, which can provide reference for the follow-utreatment of novel coronavirus and the development of corresponding drugs. Based on the theory of traditional Chinese medicine, this paper discusses the role of aromatic Chinese herbs in the prevention and treatment of COVID-19, and speculates the possible mechanism of its function, in order to provide a basis for attaching importance to the prevention and treatment of COVID-19.

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