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1.
Innovation in Aging ; 5:465-465, 2021.
Article in English | Web of Science | ID: covidwho-2012892
3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-335302

ABSTRACT

Individual responses to SARS-CoV-2 infection vary significantly, ranging from mild courses of infection that do not require hospitalisation to the development of disease which not only requires hospitalisation but can be fatal. Whilst many immunological studies have revealed fundamental insights into SARS-CoV-2 infection and COVID-19, mathematical and computational modelling can offer an additional perspective and enhance understanding. The majority of mathematical models for the within-host spread of SARS-CoV-2 infection are ordinary differential equations, which neglect spatial variation. In this article, we present a hybrid, multiscale, individual-based model to study the within-host spread of SARS-CoV-2 infection. The model incorporates epithelial cells (each containing a dynamical model for viral entry and replication), macrophages and a subset of cytokines. We investigate the role of increasing initial viral deposition, increasing delay in type I interferon secretion from epithelial cells (as well as the magnitude of secretion), increasing macrophage virus internalisation rate and macrophage activation, on the spread of infection.

4.
J Hosp Infect ; 109: 1-9, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-916875

ABSTRACT

Outbreaks pose a significant risk to patient safety as well as being costly and time consuming to investigate. The implementation of targeted infection prevention and control measures relies on infection prevention and control teams having access to rapid results that detect resistance accurately, and typing results that give clinically useful information on the relatedness of isolates. At present, determining whether transmission has occurred can be a major challenge. Conventional typing results do not always have sufficient granularity or robustness to define strains unequivocally, and sufficient epidemiological data are not always available to establish links between patients and the environment. Whole-genome sequencing (WGS) has emerged as the ultimate genotyping tool, but has not yet fully crossed the divide between research method and routine clinical diagnostic microbiological technique. A clinical WGS service was officially established in 2014 as part of the Scottish Healthcare Associated Infection Prevention Institute to confirm or refute outbreaks in hospital settings from across Scotland. This article describes the authors' experiences with the aim of providing new insights into practical application of the use of WGS to investigate healthcare and public health outbreaks. Solutions to overcome barriers to implementation of this technology in a clinical environment are proposed.


Subject(s)
Disease Outbreaks , Public Health , Whole Genome Sequencing , Delivery of Health Care , Genome, Bacterial , Genotyping Techniques , Humans , Scotland
5.
Thorax ; 76(SUPPL 1):A6-A7, 2021.
Article in English | EMBASE | ID: covidwho-1194236

ABSTRACT

Introduction The Rockwood clinical frailty score (CFS) has been recommended for use in assessing patients during the COVID-19 pandemic. However, a recent cohort study has suggested it has little impact on the hazard of dying due to COVID-19,1 while use to inform escalation decisions has proven contentious. Method We identified patients hospitalised with COVID-19 from 11 March 2020 to 28 April 2020. Age, gender, key co-morbidities, inpatient mortality, length of stay, CFS, respiratory support, chest X-ray (CXR) appearance and C-reactive protein (CRP) were collected retrospectively from electronic records and medical notes. Multiple imputation used for missing values (CFS n= 1;CRP n= 5;CXR n= 9). Univariate relationships with in-hospital mortality were examined (Fisher's exact, T test and Mann-Whitney U as appropriate) and independent predictors of mortality were identified via backward stepwise logistic regression. CFS was verified in patients referred for CPAP/NIV on the Respiratory Support Unit (RSU;maximum level of care);mortality outcomes are separately shown. Results Among 414 patients;mean age was 73 (SD 14.297) years, 241 males (58%), 135 died (33%) and median CFS 4 (IQR 2.75-5.00). Older age (mean 69.90 [SD 15.122] vs. 79.40 [SD 9.616];p< 0.0001) and CFS (median 3 [IQR 2-4] vs. 5 [IQR 3-6];p< 0.0001) were significantly associated with mortality. Mortality was higher in those invasively (10/13, 76.9%, p= 0.001) and non-invasively (16/32, 50.0%, p= 0.027) ventilated. Independent predictors associated with mortality are shown in table 1. Among patients receiving CPAP/NIV on the RSU, mortality increased with each CFS category (1-3 n=6/17, 35.3%;4-5 n=9/14, 64.3%;6-7 n=5/6, 83.3%). Conclusion We report a large, single centre series of COVID-19 patients. Consecutive patients were identified, and missing data were few. CFS is a strong independent predictor of mortality in patients with COVID-19. This data would suggest that, in our population, the continuing use of CFS is important in our management and decision making in patients with COVID-19.

6.
IDS Bulletin ; 52(1):73-94, 2021.
Article in English | Scopus | ID: covidwho-1187204

ABSTRACT

Measures to slow down the spread of Covid-19 have had profound effects on the food and nutrition security of poor and marginalised households and communities. This article provides an overview of the effects of Covid-19 on food systems across low-and middle-income countries using resilience and political economy lenses, before proposing approaches to build back resilient and equitable food systems. First, future interventions need to target structural issues that limit people’s agency in accessing nutritious and diverse food and production capital. Second, local innovation systems and institutions require investment to create a market environment that benefits domestic (small and medium) enterprises and agri-food supply chain workers without jeopardising the environment. Third, interventions need to be informed by a diverse set of opinions that include the voices of the most marginalised. © 2021 The Authors. IDS Bulletin © Institute of Development Studies.

7.
Farmers Weekly ; 2020(May 15):34-35, 2020.
Article in English | Africa Wide Information | ID: covidwho-1098158
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