ABSTRACT
BACKGROUND: Risk perception is an important predictor of health-protective behaviors during pandemics. However, the underlying mechanism connecting risk perception and health-protective behaviors is not well understood. The current study investigates how risk perception predicts hospital pharmacists' engagement in health-protective behaviors during the peak period of COVID-19 pandemic in China and the mediating effects of lay theories of health and self-efficacy. METHOD: A cross-sectional study on risk perception and engagement in health-protective behaviors was conducted among hospital pharmacists during the COVID-19 pandemic in China. A total of 4121 hospital pharmacists completed the study. RESULTS: Risk perception, self-efficacy, and lay theories of health were significant predictors of health-protective behaviors among pharmacists. Lay (entity) theories of health and self-efficacy mediated the relationship between risk perception and engagement in health-protective behaviors among hospital pharmacists. CONCLUSION: Risk perception, self-efficacy, and lay theories (entity versus incremental) of health significantly predicted hospital pharmacists' engagement in health-protective behaviors during the COVID-19 pandemic in China.
Subject(s)
COVID-19 , Pandemics , COVID-19/prevention & control , Cross-Sectional Studies , Hospitals , Humans , Pandemics/prevention & control , Pharmacists , SARS-CoV-2 , Self EfficacyABSTRACT
PURPOSE: We aimed to analyze and evaluate the safety signals of ribavirin-interferon combination through data mining of the US Food and Drug Administration Adverse Event Reporting System (FAERS), so as to provide reference for the rationale use of these agents in the management of relevant toxicities emerging in patients with novel coronavirus pneumonia (COVID-19). METHODS: Reports to the FAERS from 1 January 2004 to 8 March 2020 were analyzed. The proportion of report ratio (PRR), reporting odds ratio (ROR), and Bayesian confidence interval progressive neural network (BCPNN) method were used to detect the safety signals. RESULTS: A total of 55 safety signals were detected from the top 250 adverse event reactions in 2200 reports, but 19 signals were not included in the drug labels. All the detected adverse event reactions were associated with 13 System Organ Classes (SOC), such as gastrointestinal, blood and lymph, hepatobiliary, endocrine, and various nervous systems. The most frequent adverse events were analyzed, and the results showed that females were more likely to suffer from anemia, vomiting, neutropenia, diarrhea, and insomnia. CONCLUSION: The ADE (adverse drug event) signal detection based on FAERS is helpful to clarify the potential adverse events related to ribavirin-interferon combination for novel coronavirus therapy; clinicians should pay attention to the adverse reactions of gastrointestinal and blood systems, closely monitor the fluctuations of the platelet count, and carry out necessary mental health interventions to avoid serious adverse events.
Subject(s)
Coronavirus Infections/drug therapy , Interferons/adverse effects , Pneumonia, Viral/drug therapy , Ribavirin/adverse effects , Adolescent , Adult , Adverse Drug Reaction Reporting Systems , Aged , Algorithms , Bayes Theorem , COVID-19 , Data Mining , Drug Administration Schedule , Drug Therapy, Combination/adverse effects , Female , Humans , Interferons/administration & dosage , Male , Middle Aged , Neural Networks, Computer , Odds Ratio , Pandemics , Patient Safety , Ribavirin/administration & dosage , Young Adult , COVID-19 Drug TreatmentABSTRACT
OBJECTIVE: To explore the feasibility of radical resection for cancer patients complicated with coronavirus disease 2019 (COVID-19). METHODS: The management and clinical outcome of a sigmoid cancer patient with COVID-19 were analyzed. RESULTS: The inflammation indicators and fever of this patient were effectively controlled and the lung lesions remained stable after active anti-viral treatment, then the radical colorectomy was performed after the viral negative conversion for twice. CONCLUSIONS: The case indicates that radical resection can be performed in SARS-CoV-2 patients with twice-negative SARS-CoV-2 nucleic acid testing results.
Subject(s)
Colonic Neoplasms , Coronavirus Infections , Pandemics , Pneumonia, Viral , Betacoronavirus/isolation & purification , COVID-19 , Colonic Neoplasms/complications , Colonic Neoplasms/surgery , Coronavirus Infections/complications , Coronavirus Infections/therapy , Disease Management , Humans , Pneumonia, Viral/complications , Pneumonia, Viral/therapy , SARS-CoV-2 , Treatment OutcomeABSTRACT
Background: Liver injury commonly occurs in patients with COVID-19. There is limited data describing the course of liver injury occurrence in patients with different disease severity, and the causes and risk factors are unknown. We aim to investigate the incidence, characteristics, risk factors, and clinical outcomes of liver injury in patients with COVID-19. Methods: This retrospective observational study was conducted in three hospitals (Zhejiang, China). From January 19, 2020 to February 20, 2020, patients confirmed with COVID-19 (≥18 years) and without liver injury were enrolled and divided into non-critically ill and critically ill groups. The incidence and characteristics of liver injury were compared between the two groups. Demographics, clinical characteristics, treatments, and treatment outcomes between patients with or without liver injury were compared within each group. The multivariable logistic regression model was used to explore the risk factors for liver injury. Results: The mean age of 131 enrolled patients was 51.2 years (standard deviation [SD]: 16.1 years), and 70 (53.4%) patients were male. A total of 76 patients developed liver injury (mild, 40.5%; moderate, 15.3%; severe, 2.3%) with a median occurrence time of 10.0 days. Critically ill patients had higher and earlier occurrence (81.5 vs. 51.9%, 12.0 vs. 5.0 days; p < 0.001), greater injury severity (p < 0.001), and slower recovery (50.0 vs. 61.1%) of liver function than non-critically ill patients. Multivariable regression showed that the number of concomitant medications (odds ratio [OR]: 1.12, 95% confidence interval [CI]: 1.05-1.21) and the combination treatment of lopinavir/ritonavir and arbidol (OR: 3.58, 95% CI: 1.44-9.52) were risk factors for liver injury in non-critically ill patients. The metabolism of arbidol can be significantly inhibited by lopinavir/ritonavir in vitro (p < 0.005), which may be the underlying cause of drug-related liver injury. Liver injury was related to increased length of hospital stay (mean difference [MD]: 3.2, 95% CI: 1.3-5.2) and viral shedding duration (MD: 3.0, 95% CI: 1.0-4.9). Conclusions: Critically ill patients with COVID-19 suffered earlier occurrence, greater injury severity, and slower recovery from liver injury than non-critically ill patients. Drug factors were related to liver injury in non-critically ill patients. Liver injury was related to prolonged hospital stay and viral shedding duration in patients with COVID-19. Clinical Trial Registration: World Health Organization International Clinical Trials Registry Platform, ChiCTR2000030593. Registered March 8, 2020.