Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 15 de 15
Filter
1.
Journal of Epidemiology & Community Health ; 25:25, 2022.
Article in English | MEDLINE | ID: covidwho-1807485

ABSTRACT

BACKGROUND: The UK began an ambitious COVID-19 vaccination programme on 8 December 2020. This study describes variation in vaccination uptake by sociodemographic characteristics between December 2020 and August 2021. METHODS: Using population-level administrative records linked to the 2011 Census, we estimated monthly first dose vaccination rates by age group and sociodemographic characteristics among adults aged 18 years or over in England. We also present a tool to display the results interactively. RESULTS: Our sample included 35 223 466 adults. A lower percentage of males than females were vaccinated in the young and middle age groups (18-59 years) but not in the older age groups. Vaccination rates were highest among individuals of White British and Indian ethnic backgrounds and lowest among Black Africans (aged >=80 years) and Black Caribbeans (18-79 years). Differences by ethnic group emerged as soon as vaccination roll-out commenced and widened over time. Vaccination rates were also lower among individuals who identified as Muslim, lived in more deprived areas, reported having a disability, did not speak English as their main language, lived in rented housing, belonged to a lower socioeconomic group, and had fewer qualifications. CONCLUSION: We found inequalities in COVID-19 vaccination uptake rates by sex, ethnicity, religion, area deprivation, disability status, English language proficiency, socioeconomic position and educational attainment, but some of these differences varied by age group. Research is urgently needed to understand why these inequalities exist and how they can be addressed.

2.
Evans, R. A.; Leavy, O. C.; Richardson, M.; Elneima, O.; McCauley, H. J. C.; Shikotra, A.; Singapuri, A.; Sereno, M.; Saunders, R. M.; Harris, V. C.; Houchen-Wolloff, L.; Aul, R.; Beirne, P.; Bolton, C. E.; Brown, J. S.; Choudhury, G.; Diar-Bakerly, N.; Easom, N.; Echevarria, C.; Fuld, J.; Hart, N.; Hurst, J.; Jones, M. G.; Parekh, D.; Pfeffer, P.; Rahman, N. M.; Rowland-Jones, S. L.; Shah, A. M.; Wootton, D. G.; Chalder, T.; Davies, M. J.; De Soyza, A.; Geddes, J. R.; Greenhalf, W.; Greening, N. J.; Heaney, L. G.; Heller, S.; Howard, L. S.; Jacob, J.; Jenkins, R. G.; Lord, J. M.; Man, W. D. C.; McCann, G. P.; Neubauer, S.; Openshaw, P. J. M.; Porter, J. C.; Rowland, M. J.; Scott, J. T.; Semple, M. G.; Singh, S. J.; Thomas, D. C.; Toshner, M.; Lewis, K. E.; Thwaites, R. S.; Briggs, A.; Docherty, A. B.; Kerr, S.; Lone, N. I.; Quint, J.; Sheikh, A.; Thorpe, M.; Zheng, B.; Chalmers, J. D.; Ho, L. P.; Horsley, A.; Marks, M.; Poinasamy, K.; Raman, B.; Harrison, E. M.; Wain, L. V.; Brightling, C. E.; Abel, K.; Adamali, H.; Adeloye, D.; Adeyemi, O.; Adrego, R.; Aguilar Jimenez, L. A.; Ahmad, S.; Ahmad Haider, N.; Ahmed, R.; Ahwireng, N.; Ainsworth, M.; Al-Sheklly, B.; Alamoudi, A.; Ali, M.; Aljaroof, M.; All, A. M.; Allan, L.; Allen, R. J.; Allerton, L.; Allsop, L.; Almeida, P.; Altmann, D.; Alvarez Corral, M.; Amoils, S.; Anderson, D.; Antoniades, C.; Arbane, G.; Arias, A.; Armour, C.; Armstrong, L.; Armstrong, N.; Arnold, D.; Arnold, H.; Ashish, A.; Ashworth, A.; Ashworth, M.; Aslani, S.; Assefa-Kebede, H.; Atkin, C.; Atkin, P.; Aung, H.; Austin, L.; Avram, C.; Ayoub, A.; Babores, M.; Baggott, R.; Bagshaw, J.; Baguley, D.; Bailey, L.; Baillie, J. K.; Bain, S.; Bakali, M.; Bakau, M.; Baldry, E.; Baldwin, D.; Ballard, C.; Banerjee, A.; Bang, B.; Barker, R. E.; Barman, L.; Barratt, S.; Barrett, F.; Basire, D.; Basu, N.; Bates, M.; Bates, A.; Batterham, R.; Baxendale, H.; Bayes, H.; Beadsworth, M.; Beckett, P.; Beggs, M.; Begum, M.; Bell, D.; Bell, R.; Bennett, K.; Beranova, E.; Bermperi, A.; Berridge, A.; Berry, C.; Betts, S.; Bevan, E.; Bhui, K.; Bingham, M.; Birchall, K.; Bishop, L.; Bisnauthsing, K.; Blaikely, J.; Bloss, A.; Bolger, A.; Bonnington, J.; Botkai, A.; Bourne, C.; Bourne, M.; Bramham, K.; Brear, L.; Breen, G.; Breeze, J.; Bright, E.; Brill, S.; Brindle, K.; Broad, L.; Broadley, A.; Brookes, C.; Broome, M.; Brown, A.; Brown, A.; Brown, J.; Brown, J.; Brown, M.; Brown, M.; Brown, V.; Brugha, T.; Brunskill, N.; Buch, M.; Buckley, P.; Bularga, A.; Bullmore, E.; Burden, L.; Burdett, T.; Burn, D.; Burns, G.; Burns, A.; Busby, J.; Butcher, R.; Butt, A.; Byrne, S.; Cairns, P.; Calder, P. C.; Calvelo, E.; Carborn, H.; Card, B.; Carr, C.; Carr, L.; Carson, G.; Carter, P.; Casey, A.; Cassar, M.; Cavanagh, J.; Chablani, M.; Chambers, R. C.; Chan, F.; Channon, K. M.; Chapman, K.; Charalambou, A.; Chaudhuri, N.; Checkley, A.; Chen, J.; Cheng, Y.; Chetham, L.; Childs, C.; Chilvers, E. R.; Chinoy, H.; Chiribiri, A.; Chong-James, K.; Choudhury, N.; Chowienczyk, P.; Christie, C.; Chrystal, M.; Clark, D.; Clark, C.; Clarke, J.; Clohisey, S.; Coakley, G.; Coburn, Z.; Coetzee, S.; Cole, J.; Coleman, C.; Conneh, F.; Connell, D.; Connolly, B.; Connor, L.; Cook, A.; Cooper, B.; Cooper, J.; Cooper, S.; Copeland, D.; Cosier, T.; Coulding, M.; Coupland, C.; Cox, E.; Craig, T.; Crisp, P.; Cristiano, D.; Crooks, M. G.; Cross, A.; Cruz, I.; Cullinan, P.; Cuthbertson, D.; Daines, L.; Dalton, M.; Daly, P.; Daniels, A.; Dark, P.; Dasgin, J.; David, A.; David, C.; Davies, E.; Davies, F.; Davies, G.; Davies, G. A.; Davies, K.; Dawson, J.; Daynes, E.; Deakin, B.; Deans, A.; Deas, C.; Deery, J.; Defres, S.; Dell, A.; Dempsey, K.; Denneny, E.; Dennis, J.; Dewar, A.; Dharmagunawardena, R.; Dickens, C.; Dipper, A.; Diver, S.; Diwanji, S. N.; Dixon, M.; Djukanovic, R.; Dobson, H.; Dobson, S. L.; Donaldson, A.; Dong, T.; Dormand, N.; Dougherty, A.; Dowling, R.; Drain, S.; Draxlbauer, K.; Drury, K.; Dulawan, P.; Dunleavy, A.; Dunn, S.; Earley, J.; Edwards, S.; Edwardson, C.; El-Taweel, H.; Elliott, A.; Elliott, K.; Ellis, Y.; Elmer, A.; Evans, D.; Evans, H.; Evans, J.; Evans, R.; Evans, R. I.; Evans, T.; Evenden, C.; Evison, L.; Fabbri, L.; Fairbairn, S.; Fairman, A.; Fallon, K.; Faluyi, D.; Favager, C.; Fayzan, T.; Featherstone, J.; Felton, T.; Finch, J.; Finney, S.; Finnigan, J.; Finnigan, L.; Fisher, H.; Fletcher, S.; Flockton, R.; Flynn, M.; Foot, H.; Foote, D.; Ford, A.; Forton, D.; Fraile, E.; Francis, C.; Francis, R.; Francis, S.; Frankel, A.; Fraser, E.; Free, R.; French, N.; Fu, X.; Furniss, J.; Garner, L.; Gautam, N.; George, J.; George, P.; Gibbons, M.; Gill, M.; Gilmour, L.; Gleeson, F.; Glossop, J.; Glover, S.; Goodman, N.; Goodwin, C.; Gooptu, B.; Gordon, H.; Gorsuch, T.; Greatorex, M.; Greenhaff, P. L.; Greenhalgh, A.; Greenwood, J.; Gregory, H.; Gregory, R.; Grieve, D.; Griffin, D.; Griffiths, L.; Guerdette, A. M.; Guillen Guio, B.; Gummadi, M.; Gupta, A.; Gurram, S.; Guthrie, E.; Guy, Z.; H Henson, H.; Hadley, K.; Haggar, A.; Hainey, K.; Hairsine, B.; Haldar, P.; Hall, I.; Hall, L.; Halling-Brown, M.; Hamil, R.; Hancock, A.; Hancock, K.; Hanley, N. A.; Haq, S.; Hardwick, H. E.; Hardy, E.; Hardy, T.; Hargadon, B.; Harrington, K.; Harris, E.; Harrison, P.; Harvey, A.; Harvey, M.; Harvie, M.; Haslam, L.; Havinden-Williams, M.; Hawkes, J.; Hawkings, N.; Haworth, J.; Hayday, A.; Haynes, M.; Hazeldine, J.; Hazelton, T.; Heeley, C.; Heeney, J. L.; Heightman, M.; Henderson, M.; Hesselden, L.; Hewitt, M.; Highett, V.; Hillman, T.; Hiwot, T.; Hoare, A.; Hoare, M.; Hockridge, J.; Hogarth, P.; Holbourn, A.; Holden, S.; Holdsworth, L.; Holgate, D.; Holland, M.; Holloway, L.; Holmes, K.; Holmes, M.; Holroyd-Hind, B.; Holt, L.; Hormis, A.; Hosseini, A.; Hotopf, M.; Howard, K.; Howell, A.; Hufton, E.; Hughes, A. D.; Hughes, J.; Hughes, R.; Humphries, A.; Huneke, N.; Hurditch, E.; Husain, M.; Hussell, T.; Hutchinson, J.; Ibrahim, W.; Ilyas, F.; Ingham, J.; Ingram, L.; Ionita, D.; Isaacs, K.; Ismail, K.; Jackson, T.; James, W. Y.; Jarman, C.; Jarrold, I.; Jarvis, H.; Jastrub, R.; Jayaraman, B.; Jezzard, P.; Jiwa, K.; Johnson, C.; Johnson, S.; Johnston, D.; Jolley, C. J.; Jones, D.; Jones, G.; Jones, H.; Jones, H.; Jones, I.; Jones, L.; Jones, S.; Jose, S.; Kabir, T.; Kaltsakas, G.; Kamwa, V.; Kanellakis, N.; Kaprowska, s, Kausar, Z.; Keenan, N.; Kelly, S.; Kemp, G.; Kerslake, H.; Key, A. L.; Khan, F.; Khunti, K.; Kilroy, S.; King, B.; King, C.; Kingham, L.; Kirk, J.; Kitterick, P.; et al..
The Lancet Respiratory Medicine ; 2022.
Article in English | ScienceDirect | ID: covidwho-1799635

ABSTRACT

Summary Background No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. Methods The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. Findings 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7–9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46–0·99]), obesity (0·50 [0·34–0·74]) and invasive mechanical ventilation (0·42 [0·23–0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment;0·88 [IQR 0·74–1·00]), at 5 months (0·74 [0·64–0·88]) to 1 year (0·75 [0·62–0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. Interpretation The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. Funding

3.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-332715

ABSTRACT

Objective To assess the risk of death involving COVID-19 following infection from Omicron (B.1.1.539/BA.1) relative to Delta (B.1.617.2). Design Retrospective cohort study. Setting England, UK, 1 December 2021 to 25 January 2022. Participants 1,035,163 people aged 18-100 years who tested positive for SARS-CoV-2 in the national surveillance programme, and had an infection identified as either Omicron- or Delta compatible. Main outcome measures Death involving COVID-19 as identified from death certification records. The exposure of interest was the SARS-CoV-2 variant identified from NHS Test and Trace PCR positive tests taken in the community (pillar 2) and analysed by Lighthouse laboratories. Cause-specific Cox proportional hazard regression models were adjusted for sex, age, vaccination status, previous infection, calendar time, ethnicity, Index of Multiple Deprivation rank, household deprivation, university degree, keyworker status, country of birth, main language, region, disability, and comorbidities. Additionally, we tested for interactions between variant and sex, age, vaccination status and comorbidities. Results The risk of death involving COVID-19 was 67% lower for Omicron compared to Delta and the reduction in the risk of death involving COVID-19 for Omicron compared to Delta was more pronounced in males than in females and in people under 70 years old than in people aged 70 years or over. Regardless of age, reduction of the risk of death from Omicron relative to Delta more was more pronounced in people who had received a booster than in those having received only two doses. Conclusions Our results support early work showing the relative reduction in severity of Omicron compared to Delta in terms of hospitalisation and extends this research to assess COVID-19 mortality. Our work also highlights the importance of the vaccination booster campaign, where the reduction in risk of death involving COVID-19 is most pronounced in individuals who had received a booster.

4.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-321033

ABSTRACT

Background: The Coronavirus disease 2019 (COVID-19) pandemic has led to a dramatic crisis in health care systems worldwide. These may have significant implications for the management of cardiometabolic diseases. We conducted a systematic review of published evidence to assess the indirect impact of the COVID-19 pandemic on hospitalisations for cardiovascular diseases and their management. Methods: : Studies that evaluated volume of hospitalisations for cardiometabolic conditions and their management with comparisons between the COVID-19 and pre-COVID periods were identified from MEDLINE, Embase and the reference list of relevant studies from January 2020 to 25 February 2021. Results: : We identified 103 observational studies, with most studies assessing hospitalisations for acute cardiovascular conditions such as acute coronary syndrome, ischemic strokes and heart failure. About 89% of studies reported a decline in hospitalisations during the pandemic compared to pre-pandemic times, with reductions ranging from 20.2 to 73%. Severe presentation, less utilization of cardiovascular procedures, and longer patient- and healthcare-related delays were common during the pandemic. Most studies reported shorter length of hospital stay during the pandemic than before the pandemic (1-8 vs 2-12 days) or no difference in length of stay. Most studies reported no change in in-hospital mortality among hospitalised patients. Conclusion: Routine and ongoing clinical care of patients for acute cardiovascular conditions, their management and outcomes have been adversely impacted by the COVID-19 pandemic. Patients should be educated via population-wide approaches on the need for timely medical contact and health systems should put strategies in place to provide timely care to patients at high risk.

5.
British Journal of Diabetes ; 21(2):222-227, 2021.
Article in English | Web of Science | ID: covidwho-1579705

ABSTRACT

Background: People with diabetes and coronavirus disease 2019 (COVID-19) have a significantly greater risk of death and/or intensive care unit (KU) admission. The Association of British Clinical Diabetologists (ABCD) recently audited out- comes for people hospitalised in the UK with diabetes and COVID-19. Methods: The ABCD COVID-19 and diabetes audit was a retrospective audit of patients admitted to UK hospitals with diabetes and COVID-19 between March and December 2020. Data related to patients admitted in Wales were compared with patients admitted in England and Scotland. Results: In Wales, 40/82 (48.7%) patients with diabetes had COVID-19-related mortality compared with 1,149/2,916 (39.1%) in the UK group (p=0.08). The Welsh cohort were more likely to be Caucasian, have a higher body mass index and HbA1c, be diagnosed with diabetic retinopathy and prescribed a sodium-glucose co-transporter 2 inhibitor or insulin than those in England and Scotland. Patients admitted to the ICU in Wales were more likely to be male and have type 2 diabetes. Conclusions: Patients admitted to hospital with diabetes and COVID-19 in Wales had a poorer outcome compared with England and Scotland. This disparity may reflect social inequality, differences in cardiovascular risk factors and/or differences in diabetes medications between hospitalised patients in Wales and the UK.

6.
Journal of the Royal Society of Medicine ; 113(12):485-486, 2020.
Article in English | CAB Abstracts | ID: covidwho-1410178

ABSTRACT

While we wait for an effective vaccine against SARS-CoV-2, the influenza and Measles-Mumps-Rubella vaccine with proven safety and efficacy profile can a play critical role in reducing the healthcare burden. First, an increase in the coverage of influenza and Measles-Mumps-Rubella vaccines will decrease the number of cases and the need for hospitalisations for severe illnesses due to these diseases. It will, thereby, reduce the burden on healthcare providers and facilities, which will be particularly crucial in resource-poor settings in making the scarce resources (e.g. hospital beds) allocated to those who need them the most. Second, live attenuated vaccines such as Measles-Mumps-Rubella and Bacillus Calmette-Guerin have been reported to provide non-specific protection against lethal infections including pneumonia and sepsis, especially in low-income settings. Third, infection with measles has been shown to increase children's susceptibility to other infections by reducing the immune system's memory against other pathogens including the influenza virus. Therefore, infection with measles may also increase the susceptibility to SARS-CoV-2 even though it is yet to be empirically tested. Therefore, as we wait for a successful vaccine for COVID-19, we can minimise winter pressures on health systems and societies by maximising the uptake of influenza and Measles-Mumps-Rubella vaccines (and potentially Bacillus Calmette-Guerin vaccines, especially in tuberculosis-endemic areas).

7.
Public Health ; 194: 146-148, 2021 May.
Article in English | MEDLINE | ID: covidwho-1203256

ABSTRACT

OBJECTIVE: The aim of the study was to investigate the impact of the COVID-19 pandemic and prevention measures on religious practices after death, by ethnic grouping, in an opportunistic/convenience sample of UK adults. METHODS: We distributed a questionnaire online and in hard copy between May 1 and June 18, 2020, via social media, post and face-to-face contact in Leicester, a multi-ethnic city in the UK. RESULTS: From 980 adults providing consent, 665 completed some or all survey items and provided ethnicity data. More than double the proportion of Black and South Asian individuals reported religious practices relating to death, burials or funerals being affected by COVID-19 than White groups. Of the 151 participants reporting practices being impacted, a greater proportion of ethnic minority groups reported restricted access/alteration to eight death-related practices (e.g., funeral attendance) compared with White groups (significantly different for all practices, P < 0.05). CONCLUSION: The initial phase of the COVID-19 pandemic in the UK has negatively impacted on the ability to conduct religious practices after death in all ethnic groups, but the impact appears greater in ethnic minority populations than in White groups. There is a need for further qualitative research on the impact of the COVID-19 pandemic on death and burial practices of minority ethnic groups.


Subject(s)
COVID-19/epidemiology , Funeral Rites , Minority Groups/statistics & numerical data , Religion , Adult , African Americans/statistics & numerical data , Aged , Attitude to Death , COVID-19/prevention & control , Female , Humans , Male , Middle Aged , Pandemics , Qualitative Research , SARS-CoV-2 , Social Media , Surveys and Questionnaires , United Kingdom , /statistics & numerical data
8.
BMC Public Health ; 21(1): 773, 2021 04 22.
Article in English | MEDLINE | ID: covidwho-1199905

ABSTRACT

BACKGROUND: Health and key workers have elevated odds of developing severe COVID-19; it is not known, however, if this is exacerbated in those with irregular work patterns. We aimed to investigate the odds of developing severe COVID-19 in health and shift workers. METHODS: We included UK Biobank participants in employment or self-employed at baseline (2006-2010) and with linked COVID-19 data to 31st August 2020. Participants were grouped as neither a health worker nor shift worker (reference category) at baseline, health worker only, shift worker only, or both, and associations with severe COVID-19 investigated in logistic regressions. RESULTS: Of 235,685 participants (81·5% neither health nor shift worker, 1·4% health worker only, 16·9% shift worker only, and 0·3% both), there were 580 (0·25%) cases of severe COVID-19. The odds of severe COVID-19 was higher in health workers (adjusted odds ratio: 2·32 [95% CI: 1·33, 4·05]; shift workers (2·06 [1·72, 2·47]); and in health workers who worked shifts (7·56 [3·86, 14·79]). Being both a health worker and a shift worker had a possible greater impact on the odds of severe COVID-19 in South Asian and Black and African Caribbean ethnicities compared to White individuals. CONCLUSIONS: Both health and shift work (measured at baseline, 2006-2010) were independently associated with over twice the odds of severe COVID-19 in 2020; the odds were over seven times higher in health workers who work shifts. Vaccinations, therapeutic and preventative options should take into consideration not only health and key worker status but also shift worker status.


Subject(s)
COVID-19 , Delivery of Health Care , Humans , SARS-CoV-2
9.
European Observatory on Health Systems and Policies. European Observatory Policy Briefs ; 2021.
Article in English | MEDLINE | ID: covidwho-1196319

ABSTRACT

COVID-19 can cause persistent ill-health. Around a quarter of people who have had the virus experience symptoms that continue for at least a month but one in 10 are still unwell after 12 weeks. This has been described by patient groups as "Long COVID". Our understanding of how to diagnose and manage Long COVID is still evolving but the condition can be very debilitating. It is associated with a range of overlapping symptoms including generalized chest and muscle pain, fatigue, shortness of breath, and cognitive dysfunction, and the mechanisms involved affect multiple system and include persisting inflammation, thrombosis, and autoimmunity. It can affect anyone, but women and health care workers seem to be at greater risk. Long COVID has a serious impact on people's ability to go back to work or have a social life. It affects their mental health and may have significant economic consequences for them, their families and for society. Policy responses need to take account of the complexity of Long COVID and how what is known about it is evolving rapidly. Areas to address include: The need for multidisciplinary, multispecialty approaches to assessment and management;Development, in association with patients and their families, of new care pathways and contextually appropriate guidelines for health professionals, especially in primary care to enable case management to be tailored to the manifestations of disease and involvement of different organ systems;The creation of appropriate services, including rehabilitation and online support tools;Action to tackle the wider consequences of Long COVID, including attention to employment rights, sick pay policies, and access to benefit and disability benefit packages;Involving patients both to foster self-care and self-help and in shaping awareness of Long COVID and the service (and research) needs it generates;and Implementing well-functioning patient registers and other surveillance systems;creating cohorts of patients;and following up those affected as a means to support the research which is so critical to understanding and treating Long COVID.

10.
11.
Bmj-British Medical Journal ; 371:2, 2020.
Article in English | Web of Science | ID: covidwho-1035255
12.
The BMJ ; 371, 2020.
Article in English | Scopus | ID: covidwho-1004144
13.
New England Journal of Medicine ; 383(20):1992-1992, 2020.
Article in English | Web of Science | ID: covidwho-970339
15.
Diabet Med ; 37(7): 1094-1102, 2020 07.
Article in English | MEDLINE | ID: covidwho-116685

ABSTRACT

The month of Ramadan forms one of the five pillars of the Muslim faith. Adult Muslims are obligated to keep daily fasts from dawn to sunset, with exceptions. This year Ramadan is due to begin on 23 April 2020 and the longest fast in the UK will be approximately 18 hours in length. In addition, due to the often high-calorie meals eaten to break the fast, Ramadan should be seen as a cycle of fasting and feasting. Ramadan fasting can impact those with diabetes, increasing the risk of hypoglycaemia, hyperglycaemia and dehydration. This year, Ramadan will occur during the global COVID-19 pandemic. Reports show that diabetes appears to be a risk factor for more severe disease with COVID-19. In addition, the UK experience has shown diabetes and COVID-19 is associated with dehydration, starvation ketosis, diabetic ketoacidosis and hyperosmolar hyperglycaemic state. This makes fasting in Ramadan particularly challenging for those Muslims with diabetes. Here, we discuss the implications of fasting in Ramadan during the COVID-19 pandemic and make recommendations for those with diabetes who wish to fast.


Subject(s)
Diabetes Mellitus, Type 1/therapy , Diabetes Mellitus, Type 2/therapy , Fasting/metabolism , Holidays , Islam , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/metabolism , Dehydration/epidemiology , Dehydration/metabolism , Dehydration/prevention & control , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/metabolism , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/metabolism , Diabetic Ketoacidosis/epidemiology , Diet Therapy , Disease Management , Fasting/adverse effects , Fluid Therapy , Humans , Hyperglycemia/epidemiology , Hyperglycemia/metabolism , Hyperglycemia/prevention & control , Hyperglycemic Hyperosmolar Nonketotic Coma/epidemiology , Hyperglycemic Hyperosmolar Nonketotic Coma/metabolism , Hypoglycemia/epidemiology , Hypoglycemia/metabolism , Hypoglycemia/prevention & control , Hypoglycemic Agents/therapeutic use , Ketosis/epidemiology , Ketosis/metabolism , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/metabolism , Risk Assessment , SARS-CoV-2 , United Kingdom
SELECTION OF CITATIONS
SEARCH DETAIL