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1.
Infect Control Hosp Epidemiol ; : 1-6, 2022 Feb 22.
Article in English | MEDLINE | ID: covidwho-1751628

ABSTRACT

BACKGROUND: Residents of long-term care facilities face significantly greater risk of contracting or dying from coronavirus disease 2019 (COVID-19). However, little is known about COVID-19 in assisted living communities (ALCs) and the potential determinants of its spread. We examined the association between COVID-19 cases in ALCs and the proportion of Medicare-Medicaid (dual) eligible minority residents, neighborhood area deprivation, and state COVID-19 policy stringency. METHODS: We conducted longitudinal analyses employing data on confirmed COVID-19 cases in ALCs in 5 states. We sought to determine the weekly cumulative number of COVID-19 cases in ALCs. Covariates were ALC characteristics, area deprivation index, and state COVID-19 policy stringency. Multivariate 2-part models were used to determine the associations between independent variables and the likelihood of an outbreak and the overall count of cases. RESULTS: In our study sample, 201 ALCs (7.04%) reported 1 or more COVID-19 cases as of August 17, 2020. A higher percentage of minority residents was associated with an increased likelihood of an ALC reporting at least 1 COVID-19 case (odds ratio [OR], 1.06; P = .032). Conditional on having at least 1 case, ALCs in states with stricter social distancing policies had lower case counts (incidence rate ratio [IRR], 0.98; P < .001). Greater neighborhood deprivation was associated with higher case count (IRR, 1.36; P = .049). CONCLUSIONS: ALCs with higher proportions of dual-eligible minority residents were more likely to have COVID-19 outbreaks within their communities. ALCs located in more socioeconomically deprived neighborhoods, and in states with less stringent state social distancing policies, tended to have more COVID-19 cases.

2.
Patterns (N Y) ; 3(3): 100435, 2022 Mar 11.
Article in English | MEDLINE | ID: covidwho-1740085

ABSTRACT

The COVID-19 pandemic has highlighted the importance of non-pharmacological interventions (NPIs) for controlling epidemics of emerging infectious diseases. Despite their importance, NPIs have been monitored mainly through the manual efforts of volunteers. This approach hinders measurement of the NPI effectiveness and development of evidence to guide their use to control the global pandemic. We present EpiTopics, a machine learning approach to support automation of NPI prediction and monitoring at both the document level and country level by mining the vast amount of unlabeled news reports on COVID-19. EpiTopics uses a 3-stage, transfer-learning algorithm to classify documents according to NPI categories, relying on topic modeling to support result interpretation. We identified 25 interpretable topics under 4 distinct and coherent COVID-related themes. Importantly, the use of these topics resulted in significant improvements over alternative automated methods in predicting the NPIs in labeled documents and in predicting country-level NPIs for 42 countries.

3.
BMC Health Serv Res ; 22(1): 299, 2022 Mar 04.
Article in English | MEDLINE | ID: covidwho-1724483

ABSTRACT

BACKGROUND: The COVID-19 pandemic has exerted an unprecedented and universal impact on global health system, resulting in noticeable challenges in traditional chronic disease care, of which diabetes was reported to be most influenced by the reduction in healthcare resources in the pandemic. China has the world's largest diabetes population, and current diabetes management in China is unsatisfactory, particularly in rural areas. Studies in developed countries have demonstrated that physician-pharmacist collaborative clinics are efficient and cost-effective for diabetes management, but little is known if this mode could be adapted in primary hospitals in China. The aim of this proposed study is to develop and evaluate physician-pharmacist collaborative clinics to manage type 2 diabetes mellitus (T2DM) in primary hospitals in Hunan province. METHODS: A multi-site randomized controlled trial will be conducted to evaluate the effectiveness and cost-effectiveness of the physician-pharmacist collaborative clinics compared with usual care for Chinese patients with T2DM. Six primary hospitals will participate in the study, which will recruit 600 eligible patients. Patients in the intervention group will receive services from both physicians and pharmacists in the collaborative clinics, while the control group will receive usual care from physicians. Patients will be followed up at the 3rd, 6th, 9th and 12th month. Comparison between the two groups will be conducted by assessing the clinical parameters, process indicators and costs on diabetes. A satisfaction survey will also be carried out at the end of the study. DISCUSSION: If effective, the physician-pharmacist collaborative clinics can be adapted and used in primary hospitals of China to improve glycemic control, enhance medication adherence, decrease incidence of complications and reduce patients' dependence on physicians. Findings from the present study are meaningful for developing evidence-based diabetes care policy in rural China, especially in the COVID-19 pandemic era. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2000031839 , Registered 12 April 2020.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Interprofessional Relations , Pharmacists , Physicians , COVID-19/epidemiology , China/epidemiology , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/epidemiology , Hospitals , Humans , Multicenter Studies as Topic , Pandemics , Randomized Controlled Trials as Topic
4.
Int J Geriatr Psychiatry ; 37(3)2022 02.
Article in English | MEDLINE | ID: covidwho-1694791

ABSTRACT

OBJECTIVES: To examine the relationship between loneliness and self-reported delay or avoidance of medical care among community-dwelling older adults during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Analyses of data from a nationally representative survey administered in June of 2020, in COVID-19 module of the Health and Retirement Study. Bivariate and multivariable analyses determined associations of loneliness with the likelihood of, reasons for, and types of care delay or avoidance. RESULTS: The rate of care delay or avoidance since March of 2020 was 29.1% among all respondents (n = 1997), and 10.1% higher for lonely (n = 1,150%, 57.6%) versus non-lonely respondents (33.5% vs. 23.4%; odds ratio = 1.59, p = 0.003 after covariate adjustment). The differences were considerably larger among several subgroups such as those with emotional/psychiatric problems. Lonely older adults were more likely to cite "Decided it could wait," "Was afraid to go," and "Couldn't afford it" as reasons for delayed or avoided care. Both groups reported dental care and doctor's visit as the two most common care delayed or avoided. CONCLUSIONS: Loneliness is associated with a higher likelihood of delaying or avoiding medical care among older adults during the pandemic.


Subject(s)
COVID-19 , Aged , Humans , Independent Living , Loneliness/psychology , Pandemics , SARS-CoV-2
5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322761

ABSTRACT

Objective: Exposure to the coronavirus disease 2019 (COVID-19) was associated with high risk of mental health problems among frontline nurses. This study examined the prevalence of depressive symptoms (depression hereafter) and its impact on quality of life (QOL) among otorhinolaryngology (ENT) nurses during the COVID-19 pandemic in China. Methods: A national online study was conducted between March 15 and March 20, 2020. Depression and QOL were assessed using standardized instruments. Results: A total of 1,757 participants were recruited. The prevalence of depression was 33.75% (95% CI: 31.59%-35.97%). Results emerging from multiple logistic regression analysis showed that direct care of COVID-19 patients (OR: 1.440, 95% CI: 1.031–2.012, P = 0.032), and current smoker (OR: 3.143, 95% CI: 1.020–9.690, P = 0.046) were significantly associated with depression. After controlling for covariates, ENT nurses with depression had a lower overall QOL compared to those without (F (1, 1757) =536.80, P <0.001). Conclusions: Depression was common among ENT nurses during the COVID-19 pandemic in China. Considering the negative impact of depression on QOL and care quality, regular screening for depression should be conducted among ENT nurses and timely treatments should be provided for those in need.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315348

ABSTRACT

Background: Frontline clinicians working in the emergency department (ED) were at disportionate risk of workplace violence (WPV). This study investigated the prevalence of WPV and its association on quality of life (QOL) among this population in China during the COVID-19 pandemic. Results: The overall prevalence of WPV was 29.2% (95%CI: 26.5%-31.9%). Multiple logistic regression analysis revealed that having family/friends/colleagues infected with COVID-19 (OR=1.81, P =0.01), current smoking status (OR=3.24, P <0.01) and severity of anxiety symptoms (OR=1.13, P <0.01) were positively associated with WPV. Working in inpatient ED units (OR=0.45, P <0.01) was negatively associated with WPV. After controlling for covariates, clinicians experiencing WPV had a lower overall QOL compared to those without (F (1, 1103) =14.2, P <0.01). Conclusions: Prevalence of workplace violence was common among ED clinicians in China during the COVID-19 pandemic. Considering the negative impact of WPV on QOL and care quality, timely preventive measures should be undertaken for ED clinicians.

7.
Adv Exp Med Biol ; 1352: 211-222, 2021.
Article in English | MEDLINE | ID: covidwho-1669705

ABSTRACT

INTRODUCTION: Excessive inflammatory responses and failed resolution are major common causes of tissue injury and organ dysfunction in a variety of diseases, including multiple sclerosis (MS), diabetes, and most recently, COVID-19, despite the distinct pathoetiology of the diseases. The promotion of the natural process of inflammatory resolution has been long recognized to improve functional recovery and disease outcomes effectively. To mitigate the excessive inflammation in MS, scientific investigations identified a group of derivatives of omega fatty acids, known as specialized pro-resolving lipid mediators (SPM) that have been significantly effective in treating preclinical disease models of MS. METHODS: This chapter is based on our observations from MS. It is being increasingly deliberated that the ongoing COVID-19 infection induces severe cytokine storm that ultimately triggers rampant inflammation. The impact of infection and associated mortality is much higher in patients with co-morbid diseases. Also, reports suggest a better outcome in diabetic patients with reasonable glycemic control, which certainly hints towards a hidden role of anti-hyperglycemic drugs such as metformin in alleviating disease pathology through its anti-inflammatory feature. Notably, SPM and metformin share common therapeutic features in exerting a broad-spectrum anti-inflammatory activity in human patients with a superior safety profile. RESULTS: When there is an immediate need to encounter the fast-rampant infection of COVID-19 and control the viral-infection associated morbid inflammatory cytokine storm causing severe organ damage, SPM and metformin should be seriously considered as a potential adjunctive treatment. CONCLUSION: Given the fact that current treatment for COVID-19 is only supportive, global research is aimed at developing safe and effective therapeutic options that can result in a better clinical course in patients with comorbid conditions. Accordingly, taking a cue from our experiences in controlling robust inflammatory response in MS and diabetes by simultaneously inhibiting inflammatory process and stimulating its resolution, combinatorial therapy of metformin and SPM in COVID-19 holds significant promise in treating this global health crisis.


Subject(s)
COVID-19 , Cytokine Release Syndrome , Multiple Sclerosis , COVID-19/complications , Cytokine Release Syndrome/virology , Humans , SARS-CoV-2
8.
Biosens Bioelectron ; 202: 113978, 2022 Apr 15.
Article in English | MEDLINE | ID: covidwho-1661800

ABSTRACT

The development of reliable, sensitive, and fast devices for the diagnosis of COVID-19 is of great importance in the pandemic of the new coronavirus. Here, we proposed a new principle of analysis based on a combination of reverse transcription and isothermal amplification of a fragment of the gene encoding the S protein of the SARS-CoV-2 and the CRISPR/Cas13a reaction for cleavage of the specific probe. As a result, the destroyed probe cannot be detected on an immunochromatographic strip using quantum fluorescent dots. Besides, the results can be obtained by an available and inexpensive portable device. By detecting SARS-CoV-2 negative (n = 25) and positive (n = 62) clinical samples including throat swabs, sputum and anal swabs, the assay showed good sensitivity and specificity of the method and could be completed within 1 h without complicated operation and expensive equipment. These superiorities showed its potential for fast point-of-care screening of SARS-CoV-2 during the outbreak, especially in remote and underdeveloped areas with limited equipment and resources.


Subject(s)
Biosensing Techniques , COVID-19 , Quantum Dots , Chromatography, Affinity , Clustered Regularly Interspaced Short Palindromic Repeats , Humans , Nucleic Acid Amplification Techniques/methods , RNA, Viral/genetics , SARS-CoV-2 , Sensitivity and Specificity
9.
Sci Rep ; 12(1): 1058, 2022 01 20.
Article in English | MEDLINE | ID: covidwho-1642015

ABSTRACT

The COVID-19 poses a disproportionate threat to nursing home residents. Although recent studies suggested the effectiveness of state social distancing measures in the United States on curbing COVID-19 morbidity and mortality among the general population, there is a lack of evidence as to how these state orders may have affected nursing home patients or what potential negative health consequences they may have had. In this longitudinal study, we evaluated changes in state strength of social distancing restrictions from June to August of 2020, and their associations with the weekly numbers of new COVID-19 cases, new COVID-19 deaths, and new non-COVID-19 deaths in nursing homes of the US. We found that stronger state social distancing measures were associated with improved COVID-19 outcomes (case and death rates), reduced across-facility disparities in COVID-19 outcomes, and somewhat increased non-COVID-19 death rate, although the estimates for non-COVID-19 deaths were sensitive to alternative model specifications.


Subject(s)
COVID-19 , Nursing Homes , Physical Distancing , SARS-CoV-2 , COVID-19/mortality , COVID-19/prevention & control , Female , Humans , Male , United States/epidemiology
10.
Chinese Journal of School Health ; 42(10):1508-1511, 2021.
Article in Chinese | GIM | ID: covidwho-1622905

ABSTRACT

Objective: To explore the relationship between an anti-epidemic mentality and post-traumatic stress disorder (PTSD) among college students during the corona virus disease 2019(COVID-19) pandemic, and to provide a scientific basis for the prevention of PTSD when college students experience sudden crisis events in the future.

11.
Biomed Environ Sci ; 34(12): 976-983, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1606117

ABSTRACT

Objective: The coronavirus disease 2019 (COVID-19) pandemic continues to present a major challenge to public health. Vaccine development requires an understanding of the kinetics of neutralizing antibody (NAb) responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: In total, 605 serum samples from 125 COVID-19 patients (from January 1 to March 14, 2020) varying in age, sex, severity of symptoms, and presence of underlying diseases were collected, and antibody titers were measured using a micro-neutralization assay with wild-type SARS-CoV-2. Results: NAbs were detectable approximately 10 days post-onset (dpo) of symptoms and peaked at approximately 20 dpo. The NAb levels were slightly higher in young males and severe cases, while no significant difference was observed for the other classifications. In follow-up cases, the NAb titer had increased or stabilized in 18 cases, whereas it had decreased in 26 cases, and in one case NAbs were undetectable at the end of our observation. Although a decreasing trend in NAb titer was observed in many cases, the NAb level was generally still protective. Conclusion: We demonstrated that NAb levels vary among all categories of COVID-19 patients. Long-term studies are needed to determine the longevity and protective efficiency of NAbs induced by SARS-CoV-2.


Subject(s)
Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , COVID-19/immunology , Adult , Aged , Aged, 80 and over , Female , Humans , Kinetics , Male , Middle Aged , Neutralization Tests , SARS-CoV-2
12.
PLoS Pathog ; 17(12): e1010092, 2021 12.
Article in English | MEDLINE | ID: covidwho-1581718

ABSTRACT

The development of safe and effective vaccines to prevent SARS-CoV-2 infections remains an urgent priority worldwide. We have used a recombinant vesicular stomatitis virus (rVSV)-based prime-boost immunization strategy to develop an effective COVID-19 vaccine candidate. We have constructed VSV genomes carrying exogenous genes resulting in the production of avirulent rVSV carrying the full-length spike protein (SF), the S1 subunit, or the receptor-binding domain (RBD) plus envelope (E) protein of SARS-CoV-2. Adding the honeybee melittin signal peptide (msp) to the N-terminus enhanced the protein expression, and adding the VSV G protein transmembrane domain and the cytoplasmic tail (Gtc) enhanced protein incorporation into pseudotype VSV. All rVSVs expressed three different forms of SARS-CoV-2 spike proteins, but chimeras with VSV-Gtc demonstrated the highest rVSV-associated expression. In immunized mice, rVSV with chimeric S protein-Gtc derivatives induced the highest level of potent neutralizing antibodies and T cell responses, and rVSV harboring the full-length msp-SF-Gtc proved to be the superior immunogen. More importantly, rVSV-msp-SF-Gtc vaccinated animals were completely protected from a subsequent SARS-CoV-2 challenge. Overall, we have developed an efficient strategy to induce a protective response in SARS-CoV-2 challenged immunized mice. Vaccination with our rVSV-based vector may be an effective solution in the global fight against COVID-19.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Spike Glycoprotein, Coronavirus/immunology , Vesicular stomatitis Indiana virus/genetics , Angiotensin-Converting Enzyme 2/genetics , Animals , COVID-19/immunology , COVID-19/virology , COVID-19 Vaccines/genetics , Chlorocebus aethiops , Humans , Immunization , Mice , Mice, Inbred C57BL , Mice, Transgenic , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/metabolism , Vero Cells , Viral Proteins/genetics , Viral Proteins/immunology
13.
Innovation in Aging ; 5(Supplement_1):367-367, 2021.
Article in English | PMC | ID: covidwho-1584613

ABSTRACT

When higher education classes went virtual at the start of the COVID-19 pandemic, converting an in-person, arts-based, service-learning course into a meaningful, virtual experience seemed impossible. However, the Opening Minds through Art (OMA) program developed online courses where students met older adults weekly over Zoom to create and discuss art. Undergraduate and graduate students at Miami and Marian Universities (n=47) came from more than 20 different areas of study and had varying knowledge of gerontology and dementia. Pre- and post-assessments were administered at the start and end of the academic semester. Paired-samples t-tests were conducted to examine pre-post changes in students’ attitudes toward people living with dementia (PLWD) using the Dementia Attitude Scale (DAS) (O’Connor & McFadden, 2010) and the extent students actually like PLWD using the Allophilia scale (Pittinsky et al, 2011). Students in virtual OMA courses showed significant improvement in overall DAS and Allophilia scores and all subdomain scores (i.e., general knowledge about dementia, affection, social comfort level, kinship, and engagement and enthusiasm when interacting with PLWD), with moderate to high effect sizes (Cohen’s d range between 0.39 and 1.10). The magnitudes of these effect sizes for virtual OMA are comparable to previous studies examining students’ participation in face-to-face OMA sessions, where Cohen’s d on DAS and Allophilia scales ranged between 0.48 and 1.07 (Lokon et al, 2017, 2018). Overall, we found that it is possible to design virtual service-learning courses that improve students’ attitudes toward PLWD as effectively as face-to-face courses.

15.
Energy Research & Social Science ; 85:102401, 2022.
Article in English | ScienceDirect | ID: covidwho-1556979

ABSTRACT

Low-income households face long-standing challenges of energy insecurity and inequality (EII). During extreme events (e.g., disasters and pandemics) these challenges are especially severe for vulnerable populations reliant on energy for health, education, and well-being. However, many EII studies rarely incorporate the micro- and macro-perspectives of resilience and reliability of energy and internet infrastructure and social-psychological factors. To remedy this gap, we first address the impacts of extreme events on EII among vulnerable populations. Second, we evaluate the driving factors of EII and how they change during disasters. Third, we situate these inequalities within broader energy systems and pinpoint the importance of equitable infrastructure systems by examining infrastructure reliability and resilience and the role of renewable technologies. Then, we consider the factors influencing energy consumption, such as energy practices, socio-psychological factors, and internet access. Finally, we propose interdisciplinary research methods to study these issues during extreme events and provide recommendations.

16.
BMJ Open ; 11(12): e056142, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1546532

ABSTRACT

INTRODUCTION: A growing number of technology-based interventions are used to support the health and quality of life of nursing home residents. The onset of COVID-19 and recommended social distancing policies that followed led to an increased interest in technology-based solutions to provide healthcare and promote health. Yet, there are no comprehensive resources on technology-based healthcare solutions that describe their efficacy for nursing home residents. This systematic review will identify technology-based interventions designed for nursing home residents and describe the characteristics and effects of these interventions concerning the distinctive traits of nursing home residents and nursing facilities. Additionally, this paper will present practical insights into the varying intervention approaches that can assist in the delivery of broad digital health solutions for nursing home residents amid and beyond the impact of COVID-19. METHODS AND ANALYSIS: Databases including the PubMed, PsycINFO, CINAHL and Scopus will be used to identify articles related to technology-based interventions for nursing home residents published between 1 January 2010 to 30 September 2021. Titles, abstracts and full-text papers will be reviewed against the eligibility criteria. The Cochrane Collaboration evaluation framework will be adopted to examine the risk of bias of the included study. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process and implications for existing interventions and research evaluated by a multidisciplinary research team. ETHICS AND DISSEMINATION: As the study is a protocol for a systematic review, ethical approval is not required. The study findings will be disseminated via peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER: CRD 42020191880.


Subject(s)
COVID-19 , Quality of Life , Health Promotion , Humans , Nursing Homes , Research Design , SARS-CoV-2 , Systematic Reviews as Topic , Technology
17.
PeerJ ; 9: e12459, 2021.
Article in English | MEDLINE | ID: covidwho-1534525

ABSTRACT

Background: Frontline clinicians working in emergency departments (ED) were at disportionate risk of workplace violence (WPV). We investigated the prevalence of WPV and its relationship with quality of life (QOL) in this group of health professionals in China during the COVID-19 pandemic. Methods: A cross-sectional, online study was conducted. The nine-item Workplace Violence Scale measured WPV. Results: A total of 1,103 ED clinicians participated in this study. The overall prevalence of WPV against ED clinicians was 29.2% (95% CI [26.5%-31.9%]). Having family/friends/colleagues infected with COVID-19 (Odds Ratio (OR) = 1.82, P = 0.01), current smoking (OR = 2.98, P < 0.01) and severity of anxiety symptoms (OR = 1.08, P < 0.01) were independently and positively associated with WPV, while working in emergency intensive care units (OR = 0.45, P < 0.01) was negatively associated with WPV. After controlling for covariates, clinicians experiencing WPV had a lower global QOL compared to those without (F(1, 1103) = 10.9,P < 0.01). Conclusions: Prevalence of workplace violence against ED clinicians was common in China during the COVID-19 pandemic. Due to the negative impact of WPV on QOL and quality of care, timely preventive measures should be undertaken for ED clinicians.

18.
Microb Biotechnol ; 14(6): 2356-2368, 2021 11.
Article in English | MEDLINE | ID: covidwho-1522630

ABSTRACT

Salinomycin, an FDA-approved polyketide drug, was recently identified as a promising anti-tumour and anti-viral lead compound. It is produced by Streptomyces albus, and the biosynthetic gene cluster (sal) spans over 100 kb. The genetic manipulation of large polyketide gene clusters is challenging, and approaches delivering reliable efficiency and accuracy are desired. Herein, a delicate strategy to enhance salinomycin production was devised and evaluated. We reconstructed a minimized sal gene cluster (mini-cluster) on pSET152 including key genes responsible for tailoring modification, antibiotic resistance, positive regulation and precursor supply. These genes were overexpressed under the control of constitutive promoter PkasO* or Pneo . The pks operon was not included in the mini-cluster, but it was upregulated by SalJ activation. After the plasmid pSET152::mini-cluster was introduced into the wild-type strain and a chassis host strain obtained by ribosome engineering, salinomycin production was increased to 2.3-fold and 5.1-fold compared with that of the wild-type strain respectively. Intriguingly, mini-cluster introduction resulted in much higher production than overexpression of the whole sal gene cluster. The findings demonstrated that reconstitution of sal mini-cluster combined with ribosome engineering is an efficient novel approach and may be extended to other large polyketide biosynthesis.


Subject(s)
Streptomyces , Multigene Family , Pyrans , Ribosomes/genetics , Streptomyces/genetics
19.
J Formos Med Assoc ; 2021 Nov 11.
Article in English | MEDLINE | ID: covidwho-1509998

ABSTRACT

BACKGROUND: Patient delay of COVID-19 patients occurs frequently, which poses a challenge to the overall epidemic situation. In this study, we aimed to evaluate the extent of patient delay, explore its factors, and investigate the effects of patient interval on epidemic situation. METHODS: A retrospective cohort study was conducted with 136 COVID-19 patients in Tianjin, China. Factors associated with patient delay were explored using logistic regression models. The relationship was investigated by spearman correlation analysis and mean absolute error between patient interval of lagging days and epidemic situation. RESULTS: The factors associated with patient delay of COVID-19 patients were mainly the imported cases, the first presentation to a tertiary hospital, close contacts and spatial accessibility to fever clinic. The longer the patient intervals of lagging days, the greater the number of new-onset and confirmed cases in 3-4 and 5-7 days after the first day symptoms, respectively. CONCLUSIONS: Identification and quarantine of close contacts, promoting the spatial accessibility to fever clinics and creating public awareness are crucial to shortening patient delays to flat the curve for COVID-19.

20.
Scand J Clin Lab Invest ; 81(8): 679-686, 2021 12.
Article in English | MEDLINE | ID: covidwho-1510707

ABSTRACT

Understanding factors associated with disease severity and mortality from coronavirus disease (COVID-19) was critical for effective risk stratification. We aimed to investigate the association between biomarkers of clinical laboratory tests, including serum C-reactive protein (CRP), serum amyloid protein (SAA), lactate dehydrogenase (LDH), and D-dimer (DD) and poor prognosis of COVID-19. We have searched many studies on COVID-19 on PubMed (Medline), Web of Science and Cochrane until 1 March 2021. The interest of this study was original articles reporting on laboratory testing projects and outcome of patients with COVID-19 that comprises mortality, acute respiratory distress syndrome (ARDS), need for care in an intensive care unit (ICU), and severe COVID-19. After synthesizing all data, we performed meta-analysis of random effects, and determined mean difference (MD) and standard mean difference at the biomarker level for different disease severity. A total of 7,739 patients with COVID-19 were pooled from 32 studies. CRP was significantly associated with poor prognosis of COVID-19 (SMD = 0.98, 95% CI = (0.85, 1.11), p < .001). Elevated SAA was associated with an increased composite poor outcome in COVID-19 (SMD = 1.06, 95% CI = (0.39, 1.72), p = .002). An elevated LDH was associated with a composite poor outcome (SMD = 1.18, 95% CI = (1.00, 1.36), p < .001). Patients with a composite poor outcome had a higher DD level (SMD = 0.91, 95% CI = (0.79, 1.02), p < .001). This meta-analysis showed that elevated serum CRP, SAA, LDH, and DD were associated with a poor outcome in COVID-19.


Subject(s)
C-Reactive Protein/analysis , COVID-19/diagnosis , Fibrin Fibrinogen Degradation Products/analysis , L-Lactate Dehydrogenase/blood , Biomarkers/blood , Humans , Intensive Care Units , Prognosis , Severity of Illness Index
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