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1.
Journal of Exercise Science & Fitness ; JOUR
Article in English | ScienceDirect | ID: covidwho-2095625

ABSTRACT

Background/objective This paper aimed to summarize the findings of the third (2022) Active Healthy Kids Hong Kong Report Card on Physical Activity for Children and Adolescents and evaluate the secular trends of physical activity related indicators. Methods Five behavioral indicators (Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, and Sedentary Behavior), three outcome indicators (Physical Fitness, Sleep, and Obesity) and four sources of influence indicators (Family and Peers, School, Community and Environment, and Government) were assigned a letter grade (ranging from A+ to F or incomplete) based on the best available evidence following a harmonized approach developed by the Active Healthy Kids Global Alliance. Data sources included published journal articles, government reports, manual searches, and personal contacts;and consisted of both pre-COVID-19 and after-COVID-19 evidence. Results Grades for Overall Physical Activity (D−**) and Sedentary Behavior (D) deteriorated compared to the 2018 Report Card. The other three behavioral indicators, Organized Sport and Physical Activity, Active Play, and Active Transportation, were assigned B−, D, and B+, respectively. Physical Fitness (D), Sleep (C−), and Obesity (D−) obtained the same grades as in the 2018 Report Card. School (B) and Government (C+) grades slightly improved, while Community and Environment grade (B) was stable. Family and Peers was not graded due to insufficient evidence. Conclusions Despite slight improvements in influence indicators, physical activity and sedentary behavior have changed unfavorably for children and adolescents in Hong Kong. Strategic investments are needed to improve adoption and implementation of effective interventions.

2.
European psychiatry : the journal of the Association of European Psychiatrists ; 65(Suppl 1):S443-S443, 2022.
Article in English | EuropePMC | ID: covidwho-2073859

ABSTRACT

Introduction Adolescent mental health problems may have increased after COVID-19 worldwide pandemic. Therefore it seems necessary to study the state of mental health inpatient adolescent units. Objectives Adolescent mental health problems may have increased after COVID-19 worldwide pandemic. Therefore it seems necessary to study the state of mental health inpatient adolescent units. Methods An observational and descriptive analysis of the sample of patients between 12 and 17 years-old, that were admitted to the inpatient mental health unit since its opening on April 2021. Results A total of 205 patients were admitted from April 2021 until October 2021. We have observed sex diferences within patients admitted, as the 82.9% of them were female. The mean age was 14.7, being 14.6 for girls and 15.3 for boys. The most common reason for admission (RFA) were suicidal ideation/attempt, eating disorders, affective disorders, conduct disorders/challenging behaviors and psychosis. Suicidal ideation/attempt was the most common RFA (57.07%) in both sexes, being higher among females (60.3%) than males (42.9%). Eating disorders were the second most common RFA in girls (17.7%) while psychosis (17.1%) and mood disorders (17.1%) were the second most common RFA within boys. Conclusions Findings on how COVID-19 affected adolescents mental health are controversial in the literature, our data suggest that there is a need of developing quality studies that analyse how the pandemic might be influencing adolescents suicidal ideation/attempt and its protective and risk factors. Disclosure No significant relationships.

3.
Revista Argentina De Ciencias Del Comportamiento ; 14(2):75-86, 2022.
Article in English | Web of Science | ID: covidwho-2068076

ABSTRACT

In Argentina, social isolation during the COVID-19 pandemic has had an impact on the practice of psychotherapy. The goal was to describe factors associated with the use of telepsychotherapy during social isolation. An online survey was conducted among 978 psychologists and psychiatrists from different provinces and the city of Buenos Aires. 77.7% of the participants started using online psychotherapy for the first time at the beginning of social isolation;62.6% of the participants treated half or more of their patients online. Significant relationships were detected between online psychotherapy and various factors that characterize psychotherapeutic practice, but these are weak effects. Participants with a higher percentage of patients in telepsychotherapy reported fewer treatment interruptions and similar or higher levels of income compared to those prior to social isolation. Drastic changes in psychotherapeutic practice during social isolation need to be studied in depth.

4.
2022 Annual Modeling and Simulation Conference, ANNSIM 2022 ; : 449-460, 2022.
Article in English | Scopus | ID: covidwho-2056833

ABSTRACT

Susceptible-Infected-Recovered (SIR) models have been widely used to study the spread of Covid-19. These models have been improved to include other states (e.g., exposed, deceased) as well as geographical level transmission dynamics. In this paper, we present an extension to an existing SEVIRD (Susceptible - Exposed - Vaccinated - Infected - Recovered - Death) model to include the effect of air and maritime travel as well as travel restrictions. We use the model to simulate the spread of Covid-19 through 13 different countries. The case study shown illustrates how the model can be used for rapid prototyping at a geographical level and adapted to include changing policies. © 2022 SCS.

5.
35th IEEE International Symposium on Computer-Based Medical Systems, CBMS 2022 ; 2022-July:19-24, 2022.
Article in English | Scopus | ID: covidwho-2051940

ABSTRACT

Pneumonia is an acute lung infection caused by a variety of organisms, such as viruses, bacteria, or fungi, that poses a serious risk to vulnerable populations. The first step in the diagnosis and treatment of pneumonia is a prompt and accurate diagnosis, especially in the context of an epidemic outbreak such as COVID-19, where pneumonia is an important symptom. To provide tools for this purpose, this article evaluates the potential of three textural image characterisation methods, fractal dimension, radiomics, and superpixel-based histon, as biomarkers both to distinguish between healthy individuals and patients affected by pneumonia and to differentiate between potential pneumonia causes. The results show the ability of the textural characterisation methods tested to discriminate between nonpathological images and images with pneumonia, and how some of the generated models show the potential to characterise the general textural patterns that define viral and bacterial pneumonia, and the specific features associated with a COVID-19 infection. © 2022 IEEE.

6.
Vaccines (Basel) ; 10(9)2022 Sep 16.
Article in English | MEDLINE | ID: covidwho-2044014

ABSTRACT

Several vaccines have been developed for COVID-19 since the pandemic began. This study aimed to evaluate the factors associated with COVID-19 vaccination intention. A global survey was conducted across 26 countries from October, 2020 to December, 2021 using an online self-administered questionnaire. Demographic information, socio-economic status, and clinical information were collected. A logistic regression examined the associations between vaccine intention and factors such as perceptions and the presence of chronic physical and mental conditions. The sample included 2459 participants, with 384 participants (15.7%) expressing lower COVID-19 vaccination intent. Individuals who identified as female; belonged to an older age group; had a higher level of education; were students; had full health insurance coverage; or had a previous history of influenza vaccination were more willing to receive vaccination. Conversely, those who were working part-time, were self-employed, or were receiving social welfare were less likely to report an intention to get vaccinated. Participants with mental or physical health conditions were more unwilling to receive vaccination, especially those with sickle cell disease, cancer history within the past five years, or mental illness. Stronger vaccination intent was associated with recommendations from the government or family doctors. The presence of chronic conditions was associated with lower vaccine intention. Individuals with health conditions are especially vulnerable to health complications and may experience an increased severity of COVID-19 symptoms. Future research should evaluate the effectiveness of interventions targeting the vaccine perceptions and behaviours of at-risk groups. As such, public awareness campaigns conducted by the government and proactive endorsement from health physicians may help improve COVID-19 vaccination intention.

8.
Front Hum Neurosci ; 16: 920383, 2022.
Article in English | MEDLINE | ID: covidwho-2022807

ABSTRACT

Background: Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment for smoking cessation and delay discounting rate is novel therapeutic target. Research to determine optimal therapeutic targets and dosing parameters for long-term smoking cessation is needed. Due to potential biases and confounds introduced by the COVID-19 pandemic, we report preliminary results from an ongoing study among participants who reached study end prior to the pandemic. Methods: In a 3 × 2 randomized factorial design, participants (n = 23) received 900 pulses of 20 Hz rTMS to the left dorsolateral prefrontal cortex (PFC) in one of three Durations (8, 12, or 16 days of stimulation) and two Intensities (1 or 2 sessions per day). We examined direction and magnitude of the effect sizes on latency to relapse, 6-month point-prevalence abstinence rates, research burden, and delay discounting rates. Results: A large effect size was found for Duration and a medium for Intensity for latency to relapse. Increasing Duration increased the odds of abstinence 7-8-fold while increasing Intensity doubled the odds of abstinence. A large effect size was found for Duration, a small for Intensity for delay discounting rate. Increasing Duration and Intensity had a small effect on participant burden. Conclusion: Findings provide preliminary support for delay discounting as a therapeutic target and for increasing Duration and Intensity to achieve larger effect sizes for long-term smoking cessation and will provide a pre-pandemic comparison for data collected during the pandemic. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT03865472].

9.
Geburtshilfe Frauenheilkd ; 82(2): 226-234, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-2016893

ABSTRACT

Purpose Detection of SARS-CoV-2-infected pregnant women admitted to maternity units during a pandemic is crucial. In addition to the fact that pregnancy is a risk factor for severe COVID-19 and that medical surveillance has to be adjusted in infected women and their offspring, knowledge about infection status can provide the opportunity to protect other patients and healthcare workers against virus transmission. The aim of this prospective observational study was to determine the prevalence of SARS-CoV-2 infection among pregnant women in the hospital setting. Material and Methods All eligible pregnant women admitted to the nine participating hospitals in Franconia, Germany, from 2 June 2020 to 24 January 2021 were included. COVID-19-related symptoms, secondary diseases and pregnancy abnormalities were documented. SARS-CoV-2 RNA was detected by RT-PCR from nasopharyngeal swabs. The prevalence of acute SARS-CoV-2 infection was estimated by correcting the positive rate using the Rogan-Gladen method. The risk of infection for healthcare workers during delivery was estimated using a risk calculator. Results Of 2414 recruited pregnant women, six were newly diagnosed RT-PCR positive for SARS-CoV-2, which yielded a prevalence of SARS-CoV-2 infection of 0.26% (95% CI, 0.10 - 0.57%). Combining active room ventilation and wearing FFP2 masks showed an estimated reduction of risk of infection for healthcare workers in the delivery room to < 1%. Conclusions The prevalence of newly diagnosed SARS-CoV-2 infection during pregnancy in this study is low. Nevertheless, a systematic screening in maternity units during pandemic situations is important to adjust hygienic and medical management. An adequate hygienic setting can minimise the calculated infection risk for medical healthcare workers during patients' labour.

10.
Nature ; 611(7934): 139-147, 2022 11.
Article in English | MEDLINE | ID: covidwho-2016757

ABSTRACT

Severe SARS-CoV-2 infection1 has been associated with highly inflammatory immune activation since the earliest days of the COVID-19 pandemic2-5. More recently, these responses have been associated with the emergence of self-reactive antibodies with pathologic potential6-10, although their origins and resolution have remained unclear11. Previously, we and others have identified extrafollicular B cell activation, a pathway associated with the formation of new autoreactive antibodies in chronic autoimmunity12,13, as a dominant feature of severe and critical COVID-19 (refs. 14-18). Here, using single-cell B cell repertoire analysis of patients with mild and severe disease, we identify the expansion of a naive-derived, low-mutation IgG1 population of antibody-secreting cells (ASCs) reflecting features of low selective pressure. These features correlate with progressive, broad, clinically relevant autoreactivity, particularly directed against nuclear antigens and carbamylated proteins, emerging 10-15 days after the onset of symptoms. Detailed analysis of the low-selection compartment shows a high frequency of clonotypes specific for both SARS-CoV-2 and autoantigens, including pathogenic autoantibodies against the glomerular basement membrane. We further identify the contraction of this pathway on recovery, re-establishment of tolerance standards and concomitant loss of acute-derived ASCs irrespective of antigen specificity. However, serological autoreactivity persists in a subset of patients with postacute sequelae, raising important questions as to the contribution of emerging autoreactivity to continuing symptomology on recovery. In summary, this study demonstrates the origins, breadth and resolution of autoreactivity in severe COVID-19, with implications for early intervention and the treatment of patients with post-COVID sequelae.


Subject(s)
Autoantibodies , B-Lymphocytes , COVID-19 , Humans , Autoantibodies/immunology , B-Lymphocytes/immunology , B-Lymphocytes/pathology , COVID-19/immunology , COVID-19/pathology , COVID-19/physiopathology , SARS-CoV-2/immunology , SARS-CoV-2/pathogenicity , Immunoglobulin G/immunology , Single-Cell Analysis , Autoantigens/immunology , Basement Membrane/immunology
11.
25th International Conference on Miniaturized Systems for Chemistry and Life Sciences, MicroTAS 2021 ; : 855-856, 2021.
Article in English | Scopus | ID: covidwho-2011960

ABSTRACT

Without global mass vaccination, COVID-19 will continue to infect and cause serious illness, disproportionately in low- and middle-income countries. Point-of-care and home-based nucleic acid amplification tests (NAATs) are valuable tools to control COVID-19 transmission. Here we present a rapid isothermal NAAT for duplexed detection of SARS-CoV-2 and an MS2 bacteriophage internal control. This assay amplifies RNA in less than 15 minutes, utilizes a low temperature of 39°C, and has fluorescence or visual lateral flow readout. This positions our assay for use in low-cost paper-based nucleic acid diagnostic devices for ultrasensitive and reliable COVID-19 detection in POC or home-based settings. © 2021 MicroTAS 2021 - 25th International Conference on Miniaturized Systems for Chemistry and Life Sciences. All rights reserved.

12.
Vaccines (Basel) ; 10(7)2022 Jul 21.
Article in English | MEDLINE | ID: covidwho-2010324

ABSTRACT

Invasive pneumococcal disease (IPD) is a leading cause of disability and mortality worldwide, particularly in the elderly population. With the implementation of the Government Vaccination Programme (GVP) and the Vaccination Subsidy Scheme (VSS), enabling factors and barriers in service provider scheme participation and vaccination uptake were examined in 32 interviews with doctors and 16 interviews with vaccine recipients. Interview data were analysed in NVivo 11.0 with reference to the Consolidated Framework for Implementation Research (CFIR) and the REAIM Framework to develop codes and themes. Barriers to pneumococcal vaccination uptake included concerns on vaccine efficacy and poor understanding of the disease and vaccine schemes, whilst service provider participation was hindered by ill-defined parameters for patient eligibility and time, location, and logistical constraints. Enabling factors to improve intervention implementation were involvement of the government and physicians to encourage participation, clarifying eligibility criteria, and improving individual knowledge of IPD and vaccination schemes. As participation rates in the GVP and VSS remains low in Hong Kong, efforts concentrating on health promotion strategies encouraging pneumococcal vaccination amongst the elderly population are recommended.

13.
Journal of Emdr Practice and Research ; 16(3):156-168, 2022.
Article in English | Web of Science | ID: covidwho-2005792

ABSTRACT

Recent research has provided new information on the impact of COVID-19 and previous pandemics on the mental health of healthcare professionals (HCP). Several studies have found that HCP are greatly affected by pandemics and may develop anxiety disorders, mood disorders, and posttraumatic stress disorder. The stress caused by the intense working conditions and the fear of contracting and transmitting the virus are major vulnerability factors for these workers, increasing their risk of developing a mental health condition. It is therefore essential to provide appropriate support to this population in order to reduce and avoid the psychological burden of the current pandemic on their mental health. Considering the data previously published on the COVID-19 pandemic and past epidemics, the present article aims to provide an epidemiological review of the psychological impact of a pandemic on healthcare professionals. Furthermore, it examines, from a theoretical perspective, whether EMDR early interventions (EEI) may constitute an effective solution in order to provide psychological support to HCP in hospitals. Lastly, the article will identify various protocols for EEI, which, it argues, should be the approaches of choice for providing early support following a potentially traumatic event.

14.
J Clin Med ; 11(17)2022 Aug 30.
Article in English | MEDLINE | ID: covidwho-2006088

ABSTRACT

BACKGROUND: To investigate whether vaccination against SARS-CoV-2 is associated with the onset of retinal vascular occlusive disease (RVOD). METHODS: In this multicentre study, data from patients with central and branch retinal vein occlusion (CRVO and BRVO), central and branch retinal artery occlusion (CRAO and BRAO), and anterior ischaemic optic neuropathy (AION) were retrospectively collected during a 2-month index period (1 June-31 July 2021) according to a defined protocol. The relation to any previous vaccination was documented for the consecutive case series. Numbers of RVOD and COVID-19 vaccination were investigated in a case-by-case analysis. A case-control study using age- and sex-matched controls from the general population (study participants from the Gutenberg Health Study) and an adjusted conditional logistic regression analysis was conducted. RESULTS: Four hundred and twenty-one subjects presenting during the index period (61 days) were enrolled: one hundred and twenty-one patients with CRVO, seventy-five with BRVO, fifty-six with CRAO, sixty-five with BRAO, and one hundred and four with AION. Three hundred and thirty-two (78.9%) patients had been vaccinated before the onset of RVOD. The vaccines given were BNT162b2/BioNTech/Pfizer (n = 221), followed by ChadOx1/AstraZeneca (n = 57), mRNA-1273/Moderna (n = 21), and Ad26.COV2.S/Johnson & Johnson (n = 11; unknown n = 22). Our case-control analysis integrating population-based data from the GHS yielded no evidence of an increased risk after COVID-19 vaccination (OR = 0.93; 95% CI: 0.60-1.45, p = 0.75) in connection with a vaccination within a 4-week window. CONCLUSIONS: To date, there has been no evidence of any association between SARS-CoV-2 vaccination and a higher RVOD risk.

16.
Vaccines (Basel) ; 10(8)2022 Aug 09.
Article in English | MEDLINE | ID: covidwho-1979451

ABSTRACT

Niclosamide, an FDA-approved oral anthelmintic drug, has broad biological activity including anticancer, antibacterial, and antiviral properties. Niclosamide has also been identified as a potent inhibitor of SARS-CoV-2 infection in vitro, generating interest in its use for the treatment or prevention of COVID-19. Unfortunately, there are several potential issues with using niclosamide for COVID-19, including low bioavailability, significant polypharmacology, high cellular toxicity, and unknown efficacy against emerging SARS-CoV-2 variants of concern. In this study, we used high-content imaging-based immunofluorescence assays in two different cell models to assess these limitations and evaluate the potential for using niclosamide as a COVID-19 antiviral. We show that despite promising preliminary reports, the antiviral efficacy of niclosamide overlaps with its cytotoxicity giving it a poor in vitro selectivity index for anti-SARS-CoV-2 inhibition. We also show that niclosamide has significantly variable potency against the different SARS-CoV-2 variants of concern and is most potent against variants with enhanced cell-to-cell spread including the B.1.1.7 (alpha) variant. Finally, we report the activity of 33 niclosamide analogs, several of which have reduced cytotoxicity and increased potency relative to niclosamide. A preliminary structure-activity relationship analysis reveals dependence on a protonophore for antiviral efficacy, which implicates nonspecific endolysosomal neutralization as a dominant mechanism of action. Further single-cell morphological profiling suggests niclosamide also inhibits viral entry and cell-to-cell spread by syncytia. Altogether, our results suggest that niclosamide is not an ideal candidate for the treatment of COVID-19, but that there is potential for developing improved analogs with higher clinical translational potential in the future.

17.
International Journal of Operations & Production Management ; 42(8):1109-1145, 2022.
Article in English | ProQuest Central | ID: covidwho-1973394

ABSTRACT

Purpose>While various supply chain (SC) sustainability investigations exist, their connection to supply chain resilience (SCRes) remains largely unexplored. To fill this gap, the authors answer the question: “How do firms' sustainability actions affect their SCs' resilience and sustainability trajectories in turbulent environments?" by exploring the context of the COVID-19 pandemic.Design/methodology/approach>The authors conducted 10 case studies in five industries located in six European countries. A total of 19 semi-structured interviews and relevant secondary data were collected and analyzed in reference to SC sustainability learning and the literature on SCRes approaches (i.e. engineering, ecological and social-ecological).Findings>31 SC actions referring to different sustainability dimensions were identified to map SCRes learning through a temporal, spatial and functional scale analysis. While five cases are related to an engineering approach focused on “bouncing back” to pre-pandemic goals, three cases were focused on “bouncing forward” as part of an ecological approach. Moreover, the authors identified the existence of two social-ecological resilience cases which developed long-term actions, updating functional set-ups transcending the SC level. The results furthermore illustrate an influence of the SCRes approaches on SC sustainability learning, generating three different paths: flat, flat ascending and ascending SC sustainability trajectories.Research limitations/implications>The study develops an overview of the adoption of SCRes approaches due to temporal, spatial and functional scales, and their effect on SC sustainability trajectories through exploitation and exploration capabilities. Future research should elaborate on potential moderators in the proposed relationships.Practical implications>A better understanding of the link between SC sustainability actions and SCRes will help practitioners to make better informed decisions in turbulent environments.Originality/value>Unlike previous research, this paper provides empirical evidence on engineering, ecological and social-ecological SCRes approaches, as well as SC sustainability trajectories.

18.
Laryngo- Rhino- Otologie ; 101:S354, 2022.
Article in English | EMBASE | ID: covidwho-1967669

ABSTRACT

Introduction In medical school, capacity building is a central goal. During the COVID pandemic, in-classroom teaching was temporarily suspended and online teaching was used even to teach psychomotor ability skills such as specific examination skills, e.g. of the head and neck. Our study aimed to measure performance and capacity of self-evaluation in students who had only received online teaching. Methods After completing a new extensive online ENT examination course, we conducted a standardized clinical skills exam for nine different ENT examination items with 30 students. Using Likert-scales, self-evaluation was measured based on questionnaires right before the clinical skills exam and objective evaluation during the exam was assessed following a standardized regime. Self-evaluation and objective evaluation were correlated. We compared this cohort to a cohort that had completed a traditional in-classroom ENT skills course. Results Compared to in-classroom teaching, students of the online cohort self-assessed their examination skills similar whereas objective evaluation showed slightly decreased skill levels. In easier psychomotor examination techniques, students overestimated their skills more often. In more difficult examination techniques such as endoscopy, both over- and underestimation were more often observed. The highest level of misjudgment was found in techniques with intermediate difficulty. Conclusion Online courses can add additional value to in-classroom teaching in a timely and reasonable way and can help to gain ENT examination skills. Nevertheless, online-only teaching cannot replace in-classroom teaching to acquire the sophisticated psychomotor skills needed for a thorough clinical ENT examination. Virtuelle Hochschule Bayern.

19.
Frontiers in human neuroscience ; 16, 2022.
Article in English | EuropePMC | ID: covidwho-1958389

ABSTRACT

Background Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment for smoking cessation and delay discounting rate is novel therapeutic target. Research to determine optimal therapeutic targets and dosing parameters for long-term smoking cessation is needed. Due to potential biases and confounds introduced by the COVID-19 pandemic, we report preliminary results from an ongoing study among participants who reached study end prior to the pandemic. Methods In a 3 × 2 randomized factorial design, participants (n = 23) received 900 pulses of 20 Hz rTMS to the left dorsolateral prefrontal cortex (PFC) in one of three Durations (8, 12, or 16 days of stimulation) and two Intensities (1 or 2 sessions per day). We examined direction and magnitude of the effect sizes on latency to relapse, 6-month point-prevalence abstinence rates, research burden, and delay discounting rates. Results A large effect size was found for Duration and a medium for Intensity for latency to relapse. Increasing Duration increased the odds of abstinence 7–8-fold while increasing Intensity doubled the odds of abstinence. A large effect size was found for Duration, a small for Intensity for delay discounting rate. Increasing Duration and Intensity had a small effect on participant burden. Conclusion Findings provide preliminary support for delay discounting as a therapeutic target and for increasing Duration and Intensity to achieve larger effect sizes for long-term smoking cessation and will provide a pre-pandemic comparison for data collected during the pandemic. Clinical Trial Registration [www.ClinicalTrials.gov], identifier [NCT03865472].

20.
PLoS Med ; 19(7): e1004052, 2022 07.
Article in English | MEDLINE | ID: covidwho-1938407

ABSTRACT

BACKGROUND: Acute Coronavirus Disease 2019 (COVID-19) has been associated with new-onset cardiovascular disease (CVD) and diabetes mellitus (DM), but it is not known whether COVID-19 has long-term impacts on cardiometabolic outcomes. This study aimed to determine whether the incidence of new DM and CVDs are increased over 12 months after COVID-19 compared with matched controls. METHODS AND FINDINGS: We conducted a cohort study from 2020 to 2021 analysing electronic records for 1,356 United Kingdom family practices with a population of 13.4 million. Participants were 428,650 COVID-19 patients without DM or CVD who were individually matched with 428,650 control patients on age, sex, and family practice and followed up to January 2022. Outcomes were incidence of DM and CVD. A difference-in-difference analysis estimated the net effect of COVID-19 allowing for baseline differences, age, ethnicity, smoking, body mass index (BMI), systolic blood pressure, Charlson score, index month, and matched set. Follow-up time was divided into 4 weeks from index date ("acute COVID-19"), 5 to 12 weeks from index date ("post-acute COVID-19"), and 13 to 52 weeks from index date ("long COVID-19"). Net incidence of DM increased in the first 4 weeks after COVID-19 (adjusted rate ratio, RR 1.81, 95% confidence interval (CI) 1.51 to 2.19) and remained elevated from 5 to 12 weeks (RR 1.27, 1.11 to 1.46) but not from 13 to 52 weeks overall (1.07, 0.99 to 1.16). Acute COVID-19 was associated with net increased CVD incidence (5.82, 4.82 to 7.03) including pulmonary embolism (RR 11.51, 7.07 to 18.73), atrial arrythmias (6.44, 4.17 to 9.96), and venous thromboses (5.43, 3.27 to 9.01). CVD incidence declined from 5 to 12 weeks (RR 1.49, 1.28 to 1.73) and showed a net decrease from 13 to 52 weeks (0.80, 0.73 to 0.88). The analyses were based on health records data and participants' exposure and outcome status might have been misclassified. CONCLUSIONS: In this study, we found that CVD was increased early after COVID-19 mainly from pulmonary embolism, atrial arrhythmias, and venous thromboses. DM incidence remained elevated for at least 12 weeks following COVID-19 before declining. People without preexisting CVD or DM who suffer from COVID-19 do not appear to have a long-term increase in incidence of these conditions.


Subject(s)
COVID-19 , Cardiovascular Diseases , Diabetes Mellitus , Pulmonary Embolism , COVID-19/complications , COVID-19/epidemiology , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Cohort Studies , Diabetes Mellitus/epidemiology , Humans , United Kingdom/epidemiology
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