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1.
Risk management and healthcare policy ; 15:901-908, 2022.
Article in English | EuropePMC | ID: covidwho-1823612

ABSTRACT

Background The COVID-19 pandemic, declared by the World Health Organization as a public health international emergency concern in March 2020, has caused serious impacts on individuals, families, communities, and societies across the globe. The COVID-19 pandemic not only disrupted the health systems and the economy, but also significantly impacted routine immunization programs. Aim To study the impact of the COVID-19 pandemic lockdown on the routine immunization coverage program in the province of Laghman, Afghanistan. Methods A comparative cross-sectional quantitative study was conducted to understand the impact of COVID-19 on routine childhood immunization during the study period. Secondary data was used from the Ministry of Health from April to July 2020 and compared with the historical data of the same period in 2019. Student t-test was used to test the association between the mean changes in the daily immunization coverage. A p-value<0.05 was considered as statistically significant with 95% confidence interval. Results There was a 21.4% significant (p<0.01) decline in the total immunization coverage during April–July 2020 compared to April–July 2019. This reduction was diverse across all districts and all vaccine antigens. The most affected district was Alingar, and the most affected vaccines were measles and OPV4, with 28% declines, followed by PCV3 at 26%, and DPT3, IPV, OPV3, PCV2 and rotavirus at 23%. The outreach vaccination coverage declined by 56.1% compared to the fixed, at 13.4%. Conclusion The COVID-19 pandemic seriously affected the routine immunization in Afghanistan. On average, 325 children per day missed out on a lifesaving vaccine in Laghman province which put them at risk of getting preventable diseases. To provide access to routine immunization during pandemics, the study suggests a set of customized interventions to strengthen and sustain routine immunization.

2.
Int J Infect Dis ; 118: 197-202, 2022 Mar 05.
Article in English | MEDLINE | ID: covidwho-1778199

ABSTRACT

OBJECTIVES: We described the current incidence and risk factors of bacterial co-infection in hospitalized patients with COVID-19. METHODS: Observational cohort study was performed at the Hospital Clinic of Barcelona (February 2020-February 2021). All patients with COVID-19 who were admitted for >48 hours with microbiological sample collection and procalcitonin (PCT) determination within the first 48 hours were included. RESULTS: A total of 1125 consecutive adults met inclusion criteria. Co-infections were microbiologically documented in 102 (9.1%) patients. Most frequent microorganisms were Streptococcus pneumoniae (79%), Staphylococcus aureus (6.8%), and Haemophilus influenzae (6.8%). Test positivity was 1% (8/803) for blood cultures, 10.1% (79/780) for pneumococcal urinary antigen test, and 11.4% (15/132) for sputum culture. Patients with PCT higher than 0.2, 0.5, 1, and 2 ng/mL had significantly more co-infections than those with lower levels (p=0.017, p=0.031, p<0.001, and p<0.001, respectively). In multivariate analysis, oxygen saturation ≤94% (OR 2.47, CI 1.57-3.86), ferritin levels <338 ng/mL (OR 2.63, CI 1.69-4.07), and PCT higher than 0.2 ng/mL (OR 1.74, CI 1.11-2.72) were independent risk factors for co-infection at hospital admission owing to COVID-19. CONCLUSIONS: Bacterial co-infection in patients hospitalized for COVID-19 is relatively common. However, clinicians could spare antibiotics in patients with PCT values <0.2, especially with high ferritin values and oxygen saturation >94%.

3.
Sci Rep ; 12(1): 5250, 2022 03 28.
Article in English | MEDLINE | ID: covidwho-1764201

ABSTRACT

Dexamethasone and tocilizumab have been associated with reduction in mortality, however, the beneficial effect is not for all patients and the impact on viral replication is not well defined. We hypostatized that C-reactive protein (CRP) could help in the identification of patients requiring anti-inflammatory therapy. Patients admitted for > 48 h in our hospital for a confirmed or suspected infection by SARS-CoV-2 from February 2020 to February 2021 were retrospectively evaluated. The primary outcome was mortality at 30 days. Demographics and the most relevant variables related with the outcome were included. CRP was stratified by percentiles. Univariate and multivariate analysis were performed. A total of 3218 patients were included with a median (IQR) age of 66 (74-78) years and 58.9% were males. The rate of intensive care unit admission was 24.4% and the 30-day mortality rate was 11.8%. Within the first 5 days from admission, 1018 (31.7%) patients received dexamethasone and 549 tocilizumab (17.1%). The crude analysis showed a mortality reduction in patients receiving dexamethasone when CRP was > 13.75 mg/dL and > 3.5 mg/dL for those receiving tocilizumab. Multivariate analysis identified the interaction of CRP > 13.75 mg/dL with dexamethasone (OR 0.57; CI 95% 0.37-0.89, P = 0014) and CRP > 3.5 mg/dL with tocilizumab (0.65; CI95%:0.44-0.95, P = 0.029) as independent predictors of mortality. Our results suggest that dexamethasone and tocilizumab are associated with a reduction in mortality when prescribed to patients with a certain inflammatory activity assessed by C-reactive protein.


Subject(s)
Antibodies, Monoclonal, Humanized , C-Reactive Protein , COVID-19 , Dexamethasone , Aged , Antibodies, Monoclonal, Humanized/therapeutic use , C-Reactive Protein/metabolism , COVID-19/drug therapy , Dexamethasone/therapeutic use , Female , Humans , Male , Retrospective Studies , SARS-CoV-2
4.
Am J Manag Care ; 28(3): 124-130, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1754307

ABSTRACT

OBJECTIVES: To build a model of local hospital utilization resulting from SARS-CoV-2 and to continuously update it with new data. STUDY DESIGN: Retrospective analysis of real performance resulting from a model deployed in a major regional health system. METHODS: Using hospitalization data from the Kaiser Permanente Mid-Atlantic States integrated care system during the period from March 10, 2020, through December 31, 2020, and a custom-developed genetic particle filtering algorithm, we modeled the SARS-CoV-2 outbreak in the mid-Atlantic region. This model produced weekly forecasts of COVID-19-related hospital admissions, which we then compared with actual hospital admissions over the same period. RESULTS: We found that the model was able to accurately capture the data-generating process (weekly mean absolute percentage error, 10.0%-48.8%; Anderson-Darling P value of .97 when comparing percentiles of observed admissions with the uniform distribution) once the effects of social distancing could be accurately measured in mid-April. We also found that our estimates of key parameters, including the reproductive rate, were consistent with consensus literature estimates. CONCLUSIONS: The genetic particle filtering algorithm that we have proposed is effective at modeling hospitalizations due to SARS-CoV-2. The methods used by our model can be reproduced by any major health care system for the purposes of resource planning, staffing, and population care management to create an effective forecasting regimen at scale.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , Delivery of Health Care , Forecasting , Hospitalization , Humans , Retrospective Studies
5.
Prehosp Disaster Med ; : 1-19, 2022 Mar 18.
Article in English | MEDLINE | ID: covidwho-1751636

ABSTRACT

OBJECTIVE: The objective of this study was to identify the perceived problems by medical and nursing professionals that have arisen in the Spanish Emergency Medical Services (EMS) as a consequence of the first wave of the severe acute respiratory syndrome-coronavirus-2/SARS-CoV-2 pandemic, as well as the measures or solutions adopted to manage those problems and improve response. METHOD: This was a cross-sectional study of quantitative and qualitative methodology ("mixed methods") using a self-administered questionnaire in 23 key informants of EMS of Spain selected by purposeful sampling, followed by the statistical analysis of both types of variables and an integration of the results in the discussion. RESULTS: Common problems had been identified in many EMS, as well as similar solutions in some of them. Among the former, the following had been found: lack of leadership and support from managers, initial shortage of personal protective equipment (PPE), lack of participation in decision making, initial lack of clinical protocols, and slowness and/or lack of adaptability of the system, among others. Among the solutions adopted: reinforcement of emergency call centers, development of specific coronavirus disease 2019 (COVID-19) telephone lines and new resources, personal effort of professionals, new functions of EMS, support to other structures, and reinforcement of the role of nursing. CONCLUSION: The general perception among the respondents was that there was a lack of support and communication with health care managers and that the staff expertise was not used by policy makers to make decisions adapted to reality, also expressing the need to improve the capacity for analysis of the EMS response. Few respondents reported good overall satisfaction with their EMS response. The EMS adopted different types of measures to adapt to the COVID-19 pandemic.

7.
Sustainable Technology and Entrepreneurship ; 1(1):100006-100006, 2022.
Article in English | EuropePMC | ID: covidwho-1728195

ABSTRACT

The scientific community has become concerned about the impact of blockchain technology as a motivational tool in the COVID-19 era. Since the beginning of the pandemic, the number of scientific articles published in this field has been increasing, making it highly desirable to carry out a bibliometric study to identify research efforts. Therefore, the aim of this work was to conduct a literature review of blockchain and COVID-19 technology in the field of Business Management to identify recent lines of research. To do so, we used a text mining technique on a corpus composed of 37 articles in the Web of Science database. The results obtained clearly show 3 distinct clusters. The first represents the blockchain technology framework in organizations and stakeholders in which the research methodology in artificial intelligence is very important. The second shows the need to take into account business sustainability caused by COVID-19. The third indicates the impact of the pandemic on the supply chain industry.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-317353

ABSTRACT

Background: The ongoing COVID-19 pandemic has not only globally caused a high number of causalities, but is also an unprecedented challenge for scientists. False-positive virus detection tests not only aggravate the situation in the healthcare sector, but also provide ground for conspiracy theorists. Previous studies have highlighted the importance of software choice and data interpretation in virome studies. We aimed to further expand theoretical and practical knowledge in virome studies by focusing on short, virus-like DNA sequences in metagenomic data.ResultsExemplarily, analyses of metagenomic data from the dried-out Aral Sea basin in Uzbekistan showed that Coronavirus-like sequences have existed in environmental samples before the current COVID-19 crisis. In the analyzed environmental datasets, diverse Betacoronavirus-like sequences were detected, which also included SARS-CoV-2 matches. Moreover, the data sets harbored regions that show complementarity to PCR primers that are currently in use for virus detection and origin tracing.ConclusionsOur study confirms the importance of parameter selection, especially in terms of read length, for reliable virome profiling. Natural environments are an important source of Coronavirus-like nucleotide sequences that should be taken into account when virome datasets are analyzed and interpreted. Moreover, the identified test primer binding sites in metagenomic data might play an important role for the development of reliable test systems and origin tracing.

9.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327346

ABSTRACT

Production of affordable coronavirus disease 2019 (COVID-19) vaccines in low- and middle-income countries is needed. NDV-HXP-S is an inactivated egg-based Newcastle disease virus (NDV) vaccine expressing the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Wuhan-Hu-1. The spike protein was stabilized and incorporated into NDV virions by removing the polybasic furin cleavage site, introducing the transmembrane domain and cytoplasmic tail of the fusion protein of NDV, and introducing six prolines for stabilization in the prefusion state. Vaccine production and clinical development was initiated in Vietnam, Thailand, and Brazil. Here the interim results from the first stage of the randomized, dose-escalation, observer-blind, placebo-controlled, phase 1/2 trial conducted at the Hanoi Medical University (Vietnam) are presented. Healthy adults aged 18-59 years, non-pregnant, and with self-reported negative history for SARS-CoV-2 infection were eligible. Participants were randomized to receive one of five treatments by intramuscular injection twice, 28 days apart: 1 μg +/-CpG1018 (a toll-like receptor 9 agonist), 3 μg alone, 10 μg alone, or placebo. Participants and personnel assessing outcomes were masked to treatment. The primary outcomes were solicited adverse events (AEs) during 7 days and subject-reported AEs during 28 days after each vaccination. Investigators further reviewed subject-reported AEs. Secondary outcomes were immunogenicity measures (anti-spike immunoglobulin G [IgG] and pseudotyped virus neutralization). This interim analysis assessed safety 56 days after first vaccination (day 57) in treatment-exposed individuals and immunogenicity through 14 days after second vaccination (day 43) per protocol. Between March 15 and April 23, 2021, 224 individuals were screened and 120 were enrolled (25 per group for active vaccination and 20 for placebo). All subjects received two doses. The most common solicited AEs among those receiving active vaccine or placebo were all predominantly mild and included injection site pain or tenderness (<58%), fatigue or malaise (<22%), headache (<21%), and myalgia (<14%). No higher proportion of the solicited AEs were observed for any group of active vaccine. The proportion reporting vaccine-related AEs during the 28 days after either vaccination ranged from 4% to 8% among vaccine groups and was 5% in controls. No vaccine-related serious adverse event occurred. The immune response in the 10 μg formulation group was highest, followed by 1 μg +CpG1018, 3 μg, and 1 μg formulations. Fourteen days after the second vaccination, the geometric mean concentrations (GMC) of 50% neutralizing antibody against the homologous Wuhan-Hu-1 pseudovirus ranged from 56.07 IU/mL (1 μg, 95% CI 37.01, 84.94) to 246.19 IU/mL (10 μg, 95% CI 151.97, 398.82), with 84% to 96% of vaccine groups attaining a ≥ 4-fold increase over baseline. This was compared to a panel of human convalescent sera (N=29, 72.93 95% CI 33.00-161.14). Live virus neutralization to the B.1.617.2 (Delta) variant of concern was reduced but in line with observations for vaccines currently in use. Since the adjuvant has shown modest benefit, GMC ratio of 2.56 (95% CI, 1.4 - 4.6) for 1 μg +/-CpG1018, a decision was made not to continue studying it with this vaccine. NDV-HXP-S had an acceptable safety profile and potent immunogenicity. The 3 μg dose was advanced to phase 2 along with a 6 μg dose. The 10 μg dose was not selected for evaluation in phase 2 due to potential impact on manufacturing capacity. ClinicalTrials.gov NCT04830800 .

10.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327146

ABSTRACT

NDV-HXP-S is a recombinant Newcastle disease virus based-vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which expresses an optimized (HexaPro) spike protein on its surface. The vaccine can be produced in embryonated chicken eggs using the same process as that employed for the production of influenza virus vaccines. Here we performed a secondary analysis of the antibody responses after vaccination with inactivated NDV-HXP-S in a Phase I clinical study in Thailand. The SARS-CoV-2 neutralizing and spike binding activity of NDV-HXP-S post-vaccination serum samples was compared to that of matched samples from mRNA BNT162b2 (Pfizer) vaccinees. Neutralizing activity of sera from NDV-HXP-S vaccinees was comparable to that of individuals vaccinated with BNT162b2. Interstingly, the spike binding activity of the NDV-HXP-S vaccinee samples was lower than that of sera obtained from individuals vaccinated with the mRNA vaccine. This let us to calculate ratios between binding and neutralizing antibody titers. Samples from NDV-HXP-S vaccinees had binding to neutralizing activity ratios similar to those of convalescent sera suggesting a very high proportion of neutralizing antibodies and low non-neutralizing antibody titers. Further analysis showed that, in contrast to mRNA vaccination, which induces strong antibody titers to the receptor binding domain (RBD), the N-terminal domain, and the S2 domain, NDV-HXP-S vaccination induces a very RBD focused response with little reactivity to S2. This explains the high proportion of neutralizing antibodies since most neutralizing epitopes are located in the RBD. In conclusion, vaccination with inactivated NDV-HXP-S induces a high proportion of neutralizing antibodies and absolute neutralizing antibody titers comparable to those after mRNA vaccination.

11.
Acta Haematol ; 2022 Feb 08.
Article in English | MEDLINE | ID: covidwho-1673577

ABSTRACT

Patients with hematologic malignancies are particularly vulnerable to infections due to underlying humoral and cellular immune dysfunction, cytotoxic chemotherapy regimens, advanced age, and the presence of comorbid conditions. Infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of the COVID-19 pandemic, has become a leading cause of death globally and has disproportionally affected this high-risk population. Here, we review the cumulative evidence demonstrating worse outcomes for patients with hematologic malignancies when compared to patients with solid tumors and the general population. We examine risk factors shared with the general population (age, sex, comorbid conditions, race) and those that are cancer-specific (cytotoxic chemotherapy, progressive disease, cancer type), all of which confer an increased risk of severe COVID-19. Despite the historical exclusion of cancer patients from COVID-19 therapy trials, we review the emerging evidence that patients with hematologic malignancies benefit from specific treatments such as convalescent plasma. Although COVID-19 vaccines are significantly less effective in this patient population, encouraging results are observed in a subset of these patients after receiving a booster dose.

13.
Adv Rheumatol ; 62(1): 3, 2022 01 17.
Article in English | MEDLINE | ID: covidwho-1638265

ABSTRACT

OBJECTIVE: To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making decision (SMD) process. METHODS: A task force was constituted by 24 rheumatologists (panel members), with clinical and research expertise in immunizations and infectious diseases in immunocompromised patients, endorsed by the Brazilian Society of Rheumatology (BSR), to develop guidelines for COVID-19 vaccination in patients with IMRD. A consensus was built through the Delphi method and involved four rounds of anonymous voting, where five options were used to determine the level of agreement (LOA), based on the Likert Scale: (1) strongly disagree; (2) disagree, (3) neither agree nor disagree (neutral); (4) agree; and (5) strongly agree. Nineteen questions were addressed and discussed via teleconference to formulate the answers. In order to identify the relevant data on COVID-19 vaccines, a search with standardized descriptors and synonyms was performed on September 10th, 2021, of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and LILACS to identify studies of interest. We used the Newcastle-Ottawa Scale to assess the quality of nonrandomized studies. RESULTS: All the nineteen questions-answers (Q&A) were approved by the BSR Task Force with more than 80% of panelists voting options 4-agree-and 5-strongly agree-, and a consensus was reached. These Guidelines were focused in SMD on the most appropriate timing for IMRD patients to get vaccinated to reach the adequate covid-19 vaccination response. CONCLUSION: These guidelines were developed by a BSR Task Force with a high LOA among panelists, based on the literature review of published studies and expert opinion for COVID-19 vaccination in IMRD patients. Noteworthy, in the pandemic period, up to the time of the review and the consensus process for this document, high-quality evidence was scarce. Thus, it is not a substitute for clinical judgment.


Subject(s)
COVID-19 , Rheumatic Diseases , Vaccination/methods , COVID-19 Vaccines , Humans , Rheumatology , SARS-CoV-2
14.
Arch Prev Riesgos Labor ; 25(1): 8-17, 2022 01 17.
Article in Spanish | MEDLINE | ID: covidwho-1625858

ABSTRACT

Al igual que ya sucedió en 2020, 2021 ha estado dominado por la pandemia de COVID-19. Si hace un año escribíamos esta Nota Editorial con gran preocupación por la evolución de la situación de la infección originada por el SARS-CoV-2 y, a su vez, con grandes esperanzas puestas en las vacunas como estrategia preventiva, la actual viene marcada por la incertidumbre generada por la irrupción de la nueva variante de preocupación: Omicrón….


Subject(s)
COVID-19 , Pulmonary Medicine , Bibliometrics , Humans , Pandemics/prevention & control , SARS-CoV-2
15.
Clin Infect Dis ; 74(1): 127-132, 2022 01 07.
Article in English | MEDLINE | ID: covidwho-1621567

ABSTRACT

Hospitalized patients with coronavirus disease 2019 (COVID-19) experiencing respiratory symptoms have different complications (inflammatory, co-infection, and thrombotic) that are identifiable by analytics patterns. Personalized treatment decisions decreased early mortality (odds ratio [OR] .144; 95% confidence interval [CI] .03-.686; P = .015). Increasing age (OR 1.06; P = .038) and therapeutic effort limitation (OR 9.684; P < .001) were associated with higher mortality.


Subject(s)
COVID-19 , Hospitalization , Humans , Odds Ratio , SARS-CoV-2
16.
PLoS One ; 17(1): e0261853, 2022.
Article in English | MEDLINE | ID: covidwho-1622346

ABSTRACT

Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) is used worldwide to test and trace the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). "Extraction-less" or "direct" real time-reverse transcription polymerase chain reaction (RT-PCR) is a transparent and accessible qualitative method for SARS-CoV-2 detection from nasopharyngeal or oral pharyngeal samples with the potential to generate actionable data more quickly, at a lower cost, and with fewer experimental resources than full RT-qPCR. This study engaged 10 global testing sites, including laboratories currently experiencing testing limitations due to reagent or equipment shortages, in an international interlaboratory ring trial. Participating laboratories were provided a common protocol, common reagents, aliquots of identical pooled clinical samples, and purified nucleic acids and used their existing in-house equipment. We observed 100% concordance across laboratories in the correct identification of all positive and negative samples, with highly similar cycle threshold values. The test also performed well when applied to locally collected patient nasopharyngeal samples, provided the viral transport media did not contain charcoal or guanidine, both of which appeared to potently inhibit the RT-PCR reaction. Our results suggest that direct RT-PCR assay methods can be clearly translated across sites utilizing readily available equipment and expertise and are thus a feasible option for more efficient COVID-19 coronavirus disease testing as demanded by the continuing pandemic.


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnosis , RNA, Viral/genetics , Real-Time Polymerase Chain Reaction/methods , Reverse Transcription/genetics , SARS-CoV-2/genetics , COVID-19/virology , Feasibility Studies , Humans , Nasopharynx/virology , Pandemics/prevention & control , Sensitivity and Specificity , Serologic Tests/methods , Specimen Handling/methods
18.
Gac Med Mex ; 157(3): 225-230, 2021.
Article in English | MEDLINE | ID: covidwho-1604163

ABSTRACT

INTRODUCTION: In America, the United States was particularly affected by the COVID-19 pandemic. OBJECTIVES: To estimate how many daily COVID-19 deaths per 100,000 population would have been avoided if each one of five restrictive measures had been implemented at the time of diagnosis and to estimate a multiple linear regression model predictive of the number of deaths per 100,000 population based on the measures adopted by the countries. METHODS: A simple linear regression was performed between the days elapsed since the first COVID-19 diagnosed case and the implementation of each one of the five restrictive measures by the 27 American countries studied and the number of COVID-19 deaths per 100,000 population. RESULTS: For each day between the first COVID-19 reported case and the adoption of restrictive measures, between 0.250 (p = 0.021) and 0.600 (p = 0.001) patients per 100,000 population died, depending on the measure in question. CONCLUSIONS: Adoption of restrictive measures and social distancing are necessary for reducing the number of people infected with COVID-19 and their mortality. In addition, promptness of their establishment is essential in order to reduce the number of deaths.


INTRODUCCIÓN: En América, Estados Unidos se vio particularmente afectado por la pandemia de COVID-19. OBJETIVOS: Estimar cuántas muertes diarias por COVID-19 por 100 000 habitantes se hubiesen evitado si cada una de las cinco medidas restrictivas se hubiera implementado en el momento del diagnóstico, así como estimar un modelo de regresión lineal múltiple predictivo del número de muertes por 100 000 habitantes basado en las medidas adoptadas por los países. MÉTODOS: Se realizó una regresión lineal simple entre los días transcurridos desde el primer caso diagnosticado de COVID-19 y la implantación de cada una de las cinco medidas restrictivas llevadas a cabo por los 27 países americanos estudiados y el número de muertes por COVID-19 por cada 100 000 habitantes. RESULTADOS: Por cada día entre el primer caso reportado de COVID-19 y la adopción de medidas restrictivas, fallecieron entre 0.250 (p = 0.021) y 0.600 (p = 0.001) pacientes por cada 100 000 habitantes, dependiendo de la medida en cuestión. CONCLUSIONES: La adopción de medidas restrictivas y la distancia social son necesarias para reducir el número de personas infectadas con COVID-19 y su mortalidad; además, la velocidad de su establecimiento es esencial para reducir el número de muertes.


Subject(s)
COVID-19/mortality , Physical Distancing , COVID-19/prevention & control , Humans , Time Factors , United States/epidemiology
19.
World J Psychiatry ; 11(11): 997-1016, 2021 Nov 19.
Article in English | MEDLINE | ID: covidwho-1560089

ABSTRACT

Unipolar depressive disorder (UDD) affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted life years lost in 2030. It is imperative for leading economies to implement preventive strategies targeted towards UDD, given consistent policies are currently lacking. Recently established similarities between the aetiological hypotheses of depression and cardiometabolic diseases are shifting paradigms within this field. It is believed that dietary practices could potentially reduce the incidence of depression; similar to their effects on metabolism. Thus, the aim of this review was to compile current evidence on healthy dietary patterns as suitable contributors towards primary prevention strategies against UDD. Most of the well-known biological mechanisms behind depression have been positively associated with healthful diets and dietary patterns to varying degrees. Interestingly, a common factor of UDD is the production and overall effects of inflammatory cytokines, such as interleukin-6, tumor necrosis factor-α, and C-reactive protein. These compounds have been associated with depressive symptoms, disturbances in neuroendocrine function, leaky gut, monoamine activity and brain function, while also being key factors in the development of cardiometabolic diseases. The Mediterranean diet (MD) in particular, is well supported by first-level evidence regarding its preventive qualities against metabolic and cardiovascular diseases and thus considered a model for healthy eating by various organizations. In one of the few clinical trials investigating these associations, the PREDIMED trial, individuals with diabetes assigned to a MD supplemented with mixed tree nuts experienced a 41% relative risk reduction for developing depression. Lastly, there is a need to include health related quality of life as an indicator of physical and mental well-being, considering its putative associations with depression and suicide risk. Going forward, focusing on clinical trials, using precise nutritional assessments, and identifying nutritional biomarkers which may be related to depression are needed to fully support the implementation of dietary recommendations in the field of psychiatry.

20.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-295486

ABSTRACT

Reverse transcription–quantitative polymerase chain reaction (RT-qPCR) is used worldwide to test and trace the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). “Extraction-less” or “direct” real time–reverse transcription polymerase chain reaction (RT-PCR) is an open-access qualitative method for SARS-CoV-2 detection from nasopharyngeal or oral pharyngeal samples with the potential to generate actionable data more quickly, at a lower cost, and with fewer experimental resources than full RT-qPCR. This study engaged 10 global testing sites, including laboratories currently experiencing testing limitations due to reagent or equipment shortages, in an international interlaboratory ring trial. Participating laboratories were provided a common protocol, common reagents, aliquots of identical pooled clinical samples, and purified nucleic acids and used their existing in-house equipment. We observed 100% concordance across laboratories in the correct identification of all positive and negative samples, with highly similar cycle threshold values. The test also performed well when applied to locally collected patient nasopharyngeal samples, provided the viral transport media did not contain charcoal or guanidine, both of which appeared to potently inhibit the RT-PCR reaction. Our results suggest that open-access, direct RT-PCR assays are a feasible option for more efficient COVID-19 coronavirus disease testing as demanded by the continuing pandemic.

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