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1.
BMJ Open ; 13(1), 2023.
Article in English | ProQuest Central | ID: covidwho-2193757

ABSTRACT

ObjectivesThe Computer-Aided Risk Score for Mortality (CARM) estimates the risk of in-hospital mortality following acute admission to the hospital by automatically amalgamating physiological measures, blood tests, gender, age and COVID-19 status. Our aims were to implement the score with a small group of practitioners and understand their first-hand experience of interacting with the score in situ.DesignPilot implementation evaluation study involving qualitative interviews.SettingThis study was conducted in one of the two National Health Service hospital trusts in the North of England in which the score was developed.ParticipantsMedical, older person and ICU/anaesthetic consultants and specialist grade registrars (n=116) and critical outreach nurses (n=7) were given access to CARM. Nine interviews were conducted in total, with eight doctors and one critical care outreach nurse.InterventionsParticipants were given access to the CARM score, visible after login to the patients' electronic record, along with information about the development and intended use of the score.ResultsFour themes and 14 subthemes emerged from reflexive thematic analysis: (1) current use (including support or challenge clinical judgement and decision making, communicating risk of mortality and professional curiosity);(2) barriers and facilitators to use (including litigation, resource needs, perception of the evidence base, strengths and limitations), (3) implementation support needs (including roll-out and integration, access, training and education);and (4) recommendations for development (including presentation and functionality and potential additional data). Barriers and facilitators to use, and recommendations for development featured highly across most interviews.ConclusionOur in situ evaluation of the pilot implementation of CARM demonstrated its scope in supporting clinical decision making and communicating risk of mortality between clinical colleagues and with service users. It suggested to us barriers to implementation of the score. Our findings may support those seeking to develop, implement or improve the adoption of risk scores.

2.
Discover Psychology ; 3(1):2, 2023.
Article in English | ProQuest Central | ID: covidwho-2175643

ABSTRACT

BackgroundThe suicide rate has increased during the pandemic in India. Moreover, several studies, especially press-media reporting suicide studies have been conducted but no systematic review has been attempted in this context. Therefore, the present study systematically investigated the risk factors associated with suicidal behaviors, and the method of suicide during the COVID-19 pandemic in India.MethodsFollowing the PRISMA guidelines, a systematic search was performed to include papers published up until September 30, 2022. From an initial 144 papers, 18 studies which met the inclusion criteria were included in the present review. The Pierson's method was used for quality assessment of the included studies in the present review.ResultsThe risk factors associated with suicide comprised: (i) socio-demographic factors (e.g., being aged between 31 and 50 years, male, married, unemployed), (ii) behavior and health-related factors (e.g., unavailability of alcohol and alcohol withdrawal symptoms, poor state of physical health and health issues, family disputes, relationship complexities, and sexual harassment), (iii) COVID-19-related factors (e.g., fear of COVID-19, COVID-19 test results, quarantine or isolation, financial hardship due to the pandemic, having influenza-like symptoms, experiencing stigmatization and ostracism despite testing negative, separation from family due to transport restrictions, misinterpreting other illness symptoms as COVID-19, saving the village from infection, watching COVID-19 videos on social media, online schooling, perceived stigma toward COVID-19, and being suspected of having COVID-19), and (iv) psychopathological stressors (depression, loneliness, stress, TikTok addiction, and poor mental health, suicidal tendencies, helplessness, and worrying). Hanging was the most common method of suicide. In addition, jumping from high buildings, poisoning, drowning, burning, cutting or slitting throat or wrists, self-immolation, medication overdose, electrocution, pesticide, and gun-shot were also used to carry out the suicide.ConclusionsFindings from this research suggest multiple reasons for suicide during the COVID-19 pandemic and knowledge of such factors could aid in developing suicide prevention strategies focusing the most vulnerable cohorts inside and outside India.

3.
Heliyon ; 8(5): e09424, 2022 May.
Article in English | MEDLINE | ID: covidwho-2178992

ABSTRACT

The aim of this study was to measure anxiety levels and many co-factors that might influence the levels of anxiety during the COVID-19 outbreak in southern Saudi Arabia (KSA). A cross-sectional self-reporting survey was conducted to determine the level of generalized anxiety disorder (GAD) symptoms related to COVID-19 and quarantining. We selected a convenience sample of eligible participants who had been invited online through social media apps. The survey instrument was distributed, and 981 participants responded. Of the total sample, almost 90% were under the age of 40, 75% were women, and 77% had an educational level beyond high school. Just over half were single, with nearly all participants Saudi nationals. The overall prevalence of anxiety related to COVID-19 was 27%. Factors most strongly related to reporting anxiety included having a diagnosis of COVID-19, spending 1- ≥ 3 h focused on COVID-19, having a previous mental illness history, being a current or former smoker, being female, having a previous diagnosis of chronic or respiratory illness, being below age 40, having a limited standard of living, and being a student. Our study reveals how critical it is to emphasize preventive mental health care during pandemics and what factors may make some individuals most vulnerable to anxiety. Further research is recommended to examine GAD levels pre, during and post pandemic. Additional research to explore the long-term impact of the pandemic on mental health is also needed. being a student, and a limited standard of living.

4.
Hygiene ; 3(1):1-11, 2023.
Article in English | MDPI | ID: covidwho-2166404

ABSTRACT

The global COVID-19 pandemic has caused countries to develop novel methods to detect and trace active cases. These methods aim to limit its spread;however, they can also be used to detect other endemic infectious diseases, such as tuberculosis (TB). The current methods used to detect COVID-19 cases, such as temperature-checking and tracing applications, led to the detection of these specific TB cases and their referral to the hospital. In this study, we present four cases of TB in which the patients come from different working backgrounds. We conclude that the current measures used for COVID-19 could also prove to be beneficial in the context of other infectious diseases, mainly TB.

6.
Healthcare ; 10(12):2504, 2022.
Article in English | MDPI | ID: covidwho-2154954

ABSTRACT

In recent decades, epidemic and pandemic illnesses have grown prevalent and are a regular source of concern throughout the world. The extent to which the globe has been affected by the COVID-19 epidemic is well documented. Smart technology is now widely used in medical applications, with the automated detection of status and feelings becoming a significant study area. As a result, a variety of studies have begun to focus on the automated detection of symptoms in individuals infected with a pandemic or epidemic disease by studying their body language. The recognition and interpretation of arm and leg motions, facial recognition, and body postures is still a developing field, and there is a dearth of comprehensive studies that might aid in illness diagnosis utilizing artificial intelligence techniques and technologies. This literature review is a meta review of past papers that utilized AI for body language classification through full-body tracking or facial expressions detection for various tasks such as fall detection and COVID-19 detection, it looks at different methods proposed by each paper, their significance and their results.

7.
J Soc Cardiovasc Angiogr Interv ; : 100551, 2022.
Article in English | EuropePMC | ID: covidwho-2150191
8.
Coronavirus Drug Discovery: Druggable Targets and In Silico Update: Volume 3 ; : 355-376, 2022.
Article in English | Scopus | ID: covidwho-2149156

ABSTRACT

The present study conducted an in silico investigation and identifications of bioactive compounds from medicinal plants against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) cellular entry. Thirty nine (39) bioactive compounds with evidence of in vitro or in vivo antidiabetic activities from medicinal plants were utilized in order to provide insight about their possible inhibitory potentials against SARS-CoV-2 cellular entry. Results from this study showed that silymarin, sanguinarine, withanolides, boswellic acids, fisetin, celastrol, neferine, ursolic acid, rutin, gambogic acid, quercetin, and luteolin expressed multiple binding capacity against nucleocapsid dimerization domain (−10.7 to −8.4kcal/mol), spike's protein binding domain (−10.0 to −8.1kcal/mol), and spike receptor-binding domain (−10.8 to −9.0kcal/mol) compared to lopinavir and remdesivir which were used as reference compounds in the study. However, withanolides, fisetin, luteolin, sanguinarine, and silymarin are most druggable phytochemicals as they obey the Lipinski's rule of five analyses with no signs of in silico predictory toxicity. Thus, they are recommended for further studies for the development of phytotherapy formulation to combat SARS-CoV-2 disease. © 2022 Elsevier Inc. All rights reserved.

9.
Egyptian Journal of Hospital Medicine ; 89(2):6786-6794, 2022.
Article in English | Scopus | ID: covidwho-2146010

ABSTRACT

Background: It has been demonstrated that the use of personal protective equipment (PPE) by health care workers, including dentists, reduces the transmission of COVID-19. PPE lowers patient morbidity and death as well as illness and absenteeism. Aim: The purpose of the study was to evaluate the impact of dentists' perceptions of personal infection control and their level of trust in PPE as part of the dental profession's response to the COVID-19 pandemic. Materials and Method: The sample size was (388) participants distributed as specialist, general dental practitioners, dental branch practitioners, and rotators. Google form prepared with specific questions;demographical and knowledge questions translated to the mother language (Arabic Language). Structured and distributed online by sharing the link through electronic platforms. Two responses were used in a statistical analysis using the SPSS version (SPSS Package version (21). Significant p value of 0.05 or less was used. Descriptive statistics were used in the data analysis to analyze the percentage, and mean values. All questions employ the spearman test to determine correlations. Kruskal-Wallis for comparing differences between groups including qualification and experience period between participants. Result: Significant results were shown in both rotators and general practitioners for comparison of different qualification levels between dentists. All dentists had good knowledge regarding the PPE. Conclusions: Overall, dentists in the current study had good knowledge of the PPE used for COVID-19 protection. However, it was discovered that knowledge is important for rotators and general practitioners in the majority of the PPE questions. © 2022, Ain Shams University Faculty of Medicine. All rights reserved.

10.
Vaccines ; 10(12):2071, 2022.
Article in English | MDPI | ID: covidwho-2143808

ABSTRACT

Background: Monkeypox disease (MPOX) recently re-emerged in May 2022, causing international outbreaks in multiple non-endemic countries. This study demonstrates a novel comparison between the knowledge and perceptions of Saudi healthcare workers (HCWs) and the general public regarding MPOX. Methods: An online survey, conducted from 27 May to 5 June 2022, assessing participants' MPOX and monkeypox virus (MPV) knowledge in terms of transmission, vaccination, isolation precautions, and their attitudes toward seeking more information. Results: A total of 1546 members of the public and 1130 HCWs completed the survey. Briefly, 61.3% of the public and 74.2% of HCWs showed interest in seeking more information about MPOX. Both groups had average overall mean MPOX knowledge scores. Members of the public holding university degrees and those showing high levels of worry regarding MPOX had significantly higher knowledge scores. However, HCWs showed a poor vaccination knowledge score, while only 57% recognized that MPOX can present similarly to COVID-19 in the early stages. Female HCWs and those with high self-rated MPOX awareness had significantly high knowledge scores. HCWs in secondary and tertiary centers had significantly higher knowledge scores. Conclusion: Both groups showed a decent attitude in terms of seeking more MPOX knowledge, which correlated positively with their worry about and awareness of the disease. These observations are mostly as a consequence of the ongoing COVID-19 pandemic, which encouraged the public and HCW to acquire more information about any novel emerging disease. Policymakers should make the most of this attitude in their awareness campaigns to prevent the spread of the disease and encourage vaccination in cases where it is needed. The knowledge gaps among HCWs were most evident in terms of clinical presentation and vaccinations;this problem needs addressing if we are to avoid further emerging MPOX cases.

11.
BJPsych Open ; 9(1), 2023.
Article in English | ProQuest Central | ID: covidwho-2139817

ABSTRACT

BackgroundEvidence from pandemic and pre-pandemic studies conducted globally indicates that people with disabilities (PWDs) have a higher risk for suicidality. However, none of these studies has assessed suicidality among PWDs in Bangladesh.AimsThe purpose of this study was to determine the prevalence of and factors associated with suicidal ideation among PWDs during the COVID-19 pandemic in Bangladesh.MethodUsing a snowball sampling technique, a cross-sectional survey was conducted from February to April 2021 among PWDs from six districts in the northern region of Bangladesh. Information related to sociodemographic factors, clinical characteristics, behavioural factors and suicidal ideation was collected. Chi-squared test and logistic regression were used to describe the data and explain the relationship of factors associated with suicidal ideation.ResultsThe prevalence of COVID-19-related past-year suicidal ideation was 23.9%. The factors associated with suicidal ideation included: age above 35 years, being female, acquiring a disability later in life, lack of sleep and current substance use. In addition, higher education appeared to be a protective factor against suicidal ideation.ConclusionsThis study highlighted that PWDs had an increased risk of suicide;that is, one-fourth of them had past-year suicidal ideation. This may have been because of COVID-19-related restrictions and stressors. Thus, the government and policy makers need to pay more attention to developing effective suicide assessment, treatment and management strategies, especially for at-risk groups, to minimise the impact of the COVID-19 outbreak.

12.
European Journal of Pharmaceutical Sciences ; : 106345, 2022.
Article in English | ScienceDirect | ID: covidwho-2130708

ABSTRACT

SARS-CoV-2 was shown to infect and persist in the human brain cells up to 230 days, highlighting the need to treat the brain viral load. The CNS disposition of antiCOVID-19 drugs: Remdesivir, Molnupiravir, and Nirmatrelvir, remains, however, unexplored. Here, we assessed the human brain pharmacokinetic profile (PK) against the EC90 values of antiCOVID-19 drugs to predict drugs with favorable brain PK against the delta and omicron variants. We also evaluated the intracellular PK of GS443902 and EIDD2061, the active metabolites of Remdesivir and Molnupiravir. Towards this, we applied LeiCNS-PK3.0, the physiologically based pharmacokinetic framework with demonstrated adequate predictions of human CNS PK. Under the recommended dosing regimens, the predicted brain extracellular fluid PK of only Nirmatrelvir was above the variants’ EC90. The intracellular levels of GS443902 and EIDD2061 were below the intracellular EC90. Summarizing, our model recommends Nirmatrelvir as the promising candidate for (pre)clinical studies investigating the CNS efficacy of antiCOVID-19 drugs.

13.
Res Militaris ; 12(2):4897-4909, 2022.
Article in English | Scopus | ID: covidwho-2125546

ABSTRACT

This research aims to demonstrate the nature and concept of the Corona pandemic, its implications for the global economy, and the management and performance of companies in particular. Additionally, the research intends to measure the impact of the Corona pandemic on companies' financial performance. Listed on the Iraqi Stock Exchange, which has finished compiling its year-end financial statements for 2019-2020. The investigation arrived at several findings, the most significant of which was that most businesses were not prepared for such a crisis technologically or to develop human resources to deal with this pandemic. In addition, most companies experienced a decrease in their financial performance as a direct result of the Corona pandemic, as indicated by the findings of the investigated financial performance indicators. Finally, the research resulted in several recommendations, the most important of which is that businesses should invest more in technology and the development of human resources to prepare for such crises in the future and that the government should provide support for companies that were impacted by the pandemic by waiving taxes, removing customs duties, and providing banking facilities from the Central Bank. © 2022, Association Res Militaris. All rights reserved.

14.
Cureus ; 14(10), 2022.
Article in English | EuropePMC | ID: covidwho-2124525

ABSTRACT

Multisystem inflammatory syndrome in children (MIS-C) can develop weeks after the Coronavirus disease 2019 (COVID-19). The disease’s clinical spectrum includes persistent febrile illness, features resembling Kawasaki disease, and cytokine storm symptoms. In severe cases, multisystem organ failure and death may result if not treated promptly. This report discusses a rare case of a 13-year-old girl presenting with fever and acute kidney injury (AKI) eight weeks after recovering from COVID-19 who was diagnosed with MIS-C. A 13-year-old female presented with a fever and abdominal pain following a recent COVID-19. A physical examination revealed a febrile, ill-looking child with abdominal tenderness. Pancytopenia, transaminitis, AKI, and a hyperinflammatory state were noted in the initial laboratory workup. Furthermore, blast cells were seen on the peripheral blood smear. Despite appropriate empiric antibiotic therapy for sepsis, she did not show signs of clinical improvement. An abdominal computed tomography (CT) scan revealed multiple focal areas of hypoattenuating lesions involving both kidneys, suggestive of bilateral renal infarction. Since she met the criteria of the Centers for Disease Control and Prevention (CDC) for MIS-C diagnosis, a high dose of intravenous immunoglobulin (IVIG) led to a dramatic improvement in the patient’s condition and complete recovery from her illness. This case report describes a rare clinical presentation of MIS-C in a child who presented with AKI due to presumably thrombotic events and transient blast cells in blood film secondary to a severe inflammatory process. Further studies are needed to determine the prevalence of thrombotic AKI associated with MIS-C.

15.
Front Public Health ; 10: 1020801, 2022.
Article in English | MEDLINE | ID: covidwho-2142352

ABSTRACT

Introduction: While most governments instituted several interventions to stall the spread of COVID-19, little is known regarding the continued observance of the non-pharmaceutical COVID-19 preventive measures particularly in Sub-Saharan Africa (SSA). We investigated adherence to these preventive measures during the initial 6 months of the COVID-19 outbreak in some SSA countries. Methods: Between March and August 2020, the International Citizen Project on COVID-19 consortium (www.icpcovid.com) conducted online surveys in six SSA countries: Benin, Cameroon, Democratic Republic of Congo, Mozambique, Somalia, and Uganda. A five-point individual adherence score was constituted by scoring respondents' observance of the following measures: mask use, physical distancing, hand hygiene, coughing hygiene, and avoiding to touch one's face. Community behaviors (going to public places, traveling during the pandemic) were also assessed. Data were analyzed in two time periods: Period 1 (March-May) and Period 2 (June-August). Results: Responses from 26,678 respondents were analyzed (mean age: 31.0 ± 11.1 years; 54.1% males). Mean individual adherence score decreased from 3.80 ± 1.37 during Period 1, to 3.57 ± 1.43 during Period 2; p < 0.001. At the community level, public events/places were significantly more attended with increased travels during Period 2 compared to Period 1 (p < 0.001). Using linear mixed models, predictors of increased individual adherence included: higher age (Coef = 0.005; 95% CI: 0.003-0.007), female gender (Coef = 0.071; 95% CI: 0.039-0.104), higher educational level (Coef = 0.999; 95% CI: 0.885-1.113), and working in the healthcare sector (Coef = 0.418; 95% CI: 0.380-0.456). Conclusion: Decreasing adherence to non-pharmaceutical measures over time constitutes a risk for the persistence of COVID-19 in SSA. Younger persons and those with lower education levels constitute target groups for improving adherence to such measures.


Subject(s)
COVID-19 , Pandemics , Male , Female , Humans , Young Adult , Adult , Pandemics/prevention & control , COVID-19/epidemiology , COVID-19/prevention & control , Africa South of the Sahara/epidemiology , Surveys and Questionnaires , Disease Outbreaks
16.
PLoS One ; 17(11): e0273256, 2022.
Article in English | MEDLINE | ID: covidwho-2140475

ABSTRACT

The RNA-dependent RNA polymerase (RdRp) of SARS-CoV-2 is one of the optimum targets for antiviral drug design and development. The hydroxyl groups of cytidine structures were modified with different aliphatic and aromatic groups to obtain 5´-O-acyl and 2´,3´-di-O-acyl derivatives, and then, these derivatives were employed in molecular modeling, antiviral prediction, molecular docking, molecular dynamics, pharmacological and POM studies. Density functional theory (DFT) at the B3LYP/6-31G++ level analyzed biochemical behavior and molecular electrostatic potential (MESP) of the modified cytidine derivatives. The antiviral parameters of the mutated derivatives revealed promising drug properties compared with those of standard antiviral drugs. Molecular docking has determined binding affinities and interactions between the cytidine derivatives and SARS-CoV-2 RdRp. The modified derivatives strongly interacted with prime Pro620 and Lys621 residues. The binding conformation and interactions stability were investigated by 200 ns of molecular dynamics simulations and predicted the compounds to firmly dock inside the RdRp binding pocket. Interestingly, the binding residues of the derivatives were revealed in high equilibrium showing an enhanced binding affinity for the molecules. Intermolecular interactions are dominated by both Van der Waals and electrostatic energies. Finally, the pharmacokinetic characterization of the optimized inhibitors confirmed the safety of derivatives due to their improved kinetic properties. The selected cytidine derivatives can be suggested as potential inhibitors against SARS-CoV-2. The POM Theory supports the hypothesis above by confirming the existence of an antiviral (Oδ--O'δ-) pharmacophore site of Hits.


Subject(s)
COVID-19 , Molecular Dynamics Simulation , Humans , Molecular Docking Simulation , SARS-CoV-2 , Cytidine/pharmacology , COVID-19/drug therapy , Receptors, Drug , Antiviral Agents/pharmacology , RNA-Dependent RNA Polymerase
17.
Diabetes & Metabolic Syndrome: Clinical Research & Reviews ; : 102676, 2022.
Article in English | ScienceDirect | ID: covidwho-2122422

ABSTRACT

Background and aims To compare Saudi Arabia with other countries regarding patient attitudes towards fasting Ramadan and complications related to fasting during the COVID-19 pandemic. Methods Data collected from Saudi Arabia and 12 other mostly Muslim majority countries, via physician administered questionnaire within post Ramadan 2020. Results 1485 Type1 diabetes (T1DM) patients analyzed;705 (47.5%) from Saudi Arabia vs. 780 (52.5%) from other countries. 1056 (71.1%) fasted Ramadan;636 (90.2%) of Saudi patients vs. 420 (53.8%) of other countries. Experiencing Ramadan during the COVID-19 pandemic did not affect the Saudi T1DM patients’ decision to fast while it significantly influenced their decision in other countries (1.4 vs 9.9%, P < 0.001). More Saudi patients needed to break the fast due to a diabetes related complication compared to other countries (67.4% vs. 46.8%, p=<0.001). The mean number of days fasted in Saudi and other countries was 24 ± 7 and 23 ± 8 days respectively. Hypoglycemic events were more common among Saudi patients during Ramadan compared to other countries 72% and 43.6% (p < 0.001) respectively. There was a significant difference in timing;the largest peak for Saudi Arabia patients was after dawn (35% vs 7%, p < 0.001), while it was pre-sunset for the other countries (23 vs 54%, p = 0.595). Day time-hyperglycemia was also more common among Saudi patients (48.6% vs. 39%, p < 0.001), however it was a less likely cause to break the fast (25.6% vs 38.3%, p < 0.001). Conclusion Observing the fast of Ramadan is extremely common among Saudi T1DM patients compared to other Muslim countries and was not affected by the COVID-19 pandemic. However, it was associated with higher frequency of hypoglycemic and hyperglycemic episodes.

18.
Trop Med Infect Dis ; 7(11)2022 Nov 15.
Article in English | MEDLINE | ID: covidwho-2115938

ABSTRACT

BACKGROUND: Coinfection with bacteria, fungi, and respiratory viruses has been described as a factor associated with more severe clinical outcomes in children with COVID-19. Such coinfections in children with COVID-19 have been reported to increase morbidity and mortality. OBJECTIVES: To identify the type and proportion of coinfections with SARS-CoV-2 and bacteria, fungi, and/or respiratory viruses, and investigate the severity of COVID-19 in children. METHODS: For this systematic review and meta-analysis, we searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus, and Nature through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for studies on the incidence of COVID-19 in children with bacterial, fungal, and/or respiratory coinfections, published from 1 December 2019 to 1 October 2022, with English language restriction. RESULTS: Of the 169 papers that were identified, 130 articles were included in the systematic review (57 cohort, 52 case report, and 21 case series studies) and 34 articles (23 cohort, eight case series, and three case report studies) were included in the meta-analysis. Of the 17,588 COVID-19 children who were tested for co-pathogens, bacterial, fungal, and/or respiratory viral coinfections were reported (n = 1633, 9.3%). The median patient age ranged from 1.4 months to 144 months across studies. There was an increased male predominance in pediatric COVID-19 patients diagnosed with bacterial, fungal, and/or viral coinfections in most of the studies (male gender: n = 204, 59.1% compared to female gender: n = 141, 40.9%). The majority of the cases belonged to White (Caucasian) (n = 441, 53.3%), Asian (n = 205, 24.8%), Indian (n = 71, 8.6%), and Black (n = 51, 6.2%) ethnicities. The overall pooled proportions of children with laboratory-confirmed COVID-19 who had bacterial, fungal, and respiratory viral coinfections were 4.73% (95% CI 3.86 to 5.60, n = 445, 34 studies, I2 85%, p < 0.01), 0.98% (95% CI 0.13 to 1.83, n = 17, six studies, I2 49%, p < 0.08), and 5.41% (95% CI 4.48 to 6.34, n = 441, 32 studies, I2 87%, p < 0.01), respectively. Children with COVID-19 in the ICU had higher coinfections compared to ICU and non-ICU patients, as follows: respiratory viral (6.61%, 95% CI 5.06-8.17, I2 = 0% versus 5.31%, 95% CI 4.31-6.30, I2 = 88%) and fungal (1.72%, 95% CI 0.45-2.99, I2 = 0% versus 0.62%, 95% CI 0.00-1.55, I2 = 54%); however, COVID-19 children admitted to the ICU had a lower bacterial coinfection compared to the COVID-19 children in the ICU and non-ICU group (3.02%, 95% CI 1.70-4.34, I2 = 0% versus 4.91%, 95% CI 3.97-5.84, I2 = 87%). The most common identified virus and bacterium in children with COVID-19 were RSV (n = 342, 31.4%) and Mycoplasma pneumonia (n = 120, 23.1%). CONCLUSION: Children with COVID-19 seem to have distinctly lower rates of bacterial, fungal, and/or respiratory viral coinfections than adults. RSV and Mycoplasma pneumonia were the most common identified virus and bacterium in children infected with SARS-CoV-2. Knowledge of bacterial, fungal, and/or respiratory viral confections has potential diagnostic and treatment implications in COVID-19 children.

19.
Children (Basel) ; 9(11)2022 Nov 14.
Article in English | MEDLINE | ID: covidwho-2115937

ABSTRACT

BACKGROUND: Intussusception (ISN) post-COVID-19 infection in children is rare but can occur. SARS-CoV-2 may play a role in the pathogenesis of ISN and trigger immune activation and mesenteric adenitis, which predispose peristaltic activity to "telescope" a proximal bowel segment into the distal bowel lumen. OBJECTIVES: To estimate the prevalence of SARS-CoV-2 infection in ISN children and analyze the demographic parameters, clinical characteristics and treatment outcomes in ISN pediatric patients with COVID-19 illness. METHODS: We performed this systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Studies reporting on the incidence of ISN post-SARS-CoV-2 infection in children, published from 1 December 2019 until 1 October 2022, in PROQUEST, MEDLINE, EMBASE, PUBMED, CINAHL, WILEY ONLINE LIBRARY, SCOPUS and NATURE, with a restriction to articles available in the English language, were included. RESULTS: Of the 169 papers that were identified, 34 articles were included in the systematic review and meta-analysis (28 case report, 5 cohort and 1 case-series studies). Studies involving 64 ISN patients with confirmed COVID-19 (all patients were children) were analyzed. The overall pooled proportions of the ISN patients who had PCR-confirmed SARS-CoV-2 infection was 0.06% (95% CI 0.03 to 0.09, n = 1790, four studies, I2 0%, p = 0.64), while 0.07% (95% CI 0.03 to 0.12, n = 1552, three studies, I2 0%, p = 0.47) had success to ISN pneumatic, hydrostatic and surgical reduction treatment and 0.04% (95% CI 0.00 to 0.09, n = 923, two studies, I2 0%, p = 0.97) had failure to ISN pneumatic, hydrostatic and surgical reduction treatment. The median patient age ranged from 1 to 132 months across studies, and most of the patients were in the 1-12 month age group (n = 32, 50%), p = 0.001. The majority of the patients were male (n = 41, 64.1%, p = 0.000) and belonged to White (Caucasian) (n = 25, 39.1%), Hispanic (n = 13, 20.3%) and Asian (n = 5, 7.8%) ethnicity, p = 0.000. The reported ISN classifications by location were mostly ileocolic (n = 35, 54.7%), and few children experienced ileo-ileal ISN (n = 4, 6.2%), p = 0.001. The most common symptoms from ISN were vomiting (n = 36, 56.2%), abdominal pain (n = 29, 45.3%), red currant jelly stools (n = 25, 39.1%) and blood in stool (n = 15, 23.4%). Half of the patients never had any medical comorbidities (n = 32, 50%), p = 0.036. The approaches and treatments commonly used to manage ISN included surgical reduction of the ISN (n = 17, 26.6%), pneumatic reduction of the ISN (n = 13, 20.2%), antibiotics (n = 12, 18.7%), hydrostatic reduction of the ISN (n = 11, 17.2%), laparotomy (n = 10, 15.6%), intravenous fluids (n = 8, 12.5%) and surgical resection (n = 5, 7.8%), p = 0.051. ISN was recurrent in two cases only (n = 2, 3.1%). The patients experienced failure to pneumatic (n = 7, 10.9%), hydrostatic (n = 6, 9.4%) and surgical (n = 1, 1.5%) ISN treatment, p = 0.002. The odds ratios of death were significantly higher in patients with a female gender (OR 1.13, 95% CI 0.31-0.79, p = 0.045), Asian ethnicity (OR 0.38, 95% CI 0.28-0.48, p < 0.001), failure to pneumatic or surgical ISN reduction treatment (OR 0.11, 95% CI 0.05-0.21, p = 0.036), admission to ICU (OR 0.71, 95% CI 0.83-1.18, p = 0.03), intubation and placement of mechanical ventilation (OR 0.68, 95% CI 0.51-1.41, p = 0.01) or suffering from ARDS (OR 0.88, 95% CI 0.93-1.88, p = 0.01) compared to those who survived. CONCLUSION: Children with SARS-CoV-2 infection are at low risk to develop ISN. A female gender, Asian ethnicity, failure to ISN reduction treatment (pneumatic or surgical), admission to ICU, mechanical ventilation and suffering from ARDS were significantly associated with death following ISN in pediatric COVID-19 patients.

20.
Front Med (Lausanne) ; 9: 856156, 2022.
Article in English | MEDLINE | ID: covidwho-2115110

ABSTRACT

Background: Numerous studies on knowledge, attitude, and practice (KAP) about the prevention of COVID-19 infections are available in Bangladeshi contexts, with results that vary significantly. However, no earlier attempt has been made to analyze the available COVID-19 KAP studies in Bangladesh, which is incorporated in this meta-analysis for the first time. Methods: Following the PRISMA guidelines, articles relevant to COVID-19 KAP that were conducted among the Bangladeshi population were found in databases such as PubMed, Scopus, CINAHL, Google Scholar, and ResearchGate. Random-effect meta-analysis was used to generate a pooled prevalence of knowledge, attitude, and practice level toward the prevention of COVID-19 infection. Results: This review included 18 articles that were published between March 2020 and November 2021. Overall, 89.87% (95% CI: 67.71-97.40) understood about COVID-19 symptoms, 92.09% (95% CI: 84.32-96.18) knew about how it spreads, and 79.51% (95% CI: 59.38-91.15) knew about how to treat it. The public's perception of controlling COVID-19 is mixed, with only 44.16% (95% CI: 35.74-52.93) and 60.28% (95% CI: 49.22-70.38) believing the country would win the struggle against the pandemic and the infection will be successfully controlled, respectively. Although overall COVID-19 preventative practice was good, subgroup analysis found that men had a poor practice toward controlling the infection. The practice of avoiding crowded places (70.15%) and maintaining social distance (77.17%) was found to be satisfactory in institution-based studies. Conclusion: The findings of this study revealed that the Bangladeshi population had a good awareness of COVID-19 symptoms, treatment, attitudes, and behaviors. The findings of this study are likely to aid Bangladeshi governments and policymakers in putting evidence into action by identifying gaps and emphasizing the importance of educating the less informed public about COVID-19 transmission.

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