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1.
Health psychology and behavioral medicine ; 10(1):762-785, 2022.
Article in English | EuropePMC | ID: covidwho-1999050

ABSTRACT

This study assessed the validity and reliability of the Pandemic Coping Scale (PCS), a new brief measure of coping with pandemic-related stressors. Methods The PCS was administered to N = 2316 German participants during the COVID-19 pandemic. Exploratory and confirmatory factor analysis was applied among random splits of the sample. Global goodness of fit (χ2, RMSEA, SRMR, CFI, TLI), local goodness of fit (factor loadings, communalities, factor reliability, discriminant validity) and additional test quality criteria (internal consistency, item discrimination and difficulty) were evaluated for a four-factor model vs. a four-factor model combined with a second-order general factor. Convergent and divergent validity were examined by Pearson correlations of the PCS subscales with the Brief-COPE subscales;criterion validity was evaluated by correlations with wellbeing (WHO-5), depressive (PHQ-9) and anxiety symptoms (GAD-2). Results Exploratory factor analysis suggested a four-factor solution (‘Healthy Lifestyle’, ‘Joyful Activities’, ‘Daily Structure’, ‘Prevention Adherence’). Confirmatory factor analysis showed a sufficient global fit for both specified models which did not differ in their fit to the data. Local goodness of fit indices showed moderate to large factor loadings and good factor reliabilities except for the subscale ‘Prevention Adherence’. Internal consistencies were good for the PCS total scale (α = .83), the ‘Healthy Lifestyle’ (α = .79) and the ‘Daily Structure’ (α = .86) subscales, acceptable for ‘Joyful Activities’ (α = .60), and low for ‘Prevention Adherence’ (α = .52). The four subscales evidenced convergent and divergent validity with the Brief-COPE subscales. The subscales ‘Healthy lifestyle’, ‘Joyful activities’ and ‘Daily structure’ showed criterion validity with wellbeing, depressive and anxiety symptoms. Conclusions The PCS is a reliable and valid measure to assess pandemic-specific coping behavior in the domains of ‘Healthy Lifestyle’, ‘Joyful Activities’, and ‘Daily Structure’. The PCS subscale ‘Prevention Adherence’ might be improved by adding items with varying item difficulties.

2.
Mycoses ; 65(8): 824-833, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1879087

ABSTRACT

BACKGROUND: In the absence of lung biopsy, there are various algorithms for the diagnosis of invasive pulmonary aspergillosis (IPA) in critically ill patients that rely on clinical signs, underlying conditions, radiological features and mycology. The aim of the present study was to compare four diagnostic algorithms in their ability to differentiate between probable IPA (i.e., requiring treatment) and colonisation. METHODS: For this diagnostic accuracy study, we included a mixed ICU population with a positive Aspergillus culture from respiratory secretions and applied four different diagnostic algorithms to them. We compared agreement among the four algorithms. In a subgroup of patients with lung tissue histopathology available, we determined the sensitivity and specificity of the single algorithms. RESULTS: A total number of 684 critically ill patients (69% medical/31% surgical) were included between 2005 and 2020. Overall, 79% (n = 543) of patients fulfilled the criteria for probable IPA according to at least one diagnostic algorithm. Only 4% of patients (n = 29) fulfilled the criteria for probable IPA according to all four algorithms. Agreement among the four diagnostic criteria was low (Cohen's kappa 0.07-0.29). From 85 patients with histopathological examination of lung tissue, 40% (n = 34) had confirmed IPA. The new EORTC/MSGERC ICU working group criteria had high specificity (0.59 [0.41-0.75]) and sensitivity (0.73 [0.59-0.85]). CONCLUSIONS: In a cohort of mixed ICU patients, the agreement among four algorithms for the diagnosis of IPA was low. Although improved by the latest diagnostic criteria, the discrimination of invasive fungal infection from Aspergillus colonisation in critically ill patients remains challenging and requires further optimization.


Subject(s)
Invasive Pulmonary Aspergillosis , Aspergillus , Cohort Studies , Critical Illness , Humans , Invasive Pulmonary Aspergillosis/diagnosis , Invasive Pulmonary Aspergillosis/microbiology , Sensitivity and Specificity
3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315845

ABSTRACT

Background: This study aimed to assess the factorial validity and reliability of the Pandemic Coping Scale, a new brief measure of coping behavior in response to the stressors of a pandemic. Methods: The scale was administered to N = 2,316 German participants during the COVID-19 pandemic. An exploratory and a confirmatory factor analysis were applied among two random splits of the sample. The global goodness of fit (χ², RMSEA, SRMR, CFI, TLI), the local goodness of fit (factor loadings, communalities, factor reliability, discriminant validity), and test quality criteria (internal consistency, item discrimination, and difficulty) were evaluated for two models (Model 1: four-factor model;Model 2: four-factor model combined with a second-order general factor). Results: The exploratory factor analysis suggested a four-factor solution with factor loadings accounting for 44.6% of the total variance (Factor 1 ‘Healthy Lifestyle’, Factor 2 ‘Joyful Activities’, Factor 3 ‘Daily Structure’, Factor 4 ‘Prevention Adherence’). The confirmatory factor analysis showed a sufficient global fit for both specified models (Model 1: χ² (59, N =1172) = 366.97, p < .001, RMSEA = .067, SRMR = .043, CFI = .926, TLI = .902;Model 2: χ² (61, N = 1172) = 373.33, p < .001, RMSEA = .066, SRMR = .043, CFI = .925, TLI = .904). Model 1 and Model 2 did not significantly differ in their fit to the data (∆χ² (2, N = 1172) = 6.36, p = .042). Local goodness of fit indices were similar for both models and mostly showed moderate to large factor loadings, and good factor reliabilities except for ‘Prevention Adherence’. Conclusion: The Pandemic Coping Scale showed sufficient factorial validity for the four measured dimensions of coping and reliability for the scales except for ‘Prevention Adherence’ to assess coping during the current COVID-19 pandemic. The ‘Prevention Adherence’ subscale might be improved by adding items with higher item difficulties.

4.
PLoS One ; 16(3): e0247686, 2021.
Article in English | MEDLINE | ID: covidwho-1574773

ABSTRACT

OBJECTIVES: The aim of this study was to investigate possible patterns of demand for chest imaging during the first wave of the SARS-CoV-2 pandemic and derive a decision aid for the allocation of resources in future pandemic challenges. MATERIALS AND METHODS: Time data of requests for patients with suspected or confirmed coronavirus disease 2019 (COVID-19) lung disease were analyzed between February 27th and May 27th 2020. A multinomial logistic regression model was used to evaluate differences in the number of requests between 3 time intervals (I1: 6am - 2pm, I2: 2pm - 10pm, I3: 10pm - 6am). A cosinor model was applied to investigate the demand per hour. Requests per day were compared to the number of regional COVID-19 cases. RESULTS: 551 COVID-19 related chest imagings (32.8% outpatients, 67.2% in-patients) of 243 patients were conducted (33.3% female, 66.7% male, mean age 60 ± 17 years). Most exams for outpatients were required during I2 (I1 vs. I2: odds ratio (OR) = 0.73, 95% confidence interval (CI) 0.62-0.86, p = 0.01; I2 vs. I3: OR = 1.24, 95% CI 1.04-1.48, p = 0.03) with an acrophase at 7:29 pm. Requests for in-patients decreased from I1 to I3 (I1 vs. I2: OR = 1.24, 95% CI 1.09-1.41, p = 0.01; I2 vs. I3: OR = 1.16, 95% CI 1.05-1.28, p = 0.01) with an acrophase at 12:51 pm. The number of requests per day for outpatients developed similarly to regional cases while demand for in-patients increased later and persisted longer. CONCLUSIONS: The demand for COVID-19 related chest imaging displayed distinct distribution patterns depending on the sector of patient care and point of time during the SARS-CoV-2 pandemic. These patterns should be considered in the allocation of resources in future pandemic challenges with similar disease characteristics.


Subject(s)
COVID-19/diagnostic imaging , Diagnostic Imaging/trends , Thorax/diagnostic imaging , Adult , Aged , COVID-19/epidemiology , Diagnostic Tests, Routine/trends , Female , Humans , Male , Middle Aged , Models, Theoretical , Pandemics , Pilot Projects , SARS-CoV-2/pathogenicity , Thorax/virology
5.
Gut ; 70(Suppl 4):A7-A8, 2021.
Article in English | ProQuest Central | ID: covidwho-1504357

ABSTRACT

OTH-1 Figure 1(A) AIH v non-AIH CLD (B) AIH v non-CLD[Figure omitted. See PDF]ConclusionDespite immunosuppressive treatment, AIH patients were not at increased risk of adverse outcomes from COVID-19 compared to other causes of CLD and to matched cases without liver disease.

6.
J Hepatol ; 74(6): 1335-1343, 2021 06.
Article in English | MEDLINE | ID: covidwho-1065332

ABSTRACT

BACKGROUND & AIMS: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) continues to have a devastating impact across the globe. However, little is known about the disease course in patients with autoimmune hepatitis (AIH). METHODS: Data for patients with AIH and SARS-CoV-2 infection were combined from 3 international reporting registries and outcomes were compared to those in patients with chronic liver disease of other aetiology (non-AIH CLD) and to patients without liver disease (non-CLD). RESULTS: Between 25th March and 24th October 2020, data were collected for 932 patients with CLD and SARS-CoV-2 infection including 70 with autoimmune hepatitis (AIH). Fifty-eight (83%) patients with AIH were taking ≥1 immunosuppressive drug. There were no differences in rates of major outcomes between patients with AIH and non-AIH CLD, including hospitalization (76% vs. 85%; p = 0.06), intensive care unit admission (29% vs. 23%; p = 0.240), and death (23% vs. 20%; p = 0.643). Factors associated with death within the AIH cohort included age (odds ratio [OR] 2.16/10 years; 1.07-3.81), and Child-Pugh class B (OR 42.48; 4.40-409.53), and C (OR 69.30; 2.83-1694.50) cirrhosis, but not use of immunosuppression. Propensity score matched (PSM) analysis comparing patients with AIH with non-AIH CLD demonstrated no increased risk of adverse outcomes including death (+3.2%; -9.2%-15.7%). PSM analysis of patients with AIH vs. non-CLD (n = 769) demonstrated increased risk of hospitalization with AIH (+18.4%; 5.6-31.2%), but equivalent risk of all other outcomes including death (+3.2%; -9.1%-15.6%). CONCLUSION: Patients with AIH were not at increased risk of adverse outcomes despite immunosuppressive treatment compared to other causes of CLD and to matched cases without liver disease. LAY SUMMARY: Little is known about the outcomes of COVID-19 in patients with autoimmune hepatitis (AIH), a rare chronic inflammatory liver disease. This study combines data from 3 large registries to describe the course of COVID-19 in this patient group. We show that AIH patients do not appear to have an increased risk of death from COVID-19 compared to patients with other forms of liver disease and compared to patients without liver disease, despite the use of medications which suppress the immune system.


Subject(s)
COVID-19/mortality , Hepatitis, Autoimmune/mortality , SARS-CoV-2 , Adult , Aged , Cohort Studies , Female , Hospitalization , Humans , Intensive Care Units , Male , Middle Aged , Propensity Score
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