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1.
J Relig Health ; 61(3): 2212-2232, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1820959

ABSTRACT

Historically, there has be a close relationship between the nursing services and spiritual care provision to patients, arising due to the evolvement of many hospitals and nursing programmes from faith-based institutions and religious order nursing. With increasing secularism, these relationships are less entwined. Nonetheless, as nurses typically encounter patients at critical life events, such as receiving bad news or dying, nurses frequently understand the need and requirement for both spiritual support and religious for patients and families during these times. Yet there are uncertainties, and nurses can feel ill-equipped to deal with patients' spiritual needs. Little education or preparation is provided to these nurses, and they often report a lack of confidence within this area. The development of this confidence and the required competencies is important, especially so with increasingly multicultural societies with diverse spiritual and religious needs. In this manuscript, we discuss initial field work carried out in preparation for the development of an Erasmus Plus educational intervention, entitled from Cure to Care Digital Education and Spiritual Assistance in Healthcare. Referring specifically to post-COVID spirituality needs, this development will support nurses to respond to patients' spiritual needs in the hospital setting, using digital means. This preliminary study revealed that while nurses are actively supporting patients' spiritual needs, their education and training are limited, non-standardised and heterogeneous. Additionally, most spiritual support occurs within the context of a Judeo-Christian framework that may not be suitable for diverse faith and non-faith populations. Educational preparation for nurses to provide spiritual care is therefore urgently required.


Subject(s)
COVID-19 , Spiritual Therapies , Christianity , Hospitals , Humans , Spirituality
2.
Int J Infect Dis ; 112: 81-88, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1654537

ABSTRACT

BACKGROUND: The advent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines has been associated with a significant decline in coronavirus disease 2019 (COVID-19) hospitalizations and deaths. However, little is known about the benefits experienced by different population groups and/or using distinct vaccines. METHODS: The Spanish public registry was analyzed to examine associations between weekly vaccination scale-up and the incidence of COVID-19 hospitalizations by age, sex, and vaccine modality. The study period extended from January 2020 to June 2021. RESULTS: A total of 363 960 COVID-19 hospitalizations were recorded in Spain during the study period, with three peaks in March 2020, November 2020, and January 2021. The incidence of COVID-19 hospitalizations per 100 000 population increased exponentially with age, on average 71.5% for each decade older. Overall, individuals older than 60 years of age accounted for 65% of all COVID-19 hospitalizations. The speedy vaccination rollout since the end of 2020, with prioritization of the elderly groups, resulted in a rapid fall in COVID-19 hospitalizations starting in February 2021. The benefit was already noticed 3-4 weeks after the first dose, regardless of the vaccine modality. CONCLUSIONS: COVID-19 hospitalizations increased exponentially with age in all three peaks of SARS-CoV-2 infection in Spain. Early mass vaccination of people over 60 years of age prevented a fourth wave of COVID-19 hospitalizations during the spring of 2021.


Subject(s)
COVID-19 , Aged , COVID-19 Vaccines , Hospitalization , Humans , Middle Aged , SARS-CoV-2 , Spain/epidemiology , Vaccination
3.
AIDS Rev ; 24(1): 41-49, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1650093

ABSTRACT

Vaccines and antivirals are the classical weapons deployed to contain, prevent, and treat life-threatening viral illnesses. Specifically, for SARS-CoV-2 infection, vaccines protect against severe COVID-19 disease manifestations and complications. However, waning immunity and emergence of vaccine escape mutants remains a growing threat. This is highlighted by the current surge of the omicron COVID-19 variant. Thus, there is a race to find treatment alternatives. We contend that oral small molecule antivirals that halt SARSCoV- 2 infection are essential. Compared to currently available monoclonal antibodies and remdesivir, where parenteral administration is required, oral antivirals offer treatments in an outpatient setting with dissemination available on a larger scale. In response to this need at 2021's end, regulatory agencies provided emergency use authorization for both molnupiravir and nirmatrelvir. These medicines act on the viral polymerase and protease, respectively. Each is given for 5 days and can reduce disease progression by 30% and 89%, respectively. The advent of additional oral antivirals, the assessment of combination therapies, the formulation of extended-release medications, and their benefit for both early treatment and prophylaxis will likely transform the landscape of the COVID-19 pandemic.


Subject(s)
COVID-19 , HIV Infections , Antiviral Agents/therapeutic use , COVID-19/drug therapy , HIV Infections/drug therapy , Humans , Pandemics/prevention & control , SARS-CoV-2
5.
Int J Infect Dis ; 112: 81-88, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1428022

ABSTRACT

BACKGROUND: The advent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines has been associated with a significant decline in coronavirus disease 2019 (COVID-19) hospitalizations and deaths. However, little is known about the benefits experienced by different population groups and/or using distinct vaccines. METHODS: The Spanish public registry was analyzed to examine associations between weekly vaccination scale-up and the incidence of COVID-19 hospitalizations by age, sex, and vaccine modality. The study period extended from January 2020 to June 2021. RESULTS: A total of 363 960 COVID-19 hospitalizations were recorded in Spain during the study period, with three peaks in March 2020, November 2020, and January 2021. The incidence of COVID-19 hospitalizations per 100 000 population increased exponentially with age, on average 71.5% for each decade older. Overall, individuals older than 60 years of age accounted for 65% of all COVID-19 hospitalizations. The speedy vaccination rollout since the end of 2020, with prioritization of the elderly groups, resulted in a rapid fall in COVID-19 hospitalizations starting in February 2021. The benefit was already noticed 3-4 weeks after the first dose, regardless of the vaccine modality. CONCLUSIONS: COVID-19 hospitalizations increased exponentially with age in all three peaks of SARS-CoV-2 infection in Spain. Early mass vaccination of people over 60 years of age prevented a fourth wave of COVID-19 hospitalizations during the spring of 2021.


Subject(s)
COVID-19 , Aged , COVID-19 Vaccines , Hospitalization , Humans , Middle Aged , SARS-CoV-2 , Spain/epidemiology , Vaccination
6.
AIDS Res Hum Retroviruses ; 37(8): 610-612, 2021 08.
Article in English | MEDLINE | ID: covidwho-1367005

ABSTRACT

The medical demand imposed by COVID-19 has distracted proper care of other illnesses. Herein, we report the impact on new diagnoses of HTLV-1, HTLV-2, and HIV-2 in Spain, where these infections are mostly driven by immigration flows from endemic regions. As expected, case reporting declined for all three retroviral infections with respect to prior years. Furthermore, late presentations were more common. The two major reasons for these observations were significant declines in the arrival of foreigners from endemic regions and a shift in medical resources to prioritize COVID-19.


Subject(s)
COVID-19/epidemiology , Deltaretrovirus Infections/epidemiology , HIV Infections/epidemiology , HIV Infections/virology , HIV-2/isolation & purification , Deltaretrovirus Infections/diagnosis , Emigration and Immigration/legislation & jurisprudence , HIV Infections/diagnosis , Humans , Incidence , SARS-CoV-2 , Spain/epidemiology
7.
Clin Infect Dis ; 73(3): e754-e764, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1338688

ABSTRACT

BACKGROUND: Understanding the drivers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is crucial for control policies, but evidence of transmission rates in different settings remains limited. METHODS: We conducted a systematic review to estimate secondary attack rates (SARs) and observed reproduction numbers (Robs) in different settings exploring differences by age, symptom status, and duration of exposure. To account for additional study heterogeneity, we employed a beta-binomial model to pool SARs across studies and a negative-binomial model to estimate Robs. RESULTS: Households showed the highest transmission rates, with a pooled SAR of 21.1% (95% confidence interval [CI]:17.4-24.8). SARs were significantly higher where the duration of household exposure exceeded 5 days compared with exposure of ≤5 days. SARs related to contacts at social events with family and friends were higher than those for low-risk casual contacts (5.9% vs 1.2%). Estimates of SARs and Robs for asymptomatic index cases were approximately one-seventh, and for presymptomatic two-thirds of those for symptomatic index cases. We found some evidence for reduced transmission potential both from and to individuals younger than 20 years of age in the household context, which is more limited when examining all settings. CONCLUSIONS: Our results suggest that exposure in settings with familiar contacts increases SARS-CoV-2 transmission potential. Additionally, the differences observed in transmissibility by index case symptom status and duration of exposure have important implications for control strategies, such as contact tracing, testing, and rapid isolation of cases. There were limited data to explore transmission patterns in workplaces, schools, and care homes, highlighting the need for further research in such settings.


Subject(s)
COVID-19 , SARS-CoV-2 , Contact Tracing , Family Characteristics , Humans , Incidence
8.
Int J Infect Dis ; 107: 212-214, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1300803

ABSTRACT

A third wave of COVID-19 occurred after Christmas 2020 in Madrid, one of the European pandemic epicenters. We noticed 6 major differential features to previous waves. First, household contacts were a large proportion of cases. Second, access to rapid antigen tests allowed prompt diagnosis and isolation. Third, clinically severe cases and mortality rates were lower. Fourth, the more transmissible B.1.1.7 strain was increasingly found. Fifth, vaccination benefits were seen in healthcare workers and nursing homes. Lastly, reinfections were more common. By Easter 2021, approximately 25% of the population in Madrid had been infected with SARS-CoV-2. Therefore, massive and accelerated vaccination campaigns are warranted to prevent new COVID-19 waves.


Subject(s)
COVID-19/epidemiology , SARS-CoV-2 , COVID-19/mortality , COVID-19/prevention & control , Health Personnel , Humans , Middle Aged , Nursing Homes , Spain/epidemiology , Vaccination
9.
AIDS Rev ; 23(2): 115-116, 2021 Jun 07.
Article in English | MEDLINE | ID: covidwho-1259850

ABSTRACT

The arrival of coronavirus disease (COVID-19) in Europe exploded initially in North Italy and soon thereafter at several other major European cities, including Madrid. Indeed, Madrid was the epicenter of SARSCoV-2 infection in Spain, with a dramatic surge of cases since mid-March 2020.


Subject(s)
COVID-19/prevention & control , Pandemics/prevention & control , COVID-19/epidemiology , COVID-19/mortality , Communicable Disease Control , Humans , Pandemics/statistics & numerical data , Spain/epidemiology
12.
Expert Opin Investig Drugs ; 30(5): 505-518, 2021 May.
Article in English | MEDLINE | ID: covidwho-1132283

ABSTRACT

Background: COVID-19 has several overlapping phases. Treatments to date have focused on the late stage of disease in hospital. Yet, the pandemic is by propagated by the viral phase in out-patients. The current public health strategy relies solely on vaccines to prevent disease.Methods: We searched the major national registries, pubmed.org, and the preprint servers for all ongoing, completed and published trial results.Results: As of 2/15/2021, we found 111 publications reporting findings on 14 classes of agents, and 9 vaccines. There were 62 randomized controlled studies, the rest retrospective observational analyses. Only 21 publications dealt with outpatient care. Remdesivir and high titer convalescent plasma have emergency use authorization for hospitalized patients in the U.S.A. There is also support for glucocorticoid treatment of the COVID-19 respiratory distress syndrome. Monoclonal antibodies are authorized for outpatients, but supply is inadequate to treat all at time of diagnosis. Favipiravir, ivermectin, and interferons are approved in certain countries.Expert Opinion: Vaccines and antibodies are highly antigen specific, and new SARS-Cov-2 variants are appearing. We call on public health authorities to authorize treatments with known low-risk and possible benefit for outpatients in parallel with universal vaccination.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/therapy , Ambulatory Care/methods , Antibodies, Monoclonal/administration & dosage , COVID-19/diagnosis , COVID-19/drug therapy , COVID-19/prevention & control , Hospitalization , Humans , Immunization, Passive , Randomized Controlled Trials as Topic , Time Factors
13.
Int J Infect Dis ; 105: 374-376, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1121483

ABSTRACT

BACKGROUND: The emergence and rapid global spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) represents a major challenge to health services, and has disrupted social and economic activities worldwide. In Spain, the first pandemic wave started in mid-March 2020 and lasted for 3 months, requiring home confinement and strict lockdown. Following relaxation of the measures during the summer, a second wave commenced in mid-September 2020 and extended until Christmas 2020. METHODS: The two pandemic waves were compared using information collected from rapid diagnostic tests and polymerase chain reaction assays at one university clinic in Madrid, the epicentre of the pandemic in Spain. RESULTS: In total, 1569 individuals (968 during the first wave and 601 during the second wave) were tested for SARS-CoV-2-specific antibodies using fingerprick capillary blood. In addition, during the second wave, 346 individuals were tested for SARS-CoV-2-specific antigen using either oral swabs or saliva. The overall seroprevalence of first-time-tested individuals was 12.6% during the first wave and 7.7% during the second wave (P < 0.01). Seroconversions and seroreversions within 6 months occurred at low rates, both below 5%. During the second wave, 3.5% of tested individuals were SARS-CoV-2 antigen positive, with two cases considered as re-infections. Severe clinical symptoms occurred in a greater proportion of cases during the first wave compared with the second wave (27.8% vs 10.6%, respectively; P = 0.03). CONCLUSION: The cumulative seroprevalence of SARS-CoV-2 antibodies in Madrid at the end of 2020 was approximately 20%. Seroreversions within 6 months occurred in 4% of cases. Seroconversions and re-infections were clinically less severe during the second wave than during the first wave. Hypothetically, a lower viral inoculum as a result of social distancing, increased use of face masks, promotion of outdoor activities and restrictions on gatherings may have contributed to this lower pathogenicity.


Subject(s)
COVID-19/epidemiology , Pandemics , Adult , Antibodies, Viral/isolation & purification , Antigens, Viral/isolation & purification , COVID-19/diagnosis , Communicable Disease Control/methods , Humans , Male , Masks , Middle Aged , Physical Distancing , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification , Saliva/virology , Seroepidemiologic Studies , Spain/epidemiology
14.
Clin Infect Dis ; 73(3): e754-e764, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1072352

ABSTRACT

BACKGROUND: Understanding the drivers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is crucial for control policies, but evidence of transmission rates in different settings remains limited. METHODS: We conducted a systematic review to estimate secondary attack rates (SARs) and observed reproduction numbers (Robs) in different settings exploring differences by age, symptom status, and duration of exposure. To account for additional study heterogeneity, we employed a beta-binomial model to pool SARs across studies and a negative-binomial model to estimate Robs. RESULTS: Households showed the highest transmission rates, with a pooled SAR of 21.1% (95% confidence interval [CI]:17.4-24.8). SARs were significantly higher where the duration of household exposure exceeded 5 days compared with exposure of ≤5 days. SARs related to contacts at social events with family and friends were higher than those for low-risk casual contacts (5.9% vs 1.2%). Estimates of SARs and Robs for asymptomatic index cases were approximately one-seventh, and for presymptomatic two-thirds of those for symptomatic index cases. We found some evidence for reduced transmission potential both from and to individuals younger than 20 years of age in the household context, which is more limited when examining all settings. CONCLUSIONS: Our results suggest that exposure in settings with familiar contacts increases SARS-CoV-2 transmission potential. Additionally, the differences observed in transmissibility by index case symptom status and duration of exposure have important implications for control strategies, such as contact tracing, testing, and rapid isolation of cases. There were limited data to explore transmission patterns in workplaces, schools, and care homes, highlighting the need for further research in such settings.


Subject(s)
COVID-19 , SARS-CoV-2 , Contact Tracing , Family Characteristics , Humans , Incidence
15.
AIDS Rev ; 23(1): 40-47, 2021 02 08.
Article in English | MEDLINE | ID: covidwho-1070036

ABSTRACT

COVID-19, caused by SARS-CoV-2, continues to be a major health problem since its first description in Wuhan, China, in December 2019. Multiple drugs have been tried to date in the treatment of COVID-19. Critical to treatment of COVID-19 and advancing therapeutics is an appreciation of the multiple stages of this disease and the importance of timing for investigation and use of various agents. We considered articles related to COVID-19 indexed on PubMed published January 1, 2020-November 15, 2020, and considered papers on the medRxiv preprint server. We identified relevant stages of COVID-19 including three periods: pre-exposure, incubation, and detectable viral replication; and five phases: the viral symptom phase, the early inflammatory phase, the secondary infection phase, the multisystem inflammatory phase, and the tail phase. This common terminology should serve as a framework to guide when COVID-19 therapeutics being studied or currently in use is likely to provide benefit rather than harm.


Subject(s)
COVID-19/drug therapy , Clinical Trials as Topic , SARS-CoV-2 , COVID-19/complications , COVID-19/immunology , Cytokine Release Syndrome/etiology , Humans , RNA, Viral/analysis , Time Factors , Virus Replication
16.
AIDS Rev ; 22(4): 227-228, 2020 12 23.
Article in English | MEDLINE | ID: covidwho-1006729

ABSTRACT

The clinical spectrum of "Severe Acute Respiratory Syndrome Coronavirus type 2" (SARS-CoV-2) infection is wider than initially thought. The coronavirus does not establish a chronic cellular infection, in contrast with HIV or the hepatitis B virus, that keeps their genomes, respectively, as proviruses integrated within the chromosomes or as episomes (Soriano et al. J Antimicrob Chemother 2014).


Subject(s)
COVID-19/virology , SARS-CoV-2/genetics , SARS-CoV-2/pathogenicity , HIV-1/genetics , HIV-1/pathogenicity , Hepatitis B virus/genetics , Hepatitis B virus/pathogenicity , Humans
18.
Curr Opin Environ Sci Health ; 17: 41-48, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-792043

ABSTRACT

The recent emergence of a novel coronavirus (severe acute respiratory syndrome coronavirus 2) has caused a pandemic, which is the most severe infectious disease outbreak in many decades. Other infective agents such as influenza as well as other neglected viruses such as Lassa virus, Nipah virus or poxviruses are also a cause for concern owing to their attack rate and potential for global spread. Drug-resistant bacteria, such as Mycobacterium tuberculosis, are already a significant public health issue in many countries, and it is expected that they will be expanding in the near future. Finally, airborne bioterrorism agents have high morbidity and mortality rates and should be looked with concern in the current international unrest.

19.
AIDS Rev ; 22(2): 123-124, 2020 07 08.
Article in English | MEDLINE | ID: covidwho-646293

ABSTRACT

The unprecedented COVID-19 pandemic has risen a number of clinical situations where the principles of the medical act, the singularity of the patient-physician relationship and the need for revitalizing the medical vocation have all become at front line. Original articles, viewpoints, and perspectives addressing these aspects have appeared in major medical journals. Never before but perhaps with AIDS in the eighties, a disease awakened such feelings of commitment in medicine. Herein, we discuss some of these very sensitive issues for physicians that emerged during the past months of global COVID-19 crisis.


Subject(s)
Clinical Decision-Making/ethics , Health Care Rationing/ethics , Pandemics/ethics , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Ethics, Medical , Humans , Intensive Care Units , Nursing Homes , Physician's Role , Physician-Patient Relations , Physicians/ethics , Physicians/psychology , Pneumonia, Viral/epidemiology , Respiration, Artificial , SARS-CoV-2 , Social Identification , Stress, Psychological/psychology , Triage/ethics
20.
AIDS Rev ; 22(2): 124-127, 2020 07 08.
Article in English | MEDLINE | ID: covidwho-634163

ABSTRACT

Following the advent of penicillin as first widely used antibiotic during World War II, viruses have steadily replaced bacteria as major agents of infections, particularly for microorganisms that can spread globally. Good examples are pandemics caused by HIV, hepatitis B, hepatitis C, and nowadays severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the coronavirus of coronavirus disease (COVID)-19.


Subject(s)
Antiviral Agents/therapeutic use , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Viral Vaccines/therapeutic use , Anti-HIV Agents/therapeutic use , Betacoronavirus/immunology , COVID-19 , COVID-19 Vaccines , Delayed-Action Preparations , HIV Infections/drug therapy , HIV Infections/prevention & control , Humans , Pre-Exposure Prophylaxis , SARS-CoV-2 , Vaccines
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