Physiotherapy Screening for Referral of a Patient with Patent Foramen Ovale Presenting with Neck Pain as Primary Complaint: A Case Report.

Neck pain is a common musculoskeletal disorder encountered by physiotherapists. However, it may be the early manifestation of more alarming conditions, such as cardiovascular diseases mimicking musculoskeletal pain. Patent foramen ovale (PFO) is a congenital heart defect consisting of a small opening between the right and the left atrium. A 56-year-old male presented with neck pain and head heaviness as primary complaints. The cardiovascular profile and the behavioral symptoms led the physiotherapist to find an exaggerated blood pressure response during exercise; in addition to subtle neurological signs, this prompted the physiotherapist to make an urgent referral. At the emergency department a PFO was diagnosed. To the best of the authors' knowledge, this is the first case to describe a rare clinical presentation of a PFO presenting neck pain as primary complaint. This case report emphasizes the importance for physiotherapists to be able to triage patients for conditions outside their scope suggestive of further medical investigation.

SMOKING PLAYING AS A RISK FACTOR TO OTHER DISEASES: A META-ANALYSIS

On July 21, 2021, a report from the World Health Organization indicated that there are presently 1.3 billion tobacco smokers globally. Data statistics show that the mortality rate of tobacco use is already at 3,021,098. Although smoking receives the lowest mortality rate among other communicable and non-communicable diseases in 2021, research suggests that smoking could hamper the quality of life of someone who already has an existing illness. This study investigated the adverse effects of smoking as a contributory factor to communicable diseases such as HIV/AIDS, Tuberculosis, and COVID-19, noncommunicable diseases like Malaria and Dengue, and risk factors such as alcohol and obesity. The locale of the study is Philippines. Meta-analysis is utilized in order to examine data statistics of the Philippines in comparison to its Southeast Asian neighbors. Meta-analysis was used by the author to extrapolate data from various quantitative and qualitative documents from 2000 up to the present. Specifically, open-access journal articles and data from legitimate databases like ISI Scopusindexed journals and/or websites were collated substantially. [ FROM AUTHOR] Copyright of Journal of Pharmaceutical Negative Results is the property of ResearchTrentz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The effect of family empowerment on preventive lifestyle of cardiovascular disease risk factors in middle-aged women during the covid-19 pandemic: A Randomized Clinical Trial.

Background and Objective: The Covid-19 pandemic doubled the need for creative interventions to prevent cardiovascular diseases. Therefore, the present study was conducted with the aim of determining the effect of intervention based on family empowerment on preventive lifestyle of cardiovascular disease risk factors in middle-aged women. Materials and Methods: In this randomized clinical trial study, 74 middle-aged women covered by comprehensive health service centers in the south of Tehran were selected based on inclusion criteria and randomly assigned to two intervention and control groups and were investigated. The family-centered empowerment program based on the preventive lifestyle of the risk factors of cardiovascular diseases was conducted for the intervention group during 6 sessions and each session lasted for 30 minutes virtually and through the WhatsApp application. After 8 weeks, the questionnaires were re-completed and the data were collected using demographic information, Food Frequency questionnaire, Baecke and metabolic health questionnaires and descriptive statistics methods (frequency distribution tables - index numerical values calculation) and inferential statistics (chi-square test, independent t, paired t and Fisher) were used and analyzed in SPSS statistical software version 20. Results: The findings of this study showed that the average age in the control group was 44.03 ± 2.35 in the intervention group was 46.65 ± 3.29 and the intervention and control groups were homogenous in terms of demographic variables, eating habits, physical activity, and metabolic health, and there were no significant differences (P<0.001). After the intervention in metabolic health (control of blood sugar, blood pressure, blood cholesterol and smoking), physical activity and eating habits, there was a significant difference between the two groups, which indicates the effectiveness of the intended intervention (P<0.001). Conclusion: Family empowerment is one of the most effective methods to prevent modifiable risk factors in chronic diseases, especially cardiovascular diseases. The covid-19 pandemic created a good opportunity for families to participate in the implementation of the above programs. Programs that focus on the foundation of the family leads positive effects in the direction of educating people, especially older people in the family, in relation to changing behavior, and it can be used as a safe and effective method for cardiovascular disease prevention. [ABSTRACT FROM AUTHOR] Copyright of Iranian Journal of Health Education & Health Promotion is the property of Iranian Association of Health Education & Health Promotion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Effectiveness of eHealth Interventions on Moderate-to-Vigorous Intensity Physical Activity Among Patients in Cardiac Rehabilitation: Systematic Review and Meta-analysis.

BACKGROUND: Cardiac rehabilitation is a class IA recommendation for patients with cardiovascular diseases. Physical activity is the core component and core competency of a cardiac rehabilitation program. However, many patients with cardiovascular diseases are failing to meet cardiac rehabilitation guidelines that recommend moderate-to-vigorous intensity physical activity. OBJECTIVE: The major objective of this study was to review the evidence of the effectiveness of eHealth interventions in increasing moderate-to-vigorous intensity physical activity among patients in cardiac rehabilitation. The secondary objective was to examine the effectiveness of eHealth interventions in improving cardiovascular-related outcomes, that is, cardiorespiratory fitness, waist circumference, and systolic blood pressure. METHODS: A comprehensive search strategy was developed, and a systematic search of 4 electronic databases (PubMed, Web of Science, Embase, and Cochrane Library) was conducted for papers published from the start of the creation of the database until November 27, 2022. Experimental studies reporting on eHealth interventions designed to increase moderate-to-vigorous intensity physical activity among patients in cardiac rehabilitation were included. Multiple unblinded reviewers determined the study eligibility and extracted data. Risk of bias was evaluated using the Cochrane Collaboration Tool for randomized controlled trials and the Cochrane Effective Practice and Organization of Care group methods for nonrandomized controlled trials. A random-effect model was used to provide the summary measures of effect (ie, standardized mean difference and 95% CI). All statistical analyses were performed using Stata 17. RESULTS: We screened 3636 studies, but only 29 studies were included in the final review, of which 18 were included in the meta-analysis. The meta-analysis demonstrated that eHealth interventions improved moderate-to-vigorous intensity physical activity (standardized mean difference=0.18, 95% CI 0.07-0.28; P=.001) and vigorous-intensity physical activity (standardized mean difference=0.2, 95% CI 0.00-0.39; P=.048) but did not improve moderate-intensity physical activity (standardized mean difference=0.19, 95% CI -0.12 to 0.51; P=.23). No changes were observed in the cardiovascular-related outcomes. Post hoc subgroup analyses identified that wearable-based, web-based, and communication-based eHealth intervention delivery methods were effective. CONCLUSIONS: eHealth interventions are effective at increasing minutes per week of moderate-to-vigorous intensity physical activity among patients in cardiac rehabilitation. There was no difference in the effectiveness of the major eHealth intervention delivery methods, thereby providing evidence that in the future, health care professionals and researchers can personalize convenient and affordable interventions tailored to patient characteristics and needs to eliminate the inconvenience of visiting center-based cardiac rehabilitation programs during the COVID-19 pandemic and to provide better support for home-based maintenance of cardiac rehabilitation. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42021278029; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=278029.

The Impact of Cardiovascular Risk Factors and Renal Disease on Outcomes in Patients Hospitalized with COVID-19: An Observational Study from Two Public Hospitals in Brazil

Abstract Background Cardiovascular risk factors are prognostic factors in coronavirus disease 2019 (COVID-19) and have been scarcely studied in Brazil. Objective The aim of this study was to assess the impact of cardiovascular risk factors on the outcomes of patients admitted for COVID-19. Methods From July 2020 to February 2021, 200 patients from two public hospitals were enrolled. Patients were included if they had typical symptoms or signs of COVID-19, a positive real-time polymerase chain reaction test (RT-PCR) for COVID-19, and an age above 18 years. This is a prospective, observational, and longitudinal study. Data were collected within 24 h of admission. The primary endpoint was a combination of hospital lethality, mechanical ventilation, hemodialysis, or length of hospital stay >28 days. Continuous variables were compared with the Student's t-test for independent samples or the Mann-Whitney test. For comparisons of proportions, the χ 2 test was applied. ROC curves and survival curves were constructed. Multivariate logistic regression was performed to identify independent predictors of events. The level of significance was 0.05. Results There were 98 (49%) events during the hospital course, and 72 (36%) died in the hospital. Patients with a primary endpoint were older and more likely to have a history of hypertension, diabetes, chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD). Vital signs at admission associated with events were diastolic blood pressure, respiratory rate, and oxygen saturation in ambient air (O 2 Sat). Serum creatinine >1.37 mg/dL at admission had a sensitivity of 51.6 and a specificity of 82% to predict the primary endpoint, with an area under the curve (AUC) of 0.68. In multivariate analysis, age, diabetes, CKD, and COPD were independent predictors of the primary endpoint. Age and CKD were independent predictors of in-hospital lethality. Conclusion Cardiovascular risk factors, such as diabetes and CKD, were related to a worse prognosis in patients hospitalized with COVID-19 in this sample from two public hospitals in the state of Rio de Janeiro.

Setting Goals to Reduce Cardiovascular Risk: A Retrospective Chart Review of a Pharmacist-Led Initiative in the Workplace.

Background: Cardiovascular diseases (CVD) are the second leading cause of death in Canada with many modifiable risk factors. Pharmacists at a Canadian university delivered a novel CVD risk management program, which included goal-setting and medication management. Aim: This study aimed to describe what CVD prevention goals are composed of in a workplace CVD risk reduction program, and how might these goals change over time. Methods: A longitudinal, descriptive qualitative study using a retrospective chart review of clinical care plans for 15 patients enrolled in a CVD prevention program. Data across 6 visits were extracted from charts (n = 5413 words) recorded from May 2019-November 2020 and analyzed using quantitative content analysis and descriptive statistics. Results: Behavioural goals were most popular among patients and were more likely to change over the 12-month follow-up period, compared to health measure goals. Behavioural goals included goals around diet, physical activity (PA), smoking, medication, sleep and alcohol; health measure goals centered on weight measures, blood pressure (BP) and blood lipid levels. The most common behavioural goals set by patients were for diet (n = 11) and PA (n = 9). Over time, goals around PA, medication, alcohol and weight were adapted while others were added (e.g. diet) and some only continued. Patients experienced a number of barriers to their goal(s) which informed how they adapted their goal(s). These included environmental limitations (including COVID-19) and work-related time constraints. Conclusions: This study found CVD goal-setting in the pharmacist-led workplace wellness program was complex and evolved over time, with goals added and/or adapted. More detailed qualitative research could provide further insights into the patient-provider goal-setting experience in workplace CVD prevention.

Sustainable Estimation of Cardiovascular Risk with the Predictive Gaziano's Tables without Laboratory

Background: identifying cardiovascular risk factors is very important, because by taking actions to counteract them, the probability of presenting cardiovascular and cerebrovascular diseases can decrease significantly. Objective: to demonstrate the feasibility of using the Gaziano's tables without a laboratory to estimate cardiovascular risk. Method: 72 health workers linked to the University of Medical Sciences of Camaguey were interviewed during November 2021, in addition, their blood pressure, weight and height were measured and they were asked in the survey: age, if they were diabetic and if they smoked. These people underwent Cronbach's Alpha reliability test. They were asked if they had other modifiable habits (frequency of physical exercise, consumption of alcoholic beverages, if they have snacks between meals and if they add salt to them). Cardiovascular risk was determined with the Gaziano's tables without laboratory. Results: 21 % of the interviewees presented high and very high risk. Of the study participants, 40 % declared they were hypertensive. The mean body mass index was 29.3 +/- 4 kg/m(2) and there was a correlation between this and age, with high and very high risks. Conclusions: Gaziano's predictive tables without laboratory were feasible to apply, their use could be extended to the first level of health care, as it is a sustainable, non-invasive and fast method in times of the COVID-19 pandemic. Knowledge of its use in undergraduate and postgraduate teaching should be transmitted.

Assessment of thromboembolism risk in COVID-19 patients with cardiovascular disease risk factors: Analysis of a Japanese Nationwide Registry.

INTRODUCTION: Patients with COVID-19 and cardiovascular disease risk factors (CVDRF) have been reported to develop coagulation abnormalities frequently. However, there are limitations in conventional predictive models for the occurrence of thromboembolism in patients with COVID-19 and CVDRF. METHODS: Among data on 1518 hospitalized patients with COVID-19 registered with CLAVIS-COVID, a Japanese nationwide cohort study, 693 patients with CVDRF were subjected to least absolute shrinkage and selection operator (LASSO) analysis; a method of shrinking coefficients for reducing variance and minimizing bias to increase predictive accuracy. LASSO analysis was performed to identify risk factors for systemic thromboembolic events; occurrence of arterial and venous thromboembolism during the index hospitalization as the primary endpoint. RESULTS: LASSO analysis identified a prior systemic thromboembolism, male sex, hypoxygenemia requiring invasive mechanical ventilation support, C-reactive protein levels and D-dimer levels at admission, and congestion on chest X-ray at admission as potential risk factors for the primary endpoint. The developed risk model consisting of these risk factors showed good discriminative performance (AUC-ROC: 0.83, 95 % confidence interval [CI]: 0.77-0.90), which was significantly better than that shown by D-dimer (AUC-ROC: 0.70, 95 % CI: 0.60-0.80) (p < 0.001). Furthermore, systemic embolic events were independently associated with in-hospital mortality (adjusted odds ratio: 3.29; 95 % CI: 1.31-8.00). CONCLUSIONS: Six parameters readily available at the time of admission were identified as risk factors for thromboembolic events, and these may be capable of stratifying the risk of in-hospital thromboembolic events, which are associated with in-hospital mortality, in patients with COVID-19 and CVDRF.

Targeting metabolic health promotion to optimise maternal and offspring health

There is an increase in maternal metabolic burden due to the rise in pregnancies complicated by obesity, gestational diabetes, type 2 diabetes and polycystic ovary syndrome. Metabolic dysfunction during pregnancy is associated with increased risks of long-term morbidity and mortality for women and their offspring. Lifestyle interventions in pregnancy in women at risk of metabolic dysfunction have demonstrated short-term improvements such as reduced gestational weight gain and lowered risk of gestational diabetes. It is not known whether these interventions lead to sustained improvements in the metabolic health of the mother and baby. Pharmacological interventions have also shown benefits for the mother and baby in pregnancy, including improvements in glycaemic control, reduction in gestational weight gain and reduction in large for gestational age infants;however, there remains uncertainty over long-term outcomes for mother and child. Existing studies on interventions targeting metabolic health are limited to selected populations in the preconception and postpartum periods and lack follow-up beyond delivery of the intervention. The COVID-19 pandemic has refocused our attention on the effects of maternal metabolic ill-health that play a role in contributing to premature morbidity and mortality. There is an urgent need for strategies to accurately identify the growing number of women and offspring at risk of long-term adverse metabolic health. Strategies which focus on early identification and risk stratification using individualised risk scores in the pre and inter-conception periods must take priority if we are to target and improve the metabolic health of women and their offspring who are at highest risk. [ FROM AUTHOR] Copyright of European Journal of Endocrinology is the property of Bioscientifica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Clinical particularities regarding rehabilitation treatment of a young patient with right pontine ischemic stroke, resulting in dysarthria and left side brachial and crural hemiparesis, and quite recent COVID-19 history

Introduction. Cerebrovascular attacks are one of the leading causes of mortality and morbidity in the world. The most severe are considered to be pontine strokes, because of the high risk of vital functions impairment. The clinical presentation of a pontine stroke can vary from the classical crossed syndrome (ipsilateral cranial nerve palsy and contralateral motor and/or sensory impairment) to pure motor hemiplegia or pure sensory stroke, which are less common.(1) Materials and methods. This presentation describes the case of a 39-year-old patient with a recent history of untreated SARS-COV 2 infection that was followed in the next month by a sudden onset of facial paralysis, dysarthria and a progressive left hemiplegia. The patient's functional status was assessed in our Neuromuscular Clinical Division and he underwent a rehabilitation program consisting of physical, occupational and speech therapies. Multidisciplinary efforts were made in order to find the underlying cause of the pontine ischemic stroke. Results. The patient had a personal history of cardiovascular disease risk factors (essential hypertension and hyperlipidaemia), without other pathological brain imagining outcomes and normal bleeding tests. The suspicion of an interatrial communication was raised. The patient managed to rapidly maintain the standing posture and to practice walking with unilateral support. At discharge, the facial paralysis and dysarthria were almost completely remitted. The left brachial extremity also showed signs of improvement, as the patient was able to perform flexion and extension movements of the fingers, wrist and forearm. Conclusion. To conclude, the patient's evolution was favourable, although the certain cause of the underlying stroke has not been clarified. The neurological complications of COVID-19 include ischemic strokes, and cases were reported in young adults too(2,3). If this were the case, prevention of further cerebrovascular attacks and their complications is necessary(1). Caution in terms of medium/long-term prophylactic anticoagulant therapy and careful control of associated cardiovascular disease risk factors has been proposed and discussed in the multidisciplinary team: rehabilitation physician, neurologist, cardiologist.

Co-Morbidity and COVID-19: A Study of Case Severity and Early Outcome

Background: The corona virus disease 2019 (COVID-19) has spread around the world and mutating rapidly. It is absolutely essential to evaluate the potential risk factor influencing disease progression and better understanding of high risk co-morbidities among COVID-19 patients. Objectives: To evaluate the association of serious events in COVID-19 patients according to the number and type of co-morbidities also the association of co-morbidities with the adverse events and the risk of early outcomes with any co-morbidity. Methods: This was a prospective observational study among 1,583 laboratory-confirmed COVID-19 cases admitted during the study period from Apr 2020 to March 2021. Odds ratio (OR) and risk ratio (RR) with respective confidence intervals have been calculated to evaluate the presence and strength of association of case severity with the presence and number of co morbidities. Results: There was 302 study subjects with one or more than one co-morbidities having the mean (SD) age of 54(15) year and 206(68.2%) male cases compared to female. The leading comorbidities were diabetes (146, 9.2%), hypertension (142, 9%) with respiratory disease (50, 3.2%), CAD (16, 1%). Any co-morbid patient has 6 times odds of getting admitted in ICU in comparison to non-co-morbid patient while the risk ratio signifies that five times higher chance of getting admitted in ICU than any non-co-morbid patient. The chances of death in them are always higher than non-co-morbid specially diabetes and hypertensive with CAD. Conclusions: Among patients with COVID-19 disease any co-morbidity resulted to poorer clinical outcomes and more the number of co-morbidities, poorer the clinical outcomes. [ FROM AUTHOR];Copyright of Journal of Clinical & Experimental Investigations is the property of Modestum Publications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

NewsCAP: Wearing a baby in a carrier may increase the infant's risk of injury

The article presents the discussion on researchers examining data from 2011 through 2020 on injuries associated with a baby carrier in children up to five years of age reported to the National Electronic Injury Surveillance System.

Guideline in a nutshell: New insights into COPD

The article focuses on the annually-updated GOLD report on the management of chronic obstructive lung disease (COPD) offers new insights into the disease, treatment and the increased incidence of lung cancer in COPD patients. It mention that the aim of the Global initiative for Chronic Obstructive Lung Disease (GOLD) Report is to provide a non-biased review of the current evidence for the assessment, diagnosis and treatment of patients with COPD.

SUCCESSFUL MANAGEMENT OF NOSOCOMIAL OUTBREAK OF SARS-COV-2 AMONG CHRONICALLY VENTILATED CHILDREN

B Conclusion: b A systematic, team-based approach to a nosocomial outbreak of SARS-CoV-2 among children with chronic mechanical ventilation prevented the spread of COVID-19 in this vulnerable population preventing high morbidity and mortality. All patients required transient escalation of ventilatory support, and 4/5 patients (80%) demonstrated gastrointestinal symptoms. We report a review of five children with tracheostomy and long-term mechanical ventilation admitted to an intermediate care facility who contracted SARS-CoV-2 virus during hospitalization. [Extracted from the article] Copyright of Critical Care Medicine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

COVID-19 in Single Kidney Patient

The COVID-19 pandemic has affected all people in the world, especially those at risk of kidney disorders. Early kidney damage in patients born with unilateral renal agenesis (URA) or solitary kidney can happen. These patients are at risk of chronic kidney disease (CKD), high blood pressure, and developing proteinuria. Unilateral renal agenesis is a cause of CKD. Therefore, it is very interesting that observe a unilateral renal Patient that Suffers from COVID-19. Hence, the management of these patients with COVID-19 is an area of interest, and a unique approach is warranted. A 43-year-old male patient with unilateral renal presented to our hospital for corona disease. The case was discussed between the nephrologists, Infectious disease specialists, and nursing head nurses for a care plan daily. The patient had unilateral renal disease, and COVID-19 could have a detrimental effect on the renal, but renal tests were normal, and the patient recovered without acute renal complications. The treatment of such patients is the need for teamwork contain nephrologists, critical care nurses, and specialists in infectious and tropical diseases. This was a new experience in Iran. [ FROM AUTHOR] Copyright of Acta Medica Iranica is the property of Tehran University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Epidemiology, clinical characteristics, and virologic features of COVID-19 patients in Kazakhstan: A nation-wide retrospective cohort study.

BACKGROUND: The earliest coronavirus disease-2019 (COVID-19) cases in Central Asia were announced in March 2020 by Kazakhstan. Despite the implementation of aggressive measures to curb infection spread, gaps remain in the understanding of the clinical and epidemiologic features of the regional pandemic. METHODS: We did a retrospective, observational cohort study of patients with laboratory-confirmed COVID-19 hospitalized in Kazakhstan between February and April 2020. We compared demographic, clinical, laboratory and radiological data of patients with different COVID-19 severities on admission. Logistic regression was used to assess factors associated with disease severity and in-hospital death. Whole-genome SARS-CoV-2 analysis was performed in 53 patients. FINDINGS: Of the 1072 patients with laboratory-confirmed COVID-19 in March-April 2020, the median age was 36 years (IQR 24-50) and 484 (45%) were male. On admission, 683 (64%) participants had asymptomatic/mild, 341 (32%) moderate, and 47 (4%) severe-to-critical COVID-19 manifestation; 20 in-hospital deaths (1•87%) were reported by 5 May 2020. Multivariable regression indicated increasing odds of severe disease associated with older age (odds ratio 1•05, 95% CI 1•03-1•07, per year increase; p<0•001), the presence of comorbidities (2•34, 95% CI 1•18-4•85; p=0•017) and elevated white blood cell count (WBC, 1•13, 95% CI 1•00-1•27; p=0•044) on admission, while older age (1•09, 95% CI 1•06-1•13, per year increase; p<0•001) and male sex (5•63, 95% CI 2•06-17•57; p=0•001) were associated with increased odds of in-hospital death. The SARS-CoV-2 isolates grouped into seven phylogenetic lineages, O/B.4.1, S/A.2, S/B.1.1, G/B.1, GH/B.1.255, GH/B.1.3 and GR/B.1.1.10; 87% of the isolates were O and S sub-types descending from early Asian lineages, while the G, GH and GR isolates were related to lineages from Europe and the Americas. INTERPRETATION: Older age, comorbidities, increased WBC count, and male sex were risk factors for COVID-19 disease severity and mortality in Kazakhstan. The broad SARS-CoV-2 diversity suggests multiple importations and community-level amplification predating travel restriction. FUNDING: Ministry of Education and Science of the Republic of Kazakhstan.

The effects of COVID-19 lockdown on lifestyle and emotional state in women undergoing assisted reproductive technology: Results of an Italian survey.

PURPOSE: On March 8, 2020, the Italian Government implemented extraordinary measures to limit viral transmission of COV-19/SARS-CoV-2. We evaluated the impact of COVID-19 lockdown on lifestyle and emotional state in women planning infertility treatments. BASIC PROCEDURES: We performed a quantitative research study using a web-based survey, in 140 women referred to Assisted Reproductive Technologies Center. MAIN FINDINGS: We observed changes in body weight during lockdown in 80 % of women, and a significant increase in BMI in comparison to that observed before (p=.001). We observed a high percentage of non-adherence to the Mediterranean pattern during lockdown due to higher frequency of consumption of sweet/pastries, cheese and meat, rather than fruit, vegetables and legumes. Before lockdown 36.4 % women were snack consumers while during lockdown 55 % (p=.002). By considering individuals' attitude to snack consumption, we observed an increase related to boredom (p=<.0001) and anxiety (p=.05) during lockdown. Increased levels of anxiety and sadness were observed in about 30 %, and of boredom in 25 %. The percentage of women worried about their planning infertility treatment was more than 50 %. PRINCIPAL CONCLUSIONS: Quarantine-related restrictions strongly influenced lifestyle psychological behavior leading to an increased burden of cardiovascular disease.