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Objectives: The coronavirus disease 2019 (COVID-19) pandemic has imposed significant burden on Brazil's health system. The present study aims to describe patients' demographic and clinical characteristics, vaccine uptake and assess healthcare resource utilization (HCRU) and costs associated with acute COVID-19 in Brazil during the Omicron predominant period. Method(s): A population-based retrospective study was conducted using the National Health Data Network (RNDS), National Vaccination Campaign against COVID-19 data and surveillance data in public setting. Individuals with positive COVID-19 test results between January-April 2022 were identified. Patients' demographics, comorbidities, vaccination status, HCRU for those who were admitted to hospitals and their associated costs were described by age groups. Result(s): A total of 8,160,715 COVID-19 cases were identified and 2.7% were aged <5 years, 11.6% were 5-19 years, 76.9% were 20-64 years and 8.7% were >= 65 years. The presence of comorbidity was 23.1% with a higher prevalence of comorbidities in the elderly (61.8% for 65-74 years and 71.2% for >=75 years). Regarding COVID -19 vaccination uptake, among those aged <=19 years, 20-64 years and >=65 years, 40.6%, 86.5% and 92.2% had primary series, respectively. Among adults, the booster uptake was 47.3% and 75.8% for those aged 20-64 years and >= 65 years, respectively. Among those with confirmed COVID-19, regardless of vaccination status, 87% were being symptomatic and 1.7% were hospitalized (3.8% in aged <5 years, 4.2% in 5-19 years, 34.3% in 20-64 years and 57.6% in >= 65 years). Among hospitalized patients, 32,6% were admitted to ICU and 80% required mechanical ventilation support. The average cost per day in normal wards and ICU without ventilation was R$291,89 and R$923,90, respectively. Conclusion(s): Our results quantify the public health and economic burden of COVID-19 in Brazil, suggesting substantial healthcare resources required to manage the COVID-19 pandemic.Copyright © 2023
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Objectives: COVID-19 infected over 150 million people and caused over 1 million deaths in the US. This study evaluates several variables thought to be associated with mortality risk in the COVID-19 population. Method(s): The IQVIA longitudinal medical and pharmacy claims databases identified 17,682,111 patients with a COVID-19 diagnosis between 4/1/2020-4/30/2022 from a population of >277 million patients in the US. Patients were linked to Veritas Data Research fact-of-death records (90% complete compared to CDC reporting) and confirmed deaths were flagged. Confirmed mortality rates (CMR) were evaluated by age group, socioeconomic status (SES) using the Area Deprivation Index (v2.0, University of Wisconsin, 2015), co-morbidities and COVID-specific (approved and unapproved) treatments. Result(s): Of the 563,744 patients (3.2%) identified as dead (3.67% in men, 2.85% in women overall), CMR was lowest in patients aged 0-17 (0.08%), highest in age 65-75 (5.92%) and >75 (16.40%). Patients in the lowest 40% of SES had CMR of 4.43% while in the highest 20% was 1.56%. Respiratory failure, pneumonia and sepsis were the most common acute diagnoses accompanying COVID-19 deaths in all SES. In patients with comorbid dementia or Alzheimer's disease, CMR were 21.62% and 23.40% respectively. Additionally, congestive heart failure (15.79%), atrial fibrillation (15.50%), chronic kidney disease (15.30%) and COPD (12.19%) were associated with high CMR. Among patients receiving approved therapies, casirivimab/imdevimab and remdesivir had CMR of 1.41% and 12.63% respectively, while for those receiving unapproved therapies, ivermectin and hydroxychloroquine had CMR of 2.54% and 2.45%. Conclusion(s): Compared to the 1.1% case-mortality rate (Johns Hopkins 2023) among US COVID-19 patients, we found CMR exceeded 3% among those with a medical claim for COVID-19. Advanced age, dementia, and cardio-renal disease were associated with mortality. Patients with the lowest SES had approximately 3 times the confirmed mortality rate compared to those in the highest SES group.Copyright © 2023
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Objectives: To analyze the budget impact (BI) of Covid-19 vaccines from a mixed U.S commercial and Medicare payer perspective after depletion of the Federally-Purchased Supply (FPS). Method(s): BI analyses were conducted in a hypothetical one-million member health plan with a mixed commercial (55%) and Medicare (45%) population over a one-year time horizon based on the current (January 2023) Covid-19 vaccine recommendations from the Centers for Disease Control and Prevention (CDC). The two scenarios in the model include 1) the health plan does not pay for Covid-19 vaccines, and 2) after the depletion of FPS, the health plan must cover all costs for Covid-19 vaccines. Model inputs include the market shares of available Covid-19 vaccines in the US as of December 2022, Covid-19 vaccine utilization trends stratified into age groups (<12, 12-17, 18-24, 25-49, 50-64, >=65 years old) between commercial and Medicare populations, and predicted Covid-19 vaccine costs. Model inputs were based on the CDC publicly available data, real world evidence, published literature, and expert opinions. Sensitivity analyses (SA) were conducted to test uncertainties arising from the input values in the model. Result(s): The number of members receiving one primary dose, completed Covid-19 vaccine series, one booster dose and two booster doses was estimated at 9,253, 49,720, 594,933 and 29,387, respectively. The incremental Covid-19 vaccine cost per member per month over one year after depletion of the FPS was $5.92 for the commercial population, $8.93 for the Medicare population, and $7.27 for the total population in the health plan. In the SA, the largest effect was observed for the scenario which varied the percentage of population >=65 years old receiving one booster dose. Conclusion(s): The model results indicate that there will be a high budget impact from a mixed U.S commercial and Medicare perspective after depletion of the FPS of Covid-19 vaccines.Copyright © 2023
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Objectives: Potential cutaneous adverse drug reactions (cADRs) associated with COVID-19 vaccinations are well-known. However, comprehensive evaluation including detailed patient characteristics, vaccine types, signs and symptoms, treatments and outcomes from such cADRs are still lacking in Taiwan. Method(s): A cross-sectional study was conducted from December 2019 to October 2022 to analyze spontaneous ADR reporting data from Taiwan's largest multi-institutional healthcare system. Physicians and pharmacists initially ensured the data quality and completeness of the reported ADR records. Subsequently, we applied descriptive statistics to analyze the patient cohort based on demographic characteristics, administered COVID-19 vaccines, clinical manifestations, and patient management. Result(s): We identified 242 cADRs from 759 reported COVID-19 vaccine-related ADRs, 88.3% of which were judged as "possible" using the Naranjo Scale. The mean age of patients with cADRs was 48.1+/-17.5 years, with the majority (44.2%) of cADRs reported in the 40-64yr old age group. cADRs were more common in women (68.2%) and most of the patients had no history of allergy to vaccines (99.6%). Oxford/AstraZeneca (58.6%) accounted for the most reported brand of COVID-19 vaccines. Patients developed cADRs within 1 to 198 days (median = 5.5 days), and mostly after first-dose vaccination (77.8%). The most frequently reported cADR was rash/eruption (18.7%), followed by itchiness/pruritus (11.7%) and urticaria (9.2%), mainly affecting the lower limbs (23.8%) and upper limbs (22.6%). Medications were prescribed for 65.1% of the cADRs, and signs and symptoms were resolved within 1 to 167 days (median = 7 days) after treatment with oral antihistamines (23.0%), topical corticosteroids (14.6%) or oral corticosteroids (14.4%). Conclusion(s): Our findings provide comprehensive details regarding COVID-19 vaccine-related cADRs in Taiwan. Certain groups, especially women and the middle-aged, who reported a relatively higher rate of cADRs, may benefit from pre-vaccination counseling about the risks of cADRs and the use of appropriate medications.Copyright © 2023
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This study explores the association between experiencing food insecurity and COVID-19 diagnosis in the United States, and what sociodemographic characteristics moderate this relationship. We analyzed a national sample of adults in the United States (n = 6,475). Multiple logistic regression results revealed respondents experiencing food insecurity had an approximately 3.0 times significantly higher odds of a positive COVID-19 diagnosis (odds ratio [OR] = 2.95, 95% confidence interval [CI] = 1.38-6.32, p < 0.01), which remained significant after adjusting for sociodemographics and COVID-19 mitigation behaviors (OR = 2.59, 95% CI = 1.09-6.18, p < 0.05). Age group had a significant moderating effect (OR = 42.55, 95% CI = 3.13-579.15, p < 0.01). Results indicate experiencing food insecurity is associated with contracting COVID-19.Copyright © 2022 Taylor & Francis Group, LLC.
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Objectives: This analysis was conducted to develop a comprehensive list of ICD-10 CM codes for underlying conditions identified by the CDC as being associated with high-risk of developing severe COVID-19 and assessed the consistency of these codes when applied to large US based datasets. Method(s): The comprehensive list of ICD 10-CM codes for CDC-defined high-risk underlying conditions were mapped from CDC references and FDA Sentinel code lists. These codes were subsequently applied to Optum's de-identified Clinformatics Data Mart Database (claims) and the Optum de-identified Electronic Health Record (EHR) database across 3 years (2018, 2019 and 2020) among continuously enrolled subjects >= 12 years of age to determine the performance and consistency in identifying these high-risk underlying conditions annually over these years. Result(s): A total of 10,276 ICD-10 codes were mapped to 21 underlying conditions. Within the claims data, 62.7% of subjects >= 12 years had >= 1 CDC-defined high-risk condition (excluding age) with 26.6% of patients >= 65 years while in the EHR data 38% had >= 1 high-risk underlying condition (excluding age) with 14.4% >= 65 years. These results were similar and consistent in both datasets across all years. Patients aged 12-64 years in the claims data had a higher rate of >=1 high risk underlying condition relative to the EHR data, 49.3% and 34%, respectively. The top 5 conditions among the >= 65 were identical across both databases: hypertension, immunocompromised status, heart conditions, diabetes (type 1 or 2), and overweight/obesity. The top 5 conditions among the 12-64 age group were also similar among the databases and included: immunocompromised status, hypertension, overweight/obesity, smoking (current or former), and mental health conditions. Conclusion(s): These findings present a comprehensive list of codes that can be used by researchers, clinicians and policy makers to identify and characterize patients that may be at high-risk for severe COVID-19 outcomes.Copyright © 2023
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The Sickle Cell Society have issued standards for additional immunisations that adults with sickle cell disease (SCD) require. These include annual influenza, 5-yearly pneumococcal conjugate vaccine (PPV23) and Hepatitis B vaccination. Patients who have not received their primary vaccination as part of the national schedule in the UK should also receive further additional vaccines. We reviewed whether adults with SCD in South Wales currently receive these. 49 adult patients were identified as having SCD under the care of the Hereditary Anaemia Service based in the University Hospital of Wales, Cardiff. GP records were not available for 5 patients leaving a final cohort of 44 patients to analyse. Average age was 33 years (range 17-67). Median age was 27 with the cohort predominantly lying in the 17-29 year category (52%). Results showed good compliance with the annual influenza vaccine in those over 40 (>80%). However, compliance for the 17-29 category and 30-39 categories were 37.5% and 42.8%, respectively. The improved compliance in those >40 was not seen with the 5-yearly pneumococcal vaccine. Compliance was worse in all age groups compared to the annual flu vaccine with only 23% compliance overall. However, when looking at those who had received a single dose of PPV23, the numbers improved to nearly 60%. Compliance with the SARS-CoV2 vaccination was highest at 61.3%. However, rates were lower in the 17-29 and 30-39 age groups in keeping with previous trends. Only 34.1% of patients had full hepatitis B cover. Again, trends in compliance mirrored previous with poorer rates in those under 40. Assessing compliance for the remainder of the standards was more challenging given that we could not confirm retrospectively how many of our cohort had received their primary vaccinations in other parts of the UK, thought to be around half. However, most of the cohort had not received any additional vaccines suggesting high non-compliance regardless. This review looked at data from 2020 and likely reflects the impact of the SARS-CoV2, whether positive or negative. The reduced compliance in 5-yearly pneumococcal compared to flu suggest better health-professional education is needed;if patients are attending for their annual flu vaccine, there is ample opportunity to administer other vaccines. The vaccination rate for our patient group is comparable to national rates by ethnicity although lower than the national average for age. Vaccination rates for the SCD population of South Wales are not adequate. Better education and engagement is needed.
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Background: The second wave of the COVID-19 pandemic caused significant demand for beds capable of delivering enhanced respiratory support. NHS England recommended the use of CPAP for patients with COVID-19 respiratory failure, a treatment which can be offered outside of a critical care facility, and on a Respiratory High Care/ Support Unit (RSU). The enhancement of Portsmouth's RSU provided CPAP and NIV for patients with COVID-19 respiratory failure. With our intensive care facilities at 300% their normal capacity, this greatly alleviated bed pressures on critical care. Varied levels of deprivation exist in Portsmouth's dense population. Deprivation has an impact on overall health, however the effect of postcode on outcomes for people going onto support for COVID-19 respiratory failure, is unknown. Method(s): Retrospective cohort analysis of consecutive patients admitted to Respiratory Support Unit during the second wave of the COVID-19 pandemic, from 02/11/2020 to 31/01/2021. 227 patients were included in the study with 8 removed due to incomplete data, all of the patients received respiratory support in the form of CPAP or NIV. We collected multivariate data including biochemical markers, demographics, oxygenation status, co-morbidities and outcomes. Outcomes measured were: 1) Death in RSU, 2) Discharge from RSU or 3) Intubation and Ventilation. To measure deprivation, we linked a persons postcode to an area called an LSOA (Lower-layer Super Output Area). These are small areas of similar population size, each of which has a deprivation score (ie. top 10%, to the lowest 10% areas of deprivation in the UK). This is measured using an 'index of multiple deprivation'. An individual's outcome from the RSU was then analysed in relation to the deprivation score allocated to their postcode. Result(s): We observed a significant number of patients discharged from RSU, without needing invasive mechanical ventilation. 80/219 were discharged directly. 45/219 died in RSU, and 94 were eventually admitted to ITU. The average stay on CPAP or NIV before needing admission to ITU was 3 days. Some biochemical markers which stood out in relation to the outcomes described were as follows: average LDH, D-dimer and Troponin levels were higher in those who were admitted to intensive care. In patients who died, the PCT was significantly higher on average when compared to the other two groups. In the group who were discharged, mean lymphocyte count was >1, in the other two groups this was <1. From our observations in Portsmouth, there is a negative correlation between deprivation and lower aged individuals admitted for COVID-19 related respiratory support. Overall, we also saw disproportionate representation of those from the most deprived 50% of the UK in our respiratory support unit. Conclusion(s): CPAP and NIV can effectively be used in an RSU during a spike of COVID-19, to safely minimise demand on critical care services. Deprivation may have an impact on outcomes in patients needing respiratory support related to COVID-19. Deprivation levels may help predict risk of needing enhanced respiratory support in certain age groups. Multiple biochemical markers may be of prognostic value in COVID-19.
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We have an established transition clinic for the patients with diabetes aged 16 to 19. Our Transition clinic covers a vast area including deprived areas such as Ellesmereport. We do have 3 monthly follow up in addition to the home visits by paedatric diabetes specialist nurses. The team involves paediatric consultants, pdsn and dietcician from adult and paedatrics departments. Virtual consultation were the main mode of consultations during covid. We used Accu Rx, Attendanywhere and telephone consultations. We compared the clinic attendance pre and post covid. We compared clinic attendance for 9 months from March 2019 to December 2019 which were pre Covid to March 2020 to December 2020 during Covid. We had 150 appointments in 2019 and 112 appointments in 2020. The DNAs were 21 during covid with virtual consultations and 28 pre Covid with face to face appointments. The DNA rates were 18.6% in 2019 as face to face review and 18.75% during covid as virtual consultations. Surprisingly, the DNA rates did not improve when the clinics were virtual as we expected. In Conclusion, the virtual consultations did not improve the attendance in this vulnerable age group. Due to vulnerability of this age group, we felt that the face to face consultations were more appropriate. All of our appointments for the diabetes transition clinics are face to face in person due to above findings.
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OBJECTIVE: To explore the experiences of a virtual group therapy programme for children with Osteogenesis Imperfecta (OI) who were unable to access face to face therapy due to a global pandemic. In a regional OI service up to 3 face to face 6-week therapy groups are offered for children during summer school holidays. Throughout the Covid-19 pandemic, OI children were at risk of deconditioning due to government restrictions in school attendance, exercise and socialisation. An alternative means of delivering therapy was required. METHOD(S): 30 families with school age children were invited to attend a virtual therapy group. Following initial interest from 21 children, 14 (age range 4-14 years) participated in a 5 week therapy group. Children were split into 3 age groups (4-7/8-12/13-14). Weekly 75 minute sessions comprised functional gross and fine motor activities. Educational elements with opportunities to explore thoughts and feelings were included. Each group were set a challenge to compete a virtual race from Bristol to Lands' End, recording their distance (walking, wheeling, cycling) throughout the week. Feedback was collected from participants and parents. RESULT(S): Feedback was received from 12/14 of attendees and parents and 4/7 who did not attend. Reasons for non-attendance included anxiety around video calls, other commitments and injuries. Of those that attended 100% (n=12) enjoyed the group and reported increased activity levels. Scavenger Hunt was cited as the favourite activity. 16.6% (n=2) children reported discussion on personal feelings uncomfortable. 16.6% (n=2) reported exercises were hard. 100% (n=9) of parents reported no significant difficulties with IT. Parent reported benefits included positive social interaction with other children with OI (66%, n=6), improving routine in preparation for school return (55%, n=5). Challenges for therapy team included identifying appropriate IT platform, choosing activities appropriate for various abilities and virtual instruction. Successes included time efficiency, full inclusion regardless of geographic location, increased activity levels of children with OI in preparation for school return. CONCLUSION(S): A safe, socially distanced method of delivering group therapy during a pandemic was achieved. Virtual therapy can be a useful adjunct, however this should not replace face to face therapy where possible.
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Objectives: To estimate the public health impact of COVID-19 booster vaccination in the UK during Omicron predominance, and to explore the impact in counterfactual scenarios with different booster eligibility or uptake. Method(s): A dynamic transmission model was developed to compare public health outcomes for actual and hypothetical UK Spring and Autumn 2022 booster programs. Outcomes were projected over an extended time horizon from April 2022-April 2023, assuming continued Omicron predominance as in Jan-Mar 2022. Health outcomes included averted cases, hospitalizations, long COVID cases, and deaths. NHS resource use outcomes were averted general ward and intensive care unit bed days and general practitioner visits. Patient productivity loss outcomes considered productive days lost for those in and outside the paid work force. Analyses used publicly available data. Result(s): Model output suggested that actual Spring and Autumn 2022 programs, which offered boosters to older adults and vulnerable populations, would avert approximately 716,000 hospitalizations, 1.9M long COVID cases and 125,000 deaths compared to not offering boosters in Spring and Autumn 2022. In a scenario that broadened eligibility to individuals aged >=5 years, an estimated 1.6M hospitalizations, 8.3M long COVID cases, and 222,000 deaths were averted. A scenario assuming broadened eligibility and increased uptake produced the greatest benefit among scenarios analyzed: 1.6M hospitalizations, 9.2M long COVID cases, and 228,000 deaths averted;and 953M productive days saved. Scenarios offering boosters only to high-risk individuals (aged >=5 years) were also estimated to improve benefit relative to actual programs. High-risk-only programs assuming increased uptake provided about half to two-thirds of the benefit estimated for programs assuming broadened eligibility and increased uptake. Conclusion(s): UK booster vaccination programs were estimated to provide substantial benefit to public health during Omicron predominance. Public health benefits could be maximized by broadening booster eligibility to younger age groups and increasing uptake.Copyright © 2023
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Objective: To describe the prevalence of alcohol consumption before and during the COVID-19 pandemic and to analyze the factors associated with this behavior during the period of social distancing among Brazilian adolescents. Method(s): Cross-sectional study using data from the ConVid Adolescents survey, carried out via the Internet between June and September 2020. The prevalence of alcohol consumption before and during the pandemic, as well as association with sociodemographic variables, mental health, and lifestyle were estimated. A logistic regression model was used to assess associated factors. Result(s): 9,470 adolescents were evaluated. Alcohol consumption decreased from 17.70% (95%CI 16.64-18.85) before the pandemic to 12.80% (95%CI 11.85-13.76) during the pandemic. Alcohol consumption was associated with the age group of 16 and 17 years (OR=2.9;95%CI 1.08-1.53), place of residence in the South (OR=1.82;95%CI 1.46-2.27) and Southeast regions (OR=1.33;95%CI 1.05-1.69), having three or more close friends (OR=1.78;95%CI 1.25-2.53), reporting worsening sleep problems during the pandemic (OR=1.59;95%CI 1.20-2.11), feeling sad sometimes (OR=1,83;95%CI 1,40-2,38) and always (OR=2.27;95%CI 1.70-3.05), feeling always irritated (OR=1,60;95%CI 1,14-2,25), being a smoker (OR=13,74;95%CI 8.63-21.87) and a passive smoker (OR=1.76;95%CI 1.42-2.19). Strict adherence to social distancing was associated with lower alcohol consumption (OR=0.40;95%CI 0.32-0.49). Conclusion(s): The COVID-19 pandemic led to a decrease in consumption of alcoholic beverages by Brazilian adolescents, which was influenced by sociodemographic and mental health factors, adherence to social restriction measures and lifestyle in this period. Managers, educators, family and the society must be involved in the articulation of Public Policies to prevent alcohol consumption.Copyright © 2023 A Epidemio e uma publicacao da Associacao Brasileira de Saude Coletiva-ABRASCO.
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Objective: This study aimed to evaluate the psychological distress experienced by healthcare and non-healthcare professionals working in a hospital setting during the Coronavirus Disease 2019 (COVID-19) pandemic. Methodology: This survey-based cross-sectional study included 361 professionals (288 healthcare and 73 non-healthcare professionals) working at Ziauddin University Hospital, Karachi, Pakistan. Psychological distress was assessed using Depression Anxiety Stress Scale - 21 (DASS-21). Result(s): There was a higher prevalence of anxiety, depression, and stress among healthcare professionals as compared to the non-healthcare professionals, as indicated by the mean depression, anxiety, and stress scores on DASS-21 (p<0.05). The univariate logistic regression analysis showed that the odds of psychological distress were similar in both genders and individuals of all age groups. Healthcare professionals were twice more likely to be severely depressed and stressed as compared to non-healthcare professionals (p<0.05). Conclusion(s): This study concludes that psychological distress is more prevalent among healthcare workers than non-healthcare workers.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Background: Serological studies can demonstrate pathogen circulation in regional populations and reflect public health mea-sures' effectiveness during different pandemic phases. By late November 2021, coinciding with the third pandemic wave, the sero-prevalence of SARS-CoV-2 spike IgG antibodies among the Iranian population was 32.63%. Objective(s): This study aimed to assess the Iranian population's seroprevalence during the fifth pandemic wave by analyzing donated blood samples. Method(s): This population-based cross-sectional study was conducted on Iranian blood donors referred to all 31 main provincial capitals between August 2021 and September 2021. The participants selected through quota sampling were asked to complete a questionnaire on socio-demographics and coronavirus disease 2019 (COVID-19)-related information. Also, SARS-CoV-2 spike IgG antibodies were measured in serum samples using SARS-CoV-2 enzyme-linked immunosorbent assay (ELISA) kits. The seroprevalence was weighted based on the gender and age groups of the population and then adjusted for test performance. Result(s): Totally 3,339 blood donors participated in this study. The overall population-weighted seroprevalence adjusted for test performance was 52.67% (95% confidence interval (CI): 50.14-55.21). Seroprevalence was higher among participants with a high school diploma (55.45%, 95% CI 50.61-60.29), a positive history of close contact with COVID-19 patients (65.23%, 95% CI 60.83-69.63), and previous positive COVID-19 PCR tests (86.51%, 95% CI 82.32-90.7). Conclusion(s): More than half of the study population was exposed to SARS-CoV-2, indicating a 1.7-fold increase in the seroprevalence between late November 2020 and mid-September 2021. Our finding illuminated the pattern of Iran's fifth wave of the pandemic.Copyright © 2023, Author(s).
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Aims and objectives: The aim of this study was to compare the immediate adverse effects of the coronavirus disease 2019 (COVID-19) vaccine (COVAXIN) in a pregnant woman with that of a nonpregnant woman. Material(s) and Method(s): It is a prospective observational study done at Vanivilas Hospital, Bangalore Medical College & Research Institute (BMCRI) for 2 months. The sample size was 100 pregnant and 100 nonpregnant women. Telephonically, patients were followed-up, and details of the side/adverse effects were collected in a proforma after 2 and 14 days. Data collected from both groups were analyzed using the Chi-square test or Fisher's exact test. Result(s): The majority of women were in the age group of <=25 years (64.0% and 36.0%, respectively) with a mean age of 25.01 +/- 3.71 years among the pregnant and 28.52 +/- 6.00 years among nonpregnant women. About 25.0% of pregnant women and 38.0% of nonpregnant women reported side effects. About 15.0% and 22.0% had taken treatment for side effects among pregnant women and nonpregnant women, respectively. Among the pregnant women, the common side effects reported were injection site pain (17) followed by fever (5), fatigue (4), and myalgia (03). Whereas among the nonpregnant women, the common side effects reported were injection site pain (28) followed by fever (6), myalgia (3), headache (2), and fatigue (1). Conclusion(s): Side effects reported following the administration of Covaxin in pregnant and nonpregnant women are fever, fatigue, injection site pain, myalgia, and headache. The proportion of side effects was not significantly different in the pregnant and nonpregnant women following Covaxin administration. Clinical significance: Covaxin is an inactivated killed vaccine against COVID-19 by Bharat Biotech. The vaccine has been recommended for pregnant women by the Government of India during corona pandemic. Studies are lacking regarding the difference in adverse events in pregnant versus nonpregnant women, after vaccine administration.Copyright © The Author(s).
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The aim of this study was to conduct a survey of the fungal species associated with COVID-19 viral infection in 150 patients who were admitted to the intensive care unit (ICU) in Al-Diwaniyah Teaching Hospital in Al-Diwaniyah City, Iraq, for a five-month period from October 2021 to February 2022. The results indicated the dominance of Candida spp. over the rest of the isolated fungal species, with 97 isolates (64.66%). Aspergillus spp., with 15 isolates (10%), came in second. Rhizopus sp. with 2 isolates (1.33%). Then with 1 isolate (0.66%) for each of Penicillium sp., Coccidiodes sp., and Rhodotorula sp., Also, results show that the male has a higher percentage than the female (54.9%) and co-infections with fungi were more common in the 60-69 age group then in the 70-79 age group (34% versus 24%, respectively). Taking a deeper look at the patients' medical histories, it was shown that fungal co-infection was more prevalent in those with chronic sickness than in those without chronic disease (55.66% versus 43.14%, respectively).Copyright © RJPT All right reserved.
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Introduction: Miliaria crystallina occurring during neonatal period is one of the differential diagnosis for vesiculopustular lesions in that age group. Congenital miliaria crystallina is a rare condition developing due to various causes. Case Report: An otherwise well, term female neonate born by caesarean section presented with generalised clear fluid filled vesicles over the trunk, upper limbs, face and scalp at birth. Mother was COVID-19 positive with fever and cough for 1 week. Otherwise she had an unremarkable antenatal, sexual history and examination. The vesicles were located on normal looking skin and ruptured easily on rubbing. Palms, soles and mucosae were normal. Tzanck smear from the vesicles showed a few deformed keratinocytes only. Venereal Disease Research Laboratory test in dilution for both mother and child was non-reactive. Baby's RT-PCR came negative. She fared well on follow up, the vesicles started to desquamate on the second day and completely disappeared on the third day. Mother's COVID-19 symptoms also subsided after child birth. A final diagnosis of congenital miliaria crystallina was made based on the characteristics of the vesicles. Discussion(s): Miliaria crystallina is triggered by environmental temperature and humidity. Congenital cases are associated with maternal febrile illnesses. However, there are reports of it occurring in newborns of mothers without fever in whom other factors are involved. This is the first report of congenital miliaria crystallina occurring in a neonate born to a COVID-19 positive mother. Conclusion(s): This case report highlights the importance of recognizing this benign self-limiting condition so as to avoid unnecessary investigations to find an alternative cause.
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Background: The virulent pathogen SARS-CoV-2 first appeared in the Chinese province of Hubei in December 2019. Pregnant women were a high-risk population in the pandemic because immune system alterations that occur during pregnancy make them more vulnerable to foreign infections. Late-pregnancy cholestasis is a dangerous liver condition that can cause the foetus to experience potentially fatal problems like early birth and stillbirth. In the present study we were testing the Bile acid level during pregnancy patients after covid pandemic. Objective(s): To evaluate the prevalence of intrahepatic cholestasis in pregnant patients after Covid -19 pandemic. Material(s) and Method(s): This cross-sectional study was conducted at department of Dr.fida painless and General Hospital Peshawar from jan 2022 to Dec 2022. We enrolled 186 pregnant patients after fulfilling the inclusion criteria. 5 ml blood sample were also taken from the patients. Serum was extracted and Bile acid test were performed in clinical laboratory. Data were collected in predesign questionnaire. Result(s): Total 186 patients were enrolled in the study with mean age of 37.18+/-6.39 years (Range 18-45 years). The mean value of all enrolled patients was 31.38+/-5.79 with minimum and maximum value of bile acids 20 micromol/L and 40.6.00 micromol/L. In our study 95 (56.5%) of patients belongs to 36 to 45 years of age group followed by age group of 26 to 35 years in which 60 (35.7%) patients and 13 (7.7%) patients were belongs to age group of 18 to 25 years. Practical implication: This study will help the clinical practitioner to take care of pregnant patients in order to avoid the prevalence of intrahepatic cholestasis. Conclusion(s): It is concluded from this research study that prevalence of intrahepatic cholestasis in pregnancy has increased after Covid-19 pandemic.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Objectives: Female athletes have a higher risk of concussion than their male counterparts but there is a need to investigate these differences in a general population. We assessed reported concussions during a pre-COVID time period in a claims database to compare the prevalence across sexes and ages. Method(s): Using the MerativeTM MarketScan Commercial and Medicare Databases and Treatment Pathways tool, patients were included in the current study if they had continuous enrollment in the database from January 1, 2018 - December 31, 2019 and were between the ages of 14-65. The prevalence of concussions, identified using ICD-10-DX codes, was calculated for all cohorts (14-17, 18-23, >=24 years) and compared statistically between males and females. A secondary analysis, restricted to those with at least one year of continuous enrollment after the initial concussion, was conducted to determine if the proportion of patients who had a diagnosis code for a concussion at least 30 days after the first concussion differed across cohorts. Result(s): Approximately 9 million patients met the inclusion criteria for the study. A total of 66,098 patients had a claim for a concussion during the study period (56% female). The prevalence of concussions was 0.7% and 0.8% among males and females, respectively (p-value<.0001). Females were more likely to be diagnosed with a concussion than males in all age cohorts, with prevalence decreasing with age. Among patients with at least one concussion, 11.7% of males and 16.9% of females had a diagnosis code for a concussion at least 30 days after the initial code (p-value<.0001). Conclusion(s): This study supports previous research done in athletic populations and provides evidence that in a general population the prevalence of concussions is higher among females across all age groups. Further research is needed to investigate why the risk of concussion differs across sexes.Copyright © 2023
ABSTRACT
Introduction: The COVID-19 pandemic has caused major changes to healthcare services, especially those related to early detection and screening practices like breast cancer. In Puerto Rico, breast cancer is the main cause of death, representing 18.9% of cancer deaths in women, making early detection even more important to prevent morbidity and mortality. This study aims to describe the impact of COVID-19 on breast cancer screening and assess differences in health utilization by age group and health regions in Puerto Rico. Method(s): This study used data on breast cancer screening medical claims from Puerto Rico Track, a project in collaboration with the Puerto Rico Public Health System and the Puerto Rico Institute of Statistics that aims to assess health access and utilization patterns in Puerto Rico. Claims including unilateral and bilateral mammography, sonommamography, and MRI were analyzed. Descriptive statistics and percentual changes between the COVID-19 baseline year (2016) compared with 2020 and 2021 were performed (overall, by age-group and health region). Result(s): A total of 193,793 screening tests were performed in 2016, compared to 66,463 in 2020, and 89,322 in 2021. Overall, a third of the medical claims for breast cancer screening (33.2%) were in the age group of 51-60 years. An overall decreasing percentual change was observed comparing 2016 vs. 2020 (65.7%), where the age group with the broadest gap reduction were among women 41-50 years old (68.2%). When comparing medical claims of 2016 (193,750) versus 2021 (89,320) (pre and post pandemic), an important decreasing change (53.9%) was observed. The age group with the highest decrease comparing 2016 to 2021 was the 41-50 years one (68.2%). The Western region of Mayaguez/Aguadilla had the highest decreasing percentual change, with a reduction of 73.6% in 2020 compared to 2016, and 62.6% when compared 2021 with 2016. Conclusion(s): Breast cancer screening was notably affected by the COVID-19 pandemic in Puerto Rico. A pattern of decreasing breast cancer screening was observed by health regions and by age. These efforts provide evidence of the need of tailored evidence-based interventions to increase breast cancer screening in the island.