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PURPOSE: To examine the association between provision of instrumental and personal care, and loneliness in adults aged 50 years and older during the COVID-19 pandemic. Instrumental care referred to the provision of assistance with obtaining necessary or essential products and/or services, whereas personal care referred to the assistance with daily life activities or the provision of emotional support. Social capital and caregiver stress theories served as the study's theoretical framework. MATERIALS AND METHODS: The data were obtained from the two COVID-19 waves of the Survey of Health, Ageing, and Retirement in Europe (SHARE) conducted in 2020 and 2021. The data were analyzed using logistic regression models. The analytical sample consisted of 48,722 adults in the abovementioned age bracket residing in Europe and Israel. RESULTS: Providing instrumental care negatively related to loneliness. Providing instrumental care to a single category of people negatively related to loneliness, whereas providing personal care to multiple categories of people positively related to loneliness. Providing personal care to children positively related to loneliness. CONCLUSIONS: The results suggest that different types of care provision correspond differently to the experience of loneliness while partially supporting both theoretical frameworks. Moreover, care indicators correspond differently to loneliness. The results imply that for a better understanding of the link between care provision and loneliness in later life, various parameters as well as various types of care provision should be examined.
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Background: There is scarcity of data regarding young and middle-aged adults hospitalized with severe Corona Virus Disease 2019 (COVID-19) in Africa. In this study, we describe the clinical characteristics and 30-day survival among adults aged 18 to 49 years admitted with severe COVID-19 in Uganda. Methods: We reviewed treatment records of patients admitted with severe COVID-19 across five COVID-19 treatment units (CTU) in Uganda. We included individuals aged 18 to 49 years, who had a positive test or met the clinical criteria for COVID-19. We defined severe COVID-19 as having an oxygen saturation <94%, lung infiltrates >50% on imaging and presence of a co-morbidity that required admission in the CTU. Our main outcome was the 30-day survival from the time of admission. We used a Cox proportional hazards model to determine the factors associated with 30-day survival at a 5% level of significance. Results: Of the 246 patient files reviewed, 50.8% (n = 125) were male, the mean ± (standard deviation) age was 39 ± 8 years, majority presented with cough, 85.8% (n = 211) and median C-reactive protein (interquartile range) was 48 (47.5, 178.8) mg/L. The 30-day mortality was 23.9% (59/246). At admission, anemia (hazard ratio (HR): 3.00, 95% confidence interval (CI), 1.32-6.82; p = 0.009) and altered mental state (GCS <15) (HR: 6.89, 95% CI: 1.48-32.08, p = 0.014) were significant predictors of 30-day mortality. Conclusion: There was a high 30-day mortality among young and middle-aged adults with severe COVID-19 in Uganda. Early recognition and targeted management of anemia and altered consciousness are needed to improve clinical outcomes.
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Objective: To investigate the effect of perioperative oral nutritional supplementation on the short-term curative effect of obese patients after laparoscopic sleeve gastrectomy (LSG). Methods: A prospective research method was adopted. The clinical data of 218 obese patients who underwent LSG in Ningxia Medical University General Hospital from January 2018 to December 2021 were selected. The patients who received oral nutritional supplement therapy during the perioperative period were set as the experimental group, and those who received conventional treatment were set as the control group. Observation indicators: (1) Grouping of enrolled patients. (2) Postoperative and follow-up situation. (3) Nutrition-related indicators. (4) Diet compliance. (5) Status of weight loss-related indicators. Follow-up visits were conducted by telephone, We Chat and outpatient visits. The patients were followed up once 30 days after discharge, including albumin (Alb), hemoglobin (Hb), dietary compliance and weight loss-related indicators. The follow-up time will end in February 2022. The measurement data with normal distribution were expressed as x+or-s, and the comparison between groups was performed by independent sample t test. The measurement data is represented by M (range), and the comparison between groups is performed by Mann?Whitney U test. Enumeration data were expressed as absolute numbers or percentages, and the X2 test was used for comparison between groups. Repeated measures data were analyzed by repeated measures analysis of variance. The rank sum test was used to compare the rank data. Results (1) Grouping of the enrolled patients. Screened 218 eligible patients;42 males and 176 females;age (32+or-9) years;body mass index (BMI) (39+or-7) kg/m2. Among the 218 patients, there were 109 cases in the test group and 109 cases in the control group. Gender (male, female), age, BMI, preoperative Alb, and preoperative Hb of patients in the test group were 17 and 92 cases, (33+or-9) years old, (39+or-7) kg/m2, (40.6+or-4.8) g /L, (141.7+or-13.9) g/L;the above indicators in the control group were 25 and 84 cases, (31+or-8) years old, (39+or-8) kg/m2, (40.9+or-4.2) g/L, (142.9+or-9.7) g/L;there was no significant difference in the above (X2=1.89, t=-1.52, 0.51, 0.40, 0.71, P > 0.05). (2) Postoperative and follow-up situation. The first hospitalization time and first hospitalization expenses of the patients in the experimental group were (9.1+or-2.9) d and (3.6+or-0.5) ten thousand yuan respectively;the above indicators of the patients in the control group were (4.9+or-1.0) ten thousand yuan respectively;There were statistically significant differences in the above indicators between the two groups (t=5.58, 12.38, P < 0.05). Among the 218 patients, 119 were followed up, including 62 in the experimental group and 57 in the control group. The 119 patients were followed up for 31.0 (25.0-38.0) days. Among the 218 patients, 14 cases had postoperative complications and led to rehospitalization, including 2 cases in the experimental group, 1 case of nausea and vomiting and 1 case of intestinal obstruction;12 cases in the control group, 10 cases of nausea and vomiting, gastric fistula 2 cases;there was a statistically significant difference between the two groups in hospital readmission (X2=7.63, P < 0.05). The time interval between re-admission and first discharge of 14 patients was (22.0+or-6.7) days. (3) Nutrition-related indicators. The Alb and Hb levels of 62 patients in the experimental group who were followed up before operation, before the first discharge, and 1 month after operation were (40.4+or-5.5) g/L, (35.9+or-3.8) g/L, (45.4+or-2.9) g/L, respectively and (140.8+or-13.9) g/L, (130.5+or-16.9) g/L, (147.8+or-17.2) g/L;the above indicators of 57 patients in the control group were (41.2+or-3.9) g/L, (34.2 +or-3.9) g/L, (42.7+or-5.3) g/L and (143.0+or-9.7) g/L, (122.9+or-12.8) g/L, (139.0+or-11.4) g/L;There was a statistically significant difference between the Alb and Hb groups from preoperative to postoperative 1 mont
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BACKGROUND: The COVID-19 pandemic has had a negative effect on the mental health on the population. It is unknown if the different types of patient isolation affect them equally. The objective of the study was to determine if the effect on the psychological discomfort caused by the isolation of the population with COVID-19 in a hotel supervised by health professionals was different compared with those who were isolated at home. METHODS: Patients diagnosed with COVID-19 during the first pandemic wave in Barcelona, consecutively selected from the Primary Care lists. A telephone survey was carried out to collect information about mental health in patients who were isolated in a hotel compared to those isolated at their homes. Descriptive statistics were performed and the study variables were analyzed using mean and standard deviation, count (percentage), Chi-square test, and Student's t-test. Logistic regression models were carried out selecting frustration and anger/irritability as response variables. RESULTS: Of the 89 patients included, 45 (50.6%) were isolated at their homes and 44 (49.4%) at the hotel. Frustration was identified in 48.3% and irritability in 29.2% of the most patients. Most of those who presented frustration were between 45 and 65 years old, while 50% of those who felt irritability were younger. Multivariate models confirmed that patients isolated at home showed a higher risk of frustration (Odds ratio 4,12;95% Confidence interval 1,60-11,49) and irritability (Odds ratio 3,81;95% Confidence interval 1,32-12,10), respectively. CONCLUSIONS: Patients isolated at home show a higher risk of presenting feelings of frustration and irritability than isolated patients in supervised hotels.
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Coronavirus Disease 2019 (COVID-19) is a new type of virus with a high intensity of spreading and has been becoming the world's health problem. People with Covid-19 need support from their families and communities, such as support in psychology, existence, relationship, growth necessity, community concern, and also supports in the religious sectors since they might affect the process of their recuperation. This research aims to explore and discover more deeply about an experience of a family whose members had already gotten infected by COVID-19. The research employed a qualitative approach with the phenomenology study method. The research participants were 8 people aged between 18 and 60 years old who were the main members of the family (father, mother, and children), and they lived in the same house along with the other members who had already been infected by COVID-19. The samples were hired by using the purposive sampling method. The data was collected by applying an interactively in-depth interview with the participants. The results of the research found that the psychological responses of the family when knowing its members got infected by COVID-19 caused the family to be anxious and frustrated. However, the spiritual responses given by the family made the fay to be more grateful and closer to God. Thus, the family and its members with covid-19 needed social support form of motivation as well as support in the fulfillment of basic needs, family affections, and medicines. It was concluded that the family's experience with family members who have been affected by COVID-19, can be an illustration, for other families when facing the same problem.
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The article is devoted to the global problems of modern medicine - HIV infection and the COVID-19 pandemic. The review of the literature highlights current ideas about the pathogenesis and course of COVID-19 in patients with HIV infection, and also touches upon the problems of concomitant pathology and mental health of patients with HIV in the setting of the COVID-19 pandemic. It has been shown that HIV-positive patients are a risk group for the severe course of COVID-19, in particular, individuals with severe immunodeficiency (CD4+ T lymphocytes 200 cells/l) due to the development of synergetic lung damage by SARS-CoV-2 and secondary infectious agents such as cytomegalovirus and Pneumocystis carinii. It has been proven that one of the targets of the SARS-CoV-2 virus is CD4+ T cells, which in COVID-19 leads to a more rapid progression of immunodeficiency in patients with HIV infection and, thus, significantly increases the risk of secondary diseases and death. Particular attention should be paid to middle-aged and elderly people living with HIV, who, compared with HIV-negative patients, are more likely to have concomitant pathology - arterial hypertension, cardiomyopathy and diabetes mellitus, which are the risk factors for severe COVID-19. The results of studies on the effect of antiretroviral drugs on the course of COVID-19 showed that HIV-infected patients receiving tenofovir + emtricitabine have a lower risk of severe COVID-19 and associated hospitalization than patients receiving other HIV treatment regimens. Clinical and preclinical data support the potential use of tenofovir in the treatment of novel coronavirus infection.
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COVID-19 lockdown, targeted at preventing the spread of coronavirus, had deleterious effects on physical and psychosocial health. This study examined the association between physical activity (PA), sedentary behaviour, health-related quality of life (HRQoL), loneliness and quality of sleep of 507 Nigerian adults during the COVID-19 lockdown. Five hundred and seven respondents (aged 18-67 years) from 12 States completed an online survey on RedCap. Questionnaires comprising the Stages of Change scale, Pittsburgh Sleep Quality Index, International Sedentary Assessment Tool, UCLA Loneliness Questionnaire, Short Form-12 Health Survey, and International Physical Activity Questionnaire were used. Respondents were categorised based on exercise behaviour as non-exercisers, non-regular exercisers, or regular exercisers;and based on age into 18-24, 25-34, 35-44 and > 44 years categories. Descriptive and inferential statistics were used to analyse the data. About 33.1% of respondents did not meet moderate-to-vigorous PA levels. The physical component of HRQoL was positively associated with total PA (p = 0.04). Among the non-exercisers, the odds of being regular exercisers during pre-COVID-19 lockdown were significantly higher for the 35-44 (odds ratio [OR] = 3.49;95% CI = 1.44, 8.48, p = 0.01) and > 44 years age groups (OR = 2.98;95% CI: 1.16, 7.62, p = 0.02) relative to 18-24 years age category. During COVID-19 lockdown, > 44 (OR = 3.65;95% CI: 1.47, 9.07, p = 0.005), 35-44 (OR = 6.42;95% CI 2.75, 14.96, p = 0.001) and 25-34 (OR = 2.35;95% CI: 1.15, 4.80, p = 0.02) years age categories had significant higher odds of being regular exercisers compared to the 18-24 years age group. There was a high rate of physical inactivity among Nigerian adults during the COVID-19 lockdown, which was directly influenced by the physical components of HRQoL. Older age was an independent predictor of exercise behaviour before and during the COVID-19 lockdown among Nigerian adults.
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The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency of international concern. However, its stress on the mental health of young to middle-aged adults is largely unexplored. This study aimed to evaluate the mental health difficulties during the resurgent phase of COVID-19 among young to middle-aged adults in China. There were 1,478 participants with a median age of 26 years (IQR, 23 - 30), including 535 males (36.2%). The prevalence of anxiety, depression, and insomnia were 8.6%, 11.4%, and 13.7%, respectively. Participants aged 29 - 59 years (OR, 95% CI: 2.46, 1.23 - 4.91) and females (2.49, 1.55 - 4.01) had a higher risk of anxiety. Education status, worried level about the current COVID-19, and the level of COVID-19's impact on life were significantly associated with the prevalence of anxiety. Besides, the level of COVID-19's impact on life was positively related to the prevalence of depression and insomnia. Our study provided novel evidence of psychological difficulties among young to middle-aged adults during the resurgent stage of the COVID-19 epidemic. Psychological intervention should be continuously implemented to prevent long-term psychological comorbidities during the COVID-19 epidemic.
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Aging populations experience disproportionate risk for cognitive decline, which may be exacerbated by coronavirus (COVID-19) illness, particularly among women. This study tested sex as a moderator of associations between COVID-19 state anxiety and cognition in middle-aged/older adults. Adults aged 50+ (N = 275; 151 men/124 women) completed the Coronavirus Anxiety Scale and Cognitive Failures Questionnaire online from remote locations in July/August 2020. A subset of participants (n = 62) completed an objective cognitive task (Stroop). Multiple regressions determined whether sex moderated associations between COVID-19 anxiety and cognitive outcomes. Sex was a significant moderator, such that for women (not men), greater COVID-19 anxiety was associated with more memory failures and blunders (subjective measures) and worse processing speed (objective measure). COVID-19 state anxiety is linked to everyday cognition and processing speed in women, but not men. Consistency across subjective and objective measures promotes the need for sex-specific understanding of the pandemic's behavioral and cognitive effects in mid-to-late life.
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Background: COVID-19 is a multi-system all-pervasive disease with protean manifestations, and its major signs and symptoms, such as incessant dry cough, fever, and pneumonia, are well known. Yet, its mucocutaneous manifestations, particularly those of the oral cavity, appear to be little recognized. This may be due either to the rarity of oral manifestations of COVID-19, or poor detection of such symptoms by attending physicians who may do only a cursory examination of the oral mucosa because of the overwhelming gravity of the other major systemic presentations. Nevertheless, there are now a considerable number of reports, including systematic reviews, on oral manifestations of COVID-19 in the literature. This observational study was performed to determine the oral manifestations among COVID-19 patients. Material & Methods: A cross-sectional study was carried out among COVID-19 recovered patients. 120 Covid 19 recovered patients were purposively selected as study samples. All the samples diagnosed as mild and moderate cases of COVID-19 disease were selected based on inclusion and exclusion criteria. Results: The study comprised the majority of males (68%) where females represent (32%) of the study population and the mean age was 39.3+or-12.4. Oral manifestations among study subjects during and after the disease illness including loss of taste being the commonest symptom (40%), followed by erythema and coated tongue (7.5%), mouth ulcerations (6.7%) and dry mouth (1.7%). The study revealed that the 41-60 age group subjects represented the highest (43%) oral manifestations. Conclusions: Early identification of oral symptoms in COVID-19 recovered or suspected cases can help a dentist or a general physician to diagnose high-risk groups, mitigate transmission, and promote overall health.
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The relationship between smoking and the lung damage volume in patients with a confirmed new coronavirus infection diagnosis, hospitalized in a temporary infectious hospital for the treatment of patients suffering from a new coronavirus infection and community-acquired pneumonia was evaluated. This was in the Odintsovo District's Patriot Park of the Moscow region. Smoking cigarettes, both active and passive, as well as exposure to tobacco smoke on the body, are important upper and lower respiratory tract infection risk factors due to local immune response suppression. Nevertheless, data from a number of international studies indicate a significantly lower number of hospitalized smoking patients compared to non-smokers. These indicators were investigated as the percentage and degree of lung damage, smoking history, the number of cigarettes smoked per day, and the smoker's index. In the course of the study, the data on a smaller percentage of smokers admitted to inpatient treatment were confirmed in comparison with non-smokers and smokers in the general population. There was no statistically significant difference in the volume of lung damage between smoking and non-smoking patients according to the chest organs computed tomography. At the same time, there was an increase in the volume of lung tissue damage, depending on the smoking experience. This is apparently due to the irreversible changes formation in lung tissue against a long-term smoking background. The median age of smoking patients was 56 years with a variation from 46 to 68 years. The minimum and maximum ages were 29 and 82. The median lung lesion was 32% with a variation from 23% to 39%. The minimum and maximum lung damage is 10% and 40%, respectively. A moderate correlation was found between the smoking experience and the volume of lung damage. An increase in lung damage by 0.309% should be expected with an increase in smoking experience by one full year. There was also no statistically significant difference in the number of cigarettes smoked per day and the smoker's index.
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Background: The health-care system has encountered exceptional circumstances, experiencing unique challenges, and manifesting as acute challenges in health-care services due to the spread of COVID-19. Aims and Objectives: The present study aimed to report the difficulties faced by the anesthetists while performing a cesarean section under the subarachnoid block (SAB) in COVID-19 patients at a dedicated COVID Level 3 hospital. Materials and Methods: Twenty healthy anesthetists (six consultants and 14 postgraduate) aged 20-40 years performed 60 elective or emergency cesarean sections of known COVID-19-positive gravida patients aged 20-35 years with no comorbidity and no spine abnormality under the SAB. Anesthetist;s responses to the challenges faced while performing procedures wearing the Level 3 personal protective equipment were recorded using a pre-structure self-administered questionnaire. To quantify the intensity of these problems, all the physical and psychological difficulties were graded as mild, moderate, and severe. Results: In the present study, 75% experienced moderate-to-severe sweating, and 60% experienced moderate-to-severe headaches. A total of 45% experienced moderate-to-severe breathlessness. Though there was little difficulty in communication among doctors and staff, almost 75% of anesthetists faced it. The fear of contracting the disease and spreading it to the family members was expressed by 75-80% of anesthetists. Conclusion: The present scenario has increased physical stress and other psychological problems among health workers. Therefore, hospital support with regular psychological counseling sessions is needed for healthcare workers to cope with the current situation.
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Introduction: The health workers are one of the most prone to becoming infected with COVID-19, due to their exposure during their relationship with patients. Background: To determine the clinical and epidemiological characteristics of COVID-19 in workers of the Pediatric Hospital of Camaguey in the period from January to December 2021. Methods: A descriptive and cross-sectional study was carried out in a universe of 238 workers with a polymerase chain reaction-confirmed diagnosis during the aforementioned period;registered in a database. The variables studied included age group, sex, occupational category, service of origin, clinical manifestations, quarter of the year, and possible source of infection. The data were processed using the statistical program SPSS (Statistical Package for Social Sciences), version 25.0, on a Pentium IV computer. Informed consent and the bioethical principles of confidentiality of information were taken into account in the research. Results: The female sex predominated (54.7%) at ages 50-59 years. They were mostly nursing staff (29.4%), infected during the third trimester (39.9%) in the community (59.3%), presenting symptoms such as nasal discharge (32.8%) and fever (17.6%), working in the pediatric medicine wards (28.2%). Conclusions: Despite the difficult epidemiological situation, the main source of infection was the community. There were no institutional transmission events and there were no deaths.
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Background: Robust data of IL-6 is available in bacterial infection, and now it can be utilized in currently ongoing COVID-19 (corona virus disease-19) pneumonia pandemic to guide treatment strategy as marker of inflammation. Methods: Prospective, observational study included 1,000 COVID-19 cases confirmed with RT PCR (reverse transcription polymerase chain reaction). All cases were undergone categorized after clinical details, HRCT (high resolution computerized tomography) thorax, oxygen saturation, IL-6 (interleukin 6) at entry point and follow up. Age, gender, comorbidity and use BIPAP/NIV (bilevel positive airway pressure/non-invasive ventilation), and outcome as with or without lung fibrosis as per HRCT severity were key observations. Statistical analysis is done by using Chi-square test. Results: In study of 1,000 COVID-19 pneumonia cases, age (<50 and >50 years) and gender has significant association with IL-6. HRCT severity score at entry point has significant correlation with IL-6 level (p < 0.00001). IL-6 level has significant association with duration of illness (p < 0.00001). Comorbidities has significant association with IL-6 level (p < 0.00001). IL-6 level has significant association with oxygen saturation (p < 0.00001). BIPAP/NIV requirement has significant association with IL-6 level (p < 0.00001). Timing of BIPAP/NIV requirement during course of hospitalization has significant association with IL-6 level (p < 0.00001). Follow-up IL-6 titer during hospitalization as compared to entry point normal and abnormal IL-6 has significant association with post-COVID-19 lung fibrosis, respectively (p < 0.00001). Conclusion: IL-6 has very crucialrole in COVID-19 pneumonia in predicting severity of illness, progression of illness including 'cytokine storm' and assessing response to treatment during hospitalization and follow-up titers in analyzing post-COVID-19 lung fibrosis.
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Objective: In our study, we aimed to show whether there is a relationship between antiphospholipid antibody (aPL) positivity and complications of COVID-19. Material and Methods: Eighty-three patients who were diagnosed with COVID-19 infection and hospitalized in the intensive care unit (ICU) of Bakirkoy Dr. Sadi Konuk Research and Training Hospital were included in our study as the case group and 79 healthy volunteers as the control group. Only patients with a positive Polymerase Chain Reaction (PCR) test were included in the case group. Serum antiphospholipid antibodies (aPL IgM/G), C-Reactive Protein (CRP), ferritin, procalcitonin (PCT), plasma D-Dimer levels, prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) were analyzed by routine laboratory methods. Results: Both groups were found statistically similar in terms of gender (X2 test, p=0.236). The mean age of the case group and control group was 60.54..16.86 and 51.47..14.64 years, respectively. When aPL positivity was evaluated between the case and control groups, a statistically remarkable difference was found between the groups (p=0.046). The case group showed an aPL positivity of 7.5% and the control group 1%. The correlation between D-Dimer, PT, INR, aPTT levels, and aPL IgM/G positivity in the case group was significant. Conclusion: Our results revealed that aPL positivity in patients with COVID-19 infection relate to the severity of the disease, independent from age and gender. To confirm the result of this study further studies with participation of larger patient groups from national and international hospitals are required.
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In this work we analyze the effectiveness of vaccination strategies for the COVID-19 epidemic in the Brazilian state of Minas Gerais. Firstly we study the effectiveness of general vaccination in the decreasing of the number of infected individuals using a traditional non structured SEIR model. Secondly we consider an age-structured SEIR model with three age classes (youngster, adult and elderly) and we analyze the current strategy in the Brazilian state of Minas Gerais, of focusing the vaccination on the elderly group. We conclude by showing this strategy to be mistaken and that a vaccination focusing on the age group of the adults would be much more efficient in decreasing the total number of infected individuals.
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It is an observational cross-sectional study, the data collected by convenience sampling method from 33 patients in the Ranya General Hospital and private clinics for follow-up patient's autoimmune diseases state in the Ranya city from the 10th November 2020 to the 20th May 2021 and the study included all the patients had autoimmune diseases that recovered from the COVID-19 disease. For the study materials, the data was collected by a questionnaire form that included demographic and autoimmune disease questions also questions about the patient's intensity of their autoimmune disease's signs and symptoms before and after they recovered from COVID-19. Determine patient's autoimmune disease signs and symptoms intensity based on the prescribed drug for a treat the autoimmune diseases which are changed by special doctors. Furthermore, the data were analysed by SPSS software to produce descriptive statistic measures and to find the difference between dependent categorical variables Sign tests were used but the Chi-square test was used for the categorical independent variables with regarding 0.05 as a significant critical value. The result reveals that the range of their age started from 42 to 74 years old with mean..standard deviation (57.3 .. 8.06) and most of the cases 15(45.5%) were between (55-65) years old, followed by less than 55 years old 13(39.4%) and more than 65 years old age 5(3.8%) cases respectively. Rheumatoid arthritis was a major type 16 (48.5%) of the autoimmune disease compared to other types, Ankylosing Spondylitis 8(24.2%) cases, and Ulcerative Colitis 6(18.2%) cases respectively while Crohn's disease was the minimum 3(9.1%) cases and before the got COVID-19 most of the cases 25(75.8%) had moderate intensity signs and symptoms of their autoimmune diseases and 8(24.2%) cases had severe signs and symptoms but after they recovered from the COVID-19 disease the rate of their signs and symptoms changed to mild 19(57.6%) and moderate 14(42.4%) intensity while severe intensity signs and symptoms were zero with highly significant differences (P-value 0.0001). Despite the current study concluded autoimmune disease patients recovered from the COVID-19 their autoimmune diseases signs and symptoms intensity decreased significantly but still further studies are needed with a bigger sample size to determine and explain this association.
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Objective: To summarize and analyze the epidemiological and clinical characteristics of COVID-19 Omicron variant cases in makeshift hospital, and the influence of age, sex and vaccination status on the disease duration, so as to provide reference for the prevention and control of the COVID-19 epidemic. Methods: The epidemiological and clinical characteristics of COVID-19 cases admitted to makeshift hospital of National Convention and Exhibition Center (Shanghai) from April 9 to May 31, 2022 were retrospectively described and analyzed, and further cohort analysis was conducted to determine the influence of age, sex and vaccination status on the disease duration of COVID-19 cases in the author's branch hospital. Results: Among the 174 466 COVID-19 cases in makeshift hospital, most of them were male, accounting for 59.38%. The infected cases were mainly young and middle-aged people aged 18-59 years old, accounting for 83.50%, followed by 12.30% of the elderly group over 60 years old;the average hospital stay was 7.40 days;the proportion of patients with fever was less than 27.79%;15.37% (26 817/174 466) of the patients complicated with underlying diseases, and the top three were hypertension, diabetes and coronary heart disease. The proportion of people who received COVID-19 vaccine accounted for 79.56% (13 799/17 956), of which the highest proportion of three doses was 44.09%. The disease duration of 17 956 COVID-19 cases in the author's branch of makeshift hospital was 10.18 (7.34, 13.05) days. The disease duration in the elderly group was the longest with 11.34 (8.35, 14.37) days, followed by 11.17 (9.07, 14.33) days in the preschool group, 10.37 (8.14, 13.34) days in the middle-aged group, 10.07 (7.37, 12.37) days in the school-age group, and 9.34 (7.05, 12.16) days in the young group. There was significant difference in the overall distribution of disease duration among the five groups (H=550.479 P < 0.01). The disease duration in each age group basically showed a V-shaped distribution. The disease duration was 10.27 (7.34, 12.57) days in males and 10.10 (7.25, 13.09) days in females, and there was no significant difference (Z=-1.505 P > 0.05). The disease duration of vaccinated patients was 10.24 (7.35, 13.05) days, and that of unvaccinated patients was 9.47 (7.09, 12.47) days. There was significant difference between the two groups (Z=-4.338 P < 0.01). Conclusions: COVID-19 Omicron variant cases have a high proportion of males, mainly young and middle-aged, and the proportion of fever patients is less than 30%. The disease duration is significantly lower than that of the original strain in Wuhan, and shows "V" distribution with each age group. Sex had no effect on the disease duration. COVID-19 vaccination did not have a clinical effect on the disease duration.
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Objective To investigate the relationship between the body mass index (BMI) levels and the negative conversion time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid in adult coronavirus disease 2019 (COVID-19) patients and the asymptomatic persons. Methods Asymptomatic infected patients and confirmed COVID-19 patients admitted to Chengdu Public Health Clinic Center from February 2021 to November 2021 were dynamically included. The epidemiological and clinical characteristics of the objects were collected, and the SARS-CoV-2 nucleic acid testing of the objects during their hospitalization was continuously monitored, and the negative nucleic acid conversion time was recorded. The t test or Wilcoxon rank sum test, X 2 test or Fisher's exact probability method examine were used to distribute characteristics of each group of variables and the connection between different variables, respectively. Then the variables showed differences in distribution (P < 0.05) between different BMI groups were included in the multivariate Cox proportional risk regression model. Results A total of 253 subjects ranged from 18 to 63 years old, with M(P25, P75) age of 37.0 (30.0, 47.0) years old, were included in this study. The male to female ratio was 4.16 to 1. The BMI was (23.97+or-3.33) kg/m2. 50.59% (128/253) of the objects were overweight or obese, and 78.13% (100/128) were overweight. The negative time of SARS-CoV-2 nucleic acid conversion of all subjects ranged from 1 to 71 days, with M(P25, P75) of 7.0 (2.0, 18.0) days (P < 0.001). The negative time of SARS-CoV-2 nucleic acid conversion of the normal weight or the thin, and the overweight or obese were 5.00 (2.00, 19.00) and 8.00 (2.00, 17.75) days respectively. The results of multivariate Cox's proportional hazards regression model showed that the BMI levels may not be associated with the negative conversion time of SARS-CoV-2 nucleic acid (HR=1.090, 95%CI: 0.843-1.410, P=0.510). Conclusions Adult asymptomatic persons and confirmed COVID-19 patients are mainly middle-aged and young males, and overweight or obesity is relatively common. Overweight or obesity cannot be considered as an independent factor influencing the negative conversion time of SARS-CoV-2 nucleic acid.
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Background: Tocilizumab (TCZ) is a new therapeutic alternative for severe cases of COVID-19 pneumonia. Aim: To evaluate the cumulative incidence (CI) of suspected adverse drug reactions (ADR) from TCZ in adult patients with COVID-19. Material and methods: An active pharmacological surveillance protocol was carried out in patients older than 18 years old, who received at least one dose of TCZ between May and August 2020 at a clinical hospital. Non-infectious ADRs were categorized according to the Common Terminology Criteria for Adverse Events and the development of infection was classified as present or absent. Causality and preventability of ADRs were determined with the Naranjo Algorithm and the modified Schumock & Thornton criteria, respectively. Results: The CI of ADRs caused by TCZ was 69.6% (95% confidence intervals (CI): 63.5-76.6). A rise in alanine and aspartate aminotransferases and the development of infections were the most frequent adverse events. Seventy-four percent were considered mild in severity. Sixty two percent of suspected non-infectious ADRs were classified as probable and all the infectious events as Possible. Of the ADRs observed, 33% were preventable. Conclusions: The occurrence of ADRs after the use of TCZ is frequent, of mild severity, and in one third of the cases, preventable. We suggest monitoring blood count, liver function tests and ruling out infection prior to TCZ administration.