ABSTRACT
Patients on maintenance hemodialysis (MHD) are highly susceptible to SARS-CoV-2 and with high mortality rates due to Coronavirus disease 2019, mainly because of the older age in this group of patients, comorbidities, compromised immune status due to uremia, as well as inability to keep social isolation because of the necessity for regular physical presence in dialysis facility. Several retrospective studies of patients on MHD in Europe, America and Asia, show high susceptibility to SARS-CoV-2 in this group of patients with very high rates of critical course of the disease and high mortality rates, reaching more than 40% The aim of this retrospective observational study was to identify risk factors among patients on intermittent hemodialysis for infection with SARS-CoV-2 as well as predictors of severe COVID-19 and fatal outcome. Materials and methods. We analyzed 69 patients receiving intermittent dialysis in Aleksandrovska University Hospital - Hemodialysis Unit. 34 of them have been tested positive for SARS-CoV-2 in the period from September 2020 (when the first case of the disease was registered for our dialysis center) up to March 2022, and are compared with a control group of 35 dialysis-dependent patients without COVID-19. Data about comorbidities, main laboratory and radiologic findings, need of hospitalization and treatment in ICU, as well as data for conducted treatment, are collected from electronic medical records. To identify predictors of severe COVID and poor outcome we compared the group of survivors with the one of non-survivors. Results. There are no significant differences between patients on MHD with and without COVID-19 except higher frequency of COPD and hypoproteinemia in the positive group. Older age, female gender, history of smoking, lymphopenia with neutrophilia, treatment in ICU and need of mechanical ventilation, signs of malnutrition - hypoproteinemia and lower levels of serum creatinine, are risk factors for severe disease and fatal outcomes. Conclusions. The course of COVID infection in dialysis-dependent patients is severe and with high mortality rate, in line with other studies worldwide. Malnutrition is the main risk factor for COVID and also main predictor for poor outcomes.
ABSTRACT
Background: The severity of COVID-19 infection has an increasing trend in the elderly, which contributes to the high morbidity and mortality rates in this population. Aging itself is a prominent risk factor for severe disease and death from COVID-19. Case Description: This case report a 71-year-old woman who complained of shortness of breath for 3 days before being admitted to the hospital. Bilateral consolidation and increased bronchovascular pattern were found on chest radiograph, and a positive SARS-COV2 nasopharyngeal swab PCR test result was noted. This patient was diagnosed with confirmed severe manifestation of COVID-19, community-acquired pneumonia and type 1 respiratory failure, as well as type II diabetes mellitus and suspicion of acute gastritis. The results of the geriatric status assessment were moderate functional status, risk of malnutrition, and moderate risk of deep vein thrombosis (DVT). This patient underwent treatment in accordance with the COVID-19 protocol along with management for geriatric status improvement. The patient was given permission to return home after 14 days of treatment, during which time her health had improved and her functional status had changed to moderate dependency. During follow-up, the patient continued to receive therapy. She is still being observed and future evaluations will be conducted. Conclusion: The increased susceptibility of the elderly to COVID-19 infection is caused by various factors. A burden of death and long-term disability brought on by this pandemic may be lessened by new or modified therapies that target aging-associated mechanisms. Therefore, COVID-19 case management in this population should be done with a comprehensive approach.
ABSTRACT
The COVID-19 outbreak which started in 2019 in China, turned out to be a deadly, infectious worldwide pandemic, caused by the SARS-CoV-2. COVID-19 affects the respiratory system, symptoms including cough, fever and shortness of breath. Upon infection, there is an uncontrolled release of pro-inflammatory cytokines, leading to acute respiratory distress syndrome, and even death. The shutdown of economies during the outbreak made acquisition of nutritious foods difficult, exposing the world to malnutrition. This was worse in underdeveloped countries where there is poor hygiene and poor healthcare systems. A good and balanced nutrition strengthens the immune system, with fruits and vegetables enhancing the anti-inflammatory responses and regulating chronic diseases which are risk factors for COVID-19. In Cameroon, decoctions against COVID-19 made from medicinal plants and foods were widely used. This included 'star yellow', a sauce formulated and used for its role in the control of the transmission of SARSCOV-2. Star yellow contains a combination of palm oil and limestone, which exposes viral RNA to zinc attacks. It also possesses anti-viral and antioxidant properties which inactivates the viral particles in the gut thus stopping the possible transmission of the SARSCOV-2 virus via faeces.
ABSTRACT
Introduction: The diagnosis of malnutrition has had a difficult historical process and its concept has gone through numerous attempts to define it. The word undernourishment and especially the term malnutrition creates a lot of confusion among scholars of the subject. In the last decade, various consensuses have emerged to classify malnutrition associated with diseases together with the burden represented by overweight and obesity in the presence of chronic and acute diseases. Background: To identify how new technologies improve knowledge of nutritional disorders through the description and integration of their body compartments, but they are not available to health teams or patients in various work settings. Findings: Nutrition is a science made up of a set of scientific disciplines that range from exact sciences to political sciences. The application of the clinical method as a modality of the scientific method makes it necessary to consider nutrition also with this vision and not as the last option of the doctor in a diagnostic or therapeutic intervention, contaminated by myths, taboos and cultural prejudices. Clinical medicine provides hard skills acquired in the form of knowledge and skills throughout pre-professional and postgraduate training, which together with soft skills will guarantee successful work, including hostile, toxic and/or chaotic cultural environments. Conclusions: There are tendencies to follow patterns and guides of societies in countries with great financial and technological resources for research, which are not always in line with our realities. The appearance of the COVID-19 pandemic has posed new challenges and serious threats to both people and health systems globally, significantly affecting elderly patients, those with cancer and chronic diseases, along with the shock of the COVID-19 pandemic, obesity with that of the Coronavirus.
ABSTRACT
The ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an emerging and rapidly evolving situation. Older people represent a uniquely vulnerable group during any infectious disease outbreaks due to their altered physiology, increased susceptibility to infections, presence of comorbidities, malnutrition, and compromised immunological and mechanical functions. The clinical symptoms, laboratory, and imaging features of SARS-CoV-2 are similar to younger adults but rapid disease progression, a high proportion of severe to critical cases, and a high fatality rate are more observed in the older people. To date, no targeted therapy is available for SARS-CoV-2, many drugs are still being tested for efficacy and safety due to the novelty of the virus and little knowledge about it among the older people. In this article, we summarize the clinical, laboratory, radiological features, and clinical outcomes of SARS-CoV-2 infection in the older people and present the predictive factors associated with fatal clinical outcomes among them.
ABSTRACT
In order to address many of the world's most pressing issues, such as hunger and malnutrition, poverty, climate change, and disease, such as the coronavirus pandemic, it is crucial to comprehend population patterns. For decision-makers in politics, industry, science, and other fields looking to make well-informed choices on crucial problems, population data are a crucial resource. This bulletin offers a fundamental understanding of demography and demographic processes, such as fertility, mortality, and migration, as well as their effects on the global population. This freshly revised edition of "Population: A Lively Introduction," which was first released in 1991, helps readers better grasp why current population patterns are important, not only to academics and researchers, but to all of us.
ABSTRACT
This study describes the journey of the SMCH in its quest to improve the quality of care for wasted children by becoming a National Centre of Excellence for wasting management. Results showed that during the first year of operation of the Malnutrition Unit, the mortality of patients admitted with complicated wasting dropped from 45.7% to 14.2% and is now comparable to similar units in neighbouring countries. Improvements in patient data collection allow for the identification of areas for future research with several topics already identified such as patterns of infections and their sensitivities in the admitted patients and barriers to seeking medical help, amongst others. Data collection at the Malnutrition Unit also allowed for the identification of referral hotspots, highlighting the areas in Harare and surrounding areas with a high burden of wasting in the community such as Epworth and Hopley. This supports planning for further interventions for the improvement of wasting management in both inpatient and outpatient settings as well as strengthening the links between them. There is therefore a clear need to scale up the screening and active prevention of wasting in this vulnerable group of patients. According to the Malnutrition Unit data, human immunodeficiency virus infection also represents a significant burden in admitted patients and currently stands at just over 10%. This figure is likely to rise as they see the long-term effects of the COVID-19 pandemic on the routine health care programmes in the country.
ABSTRACT
Introduction: Temporary disability due to COVID-19 was expressly regulated, through various rules and instructions, covering both isolation by contact, by infection or for sensitive workers. It involved the integration of preventive labor protection covered by its protection in a financial benefit with the highest amount. Analyzing the consequences of the pandemic in the first wave, confinement, de-escalation and return to normality, months from March to October, the ..collapsing.. impact of COVID-19 on the health system led to the paralysis and increase of waiting lists for tests, operations and non-urgent consultations of the rest of pathologies, and consequently a high increase in the average duration of sick leave for all processes, in confinement and de-escalation in 84.48% and in 25.27% the prolonged casualties that reached more than 365 days. Consequently, COVID-19 as a collateral effect led to a poor evolution of the rest of the processes, prolonging the duration of temporary disabilities, which implies a worsening of occupational health, a greater risk of not returning to work that occurs during sick leave long, higher risk of unemployment, higher spending on benefits and economic decline for companies and the self-employed. Temporary disability due to COVID-19 accounted for 38.73% of all casualties at the end of October 2020. Conclusions: The pandemic forced to prioritize resources around COVID-19, collapsing the care of the rest of pathologies, except for emergencies or vital treatments. This meant an increase in waiting lists for non-urgent consultations, tests or surgical interventions, as well as the cancellation or postponement of consultations or treatments and therefore an increase in the longer duration of sick leave and also the worsening of occupational health, consequently, by not being able to have treatment in a timely manner. In confinement and de-escalation, the average duration of casualties increased by 84.48%;by processes, the increase was 503.58% in respiratory diseases, 215.88%, in infectious diseases, 60.73% in endocrine diseases, 45;42% of blood diseases, 45 09% for digestive diseases, 35.63% for osteomyoarticular disorders, 34.12% for neoplasms, 33.37% for circulatory diseases, 31.94% for ..procedures.., and 29.56% of mental disorders. Long-term sick leave (PIT) that reached 365 days increased by 25.27%, compared to the month of October of the previous year. Prolonged sick leave due to endocrine and nutritional diseases increased by 28.50, from mental disorders by 28.20%, from musculoskeletal disorders by 26.70, from neoplasms by 26.49%, from respiratory diseases in 24.27%, for diseases of the nervous system in 22.79%, for cardiovascular diseases in 20.48%, and for digestive diseases in 19.24%. As a consequence of COVID-19, the working population was exposed to an added and new risk;health and social health workers suffered the disease as a direct consequence of their work due to illness of an undoubted professional nature. The effects of COVID-19 on the delay of tests, surgeries or treatments in ..No COVID-19.. processes and the difficulties of contact with care worsened occupational health, prolonging disability situations and increasing the risk of prolonged non-COVID-19 disabilities, return to work due to the expected poor evolution of any process when it cannot be treated and attended to early.