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This study aimed to find out the level of stress and coping methods among elderly in Sulaimanya city during the pandemic COVID-19. Through the snowballing sampling method, 394 elders were included to this study. After validation, two scales were used in this study;stress subscale from Depression, Anxiety and Stress Scale (DASS-21) and a culture-bound scale for determining coping methods. The results of this study showed that participants experienced a mild level of stress. Male participants, elders who live with their family, unvaccinated elders, physically passive elders have had higher stress level than female, elderly home, vaccinated, physical active elders. The findings also indicated that spiritual connection was the most common coping method used by the sample. Results of this study are the first and foremost way to share elder's unexpressed messages;it also can be a way for verbalizing their unspoken feelings. These results may also inform the elder's caregivers that elder's stress level and illness anxiety was not very high, strengthening their social support and spiritual connection may help them to reduce their distress into a lesser degree.
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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.
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Background: This study investigated the association of frequency of going out with physical activity, low back pain, and loneliness among urban Japanese community-dwelling older adults affected by the coronavirus disease 2019 pandemic. Methods: This cross-sectional study recruited older adults aged 65 and over residing in apartment buildings in an urban area of Japan as participants. The questionnaire comprised items on participants' frequency of going out, musculoskeletal pain, physical activity, mobility, loneliness, and sociodemographic characteristics. Multiple logistic regression analysis was performed to explore the associations of decreased frequency of going out (less than once a week) during the pandemic with musculoskeletal pain, physical activity, and loneliness after controlling for age, sex, living alone, comorbidity, and social activity as confounding factors. Results: This study analyzed 236 older adults (mean age: 75.5 years;females 54.2%) whowent out more than two to three days a week before the pandemic. Participants who went out less than once a week during the pandemic (14%) had more arthritis than those who went out more. They also had a higher prevalence of reduced physical activity, low back pain, gait disability, and loneliness. Additionally, decreased frequency of going out was associated with lower physical activity [adjusted odds ratio (OR) = 3.91, 95% confidence interval (CI): 1.78-8.61], low back pain (OR = 2.79, 95% CI: 1.08-7.24), and loneliness (OR = 1.50, 95% CI: 1.14-1.98). Conclusions: This study indicated that reduced physical activity, loneliness, and low back pain are associated with a decreased frequency of going out during the pandemic among older adults.
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Background: The COVID-19 pandemic has had a significant impact on the mental health of older people. One concern is the exposure to a lot of pandemic-related information without any evidence-based background through the media and social networks. This study aimed to examine the effect of exposure to such information on the mental health of older people. Methods: The study is a cross-sectional correlational study. Sampling was focused on selecting older people through a systematic sample according to a random starting point and with a fixed, periodic interval, between late 2020 and early 2021, with a total of 200 participants age above 60 considered as older people. Results: We found that a significant percentage of older people had a high level of clinical symptoms/distress, according to the General Health Questionnaire (GHQ) scales. These results show that being exposed COVID-19 information from the media during the pandemic is a risk predictor for mental health/distress, GHQ-28 scores, (OR ExpB = 2.11, p =0.001). Similar results were found for Media Info (OR ExpB = 1.37, p =0.008). For each point increase in media information, the risk for general mental health problems increases 1.37 times. Conclusion: Through the results it was clear that older people are at risk of mental health problems, and being exposed to the infodemic increased this risk significantly, as well as being exposed to media where elevated risk of death from SARS-CoV-2 for older people was reported.
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The physical and mental health of older adults is a critical issue that is often overlooked. With the recent increase in the number of people infected with the new variants of coronavirus, we are facing several problems, including a dearth of high-quality medical care. iAssist aims to be a platform that primarily focuses on the social benefit of promptly delivering medical aid to the elderly in our nation. It enables a variety of functions, such as doctor appointments, medicine orders, and lab appointments under one roof, with the goal of assisting caregivers, such as family members and healthcare professionals. Additionally, it offers a chatbot component that uses a social media messaging service, to inform users of new developments and assist in swiftly answering user questions. The technology stack used in iAssist makes the platform efficient and user-friendly for everyone involved. © 2022 IEEE.
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Deaths from COVID-19 are increasing in patients with comorbidities. One of the most common comorbidities is diabetes mellitus. The researchers wanted to see how having diabetes affected the mortality rate of COVID-19 participants. This investigation is a case control observational analytical study. Different types of people, called "cases", and "controls", complete the research sample. Each group had 68 responders, for a grand total of 136. Medical records from COVID-19 patients treated at Airlangga University Hospital, Surabaya, between March 2020 and September 2021 serve as the study's secondary data source. The purpose of this study's data analysis is to calculate an odds ratio. Patients with COVID-19 with concomitant diabetes mellitus had an increased risk of death, and this risk increased with age, gender, and COVID-19 symptoms. In contrast, education, occupation, and laboratory results were not significantly related to mortality among COVID-19 individuals with concomitant diabetes mellitus (GDA status). The results of this study show that COVID-19 patients with concomitant diabetes mellitus are at a higher risk of death if they are over the age of 65, if they are male, and if they have severe symptoms.
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The world is facing a serious viral infection caused by the new Severe Acute Respiratory Syndrome Coronavirus 2. We aimed to evaluate and map the high-risk clusters of COVID-19 in the State of Alagoas, a touristic area in northeastern Brazil, after two years of pandemic by a population-based ecological study, using COVID-19 cases reported in the State of Alagoas, between March, 2020 and April, 2022. We performed a descriptive and statistical analysis of epidemiological data. We then map high-risk areas for COVID-19, using spatial analysis, considering the incidence rate by municipality. 297,972 positive cases were registered;56.9% were female and 42.7% aged between 20 and 39 years old. Men (OR = 1.59) and older than 60 years old (OR = 29.64) had a higher risk of death, while the highest incidence rates of the disease occurred in the metropolitan region. Our data demonstrate the impact of COVID-19 in the State of Alagoas, through the two years of pandemic. Although the number of cases were greater among women and young adults, the chance of death was greater among men and older adults. High-risk clusters of the disease initially occur in metropolitan cities and tourist areas.
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Objective: To analyze the epidemic characteristics of coronavirus disease 2019 (COVID-19) cases aged 60 years or older during the outbreak epidemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant in Sanya City, Hainan Province, August-September 2022, and to provide scientific and effective basis for formulating strategies for the prevention and treatment of COVID-19 in the elderly in the future. Methods: The data of 1 785 COVID-19 cases aged 60 years reported from August 1 to September 8, 2022 in Sanya City, and 537 local COVID-19 inpatients aged 60 years treated in Sanya Central Hospital were collected and analyzed using WPS Office 2018 software for data cleaning, database assistance, and drawing, and SPSS 22.0 software was used to statistically describe and analyze the counting data. Results: A total of 1 785 local COVID-19 cases aged 60 years were reported in China's Disease Prevention and Control Information System, including 1 509 confirmed cases (84.54%) and 276 asymptomatic cases (15.46%). Of the confirmed cases, 1 448 were mild cases (95.96%), 40 were common cases (2.65%), 10 were severe cases (0.66%), and 11 were critical cases (0.73%), and no deaths were reported. The ratio of male to female was 0.88:1. The youngest was 60 years old, the oldest age was 107 years old, with a median age of 67 years old. Most of them (1 559 cases, 87.34%) were non-social employed personnel. Among them, 952 (53.33%) were from Tianya District and 733 (41.06%) from Jiyang District. Among the 537 COVID-19 elderly infected patients hospitalized in Sanya Central Hospital, infected patients with underlying diseases accounted for 287 (53.45%) cases of hypertension, diabetes and other types of basic diseases (chronic kidney disease, hyperlipidemia, chronic gastritis, gastric ulcer, etc.), and there were serious infections. Conclusions: Most of the elderly infected with Omicron variants were mild cases with few symptoms, but the elderly infected with Omicron variants were difficult to recover or even worsen the condition due to old age and underlying diseases. Therefore, by analyzing the various aspects of elderly infected cases, scientific and effective basis can be provided to prevent and control the epidemic situation in the future, and reduce the occurrence of severe, critical and death cases of COVID-19 in the elderly.
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Objective: Coronavirus disease-2019 (COVID-19) is a newly emerging infectious disease that has become a global pandemic. This study aimed to identify the risk factors at presentation to predict intensive care unit (ICU) admissions. Materials & Methods: This retrospective observational study recruited 188 confirmed laboratory COVID-19 patients who were hospitalized in Jidhafs Maternity Hospital (JMH) from 1st June to 5th July 2020. Univariate and multivariate analyses were used to Explore risk factors associated with the increased risk of ICU admission. Results: The study revealed that older age (>60 years old) (16[38.1%], P=0.044), male gender (30 [40.0%], P=0.000) were significantly associated with the increased risk of ICU admissions. The most prevalent symptoms in admission were myalgia (13[40.6%], P=0.035), fever (39[34.2%], P=0.002) and cough (37[31.4%], P=0.032). In addition, raised serum level of alanine amino-transferase (ALAT) (34.7% vs. 20.7%, P=0.033), D-dimers (30.7% vs 12.2%, P=0.012), lactate dehydrogenase (LDH) (31.6% vs 0.0%, P=0.025) and ferritin (37.7% vs 16.7%, P=0.011) found to be important predictor of ICU admission. Conclusion: The finding indicates that older age, male gender, with increased alanine transferase (ALT), increased lactate dehydrogenase (LDH), high D-dimer and high ferritin was associated with an increased risk of ICU admissions. Identification of such factors will help to detect people who are more likely to develop severe COVID-19 disease and will help physicians to determine if patients need regular health care or ICU admission.
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Introduction: Coronavirus infection is a disease that causes respiratory failure and complications in certain groups of people, leading to death. The factors associated with the severe course of COVID-19 have been fairly well studied by now;at the present stage, it is necessary to search for and study them in separate groups of people that differ in age, gender, ethnicity, the presence of background diseases, etc. to develop more personalized approaches to severe disease prevention. Background: To conduct a comparative analysis of the factors associated with the severe course of COVID-19 in people under and over 60 years of age and evaluate their prognostic significance in combination of factors. Materials and methods: A retrospective analysis of the clinical and laboratory parameters of 812 COVID-19 patients was carried out. Multiple logistic regression analysis was used to identify factors associated with the development of severe COVID-19. ROC analysis was performed to assess the prognostic significance of the set of identified statistically significant factors in the development of a severe course of COVID-19. Results: Multivariate logistic regression analysis showed that patients under 60 diabetes mellitus (OR=2,561, p=0,048), lymphopenia (OR=2,133, p=0,030), and pneumonia at admission (OR=2,556, p=0,011), rapid breathing (OR=3,497, p=0,001), low saturation (OR=4,076, p=0,006) were significantly associated with the development of severe COVID-19. At the same time, in patients older than 60 years, the presence of diabetes mellitus (OR=1,899, p=0,029), rapid breathing (OR=2,338, p=0,007) and low saturation (OR=4,248, p < 0,0001) were significantly associated with the development of a severe course of COVID-19. In groups under 60 and over 60 years of age, the prognostic value of the combination of all statistically significant factors corresponding to the groups was equal to the average level (AUC=0,760 and AUC=0,709, respectively) Conclusion: Factors associated with the development of a severe course of COVID-19 in elderly and middle-aged people have some differences related to the pathogenesis of the disease. For individuals under 60 years of age, factors associated with severe COVID-19 are diabetes mellitus, the presence of pneumonia on admission, dyspnea, low oxygen saturation, and lymphopenia. For individuals over 60 years of age, factors associated with severe COVID-19 are the presence of diabetes mellitus, shortness of breath, and low saturation. The combination of all the studied factors significantly increases the risk of developing a severe course of COVID-19 in both age groups.
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Introduction: Coronavirus infection (COVID-19), first reported at the end of 2019, which has spilled over into a worldwide pandemic and has affected all aspects of our modern lives. The aim is to study and analyze the epidemiological features of COVID-19 in the Pavlodar region. Materials and methods: Study design is a descriptive retrospective study analysis. The data were obtained from official sources of the Republican Center for e-Health of the Ministry of Health of the Republic of Kazakhstan. The study includes patients from June 30, 2020 to October 31, 2021 who received outpatient and inpatient treatment for coronavirus infection in medical institutions of the Pavlodar region. Study materials - uploading reports from the Republican Center for e-Health of the Ministry of Health of the Republic of Kazakhstan. Results: This article presents epidemiological data on the incidence of coronavirus infection in the population of Pavlodar region. The number of detected cases of COVID-19 from June 30, 2020 to October 31, 2021 was 29,443. Distribution of patients by sex predominated women - 17,831 (60.56%), than men - 11,612 (39.44%). The majority of cases were in the age group from 61 to 70 years old, with a male to female ratio of 1:1.54. Statistical significance was found between duration of stay and type of inpatient care (p < 0.001, VS-MPR*=2.135 x 10+22). Conclusion: The study showed that the number of women who fell ill prevailed over the number of men who fell ill, although the number of deaths among men prevailed over the number of deaths among women. In the study, there was no significant difference in the duration of stay for men and women in home care, compared to patients under 24-hour observation.
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ObjectiveTo assess the effects of countermeasures against coronavirus disease 2019 (COVID-19) in Shanghai from March to May 2022 in comparison with epidemiological trend of COVID-19 in New York City. MethodsDaily confirmed cases, asymptomatic SARS-CoV-2 carriers, and daily deaths were obtained in the Shanghai Municipal Health Commission and the Center for Disease Control and Prevention (CDC) of the United States. Descriptive study was conducted by using these data. ResultsFrom March 1 to May 17, the number of daily asymptomatic SARS-CoV-2 infections in Shanghai was up to 58 times as large as that of daily confirmed cases;however, the number of daily confirmed cases in Shanghai was generally less than that in New York in the same time period. At the peak of the COVID-19 epidemic, the growth of daily attack rate in Shanghai was significantly lower than that in New York (P < 0.05). Moreover, the number of daily death was evidently less than that in New York. In addition, the vaccination rate in the elderly (aged 60 years) in Shanghai was evidently lower than that in New York (aged 65 years). ConclusionThe COVID-19 epidemics in Shanghai from March to May 2022 and in New York after December 2021 were both caused by the Omicron variant. Compared with the Delta variant, the Omicron variant has stronger replication ability and infectivity, resulting in challenges to the containment of the epidemic in metropolis such as Shanghai and New York City. The epidemic in New York City remained crucial due to absence of effective countermeasures, while that in Shanghai has been effectively contained with strict countermeasures. The prevention and control strategies may be adjusted along with the continual evolution of SARS-CoV-2 and increasing trend of imported COVID-19 cases.
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In this paper we compared brand-specific COVID-19 vaccine effectiveness (VE) during August 2021 in persons born 1962-1971 and vaccinated during June. For SARS-CoV-2 symptomatic infection, protection was lower for Janssen (56%;CI95%: 53-59) or AstraZeneca [Vaxzevria] (68%;CI95%: 65-70), compared to Pfizer-BioNTech [Comirnaty] (78%;CI95%: 77-78), AstraZeneca/Pfizer (86%;CI95%: 80-90) or Moderna [Spikevax] (89%;CI95%: 88-90). VE against hospitalization was ranged 86% for Janssen to 97%-98% for other vaccines.
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We compared brand-specific vaccine effectiveness during August 2021 in people born between 1962 and 1971, vaccinated during June. For symptomatic infection, protection was lower for Janssen (56%;53-59) or Astra Zeneca (68%;65-70), compared to Pfizer (78%;77- 78), AZ/Pfizer (86%;80-90) or Moderna (89%;88-90). VE against hospitalization ranged 86% for Janssen to 97-98% for other vaccines.
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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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Background: SARS-CoV-2 affects all age groups, but higher mortality rates are recorded in older people, men and with comorbidities, mainly hypertension, diabetes and obesity. Aim: To describe the main clinical characteristics, evolution and prognostic factors for death in older patients hospitalized for COVID-19. Materials and methods: Retrospective analysis of 128 Patients aged 73 years, 66% men, hospitalized at a clinical hospital, with a diagnosis of COVID-19, admitted from May 1 to August 1, 2020. Data were collected from the clinical records, a description of the study population was made, and a univariate analysis and logistic regression were performed. Results: Seventy-two percent of patients had two or more comorbidities, mainly arterial hypertension in 66%, diabetes mellitus in 34% and cardiovascular disease in 19%. Forty-one percent were admitted to intensive care and 31% were connected to mechanical ventilation. In-hospital mortality was 26.6%. A multivariate analysis was performed in two blocks, finding in the first that arterial hypertension and older age significantly predict mortality. However, when previous institutionalization and immunosuppression were included as variables in the second block, age ceased to be a significant predictor. Conclusions: Prognostic factors associated with death in this age group are arterial hypertension and previous institutionalization.
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Objective: Nowadays community immunity is trying to be achieved through vaccination. If the threshold value can be exceeded, COVID-19 may also be one of the seasonal infections with annual epidemics like influenza. The current study intends to understand how the most common underlying comorbidities affect the intensive care unit (ICU) and mechanical ventilation (MV) requirements and mortality of COVID-19. Materials and Methods: Main demographic data, laboratory, and radiological findings were obtained retrospectively from medical records of 152 patients diagnosed with COVID-19. Comorbidities were ensured from the prescription information system. Effect of all data on ICU and MV requirements and mortality were analyzed with Student's t-test, Mann-Whitney-U, or Chi-square tests. Length of hospital stay was evaluated according to univariate analyzes. Results: Out of 152 patients, 72 were men. The median age was 56.5 years. The median length of hospital stay was 7 days. The case fatality rate was 5.9%. Elderly ages, clinical symptoms during admission, and laboratory values increased the risk of ICU, MV and mortality significantly (p < 0.05). At least one or more comorbidities were present in nearly half of the patients. The most prevalent comorbidities were hypertension, diabetes, and cardiovascular diseases, respectively. Especially diabetes was significantly associated with poor prognosis (p < 0.05). Conclusion: COVID-19 patients with any comorbidity yielded poorer clinical outcomes. Awareness of comorbidities, trying to cure them, and striving for maintaining a high personal health status seems to prevent the bad prognosis of the COVID-19.
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Introduction: Considering that the new corona virus (COVID -19) is still prevalent, one of the important concerns is the variables affecting the severity of the corona disease in the health of society. In this study, the CART algorithm was fitted to predict and determine the status of patients infected with COVID-19 in Mashhad University of Medical Sciences. Methods: This paper is a cross sectional-analytical study. Datasets were obtained from all of the people referred for the disease of COVID -19 collected at the Sinai system during the second peak and the fourth peak of the disease in Mashhad University of Medical Sciences. Data analysis was performed using JMP statistical software version 13. Then for modeling, data mining methods and CART algorithm are used. Results: The descriptive findings of our study showed that 6% of patients with positive PCR suffer from severe disease of COVID-19. The age variable was very important in the severity of the disease. The age of 60 years old is the cut-off point for the severity of the disease, which increases COVID-19 severe from about 3% under the age of 60 to about 18% over the age of 60. The diseases of heart, kidney, respiratory, blood fat, and diabetes were other important variables. Conclusion: The results of the CART model showed that for the age under 60 years the variables of heart disease, age, diabetes, respiratory disease, fat, gender, and kidney, and for the age over 60 years the variables of age, heart disease, kidney, respiratory and diabetes were respectively the most critical risk factors. According to the ROC curve, the fitted model has a good performance for COVID-19 severe disease, so it increases up to 6 times the prediction of the COVID-19 severe disease.
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Introduction: COVID-19 infection caused by the SARS COV-2 virus is one of the largest pandemics and has affected every nation worldwide. The introduction of different vaccines against COVID-19 infection has bought new hope in the fight against COVID-19, which would decrease the ongoing crisis. These vaccines were approved for emergency purposes, which had fewer clinical trials involving elderly populations. Hence, this study intends to know the safety profile of the COVID-19 vaccine in the elderly population. Methods: In a cross-sectional study, we have collected data regarding the onset of symptoms within 72 hrs following first dose of COVID-19 Vaccination among elderly people through a direct interview and by phone call, using a questionnaire. Results: Among 1373 elderly, 445 (32.41%) had no symptoms, while the remaining 928 (67.54%) had developed symptoms. The commonest symptoms were fever 738 (53.75%), pain at local site 536 (39.01%), and body ache 382 (27.82%). All these symptoms were relieved by taking Paracetamol 650 mg tablet provided by the vaccination center. The commonest co-morbidities observed were hypertension, diabetes, and ischemic heart disease. There was no mortality. Conclusion: So far, very few studies have been conducted on the elderly population. Our study has an advantage where it has involved a large number of elderly populations. The majority of the elderly in our study received covishield vaccine. We conclude covishield and covaxin vaccines had minor side effects which were self-limiting and can be considered safe in the elderly population despite having multiple co-morbidities. This study endorses that vaccines are safe in the elderly population irrespective of co-morbidities and increasing age.
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Introduction: COVID-19 vaccines stimulate immune processes that allow SARS-CoV-2, which affected a large part of the population, to be mitigated. The research on the adverse reactions presented by the COVID-19 vaccines must be continuous, since at present there is not enough information on their consequences. Background: to determine the possible adverse reactions in young and older adults belonging to the Recinto Umpechico, inoculated against SARS-CoV-2 in Santo Domingo, during 2021. Method: a descriptive study was carried out in a population of 600 residents of said locality, inoculated against SARS-CoV-2. Non-probability convenience sampling was used, with a sample of 235 inhabitants. The study variables were: adverse reactions to COVID-19 vaccines, name of the vaccine received, number of doses, intensity and duration of symptoms, medications used to mitigate said adverse reactions. Results: 31.5% of the respondents who presented symptoms were male. The most common vaccine was Pfizer with 47.65%, with a percentage of symptoms of 29.36%. The most common adverse reaction was arm pain with 31.98%, lasting two to three days, equivalent to 48.96%;62.65% used paracetamol and 20.5% used cold water baths to reduce symptoms. Conclusions: the vaccines manufactured by the different pharmaceutical companies cause adverse reactions that range from mild to severe, manifesting at any age and for a short or long term, which in most cases are easily treated with pharmacological and non-pharmacological medications.