Pandemic techno-politics in the global South

Brazil has been standing out as one of the worst places on Earth to be during a global health crisis, especially for those whose struggle for basic humanitarian rights is already routine. How do the political environment and historical inequalities in countries like Brazil affect the ways in which public policy and technologies are framed as responses for the pandemic crisis? In this paper we aim to present the sequence of actions and omissions in the fight against sars-cov2 in Brazil, concentrating on measures based on the use of digital technologies and the sociotechnical arrangements unfolding in materialities that give shape to such measures. We will also discuss possible repercussions of the widespread adoption of surveillance technologies as a quick fix to the effects of the pandemic. Our focus is to explain how the materiality of the virus and its political as well as territorial effects are combined with digital technologies as responses (or lack of them) in the fields of healthcare, education, communication and labour in the context of the global South. [ FROM AUTHOR] Copyright of Information Polity: The International Journal of Government & Democracy in the Information Age is the property of IOS Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Does Cardiac Arrhythmia Predict Worse Outcome in Mild or Moderate Covid-19 Infection?

Covid-19 is a multisystem disease with the lungs being predominantly affected. Cardiac involvement is mostly seen as a rise in troponins, arrhythmias, and ventricular dysfunction. This study aimed to estimate the incidence of arrhythmias seen in Covid-19 infection and assess if arrhythmias predict worsening or mortality. Prospective observational study involving patients with mild to moderate Covid illness admitted in a tertiary care centre. Among the 85 patients (Mean age 45.8 + 14.1 years; 75.31% men), worsening of Covid-19 illness was seen in 29 (34.1%) patients. New onset arrhythmias were detected on Holter in 9 (10.5%) patients. Supraventricular tachycardia was seen in 7 (8.2%) patients of whom 6 showed worsening which was statistically significant (p-value-0.006). Risk factors associated with worsening on univariate analysis were male gender (OR [95%CI] = 6.93(1.49-32.31), p-value - 0.014), new onset supraventricular tachycardia (OR [95% CI] = 14.35 [1.64-125.94], p-value - 0.016) and D-dimer elevation (OR [95% CI] = 1.00(1.00-1.01), p-value - 0.02). On multivariate analysis D-dimer (OR [95% CI] = 1.00(1.00-1.01; p-value 0.046) and supraventricular arrhythmias (OR [95% CI] = 11.12 (1.22-101.14); p-value - 0.033) were independently associated with worsening. Covid-19 infection can lead to cardiac arrhythmias. The development of supraventricular tachycardia in patients with Covid-19 infection predicts higher morbidity and worsening.

Serological response to COVID-19 pneumonia and increasing severity over 18 months in a prospective cohort of hospitalized patients.

In this study, we present an 18-month serological follow-up of 294 patients with COVID-19 pneumonia. The aim was to assess the dynamics of serological response and its correlation with clinical worsening, as well as to describe clinical worsening determinants. Results of the study showed an early immunoglobulin M response, which clearly diminished starting at 4 months, but nonetheless, a small group of patients remained positive. As for immunoglobulin G, levels were higher up to 6 months in patients who presented clinical worsening during hospitalization. High titers of the immunoglobulin were maintained in all patients during follow-up, which would indicate that humoral immunity due to infection is long-lasting. Male sex, presence of myalgias and extensive radiological affectation were significantly correlated with clinical worsening.

Association Between the Development of Thrombosis and Worsening of Disease Severity in Patients With Moderate COVID-19 on Admission　- From the CLOT-COVID Study.

BACKGROUND: The worsening of coronavirus disease 2019 (COVID-19) severity is a critical issue in current clinical settings and may be associated with the development of thrombosis.Methods and Results: This study used patient data obtained in the CLOT-COVID study, a retrospective multicenter cohort study. The demographics of patients with moderate COVID-19 on admission with and without worsened severity during hospitalization were compared and predictors were identified. Of 927 patients with moderate COVID-19 on admission, 182 (19.6%) had worsened severity during hospitalization. Patients with worsening of severity were older, more likely to have hypertension, diabetes, heart disease, and active cancer, and more likely to use pharmacological thromboprophylaxis. Patients with worsening of severity had higher D-dimer levels on admission and were more likely to develop thrombosis and major bleeding during hospitalization than those without worsening. Increased age (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01-1.03, P=0.005), diabetes (OR: 1.63, 95% CI: 1.11-2.33, P=0.012), D-dimer levels >1.0 µg/mL on admission (OR: 2.10, 95% CI: 1.45-3.03, P<0.001), and thrombosis (OR: 6.28, 95% CI: 2.72-14.53, P<0.001) were independently associated with worsening of COVID-19 severity. CONCLUSIONS: Approximately 20% of patients with moderate COVID-19 had worsened severity during hospitalization. Increased age, diabetes, D-dimer levels >1.0 µg/mL on admission, and the development of thrombosis during hospitalization were significantly associated with worsened COVID-19 severity.

COVID-19 vaccination hesitancy and safety among adult people with epilepsy in eastern China.

OBJECTIVE: This study assesses the hesitancy and safety of vaccination administration for the novel 2019 Coronavirus Disease (COVID-19) among adult people with epilepsy (PWE). METHODS: We recruited adult PWE who visited the outpatient epilepsy clinic from August 2021 to February 2022. We administered a structured questionnaire and a face-to-face interview regarding demographic factors, epilepsy characteristics, and relevant vaccine issues to all patients. Factors related to receiving a vaccine and epilepsy-related events after vaccination were then analyzed. RESULTS: A total of 501 PWE were surveyed; 288 were unvaccinated and 213 were vaccinated. Patients without jobs (OR: 0.59; 95% CI: 0.37-0.95, p = 0.03) were less likely to receive the vaccine compared to students or those with jobs. Other factors associated with vaccination were a higher number of anti-seizure medications (OR: 0.72; 95% CI: 0.55-0.95, p = 0.02) and a lower pre-vaccine seizure frequency (OR: 2.21; 95% CI: 1.06-4.59, p = 0.03). Of the 213 vaccinated patients, 10 (4.70%) reported at least one local and/or systemic side effect. Most patients (92.50%) did not report worse seizures within one month of vaccination. Poor ASM adherence (OR: 15.06; 95% CI: 1.75-129.87, p = 0.01) and fatigue/stimulant drinks such as caffeine (OR: 50.59; 95% CI: 7.57-337.94, p < 0.01) were significantly associated with seizure worsening within one month of receiving the COVID-19 vaccination. CONCLUSION: Almost two-fifths of patients with adult PWE have received a COVID-19 vaccine. Attention should be paid to educating epilepsy patients without jobs on the significance and safety of the vaccine. There was a low risk of seizure worsening in the short term after vaccination in PWE.

Conventional and Kampo Medicine Treatment for Mild-to-moderate COVID-19: A Multicenter, Retrospective, Observational Study by the Integrative Management in Japan for Epidemic Disease (IMJEDI study-Observation).

Objective Patients in whom coronavirus disease 2019 (COVID-19) was suspected or confirmed between January 1, 2020, and October 31, 2021, were enrolled from Japanese hospitals in this multicenter, retrospective, observational study. Methods Data on the treatment administered (including conventional and Kampo medicine) and changes in common cold-like symptoms (such as fever, cough, sputum, dyspnea, fatigue, and diarrhea) were collected from their medical records. The primary outcome was the number of days without a fever (with a body temperature <37 °C). The secondary outcomes were symptomatic relief and the worsening of illness, defined as the presence of a condition requiring oxygen inhalation. The outcomes of patients treated with and without Kampo medicine were compared. Patients We enrolled 962 patients, among whom 528 received conventional and Kampo treatment (Kampo group) and 434 received conventional treatment (non-Kampo group). Results Overall, after adjusting for the staging of COVID-19 and risk factors, there were no significant between-group differences in the symptoms or number of days being afebrile. After performing propensity score matching and restricting the included cases to those with confirmed COVID-19 who did not receive steroid administration and initiated treatment within 4 days from the onset, the risk of illness worsening was significantly lower in the Kampo group than in the non-Kampo group (odds ratio=0.113, 95% confidence interval: 0.014-0.928, p=0.0424). Conclusion Early Kampo treatment may suppress illness worsening risk in COVID-19 cases without steroid use. Further randomized controlled studies are needed to confirm the clinical benefit of Kampo medicine for COVID-19.

The Effects of Covid-19 Lockdown on Persons with Dementia

The COVID-19 pandemic has had a profound impact on the lives of all, especially vulnerable groups, like persons with dementia. During lockdown, access to healthcare was limited, loneliness and the burden of caregivers increased. We reviewed the literature, using PRISMA methodology, on dynamic of dementia symptoms after the beginning of the pandemic and lockdown. According to the studies included in the results in our research, the proportions of worsening neuropsychiatric symptoms ranged from 14% to 72%, cognitive decline ranged from 19% to 60% and the need for pharmacological adjustment of treatment ranged from 7.2% to 27.6%. The most common symptoms that worsened during the pandemic were apathy, agitation, anxiety, depressive symptoms and sleeping disorders. On the other hand, few researches have not shown a link between the pandemic and worsening of dementia symptoms. For a more holistic view of the impact of the pandemic on persons with dementia, future monitoring of the change in dementia symptoms, for example at the end of the pandemic, would be necessary. © 2022, Croatian Anthropological Society. All rights reserved.

Immediate and 6-month seizure outcomes following first and second SARS-CoV2 mRNA vaccinations: A multicenter study with a nationwide survey.

OBJECTIVE: This study aimed to identify seizure outcomes in people with epilepsy (PWE) following severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) messenger RNA vaccination. METHODS: We examined PWE (n = 332, age ≥ 14 years) treated in four tertiary hospitals between 2021 and 2022 to assess the incidence of seizure worsening following vaccination using closed questions. We identified the clinical factors associated with worsening and 6-month vaccination outcomes. We also conducted a nationwide survey on self-reported seizure worsening using open questions, to which 261 general practitioners from 99 institutes contributed. RESULTS: Of the 282 PWE vaccinated in the four hospitals, 16 (5.7%) exhibited seizure worsening; most of them emerged within 48 h of vaccination and were not sustained. Thus, all PWE were at baseline condition 6 months after their vaccination. PWE with seizure worsening were more significantly associated with focal impaired awareness seizures (p < 0.001), high seizure frequency (p = 0.025), and drug-resistant epilepsy (p = 0.007) at baseline compared to PWE without worsening. Multivariate logistic regression analysis revealed that focal impaired awareness seizures were independently associated with worsening (odds ratio, 7.0; 95% confidence interval, 1.50-32.77). A nationwide survey of 5156 PWE data (real-world data) confirmed an extremely low incidence rate of self-reported seizure worsening (0.43%). SIGNIFICANCE: Some PWE, particularly refractory focal epilepsy, exhibit seizure worsening. However, the worsening events were infrequent, non-sustainable, and probably under-reported by PWE, suggesting that there is little evidence that worsening seizures discourage current and future vaccinations.

Factors Associated with Willingness to Call Emergency Medical Services for Worsening Symptoms of COVID-19 in Addis Ababa, Ethiopia.

Background: In response to the COVID-19 pandemic, the Ethiopian Ministry of Health has established ambulances and dispatch centers specifically designed to transport COVID-19 patients to city medical centers. Due to a lack of evidence in this area, it is critical to assess the factors that influence the willingness to call for emergency medical services. Methods: A community-based cross-sectional study was conducted from June to July 2021 in Addis Ababa. The data were gathered through use of a pretested questionnaire and analyzed using SPSS 25. Logistic regression was used to calculate odds ratios with and without confounding variable controls, and significant associations were declared at (0.05). For the variables that show significant associations in bivariate and multivariate analyses, a 95% confidence interval is provided. Results: Three-quarters of those surveyed said they would call ambulance if they experienced worsening COVID-19 symptoms. The individual's language was associated with the willingness to call EMS for worsening COVID-19 symptoms [AOR 0.51(95% CI: 0.28-0.92)].; awareness of the availability of toll-free ambulance services [AOR 3.4(95% CI: 1.92-5.95)]; recalling an EMS number [AOR 4.3(95% CI: 1.71-10.67)]; ambulance crew quality of care perception [AOR 3.6(95% CI: 2.09-6.10)]; ambulance service adequacy and accessibility perception [AOR 0.25(95% CI: 0.11-0.55)]. Conclusion: The study showed significant portion of the Addis Ababa community recognized the need to call EMS due to worsening COVID-19 symptoms. The individual's language, awareness of toll-free ambulance; ability to recall an ambulance number, perception of the ambulance crew's quality of care and adequacy and accessibility of service in the city influence the decision to call an ambulance. The finding highlights the significance of addressing problems through various media outlet, for advocacy and public awareness. More research, including qualitative studies, is needed to investigate the factors that encourage people to seek EMS.

Hydropneumothorax Post COVID-19 Infection.

A 32-year-old male presented to the hospital with chief complaints of fever, cough, and breathlessness for the past 4 days and was found to be positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). On arrival at the hospital, the patient required supplemental oxygen. In addition, injection enoxaparin 80 mg subcutaneous twice a day and injection methylprednisolone 40 mg IV twice a day were administered for 10 days. Following this, the patient reported symptomatic improvement and was shifted to the ward with O2 @ 2 L/min through nasal prongs. However, the same evening he complained of right-sided pleuritic chest pain and developed worsening hypoxemia. CT scan of the thorax confirmed the presence of hydropneumothorax with a mediastinal shift to the left side. An intercostal drain (ICD) was placed after shifting him to the intensive care unit (ICU); pleural fluid sent for analysis confirmed the presence of a secondary bacterial infection for which he was treated with appropriate parenteral antibiotics.

Morphofunctional Characteristics of Erythrocytes and Blood Erythropoietin Level in Patients as Predictors of Severe Course of COVID-19.

Morphological and functional characteristics of erythrocytes, hemoglobin, and erythropoietin level in the venous blood were evaluated by laser interference microscopy, Raman spectroscopy with a short-focus extreme aperture lens monochromator, and by ELISA, respectively, in 30 patients with verified moderate COVID-19 at the time of hospitalization and 30 healthy volunteers. The patients whose course of COVID-19 has worsened to critical by day 5 had already had lower (p<0.001) indicators at the time of hospitalization such as the area and thickness of erythrocytes, the hemoglobin distribution and packing density, hemoglobin conformation index (I1355/I1550)/(I1375/I1580) reflecting its oxygen affinity, and blood erythropoietin content. Our findings suggest that these characteristics of erythrocytes, hemoglobin, and erythropoietin can serve as potential predictors of COVID-19 aggravation in hospitalized patients.

A Convenient Risk Prediction Score for COVID-19 for Determining Whether or Not Hospitalization Is Recommended: Kanagawa Admission Priority Assessment Score.

Objective Coronavirus disease 2019 (COVID-19) has caused a collapse of the medical care system, with effective triage proving vital. The Kanagawa admission priority assessment score, version-1 (KAPAS-1) and version-2 (KAPAS-2), was developed to determine the need for hospitalization. Patients with a high KAPAS (≥5) are recommended for hospitalization. We retrospectively investigated the correlation between the KAPAS and oxygen requirement during hospitalization. Methods We collected the clinical data of COVID-19 patients admitted between February 5 and December 6, 2020. Patients were divided into two groups: those who required oxygen therapy during hospitalization (OXY) and those who did not (NOXY). We assessed the correlations between the groups and KAPAS-1 and KAPAS-2. Results Overall, 117 COVID-19 patients were analyzed, including 20 OXY and 97 NOXY and 54 high KAPAS-1 and 63 high KAPAS-2. The median KAPAS-1 and KAPAS-2 were significantly higher in OXY than in NOXY (6.5 vs. 3, and 9 vs. 4, respectively). The areas under the receiver operating characteristic curves of KAPAS-1 and KAPAS-2 for oxygen requirement were 0.777 and 0.825, respectively, and the maximum values of Youden's index were 4 and 6, respectively. The proportions of high KAPAS-1 and high KAPAS-2 were significantly higher in OXY than in NOXY (90.0% vs. 37.1%, and 90.0% vs. 46.4%, respectively). Conclusion The KAPAS was significantly correlated with oxygen requirement. Furthermore, the KAPAS may be useful for deciding which patients are most likely to require hospitalization and for selecting non-hospitalized patients who should be carefully monitored.

Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score.

This monocentric, retrospective, two-stage observational study aimed to recognize the risk factors for a poor outcome in patients hospitalized with SARS-CoV-2 infection, and to develop and validate a risk score that identifies subjects at risk of worsening, death, or both. The data of patients with SARS-CoV-2 infection during the first wave of the pandemic were collected and analyzed as a derivation cohort. Variables with predictive properties were used to construct a prognostic score, which was tried out on a validation cohort enrolled during the second wave. The derivation cohort included 494 patients; the median age was 62 and the overall fatality rate was 22.3%. In a multivariable analysis, age, oxygen saturation, neutrophil-to-lymphocyte ratio, C-reactive protein and lactate dehydrogenase were independent predictors of death and composed the score. A cutoff value of 3 demonstrated a sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of 93.5%, 68.5%, 47.4% and 97.2% for death, and 84.9%, 84.5%, 79.6% and 87.9% for worsening, respectively. The validation cohort included 415 subjects. The score application showed a Se, Sp, PPV and NPV of 93.4%, 61.6%, 29.5% and 98.1% for death, and 81%, 76.3%, 72.1% and 84.1% for worsening, respectively. We propose a new clinical, easy and reliable score to predict the outcome in hospitalized SARS-CoV-2 patients.

Association of Complement C3 with Clinical Deterioration Among Hospitalized Patients with COVID-19.

BACKGROUND: The role of the complement system in coronavirus disease 2019 (COVID-19) remains controversial. This study aimed to evaluate the relationship between serum complement C3 levels, clinical worsening, and risk of death in hospitalized patients with COVID-19. METHODS: Data were collected from 216 adults with COVID-19 admitted to a designated clinical center in Wuhan Union Hospital (China) between February 13, 2020, and February 29, 2020. Their complement C3 levels were measured within 24 h of admission. The primary outcome was a clinical worsening of 2 points on a 6-point ordinal scale. The secondary outcome was all-causes of death. Inverse probability of treatment weighting (IPTW) analysis was conducted to adjust for the baseline confounders. RESULTS: The median value of C3 was 0.89 (interquartile range, 0.78-1.01) g/L. Clinical worsening occurred in 12.3% (7/57) and 2.5% (4/159) of patients with baseline C3 levels < and ≥0.79 g/L, respectively (hazard ratio [HR], 5.22; 95% confidence interval [CI], 1.53-17.86). After IPTW adjustment, the risk for clinical worsening was 4-fold greater (weighted HR, 4.61; 95% CI, 1.16-18.4) in patients with C3 levels less than 0.79 g/L comparatively. The sensitivity analyses revealed the robustness of the results. No significant associations between C3 levels and death were observed on unadjusted (HR, 2.92; 95% CI, 0.73-11.69) and IPTW analyses (weighted HR, 3.78; 95% CI, 0.84-17.04). CONCLUSION: Low complement C3 levels are associated with a higher risk for clinical worsening among inpatients with COVID-19. The serum C3 levels may contribute to the identification of patient populations that could benefit from therapeutic complement inhibition.

Evaluation of the toxicity of glucocorticoids in patients with autoimmune blistering disease using the Glucocorticoid Toxicity Index: A cohort study.

BACKGROUND: Glucocorticoids are the mainstay of treatment for autoimmune blistering diseases (AIBDs). The Glucocorticoid Toxicity Index (GTI) is a novel, outcome-based glucocorticoid-induced adverse effects monitoring instrument. OBJECTIVE: To investigate whether the GTI score was able to accurately quantify the glucocorticoid-induced toxicity in patients with AIBDs. METHODS: The prospective cohort study included patients with confirmed diagnoses of AIBDs (group1, currently receiving glucocorticoids; and group 2, had glucocorticoids ceased earlier). Data were collected minimally at baseline (V1) and 3 months (V2). Further data from patients who were able to complete the follow-up visits at 6 months (V3) and 12 months (V4) amid the COVID-19 pandemic were also included. GTI scores were calculated after data collection. RESULTS: Analysis of data from V1 and V2 found a linear correlation between GTI score and prednisone doses (P < .05) and a significant difference in GTI scores between group1 and group 2 (P < .05). Data from V3 and V4 suggested that GTI scores continued to rise progressively alongside increasing cumulative prednisone dose. LIMITATIONS: Small sample size, further exacerbated by the COVID-19 pandemic. Single-center study. CONCLUSION: The GTI sensitively and specifically captured the changes in glucocorticoids toxicity over time among patients with AIBDs. The GTI could be a feasible tool that can be used in future clinical trials as a glucocorticoid-induced toxicity outcome measure.

Ambulatory Management of Worsening Heart Failure: Current Strategies and Future Directions.

Heart failure (HF) is a highly prevalent and morbid disease in the USA. The chronic, progressive course of HF is defined by periodic exacerbations of symptoms, described as 'worsening heart failure' (WHF). Previously, episodes of WHF have required hospitalization for intravenous diuretics; however, recent innovations in care delivery models for patients with HF have allowed a transition from the acute care setting to the ambulatory setting. The development of remote monitoring strategies, including device-based algorithms and implantable haemodynamic monitoring systems, has facilitated more advanced surveillance of patients, aiming to prevent the clinical deterioration that leads to hospitalization. Additionally, the establishment of multidisciplinary HF clinics has provided the setting and resources for the outpatient treatment of WHF, specifically the administration of intravenous diuretics. Here we review the current state of ambulatory HF management, including mechanisms for patient monitoring and treatment, and outline future opportunities for outpatient management of this patient population.

Coronashaming: interpersonal affect worsening in contexts of COVID-19 rule violations.

ABSTRACTExperiencing empathy for others has been linked to worsening others' feelings against their wishes. These paternalistic empathic goals have been theorised to happen at the dyad level when an agent aims to worsen a target's emotional state. They may also operate at a broader level when agents are third-party observers of COVID-19 lockdown rule violations. In these instances, agents can impact transgressors' affect engaging in Coronashaming. In three studies, we measured British people's (Ntotal = 767) vulnerability (Study 1), age (Studies 2 and 3), and empathy towards COVID-19 victims and presented them with different scenarios depicting a breach of lockdown rules to assess the emotions participants wanted to inflict in transgressor, the strategies used, and whether they wanted stricter rules to be enforced. Results confirmed shame as the emotion preferred to induce in violators, with this preference linked to higher use of engagement strategies (i.e. to make transgressors understand what they did wrong). Finally, empathy was positively linked to higher affect worsening and wanting stricter rules to be enforced. This suggests that empathy towards potential victims of COVID-19 rules violations can motivate people to worsen the feelings of transgressors.

Effect of COVID-19 and sociocultural milieu on the psychopathology of mental health disorders: A hospital-based study.

BACKGROUND: Coronavirus disease (COVID-19) has posed a remarkable threat to mental health all around the world. This pandemic has increased the incidence of common as well as severe mental illness (SMI) all around the world. MATERIALS AND METHODS: We report 10 cases presenting to the psychiatric outpatient department (OPD) of Institute of Medical Sciences, Banaras Hindu University, from August to October 2020. They were either referred by other departments (3 patients) or came primarily to psychiatric OPD (7). RESULTS: Five out of these 10 cases presented with predominant psychotic features; 3 cases had predominant obsessive-compulsive features; and 1 case was of dissociative trance possession. CONCLUSION: COVID-19 can affect the psychopathology of both types of patients either with preexisting mental illness as well as new-onset SMI.

COVID-19 and exacerbation of dermatological diseases: A review of the available literature.

Since the emergence of the new coronavirus disease 19 (COVID-19) pandemic, there has been a concern for the patients with chronic autoimmune diseases including dermatological conditions over the potential exacerbation of these underlying conditions after infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV2). We performed a systematic review to evaluate presentations, postinfection change in the manifestation, diagnosis, and management of flare-ups of underlying dermatologic disease in patients with COVID-19. A total of 17 articles were recovered reporting on flare-ups of dermatological disease including pemphigus vulgaris, psoriasis, subacute cutaneous lupus erythematosus, acrodermatitis continua of Hallopeau, systemic sclerosis sine scleroderma, and Sézary syndrome (SS). Out of these, psoriasis and alopecia areata were the most common conditions. However, most cases of psoriasis could have been attributed to either antimalarial agents that were initially used for the treatment of COVID-19 or discontinuation of treatment following SARS-CoV2 infection.

Development and Validation of a Nomogram for Predicting the Disease Progression of Nonsevere Coronavirus Disease 2019.

BACKGROUND AND OBJECTIVES: The majority of coronavirus disease 2019 (COVID-19) cases are nonsevere, but severe cases have high mortality and need early detection and treatment. We aimed to develop a nomogram to predict the disease progression of nonsevere COVID-19 based on simple data that can be easily obtained even in primary medical institutions. METHODS: In this retrospective, multicenter cohort study, we extracted data from initial simple medical evaluations of 495 COVID-19 patients randomized (2:1) into a development cohort and a validation cohort. The progression of nonsevere COVID-19 was recorded as the primary outcome. We built a nomogram with the development cohort and tested its performance in the validation cohort. RESULTS: The nomogram was developed with the nine factors included in the final model. The area under the curve (AUC) of the nomogram scoring system for predicting the progression of nonsevere COVID-19 into severe COVID-19 was 0.875 and 0.821 in the development cohort and validation cohort, respectively. The nomogram achieved a good concordance index for predicting the progression of nonsevere COVID-19 cases in the development and validation cohorts (concordance index of 0.875 in the development cohort and 0.821 in the validation cohort) and had well-fitted calibration curves showing good agreement between the estimates and the actual endpoint events. CONCLUSIONS: The proposed nomogram built with a simplified index might help to predict the progression of nonsevere COVID-19; thus, COVID-19 with a high risk of disease progression could be identified in time, allowing an appropriate therapeutic choice according to the potential disease severity.