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The COVID‑19 pandemic has highlighted the importance of vaccines to prevent infectious diseases, but also the issues related to vaccine acceptance among individuals and groups targeted by vaccination programs. The concept of vaccine hesitancy is now commonly used in public health spheres to refer to the fact that a portion of the population has significant doubts and concerns about vaccines that can lead to a vaccine refusal or delay. Most research on vaccine hesitancy focuses on individual knowledge, beliefs, values, attitudes, life trajectories and experiences. However, the focus on individual determinants of vaccine hesitancy can lessen the importance of broader structural and socio-cultural influences on attitudes and decisions about immunization. Based on interviews conducted in Nunavik, this article proposes to explore how organizational and historical factors, social norms, and shared values and beliefs about the etiology of COVID‑19 and the efficacy and usefulness of vaccines to prevent the virus, influence COVID‑19 vaccine hesitancy in Inuit communities.Alternate :La pandemia de la COVID‑19 evidenció la importancia de la vacunación para prevenir las enfermedades infecciosas, pero también los retos ligados a la aceptación de las vacunas entre individuos o grupos específicos. El concepto de desconfianza en la vacunación se volvió de uso común en la salud pública para referirse al hecho de que una parte de la población tiene temores importantes relacionados con la vacunación;temores que pueden llevar al rechazo o postergar la vacunación. La importancia de los conocimientos, creencias, valores, actitudes, trayectorias de vida y experiencias individuales en las investigaciones sobre la vacunación a veces puede ocultar la importancia de influencias estructurales y socioculturales más amplias sobre las actitudes y decisiones con respecto a la vacunación. A partir de entrevistas realizadas en Nunavik, este artículo se propone explorar cómo los factores organizacionales e históricos, las normas sociales, los valores y las creencias compartidas respecto a la etiología de la COVID‑19 y sobre la efectividad y el poder de las vacunas en la prevención, influyen sobre la desconfianza en la vacunación contra la COVID‑19 en las comunidades inuit.Alternate :La pandémie de la COVID‑19 a mis en évidence l'importance de la vaccination pour prévenir des maladies infectieuses, mais également les enjeux liés à l'acceptation des vaccins par les individus et groupes ciblés par les programmes. Le concept d'hésitation à la vaccination est désormais couramment utilisé en santé publique pour référer au fait qu'une partie de la population entretient des craintes importantes par rapport à la vaccination ;craintes qui peuvent mener à refuser ou à retarder la vaccination. L'accent important mis sur les connaissances, les croyances, les valeurs, les attitudes, les trajectoires de vie et les expériences individuelles dans les recherches sur la vaccination peut toutefois occulter l'importance des influences structurelles et socioculturelles plus larges sur les attitudes et décisions à l'égard de la vaccination. À partir d'entretiens menés au Nunavik, cet article propose donc d'explorer comment les facteurs organisationnels et historiques, les normes sociales, les valeurs et les croyances partagées à propos de l'étiologie de la COVID‑19 et à propos de l'efficacité et de la puissance des vaccins pour la prévenir, influent sur l'hésitation à la vaccination contre la COVID‑19 dans des communautés inuit.
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This editorial lists the main current theories on long COVID, such as the theory of viral persistence and the one of immunothrombosis associated with deregulation of the immune system;it is discussed as well their interrelation, which finally explains the etiopathogenesis and physiopathology of this new syndrome that afflicts the survivors of COVID-19;it is also discussed the link between viral persistence with the formation of amyloid microthrombi based on the hypothesis that the spike protein causes amyloidogenesis, inducing organic chronic damage that will characterize long COVID. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
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The global epidemic of coronavirus disease 2019 (COVID-19) is still growing. The response to this emerging disease should be considered with the context of its clinical characteristics and pathophysiological mechanisms. Although available therapeutic options are still very limited, current experience has suggested that the choice of clinical strategies should be based upon the disease stage and immune functions of the patients. The present article reviews the clinical characteristics of COVID-19 and current evidence of various treatment approaches. Combined with first-line experience, we summarize the current clinical strategies for COVID-19 management based on disease progress and staging.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.
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Background: Acute kidney injury (AKI) is frequent in sepsis (25 to 51%), with high mortality (40 to 80%) and long-term complications. Despite its importance we do not have accessible markers in intensive care. In other entities (post-surgical and COVID-19) the neutrophil/lymphocyte and platelet (N/LP) ratio has been associated with acute kidney injury;however, this relationship has not been studied in a pathology with a severe inflammatory response such as sepsis. Objective: To demonstrate the association between N/LP with AKI secondary to sepsis in intensive care. Material and methods: Ambispective cohort study in patients over 18 years who were admitted to intensive care with a diagnosis of sepsis. The N/LP ratio was calculated from admission up to the seventh day and up to the diagnosis of AKI and outcome. Statistical analysis was performed with chi squared test, Cramer's V and multivariate logistic regression. Results: Out of the 239 patients studied, the incidence of AKI developed in 70%. 80.9% of patients with N/LP ratio > 3 had AKI (p < 0.0001, Cramer's V 0.458, OR 3.05, 95% CI 1.602-5.8) and increased renal replacement therapy (21.1 vs. 11.1%, p = 0.043). Conclusion: N/LP ratio > 3 has a moderate association with AKI secondary to sepsis in the intensive care unit. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
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Background: COVID-19 in pregnancy can increase the risk of complications due to the cardiorespiratory and immunological changes typical of pregnancy. Objective: To report the epidemiological characterization of COVID-19 in Mexican pregnant women. Material and methods: Cohort study on pregnant women with a positive COVID-19 test, which were followed until delivery and one month later. Results: 758 pregnant women were included in the analysis. Mothers' mean age was 28.8 +/- 6.1 years;the majority were workers 497 (65.6%) and with an urban origin (482, 63.6%);the most common blood group was O with 458 (63.0%);478 (63.0%) were nulliparous women and more than 25% had some comorbidities;the average gestation weeks at infection were 34.4 +/- 5.1 weeks;only 170 pregnant women (22.4%) received vaccination;the most frequent vaccine was BioNTech Pfizer (96, 60%);there were no serious adverse events attributed to vaccination. The mean gestational age at delivery was 35.4 +/- 5.2 weeks;85% of pregnancies were cesarean section;the most frequent complication was prematurity (406, 53.5%), followed by preeclampsia (199, 26.2%);there were 5 cases of maternal death and 39 cases of perinatal death. Conclusions: COVID-19 in pregnancy increases the risk of preterm birth, preeclampsia, and maternal death. Vaccination against COVID-19 in this series showed no risk for pregnant women and their newborns. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
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PURPOSE: The onset of the COVID-19 (SARS-CoV-2) pandemic in December 2019 created the need for multiple scientific research activities and clinical trials in an attempt to find solutions to mitigate the impact of the virus. One of the important tools to combat the virus is the development of vaccination programs. All types of vaccines have been associated with a mild to severe risk of neurological adverse events. One of these severe adverse events is Guillain-Barré syndrome. CASE REPORT: Here, we describe a case of Guillain-Barré syndrome after the first dose of the BNT162b2 mRNA COVID-19 vaccine and review the literature to increase the current knowledge regarding this complication. CONCLUSION: Guillain-Barré syndrome after COVID-19 vaccination is responsive to treatment. The benefits of administering the vaccine outweigh the risks. Due to the negative impact of COVID-19, it is essential to recognize the development of neurological complications that are potentially associated with vaccination, including Guillain-Barré syndrome.
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[Background] Sleep is closely related to immune function and human health, and adequate sleep is an important foundation for human health. [Objective] This study investigates the sleep status of the first-line medical staff in Wuhan in a fight against the coronavirus disease 2019 (COVID-19) outbreak, provides reference for improving the sleep quality of the first-line medical staff in public health emergencies. [Methods] Through convenience sampling, 112 medical workers (first-line group) who aided the COVID-19 fight in Wuhan and 134 medical staff (non-first-line group) who did not participate in the fight were selected. The Pittsburgh Sleep Quality Index (PSQI) was employed to collect data on the incidence of sleep disorders, time to fall asleep, duration of sleep, sleep efficiency, sleep disorders, use of sleep aid, and daytime functions. In addition, a self-made questionnaire was used to investigate the common concerns and time allocation characteristics of the first-line medical workers in the context of major infectious disease outbreaks. [Results] There were no significant differences between the two groups in demographic variables such as gender, age, job title, educational background, marriage status, number of children, and working years (P > 0.05). In the first-line group, 62 medical workers (55.36%) reported sleep disorders, while in the non-first-line group, 54 medical workers (40.30%) did;the difference was statistically significant (P=0.008). Among the seven components of the PSQI, the median sleep time (component 3) score of the first-line group was 1.5, which was higher than that of the non-first-line group (median 1.0) (P < 0.001);the median sleep efficiency (component 4) score of the first-line group was 1.0, which was higher than that of the non-first-line group (median 0) (P < 0.001). The actual sleep duration of the first-line group [(5.65+/-1.15) h] was lower than that of the non-first-line group [(7.00+/-1.40) h] (P < 0.001). The distributions of common concerns were different between the two group. The top three concerns were being infected (76.79%), exhausted (37.50%), and overloaded (27.68%) in the first-line group, and family members being infected (53.73%), being infected (45.52%), and child care (33.58%) in the non-first-line group. [Conclusion] The first-line medical team members report poor sleep quality, short sleep time, low sleep efficiency, sleep disorders, and many psychological concerns. It is necessary to take appropriate measures to improve their sleep quality.Copyright © 2021, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.
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A doctor of any specialty in his practice is faced with an infectious pathology, in connection with which the early diagnosis of infectious diseases is important both from a clinical and epidemiological standpoint. The aim - design and development of a unified practical guide to infectious diseases with elements of digitalization of content on pharmacotherapy. Material and methods. When developing the structure of the practical guide "Tactics of an infectious disease doctor", prototypes of educational and methodological materials were worked out. The structure of the practical guide included socially significant infectious diseases of viral, bacterial etiology, the most important helminthiases and protozoses, which practitioners of various specialties may encounter, both in inpatient and outpatient settings. Results and discussion. In the practical guide "Tactics of an infectious disease doctor" all nosologies are presented in a unified form: a brief definition of nosologies, characteristics of the etiological agent, epidemic process, clinical classification, examples of the formulation of a diagnosis, diagnosis, organization of medical care, treatment, pharmacotherapy, approximate terms of temporary disability, criteria recovery, rehabilitation, dispensary observation, recommendations for treatment and prevention. The practical guide contains a short guide to medicines. An innovation is the presentation of medicines via a QR code. Also, by means of a QR code, it is possible to switch to the electronic version of the practical guide. Recommendations for the prevention of infectious diseases are given in the form of pictographic diagrams. Conclusion. The practical guide "Tactics of an infectious disease doctor" allows primary care physicians and general practitioners in a short time period to make the optimal decision on the tactics of managing patients with infectious diseases, within the framework of modern clinical guidelines and approaches set out in national guidelines.Copyright © 2021 Infectious Diseases: News, Opinions, Training. All rights reserved.
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The global pandemic coronavirus pneumonia (COVID-19), the disease infected by the new coronavirus (SARS-CoV-2), is extremely contagious. It is mainly spread among people through respiratory droplets, aerosols, direct or indirect contact, fecal-oral transmission, and cold chain transportation. Especially, patients who are in the incubation period or have no obvious symptoms already have the ability to infect others. SARS-C0V-2 is a positive-sense single-stranded RNA virus, with a single linear RNA segment. Each SARS-CoV-2 virion is 60-140 mm in diameter. Like other coronaviruses, SARS-CoV-2 has four structural proteins, known as the spike (S), envelope(E), membrane (M), and nucleocapsid (N) proteins. To date, a variety of detection methods for the SARS-CoV-2 have been developed based on the virus structural basis and 'etiological characteristics, which would provide an effective guarantee for the diagnosis of COVID-19 patients and the control of the epidemic. In order to help for the early diagnosis and prevention of COVID-19, the pathogenic characteristics and recent progresses of detection base on nucleic acid, immunology and biosensors of the SARS-CoV-2 are reviewed in this paper.
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Postoperative atrial fibrillation (POAF) is a common complication of cardiac surgery, including coronary artery bypass grafting, which has great clinical and economic importance for the healthcare system. Despite the improvement of surgical tactics, anesthetic and care benefits, POAF incidence has been increasing over the past decade. The mechanisms of POAF are different. Chronic coronary artery disease and its frequent comorbidities such as arterial hypertension, obesity, diabetes mellitus and heart failure, - are associated with various structural and functional changes in the heart, contributing to electrical atrial remodeling. Today, such risk factors for POAF as age, enlarged left atrium, post heart valve surgery, and obesity are well known. A new coronovirus infection that occurred in the early postoperative period can also be a trigger for atrial fibrillation. Postoperative arrhythmias can worsen both hospital and long-term results of treatment, increase the length of the patient's stay in the hospital, and the risk of complications. This review updates the data on the pathogenesis, incidence and complications of POAF, taking into account the current epidemiological situation.Copyright © 2022 Authors. All rights reserved.
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Acute respiratory viral infections (ARVI) play an important role in morbidity formation among children. At the same time, studies about the ARVI etiological structure are not enough. The article presents the results of structure analyses of ARVI in children with severe and moderate degrees of disease hospitalized in the children's clinical hospital of Novosibirsk for the period 2015-2018. This research aimed to analyze the morbidity of acute respiratory viral infections with the estimation of a causal virus in children admitted to the hospital for the period 2015-2018. Material and methods. In this study, 1137 children aged between 0 and 15 years were examined. In order to determine the etiological factor in children with damage of the upper or lower respiratory tract, by using the method of RT-PCR (AmpliSensARVI-screen-FL test systems (InterLabService, Russia), mucus from the nose and throat was examined for the presence of genetic material of viruses that cause ARVI (influenza A and B viruses, parainfluenza viruses of types 1-4, respiratory syncytial virus, metapneumovirus, four types of human coronavirus, rhinovirus, adenovirus, and bocavirus). Results. The research found that the most frequently detected pathogens are respiratory syncytial virus (23.52%), influenza A and B viruses (19.73%) and rhinovirus (19.21%). Observe the dynamics some fluctuations in the detection of mentioned viral agents and increasing of mixed infections were detected. In addition, the importance of respiratory and gastrointestinal tract combined lesions, particularly for infants and preschool - age children has been noted. Conclusion. The distribution of respiratory viruses in children with severe ARVI who required hospitalization was assessed. It was shown the significance of the respiratory syncytial infection virus, influenza virus and rhinovirus in the etiological structure of hospitalized children of different ages that damage not only the respiratory tract, but also to the gastrointestinal tract. This is an important factor in optimizing the diagnosis, treatment and prevention of viral infections in children.Copyright © Infectious Diseases: News, Opinions, Training 2021.
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Secondary bacterial infection is one of the important risk factors for the development of severe course and death in COVID-19. The rational choice of antibacterial therapy is based on the data of microbiological monitoring of pathogens of healthcare-associated infections. The aim of the study is to determine the main options for antibiotic therapy of Acinetobacter baumannii bloodstream infection in COVID-19 patients. Material and methods. A retrospective, single-centre, uncontrolled study of the incidence of A. baumannii bacteremia in COVID-19 patients treated at the City Clinical Hospital No. 52 in Moscow from October 2020 to September 2021 was performed. For each strain of A. baumannii sensitivity to the main antibacterial agents was determined. Genetic determinants of antibiotic resistance were studied by real-time multiplex polymerase chain reaction. The main therapeutic options for A. baumannii bloodstream infection were analyzed. Results and discussion. Bloodstream infections were diagnosed in 4.7% of hospitalized patients with COVID-19 (758/16 047). Gram-negative bacteria were the causative agents of bloodstream infections in 76% of cases. A. baumannii were isolated from the blood of 143 patients (0.89%). Detection of the pathogen in the blood of COVID-19 patients was associated with severe and extremely severe course of the disease. Most of the strains (93%) were isolated in the intensive care unit. The A. baumannii strains studied were carbapenem-resistant (CRAb) and phenotypically belonged to the XDR class. According to a PCR study, A. baumannii strains were producers of oxacillinases OXA-23, OXA-40, and OXA-51. Conclusion. The circulation of A. baumannii CRAb in intensive care units makes empiric therapy based on carbapenems irrational and ineffective. For the etiotropic therapy of A. baumannii bloodstream infection it is recommended to use combined antibiotic therapy regimens with the inclusion of polymyxin B and sulbactam.Copyright © Eco-Vector, 2022.
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Coronavirus disease 2019 (COVID-19) has become a major threat to global public health.In addition to injury in the respiratory system, some patients may have varying degrees of liver injury.With reference to related articles, this article analyzes the etiological characteristics and pathogenesis of COVID-19 and discusses the possible causes of COVID-19 with liver injury, including the direct effect of virus, inflammatory cytokine storm, drug-induced liver injury, hypoxic liver injury, and immune dysfunction.It is suggested that reasonable drugs should be selected in clinical practice to protect the liver and reduce the incidence rate of liver injury. .Copyright © 2021 Editorial Board of Jilin University. All rights reserved.
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The new coronavirus infection COVID-19 causes damage to many organs and systems, is a multi-organ disease. Many researchers are studying the relationship of the new coronavirus infection with polymorbid pathology, frailty, sarcopenia. The SARS-CoV-2 virus has the property of neurotropism, therefore, olfactory, taste disorders, as well as cognitive impairments can join the spectrum of clinical manifestations and consequences of the disease. Alzheimer's disease is the most common cause of dementia in the world. It is of interest that there is a link between the coronavirus infection and the development of cognitive impairment, including Alzheimer's disease.
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Introduction. Currently it is well-recognized that tissue markers allow to classify the process of different infectious diseases and help to identify patients' to subclasses and endotypes for clarifying the prognosis and therapy effectiveness. Objective. To detect different COVID-19 course types according to pathophysiological mechanisms, and evaluate clinical, lab and instrumental features of each clinical course. Material and methods. 108 first COVID-19 patients were admitted at special hospital based on Bakoulev National Medical Research Center for Cardiovascular Surgery. The average age of patients was 57.4 +/- 2.3 years, 54.6% of women, the degree of lung damage was 36.2 +/- 2.3%. All patients were identified with C-reactive protein (CRP) and D-dimer. Results. The patients were divided in 4 groups depending on the degree of main pathophysiological process of system inflammatory response (SIR) and hypercoagulation: with inflammatory (1group) (n = 22), coagulation (2 group) (n = 8), inflammatory-coagulation (3 group) (n = 71) and affectless (4 group) (n = 7) types of disease progression. All the 4 groups of the discharged patients were equal in pulmonic parenchymatous tissue damage degree. The level of lactate dehydrogenase (LDH) was significantly higher in patients of group 3 (334.2 +/- 20.6 U/L) compared with LDH in groups 1, 2 and 4 (respectively 264.2 +/- 21.5, 231 +/- 14.2, 206.3 +/- 32.2 U/L, p < 0.01), which indicates more severe damage to the pulmonary parenchyma. In groups 1 and 3, the level of lymphocytes was lower than in groups 2 and 4. In terms of the D-dimer level, the 3rd and 2nd groups did not differ (1537.4 +/- 126.7 and 1682.5 +/- 394.2, respectively, p > 0.05), but its level was significantly higher in the 3rd group compared with the 1st and 4th (359 +/- 32.9 and 309.3 +/- 50.8, p < 0.01). Over the course of staying in hospital the features of each type of disease progression kept preserved. Conclusions. It is possible to accentuate 4 possible development scenario of the COVID-19: the inflammatory one (with SVR manifestation without hypercoagulation), the hypercoagulation one (without SVR activation), the inflammatory-coagulation (active SVR together with hypercoagulation) and affectless type (without SVR and hypercoagulation). The most prevalent type of COVID-19 disease progression is inflammatory-coagulation scenario which is manifested at 65% of patients.Copyright © Creative Cardiology 2021.
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Objectives: Since its first appearance in Wuhan December 2019, SARS-CoV2 virus received great attention due to its severe symptoms and high spread causing COVID-19 disease which spread all over the world like a pandemic. The causative virus is capable of human-to-human transmission via droplet and direct contact suggesting that upper respiratory tract is the main site to virus manifestations. There is a great diversity in its clinical picture, although the severe respiratory and neurological symptoms are commonly present;however, other symptoms are present. Although otological manifestations are reported in many COVID-19 patients even in asymptomatic cases, they did not receive much attention compared with other critical manifestations. In this article, we paid our attention specifically to the otological manifestations of COVID-19 and their relevance either to the virus infection, treatment, or vaccination through literature review. Conclusion(s): COVID-19 disease has a deleterious effect on the inner ear. This effect is not only due to SARS-Cov-2 infection, but it could be also due to the ototoxic drugs used for treatment. The COVID-19 vaccinations are found to be implicated in the otological symptoms in some cases.Copyright © 2022, The Author(s).
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Pericardial disease includes a variety of pericardial diseases including inflammatory pericarditis, pericardial effusions, constrictive pericarditis, pericardial cysts, primary and secondary pericardial neoplasms. The true incidence of this varied condition is not well established, and the causes vary greatly across the world. This review aims to describe the changing pattern of epidemiology of pericardial disease and to provide an overview of causative etiologies. Idiopathic pericarditis (assumed most often to be viral) remains the most common etiology for pericardial disease globally, with tuberculous pericarditis being most common in developing countries. Other important etiologies include fungal, autoimmune, autoinflammatory, neoplastic (both benign and malignant), immunotherapy-related, radiation therapy-induced, metabolic, post cardiac injury, post-operative, and post-procedural causes. Improved understanding of the immune pathophysiologic pathways has led to identification and reclassification of some idiopathic pericarditis cases into autoinflammatory etiologies, including IgG4-related pericarditis, tumor necrosis factor receptor-associated periodic syndrome (TRAPS) and familial Mediterranean fever in the current era. Contemporary advances in percutaneous cardiac interventions and the recent Covid-19 pandemic have also resulted in changes in the epidemiology of pericardial diseases. Further research is needed to improve our understanding of the etiologies of pericarditis, utilizing the assistance of contemporary advanced imaging techniques and laboratory testing. Careful consideration of the range of potential causes and local epidemiological patterns of causality are important for the optimization of diagnostic and therapeutic approaches.