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1.
J Assoc Med Microbiol Infect Dis Can ; 6(3): 177-180, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-2109655
2.
JMIR Form Res ; 6(11): e35730, 2022 Nov 17.
Article in English | MEDLINE | ID: covidwho-2109548

ABSTRACT

BACKGROUND: The ongoing COVID-19 pandemic has brought forth conversations about effective behavior change models for increasing prevention behavior, ranging from wearing masks in public to physical distancing. Among the considered behavior change techniques is the use of fear appeals, through which a negative possible outcome is emphasized to invoke fear, which in turn may promote prevention behaviors to counter the likelihood of the negative outcome. Although fear is hypothesized as health promoting in some theories of health behavior, little research has rigorously assessed the relationship. OBJECTIVE: In our exploratory analyses, we aim to examine the association, including directionality of the association between fear of COVID-19 and COVID-19 prevention behaviors across 2 time points during the early COVID-19 pandemic among a sample of US women. METHODS: The COPE study, a web-based survey of US women's COVID-19 experiences, was deployed in May-June 2020 (time 1) with follow-up in December 2020-January 2021 (time 2; n=200). Demographic characteristics as well as fear of COVID-19 and COVID-19 prevention behaviors (eg, staying home except for essential activities, physical distancing in public, and masking in public) were measured. Descriptive and bivariate analyses were used to characterize COVID-19 prevention behaviors and fear of COVID-19 among participants. Cross-lagged panel analysis, a type of structural equation modeling that assesses directionality of temporal associations, was used to understand relationships, if any, between variables of interest. RESULTS: We found cross-sectional associations between fear of COVID-19 and staying home and physical distancing, as well as temporal associations between fear at time 1 and time 2 and prevention behaviors at time 1 and time 2. However, results of the cross-lagged panel analysis indicated no cross-lagged temporal relationships between fear of COVID-19 and COVID-19 prevention behaviors 6 months apart. CONCLUSIONS: Fear of COVID-19 did not appear to predict COVID-19 prevention behaviors 6 months after initial measurements among the sample of women recruited for our study. Future research should rigorously test these associations longitudinally, and alternative methods of public health prevention promotion should be considered.

3.
Subst Abuse Treat Prev Policy ; 17(1): 73, 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2108856

ABSTRACT

BACKGROUND: COVID-19 dramatically limited the scale and scope of local health department (LHD) work, redirecting resources to the response. However, the need for essential public health services-including substance use prevention-was not reduced. METHODS: We examined six quantitative data sources, collected between 2016 and 2021, to explore the impact of the COVID-19 pandemic on LHD substance use-related services. RESULTS: Before the pandemic, the proportion of LHDs providing some level of substance use prevention services was increasing, and many were expanding their level of provision. During the pandemic, 65% of LHDs reduced their level of substance use-related service provision, but the proportion of LHDs providing some level of services remained steady from prior to COVID-19. CONCLUSION: We discuss policy recommendations to mitigate the risk of service disruptions during future public health emergencies, including direct and flexible funding for LHDs and federal directives declaring substance use prevention services as essential.


Subject(s)
COVID-19 , Substance-Related Disorders , Humans , Local Government , Public Health , COVID-19/prevention & control , Pandemics , Substance-Related Disorders/epidemiology , Substance-Related Disorders/prevention & control
4.
J Prim Care Community Health ; 13: 21501319221134851, 2022.
Article in English | MEDLINE | ID: covidwho-2108670

ABSTRACT

BACKGROUND: Our study aimed to describe the variation in the frequency of correct mask use among pedestrians in the first and second waves of the COVID-19 pandemic in high-flow indoor public spaces from different geographic and social settings in Peru. METHODS: We carried out a cross-sectional exploratory study among pedestrians in Lima (the capital city) and other coastal and highland cities in Peru. Pedestrians were directly observed by trained medical students in 2 high-flow indoor areas at different times in November 2020 (first wave) and October 2021 (second wave). Primary outcomes included the frequencies of mask use and correct use. We applied multinomial logistic models and estimated crude and adjusted relative prevalence ratios for sex, age, obesity, and location. Additionally, we used binomial generalized linear models to estimate prevalence ratios in crude and adjusted models. RESULTS: We included 1996 participants. The frequency of mask use was similar in both years: 96.9% in 2020 and 95.5% in 2021. However, the frequency of correct mask use significantly decreased from 81.9% (95% CI, 79.4-84.3) in 2020 to 60.3% (95% CI, 57.2-67.3) in 2021. In 2020, we observed an increase in the probability of misuse in the cities of Lima (aRP: 1.42; P = .021) and Chiclayo (aPR: 1.62, P = .001), whereas, in 2021, we noted an increase in the probability of misuse in the cities of Lima (aRP: 1.72; P < .001) and Piura (aPR: 1.44; P < .001). CONCLUSIONS: The correct mask use decreased during the second wave, although no significant overall variations were observed in mask use in pedestrians between both periods. Also, we found regional differences in correct mask use in both periods.


Subject(s)
COVID-19 , Pedestrians , Humans , COVID-19/epidemiology , Pandemics , Cross-Sectional Studies , Peru/epidemiology
5.
Int J Environ Res Public Health ; 19(22)2022 Nov 10.
Article in English | MEDLINE | ID: covidwho-2110079

ABSTRACT

BACKGROUND: During the outbreak of COVID-19, online public opinion related to the epidemic was rapidly generated and developed rapidly. If some online public opinions cannot be effectively responded to and guided, it will bring risks to social order. The government should understand how to use information on social media to grasp public demands, provide useful information in a timely manner and take countermeasures. Studying the formation mechanism of online public opinion during the outbreak can help the government make scientific decisions and improve risk management capabilities. METHODS: The research selects the public opinion information of online platforms represented by WeChat, online communities, Sina Weibo and search engines, involving 75 relevant texts (1 January to 31 March 2022). According to the grounded theory method, using the QSR NVivo12 qualitative research software, the collected network texts were successively researched using open coding, axial coding and theoretical coding. RESULTS: The structure of online public opinion during the COVID-19 epidemic was obtained. The operation mechanism of the online public opinion system about COVID-19 was mainly affected by the interaction of online public opinion objects, online public opinion subjects, online public opinion intermediaries and government forces. It was based on social facts and citizens' appeals as the starting point, subject behaviors and prevention and control measures as the focus, government's governance as macro-control and citizens' evaluation as the guide. CONCLUSIONS: Scientific analysis of online public opinion is an important tool to identify and manage risks and improve the quality of government activities. Online public opinion has the function of assisting government decision-making, and the government can identify the important information reflected in it, especially the mainstream public opinion, as a reference for decision-making. By taking effective measures and properly responding to citizens' reasonable demands, the government can prevent social risks and avoid new negative public opinions. Contributions: According to the characteristics of the basic model of online public opinion, this study provides risk mitigation suggestions for Chinese public sectors to use online public opinion, optimize epidemic prevention policies and formulate strategic measures.


Subject(s)
COVID-19 , Public Opinion , Humans , COVID-19/epidemiology , Grounded Theory , China/epidemiology , Risk Management
6.
Children (Basel) ; 9(11)2022 Nov 11.
Article in English | MEDLINE | ID: covidwho-2109963

ABSTRACT

Pediatric burns represent a significant public health problem. We analyzed the characteristics of pediatric burns in a reference center, in order to identify better strategies for prevention and care. Burn patients admitted to the pediatric departments of our hospital from January 2020 to June 2022 were retrospectively evaluated. Age, gender, the etiology of injuries, the total burn surface area (TBSA), the degree of burns, the length of hospital stay (LOS), concomitant SARS-CoV-2 infection, and burn surface microbial colonization were analyzed. Forty-seven patients were included in the analysis (M:F = 1:0.67). Most of the cases involved patients between 0 and 4 years of age (83%). Hot liquid burns accounted for 79% of cases, flame burns for 9%, thermal burns for 6%, scald burns for 4% and chemical burns for 2%. Mean TBSA was 14 ± 11%. A second-degree lesion was detected in 79% of patients and third-degree in 21%. Mean LOS was 17 days. No additional infection risks or major sequelae were reported in patients with SARS-CoV-2 infection. Fifteen different species of bacteria plus C. parapsilosis were isolated, while no anaerobic microorganisms were detected. In the light of our experience, we recommend a carefully planned and proactive management strategy, always multidisciplinary, to ensure the best care for the burned child.

7.
Egyptian Journal of Anaesthesia ; 38(1):629-635, 2022.
Article in English | Web of Science | ID: covidwho-2107025

ABSTRACT

Background Critically ill COVID-19 patients are at risk of developing major complications with high mortality rate. Aspirin might have favorable effects in severe COVID-19 via various mechanisms besides inhibition of platelet aggregation. The role of aspirin as adjuvant therapy in critically ill patients with COVID-19 has not been studied. In this study, we investigated the correlation between aspirin use and the clinical outcome in critically ill COVID-19 patients. Methods This is a retrospective cohort observational study of critically ill COVID-19 Egyptian patients. Participants were divided into two groups: patients who received aspirin, 150 mg per day orally, upon admission to the intensive care unit, and those who did not. The primary outcome in this study was the shift to invasive ventilatory support. Results A total of 1190 patients were involved in the study, 660 patients received aspirin, while 530 patients did not. Among aspirin group compared to non-aspirin group, invasive ventilatory support, DVT, PE, stroke, ACS, ARDS, AKI, septic shock, and mortality were less frequent, and the differences were significant except for ACS, AKI, and septic shock. Major bleeding was non-significantly more frequent. The length of ICU stay was significantly longer among non-survivors, and shorter among survivors. The variations between the two groups were significant among subgroups >= 40 or 60. Conclusions In critically ill patients with COVID-19, aspirin has the potential role as an adjuvant therapeutic, lowering the risk of mechanical ventilation, thromboembolic events, ARDS, and ICU mortality. Patients older than 40 years were a significant category that might benefit from aspirin.

8.
Eur J Gen Pract ; : 1-7, 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2107052

ABSTRACT

BACKGROUND: Physical activity (PA) is associated with health benefits. Previous studies have shown that regular PA decreases the incidence of viral respiratory tract infections, but data on severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection are unavailable. OBJECTIVES: The objective of this study is to examine the association between PA frequency and SARS-CoV-2 infection. METHODS: A population-based cross-sectional study was conducted on data from 1 February 2020 to 31 December 2020, using the registry of Leumit Health Services (LHS), a national health maintenance organisation in Israel. All LHS patients aged 18 to 80 years who underwent at least one RT-PCR test for SARS-CoV-2 during the study period were included. We examined the association between PA frequency (hours per week) and being tested positive for SARS-CoV-2. RESULTS: Of 113,075 subjects tested for SARS-CoV-2 by RT-PCR (mean age 41.6 years, 54.4% female), 17,465 (15%) were positive. In the SARS-CoV-2-negative group, significantly more subjects were engaged with PA than in the SARS-CoV-2-positive group [crude odds ratio (OR) for any PA 0.75 (95% confidence interval (CI) 0.72-0.77)]. After adjusting for possible confounders, PA frequency had a significant negative association with the likelihood of being SARS-CoV-2 positive (adjusted OR 0.67, 95% CI 0.64-0.68). Moreover, as the frequency of PA increased, the ORs of being SARS-CoV-2-positive decreased (occasional PA: OR 0.71, 95% CI 0.67-0.74; PA 1-3 times/week: OR 0.62, 95% CI 0.58-0.65 and PA > 3 times/week: OR 0.54, 95% CI 0.49 - 0.59). CONCLUSION: Our large population-based study in patients undergoing SARS-CoV-2 RT-PCR testing showed that a higher frequency of PA is associated with a lower rate of positive test results.

9.
J Clin Virol ; 158: 105326, 2022 Nov 12.
Article in English | MEDLINE | ID: covidwho-2105316

ABSTRACT

BACKGROUND: To prevent spread to patients and co-workers, health care workers (HCWs) infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) should quickly be identified. Although real time polymerase chain reaction (RT-PCR) is the gold standard, this test takes several hours, during which a HCW is unable to work. Antigen (Ag) tests may be an efficacious means of screening HCWs since they are easy to perform and provide fast results. METHODS: In this study, 48,010 paired results of Ag-testing and RT-PCR, performed on HCWs between January 2021 and April 2022, were evaluated to determine the diagnostic accuracy of SARS-CoV-2 Ag-tests in diagnosing potentially infectious individuals. This analysis was performed with cycling threshold values (Ct-values) ≤30 and ≤25 as cut-offs. RESULTS: Respectively 3.1% (n = 1507) and 0.3% (n = 140) of Ag-tests were positive or indeterminate, and thus indicative for SARS-CoV-2 infection. In total, 2479 (5.2%) RT-PCRs were positive, of which 1529 (61.7%) had a Ct-value ≤25 and 402 (16.2%) a Ct-value between 26 and 30. At Ct-value ≤30 as a cut-off, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Ag-tests were 79.0%, 99.8%, 93.8% and 99.1%, respectively. At Ct-value ≤25, sensitivity further improved to 92.0%, by which the NPV increased to 99.7%. CONCLUSIONS: To prevent transmission from HCWs to patients and co-workers, while maintaining workforce capacity, Ag-tests are a valuable addition to RT-PCR tests, as they have a quick turnaround time and excellent sensitivity for identifying individuals with high potential for transmission.

12.
Journal of Education Culture and Society ; 13(2):285-295, 2022.
Article in English | Web of Science | ID: covidwho-2102026

ABSTRACT

Aim. At-risk individuals have many forms, often it is the two opposing sides of a personality which can ultimately implement risky behaviour only to accept an individual into a peer group. Concept. The risky behaviour of young people and children currently associated with a consumer society aggravated by the pandemic situation Covid-19 is the subject of interest in professional as well as scientific research of various professionals who work in different areas of life. Methods. This study deals with the risks, social, but also individual consequences of at-risk youth, which occur at all levels of society. In the study, we proceeded in an analytical-synthetic way, interpreting and ascertaining the results of various other scientific and professional studies by foreign authors who deal with the given issue. Results. The study confirms that risky behaviour requires a constant approach to educating a young person through not only the family but also the school environment, which allows a new perspective on risky youth behaviour. However, it is very important to integrate young people into society to see the risks of their behaviour not only for themselves. but for a narrower or wider comm unity. Conclusion. The scientific articles and contributions offered in this study point out the risky behaviour of young people, the risks of behaviour not only for individuals but also for groups, it points out the possible causes, reasons, but also consequences of risky behaviour.

13.
Dissertation Abstracts International: Section B: The Sciences and Engineering ; 83(12-B):No Pagination Specified, 2022.
Article in English | APA PsycInfo | ID: covidwho-2101952

ABSTRACT

Teaching is one of the most emotionally exhausting careers due to high demands and workload, insufficient resources and supports, and student behavior management (Day et al., 2007;Demerouti et al., 2001;Trait, 2008). Increased stress related to teaching makes teachers highly susceptible to developing burnout, a psychological state characterized by emotional exhaustion, depersonalization, and a reduced sense of accomplishment (Maslach et al., 2001). Burnout in teachers is associated with lower levels of student achievement as students are directly impacted by the environment around them, including teacher well-being (Yavuz, 2009). With the COVID-19 pandemic disrupting schools since March of 2020, teachers have been asked to adapt to challenging circumstances in their professional and personal lives. Research is limited on how the COVID-19 pandemic has impacted teachers' psychological well-being and the development of burnout in this population (Sokal et al., 2020). Variables have been found in the literature that protect against burnout, and some are explicitly associated with teachers. Optimism, intrinsic motivation, and social support are variables that have been found to protect against burnout in the teaching profession (Hassan et al., 2017;Otero-Lopez et al., 2014;Tornuk & Gunes, 2020). In the current study, the researcher aims to expand on research regarding burnout in teachers related to the COVID-19 pandemic and whether personal variables that have previously served as a buffer against burnout have remained protective in the pandemic. Support was provided for the relationship between burnout and the resiliency variables intrinsic motivation, optimism, and social support. Within this sample, individuals who presented with greater levels of these resiliency variables were less likely to demonstrate high levels of burnout. Perceived stress was also examined and accounted for the most variance in burnout in this sample, suggesting that stress levels were high in the sample. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

14.
G Ital Med Lav Ergon ; 44(1): 32-40, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-2101747

ABSTRACT

SUMMARY: SARS-CoV-2-related infection can determine hospital-acquired infections among patients and healthcare workers. Aim of this paper was to review the literature for developing a strategy for protecting healthcare workers, patients, and visitors by COVID-19 hospital infection. A critical and rapid revision of the literature and international standards and Regulations on this topic allowed us to propose an evidencebased strategy in the framework of the workplace risk assessment for preventing nosocomial COVID-19 outbreaks. The virus' high transmissibility, the high prevalence of asymptomatic carriers and false-negative Covid-19 rates on naso- and oropharingeal swabs, put hospitals at high-risk of COVID-19 outbreaks. A comprehensive strategy based on standard precautions, administrative, environmental, and engineering controls, a screening protocol for patients on their admission to hospital, and a testing-based strategy for HCWs within health surveillance programs may prevent the onset of hospital outbreaks, which are a threat to community, patients and HCWs, compromising the sustainability of healthcare facilities.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , SARS-CoV-2 , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infection Control , Health Personnel , Hospitals
15.
Antimicrobial resistance policy information and action brief series| ; 2022.
Article in English | WHOIRIS | ID: covidwho-2101138
16.
Nutricion Clinica Y Dietetica Hospitalaria ; 42(3):152-159, 2022.
Article in English | Web of Science | ID: covidwho-2100424

ABSTRACT

Introduction: Skipping meals has been associated with cardiometabolic risk factors such as overweight and insulin re-sistance. Despite this, data on the frequency of meals and the influence on the nutritional and metabolic status of individu-als with type 2 Diabetes Mellitus (DM2) are scarce.Objective: To investigate the correlation between missed meals, body mass index (BMI) and metabolic profile of DM2 patients during the COVID-19 pandemic.Methodology: Cross-sectional study with 107 individuals followed at a Nutrition outpatient clinic of a reference hospi-tal in Fortaleza, Ceara. Socioeconomic, clinical, anthropomet-ric and biochemical data were collected. Meal omission was verified using a 24-hour dietary recall. The correlation be-tween the variables was verified by the Spearman and Chi -Square test, considering p<0.05 as significant.Results: The mean age of participants was 62 +/- 11.34 years, where most were women (57.9%). The mean BMI was 28.67 +/- 5.13 kg/m2 and most were overweight (68%). Participants ate an average of 5 +/- 0.94 meals per day. The median number of meals skipped was 1 (0 -3) and 60.7% skipped at least 1 meal. The most missed meals were supper (41%) and a morning snack (38%). There was a significant positive correlation between the number of skipped meals with BMI and weight.Conclusion: The number of skipped meals is directly cor-related with the nutritional status of older adults and elderly people with DM2.

17.
Psychiatry Investig ; 19(10): 847-856, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2100913

ABSTRACT

OBJECTIVE: Owing to prolonged social distancing and the resultant isolation, the prevalence of depression and suicidality has increased during the COVID-19 pandemic. This study aimed to investigate the severity of depression and suicidality in Korean community populations and examine their awareness of suicide and suicide prevention during the pandemic. METHODS: This study surveyed a community population in 2020 and 2021, involving 668 participants. We evaluated the severity of depression and suicidality using the Patient Health Questionnaire-9 and Beck Scale for Suicidal Ideation as well as questions about awareness of suicide. We performed a correlation analysis to confirm the association between variables, and compared participants' suicide awareness according to the severity of depression. RESULTS: The severity of depression and suicidality in the community population decreased in 2021 compared to 2020. Awareness of the importance of suicide prevention increased in 2021, but the percentage reporting that it is possible decreased slightly. The group with higher depressive symptoms reported a lower possibility of suicide prevention. CONCLUSION: Increasing social interest in suicide, as well as awareness of suicide prevention, is important for reducing suicide rates. Suicide prevention campaigns, education, and social policies are needed, particularly during the pandemic.

18.
Rev Panam Salud Publica ; 46: e23, 2022.
Article in Spanish | MEDLINE | ID: covidwho-2100871

ABSTRACT

Objective: Assess the impact of interventions introduced in Costa Rica during 2020 and 2021 to control the COVID-19 pandemic. Methods: A Bayesian Poisson regression model was used, incorporating control or intervention measures as independent variables in the changes in reported case numbers per epidemiological week. Results: The results showed the relative and combined impact of containment policies and measures on the reduction of cases: mainly vehicular traffic restrictions, use of masks, and implementation of health guidelines and protocols. Evidence of impact was optimized and made available for decision-making by the country's health and emergency authorities. Several iterations were generated for constant monitoring of variations in impact at four different moments in the pandemic's spread. Conclusion: The simultaneous implementation of different mitigation measures in Costa Rica has been a driving force in reducing the number of COVID-19 cases.


Objetivo: Avaliar o impacto das intervenções realizadas na Costa Rica durante 2020 e 2021 para o controle da pandemia de COVID-19. Método: Foi utilizado um modelo Bayesiano de regressão de Poisson que incorporou as medidas de controle ou intervenção como variáveis independentes sobre a variação do número de casos por semana epidemiológica. Resultados: Os resultados evidenciaram o efeito relativo e conjunto que as políticas ou medidas de contenção tiveram na redução de casos, principalmente as restrições a veículos, o uso de máscaras e a implementação de diretrizes e protocolos de saúde. As evidências dos efeitos foram otimizadas e disponibilizadas às autoridades sanitárias e de emergência do país para auxiliar na tomada de decisão. Diversas iterações foram geradas para o monitoramento constante da variação nos efeitos em quatro momentos distintos do avanço da pandemia. Conclusão: A aplicação simultânea de diferentes medidas de mitigação na Costa Rica tem sido um agente promotor da diminuição de casos de COVID-19.

19.
Cureus ; 14(9): e29686, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2100377

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic, which started in 2019, has created unprecedented public health problems, mental health crises, and economic and social problems. These effects have been studied by numerous researchers on the general population but none on hospitalized and discharged COVID-19 patients. AIM: To assess psychological and social problems among hospitalized and discharged COVID-19 patients. METHODS: During lockdown and post-lockdown in India, we interviewed 500 COVID-19 patients admitted at our tertiary care center during their hospitalization and post-discharge period for psychological and social problems. RESULTS: The common psychological issues in hospitalized patients during lockdown were anxiety and misconceptions about COVID-19, while insomnia, anxiety, and frustration were common during the post-lockdown period. The typical social problems in hospitalized patients during the lockdown were containment-related issues, discrimination, longer wait for repeat COVID-19 tests, and boredom; whereas issues related to employment and financial matters were common during post-lockdown. Psychological problems comparatively decreased whereas social problems increased after discharge. CONCLUSION: Unrehearsed mitigation strategies at the beginning of the pandemic unknowingly led to various psychological and social problems. It was further aggravated by a lack of information and miscommunication.

20.
Viruses ; 14(11)2022 Nov 06.
Article in English | MEDLINE | ID: covidwho-2099864

ABSTRACT

Otitis media is one of the most common diseases in children, with 80% of children experiencing it by the age of three years. Therefore, the resulting social burden is enormous. In addition, many countries still suffer from complications due to otitis media. Meanwhile, COVID-19 has affected many diseases, with otitis media being one of the most strongly affected. This review aims to find out how COVID-19 has affected otitis media and its significance. A series of measures brought about by COVID-19, including emphasis on personal hygiene and social distancing, had many unexpected positive effects on otitis media. These can be broadly classified into four categories: first, the incidence of otitis media was drastically reduced. Second, antibiotic prescriptions for otitis media decreased. Third, the incidence of complications of otitis media was reduced. Fourth, the number of patients visiting the emergency room due to otitis media decreased. The quarantine measures put in place due to COVID-19 suppressed the onset and exacerbation of otitis media. This has great implications for the treatment and prevention of otitis media.


Subject(s)
COVID-19 , Otitis Media , Child , Humans , Child, Preschool , COVID-19/epidemiology , Pandemics/prevention & control , Otitis Media/epidemiology , Otitis Media/prevention & control , Otitis Media/complications , Incidence , Anti-Bacterial Agents/therapeutic use
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