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1.
Ann Oper Res ; : 1-43, 2022 May 03.
Article in English | MEDLINE | ID: covidwho-1820664

ABSTRACT

The year 2020 can be earmarked as the year of global supply chain disruption owing to the outbreak of the coronavirus (COVID-19). It is however not only because of the pandemic that supply chain risk assessment (SCRA) has become more critical today than it has ever been. With the number of supply chain risks having increased significantly over the last decade, particularly during the last 5 years, there has been a flurry of literature on supply chain risk management (SCRM), illustrating the need for further classification so as to guide researchers to the most promising avenues and opportunities. We therefore conduct a bibliometric and network analysis of SCRA publications to identify research areas and underlying themes, leading to the identification of three major research clusters for which we provide interpretation and guidance for future work. In doing so we focus in particular on the variety of parameters, analytical approaches, and characteristics of multi-criteria decision-making techniques for assessing supply chain risks. This offers an invaluable synthesis of the SCRA literature, providing recommendations for future research opportunities. As such, this paper is a formidable starting point for operations researchers delving into this domain, which is expected to increase significantly also due to the current pandemic.

4.
J Korean Med Sci ; 37(41): e300, 2022 Oct 24.
Article in English | MEDLINE | ID: covidwho-2089757

ABSTRACT

BACKGROUND: The Democratic People's Republic of Korea (North Korea) had successfully suppressed the coronavirus disease 2019 (COVID-19) epidemic via border closures. However, a rapid surge in incidence was reported due to the spread of the omicron variant (B.1.1.529), leading to a national emergency declaration in May 2022. Moreover, with the lack of vaccine accessibility and medical facilities, it is unclear how the disease burden may be exacerbated. Despite the limited epidemiological data, we aimed to project the COVID-19 transmissions in North Korea and quantify the potential impact of nationwide vaccination, comparing epidemiological outcomes via scenario analysis. METHODS: A discrete-time deterministic compartmental model was used. The parameters were calibrated using empirical data. Numerical simulations incorporated nationwide COVID-19 vaccination into the proposed model with various asymptomatic proportions. RESULTS: Our model suggested that the stringent public health and social measures (PHSMs) reduced the severe acute respiratory syndrome coronavirus 2 transmissibility by more than 80% in North Korea. Projections that explicitly incorporated vaccination indicated that nationwide vaccination would be necessary to suppress a huge resurgence in both COVID-19 cases and hospitalizations after the stringent PHSMs are eased. Moreover, vaccinating more than 80% of the population with two doses may keep the peak prevalence of hospitalizations below 1,500, averting more than 40,000 hospitalizations across all scenarios. CONCLUSION: Nationwide vaccination would be essential to suppress the prevalence of COVID-19 hospitalizations in North Korea after the stringent PHSMs are lifted, especially in the case of a small asymptomatic proportion.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , SARS-CoV-2 , Democratic People's Republic of Korea/epidemiology , COVID-19 Vaccines , Vaccination
5.
Indoor Air ; 32(10): e13125, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2088233

ABSTRACT

Contaminant transport and flow distribution are very important during an elevator ride, as the reduced social distancing may increase the infection rate of airborne diseases such as COVID-19. Studying the airflow and contaminant concentration in an elevator is not straightforward because the flow pattern inside an elevator changes dramatically with passenger movement and frequent door opening. Since very little experimental data were available for elevators, this investigation validated the use of computational fluid dynamics (CFD) based on the RNG k- ∈ $$ \in $$ turbulence model to predict airflow and contaminant transport in a scaled, empty airliner cabin with a moving passenger. The movement of the passenger in the cabin created a dynamic airflow and transient contaminant dispersion that were similar to those in an elevator. The computed results agreed reasonably well with the experimental data for the cabin. The validated CFD program was then used to calculate the distributions of air velocity, air temperature, and particle concentration during an elevator ride with an index patient. The CFD results showed that the airflow pattern in the elevator was very complex due to the downward air supply from the ceiling and upward thermal plumes generated by passengers. This investigation studied different respiratory activities of the index patient, that is, breathing only, breathing, and coughing with and without a mask, and talking. The results indicated that the risk of infection was generally low because of the short duration of the elevator ride. If the index patient talked in the elevator, two passengers in the closest proximity to distance would be infected.


Subject(s)
Air Pollution, Indoor , COVID-19 , Humans , Elevators and Escalators , Aircraft , Hydrodynamics
6.
J Environ Sci Health A Tox Hazard Subst Environ Eng ; 57(11): 970-976, 2022.
Article in English | MEDLINE | ID: covidwho-2087557

ABSTRACT

The main goal of this study is to compare concentrations of atmospheric Hg(p) for various particles sizes Total Suspended Particulates (TSP), PM18, PM10, PM2.5, PM1, PM<1 before (2018-2019) and during (2019-2020 and 2020-2021) COVID-19 occurred periods in central Taiwan. In addition, test the statistical differences concentrations of Hg(p) for various particles sizes before and during COVID-19 occurred periods in central Taiwan. Finally, calculate the Hg(p) health risk assessment before and during COVID-19 occurred period in central Taiwan.The result indicated that the mean Hg(p) concentrations in TSP and PM2.5 were higher during (2020-2021) the COVID-19 occurred period than that of the mean Hg(p) concentrations in TSP and PM2.5 before the COVID-19 occurred period. In addition, the Hg(p)concentrations PM18, PM10, PM2.5, PM1 and PM<1 were all increased during the COVID-19 occurred period. The Hg(p) concentrations in TSP were decreased during (2019-2020) the COVID-19 occurred period when compared with that of the before the COVID-19 occurred period. Moreover, significant mean Hg(p) concentrations differences were existed at PM18, PM10 and PM2.5 before and during (2020-2021) COVID-19 occurred periods. Finally, the HQ and HI values for Hg(p) were both increased during COVID-19 occurred periods when compared with before COVID-19 occurred period in this study.


Subject(s)
Air Pollutants , COVID-19 , Mercury , Humans , Air Pollutants/analysis , Particle Size , Environmental Monitoring , COVID-19/epidemiology , Taiwan/epidemiology , Mercury/analysis , Dust , Particulate Matter/analysis , Seasons
7.
Dialogues in Health ; JOUR: 100061,
Article in English | ScienceDirect | ID: covidwho-2086113

ABSTRACT

Introduction Arbaeen is a religious ceremony held annually with the participation of a large number of pilgrims. During the pandemic of Covid-19, a mass gathering of Arbaeen pilgrims can strengthen the transmission of this disease and put more pressure on the health care system of countries. The aim of the study is to evaluate the risk of Arbaeen ceremony in the Covid-19 pandemic in 2021. Materials and methods A mixed method was performed to perform the study using qualitative and quantitative methods. A national risk assessment tool was used that consisted of hazard identification and assessment, scenario development, exposure assessment, vulnerability assessment and risk estimation. The national risk assessment tool was completed through a focused group discussion and the opinions of 20 representatives of the health system and the level of risks were estimated. Data were collected, analyzed, and integrated by the research team. Results Based on the results of risk matrix analysis, factors such as the increase in the number of new cases of COVID-19, the probability of exposure to a new variant of COVID-19, the probability of arrival of a new variant of COVID-19 to the country, the probability of increasing referrals to healthcare facilities (score 16), the probability of getting respiratory diseases, and the environmental contamination (score 12) occupied the red area of the matrix and were found to have the highest risk (unbearable risk), that needs immediate action. Conclusion Preparing for a mass gathering such as Arbaeen is very important in order to reduce the risk of communicable disease, and the first step in improving preparedness is risk assessment and its continuity in the various stages of the ceremony. Therefore, policy makers and planners of such events should conduct risk assessments with the participation of local and national public health authorities regularly.

8.
Dissertation Abstracts International: Section B: The Sciences and Engineering ; JOUR(12-B):No Pagination Specified, 83.
Article in English | APA PsycInfo | ID: covidwho-2083881

ABSTRACT

This study aimed to understand the usefulness of the Basic Adlerian Scales for Interpersonal Success - Adult Form (BASIS-A) profile scores in the risk assessment of individuals convicted of a sexual criminal offense. Specifically, this study attempted to determine if a correlation existed between an individual's level of social interest and the difference in that individual's level of risk over time as measured by the STABLE-2007 and the Sex Offender Treatment Intervention and Progress Scale (SOTIPS) dynamic risk assessments. Due to the COVID-19 pandemic, the study was adapted to a hybrid of both in-person and virtual participation involving six total participants recruited from a private practice in suburban Illinois. Results of the partial correlation were not significant and deemed inconclusive due to low study participation. The impact of the pandemic on the study's outcome and the study's contribution to practice-oriented research as well as recommendations for future research regarding the BASIS-A, risk assessment, and practice-oriented research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

9.
Research and Practice in Thrombosis and Haemostasis ; JOUR(7), 6.
Article in English | Web of Science | ID: covidwho-2082399

ABSTRACT

Background A rise in hospital-acquired venous thromboembolism (HA-VTE) in children has led to increased awareness regarding VTE prophylaxis and risk assessment. Despite this, no consensus exists regarding these practices in pediatrics. Objective To describe common practices in VTE prophylaxis, VTE risk assessment models, and anticoagulation dosing strategies in pediatric hospitals that are members of the Children's Hospital Acquired Thrombosis (CHAT) Consortium. Methods An electronic survey of 44 questions evaluating practices surrounding pediatric HA-VTE risk assessment and prevention was distributed between August 9, 2021, and August 30, 2021, to the primary investigators from the 32 institutions within the CHAT Consortium. Results The survey response rate was 100% (n = 32). In total, 85% (n = 27) of the institutions assess HA-VTE, but only 63% (n = 20) have formal hospital guidelines. Within the institutions with formal guidelines, 100% (n = 20) include acute systemic inflammation or infection and presence of a central venous catheter (CVC) as risk factors for VTE. Pharmacologic prophylaxis is prescribed at 87% (28) of institutions, with enoxaparin being the most frequent (96%, n = 27). Variability in responses persisted regarding risk factors, risk assessment, thromboprophylaxis, dosing of prophylactic anticoagulation or anticoagulant drug monitoring. A majority of providers were comfortable providing thromboprophylaxis across all age groups. In addition, the global coronavirus disease 2019 increased the providers' use of prophylactic anticoagulation 78% (n = 25). Conclusion Practices among institutions are variable in regard to use of HA-VTE prophylaxis, risk assessment, or guideline implementation, highlighting the need for further research and a validated risk assessment model through groups like the CHAT Consortium.

10.
J Med Imaging Radiat Sci ; 2022 Oct 23.
Article in English | MEDLINE | ID: covidwho-2082619

ABSTRACT

INTRODUCTION: The COVID-19 pandemic had a profound impact on the provision of obstetric ultrasound services, leading to the publication of new guidance and requirement for individual departmental risk assessments in the UK. The impact of these changes on clinical practice for UK obstetric sonographers is not currently well reported in published literature. METHODS: Obstetric sonographers working in the UK (n = 138) used the Qualtrics XMTM platform to complete an anonymous, online questionnaire about their experiences during the pandemic. Participants responded to closed-type questions about national guidance, risk assessment and their perception of support, and provided additional detail about their experiences in these areas through free-text response options. RESULTS: Over 90% of respondents were aware of or had read guidance issued by professional organisations, although challenges for its implementation in departments were identified. These were commonly related to the clinical working environment and included limitations on physical space (76.3%), time constraints (67.5%) and ventilation (61.3%). Sonographers felt most supported by their ultrasound colleagues (83.5%) and line managers (41.2%). They felt least supported by senior management and leadership personnel (60.8%), other antenatal colleagues (51.5%) and professional organisations (41.2%). CONCLUSION: Obstetric sonographers will need support from the wider service team and professional organisations to facilitate post-pandemic recovery of the workforce. Formal clinical supervision programmes may be beneficial in facilitating a more holistic approach to peer-support, although there is currently limited evidence of their use in sonographic practice.

11.
Sci Total Environ ; : 159682, 2022 Oct 24.
Article in English | MEDLINE | ID: covidwho-2082446

ABSTRACT

The Bohai Bay as a typical semi-enclosed bay in northern China with poor water exchange capacity and significant coastal urbanization, is greatly influenced by land-based inputs and human activities. As a class of pseudo-persistent organic pollutants, the spatial and temporal distribution of Pharmaceuticals and Personal Care Products (PPCPs) is particularly important to the ecological environment, and it will be imperfect to assess the ecological risk of PPCPs for the lack of systematic investigation of their distribution in different season. 14 typical PPCPs were selected to analyze the spatial and temporal distribution in the Bohai Bay by combining online solid-phase extraction (SPE) and HPLC-MS/MS techniques in this study, and their ecological risks to aquatic organisms were assessed by risk quotients (RQs) and concentration addition (CA) model. It was found that PPCPs widely presented in the Bohai Bay with significant differences of spatial and seasonal distribution. The concentrations of ∑PPCPs were higher in autumn than in summer. The distribution of individual pollutants also showed significant seasonal differences. The high values were mainly distributed in estuaries and near-shore outfalls. Mariculture activities in the northern part of the Bohai Bay made a greater contribution to the input of PPCPs. Caffeine, florfenicol, enrofloxacin and norfloxacin were the main pollutants in the Bohai Bay, with detection frequencies exceeding 80 %. The ecological risk of PPCPs to algae was significantly higher than that to invertebrates and fish. CA model indicated that the potential mixture risk of total PPCPs was not negligible, with 34 % and 88 % of stations having mixture risk in summer and autumn, respectively. The temporary stagnation of productive life caused by Covid-19 weakened the input of PPCPs to the Bohai Bay, reducing the cumulative effects of the pollutants. This study was the first full-coverage investigation of PPCPs in the Bohai Bay for different seasons, providing an important basis for the ecological risk assessment and pollution prevention of PPCPs in the bay.

12.
Int J Environ Health Res ; : 1-17, 2022 Oct 15.
Article in English | MEDLINE | ID: covidwho-2077382

ABSTRACT

Synthetic polymers with additives are used in the manufacturing of face masks (FMs); hence, FMs could be a potential source of exposure to phthalic acid esters (PAEs). India stands second in the world in terms of the FMs usage since the beginning of Covid-19 pandemic. However, little is known about the PAEs content of FMs used in India. Some PAEs, such as DEHP and DBP are suspected endocrine disrupting chemicals (EDCs); hence, wearing FM may increase the risk of exposure to these EDCs. In this study, we collected 91 samples of FMs from eight Indian cities and analyzed for five PAEs viz. DMP, DEP, DBP, BBP, and DEHP. The PAEs contents in FMs ranged from 101.79 to 27,948.64 ng/g. The carcinogenic risk of N 95 with filter, N-95, and cloth masks was higher than the threshold levels. The findings indicate the need to control PAEs in FMs through regulatory actions.

13.
Wilderness Environ Med ; 2022 Oct 13.
Article in English | MEDLINE | ID: covidwho-2069789

ABSTRACT

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic impacted the ski industry worldwide by closing or limiting access to ski resorts. Subsequently, anecdotal reports of increased backcountry use emerged in the press, with concerns of inexperienced skiers causing or having problems in the backcountry. This study attempted to quantify this and identify motivations for new backcountry skiers. METHODS: Self-identified backcountry skiers and snowboarders (aged ≥18 y) in the United States and Canada completed an anonymous 29-question online survey distributed by regional avalanche centers, education providers, and skiing organizations (n=4792). Respondents were stratified by backcountry experience, defining "newcomers" who began backcountry skiing from 2019 to 2021, coincident with the COVID-19 pandemic. Percentages of ski days spent in the backcountry were compared before and during the COVID-19 pandemic using paired t-tests and across cohorts using repeated-measures analysis of variance. Avalanche education was compared using unpaired χ2 tests. RESULTS: Of established skiers, 81% noticed more people in the backcountry and 27% reported increasing their own use. Participants reported spending 17% (95% CI, 15.8-17.9) more of their days in the backcountry during the COVID-19 pandemic, with newcomers increasing their time spent by 36% and established skiers increasing their time spent by 13% (P<0.0001). Of newcomers, 27% cited the COVID-19 pandemic as motivation to enter the backcountry and 24% lacked formal avalanche education, which is significantly higher than the 14% of established skiers (P<0.0001). CONCLUSIONS: Influenced by factors related to COVID-19, reported backcountry use increased during the pandemic. Newcomers had a lower level of avalanche education and less confidence in evaluating terrain. Because 80% of participants were recruited from avalanche safety or education websites, this likely underestimates skiers lacking avalanche awareness or education and is further limited by the nature of online surveys.

14.
Atmosphere ; 13(9), 2022.
Article in English | Web of Science | ID: covidwho-2071181

ABSTRACT

In this study, the levels of fine particulate matter (PM2.5), polycyclic aromatic hydrocarbons (PAHs) and nitro-PAHs (NPAHs) in PM2.5 samples were determined from 2020 to 2021 in Singapore. For analysis convenience, the sampling period was classified according to two monsoon periods and the inter-monsoon period. Considering Singapore's typically tropical monsoon climate, the four seasons were divided into the northeast monsoon season (NE), southwest monsoon season (SW), presouthwest monsoon season (PSW) and prenortheast monsoon season (PNE)). The PM2.5 concentration reached 17.1 +/- 8.38 mu g/m(3), which was slightly higher than that in 2015, and the average PAH concentration continuously declined during the sampling period compared to that reported in previous studies in 2006 and 2015. This is the first report of NPAHs in Singapore indicating a concentration of 13.1 +/- 10.7 pg/m(3). The seasonal variation in the PAH and NPAH concentrations in PM2.5 did not obviously differ owing to the unique geographical location and almost uniform climate changes in Singapore. Diagnostic ratios revealed that PAHs and NPAHs mainly originated from local vehicle emissions during all seasons. 2-Nitropyrene (2-NP) and 2-nitrofluoranthene (2-NFR) in Singapore were mainly formed under the daytime OH-initiated reaction pathway. Combined with airmass backward trajectory analysis, the Indonesia air mass could have influenced Singapore's air pollution levels in PSW. However, these survey results showed that no effect was found on the concentrations of PAHs and NPAHs in PM2.5 in Indonesia during SW because of Indonesia's efforts in the environment. It is worth noting that air masses from southern China could impact the PAH and NPAH concentrations according to long-range transportation during the NE. The results of the total incremental lifetime cancer risk (ILCR) via three exposure routes (ingestion, inhalation and dermal absorption) for males and females during the four seasons indicated a low long-term potential carcinogenic risk, with values ranging from 10(-10) to 10(-7). This study systematically explains the latest pollution conditions, sources, and potential health risks in Singapore, and comprehensively analyses the impact of the tropical monsoon system on air pollution in Singapore, providing a new perspective on the transmission mechanism of global air pollution.

15.
iScience ; 25(11): 105350, 2022 Nov 18.
Article in English | MEDLINE | ID: covidwho-2069209

ABSTRACT

Public climate change awareness is indispensable to dealing with climate change threats. Understanding whether and how the COVID-19 pandemic impacts on individuals' climate change risk perception would thus be critical to green economic recovery. We conducted a longitudinal survey study in China when the pandemic was at its height and when it was mitigated. The cross-lagged analysis confirmed our assumed "arousal" effect of perceived COVID-19 risks on climate change risk awareness. We further tested and verified the proposed "dual-pathway" mechanisms of affective generalization (i.e., negative affective states aroused by COVID-19 "spillover" to the assessment of climate change risk) and cognitive association (i.e., the outbreak of COVID-19 awakens people's recognition of the human-nature-climate issues) via multiple mediation analyses. Our results implied that climate policies could be integrated into pandemic control, and that the public should be more awakened to confront multiple crises with proper guidance.

16.
Journal of Hazardous Materials ; : 130176, 2022.
Article in English | ScienceDirect | ID: covidwho-2069325

ABSTRACT

Serious human health concerns have been recently raised from daily use of face masks, due to the possible presence of hazardous compounds as the phthalic acid esters (PAEs). In this study, the content of 11 PAEs in 35 commercial masks was assessed by applying a specific and accurate method, using Gas Chromatography/Mass Spectrometry. Surgical, FFP2 and non-surgical models, for both adults and children were collected from the Italian market. Analyses showed that four of the target analytes were detected in all tested samples with median total concentrations ranging between 23.6mg/kg and 54.3mg/kg. Results obtained from the experimental analysis were used in the risk assessment studies carried out for both carcinogenic and non-carcinogenic effects. Doses of exposure (Dexp) of PAEs ranged from 6.43 ×10-5mg/kg bw/day to 1.43 ×10-2 mg/kg bw/day. Cumulative risk assessment was performed for non-carcinogenic and carcinogenic effects. No potential risk was found for non-carcinogenic effects, yet the 20% of the mask samples showed potential carcinogenic effects for humans. A refined exposure assessment was performed showing no risk for carcinogenic effects. This paper presents a risk assessment approach for the identification of potential risks associated to the use of face masks.

17.
International Journal of Disaster Risk Reduction ; : 103350, 2022.
Article in English | ScienceDirect | ID: covidwho-2069096

ABSTRACT

Low-income countries (LICs) in Africa, southeast Asia, Latin America, and the Caribbeans constitute potential hotspots for future outbreaks of zoonoses. A comprehensive framework on risk drivers, assessment, and mitigation in LICs is lacking. This paper presents the nature, history, risk factors, and drivers of zoonoses in LICs. A Quantitative Microbial Risk Assessment and Hazard Analysis of Critical Control Points are proposed for assessing human health risks. The mitigation framework entails: (i) learning from the COVID-19 pandemic, (ii) the precautionary principle, (iii) raising public and stakeholder awareness, and (iv) the One World, One Health concept. Future perspectives are discussed on: (i) curbing poaching and illicit wildlife trade, (ii) translating the ‘One Health’ concept to practice, (iii) the dilemma of dealing with wildlife hosts of zoonoses, including the morality and ethics of culling versus non-culling, (iv) the challenges of source tracking and apportionment of zoonoses, and (v) decision scenarios accounting for the high human health risks and the high uncertainty in current evidence. Future directions on zoonoses include: (i) the occurrence of antimicrobial resistance, (ii) environmental reservoirs and hosts, (iii) the development of tools for source tracking and apportionment, and (iv) host-receptor-pathogen interactions. Funding models and the application of novel tools, i.e., game theory, genomics, shell disorder analysis, and geographical information systems, are discussed. The proposed framework enables a better understanding of the key risk drivers, assessment, and mitigation in LICs. Further work is needed to test and validate the framework and develop generic lessons for risk assessment and mitigation in LICs.

18.
Present Knowledge in Food Safety ; : 972-991, 2023.
Article in English | ScienceDirect | ID: covidwho-2068596

ABSTRACT

Both hazard- and risk-based approaches are used to manage the safety of foods. Each approach has merits. However, the different methodologies and terminology used can lead to challenges for public understanding and for risk communication. The widespread application of hazard analysis and critical control point (now evolving as hazard analysis and risk-based preventive controls) supported by chemical and microbial risk assessment is part of a modern food system that delivers very safe food. Nonetheless, many consumers are worried about food safety and there are professional differences about the best ways of protecting public health. Several approaches have been proposed for the better classification of chemical hazards. In addition, frameworks are evolving that can support better regulation based on hazards and risks. This has the potential to improve priority setting and public understanding. Risk assessment has been in the public spotlight during the COVID-19 pandemic and new scientific tools have been deployed (e.g., wastewater surveillance) that have the potential to improve food microbial risk assessment and consumer understanding. Finally, data triangulation from multiple methods may support better hazard identification and risk assessment with the potential to improve public confidence in food safety.

19.
Vaccines (Basel) ; 10(10)2022 Sep 28.
Article in English | MEDLINE | ID: covidwho-2066598

ABSTRACT

The active immunization of health care workers (HCWs) is a crucial measure to avoid nosocomial infection; nevertheless, vaccine coverage (VC) among health personnel in Italy is unsatisfactory. To improve VC in the healthcare set, the Hygiene and Occupational Medicine departments of Bari Policlinico General University Hospital applied a specific program. The operative procedure demands that in the context of the occupational medical examination, all workers are evaluated for susceptibility to vaccine-preventable diseases (VDPs), with immunization prophylaxis offered to those determined to be susceptible. This study analyzed data from workers who attended the biological risk assessment protocol from December 2017 to October 2021 (n = 1477), who were evaluated for the immune status for measles, mumps, rubella, and varicella. Among the enrolled subjects, non-protective antibody titers were higher for measles and mumps (13%), followed by rubella (11%) and varicella (8%). Appropriate vaccinations were offered to all susceptible HCWs, and HCWs were re-tested one month after immunization. The seroconversion rate after the administration of one or more booster dose(s) was over 80%. Overall, 2.5% of the subjects refused the offered vaccine(s); the main determinant of immunization compliance was younger age (aOR = 0.86; 95%CI = 0.80-0.92). Especially during the COVID-19 pandemic, VPDs may still present a hazard in nosocomial environment. Our experience suggests that, despite hospital procedures and dedicated human assets, satisfactory VC cannot be reached without the provision of federal regulations. Nevertheless, public health policymakers have to improve the promotion of vaccine prophylaxis and education to reach higher VC.

20.
Archives of Iranian Medicine ; 25(7):443-449, 2022.
Article in English | EMBASE | ID: covidwho-2067651

ABSTRACT

Background: This study aimed to investigate CURB-65, quick COVID-19 Severity Index (qCSI) and quick Sepsis Related Organ Failure Assessment (qSOFA) scores in predicting mortality and risk factors for death in patients with COVID-19. Method(s): We retrospectively analyzed a total of 1919 cases for whom the rRT-PCR assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was positive. For mortality risk factors, univariate and multivariate logistic regression analyses were used. Receiver operator characteristics (ROC) analysis and Kaplan-Meier survival analysis were performed for CURB-65, qCSI and qSOFA scores. Result(s): The patients' average age was 45.7 (21.6) years. Male patients accounted for 51.7% (n = 992). In univariate analysis, some clinical variables including age over 65 years and comorbid diseases such as hypertension, chronic kidney disease, malignancy, lymphopenia, troponin, lactate dehydrogenase (LDH) and fibrinogen elevation were associated with the mortality rate. In multivariate logistic regression analysis: Neutrophil lymphocyte ratio (NLR) 3.3 and above (OR, 9.1;95% CI, 1.9-42), C-reactive protein (CRP)30 mg/L and above (OR, 4.1;95% CI, 1.2-13.6), D-dimer 1000 ng/mL and above (OR, 4;95% CI, 1.5-10.7) and age (OR, 1.11;95% CI, 1.04-1.18-year increase) were identified as risk factors for mortality among COVID-19 patients. The CURB-65 and qCSI scores exhibited a high degree of discrimination in mortality prediction (AUC values were 0.928 and 0.865, respectively). Also, the qSOFA score had a moderate discriminant power (AUC value was 0.754). Conclusion(s): CURB-65 and qSCI scores had a high discriminatory power to predict mortality. Also, this study identified CURB-65, qCSI and qSOFA scores, NLR, CRP, D-dimer level, and annual age increase as important mortality risk factors. Copyright © 2022 Academy of Medical Sciences of I.R. Iran. All rights reserved.

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