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1.
Biomedical Reports ; 18(1) (no pagination), 2023.
Article in English | EMBASE | ID: covidwho-2163771

ABSTRACT

Diabetes mellitus causes a decline in immunological function, an increase in proinflammatory cytokines, and a prothrombotic state, thus providing risk factors for the severity of coronavirus disease 2019 (COVID-19) in patients with type 2 diabetes mellitus (T2DM). The aim of the present study was to analyze the risk factors associated with the severity of COVID-19 in patients with T2DM. A cross-sectional observational study was performed on 201 patients with T2DM from May 1 to August 31, 2020 and admitted to the isolation ward of Dr Soetomo General Hospital (Surabaya, Indonesia). The patients were divided into severe (108 cases;53.7%) and non-severe (93 cases;46.3%) groups, which were considered the dependent variables. Univariate and multivariate analysis was performed. The independent variables were age, sex, diabetes onset, chronic complications, presence of hypertension, randomized blood glucose, HbA1c, albumin, and neutrophil-lymphocyte ratio (NLR). A P-value <0.05 was considered to be statistically significant. The median age of the 201 subjects was 56 years, with 70.1% <60 years old, 52.7% male, 76.1% with diabetes onset <10 years, and 108 patients (53.7%) in severe condition. The results of the bivariate analysis revealed that diabetes onset >10 years (OR 2.5;P=0.011) was associated with severity of COVID-19 in patients with T2DM, however hypoalbumin (OR 1.93;P=0.054) was not associated with disease severity. Furthermore, multivariate analysis revealed that male sex (OR 2.07;P=0.042), age (>=60 years) (OR 2.92;P=0.008), HbA1c (>=8%) (OR 3.55;P=0.001), hypertension (OR 4.07;P=0.001), and an NLR >=7.36 (OR 6.39;P=0.001) were associated with severe COVID-19. Collectively, it was revealed that increased NLR, hypertension, poor glycemic control, older age, and male sex were risk factors associated with the severity of COVID-19 among diabetic patients. Copyright © 2023, Spandidos Publications. All rights reserved.

2.
Journal of Pharmaceutical Negative Results ; 13:135-140, 2022.
Article in English | EMBASE | ID: covidwho-2156356

ABSTRACT

Background: The outbreak of the Covid-19 pandemic in Indonesia impacts women's reproductive health services, including pregnant women services that meet the standard, namely the administration of TT immunization. Officers at the Community Health Center (Puskesmas) are more focused on controlling the spread of COVID-19. The problem that arises due to pregnant women who are not administered Tetanus Toxoid during pregnancy is the occurrence of tetanus in the mother and baby. Objective(s): To determine the relationship between knowledge, attitudes, and support of MCH officers towards the administration of Tetanus Toxoid immunization during the COVID-19 pandemic at UPT PuskesmasPasundan, Garut Regency, for the period of June-July 2021. Method(s): Analytic observational with the cross-sectional approach. The study was conducted from June to July 2021. The population and research sample consisted of 50 people. A questionnaire was used as a research instrument.Analysis: Univariate to explain the research variables and bivariate analysis to explain the relationship between knowledge, attitudes of pregnant women, and the support of MCH officers in administering Tetanus Toxoid immunization during the covid-19 pandemic. Hypothesis testingused a statistical test, namely the Chi-Square test with SPSS 2013, and the significance level was 0.05. Result(s): Relationship between Knowledge and Administration of Tetanus Toxoid Immunization, p-value = 0.015 (p < 0.05). Relationship between Attitude and Administration of Tetanus Toxoid Immunization, p-value = 0.0001 (P <0.05). Relationship between support of MCH officers and Administration of Tetanus Toxoid immunization, p-value = 0.0001 (p < 0.05). Conclusion(s): There is a relationship between knowledge, attitudes, and support of MCH officerstowards the administration of Tetanus Toxoid immunization. It illustrates that the presence of COVID-19 slightly interferes with the administration of TT immunization to pregnant women.Suggestion: It is important to make various efforts and ways to increase the coverage of TT immunization for pregnant women during the covid-19 pandemic. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

3.
Anales de la Facultad de Medicina ; 83(4), 2022.
Article in Spanish | EMBASE | ID: covidwho-2155880

ABSTRACT

Introduction. The current COVID-19 pandemic has forced medical education to change to a virtual modality. This can influence the quality of teaching and the perception that students have about older adults. Objective. Our objective is to evaluate the perception of the self-report fulfillment of geriatric competencies (SRFGC) in medical students from universities in Lima-Peru, comparing face-to-face and virtual techniques. Methods. A cross-sectional study was designed including students from 3 universities in Lima, Peru who have taken the geriatrics course in person or virtually, measuring the main variables such as ACCG according to the recommendations of the pogoe web portal and ageing the UCLA-GAS scale. Averages and standard deviations were calculated for numerical variables and frequency for categorical variables. Bivariate analysis was also performed between ACCG and the rest of the variables measured. Results. Means 0.72 (SD=0.22) were found for the face-to-face modality and 0.75 (SD=0.23) for virtual teaching. We found no statistical association between the study variables (p value = 0.39), so there is no difference between the SRFGC between the virtual and face-to-face modalities. Through a linear regression model of SRFGC and ageism adjusted to statistically significant variables of the study, it was found that the greater the SRFGC, the greater the ageism. Conclusions. So far, it cannot be said that virtual education is inferior to face-to-face educationwith regard to the SRFGC. Copyright © 2022 Vittorio Klostermann. All rights reserved.

4.
Journal of the American Society of Nephrology ; 33:333, 2022.
Article in English | EMBASE | ID: covidwho-2124820

ABSTRACT

Background: Patients with COVID-19 have a high incidence of acute kidney injury (AKI), which is associated with mortality. The objetive of our study is to know the factors associated with AKI, to manage the level of care and health resources according to risk. Method(s): We design an observational retrospective cohort study in 2 hospitals in Bogota, Colombia. Adults hospitalized for > 48 hours between March 2020 and March 2021, with confirmed SARS-CoV-2 infection. The main outcome was incidence of AKI during the first 28 days from admission. A descriptive analysis of the sociodemographic and clinical characteristics of the study population was performed. Univariate and bivariate analysis and multivariate logistic regression model was conducted for the outcome AKI. Result(s): We included 1584 patients, 60.4% male, 46.8% older than 65 years. The incidence of AKI was 46.5%, stage 1 in 60.7%, Stage 2 in 15.7%, and stage 3 in 23.6%. Renal replacement therapy was performed in 11.1% of patients with AKI. Table 1 summarizes cohort characteristics and the bivariate analysis. In the multivariate analysis, sex, age, hypertension, CKD, treatment with oral antidiabetics, diuretics, statins, qSOFA, platelet count, CRP, D-dimer, treatment with vancomycin, piperacillin tazobactam, requirement of vasopressor support were realated with AKI. The interactions antihypertensive /diuretics, PAFI /Requirement of invasive mechanical ventilation, Hypertension /antihypertensives, were associated with AKI (P value <0.5). Hospital crude mortality for AKI was 45.5% versus 11.7% without AKI (p<0.0001) Conclusion(s): AKI is frequent in patients hospitalized with COVID 19, conventional risk factors are the rule, we denote other known markers of severity for COVID-19 in association with AKI. These results allowed us to manage the hospital resource.

5.
Revista Chilena de Infectologia ; 39(4):382-387, 2022.
Article in Spanish | EMBASE | ID: covidwho-2144033

ABSTRACT

Background: The COVID-19 pandemic that emerged in Wuhan, China at the end of 2019, spread rapidly around the world with almost 600 million cases and 6.3 million deaths today. The most affected were health workers with at least three times the risk of contracting the disease than the general community. Most studies on seroprevalence in health workers focus on hospital care establishments and what happens in Primary Health Care (PHC) has not been investigated with the same intensity. Aim(s): To determine the prevalence of SARS-CoV-2 using IgG antibodies in primary health care personnel in La Pintana commune, risk factors and clinical characteristics, prior to vaccination in Chile. Method(s): A cross-sectional design carried out in November 2020. Sociodemographic and clinical data were collected through face-to-face interviews, after providing informed consent. Specific IgG was determined by ELISA using N and S proteins. The differences between positive and negative subjects were studied using bivariate analysis and multivariate models, controlling for potential confounding variables. The study was approved by the Universidad del Desarrollo Scientific Ethics Committee. Result(s): 463 employees (51.4%) participated, finding a prevalence of 21.8%. The risk factors found were younger age, being a physician and having been in close contact with a case. 22% were asymptomatic. Among those with anosmia/ageusia, the probability of IgG+ was greater than 70%. Antibody titers increase with severity. Conclusion(s): Prevalence found in primary health care personnel is consistent with previous evidence. Younger age and medical profession are associated with a higher risk of illness. Copyright © 2022, Sociedad Chilena de Infectologia. All rights reserved.

6.
Open Access Macedonian Journal of Medical Sciences ; Part B. 10:2208-2214, 2022.
Article in English | EMBASE | ID: covidwho-2143916

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a respiratory disease that has become the largest pandemic and also could put the heart at risk of dysfunction. Galectin-3 is involved in the inflammatory process that continues with remodeling and eventually fibrosis. Using galectin-3 examination, we could predict the possible worsening of heart function and evaluate data on influencing factors for increased left ventricular end-diastolic volume (LVEDV) which could later progress to heart failure. METHOD(S): This is an observational prospective analytic study in the COVID-19 ICU of Sanglah Hospital, Bali, Indonesia. The study was conducted from June to October 2021. All research subjects had their blood samples taken for galectin-3 levels examination using enzyme-linked immunosorbent assay (ELISA). Subjects were also evaluated for left ventricular end-diastolic volume (LVEDV) with echocardiography, SOFA scores, and troponin I levels. Subjects were treated with COVID-19 standard protocol established by the Ministry of Health. After 72 h post-admission, subjects were re-examined for galectin-3 levels and LVEDV. Data were analyzed using STATATM. RESULT(S): A total of 45 research subjects were analyzed. Bivariate analysis of the difference of galectin-3 and LVEDV was shown to be insignificant (r = 0.08), no correlation was found between galectin-3 level and LVEDV on ICU admission (r = 0.191), and no correlation found between galectin-3 level and LVEDV after 72 h of hospitalization (r=0.197). Multivariate analysis also showed that none of the variables, namely, difference of galectin-3 level, age, gender, troponin I, SOFA, and Charlson scores had statistically significant correlation with LVEDV (p < 0.05). CONCLUSION(S): No significant correlation was found between galectin-3 level and an increase in LVEDV. Copyright © 2022 Marilaeta Cindryani Lolobali, I. M. G. Widnyana, Ni Made Ayu Wulansari, Ida Bagus Rangga Wibhuti, Made Wiryana, Rudyanto Sedono, Aldy Heriwardito.

7.
IOP Conference Series. Earth and Environmental Science ; 1098(1):012018, 2022.
Article in English | ProQuest Central | ID: covidwho-2119072

ABSTRACT

The Covid-19 pandemic in Indonesia has encouraged changes in society, especially in the aspect of education. Learning is conducted online and educators carry out activities from home. However, this has a negative impact on physical health, which may occur due to WFH behavior, which is Eye Fatigue. Laptop usage behavior depend on the size of the laptop, the duration and frequency of laptop usage, the visual distance, the position of the monitor and eye rest. This study intends to determine the effect of laptop usage behavior on Eye Fatigue. This study uses an observational design with a cross-sectional design. The sample of this study is 175 lecturers and use a simple random sampling technique. The used instruments are laptop usage behavior and visual fatigue index questionnaires distributed through Google Forms. Bivariate analysis was performed using the Somers’d correlation statistical test. The results show a significant level of laptop size with eye fatigue with a p-value = 0.005, while the other variables were not related. The behavior of using a laptop has affected eye fatigue especially because of the size of the laptop. They use standard laptop size and use laptop support when operating laptops.

8.
Tumori ; 108(4 Supplement):137, 2022.
Article in English | EMBASE | ID: covidwho-2115148

ABSTRACT

Background: A satisfying development of antibody title after vaccine finds out his protagonist in immune system. In oncological patient immune system can be influenced by type of active treatment as Immunotherapy, Target therapy, Chemo therapy and its premedication with anti inflammatory steroids. This study aim to determine whether cancer medical treatment influenced antibody title response to Covid 19 mRNA vaccine. Material(s) and Method(s): We retrospectively analyzed 256 vaccinated patients with two doses of Covid19 mRNA vaccine, undergoing treatment with immuno chekpoint inhibitors, target therapy, chemo therapy, in our institution between february and july 2021. Total IgG and antiSpike protein anti SARS Covid 19 antibody title, a complete blood cell count and blood dosage of vitamine D have been determined at four weeks from the end of vaccination cycle. Differences in antiCovid19 antibody title has been evaluated and compared with t-student, test Wilcoxon Mann Whitney, Kilmogorov Smirnov among each subgroup of patients according to different types of treatment. Bivariate analysis has been performed in order to asses correlation between continous variables: blood dosage of vitamine D, Neutrophils-lymphocyte-ratio (NLR) and antiSpike protein antibody title. Result(s): No statistically significant difference has been observed in total and antispike protein antibody title between subgroups according to type of oncological treatment. Bivariate analysis revealed a correlation between blood levels of vitamine D, NLR and antiSpike protein title reached. Conclusion(s): Different types of Oncological treatment as Immunotherapy, Target therapy and Chemotherapy do not influence the development of antibody title response to Covid19 mRNA vaccine;Vitamin D seems to have an important role to promote humoral immunity as well as NLR.

9.
United European Gastroenterology Journal ; 10(Supplement 8):933-934, 2022.
Article in English | EMBASE | ID: covidwho-2114211

ABSTRACT

Introduction: Trained Immunity (TI) represents a novel concept of the immunological reaction involving the innate immune cells, triggered by a second antigenic contact, gaining a long-term reversible pro-inflammatory phenotype. In liver cirrhosis, immune dysfunction impacts the onset of chronic local and systemic inflammation, the disease worsening, and the development of its complications. Aims & Methods: The aim was to highlight TI response impairment along with the progression of chronic liver disease and to estimate its implications on the cirrhosis outcome. Healthy subjects, patients with chronic hepatitis (CH) (alcoholic and nonalcoholic fatty liver disease ones), and liver cirrhosis (LC) were enrolled. For each patient, medical history and a peripheral venous blood sample were collected (20 ml). After a per gradient isolation, monocytes were sequentially stimulated with beta-glucan for 24 h (1 mug/mL) and lipopolysaccharide (LPS) (10 ng/mL) for 24 hours in order to assess the pro-inflammatory [tumor necrosis factor (TNF)-alpha, interleukin (IL)-6] and anti-inflammatory response(IL-10)(at day 3 and 6 respectively).Evaluation of blood levels of LPS, IL-6, and TNF-alpha was also performed. Result(s): Regarding TNF-alpha and IL-6, the maintenance of TI was highlighted in healthy subjects (n.10) and CH (n.15) as well but not in LC patients (n.38) (TNF-alpha controls, LPS:2800+/-628.8, beta-glucan+LPS:5046+/-136.2 pg/ ml, p:0.008, IL-6 controls, LPS:2487+/-562.4, beta-glucan+LPS:4556+/-190.2 pg/ ml, p:0.008;TNF-alpha CH, LPS:1839+/-70.7, beta-glucan+LPS:4445+/-162.6 pg/ ml, p:0.007, IL-6 CH, LPS:2576+/-177.9, beta-glucan+LPS:3865+/-332.3 pg/ml, p:0.008 ). IL-10 levels showed a typical TI trend only in healthy subjects (LPS:2797+/-518.9, beta-glucan+LPS:6001+/-1523 pg/ml p: 0.001). In cirrhotic group, the bivariate analysis revealed an inverse correlation between circulating LPS, IL-6 (R = -2.511;p = 0.01) and TNF-alpha (R: -1.887;p = 0.02). The Kaplan-Meier Log-Rank test analysis (24 LC patients with inefficient and 14 with efficient TI response) on not SARS-CoV-2 infections development and liver-related hospitalizations (HR 4.09, 95% CI: 1.57-10.61, p= 0.01;HR: 4.66, 95% CI: 1.5-14.47, p= 0.02 respectively) revealed lower risk for patients with efficient TI response. Conclusion(s): The worsening of chronic liver disease appears related to the progressive impairment of the TI response whose maintenance seems to be associated with a lower risk of unfavorable clinical events in cirrhotic patients. (Table Presented).

10.
Indian Journal of Forensic Medicine and Toxicology ; 16(3):63-68, 2022.
Article in English | EMBASE | ID: covidwho-2067687

ABSTRACT

Background: COVID-19 is a pandemic disease caused by droplet infection from SARS-CoV-2. Due to its rapid transmission and high case fatality rate, the identification of risk factors and prognostic factors is important. Obesity is a risk factor for poor outcomes in COVID-19. It is associated with chronic inflammation, disorders of the immune system. Obesity can be determined based on BMI. Chest X-Ray is supported in establishing the diagnosis and prognosis of COVID-19 patients. Assessment of the severity index of Chest X-Ray radiographs can use the Modified Chest X-Ray Scoring System of RSUP Dr. Soetomo. This study was conducted to analyze the relationship between BMI and chest radiography severity index in hospitalized COVID-19 patients at dr. Mohammad Hoesin Palembang in 2021. Methods: This research used a cross-sectional analytic observational design. Sampling was done using a consecutive sampling technique with 70 samples and obtained from the patient's medical record. The data were analyzed by univariate and bivariate (Chi-Square) using IBM SPSS Statistics 26 software. Results: Patients with BMI Overweight-Obesity had more in Moderate-Severe (18.6%) radiographic severity index scores (18.6%) than Normal-Mild (15.7%). Chi-Square bivariate analysis, BMI (p=0.033;p-value <0.05) had a significant relationship with the chest radiographic severity index with Odds Ratio 3,00, 95% CI (1,073–8,386). Conclusion: There is a significant relationship between body mass index and chest radiography severity index in COVID-19 patients. Overweight-Obesity BMI patients have a 3-fold chance of having a Moderate-Severe category of radiographic severity index compared to Underweight-Normal BMI patients.

11.
Iatreia ; 35(4):414-423, 2022.
Article in Spanish | EMBASE | ID: covidwho-2067412

ABSTRACT

Objective: To identify the clinical presentation and factors associated with anosmia and ageusia in patients with COVID-19 in a health center in a province of Peru for the period 2020-2021. Method(s): Cross-sectional analytical study through data from the COVID-19 program of the Essalud Po-lyclinic in Jauja, Peru. Sociodemographic characte-ristics, symptoms and comorbidities of the patients were detailed. A bivariate analysis identified the factors associated with anosmia and ageusia. Result(s): 356 patients were identified: 53.1 % were wo-men, mean age was 48.7 years (+/-17.8) and 261 (73.3%) with mild COVID-19. Of the total, 22.2% had anosmia and 19.9% ageusia;of which the majority were un-der 65 and female. Associated symptoms were found in 86.1% of patients with anosmia and 83.1% with ageusia. The main factors associated with anosmia were age younger than 65 years (p=0.027), cough (p<0.001), headache (p<0.001), dyspnea (p<0.001), nasal congestion (p<0.001) and fever (p<0.001);and ageusia: age younger than 65 years (p=0.006), cough (p=0.001), headache (p<0.001), dyspnea (p<0.001), nasal congestion (p<0.001) and diarrhea (p<0.001). Conclusion(s): Anosmia and ageusia are common symptoms of COVID-19. Most patients had these symptoms associated with common symptoms. Many of those who had anosmia had nasal congestion, so it is advisable to consider differentiating them when making the diagnosis. Copyright © 2022, Universidad de Antioquia. All rights reserved.

12.
CMAJ. Canadian Medical Association Journal ; 64(5 Supplement 1):S59-S60, 2021.
Article in English | EMBASE | ID: covidwho-2065172

ABSTRACT

Background: Injured adolescents may go to pediatric (PTC) or adult (ATC) trauma centres. Although there appears to be little difference in mortality when adolescents are managed in PTCs versus ATCs, evidence suggests differences in clinical processes (e.g., computed tomographic scanning, operative intervention). Moreover, there is little information on nonclinical outcome variation. We aimed to examine differences in nonclinical outcomes of injured adolescents admitted to the lead PTC or ATC within a regional Canadian trauma system. Method(s): After injury-related hospital admission at the PTC or ATC, adolescents (15-17 yr, inclusive) and parents completed the following: the Quality of Trauma Acute Care Patient-Reported (or Parent- Reported) Experience Measure (QTAC-PREM), examining clinical care, information delivery, education and social supports, and opioid exposure;the Pediatric Quality of Life Inventory;and the Brief Symptom Inventory, a psychological distress measure. Data were collected on clinical outcomes and processes. Descriptive bivariate analyses compared outcomes by trauma centre type. Result(s): Twenty-six ATC and 32 PTC patients have been enrolled to date. Survey response rates were 69% (patients) and 75% (parents) at the PTC and 58% (patients) and 54% (parents) at the ATC. There was a similar age and sex distribution between the 2 centres. Injury severity was higher at the ATC, reflected by greater mean lengths of stay (PTC 2.3 d [standard deviation (SD) 2.1 d], ATC 13.3 d [SD 23.7 d]), and lower mean Glasgow Coma Scale scores (PTC 15.0, ATC 13.8) at the ATC. There were also 3 critical care admissions at the ATC and none at the PTC among recruited patients. No differences were observed in patient- or parent-reported clinical care and follow-up experiences. There was also no difference in patient- or parent-reported social and educational support, although subscales were limited by visitor restrictions because of the COVID-19 pandemic, and the majority of injuries occurring during summer months when students were out of school. Parents at the ATC reported fewer opportunities to stay with or near their child compared with those at the PTC (100% v. 69.2%). Parents reported better information provision at the PTC (mean 17.3 [SD 1.3] v. 13.9 [SD 5.2], out of 18 as measured by the QTAC-PREM). Patients and parents were more likely to report receiving opioid prescriptions on discharge at the ATC (55.6% v. 14.3%). There was no difference in quality of life or psychological distress between the PTC and ATC. Conclusion(s): Injured adolescents and their parents indicated similar clinical and follow-up experiences, although parents felt better informed at the PTC and reported better opportunities to stay near their child. Parents and patients reported higher opioid exposures at the ATC. Sharing of communication, accommodation and opioid prescribing practices may allow for improved experiences and reduced opioid exposures in injured adolescents presenting to ATCs. Multivariable analyses are necessary in the future to adjust for injury severity differences..

13.
IOP Conference Series. Earth and Environmental Science ; 1083(1):012048, 2022.
Article in English | ProQuest Central | ID: covidwho-2062806

ABSTRACT

Covid-19 has become a disease spread pandemic around the world and treatment and prevention is carried out in compliance with government-issued health protocols. However, it doesn’t run optimally because many people don’t comply with health protocols, especially when going to health facilities. The purpose of this study is to find out the factors that affect the application of health protocols in Klinik Pratama Serasi Kec. Medan Helvetia. This type of research is quantitative descriptive design. The population was patients who visited Klinik Pratama Serasi Kec. Medan Helvetia with a sample of 186 selected with slovin formula. Data collection using health protocol behavior questionnaires that have been tested for validity and reliability and analyzed with univariate and bivariate analysis. The result is three factors that have a meaningful relationship with the application of health protocols in Klinik Pratama Serasi Kec. Medan Helvetia namely knowledge (p = 0.022), education level (p = 0.047), and compliance (p = 0.001). It is expected that patients who visit Klinik Pratama Serasi Kec. Medan Helvetia adhere more to health protocols, not only when going to the clinic, but to other public places in order to prevent the transmission of the Covid-19 virus.

14.
ASAIO Journal ; 68(Supplement 3):24, 2022.
Article in English | EMBASE | ID: covidwho-2057636

ABSTRACT

Extracorporeal membrane oxygenation (ECMO) has been used within the SARS-Cov-2 (COVID-19) pandemic to support patients with severe COVID-19 related acute hypoxemic respiratory failure that is refractory to lung-protective mechanical ventilation. The decision to offer and support patients with ECMO therapy comes from selection criteria which is more likely to demonstrate a positive outcome. However, providers may be faced with challenges regarding discontinuation of therapy when recovery appears unlikely. The in-hospital mortality rate for COVID-19 ECMO patients as reported by ELSO's registry is 47%. This retrospective single-institution study sought to determine the effect of the development of renal dysfunction on mortality rates for COVID-19 ECMO patients. In a cohort of 53 patients, 22 of these patients (41.5%) experienced mortality while receiving ECMO therapy, with a total of 26 (49.1%) experiencing mortality during ECMO therapy or within 90 days after ECMO decannulation. Correlating the outcome of mortality with the stages of severity of AKI as defined by KDIGO guidelines, this study demonstrated a significantly lower percentage of study participants in the No AKI group experienced mortality (12.5%;n=2) relative to all other categories of renal dysfunction, X2(4)=4.96, p<.05. Additionally, bivariate analysis indicated that a significantly higher percentage of study participants who required CRRT experienced mortality (77.8%;n=14) relative to all other categories of renal dysfunction, X2(1)=9.00, p<.01. This demonstrates patients requiring CRRT while on ECMO therapy for ARDS related to COVID-19 are 6.71 times more likely to experience mortality relative to those in other categories.

15.
NeuroQuantology ; 20(6):8704-8713, 2022.
Article in English | EMBASE | ID: covidwho-2033441

ABSTRACT

In 2019 the Rumbai Bukit Public Health Center was the health center with the highest prevalence of stunting in Pekanbaru City at 38.8%;this is still above Indonesia's target of 14%. This study aims to analyze the factors associated with the incidence of stunting in children under five (12-59 months) in the working area of the Rumbai Bukit Public Health Center, Pekanbaru City, in 2021. This study is a cross-sectional study. The research sample was 161 mothers with children under five aged 12-59 months in the Rumbai Bukit Health Center working area. Data on stunting children were obtained from direct measurements. Data on knowledge, birth weight of children under five, exclusive breastfeeding, age of complementary feeding, immunization, parenting, economic status, and history of infectious diseases were collected through questionnaire interviews. Bivariate analysis was carried out with a chi-square test and multivariate with a multiple logistic regression test. The study found that 19.9% of children under five were stunted. A history of infectious disease was significantly related to stunting in children under five (p < 0.05). Children under five who have infectious diseases have a 5.5 times chance of becoming stunted. It is recommended that MCH and Nutrition program holders work together to continue counseling about the importance of good parenting for children under five and increase basic immunization coverage to prevent infection during the COVID-19 pandemic.

16.
Journal of Clinical and Diagnostic Research ; 16(8):DC33-DC38, 2022.
Article in English | EMBASE | ID: covidwho-2033411

ABSTRACT

Introduction: It is crucial to determine possible factors associated with exacerbation of the disease due to the alarming global spread, morbidity and mortality associated with Coronavirus Disease-2019 (COVID-19). It is important to determine the co-morbidities associated with this disease which will help in better treatment of patients in time and to make amendments to management policy. Aim: To compare the clinical features, and predisposing factors (socio-demographic factors and co-morbidities) influencing the outcome in COVID-19 infected patients admitted in a tertiary care centre in the first and second wave of COVID-19 pandemic. Materials and Methods: The retrospective study was conducted at the Department of Microbiology, Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra, India. The data was collected from the electronic resource which was maintained by the institute Integrated Disease Surveillance Program (IDSP) health record reporting database for the duration of June 2020 to August 2021. This data included patient’s demographic details (age, sex, address, contact number), other details (history of close contacts, international travel) clinical history, different types of symptoms (ICMR patient category), co-morbidities, number of patients requiring ICU admission, type of sample, the outcome in terms of death and discharge, cause of death. The analysis was done for the complete data and then for two separate durations of the first and second wave which were compared later with Chi-square test (Bivariate analysis). Results: A total of 8841 patients were involved and the majority of patients in the study were between the age group of 30-75 years, there was a predominance of males in first and second waves with 6514 (73.7%) and 5795 (58.6%) respectively. The paediatric patients had a mortality rate of 100% (n=7) found in the second wave. Fever (39%) and dyspnea (22%) were found as the commonest presentation in both waves. Gastrointestinal manifestations were observed relatively more in the second wave. The serious patients on ventilator were found to have (>91%) the highest mortality. It appeared that the highest attributable risk to severity and mortality (eight to ten times increased) was due to hypertension, diabetes and other co-morbidities. Pregnancy did not predisposed to be as a risk factor. Conclusion: Prompt management and preventive care are needed for patients with co-morbidities to avoid the exacerbation of COVID-19 as well as drug cross interactions.

17.
European Journal of Molecular and Clinical Medicine ; 9(4):3249-3256, 2022.
Article in English | EMBASE | ID: covidwho-2030822

ABSTRACT

Background: Corona pandemic and its resultant lockdown have caused a devastated effect of life of human beings. We conducted this study during Covid-19 period to analyze the effects of lockdown on pediatric trauma variations in injury pattern and its severity among children in a tertiary hospital. Materials and Methods: Patients of less than 16 year presented to orthopedic trauma were defined in this study. The study has been divided into three time periods. Patients presented from March 2019 to July 2019 (base line period), March 2020 to July 2020 (Lockdown period) and March 2021 to July 2021 (post lockdown period) were identified and compared in this retrospective cross sectional study. The children included in this study were either requiring manipulation under anesthesia or surgical intervention in operation theatre. We conducted unadjusted bivariate analyses of injury patterns during these periods. Segmented linear regression models were used to evaluate the rates of injuries before, during and after pandemic period. The one way analysis of variance (ANOVA) was used to evaluate the differences in means of three independent groups. Results: A total of 231 numbers of children with orthopedic trauma were presented to our tertiary hospital. Out of these, 111 were admitted during pre-pandemic period and 45 in the pandemic period with 75 children during post pandemic period. During lockdown period, mean age of children with significant orthopedic trauma has decreased to 7.5 years in comparison to base line which was about 8.5 years and post lockdown period 9.25 years. Boys outnumbered the girls during this study. The outdoor injury has drastically decreased from 65.75% in base line to 35.65% in lockdown period, but this pattern has increased to 85.25% in post lockdown period. Conclusion: Our study has shown that during lock down in Covid pandemic, there was a decrease of 59.46% cases of pediatric trauma patients in which surgical intervention or manipulation in operation theatre was required. These changes in epidemiology may be due to modified approach followed by surgeon while following strict Covid guidelines. Our study has also mentioned increase in domestic injuries requiring surgical intervention which may be due to lock down implications by national protocols. We recommend to create a safe environment for children during indoor and outdoor activities and creating awareness among parents to safe guard their siblings. All above these measures may reduce the burden on health care facilities.

18.
Journal of Probability and Statistics ; 2022, 2022.
Article in English | ProQuest Central | ID: covidwho-2020486

ABSTRACT

This manuscript considers some improved combined and separate classes of estimators of population mean using bivariate auxiliary information under stratified simple random sampling. The expressions of bias and mean square error of the proposed classes of estimators are determined to the first order of approximation. It is exhibited that under some particular conditions, the proposed classes of estimators dominate the existing prominent estimators. The theoretical findings are supported by a simulation study performed over a hypothetically generated population.

19.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009582

ABSTRACT

Background: Patients with cancer, especially minority and low-income individuals, are at increased risk of financial toxicity and food insecurity. The COVID-19 pandemic has added dire economic challenges to vulnerable populations leading to a global increase in food insecurity. We sought to evaluate the severity and predictors of food insecurity among low-income patients with cancer. Methods: We conducted a cross-sectional multi-lingual survey (i.e., English, Spanish, and Chinese) on a convenience sample of patients with cancer who receive oncologic care at a safety-net hospital. Food insecurity and financial toxicity were measured using validated scales [i.e., US Department of Agriculture Household Food Security Survey and the Comprehensive Score for Financial Toxicity (COST)]. The primary outcome was food insecurity during COVID-19 and predictors of interest included sex, financial toxicity, insurance change, and degree of acculturation. Data was summarized using descriptive statistics and we explored associations between food insecurity and predictors of interest using bivariate regression. Results: A total of 140 patients participated in the study, of whom 56% were male and 47% were 50-64 years old. The most common cancer diagnoses were breast cancer (33%), followed by prostate (13%) and lung cancer (12%). The diverse study participants self-reported being 42% Hispanic/Latinx, 33% Asian, 18% Black or African American, and 14% White. Over half (52%) reported an annual household income ≤$24,999 and 50% experienced a decrease in income during the COVID-19 pandemic. The median COST score was 24 (IQR: 19-31) with 41% experiencing financial toxicity (COST < 26). Most participants experienced food insecurity, including 42% with low food security and an additional 19% with very low food security. In bivariate analysis, increasing financial toxicity (i.e., lower COST score) was associated with a 21% increased risk of very low or low food security (95% CI: 1.11-1.32) and 13% increased risk of low food security (95% CI: 1.05-1.21). Male sex was associated with 312% increased risk of very low food insecurity when compared to female sex (95% CI: 1.02-9.55). Acculturation and changes in insurance coverage were not associated with increased risk of food insecurity. Conclusions: Food insecurity was highly prevalent in this multi-ethnic cohort of low-income patients with cancer. Interestingly, male sex was significantly associated with increased risk of very low food insecurity. Further analyses should explore this potentially at-risk population, their access to nutrition-related support, and the impact of food insecurity in cancer outcomes.

20.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009577

ABSTRACT

Background: The COVID-19 pandemic rapidly altered cancer care delivery globally, providing a compelling opportunity to empirically study how these changes impacted persistent disparities in care. Cervical cancer is one of the most common female cancers worldwide, with approximately 90% of cases and deaths occurring in low- and middle-income countries (LMICs). In Botswana, a LMIC with a particularly high prevalence of HIV and cervical cancer, delays in cervical cancer diagnosis and treatment have been documented but is unknown how these delays may have been mitigated or exacerbated since the pandemic. Methods: The objective of this analysis is to evaluate patterns of cervical cancer diagnosis and treatment initiation before (January 2015-March 2020) and during the pandemic (April 2020-July 2021) using longitudinal clinical and patient-reported data from a cohort of over 1,000 patients receiving care for gynecologic cancers in Botswana. The primary outcome is timeliness of treatment defined by the number of days between first clinical visit and initiation of first-line treatment and categorized dichotomously (> 30 days classified as delay). Primary exposure is the time period (prepandemic and pandemic) defined by the month of first visit. We calculated unadjusted proportion of delays and covariates stratified by time period and used bivariate analysis to examine factors associated with each time period. We used multivariable logistic regression models to examine the association between delay and time period, adjusting for all covariates (age, stage, HIV status, rurality, screening history, and partner status). Results are presented as unadjusted proportions, adjusted odds ratios (AOR), and 95% confidence intervals. Results: Of the 1,200 patients treated for cervical cancer at the multidisciplinary clinic, 990 (82.5%) were diagnosed pre-pandemic and 210 (17.5%) during the pandemic. Among all patients with gynecologic cancers (n = 1,568), the proportion of patients with cervical cancer significantly decreased from 78.6% pre-pandemic to 68.0% during the pandemic (p < 0.001). In comparison to pre-pandemic, patients with cervical cancer during the pandemic were significantly less likely to have attended a screening clinic prior to their treatment (57.6% vs 15.3%;p < 0.001) and significantly more likely to experience treatment delays (61.6% vs 92.9%;p < 0.001). In the multivariable model, patients diagnosed during the pandemic had a 7-fold higher likelihood of treatment delays than those patients diagnosed pre-pandemic (AOR: 7.95;95% CI: 4.45-14.19). Conclusions: The pandemic significantly increased delays in treatment for nearly all patients with cervical cancer in Botswana. Given persistent global disparities in cervical cancer, there is a great need to implement evidence-based strategies for improving screening and timeliness of care in Botswana and other LMICs.

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