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1.
Computational Approaches for Novel Therapeutic and Diagnostic Designing to Mitigate SARS-CoV2 Infection: Revolutionary Strategies to Combat Pandemics ; : 1-22, 2022.
Article in English | Scopus | ID: covidwho-2149120

ABSTRACT

During the last months of 2019, numerous cases of respiratory illness such as pneumonia and acute respiratory distress syndrome were described in Wuhan, the capital city of Hubei province in China. At the same time, several research groups identified and reported the etiological agent, that included within the Coronaviridae family and the order Nidovirales, named SARS-CoV-2. Subsequently, the pathological and clinical status caused by the pathogen is commonly known as Coronavirus disease 2019 (COVID-19). In a short period, the outbreak of emerging spread across the world. Therefore the World Health Organization declared a public health emergency of international concern on January 30, 2020, and as a pandemic on March 11, 2020. Many different public health and epidemiological studies have been published since the COVID-19 outbreak, but fatality rates (those that relate the number of cases to mortality) are difficult to assess with certainty. Mean and median case-fatality rates worldwide are near to 3% and 2%, respectively. The median infection fatality calculated from serologic prevalence varies from 0.00% to 1.63% but is mostly estimated between 0.27% and 0.9%. These indexes are influenced by geographic location, socioeconomic status, sex, age, and health conditions, among others. © 2022 Elsevier Inc. All rights reserved.

2.
18th EAI International Conference on Computer Science and Education in Computer Science, CSECS 2022 ; 450 LNICST:102-115, 2022.
Article in English | Scopus | ID: covidwho-2148573

ABSTRACT

We estimate the case fatality rate from COVID-19 with our method by age groups for three waves - September 2020 to January 2021 (wild type), February 2021 to May 2021 (alpha), and July 2021 to January 2022 (delta). We use linear regression with optimal lag with 21 days moving averaging to correct for reporting delays. We take the coefficient from the regression as the case fatality ratio. We unite the lower age groups into one to achieve a good correlation. We have new cases by age group and deaths by age group and sex. Our results indicate that the delta variant is more severe than alpha, and this is enough to outweigh any improvements in treatment since the first major wave, 14.08.2020–01.01.2021. © 2022, ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering.

3.
Medical Journal of Malaysia ; 77(Supplement 4):19, 2022.
Article in English | EMBASE | ID: covidwho-2147357

ABSTRACT

Dengue, a mosquito borne viral disease, remains a public health threat in Malaysia due to its associated morbidity and mortality. Malaysia is endemic to dengue with the annual incidence hovering between 200 to 400 cases per 100,000 population for the past one decade. Nonetheless, the local dengue case fatality rate has been kept below 0.50% since 2012. Dengue in Malaysia has demonstrated a cyclical trends with four to five years interval between peaks. The last two peaks were observed in 2015 and 2019 and based on the observed cyclical trends, 2020 and 2021 were the years when dengue incidence was expected to be at the lowest level. Coincidentally the COVID-19 pandemic occurred in 2020 and 2021 with concurrent reduction of dengue incidence in Malaysia below 400 cases per week. During the pandemic, people spent less time in nonresidential areas due to the movement control order implemented by the government and were less exposed to dengue infection risk. Among the public health measures implemented were closure of schools, closing of public transport system and cancellation of public events. The combined effect of the dengue cyclical trends and the public health measures implemented by the government during the COVID-19 pandemic gave rise to historically low dengue incidence in 2020 and 2021. Malaysia has recorded zero indigenous human malaria since 2018. However, Malaysia continues to report imported human malaria. Currently, most of the malaria cases in Malaysia are zoonotic malaria. During the COVID-19 pandemic, the incidence of zoonotic malaria increased from 2,609 cases in 2020 to 3,575 cases in 2021. The opposite was observed for imported human malaria whereby the number was reduced from 621 cases in 2019 to 111 cases in 2021. However, as the country opens its economy in 2022, imported cases of human malaria have started to increase again.

4.
BMC Public Health ; 22(1): 2131, 2022 11 19.
Article in English | MEDLINE | ID: covidwho-2139231

ABSTRACT

BACKGROUND: Vaccination reduces the overall burden of COVID-19, while its allocation procedure may introduce additional health inequality, since populations characterized with certain social vulnerabilities have received less vaccination and been affected more by COVID-19. We used structural equation modeling to quantitatively evaluate the extent to which vaccination disparity would amplify health inequality, where it functioned as a mediator in the effect pathways from social vulnerabilities to COVID-19 mortality. METHODS: We used USA nationwide county (n = 3112, 99% of the total) level data during 2021 in an ecological study design. Theme-specific rankings of social vulnerability index published by CDC (latest data of 2018, including socioeconomic status, household composition & disability, minority status & language, and housing type & transportation) were the exposure variables. Vaccination coverage rate (VCR) during 2021 published by CDC was the mediator variable, while COVID-19 case fatality rate (CFR) during 2021 published by John Hopkinson University, the outcome variable. RESULTS: Greater vulnerabilities in socioeconomic status, household composition & disability, and minority status & language were inversely associated with VCR, together explaining 11.3% of the variance of VCR. Greater vulnerabilities in socioeconomic status and household composition & disability were positively associated with CFR, while VCR was inversely associated with CFR, together explaining 10.4% of the variance of CFR. Our mediation analysis, based on the mid-year data (30th June 2021), found that 37.6% (mediation/total effect, 0.0014/0.0037), 10% (0.0003/0.0030) and 100% (0.0005/0.0005) of the effects in the pathways involving socioeconomic status, household composition & disability and minority status & language, respectively, were mediated by VCR. As a whole, the mediation effect significantly counted for 30.6% of COVID-19 CFR disparity. Such a mediation effect was seen throughout 2021, with proportions ranging from 12 to 32%. CONCLUSIONS: Allocation of COVID-19 vaccination in the USA during 2021 led to additional inequality with respect to COVID-19 mortality. Viable public health interventions should be taken to guarantee an equitable deployment of healthcare recourses across different population groups.


Subject(s)
COVID-19 , Health Status Disparities , Humans , United States/epidemiology , COVID-19/prevention & control , Socioeconomic Factors , COVID-19 Vaccines , Social Vulnerability , Vaccination
5.
1st International Conference on Advanced Research in Pure and Applied Science, ICARPAS 2021 ; 2398, 2022.
Article in English | Scopus | ID: covidwho-2133850

ABSTRACT

Objectives: Documentation the risk of the COVID-19 in Iraq is occurred by interpretation of the case fatality rate (CFR) across a period of time. and different regions. This could highlight the reason behind the rapid spreading of COVID-19 among Iraqi population. Methods: in this work we introduced and applied a protocol to evaluate and elucidate the behavior of the case fatality rate (CFR) of COVID-19 at different regions in Iraq. This evaluation was performed across 6 months (27th March - 27th September). All data of COVID-19 pandemic in Iraq were obtained from the websites of Health Ministry in Iraq (https://moh.gov.iq/). Results: During the study period, Baghdad score is the highest fatality rate compering with other cities flowed by Basara then Babylon. Baghdad has the highest CFR value (8.5) compared with Arbil and Mosil have 2.5 and 3.19 respectively, in which are better than (Baghdad, Basra and Babil) there was more than 50% less than Baghdad. Furthermore, Babylon city ranks the first in terms of the death rate among population (0.25%) and (0.0017%) to Iraq population. The reason behind that could be related to the population density in the rural area, and the lag during transfer COVID-19 patients to specialized tertiary. On the other hand, Mosil had the lowest death rate population (0.012%) compared with other cities in this study. Conclusion: Comparing fatality rate and death rate of COVID-19 pandemic across different Iraqi cities would help to illustrate the strength and spreading rate of the pandemic. © 2022 American Institute of Physics Inc.. All rights reserved.

6.
Journal of the American Society of Nephrology ; 33:324, 2022.
Article in English | EMBASE | ID: covidwho-2126303

ABSTRACT

Background: Around 800 ESRD patients from March 2021 to July 2021 were affected by COVID-19 in a tertiary specialized hospital in the Philippines, with a case fatality rate of 2.3%. These subset of patients have one of the highest morbidity and mortality among others. That is why numerous tools such as the COVID GRAM and 4C Mortality Score were formulated to predict the critical events in COVID-19 patient and may hopefully be useful for ESRD patients as well. Method(s): This is a retrospective cohort design to determine the diagnostic value of COVID GRAM and Mortality 4C score in predicting critical events. Participants were end stage renal disease (ESRD) patients infected with COVID19 seen at the National Kidney and Transplant Institute from March 2020 to July 2021. Chart review was done from August 2021 to October 2021. Inclusion Criteria: Age >=19 years old Admitted patients for at least 24hrs COVID-19 confirmed via RT PCR or GeneXpert with nasopharyngeal or oropharyngeal swab, provided that: Testing performed in an accredited institution ESRD Filipino patients already on RRT or for RRT initiation Exclusion Criteria: Kidney transplant patients Acute kidney injury needing renal replacement therapy Incomplete data on 4C mortality and COVID GRAM Results: This study included a total of 97 patients (41 in the critical group, 56 in non-critical group). Both COVID GRAM and 4C mortality score showed high levels of discriminative ability, accuracy, sensitivity, specificity. The discriminative ability or AUC of both COVID GRAM and 4C Mortality Score were at 0.93 and 0.95, respectively. Overall accuracy was at 93.81% and 96.91%. Conclusion(s): Even with the advent of vaccination, COVID 19 remains to be a leading cause of morbidity and mortality in our country and has cost the Philippine government $30.72B. Therefore, proper allocation of the budget and expenses remains to be a priority. With both COVID GRAM and 4C Mortality, these tools can aid physicians in decision making especially for those at high risk of experiencing a critical event and maybe be used to determine if patients need to be admitted or can be managed at an outpatient basis.

7.
Journal of the American Society of Nephrology ; 33:314, 2022.
Article in English | EMBASE | ID: covidwho-2126207

ABSTRACT

Background: Patients requiring haemodialysis (HD) have disproportionately poorer outcomes from SARS-CoV-2 infection and vaccines afford an opportunity to improve this. However, the efficacy of booster doses on infection with emerging variants remains unclear in this population. Method(s): We report the real-world impact of SARS-CoV-2 booster vaccinations in an ethnically diverse urban cohort of 1172 patients receiving in-centre HD who were routinely screened for SARS-CoV-2 infection by weekly nasopharyngeal PCR between 1st December 2021 and 31st March 2022, during dominant UK prevalence of B.1.1.529 variant ("Omicron"). Where possible, genomic sequencing was performed as standard of care. Result(s): At the start of the observation period, 896 (76.5%) had received 3 doses of SARS-CoV-2 vaccine and only 87 (7.4%) were unvaccinated. By end of study 664 (59.5%) had received 4 vaccine doses. 305 patients had PCR positive SARS-CoV-2 infection, with Omicron variant confirmed in all but one of samples successfully tested. Clinical course of infection was mild: around half of patients asymptomatic, only 1 in 20 hospitalised, case fatality 3%. Three or more vaccine doses significantly associated with reduced risk of SARS-CoV-2 PCR positivity compared to unvaccinated status, together with White ethnicity and lower deprivation index (Cox regression p<0.03). However, 2 booster doses further reduced the risk of infection by around a third compared to 1 boost, independent of age, gender and comorbidity. Conclusion(s): A second SARS-CoV-2 booster vaccine further reduces the risk of Omicron infection in haemodialysis patients. As such, a double-boost policy could significantly reduce the burden and associated spread of SARS-CoV-2 infection in this vulnerable population.

8.
SAJCH South African Journal of Child Health ; 16(3):184-185, 2022.
Article in English | EMBASE | ID: covidwho-2126196

ABSTRACT

Introduction. Poisoning has been reported as the fifth most common cause of injury-related deaths in children <5 years worldwide. Little is known about accidental poisoning among children in the regional setting. During the COVID-19 pandemic, lockdown measures may have increased home-based unintentional poisoning. Objectives. To determine the frequency, outcome and type of accidental poisoning in children admitted to a regional hospital and compare cases before and during the COVID-19 pandemic. Methods. A review of admissions to Queen Nandi Regional Hospital in Empangeni was performed to document cases of accidental poisoning >2 years. Equal periods during 2019 and 2020 (April to December) were compared. Children <13 years were included. Age, sex, date of admission, death, survival and type of poisoning were collected. Results. Accidental poisoning made up a small proportion of the total admissions (n=252/5 071;4.97%) with a low case fatality rate (0.40%). Boys made up the majority (n=132/252, 52.38%). Most were <5 years (n=220/252, 87.30%,). Medicines (n=114/252, 45.24%), hydrocarbons (n=61/252, 24.21%) and pesticides (n=26/252, 10.32%) were the main types of poisoning. Domestic cleaner, sanitiser or disinfectant-related admissions were significantly increased during the pandemic (p=0.020). Conclusion. Accidental poisoning commonly occurs in younger children. Medicines, hydrocarbons and pesticides make up the majority of cases. Domestic cleaner, hand sanitiser and disinfectant ingestion increased during the COVID pandemic. Future research involving primary care facilities and risk factors related to poisoning should be investigated.

9.
Anaesthesia, Pain and Intensive Care ; 26(5):656-662, 2022.
Article in English | EMBASE | ID: covidwho-2115336

ABSTRACT

Background & objective: SARS-CoV-2 virus caused acute respiratory illness called COVID-19 with rising case mortality rates. One of the preventive measures to arrest the spread of a contagious disease is the use of vaccines. We assessed the effectiveness of the inactivated vaccine (Coronavac) through three inflammatory parameters e.g., total lymphocyte count, neutrophil-lymphocyte ratio, and C-reactive protein (CRP), in severe COVID-19 patients. Methodology: This study was an observational study with a retrospective cross-sectional design. The study was conducted in the Intensive Care Unit (ICU) of Hasan Sadikin Hospital Bandung, from January 2021 to December 2021. The data of total lymphocyte count, neutrophil-lymphocyte ratio, and C-reactive protein, was collected retrospectively from the medical record documents of 54 patients of COVID-19. The assessment was performed on severe COVID-19 subjects on the 7th day of illness. Data normality test was done using the Shapiro Wilk test. Study data were not normally distributed, and statistical analyses were performed using the Mann-Whitney test for numerical data and the Chi-Square test for categorical data. Result(s): There were significant differences in inflammation parameters, e.g., total lymphocyte count, neutrophil-lymphocyte ratio, and CRP, between the two groups (P < 0.0001) and the subject outcome between two groups (P < 0.0001). Total lymphocyte count in severe vaccinated COVID-19 patients was higher than in non-vaccinated patients, while neutrophil-lymphocyte ratio and CRP were lower in vaccinated subjects. Mortality was also lower in the vaccinated patients compared to unvaccinated patients. Conclusion(s): The inactivated vaccine (Coronavac) effectively reduces the mortality rate of severe COVID-19 patients based on inflammatory parameters including total lymphocyte count, neutrophil-lymphocyte ratio, and C-reactive protein. Abbreviations: ACE: Angiotensin Converting Enzyme;ARB: Angiotensin Receptor Blocker;ARDS: Acute Respiratory Distress Syndrome;BMI: Body Mass Index;CFR: Case Fatality Rate;COVID-19: Coronaviruses Disease 2019;CRP: C-Reactive Protein;IL: Interleukin;NLR: Neutrophil Lymphocyte Ratio;SPSS: Statistical Product Service Solution;TLC: Total Lymphocyte Count;TNF: Tumor Necrosis Factor;VEGF: Vascular Endothelial Growth Factor Copyright © 2022 Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.

10.
Tumori ; 108(4 Supplement):112-113, 2022.
Article in English | EMBASE | ID: covidwho-2114183

ABSTRACT

Background: The Omicron (B.1.1.529) SARS-CoV-2 variant is highly transmissible and escapes vaccinal immunity. Evidence is lacking as to the impact of Omicron in oncological patients. Method(s): Capitalizing on OnCovid study data (NCT04393974), we analysed COVID-19 morbidity and case fatality rate at 28 days (CFR28) of unvaccinated patients across 3 phases defined following the evolution of the pandemic in Europe, according to date of COVID-19 diagnosis: "Pre-vaccination" phase (27/02/2020-30/11/2020), "Alpha- Delta variant" phase (01/12/2020-14/12/2021), "Omicron variant" phase (15/12/2021-31/01/2022). Finding(s): By the data lock of 04/02/2022, 3820 patients from 37 institutions across 6 countries were entered. Out of 3473 eligible patients, 2033 (58.6%), 1075 (30.9%) and 365 (10.5%) were diagnosed during the Pre-vaccination, Alpha-Delta and Omicron phases. In total 659 (61.3%) and 42 (11.5%) were unvaccinated in the Alpha-Delta and Omicron. Unvaccinated patients across the Omicron, Alpha-Delta and Pre-vaccination phases experienced similar CFR28 (27.5%, 28%, 29%, respectively). Following propensity score matching, 42 unvaccinated Omicron patients were matched with 122 and 121 patients from the Pre-vaccination and Alpha-Delta phases respectively, based on country of origin, sex, age, comorbidity burden, primary tumour, cancer stage and status, and the receipt of systemic anticancer therapy at COVID-19. Unvaccinated Omicron patients experienced improved COVID-19 outcomes in comparison to patients diagnosed during the Prevaccination phase. Morbidity and mortality were comparable to those of unvaccinated patients diagnosed during the Alpha-Delta phase. Interpretation(s): Despite time-dependent improvements in outcomes reported in the Omicron phase, patients with cancer remain highly vulnerable to SARS-CoV-2 in absence of vaccinal protection. This study provides unequivocal evidence in support of universal vaccination of patients with cancer as a protective measure against morbidity and mortality from COVID-19.

11.
Int J Infect Dis ; 111: 186-189, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-2113752

ABSTRACT

OBJECTIVES: In Italy, the case fatality rate (CFR) of coronavirus disease 2019 (COVID-19) during the first wave of the pandemic showed significant geographic heterogeneity. The aim of this study was to explore the possible association between the CFR and measures of disease burden in the Italian regions using an ecological approach. METHODS: Cumulated regional data for the period February 24 to May 11, 2020 were analysed to assess the association of the CFR with the cumulative incidence of COVID-19 and the ratio between the maximum number of COVID-19 patients in intensive care units (ICU) and ICU beds available before the pandemic (ICU load), adjusting for median age of the patients at disease onset, number of nasopharyngeal swabs performed per confirmed case, and prevalence of chronic diseases . RESULTS: During the study period, the COVID-19 CFR in the Italian regions ranged between 5.0% and 18.4%. On multivariable regression analysis, the CFR was found to be significantly associated with the cumulative incidence (relative rate (RR) 1.02 per 100 cases/1 million increase), median patient age (RR 1.07 per 1 year increase), and ICU load (RR 1.72, 2.18, and 2.57, for >40-70% vs ≤40%, 70-140% vs ≤40%, and ≥140 vs ≤40%, respectively). CONCLUSIONS: A high burden of COVID-19 may contribute to increased disease fatality, possibly as a result of the increasing demand for care of critically ill patients beyond health system capability.


Subject(s)
COVID-19 , Cost of Illness , Humans , Italy/epidemiology , Pandemics , SARS-CoV-2
12.
Israa University Journal of Applied Science ; 6(1):42-51, 2022.
Article in English | Scopus | ID: covidwho-2101098

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19), is rapidly spreading globally due to high transmissibility and pathogenicity. Aim: The purpose of this study is to determine the growth rate and CFR of COVID-19 in Palestine, as well as to compare them in the pre and post-vaccination periods. Methods: A retrospective analytical design was used. The data of daily confirmed cases and daily deaths were taken from the Worldometer statistics, WHO websites, and MOH report for the two politically split regions of Palestine, the Gaza Strip, and the West Bank. The data was gathered to include one hundred days before initiating vaccination against the disease, beginning on December 7, 2020, and ending on June 25, 2021. The growth rate and case fatality rate were calculated using related formulas and the Microsoft Excel program was used to analyze the data. Results: During the study period, there were 217386 cases of COVID-19 and 2772 deaths in Gaza and the west bank. The high growth rate was found in two months December 2020 (38.3%), and March 2021 (30.8%), and was declined in May and June 2021. The case fatality rate, on the other hand, fluctuated throughout the research period. During the study period, the number of patients with COVID-19 and the number of deaths from this disease is decreasing in Palestine. Conclusion: The intervention measures in Palestine seem to be effective in controlling the COVID-19 epidemic and reducing the reproduction rate in the study period. Continuous preventive measures and vaccination for the population are recommended. © 2022 Pravnehistoricke Studie. All rights reserved.

13.
Environ Health Prev Med ; 27: 41, 2022.
Article in English | MEDLINE | ID: covidwho-2089300

ABSTRACT

BACKGROUND: COVID-19 pandemic is tremendously impacted by socioeconomic and health determinants worldwide. This study aimed to determine factors associated with COVID-19 fatality among member states and partner countries of the Organization for Economic Cooperation and Development (OECD). METHODS: An ecological study was conducted using COVID-19 data of 48 countries for the period between 31 December 2019-31 December 2021. The outcome variables were COVID-19 case fatality rate (CFR) and years of life lost to COVID-19 (YLLs). Countries' sociodemographics and COVID-19-related data were extracted from OECD website, Our World in Data, John Hopkins Coronavirus Resource Center, Economist Intelligence Unit (EIU) and WHO. RESULTS: In the first year of the pandemic (December 2019-January 2021), highest CFR was observed in Mexico, 8.51%, followed by China, 5.17% and Bulgaria, 4.12%), and highest YLLs was observed in Mexico, 2,055 per 100,000. At regional level, highest CFR was observed in North & central America, 4.25 (3.71) %, followed by South America (2.5 (0.1) %); whereas highest YLLs was observed in South America region 1457.5 (274.8) per 100,000, followed by North & central America, 1207.3 (908.1) per 100,000. As of 31 December 2021, Mexico (7.52%) and Bulgaria (4.78%) had highest CFR; on the other hand, highest YLLs was observed in England, 26.5 per 1,000, followed by the United States, 25.9 per 1,000. At regional level, highest CFR (3.37(3.19) %) and YLLs (16.7 (13) per 1,000) were both observed in North & central America. Globally, the analysis of the 2-year cumulative data showed inverse correlation between CFR and nurse per 10,000 (R = -0.48; p < 0.05) and GDP per capita (R = -0.54; p < 0.001), whereas positive correlation was observed between YLLs and elderly population rate (R = 0.66; p < 0.05) and overweight/obese population rates (R = 0.55; p < 0.05). CONCLUSION: This study provides insights on COVID-19 burden among OECD states and partner countries. GDP per capita, overweight/obesity and the rate of elderly population emerged as major social and health determinants of COVID-19 related burden and fatality. Findings suggest that a robust economy and interventions designed to promote healthy longevity and prevent weight gain in at-risk individuals might reduce COVID-19 burden and fatality among OECD states and partner countries.


Subject(s)
COVID-19 , Aged , Humans , United States , COVID-19/epidemiology , Pandemics , Organisation for Economic Co-Operation and Development , Overweight , Health Status
14.
Open Access Macedonian Journal of Medical Sciences ; 10:1698-1705, 2022.
Article in English | EMBASE | ID: covidwho-2066674

ABSTRACT

BACKGROUND: The rapid worldwide spread of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) or COVID-19 pandemic from its epicenter;Wuhan was first reported in December 2019. Egypt reported its first COVID-19 case on February 14, 2020. Thereafter, Egypt scaled-up preventive measures, with a partial lockdown starting on March 25. Several therapeutic agents along with convalescent plasma transfusion (CPT) are under investigation and data from CPTs have been receiving a lot of attention, after Emergency approvals from the Food and Drug Administration suggesting that it may provide a clinical effect in the treatment of SARS-COV-2. IMPORTANCE: Early and effective treatment of COVID-19 is vital for control of SARS-CoV-2 infection. METHODS: Designs: An interventional, single-arm, and non-randomized clinical trial conducted in Egypt from April 15 to July 21, 2020. Settings: This was a multi-center study conducted in three hospitals in Egypt. Participants: A total of 94 COVID-19 laboratory-confirmed patients using quantitative real-time polymerase chain reaction were enrolled in the study. Intervention: All patients were administered with two plasma units (each unit is 200 cc). The volume of donated plasma was 800 cc. Main Outcome and measures: Primary measure was the degree of clinical improvement among the COVID-19 patients who received CPT within 7 days. RESULTS: A total of 94 patients were enrolled who received CPT either within 7 days or after 7 days of hospitalization. 82 were severely ill and 12 were critically ill. The average age remained 58 years (±standard deviation 15.1 years). Male were 69% and 49% patients got cured while 51% died with case fatality rate 51%. Seventy-five percent deaths were above 45 years of age. The symptoms were dyspnea (55%), fever (52%), cough (46%), and loss of taste and smell (21%), and cyanosis (15%). The most common co-morbidities among the <40 years remained diabetes mellitus (21%) and asthma (14%). Among 40–60 years hypertension (56%), diabetes mellitus (39%) and among >60 years age group hypertension (57%), and chronic heart disease (24%) were reported. CPT within 7 days remained significant as compared with the CPT after 7 days with the number of days to cure (p=0.007) and ICU stay (p = 0.008) among severely ill cured cases. CONCLUSIONS: Among patients with COVID-19 and severe or critical illness, the use of CPT along with routine standard therapy resulted in a statistically significant improvement when administered within seven days of hospital admission. However, plasma transfusion, irrespective of days to transfusion may not help treat critically ill patients. The overall mean time to cure in severely ill patients was 15 days if CPT provided within 7 days with 65% cure rate. TRIAL REGISTRATION: Clinical Intervention identifier: MOHP_COVID-19_Ver1.1 registered April 2020.

15.
American Journal of Transplantation ; 22(Supplement 3):440, 2022.
Article in English | EMBASE | ID: covidwho-2063396

ABSTRACT

Purpose: Organ transplant recipients (OTR) have worse outcomes from COVID-19 and weaker antibody responses to vaccination than do immunocompetent individuals. Data on clinical outcomes among OTR with breakthrough COVID-19 are urgently needed, given decreased vaccine efficacy against the B.1.617.2 (Delta) variant. We compared crude case fatality rates (CFR) between fully vaccinated and unvaccinated kidney transplant recipients (KTR) with COVID-19. Method(s): We identified KTR with COVID-19 at our institution between 3/1/20 and 11/17/21. Multi-organ transplant recipients, KTR who received additional ("booster") doses, and those with partial or unknown vaccination status were excluded due to small numbers. KTR were considered fully vaccinated 2 weeks after receiving either the second dose of an mRNA vaccine series (Moderna, Pfizer-BioNTech) or one dose of the Janssen viral vector vaccine. Demographics, clinical characteristics, and in-hospital or hospice care mortality were extracted from electronic medical records. Result(s): Among 109 KTR with COVID-19, 19 were fully vaccinated at symptom onset. Vaccinated KTR with COVID-19 were older (median: 63.5 vs. 57.5 years, P<0.05) and waited longer to seek care after symptom onset (median: 6 vs. 3 days, P<0.05). Comorbidities and time from transplant were comparable between the two groups. CFR was higher among vaccinated KTR (26% vs. 10%, HR 0.34, 95%CI 0.11-1, P=0.05;Fig. 1), although the difference was not significant after adjustment for age (aHR 0.53, 95%CI 0.17-1.61, P>0.1). All fatal breakthrough infections occurred when the Delta variant accounted for >98% of COVID-19 cases in our HHS region. Conclusion(s): Vaccinated OTR remain at high risk for fatal COVID-19. Younger OTR are likely more immunoprotected than older OTR, which-combined with the emergence of the Delta variant and easing of restrictions-may have contributed to the observed shift toward older age among KTR with breakthrough COVID-19 and the high resultant CFR. Vaccinated OTR may delay seeking care for breakthrough symptoms due to a false sense of security. Our findings highlight the importance of pretransplant vaccination, and, among OTR, the need for ongoing preventive measures (masks, social distancing, vaccination of close contacts, post-vaccine education) and additional vaccine doses. OTR should be linked to care immediately after exposure or onset of symptoms consistent with COVID-19, given the availability of anti-spike monoclonal antibodies for prevention or treatment. (Figure Presented).

16.
Chest ; 162(4):A877, 2022.
Article in English | EMBASE | ID: covidwho-2060716

ABSTRACT

SESSION TITLE: Critical Care Infections SESSION TYPE: Case Reports PRESENTED ON: 10/19/2022 09:15 am - 10:15 am INTRODUCTION: Francisella tularensis is a zoonotic disease by an aerobic, gram negative coccobacillus. It is transmitted by exposure to infected animal or vectors in individuals who landscape or camp. Common symptoms are fever, chills, anorexia, and headache. Abdominal tularemia can present with abdominal pain, emesis, diarrhea, and rarely intestinal ulceration and hemorrhage. It is treated with aminoglycosides, fluoroquinolones and tetracycline. CASE PRESENTATION: 38-year-old male presented with fever, cough, anorexia, and black stool for 5 days. Patient worked as a landscaper. He has no pets, travel history or sick contacts. He does not take any medications at home. Physical exam was significant for sinus tachycardia and rhonchi of right upper lobe. Significant labs include WBC of 9.8 with 41% bands, hemoglobin 15.5, sodium 125, procalcitonin 27.3, and lactic acid 1.8. COVID-19, MRSA, Legionella and Pneumococcal urine antigen were negative. CTA chest revealed mass-like opacity in right upper lobe with multiple bilateral pulmonary nodules. Lower respiratory culture showed Candida albicans. Patient was empirically started on ceftriaxone and azithromycin. He was transferred to intensive care for worsening respiratory status and was placed on non-invasive ventilation on hospital day 1. Antibiotics were broadened to ceftaroline and levofloxacin due to suspicion of tularemia. Amphotericin B was added. Labs for Histoplasma, Blastomyces, TB, Leptospira, and HIV were negative. Patient then suffered a cardiac arrest on hospital day 2 after having large brown secretions pouring from his mouth. Cardiopulmonary resuscitation was initiated and patient was intubated and started on vasopressors with return of spontaneous circulation. Massive blood transfusion protocol was initiated. Emergent bedside upper endoscopy showed large blood clot adherent to duodenal ulcer. Interventional radiology planned on performing gastric duodenal artery embolization. However, patient suffered two more cardiac arrest with resuscitation efforts terminated per family request. Karius Digital Culture later was positive for Francisella tularensis. Autopsy revealed diffuse alveolar hemorrhage, hilar lymphadenopathy, and perforated duodenal ulceration with large adherent clot. DISCUSSION: Gastrointestinal tularemia is rare and usually from drinking contaminated water or oral inoculation of bacteria. Intestinal tract involvement can present with mesenteric lymphadenopathy and ulcerative lesions resulting in gastrointestinal bleeding with case fatality rate of 50%. Even though this is noted in the literature, to our knowledge no case reports have been published. CONCLUSIONS: Careful history taking and early identification of risk factors are important when severe tularemia infection is suspected such as in individuals with extensive outdoor activities. Treatment should be empirically initiated in high risk patients. Reference #1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4585636/ Reference #2: https://casereports.bmj.com/content/2017/bcr-2017-22125. Reference #3: Altman GB, Wachs JE. Tularemia: A pathogen in nature and a biological weapon. Aaohn Journal. 2002 Aug;50(8):373-9. DISCLOSURES: No relevant relationships by Maria Haider Baig

17.
Chest ; 162(4):A720, 2022.
Article in English | EMBASE | ID: covidwho-2060675

ABSTRACT

SESSION TITLE: Acute COVID-19 and Beyond: from Hospital to Homebound SESSION TYPE: Original Investigations PRESENTED ON: 10/18/2022 02:45 pm - 03:45 pm PURPOSE: In-hospital cardiac arrest (IHCA) has been reported to be as high as 75%, with pooled worldwide case fatality rates (CFR) of COVID-19 patients in the ICU estimated as 37%. To our knowledge, there has not been any systematic reviews specifically investigating world-wide survival outcomes of intubated COVID-19 adult patients who undergo IHCA and receive cardiopulmonary resuscitation (CPR). The aim of our study was to evaluate the outcomes of such patients up until hospital discharge. METHODS: A systematic literature search using relevant keywords was performed for original articles published in Embase, Medline and Pubmed Central databases from 2019 to February 6 2022. Patients aged 18 and older who had COVID-19 and were intubated prior to undergoing cardiac arrest were included. Extracted data were summarized in a table showing publication details and country, study designs, total sample size, comorbidities, age, gender, initial cardiac rhythm during cardiac arrest, initial survival after CPR and survival outcomes up until discharge. STATISTICAL ANALYSIS We performed descriptive statistics using Microsoft Excel. Where applicable, measures such as mean, frequency, proportion and range were used. Case fatality rate was also calculated. Methological quality was assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Interrater accuracy and reliability were assessed using Cohen’s kappa. RESULTS: We screened 912 deduplicated articles, of which 38 studies met our criteria for final inclusion. There were 230 total patients, of which 174 patients (75.7%) were intubated. Out of those, 161 patients (70%) underwent CPR and only 4 survived. CFR defined as total number of intubated COVID-19 patients who underwent CPR and died (n= 157) divided by total number of intubated COVID-19 patients who underwent CPR (n=161) was calculated to be 97.5% (95% Cl: 95.1 – 99.92%). Mean age of intubated COVID-19 patients who underwent CPR was 54 years, with 27.5% being females and 72.5% males. The most reported comorbidities of intubated COVID-19 patients who underwent CPR were hypertension (37.5%), diabetes (30%), prior lung pathology (17.5%), obesity(7.5%), hyperlipidemia (5%), stroke (5%), Coronary Artery Disease (CAD) (2.5%). CONCLUSIONS: Our CFR were higher than has been previously recorded for ICU patients with COVID-19. This suggests that COVID-19 patients on mechanical ventilation who deteriorate to the point of going into cardiac arrest are a particularly vulnerable population, and CPR in this subset of COVID-19 patients may be nearly futile. More studies are needed to investigate preventive and management strategies to mitigate such poor outcomes. CLINICAL IMPLICATIONS: Knowledge of survival outcomes in intubated COVID-19 adult patients can help facilitate early plan of care discussions given the limited resources many hospitals experienced during the pandemic. DISCLOSURES: No relevant relationships by Stephen Avera No relevant relationships by Marshaleen Henriques King No relevant relationships by Sorochi Iloanusi No relevant relationships by Chinedu Ivonye No relevant relationships by Ifeoma Ogbuka No relevant relationships by Titilope Olanipekun

18.
Int J Environ Res Public Health ; 19(18)2022 Sep 17.
Article in English | MEDLINE | ID: covidwho-2055247

ABSTRACT

A range of health-related and behavioral risk factors are associated with COVID-19 incidence and mortality. In the present study, we assess the association between incidence, mortality, and case fatality rate due to COVID-19 and the prevalence of hypertension, obesity, overweight, tobacco and alcohol use in the Peruvian population aged ≥15 years during the first and second year of the COVID-19 pandemic. In this ecological study, we used the prevalence rates of hypertension, overweight, obesity, tobacco, and alcohol use obtained from the Encuesta Demográfica y de Salud Familiar (ENDES) 2020 and 2021. We estimated the crude incidence and mortality rates (per 100,000 habitants) and case fatality rate (%) of COVID-19 in 25 Peruvian regions using data from the Peruvian Ministry of Health that were accurate as of 31 December 2021. Spearman correlation and lineal regression analysis was applied to assess the correlations between the study variables as well as multivariable regression analysis adjusted by confounding factors affecting the incidence and mortality rate and case fatality rate of COVID-19. In 2020, adjusted by confounding factors, the prevalence rate of obesity (ß = 0.582; p = 0.037) was found to be associated with the COVID-19 mortality rate (per 100,000 habitants). There was also an association between obesity and the COVID-19 case fatality rate (ß = 0.993; p = 0.014). In 2021, the prevalence of obesity was also found to be associated with the COVID-19 mortality rate (ß = 0.713; p = 0.028); however, adjusted by confounding factors, including COVID-19 vaccination coverage rates, no association was found between the obesity prevalence and the COVID-19 mortality rate (ß = 0.031; p = 0.895). In summary, Peruvian regions with higher obesity prevalence rates had higher COVID-19 mortality and case fatality rates during the first year of the COVID-19 pandemic. However, adjusted by the COVID-19 vaccination coverage, no association between the obesity prevalence rate and the COVID-19 mortality rate was found during the second year of the COVID-19 pandemic.


Subject(s)
COVID-19 , Hypertension , Noncommunicable Diseases , COVID-19/epidemiology , COVID-19 Vaccines , Humans , Hypertension/epidemiology , Noncommunicable Diseases/epidemiology , Obesity/epidemiology , Overweight/epidemiology , Pandemics , Peru/epidemiology
19.
J Epidemiol Glob Health ; 2022 Sep 26.
Article in English | MEDLINE | ID: covidwho-2048730

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, reducing the case fatality rate (CFR) becomes an urgent goal. OBJECTIVE: This study explored the effect of vaccination and variants on COVID-19 fatality and provide a basis for the adjustment of control measures. METHODS: This study collected epidemiological information on COVID-19 from January to October 2021. By setting different lag times, we calculated the adjusted CFR. The Spearman correlation coefficient and beta regression were used to explore factors that may affect COVID-19 fatality. RESULTS: Every 1% increase in the percentage of full vaccinations may reduce the 3 weeks lagging CFR by 0.66%. Increasing the restrictions on internal movement from level 0 to 1, restrictions on international travel controls from level 2 to 3, and stay-at-home restrictions from level 0 to 2 were associated with an average reduction in 3 weeks lagging CFR of 0.20%, 0.39%, and 0.36%, respectively. Increasing strictness in canceling public events from level 0 to 1 and 2 may reduce the 3 weeks lagging CFR by 0.49% and 0.37, respectively. Increasing the severity of school and workplace closures from level 1 or level 0 to 3 may increase the 3 weeks lagging CFR of 0.39% and 0.83, respectively. Every 1-point increase in the Global Health Security (GHS) index score may increase the 3 weeks lagging CFR by 0.12%. CONCLUSION: A higher percentage of full vaccinations, higher levels of internal movement restrictions, international travel control restrictions, cancelations of public events, and stay-at-home restrictions are factors that may reduce the adjusted CFR.

20.
Borneo Journal of Pharmacy ; 5(2):179-185, 2022.
Article in English | EMBASE | ID: covidwho-2044371

ABSTRACT

Covid-19 has spread globally and causes severe acute respiratory syndrome. The symptoms of covid-19 have similarities with influenza, such as cough, fever, runny nose, and sore throat. Therefore, the internet sources tend to have an increasing search related to influenza symptoms drugs. This study aims to assess the search trend of influenza symptoms drugs using google trend analysis in Indonesia. We explore Google trend analysis using search terms in the Indonesian language related to influenza symptoms drugs from December 6th, 2020 to November 30th, 2021. The positive confirmed cases were obtained from the Indonesian government website https://covid19.go.id/. Our results demonstrated the increasing search terms related to influenza drug symptoms during July and August. The highest term search was “obat batuk”. The positive covid-19 confirmed cases in Indonesia increased during July and August. During the peak of the covid-19 outbreak in Indonesia in July-August 2021, there was an increase in Google Trends searching related to influenza’s drug symptoms.

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