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1.
Epidemiol Health ; : e2022041, 2022 Apr 25.
Article in English | MEDLINE | ID: covidwho-1841570

ABSTRACT

Objectives: We investigated the trends in obesity, hypertension, diabetes, and hypercholesterolemia before and during the COVID-19 outbreak in the Korean adult population. Methods: Data from 60,098 individuals of the Korea National Health and Nutritional Examination Survey between 2011 and 2020 aged ≥ 19 were used. The age-standardized prevalence and annual percent changes (APC) were calculated for obesity (body mass index ≥ 25kg/m2), hypertension (systolic/diastolic blood pressure ≥ 140/90mmHg or under treatment), diabetes (hemoglobin A1c ≥ 6.5%, fasting glucose ≥ 126 mg/dL, physician diagnosis, or under treatment), and hypercholesterolemia (total cholesterol ≥ 240mg/dL or under treatment). Results: Over the past decade of 2011-2020, age-standardized APCs (95% confidence interval) during 2011-2020 for obesity, hypertension, diabetes and hypercholesterolemia were 3.0% (2.1 to 3.8%), 0.1% (-1.3 to 1.5%), 1.5% (-1.0 to 4.0%) and 8.0% (5.7 to 10.3%), respectively in men; and -0.2% (-1.5 to 1.2%), -0.5% (-1.9 to 0.9%), -0.1% (-2.3 to 2.2%) and 5.9% (3.9 to 8.0%), respectively in women. In 2020 compared to the previous three years (2017-2019), obesity, hypertension, diabetes, and hypercholesterolemia increased in men (+6.0, +1.8, +1.9 and +2.8 percentage points, respectively), but the increase was not apparent in women (+2.5, -1.1, +0.8 and +0.7 percentage points, respectively). Conclusion: An increase in major chronic diseases was observed in Korean adults, especially men, during the COVID-19 epidemic. In order to reduce the burden of cardiovascular and metabolic diseases in the future, effective intervention strategies need to be developed according to the characteristics of the target groups. .

2.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-335579

ABSTRACT

Background: The impact of chronic health conditions (CHC) on serostatus post-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is unknown. Methods: We assessed serostatus post-SARS-CoV-2 vaccination among fully vaccinated participants recruited between April 2021 through August 2021 in 18 years and older residents of Jefferson County, Kentucky, USA. Serostatus was determined by measuring SARS-CoV-2 Spike protein specific immunoglobulin (Ig) G (Spike IgG) antibodies via enzyme-linked immunoassay (ELISA) in peripheral blood samples. Results: Of the 5,178 fully vaccinated participants, 51 were seronegative and 5,127 were seropositive. Chronic kidney disease (CKD) (OR=13.49;95% CI: 4.88–37.3;P<0.0001) and autoimmune disease (OR=11.34;95% CI: 5.21–24.69;P<0.0001) showed highest association with negative serostatus in fully vaccinated participants. The absence of any CHC was strongly associated with positive serostatus (OR=0.37;95% CI: 0.19–0.73;P=0.003). The risk of negative serostatus increased in the presence of two CHCs (OR=2.82;95% CI: 1.14–7) to three or more CHCs (OR=4.52;95% CI: 1.68–12.14). Similarly, use of 2 or more CHC related medications was significantly associated with seronegative status (OR=6.08;95%: 2.01–18.35). Conclusions: Presence of any CHC, especially CKD or autoimmune disease, increased the likelihood of seronegative status among individuals who were fully vaccinated to SAR-CoV-2. This risk increased with a concurrent increase in number of comorbidities, especially with multiple medications. Absence of any CHC was protective and increased the likelihood of a positive serological response post-vaccination. These results will help develop appropriate guidelines for booster doses and targeted vaccination programs.

3.
International Journal of Environmental Research and Public Health ; 19(9):5674, 2022.
Article in English | ProQuest Central | ID: covidwho-1837807

ABSTRACT

This study explores the impact of the coronavirus disease 2019 (COVID-19) pandemic on outpatient visits for all-cause and chronic diseases in 2020. We extracted the data of patients who visited medical institutions over the past five years (2016–2020) from nationwide claims data and measured the number of monthly outpatient visits. A negative binomial regression model was fitted to monthly outpatient visits from 2016 to 2019 to estimate the numbers of 2020. The number of all-cause outpatient visits in 2020 was 12% lower than expected. However, this change was relatively stable in outpatient visits for chronic diseases, which was 2% lower than expected. Deficits in all-cause outpatient visits were observed in all months except January;however, deficits in outpatient visits for chronic diseases have rebounded since April 2020. The levels of change in healthcare utilization were observed differently among disease groups, which indicates that the impacts of the pandemic were disproportionate. This study calls for a policy response to emerging and reemerging infectious diseases, as the findings confirm that a health crisis, such as the COVID-19 pandemic, could disrupt the healthcare system. Assessing the mid-to long-term impacts of COVID-19 on healthcare utilization and health consequences will require further research.

4.
Rev Panam Salud Publica ; 46: e40, 2022.
Article in Spanish | MEDLINE | ID: covidwho-1836409

ABSTRACT

Objective: To determine the relative risk of a lethal outcome associated with chronic degenerative conditions in patients with COVID-19. Methods: A cohort study was conducted using electronic medical records belonging to patients who tested positive for COVID-19 on RT-PCR while receiving care as outpatients or inpatients in a social security system facility between March 2020 and March 2021. Two study groups were formed. The exposed group was divided into four subgroups, each of which was diagnosed with one and only one chronic condition (diabetes, hypertension, obesity, or chronic kidney disease); the unexposed group was obtained from the medical records of patients without comorbidities. A total of 1 114 medical records were examined using simple random sampling. Once the minimum sample size was reached, the relative risk was calculated for each chronic condition. Combinations of two, three, and four conditions were created, and each of them was included in the analysis. Results: In the absence of a chronic degenerative condition, the prevalence of a lethal outcome from COVID-19 is 3.8%; in the presence of type 2 diabetes mellitus, 15.8%; in the presence of arterial hypertension, 15.6%; and in the presence of obesity, 15.0%. For diabetes and hypertension combined, the prevalence of a lethal outcome is 54.1%; for diabetes and obesity combined, 36.8%, and for obesity and hypertension combined, 28.1%. Conclusion: In patients with COVID-19, the relative risk of a lethal outcome is 4.17 for those with diabetes, 4.13 for those with hypertension, and 3.96 for those with obesity. For two chronic conditions combined, the relative risk doubles or triples. The relative risk of a lethal outcome is 14.27 for diabetes plus hypertension; 9.73 for diabetes plus obesity, and 7.43 for obesity plus hypertension. Chronic conditions do not present alone; they generally occur together, hence the significance of the relative risks for lethal outcomes presented in this paper.


Objetivo: Determinar o risco de letalidade conferido por doenças crônicas degenerativas em pacientes com COVID-19. Métodos: Foi realizado um estudo de coorte em prontuários eletrônicos de pacientes com RT-PCR positivo para COVID-19 em atendimento ambulatorial ou hospitalar em uma instituição de previdência social, no período de março de 2020 a março de 2021. Foram constituídos dois grupos de estudo. O grupo exposto foi dividido em quatro subgrupos, cada um com diagnóstico único e exclusivo de uma doença crônica (diabetes, hipertensão, obesidade ou doença renal crônica). O grupo não exposto foi constituído por prontuários de pacientes sem comorbidades. Foram revisados 1.114 prontuários no total, utilizando técnica de amostragem aleatória simples. Uma vez obtido o tamanho mínimo da amostra, foi calculado o risco relativo para cada doença crônica. Foram realizadas combinações de 2, 3 e 4, tendo sido feita a análise com cada uma delas. Resultados: Na ausência de doença crônica degenerativa, a prevalência de letalidade na COVID-19 é de 3,8%; na presença de diabetes mellitus tipo 2, a letalidade é de 15,8%; na presença de hipertensão arterial, 15,6%; e na presença de obesidade, 15%. Quando tanto diabetes como hipertensão estão presentes, a letalidade é de 54,1%; com diabetes e obesidade, 36,8%; e obesidade com hipertensão, 28,1%. Conclusões: Em pacientes com COVID-19, o risco relativo de letalidade é de 4,17 naqueles com diabetes; 4,13 naqueles com hipertensão; e 3,96 naqueles com obesidade. Quando duas doenças crônicas são combinadas, o risco relativo dobra ou triplica. Para diabetes e hipertensão, o risco relativo de letalidade é 14,27; para diabetes e obesidade, 9,73; e para obesidade e hipertensão, 7,43. As doenças crônicas não ocorrem sozinhas (geralmente estão associadas), e nessa perspectiva os riscos relativos de letalidade apresentados neste artigo tornam-se relevantes.

5.
12th International Conference on Computer Communication and Informatics, ICCCI 2022 ; 2022.
Article in English | Scopus | ID: covidwho-1831792

ABSTRACT

In today's world, as population is at high peak and due to changing life style of people, individuals are suffering from various chronic disease. With shift towards modern methodology, involvement of human efforts has decreased, as know a day's people need to finish particular amount of task within few hours and with less effort. No doubt technology has made less intervention of human but it has certain limitations too. Due to less physical involvement, humans are more prone to diseases. Internet of things (IoT) plays a very crucial role in health care sector. Using various sensors, it become possible to trace the medical health condition of the human, and a message can be forwarded to nearby hospitals which helps the patients with ease. In this paper, three different diseases like heart disease, diabetes and novel COVID-19 are discussed where different machine learning algorithms are reviewed with involvement of IoT sensors. © 2022 IEEE.

6.
Journal of Animal Science ; 99(Supplement_3):70-71, 2021.
Article in English | ProQuest Central | ID: covidwho-1831221

ABSTRACT

Beef is an abundant source of all proteinogenic amino acids (AAs;in both adequate amounts and balanced ratios) and physiologically essential nonproteinogenic AAs (taurine and β-alanine). The content and bioavailabilities of proteinogenic AAs in beef are greater than those in plant-sourced foods. Taurine (a potent anti-oxidant) is essential for the integrity and functions of tissues, including eyes, heart, and skeletal muscle, whereas β-alanine is required for the production of antioxidative and neuromodulatory dipeptides. Furthermore, beef contains a large amount of creatine (essential for energy metabolism in tissues, particularly brain and skeletal muscle), anti-oxidative dipeptides (carnosine and anserine), and 4-hydroxyproline (an anti-inflammatory nutrient that maintains intestinal integrity and inhibits colitis). There are myths that plants provide all nutrients that are available in animal-sourced foods. However, taurine, vitamin B12, creatine, carnosine, and anserine are absent from plants, whereas β-alanine and 4-hydroxyproline are low or negligible in plants. Like other animal-sourced foods, beef plays an important role in the optimum growth of children and the prevention of anemia in humans, as well as maintaining muscle mass, delaying ageing, and mitigating sarcopenia in adults, while meeting the high demands of exercising individuals for high-quality protein. Some epidemiological studies raised concern that the consumption of red meat might increase risks for chronic diseases in humans, including obesity, type 2 diabetes mellitus, cardiovascular disease, kidney disease, and cancers. However, findings from many epidemiological and clinical studies do not support these claims. Beef-derived AAs and other nutrients enhance the metabolism (e.g., nitric-oxide and glutathione syntheses) and the functions of monocytes, macrophages, lymphocytes, and other cells of the immune system, thereby helping the human host to kill pathogenic bacteria, fungi, parasites, and viruses. The latter include severe acute respiratory syndrome coronavirus (SARS-CoV) and SARS-CoV-2 (COVID-19). Therefore, beef is a functional food for optimizing human growth, development, and health.

7.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-334973

ABSTRACT

It is becoming increasingly clear that individuals recovered from acute coronavirus disease 2019 (COVID-19) can develop into long-term sequelae (post-acute sequala of SARS-CoV-2 infection, PACS). While antibody response kinetics against viral particles is well studied in natural infection and vaccine, the molecular mechanisms governing disease formation remain elusive. We investigated plasma and saliva samples from COVID-19 and healthy control subjects to understand early immune responses globally after exposure to the virus. Antibody analyses showed robust IgA and IgG responses, neutralizing functions to the SARS-CoV-2, and positive correlations between matched plasma and saliva fluids. Shotgun proteomics revealed persistent inflammatory patterns in convalescent samples including dysfunction of neutrophil-fibrinogen axis, and dysregulated immune and clotting functions. Our study suggests saliva as fluid to monitor serology and immune functions to detect early and chronic signs of disease development. Further delineation of the pathophysiology in saliva may lead to discovery of novel biomarkers and therapeutic targets to patients at risk to develop PASC and chronic conditions.

8.
2nd International Conference on Emerging Technologies for Computing, Communications, and Smart Cities, ETCCS 2021 ; 875:649-659, 2022.
Article in English | Scopus | ID: covidwho-1826302

ABSTRACT

The eruption of chronic diseases such as COVID-19 has re-emphasized the need for people all over the world to have access to urgent healthcare. The latest pandemic has shown the flaws in the conventional healthcare system, namely that hospitals and clinics alone are incapable of dealing with such a crisis. Smart and integrated wearables are one of the main technologies that favor modern healthcare solutions (Godi, B., Viswanadham, S., Muttipati, A.S., Prakash Samantray, O., Gadiraju student, S.R.: E-Healthcare Monitoring System using IoT with Machine Learning Approaches. In: 2020 International Conference on Computer Science, Engineering and Applications (ICCSEA). pp. 1–5. IEEE, Gunupur, India (2020). https://doi.org/10.1109/ICCSEA49143.2020.9132937 ). These wearables can now gather data on an unparalleled scale thanks to advancements in the Internet of Things (IoT). Healthcare is among many fields that have been transformed by IoT, with the Internet of Medical Things (IoMT) systems being introduced as an IoT branch. Patients with chronic diseases can be monitored remotely using IoMT systems. As a result, it can offer prompt diagnostics to patients, potentially saving their lives in the event of an emergency. However, protection in these vital systems is a major issue that has arisen as a result of their widespread use. This paper presents an overview of the technologies that are being used on IoMT as well as some security problems found in the literature. This survey will give an insight to the readers regarding the importance of security in healthcare and the different machine learning methods used to address that issue. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

9.
20th International Conference on Informatics in Economy, IE 2021 ; 276:3-14, 2022.
Article in English | Scopus | ID: covidwho-1826275

ABSTRACT

Most u-healthcare applications were developed based on five important dimensions: education, prevention, diagnosis, treatment, and monitoring of patients. The starting point of our research was the need of finding out the way in which the current COVID-19 pandemic influenced the dependency of chronic diseases’ persons over 50 to the M-health and E-health solutions in Romania. We focused on user’s experience and ability to use these systems, starting from the already known Smart-healthcare and U-healthcare ones, as developed in EU’s Horizon 2020 program and the way the new technologies like IoT, Smart Device, and Wearable Technologies as part of U-Healthcare are accepted and used in Romania. The focus group is made up of people aged 50 to 84, and the on-line questionnaire contained issues related to the acceptance of the IoT and the new technologies used in Telemedicine and U-healthcare systems for the prevention and monitoring of the chronic disease’s patients, starting from the influence UX factors. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

10.
Urologiia (Moscow, Russia) ; - (2):43-53, 2022.
Article in Russian | MEDLINE | ID: covidwho-1824286

ABSTRACT

INTRODUCTION: Chronic prostatitis (CP) has long been considered one of the common causes of male infertility. The influence of therapy for CP on spermatogenesis is well studied. However, recently, especially in the era of the new coronavirus infection (COVID-19), much attention has been paid to the effects of cytokines on the pathogenesis of the inflammatory process, and their impact on male fertility. AIM: To study the effect of a complex of natural antimicrobial peptides and cytokines (Superlymph) on ejaculate, MAR test, oxidative stress (OS), and sperm DNA fragmentation (SDF) in men with infertility and a history of CP. In some patients, the level of cytokines before and after treatment was determined. MATERIALS AND METHODS: A total of 583 infertile men with a history of CP, aged 18-75 years, were screened according to the inclusion/ exclusion criteria. In group I, patients received antioxidant stimulation of spermatogenesis (triovit, trental, mexidol) in combination with a complex of natural antimicrobial peptides and cytokines (Superlymph) one suppository 25 IU at night for 20 days for 1-3 weeks and for 6-8 weeks for 2 months. In group II, antioxidant stimulation of spermatogenesis was prescribed along with suppositories for the prevention of CP for 2 months. The evaluated criteria included sperm analysis, MAR test, oxidative stress in spermatozoa (reactive oxygen species (ROS)) and SDF. The levels of seminal plasma cytokines were also measured before and after treatment in 32 patients using the Bio-Plex Pro panel for the simultaneous determination of 17 human cytokines, the Human Cytokine 17-plex Assay. Statistica-10 software was used for statistical analysis (p<0.05). RESULTS: Of 135 eligible patients, results were collected from 125 men (mean age 31.7 +/- 13.4 years). In group I, there was a more pronounced increase in motility by 42.3%, a decrease in the MAR-test level by 64.7%, oxidative stress in spermatozoa by 56.1%, and SDF by 25.6%, compared to group II (30.4 %, 10.5%, 45.7%, 21.9%), respectively. All these changes were significant with the exception of a decrease in the level of SDF. In group I, there was a predominant increase in the activity of anti-inflammatory cytokines (IL-4, 10, 13), a decrease in the level of pro-inflammatory cytokines ((IL-2, 12). In group II, there was a significant decrease in both pro-inflammatory (IL-2, 6, 8), and anti-inflammatory cytokines (IL-4). The remaining changes were insignificant. Among mild side effects, there were a change in the color of the sclera in 4 (3.2%), anal pain in 3 (2.4%), a decrease in libido in 2 (1.6%) patients. No differences between groups in the frequency of side effects were recorded (p>0.05). CONCLUSION: Antioxidant stimulation of spermatogenesis in infertile men and CP is an effective and safe. The addition of a complex of natural antimicrobial peptides and cytokines (Superlymph) leads to a more profound increase in sperm motility, a decrease in the MAR-test, oxidative stress in sperm cells, which potentiates the effects of therapy. The use of Superlymph is accompanied by a more pronounced positive effect on pathospermia, an increase in anti-inflammatory and a decrease in pro-inflammatory cytokines. In the contrary, in control group, where patients received antioxidant stimulation of spermatogenesis, only a decrease in the level of main cytokines was observed. The effect of a complex of natural antimicrobial peptides and cytokines (Superlymph) on the level of SDF, as well as the relationship with fertility and childbirth rates, requires further study.

11.
European Journal of Molecular and Clinical Medicine ; 9(3):2682-2693, 2022.
Article in English | EMBASE | ID: covidwho-1820559

ABSTRACT

The availability of different vaccines plays a crucial role in bringing the COVID-19 pandemic to a standstill. All the vaccines with two initial and a booster dose have reduced the mortality rate and do not elicit serious symptoms or illness. However, the clinical trials on different vulnerable populations are still not reliable. In particular, COVID-19 patients belonging to the diabetic population exhibited higher morbidity and mortality. Therefore, the prioritization of vaccination for these populations may reduce further complications. Yet, the hesitancy toward vaccines hinders the process of vaccination campaigns. Hence, this review focuses on the availability of different vaccines against COVID-19 and their role in eradicating previous epidemics. The effect of this vaccination on the diabetic group and the management of chronic illness have been emphasized.

12.
Biomedicines ; 10(4)2022 Mar 30.
Article in English | MEDLINE | ID: covidwho-1820167

ABSTRACT

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) generated a worldwide emergency, until the declaration of the pandemic in March 2020. SARS-CoV-2 could be responsible for coronavirus disease 2019 (COVID-19), which goes from a flu-like illness to a potentially fatal condition that needs intensive care. Furthermore, the persistence of functional disability and long-term cardiovascular sequelae in COVID-19 survivors suggests that convalescent patients may suffer from post-acute COVID-19 syndrome, requiring long-term care and personalized rehabilitation. However, the pathophysiology of acute and post-acute manifestations of COVID-19 is still under study, as a better comprehension of these mechanisms would ensure more effective personalized therapies. To date, mounting evidence suggests a crucial endothelial contribution to the clinical manifestations of COVID-19, as endothelial cells appear to be a direct or indirect preferential target of the virus. Thus, the dysregulation of many of the homeostatic pathways of the endothelium has emerged as a hallmark of severity in COVID-19. The aim of this review is to summarize the pathophysiology of endothelial dysfunction in COVID-19, with a focus on personalized pharmacological and rehabilitation strategies targeting endothelial dysfunction as an attractive therapeutic option in this clinical setting.

13.
Profilakticheskaya Meditsina ; 24(12):79-83, 2021.
Article in Russian | EMBASE | ID: covidwho-1818838

ABSTRACT

The article describes a clinical case of death of a 57-year-old patient from idiopathic AL-amyloidosis after infection with SARS-CoV-2. Histological examination revealed signs of pneumonia with symptoms of pneumosclerosis, histologically determined di-apedesic hemorrhages, necrosis and desquamation of the alveolar epithelium, along the contours of the alveolar passages, al-veolar sacs — hyaline membranes. In many areas, the histoarchitectonics of the pulmonary parenchyma was sharply disturbed, connective tissue was determined in the alveolar passages, in the lumens of the alveoli. The interalveolar septa were thickened due to the proliferation of connective tissue. Positive Congo red staining was visualized mainly in the perivascular and interalveo-lar septa, along the vessels;in the heart — between cardiomyocytes, in the kidneys — in the capillary loops of the glomeruli, base-ment membranes of individual tubules of the cortical layer, in the walls of blood vessels. Thus, the cause of death of the patient was the severe course of infection with SARS-CoV-2;the presence of a concomitant disease in the form of idiopathic AL-amyloi-dosis of internal organs and chronic diseases, obviously, aggravated the patient’s condition and contributed to the onset of death.

14.
Journal of Clinical Obstetrics and Gynecology ; 32(1):7-12, 2022.
Article in English | EMBASE | ID: covidwho-1818564

ABSTRACT

Objective: As approval of one of many coronavirus disease-2019 (COVID-19) vaccines' use for pregnancy is getting closer, vaccine hesitancy may take place in pregnant individuals for this new vaccine. Our study aimed to evaluate vaccine acceptance and factors affecting vaccine acceptance in case of an approved COVID-19 vaccine for pregnant individuals. Material and Methods: Our study was designed as one group, cross-sectional, prospective study. Sample consisted of pregnant individuals who didn't have any chronic illnesses and didn't contract COVID-19 in the last 6 months. In-person style survey was used to collect data about demographics, knowledge about COVID- 19 disease and it's effects on pregnant individuals, vaccine acceptance and reasons for acceptance or refusal. Results were analyzed with descriptive statistics, chi-square test and Shapiro-Wilk test of normality using Number Cruncher Statistical System. Results: Among 250 participants, 183 (73.2%) reported they wouldn't accept COVID-19 vaccination if there was a safe and effective vaccine approved for use in pregnancy. Main reasons of refusal were the belief that vaccine hadn't been studied on humans enough or that it might have adverse effectes on baby and/or pregnant individual. Only factor associated with vaccine acceptance was found to be knowing someone who had severe COVID-19 disease (p=0.022). Conclusion: Our study shows that vaccine hesitancy rates may be high among pregnant individuals when a COVID-19 vaccine is approved for use in pregnancy. The main reason for vaccine hesitancy is safety concerns.

15.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816910

ABSTRACT

INTRODUCTION: COVID-19 has been declared as a pandemic by the World Health Organisation (WHO)in December 2019, as it spread globally and confirmed cases approach 5,000 000 patients and will exceed 365000 deaths on the 25 May 2020 across over 160 countries. Cancer patients are one of the most vulnerable groups in the current (COVID-19) pandemic. To date, the clinical characteristics of COVID-19-infected cancer patients remain widely not well understood. Patients and methods A retrospective study was conducted in Royal Wolverhampton NHS Trust for COVID-19 Cancer patients. Hospitalised cancer patients diagnosed with COVID-19 infection were identified between 30th March 2020 to 30th June 2020. Patients already have been diagnosed with cancer and had a laboratory-confirmed SARS-CoV-2 infection were enrolled. Clinical retrospective data were collected from hospital medical records, including demographic features, clinical features, laboratory findings, and chest radiograph and chest computed tomography (CT) images. Statistical analysis was done to assess the risk factors associated with severe events which required admission to an intensive care unit, the use of mechanical ventilation, or death Results Forty Cancer patients with Covid 19 infection during the period from 30th March 2020 to 30th June 2020 were enrolled. (52.6%) 22 of patients were females. Median age was 65 years .All patients were local residents of Wolverhampton. Among the cancer patients, Breast cancer was the most frequent type of cancer (n= 9;21.1%), followed by Gl cancers (n= 8;21%) and lymphoma (n = 6;15.8%).Twenty two patients (52.6%) were diagnosed with stage I-III cancer.18 patients (47.4%) were on active chemotherapy, 3 patients were on target therapy and 3 patients(7.9%) were on active immunotherapy. In addition to cancer, 31 (81.6%) patients had at least one or more coexisting chronic diseases. The most common clinical features on admission were fever (92.1%), dry cough (86.8%), and fatigue (92%);29 (76.3%) patients developed dyspnoea along with lymphopaenia (n = 32, 84.2%), high level C-reactive protein (n = 40, 100%), anaemia (n = 22, 57.9 %), and hypoproteinaemia (n = 21, 55.3%). The common chest computed tomography (CT) findings were ground-glass opacity (n = 13) and patchy consolidation (n= 4) .It is important to note that CT chest not done in 17 patients. A total of 19 patients had severe events and the mortality rate was (44.7%) .Median days of hospital admission was (12.5).It is noted that all patients with active immunotherapy had recovered despite disease progression. Conclusions: Cancer patients have deteriorating conditions and worse outcomes from the COVID-19 infection. It is recommended that cancer patients receiving antitumour therapies should have regular screening for COVID-19 infection and should avoid treatments causing immunosuppression or have dose reduction during COVID-19 Pandemic in second wave .Covid 19 has different response with patients on active immunotherapy need to be highlighted.

16.
Respirology ; 27(SUPPL 1):192, 2022.
Article in English | EMBASE | ID: covidwho-1816640

ABSTRACT

Introduction/Aim: The Respiratory Nursing Service (RNS) at The Queen Elizabeth Hospital (TQEH) uses various review modes including telephone, home or outpatient visits to provide support with disease and exacerbation management. Sars-COV-2 has seen telehealth access fast tracked to provided alternatives to face to face review for continuation of personalized management. Aim: To assess the feasibility and cost of using telehealth in a respiratory outreach nursing program as an alternative to home visiting for face to face patient review for disease management and support during exacerbation. Methods: Respiratory Chronic Disease clients of the TQEH RNS were invited to participate. Requiring an electronic device and internet connection, participants were supported in downloading and testing the telehealth platform. An oximeter and thermometer were provided if participants did not already have at home to enable an objective vital sign assessment of exacerbation should they become unwell. Service utilization, patient satisfaction and staff reported practicality of using telehealth were assessed. Results: Nineteen participants were enrolled, four failed to complete the 6-month study (2-withdrew and 2-died). A total of 51 telehealth episodes occurred with 21 patientreported exacerbations, 76% of these were managed at home. Projected savings on bed days, admission costs and service utilization timings for varying review modes were reported. Eighty percent of patients reported that telehealth provided the same standard of care as face to face. Sixty-seven percent said technology was easy to use, 80% would use telehealth again. Staff reported issues included variable sound and video quality, timeliness of patient to call in and technical issues resulting in platform failure. Conclusion: Telehealth presents opportunities for efficiencies in time and potential cost savings from hospital avoidance strategies for managing exacerbations in the community. Reliability of the platform and the confidence of patients using technology are challenges.

17.
J Pharm Pract ; : 8971900221087934, 2022 Apr 19.
Article in English | MEDLINE | ID: covidwho-1817031

ABSTRACT

The COVID-19 pandemic impacted primary care and required pharmacists to adapt when implementing primary care services. Many lessons learned through this process are applicable in the post-pandemic era. First, primary care pharmacists must prepare for an ever-changing role and communicate with stakeholders to align with shifting institutional priorities. Additionally, designing a workflow given limited staffing and in-person communication require flexibility for scheduling and referral processes. Proactive outreach and communication via virtual platforms may be used to build trust in place of in-office interactions with providers. Lastly, fostering relationships with patients is essential to the success of the service and often requires creation of patient-centered goals to account for personal barriers. Many pandemic obstacles are transient; however, telehealth, virtual communication, and the subsequent lessons learned in adaptability, creativity, and flexibility when building a clinic practice are everlasting.

18.
Journal of Parenteral and Enteral Nutrition ; 46(SUPPL 1):S127-S128, 2022.
Article in English | EMBASE | ID: covidwho-1813569

ABSTRACT

Background: The consequences of the COVID-19 pandemic in long-term care facilities could be severe for frail and immunocompromised older adults.1 These older adult patients are hypermetabolic due to pressure ulcers, infection, fever, and elevated inflammatory labs such as CRP.1 They experience decreased appetite due to taste and smell changes. The inadequate intake, fat, and muscle loss due to prolonged hospitalization and increased nutrition demands create a negative nutrient balance, leading to unintentional weight loss (UWL).1 According to the Center for Medicare and Medicaid Services (CMS), UWL is defined as a weight loss of 5% in 30 days, 7.5% in 90 days, and 10% in 180 days.2 In this proposal, our focus was unintentional weight loss (UWL) in long-term skilled care patients and how collaborative nursing and dietitian intervention impacts the UWL in this specific population. Methods: The data were collected retrospectively for all patients admitted between May 2020 to March 2021. The patient's demographic data was collected from the chart review using the point click care program. The top five patient diagnoses were retrieved using MDS coding for the study period. Additionally, the most common chronic disease in the geriatric population was used. The red napkin program was initiated in Oct 2020. The red napkin program was initiated to alert the nursing staff for patients with UWL and who also have pressure ulcers. Results: The results indicated that the average census was 152 patients during the study period. The majority of the patients (84%) were long-term care, with more females than males (59 vs 40%). Most of the patients were African American and Caucasian ethnic group. Nearly 40-45% of patients had diabetes, hypertension;one-fourth of the patients had CHF, dialysis, and dementia. During this period, there was a total of 77 patients who had unintentional weight loss as defined by CMS criteria. There were 60 patients before the intervention, and the numbers declined significantly to 33 patients post-intervention. Out of these 33 post-intervention patients, only 17 patients were new, and 16 were from the previous months of the preintervention period. The number has also declined from 12 to 7 expected weight loss related to hospice and comfort care patients. Most patients received oral nutrition supplements to halt weight loss. Four patients received alternate routes of nutrition support (TPN/EN) in addition to an oral diet. Almost 40% of patients had COVID-19 infection, and 38% of patients had pressure ulcers, which may have affected unintentional weight loss. Conclusion: The results indicated that appropriate and timely collaborative dietitian and nursing efforts improve patient outcomes or quality of care to halt unintentional weight loss in long-term skilled care facilities.

19.
Health Rep ; 33(4): 3-13, 2022 04 20.
Article in English | MEDLINE | ID: covidwho-1811971

ABSTRACT

Background: Canadians have been gravely impacted by the COVID-19 pandemic, and adults living with children may have been disproportionately impacted. The objective of this study was to describe changes in chronic disease risk factors and current exercise habits among adults living with and without a child younger than 18 years old. Data and Methods: A repeated cross-sectional study was conducted using data collected from Canadians aged 15 and older via the Canadian Perspective Survey Series (CPSS) in late March (CPSS1, N=4,383), early May (CPSS2, N=4,367) and mid-July 2020 (CPSS4, N=4,050). This analysis included participants aged 25 and older. At three points during 2020, participants reported whether they increased, decreased, or had not changed their consumption of alcohol, tobacco and junk food or sweets, their screen use, and whether they currently exercised indoors or outdoors. Behaviours were compared for adults living with and without a child, and unadjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. Results: The presence of a child in the household was associated with higher odds of increased (compared with decreased or no change) alcohol consumption at all three time points, consumption of junk food and sweets at CPSS1 (OR: 1.69, 95% CI: 1.09-2.60), and time on the Internet at CPSS1 (OR: 1.59, 95% CI: 1.05-2.41) and CPSS4 (OR: 1.56, 95% CI: 1.05-2.29). Compared with older adults (aged 55 and older), younger adults (aged 25 to 54) were more likely to exhibit increases in chronic disease risk factors regardless of the presence of a child in the household. Interpretation: A substantial proportion of Canadian adults reported increased chronic disease risk factors during the pandemic, with greater increases noted among adults living with a child, compared with those living without a child. Public health interventions are urgently needed to mitigate the long-term impact of the pandemic on population health.


Subject(s)
COVID-19 , Pandemics , Adolescent , Aged , Canada/epidemiology , Child , Chronic Disease , Cross-Sectional Studies , Habits , Humans , Risk Factors , SARS-CoV-2
20.
Int J Environ Res Public Health ; 19(9)2022 Apr 27.
Article in English | MEDLINE | ID: covidwho-1809929

ABSTRACT

Information on medication utilization among pregnant and postpartum women during the pandemic is lacking. We described the prevalence and patterns of self-reported medication use among pregnant and postpartum women during the third wave of the pandemic (June-August 2021). An online questionnaire was distributed in five European countries between June-August 2021. Pregnant women or women who had delivered in the three preceding months, and ≥18 years old, could participate. The prevalence of overall medication use, self-medication, and changes in chronic medication use were determined. A total of 2158 women out of 5210 participants (41.4%) used at least one medication. Analgesics (paracetamol), systemic antihistamines (cetirizine), and drugs for gastric disorders (omeprazole) were the three most used classes. Anti-infectives were less prevalent than during pre-pandemic times. Antidepressants and anxiety related medication use remained similar, despite a higher prevalence of these symptoms. Self-medication was reported in 19.4% of women, and 4.1% of chronic medication users reported that they changed a chronic medication on personal initiative due to the pandemic. In conclusion, medication use patterns in our cohort were mostly similar to those of the first COVID-19 wave and the pre-pandemic period. More studies are needed to explore factors associated with self-medication and changes in chronic medication use due to the pandemic in this perinatal population.


Subject(s)
COVID-19 , Adolescent , Anxiety/epidemiology , COVID-19/drug therapy , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Pandemics , Parturition , Postpartum Period , Pregnancy , Pregnant Women , Self Report
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