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1.
Yonsei Medical Journal ; 63(5):422-429, 2022.
Article in English | MEDLINE | ID: covidwho-1834347

ABSTRACT

PURPOSE: We previously developed learning models for predicting the need for intensive care and oxygen among patients with coronavirus disease (COVID-19). Here, we aimed to prospectively validate the accuracy of these models. MATERIALS AND METHODS: Probabilities of the need for intensive care [intensive care unit (ICU) score] and oxygen (oxygen score) were calculated from information provided by hospitalized COVID-19 patients (n=44) via a web-based application. The performance of baseline scores to predict 30-day outcomes was assessed. RESULTS: Among 44 patients, 5 and 15 patients needed intensive care and oxygen, respectively. The area under the curve of ICU score and oxygen score to predict 30-day outcomes were 0.774 [95% confidence interval (CI): 0.614-0.934] and 0.728 (95% CI: 0.559-0.898), respectively. The ICU scores of patients needing intensive care increased daily by 0.71 points (95% CI: 0.20-1.22) after hospitalization and by 0.85 points (95% CI: 0.36-1.35) after symptom onset, which were significantly different from those in individuals not needing intensive care (p=0.002 and <0.001, respectively). Trends in daily oxygen scores overall were not markedly different;however, when the scores were evaluated within <7 days after symptom onset, the patients needing oxygen showed a higher daily increase in oxygen scores [1.81 (95% CI: 0.48-3.14) vs. -0.28 (95% CI: 1.00-0.43), p=0.007]. CONCLUSION: Our machine learning models showed good performance for predicting the outcomes of COVID-19 patients and could thus be useful for patient triage and monitoring.

2.
Emerging Infectious Diseases ; 28(4), 2022.
Article in English | ProQuest Central | ID: covidwho-1834284

ABSTRACT

Patients infected with severe acute respiratory syndrome coronavirus 2 might have bacterial and fungal superinfections develop. We describe a clinical case of coronavirus disease with pulmonary aspergillosis associated with Bordetella hinzii pneumonia in an immunocompetent patient in France. B. hinzii infections are rare in humans and develop secondary to immunosuppression or debilitating diseases.

3.
PLoS ONE [Electronic Resource] ; 17(3):e0266160, 2022.
Article in English | MEDLINE | ID: covidwho-1833647

ABSTRACT

OBJECTIVE: The objective was to compare home care episode, standardised assessment, and service patterns in Ontario's publicly funded home care system during the first wave of the COVID-19 pandemic (i.e., March to September 2020) using the previous year as reference. STUDY DESIGN AND SETTING: We plotted monthly time series data from March 2019 to September 2020 for home care recipients in Ontario, Canada. Home care episodes were linked to interRAI Home Care assessments, interRAI Contact Assessments, and home care services. Health status measures from the patient's most recent interRAI assessment were used to stratify the receipt of personal support, nursing, and occupational or physical therapy services. Significant level and slope changes were detected using Poisson, beta, and linear regression models. RESULTS: The March to September 2020 period was associated with significantly fewer home care admissions, discharges, and standardised assessments. Among those assessed with the interRAI Home Care assessment, significantly fewer patients received any personal support services. Among those assessed with either interRAI assessment and identified to have rehabilitation needs, significantly fewer patients received any therapy services. Among patients receiving services, patients received significantly fewer hours of personal support and fewer therapy visits per month. By September 2020, the rate of admissions and services had mostly returned to pre-pandemic levels, but completion of standardised assessments lagged behind. CONCLUSION: The first wave of the COVID-19 pandemic was associated with substantial changes in Ontario's publicly funded home care system. Although it may have been necessary to prioritise service delivery during a crisis situation, standardised assessments are needed to support individualised patient care and system-level monitoring. Given the potential disruptions to home care services, future studies should examine the impact of the pandemic on the health and well-being of home care recipients and their caregiving networks.

4.
PLoS ONE [Electronic Resource] ; 17(3):e0266127, 2022.
Article in English | MEDLINE | ID: covidwho-1833646

ABSTRACT

BACKGROUND: City-wide lockdowns and school closures have demonstrably impacted COVID-19 transmission. However, simulation studies have suggested an increased risk of COVID-19 related morbidity for older individuals inoculated by house-bound children. This study examines whether the March 2020 lockdown in New York City (NYC) was associated with higher COVID-19 hospitalization rates in neighborhoods with larger proportions of multigenerational households. METHODS: We obtained daily age-segmented COVID-19 hospitalization counts in each of 166 ZIP code tabulation areas (ZCTAs) in NYC. Using Bayesian Poisson regression models that account for spatiotemporal dependencies between ZCTAs, as well as socioeconomic risk factors, we conducted a difference-in-differences study amongst ZCTA-level hospitalization rates from February 23 to May 2, 2020. We compared ZCTAs in the lowest quartile of multigenerational housing to other quartiles before and after the lockdown. FINDINGS: Among individuals over 55 years, the lockdown was associated with higher COVID-19 hospitalization rates in ZCTAs with more multigenerational households. The greatest difference occurred three weeks after lockdown: Q2 vs. Q1: 54% increase (95% Bayesian credible intervals: 22-96%);Q3 vs. Q1: 48% (17-89%);Q4 vs. Q1: 66% (30-211%). After accounting for pandemic-related population shifts, a significant difference was observed only in Q4 ZCTAs: 37% (7-76%). INTERPRETATION: By increasing house-bound mixing across older and younger age groups, city-wide lockdown mandates imposed during the growth of COVID-19 cases may have inadvertently, but transiently, contributed to increased transmission in multigenerational households.

6.
Nursing ; 52(5):16-18, 2022.
Article in English | CINAHL | ID: covidwho-1831368

ABSTRACT

The article reports on the development by researchers of a new clinical score to stratify patients at risk for stroke when hospitalized with COVID-19, which they presented at the 2022 International Stroke Conference held in New Orleans, Louisiana in February 2022.

7.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-335079

ABSTRACT

Background: As mortality from COVID-19 is strongly age-dependent, we aimed to identify population subgroups at an elevated risk for adverse outcomes from COVID-19 using age/gender-adjusted data from European cohort studies with the aim to identify populations that could potentially benefit from booster vaccinations. Methods: We performed a systematic literature review and meta-analysis to investigate the role of underlying medical conditions as prognostic factors for adverse outcomes due to SARS-CoV-2, including death, hospitalisation, Intensive Care Unit (ICU) admission, and mechanical ventilation within three separate settings (community, hospital and ICU). Cohort studies that reported at least age and gender-adjusted data from Europe were identified through a search of peer-reviewed articles published until 11th June 2021 in Ovid Medline and Embase. Results are presented as Odds Ratios (ORs) with 95% confidence intervals (95%C.I.) and absolute risk differences (RD) in deaths per 1,000 COVID-19 patients. Findings: We included 88 cohort studies with age/gender adjusted data from 6,653,207 SARS-CoV-2 patients from Europe. Hospital-based mortality was associated with high and moderate certainty evidence for solid organ tumours, diabetes mellitus, renal disease, arrhythmia, ischemic heart disease, liver disease, and obesity, while a higher risk, albeit with low certainty, was noted for chronic obstructive pulmonary disease and heart failure. Community-based mortality was associated with a history of heart failure, stroke, diabetes, and end-stage renal disease. Evidence of high/moderate certainty revealed a strong association between hospitalisation for COVID-19 and solid organ transplant recipients, sleep apnoea, diabetes, stroke, and liver disease. Interpretation: The results confirmed the strong association between specific prognostic factors and mortality and hospital admission. Prioritisation of booster vaccinations and the implementation of non-pharmaceutical protective measures for these populations may contribute to a reduction in COVID-19 mortality, ICU and hospital admissions.

8.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-335002

ABSTRACT

Objective: Cancer is a comorbidity that leads to progressive worsening of Covid-19 with increased mortality. This is a systematic review and meta-analysis to yield evidence of adverse outcomes of Covid-19 in gynecologic cancer. Methods: Searches through PubMed, Google Scholar, ScienceDirect, and medRxiv to find articles on the outcome of gynecologic cancer with Covid-19 (24 July 2021-19 February 2022). Newcastle-Ottawa Scale tool is used to evaluate the quality of included studies. Pooled odds ratio (OR), 95% confidence interval (CI), random-effects model were presented. This study was registered to PROSPERO (CRD42021256557). Results: We accepted 51 studies (1991 gynecologic cancer with Covid-19). Covid-19 infection was lower in gynecologic cancer vs hematologic cancer (OR 0.71, CI 0.56-0.90, p 0.005). Severe Covid and death were lower in gynecologic cancer vs lung and hematologic cancer (OR 0.36, CI 0.16-0.80, p 0.01), (OR 0.52, CI 0.44-0.62, p <0.0001), (OR 0.26, CI 0.10-0.67 p 0.005), (OR 0.63, CI 0.47-0.83, p 0.001) respectively. Increased Covid death is seen in gynecologic cancer vs breast, non-covid cancer, and non-cancer covid (OR 1.50, CI 1.20-1.88, p 0.0004), (OR 11.83, CI 8.20-17.07, p <0.0001), (OR 2.98, CI 2.23-3.98, p <0.0001) respectively. Conclusion: Gynecologic cancer has higher Covid-19 adverse outcomes compared to non-cancer, breast cancer, non-metastatic, and Covid-19 negative population. Gynecologic cancer has fewer Covid-19 adverse outcomes compared to other cancer types, lung cancer, and hematologic cancer. These findings may aid health policies and services during the ongoing global pandemic.

9.
Heart & Lung ; 54:49-55, 2022.
Article in English | MEDLINE | ID: covidwho-1828556

ABSTRACT

BACKGROUND: COVID-19 patient experiences in the intensive care unit (ICU) are marked by family separation. Families understand the importance of isolation and hospital visiting policies, but they consider it necessary to visit their loved ones and use personal protective equipment. OBJECTIVE: To describe the lived experiences of family members in their first contact with a relative in a COVID-ICU. METHODS: A phenomenological study was conducted using Cohen's method. The subjects were interviewed using an open-question format to allow them full freedom of expression. Twelve family members were recruited between February and March 2021. RESULTS: Analysis of the qualitative data resulted in five major themes: (1) fear of contagion related to donning/doffing procedures, (2) positive emotions related to first contact with the hospitalized relative, (3) concern for the emotional state of the hospitalized relative, (4) impact of the COVID-ICU and comparisons between imagination and reality regarding the severity of the disease, and (5) recognition of and gratitude toward healthcare professionals. CONCLUSIONS: It has been confirmed that visits to the ICU reduce anxiety among family members. Our findings constitute an internationally relevant contribution to understanding of the needs of relatives who meet loved ones for the first time while wearing personal protective equipment.

10.
Heart & Lung ; 54:95-96, 2022.
Article in English | MEDLINE | ID: covidwho-1828551
11.
PLoS ONE Vol 16(8), 2021, ArtID e0255774 ; 16(8), 2021.
Article in English | APA PsycInfo | ID: covidwho-1824527

ABSTRACT

Introduction: Illnesses requiring hospitalization are known to negatively impact psychological well-being and health-related quality of life (HRQoL) after discharge. The impact of hospitalization during the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) pandemic on psychological well-being and health-related quality of life is expected to be higher due to the exceptional circumstances within and outside the hospital during the pandemic surge. The objective of this study was to quantify psychological distress up to three months after discharge in patients hospitalized during the first coronavirus disease 2019 (COVID-19) pandemic wave. We also aimed to determine HRQoL, to explore predictors for psychological distress and HRQoL, and to examine whether psychological distress was higher in COVID-19 confirmed patients, and in those treated in Intensive Care Units (ICUs). Methods: In this single-center, observational cohort study, adult patients hospitalized with symptoms suggestive of COVID-19 between March 16 and April 28, 2020, were enrolled. Patients were stratified in analyses based on SARS-CoV-2 PCR results and the necessity for ICU treatment. The primary outcome was psychological distress, expressed as symptoms of post-traumatic stress disorder (PTSD), anxiety, and depression, up to three months post-discharge. Health-related quality of life (HRQoL) was the secondary outcome. Exploratory outcomes comprised predictors for psychological distress and HRQoL. Results: 294 of 622 eligible patients participated in this study (median age 64 years, 36% female). 16% and 13% of these patients reported probable PTSD, 29% and 20% probable anxiety, and 32% and 24% probabledepression at one and three months after hospital discharge, respectively. ICU patients reported less frequently probable depression, but no differences were found in PTSD, anxiety, or overall HRQoL. COVID-19 patients had a worse physical quality of life one month after discharge, and ICU patients reported a better mental quality of life three months after discharge. PTSD severity was predicted by time after discharge and being Caucasian. Severity of anxiety was predicted by time after discharge and being Caucasian. Depression severity was predicted by time after discharge and educational level. Conclusion: COVID-19 suspected patients hospitalized during the pandemic frequently suffer from psychological distress and poor health-related quality of life after hospital discharge. Non-COVID-19 and non-ICU patients appear to be at least as affected as COVID-19 and ICU patients, underscoring that (post-)hospital pandemic care should not predominantly focus on COVID-19 infected patients. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

13.
Pakistan Journal of Medical and Health Sciences ; 16(3):659-661, 2022.
Article in English | EMBASE | ID: covidwho-1822798

ABSTRACT

This article is investigating physiological childbirth statistics and obstetric service in Osh, Kyrgyzstan during the 2016 to 2021 years. Statistical analyses revealed several patients' admissions with their hospital stay days for the period from 2011 to 2020 in all departments. Growth in the population analyzed according to Kyrgyz Republic National Statistical Committee;due to spread of coronavirus infection COVID-19 pandemic and the government declared an emergency in certain territories in the Kyrgyz Republic, from March 31 to May 21, 2020, activities of public service centers and registry office by Government Registration Service were delayed. Conclusions: Quality provision in medical care is vital for both women and newborns and for a minority who experience complications in maternity service. Some statistical analyses revealed that average absolute birth number reduced by 92 births and births number variation analysis in Osh oblast for 2016 to 2021 years showed that in the 2021 year total birth number was 29902 and 31000 in 2020, which can be explained by COVID - 19 infection influence on the population. Number of births registered as 182.971 and the average annual number of births was 30.495.

14.
Infektoloski Glasnik ; 41(3):87-92, 2021.
Article in English | EMBASE | ID: covidwho-1822781

ABSTRACT

Summary Originating with unexplained symptoms from Wuhan, city of China, COVID-19 being a global pandemic causing tremendous morbidity and mortality, has proved to be the biggest challenge of the 20th century. This study aimed to explore the functional impacts of COVID-19 upon those patients who were diagnosed with this disease and were admitted in hospitals. This cross-sectional survey included 183 COVID-19 diagnosed patients from COVID-19 isolation wards of public and private hospitals of Islamabad and Rawalpindi. After getting ethical permission from Institutional Review Board of Shifa International Hospital (Ref # 070-21), this survey was conducted for the time period of 6 months from December 2020 to May 2021. Through convenient sampling, 183 patients with the age range of 25 to 55 years with no already diagnosed psychological complaints were assessed for eligibility briefed regarding the study purpose and then were asked for their voluntary participation. The Functional Status Scale for the Intensive Care Unit (FSS-ICU) was used to assess the functional status impacted due to COVID-19 during hospitalization. Frequencies and percentages were calculated through SPSS-21. On FSS-ICU, out of 183 COVID-19, 11 (6%) patients reported that they were dependent, 18 (9.8%) required maximum assistance, 32 (17.5%) required moderate assistance, 27 (14.8%) required minimal, 24 (13.1%) required supervision to complete their tasks, 28 (15.3%) required assistive devices, whereas 43 (23.5%) were totally independent. Results indicated a temporal impact of COVID-19 upon functional status of hospitalized patients in intensive care units, therefore highlighting the need of physiotherapeutic and psychotherapeutic interventions.

15.
Journal of Advances in Medical and Biomedical Research ; 30(140):215-222, 2022.
Article in English | EMBASE | ID: covidwho-1822724

ABSTRACT

Background & Objective: Measurement of inflammatory markers and lactate dehydrogenase (LDH) may contribute to the evaluation of lung involvement severity. This study aimed to evaluate relationship between severity of primary lung involvement with highest level of erythrocyte sedimentation rate (ESR) and LDH in patients with COVID-19. Materials & Methods: This descriptive-analytical study was conducted on 123 patients with COVID-19 in Shahid Sadoughi Hospital. Data including age, gender, ESR (mm/h), LDH (U/L), and high-resolution Computed Tomography scan (HRCT) findings and hospitalization ward were extracted from medical records. The regression model was used to determine the relation between HRCT findings with LDH and ESR. Results: Mean LDH, ESR, and HRCT findings were 508.41±224.65, 52.23±29.56, and 37.17± 22.18 respectively. A significant relation was seen between HRCT findings with highest level of LDH and ESR (P=0.001). A significant relation was observed between the highest levels of ESR and HRCT findings, regarding age, gender, and hospitalization wards (P<0.01). There was a significant relation between the highest level of LDH and HRCT findings regarding age group and hospitalization wards (P<0.01). Conclusion: A significant relation was seen between HRCT findings and highest levels of ESR and LDH in patients with COVID-19. Therefore, it seems that assessment of laboratory findings such as LDH and ESR can be helpful as cost-effective markers instead of chest CT scan for predicting the severity of lung injury when the CT scan report is controversial. The relation between HRCT findings with LDH and ESR were affected by age and hospitalization ward. However, more studies should be conducted in this regard.

16.
Journal of the Liaquat University of Medical and Health Sciences ; 21(1):16-22, 2022.
Article in English | EMBASE | ID: covidwho-1822684

ABSTRACT

OBJECTIVE: To evaluate the pattern of serum electrolytes abnormalities and their impact on ICU admitted Covid-19 patient outcomes. METHODOLOGY: This retrospective study was carried out at OMI hospital and Dr. Ziauddin Hospital, Karachi, Pakistan, between August to December 2020. Total 102 PCR positive, ICU admitted with severe Covid-19 patients as per WHO criteria were included. The patient's demographic characteristics, clinical features including co-morbidities, electrolytes reports at the time of admission, length of ICU and/or hospital stay, and outcome (expired/survived) were evaluated. RESULTS: Biochemical testing found abnormal electrolyte levels in 90.2% ICU admitted Covid-19 patients. Electrolytes abnormalities including hyponatremia 45.1%, hypermagnesemia 40.2%, hypocalcemia 31.4%, hyperchloremia23.5% and hyperphosphatemia in 20.6% patients. Out of the total, 28.4% of patients needed invasive respiratory support, and 37.3% could not survive. A higher incidence of mortality (39.1% vs. 20%) was seen in patients with electrolytes abnormalities compared to those presented with normal values. CONCLUSION: Electrolyte abnormalities were found in 90% of the ICU Admitted Covid-19 patients. The most common abnormalities found among the patients were hyponatremia, hypermagnesemia, and Hypocalcemia. The findings revealed that several electrolyte imbalances harm patients' in-hospital outcomes. Electrolyte assessment of Covid-19 patients at the time of admission would be helpful in risk stratification for adverse outcomes.

17.
ARYA Atherosclerosis ; 17(1), 2021.
Article in English | EMBASE | ID: covidwho-1822676

ABSTRACT

BACKGROUND: During ongoing coronavirus disease 2019 (COVID-19) pandemic, social isolation and lockdown measures were implemented to prevent spread of virus which created enormous challenges to patient healthcare. In order to overcome these challenges, teleconsultation (telecardiology) was initiated. Objective of this study was to assess outcome of telecardiology using audio/visual/audio-visual consultation among patients with implantable cardiac devices. METHODS: Telecardiology was performed (either physician-initiated or patient-initiated) among 1200 patients over a five-month period (July 13 to December 13, 2020) to review health status of patients to decide further course of treatment and to access their satisfaction level with telecardiology. RESULTS: Teleconsultation was cardiologist-and patient-initiated in 1042 (86.8%) and 158 (13.2%) cases, respectively. 1117 (93.2%) patients were stable, while scheduled admission, urgent hospitalization, and death were noted in 20 (1.8%), 45 (3.9%), and 18 (1.5%) patients, respectively. Next visit was rescheduled in 986 (82.2%), while 127 (10.6%) were called earlier because of battery depletion. Majority (n = 1077, 89.8%) were satisfied. CONCLUSION: Telecardiolgy is an effective option during COVID-19 to minimize interpersonal contact, spread of disease, psychological stress, and burden on already stretched healthcare.

18.
ARYA Atherosclerosis ; 17(2), 2022.
Article in English | EMBASE | ID: covidwho-1822674

ABSTRACT

BACKGROUND: COVID-19 was introduced by the World Health Organization (WHO) as a global pandemic. The disease manifestations ranges from a mild common cold to severe disease and death. It has a higher mortality rate in people with a history of comorbidities, including cardiovascular disease (CVD) and can also contribute to cardiac injury. This study was conducted to evaluate the relationship between troponin levels as a cardiac marker and adverse outcomes in this disease. METHODS: The study sample included 438 patients hospitalized with COVID-19;however, the troponin data of 6 patients were not available. The need to be admitted to the intensive care unit (ICU), and death were considered the adverse outcome in patients with COVID-19. Troponin levels were checked in all patients on day 1 and day 3 of hospitalization. Multiple logistic regression analysis was performed to determine whether there was an independent association between the adverse outcomes and troponin enzyme in hospitalized patients with COVID-19. RESULTS: The mean age of patients was 61.29 ± 15.84 years. Among the 432 patients tested on day 1 of hospitalization, 24 patients (5.6%) tested positive (Troponin 1), and among the 303 patients tested on day 3, 13 patients (4.3%) tested positive (Troponin 2). Based on our results, Troponin 1 showed an independent association with both death (3.008 [95%CI = 1.091-8.290];P = 0.033) and need for ICU admission (8.499 [95%CI = 3.316-21.788];P < 0.001) in multiple logistic regression analysis. Moreover, the status of Troponin 2 had an independent significant association with both death (4.159 [95%CI = 1.156-14.961];P = 0.029) and ICU admission (7.796 [95%CI = 1.954-31.097];P = 0.004). CONCLUSION: Troponin showed a significant association with adverse outcomes in people who were hospitalized with COVID-19. The periodical assessment of this enzyme from the time of hospitalization may improve the clinical decision making of clinicians.

19.
Annals of Translational Medicine ; 10(7), 2022.
Article in English | EMBASE | ID: covidwho-1822669
20.
Iatreia ; 35(2):89-97, 2022.
Article in Spanish | EMBASE | ID: covidwho-1822649

ABSTRACT

Introduction: The dissemination of infectious agents in a population can occur both in a homogeneous or heterogeneous way. SARS-CoV-2 has heterogeneous transmission by superspreaders (SS) (people with certain characteristics that transmit the infection to 80% of the exposed population). Objective: To describe the characteristics of SS in the first cases of COVID-19 in Cartagena, Colombia. Methodology: Epidemiological surveillance study carried out in Cartagena from February 25 to April 20, 2020, by the infection committee of Clínica Gestión Salud and the administrative department of health, on suspected cases, confirmed by RT-PCR for SARS-CoV-2, and close contacts of those confirmed cases for coronavirus infection. Results: In 30 days, two SS patients were confirmed, 21 secondary cases (10 and 11, each one), and two tertiary cases. The 1st SS began symptoms 48 hours after exposure, he was hospitalized on the 7th day after symptoms began and died 72 hours after hospitalization. The 2nd SS hospitalized for diabetic ketoacidosis, with subsequent finding of anosmia and dysgeusia, remained in the ICU one month. Of the secondary cases, 9.5% (2/21) were hospitalized in the ICU, 47% (10/21) in the general ward and 42% (9/21) were quarantined. Sixty one percent (14/23) of those infected were from health personnel. Conclusions: SS are important in the dynamics of transmission infectious diseases. Failure to identify or misdiagnosis a patient with COVID-19, together with hospital transfer, are the main causes of the genera-tion of a disproportionate number of secondary cases.

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