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1.
Journal of Korean Medical Science ; 37(17):e133, 2022.
Article in English | MEDLINE | ID: covidwho-1834343

ABSTRACT

BACKGROUND: The potential for a nosocomial outbreak of coronavirus disease 2019 (COVID-19) from a fully vaccinated individual is largely unknown. METHODS: In October 2021, during the time when the delta variant was dominant, a nosocomial outbreak of COVID-19 occurred in two wards in a tertiary care hospital in Seoul, Korea. We performed airflow investigations and whole-genome sequencing (WGS) of the virus. RESULTS: The index patient developed symptoms 1 day after admission, and was diagnosed with COVID-19 on day 4 post-admission. He was fully vaccinated (ChAdOx1 nCoV-19) 2 months before the diagnosis. Three inpatients and a caregiver in the same room, two inpatients in an adjacent room, two inpatients in rooms remote from the index room, and one nurse on the ward tested positive. Also, two resident doctors who stayed in an on-call room located on the same ward tested positive (although they had no close contact), as well as a caregiver who stayed on an adjacent ward, and a healthcare worker who had casual contact with this caregiver. Samples from five individuals were available for WGS, and all showed <= 1 single-nucleotide polymorphism difference. CCTV footage showed that the index case walked frequently in the corridors of two wards. An airflow study showed that the air from the corridor flowed into the resident on-call room, driven by an air circulator that was always turned on. CONCLUSION: Transmission of severe acute respiratory syndrome coronavirus 2 from a fully vaccinated index occurred rapidly via the wards and on-call room. Care must be taken to not use equipment that can change the airflow.

2.
Euro Surveillance: Bulletin Europeen sur les Maladies Transmissibles = European Communicable Disease Bulletin ; 27(17), 2022.
Article in English | MEDLINE | ID: covidwho-1834262

ABSTRACT

IntroductionIn France, three complementary surveillance networks involving hospitals and paediatrician practices currently allow pertussis surveillance among infants (<1 year old) and children (1-12 years old). Data on incidences among adolescents (13-17 years old) and adults (>= 18 years) are scarce. In 2017, a sentinel surveillance system called Sentinelles network, was implemented among general practitioners (GPs). AimThe purpose of Sentinelles network is to assess pertussis incidence, monitor the cases' age distribution and evaluate the impact of the country's vaccination policy. We present the results from the first 4 years of this surveillance. Methods GPs of the French Sentinelles network reported weekly numbers of epidemiologically or laboratory-confirmed cases and their characteristics. Results A total of 132 cases were reported over 2017-2020. Estimated national incidence rates per 100,000 inhabitants were 17 (95% confidence interval (CI): 12-22) in 2017, 10 (95% CI: 6-14) in 2018, 15 (95% CI: 10-20) in 2019 and three (95% CI: 1-5) in 2020. The incidence rate was significantly lower in 2020 than in 2017-2019. Women were significantly more affected than men (83/132;63% of women, p = 0.004);66% (87/132) of cases were aged 15 years or over (median age: 31.5 years;range: 2 months-87 years). Among 37 vaccinated cases with data, 33 had received the recommended number of doses for their age. Conclusions These results concur with incidences reported in other European countries, and with studies showing that the incidences of several respiratory diseases decreased in 2020 during the COVID-19 pandemic. The results also suggest a shift of morbidity towards older age groups, and a rapid waning of immunity after vaccination, justifying to continue this surveillance.

3.
Internal Medicine ; 61(7):1071-1076, 2022.
Article in English | MEDLINE | ID: covidwho-1834094

ABSTRACT

Myoclonus and ataxia, with or without opsoclonus, have recently been recognized as a central nervous system syndrome associated with coronavirus disease-2019 (COVID-19). A 52-year-old Japanese man developed myoclonus and ataxia 16 days after the onset of COVID-19. Brain single-photon emission computed tomography (SPECT) revealed hyperperfusion in the cerebellum and hypoperfusion in the cerebral cortices with frontal predominance during the acute stage, which improved over two months. This study indicates that brain perfusion SPECT can be effective in detecting functional alterations in COVID-19-related myoclonus and ataxia.

4.
Internal Medicine ; 61(7):1067-1069, 2022.
Article in English | MEDLINE | ID: covidwho-1834093

ABSTRACT

After BNT162b2 messenger ribonucleic acid (mRNA) coronavirus disease 2019 (COVID-19) vaccination, a 30-year-old man developed bilateral lateral gaze palsy, diplopia, absent tendon reflexes, and ataxic gait. Serum anti-GQ1b and anti-GT1a immunoglobulin G (IgG) antibodies were strongly positive. Based on those findings, he was diagnosed with Miller Fisher syndrome (MFS). Intravenous immunoglobulin therapy was administered, and his symptoms fully recovered within approximately 3 months. To the best of our knowledge, this is the first report to describe the development of MFS after COVID-19 mRNA vaccination.

5.
PLoS ONE [Electronic Resource] ; 17(3):e0266321, 2022.
Article in English | MEDLINE | ID: covidwho-1833655

ABSTRACT

The current study examines COVID-19 prevention behaviors and vaccine intentions among 83 youth at high risk for HIV. Most youth self-identified as Latinx (52%), cisgender men (84%), and homosexual (66%). Youth self-reported COVID-19 prevention behaviors and intentions to vaccinate. Participants reported wearing face masks, washing hands, and staying six feet apart, but fewer reported leaving home only for essential needs. About one-third reported that they would not get a vaccine, and lack of trust in their doctors and the government were significantly associated with non-intention. To improve efforts towards herd immunity, interventions to improve health messaging from trusted sources for at-risk youth may be necessary to achieve higher vaccine uptake.

6.
PLoS ONE [Electronic Resource] ; 17(3):e0266261, 2022.
Article in English | MEDLINE | ID: covidwho-1833652

ABSTRACT

The Coronavirus-19 global pandemic has forced many governments around the world to enforce "lockdowns" to curtail the spread of the virus. Studies conducted in the UK, France, Italy and Brazil have demonstrated that one consequence of these lockdowns is significant distortion to the speed of the passage of time. The current study sought to establish how the passage of time was experienced during the Argentinian lockdown. An online questionnaire was used to measure passage of time judgments for the day and the week, physical activity, satisfaction with social interaction, the extent to which daily routines had changed due to covid and demographic data. The results show that distortions to the passage of time were widely experienced during the lockdown in Argentina. There was a tendency for participants to report time passing more quickly than normal. A faster passage of time was associated with being a woman, of younger age and more physically active. A slower passage of time was therefore associated with being a man, of older age and less physically active. The results indicate that whilst distortions to the passage of time during the covid-19 crisis appear to be a global phenomenon, cross-cultural differences are apparent in the factors which influence temporal experience.

7.
PLoS ONE [Electronic Resource] ; 17(3):e0266014, 2022.
Article in English | MEDLINE | ID: covidwho-1833643

ABSTRACT

The COVID-19 pandemic put dents on every sector of the affected countries, and the informal sector was no exception. This study is based on the quantitative analyses of the primary data of 1,867 informal workers of Bangladesh to shed light on the impact of the pandemic-induced economic crisis on this working class. The survey was conducted between 8 July and 13 August 2020 across the eight administrative divisions of the country. Analysis points out that about ninety percent of these workers faced an income and food expenditure drop during the lockdown. The effect was higher in males, particularly among the urban-centric and educated males engaged in services and sales. The findings suggest that policy support is needed for the informal workers to face such a crisis.

8.
BMC Medicine ; 20(1):129, 2022.
Article in English | MEDLINE | ID: covidwho-1833313

ABSTRACT

BACKGROUND: SARS-CoV-2 infection portends a broad range of outcomes, from a majority of asymptomatic cases to a lethal disease. Robust correlates of severe COVID-19 include old age, male sex, poverty, and co-morbidities such as obesity, diabetes, and cardiovascular disease. A precise knowledge of the molecular and biological mechanisms that may explain the association of severe disease with male sex is still lacking. Here, we analyzed the relationship of serum testosterone levels and the immune cell skewing with disease severity in male COVID-19 patients. METHODS: Biochemical and hematological parameters of admission samples in 497 hospitalized male and female COVID-19 patients, analyzed for associations with outcome and sex. Longitudinal (in-hospital course) analyses of a subcohort of 114 male patients were analyzed for associations with outcome. Longitudinal analyses of immune populations by flow cytometry in 24 male patients were studied for associations with outcome. RESULTS: We have found quantitative differences in biochemical predictors of disease outcome in male vs. female patients. Longitudinal analyses in a subcohort of male COVID-19 patients identified serum testosterone trajectories as the strongest predictor of survival (AUC of ROC = 92.8%, p < 0.0001) in these patients among all biochemical parameters studied, including single-point admission serum testosterone values. In lethal cases, longitudinal determinations of serum luteinizing hormone (LH) and androstenedione levels did not follow physiological feedback patterns. Failure to reinstate physiological testosterone levels was associated with evidence of impaired T helper differentiation and augmented circulating classical monocytes. CONCLUSIONS: Recovery or failure to reinstate testosterone levels is strongly associated with survival or death, respectively, from COVID-19 in male patients. Our data suggest an early inhibition of the central LH-androgen biosynthesis axis in a majority of patients, followed by full recovery in survivors or a peripheral failure in lethal cases. These observations are suggestive of a significant role of testosterone status in the immune responses to COVID-19 and warrant future experimental explorations of mechanistic relationships between testosterone status and SARS-CoV-2 infection outcomes, with potential prophylactic or therapeutic implications.

9.
American Journal of Respiratory & Critical Care Medicine ; 205(9):1084-1092, 2022.
Article in English | MEDLINE | ID: covidwho-1832814

ABSTRACT

Rationale: Chronic cough remains a major and often debilitating symptom for patients with idiopathic pulmonary fibrosis (IPF). In a phase 2A study, inhaled RVT-1601 (cromolyn sodium) reduced daytime cough and 24-hour average cough counts in patients with IPF. Objectives: To determine the efficacy, safety, and optimal dose of inhaled RVT-1601 for the treatment of chronic cough in patients with IPF.

10.
Cancer Epidemiology, Biomarkers & Prevention ; 31(5):1036-1042, 2022.
Article in English | MEDLINE | ID: covidwho-1832717

ABSTRACT

BACKGROUND: Modifiable lifestyle-related factors heighten the risk and severity of coronavirus disease 2019 (COVID-19) in patients with cancer. Whether exercise lowers susceptibility or severity is not known. METHODS: We identified 944 cancer patients from Memorial Sloan Kettering Cancer Center (mean age: 64;85% female;78% White) completing an exercise survey before receiving a confirmed positive or negative SARS-CoV-2 test. Exercise was defined as reporting moderate-intensity >=5 days per week, >=30 minutes/session or strenuous-intensity >=3 days per week, >=20 minutes/session. Multivariable logistic regression was used to determine the relationship between exercise and COVID-19 susceptibility and severity (i.e., composite of hospital admission or death events) with adjustment for clinical-epidemiologic covariates. RESULTS: Twenty-four percent (230/944) of the overall cohort were diagnosed with COVID-19 and 35% (333/944) were exercisers. During a median follow-up of 10 months, 26% (156/611) of nonexercising patients were diagnosed with COVID-19 compared with 22% (74/333) of exercising patients. The adjusted OR for risk of COVID-19 was 0.65 [95% confidence interval (CI), 0.44-0.96, P = 0.03] for exercisers compared with nonexercisers. A total of 20% (47/230) of COVID-19 positive patients were hospitalized or died. No difference in the risk of severe COVID-19 as a function of exercise status was observed (P > 0.9). CONCLUSIONS: Exercise may reduce the risk of COVID-19 infection in patients with a history of cancer, but not its severity. IMPACT: This study provides the first data showing that exercise might lower the risk of COVID-19 in cancer patients, but further research is required.

11.
BMJ Open ; 12(4):e057863, 2022.
Article in English | MEDLINE | ID: covidwho-1832458

ABSTRACT

OBJECTIVE: To investigate if the physical activity (PA) prior to infection is associated with the severity of the disease in patients positively tested for COVID-19, as well as with the most common symptoms. DESIGN: A cross-sectional study using baseline data from a prospective, hybrid cohort study (Predi-COVID) in Luxembourg. Data were collected from May 2020 to June 2021. SETTING: Real-life setting (at home) and hospitalised patients. PARTICIPANTS: All volunteers aged >18 years with confirmed SARS-CoV-2 infection, as determined by reverse transcription-PCR, and having completed the PA questionnaire (n=452). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was disease severity (asymptomatic, mild illness and moderate illness). The secondary outcomes were self-reported symptoms. RESULTS: From the 452 patients included, 216 (48%) were female, the median (IQR) age was 42 (31-51) years, 59 (13%) were classified as asymptomatic, 287 (63%) as mild illness and 106 (24%) as moderate illness. The most prevalent symptoms were fatigue (n=294;65%), headache (n=281;62%) and dry cough (n=241;53%). After adjustment, the highest PA level was associated with a lower risk of moderate illness (OR 0.37;95% CI 0.14 to 0.98, p=0.045), fatigue (OR 0.54;95% CI 0.30 to 0.97, p=0.040), dry cough (OR 0.55;95% CI 0.32 to 0.96, p=0.034) and chest pain (OR 0.32;95% CI 0.14 to 0.77, p=0.010). CONCLUSIONS: PA before COVID-19 infection was associated with a reduced risk of moderate illness severity and a reduced risk of experiencing fatigue, dry cough and chest pain, suggesting that engaging in PA may be an effective approach to minimise the severity of COVID-19. Trial registration number: Nct04380987.

12.
BMJ Case Reports ; 15(4):29, 2022.
Article in English | MEDLINE | ID: covidwho-1832379

ABSTRACT

A middle age man with a history of diabetes mellitus type 2, hypertension, migraine and eosinophilic granulomatosis with polyangiitis (EGPA) with polyneuropathy in remission presented with paresthesia and motor weakness soon after receiving the Pfizer-BioNTech COVID-19 messanger RNA (mRNA) vaccine. The patient had polyneuropathy 10 years ago secondary to EGPA, which had resolved. EGPA was diagnosed on the basis of typical symptoms and positive sural nerve biopsy. Five days after receiving the first dose of COVID-19 vaccine, he developed heaviness and reduced dexterity of both the upper extremities, which progressed to patchy and asymmetric motor weakness of all four extremities. Given the lack of clear alternative explanation after a thorough work up, recrudescence of underlying asymptomatic polyneuropathy due to a possible reaction to COVID-19 mRNA vaccine was considered although a temporal association with vaccine dose does not prove causality. He was treated with corticosteroids with slow improvement of his symptoms.

13.
International Journal of Human Rights in Healthcare ; 15(1):17-30, 2022.
Article in English | APA PsycInfo | ID: covidwho-1831637

ABSTRACT

Purpose: Since the emergence of a coronavirus disease (2019-nCoV) in December 2019, the whole world is in a state of chaos. Isolation strategy with quarantine is a useful model in controlling transmission and rapid spread. As a result, people remained at home and disrupted their outside daily activities. It led to the closure of educational institutes, which is a source of many students to cope with numerous personal and familial issues. This study aims to focus on exploring the relationships and potential mediational pathways between mental health problems, illness perception, anxiety and depression disorders. Design/methodology/approach: The study incorporated snowball sampling techniques through a cross-sectional, Web-based survey and recruited 500 students from different universities of twin cities, Rawalpindi and Islamabad from March 23 to April 15, 2020, during the coronavirus outbreak lockdown. The study used four instruments, Beck Depression Scale, Beck Anxiety Inventory, Revised Illness Perception Questionnaire and The Warwick-Edinburgh Mental Well-being Scale for assessing depression, anxiety, illness perception and mental health disorders. Findings: The findings indicated normal (43.2%), mild (20.5%), moderate (13.6%) and severe (22.7%) levels of anxiety prevalence in students. Results specified a normal (65.9%), mild (9.10%), moderate (9.12%) and severe (15.90%) depression prevalence and findings stipulated that anxiety disorder prevalence was higher than depression disorder. The correlational results specified a negative and significant relationship between mental health, illness perception, anxiety and depression symptoms. The multiple regression analysis stated that anxiety and depression disorders mediated the relationship between mental health and present illness perception. The perception of illness exhibited a relation to depression and anxiety disorders. Originality/value: The study proposed a model to address mental health problems during the lockdown. The (2019-nCoV) illness perception developed mental disorders, including anxiety and depression, which has declined individuals' mental health. There is an urgent need for ongoing clinical examination and management to address psychological disorders and findings suggest assessing mental health to combatting the pandemic worldwide. Findings recommend developing strategies to promote mental health-care facilities during COVID-19 wide-ranging disasters. These results highlight the impending importance of devising strategies to treat mental health problems. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

14.
Substance Abuse ; 43(1):1143-1150, 2022.
Article in English | MEDLINE | ID: covidwho-1830535

ABSTRACT

Background: Prior to the COVID-19 pandemic, the United States (US) was already facing an epidemic of opioid overdose deaths. Overdose deaths continued to surge during the pandemic. To limit COVID-19 spread and to avoid disruptions in access to medications for opioid use disorder (MOUD), including buprenorphine and methadone, US federal and state agencies granted unprecedented exemptions to existing MOUD guidelines for Opioid Treatment Programs (OTPs), including loosening criteria for unsupervised take-home doses. We conducted a qualitative study to evaluate the impact of these policy changes on MOUD treatment experiences for providers and patients at an OTP in California. Methods: We interviewed 10 providers (including two physicians, five social worker associates, and three nurse practitioners) and 20 patients receiving MOUD. We transcribed, coded, and analyzed all interviews to identify emergent themes. Results: Patient participants were middle-aged (median age 51 years) and were predominantly men (53%). Providers discussed clinical decision-making processes and experiences providing take-homes. Implementation of expanded take-home policies was cautious. Providers reported making individualized decisions, using patient factors to decide if benefits outweighed risks of overdose and misuse. Decision-making factors included patient drug use, overdose risk, housing status, and vulnerability to COVID-19. New patient groups started receiving take-homes and providers noted few adverse events. Patients who received take-homes reported increased autonomy and treatment flexibility, which in turn increased likelihood of treatment stabilization and engagement. Patients who remained ineligible for take-homes, usually due to ongoing non-prescribed opioid or benzodiazepine use, desired greater transparency and shared decision-making. Conclusion: Federal exemptions in response to COVID-19 led to the unprecedented expansion of access to MOUD take-homes within OTPs. Providers and patients perceived benefits to expanding access to take-homes and experienced few adverse outcomes, suggesting expanded take-home policies should remain post-COVID-19. Future studies should explore whether these findings are generalizable to other OTPs and assess larger samples to quantify patient-level outcomes resulting from expanded take-home policies.

15.
PubMed; 2022.
Preprint in English | PubMed | ID: ppcovidwho-335333

ABSTRACT

Background: ELT scenario in Saudi Arabia has undergone a sea change since the pandemic. With an aim to maximize resource utilization and ensure wide learner base, college students (male and female) are taught simultaneously, the former in a face-to-face mode and the latter in an audio-only mode. The nomenclature given to this unique classroom design by the researchers is Lateral Multimodal Learning (LML), one which has its own advantages and disadvantages. This mode of learning puts a great deal of pressure on the teachers as they must attend to a huge number of students with different needs and levels of competence, whereas it ensures best utilization of infrastructural and human resources by the administrations. Being a newly developed educational model, it is important to assess the efficiency of this type of learning. Methods : This study evaluates the model from the point of view of students (99), using a questionnaire, and that of teachers (06), using semi-structured interviews. Results : The results show that Saudi female students present high perceptions of learning via LML (M=4.03);are satisfied with this type of learning (M= 3.81) and the aids applied in learning via LML (M= 4.02). Findings also show moderate perceptions on the difficulties they encountered while emerging in LML mode (M =3.39). Furthermore, the study shows correlation between the four domains, i.e., perceptions, satisfactions, challenges, and aid. The highest correlations were between perceptions and satisfactions (r=.719);perceptions and aids (r=.659), and satisfaction and aids (r=.656). The teachers' interviews show their agreement on the efficacy of LML as being professionally fulfilling and one that they would like to continue with in the future too.

16.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-335102

ABSTRACT

Objective: To examine the relationship between young adults’ labor force participation and depression in the context of the COVID-19 pandemic. Design, Setting, Participants: Data come from the nationally-representative EPICOV cohort study set up in France, and were collected in 2020 and 2021 (3 waves of online or telephone interviews) among 2217 participants aged 18-30 years. Participants with prior mental health disorder (n=50) were excluded from the statistical analyses. Results: Using Generalized Estimating Equation (GEE) models controlled for participants’ socio-demographic and health characteristics and weighted to be nationally-representative, we found that compared to young adults who were employed, those who were studying or unemployed were significantly more likely to experience depression assessed using the PHQ-9 (multivariate ORs respectively: OR: 1.29, 95% CI 1.05-1.60 and OR: 1.50, 1.13-1.99). Stratifying the analyses by age, we observed than unemployment was more strongly associated with depression among participants 25-30 years than among those who were 18-24 years (multivariate ORs respectively 1.78, 95% CI 1.17-2.71 and 1.41, 95% CI 0.96-2.09). Being out of the labor force was, to the contrary, more significantly associated with depression among participants 18-24 years (multivariate OR: 1.71, 95% CI 1.04-2.82, vs. 1.00, 95% CI 0.53-1.87 among participants 25-30 years). Stratifying the analyses by sex, we found no significant differences in the relationships between labor market characteristics and depression (compared to participants who were employed, multivariate ORs associated with being a student: men: 1.33, 95% CI 1.01-1.76;women: 1.19, 95% CI 0.85-1.67, multivariate ORs associated with being unemployed: men: 1.60, 95% CI 1.04-2.45;women: 1.47, 95% CI 1.01-2.15). Conclusions and relevance: Our study shows that in addition to students, young adults who are unemployed also experience elevated levels of depression in the context of the COVID-19 pandemic. These two groups should be the focus of specific attention in terms of prevention and mental health treatment. Supporting employment could also be a propitious way of reducing the burden of the Covid-19 pandemic on the mental health of young adults.

17.
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.

18.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-335073

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is known to present with pulmonary and extra-pulmonary organ complications. In comparison with the 2009 pandemic (pH1N1), SARS-CoV-2 infection is likely to lead to more severe disease, with multi-organ effects, including cardiovascular disease. SARS-CoV-2 has been associated with acute and long-term cardiovascular disease, but the molecular changes govern this remain unknown. In this study, we investigated the landscape of cardiac tissues collected at rapid autopsy from SARS-CoV-2, pH1N1, and control patients using targeted spatial transcriptomics approaches. Although SARS-CoV-2 was not detected in cardiac tissue, host transcriptomics showed upregulation of genes associated with DNA damage and repair, heat shock, and M1-like macrophage infiltration in the cardiac tissues of COVID-19 patients. The DNA damage present in the SARS-CoV-2 patient samples, were further confirmed by γ−H2Ax immunohistochemistry. In comparison, pH1N1 showed upregulation of Interferon-stimulated genes (ISGs), in particular interferon and complement pathways, when compared with COVID-19 patients. These data demonstrate the emergence of distinct transcriptomic profiles in cardiac tissues of SARS-CoV-2 and pH1N1 influenza infection supporting the need for a greater understanding of the effects on extra-pulmonary organs, including the cardiovascular system of COVID-19 patients, to delineate the immunopathobiology of SARS-CoV-2 infection, and long term impact on health.

19.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-335014

ABSTRACT

Background: The Omicron variant of SARS-CoV-2 led to a steep rise in transmissions. Recently, as public tolerance for isolation abated, CDC guidance on duration of at-home isolation of COVID-19 cases was shortened to five days if no symptoms, with no lab test requirement, despite more cautious approaches advocated by other federal experts. Methods: We conducted a decision tree analysis of alternative protocols for ending COVID-19 isolation, estimating net costs (direct and productivity), secondary infections, and incremental cost-effectiveness ratios. Sensitivity analyses assessed the impact of input uncertainty. Results: Per 100 individuals, five-day isolation had 23 predicted secondary infections and a net cost of $33,000. Symptom check on day five (CDC guidance) yielded a 23% decrease in secondary infections (to 17.8), with a net cost of $45,000. Antigen testing on day six yielded 2.9 secondary infections and $63,000 in net costs. This protocol, compared to the next best protocol of antigen testing on day five of a maximum eight-day isolation, cost an additional $1,300 per secondary infection averted. Antigen or polymerase chain reaction testing on day five were dominated (more expensive and less effective) versus antigen testing on day six. Results were qualitatively robust to uncertainty in key inputs. Conclusions: A six-day isolation with antigen testing to confirm the absence of contagious virus appears the most effective and cost-effective de-isolation protocol to shorten at-home isolation of individuals with COVID-19.

20.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-334938

ABSTRACT

Objective: We aimed to examine the mental health status and related factors among Vietnamese immigrants in Japan during the coronavirus disease 2019 (COVID-19) pandemic. Design: Online cross-sectional survey administered from September 21 to October 21, 2021 Setting: Online survey of Vietnamese immigrants in Japan Participants: The inclusion criteria for participation were 1) Vietnamese citizenship or Japanese citizenship in those of Vietnamese descent, current residence in Japan, and 2) age ≥18 years. Main Outcomes: Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) scores were considered the main outcome measures. Multivariable logistic regression was used to identify factors related to symptoms of depression and anxiety, and the chosen variables were entered simultaneously in the survey. Results: Among 621 participants (age: 26.0±4.8 years;male: 347 [55.9%]) who completed the questionnaire, 73.7% reported a decrease in income when compared with the period before the COVID-19 pandemic, and 60.4% reported being recently affected by poor socioeconomic status. Moderate-to-severe symptoms of depression (PHQ-9 score ≥10 points) and mild-to-severe symptoms of anxiety (GAD-7 ≥5 points) were observed in 203 (32.7%) and 285 (45.9%) individuals, respectively. Factors related to depressive symptoms were age (odds ratio [OR]=0.94, p=0.043), medical or psychiatric co-morbidity (OR=2.46, p<0.001), and low socioeconomic status (OR=2.47, p<0.001). Factors related to anxiety symptoms were being single (OR=1.72, p=0.044), medical or psychiatric co-morbidity (OR=2.52, p<0.001), low socioeconomic status (OR=2.72, p<0.001), and absence of a partner with whom to discuss one’s health (OR=1.66, p=0.013). Conclusions: The current findings demonstrate that, when compared with Japanese citizens, Vietnamese immigrants experienced a decrease in income, worsening working conditions, and poor mental health status during the COVID-19 pandemic. These findings highlight the potential contribution of low socioeconomic status and social isolation to poor mental health status.

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