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1.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 30(3): 347-355, 2022 May.
Article in English | MEDLINE | ID: covidwho-1879815

ABSTRACT

The study was carried out to evaluate the dynamics of monthly numbers of cases, deaths, tests and case fatality ratio worldwide during three phases of the COVID-19 pandemic. Material and methods: Twenty-three sets of databases, dated the 22nd of each month from January 2020 to November 2021, for 213 countries were collected from the Worldometer website. The number of cases, deaths, tests, case fatality ratio, infection fatality ratio, etc. were counted for various periods of time for each of the 213 countries, then the results related to different periods of time were compared. The analysis of main epidemiological parameters resulted in division of three phases of the global pandemic evolution. The first phase (23.01.20-22.07.20), the second phase (23.07.20-22.01.21) and the third phase (23.01.21-22.07.21) were different in terms of the number of tests performed, new cases and mortality due to COVID-19. By the end of second phase, the worldwide statistics indicated imminent end of the pandemic, but the third phase was characterized by sudden rise in the number of new cases and deaths that could not be explained rationally. The most dramatic evolution of epidemic curve occurred in the countries where physicians had successfully confronted COVID-19 during the first two phases of the pandemic. Despite the decrease in the overall numbers deaths during the latest months analyzed, additional study is necessary to identify the cause of increasing in the number of new cases and deaths during the third phase of the pandemic. Presumably, there are several causes of negative evolution of the current pandemic, including over-reliance on polymerase chain reaction tests, application of non-specialized premises for quarantine and treatment, non-professional management, following therapeutic protocols applied in countries with high number of deaths, ignoring preventive treatment, and decreasing in mass and individual immunity. It can be suggested that the use of drugs modulating T-cell immunity is necessary, and preventive and therapeutic protocols should be changed from the 'standard' to 'personalized' types.


Subject(s)
COVID-19 , COVID-19/epidemiology , Humans , Pandemics , SARS-CoV-2
3.
Ann Indian Acad Neurol ; 25(2): 218-223, 2022.
Article in English | MEDLINE | ID: covidwho-1879551

ABSTRACT

Objective: Neurological emergencies saw a paradigm shift in approach during the coronavirus disease-2019 (COVID-19) pandemic with the challenge to manage patients with and without COVID-19. We aimed to compare the various neurological disorders and 3 months outcome in patients with and without SARS-CoV-2 infection. Methods: In an ambispective cohort study design, we enrolled patients with and without SARS CoV-2 infection coming to a medical emergency with neurological disorders between April 2020 and September 2020. Demographic, clinical, biochemical, and treatment details of these patients were collected and compared. Their outcomes, both in-hospital and at 3 months were assessed by the modified Rankin Scale (mRS). Results: Two thirty-five patients (235) were enrolled from emergency services with neurological disorders. Of them, 81 (34.5%) were COVID-19 positive. The mean (SD) age was 49.5 (17.3) years, and the majority of the patients were male (63.0%). The commonest neurological diagnosis was acute ischemic stroke (AIS) (43.0%). The in-hospital mortality was higher in the patients who were COVID-19 positive (COVID-19 positive: 29 (35.8%) versus COVID-19 negative: 12 (7.8%), P value: <0.001). The 3 months telephonic follow-up could be completed in 73.2% of the patients (142/194). Four (12.1%) deaths occurred on follow-up in the COVID-19 positive versus fifteen (13.8%) in the COVID-19 negative patients (P value: 1.00). The 3-month mRS was worse in the COVID-19 positive group (P value <0.001). However, this was driven by higher in-hospital morbidity and mortality in COVID-19 positive patients. Conclusion: Patients with neurological disorders presenting with COVID-19 infection had worse outcomes, including in-hospital and 3 months disability.

4.
Front Pediatr ; 10: 905046, 2022.
Article in English | MEDLINE | ID: covidwho-1879467

ABSTRACT

Introduction: In 2020, a new disease entitled Pediatric Inflammatory Multisystem Syndrome temporally associated with COVID-19 (PIMS-TS), or Multisystem Inflammatory Syndrome in Children (MIS-C), emerged, with thousands of children affected globally. There is no available evidence based on randomized controlled trials (RCT) to date on the two most commonly used immunomodulatory treatments, intravenous immunoglobulins (IVIG) and corticosteroids. Therefore, the Swissped RECOVERY trial was conducted to assess whether intravenous (IV) methylprednisolone shortens hospital length of stay compared with IVIG. Methods and Analysis: Swissped RECOVERY is an ongoing investigator-initiated, open-label, multicenter two-arm RCT in children and adolescents <18 years hospitalized with a diagnosis of PIMS-TS. The trial is recruiting at 10 sites across Switzerland. Patients diagnosed with PIMS-TS are randomized 1:1 to methylprednisolone IV (10 mg/kg/day for 3 days) or IVIG (2 g/kg as a single dose). The primary outcome is hospital length of stay censored at day 28, death, or discharge (whichever is first). The target total sample size is ~80 patients 1:1 randomized to each study arm. Ancillary and exploratory studies on inflammation, vaccination acceptance and coverage, long-term outcomes, and healthcare costs are pre-planned. Significance: Currently, robust trial evidence for the treatment of PIMS-TS is lacking, with a controversy surrounding the use of corticosteroids vs. IVIG. This trial will provide evidence for the effectiveness and safety of these two treatments. Ethics and Dissemination: The study protocol, which was designed based on the U.K. RECOVERY trial, the patient information and consent forms, and other study-specific study documents were approved by the local ethics committees (Project ID: 2021-00362). Registration Details: The study is registered on the Swiss National Clinical Trials Portal (SNCTP000004720) and Clinicaltrials.gov (NCT04826588).

5.
J Korean Med Sci ; 37(22): e175, 2022 Jun 06.
Article in English | MEDLINE | ID: covidwho-1879451

ABSTRACT

BACKGROUND: Numerous patients around the globe are dying from coronavirus disease 2019 (COVID-19). While age is a known risk factor, risk analysis in the young generation is lacking. The present study aimed to evaluate the clinical features and mortality risk factors in younger patients (≤ 50 years) with a critical case of COVID-19 in comparison with those among older patients (> 50 years) in Korea. METHODS: We analyzed the data of adult patients only in critical condition (requiring high flow nasal cannula oxygen therapy or higher respiratory support) hospitalized with PCR-confirmed COVID-19 at 11 hospitals in Korea from July 1, 2021 to November 30, 2021 when the delta variant was a dominant strain. Patients' electronic medical records were reviewed to identify clinical characteristics. RESULTS: During the study period, 448 patients were enrolled. One hundred and forty-two were aged 50 years or younger (the younger group), while 306 were above 50 years of age (the older group). The most common pre-existing conditions in the younger group were diabetes mellitus and hypertension, and 69.7% of the patients had a body mass index (BMI) > 25 kg/m². Of 142 younger patients, 31 of 142 patients (21.8%, 19 women) did not have these pre-existing conditions. The overall case fatality rate among severity cases was 21.0%, and it differed according to age: 5.6% (n = 8/142) in the younger group, 28.1% in the older group, and 38% in the ≥ 65 years group. Age (odds ratio [OR], 7.902; 95% confidence interval [CI], 2.754-18.181), mechanical ventilation therapy (OR, 17.233; 95% CI, 8.439-35.192), highest creatinine > 1.5 mg/dL (OR, 17.631; 95% CI, 8.321-37.357), and combined blood stream infection (OR, 7.092; 95% CI, 1.061-18.181) were identified as independent predictors of mortality in total patients. Similar patterns were observed in age-specific analyses, but most results were statistically insignificant in multivariate analysis due to the low number of deaths in the younger group. The full vaccination rate was very low among study population (13.6%), and only three patients were fully vaccinated, with none of the patients who died having been fully vaccinated in the younger group. Seven of eight patients who died had a pre-existing condition or were obese (BMI > 25 kg/m²), and the one remaining patient died from a secondary infection. CONCLUSION: About 22% of the patients in the young critical group did not have an underlying disease or obesity, but the rate of obesity (BMI > 25 kg/m²) was high, with a fatality rate of 5.6%. The full vaccination rate was extremely low compared to the general population of the same age group, showing that non-vaccination has a grave impact on the progression of COVID-19 to a critical condition. The findings of this study highlight the need for measures to prevent critical progression of COVID-19, such as vaccinations and targeting young adults especially having risk factors.


Subject(s)
COVID-19 , Adult , Age Distribution , Aged , COVID-19/mortality , COVID-19/therapy , Female , Hospitalization , Humans , Male , Middle Aged , Obesity/complications , Risk Factors , SARS-CoV-2 , Young Adult
6.
Egypt Heart J ; 74(1): 47, 2022 Jun 04.
Article in English | MEDLINE | ID: covidwho-1879278

ABSTRACT

BACKGROUND: Cardiac arrhythmias have been identified as independent predictors of mortality in Coronavirus disease 2019 (COVID-19) patients. While some studies have reported poor prognosis with bradycardia in COVID-19 patients, others have not found any association between bradycardia and mortality in COVID-19 patients. This study aims to assess the relationship between bradycardia and mortality in COVID-19 patients by reviewing existing literature. MAIN BODY: Articles were obtained by systematically searching the PubMed and Google scholar databases. Qualitative and quantitative analyses of the studies on bradycardia and mortality in COVID-19 were done. A pooled estimate, with a sample size of 1320 patients, comparing the effect of patients that were bradycardic during their admission with those that were not on mortality showed that bradycardia did not lead to increased mortality in COVID-19 patients (OR 1.25, 95% CI 0.41-3.84, p = 0.7). CONCLUSIONS: This meta-analysis showed that bradycardia was not significantly associated with mortality in COVID-19 patients. However, this study is limited by the few studies on bradycardia and mortality in COVID-19 patients. Therefore, future studies should investigate this relationship so that clinicians can prognostically triage and treat COVID-19 patients appropriately.

7.
Clin Appl Thromb Hemost ; 28: 10760296221103864, 2022.
Article in English | MEDLINE | ID: covidwho-1879207

ABSTRACT

PURPOSE: Coagulation abnormalities are one of the most important complications of severe COVID-19, which might lead to venous thromboembolism (VTE). Hypercoagulability with hyperfibrinogenemia causes large vessel thrombosis and major thromboembolic sequelae. Statins are potentially a potent adjuvant therapy in COVID-19 infection due to their pleiotropic effect. This study aims to evaluate the effectiveness of statins in reducing the risk of thrombosis among hospitalized critically ill patients with COVID-19. METHODS: A multicenter, retrospective cohort study of all critically ill adult patients with confirmed COVID-19 admitted to Intensive Care Units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were categorized based on their usage of statins throughout their ICU stay and were matched with a propensity score. The primary endpoint was the odds of all cases of thrombosis; other outcomes were considered secondary. RESULTS: A total of 1039 patients were eligible; following propensity score matching, 396 patients were included (1:1 ratio). The odds of all thrombosis cases and VTE events did not differ significantly between the two groups (OR 0.84 (95% CI 0.43, 1.66), P = 0.62 and OR 1.13 (95% CI 0.43, 2.98), P = 0.81, respectively. On multivariable Cox proportional hazards regression analysis, patients who received statin therapy had lower 30-day (HR 0.72 (95 % CI 0.54, 0.97), P = 0.03) and in-hospital mortality (HR 0.67 (95 % CI 0.51, 0.89), P = 0.007). Other secondary outcomes were not statistically significant between the two groups except for D-dimer levels (peak) during ICU stay. CONCLUSION: The use of statin therapy during ICU stay was not associated with thrombosis reduction in critically ill patients with COVID-19; however, it has been associated with survival benefits.


Subject(s)
Blood Coagulation Disorders , COVID-19 , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Thrombosis , Venous Thromboembolism , Adult , COVID-19/complications , COVID-19/drug therapy , Cohort Studies , Critical Illness , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Intensive Care Units , Retrospective Studies , Thrombosis/chemically induced , Thrombosis/etiology , Venous Thromboembolism/chemically induced , Venous Thromboembolism/etiology
8.
Int Rev Immunol ; : 1-15, 2022 Jun 06.
Article in English | MEDLINE | ID: covidwho-1878617

ABSTRACT

Accumulating data emphasize a strong link between obesity and the severity of coronavirus disease-2019 (COVID-19), including mortality. Obesity interferes with several components of the immune system including lymphoid tissue's integrity, leukocytes' development and function, complement system's activation, and the coordination of innate and adaptive immune responses. Overall, obesity results in a less efficient immune response to infectious agents. Severe acute respiratory syndrome coronavirus 2 exploits this weakened immune system in people with obesity to precipitate COVID-19, and in some cases death. It is therefore the author's recommendation that obesity should be viewed as another form of acquired immunodeficiency syndrome and be treated with the appropriate seriousness. Unlike the previously described acquired immunodeficiency syndrome (AIDS) that is caused by the Human Immunodeficiency Virus (HIV), obesity is a comorbidity-acquired immunodeficiency syndrome. People with AIDS do not die from HIV, but may die from opportunistic pathogens such as Mycobacterium tuberculosis. However, AIDS is ascribed its due importance in the course of deterioration of the patient. Similarly, obesity should be acknowledged further as a risk factor for mortality from COVID-19. Obesity is a modifiable condition and even in people with a strong genetic predisposition, lifestyle modifications can reverse obesity, and even moderate weight loss can improve the inflammatory milieu. Strong public health actions are warranted to promote lifestyle measures to reduce the burden from overweight and obesity that currently affect more than one-third of the global population, with projections alarming this may reach 55-80% within the next thirty years.


Accumulating data emphasize a strong link between obesity and the severity of coronavirus disease-2019 (COVID-19), including mortality. Obesity interferes with several components of the immune system, reducing the body's capacity for defence against infectious agents, such as viruses and bacteria. Severe acute respiratory syndrome coronavirus 2 takes advantage of this weakened defence in people with obesity to precipitate COVID-19, and in some cases death. It is therefore the author's recommendation that obesity should be viewed as another form of acquired immunodeficiency syndrome and be treated with the appropriate seriousness. Unlike the previously described acquired immunodeficiency syndrome (AIDS) that is caused by the Human Immunodeficiency Virus (HIV), obesity is a comorbidity-acquired immunodeficiency syndrome. People with AIDS do not die from HIV, but may die from opportunistic pathogens such as Mycobacterium tuberculosis. However, AIDS is ascribed its due importance in the course of deterioration of the patient. Similarly, obesity should be acknowledged further as a risk factor for mortality from COVID-19. Obesity is a modifiable condition and even in people with a strong genetic predisposition, lifestyle modifications can reverse obesity. Strong public health actions are warranted to promote lifestyle measures to reduce the burden from overweight and obesity that currently affect more than one-third of the global population, with projections alarming this may reach 55-80% within the next thirty years.

9.
SAGE Open Med ; 10: 20503121221099359, 2022.
Article in English | MEDLINE | ID: covidwho-1872078

ABSTRACT

Objectives: Acute kidney injury is common among the critically ill. However, the incidence, medication use, and outcomes of acute kidney injury have been variably described. We conducted a single-center, retrospective cohort study to examine the risk factors and correlates associated with acute kidney injury in critically ill adults with a particular focus on medication class usage. Methods: We reviewed the electronic medical records of all adult patients admitted to an intensive care unit between 1 February and 30 August 2020. Acute kidney injury was defined by the 2012 Kidney Disease: Improving Global Outcomes guidelines. Data included were demographics, comorbidities, symptoms, laboratory parameters, interventions, and outcomes. The primary outcome was acute kidney injury incidence. A Least Absolute Shrinkage and Selection Operator regression model was used to determine risk factors associated with acute kidney injury. Secondary outcomes including acute kidney injury recovery and intensive care unit mortality were analyzed using a Cox regression model. Results: Among 226 admitted patients, 108 (47.8%) experienced acute kidney injury. 37 (34.3%), 39 (36.1%), and 32 patients (29.6%) were classified as acute kidney injury stages I-III, respectively. Among the recovery and mortality cohorts, analgesics/sedatives, anti-infectives, and intravenous fluids were significant (p-value < 0.05). The medication classes IV-fluid electrolytes nutrition (96.7%), gastrointestinal (90.2%), and anti-infectives (81.5%) were associated with an increased odds of developing acute kidney injury, odd ratios: 1.27, 1.71, and 1.70, respectively. Cox regression analyses revealed a significantly increased time-varying mortality risk for acute kidney injury-stage III, hazard ratio: 4.72 (95% confidence interval: 1-22.33). In the recovery cohort, time to acute kidney injury recovery was significantly faster in stage I, hazard ratio: 9.14 (95% confidence interval: 2.14-39.06) cohort when compared to the stage III cohort. Conclusion: Evaluation of vital signs, laboratory, and medication use data may be useful to determine acute kidney injury risk stratification. The influence of particular medication classes further impacts the risk of developing acute kidney injury, necessitating the importance of examining pharmacotherapeutic regimens for early recognition of renal impairment and prevention.

10.
Metas de Enfermeria ; 24(10):7-14, 2021.
Article in Spanish | Scopus | ID: covidwho-1879838

ABSTRACT

Objective: to analyse the impact of the infection by SARSCoV- 2 in pregnant women, in terms of obstetric and perinatal consequences. Method: a descriptive, longitudinal, observational and retrospective study conducted in the Hospital Infanta Cristina (Parla, Madrid) with pregnant women infected with COVID-19 during the second half of their pregnancy and/or labour, since the start of the pandemic in Spain in March until December 2020. The association between the need for hospital admission and sociodemographic, anthropometric and pregnancy variables was analysed with the Student's T test, Mann Whitney U test, Pearson's Chi Squared and Fisher's Exact Test, with a p< 0.05 significance. Results: the study included 46 women;37% of them were Spanish, and their mean age was 31.3 years. The mean Body Mass Index (BMI) of the pregnant women was of 25.9 kg/m2, the majority were multiparous, and there was a predominance of asymptomatic pregnancies (54.23%) followed by symptoms such as cough and dyspnea (13%) and fever (13%). Four women required hospital admission, and one of them required Intensive Care. No significant differences were found according to hospital admission, although the gestational age at the time of delivery was lower among hospitalized women (38 vs. 39.5 weeks;p= 0.095) and their BMI was higher (29.7 vs. 25 kg/m2;p= 0.559). There were no perinatal deaths. Conclusions: infection by COVID19 does not seem to have any impact on pregnancy evolution or perinatal survival, although further research is required. © 2021 DAE Editorial, Grupo Paradigma. All rights reserved.

11.
Publicaciones de la Facultad de Educacion y Humanidades del Campus de Melilla ; 51(2):435-444, 2021.
Article in English | Scopus | ID: covidwho-1879791

ABSTRACT

Introduction: Since the beginning of the pandemic, factors associated with mortality in patients with corona virus infection disease 2019 (COVID-19) have been investigated. Comorbidities and increased age have been frequently reported to be associated with mortality. We aimed to evaluate the factors associated with unfavorable outcome of patients with COVID-19 at an early period of the pandemic. Methodology: This single center, retrospective, observational study was conducted among laboratory confirmed COVID-19 patients hospitalized between March 11 and May 5, 2020, at Umraniye Training and Research Hospital, Istanbul, Turkey. The effects of the severity of illness, comorbidities, symptoms, and laboratory findings on the clinical outcome were evaluated. Factors associated with unfavorable outcome (necessity of mechanical ventilation or death) were examined using Cox proportional hazards models. Results: Out of a total of 728 patients, 53.8% were men and median age 54 years. The 30-day mortality rate was 4.9% among all hospitalized patients. A logistic regression model identified six predictors of unfavorable clinical outcome: age, severity of illness, the numbers of comorbidities, lymphopenia, high levels of C-reactive protein, and procalcitonin. Conclusions: The mortality rate was lower among the patients with COVID-19, hospitalized during the early period of the pandemic. Older age, higher severity score on admission, the numbers of comorbidities, higher levels of C-reactive protein, procalcitonin, and lymphopenia were identified to be associated with unfavorable outcome of the hospitalized patients with COVID-19. Copyright © 2022 Ozel et al.

12.
Journal of Obstetrics and Women's Diseases ; 71(1):11-22, 2022.
Article in English | Scopus | ID: covidwho-1879704

ABSTRACT

BACKGROUND: In the context of the COVID-19 pandemic caused by the SARS-CoV-2 virus, viral pneumonia is the leading clinical form of coronavirus infection and a significant cause of maternal mortality. AIM: The aim of this study was to assess the course of severe and extremely severe forms of COVID-19, its impact on pregnancy and fetus, as well as on maternal mortality. MATERIALS AND METHODS: In this retrospective study, we evaluated 39 case histories of patients with severe and extremely severe COVID-19, which were divided into two groups. Group 1 included 22 pregnant women with a severe course of coronavirus infection and a favorable outcome. Group 2 comprised 17 pregnant women in whom complications caused by SARS-CoV-2 were fatal. RESULTS: More than 80% of patients with severe disease course had anaemia in pregnancy. The most significant clinical and anamnestic factors of adverse outcome were gestational diabetes mellitus (p = 0.02), preeclampsia (p = 0.05), and oligoamnios (p = 0.01). Obesity in group 2 was twice more common. The clinical manifestations of the disease in the both study groups were dominated by fever, shortness of breath, weakness and dry cough. In patients with a fatal outcome at the height of the disease, the levels of leukocytosis, urea and lactate dehydrogenase were higher than in those who recovered (p = 0.05). Besides, the levels of alanine transferase and aspartate transaminase were twice as high as in pregnant women who recovered later. Patients in the both study groups required oxygen support as respiratory failure progressed. The vast majority of patients with severe and extremely severe forms of coronavirus infection were in the third trimester of pregnancy. CONCLUSIONS: Women in the third trimester of pregnancy are more susceptible to severe and extremely severe COVID-19 with an unfavorable outcome. Gestational diabetes mellitus, preeclampsia and oligoamnios are significant comorbidities that predispose to severe course and poor outcome in pregnant women and puerperas with COVID-19. The characteristic clinical manifestations of the severe course of coronavirus infection are shortness of breath and fever against a backdrop of significant damage to the lung tissue. A pronounced increase in hepatic enzymes and placental insufficiency is a harbinger of an unfavorable outcome as a manifestation of multiple organ failure. © 2022 by the authors.

13.
Central European Public Administration Review ; 20(1):57-84,169, 2022.
Article in English | ProQuest Central | ID: covidwho-1879701

ABSTRACT

Namen: Namen raziskave je ponuditi primerjavo vladnih odzivov in izzivov, s katerimi so se srečevale oblasti v državah Višegrajske skupine med izbruhom pandemije covida-19. Zasnova/Metodologija/Pristop: Raziskava temelji na metodi primerjalne analize. Vladni odzivi so analizirani s pomočjo pregleda literature in podatkov, pridobljenih iz različnih virov, npr. ourworldindata.org, OECD, WHO, Svetovne banke, Eurostata, CoronaNET in spletnega orodja za spremljanje odzivov oblasti na novi koronavirus (Covid-19 Government Response Tracker). Ugotovitve: Države Višegrajske skupine so se v začetni fazi uspešno soočile s pandemijo covida-19. V primerjavi s številnimi drugimi državami v Evropi ali po svetu so zabeležile manj obolelih in nižjo smrtnost. Uspešne so bile predvsem zahvaljujoč pravočasnemu in odločnemu odzivanju ter ostrim ukrepom za zajezitev bolezni. Povsod so se dosledno izvajali nefarmakološki ukrepi. K premagovanju covida-19 so v članicah Višegrajske skupine pomembno prispevali obvezno nošenje mask, zaupanje v vlado ter težnja prebivalstva k spoštovanju predpisov. Žal pa je v dveh državah skupine (Poljska in Madžarska) med pandemijo nazadovala demokracija. Vpliv v praksi: Raziskava kaže, da se pandemije hitro širijo in v kratkem času prizadenejo številne države. Imajo pomemben vpliv na javno zdravje, gospodarstvo ter družbene in politične strukture držav. Da bi zmanjšale ali preprečile njihove učinke, se morajo vlade odzvati hitro. Prav čas je ključni dejavnik uspeha v boju proti pandemiji in pri omilitvi njenih posledic. Izvirnost/Vrednost: Cilj raziskave je zagotoviti podrobno in primerjalno analizo vladnih odzivov in izzivov držav Višegrajske skupine v boju proti covidu-19 v začetni fazi pandemije.Alternate :Purpose: The purpose of this study is to compare government responses and the challenges faced by public authorities in the Visegrad/V4 countries during the Covid-19 outbreak. Design/Methodology/Approach: The study is based on a comparative analysis method. In this study, we analysed government responses through literature review and data obtained from various databases. The data used in the study were collected from ourworldindata.org, OECD, WHO, World Bank, Eurostat databases, CoronaNET dataset and Covid-19 Government Response Tracker. Findings: The Visegrad countries did well during the initial phase of the Covid-19 pandemic. Compared to many other countries in Europe or in the world, they had less cases and lower death rates. What made them successful was timely and decisive reactions and harsh measures to curb Covid-19. They all implemented Non-Pharmaceutical Interventions strictly. Mandatory mask wearing, trust in the government and people's tendency to obey the rules all helped V4 members in the fight against Covid-19. However, in two countries (Poland and Hungary) of the V4 Group, democracy was in decline during the outbreak. Practical Implications: The study shows that pandemics spread rapidly and affect many countries within a short time. They have a significant impact on public health, the economy, and social and political structures of the countries. In order to reduce or prevent their effects, the governments must provide a timely response. Timing is a key success factor in the fight against the pandemics and helps minimise the consequences thereof. Originality/Value: The study aims to contribute a detailed and comparative analysis of government responses and challenges of V4 countries in the fight against Covid-19 in the initial stage of the outbreak.

14.
International Journal of Applied and Basic Medical Research ; 12(2):95-102, 2022.
Article in English | ProQuest Central | ID: covidwho-1879557

ABSTRACT

Background and Objectives: Severe acute respiratory syndrome coronavirus 2, caused by the novel coronavirus disease 2019 (COVID-19), led to a devastating pandemic that hit majority of the countries globally in a wave-like pattern. The characteristics of the disease varied in different geographical areas and different populations. This study highlights the epidemiological and clinical characteristics of COVID-19 during two major waves in North India. Materials and Methods: Clinical characteristics and outcomes of all COVID-19-reverse transcription-polymerase chain reaction-positive patients, admitted from March 2020 to June 2021, to a tertiary care center in North India, were studied retrospectively. Results: During this period, total of 5652 patients were diagnosed having COVID. Patients who were incidentally diagnosed as COVID-positive (n=667) with other unrelated comorbid conditions and patients admitted under level 1 facility (n=1655;1219 from first and 436 from second wave) were excluded from final analysis. Males were most commonly affected in both waves, with male to female ratio 4:1 in first and 3:1 in second wave. First wave had significantly more people with co-morbidities like diabetes mellitus and hypertension (P=0.001), whereas younger age group (age <40 years) were significantly more affected in second wave (P= 0.000). Fever was the most common presenting complaint in both waves, followed by cough and breathlessness. Patients during first wave had more severe disease at presentation and high mortality compared to the second wave. Conclusion: Majority of the patients with COVID-19 infection presenting to our hospital were young during the second wave. Fever was noted as presenting manifestation. Mortality was low during the second wave as compared to the first wave, likely to be due to proper protocol-based treatment resulting in better outcomes.

15.
Nutrition ; 101: 111677, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1878331

ABSTRACT

OBJECTIVES: The present study aimed to identify associations between extremes in body weight status (underweight and excess body weight) before a COVID-19 diagnosis and clinical outcomes in patients infected with SARS coronavirus type 2. METHODS: A multicenter cohort study was conducted in eight different states in northeastern Brazil. Demographic, clinical (previous diagnosis of comorbidities), and anthropometric (self-reported weight and height) data about individuals who tested positive for COVID-19 were collected. Outcomes included hospitalization, mechanical ventilation, and death. Multivariable logistic regression models, adjusted based on age, sex and previous comorbidities, were used to assess the effects of extremes in body weight status on clinical outcomes. RESULTS: A total of 1308 individuals were assessed (33.6% were elderly individuals). The univariable analyses showed that only hospitalization was more often observed among underweight (3.2% versus 1.2%) and overweight (68.1% versus 63.3%) individuals. In turn, cardiovascular diseases were more often observed in all clinical outcomes (hospitalization: 19.7% versus 4.8%; mechanical ventilation: 19.9% versus 13.5%; death: 21.8% versus 14.1%). Based on the multivariable analysis, body weight status was not associated with risk of hospitalization (underweight: odds ratio [OR]: 1.10; 95% confidence interval [CI] 95%, 0.50-2.41 and excess body weight: OR: 0.81; 95 CI, 0.57-1.14), mechanical ventilation (underweight: OR: 0.92; 95% CI, 0.52-1.62 and excess weight: OR: 0.90; 95% CI, 0.67-1.19), and death (underweight: OR: 0.61; 95% CI, 0.31-1.20 and excess body weight: OR 0.88; 95% CI, 0.63-1.23). CONCLUSIONS: Being underweight and excess body weight were not independently associated with clinical outcomes in patients with COVID-19 in the herein analyzed cohort. This finding indicates that the association between these variables may be confounded by both age and comorbidities.

16.
J Hosp Infect ; 126: 29-36, 2022 Apr 23.
Article in English | MEDLINE | ID: covidwho-1878270

ABSTRACT

BACKGROUND: Tocilizumab is an interleukin-6 inhibitor that reduces mortality and the need for invasive mechanical ventilation, while increasing the possibility of successful hospital discharge for hyperinflammatory patients with severe coronavirus disease 2019 (COVID-19). No increase in adverse events or serious infections has been reported previously. AIM: To describe the characteristics and outcomes of patients with severe COVID-19 in critical care who received tocilizumab, and to compare mortality and length of hospital stay for patients who received tocilizumab (N=41) with those who did not (N=33). METHODS: Retrospective review of data related to patients with COVID-19 who received tocilizumab in a critical care setting from 1st January to 31st December 2021. FINDINGS: Amongst COVID-19 survivors, those who had received tocilizumab had longer intensive care unit (ICU) stays (median length 21 vs 9 days) and hospital stays (45 vs 34 days) compared with those who had not received tocilizumab. Thirty-day mortality (29% vs 36%; P=0.5196) and 60-day mortality (37% and 42%; P=0.6138) were not significantly lower in patients who received tocilizumab. Serious bacterial and fungal infections occurred at higher frequency amongst patients who received tocilizumab [odds ratio (OR) 2.67, 95% confidence interval (CI) 1.04-6.86; P=0.042], and at significantly higher frequency than in non-COVID-19 ICU admissions (OR 5.26, 95% CI 3.08-9.00; P<0.0001). CONCLUSIONS: In this single-centre study, patients in critical care with severe COVID-19 who received tocilizumab had a greater number of serious bacterial and fungal infections, but this may not have been a direct effect of tocilizumab treatment.

17.
Endocr Pract ; 2022 Jun 04.
Article in English | MEDLINE | ID: covidwho-1878148

ABSTRACT

OBJECTIVE: To study cardiovascular events and clinical outcomes in patients with elevated glycated hemoglobin (HbA1c) and/or admission hyperglycemia and those with type 2 diabetes hospitalized with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pneumonia. RESEARCH DESIGN AND METHODS: This was a multi-center retrospective study of 1,645 patients hospitalized with SARS-CoV-2 pneumonia. The diagnosis of SARS-CoV-2 pneumonia required a positive reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2, presence of new or worsening pulmonary infiltrates on computed tomography scan or chest X-ray, and at least one of the following: new or increased cough, temperature >37.8 °C or dyspnea. The outcomes included in-hospital cardiovascular events, intensive care unit (ICU) admission and mortality. Logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for association of elevated HbA1c and/or admission hyperglycemia and type 2 diabetes for individual outcomes. RESULTS: Among 1,645 adults hospitalized with SARS-CoV-2 pneumonia, 107 (10.8%) patients with no history of diabetes were identified with elevated HbA1c and/or admission hyperglycemia and 634 (39%) had known diagnosis of type 2 diabetes. Patients with elevated HbA1c and/or admission hyperglycemia had increased odds of developing acute in-hospital cardiovascular events (OR: 1.73, 95% CI 1.07, 2.80), ICU admissions (OR: 1.61, 95% CI 1.10, 2.34), and mortality (OR: 1.77, 95% CI 1.02, 3.07), compared to patients with type 2 diabetes and no diabetes. CONCLUSIONS: Patients with elevated HbA1c and/or admission hyperglycemia hospitalized with SARS-CoV-2 pneumonia have an increased risk of developing acute in-hospital cardiovascular complications and overall poor clinical outcomes compared to patients with type 2 diabetes and no diabetes.

18.
Arch Cardiovasc Dis ; 115(5): 276-287, 2022 May.
Article in English | MEDLINE | ID: covidwho-1878028

ABSTRACT

BACKGROUND: Coronary artery calcium (CAC) is an independent risk factor for major adverse cardiovascular events; however, its impact on coronavirus disease 2019 (COVID-19) mortality remains unclear, especially in patients without known atheromatous disease. AIMS: To evaluate the association between CAC visual score and 6-month mortality in patients without history of atheromatous disease hospitalized with COVID-19 pneumonia. METHODS: A single-centre observational cohort study was conducted, involving 293 consecutive patients with COVID-19 in Paris, France, between 13 March and 30 April 2020, with a 6-month follow-up. Patients with a history of ischaemic stroke or coronary or peripheral artery disease were excluded. The primary outcome was all-cause mortality at 6 months according to CAC score, which was assessed by analysing images obtained after the first routine non-electrocardiogram-gated computed tomography scan performed to detect COVID-19 pneumonia. RESULTS: A total of 251 patients (mean age 64.8±16.7 years) were included in the analysis. Fifty-one patients (20.3%) died within 6 months. The mortality rate increased with the magnitude of calcifications, and was 10/101 (9.9%), 15/66 (22.7%), 10/34 (29.4%) and 16/50 (32.0%) for the no CAC, mild CAC, moderate CAC and heavy CAC groups, respectively (p=0.004). Compared with the no calcification group, adjusted risk of death increased progressively with CAC: hazard ratio (HR) 2.37 (95% confidence interval [CI] 1.06-5.27), HR 3.1 (95% CI 1.29-7.45) and HR 4.02 (95% CI 1.82-8.88) in the mild, moderate and heavy CAC groups, respectively. CONCLUSIONS: Non-electrocardiogram-gated computed tomography during the initial pulmonary assessment of patients with COVID-19 without atherosclerotic cardiovascular disease showed a high prevalence of mild, moderate and heavy CAC. CAC score was related to 6-month mortality, independent of conventional cardiovascular risk factors. These results highlight the importance of CAC scoring for patients hospitalized with COVID-19, and calls for attention to patients with high CAC.


Subject(s)
Brain Ischemia , COVID-19 , Coronary Artery Disease , Stroke , Vascular Calcification , Aged , Aged, 80 and over , Calcium , Coronary Angiography/methods , Coronary Artery Disease/diagnosis , Coronary Vessels , Humans , Middle Aged , Retrospective Studies , Risk Assessment , Risk Factors , Vascular Calcification/diagnostic imaging
19.
Infection ; 2022 Jun 03.
Article in English | MEDLINE | ID: covidwho-1878000

ABSTRACT

PURPOSE: At the beginning of the COVID-19 pandemic, SARS-CoV-2 was often compared to seasonal influenza. We aimed to compare the outcome of hospitalized patients with cancer infected by SARS-CoV-2 or seasonal influenza including intensive care unit admission, mechanical ventilation and in-hospital mortality. METHODS: We analyzed claims data of patients with a lab-confirmed SARS-CoV-2 or seasonal influenza infection admitted to one of 85 hospitals of a German-wide hospital network between January 2016 and August 2021. RESULTS: 29,284 patients with COVID-19 and 7442 patients with seasonal influenza were included. Of these, 360 patients with seasonal influenza and 1625 patients with COVID-19 had any kind of cancer. Cancer patients with COVID-19 were more likely to be admitted to the intensive care unit than cancer patients with seasonal influenza (29.4% vs 24.7%; OR 1.31, 95% CI 1.00-1.73 p < .05). No statistical significance was observed in the mechanical ventilation rate for cancer patients with COVID-19 compared to those with seasonal influenza (17.2% vs 13.6% OR 1.34, 95% CI 0.96-1.86 p = .09). 34.9% of cancer patients with COVID-19 and 17.9% with seasonal influenza died (OR 2.45, 95% CI 1.81-3.32 p < .01). Risk factors among cancer patients with COVID-19 or seasonal influenza for in-hospital mortality included the male gender, age, a higher Elixhauser comorbidity index and metastatic cancer. CONCLUSION: Among cancer patients, SARS-CoV-2 was associated with a higher risk for in-hospital mortality than seasonal influenza. These findings underline the need of protective measurements to prevent an infection with either COVID-19 or seasonal influenza, especially in this high-risk population.

20.
Clin Rheumatol ; 41(6): 1919-1923, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1877849

ABSTRACT

COVID-19 has been associated with increased morbidity and mortality, globally. Whether COVID-19-related mortality is increased in patients with systemic rheumatic diseases (SRDs) is still debatable. Although results are somewhat conflicting, there are a handful of nationwide studies published indicating that, in individuals with SRD, there is signal for increased adverse COVID-19-related outcomes and higher mortality. It appears that there are differences in COVID-19-related mortality across various SRDs. Besides, certain disease-specific (disease activity, disease duration, medication received) and/or other features (e.g. comorbidities) seem to also affect COVID-19-related mortality in SRD patients. Herein, we wanted to highlight that a more individualized approach taking into consideration the effect of the aforementioned factors into the risk calculation for COVID-19 adverse outcomes, including mortality, in SRD patients is warranted. A multinational study based on nationwide data, examining all common SRDs and stratifying accordingly, would be of interest, toward this direction. Key Points • It is still debatable whether Covid-19-related mortality is increased in patients with sytemic rheumatic diseases (SRD). • Disease-specific risk factors (e.g. type of SRD, disease activity) should be taken into account in risk assessment for Covid-19-releted outcomes in SRD patients.


Subject(s)
COVID-19 , Rheumatic Diseases , Comorbidity , Humans , Rheumatic Diseases/epidemiology , Risk Factors
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