Subject(s)
American Indian or Alaska Native , Black or African American , COVID-19/complications , COVID-19/ethnology , Hispanic or Latino , Nervous System Diseases/ethnology , Anosmia/epidemiology , Anosmia/ethnology , Anosmia/physiopathology , Autonomic Nervous System Diseases/epidemiology , Autonomic Nervous System Diseases/ethnology , Autonomic Nervous System Diseases/physiopathology , COVID-19/epidemiology , COVID-19/physiopathology , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/ethnology , Cognitive Dysfunction/physiopathology , Dysgeusia/epidemiology , Dysgeusia/ethnology , Dysgeusia/physiopathology , Headache/epidemiology , Headache/ethnology , Headache/physiopathology , Health Status Disparities , Humans , Memory Disorders/epidemiology , Memory Disorders/ethnology , Memory Disorders/physiopathology , Muscle Weakness/epidemiology , Muscle Weakness/ethnology , Muscle Weakness/physiopathology , Muscular Diseases/epidemiology , Muscular Diseases/ethnology , Muscular Diseases/physiopathology , Myalgia/epidemiology , Myalgia/ethnology , Myalgia/physiopathology , Nervous System Diseases/epidemiology , Nervous System Diseases/physiopathology , Peripheral Nervous System Diseases/epidemiology , Peripheral Nervous System Diseases/ethnology , Peripheral Nervous System Diseases/physiopathology , SARS-CoV-2 , Severity of Illness Index , Stroke/epidemiology , Stroke/ethnology , Stroke/physiopathology , United States/epidemiology , Post-Acute COVID-19 SyndromeABSTRACT
BACKGROUND: Descriptions of clinical characteristics of patients hospitalised withCOVID-19, their clinical course and short-term inpatient and outpatient outcomes in deprived urban populations in the UK are still relatively sparse. We describe the epidemiology, clinical course, experience of non-invasive ventilation and intensive care, mortality and short-term sequelae of patients admitted to two large District General Hospitals across a large East London National Health Service Trust during the first wave of the pandemic. METHODS: A retrospective analysis was carried out on a cohort of 1946 patients with a clinical or laboratory diagnosis of COVID-19, including descriptive statistics and survival analysis. A more detailed analysis was undertaken of a subset of patients admitted across three respiratory units in the trust. RESULTS: Increasing age, male sex and Asian ethnicity were associated with worse outcomes. Increasing severity of chest X-ray abnormalities trended with mortality. Radiological changes persisted in over 50% of cases at early follow-up (6 weeks). Ongoing symptoms including hair loss, memory impairment, breathlessness, cough and fatigue were reported in 70% of survivors, with 39% of patients unable to return to work due to ongoing symptoms. CONCLUSIONS: Understanding the acute clinical features, course of illness and outcomes of COVID-19 will be crucial in understanding the effect of differences in risk, as well as the effectiveness of new interventions and vaccination between the successive waves of the pandemic.
Subject(s)
COVID-19/complications , COVID-19/epidemiology , Age Factors , Aged , Aged, 80 and over , Alopecia/physiopathology , COVID-19/mortality , COVID-19/physiopathology , COVID-19/therapy , Cohort Studies , Cough/physiopathology , Dyspnea/physiopathology , Ethnicity , Fatigue/physiopathology , Female , Hospital Mortality , Humans , Intensive Care Units/statistics & numerical data , London/epidemiology , Male , Memory Disorders/physiopathology , Middle Aged , Multivariate Analysis , Noninvasive Ventilation/statistics & numerical data , Proportional Hazards Models , Retrospective Studies , Return to Work , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Sex Factors , Post-Acute COVID-19 SyndromeABSTRACT
OBJECTIVE: The increased use of online pharmacy services in the midst of the COVID-19 pandemic provides an important backdrop against which to examine the role of neurocognitive functions in health-related Internet navigation skills among persons with chronic medical conditions, such as HIV disease. Prospective memory (PM) is reliably impaired in HIV disease and is related to laboratory-based measures of medication management capacity in other populations. This study examined whether PM shows veridicality in relationship to online pharmacy navigation skills in persons with HIV disease. METHOD: Participants included 98 persons with HIV disease age 50 and older who completed the Cambridge Prospective Memory Test (CAMPROMPT) and the Medication-Management Test-Revised (MMT-R) as part of a neuropsychological study. Participants also completed the Test of Online Pharmacy Skills (TOPS), which required them to navigate a simulated, experimenter-controlled online pharmacy to perform several naturalistic tasks (e.g., refill an existing prescription). RESULTS: Lower PM had medium associations with poorer MMT-R and TOPS accuracy scores that were not better explained by other neurocognitive functions. The association between PM and TOPS accuracy was driven by errors of omission and did not vary meaningfully based on whether the intention was cued by time or an event. CONCLUSIONS: These data suggest that PM cue detection processes show veridicality with online pharmacy navigation skills. Future studies might examine the benefits of PM-based strategies (e.g., salient prompts) in supporting online health navigation skills in populations that experience clinically impactful PM failures.