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1.
Lancet ; 396(10250): 535-544, 2020 08 22.
Article in English | MEDLINE | ID: covidwho-2106188

ABSTRACT

BACKGROUND: Spain is one of the European countries most affected by the COVID-19 pandemic. Serological surveys are a valuable tool to assess the extent of the epidemic, given the existence of asymptomatic cases and little access to diagnostic tests. This nationwide population-based study aims to estimate the seroprevalence of SARS-CoV-2 infection in Spain at national and regional level. METHODS: 35 883 households were selected from municipal rolls using two-stage random sampling stratified by province and municipality size, with all residents invited to participate. From April 27 to May 11, 2020, 61 075 participants (75·1% of all contacted individuals within selected households) answered a questionnaire on history of symptoms compatible with COVID-19 and risk factors, received a point-of-care antibody test, and, if agreed, donated a blood sample for additional testing with a chemiluminescent microparticle immunoassay. Prevalences of IgG antibodies were adjusted using sampling weights and post-stratification to allow for differences in non-response rates based on age group, sex, and census-tract income. Using results for both tests, we calculated a seroprevalence range maximising either specificity (positive for both tests) or sensitivity (positive for either test). FINDINGS: Seroprevalence was 5·0% (95% CI 4·7-5·4) by the point-of-care test and 4·6% (4·3-5·0) by immunoassay, with a specificity-sensitivity range of 3·7% (3·3-4·0; both tests positive) to 6·2% (5·8-6·6; either test positive), with no differences by sex and lower seroprevalence in children younger than 10 years (<3·1% by the point-of-care test). There was substantial geographical variability, with higher prevalence around Madrid (>10%) and lower in coastal areas (<3%). Seroprevalence among 195 participants with positive PCR more than 14 days before the study visit ranged from 87·6% (81·1-92·1; both tests positive) to 91·8% (86·3-95·3; either test positive). In 7273 individuals with anosmia or at least three symptoms, seroprevalence ranged from 15·3% (13·8-16·8) to 19·3% (17·7-21·0). Around a third of seropositive participants were asymptomatic, ranging from 21·9% (19·1-24·9) to 35·8% (33·1-38·5). Only 19·5% (16·3-23·2) of symptomatic participants who were seropositive by both the point-of-care test and immunoassay reported a previous PCR test. INTERPRETATION: The majority of the Spanish population is seronegative to SARS-CoV-2 infection, even in hotspot areas. Most PCR-confirmed cases have detectable antibodies, but a substantial proportion of people with symptoms compatible with COVID-19 did not have a PCR test and at least a third of infections determined by serology were asymptomatic. These results emphasise the need for maintaining public health measures to avoid a new epidemic wave. FUNDING: Spanish Ministry of Health, Institute of Health Carlos III, and Spanish National Health System.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Adolescent , Adult , Aged , Antibodies, Viral/blood , Betacoronavirus/immunology , COVID-19 , Child , Child, Preschool , Female , Humans , Immunoassay , Immunoglobulin G/blood , Immunoglobulin M/blood , Infant , Infant, Newborn , Male , Middle Aged , Pandemics , Point-of-Care Testing , Prevalence , Risk Factors , SARS-CoV-2 , Seroepidemiologic Studies , Spain/epidemiology , Young Adult
2.
Epidemiol Infect ; 150: e177, 2022 Oct 19.
Article in English | MEDLINE | ID: covidwho-2106269

ABSTRACT

Limited prospective severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) data in children regarding the impact of Omicron variant in seropositivity have been reported. We investigated SARS-CoV-2 seropositivity in children between 1 September 2021 and 30 April 2022, representing Delta and Omicron predominance periods. Serum samples from children admitted to the major tertiary Greek paediatric hospital for any cause, except for COVID-19, were randomly collected and tested for SARS-CoV-2 natural infection antibodies against nucleocapsid antigen (Elecsys® Anti-SARS-CoV-2 reagent). A total of 506/1312 (38.6%) seropositive children (0-16 years) were detected (males: 261/506(51.6%); median age (IQR): 95.2 months(24-144)). Seropositivity rates (%) increased from Delta to Omicron period from 29.7% to 48.5% (P-value<0.0001). Seropositivity increased for all age groups, except for the age group of 0-1 year (P-value:0.914). The highest seropositivity rate was detected in April 2022 (52.6%) and reached 73.9% specifically for the age group 12-16 years. No significant differences were detected in seropositivity with respect to gender, origin, or hospitalisation status. Median (IQR) antibody titres were higher in the Omicron vs. Delta period in all age groups, especially in 12-16 years [32.2 COI (7-77.1) vs. 11.4 COI(2.8-50.2), P-value:0.009). During Omicron variant period increased SARS-CoV-2 seropositivity was detected in paediatric population, especially in adolescents, implicating either increased transmissibility or reinfection rates.


Subject(s)
COVID-19 , SARS-CoV-2 , Adolescent , Child , Humans , Infant , Infant, Newborn , Male , Antibodies, Viral , COVID-19/epidemiology , Enzyme-Linked Immunosorbent Assay/methods , Prospective Studies , Seroepidemiologic Studies , Female , Child, Preschool
3.
Vaccine ; 40(45): 6512-6519, 2022 Oct 26.
Article in English | MEDLINE | ID: covidwho-2106121

ABSTRACT

BACKGROUND: Studies have reported evidence about the effectiveness of a third dose with BNT162b2 for preventing hospitalization and death by COVID-19. However, there is little evidence regarding other primary vaccine schedules such as BBIBP-CorV and ChAdOx1-S. We estimated the relative vaccine effectiveness (RVE) of the booster dose versus the primary regimens of COVID-19 vaccines based on BBIBP-CorV, ChAdOx1-S, or BNT162b2 for preventing death during the Omicron wave in Peruvian adult people. METHODS: We carried out a nested case-control study with a risk set sampling of controls using data from Peru between December 20, 2021, and February 20, 2022 (during the Omicron wave). Data on vaccination, COVID-19 tests and deaths were collected from national surveillance databases. We performed conditional logistic regression models to estimate the RVE on the adult population. In addition, we executed sub-group analysis per age group (18 to 59 years, and 60 years or more) and per primary regime (based on BNT162b2, BBIBP-CorV, or ChAdOx1-S). RESULTS: Of the 11,188,332 people eligible to enter the study 1,974 met the case definition (death from COVID-19) and were matched to 9,183 controls. The overall RVE of a third dose to prevent death was 87.2% (84.2%-89.7%), which varied according to the primary regime (87.3% for BNT162b2, 82.0% for BBIPB-CorV-2, and 79.5% for ChAdOx-S). In older adults, the RVE was 87.1%, without significant variations according to the primary regime (86.1% for BNT162b2, 86.1 for BBIBP-CorV, and 82% for ChAdOx-S). CONCLUSIONS: The booster) dose of vaccine against COVID-19 had a high RVE for preventing death by COVID-19 in the Peruvian population in all primary regimes of vaccines during the Omicron wave. This effect was consistent in people over 60 years of age, the group most vulnerable to die from this infection.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Humans , Middle Aged , Aged , Adolescent , Young Adult , Adult , COVID-19 Vaccines , BNT162 Vaccine , Peru/epidemiology , Case-Control Studies , COVID-19/prevention & control , Vaccine Efficacy , Influenza, Human/prevention & control
4.
Vaccine ; 40(46): 6640-6648, 2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2106120

ABSTRACT

BACKGROUND: Studies on sociodemographic disparities in Covid-19 vaccination uptake in the general population are still limited and mostly focused on older adults. This study examined sociodemographic differences in Covid-19 vaccination uptake in the total Swedish population aged 18-64 years. METHODS: National Swedish register data within the SCIFI-PEARL project were used to cross-sectionally investigate sociodemographic differences in Covid-19 vaccination among Swedish adults aged 18-64 years (n = 5,987,189) by 12 October 2021. Using logistic regression models, analyses were adjusted for sociodemographic factors, region of residence, history of Covid-19, and comorbidities. An intersectional analysis approach including several cross-classified subgroups was used to further address the complexity of sociodemographic disparities in vaccination uptake. FINDINGS: By 12 October 2021, 76·0% of the Swedish population 18-64 years old had received at least two doses of Covid-19 vaccine, an additional 5·5% had received only one dose, and 18·5% were non-vaccinated. Non-vaccinated individuals were, compared to vaccinated, more often younger, male, had a lower income, were not gainfully employed, and/or were born outside Sweden. The social patterning for vaccine dose two was similar, but weaker, than for dose one. After multivariable adjustments, findings remained but were attenuated indicating the need to consider different sociodemographic factors simultaneously. The intersectional analysis showed a large variation in vaccine uptake ranging from 32% to 96% in cross-classified subgroups, reflecting considerable sociodemographic heterogeneity in vaccination coverage. INTERPRETATION: Our study, addressing the entire Swedish population aged 18-64 years, showed broad sociodemographic disparities in Covid-19 vaccine uptake but also wide heterogeneities in coverage. The intersectional analysis approach indicates that focusing on specific sociodemographic factors in isolation and group average risks without considering the heterogeneity within such groups will risk missing the full variability of vaccine coverage. FUNDING: SciLifeLab / Knut & Alice Wallenberg Foundation, Swedish Research Council, Swedish government ALF agreement, FORMAS.


Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , Male , Aged , Adolescent , Young Adult , Adult , Middle Aged , Sweden/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Vaccination , Vaccination Coverage
5.
Pediatr Clin North Am ; 69(5): 847-864, 2022 10.
Article in English | MEDLINE | ID: covidwho-2105693

ABSTRACT

Adolescent Medicine addresses the health care of adolescents, young adults, and their families. Adolescent psychology constitutes an important part. The COVID-19 pandemic has given insight into adolescent needs, bringing the focus on prevention rather than mere correction. One needs to factor in the unique aspects of adolescence, their need to impress peers and gain acceptance, and their unique information processing, not calculating trade-offs between risk and reward the way adults might, in a linear, rational, logical, and verbal manner. The article focuses on the need for collaborative training among the various stakeholders in Child and Adolescent Mental Health.


Subject(s)
Adolescent Medicine , COVID-19 , Adolescent , COVID-19/epidemiology , Child , Humans , Internationality , Pandemics , Psychology, Adolescent , Young Adult
6.
Psychiatr Danub ; 32(3-4): 527-535, 2020.
Article in English | MEDLINE | ID: covidwho-2100775

ABSTRACT

BACKGROUND: Adolescents' anxiety and depression during the coronavirus disease 2019 (COVID-19) pandemic outbreak cannot be ignored. In public health crisis events, adolescents are prone to negative psychological problems, such as anxiety and depression. Hence, this research focuses on the use of reasonable and efficient methods to intervene in adolescents' psychological problems during the COVID-19 pandemic. SUBJECTS AND METHODS: From February to April 2020, we conducted an anonymous online survey on a total of 1,200 adolescents in the provinces of Hunan and Guangxi in China. Moreover, we randomly divided a total of 150 middle school students with anxiety scores greater than 50 and volunteered to participate in the intervention experiment into control and intervention groups, with 75 members in each group. On the basis of the proposed routine treatment, we conducted 8 weeks of model 328-based peer education intervention in the intervention group. RESULTS: After the intervention, the self-rating anxiety scale scores (SAS) of the intervention group are better than those of the control group (P<0.001). Moreover, the self-rating depression scale (SDS) scores of both groups are reduced, but the effect is more significant on the intervention group (P<0.001) than on the control group. Finally, the total Pittsburgh sleep quality index (PSQI) scores of both groups are reduced, but the effect is more significant on the intervention group than on the control group (P=0.001 and <0.001, respectively). CONCLUSIONS: Model 328-based peer education intervention can significantly reduce the level of anxiety and depression in adolescents and improve their sleep quality.


Subject(s)
Anxiety , COVID-19 , Depression , Sleep Wake Disorders , Adolescent , Anxiety/epidemiology , Anxiety/therapy , China , Depression/epidemiology , Depression/therapy , Humans , Pandemics , SARS-CoV-2 , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/therapy
7.
Psychiatr Danub ; 32(3-4): 499-504, 2020.
Article in English | MEDLINE | ID: covidwho-2100771

ABSTRACT

BACKGROUND: Pandemics are direct antecedent of distinctive physical, psychological, social and financial impacts. A large number of researches are being conducted regarding previous epidemics and pandemics and lot more is currently in progress vis-?-vis COVID-19. The current research is an attempt to explore psychological impacts of COVID-19 specifically to find out the existence, intensity and dynamics of COVID-19 fear in non-clinical educated population. SUBJECTS AND METHODS: A cross sectional online study was conducted with non-clinical educated Pakistani citizens. Self-structured questionnaire comprising close and open ended questions was used for data collection from different cities of Pakistan. N=317 participants (men=121, women=196) were the sample for this study. Demographic information was also sought. The age range of sample was 18 to 50+ years. Most of the participants fall in the category of age group 23-28 of sample. All the participants were educated from Intermediate till PhD but majority of participants had 16 years of education. SPSS 22 was used for quantitative data analysis. Qualitative data were analyzed using thematic analysis and content analysis. RESULTS: Results yield significant age wise and profession wise difference in existence of COVID fear. Nine major themes were extracted regarding nature of fear i.e. Corona Fear, Loss, fear of isolation or quarantine, religion related fear, death, consequences of COVID-19, Under developed country, Psychological component of fear and empathy. Those who denied fear were asked the reasons and six major themes were extracted here i.e Religion, Inevitability of death, Precautions, Belief in self, Myths or misinterpretation of disease and Avoidant approach. CONCLUSIONS: Age and profession significantly influenced fear of COVID-19. Gender-wise exploration of themes yields interesting insights. Participants reflected positivity and empathy in crisis situation.


Subject(s)
COVID-19 , Adolescent , Adult , Cross-Sectional Studies , Fear , Humans , Middle Aged , Prevalence , SARS-CoV-2 , Young Adult
8.
Psychiatr Danub ; 32(2): 273-279, 2020.
Article in English | MEDLINE | ID: covidwho-2100758

ABSTRACT

BACKGROUND: Turkey is one of the countries affected during the period of COVID-19 outbreak. The purpose of the current study is to investigate psychological resilience and depression in individuals during the period of COVID-19 outbreak in Turkey in relation to different variables. The study also aims to explore the relationship between psychological resilience and depression. SUBJECTS AND METHODS: The current study was conducted on a total of 518 people over the social media through the Google e-forms. In the study, the "Short Psychological Resilience Scale" and the "Beck Depression Scale" were used to collect data. In the analysis of the collected data, t-test, One Way Anova, Mann-Whitney U Test, Kruskal Wallis-H Test, Pearson Correlation Coefficient were used. RESULTS: In the current study, psychological resilience and depression were investigated in relation to different variables. Psychological resilience was found to be higher male participants, educators,university graduates and groups with not mental health problems. Depression was found to be higher females, university students, high school and lower graduates,with mental health problems. When the relationship between psychological resilience and depression was investigated, it was found that there is a medium and negative correlation between them. Moreover, the cut-off point for the depression score was set to be 17 and the rate of the people having 17 points or higher scores was found to be 16.6%. CONCLUSION: In light of the findings of the current study, it can be suggested to offer more mental health care services to those having higher levels of depression. Studies can be conducted to improve online psychological support services. A medium and negative correlation was found between psychological resilience and depression in the current study, which shows that more importance should be attached to activities to improve psychological resilience.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Depression/epidemiology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Resilience, Psychological , Adolescent , Adult , COVID-19 , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Pandemics , Turkey/epidemiology , Young Adult
9.
MMWR Morb Mortal Wkly Rep ; 71(44): 1401-1406, 2022 Nov 04.
Article in English | MEDLINE | ID: covidwho-2100531

ABSTRACT

On August 31, 2022, the Food and Drug Administration (FDA) authorized bivalent formulations of BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) COVID-19 vaccines; these vaccines include mRNA encoding the spike protein from the original (ancestral) strain of SARS-CoV-2 (the virus that causes COVID-19) and from the B.1.1.529 (Omicron) variants BA.4 and BA.5 (BA.4/BA.5). These bivalent mRNA vaccines were authorized for use as a single booster dose ≥2 months after completion of primary series or monovalent booster vaccination; Pfizer-BioNTech bivalent booster was authorized for persons aged ≥12 years and Moderna for adults aged ≥18 years.*,† On September 1, 2022, the Advisory Committee on Immunization Practices (ACIP) recommended that all persons aged ≥12 years receive an age-appropriate bivalent mRNA booster dose.§ To characterize the safety of bivalent mRNA booster doses, CDC reviewed adverse events and health impacts reported after receipt of bivalent Pfizer-BioNTech and Moderna booster doses during August 31-October 23, 2022, to v-safe,¶ a voluntary smartphone-based U.S. safety surveillance system established by CDC to monitor adverse events after COVID-19 vaccination, and the Vaccine Adverse Event Reporting System (VAERS),** a U.S. passive vaccine safety surveillance system managed by CDC and FDA (1). During August 31-October 23, 2022, approximately 14.4 million persons aged ≥12 years received a bivalent Pfizer-BioNTech booster dose, and 8.2 million adults aged ≥18 years received a bivalent Moderna booster dose.†† Among the 211,959 registrants aged ≥12 years who reported receiving a bivalent booster dose to v-safe, injection site and systemic reactions were frequently reported in the week after vaccination (60.8% and 54.8%, respectively); fewer than 1% of v-safe registrants reported receiving medical care. VAERS received 5,542 reports of adverse events after bivalent booster vaccination among persons aged ≥12 years; 95.5% of reports were nonserious and 4.5% were serious events. Health care providers and patients can be reassured that adverse events reported after a bivalent booster dose are consistent with those reported after monovalent doses. Health impacts after COVID-19 vaccination are less frequent and less severe than those associated with COVID-19 illness (2).


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Humans , United States/epidemiology , Adolescent , COVID-19 Vaccines/adverse effects , COVID-19/epidemiology , COVID-19/prevention & control , BNT162 Vaccine , SARS-CoV-2 , Vaccines, Synthetic/adverse effects , RNA, Messenger
10.
Asian Pac J Cancer Prev ; 23(6): 2049-2055, 2022 Jun 01.
Article in English | MEDLINE | ID: covidwho-2100937

ABSTRACT

BACKGROUND: The BNT162b2 mRNA COVID-19 vaccine has been administered to children and adolescents with cancer and hematologic diseases since they are at high risk of manifesting severe symptoms if they have COVID-19 infection but the adequate immune response after vaccination in these immunocompromised patients are questionable. OBJECTIVE: To evaluate the immune response of children and adolescents with cancer and hematologic diseases after receiving 2 doses of the BNT162b2 mRNA COVID-19 vaccine. METHODS: This is a prospective cohort study of patients with cancer and hematologic disease, who aged 12- 18 years old and received 2 doses the BNT162b2 vaccines at 4 weeks apart were enrolled. Immunogenicity was determined by measuring serum anti-SARS-CoV-2 immunoglobulin antibodies directed against the receptor binding domain (RBD) of S1 domain of the spike protein (Anti S-RBD), surrogated viral neutralization test (sVNT) of SARS-CoV-2 and Delta strain. Blood samples were collected and analyzed at 4 and 12 weeks after vaccination. The seroprotective rate was defined as sVNT ≥ 68%. RESULTS: From Oct 2021 to Jan 2022, 43 children were enrolled, 21 were on-therapy and 22 were off-therapy. 25 were hematologic malignancy, 15 solid tumor and 3 hematologic diseases with immunosuppressive drugs. The GMT (95%CI) of a anti S-RBD IgG level at 4 weeks after vaccination were 56.05 (13.2,238.2) and 3633 (2689,4908) BAU/mL in on-therapy and off-therapy group, respectively, p<0.001. The sVNT (95%CI) of delta strain were 26% (5.85-73.55%) and 97.05% (96.0-97.4%) as the seroprotective level which were 33.3% in on-therapy group and 100% in off-therapy group (p<0.001). 14 children in on-therapy group need an additional dose. CONCLUSION: After complete vaccination, the seroprotective rate and antibody level in pediatric and adolescent patients with cancer and hematologic disease who receive immunosuppressive agents are quite low, compared with patients who had complete treatment. Additional dose of primary series should be offered.


Subject(s)
COVID-19 , Hematologic Diseases , Neoplasms , Viral Vaccines , Adolescent , Antibodies, Viral , BNT162 Vaccine , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Child , Humans , Immunity , Neoplasms/therapy , Prospective Studies , RNA, Messenger , SARS-CoV-2 , Vaccination , Viral Vaccines/genetics
12.
J Korean Med Sci ; 37(42): e303, 2022 Oct 31.
Article in English | MEDLINE | ID: covidwho-2099099

ABSTRACT

BACKGROUND: The risk of severe outcomes with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant remains low in children and adolescents, but less is known about its effect on the SARS-CoV-2-naïve population. This study evaluated clinical manifestations and risk factors for moderate-to-critical coronavirus disease 2019 (COVID-19) in mostly SARS-CoV-2-naïve children and adolescents in 2021. METHODS: This multicenter retrospective study included patients aged 0-18 years who were hospitalized with COVID-19 at 8 referring hospitals in South Korea during the predelta-predominant and delta-predominant periods in 2021. Each case was labeled as either hospitalization with medical needs or for isolation. Severity was categorized as mild, moderate, severe, or critical with regard to pneumonia presence and illness severity. RESULTS: Among 753 cases, most (99.5%) had no prior history of COVID-19 or vaccination against COVID-19. The proportions of hospitalization with medical needs (3.5% vs. 19.7%), moderate illness (0.9% vs. 4.0%), and severe/critical illness (0.8% vs. 5.3%) increased during delta predominance. The risk of moderate-to-critical COVID-19 among hospitalizations with medical needs was higher among patients aged 12-18 years (adjusted odds ratio [aOR], 4.1; 95% confidence interval [CI], 1.5-11.8) and with obesity (aOR, 6.9; 95% CI, 2.4-19.6) but not among patients infected during delta predominance. However, children with obesity experienced more severe COVID-19 during delta predominance (aOR, 6.1; 95% CI, 1.2-29.6). CONCLUSION: Despite its similar severity among most SARS-CoV-2-naïve children and adolescents, the delta variant may affect COVID-19 severity in those with high-risk underlying medical conditions. Underlying conditions, particularly obesity, may cause severe COVID-19 in children and adolescents, warranting strong consideration for vaccinating high-risk children.


Subject(s)
COVID-19 , SARS-CoV-2 , Child , Humans , Adolescent , Retrospective Studies , Hospitalization , Obesity/complications , Obesity/epidemiology
13.
Trials ; 23(1): 342, 2022 Apr 23.
Article in English | MEDLINE | ID: covidwho-2098441

ABSTRACT

BACKGROUND: Methamphetamine use could jeopardize the current efforts to address opioid use disorder and HIV infection. Evidence-based behavioral interventions (EBI) are effective in reducing methamphetamine use. However, evidence on optimal combinations of EBI is limited. This protocol presents a type-1 effectiveness-implementation hybrid design to evaluate the effectiveness, cost-effectiveness of adaptive methamphetamine use interventions, and their implementation barriers in Vietnam. METHOD: Design: Participants will be first randomized into two frontline interventions for 12 weeks. They will then be placed or randomized to three adaptive strategies for another 12 weeks. An economic evaluation and an ethnographic evaluation will be conducted alongside the interventions. PARTICIPANTS: We will recruit 600 participants in 20 methadone clinics. ELIGIBILITY CRITERIA: (1) age 16+; (2) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) scores ≥ 10 for methamphetamine use or confirmed methamphetamine use with urine drug screening; (3) willing to provide three pieces of contact information; and (4) having a cell phone. OUTCOMES: Outcomes are measured at 13, 26, and 49 weeks and throughout the interventions. Primary outcomes include the (1) increase in HIV viral suppression, (2) reduction in HIV risk behaviors, and (3) reduction in methamphetamine use. COVID-19 response: We developed a response plan for interruptions caused by COVID-19 lockdowns to ensure data quality and intervention fidelity. DISCUSSION: This study will provide important evidence for scale-up of EBIs for methamphetamine use among methadone patients in limited-resource settings. As the EBIs will be delivered by methadone providers, they can be readily implemented if the trial demonstrates effectiveness and cost-effectiveness. TRIAL REGISTRATION: ClinicalTrials.gov NCT04706624. Registered on 13 January 2021. https://clinicaltrials.gov/ct2/show/NCT04706624.


Subject(s)
Amphetamine-Related Disorders , HIV Infections , Methamphetamine , Opioid-Related Disorders , Adolescent , Amphetamine-Related Disorders/diagnosis , COVID-19 , HIV Infections/prevention & control , Humans , Methadone/therapeutic use , Methamphetamine/adverse effects , Opioid-Related Disorders/diagnosis , Opioid-Related Disorders/drug therapy , Randomized Controlled Trials as Topic
14.
Trials ; 23(1): 161, 2022 Feb 19.
Article in English | MEDLINE | ID: covidwho-2098429

ABSTRACT

BACKGROUND: Science-driven storytelling and entertainment-education (E-E) media demonstrate potential for promoting improved attitudes and behavioral intent towards health-related practices. Months after the outbreak of coronavirus disease 2019 (COVID-19), emerging research highlights the essential role of interventions to improve public confidence in the COVID-19 vaccine. To improve vaccine confidence, we designed three short, animated videos employing three research-informed pedagogical strategies. These can be distributed globally through social media platforms, because of their wordless and culturally accessible design. However, the effectiveness of short, animated storytelling videos, deploying various pedagogic strategies, needs to be explored across different global regions. METHODS/DESIGN: The present study is a multi-site, parallel group, randomized controlled trial (RCT) comparing the effectiveness of (i) a storytelling-instructional-humor approach, (ii) a storytelling-analogy approach, (iii) a storytelling-emotion-focused approach, and (iv) no video. For our primary outcomes, we will measure vaccine hesitancy, and for secondary outcomes, we will measure behavioral intent to seek vaccination and hope. Using online platforms, we will recruit 12,000 participants (aged 18-59 years) from the USA and China, respectively, yielding a total sample size of 24,000. DISCUSSION: This trial uses innovative online technology, reliable randomization algorithms, validated survey instruments, and list experiments to establish the effectiveness of three short, animated videos employing various research-informed pedagogical strategies. Results will be used to scientifically support the broader distribution of these short, animated video as well as informing the design of future videos for rapid, global public health communication. TRIAL REGISTRATION: German Clinical Trials Register DRKS #00023650 . Date of registration: 2021/02/09.


Subject(s)
COVID-19 , Social Media , Vaccines , Adolescent , Adult , Humans , Middle Aged , Pandemics/prevention & control , SARS-CoV-2 , Young Adult
15.
Ann Nutr Metab ; 78 Suppl 3: 1-63, 2022.
Article in English | MEDLINE | ID: covidwho-2098084

ABSTRACT

It is a plaesaure to announce the celebration of the XXXI Congress of the Spanish Nutrition Society that will be held in Cartagena (Murcia, Spain), from September 15th to 17th, 2022. As is already a tradition in our society, the day before, on September 14th, the IX Meeting of young researchers will take place, aimed at promoting interaction and knowledge exchange among young people working in the field of nutrition and food in Spain. In addition, young reserachers will receive a workshop about how to produce videos of research with high impact in the social media. The congress will offer a scientific and multidisciplinary journey through all aspects related to a personalized diet from children to adults, healthy, safe and sustainable. The connections between lifestyles and chronic non-communicable diseases and especially obesity, will be updated, as well as precision nutrition, incorporating the outstanding advances in nutrigenomics, epigenetics and metabolomic markers. New evidence of healthy effects of bioactive, prebiotic and probiotic components is also contemplated, without forgetting the issue of food allergies and intolerances, which are increasingly prevalent in our society. The circular economy and the new preferences for sustainable and local food pose challenges that will also be addressed at the congress and in the sessions for young researchers. In addition, the problem generated by the dissemination of nutritional information poorly contrasted in the media and social networks will be considered. We encourage you to schedule these dates in your 2022 agenda to attend and participate in our congress, whose program we have designed with great enthusiasm. We would also like to extend the invitation to participate to companies and institutions related to food, which will help us reflect that optimal food is only achieved with the involvement of EVERYONE. We hope that the proposal of this congress will be attractive to you and that we can share enriching experiences in Cartagena, Spain. The program of the congress is available in the URL https://www.xxxicongresosen2022.com/index.asp Yours sincerely, Elvira Larqué Daza, Organizer of the Spanish Nutrition Society (SEÑ) Congress 2022, Cartagena, Spain. Salvador Zamora Navarro, Honour member from the Spanish Nutrition Society (SEÑ). María Puy Portillo Baquedano, President of the Spanish Nutrition Society (SEÑ).


Subject(s)
Diet , Nutritional Status , Adolescent , Child , Humans , Life Style , Spain
16.
RMD Open ; 8(2)2022 11.
Article in English | MEDLINE | ID: covidwho-2098011

ABSTRACT

OBJECTIVES: To assess the tolerance and efficacy of targeted therapies prescribed off-label in refractory low-prevalence autoimmune and inflammatory systemic diseases. METHODS: The TATA registry (TArgeted Therapy in Autoimmune Diseases) is a prospective, observational, national and independent cohort follow-up. The inclusion criteria in the registry are as follows: age >18 years; low-prevalence autoimmune and inflammatory systemic disease treated with off-label drugs started after 1 January 2019. RESULTS: Hundred (100) patients (79 women) were enrolled. The median age was 52.5 years (95% CI 49 to 56) and the median disease duration before enrolment was 5 years (3 to 7). The targeted therapies at enrolment were as follows: Janus kinase/signal transducers and activators of transcription inhibitors (44%), anti-interleukin (IL)-6R (22%), anti-IL-12/23, anti-IL-23 and anti-IL-17 (9%), anti-B cell activating factor of the tumour necrosis factor family (5%), abatacept (5%), other targeted treatments (9%) and combination of targeted treatments (6%). 73% of patients were receiving corticosteroid therapy at enrolment (median dose 10 mg/day). The current median follow-up time is 9 months (8 to 10).Safety: 11 serious infections (incidence rate of 14.8/100 patient-years) and 1 cancer (1.3 cancers/100 patient-years) were observed. Two patients died from severe COVID-19 (2.7 deaths/100 patient-years).Efficacy: the targeted treatment was considered effective by the clinician in 56% of patients and allowed, in responders, a median reduction of oral corticosteroids of 15 (9 to 21) mg/day, below 7.5 mg/day in 76% of patients, while 28% discontinued. CONCLUSION: These initial results of the TATA registry confirm the diversity of targeted treatments prescribed off-label in refractory autoimmune diseases and their corticosteroid-sparing effect when effective. Tolerance was acceptable in these refractory patients with a long history of treatment with immunosuppressive drugs.


Subject(s)
Autoimmune Diseases , COVID-19 , Adolescent , Female , Humans , Middle Aged , Interleukin-23 , Off-Label Use , Prospective Studies , Registries
17.
Pediatr Int ; 64(1): e15329, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-2097855

ABSTRACT

BACKGROUND: Although widely reported to affect older adults more, coronavirus disease 2019 (COVID-19) also affects adolescents, especially those with co-morbidities, including heart diseases. The safety and efficacy of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines has been established in healthy adolescents, yet there are few data for humoral and cellular immunogenicity in adolescents with cardiac diseases. METHODS: We evaluated anti-spike antibodies, neutralizing activities, and interferon-gamma production prior to and after SARS-CoV-2 vaccination in adolescents with cardiac diseases and healthy controls. RESULTS: Five healthy adolescents and 26 patients with cardiac diseases, including congenital heart disease (CHD, n = 10), dilated cardiomyopathy (DCM, n = 4), idiopathic pulmonary arterial hypertension (IPAH, n = 4), and those post-heart transplantation (post-HTx, n = 8) were enrolled. No severe adverse events, including myocarditis and pericarditis, were noted, even in patients with severe heart failure. Febrile events were noted after 21 of 62 injections (34%). All the healthy adolescents and 21 of the 26 patients (81%) showed sufficient elevation of neutralizing antibodies after the second dose of vaccination. Neutralizing antibodies and cellular immunity were absent in four of the eight post-HTx patients and one with single ventricle CHD. There was no correlation between the anti-spike and neutralizing antibody titers and interferon-gamma levels. When comparing the clinical characteristics of the patients post-HTx who did or did not acquire antibodies, there was no significant difference in the immunosuppressant types and trough levels. CONCLUSIONS: SARS-CoV-2 mRNA vaccine has efficient immunogenicity for adolescents with CHD, IPAH, and DCM. Half of post-HTx patients could not acquire sufficient humoral immunity.


Subject(s)
COVID-19 , Heart Diseases , Viral Vaccines , Adolescent , Humans , Aged , COVID-19 Vaccines , SARS-CoV-2 , COVID-19/prevention & control , Interferon-gamma , Antibodies, Viral , Viral Vaccines/adverse effects , Antibodies, Neutralizing , Vaccination , Heart Diseases/chemically induced
18.
Curr Opin Pediatr ; 34(4): 407-413, 2022 08 01.
Article in English | MEDLINE | ID: covidwho-2097521

ABSTRACT

PURPOSE OF REVIEW: In this review, we discuss new medical and surgical options for the treatment of children and adolescents with obesity. We review the impact of COVID-19 on this vulnerable population. We also discuss the recent availability of screening tests for rare genetic causes of obesity. RECENT FINDINGS: COVID-19 increased the prevalence of obesity among children and adolescents. This population is at increased risk for severe disease. The field of pediatric obesity has benefited from the approval of two new antiobesity medications: liraglutide and setmelanotide. We discuss indications for their use. New guidelines for surgical options for the treatment of children and adolescents with obesity are reviewed. These options are increasingly used as part of the comprehensive care for these children. SUMMARY: The epidemic of childhood obesity continues. COVID-19 and the associated isolation contributed to the problem. However, promising new medical and surgical therapies and screening tests for rare genetic causes of obesity are available. These new diagnostic and therapeutic options bring renewed enthusiasm to the treatment of children and adolescents with obesity and increased recognition that obesity is a chronic disease starting in childhood deserving intervention to prevent consequences.


Subject(s)
COVID-19 , Pediatric Obesity , Adolescent , COVID-19/epidemiology , COVID-19/therapy , Child , Humans , Pediatric Obesity/complications , Pediatric Obesity/diagnosis , Pediatric Obesity/epidemiology , Prevalence
19.
Curr Opin Pediatr ; 34(4): 334-340, 2022 08 01.
Article in English | MEDLINE | ID: covidwho-2097519

ABSTRACT

PURPOSE OF REVIEW: Substance use is common in adolescence and has distinct developmental, cognitive, and health consequences. Over the last 2 years, the coronavirus disease 2019 pandemic has isolated adolescents, disrupted typical developmental milestones, and caused pervasive stress and anxiety. Healthcare providers can help by recognizing and addressing these effects on adolescent mental health and substance use. This update reviews the immediate effects of the pandemic on adolescent substance use, potential future implications, and opportunities to use new strategies to improve care for adolescents with problematic use. RECENT FINDINGS: Initial findings suggest that fewer teens started using substances during the pandemic. This was likely influenced by stay at home orders that reduced opportunities for social use. However, increased time at home was not beneficial for all adolescents. Furthermore, adolescents who used substances prepandemic, experienced material hardship, or reported higher pandemic-related stress tended to intensify substance use during this time. SUMMARY: The adverse effects of pandemic isolation, anxiety, and developmental disruption will likely have consequences for adolescent substance use for many years to come. To comprehensively address adolescent health, healthcare providers can be sensitive to these realities and use existing screening and brief intervention strategies to address use. Innovative telehealth strategies that allow for the expansion of substance use treatment offer promising opportunities to improve care for adolescents with substance use disorder.


Subject(s)
Adolescent Behavior , COVID-19 , Substance-Related Disorders , Adolescent , Adolescent Behavior/psychology , COVID-19/epidemiology , Humans , Mental Health , Pandemics/prevention & control , Substance-Related Disorders/diagnosis , Substance-Related Disorders/epidemiology , Substance-Related Disorders/therapy
20.
Ir J Psychol Med ; 38(3): 192-207, 2021 09.
Article in English | MEDLINE | ID: covidwho-2096536

ABSTRACT

OBJECTIVES: In March 2020, the World Health Organization (WHO) officially declared the spread of coronavirus disease 2019 (COVID-19) as a pandemic. Adolescence and early adulthood are peak times for the onset of mental health difficulties. Exposure to a pandemic during this vulnerable developmental period places young people at significant risk of negative psychological experiences. The objective of this research was to summarise existing evidence on the potential impact of a pandemic on the mental health of 12-25 year olds. METHODS: A rapid review of the published peer-reviewed literature, published between 1985 and 2020, using PsycINFO (Proquest) and Medline (Proquest) was conducted. Narrative synthesis was used across studies to identify key themes and concepts. RESULTS: This review found 3,359 papers, which was reduced to 12 papers for data extraction. Results regarding the prevalence of psychological difficulties in youth were mixed, with some studies finding this group experience heightened distress during an infectious disease outbreak, and others finding no age differences or higher distress among adults. Gender, coping, self-reported physical health and adoption of precautionary measures appear to play a role in moderating the psychological impact of an infectious disease outbreak. Most studies were conducted after the peak of an epidemic/pandemic or in the recovery period. CONCLUSIONS: More longitudinal research with young people, particularly adolescents in the general population, before and during the early stages of an infectious disease outbreak is needed to obtain a clear understanding of how best to support young people during these events.


Subject(s)
COVID-19 , Pandemics , Adaptation, Psychological , Adolescent , Adult , Humans , Mental Health , SARS-CoV-2
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