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1.
Eur J Psychotraumatol ; 12(1): 2001192, 2021.
Article in English | MEDLINE | ID: covidwho-1559108

ABSTRACT

This systematic review aims to summarize the prevalence of anxiety, depression, and insomnia in the general adult population and healthcare workers (HCWs) in several key regions worldwide during the first year of the COVID pandemic. Several literature databases were systemically searched for meta-analyses published by 22 September 2021 on the prevalence rates of mental health symptoms worldwide. The prevalence rates of mental health symptoms were summarized based on 388 empirical studies with a total of 1,067,021 participants from six regions and four countries. Comparatively, Africa and South Asia had the worse overall mental health symptoms, followed by Latin America. The research effort on mental health during COVID-19 has been highly skewed in terms of the scope of countries and mental health outcomes. The mental health symptoms are highly prevalent yet differ across regions, and such evidence helps to enable prioritization of mental health assistance efforts to allocate attention and resources based on the regional differences in mental health.


El objetivo de esa revisión sistemática es el de resumir la prevalencia de la ansiedad, la depresión y el insomnio, tanto en la población general adulta como en los trabajadores de salud de diferentes regiones clave alrededor del mundo durante el primer año de la pandemia por la COVID-19. Se revisaron de manera sistemática diversas bases de datos científicas buscando metaanálisis sobre la prevalencia de síntomas en salud mental alrededor del mundo, publicados hasta el 22 de setiembre del 2021. Se resumió la prevalencia de los síntomas de salud mental sobre la base de 388 estudios empíricos, comprendiendo a 1.067.021 participantes de cuatro países y de seis regiones. África y Asia meridional tuvieron, de manera general, los peores síntomas de salud mental, seguidas por Latinoamérica. El esfuerzo por realizar investigación en salud mental durante la pandemia por la COVID-19 ha estado altamente sesgado en torno a la envergadura de los países y de las medidas de resultado empleadas en salud mental. Los síntomas de salud mental son altamente prevalentes; no obstante, difieren a lo largo de diferentes regiones. Esta evidencia ayuda a permitir la priorización de los esfuerzos de atención en salud mental asignando la atención y recursos basados sobre las diferencias regionales en salud mental.


Subject(s)
COVID-19/psychology , Global Health/statistics & numerical data , Mental Disorders/epidemiology , Pandemics , Adult , Africa/epidemiology , Asia/epidemiology , Asia, Southeastern/epidemiology , COVID-19/epidemiology , China/epidemiology , Europe, Eastern/epidemiology , Health Personnel/psychology , Humans , Latin America/epidemiology , Prevalence , Spain/epidemiology
2.
J Affect Disord ; 298(Pt B): 47-56, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1521222

ABSTRACT

BACKGROUND: This systematic review and meta-analysis aim to synthesize the extant literature reporting the effects of COVID-19 pandemic based on the pooled prevalence of depression among affected populations in Asia Pacific, as well as its risk factors. METHOD: A systematic review and meta-analysis approach was adopted as per the PRISMA guidelines, targeting articles published in PubMed, Google Scholar and Scopus from January 2021 to March 30, 2021. The screening resulted in 82 papers. RESULTS: The overall pooled depression prevalence among 201,953 respondents was 34% (95%CI, 29-38, 99.7%), with no significant differences observed between the cohorts, timelines, and regions (p > 0.05). Dominant risk factors found were fear of COVID-19 infection (13%), gender (i.e., females; 12%) and deterioration of underlying medical conditions (8.3%), regardless of the sub-groups. Specifically, fear of COVID-19 infection was the most reported risk factor among general population (k = 14) and healthcare workers (k = 8). Gender (k = 7) and increased workload (k = 7) were reported among healthcare workers whereas education disruption among students (k = 7). LIMITATION: The review is limited to articles published in three electronic databases. Conclusion The pandemic has caused depression among the populations across Asia Pacific, specifically among the general population, healthcare workers and students. Immediate attention and interventions from the concerned authorities are needed in addressing this issue.


Subject(s)
COVID-19 , Anxiety , Asia/epidemiology , Depression/epidemiology , Female , Humans , Pandemics , Prevalence , Risk Factors , SARS-CoV-2
3.
PLoS One ; 16(9): e0255338, 2021.
Article in English | MEDLINE | ID: covidwho-1518352

ABSTRACT

Global shortages of N95 respirators have led to an urgent need of N95 decontamination and reuse methods that are scientifically validated and available world-wide. Although several large scale decontamination methods have been proposed (hydrogen peroxide vapor, UV-C); many of them are not applicable in remote and low-resource settings. Heat with humidity has been demonstrated as a promising decontamination approach, but care must be taken when implementing this method at a grassroots level. Here we present a simple, scalable method to provide controlled humidity and temperature for individual N95 respirators which is easily applicable in low-resource settings. N95 respirators were subjected to moist heat (>50% relative humidity, 65-80°C temperature) for over 30 minutes by placing them in a sealed container immersed in water that had been brought to a rolling boil and removed from heat, and then allowing the containers to sit for over 45 minutes. Filtration efficiency of 0.3-4.99 µm incense particles remained above 97% after 5 treatment cycles across all particle size sub-ranges. This method was then repeated at a higher ambient temperature and humidity in Mumbai, using standard utensils commonly found in South Asia. Similar temperature and humidity profiles were achieved with no degradation in filtration efficiencies after 6 cycles. Higher temperatures (>70°C) and longer treatment times (>40 minutes) were obtained by insulating the outer vessel. We also showed that the same method can be applied for the decontamination of surgical masks. This simple yet reliable method can be performed even without electricity access using any heat source to boil water, from open-flame stoves to solar heating, and provides a low-cost route for N95 decontamination globally applicable in resource-constrained settings.


Subject(s)
COVID-19/prevention & control , Decontamination/methods , Equipment Reuse/statistics & numerical data , Hot Temperature , Humidity , Masks/standards , N95 Respirators/standards , Asia/epidemiology , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Filtration , Humans , SARS-CoV-2
6.
Biomed Res Int ; 2021: 7787624, 2021.
Article in English | MEDLINE | ID: covidwho-1476885

ABSTRACT

The ascendancy of coronavirus has become widespread all around the world. For the prevention of viral transmission, the pattern of disease is explored. Epidemiological modeling is a vital component of the research. These models assist in studying various aspects of infectious diseases, such as death, recovery, and infection rates. Coronavirus trends across several countries may analyze sufficiently using SIR, SEIR, and SIQR models. Across this study, we propose two modified versions of the SEIRD method for evaluating the transmission of this infectious disease in the South Asian countries, more precisely, in the south Asian subcontinent. The SEIRD model is updated further by fusing some new factors, namely, isolation for the suspected people and recovery and death of the people who are not under the coverage of healthcare schemes or reluctant to receive treatment for various catastrophes. We will investigate the influences of those ingredients on public health-related issues. Finally, we will predict and display the infection scenario and relevant elements with the concluding remarks through the statistical analysis.


Subject(s)
COVID-19/epidemiology , Models, Theoretical , Asia/epidemiology , Bangladesh/epidemiology , Developing Countries , Humans , Infection Control/statistics & numerical data , Physical Distancing , Public Health/statistics & numerical data
8.
Mult Scler Relat Disord ; 51: 102885, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1454374

ABSTRACT

BACKGROUND: There is evidence of an increased prevalence and disease burden of Multiple Sclerosis (MS) in parts of the world where the risk was once considered low, such as Latin America (LA), Sub-Saharan Africa, Asia and the Middle East-North Africa (MENA). Despite the growing number of clinical reports, the phenotype and course of MS in these regions remains understudied compared with Europe and North America. We aimed to investigate MS phenotypes and long-term clinical outcomes across these regions. METHOD: A Boolean search of the medical literature was conducted between January 1980 and April 30, 2020. PubMed, SCOPUS, Global Health, and the Cochrane databases, were used to identify all relevant citations. Articles were collated and managed on Covidence® software. We independently appraised the articles for meeting study criteria and for quality using the Critical Appraisal Skills Program (CASP) and the Specialist Unit for Review Evidence (SURE) system. RESULTS: A total of 1,639 studies were imported for screening. After removing 545 duplicates, two authors assessed 1,094 abstracts and selected 515 for full-text screening. 72 articles met study criteria, including 19 studies from LA, 4 from sub-Saharan Africa, 24 from Asia and 25 from MENA. The overall sex ratio was 2.5:1 (female: male). Disability was assessed using the Expanded Disability Status Scale (EDSS). Longitudinal disability progression and time to standard endpoints was compared by region and with relevant Western reports. Patients with MS living in the MENA region appear to reach disability milestones faster than those in the Western world, although this finding is not uniform. South Asia shows distinct disability features compared with East Asia, more closely resembling those of the West. Disease morbidity in East Asia appears more benign than in the West after careful exclusion of neuromyelitis optica spectrum disorder cases. Populations in LA tend to have similar MS features to the Western world, but some exceptions exist, including African descendants that reach disability milestones earlier. Using all studies with appropriate survival analysis, the mean time to EDSS 6.0 was 16.97 years with a heterogeneity index of 24.59. CONCLUSION: The clinical phenotypes and disability progression of MS in LA, Africa, Asia and the MENA region have similarities to Western MS. In some regions and subpopulations there is evidence of a more aggressive course, possibly due to a combination of genetic and environmental factors. More population-based longitudinal data are needed, particularly in Sub-Saharan Africa.


Subject(s)
Multiple Sclerosis , Africa/epidemiology , Africa, Northern/epidemiology , Asia/epidemiology , Europe , Female , Humans , Latin America/epidemiology , Male , Middle East/epidemiology , Multiple Sclerosis/epidemiology , North America
9.
Asian Pac J Cancer Prev ; 22(9): 2945-2950, 2021 Sep 01.
Article in English | MEDLINE | ID: covidwho-1441449

ABSTRACT

The COVID-pandemic has shown significant impact on cancer care from early detection, management plan to clinical outcomes of cancer patients. The Asian National Cancer Centres Alliance (ANCCA) has put together the 9 "Ps" as guidelines for cancer programs to better prepare for the next pandemic. The 9 "Ps" are Priority, Protocols and Processes, Patients, People, Personal Protective Equipments (PPEs), Pharmaceuticals, Places, Preparedness, and Politics. Priority: to maintain cancer care as a key priority in the health system response even during a global infectious disease pandemic. Protocol and processes: to develop a set of Standard Operating Procedures (SOPs) and have relevant expertise to man the Disease Outbreak Response (DORS) Taskforce before an outbreak. Patients: to prioritize patient safety in the event of an outbreak and the need to reschedule cancer management plan, supported by tele-consultation and use of artificial intelligence technology. People: to have business continuity planning to support surge capacity. PPEs and Pharmaceuticals: to develop plan for stockpiles management, build local manufacturing capacity and disseminate information on proper use and reduce wastage. Places: to design and build cancer care facilities to cater for the need of triaging, infection control, isolation and segregation. Preparedness: to invest early on manpower building and technology innovations through multisectoral and international collaborations. Politics: to ensure leadership which bring trust, cohesion and solidarity for successful response to pandemic and mitigate negative impact on the healthcare system.


Subject(s)
Cancer Care Facilities/organization & administration , Disaster Planning/methods , Infection Control/methods , Neoplasms/prevention & control , Pandemics/prevention & control , Regional Health Planning/organization & administration , Telemedicine/methods , Artificial Intelligence , Asia/epidemiology , Delivery of Health Care , Humans , Neoplasms/epidemiology
10.
Virus Res ; 305: 198551, 2021 11.
Article in English | MEDLINE | ID: covidwho-1440397

ABSTRACT

Samples from complete genomes of SARS-CoV-2 isolated during the first wave (December 2019-July 2020) of the global COVID-19 pandemic from 21 countries (Asia, Europe, Middle East and America) around the world, were analyzed using the phylogenetic method with molecular clock dating. Results showed that the first cases of COVID-19 in the human population appeared in the period between July and November 2019 in China. The spread of the virus into other countries of the world began in the autumn of 2019. In mid-February 2020, the virus appeared in all the countries we analyzed. During this time, the global population of SARS-CoV-2 was characterized by low levels of the genetic polymorphism, making it difficult to accurately assess the pathways of infection. The rate of evolution of the coding region of the SARS-CoV-2 genome equal to 7.3 × 10-4 (5.95 × 10-4-8.68 × 10-4) nucleotide substitutions per site per year is comparable to those of other human RNA viruses (Measles morbillivirus, Rubella virus, Enterovirus C). SARS-CoV-2 was separated from its known close relative, the bat coronavirus RaTG13 of the genus Betacoronavirus, approximately 15-43 years ago (the end of the 20th century).


Subject(s)
COVID-19/epidemiology , Evolution, Molecular , Genome, Viral , Mutation Rate , SARS-CoV-2/genetics , Animals , Asia/epidemiology , COVID-19/history , COVID-19/transmission , COVID-19/virology , Chiroptera/virology , Europe/epidemiology , Genomics/methods , History, 20th Century , History, 21st Century , Humans , Middle East/epidemiology , North America/epidemiology , Phylogeny , Polymorphism, Genetic , SARS-CoV-2/classification , SARS-CoV-2/pathogenicity , South America/epidemiology
11.
Global Health ; 17(1): 113, 2021 09 21.
Article in English | MEDLINE | ID: covidwho-1435257

ABSTRACT

BACKGROUND: The pandemic generated by Covid-19 has changed the way of life of citizens around the world in a short time, affecting all areas of society directly or indirectly, which is facing a global health crisis with different national responses implemented by governments. Several months into the pandemic, the first after-effects of Covid-19 are beginning to be felt by citizens, who are questioning the management carried out so far. In order to improve the performance of governmental decisions to reduce the impact of the pandemic during the coming months, we calculated the levels of efficiency in the management of health resources. In addition, we identify some country characteristics that may condition efficient management. RESULTS: We obtained significant differences according to the geographical location of the country, with European and American countries being less efficient than Asian and African countries. Likewise, we can affirm that greater freedom of expression, a higher median age and an unstable economy and labor market reduce efficiency. However, female leadership of the government and greater compliance with the rule of law offer more efficient management, as do countries that derive more revenues from tourism. CONCLUSIONS: These results provide an opportunity for political leaders to reflect on their management during these months of the pandemic in order to identify mistakes and improve the implementation of effective measures. It has been shown that using more resources does not mean managing better; therefore, policymakers need to pay special attention to the use of resources, taking into account the budgetary constraints of the public sector.


Subject(s)
COVID-19/prevention & control , Global Health/statistics & numerical data , Government , Pandemics/prevention & control , Africa/epidemiology , Asia/epidemiology , COVID-19/epidemiology , Europe/epidemiology , Geography , Humans , Politics , United States/epidemiology
12.
Virus Res ; 305: 198579, 2021 11.
Article in English | MEDLINE | ID: covidwho-1433887

ABSTRACT

The SARS-CoV2 mediated Covid-19 pandemic has impacted humankind at an unprecedented scale. While substantial research efforts have focused towards understanding the mechanisms of viral infection and developing vaccines/ therapeutics, factors affecting the susceptibility to SARS-CoV2 infection and manifestation of Covid-19 remain less explored. Given that the Human Leukocyte Antigen (HLA) system is known to vary among ethnic populations, it is likely to affect the recognition of the virus, and in turn, the susceptibility to Covid-19. To understand this, we used bioinformatic tools to probe all SARS-CoV2 peptides which could elicit T-cell response in humans. We also tried to answer the intriguing question of whether these potential epitopes were equally immunogenic across ethnicities, by studying the distribution of HLA alleles among different populations and their share of cognate epitopes. Results indicate that the immune recognition potential of SARS-CoV2 epitopes tend to vary between different ethnic groups. While the South Asians are likely to recognize higher number of CD8-specific epitopes, Europeans are likely to identify higher number of CD4-specific epitopes. We also hypothesize and provide clues that the newer mutations in SARS-CoV2 are unlikely to alter the T-cell mediated immunogenic responses among the studied ethnic populations. The work presented herein is expected to bolster our understanding of the pandemic, by providing insights into differential immunological response of ethnic populations to the virus as well as by gaging the possible effects of mutations in SARS-CoV2 on efficacy of potential epitope-based vaccines through evaluating ∼40,000 viral genomes.


Subject(s)
COVID-19/immunology , Epitopes, B-Lymphocyte/immunology , Epitopes, T-Lymphocyte/immunology , Genome, Viral , HLA Antigens/immunology , SARS-CoV-2/immunology , Africa/epidemiology , Alleles , Amino Acid Sequence , Asia/epidemiology , CD4-Positive T-Lymphocytes/immunology , CD4-Positive T-Lymphocytes/virology , CD8-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/virology , COVID-19/epidemiology , COVID-19/genetics , COVID-19/pathology , Computational Biology/methods , Disease Susceptibility , Epitopes, B-Lymphocyte/classification , Epitopes, B-Lymphocyte/genetics , Epitopes, T-Lymphocyte/classification , Epitopes, T-Lymphocyte/genetics , Europe/epidemiology , HLA Antigens/classification , HLA Antigens/genetics , Humans , Middle East/epidemiology , Oceania/epidemiology , Principal Component Analysis , RNA, Viral/genetics , RNA, Viral/immunology , SARS-CoV-2/genetics , SARS-CoV-2/pathogenicity
14.
Viruses ; 13(5)2021 04 28.
Article in English | MEDLINE | ID: covidwho-1389539

ABSTRACT

It has now been over a year since SARS-CoV-2 first emerged in China, in December 2019, and it has spread rapidly around the world. Some variants are currently considered of great concern. We aimed to analyze the numbers of SARS-CoV-2 genome sequences obtained in different countries worldwide until January 2021. On 28 January 2021, we downloaded the deposited genome sequence origin from the GISAID database, and from the "Our world in data" website we downloaded numbers of SARS-CoV-2-diagnosed cases, numbers of SARS-CoV-2-associated deaths, population size, life expectancy, gross domestic product (GDP) per capita, and human development index per country. Files were merged and data were analyzed using Microsoft Excel software. A total of 450,968 SARS-CoV-2 genomes originating from 135 countries on the 5 continents were available. When considering the 19 countries for which the number of genomes per 100 deaths was >100, six were in Europe, while eight were in Asia, three were in Oceania and two were in Africa. Six (30%) of these countries are beyond rank 75, regarding the human development index and four (20%) are beyond rank 80 regarding GDP per capita. Moreover, the comparisons of the number of genomes sequenced per 100 deaths to the human development index by country show that some Western European countries have released similar or lower numbers of genomes than many African or Asian countries with a lower human development index. Previous data highlight great discrepancies between the numbers of available SARS-CoV-2 genomes per 100 cases and deaths and the ranking of countries regarding wealth and development.


Subject(s)
COVID-19/virology , Genome, Viral , SARS-CoV-2/genetics , Africa/epidemiology , Asia/epidemiology , COVID-19/epidemiology , Databases, Genetic , Europe/epidemiology , Global Health , High-Throughput Nucleotide Sequencing , Humans , Pandemics
15.
Virus Res ; 305: 198553, 2021 11.
Article in English | MEDLINE | ID: covidwho-1386720

ABSTRACT

COVID-19 is seriously threatening human health all over the world. A comprehensive understanding of the genetic mechanisms driving the rapid evolution of its pathogen (SARS-CoV-2) is the key to controlling this pandemic. In this study, by comparing the entire genome sequences of SARS-CoV-2 isolates from Asia, Europe and America, and analyzing their phylogenetic histories, we found a lineage derived from a recombination event that likely occurred before March 2020. More importantly, the recombinant offspring has become the dominant strain responsible for more than one-third of the global cases in the pandemic. These results indicated that the recombination might have played a key role in the pandemic of the virus.


Subject(s)
COVID-19/epidemiology , Evolution, Molecular , Genome, Viral , Homologous Recombination , Mosaicism , SARS-CoV-2/genetics , Americas/epidemiology , Asia/epidemiology , Base Sequence , COVID-19/history , COVID-19/transmission , COVID-19/virology , Europe/epidemiology , Genomics/methods , History, 21st Century , Humans , Mutation , Phylogeny , SARS-CoV-2/classification , SARS-CoV-2/pathogenicity
16.
HLA ; 96(3): 277-298, 2020 09.
Article in English | MEDLINE | ID: covidwho-1388402

ABSTRACT

We report detailed peptide-binding affinities between 438 HLA Class I and Class II proteins and complete proteomes of seven pandemic human viruses, including coronaviruses, influenza viruses and HIV-1. We contrast these affinities with HLA allele frequencies across hundreds of human populations worldwide. Statistical modelling shows that peptide-binding affinities classified into four distinct categories depend on the HLA locus but that the type of virus is only a weak predictor, except in the case of HIV-1. Among the strong HLA binders (IC50 ≤ 50), we uncovered 16 alleles (the top ones being A*02:02, B*15:03 and DRB1*01:02) binding more than 1% of peptides derived from all viruses, 9 (top ones including HLA-A*68:01, B*15:25, C*03:02 and DRB1*07:01) binding all viruses except HIV-1, and 15 (top ones A*02:01 and C*14:02) only binding coronaviruses. The frequencies of strongest and weakest HLA peptide binders differ significantly among populations from different geographic regions. In particular, Indigenous peoples of America show both higher frequencies of strongest and lower frequencies of weakest HLA binders. As many HLA proteins are found to be strong binders of peptides derived from distinct viral families, and are hence promiscuous (or generalist), we discuss this result in relation to possible signatures of natural selection on HLA promiscuous alleles due to past pathogenic infections. Our findings are highly relevant for both evolutionary genetics and the development of vaccine therapies. However they should not lead to forget that individual resistance and vulnerability to diseases go beyond the sole HLA allelic affinity and depend on multiple, complex and often unknown biological, environmental and other variables.


Subject(s)
Coronavirus Infections/epidemiology , HIV Infections/epidemiology , HLA Antigens/chemistry , Influenza, Human/epidemiology , Pandemics , Peptides/chemistry , Pneumonia, Viral/epidemiology , Severe Acute Respiratory Syndrome/epidemiology , Viral Proteins/chemistry , Africa/epidemiology , Americas/epidemiology , Amino Acid Sequence , Asia/epidemiology , Australia/epidemiology , Betacoronavirus/genetics , Betacoronavirus/immunology , COVID-19 , Computational Biology , Coronavirus Infections/immunology , Coronavirus Infections/virology , Europe/epidemiology , HIV Infections/immunology , HIV Infections/virology , HIV-1/genetics , HIV-1/immunology , HLA Antigens/classification , HLA Antigens/genetics , HLA Antigens/immunology , Humans , Influenza A Virus, H1N1 Subtype/genetics , Influenza A Virus, H1N1 Subtype/immunology , Influenza A Virus, H3N2 Subtype/genetics , Influenza A Virus, H3N2 Subtype/immunology , Influenza A Virus, H7N9 Subtype/genetics , Influenza A Virus, H7N9 Subtype/immunology , Influenza, Human/immunology , Influenza, Human/virology , Kinetics , Middle East Respiratory Syndrome Coronavirus/genetics , Middle East Respiratory Syndrome Coronavirus/immunology , Peptides/genetics , Peptides/immunology , Pneumonia, Viral/immunology , Pneumonia, Viral/virology , Protein Binding , SARS Virus/genetics , SARS Virus/immunology , SARS-CoV-2 , Severe Acute Respiratory Syndrome/immunology , Severe Acute Respiratory Syndrome/virology , Viral Proteins/genetics , Viral Proteins/immunology
17.
J Med Virol ; 94(1): 197-204, 2022 01.
Article in English | MEDLINE | ID: covidwho-1370369

ABSTRACT

Coronavirus disease 2019 (COVID-19) has had different waves within the same country. The spread rate and severity showed different properties within the COVID-19 different waves. The present work aims to compare the spread and the severity of the different waves using the available data of confirmed COVID-19 cases and death cases. Real-data sets collected from the Johns Hopkins University Center for Systems Science were used to perform a comparative study between COVID-19 different waves in 12 countries with the highest total performed tests for severe acute respiratory syndrome coronavirus 2 detection in the world (Italy, Brazil, Japan, Germany, Spain, India, USA, UAE, Poland, Colombia, Turkey, and Switzerland). The total number of confirmed cases and death cases in different waves of COVID-19 were compared to that of the previous one for equivalent periods. The total number of death cases in each wave was presented as a percentage of the total number of confirmed cases for the same periods. In all the selected 12 countries, Wave 2 had a much higher number of confirmed cases than that in Wave 1. However, the death cases increase was not comparable with that of the confirmed cases to the extent that some countries had lower death cases than in Wave 1, UAE, and Spain. The death cases as a percentage of the total number of confirmed cases in Wave 1 were much higher than that in Wave 2. Some countries have had Waves 3 and 4. Waves 3 and 4 have had lower confirmed cases than Wave 2, however, the death cases were variable in different countries. The death cases in Waves 3 and 4 were similar to or higher than Wave 2 in most countries. Wave 2 of COVID-19 had a much higher spread rate but much lower severity resulting in a lower death rate in Wave 2 compared with that of the first wave. Waves 3 and 4 have had lower confirmed cases than Wave 2; that could be due to the presence of appropriate treatment and vaccination. However, that was not reflected in the death cases, which were similar to or higher than Wave 2 in most countries. Further studies are needed to explain these findings.


Subject(s)
COVID-19 Vaccines , COVID-19/epidemiology , SARS-CoV-2/genetics , Asia/epidemiology , COVID-19/mortality , COVID-19/transmission , COVID-19/virology , Europe/epidemiology , Global Health , Humans , Mutation , Severity of Illness Index , South America/epidemiology , United States/epidemiology
18.
Int J Rheum Dis ; 24(9): 1106-1111, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1349922

ABSTRACT

Rheumatoid arthritis (RA) is a major health burden in Asia Pacific affecting the quality of life of patients and consuming healthcare resources. According to recent estimates from the World Health Organization-International League Against Rheumatism-Community Oriented Program for Control of Rheumatic Diseases, prevalence is around 0.3%-0.5%. Management guidelines have helped to improve treatment across this diverse region. To gain better insight into current real-world management applications in view of these guidelines, virtual meetings were conducted in mid-2020 to explore perspectives of rheumatologists and patients, as well as discuss the impact of coronavirus disease 2019 on RA management. Patients and rheumatologists from Hong Kong, Malaysia, Singapore, the Philippines, Thailand, India, Pakistan, and Taiwan were included, representing a diverse mix of healthcare systems, wealth, ethnicity and culture. Despite many countries having prospered in recent years, similar challenges in RA diagnosis and treatment were identified. The daily impact and patient experience of RA were also similar across countries, marked by "silent" pain and disability, and universal misunderstanding of the disease. Late diagnosis and treatment, and barriers to access to appropriate treatment, remain problematic. The experience shared by Taiwan offers a glimmer of hope, however, wherein patient advocacy groups have succeeded in being included in policy-making decisions and securing access to advanced treatment. Real-world solutions that pay heed to the unique local needs and diversity of Asia Pacific are required to improve RA management, which will take time. In the interim, help can be sought from the trained, non-rheumatologist community to reduce some of the disease burden.


Subject(s)
Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , COVID-19 , Pain Management/trends , Practice Patterns, Physicians'/trends , Antirheumatic Agents/adverse effects , Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/epidemiology , Asia/epidemiology , Humans , Treatment Outcome
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