Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 20.311
Filter
Add filters

Document Type
Year range
1.
Pan Afr Med J ; 38: 384, 2021.
Article in French | MEDLINE | ID: covidwho-1547779

ABSTRACT

The first cases of infection caused by new SARS-CoV-2 coronavirus were reported in China in December 2019. This disease is called COVID-19 and has been declared as a pandemic by the WHO three months after its outbreak (in March 2020). In most cases it results in non-severe infectious syndrome associated with different degrees of benign symptoms (fever, cough, myalgia, headache and potential digestive disorders). SARS-CoV-2 can cause severe lung diseased and, sometimes, it results in death. Data on its consequences during pregnancy are limited. Currently, data on SARS-CoV-2 infection are reassuring and don´t indicate a higher risk of infection or a superimposed risk of complications in pregnant women compared to the general population. A few exceptional cases of maternal mortality have been reported, but they occur, most often, in patients with other diseases, in particular pre-eclampsia. This retrospective study highlights the clinical, biological and evolutionary materno-fetal data collected in the COVID-19 Military Field Hospital of Benslimane, Morocco, over a period of 3 months, from 21st July to 21 October 2020.


Subject(s)
COVID-19/epidemiology , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome , Adult , Female , Hospitals, Military , Humans , Morocco , Pregnancy , Pregnancy Complications, Infectious/virology , Retrospective Studies , Young Adult
2.
Pan Afr Med J ; 38: 348, 2021.
Article in French | MEDLINE | ID: covidwho-1547772

ABSTRACT

Introduction: since its appearance, the COVID-19 has exhausted global health systems. It was predictable that countries with weak health systems will be severly wiped out by the pandemic. Countries across Europe faced severe human loses and it was foreseable that Africa will experience an even worse tragedy. Suprisingly, since the evolution of the pandemic, there has been remarkable resistance from African countries, including Cameroon. Method: the study was phenomenographic. The data were collected successively from media observations (in particular the WHO site, national TV (CRTV) programs 'Parlons COVID'), social networks - Facebook and Whatsapp) and direct observations of some quarters of Garoua (Roumdé-Adjia, Foulbéré, Kakataré) and Mora for the Far North and the southern zone of Yaoundé (Ngoa-Ekelé, Nkolondom, Mokolo). These observations were associated with individual interview, reviews and note-taking around places of public circulation (places of worship, markets and discussion sites (Faada). The theory of functionalism was mobilized in this study. Results: the results show that Cameroonians perceive the pandemic as an eminently metasocial phenomenon which explains their tendency to use prayers, nature to counter this attack. Conclusion: the study suggests that a multidimensional approach is capable of offering avenues of « liberation ¼. Also, the study once again raises the place of traditional medecine in health systems and shows the close link that exists between traditional medicine and spirituality.


Subject(s)
Attitude to Health , COVID-19/epidemiology , Anthropology, Cultural , Cameroon/epidemiology , Humans , Poverty , Religion , Sociological Factors , Urban Health
3.
Pan Afr Med J ; 38: 119, 2021.
Article in French | MEDLINE | ID: covidwho-1547723

ABSTRACT

Long-lasting insecticidal mosquito nets (LLIMNs) are needed for malaria vector control. However, their distribution is not yet optimal in sub-Saharan regions. According to projections, COVID-19 pandemic will further delay the distribution of LLIMNs. In Niger, a distribution campaign of LLIMNs with a multi-sectoral approach (state-partner-civil society) was organized in compliance with barrier measures for preventing transmission of COVID-19. A door-to-door strategy was chosen to implement this campaign, in order to avoid entry into confined spaces and to engage community. A total of 13,994,681 people received LLIMNs (reflecting a success rate of 101%) in six targeted regions. A collective effort is needed to sustain the fight against malaria in the COVID-19 era.


Subject(s)
COVID-19/prevention & control , Insecticide-Treated Bednets/supply & distribution , Malaria/prevention & control , COVID-19/epidemiology , Humans , Mosquito Control , Mosquito Vectors , Niger
4.
Pan Afr Med J ; 38: 93, 2021.
Article in French | MEDLINE | ID: covidwho-1547720

ABSTRACT

Introduction: SARS-CoV-2 serology tests could play a crucial role in estimating the prevalence of COVID-19. The purpose of this study was to estimate the prevalence of COVID-19 among travellers and workers in Bukavu, a city in eastern Democratic Republic of the Congo. Methods: between May and August 2020, the Cellex qSARS-CoV-2 IgG/IgM Rapid Test (Cellex, Inc., USA), lateral flow immunoassay was used to rapidly detect and differentiate antibodies against SARS-CoV-2 among travellers and workers seeking medical certification. Results: among the 684 residents of the city of Bukavu screened for COVID-19 (4.2% Hispanic, 2.8% other African, 0.9% Asian), the seroprevalence anti-SARS-CoV-2 antibodies was 40.8% (IgG+/IgM+: 34.6%; IgG+/IgM-: 0.5%; IgG-/IgM+: 5.4%). Cumulative seroprevalence of anti-SARS-CoV-2 IgG antibodies increased from 24.5% to 35.2% from May to August 2020. Independent predictors of SARS-CoV-2 antibodies were age > 60 years [adjusted OR = 2.07(1.26-3.38)] and non-membership of the medical staff [adjusted OR = 2.28 (1.22-4.26)]. Thirteen point nine percent of patients seropositive for SARS-CoV-2 antibodies were symptomatic and hospitalized. Conclusion: this study shows a very high seroprevalence of SARS-CoV-2 antibodies among travellers and workers in Bukavu, a city in eastern Democratic Republic of the Congo, which may positively affect community immunity in the study population. Thus, the management of COVID-19 should be contextualized according to local realities.


Subject(s)
Antibodies, Viral/blood , COVID-19/epidemiology , SARS-CoV-2/isolation & purification , Travel , Adult , Age Factors , Aged , COVID-19/diagnosis , Democratic Republic of the Congo/epidemiology , Female , Hospitalization/statistics & numerical data , Humans , Immunoassay , Male , Middle Aged , SARS-CoV-2/immunology , Seroepidemiologic Studies
5.
Pan Afr Med J ; 38: 55, 2021.
Article in French | MEDLINE | ID: covidwho-1547713

ABSTRACT

The first outbreak of epidemic respiratory disease due to unknown etiology was reported in the Chinese city of Wuhan December 2019. The World Health Organization (WHO) firstly used the term "new coronavirus 2019" on December 29, 2019. This pandemic, which is currently called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a disease caused by SARS-CoV-2. It was subsequently called coronavirus disease 2019 (COVID-19) by the WHO. The purpose of this study was to determine the prevalence of antibodies against SARS-CoV-2 in all employees of the Nouakchott National Hospital Center (CHN). The study was conducted during the week 20/05/2020 to 27/05/2020. It involved 853 employees of all ranks (doctors, pharmacists, nurses, secretaries, security personnel, administrators...) of whom 504 were male and 331 were female, with a sex ratio of 1,52 with an average age of 39 years, ranging from 20 to 60 years. The screening for IgG and IgM antibodies to SARS-CoV-2 was performed using Biotime (Xiamen Biotime Biotechnology Co., Ltd.) immunochromatographic technique. Out of 835 employees included in our study, 14 were positive (1.67%) of whom 12 had IgM and IgG anti-SARS-CoV-2 antibodies and 2 had isolated IgM. Nasopharyngeal swab polymerase chain reaction (PCR) was performed in these 14 patients and was positive in six. While PCR is the gold standard for the diagnosis of SARS-CoV-2, serological tests for SARS-CoV-2 antibodies, in particular rapid tests (RDTs) are a diagnostic complement to COVID-19. They have the advantage of being easy to realize, of being safe both in the laboratories and outside the laboratories. RDTs enabled us to detect asymptomatic SARS-CoV-2 carriers within CHN employees. This allowed for patients management and isolation to protect patients and their environments.


Subject(s)
COVID-19 Testing , COVID-19/diagnosis , Health Personnel , SARS-CoV-2/isolation & purification , Adult , Antibodies, Viral/blood , COVID-19/epidemiology , Female , Humans , Immunoglobulin G/immunology , Immunoglobulin M/immunology , Male , Mauritania/epidemiology , Middle Aged , Serologic Tests/methods , Young Adult
6.
Pediatr Ann ; 50(11): e465-e469, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1547524

ABSTRACT

The widespread shutdown in response to the coronavirus disease 2019 (COVID-19) pandemic, although varied across state and county levels, has undoubtedly impacted everyone to some degree. Within the pediatric population, the closure of schools and organized youth athletic programs has resulted in a unique situation that has made athletes physically deconditioned and at risk for injury. As sports and competition gradually restart, there are considerable risks to the skeletally immature athlete. The anatomic and physiologic changes that occur to bone and cartilage during growth make the young athlete particularly susceptible to both acute and overuse injuries. In the context of the pandemic, deconditioning, obesity, lack of variety, and the resultant mental health burden pose unique challenges in ensuring that young athletes safely return to the field. This review aims to identify risk factors for sport-related injuries and to outline strategies for minimizing these injuries as pediatric patients return-to-play after COVID-19. [Pediatr Ann. 2021;50(11):e465-e469.].


Subject(s)
Athletes/psychology , Athletic Injuries/prevention & control , COVID-19/prevention & control , Return to Sport , Youth Sports , Adolescent , COVID-19/epidemiology , COVID-19/psychology , Child , Cumulative Trauma Disorders , Humans , SARS-CoV-2
7.
Ind Health ; 59(5): 318-324, 2021 Oct 05.
Article in English | MEDLINE | ID: covidwho-1547178

ABSTRACT

COVID-19 is around the world. We attempt to apply three-step method in ISO/IEC Guide 51: 2014 to COVID-19 infection control in the workplace. The results show that the COVID-19 infection control measures include the eradication of the virus, the destruction of infectivity, the detoxification and weakening and the elimination of opportunities for infection as "Inherently Safe Design Measures", the avoidance of contact as "Safeguarding and Complementary Protective Measures" and the reduction of contact and the avoidance of seriousness as "Information for Use". Among these specific measures, the New Normal, especially in the manufacturing industries, would be "telecommuting" and "unmanned workplaces", which are part of the elimination of opportunities for infection, and "changes in flow lines" and "changes in airflow", which are part of the avoidance of contact. Where "telecommuting" and "unmanned workplaces" are feasible, they should be implemented as much as possible, and where they are not, attempts should be made to minimize human-to-human contact by "changes in flow lines". In addition, in the area of "changes in airflow", there are high expectations for future research on how to establish a ventilation design for COVID-19, in which but also the source would be workers themselves, not only combustible gases and toxic gases.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Infection Control/organization & administration , Occupational Health/standards , Workplace/organization & administration , Global Health , Humans , Infection Control/standards , Manufacturing and Industrial Facilities/standards , SARS-CoV-2 , Teleworking , Ventilation/standards , Workplace/standards
8.
Ind Health ; 59(5): 293-297, 2021 Oct 05.
Article in English | MEDLINE | ID: covidwho-1547177

ABSTRACT

This paper reviews three viewpoints regarding the society after the COVID-19 infection on the concept of safety management. The first is the relationship between With COVID-19 and a zero risk. As a result of coexistence with COVID-19 for more than one year, the Japanese society thought that a zero risk is difficult to accomplish, and some risks will be accepted to maintain social activities. This leads a change in a way of thinking from zero risk to risk-based safety management. The second is the change in the way of working. As a result of having experienced remote work forcibly, it will become the hybrid model that incorporated remote work in a conventional method. Personnel evaluation changes from the seniority system to the job evaluation type, and each person's professional ability will be more focused on. The third is the review of the Japanese society system. In Japan, although the infection level was controlled to some extent by the groupism of the self-restraint of actions by mutual monitoring, there is a limit of managing based on groupism. Moreover, as seen in the delay of vaccine development and the medical care collapse, these problems should be improved by changing Japanese society system.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control/organization & administration , Safety Management/organization & administration , Teleworking , COVID-19 Vaccines , Delivery of Health Care/organization & administration , Drug Development , Fukushima Nuclear Accident , Humans , Japan , Risk Assessment , SARS-CoV-2
9.
BMC Med Imaging ; 21(1): 154, 2021 10 21.
Article in English | MEDLINE | ID: covidwho-1546762

ABSTRACT

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) causes tens of million infection world-wide. Many machine learning methods have been proposed for the computer-aided diagnosis between COVID-19 and community-acquired pneumonia (CAP) from chest computed tomography (CT) images. Most of these methods utilized the location-specific handcrafted features based on the segmentation results to improve the diagnose performance. However, the prerequisite segmentation step is time-consuming and needs the intervention by lots of expert radiologists, which cannot be achieved in the areas with limited medical resources. METHODS: We propose a generative adversarial feature completion and diagnosis network (GACDN) that simultaneously generates handcrafted features by radiomic counterparts and makes accurate diagnoses based on both original and generated features. Specifically, we first calculate the radiomic features from the CT images. Then, in order to fast obtain the location-specific handcrafted features, we use the proposed GACDN to generate them by its corresponding radiomic features. Finally, we use both radiomic features and location-specific handcrafted features for COVID-19 diagnosis. RESULTS: For the performance of our generated location-specific handcrafted features, the results of four basic classifiers show that it has an average of 3.21% increase in diagnoses accuracy. Besides, the experimental results on COVID-19 dataset show that our proposed method achieved superior performance in COVID-19 vs. community acquired pneumonia (CAP) classification compared with the state-of-the-art methods. CONCLUSIONS: The proposed method significantly improves the diagnoses accuracy of COVID-19 vs. CAP in the condition of incomplete location-specific handcrafted features. Besides, it is also applicable in some regions lacking of expert radiologists and high-performance computing resources.


Subject(s)
COVID-19/diagnosis , Deep Learning , Diagnosis, Computer-Assisted/methods , Machine Learning , SARS-CoV-2 , Tomography, X-Ray Computed/methods , COVID-19/epidemiology , Humans
10.
J Chin Med Assoc ; 84(10): 951-955, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1546069

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) spread all over the world in 2020. In the face of the sudden pandemic, workforce mobilization has been of critical concern to medical institutions. During the pandemic, the public's behaviors of seeking medical assistance have also changed. Using the real-world data of a large medical center in Taiwan, this study aimed to analyze the fluctuations of outpatient visits among various departments and divisions in the early phase of the COVID-19 pandemic and to provide suggestions for staff allocation in similar future events. METHODS: Data of outpatient visits at Taipei Veterans General Hospital were obtained for analysis. The weekly fluctuations of outpatient visits among 36 departments or divisions were computed for 8 weeks from February 3 to March 29, 2020, the early phase of the pandemic. The monthly data of outpatient visits by department and division in March 2020 were also extracted for comparison with those in March 2019. A simple regression equation was used to calculate the weekly trends. RESULTS: Average outpatient visits decreased by 26% in 2 months following the outbreak. Among the 36 departments or divisions, ophthalmology, orthopedics, and cardiology underwent marked declines after the outbreak; the slopes of the simple regression equation were -110.8, -100.7, and -99.2, respectively. By contrast, transfusion medicine, toxicology, transplantation surgery, pediatric surgery, chest surgery, technical aid, and oncology were divisions less influenced. In the year-over-year comparison, infection was the only department or division with positive growth (20.5%), whereas all others exhibited negative growth. CONCLUSION: In the future, we can fulfil the additional personnel needs during a pandemic by redeploying physicians from departments experiencing a reduced workload. Hospitals should also establish preparatory employee training programs to ensure that the reassigned personnel are adequately equipped to serve in their new positions.


Subject(s)
Ambulatory Care/statistics & numerical data , COVID-19/epidemiology , SARS-CoV-2 , Emergency Service, Hospital , Humans , Personnel Staffing and Scheduling , Taiwan/epidemiology
12.
Anesthesiology ; 135(6): 951-962, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1546049

ABSTRACT

Respiratory viruses are transmitted via respiratory particles that are emitted when people breath, speak, cough, or sneeze. These particles span the size spectrum from visible droplets to airborne particles of hundreds of nanometers. Barrier face coverings ("cloth masks") and surgical masks are loose-fitting and provide limited protection from airborne particles since air passes around the edges of the mask as well as through the filtering material. Respirators, which fit tightly to the face, provide more effective respiratory protection. Although healthcare workers have relied primarily on disposable filtering facepiece respirators (such as N95) during the COVID-19 pandemic, reusable elastomeric respirators have significant potential advantages for the COVID-19 and future respiratory virus pandemics. However, currently available elastomeric respirators were not designed primarily for healthcare or pandemic use and require further development to improve their suitability for this application. The authors believe that the development, implementation, and stockpiling of improved elastomeric respirators should be an international public health priority.


Subject(s)
COVID-19/epidemiology , Elastomers/standards , Equipment Design/standards , Health Personnel/standards , Occupational Exposure/standards , Ventilators, Mechanical/standards , COVID-19/prevention & control , COVID-19/transmission , Equipment Design/methods , Equipment Reuse/standards , Humans , Occupational Exposure/prevention & control , Pandemics/prevention & control
13.
Am J Speech Lang Pathol ; 30(2): 740-747, 2021 03 26.
Article in English | MEDLINE | ID: covidwho-1545668

ABSTRACT

Purpose Youth with cochlear implants (CIs) are at risk for delays in verbal short-term memory (STM)/working memory (WM), which adversely affect language, neurocognitive, and behavioral outcomes. Assessment of verbal STM/WM is critical for identifying and addressing these delays, but standard assessment procedures require face-to-face (FTF) administration. The purpose of this study was to determine the feasibility and validity of remote testing methods (teleassessment) of verbal STM/WM in youth with CIs as a method of addressing COVID-19-related restrictions on FTF test administration. Method Tests of verbal STM/WM for nonwords, digit spans, letter-number sequences, sentences, and stories were individually administered by speech-language pathologists over a teleassessment platform to 28 youth (aged 9-22 years) with CIs and 36 same-aged normal-hearing peers. Examiners, parents, and participants completed quality and satisfaction ratings with the teleassessment procedure. Teleassessment scores were compared to results of tests obtained at FTF visits an average of 1.6 years earlier. Results Quality and satisfaction ratings for teleassessment were high and in almost all cases did not differ between the CI and normal-hearing samples. Youth with CIs scored lower than normal-hearing peers on measures of verbal STM/WM, and scores for digit span and letter-number sequencing did not differbetween teleassessment and FTF methods. Correlations across teleassessment and FTF visits were strong for digit span, letter-number sequencing, and sentence memory, but were more modest for nonword repetition. Conclusion With some caveats, teleassessment of verbal STM/WM was feasible and valid for youth with CIs.


Subject(s)
Cochlear Implants/psychology , Memory, Short-Term , Speech Perception , Speech-Language Pathology/methods , Telemedicine/methods , Adolescent , COVID-19/epidemiology , Case-Control Studies , Child , Cochlear Implants/adverse effects , Feasibility Studies , Female , Humans , Male , Pandemics , SARS-CoV-2
14.
Am J Speech Lang Pathol ; 30(2): 532-550, 2021 03 26.
Article in English | MEDLINE | ID: covidwho-1545666

ABSTRACT

Purpose Our aim was to critically review recent literature on the use of telehealth for dysphagia during the COVID-19 pandemic and enhance this information in order to provide evidence- and practice-based clinical guidance during and after the pandemic. Method We conducted a rapid systematized review to identify telehealth adaptations during COVID-19, according to peer-reviewed articles published from January to August 2020. Of the 40 articles identified, 11 met the inclusion criteria. Full-text reviews were completed by three raters, followed by qualitative synthesis of the results and description of practical recommendations for the use of telehealth for dysphagia. Results Seven articles were guidelines articles, three were editorials, and one was a narrative review. One article focused on telehealth and dysphagia during COVID-19. The remaining 10 mentioned telehealth in varying degrees while focusing on dysphagia management during the pandemic. No articles discussed pediatrics in depth. The most common procedure for which telehealth was recommended was the clinical swallowing assessment (8/11), followed by therapy (7/11). Six articles characterized telehealth as a second-tier service delivery option. Only one article included brief guidance on telehealth-specific factors, such as legal safeguards, safety, privacy, infrastructure, and facilitators. Conclusions Literature published during the pandemic on telehealth for dysphagia is extremely limited and guarded in endorsing telehealth as an equivalent service delivery model. We have presented prepandemic and emerging current evidence for the safety and reliability of dysphagia telemanagement, in combination with practical guidelines to facilitate the safe adoption of telehealth during and after the pandemic.


Subject(s)
Deglutition Disorders/therapy , Speech-Language Pathology/methods , Telemedicine/methods , Adult , COVID-19/epidemiology , Child, Preschool , Deglutition Disorders/diagnosis , Deglutition Disorders/rehabilitation , Humans , Pandemics , Pediatrics/methods , SARS-CoV-2
15.
Am J Speech Lang Pathol ; 30(2): 503-516, 2021 03 26.
Article in English | MEDLINE | ID: covidwho-1545665

ABSTRACT

Purpose COVID-19 has shifted models of health care delivery, requiring the rapid adoption of telehealth, despite limited evidence and few resources to guide speech-language pathologists. Management of dysarthria presents specific challenges in the telehealth modality. Evaluations of dysarthria typically rely heavily on perceptual judgments, which are difficult to obtain via telehealth given a variety of technological factors such as inconsistencies in mouth-to-microphone distance, changes to acoustic properties based on device settings, and possible interruptions in connection that may cause video freezing. These factors limit the validity, reliability, and clinicians' certainty of perceptual speech ratings via telehealth. Thus, objective measures to supplement the assessment of dysarthria are essential. Method This tutorial outlines how to obtain objective measures in real time and from recordings of motor speech evaluations to support traditional perceptual ratings in telehealth evaluations of dysarthria. Objective measures include pause patterns, utterance length, speech rate, diadochokinetic rates, and overall speech severity. We demonstrate, through clinical case vignettes, how these measures were completed following three clinical telehealth evaluations of dysarthria conducted via Zoom during the COVID-19 pandemic. This tutorial describes how each of these objective measures were utilized, in combination with subjective perceptual analysis, to determine deviant speech characteristics and their etiology, develop a patient-specific treatment plan, and track change over time. Conclusion Utilizing objective measures as an adjunct to perceptual ratings for telehealth dysarthria evaluations is feasible under real-world pandemic conditions and can be used to enhance the quality and utility of these evaluations.


Subject(s)
Dysarthria/therapy , Speech-Language Pathology/methods , Telemedicine/methods , COVID-19/epidemiology , Humans , Pandemics , SARS-CoV-2 , Speech Intelligibility , Telemedicine/standards
16.
Am J Speech Lang Pathol ; 30(2): 598-608, 2021 Mar 26.
Article in English | MEDLINE | ID: covidwho-1545664

ABSTRACT

Purpose The COVID-19 pandemic has drastically increased the use of telehealth. Prior studies of telehealth clinical swallowing evaluations provide positive evidence for telemanagement of swallowing. However, the reliability of these measures in clinical practice, as opposed to well-controlled research conditions, remains unknown. This study aimed to investigate the reliability of outcome measures derived from clinical swallowing tele-evaluations in real-world clinical practice (e.g., variability in devices and Internet connectivity, lack of in-person clinician assistance, or remote patient/caregiver training). Method Seven raters asynchronously judged clinical swallowing tele-evaluations of 12 movement disorders patients. Outcomes included the Timed Water Swallow Test (TWST), Test of Masticating and Swallowing Solids (TOMASS), and common observations of oral intake. Statistical analyses were performed to examine inter- and intrarater reliability, as well as qualitative analyses exploring patient and clinician-specific factors impacting reliability. Results Forty-four trials were included for reliability analyses. All rater dyads demonstrated "good" to "excellent" interrater reliability for measures of the TWST (intraclass correlation coefficients [ICCs] ≥ .93) and observations of oral intake (≥ 77% agreement). The majority of TOMASS outcomes demonstrated "good" to "excellent" interrater reliability (ICCs ≥ .84), with the exception of the number of bites (ICCs = .43-.99) and swallows (ICCs = .21-.85). Immediate and delayed intrarater reliability were "excellent" for most raters across all tasks, ranging between ICCs of .63 and 1.00. Exploratory factors potentially impacting reliability included infrequent instances of suboptimal video quality, reduced camera stability, camera distance, and obstruction of the patient's mouth during tasks. Conclusions Subjective observations of oral intake and objective measures taken from the TWST and the TOMASS can be reliably measured via telehealth in clinical practice. Our results provide support for the feasibility and reliability of telehealth for outpatient clinical swallowing evaluations during COVID-19 and beyond. Supplemental Material https://doi.org/10.23641/asha.13661378.


Subject(s)
Deglutition Disorders/therapy , Deglutition/physiology , Speech-Language Pathology/methods , Telemedicine/methods , Aged , Aged, 80 and over , COVID-19/epidemiology , Deglutition Disorders/etiology , Female , Humans , Lewy Body Disease/complications , Male , Middle Aged , Multiple System Atrophy/complications , Pandemics , Parkinson Disease/complications , Prospective Studies , SARS-CoV-2 , Telemedicine/standards
17.
Lancet Respir Med ; 9(9): 999-1009, 2021 09.
Article in English | MEDLINE | ID: covidwho-1545508

ABSTRACT

BACKGROUND: Concurrent with the Pfizer-BioNTech BNT162b2 COVID-19 vaccine roll-out in Israel initiated on Dec 19, 2020, we assessed the early antibody responses and antibody kinetics after each vaccine dose in health-care workers of different ages and sexes, and with different comorbidities. METHODS: We did a prospective, single-centre, longitudinal cohort study at the Sheba Medical Centre (Tel-Hashomer, Israel). Eligible participants were health-care workers at the centre who had a negative anti-SARS-CoV-2 IgG assay before receiving the first dose of the intramuscular vaccine, and at least one serological antibody test after the first dose of the vaccine. Health-care workers with a positive SARS-CoV-2 PCR test before vaccination, a positive anti-SARS-CoV-2 IgG serology test before vaccination, or infection with COVID-19 after vaccination were excluded from the study. Participants were followed up weekly for 5 weeks after the first vaccine dose; a second dose was given at week 3. Serum samples were obtained at baseline and at each weekly follow-up, and antibodies were tested at 1-2 weeks after the first vaccine dose, at week 3 with the administration of the second vaccine dose, and at weeks 4-5 (ie, 1-2 weeks after the second vaccine dose). Participants with comorbidities were approached to participate in an enriched comorbidities subgroup, and at least two neutralising assays were done during the 5 weeks of follow-up in those individuals. IgG assays were done for the entire study population, whereas IgM, IgA, and neutralising antibody assays were done only in the enriched comorbidities subgroup. Concentrations of IgG greater than 0·62 sample-to-cutoff (s/co) ratio and of IgA greater than 1·1 s/co, and titres of neutralising antibodies greater than 10 were considered positive. Scatter plot and correlation analyses, logistic and linear regression analyses, and linear mixed models were used to investigate the longitudinal antibody responses. FINDINGS: Between Dec 19, 2020, and Jan 30, 2021, we obtained 4026 serum samples from 2607 eligible, vaccinated participants. 342 individuals were included in the enriched comorbidities subgroup. The first vaccine dose elicited positive IgG and neutralising antibody responses at week 3 in 707 (88·0%) of 803 individuals, and 264 (71·0%) of 372 individuals, respectively, which were rapidly increased at week 4 (ie, 1 week after the second vaccine dose) in 1011 (98·4%) of 1027 and 357 (96·5%) of 370 individuals, respectively. Over 4 weeks of follow-up after vaccination, a high correlation (r=0·92) was detected between IgG against the receptor-binding domain and neutralising antibody titres. First-dose induced IgG response was significantly lower in individuals aged 66 years and older (ratio of means 0·25, 95% CI 0·19-0·31) and immunosuppressed individuals (0·21, 0·14-0·31) compared with individuals aged 18·00-45·99 years and individuals with no immunosuppression, respectively. This disparity was partly abrogated following the second dose. Overall, endpoint regression analysis showed that lower antibody concentrations were consistently associated with male sex (ratio of means 0·84, 95% CI 0·80-0·89), older age (ie, ≥66 years; 0·64, 0·58-0·71), immunosuppression (0·44, 0·33-0·58), and other specific comorbidities: diabetes (0·88, 0·79-0·98), hypertension (0·90, 0·82-0·98), heart disease (0·86, 0·75-1·00), and autoimmune diseases (0·82, 0·73-0·92). INTERPRETATION: BNT162b2 vaccine induces a robust and rapid antibody response. The significant correlation between receptor-binding domain IgG antibodies and neutralisation titres suggests that IgG antibodies might serve as a correlate of neutralisation. The second vaccine dose is particularly important for older and immunosuppressed individuals, highlighting the need for timely second vaccinations and potentially a revaluation of the long gap between doses in some countries. Antibody responses were reduced in susceptible populations and therefore they might be more prone to breakthrough infections. FUNDING: Sheba Medical Center, Israel Ministry of Health.


Subject(s)
Antibodies, Neutralizing/blood , Antibodies, Viral/blood , COVID-19 Vaccines/immunology , COVID-19/prevention & control , Health Personnel/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , Antibodies, Viral/isolation & purification , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , COVID-19 Vaccines/administration & dosage , Female , Follow-Up Studies , Humans , Immunity, Humoral , Immunogenicity, Vaccine , Israel/epidemiology , Longitudinal Studies , Male , Middle Aged , Pandemics/prevention & control , Prospective Studies , SARS-CoV-2/immunology , Vaccination/methods , Vaccination/statistics & numerical data , Young Adult
18.
J Med Virol ; 93(12): 6722-6731, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1544325

ABSTRACT

Low vaccine acceptance is a major barrier to vaccination coverage in every health system. This study aimed to explore the prevalence and associated factors of the COVID-19 vaccine hesitancy in a sample of the general population in Iraqi Kurdistan. The general population with both genders with different educational levels and sociodemographic characteristics from the Duhok governorate was eligible to participate in this cross-sectional study in 2021. Therefore, an online Google form was sent to main pages and social groups through two main social media platforms. To obtain a representative sample of individuals with different educational levels, the author visited the main shopping center in Duhok city to collect the information from illiterate and low-level education individuals. The study found that 83.5% (n = 773) of the participants have not received and 51.4% (n = 476) did not intend to receive the COVID-19 vaccine. A small percentage has not decided to receive a COVID-19 vaccine yet (n = 17, 1.8%). The intention to receive a COVID-19 vaccine was increased with increasing level of education; 25.9%, 26.7%, 39.8%, and 53.6% in illiterate, under high school, high school, and college and higher, respectively (p < 0.0001). Healthcare workers were more likely to intend to receive a COVID-19, 57.5% vs 40.1%, p < 0.0001. Individuals who had concerns about the side effects of a COVID-19 vaccine were more likely to not receive and not intend to receive the COVID-19 vaccine. Prevalence of COVID-19 vaccine hesitancy was high in this region and was correlated with lower education and concerns about side effects.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19/epidemiology , COVID-19/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Health Personnel , Humans , Iraq/epidemiology , Male , Middle Aged , Prevalence , Vaccination/methods , Young Adult
19.
J Med Virol ; 93(12): 6660-6670, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1544317

ABSTRACT

With the wide spread of Coronavirus, most people who infected with the COVID-19, will recover without requiring special treatment. Whereas, elders and those with underlying medical problems are more likely to have serious illnesses, even be threatened with death. Many more disciplines try to find solutions and drive master plan to this global trouble. Consequently, by taking one particular population, Hungary, this study aims to explore a pattern of COVID-19 victims, who suffered from some underlying conditions. Age, gender, and underlying medical problems form the structure of the clustering. K-Means and two step clustering methods were applied for age-based and age-independent analysis. Grouping of the deaths in the form of two different scenarios may highlight some concepts of this deadly disease for public health professionals. Our result for clustering can forecast similar cases which are assigned to any cluster that it will be a serious cautious for the population.


Subject(s)
COVID-19/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Asthma/complications , COVID-19/etiology , Diabetes Complications/epidemiology , Female , Humans , Hungary/epidemiology , Lung Diseases/complications , Male , Middle Aged , Neoplasms/complications , Obesity/complications , Risk Factors , Schizophrenia/complications , Sex Factors , Young Adult
20.
J Med Virol ; 93(12): 6628-6633, 2021 12.
Article in English | MEDLINE | ID: covidwho-1544311

ABSTRACT

As the emergence of new variants of SARS-CoV-2 persists across the world, it is of importance to understand the distributional behavior of the incubation period of the variants for both medical research and public health policy-making. We collected the published individual-level data of 941 patients of the 2020-2021 winter pandemic wave in Hebei province, North China. We computed some epidemiological characteristics of the wave and estimated the distribution of the incubation period. We further assessed the covariate effects of sex, age, and living with a case with respect to the incubation period by a model. The infection-fatality rate was only 0.1%. The estimated median incubation period was at least 22 days, significantly extended from the estimates (ranging from 4 to 8.5 days) of the previous wave in mainland China and those ever reported elsewhere around the world. The proportion of asymptomatic patients was 90.6%. No significant covariate effect was found. The distribution of incubation period of the new variants showed a clear extension from their early generations.


Subject(s)
COVID-19/epidemiology , Infectious Disease Incubation Period , SARS-CoV-2/physiology , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/virology , Child , Child, Preschool , China/epidemiology , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Pandemics/statistics & numerical data , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL
...