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1.
Medicine (Baltimore) ; 101(9): e28976, 2022 Mar 04.
Article in English | MEDLINE | ID: covidwho-1730760

ABSTRACT

ABSTRACT: The Corona Virus Disease 2019 (COVID-19) pandemic has huge impacts on the world, including human health and economic decline. The COVID-19 has severe infectivity, especially the elderly with chronic diseases will cause various complications after infection and accelerate the disease process. In addition, COVID-19 will also affect their mental health. Therefore, the mental health of elderly patients with chronic diseases cannot be ignored. The aim of this study was to investigate the well-being level of elderly people with chronic disease during COVID-19 postpandemic period in Beijing and analysis related influencing factors, so as to provide a basis for improving the well-being level of elderly chronic patients during the postpandemic period.Elderly patients with chronic diseases who met the inclusion criteria in 5 different administrative regions in Beijing were selected to carry out a questionnaire survey. The contents of the questionnaire included general data, the Memorial University of Newfoundland Happiness scale and the awareness situation of the COVID-19 pandemic. A total of 500 questionnaires were distributed by WeChat and 486 valid questionnaires were collected. The t test and one-way analysis of variance were used to compare Memorial University of Newfoundland Happiness scores between 2 or more groups, multiple linear regression analysis was used to conduct multiple factor analysis to explore the related factors about well-being level of elderly chronic patients.A total of 109 cases (22.43%) were evaluated high well-being level, 319 cases (65.64%) were evaluated moderate well-being level and 58 cases (11.93%) were evaluated low well-being according to the Memorial University of Newfoundland Happiness (MUNSH) scores rating. The multiple linear regression indicated that the education level, number of chronic diseases, medical expenses, frequency of children's visits, taking care of grandchildren or not, and group activity frequency significantly affected the well-being of patients with chronic diseases during COVID-19 postpandemic period in Beijing (P < .05).Most elderly patients with chronic diseases had moderate or above sense of well-being during postpandemic period, but we should still pay attention to the mental health of those elderly chronic patients with low education level, much comorbidity, more medical expenses, less visits by children, not take care of grandchildren and never participate in group activities.


Subject(s)
COVID-19/epidemiology , Chronic Disease/epidemiology , Aged , Aged, 80 and over , Child , China/epidemiology , Health Status , Humans , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
2.
Biomed Res Int ; 2022: 4551132, 2022.
Article in English | MEDLINE | ID: covidwho-1705095

ABSTRACT

Background: Deaths due to COVID-19 are common among the elderly, especially among individuals with underlying illnesses. The pandemic of the COVID-19 impaired the mental, psychological, and physical well-being of people admitted to hospitals. Furthermore, in underdeveloped countries, scarcity of medical equipment was a challenge to manage cases in public health facilities. Thus, understanding the epidemiology and clinical outcomes of COVID-19 patients who are receiving treatment is critical for developing effective treatments and assessing service quality. Therefore, this study is aimed at assessing the treatment outcomes and associated factors among patients affected by the COVID-19 virus. Method: We used an institutional-based retrospective cross-sectional analysis of 398 patients discharged in South Central, Ethiopia, between June 1, 2020, and July 5, 2021. Data were extracted using the data abstraction format. Data were entered, coded, and analyzed using the STATA 16 software. Bivariate and multivariate logistic regression analysis was used to assess the factors associated with poor treatment outcomes. A 95% confidence interval with adjusted odds ratio (AOR) and p value less than 0.05 were considered statistically significant. Result: In our study, the proportion of poor treatment outcomes was 61 (15.3%). Chronic pulmonary disease (AOR = 5.62; 95% CI: 2.49-12.70), asthma (AOR = 2.8; 95% CI: 1.17-6.67), chronic kidney disease (AOR = 4.81; 95% CI: 1.27-18.22),diabetic mellitus (AOR = 2.27; 95% CI: 1.02-5.09), HIV positive (AOR = 10.44; 95% CI: 3.0-36.35), worsening conditions (AOR = 3.73, 95% CI: 1.17-11.95), and age 55 and above years (AOR = 4.35, 95% CI: 1.30-14.60) were statistically associated with poor treatment outcomes. Conclusion: We found a significant number of patients had favourable treatment. Moreover, aging, having complicated situations at admission, and chronic illnesses such as COPD, CKD, asthma, diabetic mellitus, and HIV/AIDS participants were significantly associated with poor treatment outcomes. Therefore, critical follow-up and management of patients with underlying diseases and worsening health conditions during admission is required.


Subject(s)
COVID-19/therapy , SARS-CoV-2/physiology , Adolescent , Adult , Age Factors , COVID-19/epidemiology , COVID-19/virology , Child , Child, Preschool , Chronic Disease/epidemiology , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Hospitalization , Humans , Infant , Male , Middle Aged , Retrospective Studies , Risk Factors , Treatment Outcome , Young Adult
3.
BMJ ; 376: e068414, 2022 02 09.
Article in English | MEDLINE | ID: covidwho-1677376

ABSTRACT

OBJECTIVE: To characterize the risk of persistent and new clinical sequelae in adults aged ≥65 years after the acute phase of SARS-CoV-2 infection. DESIGN: Retrospective cohort study. SETTING: UnitedHealth Group Clinical Research Database: deidentified administrative claims and outpatient laboratory test results. PARTICIPANTS: Individuals aged ≥65 years who were continuously enrolled in a Medicare Advantage plan with coverage of prescription drugs from January 2019 to the date of diagnosis of SARS-CoV-2 infection, matched by propensity score to three comparison groups that did not have covid-19: 2020 comparison group (n=87 337), historical 2019 comparison group (n=88 070), and historical comparison group with viral lower respiratory tract illness (n=73 490). MAIN OUTCOME MEASURES: The presence of persistent and new sequelae at 21 or more days after a diagnosis of covid-19 was determined with ICD-10 (international classification of diseases, 10th revision) codes. Excess risk for sequelae caused by infection with SARS-CoV-2 was estimated for the 120 days after the acute phase of the illness with risk difference and hazard ratios, calculated with 95% Bonferroni corrected confidence intervals. The incidence of sequelae after the acute infection was analyzed by age, race, sex, and whether patients were admitted to hospital for covid-19. RESULTS: Among individuals who were diagnosed with SARS-CoV-2, 32% (27 698 of 87 337) sought medical attention in the post-acute period for one or more new or persistent clinical sequelae, which was 11% higher than the 2020 comparison group. Respiratory failure (risk difference 7.55, 95% confidence interval 7.18 to 8.01), fatigue (5.66, 5.03 to 6.27), hypertension (4.43, 2.27 to 6.37), memory difficulties (2.63, 2.23 to 3.13), kidney injury (2.59, 2.03 to 3.12), mental health diagnoses (2.50, 2.04 to 3.04), hypercoagulability 1.47 (1.2 to 1.73), and cardiac rhythm disorders (2.19, 1.76 to 2.57) had the greatest risk differences compared with the 2020 comparison group, with similar findings to the 2019 comparison group. Compared with the group with viral lower respiratory tract illness, however, only respiratory failure, dementia, and post-viral fatigue had increased risk differences of 2.39 (95% confidence interval 1.79 to 2.94), 0.71 (0.3 to 1.08), and 0.18 (0.11 to 0.26) per 100 patients, respectively. Individuals with severe covid-19 disease requiring admission to hospital had a markedly increased risk for most but not all clinical sequelae. CONCLUSIONS: The results confirm an excess risk for persistent and new sequelae in adults aged ≥65 years after acute infection with SARS-CoV-2. Other than respiratory failure, dementia, and post-viral fatigue, the sequelae resembled those of viral lower respiratory tract illness in older adults. These findings further highlight the wide range of important sequelae after acute infection with the SARS-CoV-2 virus.


Subject(s)
COVID-19/complications , Aged , COVID-19/diagnosis , COVID-19/epidemiology , Chronic Disease/epidemiology , Cohort Studies , Female , Humans , Incidence , International Classification of Diseases , Male , Medicare Part C , Patient Acuity , Propensity Score , Retrospective Studies , Risk , United States/epidemiology
6.
Int J Obes (Lond) ; 45(12): 2577-2584, 2021 12.
Article in English | MEDLINE | ID: covidwho-1526062

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has disproportionally affected communities of color. We aimed to determine what factors are associated with COVID-19 testing and test positivity in an underrepresented, understudied, and underreported (U3) population of mothers. METHODS: This study included 2996 middle-aged mothers of the Boston Birth Cohort (a sample of predominantly urban, low-income, Black and Hispanic mothers) who were enrolled shortly after they gave birth and followed onward at the Boston Medical Center. COVID-19 testing and test positivity were defined by the SARS-CoV-2 nucleic acid test. Two-probit Heckman selection models were performed to identify factors associated with test positivity while accounting for potential selection associated with COVID testing. RESULTS: The mean (SD) age of study mothers was 41.9 (±7.7) years. In the sample, 1741 (58.1%) and 667 (22.3%) mothers were self-identified as Black and Hispanic, respectively. A total of 396 mothers had COVID-19 testing and of those, 95 mothers tested positive from March 2020 to February 2021. Among a multitude of factors examined, factors associated with the probability of being tested were obesity (RR = 1.27; 95% confidence interval (CI): 1.08-1.49); and presence of preexisting chronic medical conditions including hypertension, asthma, stroke, and other comorbidities (coronary heart disease, chronic kidney disease, and sickle cell disease) with a corresponding RR = 1.40 (95% CI: 1.23-1.60); 1.29 (95% CI: 1.11-1.50); 1.44 (95% CI: 1.23-1.68); and 1.37 (95% CI: 1.12-1.67), respectively. Factors associated with higher incident risk of a positive COVID-19 test were body mass index, birthplace outside of the USA, and being without a college-level education. CONCLUSIONS: This study demonstrated the intersectionality of obesity and social factors in modulating incident risk of COVID-19 in this sample of US Black and Hispanic middle-aged mothers. Methodologically, our findings underscore the importance of accounting for potential selection bias in COVID-19 testing in order to obtain unbiased estimates of COVID-19 infection.


Subject(s)
COVID-19/epidemiology , Chronic Disease/epidemiology , Obesity/epidemiology , Social Factors , Adult , African Americans , Boston/epidemiology , COVID-19/ethnology , COVID-19 Testing , Chronic Disease/ethnology , Comorbidity , Female , Health Knowledge, Attitudes, Practice , Humans , Middle Aged , Mothers , Obesity/ethnology , Poverty , Risk Factors
8.
J Infect Dis ; 221(2): 183-190, 2020 01 02.
Article in English | MEDLINE | ID: covidwho-1452713

ABSTRACT

BACKGROUND: Severe influenza illness is presumed more common in adults with chronic medical conditions (CMCs), but evidence is sparse and often combined into broad CMC categories. METHODS: Residents (aged 18-80 years) of Central and South Auckland hospitalized for World Health Organization-defined severe acute respiratory illness (SARI) (2012-2015) underwent influenza virus polymerase chain reaction testing. The CMC statuses for Auckland residents were modeled using hospitalization International Classification of Diseases, Tenth Revision codes, pharmaceutical claims, and laboratory results. Population-level influenza rates in adults with congestive heart failure (CHF), coronary artery disease (CAD), cerebrovascular accidents (CVA), chronic obstructive pulmonary disease (COPD), asthma, diabetes mellitus (DM), and end-stage renal disease (ESRD) were calculated by Poisson regression stratified by age and adjusted for ethnicity. RESULTS: Among 891 276 adults, 2435 influenza-associated SARI hospitalizations occurred. Rates were significantly higher in those with CMCs compared with those without the respective CMC, except for older adults with DM or those aged <65 years with CVA. The largest effects occurred with CHF (incidence rate ratio [IRR] range, 4.84-13.4 across age strata), ESRD (IRR range, 3.30-9.02), CAD (IRR range, 2.77-10.7), and COPD (IRR range, 5.89-8.78) and tapered with age. CONCLUSIONS: Our findings support the increased risk of severe, laboratory-confirmed influenza disease among adults with specific CMCs compared with those without these conditions.


Subject(s)
Chronic Disease/epidemiology , Influenza, Human/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Case-Control Studies , Cross-Sectional Studies , Female , Hospitalization/statistics & numerical data , Humans , Incidence , Influenza, Human/virology , Male , Middle Aged , New Zealand/epidemiology , Prospective Studies , Risk Assessment , Young Adult
9.
PLoS One ; 16(9): e0258015, 2021.
Article in English | MEDLINE | ID: covidwho-1443852

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, telehealth became a vital resource to contain the virus's spread and ensure continuity of care of patients with a chronic condition, notably arterial hypertension and heart disease. This paper reports the experience based on a telehealth platform used at scale to manage chronic disease patients in the Italian community. METHODS AND FINDINGS: Patients' health status was remotely monitored through ambulatory blood pressure monitoring (ABPM), resting or ambulatory electrocardiogram (ECG), spirometry, sleep oximetry, and cardiorespiratory polysomnography performed in community pharmacies or general practitioners' offices. Patients also monitored their blood pressure (BP), heart rate (HR), blood oxygen saturation (SpO2), body temperature, body weight, waist circumference, blood glucose, and lipids at home through a dedicated smartphone app. All data conveyed to the web-based telehealth platform were used to manage critical patients by doctors promptly. Data were analyzed and compared across three consecutive periods of 2 months each: i) before the national lockdown, ii) during the lockdown (from March 9 to May 17, 2020), and iii) after the end of the containment measures. Overall, 13,613 patients visited community pharmacies or doctors' offices. The number of overall tests dropped during and rose after the lockdown. The overall proportion of abnormal tests was larger during the outbreak. A significant increase in the prevalence of abnormal ECGs due to myocardial ischemia, contrasted by a significantly improved BP control, was observed. The number of home users and readings exchanged increased during the pandemic. In 226 patients, a significant increase in the proportion of SpO2 readings and a significant reduction in the entries for all other parameters, except BP, was observed. The proportion of abnormal SpO2 and BP values was significantly lower during the lockdown. Following the lockdown, the proportion of abnormal body weight or waist circumference values increased. CONCLUSIONS: Our study results support the usefulness of a telehealth solution to detect deterioration of the health status during the COVID-19 pandemic. TRIAL REGISTRATION: The study is registered with ClinicalTrials.gov at number NCT03781401.


Subject(s)
COVID-19/psychology , Disease Management , Telemedicine/trends , Adult , COVID-19/therapy , Chronic Disease/epidemiology , Chronic Disease/therapy , Communicable Disease Control , Female , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics/prevention & control , Physical Distancing , SARS-CoV-2/pathogenicity
10.
Curr Opin Allergy Clin Immunol ; 21(6): 535-544, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1440659

ABSTRACT

PURPOSE OF REVIEW: In the general population, the risk of severe COVID-19 is associated with old age, male sex, hypertension, obesity and chronic diseases. Chronic lung diseases are listed as additional risk factors for hospitalization and ICU admission. The purpose of this review is to define whether chronic lung diseases, such as bronchiectasis and interstitial diseases, represent a risk for a severe SARS-CoV-2 infection in patients affected by common variable immunodeficiency (CVID), the most common symptomatic primary antibody defect. RECENT FINDINGS: CVID patients with SARS-CoV-2 infection have been reported since the beginning of the pandemic with a wide range of clinical presentations ranging from asymptomatic to mild/moderate and severe COVID-19. The meta-analysis of 88 CVID cases described in large cohorts and case reports demonstrated that CVID patients with chronic lung involvement have an increased risk for severe COVID-19 in comparison to CVID without lung diseases (50 vs. 28%, relative risk 1.75, 95% confidence interval 1.04--2.92, P = 0.043). Differently from the general population, age and metabolic comorbidities did not represent a risk factor for severe course in this patient's population. SUMMARY: Underlying chronic lung diseases but not age represent a risk factor for severe COVID-19 in CVID. Prompt therapeutic intervention should be adopted in SARS-CoV-2 positive CVID patients with chronic lung diseases independently of their age.


Subject(s)
Bronchiectasis/epidemiology , COVID-19/diagnosis , Common Variable Immunodeficiency/complications , Lung Diseases, Interstitial/epidemiology , Severity of Illness Index , Age Factors , Bronchiectasis/immunology , COVID-19/immunology , COVID-19/virology , Chronic Disease/epidemiology , Common Variable Immunodeficiency/immunology , Disease Susceptibility , Humans , Lung Diseases, Interstitial/immunology , Risk Factors , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification
11.
PLoS One ; 16(9): e0257131, 2021.
Article in English | MEDLINE | ID: covidwho-1403313

ABSTRACT

BACKGROUND: Epidemiological features characterization of COVID-19 is highly important for developing and implementing effective control measures. In Saudi Arabia mortality rate varies between 0.6% to 1.26%. The purpose of the study was to investigate whether demographic characteristics (age and gender) and non-communicable diseases (Hypertension and Diabetes mellitus) have a significant association with mortality in COVID-19 patients. METHODS: Prior to data collection, an expedite approval was obtained from Institutional Review Board (IRB Log No: RC. RC20.09.10) in Al Habib Research Center at Dr. Sulaiman Al-Habib Medical Group, Riyadh, Saudi Arabia. This is a retrospective design where we used descriptive and inferential analysis to analyse the data. Binary logistic regression was done to study the association between comorbidities and mortality of COVID-19. RESULTS: 43 (86%) of the male patients were non-survivors while 7 (14%) of the female patients were survivors. The odds of non-survivors among hypertensive patients are 3.56 times higher than those who are not having a history of Hypertension (HTN). The odds of non-survivors among diabetic patients are 5.17 times higher than those who are not having a history of Diabetes mellitus (DM). The odds of non-survivors are 2.77 times higher among those who have a history of HTN and DM as compared to those who did not have a history of HTN and DM. CONCLUSIONS: Those patients that had a history of Hypertension and Diabetes had a higher probability of non-survival in contrast to those who did not have a history of Diabetes and hypertension. Further studies are required to study the association of comorbidities with COVID-19 and mortality.


Subject(s)
COVID-19/mortality , Chronic Disease/epidemiology , Diabetes Mellitus/epidemiology , Hypertension/epidemiology , Adolescent , Adult , Age Factors , Child , Comorbidity , Female , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors , Saudi Arabia/epidemiology , Sex Factors , Young Adult
12.
Eur Heart J Qual Care Clin Outcomes ; 7(5): 438-446, 2021 09 16.
Article in English | MEDLINE | ID: covidwho-1377964

ABSTRACT

AIMS: To evaluate the acute and chronic patterns of myocardial injury among patients with coronavirus disease-2019 (COVID-19), and their mid-term outcomes. METHODS AND RESULTS: Patients with laboratory-confirmed COVID-19 who had a hospital encounter within the Mount Sinai Health System (New York City) between 27 February 2020 and 15 October 2020 were evaluated for inclusion. Troponin levels assessed between 72 h before and 48 h after the COVID-19 diagnosis were used to stratify the study population by the presence of acute and chronic myocardial injury, as defined by the Fourth Universal Definition of Myocardial Infarction. Among 4695 patients, those with chronic myocardial injury (n = 319, 6.8%) had more comorbidities, including chronic kidney disease and heart failure, while acute myocardial injury (n = 1168, 24.9%) was more associated with increased levels of inflammatory markers. Both types of myocardial injury were strongly associated with impaired survival at 6 months [chronic: hazard ratio (HR) 4.17, 95% confidence interval (CI) 3.44-5.06; acute: HR 4.72, 95% CI 4.14-5.36], even after excluding events occurring in the first 30 days (chronic: HR 3.97, 95% CI 2.15-7.33; acute: HR 4.13, 95% CI 2.75-6.21). The mortality risk was not significantly different in patients with acute as compared with chronic myocardial injury (HR 1.13, 95% CI 0.94-1.36), except for a worse prognostic impact of acute myocardial injury in patients <65 years of age (P-interaction = 0.043) and in those without coronary artery disease (P-interaction = 0.041). CONCLUSION: Chronic and acute myocardial injury represent two distinctive patterns of cardiac involvement among COVID-19 patients. While both types of myocardial injury are associated with impaired survival at 6 months, mortality rates peak in the early phase of the infection but remain elevated even beyond 30 days during the convalescent phase.


Subject(s)
COVID-19/complications , Myocardial Infarction/blood , Myocardial Infarction/etiology , Troponin/analysis , Acute Disease/epidemiology , Acute Disease/mortality , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Chronic Disease/epidemiology , Chronic Disease/mortality , Comorbidity , Coronary Artery Disease/epidemiology , Coronary Artery Disease/mortality , Female , Heart Failure/epidemiology , Humans , Male , Middle Aged , Mortality/trends , Myocardial Infarction/epidemiology , Myocardial Infarction/mortality , New York City/epidemiology , Outcome Assessment, Health Care , Prognosis , Renal Insufficiency, Chronic/epidemiology , Retrospective Studies , SARS-CoV-2/genetics
13.
Int J Obes (Lond) ; 45(12): 2577-2584, 2021 12.
Article in English | MEDLINE | ID: covidwho-1366806

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has disproportionally affected communities of color. We aimed to determine what factors are associated with COVID-19 testing and test positivity in an underrepresented, understudied, and underreported (U3) population of mothers. METHODS: This study included 2996 middle-aged mothers of the Boston Birth Cohort (a sample of predominantly urban, low-income, Black and Hispanic mothers) who were enrolled shortly after they gave birth and followed onward at the Boston Medical Center. COVID-19 testing and test positivity were defined by the SARS-CoV-2 nucleic acid test. Two-probit Heckman selection models were performed to identify factors associated with test positivity while accounting for potential selection associated with COVID testing. RESULTS: The mean (SD) age of study mothers was 41.9 (±7.7) years. In the sample, 1741 (58.1%) and 667 (22.3%) mothers were self-identified as Black and Hispanic, respectively. A total of 396 mothers had COVID-19 testing and of those, 95 mothers tested positive from March 2020 to February 2021. Among a multitude of factors examined, factors associated with the probability of being tested were obesity (RR = 1.27; 95% confidence interval (CI): 1.08-1.49); and presence of preexisting chronic medical conditions including hypertension, asthma, stroke, and other comorbidities (coronary heart disease, chronic kidney disease, and sickle cell disease) with a corresponding RR = 1.40 (95% CI: 1.23-1.60); 1.29 (95% CI: 1.11-1.50); 1.44 (95% CI: 1.23-1.68); and 1.37 (95% CI: 1.12-1.67), respectively. Factors associated with higher incident risk of a positive COVID-19 test were body mass index, birthplace outside of the USA, and being without a college-level education. CONCLUSIONS: This study demonstrated the intersectionality of obesity and social factors in modulating incident risk of COVID-19 in this sample of US Black and Hispanic middle-aged mothers. Methodologically, our findings underscore the importance of accounting for potential selection bias in COVID-19 testing in order to obtain unbiased estimates of COVID-19 infection.


Subject(s)
COVID-19/epidemiology , Chronic Disease/epidemiology , Obesity/epidemiology , Social Factors , Adult , African Americans , Boston/epidemiology , COVID-19/ethnology , COVID-19 Testing , Chronic Disease/ethnology , Comorbidity , Female , Health Knowledge, Attitudes, Practice , Humans , Middle Aged , Mothers , Obesity/ethnology , Poverty , Risk Factors
15.
Health Psychol ; 40(6): 347-356, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1331370

ABSTRACT

OBJECTIVE: This prospective longitudinal study examined whether coronavirus disease 2019 (COVID-19) has led to changes in psychological and spiritual outcomes among adults with chronic disease. METHOD: Participants (N = 302) were a stratified, nonrandom sample of adults (Mage = 64.46, SD = 10.86, 45.7% female). The sample was representative of the chronically ill, U.S. adult population in gender, race/ethnicity, region, and religious affiliation but older in age and higher in socioeconomic status. Participants completed online-administered measures 1 month before the March 11 pandemic declaration (T1) and then 1 and 3 months after it (T2 and T3). At T1 through T3, they completed measures of depression, anxiety, personal suffering, psychological well-being, trait resilience, optimism, hope, grit, spiritual struggles, spiritual fortitude, and positive religious coping. At T2 and T3, they also completed measures of social support, physical health, resource loss, perceived stress, and COVID-19 fears and exposure. RESULTS: Overall, people did not change substantially in psychological or spiritual outcomes over time. However, trait resilience increased and personal suffering declined. People highest in prepandemic suffering increased in spiritual fortitude. Racial/ethnic minorities increased in religious importance. Roughly half (48.9%) of participants exhibited psychological resilience (no/minimal depression or anxiety symptoms) at both T2 and T3. Perceived stress and psychological resource loss were associated with adverse mental health outcomes, but social support and physical health were not. COVID-19 fears contributed more to mental health than COVID-19 exposure. CONCLUSIONS: Even among vulnerable populations such as adults with chronic disease, during pandemic conditions like COVID-19, many people may exhibit-or even increase slightly in-psychological and spiritual resilience. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
COVID-19 , Chronic Disease , Pandemics , Religion and Psychology , Adult , Aged , COVID-19/epidemiology , COVID-19/psychology , Chronic Disease/epidemiology , Chronic Disease/psychology , Female , Humans , Longitudinal Studies , Male , Middle Aged , Prospective Studies , Resilience, Psychological , Spirituality , United States/epidemiology
16.
J Res Health Sci ; 21(2): e00515, 2021 Apr 24.
Article in English | MEDLINE | ID: covidwho-1326172

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a newly identified coronavirus. Our knowledge about the survival rate and prognostic factors of the disease is not established well. Therefore, this study aimed to identify the risk factors associated with the survival of COVID-19 cases in Hamadan province, West of Iran. STUDY DESIGN: A retrospective cohort study METHODS: This retrospective cohort study was performed in Hamadan province, West of Iran. The study included patients that referred to the provincial hospitals from February 20 to September 20, 2020. The follow-up of each subject was calculated from the date of onset of respiratory symptoms to the date of death. Demographic and clinical characteristics were extracted from patients' medical records. Kaplan-Meier method, Flemington-Harrington test, and Cox regression were used for data analysis. RESULTS: The overall 1, 5, 10, 20, 30 and 49-day survival rates were estimated at 99.57%, 95.61%, 91.15%, 87.34%, 86.91%, and 86.74%, respectively. Furthermore, survival time showed a significant association with age, gender, history of traveling to contaminated areas, co-morbidity, neoplasms, chronic diseases, and hospital units. CONCLUSION: In conclusion, elderly people, male gender, and comorbidities presented a greater risk of death. Therefore, it is important to pay more attention to this group of people to reduce the incidence and consequences after infection.


Subject(s)
COVID-19/mortality , Chronic Disease/epidemiology , Hospitalization , Neoplasms/epidemiology , Pandemics , Travel , Adult , Age Factors , Aged , COVID-19/diagnosis , COVID-19/epidemiology , Comorbidity , Hospital Mortality , Hospitals , Humans , Iran/epidemiology , Male , Middle Aged , Prognosis , Registries , Retrospective Studies , Risk Factors , SARS-CoV-2 , Sex Factors , Survival Analysis , Survival Rate
18.
Mayo Clin Proc ; 96(10): 2528-2539, 2021 10.
Article in English | MEDLINE | ID: covidwho-1294052

ABSTRACT

OBJECTIVE: To identify risk factors associated with severe COVID-19 infection in a defined Midwestern US population overall and within different age groups. PATIENTS AND METHODS: We used the Rochester Epidemiology Project research infrastructure to identify persons residing in a defined 27-county Midwestern region who had positive results on polymerase chain reaction tests for COVID-19 between March 1, 2020, and September 30, 2020 (N=9928). Age, sex, race, ethnicity, body mass index, smoking status, and 44 chronic disease categories were considered as possible risk factors for severe infection. Severe infection was defined as hospitalization or death caused by COVID-19. Associations between risk factors and severe infection were estimated using Cox proportional hazard models overall and within 3 age groups (0 to 44, 45 to 64, and 65+ years). RESULTS: Overall, 474 (4.8%) persons developed severe COVID-19 infection. Older age, male sex, non-White race, Hispanic ethnicity, obesity, and a higher number of chronic conditions were associated with increased risk of severe infection. After adjustment, 36 chronic disease categories were significantly associated with severe infection. The risk of severe infection varied significantly across age groups. In particular, persons 0 to 44 years of age with cancer, chronic neurologic disorders, hematologic disorders, ischemic heart disease, and other endocrine disorders had a greater than 3-fold increased risk of severe infection compared with persons of the same age without those conditions. Associations were attenuated in older age groups. CONCLUSION: Older persons are more likely to experience severe infections; however, severe cases occur in younger persons as well. Our data provide insight regarding younger persons at especially high risk of severe COVID-19 infection.


Subject(s)
COVID-19/epidemiology , Health Status Disparities , Severity of Illness Index , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Child , Child, Preschool , Chronic Disease/epidemiology , Comorbidity , Humans , Infant , Male , Middle Aged , Midwestern United States , Risk Factors , Young Adult
20.
PLoS One ; 16(6): e0252383, 2021.
Article in English | MEDLINE | ID: covidwho-1264213

ABSTRACT

Estimation of disease prevalence at sub-city neighborhood scale allows early and targeted interventions that can help save lives and reduce public health burdens. However, the cost-prohibitive nature of highly localized data collection and sparsity of representative signals, has made it challenging to identify neighborhood scale prevalence of disease. To overcome this challenge, we utilize alternative data sources, which are both less sparse and representative of localized disease prevalence: using query data from a large commercial search engine, we identify the prevalence of respiratory illness in the United States, localized to census tract geographic granularity. Focusing on asthma and Chronic Obstructive Pulmonary Disease (COPD), we construct a set of features based on searches for symptoms, medications, and disease-related information, and use these to identify illness rates in more than 23 thousand tracts in 500 cities across the United States. Out of sample model estimates from search data alone correlate with ground truth illness rate estimates from the CDC at 0.69 to 0.76, with simple additions to these models raising those correlations to as high as 0.84. We then show that in practice search query data can be added to other relevant data such as census or land cover data to boost results, with models that incorporate all data sources correlating with ground truth data at 0.91 for asthma and 0.88 for COPD.


Subject(s)
Asthma/epidemiology , Information Seeking Behavior , Pulmonary Disease, Chronic Obstructive/epidemiology , Residence Characteristics/statistics & numerical data , Censuses , Chronic Disease/epidemiology , Humans , Models, Statistical , Prevalence , United States/epidemiology
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