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1.
Probl Endokrinol (Mosk) ; 68(3): 4-15, 2022 04 01.
Article in Russian | MEDLINE | ID: covidwho-2203929

ABSTRACT

BACKGROUND: The COVID-19 pandemic has accelerated the development of telemedicine technologies. Today there is evidence of the successful use of telemedicine in various fields of health care, in particular in endocrinology. At the same time, there is not enough information for effective integration of telemedicine into the management of patients with various endocrinopathies. AIM: The aim of this study is a clinical and demographic assessment of the structure of telemedicine consultations (TMC) conducted at the Endocrinology Research Centre in 2020-2021. MATERIALS AND METHODS: A single-stage, single-center retrospective study was conducted. The study included all patients who received at least one TMC at the Endocrinology Research Centre in 2020-2021. Clinical and demographic information was analyzed (gender, age of patients, region of residence, ICD-10 code). All patients signed voluntary informed consent for TMC. The obtained data were processed using the Microsoft Office 2013 software package. RESULTS: In 2020, 1,548 TMC were held, in 2021 - 4180 TMC. Among adults, women predominated in the structure of referrals (83-86%), among children there is a tendency towards equivalent referrals for boys and girls (in 2021 - 45% and 55%, respectively). The median age of adult patients in 2021 was 38 years [31; 53], among children - 11 years [7; 14]. In 2020, residents of 74 regions of the Russian Federation applied for TMC, in 2021 - of 82 regions. There is a tendency towards the prevalence of patients from the Central, Volga, Southern and North Caucasian federal districts in the TMC structure. Diseases of the thyroid gland predominated in the nosological structure of TMC. CONCLUSION: TMC turned out to be in demand in patients with a wide variety of endocrinopathies. It is important to conduct further analysis of both the TMC market and the effectiveness of remote counseling for various nosologies to determine the place of telemedicine in the modern healthcare structure and to introduce TMK into the system of clinical guidelines and programs of territorial compulsory medical insurance funds.


Subject(s)
COVID-19 , Telemedicine , Adult , COVID-19/epidemiology , Child , Demography , Female , Humans , Male , Pandemics , Referral and Consultation , Retrospective Studies
2.
BMC Prim Care ; 23(1): 289, 2022 11 19.
Article in English | MEDLINE | ID: covidwho-2139153

ABSTRACT

OBJECTIVES: Remote consultations were common in general practice during the COVID-19 pandemic. This approach may have affected access to GP care for people with low socio-economic status: this group has a high prevalence of chronic conditions and a higher mortality rate due to COVID-19. This study explores the association of sociodemographic and health factors with the decision to contact a GP practice, and care utilisation, among patients in low-income neighbourhoods in the Netherlands. DESIGN: Cross-sectional survey study. SETTING: General practice in low-income neighbourhoods in the Netherlands. PARTICIPANTS: Patients from low-income neighbourhoods were selected from fourteen general practices on the basis of ethnic background, chronic disease or health literacy. Participants were stratified according to categories of these background characteristics to obtain equal numbers per category. A total of 213 surveys were retained for analysis. MAIN OUTCOME MEASURES: Need for GP contact, decision to contact a GP practice, and GP service utilisation. RESULTS: Forty-five percent (N = 88) of the participants experienced health problems for which they wished to consult their GP at the start of the outbreak of COVID-19. A majority of them (81%) had contact with a GP service. The need to contact the GP was significantly associated with financial difficulties (OR 2.20 CI (1.10 to 4.39)). An interaction effect was found of health literacy with concerns about COVID-19 with in respondents with low health literacy a significant association between concerns about COVID-19 and a need for a GP appointment (OR 5.33 CI (2.09 to 13.59)) and absence of a significant association in the higher health literacy group (OR 1.14 CI (0.51 to 2.56)) . Moreover, 56% (N = 74) of the participants received remote care at least one time during the first wave of COVID-19. Female participants used remote care more often (OR 3.22 CI (1.57 to 6.59)) and participants aged 50 and over used remote care less often (OR 0.46 CI (0.21 to 0.97)). CONCLUSION: Many patients in low-income neighbourhoods were able to consult a GP, often remotely. However from the equity perspective, access to GP care should be safeguarded for patients with health problems, financial difficulties and low health literacy because of their greater need to consult a GP during times of crisis.


Subject(s)
COVID-19 , Health Services Accessibility , Telemedicine , Aged , Female , Humans , Middle Aged , COVID-19/epidemiology , Cross-Sectional Studies , Demography , Pandemics , Poverty , Residence Characteristics , General Practice
3.
BMC Health Serv Res ; 22(1): 1434, 2022 Nov 28.
Article in English | MEDLINE | ID: covidwho-2139271

ABSTRACT

BACKGROUND: Little is known about the experience of receiving in-person and virtual clinical health care services during the COVID-19 pandemic for Canadian children with developmental disabilities and delays facing multiple layers of vulnerability (e.g., low income, low educational attainment families). We examined the relationship between socio-demographic factors and the receipt of these services (physical and mental health services) during COVID-19 for Canadian children with these conditions. METHODS: Data collected in Canada for the Global Report on Developmental Delays, Disorders and Disabilities were used. The survey: (1) was developed and disseminated in collaboration with caregivers of children with disabilities, (2) included topics such as response to the pandemic and receipt of services and supports, and (3) documented the experiences of a non-random convenience sample of caregivers of children (any age) with these conditions during and prior to the pandemic. We used four logistic regression models to assess the association between socio-demographic factors and receipt of services. RESULTS: Being a single parent, having low educational attainment (high school or less), having low income (making less than $40,000 per year), working less than full time (working part-time, working reduced hours due to COVID, retired, stay home parent or student), as well as male gender and older age of the child with disability were factors associated with decreased likelihood of receiving services. CONCLUSION: Our findings point to the need for tailoring services for families of children with disabilities, particularly low socioeconomic status families, to ensure continuity of care during public health emergencies.


Subject(s)
COVID-19 , Disabled Children , Mental Health Services , Child , Male , Humans , COVID-19/epidemiology , Pandemics , Canada/epidemiology , Demography , Delivery of Health Care
4.
BMJ Open ; 12(11): e063159, 2022 11 07.
Article in English | MEDLINE | ID: covidwho-2108282

ABSTRACT

OBJECTIVE: Healthcare workers (HCWs) are at higher risk of SARS-CoV-2 infection than the general population. This group is pivotal to healthcare system resilience during the COVID-19, and future, pandemics. We investigated demographic, social, behavioural and occupational risk factors for SARS-CoV-2 infection among HCWs. DESIGN/SETTING/PARTICIPANTS: HCWs enrolled in a large-scale sero-epidemiological study at a UK university teaching hospital were sent questionnaires spanning a 5-month period from March to July 2020. In a retrospective observational cohort study, univariate logistic regression was used to assess factors associated with SARS-CoV-2 infection. A Least Absolute Shrinkage Selection Operator regression model was used to identify variables to include in a multivariate logistic regression model. RESULTS: Among 2258 HCWs, highest ORs associated with SARS-CoV-2 antibody seropositivity on multivariate analysis were having a household member previously testing positive for SARS-CoV-2 antibodies (OR 6.94 (95% CI 4.15 to 11.6); p<0.0001) and being of black ethnicity (6.21 (95% CI 2.69 to 14.3); p<0.0001). Occupational factors associated with a higher risk of seropositivity included working as a physiotherapist (OR 2.78 (95% CI 1.21 to 6.36); p=0.015) and working predominantly in acute medicine (OR 2.72 (95% CI 1.57 to 4.69); p<0.0001) or medical subspecialties (not including infectious diseases) (OR 2.33 (95% CI 1.4 to 3.88); p=0.001). Reporting that adequate personal protective equipment (PPE) was 'rarely' available had an OR of 2.83 (95% CI 1.29 to 6.25; p=0.01). Reporting attending a handover where social distancing was not possible had an OR of 1.39 (95% CI 1.02 to 1.9; p=0.038). CONCLUSIONS: The emergence of SARS-CoV-2 variants and potential vaccine escape continue to threaten stability of healthcare systems worldwide, and sustained vigilance against HCW infection remains a priority. Enhanced risk assessments should be considered for HCWs of black ethnicity, physiotherapists and those working in acute medicine or medical subspecialties. Workplace risk reduction measures include ongoing access to high-quality PPE and effective social distancing measures.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , COVID-19/epidemiology , Retrospective Studies , Health Personnel , Risk Factors , Antibodies, Viral , United Kingdom/epidemiology , Demography
5.
Int J Environ Res Public Health ; 19(21)2022 Nov 04.
Article in English | MEDLINE | ID: covidwho-2099535

ABSTRACT

The current study aimed to identify demographic and COVID experience predictors for COVID-19 risk perception among Chinese residents in Canada. A final sample of 653 participants aged 18 and up completed an online survey in simplified Chinese during the peak of the first wave of COVID-19 (25 April-10 June 2020). After removing those with missing data on demographic covariates, as missing data cannot be imputed, 444 were included in the structural equation model, and COVID-19 risk perception was indexed by three outcome variables: self-infection risk perception (i.e., likelihood of personal infection of COVID-19); threat perception (i.e., whether the pandemic is a real threat); and future infection rate prediction (i.e., a latent variable for community, Ontario, Canada, and World infection rate predictions). Predictors included demographic (i.e., income, gender, education, age, household size, employment status, and life satisfaction) and COVID experience variables (i.e., personal connection with confirmed or suspected COVID-19 cases, self-isolation experience, perceived anti-Chinese discrimination, and confusion over COVID-19 information). In the structural equation model, we found increased risk perception for the following demographic and COVID experience predictors; women, relatively higher education, living alone, working in a medical field, lower in life satisfaction, having personal connection with confirmed or suspected COVID-19 cases, with perceived anti-Chinese discrimination, or showing high confusion over COVID-19 information.


Subject(s)
COVID-19 , Female , Humans , COVID-19/epidemiology , SARS-CoV-2 , Surveys and Questionnaires , Perception , Demography , Ontario/epidemiology
6.
Psychiatr Danub ; 32(3-4): 482-490, 2020.
Article in English | MEDLINE | ID: covidwho-2100769

ABSTRACT

BACKGROUND: This study aimed to know the effect of the Corona pandemic on mental health among Al Ain University students and its relationship to some demographic variables (gender, academic level age, college, and marital status). SUBJECT AND METHOD: The sample of the study consisted of (258) male and female students from Al Ain University students from humanities and scientific colleges. The modified Mental Health Scale: R S CL-90 Symptoms Check List was used, which was developed by Derogatis, Lipman, and Linocovi, it included (74) items divided into seven dimensions: physical symptoms, obsessive-compulsive disorder, reactive sensitivity, depression, anxiety, enmity, and fear anxiety, after modifying it for the purposes of the study. RESULTS: The results showed that the level of mental health of the sample as a whole was very high. The results also showed that the level of mental health was low for females when compared to males. The second-year students were less in the level of mental health compared to the rest of the levels. For students who were less than twenty years old, the level of mental health was low compared to those over twenty years old. No differences were found in the level of mental health among students of scientific and human colleges. As for the social situation, the level of mental health among single students was low compared to married people. CONCLUSION: The results of the study indicate that the higher the average mental problems (the dimensions of the mental health level), the lower of the mental health problems. Although the level of mental health was varied according to the demographic variables.


Subject(s)
COVID-19 , Demography , Depression , Female , Humans , Male , Mental Health , Pandemics , Students , Surveys and Questionnaires , Universities , Young Adult
8.
PLoS One ; 17(10): e0274630, 2022.
Article in English | MEDLINE | ID: covidwho-2079735

ABSTRACT

The Covid-19 pandemic has led to the rise of digitally enabled remote work with consequences for the global division of labour. Remote work could connect labour markets, but it might also increase spatial polarisation. However, our understanding of the geographies of remote work is limited. Specifically, in how far could remote work connect employers and workers in different countries? Does it bring jobs to rural areas because of lower living costs, or does it concentrate in large cities? And how do skill requirements affect competition for employment and wages? We use data from a fully remote labour market-an online labour platform-to show that remote platform work is polarised along three dimensions. First, countries are globally divided: North American, European, and South Asian remote platform workers attract most jobs, while many Global South countries participate only marginally. Secondly, remote jobs are pulled to large cities; rural areas fall behind. Thirdly, remote work is polarised along the skill axis: workers with in-demand skills attract profitable jobs, while others face intense competition and obtain low wages. The findings suggest that agglomerative forces linked to the unequal spatial distribution of skills, human capital, and opportunities shape the global geography of remote work. These forces pull remote work to places with institutions that foster specialisation and complex economic activities, i. e. metropolitan areas focused on information and communication technologies. Locations without access to these enabling institutions-in many cases, rural areas-fall behind. To make remote work an effective tool for economic and rural development, it would need to be complemented by local skill-building, infrastructure investment, and labour market programmes.


Subject(s)
COVID-19 , Emigration and Immigration , Humans , Population Dynamics , Demography , Urban Population , Pandemics , Developing Countries , COVID-19/epidemiology , Economics
9.
Int J Environ Res Public Health ; 19(19)2022 Oct 01.
Article in English | MEDLINE | ID: covidwho-2066012

ABSTRACT

The Coronavirus disease 2019 (COVID-19) has greatly affected mental health worldwide. This study aimed to identify sociodemographic and psychosocial factors that influence the level of resilience among Singaporeans amidst the pandemic. An online questionnaire was administered to Singaporeans and permanent residents aged 21 and above. The online questionnaire collected information on sociodemographics, infection, and contact with COVID-19. Psychosocial variables-specifically optimism, self-efficacy, hope, and resilience-were also assessed through validated questionnaires. A total of 404 responses were collected in this study. Men were reported to have higher resilience compared to women (28.13 vs. 25.54, p-value < 0.001). Married individuals were observed to have higher resilience compared to their single counterparts (27.92 vs. 25.77, p-value < 0.001). Interestingly, participants who knew of family members/friends who had contracted COVID-19 were reported to be more resilient than those who did not (28.09 vs. 26.19, p-value = 0.013). Optimism, self-efficacy, and hope were also found to be associated with higher resilience (p-value < 0.001). In conclusion, one's sex, marital status, contact with COVID-19, level of optimism, self-efficacy, and hope were shown to significantly affect resilience. Given the long-drawn nature of the COVID-19 pandemic, interventions should aim to improve optimism, self-efficacy, and hopefulness in the community.


Subject(s)
COVID-19 , Resilience, Psychological , COVID-19/epidemiology , Demography , Female , Humans , Male , Mental Health , Pandemics
10.
PLoS One ; 17(10): e0274797, 2022.
Article in English | MEDLINE | ID: covidwho-2054347

ABSTRACT

The objective of this study is to compare the demographic characteristics and symptoms in pregnant and postpartum women who died from Severe Acute Respiratory Syndrome (SARS) caused by COVID-19 or by nonspecific cause in different states of Brazil. This is a retrospective cohort study and the analysis was conducted on SARS death records between 02/16/2020 and 04/17/2021, obtained from the Information System for the Epidemiological Surveillance of Influenza (Sistema de Informação da Vigilância Epidemiológica da Gripe, SIVEP-Gripe). Pregnant and postpartum women, aged between 10 and 55 years, who died from SARS, were included and classified into two groups: SARS due to confirmed COVID-19 or SARS due to nonspecific cause. The cases were analyzed according to the women's demographic and epidemiological characteristics, clinical symptoms, risk factors and disease evolution. As results, 19,333 pregnant and postpartum women were identified. From these, 1,279 died (1,026 deaths from COVID-19 and 253 deaths from SARS with nonspecific cause). The groups showed significant differences in age, education, race, and occurrence of obesity and chronic lung disease. The group of women who died from confirmed COVID-19 presented a significantly higher frequency of symptoms of fever, cough, fatigue, loss of taste, and loss of smell, as well as a higher rate of admission to the intensive care unit (ICU). Data analysis draws attention to the high number of cases of SARS without a causal diagnosis, the low access to ICU and orotracheal intubation (OTI), which might be explained by the demographic and regional inequalities in the access to healthcare.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Adolescent , Adult , Brazil/epidemiology , COVID-19/epidemiology , Child , Demography , Female , Humans , Middle Aged , Postpartum Period , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Retrospective Studies , SARS-CoV-2 , Young Adult
11.
Nat Commun ; 13(1): 5780, 2022 10 02.
Article in English | MEDLINE | ID: covidwho-2050383

ABSTRACT

Vaccination constitutes the best long-term solution against Coronavirus Disease-2019; however, vaccine-derived immunity may not protect all groups equally, and the durability of protective antibodies may be short. We evaluate Spike-antibody responses following BNT162b2 or ChAdOx1-S vaccination amongst SARS-CoV2-naive adults across England and Wales enrolled in a prospective cohort study (Virus Watch). Here we show BNT162b2 recipients achieved higher peak antibody levels after two doses; however, both groups experience substantial antibody waning over time. In 8356 individuals submitting a sample ≥28 days after Dose 2, we observe significantly reduced Spike-antibody levels following two doses amongst individuals reporting conditions and therapies that cause immunosuppression. After adjusting for these, several common chronic conditions also appear to attenuate the antibody response. These findings suggest the need to continue prioritising vulnerable groups, who have been vaccinated earliest and have the most attenuated antibody responses, for future boosters.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Antibodies, Viral , Antibody Formation , BNT162 Vaccine , COVID-19/prevention & control , Cohort Studies , Demography , Humans , Prospective Studies , RNA, Viral , SARS-CoV-2 , Vaccination
12.
Pan Afr Med J ; 42: 268, 2022.
Article in English | MEDLINE | ID: covidwho-2044195

ABSTRACT

The current Coronavirus Disease 2019 (COVID-19) pandemic that emerged in December 2019 in China continues to claim a thousand lives worldwide. This study aimed to report characteristics and in-hospital outcomes of a Moroccan COVID-19 cohort, and identify factors which predispose patients to hospitalization and mortality from COVID-19. We conducted a cross-sectional study of symptomatic COVID-19 patients referred to COVID-19 ward of the Settat Provincial Hospital, during October 2020. A confirmed COVID-19 case was defined by a positive detection of SARS-CoV-2 genome using real-time RT-PCR assay performed on nasopharyngeal swabs. Patients´ demographic and clinical characteristics were collected and analyzed using SPSS V22.0. Univariate followed by multivariate logistic regression analysis was performed to identify factors associated with mortality due to COVID-19. In total, 269 patients were reported. The median age was 64 years [IQR 54-73], 48.7% were elderly (≥ 65 years), 51.7% were men, and the case-fatality rate (CFR) was 5.58%. Males had a higher CFR (6.5%) than females (4.6%). In deceased people: 60% males, 73.3% were elderly, and oxygen saturation values of 90% or less on admission were more frequent (86.7%) than in recovered ones (10.9%). Most patients (80.3%) had at least one comorbidity: 100% of deaths, 59% older than 60 years, CFR was 6.94% and the most prevalent diseases were diabetes (54.6%), hypertension (41.7%), and cardiac disease (40.7%). The most common symptoms on presentation were dyspnea (67.7%), fever (65.4%) and cough (58.4%). Multivariable logistic regression analysis showed that only older age (AOR: 10.860, 95% CI: 3.382-34.86; p<0.001) and cardiac disease (AOR: 0.244, 95% CI: 0.074-0.799; p=0.02) were associated with higher mortality rates. Categorizing patients at admission according to risk factors identified by multivariate and also univariate analyses (mainly dyspnea) is essential to help in deciding the hospitalization priority and the strategy that will eventually reduce death risk.


Subject(s)
COVID-19 , Heart Diseases , Male , Female , Humans , Aged , Middle Aged , COVID-19/diagnosis , SARS-CoV-2 , Cross-Sectional Studies , Morocco/epidemiology , Hospitalization , Comorbidity , Risk Factors , Retrospective Studies , Dyspnea , Hospitals , Demography
13.
Int J Environ Res Public Health ; 19(19)2022 Sep 20.
Article in English | MEDLINE | ID: covidwho-2043706

ABSTRACT

As the COVID-19 pandemic continues, an increasing number of different research studies focusing on various aspects of the pandemic are emerging. Most of the studies focus on the medical aspects of the pandemic, as well as on the impact of COVID-19 on various areas of life; less emphasis is put on analyzing the influence of socio-environmental factors on the spread of the pandemic. In this paper, using the geographically weighted regression method, the extent to which demographic, social, and environmental factors explain the number of cases of SARS-CoV-2 is explored. The research was performed for the case-study area of Poland, considering the administrative division of the country into counties. The results showed that the demographic factors best explained the number of cases of SARS-CoV-2; the social factors explained it to a medium degree; and the environmental factors explained it to the lowest degree. Urban population and the associated higher amount and intensity of human contact are the most influential factors in the development of the COVID-19 pandemic. The analysis of the factors related to the areas burdened by social problems resulting primarily from the economic exclusion revealed that poverty-burdened areas are highly vulnerable to the development of the COVID-19 pandemic. Using maps of the local R2 it was possible to visualize how the relationships between the explanatory variables (for this research-demographic, social, and environmental factors) and the dependent variable (number of cases of SARS-CoV-2) vary across the study area. Through the GWR method, counties were identified as particularly vulnerable to the pandemic because of the problem of economic exclusion. Considering that the COVID-19 pandemic is still ongoing, the results obtained may be useful for local authorities in developing strategies to counter the pandemic.


Subject(s)
COVID-19 , COVID-19/epidemiology , Demography , Humans , Pandemics , SARS-CoV-2 , Spatial Regression
14.
PLoS Negl Trop Dis ; 16(9): e0010735, 2022 09.
Article in English | MEDLINE | ID: covidwho-2039248

ABSTRACT

The epidemic of COVID-19 has shown different developments in Africa compared to the other continents. Three different approaches were used in this study to analyze this situation. In the first part, basic statistics were performed to estimate the contribution of the elderly people to the total numbers of cases and deaths in comparison to the other continents; Similarly, the health systems capacities were analysed to assess the level of underreporting. In the second part, differential equations were reconstructed from the epidemiological time series of cases and deaths (from the John Hopkins University) to analyse the dynamics of COVID-19 in seventeen countries. In the third part, the time evolution of the contact number was reconstructed since the beginning of the outbreak to investigate the effectiveness of the mitigation strategies. Results were compared to the Oxford stringency index and to the mobility indices of the Google Community Mobility Reports. Compared to Europe, the analyses show that the lower proportion of elderly people in Africa enables to explain the lower total numbers of cases and deaths by a factor of 5.1 on average (from 1.9 to 7.8). It corresponds to a genuine effect. Nevertheless, COVID-19 numbers are effectively largely underestimated in Africa by a factor of 8.5 on average (from 1.7 to 20. and more) due to the weakness of the health systems at country level. Geographically, the models obtained for the dynamics of cases and deaths reveal very diversified dynamics. The dynamics is chaotic in many contexts, including a situation of bistability rarely observed in dynamical systems. Finally, the contact number directly deduced from the epidemiological observations reveals an effective role of the mitigation strategies on the short term. On the long term, control measures have contributed to maintain the epidemic at a low level although the progressive release of the stringency did not produce a clear increase of the contact number. The arrival of the omicron variant is clearly detected and characterised by a quick increase of interpeople contact, for most of the African countries considered in the analysis.


Subject(s)
COVID-19 , Africa/epidemiology , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Demography , Humans , SARS-CoV-2
15.
Expert Rev Respir Med ; 16(9): 1017-1021, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2037276

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) may result in rapid onset of hypoxemic respiratory failure. This study aimed to characterize the factors and outcomes associated with prolonged hypoxia in patients with COVID-19. Prolonged severe hypoxia (PSH) was defined as hypoxia requiring ≥6 L/min of oxygen by nasal cannula or equivalent for more than 10 days. RESEARCH DESIGN AND METHODS: This study was designed as a single-center retrospective analysis. Multivariable logistic regression was utilized to assess factors associated with PSH. RESULTS: The sample included 554 patients with 117 (21%) having PSH. Median length of stay of patients with PSH was significantly longer (median IQR: 18 days vs 6 days, p < 0.0001). Patients with PSH had significantly higher rates of venous thromboembolism (p < 0.0001) and major bleeding (p < 0.004). The presence of cirrhosis (OR 3.32, 95% CI [1.02 to 10.83]) and hypertension (OR 1.99, 95% CI [1.12 to 3.53]) were independently associated with PSH, while outpatient use of anti-platelet agents had an inverse association (OR 0.57, 95% CI [0.36 to 0.91]). CONCLUSION: PSH is associated with increased length of stay, morbidity, and mortality. Hypertension and liver cirrhosis were significantly associated with higher odds of PSH, while use of anti-platelet therapy had a protective effect.


Subject(s)
COVID-19 , Hypoxia , Humans , COVID-19/complications , Demography , Hypertension/epidemiology , Hypoxia/epidemiology , Hypoxia/therapy , Retrospective Studies , Risk Factors
16.
Sci Rep ; 12(1): 15703, 2022 09 20.
Article in English | MEDLINE | ID: covidwho-2036882

ABSTRACT

Severe Coronavirus disease 2019 (COVID-19) is associated with several pre-existing comorbidities and demographic factors. Similar factors are linked to critical sepsis and acute respiratory distress syndrome (ARDS). We hypothesized that age and comorbidities are more generically linked to critical illness mortality than a specific disease state. We used national databases to identify ICU patients and to retrieve comorbidities. The relative importance of risk factors for 60-day mortality was evaluated using the interaction with disease group (Sepsis, ARDS or COVID-19) in logistic regression models. We included 32,501 adult ICU patients. In the model on 60-day mortality in sepsis and COVID-19 there were significant interactions with disease group for age, sex and asthma. In the model on 60-day mortality in ARDS and COVID-19 significant interactions with cohort were found for acute disease severity, age and chronic renal failure. In conclusion, age and sex play particular roles in COVID-19 mortality during intensive care but the burden of comorbidity was similar between sepsis and COVID-19 and ARDS and COVID-19.


Subject(s)
COVID-19 , Respiratory Distress Syndrome , Sepsis , Adult , COVID-19/epidemiology , Comorbidity , Demography , Humans , Intensive Care Units , Respiratory Distress Syndrome/epidemiology , Sepsis/complications , Sepsis/epidemiology
17.
Wiad Lek ; 75(8 pt 1): 1868-1875, 2022.
Article in English | MEDLINE | ID: covidwho-2026697

ABSTRACT

OBJECTIVE: The aim: To study the structure of cognitive impairment in patients who were hospitalized with moderate to severe COVID-19 pneumonia. Investigate the correlation with demographic, biochemical parameters, as well as the emotional state of the patient. PATIENTS AND METHODS: Materials and methods: Cognitive functions were assessed using the MOCA test. PHQ-9 depression and GAD-7 anxiety questionnaires were used to study psychopathological symptoms. Demographic, clinical and laboratory data were extracted from medical records. RESULTS: Results: Cognitive performance is impaired in 94% of patients with COVID-19. This allows to suggest that COVID-19 has a serious impact on cognition, especially in elder people. Among different domains only visuospatial and executive functioning, abstract thinking, attention and delayed recall were severely impaired, while other domains stayed relatively intact. Patients after COVID-19 also tend to have a mild depressive and anxiety state. Anxiety levels were higher than depressive levels, but not connected to cognitive functioning. Also, there was seen a positive correlation between anxiety and pO2 and negative between anxiety and comorbid cardiac pathology. However, this requires further studies to reveal. Another interesting finding was non-linear relationship between cognitive performance and depression, that allows to suggest rapidly evolving depressive mood in persons with severe cognitive impairment after COVID-19. Cognitive and emotional state of patients after COVID-19 was also highly connected with working status. CONCLUSION: Conclusion: Significant cognitive impairment was presented in almost all patients with COVID-19. There was a selective impairment in domains of visuospatial/ executive functioning, abstract thinking, attention and delayed recall. Conclusions: Significant cognitive impairment was presented in almost all patients with COVID-19. There was a selective impairment in domains of visuospatial/ executive functioning, abstract thinking, attention and delayed recall.


Subject(s)
COVID-19 , Cognitive Dysfunction , Aged , COVID-19/complications , COVID-19/epidemiology , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/etiology , Demography , Depression/epidemiology , Depression/etiology , Depression/psychology , Humans , Neuropsychological Tests
18.
Int J Equity Health ; 21(1): 122, 2022 08 30.
Article in English | MEDLINE | ID: covidwho-2021297

ABSTRACT

BACKGROUND: The equality in the distribution of vaccines between and within countries along with follow sanitation tips and observe social distance, are effective strategies to rid the world of COVID-19 pandemic. Inequality in the distribution of COVID-19 vaccine, in addition to causing inequity to the population health, has a significant impact on the process of economic recovery. METHODS: All published original papers on the inequality of Covid-19 vaccine distribution and the factors affecting it were searched in PubMed, Web of Science, Scopus and ProQuest databases between December 2020 to 30 May 2022. Selection of articles, extraction of their data and qualitative assessment (by STROBE) were performed by two researchers separately. Data graphing form was used to extract detailed data from each study and then, the collected data were classified. RESULTS: A total of 4623 articles were evaluated. After removing duplicates and screening the title, abstract and full text of articles, 22 articles were selected and entered into the study. Fifteen (68.17%) studies were conducted in the United States, three (13.64%) in Europe, three (13.64%) in Asia and one (6.66%) in Oceania. Factors affecting the inequality in the distribution of COVID-19 vaccine were classified into macro and micro levels determinants. CONCLUSION: Macro determinants of inequality in the Covid-19 vaccine distribution were consisted of economic (stability and country's economic status, Gross Domestic Product (GDP) per capita, financial support and human development index), infrastructure and health system (appropriate information system, functional cold chains in vaccine transport, transport infrastructure, medical and non-medical facilities per capita, healthcare access and quality), legal and politics (vaccination allocation rules, health policies, political ideology and racial bias), and epidemiologic and demographic factors (Covid-19 incidence and deaths rate, life expectancy, vulnerability to Covid-19, working in medical setting, comorbidities, social vulnerability, incarceration and education index). Moreover, micro/ individual level factors were included in economic (household's income, home ownership, employment, poverty, access to healthy food and residency in the deprived areas) and demographic and social characteristics (sex, age, race, ethnic, religion, disability, location (urban/rural) and insurance coverage).


Subject(s)
COVID-19 Vaccines , COVID-19 , Healthcare Disparities , Asia , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/supply & distribution , Demography , Europe , Healthcare Disparities/statistics & numerical data , Humans , Oceania , Socioeconomic Factors , United States
19.
Health Rep ; 33(8): 3-18, 2022 08 18.
Article in English | MEDLINE | ID: covidwho-2002830

ABSTRACT

Background: Recently, the Canadian 24-Hour Movement Guidelines for Adults were released, and included a revised physical activity (PA) recommendation. The recommendation of 150 minutes per week of moderate-to-vigorous intensity PA (MVPA) was revised, from requiring that MVPA be accrued in bouts of 10 minutes or more (bouted) to having no bout requirement (non-bouted). The objective of this study was to assess whether there were differences in sociodemographic, health and fitness characteristics of Canadians who met the bouted and non-bouted PA recommendations. Data and methods: Using adult (aged 18 to 79 years) accelerometer data from three combined cycles of the nationally representative Canadian Health Measures Survey (N = 7,102), this study compared adherence to the bouted and non-bouted recommendations. Differences in sociodemographic, health and fitness measures were assessed using independent t-tests and chi-squares. Multivariate linear and logistic regressions controlling for age, sex, household education and smoking examined associations with health and fitness measures. Results: More adults met the PA recommendation using the non-bouted versus bouted (45.3% vs. 18.5%) requirement. Characteristics of those who met the bouted and only the non-bouted recommendations were similar. Exceptions among those who met only the non-bouted recommendation compared with meeting the bouted recommendation included fewer adults aged 65 years and older; lower MVPA, recreation PA and transport PA; and higher sedentary time, light PA and grip strength. Interpretation: Although the removal of the 10-minute bout requirement increased the proportion of Canadian adults who met the PA recommendation, there were no substantial differences in the sociodemographic and health characteristics of the populations captured by the bouted and non-bouted definitions. Results help to inform the transition in reporting for PA surveillance.


Subject(s)
Accelerometry , Exercise , Accelerometry/methods , Adult , Canada , Cross-Sectional Studies , Demography , Humans
20.
BMJ ; 378: o2023, 2022 08 19.
Article in English | MEDLINE | ID: covidwho-2001812

Subject(s)
Demography , Colombia , Humans
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