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1.
PLoS One ; 17(1): e0260836, 2022.
Article in English | MEDLINE | ID: covidwho-1613339

ABSTRACT

In the era of open data, Poisson and other count regression models are increasingly important. Still, conventional Poisson regression has remaining issues in terms of identifiability and computational efficiency. Especially, due to an identification problem, Poisson regression can be unstable for small samples with many zeros. Provided this, we develop a closed-form inference for an over-dispersed Poisson regression including Poisson additive mixed models. The approach is derived via mode-based log-Gaussian approximation. The resulting method is fast, practical, and free from the identification problem. Monte Carlo experiments demonstrate that the estimation error of the proposed method is a considerably smaller estimation error than the closed-form alternatives and as small as the usual Poisson regressions. For counts with many zeros, our approximation has better estimation accuracy than conventional Poisson regression. We obtained similar results in the case of Poisson additive mixed modeling considering spatial or group effects. The developed method was applied for analyzing COVID-19 data in Japan. This result suggests that influences of pedestrian density, age, and other factors on the number of cases change over periods.


Subject(s)
COVID-19/epidemiology , Humans , Japan/epidemiology , Markov Chains , Models, Statistical , Monte Carlo Method , Normal Distribution , Poisson Distribution , Regression Analysis , SARS-CoV-2/pathogenicity , Spatial Analysis , Spatio-Temporal Analysis
2.
Indian J Pharmacol ; 53(6): 499-510, 2021.
Article in English | MEDLINE | ID: covidwho-1603884

ABSTRACT

BACKGROUND: Till now, no meta-analysis is available to address the clinical profile, risk factors, different interventions, and outcomes among COVID-19-associated rhino-orbito-cerebral mucormycosis (C-ROCM) cases. MATERIALS AND METHODS: Eight literature databases were screened using appropriate keywords from November 1, 2019, to June 30, 2021. The objectives were to analyze the clinical and microbiological profile, risk factor/comorbidity, intervention, and outcome. "R-metafor package" was used for analysis. RESULTS: A total of 23 studies were included. The mean age of presentation of C-ROCM was 54.6 years. The most common presentation was ptosis (72.7%), lid edema (60.6%), proptosis (60.6%), ophthalmoplegia (57.3%), loss of vision (53.7%), facial edema (34.7%), and nasal-blockage (11.8%). Evidence of intracranial spread was seen in 42.8% of cases. Rhizopus was the most common fungus (57.1%) isolated in fungal culture. Among C-ROCM patients, diabetes was the commonest comorbid condition, and the use of corticosteroids related to COVID-19 treatment was the most common risk factor (85.75%). Compared to controlled diabetics, C-ROCM was significantly higher among uncontrolled diabetics (odds ratio [OR] 0.15, 95% confidence interval [C.I.] 0.041-0.544, P = 0.0010). However, no significant association was seen between C-ROCM and COVID-19 severity (OR 0.930, 95% C.I. 0.212-4.087, P = 0.923). For treatment, amphotericin-B was the most common antifungal drug used which was followed by surgical options. However, mortality was high (prevalence 0.344, 95% C.I. 0.205-0.403) despite treatment. CONCLUSION: Although local rhino-orbito symptoms were the first to appear, rapid intracranial extension was seen in a significant number of C-ROCM cases. Uncontrolled diabetes and excessive use of corticosteroid were the most common risk factors present among the C-ROCM cases. High index clinical suspicion is imperative (specifically among COVID-19 patients with diabetes), and routine screening may be helpful.


Subject(s)
Brain Diseases/complications , COVID-19/complications , Mucormycosis/complications , Nose Diseases/complications , Orbital Diseases/complications , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Brain Diseases/drug therapy , COVID-19/virology , Humans , Mucormycosis/drug therapy , Nose Diseases/drug therapy , Orbital Diseases/drug therapy , Regression Analysis , Risk Factors , SARS-CoV-2/isolation & purification
3.
Int J Environ Res Public Health ; 19(1)2021 12 30.
Article in English | MEDLINE | ID: covidwho-1599154

ABSTRACT

The COVID-19 pandemic has affected the lifestyles and training of elite athletes around the world. The detrimental effects of lockdown periods may vary among individuals, as well as among sports and sexes. This study investigated the changes in dietary habits, and the predictors of perceived stress during lockdown and a "bubble" training camp. This cross-sectional, online survey involved 76 elite and world-class athletes from six able-bodied sports and nine parasports, all of whom were involved in a 30-day "bubble" training camp. Questions were asked on socio-demographics, training routines and wellbeing, perceived stress, and dietary habits, pertaining to "normal" training (prelockdown), lockdown training, and "bubble" camp training periods. Changes in perceived stress were trivial to small during lockdown compared to "normal" training, and trivial to moderate during a "bubble" camp, compared to lockdown. Para-athletes, males, older athletes, less experienced athletes, married individuals, and specific ethnicities appeared to be more detrimentally affected (increased perceived stress) by lockdown. These negative experiences, however, were largely reversed during "bubble" camps. During lockdown, more athletes reported increased evening snack consumption (+8%), later meal-times (+6%), decreased fluid intake (-6%), and no breakfast (+7%). These changes were reversed during "bubble" camps (12-18% improvements). Sport classification accounted for 16% of the increased perceived stress (p = 0.001) during lockdown. Overall, socio-demographic factors, improvements in training routines, well-being, and dietary habits explained 28% of the decreased perceived stress during a "bubble" camp. In conclusion, better dietary habits, training routines and well-being have implications for reduced perceived stress. During lockdown, "bubble" camps may be beneficial, but this observation may be a case-by-case consideration, and short split "bubble" periods are recommended.


Subject(s)
COVID-19 , Athletes , Communicable Disease Control , Cross-Sectional Studies , Diet , Humans , Male , Pandemics , Regression Analysis , SARS-CoV-2 , Stress, Psychological/epidemiology
4.
N Engl J Med ; 385(1): 11-22, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1585668

ABSTRACT

BACKGROUND: Evidence is urgently needed to support treatment decisions for children with multisystem inflammatory syndrome (MIS-C) associated with severe acute respiratory syndrome coronavirus 2. METHODS: We performed an international observational cohort study of clinical and outcome data regarding suspected MIS-C that had been uploaded by physicians onto a Web-based database. We used inverse-probability weighting and generalized linear models to evaluate intravenous immune globulin (IVIG) as a reference, as compared with IVIG plus glucocorticoids and glucocorticoids alone. There were two primary outcomes: the first was a composite of inotropic support or mechanical ventilation by day 2 or later or death; the second was a reduction in disease severity on an ordinal scale by day 2. Secondary outcomes included treatment escalation and the time until a reduction in organ failure and inflammation. RESULTS: Data were available regarding the course of treatment for 614 children from 32 countries from June 2020 through February 2021; 490 met the World Health Organization criteria for MIS-C. Of the 614 children with suspected MIS-C, 246 received primary treatment with IVIG alone, 208 with IVIG plus glucocorticoids, and 99 with glucocorticoids alone; 22 children received other treatment combinations, including biologic agents, and 39 received no immunomodulatory therapy. Receipt of inotropic or ventilatory support or death occurred in 56 patients who received IVIG plus glucocorticoids (adjusted odds ratio for the comparison with IVIG alone, 0.77; 95% confidence interval [CI], 0.33 to 1.82) and in 17 patients who received glucocorticoids alone (adjusted odds ratio, 0.54; 95% CI, 0.22 to 1.33). The adjusted odds ratios for a reduction in disease severity were similar in the two groups, as compared with IVIG alone (0.90 for IVIG plus glucocorticoids and 0.93 for glucocorticoids alone). The time until a reduction in disease severity was similar in the three groups. CONCLUSIONS: We found no evidence that recovery from MIS-C differed after primary treatment with IVIG alone, IVIG plus glucocorticoids, or glucocorticoids alone, although significant differences may emerge as more data accrue. (Funded by the European Union's Horizon 2020 Program and others; BATS ISRCTN number, ISRCTN69546370.).


Subject(s)
COVID-19/drug therapy , Glucocorticoids/therapeutic use , Immunoglobulins, Intravenous/therapeutic use , Systemic Inflammatory Response Syndrome/drug therapy , Adolescent , Antibodies, Viral , COVID-19/immunology , COVID-19/mortality , COVID-19/therapy , Child , Child, Preschool , Cohort Studies , Confidence Intervals , Drug Therapy, Combination , Female , Hospitalization , Humans , Immunomodulation , Male , Propensity Score , Regression Analysis , Respiration, Artificial , SARS-CoV-2/immunology , Systemic Inflammatory Response Syndrome/immunology , Systemic Inflammatory Response Syndrome/mortality , Systemic Inflammatory Response Syndrome/therapy , Treatment Outcome
5.
PLoS One ; 16(12): e0260386, 2021.
Article in English | MEDLINE | ID: covidwho-1581784

ABSTRACT

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has led to radical changes in social distancing awareness and affected social relationships. Owing to large-scale lockdown, home quarantine and social distancing requirements, it was anticipated that sexual activities would be severely impacted. However, retrospective self-report studies showed that pornography use and autoerotism increased during the pandemic. AIM: This study used big-data databases available on the Internet to investigate factors that modulated pornography use during the pandemic. METHODS: Daily relative search volume (RSV) data from Google Trends for the period from 24 February 2020 to 13 July 2020 were extracted. Pornhub traffic data were extracted from the Pornhub Insights website, for the period from 24 February 2020 to 13 July 2020. The parameter was defined as 'percent change in traffic compared to an average day in 2019'. The number of daily new cases of COVID-19 was extracted from the database on Our World in Data. OUTCOME MEASURES: The normality of the data was examined using the Shapiro-Wilk test. All variables included in this study were non-normally distributed. Therefore, non-parametric tests or parametric tests with bootstrapping were adopted where appropriate. RESULTS: According to Google Trends, the RSV for 'pornography' increased after late March 2020, which is close to the date when the World Health Organization declared COVID-19 a global pandemic. The number of daily new cases of COVID-19 was positively correlated with the traffic of Pornhub, a popular pornography website, and the RSV for 'pornography'. Moderation analysis demonstrated a significant main effect of daily new cases of COVID-19 and the RSV for 'social distancing' in predicting Pornhub traffic/RSV for 'pornography'. Furthermore, the RSV for 'social distancing' significantly moderated the relationship between daily new cases and Pornhub traffic/RSV for 'pornography'. A stronger COVID-pornography use association was observed with increased social distancing awareness. CONCLUSION: Increased pornography consumption during the pandemic was observed, and it was associated with the severity of the pandemic. Social distancing awareness could be a key factor influencing interest in and use of pornography. Further studies on the changes in sexual desire and birth-rate control are worthwhile because long-term public health may be affected by the changes in sexual behaviour during the pandemic.


Subject(s)
COVID-19/epidemiology , Erotica , Internet Use/statistics & numerical data , Big Data , COVID-19/psychology , Humans , Physical Distancing , Regression Analysis
6.
Int Immunopharmacol ; 103: 108435, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1560606

ABSTRACT

INTRODUCTION AND AIM: Interleukin-6 to lymphocyte (IL-6/Lym) ratio has been identified as a potential prognostic tool in patients with SARS-CoV2 related pneumonia. The aim of our study was to compare the prognostic power of IL-6/Lym ratio with other biomarkers in patients initially admitted in a non intensive unit and suffering for respiratory failure associated with SARS-CoV2 related pneumonia. MATERIALS AND METHODS: IL-6/Lym ratio, IL-6, D-Dimer, D-Dimer/fibrinogen ratio, fibrinogen, C-reactive protein (CRP), lymphocytes count and neutrophil/lymphocyte (N/L) ratio collected at hospital admission were tested as prognosticators of negative outcome, defined as combined endpoint in-hospital mortality and/or Intensive Care Unit (ICU) admission requiring oro-tracheal intubation (OTI). RESULTS: Study population encompassed two hundreds and twenty-three patients (46% females) with mean age ± DS 69.4 ± 13.3 years. Eighty-nine patients (39.9%) suffered for severe respiratory failure and required non invasive ventilation, helmets and/or high flow nasal cannula. Fourty-one patients (18.3%) died during hospital stay and/or required OTI. In these patients mean values of IL-6/Lym ratio, IL-6, CRP and N/L were significantly higher and lymphocytes count was significantly lower compared with patients discharged alive and/or not requiring OTI, while no difference was found in mean values of D-Dimer, D-Dimer/Fibrinogen ratio and fibrinogen. AUC (0.797, 95% CI: 0.738-0.848) of IL-6/Lym ratio was the highest compared with those of all the other analyzed biomarkers and the difference was significant with the exception of IL-6. At multivariate logistic regression IL-6/Lym ratio > 66.5 resulted the only independent biomarker associated with mortality and/or OTI (OR 5.65; 95% 1.63-19.54). CONCLUSION: IL-6/Lym ratio seems to be an optimal prognosticator in SARS-CoV2 related pneumonia. Its routinary use in COVID-19 patients could be warranted.


Subject(s)
COVID-19/metabolism , COVID-19/pathology , Interleukin-6/metabolism , Lymphocytes/physiology , SARS-CoV-2 , Aged , Aged, 80 and over , Biomarkers/metabolism , COVID-19/mortality , Female , Humans , Male , Middle Aged , Multivariate Analysis , Prognosis , Regression Analysis , Respiratory Insufficiency , Retrospective Studies
7.
Sci Rep ; 11(1): 21807, 2021 11 08.
Article in English | MEDLINE | ID: covidwho-1506761

ABSTRACT

In this study, we compare the predictive value of clinical scoring systems that are already in use in patients with Coronavirus disease 2019 (COVID-19), including the Brescia-COVID Respiratory Severity Scale (BCRSS), Quick SOFA (qSOFA), Sequential Organ Failure Assessment (SOFA), Multilobular infiltration, hypo-Lymphocytosis, Bacterial coinfection, Smoking history, hyper-Tension, and Age (MuLBSTA) and scoring system for reactive hemophagocytic syndrome (HScore), for determining the severity of the disease. Our aim in this study is to determine which scoring system is most useful in determining disease severity and to guide clinicians. We classified the patients into two groups according to the stage of the disease (severe and non-severe) and adopted interim guidance of the World Health Organization. Severe cases were divided into a group of surviving patients and a deceased group according to the prognosis. According to admission values, the BCRSS, qSOFA, SOFA, MuLBSTA, and HScore were evaluated at admission using the worst parameters available in the first 24 h. Of the 417 patients included in our study, 46 (11%) were in the severe group, while 371 (89%) were in the non-severe group. Of these 417 patients, 230 (55.2%) were men. The median (IQR) age of all patients was 44 (25) years. In multivariate logistic regression analyses, BRCSS in the highest tertile (HR 6.1, 95% CI 2.105-17.674, p = 0.001) was determined as an independent predictor of severe disease in cases of COVID-19. In multivariate analyses, qSOFA was also found to be an independent predictor of severe COVID-19 (HR 4.757, 95% CI 1.438-15.730, p = 0.011). The area under the curve (AUC) of the BRCSS, qSOFA, SOFA, MuLBSTA, and HScore was 0.977, 0.961, 0.958, 0.860, and 0.698, respectively. Calculation of the BRCSS and qSOFA at the time of hospital admission can predict critical clinical outcomes in patients with COVID-19, and their predictive value is superior to that of HScore, MuLBSTA, and SOFA. Our prediction is that early interventions for high-risk patients, with early identification of high-risk group using BRCSS and qSOFA, may improve clinical outcomes in COVID-19.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/immunology , Adult , Aged , Area Under Curve , Coinfection/diagnosis , Female , Hospital Mortality , Humans , Intensive Care Units , Lymphocytosis , Male , Middle Aged , Observer Variation , Organ Dysfunction Scores , Patient Admission , Predictive Value of Tests , Prognosis , Regression Analysis , Respiration , Respiration Disorders , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Smoking , Treatment Outcome
8.
PLoS One ; 16(11): e0259362, 2021.
Article in English | MEDLINE | ID: covidwho-1504217

ABSTRACT

We analyze whether and to what extent strategies employed by governments to fight the COVID-19 pandemic made a difference for GDP growth developments in 2020. Based on the strength and speed with which governments imposed non-pharmaceutical interventions (NPIs) when confronted with waves of infections we distinguish between countries pursuing an elimination strategy and countries following a suppression / mitigation strategy. For a sample of 44 countries fixed effect panel regression results show that NPI changes conducted by elimination strategy countries had a less severe effect on GDP growth than NPI changes in suppression / mitigation strategy countries: strategy matters. However, this result is sensitive to the countries identified as "elimination countries" and to the sample composition. Moreover, we find that exogenous country characteristics drive the choice of strategy. At the same time our results show that countries successfully applying the elimination strategy achieved better health outcomes than their peers without having to accept lower growth.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Federal Government , Government , Humans , Internationality , Models, Economic , Pandemics , Physical Distancing , Public Policy , Quarantine , Regression Analysis , Risk , SARS-CoV-2
9.
PLoS One ; 16(11): e0259451, 2021.
Article in English | MEDLINE | ID: covidwho-1504036

ABSTRACT

INTRODUCTION: Our aim was to examine attitudes of the general population towards reasonableness of these costs, as well as the degree to which these costs are shared across society (solidarity financing) and to determine the factors associated with them. METHOD: Repeated cross-sectional data from a nationally representative online-survey. More precisely, data from wave 8 (21-22 April 2020) and wave 16 (7-8 July 2020) were used (in wave 8: analytical sample with n = 976, average age was 47.0 years (SD: 15.3 years), ranging from 18 to 74 years, 51.8% female; in wave 16: analytical sample with n = 978, average age was 46.1 years (SD: 15.9 years), ranging from 18 to 74 years, 50.9% female). After a short introduction emphasizing considerable economic costs associated with the measures against the spread of the coronavirus, individuals were asked to rate the following statements (outcome measures), in each case from 1 = strongly disagree to 7 = strongly agree: "These economic costs are currently reasonable in relation to the objective pursued" (reasonableness of costs), "These economic costs should be borne jointly by all citizens and depending on income" (solidarity financing). RESULTS: In wave 8 (wave 16 in parentheses), the average rating for the attitude towards reasonableness of costs was 4.3, SD: 1.8 (wave 16, average: 4.2, SD: 1.8) and the average rating for the attitude towards solidarity financing was 3.7, SD: 1.9 (wave 16, average: 3.3, SD: 2.0). In wave 8, more positive attitudes towards the reasonableness of costs and solidarity financing were associated with being male, higher education, not being in a partnership/being unmarried, higher affect regarding COVID-19 and higher presumed severity with respect to COVID-19. Furthermore, more positive attitudes towards the reasonableness of costs were associated with having a migration background. More positive attitudes towards solidarity financing was associated with higher age groups. Mainly similar findings were observed in wave 16. DISCUSSION: Agreement with reasonableness of costs of preventative measures as well as solidarity financing was moderately high. Knowledge of these attitudes is important to ensure social cohesion during the fight against COVID-19.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Adolescent , Adult , Aged , Attitude to Health , COVID-19/economics , Cross-Sectional Studies , Female , Germany/epidemiology , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Models, Economic , Perception , Regression Analysis , SARS-CoV-2 , Surveys and Questionnaires , Young Adult
10.
PLoS One ; 16(11): e0259658, 2021.
Article in English | MEDLINE | ID: covidwho-1503743

ABSTRACT

OBJECTIVES: To investigate nurses' behavioral intention toward caring for COVID-19 patients on mechanical ventilation, as well as the factors affecting their intention. BACKGROUND: COVID-19 patients undergoing mechanical ventilation have many care needs and pose more challenges for nurses, which might adversely affect nurses' intention toward caring behavior. METHODS: A cross-sectional study was conducted by using simple random sampling to recruit 598 nurses from five tertiary hospitals in Sichuan Province, China. The participants responded to an online questionnaire that included questions on demographic characteristics; the Attitude, Subjective Norms, and Behavioral Intention of Nurses toward Mechanically Ventilated Patients (ASIMP) questionnaire; the Nursing Professional Identity Scale (NPIS); and the Compassion Fatigue-Short Scale (CF-Short Scale). ANOVA, Spearman correlation analysis, and multiple linear regression were performed to analyze the data. RESULTS: The mean total behavioral intention score was 179.46 (± 14.83) out of a total score of 189.00, which represented a high level of intention toward caring for patients on mechanical ventilation. Multiple linear regression revealed that subjective norms (ß = 0.390, P<0.001), perceived behavioral control (ß = 0.149, P<0.001), professional identity (ß = 0.101, P = 0.009), and compassion fatigue (ß = 0.088 P = 0.024) were significant predictors of nurses' behavioral intention. CONCLUSIONS: Most nurses have a positive behavioral intention to care for COVID-19 patients undergoing mechanical ventilation. The findings in this study provide some insight for developing effective and tailored strategies to promote nurses' behavioral intention toward caring for ventilated patients under the pandemic situation.


Subject(s)
Attitude of Health Personnel , COVID-19/therapy , Nurses , Respiration, Artificial/methods , Adult , Behavior , China/epidemiology , Compassion Fatigue , Cross-Sectional Studies , Female , Humans , Job Satisfaction , Male , Nursing Staff, Hospital , Pandemics , Regression Analysis , Surveys and Questionnaires , Young Adult
11.
Sci Rep ; 11(1): 21174, 2021 10 27.
Article in English | MEDLINE | ID: covidwho-1493227

ABSTRACT

Lockdowns implemented to address the COVID-19 pandemic have disrupted human mobility flows around the globe to an unprecedented extent and with economic consequences which are unevenly distributed across territories, firms and individuals. Here we study socioeconomic determinants of mobility disruption during both the lockdown and the recovery phases in Italy. For this purpose, we analyze a massive data set on Italian mobility from February to October 2020 and we combine it with detailed data on pre-existing local socioeconomic features of Italian administrative units. Using a set of unsupervised and supervised learning techniques, we reliably show that the least and the most affected areas persistently belong to two different clusters. Notably, the former cluster features significantly higher income per capita and lower income inequality than the latter. This distinction persists once the lockdown is lifted. The least affected areas display a swift (V-shaped) recovery in mobility patterns, while poorer, most affected areas experience a much slower (U-shaped) recovery: as of October 2020, their mobility was still significantly lower than pre-lockdown levels. These results are then detailed and confirmed with a quantile regression analysis. Our findings show that economic segregation has, thus, strengthened during the pandemic.


Subject(s)
COVID-19/epidemiology , Pandemics , SARS-CoV-2 , COVID-19/economics , Communicable Disease Control/economics , Communicable Disease Control/methods , Humans , Income , Italy/epidemiology , Machine Learning , Pandemics/economics , Poverty , Quarantine/economics , Regression Analysis , Socioeconomic Factors , Travel
12.
Sci Rep ; 11(1): 21124, 2021 10 26.
Article in English | MEDLINE | ID: covidwho-1493211

ABSTRACT

Patients with coronavirus disease 2019 (COVID-19) can have increased risk of mortality shortly after intubation. The aim of this study is to develop a model using predictors of early mortality after intubation from COVID-19. A retrospective study of 1945 intubated patients with COVID-19 admitted to 12 Northwell hospitals in the greater New York City area was performed. Logistic regression model using backward selection was applied. This study evaluated predictors of 14-day mortality after intubation for COVID-19 patients. The predictors of mortality within 14 days after intubation included older age, history of chronic kidney disease, lower mean arterial pressure or increased dose of required vasopressors, higher urea nitrogen level, higher ferritin, higher oxygen index, and abnormal pH levels. We developed and externally validated an intubated COVID-19 predictive score (ICOP). The area under the receiver operating characteristic curve was 0.75 (95% CI 0.73-0.78) in the derivation cohort and 0.71 (95% CI 0.67-0.75) in the validation cohort; both were significantly greater than corresponding values for sequential organ failure assessment (SOFA) or CURB-65 scores. The externally validated predictive score may help clinicians estimate early mortality risk after intubation and provide guidance for deciding the most effective patient therapies.


Subject(s)
COVID-19/diagnosis , COVID-19/mortality , Intubation, Intratracheal/methods , Severity of Illness Index , Adolescent , Adult , Age Factors , Aged , Arterial Pressure , COVID-19/therapy , Female , Ferritins/blood , Humans , Hydrogen-Ion Concentration , Male , Middle Aged , New York , Nitrogen/metabolism , Oxygen/metabolism , Predictive Value of Tests , ROC Curve , Regression Analysis , Reproducibility of Results , Retrospective Studies , Sensitivity and Specificity , Vasoconstrictor Agents/pharmacology , Young Adult
14.
Sci Rep ; 11(1): 20791, 2021 10 21.
Article in English | MEDLINE | ID: covidwho-1479819

ABSTRACT

Implementation of various restrictions to eradicate viral diseases has globally affected human activity and subsequently nature. But how can the altered routines of human activity (restrictions, lockdowns) affect wildlife behaviour? This study compared the differences between human and wildlife occurrences in the study forest area with acreage of 5430.6 ha in 2018 (African swine fever outbreak, complete entrance ban), 2019 (standard pattern) and 2020 (COVID-19 restrictions) during the breeding season. The number of visitors was lower by 64% in 2018 (non-respecting of the entry ban by forest visitors) compared to standard 2019, while in 2020, the number of visitors increased to 151%. In the COVID-19 period, distinct peaks in the number of visitors were observed between 8-11 AM and 4-7 PM. The peaks of wildlife activity were recorded between 4-7 AM and 9-12 PM. Animals avoided the localities that were visited by humans during the people-influenced time (24 h after people visit), which confirmed the direct negative impact of human activities on wildlife.


Subject(s)
African Swine Fever/epidemiology , Animals, Wild , COVID-19/epidemiology , Communicable Disease Control/methods , Disease Outbreaks , Human Activities , Animals , Female , Geography , Humans , Male , Pandemics , Regression Analysis , SARS-CoV-2 , Swine , Temperature , Virus Diseases/epidemiology
15.
Sci Rep ; 11(1): 20793, 2021 10 21.
Article in English | MEDLINE | ID: covidwho-1479813

ABSTRACT

In Europe, multiple waves of infections with SARS-CoV-2 (COVID-19) have been observed. Here, we have investigated whether common patterns of cytokines could be detected in individuals with mild and severe forms of COVID-19 in two pandemic waves, and whether machine learning approach could be useful to identify the best predictors. An increasing trend of multiple cytokines was observed in patients with mild or severe/critical symptoms of COVID-19, compared with healthy volunteers. Linear Discriminant Analysis (LDA) clearly recognized the three groups based on cytokine patterns. Classification and Regression Tree (CART) further indicated that IL-6 discriminated controls and COVID-19 patients, whilst IL-8 defined disease severity. During the second wave of pandemics, a less intense cytokine storm was observed, as compared with the first. IL-6 was the most robust predictor of infection and discriminated moderate COVID-19 patients from healthy controls, regardless of epidemic peak curve. Thus, serum cytokine patterns provide biomarkers useful for COVID-19 diagnosis and prognosis. Further definition of individual cytokines may allow to envision novel therapeutic options and pave the way to set up innovative diagnostic tools.


Subject(s)
COVID-19/blood , COVID-19/epidemiology , Cytokines/blood , Aged , Biomarkers/blood , COVID-19 Testing , Case-Control Studies , Cytokines/metabolism , Discriminant Analysis , Female , Humans , Interleukin-6/metabolism , Interleukin-8/metabolism , Italy/epidemiology , Machine Learning , Male , Middle Aged , Pandemics , Regression Analysis , SARS-CoV-2
16.
Sci Rep ; 11(1): 20569, 2021 10 18.
Article in English | MEDLINE | ID: covidwho-1475480

ABSTRACT

The Brazilian Northern region registered a high incidence of COVID-19 cases, particularly in the state of Pará. The present study investigated the risk factors associated with the severity of COVID-19 in a Brazilian Amazon region of 100,819 cases. An epidemiological, cross-sectional, analytical and demographic study, analyzing data on confirmed cases for COVID-19 available at the Brazilian Ministry of Health's surveillance platform, was conducted. Variables such as, municipalities of residence, age, gender, signs and symptoms, comorbidities were included and associated with COVID-19 cases and outcomes. The spatial distribution was performed using the ArcGIS program. A total of 100,819 cases were evaluated. Overall, patients had the mean age of 42.3 years, were female (51.2%) and with lethality reaching 4.79% of cases. Main symptoms included fever (66.5%), cough (61.9%) and sore throat (39.8%). Regarding comorbidities, most of the patients presented cardiovascular disease (5.1%) and diabetes (4.2%). Neurological disease increased risk of death by nearly 15 times, followed by obesity (5.16 times) and immunodeficiency (5.09 time). The municipalities with the highest incidence rate were Parauapebas, Canaã dos Carajás and Jacareacanga. Similarity between the Lower Amazon, Marajó and Southwest mesoregions of Pará state were observed concerning the highest morbidity rates. The obtained data demonstrated that the majority of cases occurred among young adults, females, with the classic influenza symptoms and chronic diseases. Finally, data suggest that the highest incidences were no longer in the metropolitan region of the state. The higher lethality rate than in Brazil may be associated with the greater impacts of the disease in this Amazonian population, or factors associated with fragile epidemiological surveillance in the notification of cases of cure.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , Adult , Area Under Curve , Brazil/epidemiology , COVID-19/mortality , Comorbidity , Cough/epidemiology , Cross-Sectional Studies , Data Collection , Female , Fever/epidemiology , Geography , Humans , Incidence , Male , Middle Aged , Models, Statistical , Regression Analysis , Risk , Risk Factors , SARS-CoV-2 , Young Adult
17.
PLoS One ; 16(10): e0258274, 2021.
Article in English | MEDLINE | ID: covidwho-1470665

ABSTRACT

OBJECTIVE: We aim to estimate the total factor productivity and analyze factors related to the Chinese government's health care expenditure in each of its provinces after its implementation of new health care reform in the period after 2009. MATERIALS AND METHODS: We use the Malmquist DEA model to measure efficiency and apply the Tobit regression to explore factors that influence the efficiency of government health care expenditure. Data are taken from the China statistics yearbook (2004-2020). RESULTS: We find that the average TFP of China's 31 provincial health care expenditure was lower than 1 in the period 2009-2019. We note that the average TFP was much higher after new health care reform was implemented, and note this in the eastern, central and western regions. But per capita GDP, population density and new health care reform implementation are found to have a statistically significant impact on the technical efficiency of the provincial government's health care expenditure (P<0.05); meanwhile, region, education, urbanization and per capita provincial government health care expenditure are not found to have a statistically significant impact. CONCLUSION: Although the implementation of the new medical reform has improved the efficiency of the government's health expenditure, it is remains low in 31 provinces in China. In addition, the government should consider per capita GDP, population density and other factors when coordinating the allocation of health care input. SIGNIFICANCE: This study systematically analyzes the efficiency and influencing factors of the Chinese government's health expenditure after it introduced new health care reforms. The results show that China's new medical reform will help to improve the government's health expenditure. The Chinese government can continue to adhere to the new medical reform policy, and should pay attention to demographic and economic factors when implementing the policy.


Subject(s)
Government , Health Care Reform/economics , Health Expenditures , China , Regression Analysis
18.
Nat Commun ; 12(1): 5968, 2021 10 13.
Article in English | MEDLINE | ID: covidwho-1467102

ABSTRACT

There is conflicting evidence on the influence of weather on COVID-19 transmission. Our aim is to estimate weather-dependent signatures in the early phase of the pandemic, while controlling for socio-economic factors and non-pharmaceutical interventions. We identify a modest non-linear association between mean temperature and the effective reproduction number (Re) in 409 cities in 26 countries, with a decrease of 0.087 (95% CI: 0.025; 0.148) for a 10 °C increase. Early interventions have a greater effect on Re with a decrease of 0.285 (95% CI 0.223; 0.347) for a 5th - 95th percentile increase in the government response index. The variation in the effective reproduction number explained by government interventions is 6 times greater than for mean temperature. We find little evidence of meteorological conditions having influenced the early stages of local epidemics and conclude that population behaviour and government interventions are more important drivers of transmission.


Subject(s)
COVID-19/transmission , Meteorological Concepts , SARS-CoV-2/pathogenicity , Basic Reproduction Number , COVID-19/epidemiology , Cities , Cross-Sectional Studies , Humans , Meta-Analysis as Topic , Pandemics , Regression Analysis , Seasons , Temperature , Weather
19.
PLoS One ; 16(10): e0258213, 2021.
Article in English | MEDLINE | ID: covidwho-1450733

ABSTRACT

Our objective was to describe how residents of Philadelphia, Pennsylvania, coped psychologically with the first wave of COVID-19 pandemic. In a cross-sectional design, we aimed to estimate the rates and correlates of anxiety and depression, examine how specific worries correlated with general anxiety and depression, and synthesize themes of "the most difficult experiences" shared by the respondents. We collected data through an on-line survey in a convenience sample of 1,293 adult residents of Philadelphia, PA between April 17 and July 3, 2020, inquiring about symptoms of anxiety and depression (via the Hospital Anxiety and Depression Scale), specific worries, open-ended narratives of "the most difficult experiences" (coded into themes), demographics, perceived sources of support, and general health. Anxiety was evident among 30 to 40% of participants and depression-about 10%. Factor analysis revealed two distinct, yet inter-related clusters of specific worries related to mood disorders: concern about "hardships" and "fear of infection". Regression analyses revealed that anxiety, depression, and fear of infection, but not concern about hardships, worsened over the course of the epidemic. "The most difficult experiences" characterized by loss of income, poor health of self or others, uncertainty, death of a relative or a friend, and struggle accessing food were each associated with some of the measures of worries and mood disorders. Respondents who believed they could rely on support of close personal network fared better psychologically than those who reported relying primarily on government and social services organizations. Thematic analysis revealed complex perceptions of the pandemic by the participants, giving clues to both positive and negative experiences that may have affected how they coped. Despite concerns about external validity, our observations are concordant with emerging evidence of psychological toll of the COVID-19 pandemic and measures employed to mitigate risk of infection.


Subject(s)
Adaptation, Psychological , COVID-19/epidemiology , Mood Disorders/diagnosis , Adult , Anxiety/pathology , COVID-19/pathology , COVID-19/virology , Cross-Sectional Studies , Depression/pathology , Female , Humans , Internet , Male , Middle Aged , Mood Disorders/psychology , Pandemics , Philadelphia/epidemiology , Regression Analysis , SARS-CoV-2/isolation & purification , Surveys and Questionnaires
20.
PLoS One ; 16(9): e0257727, 2021.
Article in English | MEDLINE | ID: covidwho-1448574

ABSTRACT

Translators face hectic daily schedules with deadlines they must duly meet. As trainees they receive tuition on how to work swiftly to meet them efficiently. But despite the prominent role of time pressure, its effects on the translation process are still scarcely researched. Studies point to the higher occurrence of errors under stringent time constraints. Most of these studies use key-logging or eye-tracking techniques to identify the problems encountered. But no attempt has yet been made to measure the physiological effects of time pressure in English-to-Spanish translation and their interplay with trainees' psychological state. The present study researches the influence of time pressure on translation by exploring trainees' physiological response (i.e., salivary cortisol) and psychological traits (i.e., self-esteem and anxiety). 33 Spanish translation trainees translated 3 English literary texts under different time pressure conditions: Text 1 (no time limit), Text 2 (10 minutes), Text 3 (5 minutes). Regression analysis results showed that higher cortisol levels during preparation predicted higher number of meaning errors in Text 1 and lower number of translated words in Text 2 and 3. Besides, higher trait anxiety emerged as predictor of lower number of translated words, but higher accuracy under extreme time constraints and in the absence of time pressure. Higher self-esteem correlated with lower levels of anxiety and lower levels of cortisol during preparation and recovery, suggesting that it may act as a protective factor against stress. And yet, the regression analysis showed that higher self-esteem predicted lower meaning and total accuracy under extreme time pressure. Besides, in our correlation analysis self-esteem was positively related to the number of translated words in Text 2 and 3. Results suggest that even if self-esteem could be a protective factor against stress, it may also have a negative effect on task performance mediated by overconfidence.


Subject(s)
Anxiety/metabolism , Hydrocortisone/analysis , Occupational Stress/psychology , Saliva/chemistry , Female , Humans , Male , Regression Analysis , Self Concept , Self Report , Time Factors , Young Adult
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