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1.
Transl Vis Sci Technol ; 10(11): 4, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1411011

ABSTRACT

Purpose: The coronavirus disease 2019 (COVID-19) pandemic required a shift to electronic devices for education and entertainment, with children more confined to home, which may affect eye growth and myopia. Our goal was to assess behaviors during COVID-19 in myopic and non-myopic children. Methods: Parents completed a questionnaire for their children (ages 8.3 ± 2.4 years, n = 53) regarding visual activity in summer 2020, during the COVID-19 pandemic, as well as during school time and the summer before COVID-19. Children also wore an Actiwatch for 10 days in summer 2020 for objective measures of light exposure, activity, and sleep. Data were analyzed with repeated-measures analysis of variance. Results: Subjective measures showed that during COVID-19, children exhibited increased electronic device use and decreased activity and time outdoors (P < 0.05 for all), while time spent doing near work was not different than during a typical school or summer session before COVID-19 (P > 0.05). Objective measures during COVID-19 showed that myopic children exhibited lower daily light exposure (P = 0.04) and less activity (P = 0.04) than non-myopic children. Conclusions: Children demonstrated increased electronic device use and decreased activity and time outdoors during COVID-19, with myopic children exhibiting lower light exposure and activity than non-myopes. Long-term follow-up is needed to understand if these behavioral changes ultimately contribute to myopia progression. Translational Relevance: Children's behaviors changed during the COVID-19 pandemic, which may have implications in eye growth and myopia.


Subject(s)
COVID-19 , Myopia , Child , Child, Preschool , Goals , Humans , Myopia/epidemiology , Pandemics , SARS-CoV-2
2.
Shock ; 56(3): 345-351, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1410907

ABSTRACT

ABSTRACT: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been spread around the world and is currently affecting global public health. Clinical evidence indicates that the elevated number of peripheral neutrophils and higher ratio of neutrophils-to-lymphocytes are correlated with severe outcomes in COVID-19 patients, suggesting the possible immunopathological role of neutrophils during SARS-CoV-2 infection. As an abundant innate immune cell type, neutrophils are well known for their contributions to antimicrobial defense. However, their dysfunction is also associated with different inflammatory signatures during the pathogenesis of infection. Herein, in this mini-review, we summarize the recent progress on the potential role of neutrophils during COVID-19-associated inflammatory responses. In particular, we highlight the interactions between neutrophils and viruses as well as the relationship of neutrophils with cytokine storm and thrombosis in COVID-19 patients. Lastly, we discuss the importance of neutrophils as potential therapeutic targets for COVID-19.


Subject(s)
COVID-19/immunology , COVID-19/virology , Neutrophils/virology , SARS-CoV-2 , Animals , Cytokine Release Syndrome , Cytokines/immunology , Humans , Immune System , Immunity, Innate , Inflammation , Intercellular Adhesion Molecule-1/immunology , Lymphocytes/immunology , Mice , Neutrophils/metabolism , Pathogen-Associated Molecular Pattern Molecules/immunology , Thrombosis
3.
PLoS One ; 16(8): e0253610, 2021.
Article in English | MEDLINE | ID: covidwho-1410658

ABSTRACT

Urban seismology has gained scientific interest with the development of seismic ambient noise monitoring techniques and also for being a useful tool to connect society with the Earth sciences. The interpretation of the sources of seismic records generated by sporting events, traffic, or huge agglomerations arouses the population's curiosity and opens up a range of possibilities for new applications of seismology, especially in the area of urban monitoring. In this contribution, we present the analysis of seismic records from a station in the city of Brasilia during unusual episodes of silencing and noisy periods. Usually, cultural noise is observed in high-fequency bands. We showed in our analysis that cultural noise can also be observed in the low-frequency band, when high-frequency signal is attenuated. As examples of noisy periods, we have that of the Soccer World Cup in Brazil in 2014, where changes in noise are related to celebrations of goals and the party held by FIFA in the city, and the political manifestations in the period of the Impeachment trial in 2016, which reached the concentration of about 300,000 protesters. The two most characteristic periods of seismic silence have been the quarantine due to the COVID-19 pandemic in 2020, and the trucker strike that occurred across the country in 2018, both drastically reducing the movement of people in the city.


Subject(s)
Environmental Science/methods , Noise/adverse effects , Urban Population/trends , Brazil , COVID-19 , Cities , Earth Sciences/methods , Earth Sciences/trends , Humans , Pandemics , Quarantine , SARS-CoV-2 , Sports
4.
MMW Fortschr Med ; 163(15): 29, 2021 09.
Article in German | MEDLINE | ID: covidwho-1410337
5.
Medicine (Baltimore) ; 100(25): e26433, 2021 Jun 25.
Article in English | MEDLINE | ID: covidwho-1410303

ABSTRACT

ABSTRACT: The subclinical severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rate in hospitals during the pandemic remains unclear. To evaluate the effectiveness of our hospital's current nosocomial infection control measures, we conducted a serological survey of anti-SARS-CoV-2 antibodies (immunoglobulin [Ig] G) among the staff of our hospital, which is treating coronavirus disease 2019 (COVID-19) patients.The study design was cross-sectional. We measured anti-SARS-CoV-2 IgG in the participants using a laboratory-based quantitative test (Abbott immunoassay), which has a sensitivity and specificity of 100% and 99.6%, respectively. To investigate the factors associated with seropositivity, we also obtained some information from the participants with an anonymous questionnaire. We invited 1133 staff members in our hospital, and 925 (82%) participated. The mean age of the participants was 40.0 ±â€Š11.8 years, and most were women (80.0%). According to job title, there were 149 medical doctors or dentists (16.0%), 489 nurses (52.9%), 140 medical technologists (14.2%), 49 healthcare providers (5.3%), and 98 administrative staff (10.5%). The overall prevalence of seropositivity for anti-SARS-CoV-2 IgG was 0.43% (4/925), which was similar to the control seroprevalence of 0.54% (16/2970) in the general population in Osaka during the same period according to a government survey conducted with the same assay. Seropositive rates did not significantly differ according to job title, exposure to suspected or confirmed COVID-19 patients, or any other investigated factors.The subclinical SARS-CoV-2 infection rate in our hospital was not higher than that in the general population under our nosocomial infection control measures.


Subject(s)
Antibodies, Viral/blood , Asymptomatic Infections/epidemiology , COVID-19/epidemiology , Health Personnel/statistics & numerical data , Seroepidemiologic Studies , Adult , COVID-19/blood , COVID-19/immunology , COVID-19/transmission , Cross-Sectional Studies , Female , Hospitals, Urban/organization & administration , Hospitals, Urban/standards , Hospitals, Urban/statistics & numerical data , Humans , Immunoglobulin G/blood , Infection Control/organization & administration , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Japan/epidemiology , Male , Middle Aged , Pandemics/statistics & numerical data , Prevalence , Risk Factors , SARS-CoV-2/immunology , Surveys and Questionnaires/statistics & numerical data
6.
J Acquir Immune Defic Syndr ; 87(5): 1167-1172, 2021 08 15.
Article in English | MEDLINE | ID: covidwho-1409771

ABSTRACT

BACKGROUND: Data on clinical characteristics and outcomes of people living with HIV (PLWH) hospitalized with coronavirus disease 2019 (COVID-19) who develop acute kidney injury (AKI) are limited. SETTING: Large tertiary health care system in the Bronx, NY. METHODS: We performed a retrospective cohort study of 83 PLWH and 4151 patients without HIV hospitalized with COVID-19 from March 10, 2020, to May 11, 2020. We compared the clinical characteristics and outcomes associated with AKI by HIV serostatus and evaluated HIV-related factors for AKI among PLWH. AKI was defined and staged using Kidney Disease Improving Global Outcomes criteria. RESULTS: The incidence of AKI in hospitalized patients with COVID-19 did not differ significantly by HIV serostatus (54.2% in PLWH vs 49.5% in patients without HIV, P = 0.6). Despite a higher incidence of stage 3 AKI (28.9% vs 17.1% P = 0.05) in PLWH compared with those without HIV, there was no significant difference in the need for renal replacement therapy (22.2% vs 13.4% P = 0.12), renal recovery (76.9% vs 82.5% P = 0.61), or dependence on renal replacement therapy (7.7% vs 3.8% P = 0.27). CD4 T-cell count, HIV-1 RNA viral suppression, and antiretroviral therapy use were not associated with AKI. AKI was associated with increased need for invasive ventilation and in-hospital death, but HIV was not an independent risk factor of in-hospital death after AKI [adjusted hazard ratio 1.01 (95% CI: 0.59 to 1.72), P = 0.98]. CONCLUSIONS: HIV-related factors were not associated with increased risk of AKI in PLWH hospitalized with COVID-19. PLWH hospitalized with COVID-19 had more stage 3 AKI, but outcomes after AKI were similar to those without HIV.


Subject(s)
Acute Kidney Injury/drug therapy , COVID-19/complications , HIV Infections/drug therapy , Acute Kidney Injury/complications , Acute Kidney Injury/epidemiology , Aged , Antirheumatic Agents/therapeutic use , COVID-19/epidemiology , Female , HIV Infections/complications , HIV Infections/epidemiology , Hospital Mortality , Humans , Incidence , Male , Middle Aged , Retrospective Studies , Risk Factors , SARS-CoV-2
9.
Int J Infect Dis ; 108: 45-52, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1409643

ABSTRACT

OBJECTIVES: The overall death toll from COVID-19 in Africa is reported to be low but there is little individual-level evidence on the severity of the disease. This study examined the clinical spectrum and outcome of patients monitored in COVID-19 care centres (CCCs) in two West-African countries. METHODS: Burkina Faso and Guinea set up referral CCCs to hospitalise all symptomatic SARS-CoV-2 carriers, regardless of the severity of their symptoms. Data collected from hospitalised patients by November 2020 are presented. RESULT: A total of 1,805 patients (64% men, median age 41 years) were admitted with COVID-19. Symptoms lasted for a median of 7 days (IQR 4-11). During hospitalisation, 443 (25%) had a SpO2 < 94% at least once, 237 (13%) received oxygen and 266 (15%) took corticosteroids. Mortality was 5% overall, and 1%, 5% and 14% in patients aged <40, 40-59 and ≥60 years, respectively. In multivariable analysis, the risk of death was higher in men (aOR 2.0, 95% CI 1.1; 3.6), people aged ≥60 years (aOR 2.9, 95% CI 1.7; 4.8) and those with chronic hypertension (aOR 2.1, 95% CI 1.2; 3.4). CONCLUSION: COVID-19 is as severe in Africa as elsewhere, and there must be more vigilance for common risk factors such as older age and hypertension.


Subject(s)
COVID-19 , Adult , Aged , Burkina Faso/epidemiology , Female , Hospitalization , Humans , Male , Prospective Studies , Referral and Consultation , SARS-CoV-2
10.
Int J Infect Dis ; 108: 543-549, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1409633

ABSTRACT

OBJECTIVES: To investigate the association of risk of venous thromboembolism with 30-day mortality in COVID-19 patients. METHODS: A total of 1030 COVID-19 patients were retrospectively collected, with baseline data on demographics, sequential organ failure assessment (SOFA) score, and VTE risk assessment models (RAMs), including Padua prediction score (PPS), International Medical Prevention Registry (IMPROVE), and Caprini. RESULTS: Thirty-day mortality increased progressively from 2% in patients at low VTE risk to 63% in those at high risk defined by PPS. Similar findings were observed in IMPROVE and Caprini scores. Progressive increases in VTE risk were also associated with higher SOFA score. High risk of VTE was independently associated with mortality regardless of adjusted gender, smoking status and some comorbidities, with hazard ratios of 29.19, 37.37 and 20.60 for PPS, IMPROVE and Caprini RAM, respectively (P < 0.001 for all comparisons). The predictive accuracy of PPS (area under curve (AUC) 0.900), IMPROVE (AUC 0.917), or Caprini (AUC 0.861) RAM for risk of hospitalized mortality was unexpectedly strong. CONCLUSIONS: We established that the presence of a high risk of VTE identifies a group of COVID-19 patients at higher risk for mortality. Furthermore, there is a high accuracy of VTE RAMs to predict mortality in these patients.


Subject(s)
COVID-19 , Venous Thromboembolism , Humans , Retrospective Studies , Risk Assessment , Risk Factors , SARS-CoV-2 , Venous Thromboembolism/epidemiology
11.
Curr HIV/AIDS Rep ; 18(4): 261-270, 2021 08.
Article in English | MEDLINE | ID: covidwho-1408775

ABSTRACT

PURPOSE OF REVIEW: This review highlights the intersection of the COVID-19, HIV, and STI pandemics and examines how harm reduction strategies can be applied broadly to controlling a pandemic. RECENT FINDINGS: Since the onset of the COVID-19 pandemic, remarkable advances in the understanding of COVID-19 prevention, diagnosis, and treatment have been made at a much faster pace than prior pandemics, yet much more still remains to be discovered. Many of the strategies to control the COVID-19 pandemic mirror those employed to stem the HIV pandemic. Harm reduction principles used in the HIV pandemic can be applied to reduce the morbidity and mortality of the COVID-19 pandemic through effective prevention, detection, and treatment strategies.


Subject(s)
COVID-19/prevention & control , HIV Infections/prevention & control , Harm Reduction , SARS-CoV-2 , Sexually Transmitted Diseases/prevention & control , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , Chemoprevention , HIV Infections/diagnosis , HIV Infections/therapy , Humans , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/therapy , Vaccination
13.
BMJ Open ; 11(9): e049217, 2021 09 06.
Article in English | MEDLINE | ID: covidwho-1408526

ABSTRACT

INTRODUCTION: Early phase cancer clinical trials have become increasingly complicated in terms of patient selection and trial procedures-this is reflected in the increasing length of participant information sheets (PIS). Informed consent for early phase clinical trials has been contentious due to the potential ethical issues associated with performing experimental research on a terminally ill population which has exhausted standard treatment options. Empirical studies have demonstrated significant gaps in patient understanding regarding the nature and intent of these trials. This study aims to test whether enhanced informed consent for patient education can improve patient scores on a validated questionnaire testing clinical trial comprehension. METHODS AND ANALYSIS: This is a randomised controlled trial that will allocate patients who are eligible to participate in one of four investigator-initiated clinical trials at the Royal Marsden Drug Development Unit to either a standard arm or an experimental arm, stratified by age and educational level. The standard arm will involve the full length trial PIS, followed by electronic or paper administration of the Quality of Informed Consent Questionnaire Parts A and B (QuIC-A and QuIC-B). The experimental arm will involve the full length trial PIS, exposure to a two-page study aid and 10 online educational videos, followed by administration of the QuIC-A and QuIC-B. The primary endpoint will be the difference (using a one-sided two-sample t-test) in the QuIC-A score, which measures objective understanding, between the standard and experimental arm. Accrual target is at least 17 patients per arm to detect an 8 point difference (80% power, alpha 0.05). ETHICS AND DISSEMINATION: Ethics approval was granted by the National Health Service Health Research Authority on 15 June 2020-IRAS Project ID 277065, Protocol Number CCR5165, REC Reference 20/EE/0155. Results will be disseminated via publication in a relevant journal. TRIAL REGISTRATION NUMBER: NCT04407676; Pre-results.


Subject(s)
COVID-19 , Neoplasms , Humans , Informed Consent , Neoplasms/therapy , Randomized Controlled Trials as Topic , SARS-CoV-2 , State Medicine , Treatment Outcome
14.
Appl Environ Microbiol ; 87(14): e0052621, 2021 06 25.
Article in English | MEDLINE | ID: covidwho-1408384

ABSTRACT

The transmission of SARS-CoV-2 is likely to occur through a number of routes, including contact with contaminated surfaces. Many studies have used reverse transcription-PCR (RT-PCR) analysis to detect SARS-CoV-2 RNA on surfaces, but seldom has viable virus been detected. This paper investigates the viability over time of SARS-CoV-2 dried onto a range of materials and compares viability of the virus to RNA copies recovered and whether virus viability is concentration dependent. Viable virus persisted for the longest time on surgical mask material and stainless steel, with a 99.9% reduction in viability by 122 and 114 h, respectively. Viability of SARS-CoV-2 reduced the fastest on a polyester shirt, with a 99.9% reduction within 2.5 h. Viability on the bank note was reduced second fastest, with 99.9% reduction in 75 h. RNA on all surfaces exhibited a 1-log reduction in genome copy number recovery over 21 days. The findings show that SARS-CoV-2 is most stable on nonporous hydrophobic surfaces. RNA is highly stable when dried on surfaces, with only 1-log reduction in recovery over 3 weeks. In comparison, SARS-CoV-2 viability reduced more rapidly, but this loss in viability was found to be independent of starting concentration. Expected levels of SARS-CoV-2 viable environmental surface contamination would lead to undetectable levels within 2 days. Therefore, when RNA is detected on surfaces, it does not directly indicate the presence of viable virus, even at low cycle threshold values. IMPORTANCE This study shows the impact of material type on the viability of SARS-CoV-2 on surfaces. It demonstrates that the decay rate of viable SARS-CoV-2 is independent of starting concentration. However, RNA shows high stability on surfaces over extended periods. This has implications for interpretation of surface sampling results using RT-PCR to determine the possibility of viable virus from a surface, where RT-PCR is not an appropriate technique to determine viable virus. Unless sampled immediately after contamination, it is difficult to align RNA copy numbers to quantity of viable virus on a surface.


Subject(s)
COVID-19 , Fomites/virology , Personal Protective Equipment/virology , RNA, Viral/isolation & purification , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Humans , Microbial Viability , Surface Properties
15.
J Bone Joint Surg Am ; 102(12): e57, 2020 06 17.
Article in English | MEDLINE | ID: covidwho-1409849

ABSTRACT

With the onset of the COVID-19 pandemic, the shifting of clinical care to telemedicine visits has been hastened. Because of current limitations in resources, many elective surgeons have been forced to venture into utilizing telemedicine, in which the standards for orthopaedic examinations have not previously been fully developed. We report our experience with protocols and methods to standardize these visits to maximize the benefit and efficiency of the virtual orthopaedic examination. At the time of scheduling, patients are asked to prepare for their virtual visit and are given a checklist. In addition to confirming audiovisual capabilities prior to the visit, patients are given specific instructions on camera positioning, body positioning, setting, and attire to improve the efficiency of the visit. During the examination, digital tools can be utilized as needed. In the setting of outpatient injury evaluations, a systematic virtual examination can aid in triaging and managing common musculoskeletal conditions. With the rapid incorporation of telehealth visits, as well as the unknown future with regard to the pandemic, the utilization and capabilities of telemedicine will continue to expand. Future directions include the development of validated, modified examination techniques and new technology that will allow for improved interactive physical examinations, as we rapidly move forward into the realm of telemedicine due to unexpected necessity.


Subject(s)
Betacoronavirus , Coronavirus Infections , Orthopedics , Pandemics , Physical Examination , Pneumonia, Viral , Telemedicine , COVID-19 , Humans , SARS-CoV-2
16.
J Bone Joint Surg Am ; 102(12): 1022-1028, 2020 06 17.
Article in English | MEDLINE | ID: covidwho-1409848

ABSTRACT

BACKGROUND: Although elective surgical procedures in the United States have been suspended because of the coronavirus disease 2019 (COVID-19) pandemic, orthopaedic surgeons are being recruited to serve patients with COVID-19 in addition to providing orthopaedic acute care. Older individuals are deemed to be at higher risk for poor outcomes with COVID-19. Although previous studies have shown a high proportion of older providers nationwide across medical specialties, we are not aware of any previous study that has analyzed the age distribution among the orthopaedic workforce. Therefore, the purposes of the present study were (1) to determine the geographic distribution of U.S. orthopaedic surgeons by age, (2) to compare the distribution with other surgical specialties, and (3) to compare this distribution with the spread of COVID-19. METHODS: Demographic statistics from the most recent State Physician Workforce Data Reports published by the Association of American Medical Colleges were extracted to identify the 2018 statewide proportion of practicing orthopaedic surgeons ≥60 years of age as well as age-related demographic data for all surgical specialties. Geospatial data on the distribution of COVID-19 cases were obtained from the Environmental Systems Research Institute. State boundary files were taken from the U.S. Census Bureau. Orthopaedic workforce age data were utilized to group states into quintiles. RESULTS: States with the highest quintile of orthopaedic surgeons ≥60 years of age included states most severely affected by COVID-19: New York, New Jersey, California, and Florida. For all states, the median number of providers ≥60 years of age was 105.5 (interquartile range [IQR], 45.5 to 182.5). The median proportion of orthopaedic surgeons ≥60 years of age was higher than that of all other surgical subspecialties, apart from thoracic surgery. CONCLUSIONS: To our knowledge, the present report provides the first age-focused view of the orthopaedic workforce during the COVID-19 pandemic. States in the highest quintile of orthopaedic surgeons ≥60 years old are also among the most overwhelmed by COVID-19. As important orthopaedic acute care continues in addition to COVID-19 frontline service, special considerations may be needed for at-risk staff. Appropriate health system measures and workforce-management strategies should protect the subset of those who are most potentially vulnerable. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Orthopedic Surgeons/supply & distribution , Pneumonia, Viral/epidemiology , Age Distribution , Age Factors , COVID-19 , Geographic Mapping , Health Workforce/organization & administration , Humans , Middle Aged , Pandemics , SARS-CoV-2 , United States/epidemiology
17.
J Bone Joint Surg Am ; 102(12): e58, 2020 06 17.
Article in English | MEDLINE | ID: covidwho-1409847

ABSTRACT

BACKGROUND: From February 20 to April 2020, the coronavirus SARS (severe acute respiratory syndrome)-CoV-2 spread in northern Italy, drastically challenging the care capacities of the national health care system. Unprepared for this emergency, hospitals have quickly reformulated paths of assistance in an effort to guarantee treatment for infected patients. Orthopaedic departments have been focused on elderly traumatology, especially the treatment of femoral neck fractures in patients with coronavirus disease-2019 (COVID-19). The purpose of the present study was to evaluate the orthopaedic management strategy for femoral fragility fractures in COVID-19-positive patients with the hypothesis that operative treatment may contribute to the overall stability of the patient. METHODS: Sixteen patients affected by proximal femoral fracture and a recent history of fever, shortness of breath, and desaturation were admitted to the emergency room. Thoracic computed tomography (CT) and oropharyngeal swabs confirmed that they were positive for COVID-19, requiring hospitalization and prophylaxis with low-molecular-weight heparin. RESULTS: Three patients died before surgery because of severe respiratory insufficiency and multiple-organ-failure syndrome. Ten patients underwent surgery on the day after admission, whereas 3 patients had suspended their use of direct thrombin inhibitors and needed surgery to be delayed until the third day after admission. In all patients except 1, we noted an improvement in terms of O2 saturation and assisted respiration. In 9 patients, hemodynamic and respiratory stability was observed at an average of 7 days postoperatively. Four patients who underwent surgical treatment died of respiratory failure on the first day after surgery (1 patient), the third day after surgery (2 patients), or the seventh day after surgery (1 patient). CONCLUSIONS: We noted a stabilization of respiratory parameters in 12 COVID-19-positive patients who underwent surgery treatment of proximal femoral fractures. We believe that in elderly patients with COVID-19 who have proximal femoral fractures, surgery may contribute to the overall stability of the patient, seated mobilization, improvement in physiological ventilation, and general patient comfort in bed. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.


Subject(s)
Arthroplasty, Replacement, Hip/adverse effects , Betacoronavirus , Coronavirus Infections/epidemiology , Femoral Fractures/surgery , Fracture Fixation, Intramedullary/adverse effects , Frailty/complications , Pneumonia, Viral/epidemiology , Aged , Aged, 80 and over , COVID-19 , Disease Outbreaks , Female , Femoral Fractures/mortality , Femoral Fractures/virology , Frailty/mortality , Hospitalization , Humans , Italy , Male , Pandemics , SARS-CoV-2
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