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1.
Ann Med Psychol (Paris) ; 180(6): 543-550, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1899508

ABSTRACT

Purpose: COVID-19, a major "Public Health Emergencies of International Concern", had sought greater attention among researchers to study its pathogenesis, associated complications and management. However, there are only few studies that had studied its potential impact on mental health of general public, who are subjected to social distancing, community lockdown and restrictions in their routine activities. Objectives: The aim of this study is to assess the prevalence of psychological distress and mental health needs among general public in Tamil Nadu subjected to lockdown, social distancing amidst COVID-19 crisis. Tamil Nadu is one of the worst affected states of southern India. Methods: A self-administered, web-based application study using "WHO-Self Reported Questionnaire-20", in bilingual version, both English and Tamil, is used to screen the public for the level of distress. The study is done while the state is under extended lockdown and restricted movement. Key findings: A total of 918 respondents participated in the survey and it is found that about more than one third of the respondents (∼35%) are under psychological distress. A significant association between younger age group, female gender, unmarried, people with children are found to be under distress. The lockdown had increased the frequency of smoking and quantity of cigarettes among smokers, also has increased the frequency of drinking among alcohol consumers. Of the SRQ-20 items recorded, stress related neurotic symptoms (> 70%) was observed more than the depressive mood. About 33% of those scored > 7, had suicidal tendency. The districts declared red zones had significantly reported a greater number of respondents under distress. Conclusion: Besides effectively mitigating the COVID-19 crisis, in terms of prevention, control and treatment strategies, it is prerogative to effectively manage fear, distress due to the COVID-19 and associated anxiety and depression among the public.


But: Le COVID-19, une importante « Urgence de santé publique de portée internationale ¼, a demandé une plus grande attention des chercheurs pour étudier sa pathogenèse, les complications associées et la prise en charge. Cependant, rares sont les études qui ont étudié son impact potentiel sur la santé de la population, qui est soumise à l'éloignement social, au confinement communautaire et à des restrictions dans ses activités courantes. Objectifs: Le but de cette étude est d'évaluer la prévalence de la détresse psychologique et des besoins de santé mentale dans la population du Tamil Nadu soumise au confinement, à la distanciation sociale au milieu de la crise du COVID-19. Le Tamil Nadu est l'un des États les plus touchés du sud de l'Inde. Méthodes: Une étude d'application auto-administrée en ligne utilisant le « WHO-Self Reported Questionnaire-20 ¼, en version bilingue, en anglais et en tamoul, est utilisée pour dépister le niveau de détresse. L'étude est effectuée alors que l'État est sous confinement prolongé et mouvements restreints. Principales conclusions: Sur les 918 répondants qui ont participé à l'enquête, on constate qu'environ plus d'un tiers des répondants (∼35%) sont en détresse psychologique. Les plus jeunes, les femmes, les célibataires, les personnes avec enfants se trouvent en situation de détresse de façon significative. Le confinement a augmenté la fréquence du tabagisme et la quantité de cigarettes chez les fumeurs, a également augmenté la fréquence de consommation d'alcool chez les consommateurs d'alcool. Parmi les items SRQ-20 enregistrés, les symptômes névrotiques liés au stress (> 70 %) ont été plus observés que l'humeur dépressive. Environ 33 % des sujets, ayant obtenu un score supérieur à 7, avaient une tendance suicidaire. Les districts déclarés zone rouge avaient notablement signalé un plus grand nombre de répondants en détresse. Conclusion: En plus d'atténuer efficacement la pandémie du COVID-19, en termes de stratégies de prévention, de contrôle et de traitement, il est capital de gérer efficacement la peur, la détresse due au COVID-19, l'anxiété et la dépression associées et d'étendre le soutien psychosocial au public.

2.
J Am Coll Emerg Physicians Open ; 1(4): 375-378, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-1898670

ABSTRACT

COVID-19 is proving to be a devastating pandemic with both tragic economic and health consequences worldwide. Point-of-care ultrasound (POCUS) of the lungs has been thrust into the forefront of resources that could be used in the management of COVID-19 acute care patients. However, relatively little attention has been paid to POCUS utility in assessing the heart in COVID-19 patients. Anecdotal reports suggest encounters of likely COVID-19 induced pericardial effusions and myocardial electrical dysfunction. This article presents 2 cases of generally healthy patients who were noted to have classic COVID-19 bilateral pneumonia findings on lung ultrasound and incidentally discovered to have unsuspected left ventricular dysfunction likely resulting from myocarditis. POCUS videos are presented as illustrations of this potentially overlooked complication.

3.
Clin Infect Dis ; 74(1): 83-91, 2022 01 07.
Article in English | MEDLINE | ID: covidwho-1621573

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) occurs in critically ill patients with COVID-19. Risks and outcomes remain poorly understood. METHODS: A retrospective cohort study of mechanically ventilated adult patients with COVID-19 admitted to 5 Johns Hopkins hospitals was conducted between March and August 2020. CAPA was defined using composite clinical criteria. Fine and Gray competing risks regression was used to analyze clinical outcomes and, multilevel mixed-effects ordinal logistic regression was used to compare longitudinal disease severity scores. RESULTS: In the cohort of 396 people, 39 met criteria for CAPA. Patients with CAPA were more likely than those without CAPA to have underlying pulmonary vascular disease (41% vs 21.6%, respectively; P = .01), liver disease (35.9% vs 18.2%; P = .02), coagulopathy (51.3% vs 33.1%; P = .03), solid tumors (25.6% vs 10.9%; P = .02), multiple myeloma (5.1% vs 0.3%; P = .03), and corticosteroid exposure during the index admission (66.7% vs 42.6%; P = .005), and had lower body mass indexes (median, 26.6 vs 29.9 [calculated as weight in kilograms divided by height in meters squared]; P = .04). Patients with CAPA had worse outcomes, as measured by ordinal severity of disease scores, requiring longer time to improvement (adjusted odds ratio, 1.081.091.1; P < .001), and advancing in severity almost twice as quickly (subhazard ratio, 1.31.82.5; P < .001). They were intubated twice as long as those without CAPA (subhazard ratio, 0.40.50.6; P < .001) and had longer hospital stays (median [interquartile range], 41.1 [20.5-72.4) vs 18.5 [10.7-31.8] days; P < .001). CONCLUSION: CAPA is associated with poor outcomes. Attention to preventive measures (screening and/or prophylaxis) is warranted in people with high risk of CAPA.


Subject(s)
COVID-19 , Invasive Pulmonary Aspergillosis , Pulmonary Aspergillosis , Adult , Humans , Invasive Pulmonary Aspergillosis/diagnosis , Invasive Pulmonary Aspergillosis/epidemiology , Respiration, Artificial/adverse effects , Retrospective Studies , SARS-CoV-2
4.
Br J Psychiatry ; 218(1): 4-6, 2021 01.
Article in English | MEDLINE | ID: covidwho-1556723

ABSTRACT

Although long-term outcomes of girls with attention-deficit hyperactivity disorder are understudied, high risk for adolescent and young-adult self-harm is salient. We present data on predictors and mediators of such risk, highlighting a recent dual-process model involving trait impulsivity plus family- and peer-related contributors. We conclude with recommendations for assessment and preventive intervention.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Self-Injurious Behavior , Adolescent , Adult , Attention Deficit Disorder with Hyperactivity/epidemiology , Comorbidity , Female , Humans , Impulsive Behavior , Self-Injurious Behavior/epidemiology , Suicide, Attempted
5.
J Am Soc Nephrol ; 2021 Feb 18.
Article in English | MEDLINE | ID: covidwho-1496680

ABSTRACT

Obesity is a leading public health problem that currently affects over 650 million individuals worldwide. Although interest in the adverse effects of obesity has grown exponentially in recent years, less attention has been given to studying its management in individuals with CKD. This relatively unexplored area should be considered a high priority because of the rapid growth and high prevalence of obesity in the CKD population, its broad impact on health and outcomes, and its modifiable nature. This article begins to lay the groundwork in this field by providing a comprehensive overview that critically evaluates the available evidence related to obesity and kidney disease, identifies important gaps in our knowledge base, and integrates recent insights in the pathophysiology of obesity to help provide a way forward in establishing guidelines as a basis for managing obesity in CKD. Finally, the article includes a kidney-centric algorithm for management of obesity that can be used in clinical practice.

6.
Transbound Emerg Dis ; 68(4): 1995-2004, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1331772

ABSTRACT

This study reports outbreak of a new disease caused by Staphylococcus pseudintermedius (S. pseudintermedius) in raccoon dogs. The disease occurred in a breeding farm of raccoon dogs in Guan County of Shandong Province in China in August of 2019. 47% (425/896) of the raccoon dogs showed some abnormal symptoms; 17.6% (75/425) of which had severe skin and soft tissue infections (SSTIs), dyspnoea and severe pathological lesions in lungs, livers, etc; and 4.2% (18/425) of which died within 4 weeks. The pathogen of the disease was identified as S. pseudintermedius by mass spectrometer detection, animal pathogenicity tests, microscopic examination and biochemical reaction tests. Its nucleotide homology of 16S rRNA gene was 100% with that of other published strains, and its genotype was between the American and Brazilian strains from other animals. The isolated S. pseudintermedius strain from the diseased raccoon dogs could cause ulceration and suppuration in the skins and severe pathological lesions not only in raccoon dogs, but also in mice; and it is confirmed as a methicillin-resistant S. pseudintermedius (MRSP) strain by the amplification of mecA gene; and 12 sensitive drugs were screened by drug sensitivity tests. Full attention should be paid to the great economic loss and the potential zoonotic risk caused by the S. pseudintermedius in raccoon dogs, and this study can provide a reference for the clinical diagnosis and treatment of this new disease.


Subject(s)
Dog Diseases , Raccoon Dogs , Staphylococcal Infections , Animals , Anti-Bacterial Agents/pharmacology , Disease Outbreaks/veterinary , Dog Diseases/epidemiology , Dogs , Mice , RNA, Ribosomal, 16S , Rodent Diseases , Staphylococcal Infections/epidemiology , Staphylococcal Infections/veterinary , Staphylococcus
7.
JMIR Public Health Surveill ; 7(7): e29942, 2021 07 08.
Article in English | MEDLINE | ID: covidwho-1317186

ABSTRACT

BACKGROUND: Recent emergency authorization and rollout of COVID-19 vaccines by regulatory bodies has generated global attention. As the most popular video-sharing platform globally, YouTube is a potent medium for the dissemination of key public health information. Understanding the nature of available content regarding COVID-19 vaccination on this widely used platform is of substantial public health interest. OBJECTIVE: This study aimed to evaluate the reliability and quality of information on COVID-19 vaccination in YouTube videos. METHODS: In this cross-sectional study, the phrases "coronavirus vaccine" and "COVID-19 vaccine" were searched on the UK version of YouTube on December 10, 2020. The 200 most viewed videos of each search were extracted and screened for relevance and English language. Video content and characteristics were extracted and independently rated against Health on the Net Foundation Code of Conduct and DISCERN quality criteria for consumer health information by 2 authors. RESULTS: Forty-eight videos, with a combined total view count of 30,100,561, were included in the analysis. Topics addressed comprised the following: vaccine science (n=18, 58%), vaccine trials (n=28, 58%), side effects (n=23, 48%), efficacy (n=17, 35%), and manufacturing (n=8, 17%). Ten (21%) videos encouraged continued public health measures. Only 2 (4.2%) videos made nonfactual claims. The content of 47 (98%) videos was scored to have low (n=27, 56%) or moderate (n=20, 42%) adherence to Health on the Net Foundation Code of Conduct principles. Median overall DISCERN score per channel type ranged from 40.3 (IQR 34.8-47.0) to 64.3 (IQR 58.5-66.3). Educational channels produced by both medical and nonmedical professionals achieved significantly higher DISCERN scores than those of other categories. The highest median DISCERN scores were achieved by educational videos produced by medical professionals (64.3, IQR 58.5-66.3) and the lowest median scores by independent users (18, IQR 18-20). CONCLUSIONS: The overall quality and reliability of information on COVID-19 vaccines on YouTube remains poor. Videos produced by educational channels, especially by medical professionals, were higher in quality and reliability than those produced by other sources, including health-related organizations. Collaboration between health-related organizations and established medical and educational YouTube content producers provides an opportunity for the dissemination of high-quality information on COVID-19 vaccination. Such collaboration holds potential as a rapidly implementable public health intervention aiming to engage a wide audience and increase public vaccination awareness and knowledge.


Subject(s)
COVID-19 Vaccines/administration & dosage , Consumer Health Information/standards , Information Dissemination/methods , Public Health , Social Media , Video Recording , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Humans , Reproducibility of Results , United Kingdom/epidemiology
8.
Br J Sports Med ; 55(15): 843-850, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1315801

ABSTRACT

OBJECTIVES: To describe the incidence rate, severity, burden and aetiology of medical attention and time-loss injuries across five consecutive seasons at a professional ballet company. METHODS: Medical attention injuries, time-loss injuries and dance exposure hours of 123 professional ballet dancers (women: n=66, age: 28.0±8.3 years; men: n=57, age: 27.9±8.5 years) were prospectively recorded between the 2015/2016 and 2019/2020 seasons. RESULTS: The incidence rate (per 1000 hours) of medical attention injury was 3.9 (95% CI 3.3 to 4.4) for women and 3.1 (95% CI 2.6 to 3.5) for men. The incidence rate (per 1000 hours) of time-loss injury was 1.2 (95% CI 1.0 to 1.5) for women and 1.1 (95% CI 0.9 to 1.3) for men. First Soloists and Principals experienced between 2.0-2.2 additional medical attention injuries per 1000 hours and 0.9-1.1 additional time-loss injuries per 1000 hours compared with Apprentices (p≤0.025). Further, intraseason differences were observed in medical attention, but not time-loss, injury incidence rates with the highest incidence rates in early (August and September) and late (June) season months. Thirty-five per cent of time-loss injuries resulted in over 28 days of modified dance training. A greater percentage of time-loss injuries were classified as overuse (women: 50%; men: 51%) compared with traumatic (women: 40%; men: 41%). CONCLUSION: This is the first study to report the incidence rate of medical attention and time-loss injuries in professional ballet dancers. Incidence rates differed across company ranks and months, which may inform targeted injury prevention strategies.


Subject(s)
Absenteeism , Dancing/injuries , Occupational Injuries/epidemiology , Adult , Confidence Intervals , Dancing/statistics & numerical data , Female , Humans , Incidence , Injury Severity Score , Male , Musculoskeletal System/injuries , Occupational Injuries/classification , Occupational Injuries/therapy , Prospective Studies , Seasons , Sex Distribution , Time Factors
9.
J Virol ; 95(15): e0076621, 2021 07 12.
Article in English | MEDLINE | ID: covidwho-1305511

ABSTRACT

All coronaviruses (CoVs) contain a macrodomain, also termed Mac1, in nonstructural protein 3 (nsp3) that binds and hydrolyzes mono-ADP-ribose (MAR) covalently attached to proteins. Despite several reports demonstrating that Mac1 is a prominent virulence factor, there is still a limited understanding of its cellular roles during infection. Currently, most of the information regarding the role of CoV Mac1 during infection is based on a single point mutation of a highly conserved asparagine residue, which makes contact with the distal ribose of ADP-ribose. To determine if additional Mac1 activities contribute to CoV replication, we compared the replication of murine hepatitis virus (MHV) Mac1 mutants, D1329A and N1465A, to the previously mentioned asparagine mutant, N1347A. These residues contact the adenine and proximal ribose in ADP-ribose, respectively. N1465A had no effect on MHV replication or pathogenesis, while D1329A and N1347A both replicated poorly in bone marrow-derived macrophages (BMDMs), were inhibited by PARP enzymes, and were highly attenuated in vivo. Interestingly, D1329A was also significantly more attenuated than N1347A in all cell lines tested. Conversely, D1329A retained some ability to block beta interferon (IFN-ß) transcript accumulation compared to N1347A, indicating that these mutations have different effects on Mac1 functions. Combining these two mutations resulted in a virus that was unrecoverable, suggesting that the combined activities of Mac1 are essential for MHV replication. We conclude that Mac1 has multiple functions that promote the replication of MHV, and that these results provide further evidence that Mac1 is a prominent target for anti-CoV therapeutics. IMPORTANCE In the wake of the COVID-19 epidemic, there has been a surge to better understand how CoVs replicate and to identify potential therapeutic targets that could mitigate disease caused by SARS-CoV-2 and other prominent CoVs. The highly conserved macrodomain, also termed Mac1, is a small domain within nonstructural protein 3. It has received significant attention as a potential drug target, as previous studies demonstrated that it is essential for CoV pathogenesis in multiple animal models of infection. However, the functions of Mac1 during infection remain largely unknown. Here, using targeted mutations in different regions of Mac1, we found that Mac1 has multiple functions that promote the replication of MHV, a model CoV, and, therefore, is more important for MHV replication than previously appreciated. These results will help guide the discovery of these novel functions of Mac1 and the development of inhibitory compounds targeting this domain.


Subject(s)
Murine hepatitis virus/physiology , Mutation, Missense , Viral Nonstructural Proteins , Virus Replication/genetics , Amino Acid Substitution , Animals , HeLa Cells , Humans , Macrophages/metabolism , Macrophages/virology , Mice , Viral Nonstructural Proteins/genetics , Viral Nonstructural Proteins/metabolism
10.
J Public Health (Oxf) ; 43(2): e273-e274, 2021 06 07.
Article in English | MEDLINE | ID: covidwho-1276212

ABSTRACT

In recent correspondences and articles published, the role of religious and spiritual interventions has been discussed for the attention of the medical community in the time of COVID-19 pandemic and part of these interventions is to provide spiritual care. Attention has been given to provide spiritual care among COVID-19 patients. However, there is also a dire need to offer spiritual care towards healthcare professionals because they, too, are 'wounded healers'. This paper discusses the urgent call for the medical and spiritual communities to come up with comprehensive spiritual care programme for healthcare professionals so that they may attain spiritual well-being as they serve in the frontlines, risking their lives and providing spiritual care to patients especially in this trying times of the pandemic as a public health crisis.


Subject(s)
COVID-19 , Pandemics , Delivery of Health Care , Health Personnel , Humans , SARS-CoV-2
11.
J Hosp Palliat Nurs ; 23(2): 140-144, 2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-1272995

ABSTRACT

There is limited knowledge about the psychosocial stress among the nursing staff working on the COVID-19 wards. This article reports on the experiences of frontline health care workers as it was described to supervisors counseling the nursing staff engaged in the response to the outbreak of COVID-19. Frontline health care workers, nurses, and nurses' aides experienced major work changes. Some were transferred to the newly formed COVID-19 wards in a large Danish hospital, were given new tasks, and had to collaborate with new colleagues, while treating a new deadly and contagious disease. This study aimed to describe the reflections and experiences of the nursing staff attending supervision sessions. The palliative unit offered supervision from April 2020. A total of 9 supervision sessions were held as part of this study, and 57 nursing staff members participated in the sessions. The supervision was available to employees until the first COVID wave subsided in June 2020. During each session, supervisors took field notes and wrote field memos. The topics raised by the nursing staff during the supervision sessions ranged between pride and uncertainty. Nursing staff in COVID-19 wards were at risk of feeling an increasing burden, and there was a need for ongoing managerial attention as well as continuous visible presence and support.


Subject(s)
COVID-19/nursing , Nursing Staff, Hospital/psychology , COVID-19/epidemiology , Denmark/epidemiology , Emotions , Hospitals, University , Humans , Qualitative Research , Uncertainty
12.
World J Clin Cases ; 9(17): 4133-4142, 2021 Jun 16.
Article in English | MEDLINE | ID: covidwho-1270279

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic, affecting all the individuals across the planet. COVID-19 has gained significant attention due to its high prevalence among individuals with diabetes, nonalcoholic fatty liver disease (NAFLD), and metabolic syndrome. NAFLD is the hepatic manifestation of metabolic syndrome and can be associated with a high risk of developing type 2 diabetes. The association of COVID-19 and NAFLD has also gained more attention because NAFLD is highly associated with the epidemic of obesity. NAFLD is a potential risk factor for SARS-CoV-2 infection and severe COVID-19, independent of metabolic syndrome. Importantly, it is not yet clear whether the epidemics of obesity and NAFLD have perpetuated the current pandemic of COVID-19. Further research is urgently needed to assess the following: (1) Whether NAFLD is a high risk factor for SARS-CoV-2 infection; (2) Whether NAFLD is associated with the severe form of COVID-19; and (3) Whether the presence of NAFLD can explain the racial variation in the morbidity and mortality associated with COVID-19. This review summarizes the interactions between COVID-19 and NAFLD, mechanism of liver injury by COVID-19, and effect of lockdown due to COVID- 19 on patients with NAFLD.

13.
Int J Environ Res Public Health ; 18(11)2021 05 28.
Article in English | MEDLINE | ID: covidwho-1266725

ABSTRACT

Children with attention-deficit/hyperactivity disorder (ADHD) are commonly affected by medical illness. The aim of the present study was to explore the risks of contracting respiratory infectious diseases (RIDs), including upper and lower RIDs and influenza, in children with ADHD. We also examined whether methylphenidate has a protective effect regarding the risk of contracting RIDs among children with ADHD who have a history of methylphenidate treatment. Children in the Taiwan Maternal and Child Health Database from 2004 to 2016 were included in the present study. Upper and lower RIDs, influenza, ADHD, age, sex, and records of methylphenidate prescription were identified. A Cox proportional hazards regression model was used to estimate the significance of the risk of RIDs among children with ADHD in comparison with that among children without ADHD after adjustment for sex and age. The self-controlled case series analysis was conducted to examine the protective effect of methylphenidate treatment against RIDs. In total, 85,853 children with ADHD and 1,458,750 children without ADHD were included in the study. After controlling for sociodemographic variables, we observed that children with ADHD had significantly higher risks of upper RIDs, lower RIDs, and influenza infection than did those without ADHD. Among the children with ADHD who had a history of methylphenidate treatment, the risk of contracting RIDs was lower during the methylphenidate treatment period than during the nontreatment period. Children with ADHD had a higher RID risk than those without ADHD. Methylphenidate might reduce the risk of RIDs among children with ADHD who have a history of methylphenidate treatment.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Central Nervous System Stimulants , Communicable Diseases , Methylphenidate , Attention Deficit Disorder with Hyperactivity/drug therapy , Attention Deficit Disorder with Hyperactivity/epidemiology , Central Nervous System Stimulants/therapeutic use , Child , Cohort Studies , Humans , Methylphenidate/therapeutic use , Taiwan/epidemiology
14.
Med Phys ; 48(8): 4334-4349, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1265402

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has caused hundreds of thousands of infections and deaths. Efficient diagnostic methods could help curb its global spread. The purpose of this study was to develop and evaluate a method for accurately diagnosing COVID-19 based on computed tomography (CT) scans in real time. METHODS: We propose an architecture named "concatenated feature pyramid network" ("Concat-FPN") with an attention mechanism, by concatenating feature maps of multiple. The proposed architecture is then used to form two networks, which we call COVID-CT-GAN and COVID-CT-DenseNet, the former for data augmentation and the latter for data classification. RESULTS: The proposed method is evaluated on 3 different numbers of magnitude of COVID-19 CT datasets. Compared with the method without GANs for data augmentation or the original network auxiliary classifier generative adversarial network, COVID-CT-GAN increases the accuracy by 2% to 3%, the recall by 2% to 4%, the precision by 1% to 3%, the F1-score by 1% to 3%, and the area under the curve by 1% to 4%. Compared with the original network DenseNet-201, COVID-CT-DenseNet increases the accuracy by 1% to 3%, the recall by 4% to 9%, the precision by 1%, the F1-score by 1% to 3%, and the area under the curve by 2%. CONCLUSION: The experimental results show that our method improves the efficiency of diagnosing COVID-19 on CT images, and helps overcome the problem of limited training data when using deep learning methods to diagnose COVID-19. SIGNIFICANCE: Our method can help clinicians build deep learning models using their private datasets to achieve automatic diagnosis of COVID-19 with a high precision.


Subject(s)
COVID-19 , COVID-19 Testing , Humans , Radionuclide Imaging , SARS-CoV-2 , Tomography, X-Ray Computed
15.
J Child Adolesc Psychopharmacol ; 30(3): 177-188, 2020 04.
Article in English | MEDLINE | ID: covidwho-1263645

ABSTRACT

Background: Indole tryptophan metabolites (ITMs), mainly produced at the gastrointestinal level, participate in bidirectional gut-brain communication and have been implicated in neuropsychiatric pathologies, including attention-deficit/hyperactivity disorder (ADHD). Method: A total of 179 children, 5-14 years of age, including a healthy control group (CG, n = 49), and 107 patients with ADHD participated in the study. The ADHD group was further subdivided into predominantly attention deficit (PAD) and predominantly hyperactive impulsive (PHI) subgroups. Blood samples were drawn at 20:00 and 09:00 hours, and urine was collected between blood draws, at baseline and after 4.63 ± 2.3 months of methylphenidate treatment in the ADHD group. Levels and daily fluctuations of ITM were measured by tandem mass spectrometer, and S100B (as a glial inflammatory marker) by enzyme-linked immunosorbent assay. Factorial analysis of variance (Stata 12.0) was performed with groups/subgroups, time (baseline/after treatment), hour of day (morning/evening), and presence of depressive symptoms (DS; no/yes) as factors. Results: Tryptamine and indoleacetic acid (IAA) showed no differences between the CG and ADHD groups. Tryptamine exhibited higher evening values (p < 0.0001) in both groups. No changes were associated with methylphenidate or DS. At baseline, in comparison with the rest of study sample, PHI with DS+ group showed among them much greater morning than evening IAA (p < 0.0001), with treatment causing a 50% decrease (p = 0.002). Concerning indolepropionic acid (IPA) MPH was associated with a morning IPA decrease and restored the daily profile observed in the CG. S100B protein showed greater morning than evening concentrations (p = 0.001) in both groups. Conclusion: Variations in ITM may reflect changes associated with the presence of DS, including improvement, among ADHD patients.


Subject(s)
Attention Deficit Disorder with Hyperactivity/drug therapy , Central Nervous System Stimulants/administration & dosage , Depression/psychology , Methylphenidate/administration & dosage , Adolescent , Attention Deficit Disorder with Hyperactivity/psychology , COVID-19/drug therapy , Case-Control Studies , Child , Child, Preschool , Female , Humans , Impulsive Behavior/drug effects , Indoles/metabolism , Male , S100 Calcium Binding Protein beta Subunit/metabolism , Time Factors , Tryptophan/metabolism
16.
PLoS One ; 16(6): e0252351, 2021.
Article in English | MEDLINE | ID: covidwho-1262545

ABSTRACT

BACKGROUND: COVID-19 may predispose to both venous and arterial thromboembolism event (TEE). Reports on the prevalence and prognosis of thrombotic complications are still emerging. OBJECTIVE: To describe the rate of TEE complications and its influence in the prognosis of hospitalized patients with COVID-19 after a cross-sectional study. METHODS: We evaluated the prevalence of TEE and its relationship with in-hospital death among hospitalized patients with COVID-19 who were admitted between 1st March to 20th April 2020 in a multicentric network of sixteen Hospitals in Spain. TEE was defined by the occurrence of venous thromboembolism (VTE), acute ischemic stroke (AIS), systemic arterial embolism or myocardial infarction (MI). RESULTS: We studied 1737 patients with proven COVID-19 infection of whom 276 died (15.9%). TEE were presented in 64 (3.7%) patients: 49 (76.6%) patients had a VTE, 8 (12.5%) patients had MI, 6 (9.4%%) patients had AIS, and one (1.5%) patient a thrombosis of portal vein. TEE patients exhibited a diffuse profile: older, high levels of D-dimer protein and a tendency of lower levels of prothrombin. The multivariate regression models, confirmed the association between in-hospital death and age (odds ratio [OR] 1.12 [95% CI 1.10-1.14], p<0.001), diabetes (OR 1.49 [95% CI 1.04-2.13], p = 0.029), chronic obstructive pulmonary disease (OR 1.61 [95% CI 1.03-2.53], p = 0.039), ICU care (OR 9.39 [95% CI 5.69-15.51], p<0.001), and TTE (OR 2.24 [95% CI 1.17-4.29], p = 0.015). CONCLUSIONS: Special attention is needed among hospitalized COVID-19 patients with TTE and other comorbidities as they have an increased risk of in-hospital death.


Subject(s)
COVID-19/mortality , COVID-19/pathology , Thromboembolism/mortality , Thromboembolism/virology , Aged , COVID-19/epidemiology , COVID-19/virology , Cross-Sectional Studies , Female , Hospital Mortality , Hospitalization/statistics & numerical data , Humans , Male , Prognosis , Risk Factors , SARS-CoV-2/isolation & purification , Spain/epidemiology , Survival Rate , Thromboembolism/epidemiology
17.
Int J Comput Assist Radiol Surg ; 16(9): 1425-1434, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1258241

ABSTRACT

PURPOSE: The global health crisis caused by coronavirus disease 2019 (COVID-19) is a common threat facing all humankind. In the process of diagnosing COVID-19 and treating patients, automatic COVID-19 lesion segmentation from computed tomography images helps doctors and patients intuitively understand lung infection. To effectively quantify lung infections, a convolutional neural network for automatic lung infection segmentation based on deep learning is proposed. METHOD: This new type of COVID-19 lesion segmentation network is based on a U-Net backbone. First, a coarse segmentation network is constructed to extract the lung areas. Second, in the encoding and decoding process of the fine segmentation network, a new soft attention mechanism, namely the dilated convolutional attention (DCA) mechanism, is introduced to enable the network to focus on better quantitative information to strengthen the network's segmentation ability in the subtle areas of the lesions. RESULTS: The experimental results show that the average Dice similarity coefficient (DSC), sensitivity (SEN), specificity (SPE) and area under the curve of DUDA-Net are 87.06%, 90.85%, 99.59% and 0.965, respectively. In addition, the introduction of a cascade U-shaped network scheme and DCA mechanism can improve the DSC by 24.46% and 14.33%, respectively. CONCLUSION: The proposed DUDA-Net approach can automatically segment COVID-19 lesions with excellent performance, which indicates that the proposed method is of great clinical significance. In addition, the introduction of a coarse segmentation network and DCA mechanism can improve the COVID-19 segmentation performance.


Subject(s)
COVID-19 , Image Processing, Computer-Assisted , Humans , Lung/diagnostic imaging , SARS-CoV-2 , Tomography, X-Ray Computed
18.
J Environ Manage ; 293: 112860, 2021 Sep 01.
Article in English | MEDLINE | ID: covidwho-1253185

ABSTRACT

Microplastics (MPs) are emerging as a severe threat in our environment. Their diverse existence in marine environments is being researched globally and thus a widely known fact; however, their presence in the freshwater counterpart has gained attention lately only. Riverine systems, the most critical freshwater resources serve as an essential link between terrestrial and marine environments and their contamination with MPs is going to create severe environmental issues. Because of their small size and unique morphology, these polymers can exhibit variable toxicity to the interacting biota and alter their habitat properties; thus, causing serious impacts on the environment and health of living beings, including humans. These microplastics can also interact with pollutants like heavy metals and organic pollutants, which further augment their harming potential. Inefficient and poor plastic waste disposal practices play an important role in the generation of microplastic pollutants. In the present COVID 19 pandemics, the excessive use of plastic to contain the spread of infection has further added the plastic load in the environment which will eventually lead to the generation of microplastic particles. Also, a significant amount of microplastic pollutants in riverine systems are delivered through wastewater treatment plant effluents. These trade-offs create a distress situation in the environment. The present study connects these key issues for a better understanding of the diverse existence of microplastic pollutants, their sources, and fate, with a special emphasis on riverine systems. A critical appraisal of the knowledge gaps and proposal of suitable solutions through this review might open up avenues for further research and effective management of the microplastics in aquatic environments.


Subject(s)
COVID-19 , Water Pollutants, Chemical , Environmental Monitoring , Humans , Microplastics , Plastics , SARS-CoV-2 , Water Pollutants, Chemical/analysis
19.
Viruses ; 13(6)2021 05 29.
Article in English | MEDLINE | ID: covidwho-1256668

ABSTRACT

The COVID-19 pandemic, which began in Wuhan (Hubei, China), has been ongoing for about a year and a half. An unprecedented number of people around the world have been infected with SARS-CoV-2, the etiological agent of COVID-19. Despite the fact that the mortality rate for COVID-19 is relatively low, the total number of deaths has currently already reached more than three million and continues to increase due to high incidence. Since the beginning of the pandemic, a large number of sequences have been obtained and many genetic variants have been identified. Some of them bear significant mutations that affect biological properties of the virus. These genetic variants, currently Variants of Concern (VoC), include the so-called United Kingdom variant (20I/501Y), the Brazilian variant (20J/501Y.V3), and the South African variant (20H/501Y.V2). We describe here a novel SARS-CoV-2 variant with distinct spike protein mutations, first obtained at the end of January 2021 in northwest Russia. Therefore, it is necessary to pay attention to the dynamics of its spread among patients with COVID-19, as well as to study in detail its biological properties.


Subject(s)
SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics , DNA Mutational Analysis , DNA, Complementary , Genome, Viral , Humans , Models, Molecular , Mutation , Phylogeny , Protein Conformation , Russia , SARS-CoV-2/classification , SARS-CoV-2/isolation & purification , Spike Glycoprotein, Coronavirus/chemistry
20.
Semin Thromb Hemost ; 47(6): 631-642, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1246450

ABSTRACT

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality among hospitalized patients, including children. In recent years, it has become clear that hospitalization and critical illness bestow an increased VTE risk in pediatrics and relate to mortality and life-limiting comorbidities. For critically ill children, reported rates of VTE vary by study sampling techniques, presence of inherited or acquired thrombophilia, acute and chronic immobility, underlying illness prompting hospitalization, and clinical factors related to illness severity such as central venous catheterization, length of stay, mechanical ventilation, and patient age. Accordingly, critically ill children with new signs of venous congestion, acute inflammation, or unexplained acute organ dysfunction should be routinely evaluated for VTE. This narrative review summarizes recent and historical literature regarding risk factors, prevention, presentation, treatment, and outcomes of VTE in critically ill children. In addition, we identify knowledge gaps and priorities for future collaborative research on this vital condition. Special attention is given to the clinical trial opportunities, challenges, and ongoing efforts in thromboprophylaxis in critically ill children, including those hospitalized for disease related to novel coronavirus (COVID-19) and multisystem inflammatory disease in children.


Subject(s)
Critical Illness , Venous Thromboembolism/epidemiology , Venous Thromboembolism/therapy , Anticoagulants/therapeutic use , COVID-19/complications , Child , Critical Illness/epidemiology , Critical Illness/therapy , Disease Management , Humans , Risk Factors , Thrombolytic Therapy
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