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1.
Clin Infect Dis ; 2021 May 20.
Article in English | MEDLINE | ID: covidwho-1873862

ABSTRACT

BACKGROUND: Patients hospitalized for COVID-19 may experience complications following hospitalization and require readmission. This analysis estimates the rate and risk factors associated with COVID-19-related readmission and inpatient mortality. METHODS: This is a retrospective cohort study utilizing deidentified chargemaster data from 297 hospitals across 40 US states on patients hospitalized with COVID-19 February 15-June 09, 2020. Demographics, comorbidities, acute conditions, and clinical characteristics of first hospitalization are summarized. Mulitvariable logistic regression was used to measure risk factor associations with 30-day readmission and in-hospital mortality. RESULTS: Among 29,659 patients, 1,070 (3.6%) were readmitted. Readmitted patients were more likely to have diabetes, hypertension, cardiovascular disease (CVD), chronic kidney disease (CKD) vs those not readmitted (p<0.0001) and to present on first admission with acute kidney injury (15.6% vs. 9.2%), congestive heart failure (6.4% vs. 2.4%), and cardiomyopathy (2.1% vs. 0.8%) (p<0.0001). Higher odds of readmission were observed in patients age >60 vs. 1840 (odds ratio [OR]=1.92, 95% confidence interval [CI]=1.48, 2.50), and admitted in the Northeast vs. West (OR=1.43, 95% CI=1.14, 1.79) or South (OR=1.28, 95% CI=1.11, 1.49). Comorbidities including diabetes (OR=1.34, 95% CI=1.12, 1.60), CVD (OR=1.46, 95% CI=1.23, 1.72), CKD stage 1-5 (OR=1.51, 95% CI=1.25,1.81) and stage 5 (OR=2.27, 95% CI=1.81, 2.86) were associated with higher odds of readmission. 12.3% of readmitted patients died during second hospitalization. CONCLUSIONS: Among this large US population of patients hospitalized with COVID-19, readmission was associated with certain comorbidities and acute conditions during first hospitalization. These findings may inform strategies to mitigate risks of readmission due to COVID-19 complications.

2.
J Ayurveda Integr Med ; 13(1): 100424, 2022.
Article in English | MEDLINE | ID: covidwho-1838955

ABSTRACT

For centuries, traditional medicines of Ayurveda have been in use to manage infectious and non-infectious diseases. The key embodiment of traditional medicines is the holistic system of approach in the management of human diseases. SARS-CoV-2 (COVID-19) infection is an ongoing pandemic, which has emerged as the major health threat worldwide and is causing significant stress, morbidity and mortality. Studies from the individuals with SARS-CoV-2 infection have shown significant immune dysregulation and cytokine overproduction. Neutrophilia and neutrophil to lymphocyte ratio has been correlated to poor outcome due to the disease. Neutrophils, component of innate immune system, upon stimulation expel DNA along with histones and granular proteins to form extracellular traps (NETs). Although, these DNA lattices possess beneficial activity in trapping and eliminating pathogens, NETs may also cause adverse effects by inducing immunothrombosis and tissue damage in diseases including Type 2 Diabetes and atherosclerosis. Tissues of SARS-CoV-2 infected subjects showed microthrombi with neutrophil-platelet infiltration and serum showed elevated NETs components, suggesting large involvement and uncontrolled activation of neutrophils leading to pathogenesis and associated organ damage. Hence, traditional Ayurvedic herbs exhibiting anti-inflammatory and antioxidant properties may act in a manner that might prove beneficial in targeting over-functioning of neutrophils and there by promoting normal immune homeostasis. In the present manuscript, we have reviewed and discussed pathological importance of NETs formation in SARS-CoV-2 infections and discuss how various Ayurvedic herbs can be explored to modulate neutrophil function and inhibit NETs formation in the context of a) anti-microbial activity to enhance neutrophil function, b) immunomodulatory effects to maintain neutrophil mediated immune homeostasis and c) to inhibit NETs mediated thrombosis.

3.
Am J Speech Lang Pathol ; 30(1): 63-74, 2021 01 27.
Article in English | MEDLINE | ID: covidwho-1805676

ABSTRACT

Purpose Evaluation and management of voice and upper airway disorders in adults and children, by speech-language pathologists worldwide, have been significantly altered by the COVID-19 pandemic. Secondary to the pathogenic nature of the virus in the respiratory tract and upper airway, it is essential that speech-language pathologists who specialize in these disorders are knowledgeable of current practices to provide evidence-based care while minimizing viral transmission. Understanding how and when SARS-CoV-2 spreads is critical to the development of effective infection prevention within clinical practices. Method We established an evidence-based clinical practice guide for clinicians working with voice and upper airway through a comprehensive evaluation of peer-reviewed journals, non-peer-reviewed manuscripts on preprint servers, national health guidelines, and published and online consensus statements and emerging data. Emphasis was placed on risk mitigation for viral transmission via safe clinical practices, including evaluative procedures, therapy including telehealth, personal protective equipment, room, staffing, and distancing considerations. Results/Conclusions While knowledge relevant to viral transmission of SARS-CoV-2 is rapidly evolving, there is a paucity of literature specific to the evaluation and treatment of voice and upper airway disorders. Within these confines and given the potentially significant high risk of infection secondary to the nature of COVID-19, we summarize current considerations and recommend best practices that maximize risk mitigation whereby ensuring patient and provider safety.


Subject(s)
Airway Obstruction/diagnosis , COVID-19/diagnosis , Speech Disorders/diagnosis , Voice Disorders/diagnosis , Adult , Airway Obstruction/therapy , COVID-19/therapy , Child , Humans , Practice Guidelines as Topic , Risk Factors , Speech Disorders/therapy , Voice Disorders/therapy
4.
Pneumologe (Berl) ; : 1-5, 2020 Aug 21.
Article in German | MEDLINE | ID: covidwho-1797596

ABSTRACT

BACKGROUND: At the beginning of the SARS-CoV­2 pandemic the focus of attention was on children and adolescents with chronic lung diseases. Due to a lack of epidemiological data and clinical experience, it was feared that children with respiratory diseases were a risk group for particularly severe courses of COVID-19, as has been reported for adults. OBJECTIVE: The currently available (epidemiological) data on this patient group are presented as well as a description of our own experiences based on three selected cases. MATERIAL AND METHODS: A review of the literature was carried out and three selected case reports and a discussion of current recommendations are presented. RESULTS: The incidence of COVID-19 is significantly lower in children than in adults. Furthermore, the known risk factors in adults cannot be simply transferred to pediatric patients. In the majority of cases, children and adolescents with chronic lung diseases show a milder course of SARS-CoV­2 infections. CONCLUSION: Although the hitherto available data show that children and adolescents have a lower risk for COVID-19 courses than adults, it should not be ignored that fatal outcomes have also been reported in pediatric patients. Moreover, late effects, such as the pediatric inflammatory multisystem syndrome (PIMS) can sometimes lead to a fatal outcome. Nevertheless, care must be taken that this vulnerable patient group does not suffer from avoidable negative side effects of restriction and isolation measures. As an example, the no-show behavior in outpatient departments during the lockdown might have led to a relevant undertreatment of underlying chronic health conditions.

5.
Neuropsychiatr Dis Treat ; 16: 2511-2518, 2020.
Article in English | MEDLINE | ID: covidwho-1793305

ABSTRACT

BACKGROUND: COVID-19 has had a devastating impact on the mental health condition of the world's population. Although the direct effect of COVID-19 on the mental health status of chronic medical patients is well understood, the burden of depression and anxiety on patients with chronic medical conditions is not well studied yet. Therefore, the study aimed to assess the prevalence of depression, anxiety and associated factors among chronic medical patients amid the COVID-19 pandemic in Mettu Karl Referral Hospital, Mettu, Ethiopia. METHODS: A facility-based cross-sectional study was conducted from June 1 to July 30, 2020 among chronic medical patients in Mettu Karl Referral Hospital, Ethiopia. Consecutive sampling technique was applied with a total of 423 samples. Quantitative data were employed by using structured questionnaires. Descriptive statistical procedures, bivariate and multivariate logistic regressions with odds ratios and 95% confidence interval (CI) were employed. The statistical significance was declared at p value < 0.05. RESULTS: The findings showed that the prevalence of depression and anxiety among chronic medical patients was 55.7% and 61.8%, respectively. Female gender (AOR = 1.66, 95% CI (1.06, 2.59)), poor social support (AOR = 1.94, 95% CI (1.10, 3.42)), widowed/divorced (AOR = 3.92, 95% CI (1.59, 9.64)), separated (AOR = 3.66, 95% CI (1.64, 8.19)), and longer duration of illness (AOR = 1.82, 95% CI (1.15, 2.89)) were significantly associated with depression, whereas earlier age at onset of illness, having more than three co-morbid diagnoses, tobacco use and poor social support were found to have significant association with anxiety among chronic medical patients amid the COVID-19 pandemic in Ethiopia. CONCLUSION: The magnitude of concurrent depression and anxiety in the current study was high. Strategies for prompt identification and treatment of depression and anxiety should be developed among medically ill patients.

6.
Arch Acad Emerg Med ; 8(1): e34, 2020.
Article in English | MEDLINE | ID: covidwho-1787362

ABSTRACT

INTRODUCTION: The outbreak of the new Coronavirus in China in December 2019 and subsequently in various countries around the world has raised concerns about the possibility of vertical transmission of the virus from mother to fetus. The present study aimed to review published literature in this regard. METHODS: In this narrative review, were searched for all articles published in various databases including PubMed, Scopus, Embase, Science Direct, and Web of Science using MeSH-compliant keywords including COVID-19, Pregnancy, Vertical transmission, Coronavirus 2019, SARS-CoV-2 and 2019-nCoV from December 2019 to March 18, 2020 and reviewed them. All type of articles published about COVID-19 and vertical transmission in pregnancy were included. RESULTS: A review of 13 final articles published in this area revealed that COVID-19 can cause fetal distress, miscarriage, respiratory distress and preterm delivery in pregnant women but does not infect newborns. There has been no report of vertical transmission in pregnancy, and it has been found that clinical symptoms of COVID-19 in pregnant women are not different from those of non-pregnant women. CONCLUSION: Overall, due to lack of appropriate data about the effect of COVID-19 on pregnancy, it is necessary to monitor suspected pregnant women before and after delivery. For confirmed cases both the mother and the newborn child should be followed up comprehensively.

7.
J Clin Med ; 10(4)2021 Feb 11.
Article in English | MEDLINE | ID: covidwho-1753571

ABSTRACT

The perioperative use of regional anesthesia and local anesthetics is part of almost every anesthesiologist's daily clinical practice. Retrospective analyses and results from experimental studies pointed towards a potential beneficial effect of the local anesthetics regarding outcome-i.e., overall and/or recurrence-free survival-in patients undergoing cancer surgery. The perioperative period, where the anesthesiologist is responsible for the patients, might be crucial for the further course of the disease, as circulating tumor cells (shed from the primary tumor into the patient's bloodstream) might form new micro-metastases independent of complete tumor removal. Due to their strong anti-inflammatory properties, local anesthetics might have a certain impact on these circulating tumor cells, either via direct or indirect measures, for example via blunting the inflammatory stress response as induced by the surgical stimulus. This narrative review highlights the foundation of these principles, features recent experimental and clinical data and provides an outlook regarding current and potential future research activities.

8.
Pak J Med Sci ; 36(COVID19-S4): S6-S11, 2020 May.
Article in English | MEDLINE | ID: covidwho-1726836

ABSTRACT

OBJECTIVE: Recognizing the huge potential ramifications of COVID-19 pandemic, this study explores its impact on health professionals personally and professionally along with the associated challenges. METHODS: A descriptive cross-sectional qualitative survey was conducted from March-April 2020. Participants included health professionals from various disciplines in both public and private-sector institutions of Pakistan. The sample size was not predetermined, and an iterative approach of simultaneous data collection and analysis was taken until data and time saturation were reached. Thematic analysis of the qualitative data was carried out by two analysts. RESULTS: Two hundred and Ninety health professionals responded. They reported an impact on their mental, physical and social well-being. The clinicians mentioned facing an unprecedented workload in overstretched health facilities, while those in academia become engaged with planning/providing emergency remote teaching for the students affecting work-life balance. Some challenges associated with work-from-home and in the hospitals were identified. CONCLUSION: During COVID-19, the health professionals are anxious, overworked and financially unstable while planning, creating and caring for others and their families. We need to support them to do their jobs, be safe and stay alive. Future research should explore the fears and coping strategies of health professionals during pandemics.

9.
Curr Opin Clin Nutr Metab Care ; 23(4): 288-293, 2020 07.
Article in English | MEDLINE | ID: covidwho-1722683

ABSTRACT

PURPOSE OF REVIEW: The Covid-19 pandemic has daunted the world with its enormous impact on healthcare, economic recession, and psychological distress. Nutrition is an integral part of every person life care, and should also be mandatorily integrated to patient care under the Covid-19 pandemic. It is crucial to understand how the Covid-19 does develop and which risk factors are associated with negative outcomes and death. Therefore, it is of utmost importance to have studies that respect the basic tenets of the scientific method in order to be trusted. The goal of this review is to discuss the deluge of scientific data and how it might influence clinical reasoning and practice. RECENT FINDINGS: A large number of scientific manuscripts are daily published worldwide, and the Covid-19 makes no exception. Up to now, data on Covid-19 have come from countries initially affected by the disease and mostly pertain either epidemiological observations or opinion papers. Many of them do not fulfil the essential principles characterizing the adequate scientific method. SUMMARY: It is crucial to be able to critical appraise the scientific literature, in order to provide adequate nutrition therapy to patients, and in particular, to Covid-19 infected individuals.


Subject(s)
Coronavirus Infections , Nutrition Disorders , Nutrition Therapy/standards , Nutritional Physiological Phenomena , Pandemics , Pneumonia, Viral , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Humans , Nutrition Disorders/epidemiology , Nutrition Disorders/etiology , Nutrition Disorders/therapy , Nutrition Therapy/methods , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Risk Factors
10.
Trends Mol Med ; 26(6): 529-531, 2020 06.
Article in English | MEDLINE | ID: covidwho-1720652

ABSTRACT

The current coronavirus disease 2019 (COVID-19) pandemic is rapidly spreading around the world. The first doctor to report this new disease was an ophthalmologist: this exemplifies the role of ophthalmologists in an infectious disease pandemic. Here we review how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects the eye and discuss implications for ophthalmologists.


Subject(s)
Betacoronavirus/isolation & purification , Conjunctiva/virology , Conjunctivitis, Viral/virology , Coronavirus Infections/complications , Pneumonia, Viral/complications , COVID-19 , Conjunctivitis, Viral/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Eye/virology , Humans , Ophthalmologists , Ophthalmology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2
11.
J Am Soc Nephrol ; 32(9): 2147-2152, 2021 09.
Article in English | MEDLINE | ID: covidwho-1708655

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a high rate of mortality in patients with ESKD, and vaccination is hoped to prevent infection. METHODS: Between January 18 and February 24, 2021, 225 kidney transplant recipients (KTRs) and 45 patients on hemodialysis (HDPs) received two injections of mRNA BNT162b2 vaccine. The postvaccinal humoral and cellular response was explored in the first 45 KTRs and ten HDPs. RESULTS: After the second dose, eight HDPs (88.9%) and eight KTRs (17.8%) developed antispike SARS-CoV-2 antibodies (P<0.001). Median titers of antibodies in responders were 1052 AU/ml (IQR, 515-2689) in HDPs and 671 AU/ml (IQR, 172-1523) in KTRs (P=0.40). Nine HDPs (100%) and 26 KTRs (57.8%) showed a specific T cell response (P=0.06) after the second injection. In responders, median numbers of spike-reactive T cells were 305 SFCs per 106 CD3+ T cells (IQR, 95-947) in HDPs and 212 SFCs per 106 CD3+ T cells (IQR, 61-330) in KTRs (P=0.40). In KTRs, the immune response to BNT162b2 seemed influenced by the immunosuppressive regimen, particularly tacrolimus or belatacept. CONCLUSION: Immunization with BNT162b2 seems more efficient in HDPs, indicating that vaccination should be highly recommended in these patients awaiting a transplant. However, the current vaccinal strategy for KTRs may not provide effective protection against COVID-19 and will likely need to be improved.


Subject(s)
Antibodies, Viral/biosynthesis , COVID-19 Vaccines/pharmacology , COVID-19/immunology , Kidney Transplantation , Renal Dialysis , SARS-CoV-2/immunology , T-Lymphocytes/immunology , Aged , COVID-19/complications , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , Cohort Studies , Female , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/immunology , Kidney Failure, Chronic/therapy , Kidney Transplantation/adverse effects , Male , Middle Aged , Pandemics , RNA, Messenger/genetics , Retrospective Studies , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/immunology , Transplant Recipients
12.
Eur Heart J Cardiovasc Pharmacother ; 8(2): 149-156, 2022 02 16.
Article in English | MEDLINE | ID: covidwho-1706743

ABSTRACT

AIMS: Uncontrolled blood pressure (BP) increases the risk of developing heart failure (HF). The effect of spironolactone on BP of patients at risk of developing HF is yet to be determined. To evaluate the effect of spironolactone on the BP of patients at risk for HF and whether renin can predict spironolactone's effect. METHODS AND RESULTS: HOMAGE (Heart OMics in Aging) was a prospective multicentre randomized open-label blinded endpoint (PROBE) trial including 527 patients at risk for developing HF randomly assigned to either spironolactone (25-50 mg/day) or usual care alone for a maximum of 9 months. Sitting BP was assessed at baseline, Months 1 and 9 (or last visit). Analysis of covariance (ANCOVA), mixed effects models, and structural modelling equations was used. The median (percentile25-75) age was 73 (69-79) years, 26% were female, and >75% had history of hypertension. Overall, the baseline BP was 142/78 mmHg. Patients with higher BP were older, more likely to have diabetes and less likely to have coronary artery disease, had greater left ventricular mass (LVM), and left atrial volume (LAV). Compared with usual care, by last visit, spironolactone changed SBP by -10.3 (-13.0 to -7.5) mmHg and DBP by -3.2 (-4.8 to -1.7) mmHg (P < 0.001 for both). A higher proportion of patients on spironolactone had controlled BP <130/80 mmHg (36 vs. 26%; P = 0.014). Lower baseline renin levels predicted a greater response to spironolactone (interactionP = 0.041). CONCLUSION: Spironolactone had a clinically important BP-lowering effect. Spironolactone should be considered for lowering blood pressure in patients who are at risk of developing HF.


Subject(s)
Heart Failure , Spironolactone , Aged , Blood Pressure , Female , Heart Failure/diagnosis , Heart Failure/drug therapy , Heart Failure/epidemiology , Humans , Male , Mineralocorticoid Receptor Antagonists/adverse effects , Prospective Studies , Spironolactone/therapeutic use
13.
Indian J Med Ethics ; -(-): 1-4, 2020 May 31.
Article in English | MEDLINE | ID: covidwho-1675438

ABSTRACT

In India, the Covid-19 pandemic has thrown open challenges on multiple fronts: (a) the reconfiguration of care in hospitals, in response to Covid-19, has led to many patients suffering non-Covid conditions having to delay their treatment, and (b) the lockdown which though necessary has affected people unequally, some being much worse-off than others. This article unpacks the impact of Covid-19 on healthcare systems in India by raising moral and ethical questions about the plight of patients with other medical conditions while accessing care. This article also proposes a set of actions by which healthcare systems can address Covid and non-Covid related healthcare needs.

.

14.
Mini Rev Med Chem ; 22(2): 273-311, 2022.
Article in English | MEDLINE | ID: covidwho-1666892

ABSTRACT

Due to the high mortality rate of the 2019 coronavirus disease (COVID-19) pandemic, there is an immediate need to discover drugs that can help before a vaccine becomes available. Given that the process of producing new drugs is so long, the strategy of repurposing existing drugs is one of the promising options for the urgent treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19 disease. Although FDA has approved Remdesivir for the use in hospitalized adults and pediatric patients suffering from COVID-19, no fully effective and reliable drug has been yet identified worldwide to treat COVID-19 specifically. Thus, scientists are still trying to find antivirals specific to COVID-19. This work reviews the chemical structure, metabolic pathway, and mechanism of action of the existing drugs with potential therapeutic applications for COVID-19. Furthermore, we summarized the molecular docking stimulation of the medications related to key protein targets. These already established drugs could be further developed, and after their testing through clinical trials, they could be used as suitable therapeutic options for patients suffering from COVID-19.


Subject(s)
Antiviral Agents/pharmacology , COVID-19/drug therapy , COVID-19/virology , Metabolic Networks and Pathways/drug effects , SARS-CoV-2/drug effects , SARS-CoV-2/metabolism , Antiviral Agents/therapeutic use , Humans , Molecular Docking Simulation , SARS-CoV-2/growth & development , SARS-CoV-2/pathogenicity
15.
Eur J Public Health ; 31(3): 630-634, 2021 07 13.
Article in English | MEDLINE | ID: covidwho-1665968

ABSTRACT

BACKGROUND: People from South Asian and black minority ethnic groups are disproportionately affected by the COVID-19 pandemic. It is unknown whether deprivation mediates this excess ethnic risk. METHODS: We used UK Biobank with linked COVID-19 outcomes occurring between 16th March 2020 and 24th August 2020. A four-way decomposition mediation analysis was used to model the extent to which the excess risk of testing positive, severe disease and mortality for COVID-19 in South Asian and black individuals, relative to white individuals, would be eliminated if levels of high material deprivation were reduced within the population. RESULTS: We included 15 044 (53.0% women) South Asian and black and 392 786 (55.2% women) white individuals. There were 151 (1.0%) positive tests, 91 (0.6%) severe cases and 31 (0.2%) deaths due to COVID-19 in South Asian and black individuals compared with 1471 (0.4%), 895 (0.2%) and 313 (0.1%), respectively, in white individuals. Compared with white individuals, the relative risk of testing positive for COVID-19, developing severe disease and COVID-19 mortality in South Asian and black individuals were 2.73 (95% CI: 2.26, 3.19), 2.96 (2.31, 3.61) and 4.04 (2.54, 5.55), respectively. A hypothetical intervention moving the 25% most deprived in the population out of deprivation was modelled to eliminate between 40 and 50% of the excess risk of all COVID-19 outcomes in South Asian and black populations, whereas moving the 50% most deprived out of deprivation would eliminate over 80% of the excess risk of COVID-19 outcomes. CONCLUSIONS: The excess risk of COVID-19 outcomes in South Asian and black communities could be substantially reduced with population level policies targeting material deprivation.


Subject(s)
COVID-19 , Female , Humans , Male , Minority Groups , Pandemics , SARS-CoV-2
16.
Br J Nutr ; 127(6): 896-903, 2022 03 28.
Article in English | MEDLINE | ID: covidwho-1651089

ABSTRACT

Coronavirus disease 2019 (COVID-19) has caused mild illness in children, until the emergence of the novel hyperinflammatory condition paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PIMS-TS). PIMS-TS is thought to be a post-SARS-CoV-2 immune dysregulation with excessive inflammatory cytokine release. We studied 25 hydroxyvitamin D (25OHD) concentrations in children with PIMS-TS, admitted to a tertiary paediatric hospital in the UK, due to its postulated role in cytokine regulation and immune response. Eighteen children (median (range) age 8·9 (0·3-14·6) years, male = 10) met the case definition. The majority were of Black, Asian and Minority Ethnic (BAME) origin (89 %, 16/18). Positive SARS-CoV-2 IgG antibodies were present in 94 % (17/18) and RNA by PCR in 6 % (1/18). Seventy-eight percentage of the cohort were vitamin D deficient (< 30 nmol/l). The mean 25OHD concentration was significantly lower when compared with the population mean from the 2015/16 National Diet and Nutrition Survey (children aged 4-10 years) (24 v. 54 nmol/l (95 % CI -38·6, -19·7); P < 0·001). The paediatric intensive care unit (PICU) group had lower mean 25OHD concentrations compared with the non-PICU group, but this was not statistically significant (19·5 v. 31·9 nmol/l; P = 0·11). The higher susceptibility of BAME children to PIMS-TS and also vitamin D deficiency merits contemplation. Whilst any link between vitamin D deficiency and the severity of COVID-19 and related conditions including PIMS-TS requires further evidence, public health measures to improve vitamin D status of the UK BAME population have been long overdue.


Subject(s)
COVID-19 , COVID-19/complications , Child , Child, Preschool , Humans , Male , SARS-CoV-2 , Systemic Inflammatory Response Syndrome , Vitamin D
17.
Eur J Ophthalmol ; 32(1): NP168-NP172, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1633471

ABSTRACT

INTRODUCTION: Papillophlebitis is a rare condition characterized by venous congestion and optic disc edema, which has been suggested to occur as a consequence of inflammation of the retinal veins or, possibly, the capillaries of the optic disc, leading to venous insufficiency and compression of the central retina vein. The disease affects healthy young adults and commonly has a benign course, however, if complications such as macular edema or ischemia appears, treatment should be instituted immediately to avoid poor prognosis. CASE REPORT: A 40-year old white male patient consulted for a slight decrease in the sensitivity of the visual field in his left eye (OS). Visual acuities (VA) were 20/20 in both eyes. OS fundus examination showed dilated and tortuous retinal vessels, disc edema, and retinal hemorrhages. The patient was diagnosed with papillophlebitis. OS VA decreased to 20/200 due to macular edema, and he was treated with a intravitreal dexamethasone implant. An exhaustive and interdisciplinary exploration process was performed, identifying a recent disease and recovery of Covid-19 as the only factor of inflammation and coagulation alteration. Other systemic diseases were excluded. We also describe a rapid decrease in disc and macular edema after intravitreal dexametasone injection, which could support the inflammatory hypothesis. CONCLUSION: The importance of this case lies in the possible association of papillophlebitis with the new Covid-19 disease. We believe that the inflammatory reaction and the coagulation alteration present in our patient due to Sars-Cov2 coronavirus may have acted as risk factors for the development of papillophlebitis.


Subject(s)
COVID-19 , Macular Edema , Retinal Vein Occlusion , Adult , Humans , Inflammation , Male , RNA, Viral , SARS-CoV-2
18.
Eur J Neurol ; 28(10): 3467-3477, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1604178

ABSTRACT

BACKGROUND: There is debate as to whether there is an increased risk of COVID-19 infection in people with Parkinson's disease (PD), possibly due to associated factors. This study aimed to systematically review the factors associated with COVID-19 in people with PD. METHODS: A search was carried out in PubMed, Scopus, and Web of Science up to November 2020 (updated until 1 April 2021). Observational studies that analyzed factors associated with COVID-19 in people with PD were selected and revised. RESULTS: The authors included six studies (four case-controlled studies and two cross-sectional studies) in the qualitative and quantitative syntheses. The authors found that the following factors were associated with COVID-19 in people with PD: obesity (OR: 1.79, 95% CI: 1.07-2.99, I2 : 0%), any pulmonary disease (OR: 1.92, 95% CI: 1.17-3.15, I2 : 0%), COVID-19 contact (OR: 41.77, 95% CI: 4.77 - 365.56, I2 : 0%), vitamin D supplementation (OR: 0.50, 95% CI: 0.30-0.83, I2 : 0%), hospitalization (OR: 11.78, 95% CI: 6.27-22.12, I2 : 0%), and death (OR: 11.23, 95% CI: 3.92-32.18, I2 : 0%). The authors did not find any significant association between COVID-19 and hypertension, diabetes, cardiopathy, cancer, any cognitive problem, dementia, chronic obstructive pulmonary disease, renal or hepatic disease, smoking, and tremor. CONCLUSIONS: Meta-analyses were limited by the number of events and some methodological limitations. Despite this, the authors assessed the available evidence, and the results may be useful for future health policies.


Subject(s)
COVID-19 , Diabetes Mellitus , Parkinson Disease , Cross-Sectional Studies , Humans , Parkinson Disease/complications , Parkinson Disease/epidemiology , SARS-CoV-2
19.
Disaster Med Public Health Prep ; 15(5): e26-e32, 2021 10.
Article in English | MEDLINE | ID: covidwho-1598939

ABSTRACT

OBJECTIVES: Cloth face covering has been recommended by the Centers for Disease Control and Prevention to decrease community viral transmission. This study aims to determine the filtration efficiency and airflow resistance of common household materials available for homemade mask production by comparing numbers of fabrics, various layers, and manipulation. METHODS: Common household woven, knitted, and nonwoven fabrics were tested for filtration efficiency using a fit testing setup and airflow resistance with pressure gauge setup. Three different levels of layering (1, 2, and 4) were tested. Some fabric material was further tested after washing and drying. Filtration performance, the area under the fitted curve comparing airflow resistance and filtration efficiency, was calculated for each fabric material and compared. RESULTS: Layering increased filtration efficiency and airflow resistance (P < 0.0001 and P < 0.01, respectively). Polyester felt demonstrated the highest filtration performance index (P < 0.0001), higher than all tested 100% cotton materials (all P < 0.05) as well as surgical masks (P < 0.05). Washing plus drying did not alter filtration performance significantly (P > 0.05). CONCLUSIONS: A filtration performance of common household fabrics were compared. Homemade mask designers and producers will have improved data to better balance effectiveness, availability, and comfort with the goal of decreasing community viral transmission.


Subject(s)
COVID-19 , Pandemics , Humans , Masks , Pandemics/prevention & control , SARS-CoV-2 , Textiles , United States
20.
Eur J Gastroenterol Hepatol ; 33(12): 1578-1581, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1595632

ABSTRACT

AIM: Coronavirus disease 2019 (COVID-19) is a recently encountered disease that was declared a pandemic by WHO in 2020. Obesity and other components of the metabolic syndrome may aggravate the severity of COVID-19. Nonalcoholic fatty liver disease (NAFLD) represents the hepatic manifestation of metabolic syndrome. The aim of this study was to investigate a possible association between MAFLD and COVID-19 severity. METHODS: We performed a retrospective, case-control study, enrolling 71 consecutive COVID-19 patients who were divided into two groups according to the presence or absence of fatty liver by computed tomography scan. All medical records of eligible patients were reviewed including demographic, clinical, laboratory parameters and data regarding the presence of NAFLD and COVID-19 severity. RESULTS: NAFLD was identified in 22/71 (31%) of the study group. Out of 71, thirteen suffered from severe COVID-19. NAFLD patients had more severe COVID-19 compared with non-NAFLD subjects, 8/22 (36.3%) vs. 5/49(10.2%), (P < 0.005), respectively. Multiple logistic regression analysis showed that NAFLD subjects were more likely to have severe COVID-19 disease (odds ratio 3.57, 95% confidence interval: 1.22, 14.48, P = 0.0031). CONCLUSION: NAFLD represents a high risk for severe COVID-19 irrespective to gender, and independent of metabolic syndrome specifically in male gender. Moreover, obesity, hypertension and metabolic syndrome were also significantly associated with severe COVID-19.


Subject(s)
COVID-19 , Metabolic Syndrome , Non-alcoholic Fatty Liver Disease , Case-Control Studies , Humans , Male , Metabolic Syndrome/diagnosis , Metabolic Syndrome/epidemiology , Non-alcoholic Fatty Liver Disease/diagnostic imaging , Non-alcoholic Fatty Liver Disease/epidemiology , Retrospective Studies , Risk Factors , SARS-CoV-2
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