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1.
Public Health Pract (Oxf) ; 2: 100141, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1233591

ABSTRACT

OBJECTIVES: Socioeconomic factors such as elevated incidence of chronic disease, overcrowding, and increased occupational exposure result in higher risk of infectious disease. The COVID-19 pandemic has appeared to disproportionately affect communities affected by deprivation and discrimination, who also appear to be at greater risk of severe disease. Our aim was to investigate the evolution of the socioeconomic groups affected by COVID-19 over the course of the first wave of the pandemic by examining patients presenting to an acute NHS trust. STUDY DESIGN: and methods: A retrospective study using the postcodes of patients presenting to the Brighton and Sussex University Hospitals NHS Trust who tested PCR-positive for COVID-19 were used to determine average house price and index of multiple deprivation. These were used as markers of affluence to examine the trend in the socioeconomic status of affected patients from February to May 2020. RESULTS: 384 cases were included. The postcodes of those individuals who were initially infected had higher average house prices and index of multiple deprivation, both of which followed downward trends as the outbreak progressed. CONCLUSION: Our data shows that the outbreak spread from higher to lower affluence groups through the course of the pandemic. We hypothesise that this was due to wealthier individuals initially transmitting the virus from abroad. Therefore, an earlier and more effective quarantine could have reduced spread to members of the community at greater risk of infection and harm. We suggest that hospitals systematically record the socioeconomic status of affected individuals in order to monitor trends, identify those who may be at risk of severe disease, and to push for more equitable public health policy.

2.
J Epidemiol Community Health ; 2021 Jan 05.
Article in English | MEDLINE | ID: covidwho-1066919

ABSTRACT

BACKGROUND: Given the effect of chronic diseases on risk of severe COVID-19 infection, the present pandemic may have a particularly profound impact on socially disadvantaged counties. METHODS: Counties in the USA were categorised into five groups by level of social vulnerability, using the Social Vulnerability Index (a widely used measure of social disadvantage) developed by the US Centers for Disease Control and Prevention. The incidence and mortality from COVID-19, and the prevalence of major chronic conditions were calculated relative to the least vulnerable quintile using Poisson regression models. RESULTS: Among 3141 counties, there were 5 010 496 cases and 161 058 deaths from COVID-19 by 10 August 2020. Relative to the least vulnerable quintile, counties in the most vulnerable quintile had twice the rates of COVID-19 cases and deaths (rate ratios 2.11 (95% CI 1.97 to 2.26) and 2.42 (95% CI 2.22 to 2.64), respectively). Similarly, the prevalence of major chronic conditions was 24%-41% higher in the most vulnerable counties. Geographical clustering of counties with high COVID-19 mortality, high chronic disease prevalence and high social vulnerability was found, especially in southern USA. CONCLUSION: Some counties are experiencing a confluence of epidemics from COVID-19 and chronic diseases in the context of social disadvantage. Such counties are likely to require enhanced public health and social support.

3.
Int J Environ Res Public Health ; 18(4)2021 02 04.
Article in English | MEDLINE | ID: covidwho-1063399

ABSTRACT

The COVID-19 pandemic disrupted food systems and the economy in the U.S. and abroad. This cross-sectional study examined the direct and indirect impacts of COVID-19 on food access among low-income and Black, Indigenous, and people of color (BIPOC) in New York State. New York residents were recruited to complete a web-based survey through Qualtrics. The survey took place in May and June 2020 and asked participants about COVID-19 health impacts, risk factors, and food access. Chi-square analysis examined issues with food access experienced by demographic characteristics, work disruptions, health impacts, and household risk for contracting the virus and experiencing severe illness, and significant results were analyzed in a series of logistic regression models. After accounting for covariates, Hispanic respondents, those with likely Major Depressive Disorder, and essential workers were more likely to experience worse food access during COVID-19. Improved policies and services to address impacts on vulnerable populations such as BIPOC, those suffering from mental health disorders, and workers in lower-paying essential jobs can reduce the risk of food access issues at this time. Future research can identify how food access issues during the pandemic influenced diet quality, chronic disease risk and infection, and persistence of food access issues.


Subject(s)
COVID-19 , Employment , Food Insecurity , Pandemics , Cross-Sectional Studies , Depressive Disorder, Major/epidemiology , Humans , Logistic Models , New York/epidemiology , Occupations/classification , Poverty , Risk Factors , Surveys and Questionnaires
4.
Integr Med (Encinitas) ; 19(6): 18-22, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1044993

ABSTRACT

With the COVID-19 pandemic still affecting communities all over the world and "Long Haul" chronic health issues emerging, it is time for us to look back at past multi-symptom health conditions that required a different approach to their treatment, beyond just managing symptoms. It is important for us to consider how to apply what we have learned about immune rejuvenation and its impact on conditions associated with chronic immune dysfunction. We know more than we ever have before about how to reduce chronic inflammation at its source through the support of selective immune cell autophagy/mitophagy and improved immune cell mitochondrial activity, followed by remodeling of the immune epigenome, and-ultimately-a reset of immune function.

5.
J Adolesc Health ; 67(5): 653-661, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-849768

ABSTRACT

PURPOSE: Physical distancing policies in the state of New South Wales (Australia) were implemented on March 23, 2020, because of the COVID-19 pandemic. This study investigated changes in physical activity, dietary behaviors, and well-being during the early period of this policy. METHODS: A cohort of young people aged 13-19 years from Sydney (N = 582) were prospectively followed for 22 weeks (November 18, 2019, to April 19, 2020). Daily, weekly, and monthly trajectories of diet, physical activity, sedentary behavior, well-being, and psychological distress were collected via smartphone, using a series of ecological momentary assessments and smartphone sensors. Differences in health and well-being outcomes were compared pre- and post-implementation of physical distancing guidelines. RESULTS: After the implementation of physical distancing measures in NSW, there were significant decreases in physical activity (odds ratio [OR] = .53, 95% confidence interval [CI] = .34-.83), increases in social media and Internet use (OR = 1.86, 95% CI = 1.15-3.00), and increased screen time based on participants' smartphone screen state. Physical distancing measures were also associated with being alone in the previous hour (OR = 2.09, 95% CI: 1.33-3.28), decreases in happiness (OR = .38, 95% CI = .18-.82), and fast food consumption (OR = .46, 95% CI = .29-.73). CONCLUSIONS: Physical distancing and social restrictions had a contemporaneous impact on health and well-being outcomes associated with chronic disease among young people. As the pandemic evolves, it will be important to consider how to mitigate against any longer term health impacts of physical distancing restrictions.


Subject(s)
Coronavirus Infections , Exercise , Health Status , Mental Health , Pandemics , Pneumonia, Viral , Social Isolation/psychology , Adolescent , COVID-19 , Coronavirus Infections/psychology , Exercise/physiology , Exercise/psychology , Fast Foods , Female , Health Behavior , Humans , Male , New South Wales , Pneumonia, Viral/psychology , Prospective Studies , Psychology, Adolescent , Young Adult
6.
Int J Diabetes Dev Ctries ; 40(3): 346-352, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-778170

ABSTRACT

BACKGROUND: Strict isolation measures and interrupted health care services during the COVID 19 pandemic are contemplated to instigate stress universally, particularly in those with chronic illnesses such as type 1 diabetes (T1D). METHODS: A cross-sectional, observational study was done to assess determinants of stress and its impact on glycemic control in adolescents and young adults (aged 12-24 years) living with T1D in India. An online, semi-structured survey including Perceived Stress Scale (PSS-10) was distributed and results were analyzed. RESULTS: A total of 89 participants (46 males, mean age 19.61 ± 3.8 years) with T1D completed the survey. Age (r = 0.325, p = 0.005) and HBA1C level within the preceding 3 months (r = 0.274, p = 0.036) correlated positively with PSS-10 scores. There was a statistically significant difference in PSS-10 score based on gender (t(70) = - 2.147; p = 0.035), education (F (4,67) = 4.34, p = 0.003), and occupation (F(3,68) = 4.50, p = .006). On multiple linear regression, gender, occupation, and HbA1C were the significant determinants of PSS-10 (F(3,55) = 12.01, p < 0.001, R 2 = 0.363). One-way ANOVA showed a significant impact of mean PSS-10 score on the glycemic control (F(2,69) = 3.813, p = 0.027). CONCLUSION: An increased prevalence of stress was seen among Indian adolescents and young adults living with T1D. Female gender, salaried individuals, and pre-existing poorly controlled diabetes contributed to an increased risk of stress. Increased stress resulted in worsened glycemic control.

7.
Semin Arthritis Rheum ; 50(5): 1150-1157, 2020 10.
Article in English | MEDLINE | ID: covidwho-765611

ABSTRACT

BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic disease characterised by autoimmunity and increased susceptibility to infections. COVID-19 is a systemic viral disease currently spreading as a pandemic. Little is known about the impact of COVID-19 in patients with SLE. OBJECTIVE: to acquire information on the impact of COVID-19 in SLE. METHODS: A 26-item anonymous questionnaire investigating demographics, SLE clinical features, COVID-19 diagnoses and changes in treatments and daily habits was administered to patients with SLE from three referral centres through www.surveymonkey.com over 10 days. Data from the survey were compared to those from published estimates about the general population. RESULTS: Four-hundred-seventeen patients responded to the survey. More than 60% of subjects complained of symptoms that are also associated to COVID-19. Fourteen COVID-19 diagnoses (five confirmed by polymerase chain reaction) were reported, in contrast to a 0.73% prevalence of confirmed cases in Lombardy. One hospitalisation was reported. Fever, anosmia, dry cough, a self-reported history of neuropsychiatric SLE and a recent contact with confirmed COVID-19 cases were more strongly associated with COVID-19, as were symptoms and lower compliance to behavioural preventive measures in patients' contacts. No protective effect was seen in subjects on hydroxychloroquine. CONCLUSION: COVID-19 morbidity might only moderately be increased in most patients with SLE, although limited information can be inferred on more severe cases. Hydroxychloroquine apparently seems not to confer protection to infection per se, although other beneficial roles cannot be excluded. Containment policies and behavioural preventive measures could have a major role in limiting the impact of COVID-19 in patients with SLE.


Subject(s)
Communicable Disease Control/methods , Coronavirus Infections , Hydroxychloroquine/therapeutic use , Lupus Erythematosus, Systemic , Pandemics , Pneumonia, Viral , Social Isolation/psychology , Symptom Assessment , Adult , Antirheumatic Agents/therapeutic use , Betacoronavirus , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Female , Humans , Italy/epidemiology , Lupus Erythematosus, Systemic/epidemiology , Lupus Erythematosus, Systemic/therapy , Male , Middle Aged , Pandemics/prevention & control , Patient Compliance/statistics & numerical data , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Prevalence , Qualitative Research , SARS-CoV-2 , Symptom Assessment/methods , Symptom Assessment/statistics & numerical data
8.
World Med Health Policy ; 2020 Aug 09.
Article in English | MEDLINE | ID: covidwho-695502

ABSTRACT

While the impact of obesity on chronic disease has been widely examined, there has been less research regarding the influence of obesity on infectious diseases, particularly respiratory diseases. This exploratory research uses the currently available data on COVID-19 cases and mortality, along with estimates of the morbidly obese populations in the United States by county, to examine the association between morbid obesity and deaths from COVID-19 and to identify potential coincident spatial clusters of morbid obesity and COVID-19 deaths. Results indicate a statistically significant positive correlation between population-adjusted COVID-19 deaths and cases and the estimated population with a body mass index ≥ 40. Clustering analyses show there is a predominant similarity in the distribution of COVID-19 deaths and obesity. Our findings suggest it is critical to include an awareness of obesity when developing infectious disease control measures and point to a greater need to focus resources toward obesity education and policy initiatives.

9.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(6): 7-16, 2020.
Article in Russian | MEDLINE | ID: covidwho-653325

ABSTRACT

Novel coronavirus SARS-CoV-2 and COVID-19, besides affecting the respiratory system, may lead to central and peripheral nervous system disorders and also cause muscular symptoms. The authors review the literature and own clinical case with respect to nervous system involvement in COVID-19 patients. There is a correlation between the severity of COVID-19 and the severity and frequency of neurologic complications. Severe neurologic symptoms are primarily observed in patients with severe COVID-19. Neurologic-associated symptoms may include stroke, acute necrotizing encephalopathy, and Guillen-Barre syndrome. Diseases that potentially aggravate COVID-19 and increase the risk of neurologic complications include arterial hypertension, diabetes, chronic diseases of the heart and respiratory system. The probable impact of human coronaviruses on chronic and progressive diseases of the nervous system with particular respect to multiple sclerosis is reviewed. A triage plan for stroke and MS patients during the COVID-19 pandemic, depending on the risk of coronavirus infection, is presented.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , COVID-19 , Humans , SARS-CoV-2
10.
Paediatr Respir Rev ; 35: 9-14, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-548224

ABSTRACT

Severe Acute Respiratory Syndrome - Coronavirus - 2 (SARS-CoV-2) and its related Coronavirus Disease - 19 (COVID-19) has become a health emergency worldwide. The medical community has been concerned since the beginning of the outbreak about the potential impact of COVID-19 in children, especially in those with underlying chronic diseases. Fortunately, COVID-19 has been reported to be less severe in children than in adults. However, epidemiologic and clinical data are scarce. Children show unique features of SARS-CoV-2 involvement that may account for the low rate of infection and death in this age group. The purpose of this review is to summarize the most relevant evidence of COVID-19 in children highlighting similarities and differences with adults.


Subject(s)
Coronavirus Infections/physiopathology , Cough/physiopathology , Fever/physiopathology , Pharyngitis/physiopathology , Pneumonia, Viral/physiopathology , Tachypnea/physiopathology , Adolescent , Asymptomatic Infections/epidemiology , Betacoronavirus , COVID-19 , Child , Child, Preschool , Comorbidity , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Diarrhea/physiopathology , Fatigue/physiopathology , Female , Humans , Infant , Infant, Newborn , Male , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Pregnancy , Pregnancy Complications, Infectious/physiopathology , SARS-CoV-2 , Severity of Illness Index
11.
Br J Hosp Med (Lond) ; 81(4): 1-6, 2020 Apr 02.
Article in English | MEDLINE | ID: covidwho-159035

ABSTRACT

At first glance, the novel coronavirus pandemic and orthopaedic surgery appear separate entities. Orthopaedic surgeons are not generally considered front-line staff in terms of the treatment of the disease that the novel coronavirus causes compared with anaesthetic and medical colleagues. However, the impact that the novel coronavirus is likely to have on the musculoskeletal injury burden and the morbidity associated with chronic musculoskeletal disease is significant. This article summarises the strategies currently being developed for the remodelling of orthopaedic services in the UK and the emergency British Orthopaedic Association Standards for Trauma and Orthopaedic guidelines released on 24 March 2020 in managing urgent orthopaedic patients during the novel coronavirus pandemic.


Subject(s)
Coronavirus Infections/epidemiology , Musculoskeletal Diseases/therapy , Orthopedics/organization & administration , Pneumonia, Viral/epidemiology , Betacoronavirus , COVID-19 , Chronic Disease , Education, Medical/organization & administration , Elective Surgical Procedures/methods , Emergency Service, Hospital/organization & administration , Fractures, Bone/surgery , Humans , Musculoskeletal Diseases/surgery , Operating Rooms/organization & administration , Orthopedic Procedures/methods , Orthopedics/education , Pandemics , Pediatrics/organization & administration , Radiology/organization & administration , SARS-CoV-2 , United Kingdom , Workforce/organization & administration , Wounds and Injuries/surgery
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