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2.
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
3.
Disaster Med Public Health Prep ; : 1-3, 2021 Apr 19.
Article in English | MEDLINE | ID: covidwho-1708187

ABSTRACT

OBJECTIVE: This study investigates burnout and sources of stress related to the coronavirus disease 2019 (COVID-19) pandemic among a group of health care risk managers/patient safety practitioners. METHODS: An online survey was used, including the Oldenburg Burnout Inventory (OLBI) and 1 open-ended question: Since the start of the COVID-19 pandemic, what work or non-work-related issues have been causing you the most stress? RESULTS: A total of 31 participants completed the OLBI; 27 answered the open-ended question. Over 70% of participants qualified as burned out. A thematic analysis was used to analyze stressors. Key themes included impacts of social distancing, changing duties and workload, real and potential impacts of the virus (eg, fear of infection for self or others), and financial concerns (personal and organizational). Less common themes included untrustworthy and constantly changing guidance, feeling abused by persons in power, and positive comments about the experience of working during the pandemic. CONCLUSION: Burnout and pandemic-related stress may be very common in the health care risk management and patient safety workforce. Additional research is required to more robustly estimate the prevalence of burnout in this population. Meanwhile, the sources of stress identified here may aid health care organizations in taking immediate action to protect this vital workforce.

4.
Simul Healthc ; 17(1): e141-e148, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1672454

ABSTRACT

INTRODUCTION: COVID-19 has prompted the extensive use of computational models to understand the trajectory of the pandemic. This article surveys the kinds of dynamic simulation models that have been used as decision support tools and to forecast the potential impacts of nonpharmaceutical interventions (NPIs). We developed the Values in Viral Dispersion model, which emphasizes the role of human factors and social networks in viral spread and presents scenarios to guide policy responses. METHODS: An agent-based model of COVID-19 was developed with individual agents able to move between 3 states (susceptible, infectious, or recovered), with each agent placed in 1 of 7 social network types and assigned a propensity to comply with NPIs (quarantine, contact tracing, and physical distancing). A series of policy questions were tested to illustrate the impact of social networks and NPI compliance on viral spread among (1) populations, (2) specific at-risk subgroups, and (3) individual trajectories. RESULTS: Simulation outcomes showed large impacts of physical distancing policies on number of infections, with substantial modification by type of social network and level of compliance. In addition, outcomes on metrics that sought to maximize those never infected (or recovered) and minimize infections and deaths showed significantly different epidemic trajectories by social network type and among higher or lower at-risk age cohorts. CONCLUSIONS: Although dynamic simulation models have important limitations, which are discussed, these decision support tools should be a key resource for navigating the ongoing impacts of the COVID-19 pandemic and can help local and national decision makers determine where, when, and how to invest resources.


Subject(s)
COVID-19 , Pandemics , Computer Simulation , Humans , Pandemics/prevention & control , Quarantine , SARS-CoV-2
5.
Eur J Neurol ; 28(10): 3418-3425, 2021 10.
Article in English | MEDLINE | ID: covidwho-1605552

ABSTRACT

BACKGROUND AND PURPOSE: Myasthenia gravis (MG) patients could be a vulnerable group in the pandemic era of coronavirus 2019 (COVID-19) mainly due to respiratory muscle weakness, older age and long-term immunosuppressive treatment. We aimed to define factors predicting the severity of COVID-19 in MG patients and risk of MG exacerbation during COVID-19. METHODS: We evaluated clinical features and outcomes after COVID-19 in 93 MG patients. RESULTS: Thirty-five patients (38%) had severe pneumonia and we recorded 10 deaths (11%) due to COVID-19. Higher forced vital capacity (FVC) values tested before COVID-19 were shown to be protective against severe infection (95% CI 0.934-0.98) as well as good control of MG measured by the quantified myasthenia gravis score (95% CI 1.047-1.232). Long-term chronic corticosteroid treatment worsened the course of COVID-19 in MG patients (95% CI 1.784-111.43) and this impact was positively associated with dosage (p = 0.005). Treatment using azathioprine (95% CI 0.448-2.935), mycophenolate mofetil (95% CI 0.91-12.515) and ciclosporin (95% CI 0.029-2.212) did not influence the course of COVID-19. MG patients treated with rituximab had a high risk of death caused by COVID-19 (95% CI 3.216-383.971). Exacerbation of MG during infection was relatively rare (15%) and was not caused by remdesivir, convalescent plasma or favipiravir (95% CI 0.885-10.87). CONCLUSIONS: As the most important predictors of severe COVID-19 in MG patients we identified unsatisfied condition of MG with lower FVC, previous long-term corticosteroid treatment especially in higher doses, older age, the presence of cancer, and recent rituximab treatment.


Subject(s)
COVID-19 , Coronavirus Infections , Myasthenia Gravis , Aged , COVID-19/therapy , Humans , Immunization, Passive , Myasthenia Gravis/complications , Myasthenia Gravis/drug therapy , Myasthenia Gravis/epidemiology , SARS-CoV-2
6.
Transbound Emerg Dis ; 68(6): 3443-3452, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1526424

ABSTRACT

The recently emerged novel coronavirus, SARS-CoV-2, is phylogenetically related to bat coronaviruses (CoVs), specifically SARS-related CoVs from the Eurasian bat family Rhinolophidae. As this human pandemic virus has spread across the world, the potential impacts of SARS-CoV-2 on native North American bat populations are unknown, as is the ability of North American bats to serve as reservoirs or intermediate hosts able to transmit the virus to humans or to other animal species. To help determine the impacts of the pandemic virus on North American bat populations, we experimentally challenged big brown bats (Eptesicus fuscus) with SARS-CoV-2 under BSL-3 conditions. We inoculated the bats both oropharyngeally and nasally, and over the ensuing three weeks, we measured infectivity, pathology, virus concentrations in tissues, oral and rectal virus excretion, virus transmission, and clinical signs of disease. We found no evidence of SARS-CoV-2 infection in any examined bat, including no viral excretion, no transmission, no detectable virus in tissues, and no signs of disease or pathology. Based on our findings, it appears that big brown bats are resistant to infection with the SARS-CoV-2. The potential susceptibility of other North American bat species to SARS-CoV-2 remains to be investigated.


Subject(s)
COVID-19 , Chiroptera , Coronaviridae , Animals , COVID-19/veterinary , Humans , North America/epidemiology , Phylogeny , SARS-CoV-2
7.
Ophthalmology ; 128(11): 1620-1626, 2021 11.
Article in English | MEDLINE | ID: covidwho-1510165

ABSTRACT

PURPOSE: Routine use of face masks for patients and physicians during intravitreal anti-vascular endothelial growth factor (VEGF) injections has increased with the emergence of the coronavirus disease 2019 pandemic. This study evaluates the impact of universal face mask use on rates and outcomes of post-injection endophthalmitis (PIE). DESIGN: Retrospective, multicenter, comparative cohort study. PARTICIPANTS: Eyes receiving intravitreal anti-VEGF injections from October 1, 2019, to July 31, 2020, at 12 centers. METHODS: Cases were divided into a "no face mask" group if no face masks were worn by the physician or patient during intravitreal injections or a "universal face mask" group if face masks were worn by the physician, ancillary staff, and patient during intravitreal injections. MAIN OUTCOME MEASURES: Rate of endophthalmitis, microbial spectrum, and visual acuity (VA). RESULTS: Of 505 968 intravitreal injections administered in 110 547 eyes, 85 of 294 514 (0.0289%; 1 in 3464 injections) cases of presumed endophthalmitis occurred in the "no face mask" group, and 45 of 211 454 (0.0213%; 1 in 4699) cases occurred in the "universal face mask" group (odds ratio [OR], 0.74; 95% confidence interval [CI], 0.51-1.18; P = 0.097). In the "no face mask" group, there were 27 cases (0.0092%; 1 in 10 908 injections) of culture-positive endophthalmitis compared with 9 cases (0.004%; 1 in 23 494) in the "universal face mask" group (OR, 0.46; 95% CI, 0.22-0.99; P = 0.041). Three cases of oral flora-associated endophthalmitis occurred in the "no face mask" group (0.001%; 1 in 98 171 injections) compared with 1 (0.0005%; 1 in 211 454) in the "universal face mask" group (P = 0.645). Patients presented a mean (range) 4.9 (1-30) days after the causative injection, and mean logarithm of the minimum angle of resolution (logMAR) VA at endophthalmitis presentation was 2.04 (~20/2200) for "no face mask" group compared with 1.65 (~20/900) for the "universal face mask" group (P = 0.022), although no difference was observed 3 months after treatment (P = 0.764). CONCLUSIONS: In a large, multicenter, retrospective study, physician and patient face mask use during intravitreal anti-VEGF injections did not alter the risk of presumed acute-onset bacterial endophthalmitis, but there was a reduced rate of culture-positive endophthalmitis. Three months after presentation, there was no difference in VA between the groups.


Subject(s)
Angiogenesis Inhibitors/administration & dosage , COVID-19/epidemiology , Disease Transmission, Infectious/prevention & control , Endophthalmitis/prevention & control , Eye Infections, Bacterial/prevention & control , N95 Respirators , Comorbidity , Endophthalmitis/epidemiology , Endophthalmitis/etiology , Eye Infections, Bacterial/epidemiology , Eye Infections, Bacterial/etiology , Follow-Up Studies , Incidence , Intravitreal Injections/adverse effects , Retinal Diseases/drug therapy , Retinal Diseases/epidemiology , Retrospective Studies , United States/epidemiology , Vascular Endothelial Growth Factor A/antagonists & inhibitors
8.
Clin Gastroenterol Hepatol ; 19(7): 1410-1417.e9, 2021 07.
Article in English | MEDLINE | ID: covidwho-1499706

ABSTRACT

BACKGROUND & AIMS: The SARS-CoV-2 pandemic had a sudden, dramatic impact on healthcare. In Italy, since the beginning of the pandemic, colorectal cancer (CRC) screening programs have been forcefully suspended. We aimed to evaluate whether screening procedure delays can affect the outcomes of CRC screening. METHODS: We built a procedural model considering delays in the time to colonoscopy and estimating the effect on mortality due to up-stage migration of patients. The number of expected CRC cases was computed by using the data of the Italian screened population. Estimates of the effects of delay to colonoscopy on CRC stage, and of stage on mortality were assessed by a meta-analytic approach. RESULTS: With a delay of 0-3 months, 74% of CRC is expected to be stage I-II, while with a delay of 4-6 months there would be a 2%-increase for stage I-II and a concomitant decrease for stage III-IV (P = .068). Compared to baseline (0-3 months), moderate (7-12 months) and long (> 12 months) delays would lead to a significant increase in advanced CRC (from 26% to 29% and 33%, respectively; P = .008 and P < .001, respectively). We estimated a significant increase in the total number of deaths (+12.0%) when moving from a 0-3-months to a >12-month delay (P = .005), and a significant change in mortality distribution by stage when comparing the baseline with the >12-months (P < .001). CONCLUSIONS: Screening delays beyond 4-6 months would significantly increase advanced CRC cases, and also mortality if lasting beyond 12 months. Our data highlight the need to reorganize efforts against high-impact diseases such as CRC, considering possible future waves of SARS-CoV-2 or other pandemics.


Subject(s)
COVID-19 , Colorectal Neoplasms , Delayed Diagnosis , Early Detection of Cancer , Aged , Colonoscopy , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/mortality , Humans , Italy , Mass Screening , Middle Aged , Neoplasm Staging , Pandemics
9.
Gut Microbes ; 13(1): 1-9, 2021.
Article in English | MEDLINE | ID: covidwho-1493512

ABSTRACT

Gut microbiome manipulation to alter the gut-lung axis may potentially protect humans against respiratory infections, and clinical trials of probiotics show promise in this regard in healthy adults and children. However, comparable studies are lacking in overweight/obese people, who have increased risks in particular of viral upper respiratory tract infections (URTI). This Addendum further analyses our recent placebo-controlled trial of probiotics in overweight/obese people (focused initially on weight loss) to investigate the impact of probiotics upon the occurrence of URTI symptoms. As well as undergoing loss of weight and improvement in certain metabolic parameters, study participants taking probiotics experienced a 27% reduction in URTI symptoms versus control, with those ≥45 years or BMI ≥30 kg/m2 experiencing greater reductions. This symptom reduction is apparent within 2 weeks of probiotic use. Gut microbiome diversity remained stable throughout the study in probiotic-treated participants. Our data provide support for further trials to assess the potential role of probiotics in preventing viral URTI (and possibly also COVID-19), particularly in overweight/obese people.


Subject(s)
Obesity/complications , Overweight/complications , Probiotics/therapeutic use , Respiratory Tract Infections/prevention & control , Respiratory Tract Infections/therapy , Adult , Aged , Double-Blind Method , Gastrointestinal Microbiome , Humans , Middle Aged , Pandemics , Self Report
10.
Viral Immunol ; 34(6): 416-420, 2021.
Article in English | MEDLINE | ID: covidwho-1475758

ABSTRACT

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has infected millions of individuals in the world. However, the long-term effect of SARS-CoV-2 on the organs of recovered patients remains unclear. This study is to evaluate the impact of SARS-CoV-2 on the spleen and T lymphocytes. Seventy-six patients recovered from COVID-19, including 66 cases of moderate pneumonia and 10 cases of severe pneumonia were enrolled in the observation group. The control group consisted of 55 age-matched healthy subjects. The thickness and length of spleen were measured by using B-ultrasound and the levels of T lymphocytes were detected by flow cytometry. Results showed that the mean length of spleen in the observation group was 89.57 ± 11.49 mm, which was significantly reduced compared with that in the control group (103.82 ± 11.29 mm, p < 0.001). The mean thicknesses of spleen between observation group and control group were 29.97 ± 4.04 mm and 32.45 ± 4.49 mm, respectively, and the difference was significant (p < 0.001). However, no significant difference was observed in the size of spleen between common pneumonia and severe pneumonia (p > 0.05). In addition, the decreased count of T lymphocyte was observed in part of recovered patients. The counts of T suppressor lymphocytes in patients with severe pneumonia were significantly decreased compared with those with moderate pneumonia (p = 0.005). Therefore, these data indicate that SARS-CoV-2 infection affects the size of spleen and T lymphocytes.


Subject(s)
COVID-19/immunology , SARS-CoV-2 , Spleen/pathology , T-Lymphocytes/immunology , Adult , Aged , Female , Humans , Lymphocyte Count , Male , Middle Aged , Young Adult
11.
Gac Sanit ; 35(6): 594-597, 2021.
Article in Spanish | MEDLINE | ID: covidwho-1474573

ABSTRACT

In the current pandemic situation, the literature urges to consider the gender approach to avoid deepening existing inequalities, as already happened in previous epidemics. This field note aims to describe an experience of application of gender analysis to the impact of the pandemic on the public health, carried out by the students and teachers of the Diploma of Gender and Health of the Andalusian School of Public Health-University of Granada. The activity consisted of a review of the literature on caregiving and its impact on health in the context of health crisis, a gender analysis of information and shared reflection and debate. The debate was grouped into around five reflections, in which the care was putted in the center. Every reflection was linked to the need to incorporate the gender approach in measures and specific actions.


Subject(s)
COVID-19 , Pandemics , Gender Identity , Humans , Public Health , SARS-CoV-2
12.
Hum Mol Genet ; 29(6): 955-966, 2020 04 15.
Article in English | MEDLINE | ID: covidwho-1455300

ABSTRACT

γ-secretase is a macromolecular complex that catalyzes intramembranous hydrolysis of more than 100 membrane-bound substrates. The complex is composed of presenilin (PS1 or PS2), anterior pharynx defect-1 (APH-1), nicastrin (NCT) and PEN-2 and early-onset; autosomal dominant forms of Alzheimer's disease (AD) are caused by inheritance of mutations of PS. No mutations in genes encoding NCT, or PEN-2 have been identified to date that cause AD. In this regard, a large genetic meta-analysis of four cohorts consisting of more than 600 000 individuals identified a common missense variant, rs117618017 in the APH1B gene that results in a T27I mutation, as a novel genome-wide significant locus. In order to confirm the findings that rs117618017 is associated with risk of AD, we performed a genetic screen from deep whole genome sequencing of the large NIMH family-based Alzheimer's Disease (AD) dataset. In parallel, we sought to uncover potential molecular mechanism(s) by which APH-1B T27I might be associated with AD by generating stable HEK293 cell lines, wherein endogenous APH-1A and APH-1B expression was silenced and into which either the wild type APH-1B or the APH-1B T27I variant was stably expressed. We then tested the impact of expressing either the wild type APH-1B or the APH-1B T27I variant on γ-secretase processing of human APP, the murine Notch derivative mNΔE and human neuregulin-1. We now report that we fail to confirm the association of rs1047552 with AD in our cohort and that cells expressing the APH-1B T27I variant show no discernable impact on the γ-secretase processing of established substrates compared with cells expressing wild-type APH-1B.


Subject(s)
Alzheimer Disease/pathology , Amyloid Precursor Protein Secretases/metabolism , Endopeptidases/genetics , Membrane Proteins/genetics , Polymorphism, Single Nucleotide , Alzheimer Disease/genetics , HEK293 Cells , Humans , Mutation , Protein Binding
13.
J Adv Nurs ; 77(5): 2166-2184, 2021 May.
Article in English | MEDLINE | ID: covidwho-1455563

ABSTRACT

AIM: This study aimed to explore the role and impact of advanced practice nurses (APNs) in care of patients following fragility hip fracture by systematically reviewing the available evidence. REVIEW DESIGN: Systematic review. DATA SOURCES: A search of the databases Ovid Medline, CINAHL, Embase, Emcare, Cochrane Library, and Google Scholar was conducted from January-February 2019. METHOD: This systematic review adhered to The PRISMA Statement. Study selection was managed using the Covidence software platform and quality was assessed using JBI Critical appraisal tools. Studies included adults >18 years and described the role and impact of APNs in care of patients following fragility hip fracture on clinical and non-clinical outcomes. RESULTS: There were 19 papers identified that met the inclusion/exclusion criteria. Quality was graded as moderate to low risk of bias. Six characteristics of APNs were identified: (1) coordination; (2) collaboration; (3) education; (4) assessment, investigation and treatment recommendations; (5) discharge planning, support and follow up; and (6) documentation. Overall mortality and LOS improved when characteristics of the APN role were present. CONCLUSION: Key findings from this systematic review showed: (1) The APN title and role are not clearly defined, but characteristics of the APN role are evident; (2) characteristics of APNs promote the delivery of best practice hip fracture care and have a positive impact on mortality and LOS; and (3) innovative service delivery models involving APNs should be considered to address future projections of hip fracture rates and improve outcomes. IMPACT: This systematic review provides evidence of the role characteristics of APNs in fragility hip fracture and the impact of the role on outcomes. Findings from this research could be used to develop service delivery models using APNs to care for patients following fragility hip fracture and to inform practice where APN roles may improve outcomes for other patient cohorts.


Subject(s)
Advanced Practice Nursing , Nurses , Adult , Humans
14.
J Investig Med ; 69(6): 1230-1237, 2021 08.
Article in English | MEDLINE | ID: covidwho-1342804

ABSTRACT

The impact of HIV on influenza-like illness (ILI) has been incompletely described in the era of combination antiretroviral therapy, particularly in the post-H1N1 pandemic period. This analysis informs on ILI in an otherwise healthy, predominantly outpatient cohort of adults with HIV in the USA. From September 2010 to March 2015, this multisite observational cohort study enrolled otherwise healthy adults presenting to a participating US military medical center with ILI, a subset of whom were HIV positive. Demographics, clinical data, and self-reported symptom severity were ascertained, and enrollees completed a daily symptom diary for up to 10 days. 510 men were included in the analysis; 50 (9.8%) were HIV positive. Subjects with HIV were older and less likely to be on active duty. Rhinovirus and influenza A were the most commonly identified pathogens. Moderate-severe diarrhea (p<0.001) and fatigue (p=0.01) were more frequently reported by HIV-positive men. HIV positivity was associated with higher gastrointestinal scores, but not other measures of ILI symptom severity, after controlling for age, race, military status, and influenza season. Few were hospitalized. HIV-positive subjects had more influenza B (p=0.04) and were more likely to receive antivirals (32% vs 6%, p<0.01). Antiviral use was not significantly associated with symptom scores when accounting for potential confounders. In this predominantly outpatient cohort of adult men, HIV had minimal impact on ILI symptom severity. Despite similar illness severity, a higher percentage of subjects with HIV reported undergoing antiviral treatment for ILI, likely reflecting differences in prescribing practices.Trial registration number: NCT01021098.


Subject(s)
HIV Infections , Influenza, Human , Adult , Antiviral Agents , Cohort Studies , HIV Infections/complications , Humans , Influenza, Human/epidemiology , Influenza, Human/pathology , Male , Outpatients , Picornaviridae Infections/epidemiology , Picornaviridae Infections/pathology
15.
Indian J Labour Econ ; : 1-5, 2020 Sep 03.
Article in English | MEDLINE | ID: covidwho-1397094

ABSTRACT

The COVID-19 pandemic has pushed the world into an unprecedented crisis and uncertainty, calling to expedite the implementation of the Centenary Declaration. It called upon constituents to pursue 'with unrelenting vigour its [ILO] constitutional mandate for social justice by further developing its human centred approach to the future of work'. It called for putting workers' rights and the needs, aspirations and rights of all people at the heart of economic, social and environmental policies. The international community and ILO's constituents have engaged in a collective endeavour to tackle the devastating human impact of the pandemic, but more is needed.

17.
MMWR Morb Mortal Wkly Rep ; 69(29): 960-964, 2020 07 24.
Article in English | MEDLINE | ID: covidwho-1389848

ABSTRACT

Population prevalence of persons infected with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), varies by subpopulation and locality. U.S. studies of SARS-CoV-2 infection have examined infections in nonrandom samples (1) or seroprevalence in specific populations* (2), which are limited in their generalizability and cannot be used to accurately calculate infection-fatality rates. During April 25-29, 2020, Indiana conducted statewide random sample testing of persons aged ≥12 years to assess prevalence of active infection and presence of antibodies to SARS-CoV-2; additional nonrandom sampling was conducted in racial and ethnic minority communities to better understand the impact of the virus in certain racial and ethnic minority populations. Estimates were adjusted for nonresponse to reflect state demographics using an iterative proportional fitting method. Among 3,658 noninstitutionalized participants in the random sample survey, the estimated statewide point prevalence of active SARS-CoV-2 infection confirmed by reverse transcription-polymerase chain reaction (RT-PCR) testing was 1.74% (95% confidence interval [CI] = 1.10-2.54); 44.2% of these persons reported no symptoms during the 2 weeks before testing. The prevalence of immunoglobulin G (IgG) seropositivity, indicating past infection, was 1.09% (95% CI = 0.76-1.45). The overall prevalence of current and previous infections of SARS-CoV-2 in Indiana was 2.79% (95% CI = 2.02-3.70). In the random sample, higher overall prevalences were observed among Hispanics and those who reported having a household contact who had previously been told by a health care provider that they had COVID-19. By late April, an estimated 187,802 Indiana residents were currently or previously infected with SARS-CoV-2 (9.6 times higher than the number of confirmed cases [17,792]) (3), and 1,099 residents died (infection-fatality ratio = 0.58%). The number of reported cases represents only a fraction of the estimated total number of infections. Given the large number of persons who remain susceptible in Indiana, adherence to evidence-based public health mitigation and containment measures (e.g., social distancing, consistent and correct use of face coverings, and hand hygiene) is needed to reduce surge in hospitalizations and prevent morbidity and mortality from COVID-19.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Public Health Surveillance/methods , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Child , Coronavirus Infections/ethnology , Female , Humans , Indiana/epidemiology , Male , Middle Aged , Pandemics , Pneumonia, Viral/ethnology , Prevalence , Young Adult
18.
Int J Mol Sci ; 21(13)2020 Jul 07.
Article in English | MEDLINE | ID: covidwho-1389380

ABSTRACT

The SARS-CoV-2 virus is a recently-emerged zoonotic pathogen already well adapted to transmission and replication in humans. Although the mutation rate is limited, recently introduced mutations in SARS-CoV-2 have the potential to alter viral fitness. In addition to amino acid changes, mutations could affect RNA secondary structure critical to viral life cycle, or interfere with sequences targeted by host miRNAs. We have analysed subsets of genomes from SARS-CoV-2 isolates from around the globe and show that several mutations introduce changes in Watson-Crick pairing, with resultant changes in predicted secondary structure. Filtering to targets matching miRNAs expressed in SARS-CoV-2-permissive host cells, we identified ten separate target sequences in the SARS-CoV-2 genome; three of these targets have been lost through conserved mutations. A genomic site targeted by the highly abundant miR-197-5p, overexpressed in patients with cardiovascular disease, is lost by a conserved mutation. Our results are compatible with a model that SARS-CoV-2 replication within the human host is constrained by host miRNA defences. The impact of these and further mutations on secondary structures, miRNA targets or potential splice sites offers a new context in which to view future SARS-CoV-2 evolution, and a potential platform for engineering conditional attenuation to vaccine development, as well as providing a better understanding of viral tropism and pathogenesis.


Subject(s)
Betacoronavirus/genetics , Genome, Viral , MicroRNAs/metabolism , RNA, Viral/chemistry , 3' Untranslated Regions , Base Sequence , COVID-19 , Coronavirus Infections/pathology , Coronavirus Infections/virology , Databases, Genetic , Humans , MicroRNAs/chemistry , MicroRNAs/genetics , Mutation , Nucleic Acid Conformation , Pandemics , Pneumonia, Viral/pathology , Pneumonia, Viral/virology , RNA Splice Sites , RNA Splicing , SARS-CoV-2 , Sequence Alignment , Viral Nonstructural Proteins/genetics , Viral Proteins/chemistry , Viral Proteins/genetics , Viral Proteins/metabolism
19.
Emerg Top Life Sci ; 4(5): 539-549, 2020 12 15.
Article in English | MEDLINE | ID: covidwho-1387508

ABSTRACT

In the wake of the SARS-CoV-2 pandemic, the world has woken up to the importance of biosecurity and the need to manage international borders. Yet strong sectorial identities exist within biosecurity that are associated with specific international standards, individual economic interests, specific research communities, and unique stakeholder involvement. Despite considerable research addressing human, animal, plant, and environmental health, the science connections between these sectors remain quite limited. One Biosecurity aims to address these limitations at global, national, and local scales. It is an interdisciplinary approach to biosecurity policy and research that builds on the interconnections between human, animal, plant, and environmental health to effectively prevent and mitigate the impacts of invasive alien species. It provides an integrated perspective to address the many biosecurity risks that transcend the traditional boundaries of health, agriculture, and the environment. Individual invasive alien plant and animal species often have multiple impacts across sectors: as hosts of zoonotic parasites, vectors of pathogens, pests of agriculture or forestry, as well as threats to biodiversity and ecosystem function. It is time these risks were addressed in a systematic way. One Biosecurity is essential to address several major sociological and environmental challenges to biosecurity: climate change, increasing urbanisation, agricultural intensification, human global mobility, loss of technical capability as well as public resistance to pesticides and vaccines. One Biosecurity will require the bringing together of taxonomists, population biologists, modellers, economists, chemists, engineers, and social scientists to engage in a new agenda that is shaped by politics, legislation, and public perceptions.


Subject(s)
Agriculture , Environmental Health , One Health , Animals , COVID-19 , Climate Change , Humans , Pandemics , Plants , SARS-CoV-2 , Urbanization
20.
Int J Epidemiol ; 50(4): 1124-1133, 2021 08 30.
Article in English | MEDLINE | ID: covidwho-1387893

ABSTRACT

BACKGROUND: The impact of SARS-CoV-2 alongside influenza is a major concern in the northern hemisphere as winter approaches. METHODS: Test data for influenza and SARS-CoV-2 from national surveillance systems between 20 January 2020 and 25 April 2020 were used to estimate influenza infection on the risk of SARS-CoV-2 infection. A test-negative design was used to assess the odds of SARS-CoV-2 in those who tested positive for influenza compared with those who tested negative. The severity of SARS-CoV-2 was also assessed using univariable and multivariable analyses. RESULTS: The risk of testing positive for SARS-CoV-2 was 58% lower among influenza-positive cases and patients with a coinfection had a risk of death of 5.92 (95% confidence interval: 3.21-10.91) times greater than among those with neither influenza nor SARS-CoV-2. The odds of ventilator use or death and intensive care unit admission or death were greatest among coinfected patients. CONCLUSIONS: Coinfection of these viruses could have a significant impact on morbidity, mortality and health-service demand.


Subject(s)
COVID-19 , Coinfection , Influenza, Human , Coinfection/epidemiology , Humans , Influenza, Human/epidemiology , SARS-CoV-2 , Severity of Illness Index
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