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4.
J Med Internet Res ; 2021 May 31.
Artículo en Inglés | MEDLINE | ID: covidwho-1295586

RESUMEN

BACKGROUND: During lockdown due to the COVID-19 pandemic, telemedicine has become a necessary component of clinical practice for the purpose of providing safer patient care, and it has been used to support the healthcare needs of COVID-19 patients and routine primary care patients alike. However, this change has not been fully consolidated. OBJECTIVE: The objective of this study was to analyse the determinants of healthcare professionals' intention to use the eConsulta digital clinical consultations tool in the post-COVID-19 context. METHODS: A literature review of the Technology Acceptance Model (TAM) allowed us to construct a theoretical model and establish a set of hypotheses derived from it about the influence that a variety of different factors relating to both healthcare professionals and the institutions where they work had on those professionals' intention to use eConsulta. In order to confirm the proposed model, a mixed qualitative and quantitative methodology was used, and a questionnaire was designed to serve as the data collection instrument. The data were analysed using univariate and bivariate analysis techniques. To confirm the theoretical model, exploratory factor analysis and binary logistic regression were applied. RESULTS: The most important variables were those referring to perceived benefits (B=2.408) and the type of use that individuals habitually made of eConsulta (B=0.715). Environmental pressure (B=0.678), experience of technology (B=0.542), gender (B=0.639) and the degree of eConsulta implementation (B=0.266) were other variables influencing the intention to use the tool in the post-COVID-19 context. When replicating the previous analysis by professional group, experience of technology and gender in the physician group, and experience of the tool's use and the centre where a professional works in the nurse group, were found to be of considerable importance. CONCLUSIONS: The implementation and use of eConsulta had increased significantly as a consequence of the COVID-19 pandemic, and the majority of the healthcare professionals were satisfied with its use in practice and planned to incorporate it into their practices in the post-COVID-19 context. Perceived benefits and environmental pressure were determining factors in the attitude towards and intention to use eConsulta.

5.
Front Cell Infect Microbiol ; 11: 680422, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1266655

RESUMEN

Background: Sex and gender are crucial variables in coronavirus disease 2019 (COVID-19). We sought to provide information on differences in clinical characteristics and outcomes between male and female patients and to explore the effect of estrogen in disease outcomes in patients with COVID-19. Method: In this retrospective, multi-center study, we included all confirmed cases of COVID-19 admitted to four hospitals in Hubei province, China from Dec 31, 2019 to Mar 31, 2020. Cases were confirmed by real-time RT-PCR and were analyzed for demographic, clinical, laboratory and radiographic parameters. Random-effect logistic regression analysis was used to assess the association between sex and disease outcomes. Results: A total of 2501 hospitalized patients with COVID-19 were included in the present study. The clinical manifestations of male and female patients with COVID-19 were similar, while male patients have more comorbidities than female patients. In terms of laboratory findings, compared with female patients, male patients were more likely to have lymphopenia, thrombocytopenia, inflammatory response, hypoproteinemia, and extrapulmonary organ damage. Random-effect logistic regression analysis indicated that male patients were more likely to progress into severe type, and prone to ARDS, secondary bacterial infection, and death than females. However, there was no significant difference in disease outcomes between postmenopausal and premenopausal females after propensity score matching (PSM) by age. Conclusions: Male patients, especially those age-matched with postmenopausal females, are more likely to have poor outcomes. Sex-specific differences in clinical characteristics and outcomes do exist in patients with COVID-19, but estrogen may not be the primary cause. Further studies are needed to explore the causes of the differences in disease outcomes between the sexes.


Asunto(s)
COVID-19 , Linfopenia , China/epidemiología , Femenino , Humanos , Masculino , Estudios Retrospectivos , SARS-CoV-2
6.
Neurology ; 96(16): e2109-e2120, 2021 04 20.
Artículo en Inglés | MEDLINE | ID: covidwho-1223789

RESUMEN

OBJECTIVE: To describe the clinical characteristics and outcomes of coronavirus disease 2019 (COVID-19) among patients with myasthenia gravis (MG) and identify factors associated with COVID-19 severity in patients with MG. METHODS: The CO-MY-COVID registry was a multicenter, retrospective, observational cohort study conducted in neuromuscular referral centers and general hospitals of the FILNEMUS (Filière Neuromusculaire) network (between March 1, 2020, and June 8, 2020), including patients with MG with a confirmed or highly suspected diagnosis of COVID-19. COVID-19 was diagnosed based on a PCR test from a nasopharyngeal swab or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology, thoracic CT scan, or typical symptoms. The main outcome was COVID-19 severity based on location of treatment/management (home, hospitalized in a medical unit, or in an intensive care unit). We collected information on demographic variables, general history, and risk factors for severe COVID-19. Multivariate ordinal regression models were used to identify factors associated with severe COVID-19 outcomes. RESULTS: Among 3,558 patients with MG registered in the French database for rare disorders, 34 (0.96%) had COVID-19. The mean age at COVID-19 onset was 55.0 ± 19.9 years (mean MG duration: 8.5 ± 8.5 years). By the end of the study period, 28 patients recovered from COVID-19, 1 remained affected, and 5 died. Only high Myasthenia Gravis Foundation of America (MGFA) class (≥IV) before COVID-19 was associated with severe COVID-19 (p = 0.004); factors that were not associated included sex, MG duration, and medium MGFA classes (≤IIIb). The type of MG treatment had no independent effect on COVID-19 severity. CONCLUSIONS: This registry-based cohort study shows that COVID-19 had a limited effect on most patients, and immunosuppressive medications and corticosteroids used for MG management are not risk factors for poorer outcomes. However, the risk of severe COVID-19 is elevated in patients with high MGFA classes (odds ratio, 102.6 [4.4-2,371.9]). These results are important for establishing evidence-based guidelines for the management of patients with MG during the COVID-19 pandemic.


Asunto(s)
COVID-19/terapia , COVID-19/virología , Miastenia Gravis/virología , SARS-CoV-2/patogenicidad , Adulto , Anciano , Anciano de 80 o más Años , Francia , Historia del Siglo XXI , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo
7.
Scand J Public Health ; 49(1): 17-26, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: covidwho-1207566

RESUMEN

This article examines gender-based health inequalities arising from the COVID-19 pandemic by drawing on insights from research into the 'gender health paradox'. Decades of international research shows that, across Europe, men have shorter life expectancies and higher mortality rates than women, and yet, women report higher morbidity. These gender-based health inequalities also appear to be evident within the pandemic and its aftermath. The article starts by providing an overview of the 'gender health paradox' and the biological, social, economic and political explanations for it. It then outlines the international estimates of gender-based inequalities in COVID-19 morbidity and mortality rates - where emerging data suggests that women are more likely to be diagnosed with COVID-19 but that men have a higher mortality rate. It then explores the longer term consequences for gender-based health inequalities of the aftermath of the COVID-19 pandemic, focusing on the impacts of government policy responses and the emerging economic crisis, suggesting that this might lead to increased mortality amongst men and increased morbidity amongst women. The essay concludes by reflecting on the pathways shaping gender-based health inequalities in the COVID-19 pandemic and the responses needed to ensure that it does not exacerbate gender-based health inequalities into the future.


Asunto(s)
COVID-19/epidemiología , Disparidades en el Estado de Salud , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Distribución por Sexo
8.
J Infect Public Health ; 14(7): 886-891, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: covidwho-1198898

RESUMEN

BACKGROUND: The COVID-19 pandemic has had an immeasurable impact, affecting healthcare systems, the global economy, and society. Exploration of trends within the existing COVID-19 data may guide directions for further study and novel treatment development. As the world faces COVID-19 disease, it is essential to study its epidemiological and clinical characteristics further to better understand and aid in its detection and containment. METHODS: We aimed to study the clinical characteristics of patients infected with COVID-19 in Dubai, a multi-national Society. RESULTS: Our findings demonstrate that during the first wave of the COVID-19 epidemic, age, gender, and country of origin were associated with more severe cases of COVID-19, higher risk for hospitalization and death. Male individuals between 41 and 60 years of age from India had the most significant hospitalization and death predictor (p=.0001). The predictors for COVID-19 related deaths were slightly less than UAE Nationals by individuals from GCC (p=.02) that were followed closely behind by Pilipino (p=.02) and Arabs (p=.001). CONCLUSION: The vulnerability of individuals to infection and in the spectrum of COVID-19 symptoms remains to be understood. There are large variations in disease severity, one component of which may be genetic variability in responding to the virus. Genomics of susceptibility to COVID-19 infection and the wide variation in clinical response to COVID-19 in patients should become active investigation areas.


Asunto(s)
COVID-19 , SARS-CoV-2 , Hospitalización , Humanos , India/epidemiología , Unidades de Cuidados Intensivos , Masculino , Pandemias , Índice de Severidad de la Enfermedad
9.
BMC Public Health ; 21(1): 705, 2021 04 12.
Artículo en Inglés | MEDLINE | ID: covidwho-1181098

RESUMEN

BACKGROUND: Significant differences in COVID-19 incidence by gender, class and race/ethnicity are recorded in many countries in the world. Lockdown measures, shown to be effective in reducing the number of new cases, may not have been effective in the same way for all, failing to protect the most vulnerable populations. This survey aims to assess social inequalities in the trends in COVID-19 infections following lockdown. METHODS: A cross-sectional survey conducted among the general population in France in April 2020, during COVID-19 lockdown. Ten thousand one hundred one participants aged 18-64, from a national cohort who lived in the three metropolitan French regions most affected by the first wave of COVID-19. The main outcome was occurrence of possible COVID-19 symptoms, defined as the occurrence of sudden onset of cough, fever, dyspnea, ageusia and/or anosmia, that lasted more than 3 days in the 15 days before the survey. We used multinomial regression models to identify social and health factors related to possible COVID-19 before and during the lockdown. RESULTS: In all, 1304 (13.0%; 95% CI: 12.0-14.0%) reported cases of possible COVID-19. The effect of lockdown on the occurrence of possible COVID-19 was different across social hierarchies. The most privileged class individuals saw a significant decline in possible COVID-19 infections between the period prior to lockdown and during the lockdown (from 8.8 to 4.3%, P = 0.0001) while the decline was less pronounced among working class individuals (6.9% before lockdown and 5.5% during lockdown, P = 0.03). This differential effect of lockdown remained significant after adjusting for other factors including history of chronic disease. The odds of being infected during lockdown as opposed to the prior period increased by 57% among working class individuals (OR = 1.57; 95% CI: 1.00-2.48). The same was true for those engaged in in-person professional activities during lockdown (OR = 1.53; 95% CI: 1.03-2.29). CONCLUSIONS: Lockdown was associated with social inequalities in the decline in COVID-19 infections, calling for the adoption of preventive policies to account for living and working conditions. Such adoptions are critical to reduce social inequalities related to COVID-19, as working-class individuals also have the highest COVID-19 related mortality, due to higher prevalence of comorbidities.


Asunto(s)
COVID-19 , Disparidades en el Estado de Salud , Política Pública , Cuarentena , Adolescente , Adulto , COVID-19/epidemiología , COVID-19/prevención & control , Estudios Transversales , Francia/epidemiología , Humanos , Persona de Mediana Edad , Cuarentena/legislación & jurisprudencia , Factores Socioeconómicos , Adulto Joven
10.
Signal Transduct Target Ther ; 6(1): 136, 2021 03 31.
Artículo en Inglés | MEDLINE | ID: covidwho-1164823

RESUMEN

Epidemiological studies of the COVID-19 patients have suggested the male bias in outcomes of lung illness. To experimentally demonstrate the epidemiological results, we performed animal studies to infect male and female Syrian hamsters with SARS-CoV-2. Remarkably, high viral titer in nasal washings was detectable in male hamsters who presented symptoms of weight loss, weakness, piloerection, hunched back and abdominal respiration, as well as severe pneumonia, pulmonary edema, consolidation, and fibrosis. In contrast with the males, the female hamsters showed much lower shedding viral titers, moderate symptoms, and relatively mild lung pathogenesis. The obvious differences in the susceptibility to SARS-CoV-2 and severity of lung pathogenesis between male and female hamsters provided experimental evidence that SARS-CoV-2 infection and the severity of COVID-19 are associated with gender.


Asunto(s)
COVID-19 , SARS-CoV-2/metabolismo , Caracteres Sexuales , Animales , COVID-19/metabolismo , COVID-19/patología , Modelos Animales de Enfermedad , Susceptibilidad a Enfermedades , Femenino , Masculino , Mesocricetus
11.
Int J Clin Pract ; 75(6): e14150, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: covidwho-1153499

RESUMEN

BACKGROUND: COVID-19 infection is severe in the presence of older age, male gender and risk factors. The aim of this study was to examine the relationship between the level of anxiety created by immensely spreading COVID-19-related information and age, gender and the presence of risk factors. MATERIAL AND METHODS: The data used in this study were obtained by collecting a 25-question questionnaire created through Google forms with various communication tools. RESULTS: The data of 929 people who answered the questionnaire were used. The level of anxiety increased with age significantly, upon hearing that a person from their age group was harmed by the virus (P < .001). The feelings of being depressed and hopeless significantly increased as the age increased (P < .001). There was no significant difference between the genders in terms of feeling depressed and feeling of lack of joy in life (P = .066, P = .308, respectively). Participants with chronic diseases stated that they felt more depressed and hopeless and a lack of joy in life more frequently (P < .001). CONCLUSION: Our results indicated that individuals with older age and having risk factors were more vulnerable to the stress caused by the pandemic. It is necessary for healthcare providers to identify high-risk groups by considering these situations, in order to make early psychological interventions.


Asunto(s)
COVID-19 , Pandemias , Anciano , Ansiedad/epidemiología , Depresión/epidemiología , Femenino , Humanos , Masculino , Salud Mental , Factores de Riesgo , SARS-CoV-2 , Encuestas y Cuestionarios
12.
J Nephrol ; 34(2): 305-314, 2021 04.
Artículo en Inglés | MEDLINE | ID: covidwho-1114333

RESUMEN

BACKGROUND: In February 2020 the corona virus disease 2019 (COVID-19) infection started spreading throughout Italy, hitting the Lombardy region very hard. Despite the high diffusion, only a subset of patients developed severe COVID-19: around 25% of them developed acute kidney injury (AKI) and one-third of them died. Elderly patients and patients with high comorbidities were identified as being at higher risk of severe COVID-19. METHODS: Our prospective observational cohort study includes 392 consecutive patients hospitalized for COVID-19 in Milan (median age 67 years, 75% male). We evaluated the relationship between blood pressure at presentation, presence of AKI at Emergency Department admission and during hospitalization, and total in-hospital mortality (24%). RESULTS: Although 58% of our study patients reported a history of hypertension (HYP) (86% on treatment), 30% presented with low blood pressure levels. Only 5.5% were diagnosed with AKI on admission; 75% of hypertensive patients discontinued therapy during hospitalization (only 20% were on treatment at discharge). Gender and hypertension were strongly associated with AKI at admission (odds ratio 11). Blood pressure was inversely correlated with increased risk of AKI upon admission, regardless of the severity of respiratory distress. Age over 65, history of hypertension, and severity of respiratory distress were the main predictors of AKI, which developed in 34.7% of cases during hospitalization. AKI was associated with increased in-hospital mortality. Hypertension and low blood pressure at presentation were the main predictors of in-hospital mortality, together with age over 65, baseline pulmonary involvement, and severity of illness. CONCLUSIONS: In patients hospitalized for COVID-19, hypertension and low blood pressure at presentation are important risk factors for AKI and mortality. Early reduction of antihypertensive therapy may improve outcomes in patients with SARS-CoV-2 infection.


Asunto(s)
Lesión Renal Aguda/fisiopatología , Presión Sanguínea/fisiología , COVID-19/epidemiología , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/etiología , Anciano , Femenino , Estudios de Seguimiento , Mortalidad Hospitalaria/tendencias , Humanos , Unidades de Cuidados Intensivos , Italia/epidemiología , Masculino , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia/tendencias
13.
PeerJ ; 9: e10613, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1083206

RESUMEN

BACKGROUND: Coronavirus Disease 2019 (COVID-19) has been surging globally. Risk strata in medical attention are of dynamic significance for apposite assessment and supply distribution. Presently, no known cultured contrivance is available to fill this gap of this pandemic. The aim of this study is to develop a predictive model based on vector autoregressive moving average (VARMA) model of various orders for gender based daily COVID-19 incidence in Nigeria. This study also aims to proffer empirical evidence that compares incidence between male and female for COVID-19 risk factors. METHODS: Wilcoxon signed-rank test is employed to investigate the significance of the difference in the gender distributions of the daily incidence. A VARMA model of various orders is formulated for the gender based daily COVID-19 incidence in Nigeria. The optimal VARMA model is identified using Bayesian information criterion. Also, a predictive model based on univariate autoregressive moving average model is formulated for the daily death cases in Nigeria. Fold change is estimated based on crude case-fatality risk to investigate whether there is massive underreporting and under-testing of COVID-19 cases in Nigeria. RESULTS: Daily incidence is higher in males on most days from 11 April 2020 to 12 September 2020. Result of Wilcoxon signed-rank test shows that incidence among male is significantly higher than female (p-value < 2.22 × 10-16). White neural network test shows that daily female incidence is not linear in mean (p-value = 0.00058746) while daily male incidence is linear in mean (p-value = 0.4257). McLeod-Li test shows that there is autoregressive conditional heteroscedasticity in the female incidence (Maximum p-value = 1.4277 × 10-5) and male incidence (Maximum p-value = 9.0816 × 10-14) at 5% level of significance. Ljung-Box test (Tsay, 2014) shows that the daily incidence cases are not random (p-value=0.0000). The optimal VARMA model for male and female daily incidence is VARMA (0,1). The optimal model for the Nigeria's daily COVID-19 death cases is identified to be ARIMA (0,1,1). There is no evidence of massive underreporting and under-testing of COVID-19 cases in Nigeria. CONCLUSIONS: Comparison of the observed incidence with fitted data by gender shows that the optimal VARMA and ARIMA models fit the data well. Findings highlight the significant roles of gender on daily COVID-19 incidence in Nigeria.

14.
Am J Infect Control ; 49(2): 158-165, 2021 02.
Artículo en Inglés | MEDLINE | ID: covidwho-1064714

RESUMEN

BACKGROUND: COVID-19 is a novel disease caused by SARS-CoV-2. METHODS: We conducted a retrospective evaluation of patients admitted with COVID-19 to one site in March 2020. Patients were stratified into 3 groups: survivors who did not receive mechanical ventilation (MV), survivors who received MV, and those who received MV and died during hospitalization. RESULTS: There were 140 hospitalizations; 22 deaths (mortality rate 15.7%), 83 (59%) survived and did not receive MV, 35 (25%) received MV and survived; 18 (12.9%) received MV and died. Thee mean age of each group was 57.8, 55.8 and 72.7 years, respectively (P = .0001). Of those who received MV and died, 61% were male (P = .01). More than half the patients (n = 90, 64%) were African American. First measured d-dimer >575.5 ng/mL, procalcitonin > 0.24 ng/mL, lactate dehydrogenase >445.6 units/L, and brain natriuretic peptide (BNP) >104.75 pg/mL had odds ratios of 10.5, 5, 4.5 and 2.9, respectively for MV (P < .05 for all). Peak BNP >167.5 pg/mL had an odds ratio of 6.7 for inpatient mortality when mechanically ventilated (P = .02). CONCLUSIONS: Age and gender may impact outcomes in COVID-19. D-dimer, procalcitonin, lactate dehydrogenase and BNP may serve as early indicators of disease trajectory.


Asunto(s)
COVID-19/mortalidad , Hospitalización/estadística & datos numéricos , Respiración Artificial/mortalidad , SARS-CoV-2 , Adulto , Factores de Edad , Anciano , COVID-19/sangre , COVID-19/terapia , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , L-Lactato Deshidrogenasa/sangre , Masculino , Persona de Mediana Edad , Péptido Natriurético Encefálico/sangre , Oportunidad Relativa , Puntuaciones en la Disfunción de Órganos , Polipéptido alfa Relacionado con Calcitonina/sangre , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales
15.
J Pediatr ; 231: 50-54, 2021 04.
Artículo en Inglés | MEDLINE | ID: covidwho-1044718

RESUMEN

OBJECTIVE: To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on authorship gender in articles submitted to The Journal of Pediatrics. STUDY DESIGN: Using gender-labeling algorithms and human inspection, we inferred the gender of corresponding authors of original articles submitted in January-February and April-May of 2019 and 2020 noting those articles related to the COVID-19 pandemic. We used Pearson χ2 tests to determine differences in gender proportions during the selected periods in the US and internationally. RESULTS: We analyzed 1521 original articles. Submissions increased 10.9% from January-February 2019 to January-February 2020 and 61.6% from April-May 2019 to April-May 2020. Women accounted for 56.0% of original articles in April-May 2019 but only 49.8% of original articles in April-May 2020. Original articles focused on COVID-19 represented a small percentage of additional articles submitted in January-February 2020 (1/33 or 3.0%) and (53/199 or 26.6%) in April-May 2020 compared with the number of submissions in the same months in 2019. International male corresponding authors submitted a significantly larger proportion of original articles compared with international female corresponding authors in April-May 2020 compared to April-May 2019 (P = .043). There was no difference in corresponding author gender proportion in the US (US in April-May of 2020 vs April-May of 2019; P = .95). There was no significant difference in final dispositions based on corresponding author gender for original articles from 2019 and 2020 (P = .17). CONCLUSIONS: Original article submissions to The Journal increased in April-May 2020, with the greatest increase by international male corresponding authors. The majority of the submission growth was not related to COVID-19.


Asunto(s)
Autoria , Bibliometría , COVID-19/epidemiología , Eficiencia , Pediatría , Femenino , Humanos , Masculino , Publicaciones Periódicas como Asunto , Factores Sexuales
16.
Int J Equity Health ; 19(1): 224, 2020 12 17.
Artículo en Inglés | MEDLINE | ID: covidwho-979699

RESUMEN

BACKGROUND: The COVID-19 crisis in India negatively impacted mental health due to both the disease and the harsh lockdown, yet there are almost no qualitative studies describing mental health impacts or the strategies of resilience used, and in particular, no reports from the most vulnerable groups. This study aimed to examine the acute mental health impacts of the COVID-19 crisis as well as coping strategies employed by disadvantaged community members in North India. METHODS: We used an intersectional lens for this qualitative study set in rural Tehri Garwhal and urban Dehradun districts of Uttarakhand, India. In-depth interviews were conducted in May 2020 during lockdown, by phone and in person using purposive selection, with people with disabilities, people living in slums with psychosocial disabilities and widows (total n = 24). We used the framework method for analysis following steps of transcription and translation, familiarisation, coding, developing and then applying a framework, charting and then interpreting data. FINDINGS: The participants with compounded disadvantage had almost no access to mobile phones, health messaging or health care and experienced extreme mental distress and despair, alongside hunger and loss of income. Under the realms of intrapersonal, interpersonal and social, six themes related to mental distress emerged: feeling overwhelmed and bewildered, feeling distressed and despairing, feeling socially isolated, increased events of othering and discrimination, and experiencing intersectional disadvantage. The six themes summarising coping strategies in the COVID-19 crisis were: finding sense and meaning, connecting with others, looking for positive ways forward, innovating with new practices, supporting others individually and collectively, and engaging with the natural world. CONCLUSIONS: People intersectionally disadvantaged by their social identity experienced high levels of mental distress during the COVID-19 crisis, yet did not collapse, and instead described diverse and innovative strategies which enabled them to cope through the COVID-19 lockdown. This study illustrates that research using an intersectional lens is valuable to design equitable policy such as the need for access to digital resources, and that disaggregated data is needed to address social inequities at the intersection of poverty, disability, caste, religious discrimination and gender inherent in the COVID-19 pandemic in India.


Asunto(s)
Adaptación Psicológica , COVID-19/psicología , Trastornos Mentales/psicología , Cuarentena/psicología , Estrés Psicológico/psicología , Poblaciones Vulnerables/psicología , Enfermedad Aguda , Adulto , Femenino , Humanos , India , Masculino , Trastornos Mentales/complicaciones , Persona de Mediana Edad , Pandemias , Pobreza/psicología , Investigación Cualitativa , SARS-CoV-2 , Estrés Psicológico/complicaciones , Poblaciones Vulnerables/estadística & datos numéricos
17.
SSM Popul Health ; 13: 100717, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: covidwho-971159

RESUMEN

Previous studies find preventative behaviors designed to reduce the number of infections during emerging disease outbreaks are associated with perceived risk of disease susceptibility. Few studies have attempted to identify underlying factors that explain differences in perceptions of risk during an infectious disease outbreak. Drawing from two early waves of American Trends Panel (n=7,441), as well as a National Science Foundation funded, Qualtrics national panel survey from the early stages of the pandemic (n=10,368), we test whether race and ethnicity, gender, and age were associated with six perceived threat and fear outcomes related to COVID-19. Results demonstrate race and ethnicity, gender, and age play a significant role in shaping threat and fear perceptions of COVID-19, but depending on the outcome, relationships vary in direction and magnitude. In some cases, historically marginalized racial and ethnic groups were more likely to report high fear and perceive coronavirus as a major threat to population and individual health, whereas, in others cases, the same marginalized racial and ethnic groups were less likely to perceive coronavirus to be a serious threat to the immune-comprised and the elderly population. We also find women were generally more likely to report high levels of threat and fear of COVID-19. Finally, we observe a clear age difference, whereby adults in older age groups report high-risk perceptions of COVID-19. Findings can inform public health programs designed to educate communities on the benefits of engaging in effective preventative practices during emerging infectious disease outbreaks.

18.
Am J Physiol Heart Circ Physiol ; 320(1): H296-H304, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: covidwho-961166

RESUMEN

Biological sex is increasingly recognized as a critical determinant of health and disease, particularly relevant to the topical COVID-19 pandemic caused by the SARS-CoV-2 coronavirus. Epidemiological data and observational reports from both the original SARS epidemic and the most recent COVID-19 pandemic have a common feature: males are more likely to exhibit enhanced disease severity and mortality than females. Sex differences in cardiovascular disease and COVID-19 share mechanistic foundations, namely, the involvement of both the innate immune system and the canonical renin-angiotensin system (RAS). Immunological differences suggest that females mount a rapid and aggressive innate immune response, and the attenuated antiviral response in males may confer enhanced susceptibility to severe disease. Furthermore, the angiotensin-converting enzyme 2 (ACE2) is involved in disease pathogenesis in cardiovascular disease and COVID-19, either to serve as a protective mechanism by deactivating the RAS or as the receptor for viral entry, respectively. Loss of membrane ACE2 and a corresponding increase in plasma ACE2 are associated with worsened cardiovascular disease outcomes, a mechanism attributed to a disintegrin and metalloproteinase (ADAM17). SARS-CoV-2 infection also leads to ADAM17 activation, a positive feedback cycle that exacerbates ACE2 loss. Therefore, the relationship between cardiovascular disease and COVID-19 is critically dependent on the loss of membrane ACE2 by ADAM17-mediated proteolytic cleavage. This article explores potential mechanisms involved in COVID-19 that may contribute to sex-specific susceptibility focusing on the innate immune system and the RAS, namely, genetics and sex hormones. Finally, we highlight here the added challenges of gender in the COVID-19 pandemic.


Asunto(s)
Inmunidad Adaptativa/inmunología , Andrógenos/inmunología , Enzima Convertidora de Angiotensina 2/genética , COVID-19/inmunología , Estrógenos/inmunología , Inmunidad Innata/inmunología , Receptores de Coronavirus/genética , Proteína ADAM17/metabolismo , Inmunidad Adaptativa/genética , Andrógenos/metabolismo , Enzima Convertidora de Angiotensina 2/metabolismo , COVID-19/genética , COVID-19/metabolismo , COVID-19/mortalidad , Enfermedades Cardiovasculares/genética , Enfermedades Cardiovasculares/inmunología , Estrógenos/metabolismo , Femenino , Genes Ligados a X/genética , Genes Ligados a X/inmunología , Humanos , Inmunidad Innata/genética , Masculino , Regiones Promotoras Genéticas , Receptores de Coronavirus/metabolismo , Sistema Renina-Angiotensina/genética , Sistema Renina-Angiotensina/inmunología , Elementos de Respuesta/genética , SARS-CoV-2/metabolismo , Índice de Severidad de la Enfermedad , Caracteres Sexuales , Factores Sexuales , Inactivación del Cromosoma X
19.
J Med Internet Res ; 22(11): e21646, 2020 11 05.
Artículo en Inglés | MEDLINE | ID: covidwho-926447

RESUMEN

BACKGROUND: The online discussion around the COVID-19 pandemic is multifaceted, and it is important to examine the different ways by which online users express themselves. Since emojis are used as effective vehicles to convey ideas and sentiments, they can offer important insight into the public's gendered discourses about the pandemic. OBJECTIVE: This study aims at exploring how people of different genders (eg, men, women, and sex and gender minorities) are discussed in relation to COVID-19 through the study of Twitter emojis. METHODS: We collected over 50 million tweets referencing the hashtags #Covid-19 and #Covid19 for a period of more than 2 months in early 2020. Using a mixed method, we extracted three data sets containing tweets that reference men, women, and sexual and gender minorities, and we then analyzed emoji use along each gender category. We identified five major themes in our analysis including morbidity fears, health concerns, employment and financial issues, praise for frontline workers, and unique gendered emoji use. The top 600 emojis were manually classified based on their sentiment, indicating how positive, negative, or neutral each emoji is and studying their use frequencies. RESULTS: The findings indicate that the majority of emojis are overwhelmingly positive in nature along the different genders, but sexual and gender minorities, and to a lesser extent women, are discussed more negatively than men. There were also many differences alongside discourses of men, women, and gender minorities when certain topics were discussed, such as death, financial and employment matters, gratitude, and health care, and several unique gendered emojis were used to express specific issues like community support. CONCLUSIONS: Emoji research can shed light on the gendered impacts of COVID-19, offering researchers an important source of information on health crises as they happen in real time.


Asunto(s)
COVID-19/epidemiología , Medios de Comunicación Sociales/normas , Femenino , Humanos , Masculino , Prevalencia
20.
Cell Biochem Funct ; 39(1): 35-47, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: covidwho-897741

RESUMEN

The outbreak of COVID-19 emerged in December 2019 rapidly spread across the globe and has become pandemic. Little is known about the protective factors of this infection, which is equally distributed between genders and different ages while severe and poor prognosis cases are strongly associated to old males and the presence of comorbidities. Thus, preventive measures aiming at reducing the number of infection and/or their severity are strongly needed. Vitamin D has got great attention and has been claimed as potentially protective against the infection since it may be associated with immunocompetence, inflammation, aging, and those diseases involved in determining the outcomes of COVID-19. This narrative review aims at collecting the literature available on the involvement of the vitamin D status in the pathogenesis of COVID-19 and the putative utility of vitamin D supplementation in the therapeutics. It emerges that a poor vitamin D status seems to associate with an increased risk of infection whereas age, gender and comorbidities seem to play a more important role in COVID-19 severity and mortality. While randomized control trials are needed to better inquire into this topic, vitamin D supplementation may be useful beside its potential effects on SARS-CoV-2 infection and COVID-19.


Asunto(s)
COVID-19 , Pandemias , SARS-CoV-2 , Deficiencia de Vitamina D , Vitamina D/uso terapéutico , COVID-19/tratamiento farmacológico , COVID-19/epidemiología , Humanos , Deficiencia de Vitamina D/tratamiento farmacológico , Deficiencia de Vitamina D/epidemiología
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