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1.
Risk Manag Healthc Policy ; 15: 1741-1749, 2022.
Article | MEDLINE | ID: covidwho-2166181

Résumé

Purpose: This study aimed to investigate the impact of characteristic ischemic stroke and outcomes during the first COVID-19 pandemic lockdown. Patients and Methods: A retrospective, observational cohort study of a comprehensive tertiary stroke center was conducted. Patients with ischemic stroke were divided into pre-COVID-19 lockdown (11/1/2019 to 1/30/2020) and COVID-19 lockdown (1/31/2020 to 4/30/2020) period groups. Patient data on stroke admission, thrombolysis, endovascular treatment, and 3-month routine follow-up were recorded. Data analysis was performed using SPSS according to values following a Gaussian distribution. Results: The pre-COVID-19 lockdown period group comprised 230 patients compared to 215 patients in the COVID-19 lockdown period group. Atrial fibrillation was more predominant in the COVID-19 lockdown period group (11.68% vs 5.65%, p=0.02) alongside patients who were currently smoking (38.8% vs 28.7%, p=0.02) and drinking alcohol (30.37% vs 20.00%, p=0.012) compared with that of the pre-COVID-19 lockdown period group. For patients receiving thrombolysis, the median door-to-CT time was longer in the COVID-19 lockdown period group (17.0 min (13.0, 24.0) vs 12.0 min (8.0, 17.3), p=0.012), median door to needle time was 48.0 minutes (35.5, 73.0) vs 43.5 minutes (38.0, 53.3), p=0.50, compared with that of the pre-COVID-19 lockdown period group. There were no differences for patients receiving mechanical thrombectomy. The median length of hospitalization (IQR) was no different. Discharge mRS scores (IQR) were higher in the COVID-19 lockdown period group (1.0 (1.0, 3.0) vs 1.0 (1.0, 2.0), p=0.022). Compared with the pre-COVID-19 lockdown period, hospitalization cost (Chinese Yuan) in the COVID-19 period group was higher (13,445.7 (11,009.7, 20,030.5) vs 10,799.2 (8692.4, 16,381.7), p=0.000). There was no difference observed in 3-month mRS scores. Conclusion: Patients presenting with ischemic stroke during the COVID-19 pandemic lockdown period had longer median door-to-CT time and higher hospitalization costs. There were no significant differences in 3-month outcomes. Multidisciplinary collaboration and continuous workflow optimization may maintain stroke care during the COVID-19 pandemic lockdown.

2.
Risk Manag Healthc Policy ; 15: 1859-1868, 2022.
Article Dans Anglais | MEDLINE | ID: covidwho-2166176

Résumé

Background: To prevent the spread of COVID-19 and carry out a successful vaccination program especially in low-income countries, people must have faith on scientists and health experts. The most significant challenge to vaccination programs' efficacy is now regarded to be a lack of information and trust in immunization due to myths and misinformation spread in the community. Therefore, this study aimed to identify the myth and misconceptions that are propagated about the COVID-19 vaccine, the refusal rate of the vaccine and determine the factors associated with COVID-19 vaccine refusal. Methods: A community-based cross-sectional study was conducted from December 7 to January 25, 2022. Face-to-face interviews with a standardized questionnaire were used to collect data on the variables. Data were entered into the statistical tool Epi data version 3.1 and then exported to SPSS version 25 for analysis. Binary logistic regression, both bivariable and multivariable, was conducted. In the multivariable binary logistic regression model, the adjusted odds ratio with 95% confidence interval was used to declare statistically significant factors based on a p value less than 0.05. Results: Out of the total 574 respondents, 60.3% [95% CI (55.5, 64.2)] of them refused to take COVID-19 vaccine. In this study, respondent's age [AOR = 2.1 at 95% CI: (1.8, 4.9)], perception on COVID-19 vaccine [AOR = 3.0 at 95 CI: (1.9, 4.6)], eHealth literacy [AOR = 2.7 at 95% CI: (1.7, 4.1)], source of information about the vaccine [AOR = 2.9 at 95% CI: (1.9, 4.4)], computer literacy [AOR = 2.8 at 95 CI: (1.8, 4.2)] and frequency of internet use [AOR = 2.2 at 95 CI: (1.8, 5.3)] were identified as determinant factors for COVID-19 vaccine acceptance. Conclusion: Factors like eHealth literacy, source of information about the vaccine, frequency of internet use, respondent's perception about the vaccine and computer literacy were found to be determinant factors for COVID-19 vaccine acceptance.

3.
Clin Cosmet Investig Dermatol ; 15: 2117-2127, 2022.
Article Dans Anglais | MEDLINE | ID: covidwho-2166159

Résumé

Purpose: The aim of this study was to assess the incidence and characteristics of COVID-19 cutaneous manifestations among geriatric patients infected with the SARS-CoV-2 virus. Patients and Methods: Sixty-four nursing home residents in Dobre Miasto, Poland (mean age: 79 years) infected with SARS-CoV-2 were monitored for skin lesions during the epidemic outbreak in 2020. Only five of them presented COVID-19 dermatological manifestation: vesicular (4 cases) and erythematous (1 case) skin lesions, which appeared after the remaining symptoms of the disease had resolved. Results: The average time between COVID-19 onset and cutaneous manifestation was 22 days. Skin lesions persisted in five cases 112, 17, 21,19 and 27 days, respectively, and were often accompanied by pruritus and neuropathic pain. Conclusion: Skin manifestations of SARS-CoV-2 infection might be misdiagnosed or overlooked, particularly among elderly patients with chronic diseases. The recognition of skin lesions due to COVID-19 might improve patients' quality of life by reducing the intensity of symptoms such as pruritus or neuropathic pain.

4.
International Journal of Clinical and Health Psychology ; : 100364, 2022.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165365

Résumé

The present study examined the impact of the COVID-19 pandemic on the emotional quality of dreams, the incorporation of pandemic-related themes, and the occurrence of lucid dreaming. Dream reports and lucidity ratings of psychiatric outpatients (n = 30) and healthy controls (n = 81) during two lockdowns in Germany were compared to those of healthy controls (n = 33) before the pandemic. Results confirmed previous reports that pandemic-specific themes were incorporated into dreams. Overall, however, incorporation into dreams was rare. Contrary to expectations, psychiatric outpatients did not differ from controls in the frequency of dream incorporation of pandemic-related content. Moreover, incorporation was independent of psychiatric symptoms and loneliness. Loneliness was, however, associated with threat-related content, suggesting that it represents a risk for bad dreams but not for crisis-specific dream incorporation. Regarding lucid dreaming, both groups had similar scores for its underlying core dimensions, i.e., insight, control, and dissociation, during the two lockdowns. Scores for control and dissociation but not insight were lower compared to the pre-pandemic sample. Our working hypothesis is that REM sleep during lockdowns intensified as a means of increased emotional consolidation, rendering the associated mental state less hybrid and thereby less lucid.

5.
International Journal of Cardiology Congenital Heart Disease ; : 100434, 2022.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165364

Résumé

Background The COVID-19 pandemic has significantly increased stress and strain on health professionals. With a focus on paediatric cardiac care, this study explored health professionals' concerns about COVID-19, perceptions of the impact of pandemic on healthcare, and experiences of psychological stress. Methods Paediatric health professionals working at a large quaternary hospital in Australia were invited to complete a survey between June 2020 and February 2021. Demographic factors, clinical role characteristics, and anxiety and depressive symptoms were assessed. Qualitative data on experiences and perceived effects of the pandemic on paediatric cardiac care were also collected. Results 228 health professionals (152 nurses, 37 medical doctors, 22 allied and mental health professionals, 17 medical research and administrative staff) participated in the survey (54.4% response rate, 85% women). Half the sample (52.2%) endorsed ‘moderate' to ‘extreme' worry about COVID-19 and 38% of participants perceived healthcare services as adversely impacted by the pandemic to a ‘great' or ‘very great' extent. Almost one in five health professionals reported anxiety (18%) and 11% reported depressive symptoms indicative of a need for clinical intervention. Six themes were identified in the qualitative data: (1) Concern about the consequences of visitor restrictions and disrupted patient services, (2) Intensified strain on healthcare workers, (3) Feelings of fear and loss, (4) Social isolation and disconnection, (5) Adapting to change, and (6) Gratitude. Conclusion Timely, tailored policies, supports, and interventions are needed to address health professionals' mental health needs during and beyond the pandemic, to minimize the far-reaching impact of situational stressors.

6.
International Journal of Biological Macromolecules ; 229:413-421, 2023.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165363

Résumé

Fucoidan is a highly sulfated polysaccharide with a wide range of bioactivities, including anti-pathogenic activity. However, the relationship between structure and activity of fucoidan in inhibiting pathogen infections remains unclear. Here, different-molecular-weight fucoidans were prepared by photocatalytic degradation followed by membrane ultrafiltration, and their chemical structures and anti-pathogenic microbiota activity were compared. Results showed that photocatalytic degradation could effectively degrade fucoidan while its structure block and sulfate groups were not destroyed obviously. Fucoidan (90.8 kDa) of 5 mg/mL could inhibit the growth of S. aureus, S. typhimurium and E. coli, but its degradation products, Dfuc1 (19.2 kDa) and Dfuc2 (5.5 kDa), demonstrated lower inhibitory effect. In addition, compared to Dfuc1 and Dfuc2, fucoidan showed stronger capability to prevent the adhesion of S. aureus, L. monocytogenes, V. parahaemolyticus and S. typhimurium to HT-29 cells. Moreover, the inhibitory effect against SARS-CoV-2 and the binding activity to S protein were also positively correlated to molecular weight. These results indicate that natural fucoidan with higher molecular weight are more effective to inhibit these pathogenic bacteria and SARS-CoV-2, providing a better understanding of the relationship between structure and activity of fucoidan against pathogenic microbiota.

7.
International Journal of Biological Macromolecules ; 2022.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165362

Résumé

In the last two years, the world encountered the SARS-CoV-2 virus, which is still dominating the population due to the absence of a viable treatment. To eradicate the global pandemic, scientists, doctors, and researchers took an exceptionally significant initiative towards the development of effective therapeutics to save many lifes. This review discusses about the single-domain antibodies (sdAbs), also called nanobodies, their structure, and their types against the infections of dreadful SARS-CoV-2 virus. A precise description highlights the nanobodies and their therapeutic application against the other selected viruses. It aims to focus on the extraordinary features of these antibodies compared to the conventional therapeutics like mAbs, convalescent plasma therapy, and vaccines. The stable structure of these nanobodies along with the suitable mechanism of action also confers greater resistance to the evolving variants with numerous mutations. The nanobodies developed against SARS-CoV-2 and its mutant variants have shown the greater neutralization potential than primitive ones. Engineering of these specialized antibodies by modern biotechnological approaches will surely be more beneficial in treating this COVID-19 pandemic along with certain other viral infections.

8.
International Journal of Biological Macromolecules ; 2022.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165361

Résumé

For reasons of high transmissibility and virulence, Alpha (UK, B.1.1.7) and Beta (South African, B.1.351) SARS-CoV-2 variants are classified with other types as variants of concern. Here we report on the influence of royal jelly (RJ) protein fraction (PF)50 (major RJ protein 2 and its isoform X1) on the entry of these variants into the ACE2-human embryonic kidney (HEK) 293 cells using the lentiviral system. The efficiency of PF50 on SARS-CoV-2 replication (RNA-dependent RNA polymerase "RdRp” activity), as well as its impact on bleomycin-induced lung injury in vitro, were also assessed. The PF50 efficiently inhibited infection of kidney cells with the UK and S. African variant spikes of pseudotyped lentivirus particles (IC50 = 7.25 μM and 16.92 μM, respectively) and suppressed the RdRp activity (IC50 = 29.93 μM). Moreover, PF50 displayed protective and therapeutic efficacy against lung injury due to its antioxidant, anti-inflammatory, and angiotensin II blocking activities. The current findings, taken together, offer a novel perspective on PF50 as a promising agent against COVID-19.

9.
International Journal of Antimicrobial Agents ; : 106708, 2023.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165360

Résumé

Nirmatrelvir/ritonavir (N/R) is among the most effective antiviral drugs against SARS-CoV-2. We review here the preclinical development, pharmacodynamics and pharmacokinetics of N/R. Randomized clinical trials have been exclusively run with pre-Omicron variants of concern, but in vitro studies show that efficacy against all Omicron sublineages is preserved, as confirmed by post-marketing observational studies. Nevertheless, investigations of large viral genome repositories have shown that mutation in the main protease causing resistance to N/R are increasingly frequent. In addition, virological and clinical rebounds after N/R discontinuation have been reported in immunocompetent patients. This finding is of concern when translated to immunocompromised patients, for which N/R efficacy has never been formally investigated in clinical trials. We finally discuss economical sustainability and perspectives for this therapeutic arena

10.
Infectious Disease Modelling ; 2023.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165359

Résumé

Recently some of us used a random-walk Monte Carlo simulation approach to study the spread of COVID-19. The calculations were reasonably successful in describing secondary and tertiary waves of infection, in countries such as the USA, India, South Africa and Serbia. However, they failed to predict the observed third wave for India. In this work we present a more complete set of simulations for India, that take into consideration two aspects that were not incorporated previously. These include the stochastic movement of an erstwhile protected fraction of the population, and the reinfection of some recovered individuals because of their exposure to a new variant of the SARS-CoV-2 virus. The extended simulations now show the third COVID-19 wave for India that was missing in the earlier calculations. They also suggest an additional fourth wave, which was indeed observed during approximately the same time period as the model prediction.

11.
Infectious Disease Modelling ; 2023.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165358

Résumé

Normalized interventions were implemented in different cities in China to contain the outbreak of COVID-19 before December 2022. However, the differences in the intensity and timeliness of the implementations lead to differences in final size of the infections. Taking the outbreak of COVID-19 in three representative cities Xi'an, Zhengzhou and Yuzhou in January 2022, as examples, we develop a compartmental model to describe the spread of novel coronavirus and implementation of interventions to assess concretely the effectiveness of Chinese interventions and explore their impact on epidemic patterns. After applying reported human confirmed cases to verify the rationality of the model, we apply the model to speculate transmission trend and length of concealed period at the initial spread phase of the epidemic (they are estimated as 10.5, 7.8, 8.2 days, respectively), to estimate the range of basic reproduction number (2.9, 0.7, 1.6), and to define two indexes (transmission rate vt and controlled rate vc) to evaluate the overall effect of the interventions. It is shown that for Zhengzhou, vc is always more than vt with regular interventions, and Xi'an take 8 days to achieve vc > vt twice as long as Yuzhou, which can interpret the fact that the epidemic situation in Xi'an was more severe. By carrying out parameter values, it is concluded that in the early stage, strengthening the precision of close contact tracking and frequency of large-scale nucleic acid testing of non-quarantined population are the most effective on controlling the outbreaks and reducing final size. And, if the close contact tracking strategy is sufficiently implemented, at the late stage large-scale nucleic acid testing of non-quarantined population is not essential.

12.
Infectious Disease Modelling ; 2022.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165357

Résumé

Virus evolution is a common process of pathogen adaption to host populations and environments. Frequently, a small but important fraction of virus mutations are reported to contribute to higher risks of host infection, which is one of the major determinants of infectious diseases outbreaks at population scale. The key mutations contributing to transmission advantage of a genetic variant often grows and reaches fixation rapidly. Based on classical epidemiology theories of disease transmission, we proposed a mechanistic explanation of the process that between-host transmission advantage may shape the observed logistic curve of the mutation proportion in population. The logistic growth of mutation is further generalized by incorporating time-varying selective pressure to account for impacts of external factors on pathogen adaptiveness. The proposed model is implemented in real-world data of COVID-19 to capture the emerging trends and changing dynamics of the B.1.1.7 strains of SARS-CoV-2 in England. The model characterizes and establishes the underlying theoretical mechanism that shapes the logistic growth of mutation in population.

13.
Infectious Disease Modelling ; 2022.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165356

Résumé

Analytic compartmental models are currently used in mathematical epidemiology to forecast the COVID-19 pandemic evolution and explore the impact of mitigation strategies. In general, such models treat the population as a single entity, losing the social, cultural and economical specificities. We present a network model that uses socio-demographic datasets with the highest available granularity to predict the spread of COVID-19 in the province of Barcelona. The model is flexible enough to incorporate the effect of containment policies, such as lockdowns or the use of protective masks, and can be easily adapted to future epidemics. We follow a stochastic approach that combines a compartmental model with detailed individual microdata from the population census, including social determinants and age-dependent strata, and time-dependent mobility information. We show that our model reproduces the dynamical features of the disease across two waves and demonstrates its capability to become a powerful tool for simulating epidemic events.

14.
Infectious Disease Modelling ; 2022.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165355

Résumé

Background Vaccination has been the most important measure to mitigate the COVID-19 pandemic. The vaccination coverage was relatively low in Hong Kong Special Administrative Region China, compared to Singapore, in the early 2022. Hypothetically, if the two regions, Hong Kong (HK) and Singpaore (SG), swap their vaccination coverage rate, what outcome would occur? Method We adopt the Susceptible – Vaccinated – Exposed – Infectious – Hospitalized – Death - Recovered model with a time-varying transmission rate and fit model to weekly reported COVID-19 deaths (the data up to 2022 Nov 4) in HK and SG using R package POMP. After we obtain a reasonable fitting, we rerun our model with the estimated parameter values and swap the vaccination rates between HK and SG to explore what would happen. Results Our model fits the data well. The reconstructed transmission rate was higher in HK than in SG in 2022. With a higher vaccination rate as in SG, the death total reported in HK would decrease by 37.5% and the timing of the peak would delay by 3 weeks. With a lower vaccination rate as in HK, the death total reported in SG would increase to 5.5-fold high with a peak 6-week earlier than the actual during Delta variant period. Conclusions Vaccination rate changes in HK and SG may lead to very different outcome. This is likely due that the estimated transmission rates were very different in HK and SG which reflect the different control policies and dominate variants. Because of strong control measure, HK avoided large scale community transmission of Delta variant. Given the high breakthrough infection rate and transmission rate of Omicron variant, increasing vaccination rate in HK will likely yield a mild (but significant) contribution in terms of lives saved. While in SG, lower vaccination coverage to the level of HK will be disastrous.

15.
IDCases ; : e01664, 2023.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165354

Résumé

During the COVID-19 pandemic, cases of acute sinusitis due to COVID-19 and even co-infections have been reported [1]. We want to discuss a case in Colombia where a patient with detected type 2 diabetes presented sinusitis and COVID-19.A 51-year-old man from Sincelejo, Sucre, consulted on May 23, 2020, with one day presenting general malaise and fever (38°C), lumbar pain, frequent urination, polydipsia and hyperglycemia (366 mg/dl). He denies cough, travel during the last two weeksan Physical examination revealed a blood pressure of 170/110 mmHg, heart rate of 115 beats/minute, respiratory rate of 16 breaths/minute, and temperature of 36.6°C. Neither lymphadenopathies nor cardiopulmonary disturbances were noted. A working diagnosis of febrile syndrome, ketoacidosis, and recent-onset type 2 diabetes, with uncontrolled hypertension, was contemplated at admission RT-PCR for SARS-CoV-2 was positive. A head CT Scan revealed left maxillary sinusitis with mucosal thickening of the maxillary Despite the sizeable SARS-CoV-2 pandemic, the number of reports of sinusitis in association with COVID-19 has been limited [2], [3]. Sinusitis is more often diagnosed among immunocompromised patients, including diabetes of our patient. COVID-19, as a multisystemic condition., It may affect different anatomical areas, including the paranasal sinuses and the upper and lower respiratory mucosa. Although it is uncertain whether SARS-CoV-2 was the sole cause of the sinusitis in our patient or just a contributing factor, other reports suggest a significant involvement of the virus in the development of this condition, in addition to its role in worsening the clinical course of patients with chronic rhinosinusitis

16.
IATSS Research ; 2022.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165353

Résumé

In this study, we develop a system to provide information on the sterilization of baggage carts and arriving passenger baggage to airport (Hereafter referred as arrival baggage) by using ultraviolet (UV) sterilization and information communication technology as border quarantine measures at airports. This system sterilizes arrival baggage and baggage carts by UV irradiation, and allows passengers to easily view the sterilization information recognized by radio frequency indentation technology. This is to provide safety and security not only to passengers, but also to staff, who may come into direct contact with the arrival baggage, of airport, airline, customs, and so on. In addition, the passengers can be provided with baggage tracking information, such as the current location and estimated delivering time of the baggage. This makes it possible to keep social distancing at baggage claims as an infection prevention. Furthermore, we verify the feasibility of the developed system and identify the issues to be addressed for its practical application through a demonstration of proof of concept at Central Japan International Airport.

17.
Heart & Lung ; 58:210-216, 2023.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165352

Résumé

Background The novel coronavirus disease (COVID-19) may cause vascular (e.g., endothelial dysfunction, and arterial stiffness), cardiac, autonomic (e.g., heart rate variability [HRV]), and systemic inflammatory response via direct viral attack, hypoxia-induced injury, or immunological dysregulation, especially in those patients with pre-existing cardiovascular diseases (CVD). However, to date, no study has shown prevalence of endothelial dysfunction, arterial stiffness and heart rate variability assessed by bedside peripheral arterial tonometry in patients with previous CVD hospitalized in the acute phase of COVID-19. Objective This study aimed to assess the prevalence of endothelial dysfunction, arterial stiffness, and altered HRV in patients with CVD hospitalized due to COVID-19. Methods This cross-sectional study was conducted from July 2020 to February 2021. Included male and female adult patients aged 40 to 60 years with previous CVD and diagnosed with COVID-19. Anthropometric data, comorbidities, and blood tests were analyzed. Endothelial function, arterial stiffness, and HRV were assessed using peripheral arterial tonometry (PAT), and the statistical significance was set at 5%. Results Fourteen (51.8%) patients presented endothelial dysfunction (reactive hyperemia index = 1.2 ± 0.3) and enhancement in the high-frequency component of HRV (p < 0.05). There was a high prevalence of endothelial dysfunction, especially in patients with chronic heart failure (10 (71.4%)). Patients with preserved endothelial function showed a high augmentation index normalized to a heart rate of 75 bpm (p < 0.01), suggesting arterial stiffness. Conclusion Patients with CVD hospitalized due to COVID-19 presented endothelial dysfunction assessed using PAT, which could be used as a biomarker for arterial stiffness and altered HRV. The possibility of detecting vascular and autonomic changes during phase II of COVID-19 may help to prevent possible long-term complications.

18.
19.
Heart & Lung ; 58:204-209, 2023.
Article Dans Anglais | ScienceDirect | ID: covidwho-2165350

Résumé

Background Extracorporeal membrane oxygenator (ECMO) is one of the life-saving modalities for the treatment of multiple organs dysfunction, particularly the heart and the lungs. Objective To evaluate the benefit of ECMO for the treatment of SAR-COV-2 infection and its outcomes, complications, and mortality rate. Methods A comprehensive search for articles was performed using MEDLINE and SCOPUS from December 2019 to December 2020. Two independent reviewers selected eligible studies, extracted the data, assessed the quality of the studies, reviewed the full study protocols, and reported the findings according to the PRISMA protocol. The meta-analyses were performed using the Comprehensive Meta-Analysis software version 2.0. Results Pooled data from 57 studies was analyzed. There were 7,035 patients with SAR-COV-2 infection with event rate of ECMO treatment was 58.10% (95%CI: 43.70–71.20). The mortality rate was 16.66% (95%CI: 11.49–23.53). The mean mortality rate of ECMO supported patients was 35.60% (95%CI: 30.60 to 41.00). Thirty-one percent (95%CI: 24.50–38.40) of the patients had venous thromboembolic events, 30.90% (95%CI: 17.90–47.80) of the patients had ECMO circuit thrombosis, and 24.50% (95%CI: 12.50–42.40) of the patients had bleeding. In the subgroup analysis, the mortality rate was higher among patients who were treated with ECMO, the pooled odds ratio was 4.47 (95%CI: 2.39–8.35, p < 0.001), and was significantly higher in Asia with an odds ratio of 7.88 (95%CI: 2.40–25.85, p = 0.001). Conclusion Mortality rate among patients who received ECMO therapy was high. A system of care, including patient selection, resource management and referral system, can impact the outcomes of ECMO therapy.

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