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Kamanyi E, Shagembe M, Sambaiga R, Onuekwe CE, Haonga T, Kessy AT, Mwengee W. Sociocultural practices and COVID-19 prevention: A qualitative study of Mtwara, Shinyanga, and Arusha, Tanzania. J Public Health Afr 2025; 16:713. [PMID: 40365608 PMCID: PMC12067537 DOI: 10.4102/jphia.v16i3.713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 11/13/2024] [Indexed: 05/15/2025] Open
Abstract
Background The World Health Organization pronounced COVID-19 as a public health emergency in March 2020. Studies conducted in Tanzania and beyond indicate that poor literacy, limited understanding of the disease, challenging living conditions, increasing poverty, and unemployment are key determinants, while the influence of sociocultural factors has received less attention. This study reinforces the position of sociocultural practices in determining how people practiced the preventive measures against COVID-19 pandemic. Aim This qualitative study explores the influence of sociocultural practices in the implementation of COVID-19 preventive measures in Arusha, Mtwara and Shinyanga regions of Tanzania. Setting This study was conducted in Tanzania, covering diverse sociocultural contexts of Mtwara, Arusha and Shinyanga regions. Methods Focus group discussions, key informant interviews and rapid ethnographic field observations were used to obtain more detailed information from study participants. Results Findings suggest that sociocultural practices shaped how individuals and communities responded to COVID-19 preventive measures, influencing acceptance, hesitation, resistance, or modification of public health guidelines, including vaccine uptake. In Mtwara, Arusha, and Shinyanga, people embraced their sociocultural practices to navigate the new disease, whose origins were debated or unknown. Their responses to the pandemic were mediated by sociocultural practices and other factors. Conclusion Sociocultural practices shaped the acceptance, adaptation, or resistance to COVID-19 measures in Tanzania, emphasising the need for community-integrated public health strategies. Contribution This study underscores the impact of sociocultural factors on public health, offering insights for socioculturally tailored pandemic interventions.
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Affiliation(s)
- Egidius Kamanyi
- Department of Sociology and Anthropology, College of Social Sciences, University of Dar es Salaam, Dar es Salaam, United Republic of Tanzania
| | - Magolanga Shagembe
- Department of Sociology and Anthropology, College of Social Sciences, University of Dar es Salaam, Dar es Salaam, United Republic of Tanzania
- Tanzanian Psychological Association (TAPA), Dar es Selaam, United Republic of Tanzania
| | - Richard Sambaiga
- Department of Sociology and Anthropology, College of Social Sciences, University of Dar es Salaam, Dar es Salaam, United Republic of Tanzania
| | - Chima E. Onuekwe
- Department of Immunizations, Emergency Preparedness and Response (EPR), World Health Organization, Dar es Salaam, United Republic of Tanzania
- Centre for Health and Allied Legal and Demographical Development, Research and Training (CHALADDRAT), Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Tumaini Haonga
- Department of Health Promotion Unit, Ministry of Health, Dodoma, United Republic of Tanzania
| | - Ambrose T. Kessy
- Directorate of Research, Publications and Consultancy, University of Dodoma, Dodoma, United Republic of Tanzania
- Department of Planning, Finance and Administration, The Law School of Tanzania, Dar es Salaam, United Republic of Tanzania
| | - William Mwengee
- Department of Immunizations, Emergency Preparedness and Response (EPR), World Health Organization, Dar es Salaam, United Republic of Tanzania
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Zhao J, Huang X, Li X, Li B, Rong Z, Huang X, Ren R, Li D, Li C, Li Q, Xiao J, Shi G. The spatial-temporal variations and influencing factors of COVID-19 case fatality rate: a worldwide study in 30 countries from February 2021 to May 2022. Epidemiol Infect 2024; 152:e124. [PMID: 39417399 PMCID: PMC11502459 DOI: 10.1017/s0950268824000852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/18/2024] [Accepted: 05/22/2024] [Indexed: 10/19/2024] Open
Abstract
To evaluate the variations in COVID-19 case fatality rates (CFRs) across different regions and waves, and the impact of public health interventions, social and economic characteristics, and demographic factors on COVID-19 CFRs, we collected data from 30 countries with the highest incidence rate in three waves. We summarized the CFRs of different countries and continents in each wave through meta-analysis. Spearman's correlation and multiple linear regression were employed to estimate the correlation between influencing factors and reduction rates of CFRs. Significant differences in CFRs were observed among different regions during the three waves (P < 0.001). An association was found between the changes in fully vaccinated rates (r s = 0.41), population density (r s = 0.43), the proportion of individuals over 65 years old (r s = 0.43), and the reduction rates of case fatality rate. Compared to Wave 1, the reduction rates in Wave 2 were associated with population density (β = 0.19, 95%CI: 0.05-0.33) and smoking rates (β = -4.66, 95%CI: -8.98 - -0.33), while in Wave 3 it was associated with booster vaccine rates (β = 0.60, 95%CI: 0.11-1.09) and hospital beds per thousand people (β = 4.15, 95%CI: 1.41-6.89). These findings suggest that the COVID-19 CFRs varied across different countries and waves, and promoting booster vaccinations, increasing hospital bed capacity, and implementing tobacco control measures can help reduce CFRs.
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Affiliation(s)
- Jing Zhao
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xing Huang
- School of Public Health, Southern Medical University, Guangzhou, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Bing Li
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zuhua Rong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xu Huang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ruiqi Ren
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dan Li
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chao Li
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qun Li
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianpeng Xiao
- School of Public Health, Southern Medical University, Guangzhou, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Guoqing Shi
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
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Benatia D, Godefroy R, Lewis J. Estimating population infection rates from non-random testing data: Evidence from the COVID-19 pandemic. PLoS One 2024; 19:e0311001. [PMID: 39325815 PMCID: PMC11426536 DOI: 10.1371/journal.pone.0311001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 09/10/2024] [Indexed: 09/28/2024] Open
Abstract
To effectively respond to an emerging infectious disease outbreak, policymakers need timely and accurate measures of disease prevalence in the general population. This paper presents a new methodology to estimate real-time population infection rates from non-random testing data. The approach compares how the observed positivity rate varies with the size of the tested population and applies this gradient to infer total population infections. Applying this methodology to daily testing data across U.S. states during the first wave of the COVID-19 pandemic, we estimated widespread undiagnosed COVID-19 infections. Nationwide, we found that for every identified case, there were 12 population infections. Our prevalence estimates align with results from seroprevalence surveys, alternate approaches to measuring COVID-19 infections, and total excess mortality during the first wave of the pandemic.
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Affiliation(s)
- David Benatia
- Department of Applied Economics, HEC Montréal, Quebec, Canada
| | | | - Joshua Lewis
- Department of Economics, Université de Montréal, Quebec, Canada
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Seyyedsalehi MS, Rahmati M, Ghalehtaki R, Nahvijou A, Eslami B, Shaka Z, Allameh SF, Zendehdel K. Hospital and post-discharge mortality in COVID-19 patients with a preexisting cancer diagnosis in Iran. BMC Cancer 2024; 24:1092. [PMID: 39227790 PMCID: PMC11370144 DOI: 10.1186/s12885-024-12663-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 07/19/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Despite the severe impact of COVID-19 on cancer patients, data on COVID-19 outcomes in cancer patients from low- and middle-income countries is limited. We conducted a large study about the mortality rate of COVID-19 in cancer patients in Iran. METHODS We analyzed data from 1,079 cancer (average age: 58.2 years) and 5,514 non-cancer patients (average age: 57.2 years) who were admitted for COVID-19 in two referral hospitals between March 2019 and August 2021. Patients were followed up until death or 31st August 2021. Multiple logistic regression models estimated the odds ratio (OR) and 95% confidence intervals (CI) of factors associated with ICU admission and intubation. The Cox regression model estimated hazard ratios (HRs) and 95% CI of factors associated with hospital and post-discharge 60-day mortalities. RESULTS The cancer patients had higher ICU admission (OR = 1.65, 95% CI: 1.42-1.91; P-value 0.03) and intubation (OR = 3.13, 95% CI = 2.63-3.73, P-value < 0.001) than non-cancer patients. Moreover, hospital mortality was significantly higher in cancer patients than in non-cancer patients (HR = 2.12, 95% CI: 1.89-2.41, P-value < 0.001). HR for the post-discharge mortality was higher in these patients (HR = 2.79, 95% CI: 2.49-3.11, < 0.001). The hospital, comorbidities, low oxygen saturation, being on active treatment, and non-solid tumor were significantly associated with ICU admission (P-value < 0.05) in cancer patients, while only low oxygen saturation was associated with intubation. In addition, we found that old age, females, low oxygen saturation level, active treatment, and having a metastatic tumor were associated with death due to COVID-19 (P-value < 0.05). Only lung cancer patients had a significantly higher risk of death compared to other cancer types (HR = 1.50, 95% CI: 1.06-2.10, P-value = 0.02). CONCLUSION Cancer patients are at a higher risk of ICU admission, intubation, and death due to COVID-19 than non-cancer patients. Therefore, cancer patients who are infected with COVID-19 require intensive care in the hospital and active monitoring after their discharge from the hospital.
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Affiliation(s)
- Monireh Sadat Seyyedsalehi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, 1419733133, Iran
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Marveh Rahmati
- Cancer Biology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Ghalehtaki
- Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Nahvijou
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, 1419733133, Iran
| | - Bita Eslami
- Breast Diseases Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zoha Shaka
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, 1419733133, Iran
| | - Seyed Farshad Allameh
- Department of Gastroenterology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, 1419733133, Iran.
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Iwashita H, Shrestha R, Yadav UN, Shrestha A, Makaju D, Harada Y, Masuda G, Rawal L, Shrestha A, Karmacharya B, Koju R, Sakamoto H, Sugishita T. Exploring ways to support patients with noncommunicable diseases: A pilot study in Nepal during the COVID-19 pandemic. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003509. [PMID: 39028727 PMCID: PMC11259295 DOI: 10.1371/journal.pgph.0003509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/29/2024] [Indexed: 07/21/2024]
Abstract
Global healthcare systems have faced unprecedented strain due to the COVID-19 pandemic, with a profound impact on individuals with non-communicable diseases (NCDs), a scenario particularly pronounced in low-income countries like Nepal. This study aimed to understand the experiences of and challenges faced by patients with NCDs in Nepal during the pandemic, focusing on healthcare service availability and identifying factors affecting healthcare use, with the goal of being prepared for future emergencies. This study utilized a telephonic survey of 102 patients with NCDs and 10 qualitative interviews with healthcare providers in the Kavrepalanchok and Nuwakot districts of Nepal. We used mixed methods, with both qualitative and quantitative approaches. Specifically, multiple correspondence analysis, hierarchical cluster analysis, and classification tree analysis were used as exploratory methods. The study revealed that while 69.6% of the participants reported no difficulty in obtaining medication, other questions revealed that 58.8% experienced challenges in accessing routine medical care. Major barriers, such as fear of infection, unavailability of medicine in rural areas, and lack of transportation, were found through the qualitative interviews. Meanwhile, participants identified innovative strategies, such as telemedicine and community-based awareness programs, as potential facilitators for addressing barriers that arise during pandemic situations such as COVID-19. The COVID-19 pandemic exacerbated challenges in accessing healthcare services for patients with NCDs in Nepal. Our findings suggest the need to design and implement telemedicine services for patients with NCDs, as well as community-based programs that aim to improve health literacy, encourage healthy behavior, prevent development of NCDs, and ensure continuity of care during such crises, especially in countries with limited resources.
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Affiliation(s)
- Hanako Iwashita
- Department of Hygiene and Public Health, Tokyo Women’s Medical University, Tokyo, Japan
| | - Rabina Shrestha
- Research and Development Division, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal
| | - Uday Narayan Yadav
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
| | - Abha Shrestha
- Department of Community Medicine, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Deepa Makaju
- Research and Development Division, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal
| | - Yuriko Harada
- Department of Hygiene and Public Health, Tokyo Women’s Medical University, Tokyo, Japan
| | - Gaku Masuda
- Department of Hygiene and Public Health, Tokyo Women’s Medical University, Tokyo, Japan
| | - Lal Rawal
- School of Health, Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Sydney Campus, Australia
- Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, QLD, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Archana Shrestha
- Department of Public Health and Community Programs, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Biraj Karmacharya
- Department of Public Health and Community Programs, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Rajendra Koju
- Department of Internal Medicine, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Haruka Sakamoto
- Graduate School of Public Health, St Luke’s International University, Tokyo, Japan
| | - Tomohiko Sugishita
- Department of Hygiene and Public Health, Tokyo Women’s Medical University, Tokyo, Japan
- Yakushima Onoaida Clinic, Kagoshima, Japan
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6
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Liu GG, Peng X, Yang H, Yi J. How much does government's short-term response matter for explaining cross-country variation in COVID-19 infection outcomes? A regression-based relative importance analysis of 84 countries. BMJ PUBLIC HEALTH 2024; 2:e000032. [PMID: 40018153 PMCID: PMC11812740 DOI: 10.1136/bmjph-2023-000032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 01/02/2024] [Indexed: 03/01/2025]
Abstract
Objective We study the predetermined characteristics of countries in addition to their government non-pharmaceutical interventions (NPIs) to shed light on the correlates of the variation in COVID-19 infection outcomes across countries. Methods and analysis We conduct a systematic investigation of the validity of government responses in 84 countries by gradually adding the predetermined cultural, natural and socioeconomic factors of each country using a fixed-effect model and daily panel data. A relative importance analysis is conducted to isolate the contribution of each variable to the R2 of the model. Results Government NPIs are effective in containing the virus spread and explain approximately 9% of the variations in the pandemic outcomes. COVID-19 is more prevalent in countries that are more individual-oriented or with a higher gross domestic product (GDP) per capita, while a country's government expenditure on health as a proportion of GDP and median age are negatively associated with the infection outcome. The SARS-CoV-2 lifecycle and the impacts of other unobserved factors together explain more than half of the variation in the prevalence of COVID-19 across countries. The degree of individualism explains 9.30% of the variation, and the explanatory power of the other socioeconomic factors is less than 4% each. Conclusion The COVID-19 infection outcomes are correlated with multivariate factors, ranging from state NPIs, culture-influenced human behaviours, geographical conditions and socioeconomic conditions. As expected, the stronger or faster are the government responses, the lower is the level of infections. In the meantime, many other factors underpin a major part of the variation in the control of COVID-19. As such, from a scientific perspective, it is important that country-specific conditions are taken into account when evaluating the impact of NPIs in order to conduct more cost-effective policy interventions.
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Affiliation(s)
- Gordon G Liu
- China Center for Economic Research, National School of Development, Peking University, Beijing, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, Beijing, China
| | - Xiaoyun Peng
- China Center for Economic Research, National School of Development, Peking University, Beijing, Beijing, China
| | - Hanmo Yang
- Department of Global Health and Population, T H Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Graduate School of Business, Stanford University, Stanford, California, USA
| | - Junjian Yi
- China Center for Economic Research, National School of Development, Peking University, Beijing, Beijing, China
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7
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Abolhasani FS, Moein M, Rezaie N, Sheikhimehrabadi P, Shafiei M, Afkhami H, Modaresi M. Occurrence of COVID-19 in cystic fibrosis patients: a review. Front Microbiol 2024; 15:1356926. [PMID: 38694803 PMCID: PMC11061495 DOI: 10.3389/fmicb.2024.1356926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 03/11/2024] [Indexed: 05/04/2024] Open
Abstract
Cystic fibrosis (CF) is a genetic ailment caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This autosomal recessive disorder is characterized by diverse pathobiological abnormalities, such as the disorder of CFTR channels in mucosal surfaces, caused by inadequate clearance of mucus and sputum, in addition to the malfunctioning of mucous organs. However, the primary motive of mortality in CF patients is pulmonary failure, which is attributed to the colonization of opportunistic microorganisms, formation of resistant biofilms, and a subsequent decline in lung characteristics. In December 2019, the World Health Organization (WHO) declared the outbreak of the radical coronavirus disease 2019 (COVID-19) as a worldwide public health crisis, which unexpectedly spread not only within China but also globally. Given that the respiration system is the primary target of the COVID-19 virus, it is crucial to investigate the impact of COVID-19 on the pathogenesis and mortality of CF patients, mainly in the context of acute respiratory distress syndrome (ARDS). Therefore, the goal of this review is to comprehensively review the present literature on the relationship between cystic fibrosis, COVID-19 contamination, and development of ARDS. Several investigations performed during the early stages of the virus outbreak have discovered unexpected findings regarding the occurrence and effectiveness of COVID-19 in individuals with CF. Contrary to initial expectancies, the rate of infection and the effectiveness of the virus in CF patients are lower than those in the overall population. This finding may be attributed to different factors, including the presence of thick mucus, social avoidance, using remedies that include azithromycin, the fairly younger age of CF patients, decreased presence of ACE-2 receptors, and the effect of CFTR channel disorder on the replication cycle and infectivity of the virus. However, it is important to notice that certain situations, which include undergoing a transplant, can also doubtlessly boost the susceptibility of CF patients to COVID-19. Furthermore, with an increase in age in CF patients, it is vital to take into account the prevalence of the SARS-CoV-2 virus in this population. Therefore, ordinary surveillance of CF patients is vital to evaluate and save the population from the capability of transmission of the virus given the various factors that contribute to the spread of the SARS-CoV-2 outbreak in this precise organization.
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Affiliation(s)
- Fatemeh Sadat Abolhasani
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masood Moein
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Niloofar Rezaie
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
| | | | - Morvarid Shafiei
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
| | - Hamed Afkhami
- Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Medical Microbiology, School of Medicine, Shahed University, Tehran, Iran
| | - Mohammadreza Modaresi
- Pediatric Pulmonary Disease and Sleep Medicine Research Center, Pediatric Center of Excellence, Children's Medical Center, Tehran, Iran
- Cystic Fibrosis Research Center, Iran CF Foundation (ICFF), Tehran, Iran
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8
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Sorci G. Social inequalities and the COVID-19 pandemic. Soc Sci Med 2024; 340:116484. [PMID: 38064821 DOI: 10.1016/j.socscimed.2023.116484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/15/2023] [Accepted: 11/28/2023] [Indexed: 01/23/2024]
Abstract
Social inequality has been identified as an important determinant of the outcome of infectious diseases and the recent SARS-CoV-2 pandemic has vividly reminded us that there are no "equal opportunity infectors". In a recent article, Chakrabarty et al. (2023) reported the finding of a cross-country comparison of COVID-19 cases and social deprivation, using up-to-date statistical modelling. These results add to the extensive evidence showing that vulnerable populations are consistently at higher risk of contracting the infection and to suffer from more severe symptoms, whatever the spatial scale used (from the country to the neighborhood). Spatial clustering of socially deprived groups, preexisting pathologies and hotspots of COVID-19 cases and deaths indicate that the SARS-CoV-2 should be seen as a syndemic, where both the infection dynamics and the outcome of the disease strongly depend on the three-way interaction between the virus, preexisting pathologies, and the socioeconomic environment.
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Affiliation(s)
- Gabriele Sorci
- Biogéosciences, CNRS UMR 6282, Université de Bourgogne, 6 Boulevard Gabriel, 21000, Dijon, France.
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9
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Shu H, Wen Z, Li N, Zhang Z, Ceesay BM, Peng Y, Zhou N, Wang DW. COVID-19 and Cardiovascular Diseases: From Cellular Mechanisms to Clinical Manifestations. Aging Dis 2023; 14:2071-2088. [PMID: 37199573 PMCID: PMC10676802 DOI: 10.14336/ad.2023.0314] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/14/2023] [Indexed: 05/19/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), quickly spread worldwide and led to over 581 million confirmed cases and over 6 million deaths as 1 August 2022. The binding of the viral surface spike protein to the human angiotensin-converting enzyme 2 (ACE2) receptor is the primary mechanism of SARS-CoV-2 infection. Not only highly expressed in the lung, ACE2 is also widely distributed in the heart, mainly in cardiomyocytes and pericytes. The strong association between COVID-19 and cardiovascular disease (CVD) has been demonstrated by increased clinical evidence. Preexisting CVD risk factors, including obesity, hypertension, and diabetes etc., increase susceptibility to COVID-19. In turn, COVID-19 exacerbates the progression of CVD, including myocardial damage, arrhythmia, acute myocarditis, heart failure, and thromboembolism. Moreover, cardiovascular risks post recovery and the vaccination-associated cardiovascular problems have become increasingly evident. To demonstrate the association between COVID-19 and CVD, this review detailly illustrated the impact of COVID-19 on different cells (cardiomyocytes, pericytes, endothelial cells, and fibroblasts) in myocardial tissue and provides an overview of the clinical manifestations of cardiovascular involvements in the pandemic. Finally, the issues related to myocardial injury post recovery, as well as vaccination-induced CVD, has also been emphasized.
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Affiliation(s)
- Hongyang Shu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Huazhong University of Science and Technology, Wuhan 430000, China.
| | - Zheng Wen
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Huazhong University of Science and Technology, Wuhan 430000, China.
| | - Na Li
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Huazhong University of Science and Technology, Wuhan 430000, China.
| | - Zixuan Zhang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Huazhong University of Science and Technology, Wuhan 430000, China.
| | - Bala Musa Ceesay
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Huazhong University of Science and Technology, Wuhan 430000, China.
| | - Yizhong Peng
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Ning Zhou
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Huazhong University of Science and Technology, Wuhan 430000, China.
| | - Dao Wen Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China.
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Huazhong University of Science and Technology, Wuhan 430000, China.
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10
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Ma MZ, Ye S. Country's value priorities in health crisis: How dominant societal motivations shape COVID-19 severity. SSM Popul Health 2023; 24:101493. [PMID: 37664868 PMCID: PMC10474233 DOI: 10.1016/j.ssmph.2023.101493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/14/2023] [Accepted: 08/15/2023] [Indexed: 09/05/2023] Open
Abstract
This paper presents two comprehensive studies examining how Schwartz's human values dimensions at the country level predict COVID-19 pandemic severity. Study 1 aggregated survey data across 89 countries from the European Social Survey and World Values Survey to assess societal-level conservation versus openness to change (CON-OTC) and self-enhancement versus self-transcendence (SE-ST) value-continuums. Study 2 developed an innovative archival measurement approach using 10 indicators to estimate these value dimensions for over 180 countries. Both studies employed multilevel modeling to test the relationships between country-level values and COVID-19 severity, measured through epidemiological indicators of transmission speed, case fatality rate, infection prevalence and mortality burden. Results revealed that the CON-OTC and SE-ST value-continuums showed consistent, significant negative associations with transmission speed and infection prevalence before adjusting for modernization, latitude, historical pathogen prevalence and government stringency across both studies. However, after accounting for these socioecological and policy covariates, the CON-OTC value-continuum positively predicted case fatality rate in both studies, implying conservation values could increase COVID-19 lethality. In contrast, across both studies, the SE-ST value-continuum negatively predicted case fatality rate after adjusting for the covariates, suggesting countries prioritizing self-enhancement values exhibited relatively lower pandemic severity and lethality when accounting for developmental, ecological, and policy factors. Accordingly, the studies advance theoretical understanding of how country's value priorities shape COVID-19 impact. Methodologically, these studies contribute through multilevel techniques that account for spatial dependencies, as well as an innovative ecological measurement. Overall, this research demonstrates the value of applying Schwartz's framework at a societal level to predict global health crises and pandemics.
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Affiliation(s)
- Mac Zewei Ma
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, PR China
| | - Shengquan Ye
- Department of Social and Behavioural Sciences, City University of Hong Kong, PR China
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11
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Lim TY, Xu R, Ruktanonchai N, Saucedo O, Childs LM, Jalali MS, Rahmandad H, Ghaffarzadegan N. Why Similar Policies Resulted In Different COVID-19 Outcomes: How Responsiveness And Culture Influenced Mortality Rates. Health Aff (Millwood) 2023; 42:1637-1646. [PMID: 38048504 DOI: 10.1377/hlthaff.2023.00713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
In the first two years of the COVID-19 pandemic, per capita mortality varied by more than a hundredfold across countries, despite most implementing similar nonpharmaceutical interventions. Factors such as policy stringency, gross domestic product, and age distribution explain only a small fraction of mortality variation. To address this puzzle, we built on a previously validated pandemic model in which perceived risk altered societal responses affecting SARS-CoV-2 transmission. Using data from more than 100 countries, we found that a key factor explaining heterogeneous death rates was not the policy responses themselves but rather variation in responsiveness. Responsiveness measures how sensitive communities are to evolving mortality risks and how readily they adopt nonpharmaceutical interventions in response, to curb transmission. We further found that responsiveness correlated with two cultural constructs across countries: uncertainty avoidance and power distance. Our findings show that more responsive adoption of similar policies saves many lives, with important implications for the design and implementation of responses to future outbreaks.
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Affiliation(s)
- Tse Yang Lim
- Tse Yang Lim, Harvard University, Boston, Massachusetts
| | - Ran Xu
- Ran Xu, University of Connecticut, Storrs, Connecticut
| | | | - Omar Saucedo
- Omar Saucedo, Virginia Tech, Blacksburg, Virginia
| | | | | | - Hazhir Rahmandad
- Hazhir Rahmandad, Massachusetts Institute of Technology, Cambridge, Massachusetts
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12
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Moore H, Hill B, Emery J, Gussy M, Siriwardena AN, Spaight R, Tanser F. An early warning precision public health approach for assessing COVID-19 vulnerability in the UK: the Moore-Hill Vulnerability Index (MHVI). BMC Public Health 2023; 23:2147. [PMID: 37919728 PMCID: PMC10623819 DOI: 10.1186/s12889-023-17092-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/28/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Most COVID-19 vulnerability indices rely on measures that are biased by rates of exposure or are retrospective like mortality rates that offer little opportunity for intervention. The Moore-Hill Vulnerability Index (MHVI) is a precision public health early warning alternative to traditional infection fatality rates that presents avenues for mortality prevention. METHODS We produced an infection-severity vulnerability index by calculating the proportion of all recorded positive cases that were severe and attended by ambulances at small area scale for the East Midlands of the UK between May 2020 and April 2022. We produced maps identifying regions with high and low vulnerability, investigated the accuracy of the index over shorter and longer time periods, and explored the utility of the MHVI compared to other common proxy measures and indices. Analysis included exploring the correlation between our novel index and the Index of Multiple Deprivation (IMD). RESULTS The MHVI captures geospatial dynamics that single metrics alone often overlook, including the compound health challenges associated with disadvantaged and declining coastal towns inhabited by communities with post-industrial health legacies. A moderate negative correlation between MHVI and IMD reflects spatial analysis which suggests that high vulnerability occurs in affluent rural as well as deprived coastal and urban communities. Further, the MHVI estimates of severity rates are comparable to infection fatality rates for COVID-19. CONCLUSIONS The MHVI identifies regions with known high rates of poor health outcomes prior to the pandemic that case rates or mortality rates alone fail to identify. Pre-hospital early warning measures could be utilised to prevent mortality during a novel pandemic.
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Affiliation(s)
- Harriet Moore
- Department of Geography, University of Lincoln, Lincoln, United Kingdom
- Development, Inequalities, Resilience and Environments Research Group, Lincoln, United Kingdom
- EDGE Consortium, Lincoln, Ontario, United Kingdom, Canada
| | - Bartholomew Hill
- EDGE Consortium, Lincoln, Ontario, United Kingdom, Canada
- WATERWISER/WEDC, Loughborough University, Loughborough, United Kingdom
| | - Jay Emery
- Department of Geography, University of Lincoln, Lincoln, United Kingdom
- Development, Inequalities, Resilience and Environments Research Group, Lincoln, United Kingdom
| | - Mark Gussy
- EDGE Consortium, Lincoln, Ontario, United Kingdom, Canada
- Lincoln International Institute for Rural Health, Lincoln, United Kingdom
| | - Aloysius Niroshan Siriwardena
- EDGE Consortium, Lincoln, Ontario, United Kingdom, Canada
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, United Kingdom
| | - Robert Spaight
- EDGE Consortium, Lincoln, Ontario, United Kingdom, Canada
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, United Kingdom
- East Midlands Ambulance Service NHS Trust, Nottingham, England
| | - Frank Tanser
- EDGE Consortium, Lincoln, Ontario, United Kingdom, Canada
- School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
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13
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Alam MF, Wildman J, Abdul Rahim H. Income inequality and its association with COVID-19 cases and deaths: a cross-country analysis in the Eastern Mediterranean region. BMJ Glob Health 2023; 8:e012271. [PMID: 37918870 PMCID: PMC10626889 DOI: 10.1136/bmjgh-2023-012271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION There is limited evidence on the associations between economic and social disparities in the Eastern Mediterranean region (EMR) with COVID-19 infections and deaths. This study aims to investigate the relationship between income inequalities using Gini coefficients and COVID-19 cases and deaths per million population in the EMR countries. METHODS Country-level data on monthly COVID-19 cases and deaths between March 2020 and October 2021, along with data on selected confounders, were collected from publicly available databases. Mixed-effect negative binomial and inverse hyperbolic sine transformation regressions were estimated to examine the association. RESULTS The study showed that, in the EMR, a unit increase in Gini coefficient is associated with approximately 7.2% and 3.9% increase in COVID-19 cases and deaths per million population, respectively. The magnitude and direction of the association between income inequality and COVID-19 cases and deaths per-million population still remain the same after excluding four warzone countries from the analysis. CONCLUSION This increase in COVID-19 cases and deaths is underpinned by the fact that a large number of the population in the region is living in conditions of poverty, with inadequate housing, comorbidities and limited or virtually no access to essential healthcare services. Healthcare policy-makers across countries in the region need to implement effective interventions in areas of income inequality, where it may be linked to increasing the risk of COVID-19 cases and deaths.
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Affiliation(s)
- Mohammed Fasihul Alam
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - John Wildman
- Department of Economics, Newcastle University, Newcastle upon Tyne, UK
| | - Hanan Abdul Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Tu K, Chen S, Mesler RM. Policy stringency and the spread of COVID-19: The moderating role of culture and its implications on first responses. Health Policy 2023; 137:104896. [PMID: 37688952 DOI: 10.1016/j.healthpol.2023.104896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 08/14/2023] [Accepted: 08/19/2023] [Indexed: 09/11/2023]
Abstract
There has been a noticeable variance between countries in the growth rate of COVID-19 since the start of the pandemic. Researchers attempted to understand this variance from two primary perspectives: the policies implemented to curb the spread of the virus [1] and the cross-country cultural differences [2]. However, little research to date has looked at the joint effects of policy responses and national culture. We argue that the effectiveness of restrictive policies depends on cultural values. Specifically, when policies are non-mandatary, cultural values influence people's voluntary adherence to these policies, and hence, the spread of COVID-19. We analyzed the growth data in daily new cases across 78 countries, focusing on the joint impact of containment policies and cultural values. We found that although policy responses (i.e., containment policies) significantly predicted the spread rate of COVID-19 over time, their effects were moderated by cultural variables as well. Implications for policymaking are discussed.
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Affiliation(s)
- Ke Tu
- Tu is Assistant Professor of Marketing at the Dhillon School of Business at the University of Lethbridge (Calgary Campus), 345 6 Ave SE s6032, Calgary, AB T2G 4V1, Canada.
| | - Shirley Chen
- Shirley (Shuo) Chen is Assistant Professor of Marketing at the Lazaridis School of Business and Economics at the Wilfrid Laurier University, 64 University Ave W, Waterloo, ON N2L 3C7, Canada
| | - Rhiannon MacDonnell Mesler
- Rhiannon MacDonnell Mesler is Associate Professor of Marketing in the Institute for Consumer and Social Well-Being at the Dhillon School of Business at the University of Lethbridge (Calgary Campus), 345 6 Ave SE s6032, Calgary, AB T2G 4V1, Canada
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15
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Bhadola P, Chaudhary V, Markandan K, Talreja RK, Aggarwal S, Nigam K, Tahir M, Kaushik A, Rustagi S, Khalid M. Analysing role of airborne particulate matter in abetting SARS-CoV-2 outbreak for scheming regional pandemic regulatory modalities. ENVIRONMENTAL RESEARCH 2023; 236:116646. [PMID: 37481054 DOI: 10.1016/j.envres.2023.116646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 07/24/2023]
Abstract
The mutating SARS-CoV-2 necessitates gauging the role of airborne particulate matter in the COVID-19 outbreak for designing area-specific regulation modalities based on the environmental state-of-affair. To scheme the protocols, the hotspots of air pollutants such as PM2.5, PM10, NH3, NO, NO2, SO2, and and environmental factors including relative humidity (RH), and temperature, along with COVID-19 cases and mortality from January 2020 till December 2020 from 29 different ground monitoring stations spanning Delhi, are mapped. Spearman correlation coefficients show a positive relationship between SARS-COV-2 with particulate matter (PM2.5 with r > 0.36 and PM10 with r > 0.31 and p-value <0·001). Besides, SARS-COV-2 transmission showed a substantial correlation with NH3 (r = 0.41), NO2 (r = 0.36), and NO (r = 0.35) with a p-value <0.001, which is highly indicative of their role in SARS-CoV-2 transmission. These outcomes are associated with the source of PM and its constituent trace elements to understand their overtone with COVID-19. This strongly validates temporal and spatial variation in COVID-19 dependence on air pollutants as well as on environmental factors. Besides, the bottlenecks of missing latent data, monotonous dependence of variables, and the role air pollutants with secondary environmental variables are discussed. The analysis set the foundation for strategizing regional-based modalities considering environmental variables (i.e., pollutant concentration, relative humidity, temperature) as well as urban and transportation planning for efficient control and handling of future public health emergencies.
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Affiliation(s)
- Pradeep Bhadola
- Centre for Theoretical Physics & Natural Philosophy, Mahidol University, Nakhonsawan 60130, Thailand
| | - Vishal Chaudhary
- Department of Physics, Bhagini Nivedita College, University of Delhi, Delhi 110072, India.
| | - Kalaimani Markandan
- Department of Chemical & Petroleum Engineering, Faculty of Engineering, Technology and Built Environment, UCSI University, Cheras 56000, Kuala Lumpur, Malaysia
| | - Rishi Kumar Talreja
- Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India
| | - Sumit Aggarwal
- Division of Epidemiology and Communicable Diseases (ECD), Indian Council of Medical Research (ICMR)-Headquaters, New Delhi 110029, India
| | - Kuldeep Nigam
- Division of Epidemiology and Communicable Diseases (ECD), Indian Council of Medical Research (ICMR)-Headquaters, New Delhi 110029, India
| | - Mohammad Tahir
- Department of Computing, University of Turku, FI-20014, Turun Yliopisto, Finland
| | - Ajeet Kaushik
- NanoBio Tech Laboratory, Department of Environmental Engineering, Florida Polytechnic University, Lakeland, FL, 33805, USA; School of Engineering, University of Petroleum and Energy Studies (UPES), Dehradun, Uttarakhand, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttrakhand, India
| | - Mohammad Khalid
- Sunway Centre for Electrochemical Energy and Sustainable Technology (SCEEST), School of Engineering and Technology, Sunway University, No. 5, Jalan University, Bandar Sunway, 47500, Petaling Jaya, Selangor, Malaysia; Division of Research and Development, Lovely Professional University, Phagwara, 144411, Punjab, India; School of Engineering and Technology, Sharda University, Greater Noida, 201310, India.
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Martín-Sánchez V, Ruiz-Garcia A, Vitelli-Storelli F, Serrano-Cumplido A, Barquilla-Garcia A, Micó-Pérez RM, Olmo-Quintana V, Calderón-Montero A, Segura-Fragoso A. Case-fatality rate of SARS-CoV-2 infection during the third and fifth epidemic waves in Spain: Impact of vaccination. Semergen 2023; 49:102026. [PMID: 37356278 PMCID: PMC10227204 DOI: 10.1016/j.semerg.2023.102026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION During the first and second epidemic waves in Spain, the SARS-CoV-2 case-fatality rates (CFRs) showed significant differences between Autonomous Communities (ACs). Comparing CFRs in the third and fifth epidemic waves can provide information on the impact of the different vaccination coverages in the ACs. OBJECTIVE To evaluate the impact of vaccination on COVID-19 CFRs in the third and fifth epidemic waves in Spain, according to sex, age, and AC. METHODS This work is an observational, descriptive study which uses data on COVID-19 infections, deaths, and vaccinees published by the Spanish Ministry of Health and the regional Health Departments of the ACs. The third epidemic wave was defined as the period from 26th December 2020 to 19th April 2021, and the fifth wave, from 19th July to 19th September 2021. The CFRs (deaths per 1000 infected [‰]) were calculated according to sex, age group, and AC. The standardized case-fatality ratio (SCFR) was adjusted for age and sex for each wave. We estimated the correlation between CFRs and their change between the two epidemic waves with the vaccination coverages reached at the beginning of the fifth wave. RESULTS The CFR in the fifth wave (5.7‰) was lower than in the third wave (16.5‰). In addition, the CFR in both waves was significantly higher in men than in women, and in older people than in younger ones. A decrease in the CFR between both waves was only observed in those older than 49. A strong direct and positive correlation (R2a=0.8399) was found between vaccination coverage by age group and decrease in CFR between both epidemic waves. Significant differences were seen between ACs in the two waves, as regards both CFRs and SCFRs. When comparing ACs, a direct correlation was observed between vaccination coverage and CFRs in the fifth wave, and also - although weak - between vaccination coverage and decrease in CFR between both waves. CONCLUSION The CFR significantly decreased in Spain between the third and the fifth epidemic waves in population aged 50 or older, probably due to the high vaccination coverage in that age group. Differences were observed between CFRs and SCFRs between ACs that are not explained by the differences in vaccination coverage, suggesting the need for further research and evaluation.
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Affiliation(s)
- V Martín-Sánchez
- Research Group in Gene-Environment Interactions and Health, Institute of Biomedicine (IBIOMED), University of León, León, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - A Ruiz-Garcia
- Madrid Health Service (SERMAS), Department of Health, Spain
| | - F Vitelli-Storelli
- Research Group in Gene-Environment Interactions and Health, Institute of Biomedicine (IBIOMED), University of León, León, Spain.
| | | | | | - R M Micó-Pérez
- Fontanars dels Alforins Health Center, Xàtiva-Ontinyent Department of Health, 46635 Valencia, Spain
| | - V Olmo-Quintana
- Management Pharmacy Service Primary Health Care, Vice President of Ethical Committee Research with Medicine Hospital Dr. Negrín Gran Canaria Las Palmas (CEI/CEIm) Canary Health Service, Las Palmas, Spain
| | - A Calderón-Montero
- Doctor Pedro Laín Entralgo Health Center, Madrid Health Service (SERMAS), Alcorcón, Madrid, Spain
| | - A Segura-Fragoso
- Health Science Department, Castilla La Mancha University, Talavera de la Reina, Toledo, Spain
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Gao R, Liu HH. Political stability as a major determinant of the Covid-19 pandemic outcomes. Heliyon 2023; 9:e20617. [PMID: 37860511 PMCID: PMC10582285 DOI: 10.1016/j.heliyon.2023.e20617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 09/25/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
This paper explores the role of political stability in explaining the cross-country variation of Covid-19 pandemic outcomes. Based on the international evidence, we find that lower pre-Covid-19 levels of political stability are associated with worse Covid-19 pandemic outcomes. Politically unstable countries are more likely to suffered significantly higher morbidity and mortality. Further analysis shows that political stability only matters in countries prepared with requisite medical capacity to deal with health emergencies. We also find that political stability is more crucial in countries with higher poverty rates. Overall, to combat Covid-19 and the subsequential collective threats successfully, the national authorities should pay more attention to maintain political stability.
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Affiliation(s)
- Rui Gao
- School of Economics, Qingdao University, Kedazhi Road, Qingdao, Shandong, 266000, China
| | - Hai-Hong Liu
- School of Infectious Diseases, Qilu Hospital, Wenhuaxi Road, Shandong University, Jinan, Shandong, 250012, China
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18
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da Silva FF, de Abreu LC, Daboin BEG, Morais TC, Cavalcanti MPE, Bezerra IMP, da Silva CG, Figueira FAMDS, de Caldas Guedes VV, Perez Riera AR. Temporal Analysis of COVID-19 Epidemiological Indicators in a Low-Income Brazilian Context: A Retrospective Analysis in Paraiba State. Viruses 2023; 15:2016. [PMID: 37896793 PMCID: PMC10611110 DOI: 10.3390/v15102016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 10/29/2023] Open
Abstract
Northeast Brazil is a region with great international tourist potential. Among the states that make up this region, Paraíba stands out due to the presence of vulnerable groups and factors that contribute to adverse outcomes of COVID-19. Therefore, the aim of this study was to analyze the epidemiological data on the incidence, mortality, and case fatality of COVID-19 in Paraíba. An ecological, population-based study was performed, with data extracted from the Brazilian Ministry of Health database. All cases and deaths from COVID-19 from March 2020 to December 2022 were included. The time series was built by applying the Prais-Winsten regression model, and the daily percent change was calculated to analyze the trends. The highest case fatality of the entire period was in April 2020 (7.8%), but in March 2021, the state broke the dismal record of 1248 deaths and the highest mortality rate (30.5 deaths per 100,000 inhabitants). Stationary mortality and case fatality were better in 2022; however, in February 2022, the mortality rate was at levels similar to the same month of the previous year. These results illustrate that COVID-19 is evolving and needs to be constantly monitored.
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Affiliation(s)
- Fabiola Ferreira da Silva
- Laboratory of Studies Design and Scientific Writing, Postgraduate Division, University Center FMABC, Santo André 09060-870, SP, Brazil; (F.F.d.S.); (L.C.d.A.); (B.E.G.D.); (C.G.d.S.); (A.R.P.R.)
| | - Luiz Carlos de Abreu
- Laboratory of Studies Design and Scientific Writing, Postgraduate Division, University Center FMABC, Santo André 09060-870, SP, Brazil; (F.F.d.S.); (L.C.d.A.); (B.E.G.D.); (C.G.d.S.); (A.R.P.R.)
- Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria 29075-910, ES, Brazil
- School of Medicine, University of Limerick, V94 T9PX Limerick, Ireland
- Post-Graduate Program in Medical Sciences, Faculty of Medicine of the University of São Paulo, São Paulo 01246-903, SP, Brazil; (M.P.E.C.); (F.A.M.d.S.F.)
| | - Blanca Elena Guerrero Daboin
- Laboratory of Studies Design and Scientific Writing, Postgraduate Division, University Center FMABC, Santo André 09060-870, SP, Brazil; (F.F.d.S.); (L.C.d.A.); (B.E.G.D.); (C.G.d.S.); (A.R.P.R.)
- School of Medicine, University of Limerick, V94 T9PX Limerick, Ireland
| | - Tassiane Cristina Morais
- Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria 29075-910, ES, Brazil
- School of Sciences of Santa Casa de Misericórdia de Vitória (EMESCAM), Vitoria 29045-402, ES, Brazil;
| | - Matheus Paiva Emidio Cavalcanti
- Post-Graduate Program in Medical Sciences, Faculty of Medicine of the University of São Paulo, São Paulo 01246-903, SP, Brazil; (M.P.E.C.); (F.A.M.d.S.F.)
| | | | - Célia Guarnieri da Silva
- Laboratory of Studies Design and Scientific Writing, Postgraduate Division, University Center FMABC, Santo André 09060-870, SP, Brazil; (F.F.d.S.); (L.C.d.A.); (B.E.G.D.); (C.G.d.S.); (A.R.P.R.)
| | | | | | - Andres Ricardo Perez Riera
- Laboratory of Studies Design and Scientific Writing, Postgraduate Division, University Center FMABC, Santo André 09060-870, SP, Brazil; (F.F.d.S.); (L.C.d.A.); (B.E.G.D.); (C.G.d.S.); (A.R.P.R.)
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Sun MW, Troxell D, Tibshirani R. Public health factors help explain cross country heterogeneity in excess death during the COVID19 pandemic. Sci Rep 2023; 13:16196. [PMID: 37758827 PMCID: PMC10533501 DOI: 10.1038/s41598-023-43407-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 09/23/2023] [Indexed: 09/29/2023] Open
Abstract
The COVID-19 pandemic has taken a devastating toll around the world. Since January 2020, the World Health Organization estimates 14.9 million excess deaths have occurred globally. Despite this grim number quantifying the deadly impact, the underlying factors contributing to COVID-19 deaths at the population level remain unclear. Prior studies indicate that demographic factors like proportion of population older than 65 and population health explain the cross-country difference in COVID-19 deaths. However, there has not been a comprehensive analysis including variables describing government policies and COVID-19 vaccination rate. Furthermore, prior studies focus on COVID-19 death rather than excess death to assess the impact of the pandemic. Through a robust statistical modeling framework, we analyze 80 countries and show that actionable public health efforts beyond just the factors intrinsic to each country are important for explaining the cross-country heterogeneity in excess death.
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Affiliation(s)
- Min Woo Sun
- Department of Biomedical Data Science, Stanford University, 450 Serra Mall, Stanford, CA, 94305, USA.
| | - David Troxell
- Department of Statistics, Stanford University, 450 Serra Mall, Stanford, CA, 94305, USA
| | - Robert Tibshirani
- Department of Biomedical Data Science, Stanford University, 450 Serra Mall, Stanford, CA, 94305, USA
- Department of Statistics, Stanford University, 450 Serra Mall, Stanford, CA, 94305, USA
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Sorsa VP, Kivikoski K. COVID-19 and democracy: a scoping review. BMC Public Health 2023; 23:1668. [PMID: 37649016 PMCID: PMC10469824 DOI: 10.1186/s12889-023-16172-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 06/22/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND The resilience of democracy is tested under exogenous shocks such as crises. The COVID-19 pandemic has recently tested the resilience of democratic institutions and practices around the world. AIM The purpose of this article is to scope the early research literature that discusses democracy and the COVID-19 pandemic. We review scientific journal articles published during the first two years of the pandemic. We ask three research questions in scoping this body of literature: (1) what are the key topic areas of all published research that associates itself with both democracy and COVID-19, (2) what kinds of conceptual and theoretical contributions has research literature that more specifically discusses democracy under the pandemic produced, and (3) what are the impacts of democracy to the pandemic and vice versa according to empirical research? METHODS The scoping review methodology draws on systematic literature search strategies, computational methods, and manual coding. The systematic Web of Science search produced 586 articles for which we conducted a Correlated Topic Model. After technical and manual screening, we identified 94 journal articles that were manually coded. RESULTS The early research on democracy and the COVID-19 pandemic offers a versatile body of scholarship. The topic modeling shows that the scholarship discusses issues of crises, governance, rights, society, epidemiology, politics, electorate, technology, and media. The body of papers with conceptual and theoretical contributions has offered new insights on the difficulties, possibilities, and means to maintain democracy under a pandemic. Empirical research on democracy's impact on the COVID-19 pandemic and vice versa varies in terms of methodology, geographical scope, and scientific contributions according to the direction of influence studied. Democracy appears to have a significant impact on some aspects of policy responses and epidemiological characteristics of the pandemic. In most parts of the world, the scope, franchise, and authenticity of democracy narrowed down due to the pandemic, albeit in most cases only temporarily. CONCLUSIONS A significant number of papers show that the pandemic has accentuated democratic backsliding but is unlikely to have undermined established democracies that have proved resilient in face of the pandemic. But empirical research has also made visible some weak signals of antidemocratic tendencies that may become more accentuated in the longer run.
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Affiliation(s)
- Ville-Pekka Sorsa
- Faculty of Social Sciences, University of Helsinki, P.O. Box 18, FI-00014, Helsinki, Finland.
| | - Katja Kivikoski
- Faculty of Social Sciences, University of Helsinki, P.O. Box 18, FI-00014, Helsinki, Finland
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21
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Gao C, Jiang JJ, Mao JF, Yu XH, Zheng XF, Zhang JC. Risk factors of infection among close contacts of COVID-19: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34314. [PMID: 37478226 PMCID: PMC10662811 DOI: 10.1097/md.0000000000034314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/22/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) was first detected in December 2019, and declared as a pandemic by the World Health Organization (WHO) on March 11, 2020. The current management of COVID-19 is based generally on supportive therapy and treatment to prevent respiratory failure. METHODS PubMed, Web of Science, Embase, CNKI, and other databases were searched by computer, and relevant literature published from December 2019 to November 2022 on the influencing factors of infection in close contacts with novel coronavirus pneumonia was collected. Meta-analysis was carried out after literature screening, quality assessment, and data extraction. RESULTS A total of 425 articles were retrieved and 11 were included. Meta-analysis showed that there were 6 risk factors, and the combined OR value and 95% CI of each influencing factor were 5.23 (3.20, 8.57) for family members, 1.63 (0.56, 4.77) for regular contact, 2.14 (0.62, 7.32) for the elderly, 0.58 (0.001569.89) for cohabitation, 1.97 (1.02, 3.82) for women and 0.75 (0.01, 54.07) for others. The Deeks' funnel diagram indicates that there is no potential publication bias among the included studies. CONCLUSION Family members and gender differences are the risk factors of infection among close contacts, and it cannot be proved that there are differences in infection among frequent contact, advanced age, and living together.
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Affiliation(s)
- Chun Gao
- Department of Gastroenterology, The 940 Hospital of Joint Logisitic Support Forces of PLA, Lanzhou, China
- First School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou, China
| | - Jing-Jing Jiang
- Department of Gastroenterology, The 940 Hospital of Joint Logisitic Support Forces of PLA, Lanzhou, China
- First School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou, China
| | - Jun-Feng Mao
- Department of Nuclear Medicine, The 940 Hospital of Joint Logisitic Support Forces of PLA, Lanzhou, China
| | - Xiao-Hui Yu
- Department of Gastroenterology, The 940 Hospital of Joint Logisitic Support Forces of PLA, Lanzhou, China
| | - Xiao-Feng Zheng
- Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou, China
| | - Jiu-Cong Zhang
- Department of Gastroenterology, The 940 Hospital of Joint Logisitic Support Forces of PLA, Lanzhou, China
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22
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Sania A, Mahmud AS, Alschuler DM, Urmi T, Chowdhury S, Lee S, Mostari S, Shaikh FZ, Sojib KH, Khan T, Khan Y, Chowdhury A, Arifeen SE. Risk factors for COVID-19 mortality among telehealth patients in Bangladesh: A prospective cohort study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001971. [PMID: 37315095 DOI: 10.1371/journal.pgph.0001971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 05/03/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Estimating the contribution of risk factors of mortality due to COVID-19 is particularly important in settings with low vaccination coverage and limited public health and clinical resources. Very few studies of risk factors of COVID-19 mortality used high-quality data at an individual level from low- and middle-income countries (LMICs). We examined the contribution of demographic, socioeconomic and clinical risk factors of COVID-19 mortality in Bangladesh, a lower middle-income country in South Asia. METHODS We used data from 290,488 lab-confirmed COVID-19 patients who participated in a telehealth service in Bangladesh between May 2020 and June 2021, linked with COVID-19 death data from a national database to study the risk factors associated with mortality. Multivariable logistic regression models were used to estimate the association between risk factors and mortality. We used classification and regression trees to identify the risk factors that are the most important for clinical decision-making. FINDINGS This study is one of the largest prospective cohort studies of COVID-19 mortality in a LMIC, covering 36% of all lab-confirmed COVID-19 cases in the country during the study period. We found that being male, being very young or elderly, having low socioeconomic status, chronic kidney and liver disease, and being infected during the latter pandemic period were significantly associated with a higher risk of mortality from COVID-19. Males had 1.15 times higher odds (95% Confidence Interval, CI: 1.09, 1.22) of death compared to females. Compared to the reference age group (20-24 years olds), the odds ratio of mortality increased monotonically with age, ranging from an odds ratio of 1.35 (95% CI: 1.05, 1.73) for ages 30-34 to an odds ratio of 21.6 (95% CI: 17.08, 27.38) for ages 75-79 year group. For children 0-4 years old the odds of mortality were 3.93 (95% CI: 2.74, 5.64) times higher than 20-24 years olds. Other significant predictors were severe symptoms of COVID-19 such as breathing difficulty, fever, and diarrhea. Patients who were assessed by a physician as having a severe episode of COVID-19 based on the telehealth interview had 12.43 (95% CI: 11.04, 13.99) times higher odds of mortality compared to those assessed to have a mild episode. The finding that the telehealth doctors' assessment of disease severity was highly predictive of subsequent COVID-19 mortality, underscores the feasibility and value of the telehealth services. CONCLUSIONS Our findings confirm the universality of certain COVID-19 risk factors-such as gender and age-while highlighting other risk factors that appear to be more (or less) relevant in the context of Bangladesh. These findings on the demographic, socioeconomic, and clinical risk factors for COVID-19 mortality can help guide public health and clinical decision-making. Harnessing the benefits of the telehealth system and optimizing care for those most at risk of mortality, particularly in the context of a LMIC, are the key takeaways from this study.
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Affiliation(s)
- Ayesha Sania
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Ayesha S Mahmud
- Department of Demography, University of California, Berkeley, Berkeley, California, United States of America
| | - Daniel M Alschuler
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Tamanna Urmi
- Network Science Institute, Northeastern University, Boston, Massachusetts, United States of America
| | - Shayan Chowdhury
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
- Aspire to Innovate (a2i) ICT Division, Dhaka, Bangladesh
| | - Seonjoo Lee
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, United States of America
| | | | | | - Kawsar Hosain Sojib
- Aspire to Innovate (a2i) ICT Division, Dhaka, Bangladesh
- Department of Economics, Jahangirnagar University, Dhaka, Bangladesh
| | - Tahmid Khan
- Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Yiafee Khan
- Aspire to Innovate (a2i) ICT Division, Dhaka, Bangladesh
| | - Anir Chowdhury
- Aspire to Innovate (a2i) ICT Division, Dhaka, Bangladesh
| | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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Palus DK, Gołębiewska ME, Piątek O, Grudziński K, Majeranowski A, Owczuk R, Kuziemski K, Stefaniak T. Analysing COVID-19 treatment outcomes in dedicated wards at a large university hospital in northern Poland: a result-based observational study. BMJ Open 2023; 13:e066734. [PMID: 37308272 DOI: 10.1136/bmjopen-2022-066734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVES Presenting outcomes of patients hospitalised for COVID-19 should be put in context and comparison with other facilities. However, varied methodology applied in published studies can impede or even hinder a reliable comparison. The aim of this study is to share our experience in pandemic management and highlight previously under-reported factors affecting mortality. We present outcomes of COVID-19 treatment in our facility that will allow for an intercentre comparison. We use simple statistical parameters-case fatality ratio (CFR) and length of stay (LOS). SETTING Large clinical hospital in northern Poland serving over 120 000 patients annually. PARTICIPANTS Data were collected from patients hospitalised in COVID-19 general and intensive care unit (ICU) isolation wards from November 2020 to June 2021. The sample consisted of 640 patients-250 (39.1 %) were women and 390 (60.9 %) were men, with a median age of 69 (IQR 59-78) years. RESULTS Values of LOS and CFR were calculated and analysed. Overall CFR for the analysed period was 24.8%, varying from 15.9 % during second quarter 2021 to 34.1% during fourth quarter 2020. The CFR was 23.2% in the general ward and 70.7% in the ICU. All ICU patients required intubation and mechanical ventilation, and 44 (75.9 %) of them developed acute respiratory distress syndrome. The average LOS was 12.6 (±7.5) days. CONCLUSIONS We highlighted the importance of some of the under-reported factors affecting CFR, LOS and thus, mortality. For further multicentre analysis, we recommend broad analysis of factors affecting mortality in COVID-19 using simple and transparent statistical and clinical parameters.
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Affiliation(s)
- Damian Krystian Palus
- Faculty of Medicine, Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | | | - Olga Piątek
- Faculty of Medicine, Department of Pulmonology and Allergology, Medical University of Gdansk, Gdansk, Poland
- Faculty of Medicine, Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdansk, Gdansk, Poland
| | | | - Alan Majeranowski
- Department of Hematology and Transplantology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
- Department of Cell Biology and Immunology, Intercollegiate Faculty of Biotechnology, University of Gdansk, Medical University of Gdansk, Gdansk, Poland
| | - Radosław Owczuk
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Krzysztof Kuziemski
- Faculty of Medicine, Department of Pulmonology and Allergology, Medical University of Gdansk, Gdansk, Poland
| | - Tomasz Stefaniak
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
- Board of Directors, University Clinical Center of Medical University of Gdansk, Medical University of Gdansk, Gdansk, Poland
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24
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Shi X, Ling GHT, Leng PC, Rusli N, Matusin AMRA. Associations between institutional-social-ecological factors and COVID -19 case-fatality: Evidence from 134 countries using multiscale geographically weighted regression (MGWR). One Health 2023; 16:100551. [PMID: 37153369 PMCID: PMC10141798 DOI: 10.1016/j.onehlt.2023.100551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/25/2023] [Accepted: 04/23/2023] [Indexed: 05/09/2023] Open
Abstract
During the period in which the Omicron coronavirus variant was rapidly spreading, the impact of the institutional-social-ecological dimensions on the case-fatality rate was rarely afforded attention. By adopting the diagnostic social-ecological system (SES) framework, the present paper aims to identify the impact of institutional-social-ecological factors on the case-fatality rate of COVID-19 in 134 countries and regions and test their spatial heterogeneity. Using statistical data from the Our World In Data website, the present study collected the cumulative case-fatality rate from 9 November 2021 to 23 June 2022, along with 11 country-level institutional-social-ecological factors. By comparing the goodness of fit of the multiple linear regression model and the multiscale geographically weighted regression (MGWR) model, the study demonstrated that the effects of SES factors exhibit significant spatial heterogeneity in relation to the case-fatality rate of COVID-19. After substituting the data into the MGWR model, six SES factors were identified with an R square of 0.470 based on the ascending effect size: COVID-19 vaccination policy, age dependency ratio, press freedom, gross domestic product (GDP), COVID-19 testing policy, and population density. The GWR model was used to test and confirm the robustness of the research results. Based on the analysis results, it is suggested that the world needs to meet four conditions to restore normal economic activity in the wake of the COVID-19 pandemic: (i) Countries should increase their COVID-19 vaccination coverage and maximize COVID-19 testing expansion. (ii) Countries should increase public health facilities available to provide COVID-19 treatment and subsidize the medical costs of COVID-19 patients. (iii) Countries should strictly review COVID-19 news reports and actively publicize COVID-19 pandemic prevention knowledge to the public through a range of media. (iv) Countries should adopt an internationalist spirit of cooperation and help each other to navigate the COVID-19 pandemic. The study further tests the applicability of the SES framework to the field of COVID-19 prevention and control based on the existing research, offering novel policy insights to cope with the COVID-19 pandemic that coexists with long-term human production and life for a long time.
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Affiliation(s)
- Xuerui Shi
- Department of Urban and Regional Planning, Faculty of Built Environment & Surveying, Universiti Teknologi Malaysia, 81310 Johor Bahru, Malaysia
| | - Gabriel Hoh Teck Ling
- Department of Urban and Regional Planning, Faculty of Built Environment & Surveying, Universiti Teknologi Malaysia, 81310 Johor Bahru, Malaysia
| | - Pau Chung Leng
- Department of Architecture, Faculty of Built Environment & Surveying, Universiti Teknologi Malaysia, 81310 Johor Bahru, Malaysia
| | - Noradila Rusli
- Department of Urban and Regional Planning, Faculty of Built Environment & Surveying, Universiti Teknologi Malaysia, 81310 Johor Bahru, Malaysia
- Centre for Innovative Planning and Development (CIPD), Faculty of Built Environment & Surveying, Universiti Teknologi Malaysia, 81310 Johor Bahru, Malaysia
| | - Ak Mohd Rafiq Ak Matusin
- Department of Urban and Regional Planning, Faculty of Built Environment & Surveying, Universiti Teknologi Malaysia, 81310 Johor Bahru, Malaysia
- Centre for Innovative Planning and Development (CIPD), Faculty of Built Environment & Surveying, Universiti Teknologi Malaysia, 81310 Johor Bahru, Malaysia
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25
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Hartnady Z, Krehbiel B, Stenzel A, Tierney D. Outcomes and Clinical Characteristics of COVID-19 in Patients with Tuberculosis: A Retrospective Matched Cohort Study. Infect Dis Rep 2023; 15:204-209. [PMID: 37102981 PMCID: PMC10137917 DOI: 10.3390/idr15020021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
The outcomes and characteristics of acute coronavirus disease 2019 (COVID-19) infection in patients with tuberculosis (TB) represent an evolving area of literature. This retrospective cohort study (March 2020–January 2021) within a large United States health system evaluated clinical and demographic characteristics, illness severity, complications, and mortality associated with acute COVID-19 infection in patients with TB (n = 31) compared to a matched (1:3) COVID-19 cohort without TB (n = 93). In the COVID-19 + TB cohort, TB was active in 32% and latent in 65% of patients, most patients (55%) had pulmonary TB, and 68% had previously undergone treatment for their TB. Patients with COVID-19 + TB infection had higher rates of hospitalization (45% vs. 36%, p = 0.34), intensive care unit (ICU) stay (16% vs. 8%, p = 0.16), and need for mechanical ventilation (13% vs. 3% p = 0.06). Discordant with those higher rates of markers typically denoting more severe illness, TB patients with acute COVID-19 did not have longer length-of-stay (5.0 vs. 6.1 days, p = 0.97), in-hospital mortality (3.2% vs. 3.2%, p = 1.00), or 30-day mortality (6.5% vs. 4.3%, p = 0.63). This study, while having limitations for extrapolation, cautions the notion that patients with COVID-19 and TB infers worse outcomes and adds to the growing body of literature on the interaction between these two infections.
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Affiliation(s)
- Zachary Hartnady
- Department of Medical Education, Abbott Northwestern Hospital, Minneapolis, MN 55407, USA
| | - Benjamin Krehbiel
- Department of Medical Education, Abbott Northwestern Hospital, Minneapolis, MN 55407, USA
| | - Ashley Stenzel
- Care Delivery Research, Allina Health, Minneapolis, MN 55407, USA
| | - David Tierney
- Department of Medical Education, Abbott Northwestern Hospital, Minneapolis, MN 55407, USA
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26
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Obasanjo IO, Ahmad Z, Akkaladevi S, Adekoya A, Abass O. Dynamics of factors associated with rates of COVID-19 cases and deaths in African countries. Global Health 2023; 19:20. [PMID: 36959604 PMCID: PMC10034252 DOI: 10.1186/s12992-023-00918-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 03/07/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND African countries have not had the high case and death rates from COVID-19 as was predicted early in the pandemic. It is not well understood what factors modulated the rate of COVID-19 cases and death on the continent. METHODS We collated data from the World Bank data site, Our World in Data and Freedom House for African for 54 African countries who are members of the African Union. We used them as explanatory variables in two general linear model regression analyses. COVID cases and deaths per 100,000 obtained from WHO COVID-19 dashboard on August 12, 2021, as outcome variables in two prediction models. RESULTS GDP, percentage of population under 14 years of age, Maternal Mortality Ratio, number of international tourists visiting per year and public transportation closures were not significant in predicting COVID-19 cases. Higher percentage of unemployed adults in the population, lower percentage of the population over 25 years of age with secondary education, internal travel restrictions increased spread of COVID-19 while international travel restrictions were associated with lower COVID-19 cases per 100,000 population. Higher levels of democratization results in higher cases of COVID-19. Unemployment, education and democratization were still significant for COVID-19 death in the same direction as they were for COVID-19 cases. Number of tourism visitors per year was also associated with higher COVID-19 death rates but not with case rates. CONCLUSION In African countries, internal movement restrictions enacted to inhibit COVID-19, had the opposite effect and enabled COVID-19 spread. Low Education levels and high unemployment were associated with having higher death rates from COVID-19. More studies are needed to understand the impact of tourism on COVID-19 and other infectious diseases arising from other regions on African countries, in order to put in place adequate control protocols.
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Affiliation(s)
- Iyabo O. Obasanjo
- Department of Kinesiology and Health Sciences, College of William and Mary, Williamsburg, VA 23185 USA
| | - Zain Ahmad
- College of William and Mary, Williamsburg, VA 23185 USA
| | - Somasheker Akkaladevi
- Reginald F. Lewis College of Business, Virginia State University, Petersburg, VA 23806 USA
| | - Adeyemi Adekoya
- Reginald F. Lewis College of Business, Virginia State University, Petersburg, VA 23806 USA
| | - Olayide Abass
- Bells University of Technology, Otta, Ogun State Nigeria
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27
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Chakrabarty D, Bhatia B, Jayasinghe M, Low D. Relative deprivation, inequality and the Covid-19 pandemic. Soc Sci Med 2023; 324:115858. [PMID: 36989836 PMCID: PMC10027304 DOI: 10.1016/j.socscimed.2023.115858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 02/13/2023] [Accepted: 03/17/2023] [Indexed: 03/24/2023]
Abstract
There is a growing concern that inequalities are hindering health outcomes. This paper's primary objective is to investigate the role of relative deprivation and inequality in explaining the daily spread of the Covid-19 pandemic. For this purpose, we use secondary cross-sectional data across 119 (developed and developing) countries from January 2020 – to April 2021. For the empirical analysis, we use a recent dynamic panel data modelling approach that allows us to identify the role of time-invariant variables such as degree of globalisation, political freedom and income inequality on the dynamics of the pandemic and fatality rates across countries. We find that new cases per million and fatality rates are highly persistent processes. After controlling for time-varying mobility statistics from the Google mobility database and region-specific dummy variables, the two significant factors that explain the severity of Covid-19 spread in a country are per-capita Gross Domestic Product (GDP) and Yitzhaki's relative income deprivation index. Lagged value of new cases per million significantly explains cross-country variations in the daily case fatality rates. A higher proportion of the older population and pollution increased fatality rates while better medical infrastructure reduced it.
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Affiliation(s)
- Debajyoti Chakrabarty
- Asia Pacific College of Business and Law, Charles Darwin University, 21 Kitchener Dr. Waterfront, Darwin City, Northern Territory, 0800, Australia.
| | - Bhanu Bhatia
- Asia Pacific College of Business and Law, Charles Darwin University, 21 Kitchener Dr. Waterfront, Darwin City, Northern Territory, 0800, Australia.
| | - Maneka Jayasinghe
- Asia Pacific College of Business and Law, Charles Darwin University, 21 Kitchener Dr. Waterfront, Darwin City, Northern Territory, 0800, Australia.
| | - David Low
- Asia Pacific College of Business and Law, Charles Darwin University, 21 Kitchener Dr. Waterfront, Darwin City, Northern Territory, 0800, Australia.
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28
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Colston JM, Hinson P, Nguyen NLH, Chen YT, Badr HS, Kerr GH, Gardner LM, Martin DN, Quispe AM, Schiaffino F, Kosek MN, Zaitchik BF. Effects of hydrometeorological and other factors on SARS-CoV-2 reproduction number in three contiguous countries of tropical Andean South America: a spatiotemporally disaggregated time series analysis. IJID REGIONS 2023; 6:29-41. [PMID: 36437857 PMCID: PMC9675637 DOI: 10.1016/j.ijregi.2022.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 06/09/2023]
Abstract
Background The COVID-19 pandemic has caused societal disruption globally, and South America has been hit harder than other lower-income regions. This study modeled the effects of six weather variables on district-level SARS-CoV-2 reproduction numbers (Rt ) in three contiguous countries of tropical Andean South America (Colombia, Ecuador, and Peru), adjusting for environmental, policy, healthcare infrastructural and other factors. Methods Daily time-series data on SARS-CoV-2 infections were sourced from the health authorities of the three countries at the smallest available administrative level. Rt values were calculated and merged by date and unit ID with variables from a unified COVID-19 dataset and other publicly available sources for May-December, 2020. Generalized additive models were fitted. Findings Relative humidity and solar radiation were inversely associated with SARS-CoV-2 Rt . Days with radiation above 1000 kJ/m2 saw a 1.3% reduction in Rt , and those with humidity above 50% recorded a 0.9% reduction in Rt . Transmission was highest in densely populated districts, and lowest in districts with poor healthcare access and on days with lowest population mobility. Wind speed, temperature, region, aggregate government policy response, and population age structure had little impact. The fully adjusted model explained 4.3% of Rt variance. Interpretation Dry atmospheric conditions of low humidity increase district-level SARS-CoV-2 reproduction numbers, while higher levels of solar radiation decrease district-level SARS-CoV-2 reproduction numbers - effects that are comparable in magnitude to population factors like lockdown compliance. Weather monitoring could be incorporated into disease surveillance and early warning systems in conjunction with more established risk indicators and surveillance measures. Funding NASA's Group on Earth Observations Work Programme (16-GEO16-0047).
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Affiliation(s)
- Josh M. Colston
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, 22903, USA
| | - Patrick Hinson
- College of Arts and Sciences, University of Virginia, VA, USA
| | | | - Yen Ting Chen
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Hamada S. Badr
- Department of Earth and Planetary Sciences, Johns Hopkins Krieger School of Arts and Sciences, Baltimore, MD, 21218, USA
| | - Gaige H. Kerr
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Lauren M. Gardner
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - David N. Martin
- Claude Moore Health Sciences Library, University of Virginia School of Medicine, VA, USA
| | | | - Francesca Schiaffino
- Faculty of Veterinary Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Infectious Diseases and International Health and Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22903, USA
| | - Margaret N. Kosek
- Division of Infectious Diseases and International Health and Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22903, USA
| | - Benjamin F. Zaitchik
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
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29
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Sorci G, Faivre B. [Age and case fatality rate of infectious diseases]. Med Sci (Paris) 2023; 39:287-289. [PMID: 36943127 DOI: 10.1051/medsci/2023020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Affiliation(s)
- Gabriele Sorci
- Biogéosciences, CNRS UMR 6282, université de Bourgogne, Dijon, France
| | - Bruno Faivre
- Biogéosciences, CNRS UMR 6282, université de Bourgogne, Dijon, France
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30
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Melnyk A, Kozarov L, Wachsmann-Hogiu S. A deconvolution approach to modelling surges in COVID-19 cases and deaths. Sci Rep 2023; 13:2361. [PMID: 36759700 PMCID: PMC9910232 DOI: 10.1038/s41598-023-29198-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
The COVID-19 pandemic continues to emphasize the importance of epidemiological modelling in guiding timely and systematic responses to public health threats. Nonetheless, the predictive qualities of these models remain limited by their underlying assumptions of the factors and determinants shaping national and regional disease landscapes. Here, we introduce epidemiological feature detection, a novel latent variable mixture modelling approach to extracting and parameterizing distinct and localized features of real-world trends in daily COVID-19 cases and deaths. In this approach, we combine methods of peak deconvolution that are commonly used in spectroscopy with the susceptible-infected-recovered-deceased model of disease transmission. We analyze the second wave of the COVID-19 pandemic in Israel, Canada, and Germany and find that the lag time between reported cases and deaths, which we term case-death latency, is closely correlated with adjusted case fatality rates across these countries. Our findings illustrate the spatiotemporal variability of both these disease metrics within and between different disease landscapes. They also highlight the complex relationship between case-death latency, adjusted case fatality rate, and COVID-19 management across various degrees of decentralized governments and administrative structures, which provides a retrospective framework for responding to future pandemics and disease outbreaks.
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Affiliation(s)
- Adam Melnyk
- Department of Bioengineering, McGill University, 3480 Rue University, Montreal, QC, H3A 0E9, Canada.
| | - Lena Kozarov
- Department of Bioengineering, McGill University, 3480 Rue University, Montreal, QC, H3A 0E9, Canada
| | - Sebastian Wachsmann-Hogiu
- Department of Bioengineering, McGill University, 3480 Rue University, Montreal, QC, H3A 0E9, Canada.
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Epsi NJ, Powers JH, Lindholm DA, Mende K, Malloy A, Ganesan A, Huprikar N, Lalani T, Smith A, Mody RM, Jones MU, Bazan SE, Colombo RE, Colombo CJ, Ewers EC, Larson DT, Berjohn CM, Maldonado CJ, Blair PW, Chenoweth J, Saunders DL, Livezey J, Maves RC, Sanchez Edwards M, Rozman JS, Simons MP, Tribble DR, Agan BK, Burgess TH, Pollett SD, for the EPICC COVID-19 Cohort Study Group. A machine learning approach identifies distinct early-symptom cluster phenotypes which correlate with hospitalization, failure to return to activities, and prolonged COVID-19 symptoms. PLoS One 2023; 18:e0281272. [PMID: 36757946 PMCID: PMC9910657 DOI: 10.1371/journal.pone.0281272] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/19/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Accurate COVID-19 prognosis is a critical aspect of acute and long-term clinical management. We identified discrete clusters of early stage-symptoms which may delineate groups with distinct disease severity phenotypes, including risk of developing long-term symptoms and associated inflammatory profiles. METHODS 1,273 SARS-CoV-2 positive U.S. Military Health System beneficiaries with quantitative symptom scores (FLU-PRO Plus) were included in this analysis. We employed machine-learning approaches to identify symptom clusters and compared risk of hospitalization, long-term symptoms, as well as peak CRP and IL-6 concentrations. RESULTS We identified three distinct clusters of participants based on their FLU-PRO Plus symptoms: cluster 1 ("Nasal cluster") is highly correlated with reporting runny/stuffy nose and sneezing, cluster 2 ("Sensory cluster") is highly correlated with loss of smell or taste, and cluster 3 ("Respiratory/Systemic cluster") is highly correlated with the respiratory (cough, trouble breathing, among others) and systemic (body aches, chills, among others) domain symptoms. Participants in the Respiratory/Systemic cluster were twice as likely as those in the Nasal cluster to have been hospitalized, and 1.5 times as likely to report that they had not returned-to-activities, which remained significant after controlling for confounding covariates (P < 0.01). Respiratory/Systemic and Sensory clusters were more likely to have symptoms at six-months post-symptom-onset (P = 0.03). We observed higher peak CRP and IL-6 in the Respiratory/Systemic cluster (P < 0.01). CONCLUSIONS We identified early symptom profiles potentially associated with hospitalization, return-to-activities, long-term symptoms, and inflammatory profiles. These findings may assist in patient prognosis, including prediction of long COVID risk.
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Affiliation(s)
- Nusrat J. Epsi
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America
| | - John H. Powers
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - David A. Lindholm
- Molecular Biology Laboratory, Brooke Army Medical Center, San Antonio, Texas, United States of America
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Katrin Mende
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America
- Molecular Biology Laboratory, Brooke Army Medical Center, San Antonio, Texas, United States of America
| | - Allison Malloy
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America
| | - Anuradha Ganesan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America
- Infectious Disease Clinic, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America
| | - Nikhil Huprikar
- Infectious Disease Clinic, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America
| | - Tahaniyat Lalani
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America
- Infectious Disease Clinical Research Program, Naval Medical Center Portsmouth, Portsmouth, Virginia, United States of America
| | - Alfred Smith
- Infectious Disease Clinical Research Program, Naval Medical Center Portsmouth, Portsmouth, Virginia, United States of America
| | - Rupal M. Mody
- Infectious Disease Clinic, William Beaumont Army Medical Center, El Paso, Texas, United States of America
| | - Milissa U. Jones
- Pediatric Infectious Diseases, Tripler Army Medical Center, Honolulu, Hawaii, United States of America
| | - Samantha E. Bazan
- Family Nurse Practitioner and Women’s Health Nurse Practitioner Program, Carl R. Darnall Army Medical Center, Fort Hood, Texas, United States of America
| | - Rhonda E. Colombo
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Infectious Disease Clinic, Madigan Army Medical Center, Tacoma, Washington, United States of America
| | - Christopher J. Colombo
- Infectious Disease Clinic, Madigan Army Medical Center, Tacoma, Washington, United States of America
| | - Evan C. Ewers
- Internal Medicine, Fort Belvoir Community Hospital, Fort Belvoir, Virginia, United States of America
| | - Derek T. Larson
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Internal Medicine, Fort Belvoir Community Hospital, Fort Belvoir, Virginia, United States of America
- Infectious Disease Clinic, Naval Medical Center San Diego, San Diego, California, United States of America
| | - Catherine M. Berjohn
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Infectious Disease Clinic, Naval Medical Center San Diego, San Diego, California, United States of America
| | - Carlos J. Maldonado
- Department of Research and Clinical Investigation, Womack Army Medical Center, Fort Bragg, North Carolina, United States of America
| | - Paul W. Blair
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America
- Department of Pathology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Josh Chenoweth
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America
| | - David L. Saunders
- Translational Medicine Unit, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Jeffrey Livezey
- Translational Medicine Unit, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Ryan C. Maves
- Infectious Diseases and Critical Care Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Margaret Sanchez Edwards
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America
| | - Julia S. Rozman
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America
| | - Mark P. Simons
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - David R. Tribble
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Brian K. Agan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America
| | - Timothy H. Burgess
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Simon D. Pollett
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America
| | - for the EPICC COVID-19 Cohort Study Group
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America
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Almada L, Angiolini SC, Dho ND, Dutto J, Gazzoni Y, Manzone-Rodríguez C, Marín C, Ponce NE, Arroyo DS, Quiróz JN, Iribarren P, Cerbán FM, Morón G, Amezcua Vesely MC, Cervi L, Chiapello LS, Fozzatti L, Icely PA, Maccioni M, Montes CL, Motrán CC, Rodríguez-Galán MC, Stempin CC, Viano ME, Mena C, Bertone M, Abiega CD, Escudero D, Kahn A, Caeiro JP, Maletto BA, Acosta Rodríguez EV, Gruppi A, Sotomayor CE. Different cytokine and chemokine profiles in hospitalized patients with COVID-19 during the first and second outbreaks from Argentina show no association with clinical comorbidities. Front Immunol 2023; 14:1111797. [PMID: 36817433 PMCID: PMC9929547 DOI: 10.3389/fimmu.2023.1111797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/09/2023] [Indexed: 02/04/2023] Open
Abstract
Background COVID-19 severity has been linked to an increased production of inflammatory mediators called "cytokine storm". Available data is mainly restricted to the first international outbreak and reports highly variable results. This study compares demographic and clinical features of patients with COVID-19 from Córdoba, Argentina, during the first two waves of the pandemic and analyzes association between comorbidities and disease outcome with the "cytokine storm", offering added value to the field. Methods We investigated serum concentration of thirteen soluble mediators, including cytokines and chemokines, in hospitalized patients with moderate and severe COVID-19, without previous rheumatic and autoimmune diseases, from the central region of Argentina during the first and second infection waves. Samples from healthy controls were also assayed. Clinical and biochemical parameters were collected. Results Comparison between the two first COVID-19 waves in Argentina highlighted that patients recruited during the second wave were younger and showed less concurrent comorbidities than those from the first outbreak. We also recognized particularities in the signatures of systemic cytokines and chemokines in patients from both infection waves. We determined that concurrent pre-existing comorbidities did not have contribution to serum concentration of systemic cytokines and chemokines in COVID-19 patients. We also identified immunological and biochemical parameters associated to inflammation which can be used as prognostic markers. Thus, IL-6 concentration, C reactive protein level and platelet count allowed to discriminate between death and discharge in patients hospitalized with severe COVID-19 only during the first but not the second wave. Conclusions Our data provide information that deepens our understanding of COVID-19 pathogenesis linking demographic features of a COVID-19 cohort with cytokines and chemokines systemic concentration, presence of comorbidities and different disease outcomes. Altogether, our findings provide information not only at local level by delineating inflammatory/anti-inflammatory response of patients but also at international level addressing the impact of comorbidities and the infection wave in the variability of cytokine and chemokine production upon SARS-CoV-2 infection.
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Affiliation(s)
- Laura Almada
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Sofía Carla Angiolini
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Nicolás Daniel Dho
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Jeremías Dutto
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Yamila Gazzoni
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Clarisa Manzone-Rodríguez
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Constanza Marín
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Nicolás Eric Ponce
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Daniela Soledad Arroyo
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Juan Nahuel Quiróz
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Pablo Iribarren
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Fabio Marcelo Cerbán
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Gabriel Morón
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - María Carolina Amezcua Vesely
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Laura Cervi
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Laura Silvina Chiapello
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Laura Fozzatti
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Paula Alejandra Icely
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Mariana Maccioni
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Carolina Lucia Montes
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Claudia Cristina Motrán
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - María Cecilia Rodríguez-Galán
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Cinthia Carolina Stempin
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - María Estefanía Viano
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Cristian Mena
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Mariana Bertone
- Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Claudio Daniel Abiega
- Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Daiana Escudero
- Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Adrián Kahn
- Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Juan Pablo Caeiro
- Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Belkys Angélica Maletto
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Eva Virginia Acosta Rodríguez
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Adriana Gruppi
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Claudia Elena Sotomayor
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
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Wang F, Lui J, Wang JD. Losses of Life Expectancy and Productivity Associated with COVID-19 Pandemic in Canada: Policy Implication for Future Communicable Disease Control. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2419. [PMID: 36767785 PMCID: PMC9916087 DOI: 10.3390/ijerph20032419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
This research examines whether the Coronavirus disease 2019 (COVID-19) did harm to the population's health through comparing the changes in the life expectancy of Canadians with those of Australians over the period from March 2019 to February 2021 by using a difference-in-differences (DID) estimation method. We found that the pandemic did cause differences in life expectancies between Canada and Australia, probably because of different initial control policies for COVID-19. This study uses the indicator of disability-adjusted life years (DALYs) to measure the societal health burden, which was corroborated by estimating temporal productivity loss (TPL) and permanent productivity loss (PPL) based on the human capital approach (HCA) using data from Health Canada. The societal health burden in Canada amounted to 6.493 DALYs per 1000 male persons and 5.316 DALYs per 1000 female persons. The economy's permanent productivity loss was around USD 5.3 billion, while the temporary productivity loss was around USD 3 billion from February 2020 to April 2022. The sum of the above two losses amounted to 0.477% of the GDP in 2019. Swift and decisive decisions at the very early stage of a pandemic can nip contagions in the bud before numbers get out of hand and would be less damaging to people's health and the economy, as seen in Australia, in contrast to what happened in Canada. We thus recommend that such policies plus telecommunication systems in healthcare services be implemented early on to cope with the future outbreak of any emerging infectious diseases such as COVID-19.
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Affiliation(s)
- Fuhmei Wang
- Department of Economics, College of Social Science, National Cheng Kung University, Tainan 704, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Jinwei Lui
- Department of Economics, College of Social Science, National Cheng Kung University, Tainan 704, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
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Patterson AC. Is Economic Growth Good for Population Health? A Critical Review. CANADIAN STUDIES IN POPULATION 2023; 50:1. [PMID: 36938118 PMCID: PMC10009865 DOI: 10.1007/s42650-023-00072-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/17/2023] [Indexed: 03/16/2023]
Abstract
A large multidisciplinary literature discusses the relationship between economic growth and population health. The idea that economic growth is good for societies has inspired extensive academic debate, but conclusions have been mixed. To help shed light on the subject, this paper focuses on opportunities for consensus in this large literature. Much scholarship finds that the health-growth relationship varies according to (1) which aspect of "health" is under consideration, (2) shape (e.g., positive linear or logarithmic), (3) issues of timing (e.g., growth over the short or long term), (4) a focus on health inequalities as opposed to population averages, and (5) multivariable relationships with additional factors. After reflecting upon these findings, I propose that economic growth promotes health in some respects, for some countries, and in conjunction with other life-supporting priorities, but does not by itself improve population health generally speaking. I then argue there is already wide, interdisciplinary consensus to support this stance. Moreover, policies focusing exclusively on economic growth threaten harm to both population health and growth, which is to say that political dynamics are also implicated. Yet multivariable approaches can help clarify the bigger picture of how growth relates to health. For moving this literature forward, the best opportunities may involve the simultaneous analysis of multiple factors. The recognition of consensus around these issues would be welcome, and timely. Supplementary Information The online version contains supplementary material available at 10.1007/s42650-023-00072-y.
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Khedhiri S. COVID-19 case-fatality variations with application to the Middle East countries. GEOJOURNAL 2023; 88:1127-1137. [PMID: 35378737 PMCID: PMC8966859 DOI: 10.1007/s10708-022-10635-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 05/09/2023]
Abstract
During a pandemic outbreak, it is important for health officials to know the proportions of deaths among infected individuals and to understand how these proportions change overtime, to accurately predict the impact of the pandemic and to implement effectively new intervention policies and health protocols and to adjust them accordingly. However, most studies where efforts have been made to estimate accurately the case fatality rates did not address the issue of measuring the dynamics of the pandemic deadliness during its course. Daily data on COVID-19 cases and deaths were collected from selected MENA countries. In this paper, two new measures of the pandemic fatality are developed based on the estimated time it takes hospitalized infected patients to eventually die from the disease. The first measure assigns COVID-19 deaths to its most significant lagged number of cases based on a fixed-effects panel data model. The second fatality measure relates pandemic deaths and cases based on their respective change points. The results find notable variations of the pandemic lethality between the Middle East countries, likely due to the difference in the quality of health care. Although crude case-fatality rate does not identify the pandemic lethality variations during the ongoing of the disease, this paper develops two novel measures for COVID-19 case fatality which can identify the dynamics and the variations of the pandemic deadliness.
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Affiliation(s)
- Sami Khedhiri
- School of Mathematical and Computational Sciences, University of Prince Edward Island, Charlottetown, PE Canada
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Kim Y, Kim BI, Tak S. Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates. Osong Public Health Res Perspect 2022; 13:424-434. [PMID: 36617548 DOI: 10.24171/j.phrp.2022.0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/18/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Although it is widely used as a measure for mortality, the case fatality rate (CFR) ofcoronavirus disease 2019 (COVID-19) can vary over time and fluctuate for many reasons otherthan viral characteristics. To compare the CFRs of different countries in equal measure, weestimated comparable CFRs after adjusting for multiple covariates and examined the mainfactors that contributed to variability in the CFRs among 21 countries. METHODS For statistical analysis, time-series cross-sectional data were collected from OurWorld in Data, CoVariants.org, and GISAID. Biweekly CFRs of COVID-19 were estimated bypooled generalized linear squares regression models for the panel data. Covariates includedthe predominant virus variant, reproduction rate, vaccination, national economic status,hospital beds, diabetes prevalence, and population share of individuals older than age 65. Intotal, 21 countries were eligible for analysis. RESULTS Adjustment for covariates reduced variation in the CFRs of COVID-19 across countriesand over time. Regression results showed that the dominant spread of the Omicron variant,reproduction rate, and vaccination were associated with lower country-level CFRs, whereasage, the extreme poverty rate, and diabetes prevalence were associated with higher countrylevel CFRs. CONCLUSION A direct comparison of crude CFRs among countries may be fallacious, especiallyin a cross-sectional analysis. Our study presents an adjusted comparison of CFRs over timefor a more proper comparison. In addition, our findings suggest that comparing CFRs amongdifferent countries without considering their context, such as the epidemic phase, medicalcapacity, surveillance strategy, and socio-demographic traits, should be avoided.
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Affiliation(s)
- Yongmoon Kim
- Division of Risk Assessment, Bureau of Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Bryan Inho Kim
- Division of Risk Assessment, Bureau of Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sangwoo Tak
- Division of Risk Assessment, Bureau of Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Korea
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Wakabayashi Y, Nakayama S, Yamamoto A, Kitazawa T. High D-glucose levels induce ACE2 expression via GLUT1 in human airway epithelial cell line Calu-3. BMC Mol Cell Biol 2022; 23:29. [PMID: 35836103 PMCID: PMC9282902 DOI: 10.1186/s12860-022-00427-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/27/2022] [Indexed: 12/15/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the host cell by binding to angiotensin-converting enzyme 2 (ACE2) receptors. ACE2 is expressed on human airway epithelial cells. Increased ACE2 expression may be associated with potentially high risk of COVID-19. However, the factors responsible for the regulation of ACE2 expression in human airway epithelial cells are unknown. Furthermore, hyperglycemia is a risk factor for poor disease prognosis. Results In this study, we investigated the effects of D-glucose on ACE2 mRNA and protein expressions in Calu-3 bronchial submucosal cells. The cells were cultured in minimal essential medium containing different D-glucose concentrations. After 48 and 72 h of high D-glucose (1000 mg/dL) treatment, ACE2 mRNA expressions were significantly increased. ACE2 protein expressions were significantly increased after 24 h of high D-glucose treatment. ACE2 mRNA expression was enhanced by a D-glucose concentration of 550 mg/dL or more after 72 h of treatment. In addition, we investigated the role of glucose transporters (GLUTs) in Calu-3 cells. ACE2 mRNA and protein expressions were suppressed by the GLUT1 inhibitor BAY-876 in high D-glucose-treated Calu-3 cells. GLUT-1 siRNA was also used and ACE2 mRNA expressions were suppressed in high D-glucose-treated Calu-3 cells with GLUT-1 knockdown. Conclusions This is the first report indicating that high D-glucose levels induced ACE2 expression via GLUT1 in bronchial submucosal cells in vitro. As hyperglycemia can be treated appropriately, these findings could help reduce the risk of worsening of coronavirus disease 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s12860-022-00427-4.
SARS-CoV-2 enters the host cell by binding to its receptor, angiotensin-converting enzyme 2 (ACE2). ACE2 is expressed in many cell types, including bronchial epithelial cells. High D-glucose medium induced ACE2 expression in bronchial epithelial Calu-3 cells. Glucose transporter 1 (GLUT1) is expressed in Calu-3 cells, and GLUT1 inhibition decreased ACE2 expression.
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Gebremichael B, Hailu A, Letebo M, Berhanesilassie E, Shumetie A, Biadgilign S. Impact of good governance, economic growth and universal health coverage on COVID-19 infection and case fatality rates in Africa. Health Res Policy Syst 2022; 20:130. [PMID: 36437476 PMCID: PMC9702649 DOI: 10.1186/s12961-022-00932-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 11/01/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has disrupted lives across all countries and communities. It significantly reduced the global economic output and dealt health systems across the world a serious blow. There is growing evidence showing the progression of the COVID-19 pandemic and the impact it has on health systems, which should help to draw lessons for further consolidating and realizing universal health coverage (UHC) in all countries, complemented by more substantial government commitment and good governance, and continued full implementation of crucial policies and plans to avert COVID-19 and similar pandemic threats in the future. Therefore, the objective of the study was to assess the impact of good governance, economic growth and UHC on the COVID-19 infection rate and case fatality rate (CFR) among African countries. METHODS We employed an analytical ecological study design to assess the association between COVID-19 CFR and infection rate as dependent variables, and governance, economic development and UHC as independent variables. We extracted data from publicly available databases (i.e., Worldometer, Worldwide Governance Indicators, Our World in Data and WHO Global Health Observatory Repository). We employed a multivariable linear regression model to examine the association between the dependent variables and the set of explanatory variables. STATA version 14 software was used for data analysis. RESULTS All 54 African countries were covered by this study. The median observed COVID-19 CFR and infection rate were 1.65% and 233.46%, respectively. Results of multiple regression analysis for predicting COVID-19 infection rate indicated that COVID-19 government response stringency index (β = 0.038; 95% CI 0.001, 0.076; P = 0.046), per capita gross domestic product (GDP) (β = 0.514; 95% CI 0.158, 0.87; P = 0.006) and infectious disease components of UHC (β = 0.025; 95% CI 0.005, 0.045; P = 0.016) were associated with COVID-19 infection rates, while noncommunicable disease components of UHC (β = -0.064; 95% CI -0.114; -0.015; P = 0.012), prevalence of obesity among adults (β = 0.112; 95% CI 0.044; 0.18; P = 0.002) and per capita GDP (β = -0.918; 95% CI -1.583; -0.254; P = 0.008) were associated with COVID-19 CFR. CONCLUSIONS The findings indicate that good governance practices, favourable economic indicators and UHC have a bearing on COVID-19 infection rate and CFR. Effective health system response through a primary healthcare approach and progressively taking measures to grow their economy and increase funding to the health sector to mitigate the risk of similar future pandemics would require African countries to move towards UHC, improve governance practices and ensure economic growth in order to reduce the impact of pandemics on populations.
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Affiliation(s)
| | - Alemayehu Hailu
- Department of Global Public Health and Primary Care, Bergen Center for Ethics and Priority Setting, University of Bergen, Bergen, Norway
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, United States of America
| | - Mekitew Letebo
- Independent Public Health Analyst and Research Consultant, P.O. BOX 24414, Addis Ababa, Ethiopia
| | - Etsub Berhanesilassie
- Independent Public Health Analyst and Research Consultant, P.O. BOX 24414, Addis Ababa, Ethiopia
| | | | - Sibhatu Biadgilign
- Independent Public Health Analyst and Research Consultant, P.O. BOX 24414, Addis Ababa, Ethiopia
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Nuhu K, Humagain K, Alorbi G, Thomas S, Blavos A, Placide V. Global COVID-19 case fatality rates influenced by inequalities in human development and vaccination rates. DISCOVER SOCIAL SCIENCE AND HEALTH 2022; 2:20. [PMID: 36340573 PMCID: PMC9628401 DOI: 10.1007/s44155-022-00022-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
AIM COVID-19 has exerted distress on virtually every aspect of human life with disproportionate mortality burdens on older individuals and those with underlying medical conditions. Variations in COVID-19 incidence and case fatality rates (CFRs) across countries have incited a growing research interest regarding the effect of social factors on COVID-19 case-loads and fatality rates. We investigated the effect of population median age, inequalities in human development, healthcare capacity, and pandemic mitigation indicators on country-specific COVID-19 CFRs across countries and regions. SUBJECT AND METHODS Using population secondary data from multiple sources, we conducted a cross-sectional study and used regional analysis to compare regional differences in COVID-19 CFRs as influenced by the selected indicators. RESULTS The analysis revealed wide variations in COVID-19 CFRs and the selected indicators across countries and regions. Mean CFR was highest for South America at 1.973% (± 0.742) and lowest for Oceania at 0.264% (± 0.107), while the Africa sub-region recorded the lowest scores for pandemic preparedness, vaccination rate, and other indicators. Population Median Age [0.073 (0.033 0.113)], Vaccination Rate [-3.3389 (-5.570.033 -1.208)], and Inequality-Adjusted Human Development Index (IHDI) [-0.014 (-0.023 -0.004)] emerged as statistically significant predictors of COVID-19 CFR, with directions indicating increasing Population Median Age, higher inequalities in human development and low vaccination rate are predictive of higher fatalities from COVID-19. CONCLUSION Regional differences in COVID-19 CFR may be influenced by underlying differences in sociodemographic and pandemic mitigation indicators. Populations with wide social inequalities, increased population Median Age and low vaccination rates are more likely to suffer higher fatalities from COVID-19.
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Affiliation(s)
- Kaamel Nuhu
- Health Department, State University of New York at Cortland, Cortland, USA
| | - Kamal Humagain
- Geology Department, State University of New York at Potsdam, Potsdam, USA
| | - Genevieve Alorbi
- Economics Department, State University of New York at Oswego, Oswego, USA
| | - Sabena Thomas
- College of Nursing and Public Health, Adelphi University, Garden City, USA
| | - Alexis Blavos
- Health Department, State University of New York at Cortland, Cortland, USA
| | - Vierne Placide
- Health Department, State University of New York at Cortland, Cortland, USA
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Gisselquist RM, Vaccaro A. COVID-19 and the state: Exploring a puzzling relationship in the early stages of the pandemic. JOURNAL OF INTERNATIONAL DEVELOPMENT 2022; 35:JID3702. [PMID: 36714218 PMCID: PMC9874542 DOI: 10.1002/jid.3702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 08/09/2022] [Accepted: 08/20/2022] [Indexed: 06/18/2023]
Abstract
During the first year of the Covid-19 pandemic, it was wealthier countries with stronger institutions that suffered the highest numbers of cases and fatalities. Many weaker countries were instead praised for more effective pandemic response. What explains this seeming puzzle? We re-consider these relationships in the cross-country data, drawing on measures of the state, Covid's health impact and pandemic response. In brief, our analysis suggests that, when appropriate additional factors are taken into account, the expected relationship between state effectiveness and pandemic health outcomes in fact is clear. We also offer insight into how different dimensions of the state influence policy and outcomes and how particular countries compare with others.
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Affiliation(s)
- Rachel M. Gisselquist
- World Institute for Development Economics Research (UNU‐WIDER)United Nations UniversityHelsinkiFinland
| | - Andrea Vaccaro
- World Institute for Development Economics Research (UNU‐WIDER)United Nations UniversityHelsinkiFinland
- Department of EconomicsUniversity of InsubriaVareseItaly
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Recchi E, Ferrara A, Rodriguez Sanchez A, Deutschmann E, Gabrielli L, Iacus S, Bastiani L, Spyratos S, Vespe M. The impact of air travel on the precocity and severity of COVID-19 deaths in sub-national areas across 45 countries. Sci Rep 2022; 12:16522. [PMID: 36192435 PMCID: PMC9527720 DOI: 10.1038/s41598-022-20263-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 09/12/2022] [Indexed: 11/24/2022] Open
Abstract
Human travel fed the worldwide spread of COVID-19, but it remains unclear whether the volume of incoming air passengers and the centrality of airports in the global airline network made some regions more vulnerable to earlier and higher mortality. We assess whether the precocity and severity of COVID-19 deaths were contingent on these measures of air travel intensity, adjusting for differences in local non-pharmaceutical interventions and pre-pandemic structural characteristics of 502 sub-national areas on five continents in April-October 2020. Ordinary least squares (OLS) models of precocity (i.e., the timing of the 1st and 10th death outbreaks) reveal that neither airport centrality nor the volume of incoming passengers are impactful once we consider pre-pandemic demographic characteristics of the areas. We assess severity (i.e., the weekly death incidence of COVID-19) through the estimation of a generalized linear mixed model, employing a negative binomial link function. Results suggest that COVID-19 death incidence was insensitive to airport centrality, with no substantial changes over time. Higher air passenger volume tends to coincide with more COVID-19 deaths, but this relation weakened as the pandemic proceeded. Different models prove that either the lack of airports in a region or total travel bans did reduce mortality significantly. We conclude that COVID-19 importation through air travel followed a 'travel as spark' principle, whereby the absence of air travel reduced epidemic risk drastically. However, once some travel occurred, its impact on the severity of the pandemic was only in part associated with the number of incoming passengers, and not at all with the position of airports in the global network of airline connections.
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Affiliation(s)
- Ettore Recchi
- Sciences Po, Centre for Research On Social Inequalities (CRIS), CNRS, Paris, France.
- Migration Policy Centre (MPC), European University Institute, Florence, Italy.
| | | | - Alejandra Rodriguez Sanchez
- Humboldt Universität, Berlin, Germany
- Deutsche Zentrum für Integrations-und Migrationsforschung (DeZIM), Berlin, Germany
| | - Emanuel Deutschmann
- Migration Policy Centre (MPC), European University Institute, Florence, Italy
- Europa-Universität Flensburg, Flensburg, Germany
| | - Lorenzo Gabrielli
- Migration Policy Centre (MPC), European University Institute, Florence, Italy
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Stefano Iacus
- Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| | - Luca Bastiani
- Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche (CNR), Pisa, Italy
| | | | - Michele Vespe
- European Commission, Joint Research Centre (JRC), Ispra, Italy
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Do B, Kirkland C, Besenyi GM, Carissa Smock M, Lanza K. Youth physical activity and the COVID-19 pandemic: A systematic review. Prev Med Rep 2022; 29:101959. [PMID: 36034528 PMCID: PMC9394097 DOI: 10.1016/j.pmedr.2022.101959] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/17/2022] [Accepted: 08/15/2022] [Indexed: 12/01/2022] Open
Abstract
Numerous studies examined youth physical activity (PA) during the COVID-19 pandemic. Overall decreases in youth PA were seen during the first 1.5 years of the pandemic. There were differences in PA by sub-populations (e.g., age, sex/gender) There were also differences in PA by location/type (e.g., outdoor, play) Programming and policy should focus on evolving PA promotion for youth. The purpose of the systematic review was to identify, evaluate, and synthesize evidence from available published literature examining the impact of the coronavirus disease 2019 (COVID-19) pandemic on youth physical activity (PA). A systematic review of the literature was conducted for years 2020–2021. Published articles were searched in eight databases. Inclusion criteria included: availability of full-text, written in English language, and reported quantitative or qualitative results of original or secondary data on PA and COVID-19 related factors among youth (ages 5–17 years). A standard quality assessment tool assessed risk of bias and quality of included articles. The search retrieved 2,899 articles with 51 articles ultimately meeting inclusion criteria. The majority of articles (65 %) investigated change in PA from before to during the pandemic. Most evidence indicated an overall decrease in youth PA levels during the pandemic with differences observed among sub-populations (e.g., age, sex or gender), type, and location. Findings suggest pandemic-related closures hindered PA participation due to a high reliance on school- and sport-based PA. Programmatic strategies (e.g., activity breaks, active curriculum, free online activities/lessons) should include aligning intervention measures and geared towards evolving and ongoing PA promotion based on the latest findings.
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Affiliation(s)
- Bridgette Do
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90032, USA
| | - Chelsey Kirkland
- Center for Public Health Systems, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA.,College of Public Health, Kent State University, Kent, OH 44240, USA
| | - Gina M Besenyi
- Department of Kinesiology, College of Health and Human Sciences, Kansas State University, Manhattan, KS 66506, USA
| | - Mph Carissa Smock
- School of Business, Northcentral University, San Diego, CA 92123, USA
| | - Kevin Lanza
- School of Public Health in Austin, University of Texas Health Science Center at Houston, Austin, TX 78701, USA
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Davidson SM, Lukhna K, Gorog DA, Salama AD, Castillo AR, Giesz S, Golforoush P, Kalkhoran SB, Lecour S, Imamdin A, do Carmo HRP, Bovi TG, Perroud MW, Ntsekhe M, Sposito AC, Yellon DM. RIC in COVID-19-a Clinical Trial to Investigate Whether Remote Ischemic Conditioning (RIC) Can Prevent Deterioration to Critical Care in Patients with COVID-19. Cardiovasc Drugs Ther 2022; 36:925-930. [PMID: 34169381 PMCID: PMC8225459 DOI: 10.1007/s10557-021-07221-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE Coronavirus disease 19 (COVID-19) has, to date, been diagnosed in over 130 million persons worldwide and is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several variants of concern have emerged including those in the United Kingdom, South Africa, and Brazil. SARS-CoV-2 can cause a dysregulated inflammatory response known as a cytokine storm, which can progress rapidly to acute respiratory distress syndrome (ARDS), multi-organ failure, and death. Suppressing these cytokine elevations may be key to improving outcomes. Remote ischemic conditioning (RIC) is a simple, non-invasive procedure whereby a blood pressure cuff is inflated and deflated on the upper arm for several cycles. "RIC in COVID-19" is a pilot, multi-center, randomized clinical trial, designed to ascertain whether RIC suppresses inflammatory cytokine production. METHODS A minimum of 55 adult patients with diagnosed COVID-19, but not of critical status, will be enrolled from centers in the United Kingdom, Brazil, and South Africa. RIC will be administered daily for up to 15 days. The primary outcome is the level of inflammatory cytokines that are involved in the cytokine storm that can occur following SARS-CoV-2 infection. The secondary endpoint is the time between admission and until intensive care admission or death. The in vitro cytotoxicity of patient blood will also be assessed using primary human cardiac endothelial cells. CONCLUSIONS The results of this pilot study will provide initial evidence on the ability of RIC to suppress the production of inflammatory cytokines in the setting of COVID-19. TRIAL REGISTRATION NCT04699227, registered January 7th, 2021.
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Affiliation(s)
- Sean M Davidson
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK
| | - Kishal Lukhna
- Division of Cardiology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Diana A Gorog
- Postgraduate Medicine, University of Hertfordshire, UK & East and North Hertfordshire NHS Trust, Stevenage, Hertfordshire, UK
| | - Alan D Salama
- Department of Renal Medicine, Royal Free Hospital, London, UK
| | | | - Sara Giesz
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK
| | - Pelin Golforoush
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK
| | | | - Sandrine Lecour
- The Hatter Institute for Cardiovascular Research, University of Cape Town, Cape Town, South Africa
| | - Aqeela Imamdin
- The Hatter Institute for Cardiovascular Research, University of Cape Town, Cape Town, South Africa
| | - Helison R P do Carmo
- Atherosclerosis and Vascular Biology Laboratory, State University of Campinas, Campinas, Brazil
| | - Ticiane Gonçalez Bovi
- Atherosclerosis and Vascular Biology Laboratory, State University of Campinas, Campinas, Brazil
| | - Mauricio W Perroud
- Atherosclerosis and Vascular Biology Laboratory, State University of Campinas, Campinas, Brazil
| | - Mpiko Ntsekhe
- Division of Cardiology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Andrei C Sposito
- Atherosclerosis and Vascular Biology Laboratory, State University of Campinas, Campinas, Brazil
| | - Derek M Yellon
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London, WC1E 6HX, UK.
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Novel methods for estimating the instantaneous and overall COVID-19 case fatality risk among care home residents in England. PLoS Comput Biol 2022; 18:e1010554. [PMID: 36279279 PMCID: PMC9632866 DOI: 10.1371/journal.pcbi.1010554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 11/03/2022] [Accepted: 09/08/2022] [Indexed: 11/05/2022] Open
Abstract
The COVID-19 pandemic has had high mortality rates in the elderly and frail worldwide, particularly in care homes. This is driven by the difficulty of isolating care homes from the wider community, the large population sizes within care facilities (relative to typical households), and the age/frailty of the residents. To quantify the mortality risk posed by disease, the case fatality risk (CFR) is an important tool. This quantifies the proportion of cases that result in death. Throughout the pandemic, CFR amongst care home residents in England has been monitored closely. To estimate CFR, we apply both novel and existing methods to data on deaths in care homes, collected by Public Health England and the Care Quality Commission. We compare these different methods, evaluating their relative strengths and weaknesses. Using these methods, we estimate temporal trends in the instantaneous CFR (at both daily and weekly resolutions) and the overall CFR across the whole of England, and dis-aggregated at regional level. We also investigate how the CFR varies based on age and on the type of care required, dis-aggregating by whether care homes include nursing staff and by age of residents. This work has contributed to the summary of measures used for monitoring the UK epidemic. During an epidemic, the case fatality risk (CFR), i.e. the probability that an individual dies after testing positive for a disease, is a key parameter informing the public health response. However, calculating the CFR is not trivial, since there are cases who may die in the future but have not died yet. Therefore, statistical methods are required to correct for the distribution of times between testing positive and dying. In this paper, we derive multiple methods, some existing and some novel, within a consistent methodological framework. This allows us to understand how these different approaches are related and their relative strengths and weaknesses. During the COVID-19 pandemic, care homes have been particularly affected, due to the high risk of COVID-19-associated mortality in the frail and elderly. We apply our CFR methods to data from English care homes to analyse changes in the care home CFR throughout the pandemic.
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Sorci G, Faivre B. Age-dependent virulence of human pathogens. PLoS Pathog 2022; 18:e1010866. [PMID: 36137159 PMCID: PMC9531802 DOI: 10.1371/journal.ppat.1010866] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/04/2022] [Accepted: 09/08/2022] [Indexed: 11/19/2022] Open
Abstract
Host age is often evoked as an intrinsic factor aggravating the outcome of host-pathogen interactions. However, the shape of the relationship between age and infection-induced mortality might differ among pathogens, with specific clinical and ecological traits making some pathogens more likely to exert higher mortality in older hosts. Here, we used a large dataset on age-specific case fatality rate (CFR) of 28 human infectious diseases to investigate i) whether age is consistently associated to increased CFR, ii) whether pathogen characteristics might explain higher CFR in older adults. We found that, for most of the infectious diseases considered here, CFR slightly decreased during the first years of life and then steeply increased in older adults. Pathogens inducing diseases with long-lasting symptoms had the steepest increase of age-dependent CFR. Similarly, bacterial diseases and emerging viruses were associated with increasing mortality risk in the oldest age classes. On the contrary, we did not find evidence suggesting that systemic infections have steeper slopes between CFR and age; similarly, the relationship between age and CFR did not differ according to the pathogen transmission mode. Overall, our analysis shows that age is a key trait affecting infection-induced mortality rate in humans, and that the extent of the aggravating effect on older adults depends on some key traits, such as the duration of illness. Mortality due to infectious diseases varies tremendously among infectious agents, with some pathogens producing no mortality, and others being often associated with a fatal outcome. Such variability depends on characteristics of the pathogen, the host and the environment where hosts and pathogens interact. Age is one of the main host traits that accounts for differences in infection-induced mortality (with mortality being higher at the extremes of the age spectrum). Here, we used a large dataset on 28 human infectious diseases to explore the clinical and ecological traits that might account for differences in age-specific mortality risk. We found that pathogens producing long-lasting disease symptoms exert the highest mortality risk in the older adults. Similarly, emerging pathogens are also associated with higher mortality risk in the oldest age classes. These results confirm that age is a key trait affecting infection-induced mortality rate in humans, and show that the extent of the aggravating effect in older adults depends on some key traits, such as the duration of illness.
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Affiliation(s)
- Gabriele Sorci
- Biogéosciences, UMR 6282 CNRS, Université de Bourgogne Franche-Comté, Dijon, France
- * E-mail:
| | - Bruno Faivre
- Biogéosciences, UMR 6282 CNRS, Université de Bourgogne Franche-Comté, Dijon, France
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Neumayer E, Plümper T. Does ‘Data fudging’ explain the autocratic advantage? Evidence from the gap between Official Covid-19 mortality and excess mortality. SSM Popul Health 2022; 19:101247. [PMID: 36199983 PMCID: PMC9523905 DOI: 10.1016/j.ssmph.2022.101247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 09/29/2022] [Accepted: 09/29/2022] [Indexed: 11/19/2022] Open
Abstract
Governments can underreport Covid-19 mortality to make their performance appear more successful than it is. Autocracies are more likely to ‘fudge’ these data since many autocratic regimes restrict media freedom and thus can prevent domestic media from reporting evidence of undercounting deaths. Autocracies also enjoy greater leverage over reporting health authorities to either fudge data or adopt restrictive definitions of what constitutes Covid-19 mortality. Controlling for other factors that explain official Covid-19 mortality, excess mortality and the difference between the two, our results suggest that any apparent ‘autocratic advantage’ in fighting the pandemic is likely to only exist in official Covid-19 mortality. Analyzing the gap between excess mortality and official Covid-19 mortality we find that autocracies on average have a larger gap between official Covid-19 mortality data and excess mortality data, which points towards ‘autocratic data fudging’ of their official Covid-19 mortality statistics.
Autocracies have greater incentives and opportunity to underreport Covid-19 mortality. Excess mortality provides a check on the reliability of official Covid-19 mortality. Autocracies seemingly experience lower official Covid-19 mortality rates. Autocracies exhibit a larger gap between excess and reported Covid-19 mortality. More autocratic countries are more likely to ‘fudge’ their Covid-19 mortality data.
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Affiliation(s)
- Eric Neumayer
- Department of Geography & Environment, London School of Economics and Political Science (LSE), London, UK
- Corresponding author.
| | - Thomas Plümper
- Department of Socioeconomics, Vienna University of Economics and Business, Vienna, Austria
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Althobaity Y, Wu J, Tildesley MJ. A comparative analysis of epidemiological characteristics of MERS-CoV and SARS-CoV-2 in Saudi Arabia. Infect Dis Model 2022; 7:473-485. [PMID: 35938094 PMCID: PMC9343745 DOI: 10.1016/j.idm.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/24/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
In this study, we determine and compare the incubation duration, serial interval, pre-symptomatic transmission, and case fatality rate of MERS-CoV and COVID-19 in Saudi Arabia based on contact tracing data we acquired in Saudi Arabia. The date of infection and infector-infectee pairings are deduced from travel history to Saudi Arabia or exposure to confirmed cases. The incubation times and serial intervals are estimated using parametric models accounting for exposure interval censoring. Our estimations show that MERS-CoV has a mean incubation time of 7.21 (95% CI: 6.59-7.85) days, whereas COVID-19 (for the circulating strain in the study period) has a mean incubation period of 5.43(95% CI: 4.81-6.11) days. MERS-CoV has an estimated serial interval of 14.13(95% CI: 13.9-14.7) days, while COVID-19 has an estimated serial interval of 5.1(95% CI: 5.0-5.5) days. The COVID-19 serial interval is found to be shorter than the incubation time, indicating that pre-symptomatic transmission may occur in a significant fraction of transmission events. We conclude that during the COVID-19 wave studied, at least 75% of transmission happened prior to the onset of symptoms. The CFR for MERS-CoV is estimated to be 38.1% (95% CI: 36.8-39.5), while the CFR for COVID-19 1.67% (95% CI: 1.63-1.71). This work is expected to help design future surveillance and intervention program targeted at specific respiratory virus outbreaks, and have implications for contingency planning for future coronavirus outbreaks.
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Affiliation(s)
- Yehya Althobaity
- The Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom
- Department of Mathematics, Taif University, Taif, P. O. Box 11099, Saudi Arabia
| | - Jianhong Wu
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, Ontario, M3J 1P3, Canada
| | - Michael J. Tildesley
- The Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom
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Lajunen T, Gaygısız E, Gaygısız Ü. Socio-cultural Correlates of the COVID-19 Outcomes. J Epidemiol Glob Health 2022; 12:328-339. [PMID: 35997899 PMCID: PMC9395878 DOI: 10.1007/s44197-022-00055-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 08/10/2022] [Indexed: 11/03/2022] Open
Abstract
While basically all countries have been hit by the COVID-19 pandemic, the impact has varied in large degrees among countries. In the present study, national differences in six COVID-19 indicators (COVID-19 deaths per capita, excess mortality, change in GDP per capita, vaccination rate, stringency index, and overall impact of the pandemic) were studied in relation to socio-economic and Hofstede's cultural dimensions by using the latest data available. The results differed to some degree from the studies conducted in the earlier stage of the pandemic. COVID-19 deaths per capita were predicted by Uncertainty Avoidance (UA) and Indulgence (IVR); excess mortality by UA; the impact of pandemics by Power Distance (PDI), Long-term Orientation (LTOWS) and IVR; change in GDP per capita by PDI; vaccination rate by Individualism and UA; and Stringency Index by LTOWS. In addition to further clarifying the role of cultural dimensions in the pandemic, three conclusions can be drawn. First, the pandemic reached different countries at different times, which is reflected in the results. The conclusion about the role of socio-economic and cultural factors can be drawn only after the pandemic. Second, cultural dimensions were related to COVID-19 measures only when socio-economic indicators were not considered but lost their significance when socio-economic variables were entered into the models. Cultural dimensions influence the outcome variables via socio-economic factors. Third, earlier studies have focused mainly on COVID-19 deaths. The impact of the COVID-19 pandemic is a complex phenomenon and cannot be reduced to the death rate.
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Affiliation(s)
- Timo Lajunen
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Esma Gaygısız
- Department of Economics, Middle East Technical University, Ankara, Turkey
| | - Ümmügülsüm Gaygısız
- Department of Anesthesia Intensive Care, Faculty of Medicine, Gazi University, 06560, Ankara, Turkey
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Abstract
The COVID-19 pandemic has resulted in unprecedented numbers of critically ill patients. Critical care providers have been challenged to increase the capacity for critical care, prevent the spread of syndrome coronavirus 2 in hospitals, determine the optimal treatment approaches for patients with critical COVID-19, and to design and implement systems for fair allocation of scarce life-saving resources when capacity is exhausted. The global burden of COVID-19 highlighted disparities, across geographic regions and among minority patient populations. Faced with a novel pathogen, critical care providers grappled with the extent to which conventional supportive critical care practices should be followed versus adapted to treat patients with COVID-19. Fiercely debated practices included the use of awake prone positioning, the timing of intubation, and optimal approach to sedation. Advances in clinical trial design were necessary to rapidly identify appropriate therapeutics for the critically ill patient with COVID-19. In this article, we review the epidemiology, outcomes, and treatments for the critically ill patient with COVID-19.
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Affiliation(s)
- Matthew K Hensley
- Department of Internal Medicine, Division of Pulmonary and Critical Care, University of Pittsburgh Medical Center, 5200 Centre Avenue, Suite 610, Pittsburgh, PA 15232, USA.
| | - Hallie C Prescott
- Department of Internal Medicine, University of Michigan, NCRC Building 16, Room 341E / 2800 Plymouth Road, Ann Arbor, MI 48109-2800, USA; VA Center for Clinical Management Research, HSR&D Center of Innovation, Ann Arbor, MI, USA. https://twitter.com/HalliePrescott
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50
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Ma MZ. Heightened religiosity proactively and reactively responds to the COVID-19 pandemic across the globe: Novel insights from the parasite-stress theory of sociality and the behavioral immune system theory. INTERNATIONAL JOURNAL OF INTERCULTURAL RELATIONS : IJIR 2022; 90:38-56. [PMID: 35855693 PMCID: PMC9276875 DOI: 10.1016/j.ijintrel.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 07/05/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
According to the parasite-stress theory of sociality and the behavioral immune system theory, heightened religiosity serves an anti-pathogen function by promoting in-group assortative sociality. Thus, highly religious countries/territories could have better control of the COVID-19 (proactively avoids disease-threat), and heightened COVID-19 threat could increase religiosity (reactively responds to disease-threat). As expected, country-level religiosity (religion-related online searches (Allah, Buddhism, Jesus, etc.) and number of total religions/ethnoreligions) negatively and significantly predicted COVID-19 severity (a composite index of COVID-19 susceptibility, reproductive rate, morbidity, and mortality rates) (Study 1a), after accounting for covariates (e.g., socioeconomic factors, ecological factors, collectivism index, cultural tightness-looseness index, COVID-19 policy response, test-to-case ratio). Moreover, multilevel analysis accounting for daily- (e.g., time-trend effect, season) and macro-level (same as in Study 1a) covariates showed that country-level religious searches, compared with the number of total religions/ethnoreligions, were more robust in negatively and significantly predicting daily-level COVID-19 severity during early pandemic stages (Study 1b). At weekly level, perceived coronavirus threat measured with coronavirus-related searches (corona, covid, covid-19, etc.), compared with actual COVID-19 threat measured with epidemiological data, showed larger effects in positively predicting religious searches (Study 2), after accounting for weekly- (e.g., autocorrelation, time-trend effect, season, religious holidays, major-illness-related searches) and macro-level (e.g., Christian-majority country/territory and all country-level variables in Study 1) covariates. Accordingly, heightened religiosity could proactively and reactively respond to the COVID-19 pandemic across the globe.
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Affiliation(s)
- Mac Zewei Ma
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
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