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THE BMJ
Authors Peter Doshi
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NATURE
Authors Philipp Sprengholz; Luca Henkel
Authors Elisabeth Mahase
Authors Adele Waters
THE NEW ENGLAND JOURNAL OF MEDICINE
Authors Peter W. Marks, Hilary D. Marston, Lindsey R. Baden
Authors Jocalyn Clark
Authors Ying Sun, Yin Wu, Suiqiong Fan, Tiffany Dal Santo, Letong Li, Xiaowen Jiang, Kexin Li, Yutong Wang, Amina Tasleem, Ankur Krishnan, Chen He, Olivia Bonardi, Jill T Boruff, Danielle B Rice, Sarah Markham, Brooke Levis, Marleine Azar, Ian Thombs-Vite, Dipika Neupane, Branka Agic, Christine Fahim, Michael S Martin, Sanjeev Sockalingam, Gustavo Turecki, Andrea Benedetti, Brett D Thombs
Abstract Objective To synthesise results of mental health outcomes in cohorts before and during the covid-19 pandemic. Design Systematic review. Data sources Medline, PsycINFO, CINAHL, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, medRxiv, and Open Science Framework Preprints. Eligibility criteria for selecting studies Studies comparing general mental health, anxiety symptoms, or depression symptoms assessed from 1 January 2020 or later with outcomes collected from 1 January 2018 to 31 December 2019 in any population, and comprising ≥90% of the same participants before and during the covid-19 pandemic or using statistical methods to account for missing data. Restricted maximum likelihood random effects meta-analyses (worse covid-19 outcomes representing positive change) were performed. Risk of bias was assessed using an adapted Joanna Briggs Institute Checklist for Prevalence Studies. Results As of 11 April 2022, 94 411 unique titles and abstracts including 137 unique studies from 134 cohorts were reviewed. Most of the studies were from high income (n=105, 77%) or upper middle income (n=28, 20%) countries. Among general population studies, no changes were found for general mental health (standardised mean difference (SMD)change 0.11, 95% confidence interval −0.00 to 0.22) or anxiety symptoms (0.05, −0.04 to 0.13), but depression symptoms worsened minimally (0.12, 0.01 to 0.24). Among women or female participants, general mental health (0.22, 0.08 to 0.35), anxiety symptoms (0.20, 0.12 to 0.29), and depression symptoms (0.22, 0.05 to 0.40) worsened by minimal to small amounts. In 27 other analyses across outcome domains among subgroups other than women or female participants, five analyses suggested that symptoms worsened by minimal or small amounts, and two suggested minimal or small improvements. No other subgroup experienced changes across all outcome domains. In three studies with data from March to April 2020 and late 2020, symptoms were unchanged from pre-covid-19 levels at both assessments or increased initially then returned to pre-covid-19 levels. Substantial heterogeneity and risk of bias were present across analyses. Conclusions High risk of bias in many studies and substantial heterogeneity suggest caution in interpreting results. Nonetheless, most symptom change estimates for general mental health, anxiety symptoms, and depression symptoms were close to zero and not statistically significant, and significant changes were of minimal to small magnitudes. Small negative changes occurred for women or female participants in all domains. The authors will update the results of this systematic review as more evidence accrues, with study results posted online (https://www.depressd.ca/covid-19-mental-health).
THE LANCET
Authors Richard M Carpiano, Timothy Callaghan, Renee DiResta, Noel T Brewer, Chelsea Clinton, Alison P Galvani, Rekha Lakshmanan, Wendy E Parmet, Saad B Omer, Alison M Buttenheim, Regina M Benjamin, Arthur Caplan, Jad A Elharake, Lisa C Flowers, Yvonne A Maldonado, Michelle M Mello, Douglas J Opel, Daniel A Salmon, Jason L Schwartz, Joshua M Sharfstein, Peter J Hotez
Authors Eleonora Genovese, Kathleen R. Page, Johann Cailhol, Yves Jackson
JAMA
Authors Melissa Suran
Authors Lili Li, Araz Taeihagh, Si Ying Tan
Abstract Most governments have enacted physical or social distancing measures to control COVID-19 transmission. Yet little is known about the socio-economic trade-offs of these measures, especially for vulnerable populations, who are exposed to increased risks and are susceptible to adverse health outcomes. To examine the impacts of physical distancing measures on the most vulnerable in society, this scoping review screened 39,816 records and synthesised results from 265 studies worldwide documenting the negative impacts of physical distancing on older people, children/students, low-income populations, migrant workers, people in prison, people with disabilities, sex workers, victims of domestic violence, refugees, ethnic minorities, and people from sexual and gender minorities. We show that prolonged loneliness, mental distress, unemployment, income loss, food insecurity, widened inequality and disruption of access to social support and health services were unintended consequences of physical distancing that impacted these vulnerable groups and highlight that physical distancing measures exacerbated the vulnerabilities of different vulnerable populations.
Authors Guiqing He, Jeffery A Jones, Wenjie Sun
Authors Tamara Giles-Vernick, Phaik Yeong Cheah, Gustavo Matta, Nisia Trindade Lima
Authors Lawrence O Gostin, Eric A Friedman, Sara Hossain, Joia Mukherjee, Saman Zia-Zarifi, Chelsea Clinton, Umunyana Rugege, Paulo Buss, Miriam Were, Ames Dhai
Authors AA.VV.
Authors The Lancet Digital Health
Authors Siwen Wang, MD; Luwei Quan, BA; Jorge E. Chavarro, ScD; Natalie Slopen, ScD; Laura D. Kubzansky, PhD; Karestan C. Koenen, PhD; Jae Hee Kang, ScD; Marc G. Weisskopf, PhD; Westyn Branch-Elliman, MD; Andrea L. Roberts, PhD
Authors Kamran Abbasi
Authors Heidi J. Larson, Emmanuela Gakidou, Christopher J.L. Murray
Authors Joseph A. Grubenhoff, Beau A. Carubia
Authors Stacey A. Fedewa, Jessica Star, Priti Bandi, Adair Minihan, Xuesong Han, K. Robin Yabroff, Ahmedin Jemal
Abstract Importance Health care was disrupted in the US during the first quarter of 2020 with the emergence of the COVID-19 pandemic. Early reports in selected samples suggested that cancer screening services decreased greatly, but population-based estimates of cancer screening prevalence during 2020 have not yet been reported. Objective To examine changes in breast cancer (BC), cervical cancer (CC), and colorectal cancer (CRC) screening prevalence with contemporary national, population-based Behavioral Risk Factor Surveillance System (BRFSS) data. Design, Setting, and Participants This survey study included respondents from the 2014, 2016, 2018, and 2020 BRFSS surveys who were eligible for BC (women aged 50-74 years), CC (women aged 25-64 years), and CRC (women and men aged 50-75 years) screening. Data analysis was performed from September 2021 to February 2022. Exposures Calendar year. Main Outcomes and Measures Self-reported receipt of a recent (defined as in the past year) BC, CC, and CRC screening test. Adjusted prevalence ratios (aPRs) comparing 2020 vs 2018 prevalence and 95% CIs were computed. Results In total, 479 248 individuals were included in the analyses of BC screening, 301 453 individuals were included in CC screening, and 854 210 individuals were included in CRC screening, In 2020, among respondents aged 50 to 75 years, 14 815 (11.4%) were Black, 12 081 (12.6%) were Hispanic, 156 198 (67.3%) were White, and 79 234 (29.9%) graduated from college (all percentages are weighted). After 4 years (2014-2018) of nearly steady prevalence, past-year BC screening decreased by 6% between 2018 and 2020 (from 61.6% in 2018 to 57.8% in 2020; aPR, 0.94; 95% CI, 0.92-0.96), and CC screening decreased by 11% (from 58.3% in 2018 to 51.9% in 2020; aPR, 0.89; 95% CI, 0.87-0.91). The magnitude of these decreases was greater in people with lower educational attainment and Hispanic persons. CRC screening prevalence remained steady; past-year stool testing increased by 7% (aPR, 1.07; 95% CI, 1.02-1.12), offsetting a 16% decrease in colonoscopy (aPR, 0.84; 95% CI, 0.82-0.88) between 2018 and 2020. Conclusions and Relevance In this survey study, stool testing increased and counterbalanced a decrease in colonoscopy during 2020, and BC and CC screening modestly decreased. How these findings might be associated with outcomes is not yet known, but they will be important to monitor, especially in populations with lower socioeconomic status, who experienced greater screening decreases during the COVID-19 pandemic.
Authors Holly Else
Authors Alexandra L. Phelan
Authors The Lancet Public Health
Authors William M. Sage, Y. Tony Yang
Authors Nobuyuki Horita, Sho Moriguchi
Authors Sam Egger, Garry Egger
Authors Jonathan Campion, Afzal Javed, Crick Lund, Norman Sartorius, Shekhar Saxena, Michael Marmot, John Allan, Pichet Udomratn
Authors Jennifer B. Nuzzo, Lawrence O. Gostin
Authors Ezekiel J. Emanuel, Michael Osterholm, Celine R. Gounder
Authors Stephan Zipfel, Ulrike Schmidt, Katrin E Giel
Authors Nazrul Islam, Dmitri A Jdanov,Vladimir M Shkolnikov,Kamlesh Khunti, Ichiro Kawachi, Martin White, Sarah Lewington,Ben Lacey
Abstract Objective To estimate the changes in life expectancy and years of life lost in 2020 associated with the covid-19 pandemic. Design Time series analysis. Setting 37 upper-middle and high income countries or regions with reliable and complete mortality data. Participants Annual all cause mortality data from the Human Mortality Database for 2005-20, harmonised and disaggregated by age and sex. Main outcome measures Reduction in life expectancy was estimated as the difference between observed and expected life expectancy in 2020 using the Lee-Carter model. Excess years of life lost were estimated as the difference between the observed and expected years of life lost in 2020 using the World Health Organization standard life table. Results Reduction in life expectancy in men and women was observed in all the countries studied except New Zealand, Taiwan, and Norway, where there was a gain in life expectancy in 2020. No evidence was found of a change in life expectancy in Denmark, Iceland, and South Korea. The highest reduction in life expectancy was observed in Russia (men: −2.33, 95% confidence interval −2.50 to −2.17; women: −2.14, −2.25 to −2.03), the United States (men: −2.27, −2.39 to −2.15; women: −1.61, −1.70 to −1.51), Bulgaria (men: −1.96, −2.11 to −1.81; women: −1.37, −1.74 to −1.01), Lithuania (men: −1.83, −2.07 to −1.59; women: −1.21, −1.36 to −1.05), Chile (men: −1.64, −1.97 to −1.32; women: −0.88, −1.28 to −0.50), and Spain (men: −1.35, −1.53 to −1.18; women: −1.13, −1.37 to −0.90). Years of life lost in 2020 were higher than expected in all countries except Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea. In the remaining 31 countries, more than 222 million years of life were lost in 2020, which is 28.1 million (95% confidence interval 26.8m to 29.5m) years of life lost more than expected (17.3 million (16.8m to 17.8m) in men and 10.8 million (10.4m to 11.3m) in women). The highest excess years of life lost per 100 000 population were observed in Bulgaria (men: 7260, 95% confidence interval 6820 to 7710; women: 3730, 2740 to 4730), Russia (men: 7020, 6550 to 7480; women: 4760, 4530 to 4990), Lithuania (men: 5430, 4750 to 6070; women: 2640, 2310 to 2980), the US (men: 4350, 4170 to 4530; women: 2430, 2320 to 2550), Poland (men: 3830, 3540 to 4120; women: 1830, 1630 to 2040), and Hungary (men: 2770, 2490 to 3040; women: 1920, 1590 to 2240). The excess years of life lost were relatively low in people younger than 65 years, except in Russia, Bulgaria, Lithuania, and the US where the excess years of life lost was >2000 per 100 000. Conclusion More than 28 million excess years of life were lost in 2020 in 31 countries, with a higher rate in men than women. Excess years of life lost associated with the covid-19 pandemic in 2020 were more than five times higher than those associated with the seasonal influenza epidemic in 2015.
Authors David J Pinato, Josep Tabernero, Mark Bower, Lorenza Scotti, Meera Patel, Emeline Colomba, Saoirse Dolly, Angela Loizidou, John Chester, Uma Mukherjee, Alberto Zambelli, Alessia Dalla Pria, Juan Aguilar-Company, Diego Ottaviani,Amani Chowdhury, Eve Merry, Ramon Salazar, Alexia Bertuzzi, Joan Brunet, Matteo Lambertini, Marco Tagliamento, Anna Pous, Ailsa Sita-Lumsden, Krishnie Srikandarajah, Johann Colomba, Fanny Pommeret, Elia Seguí, Daniele Generali, Salvatore Grisanti, Paolo Pedrazzoli, Gianpiero Rizzo, Michela Libertini, Charlotte Moss, Joanne S Evans, Beth Russell, Nadia Harbeck, Bruno Vincenzi, Federica Biello, Rossella Bertulli, Raquel Liñan, Sabrina Rossi, Maria Carmen Carmona-García, Carlo Tondini, Laura Fox, Alice Baggi, Vittoria Fotia, Alessandro Parisi, Giampero Porzio, Maristella Saponara, Claudia Andrea Cruz, David García-Illescas, Eudald Felip, Ariadna Roqué Lloveras, Rachel Sharkey, Elisa Roldán, Roxana Reyes, Irina Earnshaw, Daniela Ferrante, Javier Marco-Hernández, Isabel Ruiz-Camps, Gianluca Gaidano, Andrea Patriarca, Riccardo Bruna, Anna Sureda, Clara Martinez-Vila, Ana Sanchez de Torre, Luca Cantini, Marco Filetti, Lorenza Rimassa, Lorenzo Chiudinelli, Michela Franchi, Marco Krengli, Armando Santoro, Aleix Prat, Mieke Van Hemelrijck, Nikolaos Diamantis, Thomas Newsom-Davis, Alessandra Gennari, Alessio Cortellini
Authors Teresa Spadea, Chiara Di Girolamo, Tania Landriscina, Olivia Leoni, Silvia Forni, Paola Colais, Caterina Fanizza, Alessandra Allotta, Roberta Onorati, Roberto Gnavi, the Mimico-19 working group
Abstract Earlier in 2020, seven Italian regions, which cover 62% of the Italian population, set up the Mimico-19 network to monitor the side effects of the restrictive measures against Covid-19 on volumes and quality of care. To this aim, we retrospectively analysed hospital discharges data, computing twelve indicators of volume and performance in three clinical areas: cardiology, oncology, and orthopaedics. Weekly indicators for the period January–July 2020 were compared with the corresponding average for 2018–2019; comparisons were performed within 3 sub-periods: pre-lockdown, lockdown, and post-lockdown. The weekly trend of hospitalisations for ST-segment elevation myocardial infarction (STEMI) showed a 40% reduction, but the proportion of STEMI patients with a primary PTCA did not significantly change from previous years. Malignant neoplasms surgery volumes differed substantially by site, with a limited reduction for lung cancer (< 20%) and greater declines (30–40%) for breast and prostate cancers. The percentage of timely surgery for femoral neck in the elderly remained constantly higher than the previous 2 years whereas hip and knee replacements fell dramatically. Hospitalisations have generally decreased, but the capacity of a timely and effective response in time-dependent pathways of care was not jeopardized throughout the period. General trends did not show important differences across regions, regardless of the different burden of Covid-19. Preventive and primary care services should adopt a pro-active approach, moving towards the identification of at-risk conditions that were neglected during the pandemic and timely addressing patients to the secondary care system.
Authors Peter Nordström, Marcel Ballin, Anna Nordström
Abstract Importance The association between COVID-19 immunity within families and the risk of infection in nonimmune family members is unknown. Objective To investigate the association between risk of COVID-19 in nonimmune individuals and the number of their family members with known immunity acquired from a previous COVID-19 infection or full vaccination (2 vaccine doses). Design, Setting, and Participants In this cohort study of data from nationwide registries in Sweden, all individuals who acquired immunity from either previous COVID-19 infection or full vaccination until May 26, 2021, were considered for inclusion. Each person with immunity was matched 1:1 to an individual without immunity from an identified cohort of individuals with families comprising 2 to 5 members. Exposures Number of immune family members in each family on April 14, 2021 (index date), who acquired immunity from a previous COVID-19 infection or full vaccination (2 doses of the mRNA-1273, BNT162b2 mRNA, or ChAdOx1 nCoV-19 vaccine). Main Outcomes and Measures Incident COVID-19 infection in nonimmune family members from April 15 to May 26, 2021. Results A total of 1 789 728 individuals from 814 806 families were included in the analysis. Each family comprised 2 to 5 family members, with a mean (SD) age at baseline of 51.3 (19.5) years. During a mean (range) follow-up time of 26.3 (1-40) days, 88 797 of 1 549 989 (5.7%) nonimmune family members (mean [SD] age, 51.6 [17.7] years; 790 276 men [51.0%]) were diagnosed with COVID-19. There was an inverse dose-response association between the number of immune members in each family and the risk of incident COVID-19 infection in nonimmune family members. Nonimmune families with 1 immune family member had a 45% to 61% lower risk of contracting COVID-19 (hazard ratio [HR], 0.39-0.55; 95% CI, 0.37-0.61, P < .001). The risk reduction increased to 75% to 86% in families with 2 immune family members (HR, 0.14-0.25; 95% CI, 0.11-0.27; P < .001), 91% to 94% with 3 immune family members (HR, 0.06-0.09; 95% CI, 0.04-0.10; P < .001), and 97% with 4 immune family members (HR, 0.03; 95% CI, 0.02-0.05; P < .001). The results were similar for the outcome of COVID-19 infection that was severe enough to warrant a hospital stay. Conclusions and Relevance In this cohort study, family members without immunity had a 45% to 97% lower risk of contracting COVID-19 as the number of immune family members increased. Vaccination is a key strategy for decreasing the transmission of the virus within families.
Authors Jarmo S. Kikstra, Adriano Vinca, Francesco Lovat, Benigna Boza-Kiss, Bas van Ruijven, Charlie Wilson, Joeri Rogelj, Behnam Zakeri, Oliver Fricko, Keywan Riahi
Abstract The COVID-19 pandemic caused radical temporary breaks with past energy use trends. How post-pandemic recovery will impact the longer-term energy transition is unclear. Here we present a set of global COVID-19 shock-and-recovery scenarios that systematically explore the effect of demand changes persisting. Our pathways project final energy demand reductions of 1–36 EJ yr−1 by 2025 and cumulative CO2 emission reductions of 14–45 GtCO2 by 2030. Uncertainty ranges depend on the depth and duration of the economic downturn and demand-side changes. Recovering from the pandemic with energy-efficient practices embedded in new patterns of travel, work, consumption and production reduces climate mitigation challenges. A low energy demand recovery reduces carbon prices for a 1.5 °C-consistent pathway by 19%, lowers energy supply investments until 2030 by US$1.8 trillion and softens the pressure to rapidly upscale renewable energy technologies.
Authors COVID-19 Mental Disorders Collaborators
Authors Lilia Cervantes
Authors Noel T. Brewer, Neetu Abad
Authors Rishabh Singh Chauhan, Matthew Wigginton Bhagat-Conway, Denise Capasso da Silva, Deborah Salon, Ali Shamshiripour, Ehsan Rahimi, Sara Khoeini, Abolfazl (Kouros) Mohammadian, Sybil Derrible, Ram Pendyala
Abstract The COVID-19 pandemic has impacted billions of people around the world. To capture some of these impacts in the United States, we are conducting a nationwide longitudinal survey collecting information about activity and travel-related behaviors and attitudes before, during, and after the COVID-19 pandemic. The survey questions cover a wide range of topics including commuting, daily travel, air travel, working from home, online learning, shopping, and risk perception, along with attitudinal, socioeconomic, and demographic information. The survey is deployed over multiple waves to the same respondents to monitor how behaviors and attitudes evolve over time. Version 1.0 of the survey contains 8,723 responses that are publicly available. This article details the methodology adopted for the collection, cleaning, and processing of the data. In addition, the data are weighted to be representative of national and regional demographics. This survey dataset can aid researchers, policymakers, businesses, and government agencies in understanding both the extent of behavioral shifts and the likelihood that changes in behaviors will persist after COVID-19. Measurement(s) travel-related behavior • travel-related attitude Technology Type(s) Survey Factor Type(s) temporal interval Sample Characteristic - Organism Homo sapiens Sample Characteristic - Location United States of America Machine-accessible metadata file describing the reported data: https://doi.org/10.6084/m9.figshare.15141945
Authors Claudia Mazzuca, Ilenia Falcinelli, Arthur-Henri Michalland, Luca Tummolini, Anna M. Borghi
Abstract Several studies have highlighted the flexible character of our conceptual system. However, less is known about the construction of meaning and the impact of novel concepts on the structuring of our conceptual space. We addressed these questions by collecting free listing data from Italian participants on a newly–and yet nowadays critical–introduced concept, i.e., COVID-19, during the first Italian lockdown. We also collected data for other five illness-related concepts. Our results show that COVID-19’s representation is mostly couched in the emotional sphere, predominantly evoking fear—linked to both possible health-related concerns and social-emotional ones. In contrast with initial public debates we found that participants did not assimilate COVID-19 neither completely to severe illnesses (e.g., tumor) nor completely to mild illnesses (e.g., flu). Moreover, we also found that COVID-19 has shaped conceptual relations of other concepts in the illness domain, making certain features and associations more salient (e.g., flu-fear; disease-mask). Overall, our results show for the first time how a novel, real concept molds existing conceptual relations, testifying the malleability of our conceptual system.
Authors Samreen Malik, Benedikt Mihm, Malte Reichelt
Authors Susan J. Woolford, Margo Sidell, Xia Li, Veronica Else, Deborah R. Young, Ken Resnicow, Corinna Koebnick
Authors Stefan Moritz, Cornelia Gottschick, Johannes Horn, Mario Popp, Susan Langer, Bianca Klee, Oliver Purschke, Michael Gekle, Angelika Ihling, Frank D. L. Zimmermann, Rafael Mikolajczyk
Nearly all mass gathering events worldwide were banned at the beginning of the COVID-19 pandemic, as they were suspected of presenting a considerable risk for the transmission of SARS-CoV-2. We investigated the risk of transmitting SARS-CoV-2 by droplets and aerosols during an experimental indoor mass gathering event under three different hygiene practices, and used the data in a simulation study to estimate the resulting burden of disease under conditions of controlled epidemics. Our results show that the mean number of measured direct contacts per visitor was nine persons and this can be reduced substantially by appropriate hygiene practices. A comparison of two versions of ventilation with different air exchange rates and different airflows found that the system which performed worst allowed a ten-fold increase in the number of individuals exposed to infectious aerosols. The overall burden of infections resulting from indoor mass gatherings depends largely on the quality of the ventilation system and the hygiene practices. Presuming an effective ventilation system, indoor mass gathering events with suitable hygiene practices have a very small, if any, effect on epidemic spread.
Authors Praveen Suthaharan, Erin J. Reed, Pantelis Leptourgos, Joshua G. Kenney, Stefan Uddenberg, Christoph D. Mathys, Leib Litman, Jonathan Robinson, Aaron J. Moss, Jane R. Taylor, Stephanie M. Groman, Philip R. Corlett
Abstract The COVID-19 pandemic has made the world seem less predictable. Such crises can lead people to feel that others are a threat. Here, we show that the initial phase of the pandemic in 2020 increased individuals’ paranoia and made their belief updating more erratic. A proactive lockdown made people’s belief updating less capricious. However, state-mandated mask-wearing increased paranoia and induced more erratic behaviour. This was most evident in states where adherence to mask-wearing rules was poor but where rule following is typically more common. Computational analyses of participant behaviour suggested that people with higher paranoia expected the task to be more unstable. People who were more paranoid endorsed conspiracies about mask-wearing and potential vaccines and the QAnon conspiracy theories. These beliefs were associated with erratic task behaviour and changed priors. Taken together, we found that real-world uncertainty increases paranoia and influences laboratory task behaviour.
Authors Benedetta Vai, Mario Gennaro Mazza, Claudia Delli Colli, Marianne Foiselle, Bennett Allen, Francesco Benedetti, Alessandra Borsini, Marisa Casanova Dias, Ryad Tamouza, Marion Leboyer, Michael E Benros, Igor Branchi, Paolo Fusar-Poli, Livia J De Picker
Authors David CG Skegg, Philip C Hill
Authors Fiona Godlee
Authors Cassandra Willyard
Authors Cassandra Willjard
MEDRXIV
Authors Amy Gimma, James D Munday, Kerry LM Wong, Pietro Coletti, Kevin van Zandvoort, Kiesha Prem, CMMID COVID-19 working group, Petra Klepac, G. James Rubin, Sebastian Funk, W John Edmunds, Christopher I Jarvis
Abstract Background During the COVID-19 pandemic, the UK government imposed public health policies in England to reduce social contacts in hopes of curbing virus transmission. We measured contact patterns weekly from March 2020 to March 2021 to estimate the impact of these policies, covering three national lockdowns interspersed by periods of lower restrictions. Methods Data were collected using online surveys of representative samples of the UK population by age and gender. We calculated the mean daily contacts reported using a (clustered) bootstrap and fitted a censored negative binomial model to estimate age-stratified contact matrices and estimate proportional changes to the basic reproduction number under controlled conditions using the change in contacts as a scaling factor. Results The survey recorded 101,350 observations from 19,914 participants who reported 466,710 contacts over 53 weeks. Contact patterns changed over time and by participants’ age, personal risk factors, and perception of risk. The mean of reported contacts among adults have reduced compared to previous surveys with adults aged 18 to 59 reporting a mean of 2.39 (95% CI 2.20 - 2.60) contacts to 4.93 (95% CI 4.65 - 5.19) contacts, and the mean contacts for school-age children was 3.07 (95% CI 2.89 - 3.27) to 15.11 (95% CI 13.87 - 16.41). The use of face coverings outside the home has remained high since the government mandated use in some settings in July 2020. Conclusions The CoMix survey provides a unique longitudinal data set for a full year since the first lockdown for use in statistical analyses and mathematical modelling of COVID-19 and other diseases. Recorded contacts reduced dramatically compared to pre-pandemic levels, with changes correlated to government interventions throughout the pandemic. Despite easing of restrictions in the summer of 2020, mean reported contacts only returned to about half of that observed pre-pandemic.
Authors Gertrud Sofie Hafstad, Else-Marie Augusti
Authors Stéphane Horel, Ties Keyzer
Authors Peter J. Hotez, K. M. Venkat Narayan
Authors Hayley S. Thompson, Mark Manning, Jamie Mitchell, Seongho Kim, Felicity W. K. Harper, PhD; Sheena Cresswell, Kristopher Johns, Shoma Pal, Brittany Dowe, Madiha Tariq, Nadia Sayed, Lisa M. Saigh, Lisa Rutledge, Curtis Lipscomb, Jametta Y. Lilly, Heidi Gustine, Annie Sanders, Megan Landry; Bertram Marks
Abstract Importance The impact of COVID-19 in the US has been far-reaching and devastating, especially in Black populations. Vaccination is a critical part of controlling community spread, but vaccine acceptance has varied, with some research reporting that Black individuals in the US are less willing to be vaccinated than other racial/ethnic groups. Medical mistrust informed by experiences of racism may be associated with this lower willingness. Objective To examine the association between race/ethnicity and rejection of COVID-19 vaccine trial participation and vaccine uptake and to investigate whether racial/ethnic group–based medical mistrust is a potential mediator of this association. Design, Setting, and Participants This cross-sectional survey study was conducted from June to December 2020 using a convenience sample of 1835 adults aged 18 years or older residing in Michigan. Participants were recruited through community-based organizations and hospital-academic networks. Main Outcomes and Measures Separate items assessed whether respondents, if asked, would agree to participate in a research study to test a COVID-19 vaccine or to receive a COVID-19 vaccine. Participants also completed the suspicion subscale of the Group-Based Medical Mistrust Scale. Results Of the 1835 participants, 1455 (79%) were women, 361 (20%) men, and 19 (1%) other gender. The mean (SD) age was 49.4 (17.9) years, and 394 participants (21%) identified as Black individuals. Overall, 1376 participants (75%) reported low willingness to participate in vaccine trials, and 945 (52%) reported low willingness to be vaccinated. Black participants reported the highest medical mistrust scores (mean [SD], 2.35 [0.96]) compared with other racial/ethnic groups (mean [SD] for the total sample, 1.83 [0.91]). Analysis of path models revealed significantly greater vaccine trial and vaccine uptake rejection among Black participants (vaccine trial: B [SE], 0.51 [0.08]; vaccine uptake: B [SE], 0.51 [0.08]; both P < .001) compared with the overall mean rejection. The association was partially mediated by medical mistrust among Black participants (vaccine trial: B [SE], 0.04 [0.01]; P = .003; vaccine uptake: B [SE], 0.07 [0.02]; P < .001) and White participants (vaccine trial: B [SE], −0.06 [0.02]; P = .001; vaccine uptake: B [SE], −0.10 [0.02]; P < .001). Conclusions and Relevance In this survey study of US adults, racial/ethnic group–based medical mistrust partially mediated the association between individuals identifying as Black and low rates of acceptance of COVID-19 vaccine trial participation and actual vaccination. The findings suggest that partnerships between health care and other sectors to build trust and promote vaccination may benefit from socially and culturally responsive strategies that acknowledge and address racial/ethnic health care disparities and historical and contemporary experiences of racism.
Authors Andreas Martin Lisewski
Authors Danielle G. Dooley, Dimitri Christakis
Authors Mary Chris Jaklevic
Authors Jillian L. Goldfarb, Sarah Kreps, John S. Brownstein, Douglas L. Kriner
Authors David March, Kristian Metcalfe, Joaquin Tintoré, Brendan J. Godley
Abstract The COVID-19 pandemic has resulted in unparalleled global impacts on human mobility. In the ocean, ship-based activities are thought to have been impacted due to severe restrictions on human movements and changes in consumption. Here, we quantify and map global change in marine traffic during the first half of 2020. There were decreases in 70.2% of Exclusive Economic Zones but changes varied spatially and temporally in alignment with confinement measures. Global declines peaked in April, with a reduction in traffic occupancy of 1.4% and decreases found across 54.8% of the sampling units. Passenger vessels presented more marked and longer lasting decreases. A regional assessment in the Western Mediterranean Sea gave further insights regarding the pace of recovery and long-term changes. Our approach provides guidance for large-scale monitoring of the progress and potential effects of COVID-19 on vessel traffic that may subsequently influence the blue economy and ocean health.
WHO (WORLD HEALTH ORGANIZATION)
Authors WHO (WORLD HEALTH ORGANIZATION)
REUTERS
Authors RICARDO BRITO
Authors Aldo Franco De Rose, Guglielmo Mantica, Francesca Ambrosini, Rafaela Malinaric, Federica Balzarini, Riccardo Banchero, Carlo Terrone
FOX6
Authors AUSTIN WILLIAMS
Authors Rebecca K. Delaney, Amy Locke, Mandy L. Pershing, Claudia Geist, Erin Clouse, Michelle Precourt Debbink, Benjamin Haaland, Amy J. Tanner, Yoshimi Anzai, Angela Fagerlin
Abstract Importance In March 2020, US public buildings (including schools) were shut down because of the COVID-19 pandemic, and 42% of US workers resumed their employment duties from home. Some shutdowns remain in place, yet the extent of the needs of US working parents is largely unknown. Objective To identify and address the career development, work culture, and childcare needs of faculty, staff, and trainees at an academic medical center during a pandemic. Design, Setting, and Participants For this survey study, between August 5 and August 20, 2020, a Qualtrics survey was emailed to all faculty, staff, and trainees at University of Utah Health, an academic health care system that includes multiple hospitals, community clinics, and specialty centers. Participants included 27 700 University of Utah Health faculty, staff, and trainees who received a survey invitation. Data analysis was performed from August to November 2020. Main Outcomes and Measures Primary outcomes included experiences of COVID-19 and their associations with career development, work culture, and childcare needs. Results A total of 5030 participants completed the entire survey (mean [SD] age, 40 [12] years); 3738 (75%) were women; 4306 (86%) were White or European American; 561 (11%) were Latino or Latina (of any race), Black or African American, American Indian, Alaska Native, and Native Hawaiian or Pacific Islander; and 301 (6%) were Asian or Asian American. Of the participants, 2545 (51%) reported having clinical responsibilities, 2412 (48%) had at least 1 child aged 18 years or younger, 3316 (66%) were staff, 791 (16%) were faculty, and 640 (13%) were trainees. Nearly one-half of parents reported that parenting (1148 participants [49%]) and managing virtual education for children (1171 participants [50%]) were stressors. Across all participants, 1061 (21%) considered leaving the workforce, and 1505 (30%) considered reducing hours. Four hundred forty-nine faculty (55%) and 397 trainees (60%) perceived decreased productivity, and 2334 participants (47%) were worried about COVID-19 impacting their career development, with 421 trainees (64%) being highly concerned. Conclusions and Relevance In this survey of 5030 faculty, staff, and trainees of a US health system, many participants with caregiving responsibilities, particularly women, faculty, trainees, and (in a subset of cases) those from racial/ethnic groups that underrepresented in medicine, considered leaving the workforce or reducing hours and were worried about their career development related to the pandemic. It is imperative that medical centers support their employees and trainees during this challenging time.
Authors Andrew J. Giustini, Alan R. Schroeder, David M. Axelrod
Authors Michael Day
Authors Gordon Pennycook, Ziv Epstein, Mohsen Mosleh, Antonio A. Arechar, Dean Eckles, David G. Rand
Abstract In recent years, there has been a great deal of concern about the proliferation of false and misleading news on social media1,2,3,4. Academics and practitioners alike have asked why people share such misinformation, and sought solutions to reduce the sharing of misinformation5,6,7. Here, we attempt to address both of these questions. First, we find that the veracity of headlines has little effect on sharing intentions, despite having a large effect on judgments of accuracy. This dissociation suggests that sharing does not necessarily indicate belief. Nonetheless, most participants say it is important to share only accurate news. To shed light on this apparent contradiction, we carried out four survey experiments and a field experiment on Twitter; the results show that subtly shifting attention to accuracy increases the quality of news that people subsequently share. Together with additional computational analyses, these findings indicate that people often share misinformation because their attention is focused on factors other than accuracy—and therefore they fail to implement a strongly held preference for accurate sharing. Our results challenge the popular claim that people value partisanship over accuracy8,9, and provide evidence for scalable attention-based interventions that social media platforms could easily implement to counter misinformation online.
EJOG (EUROPEAN JOURNAL OF OBSTETRICS AND GYNECOLOGY)
Authors Soumya Ranjan Panda, Mahendra Meena
Authors Tamsin Ford, Ann John, David Gunnell
Authors G David Batty, Catharine R Gale
Authors Lisa M. Meeks
Authors Sarah J Lewis, Alasdair P S Munro, George Davey Smith, Allyson M Pollock
Authors Gareth Iacobucci
Authors Kathryn E Mansfield, Rohini Mathur, John Tazare, Alasdair D Henderson, Amy R Mulick, Helena Carreira, Anthony A Matthews, Patrick Bidulka, Alicia Gayle, Harriet Forbes, Sarah Cook, Angel Y S Wong, Helen Strongman, Kevin Wing, Charlotte Warren-Gash, Sharon L Cadogan, Liam Smeeth, Joseph F Hayes, Jennifer K Quint, Martin McKee, Sinéad M Langan
Authors Yousri Marzouki, Fatimah Salem Aldossari, Giuseppe A. Veltri
Abstract During the COVID-19 outbreak, lockdown measures have been deployed worldwide. In the wake of these measures, internet and social media use has reached unprecedented peaks. We hypothesize that social media can, in the context of the pandemic, be a placeholder for collective resilient processes modulated by cognitive and emotional components. An online survey (N = 1408) using a cross-sectional design was carried out over nine weeks from the beginning of March 2020 to the end of May 2020. The triangulation via SEM statistical modeling, text mining, and sentiment, discriminant, and entropy analyses revealed the granular functional role of social media use in promoting a positive perception towards stressors during the pandemic. This study provides an empirically tested theoretical framework to understand the evolution of buffering mechanisms of social media use as a result of collective resilience. Recommendations on social media use for future lockdown scenarios were provided.
Authors Lawrence O. Gostin
Authors Rebecca J. Gorges, R. Tamara Konetzka
Abstract Importance It is important to understand differences in coronavirus disease 2019 (COVID-19) deaths by nursing home racial composition and the potential reasons for these differences so that limited resources can be distributed equitably. Objective To describe differences in the number of COVID-19 deaths by nursing home racial composition and examine the factors associated with these differences. Design, Setting, and Participants This cross-sectional study of 13 312 nursing homes in the US used the Nursing Home COVID-19 Public File from the Centers for Medicare and Medicaid Services, which contains COVID-19 cases and deaths among nursing home residents as self-reported by nursing homes beginning between January 1, 2020, and May 24, 2020, and ending on September 13, 2020. Data were analyzed from July 28 to December 18, 2020. Exposures Confirmed or suspected COVID-19 infection. Confirmed cases were defined as COVID-19 infection confirmed by a diagnostic laboratory test. Suspected cases were defined as signs and/or symptoms of COVID-19 infection or patient-specific transmission-based precautions for COVID-19 infection. Main Outcomes and Measures Deaths associated with COVID-19 among nursing home residents. Death counts were compared by nursing home racial composition, which was measured as the proportion of White residents. Results Among 13 312 nursing homes included in the study, the overall mean (SD) age of residents was 79.5 (6.7) years. A total of 51 606 COVID-19–associated deaths among residents were reported, with a mean (SD) of 3.9 (8.0) deaths per facility. The mean (SD) number of deaths in nursing homes with the lowest proportion of White residents (quintile 1) vs nursing homes with the highest proportions of White residents (quintile 5) were 5.6 (9.2) and 1.7 (4.8), respectively. Facilities in quintile 1 experienced a mean (SE) of 3.9 (0.2) more deaths than those in quintile 5, representing a 3.3-fold higher number of deaths in quintile 1 compared with quintile 5. Adjustment for the number of certified beds reduced the mean (SE) difference between these 2 nursing home groups to 2.2 (0.2) deaths. Controlling for case mix measures and other nursing home characteristics did not modify this association. Adjustment for county-level COVID-19 prevalence further reduced the mean (SE) difference to 1.0 (0.2) death. Conclusions and Relevance In this study, nursing homes with the highest proportions of non-White residents experienced COVID-19 death counts that were 3.3-fold higher than those of facilities with the highest proportions of White residents. These differences were associated with factors such as larger nursing home size and higher infection burden in counties in which nursing homes with high proportions of non-White residents were located. Focusing limited available resources on facilities with high proportions of non-White residents is needed to support nursing homes during potential future outbreaks.
Authors Philip A. Pizzo, David Spiegel, Michelle M. Mello
Authors Haruka Sakamoto, Masahiro Ishikane, Cyrus Ghaznavi, Peter Ueda
Authors Zhanwei Du, Abhishek Pandey, Yuan Bai, Meagan C Fitzpatrick, Matteo Chinazzi, Ana Pastore y Piontti, Michael Lachmann, Alessandro Vespignani, Benjamin J Cowling, Alison P Galvani, Lauren Ancel Meyers
Authors Jienchi Dorward, Thokozani Khubone, Kelly Gate, Hope Ngobese, Yukteshwar Sookrajh, Siyabonga Mkhize, Aslam Jeewa, Christian Bottomley, Lara Lewis, Kathy Baisley, Christopher C Butler, Nomakhosi Gxagxisa, Nigel Garrett
Authors Dominic Arjuna Ugarte, William G. Cumberland, Lidia Flores, Sean D. Young
Authors Lynn Eaton
Authors Emily Hotez, Peter J. Hotez, Kashia A. Rosenau, Alice A. Kuo
Authors Lauren Paremoer, Sulakshana Nandi, Hani Serag, Fran Baum
Authors Marta Calbi, Nunzio Langiulli, Francesca Ferroni, Martina Montalti, Anna Kolesnikov, Vittorio Gallese, Maria Alessandra Umiltà
Abstract The COVID-19 pandemic has dramatically changed the nature of our social interactions. In order to understand how protective equipment and distancing measures influence the ability to comprehend others’ emotions and, thus, to effectively interact with others, we carried out an online study across the Italian population during the first pandemic peak. Participants were shown static facial expressions (Angry, Happy and Neutral) covered by a sanitary mask or by a scarf. They were asked to evaluate the expressed emotions as well as to assess the degree to which one would adopt physical and social distancing measures for each stimulus. Results demonstrate that, despite the covering of the lower-face, participants correctly recognized the facial expressions of emotions with a polarizing effect on emotional valence ratings found in females. Noticeably, while females’ ratings for physical and social distancing were driven by the emotional content of the stimuli, males were influenced by the “covered” condition. The results also show the impact of the pandemic on anxiety and fear experienced by participants. Taken together, our results offer novel insights on the impact of the COVID-19 pandemic on social interactions, providing a deeper understanding of the way people react to different kinds of protective face covering.
Authors Marek Kochańczyk, Tomasz Lipniacki
Abstract Countries worldwide have adopted various strategies to minimize the socio-economic impact of the ongoing COVID-19 pandemic. Stringency of imposed measures universally reflects the standpoint from which protecting public health and avoiding damage to economy are seen as contradictory objectives. Based on epidemic trajectories of 25 highly developed countries and 10 US states in the (mobility reduction)–(reproduction number) plane we showed that delay in imposition of nation-wide quarantine elevates the number of infections and deaths, surge of which inevitably has to be suppressed by stringent and sustained lockdown. As a consequence, cumulative mobility reduction and population-normalized cumulative number of COVID-19-associated deaths are significantly correlated and this correlation increases with time. Overall, we demonstrated that, as long as epidemic suppression is the aim, the trade-off between the death toll and economic loss is illusory: high death toll correlates with deep and long-lasting lockdown causing a severe economic downturn.
Authors Mark T. Hughes, Jeffrey Kahn, Allen Kachalia
Authors Katharine Van Tassel, Carmel Shachar, Sharona Hoffman
Authors Joanne Silberner
Authors Douglas Kamerow, Robert Graham
ELSEVIER
Authors Catrin Sohrabi, Ginimol Mathew, Thomas Franchi, Ahmed Kerwan, Michelle Griffin, Jennick Soleil C Del Mundo, Syed Ahsan Ali, Maliha Agha, Riaz Agh
Abstract A pneumonia outbreak of unknown aetiology emerged in Wuhan, China in December 2019. The causative organism was identified on 7th January 2020 as a novel coronavirus (nCoV or 2019-nCoV), later renamed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The resulting coronavirus disease (COVID-19) has infected over 88 million individuals, resulted in over 1.9 million deaths, and has led to an unprecedented impact on research activities worldwide. Extraordinary challenges have also been imposed on medical and surgical trainees following redeployment to full-time clinical duties. Moreover, the introduction of travel restrictions and strict lockdown measures have forced the closure of many institutions and laboratories working on research unrelated to the pandemic. The lockdown has similarly stifled supply chains and slowed research and development endeavours, whilst research charities have endured significant financial strains that have since reshaped the allocation and availability of funds. However, worldwide scientific adaptation to the COVID-19 pandemic has been observed through unprecedented levels of international collaboration alongside the uprise of remote telecommunication platforms. Although the long-term consequence of the COVID-19 pandemic on research and academic training is difficult to ascertain, the current crises will inevitably shape working and teaching patterns for years to come. To this end, we provide a comprehensive and critical evaluation of the impact of COVID-19 on scientific research and funding, as well as academic medical and surgical training.
Authors Meghan C. Halley, Talia Stanley, Jay Maturi, Aaron J. Goldenberg, Jonathan A. Bernstein, Matthew T. Wheeler, Holly K. Tabor
Abstract Purpose Patients with rare and undiagnosed diseases (RUDs) face significant health challenges, which may be exacerbated during the COVID-19 pandemic. The goal of this study was to identify specific impacts of the pandemic on RUD patients, and targets for improving support and health-care access. Methods We conducted an online survey of RUD patients and their family members from 21 April to 8 June 2020, recruited from 76 Facebook groups for RUDs. Questions assessed patient characteristics and impacts of the pandemic on RUD diagnosis and management. Results Respondents (n = 413), including 274 RUD patients and 139 family members, were predominantly female and white, though income varied. Impacts of the pandemic included (1) barriers to accessing essential health care, (2) specific impacts of restrictive COVID-19 visitation policies on ability to advocate in health-care settings, (3) uncertainty and fear regarding COVID-19 risk, (4) exacerbated physical and mental health challenges, (5) magnified impacts of reduced educational and therapeutic services, and (6) unexpected positive changes due to the pandemic. Conclusion There are specific, serious challenges affecting RUD patients and families during the COVID-19 pandemic. There is an urgent need to develop approaches to mitigate these challenges both during and beyond the pandemic.
Authors Archisman Mazumder, Kamal Bandhu Kalanidhi, Siddharth Sarkar, Piyush Ranjan, Anamika Sahu, Tanveer Kaur, Divjyot Kaur, Aakashneel Bhattacharya, Sharda Priyadarshini Suna, Bindu Prakash, Koushik Sinha Deb, Naveet Wig
A qualitative study comprising eight focus group discussions and two in-depth interviews were con- ducted to explore the social and behavioural changes in young adults during COVID pandemic. Common themes identified were changes in interpersonal and intrapersonal relationships, changes in health- related behaviour, lifestyle modifications and impact on academic and professional life.
Authors Katya Numbers, Henry Brodaty
Authors Erez Freud, Andreja Stajduhar, R. Shayna Rosenbaum, Galia Avidan, Tzvi Ganel
Abstract The unprecedented efforts to minimize the effects of the COVID-19 pandemic introduce a new arena for human face recognition in which faces are partially occluded with masks. Here, we tested the extent to which face masks change the way faces are perceived. To this end, we evaluated face processing abilities for masked and unmasked faces in a large online sample of adult observers (n = 496) using an adapted version of the Cambridge Face Memory Test, a validated measure of face perception abilities in humans. As expected, a substantial decrease in performance was found for masked faces. Importantly, the inclusion of masks also led to a qualitative change in the way masked faces are perceived. In particular, holistic processing, the hallmark of face perception, was disrupted for faces with masks, as suggested by a reduced inversion effect. Similar changes were found whether masks were included during the study or the test phases of the experiment. Together, we provide novel evidence for quantitative and qualitative alterations in the processing of masked faces that could have significant effects on daily activities and social interactions.
Authors Yoon-Hee Kang, Seunghee You, Minah Bae, Eunhye Kim, Kyuwon Son, Changhan Bae, Yoonha Kim, Byeong-Uk Kim, Hyun Cheol Kim, Soontae Kim
Authors Shaun R. McCann
Authors Kuan-Yu Pan, Almar A L Kok, Merijn Eikelenboom, Melany Horsfall, Frederike Jörg, Rob A Luteijn, Didi Rhebergen, Patricia van Oppen, Erik J Giltay, Brenda W J H Penninx
Authors Gbenga Ogedegbe, MD, MPH; Joseph Ravenell, MD; Samrachana Adhikari, PhD; Mark Butler, PhD; Tiffany Cook, MA; Fritz Francois, MD; Eduardo Iturrate, MD; Girardin Jean-Louis, PhD; Simon A. Jones, PhD; Deborah Onakomaiya, MPH; Christopher M. Petrilli, MD; Claudia Pulgarin, MS; Seann Regan, MA; Harmony Reynolds, MD; Azizi Seixas, PhD; Frank Michael Volpicelli, MD; Leora Idit Horwitz,
Abstract Importance Black and Hispanic populations have higher rates of coronavirus disease 2019 (COVID-19) hospitalization and mortality than White populations but lower in-hospital case-fatality rates. The extent to which neighborhood characteristics and comorbidity explain these disparities is unclear. Outcomes in Asian American populations have not been explored. Objective To compare COVID-19 outcomes based on race and ethnicity and assess the association of any disparities with comorbidity and neighborhood characteristics. Design, Setting, and Participants This retrospective cohort study was conducted within the New York University Langone Health system, which includes over 260 outpatient practices and 4 acute care hospitals. All patients within the system’s integrated health record who were tested for severe acute respiratory syndrome coronavirus 2 between March 1, 2020, and April 8, 2020, were identified and followed up through May 13, 2020. Data were analyzed in June 2020. Among 11 547 patients tested, outcomes were compared by race and ethnicity and examined against differences by age, sex, body mass index, comorbidity, insurance type, and neighborhood socioeconomic status. Exposures Race and ethnicity categorized using self-reported electronic health record data (ie, non-Hispanic White, non-Hispanic Black, Hispanic, Asian, and multiracial/other patients). Main Outcomes and Measures The likelihood of receiving a positive test, hospitalization, and critical illness (defined as a composite of care in the intensive care unit, use of mechanical ventilation, discharge to hospice, or death). Results Among 9722 patients (mean [SD] age, 50.7 [17.5] years; 58.8% women), 4843 (49.8%) were positive for COVID-19; 2623 (54.2%) of those were admitted for hospitalization (1047 [39.9%] White, 375 [14.3%] Black, 715 [27.3%] Hispanic, 180 [6.9%] Asian, 207 [7.9%] multiracial/other). In fully adjusted models, Black patients (odds ratio [OR], 1.3; 95% CI, 1.2-1.6) and Hispanic patients (OR, 1.5; 95% CI, 1.3-1.7) were more likely than White patients to test positive. Among those who tested positive, odds of hospitalization were similar among White, Hispanic, and Black patients, but higher among Asian (OR, 1.6, 95% CI, 1.1-2.3) and multiracial patients (OR, 1.4; 95% CI, 1.0-1.9) compared with White patients. Among those hospitalized, Black patients were less likely than White patients to have severe illness (OR, 0.6; 95% CI, 0.4-0.8) and to die or be discharged to hospice (hazard ratio, 0.7; 95% CI, 0.6-0.9). Conclusions and Relevance In this cohort study of patients in a large health system in New York City, Black and Hispanic patients were more likely, and Asian patients less likely, than White patients to test positive; once hospitalized, Black patients were less likely than White patients to have critical illness or die after adjustment for comorbidity and neighborhood characteristics. This supports the assertion that existing structural determinants pervasive in Black and Hispanic communities may explain the disproportionately higher out-of-hospital deaths due to COVID-19 infections in these populations.
OXFORD ACADEMY
Authors Ashley N Rose, James Baggs, Hannah Wolford, Melinda M Neuhauser, Arjun Srinivasan, Adi V Gundlapalli, Sujan Reddy, Lyudmyla Kompaniyets, Audrey F Pennington, Cheri Grigg, Sarah Kabbani
Abstract We described antibiotic use among inpatients with coronavirus disease 2019 (COVID-19). Most COVID-19 inpatients received antibiotic therapy. We also described hospital-wide antibiotic use during 2020 compared with 2019, stratified by hospital COVID-19 burden. Although total antibiotic use decreased between years, certain antibiotic use increased with higher COVID-19 burden.
JOURNAL OF PEDIATRIC AND ADOLESCENT GYNECOLOGY
Authors Paula J. Adams Hillard
Authors Abraar Karan
Authors Fatemeh Sadat Mirfazeli, Atiye Sarabi-Jamab, Amin Jahanbakhshi, Alireza Kordi, Parisa Javadnia, Seyed Vahid Shariat, Oldooz Aloosh, Mostafa Almasi-Dooghaee, Seyed Hamid Reza Faiz
Abstract Several studies have reported clinical manifestations of the new coronavirus disease. However, few studies have systematically evaluated the neuropsychiatric complications of COVID-19. We reviewed the medical records of 201 patients with confirmed COVID-19 (52 outpatients and 149 inpatients) that were treated in a large referral center in Tehran, Iran from March 2019 to May 2020. We used clustering approach to categorize clinical symptoms. One hundred and fifty-one patients showed at least one neuropsychiatric symptom. Limb force reductions, headache followed by anosmia, hypogeusia were among the most common neuropsychiatric symptoms in COVID-19 patients. Hierarchical clustering analysis showed that neuropsychiatric symptoms group together in three distinct groups: anosmia and hypogeusia; dizziness, headache, and limb force reduction; photophobia, mental state change, hallucination, vision and speech problem, seizure, stroke, and balance disturbance. Three non-neuropsychiatric cluster of symptoms included diarrhea and nausea; cough and dyspnea; and fever and weakness. Neuropsychiatric presentations are very prevalent and heterogeneous in patients with coronavirus 2 infection and these heterogeneous presentations may be originating from different underlying mechanisms. Anosmia and hypogeusia seem to be distinct from more general constitutional-like and more specific neuropsychiatric symptoms. Skeletal muscular manifestations might be a constitutional or a neuropsychiatric symptom.
Authors Seth A. Berkowitz, Sanjay Basu
BJC (BRITISH JOURNAL OF CANCER)
Authors Toral Gathani, Gill Clayton, Emma MacInnes, Kieran Horgan
Abstract Delays in cancer diagnosis and treatment due to the COVID-19 pandemic is a widespread source of concern, but the scale of the challenge for different tumour sites is not known. Routinely collected NHS England Cancer Waiting Time data were analysed to compare activity for breast cancer in the first 6 months of 2020 compared to the same time period in 2019. The number of referrals for suspected breast cancer was 28% lower (N = 231,765 versus N = 322,994), and the number of patients who received their first treatment for a breast cancer diagnosis was 16% lower (N = 19,965 versus N = 23,881). These data suggest that the number of breast cancers diagnosed during the first half of 2020 is not as low as initially feared, and a substantial proportion of the shortfall can be explained by the suspension of routine screening in March 2020. Further work is needed to examine in detail the impact of measures to manage the COVID-19 pandemic on breast cancer outcomes.
Authors Rueben C. Warren, Lachlan Forrow, David Augustin Hodge, Robert D. Truog
CHEST
Authors Joshua J. Brotman, Robert M. Kotloff
US FOOD AND DRUG ADMINISTRATION
Authors Chanapa Tantibanchachai
CMS.GOV
Authors U.S. Centers for Medicare & Medicaid Service
SCIENCE DIRECT
Authors Giancarlo Isaia, Henri Diémoz, Francesco MalutacIlias, Ilias Fountoulakis, Daniela Ceccon, Alcide di Sarra, Stefania Facta, Francesca Fedele, Giuseppe Lorenzetto, Anna Maria Siani, Gianluca Isaia
Abstract A significantly stronger impact in mortality and morbidity by COVID-19 has been observed in the northern Italian regions compared to the southern ones. The reasons of this geographical pattern might involve several concurrent factors. The main objective of this work is to investigate whether any correlations exist between the spatial distribution of COVID-19 cases and deaths in the different Italian regions and the amount of solar ultraviolet (UV) radiation at the Earth's surface. To this purpose, in this environmental ecological study a mixed-effect exponential regression was built to explain the incidence of COVID-19 based on the environmental conditions, and demographic and pathophysiologic factors. Observations and estimates of the cumulative solar UV exposure have been included to quantify the amount of radiation available e.g., for pre-vitamin D3 synthesis or SARS-CoV-2 inactivation by sunlight. The analysis shows a significant correlation (p-value <5 × 10−2) between the response variables (death percentage, incidence of infections and positive tests) and biologically effective solar UV radiation, residents in nursing homes per inhabitant (NHR), air temperature, death percentage due to the most frequent comorbidities. Among all factors, the amount of solar UV radiation is the variable contributing the most to the observed correlation, explaining up to 83.2% of the variance of the COVID-19 affected cases per population. While the statistical outcomes of the study do not directly entail a specific cause-effect relationship, our results are consistent with the hypothesis that solar UV radiation impacted on the development of the infection and on its complications, e.g. through the effect of vitamin D on the immune system or virus inactivation by sunlight. The analytical framework used in this study, based on commonly available data, can be easily replicated in other countries and geographical domains to identify possible correlations between exposure to solar UV radiation and the spread of the pandemic.
Authors Jinghao Nicholas Ngiam, Nicholas Chew, Sai Meng Tham, Darius Lian-Lian Beh, Zhen Yu Lim, Tony Y.W. Li, Shuyun Cen, Paul Anantharajah Tambyah, Amelia Santosa, Ching-Hui Sia, Gail Brenda Cross
Abstract Objectives The vast majority of COVID-19 cases in Singapore have occurred amongst migrant workers. This paper examined trends in the hospitalised cases and tested the assumption that the low severity of disease was related to the relatively young affected population. Methods All patients with PCR-positive SARS-CoV-2 admitted from February to April 2020 were divided into: (i) imported cases, (ii) locally-transmitted cases outside migrant worker dormitories and (iii) migrant worker dormitory cases. They were examined for underlying comorbidities, clinical progress and outcomes. Results Imported cases (n = 29) peaked in mid-March 2020, followed by local cases (n = 100) in mid-April 2020; migrant worker cases (n = 425) continued to increase in late April 2020. Migrant worker cases were younger, had few medical comorbidities and less severe disease. As the migrant worker cases increased, the proportion of patients with pneumonia decreased, whilst patients presenting earlier in their illness and asymptomatic disease became more common. Conclusion Singapore experienced a substantial shift in the population at risk of severe COVID-19. Successful control in the community protected an aging population. Large migrant worker dormitory outbreaks occurred, but the disease incurred was less severe, resulting in Singapore having one of the lowest case fatality rates in the world.
Authors Caroline S E Homer, Susannah Hopkins Leisher, Neelam Aggarwal, Joseph Akuze, Delly Babona, Hannah Blencowe, John Bolgna, Richard Chawana, Aliki Christou, Miranda Davies-Tuck, Rakhi Dandona, Sanne Gordijn, Adrienne Gordon, Rafat Jan, Fleurisca Korteweg, Salome Maswime, Margaret M Murphy, Paula Quigley, Claire Storey, Lisa M Vallely, Peter Waiswa, Clare Whitehead, Jennifer Zeitlin, Vicki Flenady
EUROPEAN MEDICINE AGENCY
Authors EMA Press office
Authors Nathan Peiffer-Smadja, Mathieu E Rebeaud, Anthony Guihur, Yahya Mahamat-Saleh, Thibault Fiolet
Authors Smriti Mallapaty
Authors Maxime Taquet, Sierra Luciano, John R Geddes, Paul J Harrison
Authors Catherine R. Butler, Susan P. Y. Wong, Aaron G. Wightman, Ann M. O’Hare
Abstract Importance Little is known about how US clinicians have responded to resource limitation during the coronavirus disease 2019 (COVID-19) pandemic. Objective To describe the perspectives and experiences of clinicians involved in institutional planning for resource limitation and/or patient care during the pandemic. Design, Setting, and Participants This qualitative study used inductive thematic analysis of semistructured interviews conducted in April and May 2020 with a national group of clinicians (eg, intensivists, nephrologists, nurses) involved in institutional planning and/or clinical care during the COVID-19 pandemic across the United States. Main Outcomes and Measures Emergent themes describing clinicians’ experience providing care in settings of resource limitation. Results The 61 participants (mean [SD] age, 46 [11] years; 38 [63%] women) included in this study were practicing in 15 US states and were more heavily sampled from areas with the highest rates of COVID-19 infection at the time of interviews (ie, Seattle, New York City, New Orleans). Most participants were White individuals (39 [65%]), were attending physicians (45 [75%]), and were practicing in large academic centers (≥300 beds, 51 [85%]; academic centers, 46 [77%]). Three overlapping and interrelated themes emerged from qualitative analysis, as follows: (1) planning for crisis capacity, (2) adapting to resource limitation, and (3) multiple unprecedented barriers to care delivery. Clinician leaders worked within their institutions to plan a systematic approach for fair allocation of limited resources in crisis settings so that frontline clinicians would not have to make rationing decisions at the bedside. However, even before a declaration of crisis capacity, clinicians encountered varied and sometimes unanticipated forms of resource limitation that could compromise care, require that they make difficult allocation decisions, and contribute to moral distress. Furthermore, unprecedented challenges to caring for patients during the pandemic, including the need to limit in-person interactions, the rapid pace of change, and the dearth of scientific evidence, added to the challenges of caring for patients and communicating with families. Conclusions and Relevance The findings of this qualitative study highlighted the complexity of providing high-quality care for patients during the COVID-19 pandemic. Expanding the scope of institutional planning to address resource limitation challenges that can arise long before declarations of crisis capacity may help to support frontline clinicians, promote equity, and optimize care as the pandemic evolves.
Authors The Lancet Child & Adolescent Health
INTERNATIONAL JOURNAL OF INFECTIUOS DISEASES
Authors Giuseppe Ippolito, Francesco Nicola Lauria, Franco Locatelli, Nicola Magrini, Chiara Montaldo, Raffaella Sadun, Markus Maeurer, Gino Strada, Francesco Vairo, Salvatore Curiale, Antoine Lafont, Antonino di Caro, Maria Rosaria Capobianchi, Rainer Meilicke, Eskild Petersen, Alimuddin Zumla, Michel Pletschette
Authors Anton Gollwitzer, Cameron Martel, William J. Brady, Philip Pärnamets, Isaac G. Freedman, Eric D. Knowles, Jay J. Van Bavel
Abstract Numerous polls suggest that COVID-19 is a profoundly partisan issue in the United States. Using the geotracking data of 15 million smartphones per day, we found that US counties that voted for Donald Trump (Republican) over Hillary Clinton (Democrat) in the 2016 presidential election exhibited 14% less physical distancing between March and May 2020. Partisanship was more strongly associated with physical distancing than numerous other factors, including counties’ COVID-19 cases, population density, median income, and racial and age demographics. Contrary to our predictions, the observed partisan gap strengthened over time and remained when stay-at-home orders were active. Additionally, county-level consumption of conservative media (Fox News) was related to reduced physical distancing. Finally, the observed partisan differences in distancing were associated with subsequently higher COVID-19 infection and fatality growth rates in pro-Trump counties. Taken together, these data suggest that US citizens’ responses to COVID-19 are subject to a deep—and consequential—partisan divide.
Authors Siegfried Hörmann, Fatima Jammoul, Thomas Kuenzer, Ernst Stadlober
Abstract Analysis of near-surface measurements at several measuring points in Graz, Austria, reveals the impact of restrictive measures during the COVID-19 pandemic on the emission of atmospheric pollutants. We quantify the effects at traffic hotspots, industrial and residential areas. Using historical data collected over several years, we are able to account for meteorological and seasonal confounders. Our analysis is based on daily means as well as intraday pollution level curves. Nitrogen dioxide (NO2) has decreased drastically while the levels of particulate matter PM10 and carbon monoxide (CO) mostly exhibit little change. Traffic data shows that the decrease in traffic frequency is parallel to the decline in the levels of NO2 and NO.
Authors Elizabeth Garrett-Mayer, Brian I. Rini
Authors Giulia Pullano, Eugenio Valdano, Nicola Scarpa, Stefania Rubrichi, Vittoria Colizza
Authors James E. Udelson, Michael A. Curtis, Ethan J. Rowin
Authors YANG LUO
Authors Marielle Wathelet, Stéphane Duhem, Guillaume Vaiva, Thierry Baubet, Enguerrand Habran, Emilie Veerapa, Christophe Debien, Sylvie Molenda, Mathilde Horn, Pierre Grandgenèvre, Charles-Edouard Notredame, Fabien D’Hondt
Abstract Importance The coronavirus disease 2019 (COVID-19) pandemic and quarantine measures have raised concerns regarding their psychological effects on populations. Among the general population, university students appear to be particularly susceptible to experiencing mental health problems. Objectives To measure the prevalence of self-reported mental health symptoms, to identify associated factors, and to assess care seeking among university students who experienced the COVID-19 quarantine in France. Design, Setting, and Participants This survey study collected data from April 17 to May 4, 2020, from 69 054 students living in France during the COVID-19 quarantine. All French universities were asked to send an email to their students asking them to complete an online questionnaire. The targeted population was approximately 1 600 000 students. Exposure Living in France during the COVID-19 quarantine. Main Outcomes and Measures The rates of self-reported suicidal thoughts, severe distress, stress, anxiety, and depression were assessed using the 22-item Impact of Events Scale–Revised, the 10-item Perceived Stress Scale, the 20-item State-Trait Anxiety Inventory (State subscale), and the 13-item Beck Depression Inventory, respectively. Covariates were sociodemographic characteristics, precariousness indicators (ie, loss of income or poor quality housing), health-related data, information on the social environment, and media consumption. Data pertaining to care seeking were also collected. Multivariable logistic regression analyses were performed to identify risk factors. Results A total of 69 054 students completed the survey (response rate, 4.3%). The median (interquartile range) age was 20 (18-22) years. The sample was mainly composed of women (50 251 [72.8%]) and first-year students (32 424 [47.0%]). The prevalence of suicidal thoughts, severe distress, high level of perceived stress, severe depression, and high level of anxiety were 11.4% (7891 students), 22.4% (15 463 students), 24.7% (17 093 students), 16.1% (11 133 students), and 27.5% (18 970 students), respectively, with 29 564 students (42.8%) reporting at least 1 outcome, among whom 3675 (12.4%) reported seeing a health professional. Among risk factors identified, reporting at least 1 mental health outcome was associated with female gender (odds ratio [OR], 2.10; 95% CI, 2.02-2.19; P < .001) or nonbinary gender (OR, 3.57; 95% CI, 2.99-4.27; P < .001), precariousness (loss of income: OR, 1.28; 95% CI, 1.22-1.33; P < .001; low-quality housing: OR, 2.30; 95% CI, 2.06-2.57; P < .001), history of psychiatric follow-up (OR, 3.28; 95% CI, 3.09-3.48; P < .001), symptoms compatible with COVID-19 (OR, 1.55; 95% CI, 1.49-1.61; P < .001), social isolation (weak sense of integration: OR, 3.63; 95% CI, 3.35-3.92; P < .001; low quality of social relations: OR, 2.62; 95% CI, 2.49-2.75; P < .001), and low quality of the information received (OR, 1.56; 95% CI, 1.49-1.64; P < .001). Conclusions and Relevance The results of this survey study suggest a high prevalence of mental health issues among students who experienced quarantine, underlining the need to reinforce prevention, surveillance, and access to care.
Authors Jacqui Wise
Authors George Davey Smith, Michael Blastland, Marcus Munafò
Authors Fengyi Hao, Wilson Tam, Xiaoyu Hu, Wanqiu Tan, Li Jiang, Xiaojiang Jiang, Ling Zhang, Xinling Zhao, Yiran Zou, Yirong Hu, Xi Luo, Roger S. McIntyre, Travis Quek, Bach Xuan Tran, Zhisong Zhang, Hai Quang Pham, Cyrus S. H. Ho, Roger C.M. Ho
Abstract This study examined the neuropsychiatric sequelae of acutely ill patients with coronavirus disease 2019 (COVID-19) infection who received treatment in hospital isolation wards during the COVID-19 pandemic. Ten COVID-19 patients who received treatment in various hospitals in Chongqing, China; 10 age- and gender-matched psychiatric patients; and 10 healthy control participants residing in the same city were recruited. All participants completed a survey that collected information on demographic data, physical symptoms in the past 14 days and psychological parameters. Face-to-face interviews with COVID-19 patients were also performed using semi-structured questions. Among the COVID-19 patients, 40% had abnormal findings on the chest computed topography scan, 20% had dysosmia, 10% had dysgeusia, and 80% had repeated positivity on COVID-19 reverse-transcription polymerase chain reaction testing. COVID-19 and psychiatric patients were significantly more worried about their health than healthy controls (p = 0.019). A greater proportion of COVID-19 patients experienced impulsivity (p = 0.016) and insomnia (p = 0.039) than psychiatric patients and healthy controls. COVID-19 patients reported a higher psychological impact of the outbreak than psychiatric patients and healthy controls, with half of them having clinically significant symptoms of posttraumatic stress disorder. COVID-19 and psychiatric patients had higher levels of depression, anxiety and stress than healthy controls. Three themes emerged from the interviews with COVID-19 patients: (i) The emotions experienced by patients after COVID-19 infection (i.e., shock, fear, despair, hope, and boredom); (ii) the external factors that affected patients’ mood (i.e., discrimination, medical expenses, care by healthcare workers); and (iii) coping and self-help behavior (i.e., distraction, problem-solving and online support). The future direction in COVID-19 management involves the development of a holistic inpatient service to promote immune and psychological resilience.
Authors Christine Moutier
Abstract Importance Suicide, a leading cause of death with devastating emotional and societal costs, is a generally preventable cause of death and a critical global public health issue. The coronavirus disease 2019 (COVID-19) pandemic may increase the risk of population suicide through its effects on a number of well-established suicide risk factors. Observations Prior to the pandemic, many countries were engaging in suicide prevention strategies, and although the overall global burden of suicide deaths has increased, some national efforts were beginning to see positive results. Additionally, the gap between mental health needs and services has been increasing in many nations. With the added physical and mental health, social, and economic burdens imposed by the pandemic, many populations worldwide may experience increased suicide risk. Data and recent events during the first 6 months of the pandemic reveal specific effects on suicide risk. However, increases in suicide rates are not a foregone conclusion even with the negative effects of the pandemic. In fact, emerging suicide data from several countries show no evidence of an increase in suicide during the pandemic thus far. There are actionable steps that policy makers, health care leaders, and organizational leaders can take to mitigate suicide risk during and after the pandemic. Conclusions and Relevance COVID-19 presents a new and urgent opportunity to focus political will, federal investments, and global community on the vital imperative of suicide prevention. Suicide prevention in the COVID-19 era requires addressing not only pandemic-specific suicide risk factors, but also prepandemic risk factors. This Special Communication provides prioritized, evidence-based strategies for clinicians and health care delivery systems, along with national and local policy and educational initiatives tailored to the COVID-19 environment. If implemented to scale, these interventions could significantly mitigate the pandemic’s negative effects on suicide risk.
Authors Harald Schmidt, Lawrence O. Gostin, Michelle A. Williams
Authors David M. Cutler, Lawrence H. Summers
Authors Naomi M. Simon, Glenn N. Saxe, Charles R. Marmar
Authors Lisa A. Cooper, MD, David R. Williams
Authors Matteo Cinelli, Walter Quattrociocchi, Alessandro Galeazzi, Carlo Michele Valensise, Emanuele Brugnoli, Ana Lucia Schmidt, Paola Zola, Fabiana Zollo, Antonio Scala
Abstract We address the diffusion of information about the COVID-19 with a massive data analysis on Twitter, Instagram, YouTube, Reddit and Gab. We analyze engagement and interest in the COVID-19 topic and provide a differential assessment on the evolution of the discourse on a global scale for each platform and their users. We fit information spreading with epidemic models characterizing the basic reproduction number R0 for each social media platform. Moreover, we identify information spreading from questionable sources, finding different volumes of misinformation in each platform. However, information from both reliable and questionable sources do not present different spreading patterns. Finally, we provide platform-dependent numerical estimates of rumors’ amplification.
Authors Krishna Prasad Vadrevu, Aditya Eaturu, Sumalika Biswas, Kristofer Lasko, Saroj Sahu, J. K. Garg, Chris Justice
Abstract In this study, we characterize the impacts of COVID-19 on air pollution using NO2 and Aerosol Optical Depth (AOD) from TROPOMI and MODIS satellite datasets for 41 cities in India. Specifically, our results suggested a 13% NO2 reduction during the lockdown (March 25–May 3rd, 2020) compared to the pre-lockdown (January 1st–March 24th, 2020) period. Also, a 19% reduction in NO2 was observed during the 2020-lockdown as compared to the same period during 2019. The top cities where NO2 reduction occurred were New Delhi (61.74%), Delhi (60.37%), Bangalore (48.25%), Ahmedabad (46.20%), Nagpur (46.13%), Gandhinagar (45.64) and Mumbai (43.08%) with less reduction in coastal cities. The temporal analysis revealed a progressive decrease in NO2 for all seven cities during the 2020 lockdown period. Results also suggested spatial differences, i.e., as the distance from the city center increased, the NO2 levels decreased exponentially. In contrast, to the decreased NO2 observed for most of the cities, we observed an increase in NO2 for cities in Northeast India during the 2020 lockdown period and attribute it to vegetation fires. The NO2 temporal patterns matched the AOD signal; however, the correlations were poor. Overall, our results highlight COVID-19 impacts on NO2, and the results can inform pollution mitigation efforts across different cities of India.
Authors Gregg Gonsalves, Gavin Yamey
Authors Gill Livingston, Hossein Rostamipour, Paul Gallagher, Chris Kalafatis, Abhishek Shastri, Lauren Huzzey, Kathy Liu, Andrew Sommerlad, Louise Marsto
Authors Davide Piccinini, Carlo Giunchi, Marco Olivieri, Federico Frattini, Matteo Di Giovanni, Giorgio Prodi, Claudio Chiarabba
Abstract The Italian Government has decreed a series of progressive restrictions to delay the COVID-19 pandemic diffusion in Italy since March 10, 2020, including limitation in individual mobility and the closure of social, cultural, economic and industrial activities. Here we show the lockdown effect in Northern Italy, the COVID-19 most affected area, as revealed by noise variation at seismic stations. The reaction to lockdown was slow and not homogeneous with spots of negligible noise reduction, especially in the first week. A fresh interpretation of seismic noise variations in terms of socio-economic indicators sheds new light on the lockdown efficacy pointing to the causes of such delay: the noise reduction is significant where non strategic activities prevails, while it is small or negligible where dense population and strategic activities are present. These results are crucial for the a posteriori interpretation of the pandemic diffusion and the efficacy of differently targeted political actions.
Authors Jane Galvão
Authors Qin Xie, Fang Fan, Xue-Peng Fan, Xiao-Jiang Wang, Ming-Jian Chen, Bao-Liang Zhong, Helen Fung-Kum Chiu
Abstract Data are scarce regarding the comorbid mental disorders and their management among COVID-19 patients. This study described the clinical characteristics and management of COVID-19 patients treated in psychiatric inpatient settings due to comorbid first-onset mental disorders in Wuhan, China. This electronic medical records-based study included 25 COVID-19 patients with first-onset mental disorders and 55 patients with first-onset mental disorders without COVID-19 (control group). Data collected included ICD-10 diagnoses of mental disorders, psychiatric and respiratory symptoms, treatments, and outcomes. Adjustment disorder (n = 11, 44.0%) and acute and transient psychotic disorders, with associated acute stress (n = 6, 24.0%) were main clinical diagnoses in the COVID-19 group while serious mental illnesses (i.e., schizophrenia, 24.5%) and alcohol use disorders (10.9%) were overrepresented in the control group. On admission, the most common psychiatric symptom in COVID-19 patients was insomnia symptoms (n = 18, 72.0%), followed by aggressive behaviors (n = 16, 64.0%), delusion (n = 10, 40.0%), and severe anxiety (n = 9, 36.0%). In addition to respiratory treatments, 76.0% COVID-19 patients received antipsychotics, 40.0% sedative-hypnotics, and 24.0% mood stabilizers. At the end of inpatient treatment, 4 (16.0%) COVID-19 patients were transferred to other hospitals to continue respiratory treatment after their psychiatric symptoms were controlled while the remaining 21 (84.0%) all recovered. Compared to the control group, COVID-19 group had significantly shorter length of hospital stay (21.2 vs. 37.4 days, P < 0.001). Adjustment disorder and acute and transient psychotic disorders are the main clinical diagnoses of COVID-19 patients managed in psychiatric inpatient settings. The short-term prognosis of these patients is good after conventional psychotropic treatment.
Authors Rui Pombal, Ian Hosegood, David Powell
Authors Lindsey R. Baden, Caren G. Solomon, Michael F. Greene, Ralph B. D’Agostino, David Harrington
Authors Sarah Y Vinson, Randee J Waldman
Authors L. Silvia Muñoz-Price, Ann B. Nattinger, Frida Rivera, Ryan Hanson, Cameron G. Gmehlin, Adriana Perez, Siddhartha Singh, Blake W. Buchan, Nathan A. Ledeboer, Liliana E. Pezzin
Abstract Importance Initial public health data show that Black race may be a risk factor for worse outcomes of coronavirus disease 2019 (COVID-19). Objective To characterize the association of race with incidence and outcomes of COVID-19, while controlling for age, sex, socioeconomic status, and comorbidities. Design, Setting, and Participants This cross-sectional study included 2595 consecutive adults tested for COVID-19 from March 12 to March 31, 2020, at Froedtert Health and Medical College of Wisconsin (Milwaukee), the largest academic system in Wisconsin, with 879 inpatient beds (of which 128 are intensive care unit beds). Exposures Race (Black vs White, Native Hawaiian or Pacific Islander, Native American or Alaska Native, Asian, or unknown). Main Outcomes and Measures Main outcomes included COVID-19 positivity, hospitalization, intensive care unit admission, mechanical ventilation, and death. Additional independent variables measured and tested included socioeconomic status, sex, and comorbidities. Reverse transcription polymerase chain reaction assay was used to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results A total of 2595 patients were included. The mean (SD) age was 53.8 (17.5) years, 978 (37.7%) were men, and 785 (30.2%) were African American patients. Of the 369 patients (14.2%) who tested positive for COVID-19, 170 (46.1%) were men, 148 (40.1%) were aged 60 years or older, and 218 (59.1%) were African American individuals. Positive tests were associated with Black race (odds ratio [OR], 5.37; 95% CI, 3.94-7.29; P = .001), male sex (OR, 1.55; 95% CI, 1.21-2.00; P = .001), and age 60 years or older (OR, 2.04; 95% CI, 1.53-2.73; P = .001). Zip code of residence explained 79% of the overall variance in COVID-19 positivity in the cohort (ρ = 0.79; 95% CI, 0.58-0.91). Adjusting for zip code of residence, Black race (OR, 1.85; 95% CI, 1.00-3.65; P = .04) and poverty (OR, 3.84; 95% CI, 1.20-12.30; P = .02) were associated with hospitalization. Poverty (OR, 3.58; 95% CI, 1.08-11.80; P = .04) but not Black race (OR, 1.52; 95% CI, 0.75-3.07; P = .24) was associated with intensive care unit admission. Overall, 20 (17.2%) deaths associated with COVID-19 were reported. Shortness of breath at presentation (OR, 10.67; 95% CI, 1.52-25.54; P = .02), higher body mass index (OR per unit of body mass index, 1.19; 95% CI, 1.05-1.35; P = .006), and age 60 years or older (OR, 22.79; 95% CI, 3.38-53.81; P = .001) were associated with an increased likelihood of death. Conclusions and Relevance In this cross-sectional study of adults tested for COVID-19 in a large midwestern academic health system, COVID-19 positivity was associated with Black race. Among patients with COVID-19, both race and poverty were associated with higher risk of hospitalization, but only poverty was associated with higher risk of intensive care unit admission. These findings can be helpful in targeting mitigation strategies for racial disparities in the incidence and outcomes of COVID-19.
EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES
Authors Scopetta Ciriaco
Authors Richard Williams, David A Jenkins, Darren M Ashcroft,Ben Brown, Stephen Campbell, Matthew J Carr, Sudeh Cheraghi-sohi, Navneet Kapur, Owain Thomas, Roger T Webb, Niels Peek
Authors Ewan Macdonald, John Middleton, Drushca Lalloo, Trisha Greenhalgh
Authors Yongjie Zhou, Hui Shi, Zhengkui Liu, Songxu Peng, Ruoxi Wang, Ling Qi, Zezhi Li, Jiezhi Yang, Yali Ren, Xiuli Song, Lingyun Zeng, Wei Qian, Xiangyang Zhang
Abstract Coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide, with a staggering number of cases and deaths. However, available data on the psychological impacts of COVID-19 on pregnant women are limited. The purposes of this study were to assess the prevalence of psychiatric symptoms among pregnant women, and to compare them with non-pregnant women. From February 28 to March 12, 2020, a cross-sectional study of pregnant and non-pregnant women was performed in China. The online questionnaire was used to collect information of participants. The mental health status was assessed by patient health questionnaire, generalized anxiety disorder scale, insomnia severity index, somatization subscale of the symptom checklist 90, and post-traumatic stress disorder (PTSD) checklist-5. Totally, 859 respondents were enrolled, including 544 pregnant women and 315 non-pregnant women. In this study, 5.3%, 6.8%, 2.4%, 2.6%, and 0.9% of pregnant women were identified to have symptoms of depression, anxiety, physical discomfort, insomnia, and PTSD, respectively. However, the corresponding prevalence rates among non-pregnant women were 17.5%, 17.5%, 2.5%, 5.4%, 5.7%, respectively. After adjusting for other covariates, we observed that pregnancy was associated a reduced risk of symptoms of depression (OR = 0.23; 95% CI: 0.12–0.45), anxiety (OR = 0.26; 95% CI: 0.16–0.42), insomnia (OR = 0.19; 95% CI: 0.06–0.58), and PTSD (OR = 0.15; 95% CI: 0.04–0.53) during the COVID-19 epidemic. Our results indicate that during the COVID-19 epidemic in China, pregnant women have an advantage of facing mental problems caused by COVID-19, showing fewer depression, anxiety, insomnia, and PTSD symptoms than non-pregnant women.
Authors MARTHA LINCOLN
Authors Alexandra Shaw, Kelsey Flott, Gianluca Fontana, Mike Durkin, Ara Darzi
Authors Drew Altman
Authors Quan Qiu Wang, David C. Kaelber, Rong Xu, Nora D. Volkow
Abstract The global pandemic of COVID-19 is colliding with the epidemic of opioid use disorders (OUD) and other substance use disorders (SUD) in the United States (US). Currently, there is limited data on risks, disparity, and outcomes for COVID-19 in individuals suffering from SUD. This is a retrospective case-control study of electronic health records (EHRs) data of 73,099,850 unique patients, of whom 12,030 had a diagnosis of COVID-19. Patients with a recent diagnosis of SUD (within past year) were at significantly increased risk for COVID-19 (adjusted odds ratio or AOR = 8.699 [8.411–8.997], P < 10−30), an effect that was strongest for individuals with OUD (AOR = 10.244 [9.107–11.524], P < 10−30), followed by individuals with tobacco use disorder (TUD) (AOR = 8.222 ([7.925–8.530], P < 10−30). Compared to patients without SUD, patients with SUD had significantly higher prevalence of chronic kidney, liver, lung diseases, cardiovascular diseases, type 2 diabetes, obesity and cancer. Among patients with recent diagnosis of SUD, African Americans had significantly higher risk of COVID-19 than Caucasians (AOR = 2.173 [2.01–2.349], P < 10−30), with strongest effect for OUD (AOR = 4.162 [3.13–5.533], P < 10−25). COVID-19 patients with SUD had significantly worse outcomes (death: 9.6%, hospitalization: 41.0%) than general COVID-19 patients (death: 6.6%, hospitalization: 30.1%) and African Americans with COVID-19 and SUD had worse outcomes (death: 13.0%, hospitalization: 50.7%) than Caucasians (death: 8.6%, hospitalization: 35.2%). These findings identify individuals with SUD, especially individuals with OUD and African Americans, as having increased risk for COVID-19 and its adverse outcomes, highlighting the need to screen and treat individuals with SUD as part of the strategy to control the pandemic while ensuring no disparities in access to healthcare support.
NPJ
Authors Ayansina Ayanlade, Maren Radeny
ABSTRACT COVID-19 pandemic movement restrictions as part of the control measures put in place by countries in Sub-Saharan Africa (SSA) has implications on food security, as movement restrictions coincided with planting periods for most of the staple crops. The measures are affecting important staple crops in SSA, and are likely to exacerbate food security challenges in many countries. Achieving adequate food supply in SSA requires developing better policies and packages to confronting the challenge of reducing hunger post COVID-19 pandemic. The lessons learned after COVID-19 crisis will be very important for African countries to rethink their strategies and policies for sustainable economic growth, as COVID-19 many have significant impacts on all sectors of their economies.
Authors Jeremy M. Levin, Tudor I. Oprea, Sagie Davidovich, Thomas Clozel, John P. Overington, Quentin Vanhaelen, Charles R. Cantor, Evelyne Bischof, Alex Zhavoronkov
Authors THE LANCET
Authors Jared W.Feinman, Monique L.Roberts, LourdesAl-Ghofaily, AdamAdenwala, John G.Augoustides
Authors Joshua Sharfstein
Authors Elia Rossella, Giudice Giuseppe, Maruccia Michele
Authors Meira Levinson, D.Phil., Muge Cevik, M.D., and Marc Lipsitch, D.Phil
Authors Sonja A. Rasmussen, Denise J. Jamieson
Authors Catherine K. Ettman, Salma M. Abdalla, Gregory H. Cohen, MPhil, Laura Sampson, Patrick M. Vivier, Sandro Galea
ABSTRACT Importance The coronavirus disease 2019 (COVID-19) pandemic and the policies to contain it have been a near ubiquitous exposure in the US with unknown effects on depression symptoms. Objective To estimate the prevalence of and risk factors associated with depression symptoms among US adults during vs before the COVID-19 pandemic. Design, Setting, and Participants This nationally representative survey study used 2 population-based surveys of US adults aged 18 or older. During COVID-19, estimates were derived from the COVID-19 and Life Stressors Impact on Mental Health and Well-being study, conducted from March 31, 2020, to April 13, 2020. Before COVID-19 estimates were derived from the National Health and Nutrition Examination Survey, conducted from 2017 to 2018. Data were analyzed from April 15 to 20, 2020. Exposures The COVID-19 pandemic and outcomes associated with the measures to mitigate it. Main Outcomes and Measures Depression symptoms, defined using the Patient Health Questionnaire-9 cutoff of 10 or higher. Categories of depression symptoms were defined as none (score, 0-4), mild (score, 5-9), moderate (score, 10-14), moderately severe (score, 15-19), and severe (score, ≥20). Results A total of 1470 participants completed the COVID-19 and Life Stressors Impact on Mental Health and Well-being survey (completion rate, 64.3%), and after removing those with missing data, the final during–COVID-19 sample included 1441 participants (619 participants [43.0%] aged 18-39 years; 723 [50.2%] men; 933 [64.7%] non-Hispanic White). The pre–COVID-19 sample included 5065 participants (1704 participants [37.8%] aged 18-39 years; 2588 [51.4%] women; 1790 [62.9%] non-Hispanic White). Depression symptom prevalence was higher in every category during COVID-19 compared with before (mild: 24.6% [95% CI, 21.8%-27.7%] vs 16.2% [95% CI, 15.1%-17.4%]; moderate: 14.8% [95% CI, 12.6%-17.4%] vs 5.7% [95% CI, 4.8%-6.9%]; moderately severe: 7.9% [95% CI, 6.3%-9.8%] vs 2.1% [95% CI, 1.6%-2.8%]; severe: 5.1% [95% CI, 3.8%-6.9%] vs 0.7% [95% CI, 0.5%-0.9%]). Higher risk of depression symptoms during COVID-19 was associated with having lower income (odds ratio, 2.37 [95% CI, 1.26-4.43]), having less than $5000 in savings (odds ratio, 1.52 [95% CI, 1.02-2.26]), and exposure to more stressors (odds ratio, 3.05 [95% CI, 1.95-4.77]). Conclusions and Relevance These findings suggest that prevalence of depression symptoms in the US was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. Individuals with lower social resources, lower economic resources, and greater exposure to stressors (eg, job loss) reported a greater burden of depression symptoms. Post–COVID-19 plans should account for the probable increase in mental illness to come, particularly among at-risk populations.
Authors K Belesova
Authors THE LANCET INFECTIOUS DISEASES
Authors Carlos Blanco, Wilson M. Compton, Nora D. Volkow
Authors THE LANCET GLOBAL HEALTH
WILEY ONLINE LIBRARY
Authors Kinga Bierwiaczonek, Jonas R. Kunst, Olivia Pich
ABSTRACT Background Conspiracy theories about the origins of COVID‐19 are widespread and have even been propagated by highly ranked state officials and politicians in the US. Health authorities have cautioned that such theories, although not questioning the existence of the pandemic, may increase the spread of the virus by reducing people's efforts to socially distance. Methods We test this proposition empirically using longitudinal survey data collected at five timepoints during the early outbreak of the virus in the US (N = 403). Results Multivariate growth curve analyses showed that, although conspiracy beliefs decreased and social distancing increased over time, people holding more conspiracy beliefs at the beginning of the pandemic showed the lowest increase in social distancing. Moreover, cross‐lagged analyses demonstrated that people who reported more conspiracy beliefs at any wave tended to report less social distancing at the following wave. Conclusions Our findings show that COVID‐19 conspiracy theories pose a significant threat to public health as they may reduce adherence to social distancing measures.
Authors Catherine R. Lucey; S. Claiborne Johnston
Authors Yuming Guo, Yao Wu, Bo Wen, Wenzhong Huang, Ke Ju, Yuan Gao, Shanshan Li
Authors Nicholas R Jones, Zeshan U Qureshi, Robert J Temple, Jessica P J Larwood, Trisha Greenhalgh, Lydia Bourouiba
Authors Corrado Cabona, Francesco Deleo, Lucio Marinelli, Daniela Audenino, Dario Arnaldi, Francesca Rossi, Roberta Di Giacomo, Claudia Buffoni, Giuseppa Jolanda Rosa, Giuseppe Didato, Eleonora Arboscello, Marco de Curtis, Flavio Villani
ABSTRACT During epidemic outbreaks, epilepsy course can be modified by different physical and psychological stressors and, most importantly, by irregular therapy intake. The effect of COVID-19 and quarantine isolation on the course of epilepsy and on incidence of new-onset seizures is still unclear. With the aim of managing epilepsy in quarantined patients, three Italian Epilepsy Centers set up telephone consultations using a semistructured interview, allowing a prospective collection of data on seizure course and other seizure-related problems during pandemic. The collected data on seizure course were compared with the analogous period of 2019. The level of patients' concern relating to the COVID-19 pandemic was also assessed using a numeric rating scale. To address the effect of COVID-19 pandemic on seizure incidence, data collection included the number of consultations for first seizures, relapse seizures, and status epilepticus (SE) in the emergency department of one of the participating centers. Clinical telephone interviews suggest the absence of quarantine effect on epilepsy course in our cohort. No differences in incidence of emergency consultations for seizures over a two-month period were also observed compared with a control period. As demonstrated in other infective outbreaks, good antiepileptic drug (AED) supplying, precise information, and reassurance are the most important factors in chronic conditions to minimize psychological and physical stress, and to avoid unplanned treatment interruptions.
Authors Lennard Y W Lee, Jean-Baptiste Cazier, Thomas Starkey, Sarah E W Briggs, Roland Arnold, Vartika Bisht, Stephen Booth, Naomi A Campton, Vinton W T Cheng, Graham Collins, Helen M Curley, Philip Earwaker, Matthew W Fittall, Spyridon Gennatas, Anshita Goel, Simon Hartley, Daniel J Hughes, David Kerr, Alvin J X Lee, Rebecca J Lee, Siow Ming Lee, Hayley Mckenzie, Chris P Middleton, Nirupa Murugaesu, Tom Newsom-Davis, Anna C Olsson-Brown, Claire Palles, Thomas Powles, Emily A Protheroe, Karin Purshouse, Archana Sharma-Oates, Shivan Sivakumar, Ashley J Smith, Oliver Topping, Chris D Turnbull, Csilla Várnai, Adam D M Briggs, Gary Middleton, Rachel Kerr,
Authors Atif Rahman, John A Naslund, Theresa S Betancourt, Candace J Black, Anant Bhan, William Byansi, Hongtu Chen, Bradley N Gaynes, Carlos Gomez Restrepo, Lídia Gouveia, Syed Usman Hamdani, Lisa A Marsch, Inge Petersen, Ozge Sensoy Bahar, Laura Shields-Zeeman, Fred Ssewamala, Milton L Wainberg
ACKD
Authors Preethi Yerram, Madhukar Misra
DIABETES RESEARCH AND CLINICAL PRACTICE
Authors Heather Koga, Yemurai Machirori
Authors SOPHIE COUSINS
Authors Luca Steardo Jr., Luca Steardo, Alexei Verkhratsky
ABSTRACT The Coronavirus Disease 2019 (COVID-19) represents a severe multiorgan pathology which, besides cardio-respiratory manifestations, affects the function of the central nervous system (CNS). The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), similarly to other coronaviruses demonstrate neurotropism; the viral infection of the brain stem may complicate the course of the disease through damaging central cardio-respiratory control. The systemic inflammation as well as neuroinflammatory changes are associated with massive increase of the brain pro-inflammatory molecules, neuroglial reactivity, altered neurochemical landscape and pathological remodelling of neuronal networks. These organic changes, emerging in concert with environmental stress caused by experiences of intensive therapy wards, pandemic fears and social restrictions, promote neuropsychiatric pathologies including major depressive disorder, bipolar disorder (BD), various psychoses, obsessive-compulsive disorder and post-traumatic stress disorder. The neuropsychiatric sequelae of COVID-19 represent serious clinical challenge that has to be considered for future complex therapies.
Authors Michele K. Evans
Authors Eleni Mantzari, G James Rubin, Theresa M Marteau
SCIENCE
Authors A. Aassve,N. Cavalli, L. Mencarini, S. Plach, M. Livi Bacci
Authors Sheikh Taslim Ali, Lin Wang, Eric H. Y. Lau, Xiao-Ke Xu, Zhanwei Du, Ye Wu, Gabriel M. Leung, Benjamin J. Cowling
ABSTRACT Studies of novel coronavirus disease (COVID-19) have reported varying estimates of epidemiological parameters including serial interval distributions, i.e., the time between illness onset in successive cases in a transmission chain, and reproduction numbers. By compiling a line-list database of transmission pairs in mainland China, we show that mean serial intervals of COVID-19 have shortened substantially from 7.8 days to 2.6 days within a month (January 9 to February 13, 2020). This change is driven by enhanced non-pharmaceutical interventions, in particular case isolation. We also show that using real-time estimation of serial intervals allowing for variation over time, provides more accurate estimates of reproduction numbers than using conventionally fixed serial interval distributions. These findings could improve assessment of transmission dynamics, forecasting future incidence, and estimating the impact of control measures.
Authors Amit Sud, Bethany Torr, Michael E Jones, John Broggio, Stephen Scott, Chey Loveday, Alice Garrett, Firza Gronthoud, David L Nicol, Shaman Jhanji, Stephen A Boyce, Matthew Williams, Elio Riboli, David C Muller, Emma Kipps, James Larkin, Neal Navani, Charles Swanton, Georgios Lyratzopoulos, Ethna McFerran, Mark Lawler, Richard Houlston, Clare Turnbull
Authors Rodolphe Dard, Nathalie Janel, François Vialard
Authors Catherine L. Auriemma, Scott D. Halpern, Jeremy M. Asch, Matthew Van Der Tuyn, David A. Asch
Authors Harry Rutter, Richard Horton, Theresa M Marteau
Authors Ann Danaiya Usher
Authors The Lancet Infectious Diseases
Authors Halide Bilge Türközer, Dost Öngür
ABSTRACT The COVID-19 pandemic has transformed the face of psychiatry over a very short time period. Given the detrimental impact of the pandemic on mental health and the economy, more difficult days are ahead for psychiatry. The rising public health burden of mental illnesses will inevitably exceed the capacity of psychiatric services in the United States and worldwide. The pandemic has also profoundly affected psychiatric research due to safety concerns and containment efforts. Intermediate and long-term ramifications may even be more serious. In addition to the effects of the economic downturn on available research funding, existing research tools and protocols may not meet the emerging needs in the post-COVID-19 era. This paper discusses potential trends and challenges that psychiatric practice and research may encounter in this period from the viewpoint of workers in the field. We outline some measures that clinicians and researchers can implement to adapt to the emerging changes in psychiatry and to mitigate the forthcoming effects of the crisis. The COVID-19 pandemic has created a sense of danger, uncertainty, and loss of control in populations worldwide, placing mental health discussions high on the public’s agenda. Disasters traumatize societies, typically in a time-limited event with destructive outcomes that hit one community and require others to help. The pandemic is unusual because the world faces a danger with an unknown end date. Communities that support each other in normal times are now competing for scarce resources to cope with their own crises. The impact of this crisis on individuals and societies is compounded by the experience of facing danger without help. If the pandemic lasts for an extended period, as projected by some models [1, 2], psychiatric practice and the place of psychiatry in medicine are likely to undergo lasting changes. Here, we will (i) identify potential trends and challenges that psychiatric practice and research may encounter during this period, (ii) will suggest concrete measures that clinicians and researchers can take to mitigate the effects of this crisis at individual and institutional levels.
Authors DANIELA PONCE
Authors Renee N. Salas, James M. Shultz, Caren G. Solomon
Authors Megan M. Hosey, Dale M. Needham
Authors Michael Doumas, Dimitrios Patoulias, Alexandra Katsimardou, Konstantinos Stavropoulos, Konstantinos Imprialos, Asterios Karagiannis
Authors Joy Phumaphi, Elizabeth Mason, Nicholas Kojo Alipui, Jovana Ríos Cisnero, Carol Kidu, Brenda Killen, Giorgi Pkhakadze, Gita Sen, Alicia Ely Yamin, Shyama Kuruvilla
Authors Heather Kovich
Authors Joshua Chodosh, Michael L Freedman, Barbara E Weinstein, Jan Blustein
Authors David M. Studdert, Mark A. Hall
Authors A. Pan, M. Giorgi-Pierfranceschi, G. Bosio, L. Cammelli, R. Canino, A. Coluccello, A. Cuzzoli, A. Machiavelli, L. Romanini, A. Zoncada, S. Testa
Authors Catherine F Houlihan, Nina Vora, Thomas Byrne, Dan Lewer, Gavin Kelly, Judith Heaney, Sonia Gandhi, Moira J Spyer, Rupert Beale, Peter Cherepanov, David Moore, Richard Gilson, Steve Gamblin, George Kassiotis, Laura E McCoy, Charles Swanton, Andrew Hayward, Eleni Nastouli
SAGE JOURNALS
Authors Sheldon Cohen
ABSTRACT For 35 years, our laboratory has been involved in identifying psychosocial factors that predict who becomes ill when they are exposed to a virus affecting the upper respiratory tract. To pursue this question, we used a unique viral-challenge design in which we assessed behavioral, social, and psychological factors in healthy adults. We subsequently exposed these adults to a cold or influenza virus and then monitored them in quarantine for 5 to 6 days for onset of respiratory illness. Factors we found to be associated with greater risk of respiratory illnesses after virus exposure included smoking, ingesting an inadequate level of vitamin C, and chronic psychological stress. Those associated with decreased risk included social integration, social support, physical activity, adequate and efficient sleep, and moderate alcohol intake. We cautiously suggest that our findings could have implications for identifying who becomes ill when exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). This argument is based on evidence that the associations we report are replicable across multiple respiratory viruses and that the pathways found to link psychosocial factors to colds and influenza may play similar roles in COVID-19.
Authors Giorgio Costantino, Flora Peyvandib, Nicola Montano, Carlo Agostoni
PNAS (PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA)
Authors Seyed M. Moghadas, Meagan C. Fitzpatrick, Pratha Sah, Abhishek Pandey, Affan Shoukat, Burton H. Singer, Alison P. Galvani
ABSTRACT Since the emergence of coronavirus disease 2019 (COVID-19), unprecedented movement restrictions and social distancing measures have been implemented worldwide. The socioeconomic repercussions have fueled calls to lift these measures. In the absence of population-wide restrictions, isolation of infected individuals is key to curtailing transmission. However, the effectiveness of symptom-based isolation in preventing a resurgence depends on the extent of presymptomatic and asymptomatic transmission. We evaluate the contribution of presymptomatic and asymptomatic transmission based on recent individual-level data regarding infectiousness prior to symptom onset and the asymptomatic proportion among all infections. We found that the majority of incidences may be attributable to silent transmission from a combination of the presymptomatic stage and asymptomatic infections. Consequently, even if all symptomatic cases are isolated, a vast outbreak may nonetheless unfold. We further quantified the effect of isolating silent infections in addition to symptomatic cases, finding that over one-third of silent infections must be isolated to suppress a future outbreak below 1% of the population. Our results indicate that symptom-based isolation must be supplemented by rapid contact tracing and testing that identifies asymptomatic and presymptomatic cases, in order to safely lift current restrictions and minimize the risk of resurgence.
Authors Mariano Cingolani, Lina Caraceni, Nunzia Cannovo, Piergiorgio Fedeli
ABSTRACT The Italian Ministry of Justice and that of Health have established two strategies to limit the spread of COVID-19 in prisons: progressive isolation from the external world and adoption of practices to identify possible cases and to treat infected subjects. After the announcement of regulations revolts erupted in numerous Italian prisons. The motivations and effects of these strategy are discussed critically into the search for a balance between the right to health and other rights of prisoners in Italian prisons with the problem of an occupancy level of 121.75%.
Authors Hicham Achebak, Hervé Petetin, Marcos Quijal-Zamorano, Dene Bowdalo, Carlos Pérez García-Pando, Joan Ballester
Authors Prof Simon J Stanworth, Helen V New, Torunn O Apelseth, Susan Brunskill, Rebecca Cardigan, Carolyn Doree, Marc Germain, Mindy Goldman, Edwin Massey, Daniele Prati, Nadine Shehata, Cynthia So-Osman, Jecko Thachil
Authors Ben Teasdale, M.Phil., Kevin A. Schulman
CRITICAL CARE AND RESUSCITATION
Authors Alberto Zangrillo, Luigi Beretta, Paolo Silvani, Sergio Colombo, Anna Mara Scandroglio, Antonio Dell’Acqua, Evgeny Fominskiy, Giovanni Landoni, Giacomo Monti, Maria Luisa Azzolini, Fabrizio Monaco, Alessandro Oriani, Alessandro Belletti, Marianna Sartorelli, Ottavia Pallanch, Omar Saleh, Chiara Sartini, Pasquale Nardelli, Gaetano Lombardi, Federica Morselli, Tommaso Scquizzato, Antonio Frontera, Annalisa Ruggeri, Raffaella Scotti, Andrea Assanelli, Lorenzo Dagna, Patrizia Rovere-Querini, Antonella Castagna, Paolo Scarpellini, Davide Di Napoli, Alberto Ambrosio, Fabio Ciceri, Moreno Tresoldi
ABSTRACT At the end of 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak spread from China all around the world, causing thousands of deaths. In Italy, the hardest hit region was Lombardy, with the first reported case on 20 February 2020. San Raffaele Scientific Institute — a large tertiary hospital and research centre in Milan, Italy — was immediately involved in the management of the public health emergency. Since the beginning of the outbreak, the elective surgical activity of the hospital was rapidly reduced and large areas of the hospital were simultaneously reorganised to admit and assist patients with coronavirus disease 2019 (COVID-19). In addition, the hospital became the regional referral hub for cardiovascular emergencies in order to keep ensuring a high level of health care to non-COVID-19 patients in northern Italy. In a few days, a COVID-19 emergency department was created, improving the general ward capacity to a total number of 279 beds dedicated to patients with COVID-19. Moreover, the number of intensive care unit (ICU) beds was increased from 28 to 72 (54 of them dedicated to patients with COVID-19, and 18 to cardiology and cardiac surgery hub emergencies), both converting pre-existing areas and creating new high technology spaces. All the involved health care personnel were rapidly trained to use personal protection equipment and to manage this particular category of patients both in general wards and ICUs. Furthermore, besides clinical activities, continuously important research projects were carried out in order to find new strategies and more effective therapies to better face an unprecedented health emergency in Italy.
Authors Trevor A Sheldon, John Wright
Authors Havi Carel, Matthew Ratcliffe,Tom Froese
SPRINGER LINK
Authors Pierluigi Innocenti, Antonella Puzella, Maria Paola Mogavero, Oliviero Bruni, Raffaele Ferri
Authors Jennifer Abbasi
Authors Benjamin P. George, Adam G. Kelly
Authors Benjamin Oosterhoff, Cara A. Palmer
ABSTRACT Importance As coronavirus disease 2019 (COVID-19) spreads across the world, it is critical to understand the psychological factors associated with pandemic-related behaviors. This perspecitve may be especially important to study among adolescents, who are less likely to experience severe symptoms but contribute to the spread of the virus. Objective To examine psychological factors associated with adolescents’ behaviors during the COVID-19 pandemic. Design, Setting, and Participants This self-reported survey conducted from March 20 to 22, 2020, recruited a population-based sample of adolescents via social media to complete an anonymous survey. Participants were eligible if they had internet access, lived in the United States, and were aged 13 to 18 years. Main Outcomes and Measures Outcomes included COVID-19 news monitoring, social distancing, disinfecting, and hoarding behaviors during the 7 days after the United States declared a national emergency. The psychological factors were attitudes about COVID-19 severity, social responsibility values, social trust, and self-interest. The a priori hypotheses were that greater attitudes about the severity of COVID-19, greater social responsibility, and greater social trust would be associated with greater news monitoring, social distancing, and disinfecting, whereas greater self-interest would be associated with more hoarding. Results The sample included 770 adolescents collected via convenience sampling (mean [SD] age, 16.3 [1.1] years; 575 girls [74.7%]). Many teens reported not engaging in pure social distancing (528 [68.6%]), but they were monitoring the news (688 [89.4%]) and disinfecting daily (676 [87.8%]). Some teens reported hoarding (152 [19.7%]). Attitudes about the greater severity of COVID-19 were associated with more social distancing (β = 0.18; 95% CI = 0.10 to 0.25), disinfecting (β = 0.16; 95% CI = 0.08 to 0.23), and news monitoring (β = 0.26; 95% CI = 0.18 to 0.33) but also more hoarding (β = 0.08; 95% CI = 0.01 to 0.16). Greater social responsibility was associated with more disinfecting (β = 0.24; 95% CI = 0.17 to 0.32) and news monitoring (β = 0.14; 95% CI = 0.07 to 0.22) and less hoarding (β = −0.07; 95% CI = −0.14 to −0.01). Greater self-interest values were associated with less social distancing (β = −0.08; 95% CI = −0.15 to −0.01) and more hoarding (β = 0.08; 95% CI = 0.01 to 0.15). Greater social trust was associated with less hoarding (β = −0.09; 95% CI, −0.16 to −0.02). Conclusions and Relevance The results of this survey study suggest that emphasizing the severity of COVID-19 and the social implications of pandemic-related behaviors may be important for teens, particularly for those who are not following preventive health behaviors or who are engaging in hoarding.
Authors Scott D. Halpern, Robert D. Truog, Franklin G. Miller
Authors Debasree Das Gupta, David W. S. Wong
Authors Aitor Uribarri, Iván J. Núñez-Gil, Alvaro Aparisi, Victor M. Becerra-Muñoz, Gisela Feltes, Daniela Trabattoni, Inmaculada Fernández-Rozas, María C. Viana-Llamas, Martino Pepe, Enrico Cerrato, Thamar Capel-Astrua, Rodolfo Romero, Alex F. Castro-Mejía, Ibrahim El-Battrawy, Javier López-País, Fabrizio D’Ascenzo, Oscar Fabregat-Andres, Alfredo Bardají, Sergio Raposeiras-Roubin, Francisco Marín, Antonio Fernández-Ortiz, Carlos Macaya, Vicente Estrada
ABSTRACT Background Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite its international aggressive extension, with a significant morbidity and mortality, the impact of renal function on its prognosis is uncertain. Methods Analysis from the international HOPE-Registry (NCT04334291). The objective was to evaluate the association between kidney failure severity on admission with the mortality of patients with SARS-CoV-2 infection. Patients were categorized in 3 groups according to the estimated glomerular filtration rate on admission (eGFR > 60 mL/min/1.73 m2, eGFR 30–60 mL/min/1.73 m2 and eGFR < 30 mL/min/1.73 m2). Results 758 patients were included: mean age was 66 ± 18 years, and 58.6% of patient were male. Only 8.5% of patients had a history of chronic kidney disease (CKD); however, 30% of patients had kidney dysfunction upon admission (eGFR < 60 mL/min/1.73 m2). These patients received less frequently pharmacological treatment with hydroxychloroquine or antivirals and had a greater number of complications such as sepsis (11.9% vs 26.4% vs 40.8%, p < 0.001) and respiratory failure (35.4% vs 72.2% vs 62.0%, p < 0.001) as well as a higher in-hospital mortality rate (eGFR > 60 vs eGFR 30-60 vs and eGFR < 30, 18.4% vs 56.5% vs 65.5%, p < 0.001). In multivariate analysis: age, hypertension, renal function, 02 saturation < 92% and lactate dehydrogenase elevation on admission independently predicted all-cause mortality. Conclusions Renal failure on admission in patients with SARS-CoV-2 infection is frequent and is associated with a greater number of complications and in-hospital mortality. Our data comes from a multicenter registry and therefore does not allow to have a precise mortality risk assessment. More studies are needed to confirm these findings.
BMC
Authors Raffaele Scala, Teresa Renda, Antonio Corrado, Adriano Vaghi
Authors Duncan E. K. Sutherland
ABSTRACT Background COVID-19 has infected millions of people, with an estimated total dead in the hundreds of thousands. This has significantly impacted health care, including who is delivering it, how it is delivered, and how it is taught. This article describes challenges of the COVID-19 pandemic from the perspective of a Canadian nuclear medicine resident, including new risks with nuclear imaging, navigating new and sometimes challenging guidelines, as well as working and living within the confines of social distancing. At the time of writing this article, it has been 113 days since the World Health Organization declared COVID-19 a public health emergency, and 72 days since it was declared a Pandemic. From the Johns Hopkins COVID-19 online interactive dashboard,1 there are approximately 5 million global cases with an estimated 328,000 deaths. There is even concern about multiple COVID-19 waves with the potential to extend the pandemic out for a year or longer.2 Pretty impressive, and frankly scary, for a virus that is less than a year old.
Authors THE LANCET COMMISSION
Authors Siming You, Christian Sonne, Yong Sik Ok
Authors The Lancet Respiratory Medicine
Authors Katrine Bach Habersaat, Cornelia Betsch, Margie Danchin, Cass R. Sunstein, Robert Böhm, Armin Falk, Noel T. Brewer, Saad B. Omer, Martha Scherzer, Sunita Sah, Edward F. Fischer, Andrea E. Scheel, Daisy Fancourt, Shinobu Kitayama, Eve Dubé, Julie Leask, Mohan Dutta, Noni E. MacDonald, Anna Temkina, Andreas Lieberoth, Mark Jackson, Stephan Lewandowsky, Holly Seale, Nils Fietje, Philipp Schmid, Michele Gelfand, Lars Korn, Sarah Eitze, Lisa Felgendreff, Philipp Sprengholz, Cristiana Salvi, Robb Butler
ABSTRACT Governments around the world have implemented measures to manage the transmission of coronavirus disease 2019 (COVID-19). While the majority of these measures are proving effective, they have a high social and economic cost, and response strategies are being adjusted. The World Health Organization (WHO) recommends that communities should have a voice, be informed and engaged, and participate in this transition phase. We propose ten considerations to support this principle: (1) implement a phased approach to a ‘new normal’; (2) balance individual rights with the social good; (3) prioritise people at highest risk of negative consequences; (4) provide special support for healthcare workers and care staff; (5) build, strengthen and maintain trust; (6) enlist existing social norms and foster healthy new norms; (7) increase resilience and self-efficacy; (8) use clear and positive language; (9) anticipate and manage misinformation; and (10) engage with media outlets. The transition phase should also be informed by real-time data according to which governmental responses should be updated.
Authors Rachel Hilburg, Niralee Patel, Sophia Ambruso, Mollie A. Biewald, Samira S. Farouk
ABSTRACT As paradigms of clinical care delivery have been significantly impacted by the novel coronavirus disease 2019 (COVID-19) pandemic, so has the structure, delivery, and future of medical education. Both undergraduate and graduate medical education have seen disruptions ranging from fully virtual delivery of educational content and limited clinical care for medical students to increased clinical demands with redeployment for residents and fellows. Adherence to social distancing has led to the adoption and implementation of already available technologies in medical education, including video conferencing softwares and social media platforms. Efficient and effective use of these technologies requires an understanding not only of these platforms and their features, but also of their inherent limitations. During a time of uncertainty and increased clinical demands, the approach to medical education must be thoughtful with attention to wellness of both the educator and learner. In this review, we discuss the influence of the pandemic on the existing medical education landscape, outline existing and proposed adaptations to social distancing, and describe challenges that lie ahead.
TAYLOR AND FRANCIS ONLINE
Authors Chang Park, Kapil Sugand, Dinesh Nathwani, Rajarshi Bhattacharya, Khaled M Sarraf
ABSTRACT Background and purpose — The COVID-19 pandemic has been recognized as an unprecedented global health crisis. This is the first observational study to evaluate its impact on the orthopedic workload in a London level 1 trauma center (i.e., a major trauma center [MTC]) before (2019) and during (2020) the “golden month” post-COVID-19 lockdown. Patients and methods — We performed a longitudinal observational prevalence study of both acute orthopedic trauma referrals, operative and anesthetic casemix for the first “golden” month from March 17, 2020. We compared the data with the same period in 2019. Statistical analyses included median (median absolute deviation), risk and odds ratios, as well as Fisher’s exact test to calculate the statistical significance, set at p ≤ 0.05. Results — Acute trauma referrals in the post-COVID period were almost halved compared with 2019, with similar distribution between pediatric and adult patients, requiring a significant 19% more admissions (RR 1.3, OR 2.6, p = 0.003). Hip fractures and polytrauma cases accounted for an additional 11% of the modal number of injuries in 2020, but with 19% reduction in isolated limb injuries that were modal in 2019. Total operative cases fell by a third during the COVID-19 outbreak. There was a decrease of 14% (RR 0.85, OR 0.20, p = 0.006) in aerosol-generating anesthetic techniques used. Interpretation — The impact of the COVID-19 pandemic has led to a decline in the number of acute trauma referrals, admissions (but increased risk and odds ratio), operations, and aerosolizing anesthetic procedures since implementing social distancing and lockdown measures during the “golden month.”
Authors Max Joachim Temmesfeld,Rune Bruhn Jakobsen, Peter Grant
ABSTRACT Background and purpose — The COVID-19 pandemic caused by infection with SARS-CoV-2 has led to a global shortage of personal protective equipment (PPE). Various alternatives to ordinary PPE have been suggested to reduce transmission, which is primarily through droplets and aerosols. For many years orthopedic surgeons have been using surgical helmets as personal protection against blood-borne pathogens during arthroplasty surgery. We have investigated the possibility of using the Stryker Flyte surgical helmet as a respiratory protective device against airborne- and droplet-transmitted disease, since the helmet shares many features with powered air-purifying respirators. Materials and methods — Using an aerosol particle generator, we determined the filtration capacity of the Stryker Flyte helmet by placing particle counters measuring the concentrations of 0.3, 0.5, and 5 µm particles inside and outside of the helmet. Results — We found that the helmet has insufficient capacity for filtrating aerosol particles, and, for 0.3 µm sized particles, we even recorded an accumulation of particles inside the helmet. Interpretation — We conclude that the Stryker Flyte surgical helmet should not be used as a respiratory protective device when there is a risk for exposure to aerosol containing SARS-CoV-2, the virus causing COVID-19, in accordance with the recommendation from the manufacturer The rapid development of the COVID-19 pandemic has led to severe shortages around the globe of personal protective equipment (PPE) for healthcare personnel such as regular surgical masks, tight-fitting masks (filtering facepieces [FFP]), protective eyeglasses, and face shields (Kamerow 2020, World Health Organization 2020). The virus causing COVID-19, SARS-CoV-2, is believed to spread primarily through droplets and aerosol in the immediate vicinity of an infected person (Bahl et al. 2020). A recent study showed that SARS-CoV-2 aerosols remain airborne and viable for at least 3 hours in closed spaces, thus raising the concern of airborne transmission (van Doremalen et al. 2020). A recent review also discussed the transmission of viral particles from aerosolized body fluids by using power drills, pulsed lavage, and other equipment during surgery (Basso et al. 2020). This has not been reported for SARS-CoV-2, but it is conceivable and has been shown in vitro for other viruses (Johnson and Robinson 1991, Garden et al. 2002). Numerous alternative concepts of respiratory PPE have been suggested, for example the use of powered air-purifying respirators (PAPR). In these devices, filtered air is drawn by an electric fan into a closed helmet. Even though PAPRs offer superior protection compared with standard FFPs, hospitals would have to pay a lot to commercially acquire a sufficient number of PAPRs to equip their healthcare personnel. Additionally, a shortage of PAPRs is to be expected during a pandemic. Surgical helmets with internal electric fans share many features of a PAPR and were suggested as an alternative during the SARS epidemic in China in 2003 (Ahmed et al. 2005). Such helmets are regularly used in orthopedic arthroplasty surgery. The hood of the surgical helmet is air-permeable over the fan intake, while the rest of the hood material is practically air impermeable. The original purpose of surgical helmets was to protect patients from particles that the surgical team might emit into the wound. Additionally, surgical helmets will protect the surgeon from direct body fluid contamination. The Flyte model (Stryker Instruments, Kalamazoo, MI, USA) is commonly used in Scandinavia, continental Europe, and the United States and thus available in many Western hospitals. We investigated the protective abilities of this helmet in the context of the ongoing COVID-19 pandemic as part of an ongoing research project, which aims to convert surgical helmets into PAPRs with the help of specialized filters.
Authors Tessa K.Novick, Katherine Rizzolo, Lilia Cervantes
ABSTRACT Racial, ethnic, socioeconomic, age, and sex-related health disparities in kidney disease are prominent in the United States. The Coronavirus Disease 2019 (COVID-19) pandemic has disproportionately affected marginalized populations. Older adults, people experiencing unstable housing, racial and ethnic minorities and immigrants are potentially at increased risk for infection and severe complications from COVID-19. The direct and societal effects of the pandemic may increase risk of incident kidney disease and lead to worse outcomes for those with kidney disease. The rapid transition to telemedicine potentially limits access to care for older adults, immigrants, and people experiencing unstable housing. The economic impact of the pandemic has had a disproportionate effect on women, minorities and immigrants, which may limit their ability to manage kidney disease, and lead to complications or kidney disease progression. We describe the impact of COVID-19 on marginalized populations and highlight how the pandemic may exacerbate existing disparities in kidney disease.
Authors Paolo Manzoni, Maria Angela Militello, Lorenzo Fiorica, Mariano Manzionna, Annarita Cappiello
Authors Ina Vandebroek, Andrea Pieroni, John Richard Stepp, Natalia Hanazaki, Ana Ladio, Rômulo Romeu Nóbrega Alves, David Picking, Rupika Delgoda, Alfred Maroyi, Tinde van Andel, Cassandra L. Quave, Narel Y. Paniagua-Zambrana, Rainer W. Bussmann, Guillaume Odonne, Arshad Mehmood Abbasi, Ulysses Paulino Albuquerque, Janelle Baker, Susan Kutz, Shrabya Timsina, Masayoshi Shigeta, Tacyana Pereira Ribeiro Oliveira, Julio A. Hurrell, Patricia M. Arenas, Jeremias P. Puentes, Jean Hugé, Yeter Yeşil, Laurent Jean Pierre, Temesgen Magule Olango & Farid Dahdouh-Guebas
Authors Matteo Bassetti, Filippo Ansaldi, Giancarlo Icardi, Paolo Pelosi, Chiara Robba, Lucia Taramasso, Cecilia Trucchi Antonio Vena, Daniele Roberto Giacobbe
Authors RICHARD NORTON
Authors Melissa McCullough
JMIR
Authors Silvia Maria Francesca Pizzoli, Chiara Marzorati, Davide Mazzoni, Gabriella Pravettoni
ABSTRACT Background: Psychophysiological stress and decreased well-being are relevant issues during prolonged social isolation periods. Relaxation practices may represent helpful exercises to cope with anxiety and stressful sensations. Objective: The aim of this research protocol is to test whether remote relaxation practices such as natural sounds, deep respiration, and body scan meditation promote relaxation and improved emotional state and reduce psychomotor activation and the preoccupation related to the coronavirus disease (COVID-19) pandemic. Methods: The study population will consist of 3 experimental groups that will randomly receive one of 3 internet-based audio clips containing a single session of guided breathing exercise, guided body scan exercise, or natural sounds. The participants will listen to the fully automated audio clip for 7 minutes and complete pre-post self-assessment scales on their perceived relaxation, psychomotor activation, level of worry associated with COVID-19, and emotional state. At the end of the session, the participants will also be asked to provide qualitative reports on their subjective experiences. Results: Analyses will be performed to test the differences in the efficacy of the different audio clips in an internet-based intervention on 252 participants (84 per group), investigating whether natural sounds or remote guided practices such as deep respiration and body scan meditation positively enhance the participants’ perceived psychological state. Conclusions: The study will provide information on if and to what extent guided practices can help in reducing psychological side effects related to social isolation during the COVID-19 pandemic
Authors Abdullah Wahbeh, Tareq Nasralah, Mohammad Al-Ramahi, Omar El-Gayar
ABSTRACT Background: The coronavirus disease (COVID-19) pandemic is considered to be the most daunting public health challenge in decades. With no effective treatments and with time needed to develop a vaccine, alternative approaches are being used to control this pandemic. Objective: The objective of this paper was to identify topics, opinions, and recommendations about the COVID-19 pandemic discussed by medical professionals on the Twitter social medial platform. Methods: Using a mixed methods approach blending the capabilities of social media analytics and qualitative analysis, we analyzed COVID-19–related tweets posted by medical professionals and examined their content. We used qualitative analysis to explore the collected data to identify relevant tweets and uncover important concepts about the pandemic using qualitative coding. Unsupervised and supervised machine learning techniques and text analysis were used to identify topics and opinions. Results: Data were collected from 119 medical professionals on Twitter about the coronavirus pandemic. A total of 10,096 English tweets were collected from the identified medical professionals between December 1, 2019 and April 1, 2020. We identified eight topics, namely actions and recommendations, fighting misinformation, information and knowledge, the health care system, symptoms and illness, immunity, testing, and infection and transmission. The tweets mainly focused on needed actions and recommendations (2827/10,096, 28%) to control the pandemic. Many tweets warned about misleading information (2019/10,096, 20%) that could lead to infection of more people with the virus. Other tweets discussed general knowledge and information (911/10,096, 9%) about the virus as well as concerns about the health care systems and workers (909/10,096, 9%). The remaining tweets discussed information about symptoms associated with COVID-19 (810/10,096, 8%), immunity (707/10,096, 7%), testing (605/10,096, 6%), and virus infection and transmission (503/10,096, 5%). Conclusions: Our findings indicate that Twitter and social media platforms can help identify important and useful knowledge shared by medical professionals during a pandemic.
Authors Renae Smith-Ray, Erin E Roberts, Devonee E Littleton, Tanya Singh, Thomas Sandberg, Michael Taitel
ABSTRACT Background: Coronavirus disease (COVID-19) has spread exponentially across the United States. Older adults with underlying health conditions are at an especially high risk of developing life-threatening complications if infected. Most intensive care unit (ICU) admissions and non-ICU hospitalizations have been among patients with at least one underlying health condition. Objective: The aim of this study was to develop a model to estimate the risk status of the patients of a nationwide pharmacy chain in the United States, and to identify the geographic distribution of patients who have the highest risk of severe COVID-19 complications. Methods: A risk model was developed using a training test split approach to identify patients who are at high risk of developing serious complications from COVID-19. Adult patients (aged ≥18 years) were identified from the Walgreens pharmacy electronic data warehouse. Patients were considered eligible to contribute data to the model if they had at least one prescription filled at a Walgreens location between October 27, 2019, and March 25, 2020. Risk parameters included age, whether the patient is being treated for a serious or chronic condition, and urban density classification. Parameters were differentially weighted based on their association with severe complications, as reported in earlier cases. An at-risk rate per 1000 people was calculated at the county level, and ArcMap was used to depict the rate of patients at high risk for severe complications from COVID-19. Real-time COVID-19 cases captured by the Johns Hopkins University Center for Systems Science and Engineering (CSSE) were layered in the risk map to show where cases exist relative to the high-risk populations. Results: Of the 30,100,826 adults included in this study, the average age is 50 years, 15% have at least one specialty medication, and the average patient has 2 to 3 comorbidities. Nearly 28% of patients have the greatest risk score, and an additional 34.64% of patients are considered high-risk, with scores ranging from 8 to 10. Age accounts for 53% of a patient’s total risk, followed by the number of comorbidities (29%); inferred chronic obstructive pulmonary disease, hypertension, or diabetes (15%); and urban density classification (5%). Conclusions: This risk model utilizes data from approximately 10% of the US population. Currently, this is the most comprehensive US model to estimate and depict the county-level prognosis of COVID-19 infection. This study shows that there are counties across the United States whose residents are at high risk of developing severe complications from COVID-19. Our county-level risk estimates may be used alongside other data sets to improve the accuracy of anticipated health care resource needs. The interactive map can also aid in proactive planning and preparations among employers that are deemed critical, such as pharmacies and grocery stores, to prevent the spread of COVID-19 within their facilities.
Authors Mark Barnes, Paul E. Sax
Authors Jeremy F Huckins, Alex W daSilva, Weichen Wang, Elin Hedlund, Courtney Rogers, Subigya K Nepal, Jialing Wu, Mikio Obuchi, Eilis I Murphy, Meghan L Meyer, Dylan D Wagner, Paul E Holtzheimer, Andrew T Campbell
ABSTRACT Background: The vast majority of people worldwide have been impacted by coronavirus disease (COVID-19). In addition to the millions of individuals who have been infected with the disease, billions of individuals have been asked or required by local and national governments to change their behavioral patterns. Previous research on epidemics or traumatic events suggests that this can lead to profound behavioral and mental health changes; however, researchers are rarely able to track these changes with frequent, near-real-time sampling or compare their findings to previous years of data for the same individuals. Objective: By combining mobile phone sensing and self-reported mental health data among college students who have been participating in a longitudinal study for the past 2 years, we sought to answer two overarching questions. First, have the behaviors and mental health of the participants changed in response to the COVID-19 pandemic compared to previous time periods? Second, are these behavior and mental health changes associated with the relative news coverage of COVID-19 in the US media? Methods: Behaviors such as the number of locations visited, distance traveled, duration of phone usage, number of phone unlocks, sleep duration, and sedentary time were measured using the StudentLife smartphone sensing app. Depression and anxiety were assessed using weekly self-reported ecological momentary assessments of the Patient Health Questionnaire-4. The participants were 217 undergraduate students, with 178 (82.0%) students providing data during the Winter 2020 term. Differences in behaviors and self-reported mental health collected during the Winter 2020 term compared to previous terms in the same cohort were modeled using mixed linear models. Results: During the first academic term impacted by COVID-19 (Winter 2020), individuals were more sedentary and reported increased anxiety and depression symptoms (P<.001) relative to previous academic terms and subsequent academic breaks. Interactions between the Winter 2020 term and the week of the academic term (linear and quadratic) were significant. In a mixed linear model, phone usage, number of locations visited, and week of the term were strongly associated with increased amount of COVID-19–related news. When mental health metrics (eg, depression and anxiety) were added to the previous measures (week of term, number of locations visited, and phone usage), both anxiety (P<.001) and depression (P=.03) were significantly associated with COVID-19–related news. Conclusions: Compared with prior academic terms, individuals in the Winter 2020 term were more sedentary, anxious, and depressed. A wide variety of behaviors, including increased phone usage, decreased physical activity, and fewer locations visited, were associated with fluctuations in COVID-19 news reporting. While this large-scale shift in mental health and behavior is unsurprising, its characterization is particularly important to help guide the development of methods to reduce the impact of future catastrophic events on the mental health of the population.
Authors Adam J Kucharski, Petra Klepac, Andrew J K Conlan, Stephen M Kissler, Maria L Tang, Hannah Fry, Julia R Gog, W John Edmunds,
Authors Changjie Cai, Evan L. Floyd
THE ONCOLOGIST
Authors EricA. Coomes Humaid O. Al‐Shamsi Brandon M. Meyers Waleed Alhazzani Ahmad Alhuraiji Roy F. Chemaly Meshari Almuhanna Robert A. Wolff Nuhad K. Ibrahim Melvin L.K. Chua Sebastien J. Hotte Tarek Elfiki Giuseppe Curigliano Cathy Eng Axel Grothey Conghua Xie
BMJ JOURNAL
Authors Luca Cegolon, Jennifer Pichierri, Giuseppe Mastrangelo, Sandro Cinquetti, Giovanni Sotgiu, Saverio Bellizzi, Giuseppe Pichierri
Authors Lawrence O. Gostin, Daniel A. Salmon
Authors JENNIFER ABBASI
Authors Johannes Haushofer, C. Jessica E. Metcalf
Authors Karl Pillemer, Lakshminarayanan Subramanian, Nathaniel Hupert
Authors Will Zerhouni, Gary J. Nabel, Elias Zerhouni
Authors Heidi Ledford
The Lancet
Authors Elizabeth Rapa, Louise Dalton, Alan Stein
Authors Ewen Callaway
Authors Derek K Chu, Prof Elie A Akl, Stephanie Duda, Karla Solo, Sally Yaacoub,Prof Holger J Schünemann
Authors Brigida Barberio, Davide Massimi, Anna Dipace, Fabiana Zingone, Fabio Farinati, Edoardo V. Savarino
Authors The Lancet Planetary Health
MINERVA MEDICA
Authors Alberto GIANNINI, Alessandro MANTOVANI, Cesare VEZZOLI, Diego FRANCHINI, Paolo FINAZZI
Authors Rodolfo Rossi, Valentina Socci, Francesca Pacitti, Giorgio Di Lorenzo, Antinisca Di Marco, Alberto Siracusano, Alessandro Rossi
Authors Neil Greenberg, Samantha K Brooks, Simon Wessely, Derek K Tracy
SPRINGER NATURE
Authors Nature
Authors Eboni G. Price-Haywood, Jeffrey Burton, Daniel Fort, and Leonardo Seoane
ABSTRACT BACKGROUND Many reports on coronavirus disease 2019 (Covid-19) have highlighted age- and sex-related differences in health outcomes. More information is needed about racial and ethnic differences in outcomes from Covid-19. METHODS In this retrospective cohort study, we analyzed data from patients seen within an integrated-delivery health system (Ochsner Health) in Louisiana between March 1 and April 11, 2020, who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the virus that causes Covid-19) on qualitative polymerase-chain-reaction assay. The Ochsner Health population is 31% black non-Hispanic and 65% white non-Hispanic. The primary outcomes were hospitalization and in-hospital death. RESULTS A total of 3626 patients tested positive, of whom 145 were excluded (84 had missing data on race or ethnic group, 9 were Hispanic, and 52 were Asian or of another race or ethnic group). Of the 3481 Covid-19–positive patients included in our analyses, 60.0% were female, 70.4% were black non-Hispanic, and 29.6% were white non-Hispanic. Black patients had higher prevalences of obesity, diabetes, hypertension, and chronic kidney disease than white patients. A total of 39.7% of Covid-19–positive patients (1382 patients) were hospitalized, 76.9% of whom were black. In multivariable analyses, black race, increasing age, a higher score on the Charlson Comorbidity Index (indicating a greater burden of illness), public insurance (Medicare or Medicaid), residence in a low-income area, and obesity were associated with increased odds of hospital admission. Among the 326 patients who died from Covid-19, 70.6% were black. In adjusted time-to-event analyses, variables that were associated with higher in-hospital mortality were increasing age and presentation with an elevated respiratory rate; elevated levels of venous lactate, creatinine, or procalcitonin; or low platelet or lymphocyte counts. However, black race was not independently associated with higher mortality (hazard ratio for death vs. white race, 0.89; 95% confidence interval, 0.68 to 1.17). CONCLUSIONS In a large cohort in Louisiana, 76.9% of the patients who were hospitalized with Covid-19 and 70.6% of those who died were black, whereas blacks comprise only 31% of the Ochsner Health population. Black race was not associated with higher in-hospital mortality than white race, after adjustment for differences in sociodemographic and clinical characteristics on admission.
Authors Marc R. Larochelle
Authors Livio Garattini, Michele Zanetti, Nicholas Freemantle
Authors Annamaria Colao, Prisco Piscitelli, Manuela Pulimeno, Salvatore Colazzo, Alessandro Miani, Stefania Giannini
Authors Talha Burki
Authors Seema K. Shah, Franklin G. Miller, Thomas C. Darton, Devan Duenas, Claudia Emerson, Holly Fernandez Lynch, Euzebiusz Jamrozik, Nancy S. Jecker, Dorcas Kamuya, Melissa Kapulu, Jonathan Kimmelman, Douglas MacKay, Matthew J. Memoli, Sean C. Murphy, Ricardo Palacios, Thomas L. Richie, Meta Roestenberg, Abha Saxena, Katherine Saylor, Michael J. Selgelid, Vina Vaswani, Annette Rid
BRITISH JOURNAL OF HOSPITAL MEDICINE
Authors Iqbal Singh,Kailash Chand,Arun Singh,Kondal R Kandadi
ABSTRACT Following a number of epidemics in the 21st century, including Ebola and Middle East respiratory syndrome, the SARS-COV-2 virus, causing COVID-19 disease, was declared a pandemic health emergency of international concern in January 2020.The SARS-COV-2 virus has had a devastating impact, with over 35 000 deaths in the UK across all sectors as of 18 May (hospitals, care homes, hospices and in the community) (Department of Health and Social Care and Public Health England, 2020). In the UK there has been increasing concern regarding the disproportionate impact that COVID-19 is having on black and minority ethnic communities. The Health Service Journal (Cook et al, 2020) identified that out of 119 NHS staff who had died from COVID-19, 64 were from ethnic minority backgrounds. People from ethnic minorities account for 14% of the population but have accounted for 34% of COVID-19-related intensive care unit admissions as of 24 April 2020 (Intensive Care National Audit and Research Centre, 2020). Black men are 4.2 and black women 4.3 times are more likely to die from a COVID-19-related death than men and women of white ethnicity (Office for National Statistics, 2020). Men in the Bangladeshi and Pakistani ethnic group were 1.8 times more likely to have a COVID-19-related death than white males when age and other sociodemographic and health characteristics were taken into account (Office for National Statistics, 2020). This difference in the incidence and mortality of COVID-19 between ethnic groups is only partly accounted for by socioeconomic disadvantage and other circumstances; the remaining gap has not yet been explained (Docherty et al, 2020; Intensive Care National Audit and Research Centre, 2020; Office for National Statistics, 2020).
Authors Sandro Galea
Authors Bruno J Strasser, Thomas Schlich
Authors David C. Grabowski, Vincent Mor
Authors Corey M Peak, Rebecca Kahn, Yonatan H Grad, Lauren M Childs, Ruoran Li, Prof Marc Lipsitch, Caroline O Buckee
AUSTRALIAN JOURNAL OF GENERAL PRACTICE
Authors MIKE STARR
Authors Baggett, T. P., Keyes, H., Sporn, N. & Gaeta
PROSTATE CANCER
Authors Alessandro Sciarra, Stefano Salciccia, Martina Maggi, Francesco Del Giudice, Gian Maria Busetto, Daniela Musio, Antonio Ciardi, Carlo Catalano, Enrico Cortesi, Valeria Panebianco
ABSTRACT Coronavirus disease 2019 (COVID-19) has been declared pandemic since March 2020. In Europe, Italy has been the first nation affected by this infection. In this paper we report anamnestic data, clinical features and therapeutic management of two lung transplant recipients with confirmed COVID-19 pneumonia. Both patients were in good clinical conditions prior to the infection and were on immunosuppression with calcineurin inhibitors (CNI), mycophenolate mofetil and corticosteroids. Whilst mycophenolate mofetil was withdrawn in both cases, CNI were suspended only in the second patient. The first patient always maintained excellent oxygen saturation throughout hospitalization with no need for additional oxygen therapy. He was discharged with a satisfactory pulmonary function and a complete resolution of radiological and clinical findings. However, at discharge SARS-CoV-2 RNA could still be detected in the nasopharyngeal swab and in the stools. The second patient required mechanical ventilation, had a progressive deterioration of his clinical conditions and had a fatal outcome. Further insight into SARS-CoV-2 infection is eagerly awaited to improve the outcome transplant recipients affected by COVID-19 pneumonia.
Authors Elissa M Abrams, Stanley J Szefler
Authors Jonathan P Rogers, Edward Chesney, Dominic Oliver, Thomas A Pollak, Prof Philip McGuire, Paolo Fusar-Poli, Michael S Zandi, Glyn Lewis, Anthony S David
Authors The Lancet
BJBMS
Authors Antonio Minni, Massimo Ralli, Francesca Candelori, Fabrizio Cialente, Lucia Ercoli, Claudio Parlapiano, Antonio Greco, Marco de Vincentiis
ABSTRACT The HERe2cure project, which involved a group of breast cancer experts, members of multidisciplinary tumor boards from healthcare institutions in Bosnia and Herzegovina, was initiated with the aim of defining an optimal approach to the diagnosis and treatment of HER2 positive breast cancer. After individual multidisciplinary consensus meetings were held in all oncology centers in Bosnia and Herzegovina, a final consensus meeting was held in order to reconcile the final conclusions discussed in individual meetings. Guidelines were adopted by consensus, based on the presentations and suggestions of experts, which were first discussed in a panel discussion and then agreed electronically between all the authors mentioned. The conclusions of the panel discussion represent the consensus of experts in the field of breast cancer diagnosis and treatment in Bosnia and Herzegovina. The objectives of the guidelines include the standardization, harmonization and optimization of the procedures for the diagnosis, treatment and monitoring of patients with HER2-positive breast cancer, all of which should lead to an improvement in the quality of health care of mentioned patients. The initial treatment plan for patients with HER2-positive breast cancer must be made by a multidisciplinary tumor board comprised of at least: a medical oncologist, a pathologist, a radiologist, a surgeon, and a radiation oncologist/radiotherapist.
Authors Jane Feinmann
JB&JS
Authors White, Peter B., Cohn, Randy, Humbyrd, Casey Jo
CRITICAL CARE MEDICINE
Authors Zivot, Joel
PSYCHIATRY INVESTIGATION
Authors Rong Pan, Liqing Zhang, Jiyang Pan
Objective To analysis the anxiety status of Chinese medical workers during the epidemic of COVID-19 by meta-analysis method. Methods CNKI, VIP, WanFang Data, SinoMed, PubMed, Cochrane, EMBASE, MEDLINE, Scopus, Google Scholar and other databases were searched to collect literature on the anxiety status of Chinese medical workers during the epidemic of COVID-19. The retrieval time is from the database construction to 11/03/2020. Meta-analysis was performed on the included articles by using Stata 16.0 software. Results A total of 7 articles were included, with a total sample size of 7,741 people. Meta-analysis using the random effects model showed that the anxiety score of Chinese medical during the epidemic of COVID-19 was significantly higher than that of the national norm in each study, the difference was statistically significant [SMD (95% CI)=1.145 (0.705–1.584), p<0.001]. Conclusion The anxiety level of Chinese medical workers has increased significantly during the epidemic of COVID-19.
Authors Kelley Lee, Catherine Z Worsnop, Karen A Grépin, Adam Kamradt-Scott
IJIR
Authors Andrea Cocci, Daniel Giunti, Camilla Tonioni, Giovanni Cacciamani, Riccardo Tellini, Gaia Polloni, Gianmartin Cito, Fabrizio Presicce, Marina Di Mauro, Andrea Minervini, Sebastiano Cimino, Giorgio Ivan Russo
Authors: -
Authors Thomas H. C. Sit, Christopher J. Brackman, Sin Ming Ip, Karina W. S. Tam, Pierra Y. T. Law, Esther M. W. To, Veronica Y. T. Yu, Leslie D. Sims, Dominic N. C. Tsang, Daniel K. W. Chu, Ranawaka A. P. M. Perera, Leo L. M. Poon, Malik Peiris
ABSTRACT SARS-CoV-2 emerged in Wuhan in December 2019 and caused the pandemic respiratory disease, COVID-191,2. In 2003, the closely related SARS-CoV had been detected in domestic cats and a dog3. However, little is known about the susceptibility of domestic pet mammals to SARS-CoV-2. Two out of fifteen dogs from households with confirmed human cases of COVID-19 in Hong Kong SAR were found to be infected using quantitative RT–PCR, serology, sequencing the viral genome, and in one dog, virus isolation. SARS-CoV-2 RNA was detected in a 17-year-old neutered male Pomeranian from five nasal swabs collected over a 13-day period. A 2.5-year-old male German Shepherd dog had SARS CoV-2 RNA on two occasions and virus was isolated from nasal and oral swabs. Both dogs had antibody responses detected using plaque reduction neutralization assays. Viral genetic sequences of viruses from the two dogs were identical to the virus detected in the respective human cases. The animals remained asymptomatic during quarantine. The evidence suggests that these are instances of human-to-animal transmission of SARS-CoV-2. It is unclear whether infected dogs can transmit the virus to other animals or back to humans.
Authors Susanna Esposito, Nicola Principi
Authors Dermot Phelan, Jonathan H. Kim, Eugene H. Chung
The BMJ
Authors Helen Salisbury
Authors Neil F. Johnson, Nicolas Velásquez, Nicholas Johnson Restrepo, Rhys Leahy, Nicholas Gabriel, Sara El Oud, Minzhang Zheng, Pedro Manrique, Stefan Wuchty, Yonatan Lupu
ABSTRACT Distrust in scientific expertise1,2,3,4,5,6,7,8,9,10,11,12,13,14 is dangerous. Opposition to vaccination with a future vaccine against SARS-CoV-2, the causal agent of COVID-19, for example, could amplify outbreaks2,3,4, as happened for measles in 20195,6. Homemade remedies7,8 and falsehoods are being shared widely on the Internet, as well as dismissals of expert advice9,10,11. There is a lack of understanding about how this distrust evolves at the system level13,14. Here we provide a map of the contention surrounding vaccines that has emerged from the global pool of around three billion Facebook users. Its core reveals a multi-sided landscape of unprecedented intricacy that involves nearly 100 million individuals partitioned into highly dynamic, interconnected clusters across cities, countries, continents and languages. Although smaller in overall size, anti-vaccination clusters manage to become highly entangled with undecided clusters in the main online network, whereas pro-vaccination clusters are more peripheral. Our theoretical framework reproduces the recent explosive growth in anti-vaccination views, and predicts that these views will dominate in a decade. Insights provided by this framework can inform new policies and approaches to interrupt this shift to negative views. Our results challenge the conventional thinking about undecided individuals in issues of contention surrounding health, shed light on other issues of contention such as climate change11, and highlight the key role of network cluster dynamics in multi-species ecologies15.
THE NEW ENGLAND JOURNAL OF MEDIINE
Authors Victor J. Dzau, Darrell Kirch, Thomas Nasca
Authors Clare L Whitehead, Susan P Walker
Authors David Oliver
Authors Davide Mauri, Konstantinos Kamposioras,Maria Tolia, Filippo Alongi,Dimitrios Tzachanis
Authors Timothy Roberton, Emily D Carter, Victoria B Chou, Angela R Stegmuller, Bianca D Jackson, Yvonne Tam, Talata Sawadogo-Lewis, Neff Walker
ABSTRACT Background While the COVID-19 pandemic will increase mortality due to the virus, it is also likely to increase mortality indirectly. In this study, we estimate the additional maternal and under-5 child deaths resulting from the potential disruption of health systems and decreased access to food. Methods We modelled three scenarios in which the coverage of essential maternal and child health interventions is reduced by 9·8–51·9% and the prevalence of wasting is increased by 10–50%. Although our scenarios are hypothetical, we sought to reflect real-world possibilities, given emerging reports of the supply-side and demand-side effects of the pandemic. We used the Lives Saved Tool to estimate the additional maternal and under-5 child deaths under each scenario, in 118 low-income and middle-income countries. We estimated additional deaths for a single month and extrapolated for 3 months, 6 months, and 12 months. Findings Our least severe scenario (coverage reductions of 9·8–18·5% and wasting increase of 10%) over 6 months would result in 253 500 additional child deaths and 12 200 additional maternal deaths. Our most severe scenario (coverage reductions of 39·3–51·9% and wasting increase of 50%) over 6 months would result in 1 157 000 additional child deaths and 56 700 additional maternal deaths. These additional deaths would represent an increase of 9·8–44·7% in under-5 child deaths per month, and an 8·3–38·6% increase in maternal deaths per month, across the 118 countries. Across our three scenarios, the reduced coverage of four childbirth interventions (parenteral administration of uterotonics, antibiotics, and anticonvulsants, and clean birth environments) would account for approximately 60% of additional maternal deaths. The increase in wasting prevalence would account for 18–23% of additional child deaths and reduced coverage of antibiotics for pneumonia and neonatal sepsis and of oral rehydration solution for diarrhoea would together account for around 41% of additional child deaths. Interpretation Our estimates are based on tentative assumptions and represent a wide range of outcomes. Nonetheless, they show that, if routine health care is disrupted and access to food is decreased (as a result of unavoidable shocks, health system collapse, or intentional choices made in responding to the pandemic), the increase in child and maternal deaths will be devastating. We hope these numbers add context as policy makers establish guidelines and allocate resources in the days and months to come.
ELSIEVER
Authors P.Patel, P.A.PatelS..R.Vunnam, R.Jain, R.R.Vunnam
Authors Francesco Paolo Russo
Authors Monica Webb Hooper, Anna María Nápoles, Eliseo J. Pérez-Stable
Authors Nicole M Benson, Dost Öngür, John Hsu
AHAJOURNAL
Authors Prateeti Khazanie , Matthew Wynia, Neal W Dickert
Authors David R. Williams, Lisa A. Cooper
Authors Jay H. Shore, Christopher D. Schneck, Matthew C. Mishkind
eLife
Authors Lucy Rivett, Sushmita Sridhar, Dominic Sparkes, Matthew Routledge, Nick K Jones, Sally Forrest, Jamie Young, Joana Pereira-Dias, William L Hamilton, Mark Ferris, M Estee Torok, Luke Meredith, The CITIID-NIHR COVID-19 BioResource Collaboration, Martin D Curran, Stewart Fuller, Afzal Chaudhry, Ashley Shaw, Richard J Samworth, John R Bradley, Gordon Dougan, Kenneth G C Smith, Paul J Lehner, Nicholas J Matheson, Giles Wright, Ian G Goodfellow, Stephen Baker, Michael P Weekes
ABSTRACT Significant differences exist in the availability of healthcare worker (HCW) SARS-CoV-2 testing between countries, and existing programmes focus on screening symptomatic rather than asymptomatic staff. Over a 3-week period (April 2020), 1,032 asymptomatic HCWs were screened for SARS-CoV-2 in a large UK teaching hospital. Symptomatic staff and symptomatic household contacts were additionally tested. Real-time RT-PCR was used to detect viral RNA from a throat+nose self-swab. 3% of HCWs in the asymptomatic screening group tested positive for SARS-CoV-2. 17/30 (57%) were truly asymptomatic/pauci-symptomatic. 12/30 (40%) had experienced symptoms compatible with coronavirus disease 2019 (COVID-19) >7 days prior to testing, most self-isolating, returning well. Clusters of HCW infection were discovered on two independent wards. Viral genome sequencing showed that the majority of HCWs had the dominant lineage B∙1. Our data demonstrates the utility of comprehensive screening of HCWs with minimal or no symptoms. This approach will be critical for protecting patients and hospital staff.
Authors Guglielmo Mantica, Niccolò Riccardi, Carlo Terrone, Angelo Gratarola
Authors Syed M Qasim Hussaini
MPDI
Authors Silvia Ravalli, Giuseppe Musumeci
ABSTRACT The Coronavirus Disease 2019 (COVID-19) pandemic has forced the hardest-hit populations, like Italians, to radically change their daily habits, starting with social distancing, strict preventive measures, and self-isolation. These precautions also apply to sport-related facilities and activities. The difficulty to practice physical activity during this dramatic moment in time adds to the risks associated with sedentary habits, due to staying all the time at home. Here, the importance and the benefits of maintaining exercise routine, even at home, are emphasized in order to avoid the consequences of inactivity.
Authors Urvi A. Shah
Authors Elisabeth Roesch, Avni Amin, Jhumka Gupta,Claudia García-Moreno
Authors Antonio Frontera, Lorenzo Cianfanelli, Konstantinos Vlachos, Giovanni Landoni , George Cremona
ABSTRACT Objectives In areas of SARS-CoV-2 outbreak worldwide mean air pollutants concentrations vastly exceed the maximum limits. Chronic exposure to air pollutants have been associated with lung ACE-2 over-expression which is known to be the main receptor for SARS-CoV-2. The aim of this study was to analyse the relationship between air pollutants concentration (PM 2.5 and NO2) and COVID-19 outbreak, in terms of transmission, number of patients, severity of presentation and number of deaths. Methods COVID-19 cases, ICU admissions and mortality rate were correlated with severity of air pollution in the Italian regions. Results The highest number of COVID-19 cases were recorded in the most polluted regions with patients presenting with more severe forms of the disease requiring ICU admission. In these regions, mortality was two-fold higher than the other regions. Conclusions From the data available we propose a “double-hit hypothesis”: chronic exposure to PM 2.5 causes alveolar ACE-2 receptor overexpression. This may increase viral load in patients exposed to pollutants in turn depleting ACE-2 receptors and impairing host defences. High atmospheric NO2 may provide a second hit causing a severe form of SARS-CoV-2 in ACE-2 depleted lungs resulting in a worse outcome.
Authors Carlo Resteghini, Paola Maggioni, Vito Di Martino, Lisa Licitra & on behalf of Head and Neck Cancer Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori Milan, Italy
Authors Richard S. Quilliam, Manfred Weidmann, Vanessa Moresco, Heather Purshouse, Zoe O'Hara, David M. Oliver
Authors Paul Little, Robert C Read, Richard Amlôt, Tim Chadborn, Cathy Rice, Jennifer Bostock , Lucy Yardley
Authors Jacqui Thornton
EJCN
Authors Anna Vittoria Mattioli, Matteo Ballerini Puviani, Milena Nasi, Alberto Farinetti
ABSTRACT COVID-19 is causing a global pandemic with a high number of deaths and infected people. To contain the diffusion of COVID-19 virus, Governments have enforced restrictions on outdoor activities or even collective quarantine on the population. One important consequence of quarantine is a change in lifestyle: reduced physical activity and unhealthy diet. 2019 guidelines for primary prevention of cardiovascular disease indicate that “Adults should engage in at least 150 minute per week of accumulated moderate-intensity or 75 minute per week of vigorous-intensity aerobic physical activity (or an equivalent combination of moderate and vigorous activity) to reduce ASCVD risk.” During quarantine, strategies to further increase home-based physical activity and to follow a healthy diet should be implemented. Quarantine carries some long-term effects on cardiovascular disease, mainly related to unhealthy lifestyle and anxiety. Following quarantine a global action supporting healthy diet and physical activity is mandatory to encourage people to return to good lifestyle.
Authors Haizhou Wang, Fan Wang, Hongling Wang and Qiu Zhao
Authors Jessica A Gold
Authors Stefano Fagiuoli, Ferdinando Luca Lorini, Giuseppe Remuzzi
Authors Bryn Nelson
Authors Donald M. Berwick
Authors DanieleFattorini, FrancescoRegoli
ABSTRACT After the initial outbreak in China, the diffusion in Italy of SARS-CoV-2 is exhibiting a clear regional trend with more elevated frequency and severity of cases in Northern areas. Among multiple factors possibly involved in such geographical differences, a role has been hypothesized for atmospheric pollution. We provide additional evidence on the possible influence of air quality, particularly in terms of chronicity of exposure on the spread viral infection in Italian regions. Actual data on Covid-19 outbreak in Italian provinces and corresponding long-term air quality evaluations, were obtained from Italian and European agencies, elaborated and tested for possible interactions. Our elaborations reveal that, beside concentrations, the chronicity of exposure may influence the anomalous variability of SARS-CoV-2 in Italy. Data on distribution of atmospheric pollutants (NO2, O3, PM2.5 and PM10) in Italian regions during the last 4 years, days exceeding regulatory limits, and years of the last decade (2010–2019) in which the limits have been exceeded for at least 35 days, highlight that Northern Italy has been constantly exposed to chronic air pollution. Long-term air-quality data significantly correlated with cases of Covid-19 in up to 71 Italian provinces (updated April 27, 2020) providing further evidence that chronic exposure to atmospheric contamination may represent a favourable context for the spread of the virus. Pro-inflammatory responses and high incidence of respiratory and cardiac affections are well known, while the capability of this coronavirus to bind particulate matters remains to be established. Atmospheric and environmental pollution should be considered as part of an integrated approach for sustainable development, human health protection and prevention of epidemic spreads but in a long-term and chronic perspective, since adoption of mitigation actions during a viral outbreak could be of limited utility.
Authors COVID-19 Resource Centre
Authors David M. Cutler, Sayeh Nikpay; Robert S. Huckman
BMJ
Authors MARCO TRABUCCHI, DIEGO DE LEO
Authors Pietro Fusaroli, Sara Balena, Andrea Lisotti
Anesthesia & Analgesia Journal Publish Ahead of Print
Authors Ip, Vivian H. Y. MBChB FRCA; Sondekoppam, Rakesh V; Özelsel, Timur J. P; Tsui, Ban
Authors Christian Rose
Authors Enrico Baldi, Giuseppe M. Sechi, Claudio Mare, Fabrizio Canevari, Antonella Brancaglione
Authors John H. Krystal, Robert L. McNeil Jr
Authors Cosentino M, Assanelli E, Merlino L, Mazza M, Bartorelli AL, Marenzi G
Authors Peter Green
NCBI
Authors Donatella Rita Petretto, Roberto Pili
JAMIA
Authors Leslie Lenert, Brooke Yeager McSwain
ABSTRACT The novel coronavirus disease 2019 infection poses serious challenges to the healthcare system that are being addressed through the creation of new unique and advanced systems of care with disjointed care processes (eg, telehealth screening, drive-through specimen collection, remote testing, telehealth management). How- ever, our current regulations on the flows of information for clinical care and research are antiquated and often conflict at the state and federal levels. We discuss proposed changes to privacy regulations such as the Health Insurance Portability and Accountability Act designed to let health information seamlessly and frictionlessly flow among the health entities that need to collaborate on treatment of patients and, also, allow it to flow to researchers trying to understand how to limit its impacts.
FRONTIERS IN PUBLIC HEALTH
Authors Chuan-bin Sun, Yue-ye Wang, Geng-hao Liu, Zhe Liu
Authors Stefan R Bornstein, Francesco Rubino, Kamlesh Khunti, Geltrude Mingrone, David Hopkins, Andreas L Birkenfeld, Bernhard Boehm, Stephanie Amiel , Richard IG Holt, Jay S Skyler, J Hans DeVries, Eric Renard, Robert H Eckel, Paul Zimmet, Kurt George Alberti, Josep Vidal, Bruno Geloneze, Juliana C Chan, Linong Ji, Barbara Ludwig
FRONTIERS IN ONCOLOGY
Authors Oronzo Brunetti, Afshin Derakhshani, Behzad Baradaran, Antonio Galvano, Antonio Russo, Nicola Silvestris
Authors Philip B. Maffetone, Paul B. Laursen
Authors Sunil Kumar Panigrahi, Vineet Kumar Pathak, M Mohan Kumar, Utsav Raj, Karpaga Priya P
ABSTRACT Covid-19 is now a global pandemic. There is some evidence to suggest possible fomite transmission. Hence, inanimate objects play a significant role in their transmission. In this commentary, we discuss ‘mobile phones’ as a potential vector of severe acute respiratory syndrome-CoV-2 spread. The use of mobile phones has not been restricted in hospital and other health- care settings. Hence, mobile phones could be a missing link in controlling the covid-19 pandemic. We recommend, as part of efforts to control the covid-19 pandemic, awareness of ‘mobile phone hygiene’; restriction of mobile phone use in health- care settings; avoiding the sharing of mobile phones, headphones or headsets of any kind; and widely dis- seminated advice from mobile companies, govern- ments and WHO on how to disinfect mobile phones.
THE JOURNALS OF GERENTOLOGY
Authors Stefano Volpato, Francesco Landi, Raffaele Antonelli Incalzi
Lancet
Authors Manish Pareek, Mansoor N Bangash, Nilesh Pareek, Daniel Pan, Shirley Sze, Jatinder S Minhas, Wasim Hanif, Kamlesh Khunti
Authors Rupali Jayant Limaye, Molly Sauer, Joseph Ali, Justin Bernstein, Brian Wahl, Anne Barnhill, Alain Labrique
Authors David Gunnell, Louis Appleby, Ella Arensman, Keith Hawton, Ann John, Nav Kapur, Murad Khan, Rory C O’Connor, Jane Pirkis, and the COVID-19 Suicide Prevention Research Collaboration
Nature
Authors Adriana Balduzzi, Erica Brivio, Attilio Rovelli, Carmelo Rizzari, Serena Gasperini, Maria Luisa Melzi, Valentino Conter, Andrea Biondi
ABSTRACT Italy is the second exposed country worldwide, after China, and Lombardia is the most affected region in Italy, with more than half of the national cases, with 13% of whom being healthcare professionals. The Clinica Pediatrica Università degli Studi di Milano Bicocca is a general pediatric and hematology oncology and transplant center embedded within the designated COVID-19 general Hospital San Gerardo in Monza, located in Lombardia, Italy. Preventive and control measures specifically undertaken to cope with the emergency within hemato-oncology, transplant, and outpatient unit in the pediatric department have been described. Preliminary COVID-19 experiences with the first Italian pediatric hemato-oncology patients are reported. The few available data regarding pediatrics and specifically hemato-oncological patients are discussed. The purpose of this report is to share pediatric hemato-oncology issues encountered in the first few weeks of the COVID-19 outbreak in Italy and to alert healthcare professionals worldwide to be prepared accordingly.
Authors Howard Bauchner, Thomas J. Easley
Authors Aaron van Dorn, Rebecca E Cooney, Miriam L Sabin
Authors Samuele Cortese, Philip Asherson, Edmund Sonuga-Barke, Tobias Banaschewski, Daniel Brandeis, Jan Buitelaar, David Coghill, David Daley, Marina Danckaerts, Ralf W Dittmann, Manfred Doepfner, Maite Ferrin, Chris Hollis, Martin Holtmann, Eric Konofal, Michel Lecendreux, Paramala Santosh, Aribert Rothenberger, César Soutullo, Hans-Christoph Steinhausen, Eric Taylor, Saskia Van der Oord, Ian Wong, Alessandro Zuddas, Emily Simonoff
ABSTRACT Owing to the COVID-19 outbreak in Lombardy, Italy) there is an urgent need to manage cardiovascular emergencies, including acute coronary syndrome (ACS), with appropriate standards of care and dedicated preventive measures and pathways against the risk of SARS-CoV-2 infection. For this reason, the Government of Lombardy decided to centralize the treatment of ACS patients in a limited number of centers, including our university cardiology institute, which in the past 4 weeks became a cardiovascular emergency referral center in a regional hub-and-spoke system. Therefore, we rapidly developed a customized pathway to allocate patients to the appropriate hospital ward, and treat them according to ACS severity and risk of suspected SARS-CoV-2 infection. We present here the protocol dedicated to ACS patients adopted in our center since March 13, 2020, and our initial experience in the management of ACS patients during the first 4 weeks of its use. Certainly, the protocol has room for further improvement as everyone's experience grows, but we hope that it could be a starting point, adaptable to different realities and local resources.
Authors Lisa Rosenbaum
EJSO
Authors Luigi Marano, Daniele Marrelli, Franco Roviello
Authors Loïc Mourey, Claire Falandry, Laure de Decker, Rabia Boulahssass, Elisabeth Carola, Leila Bengrine Lefevre, Tristan Cudennec, Etienne Brain, Eléna Paillaud, Pierre Soubeyran
Authors Betty Pfefferbaum, Carol S. North
Authors Modesto Leite Rolim Neto, Ricardo Inácio de Souza, Rosa Magda Martins Quezado, Elayne Cristina Santos Mendonça, Tallys Iury de Araújo, Dayse Christina Rodrigues Pereira Luz, Willma José de Santana, Juliana Ribeiro Francelino Sampaio, Poliana Moreira de Medeiros Carvalho, Tereza Maria Siqueira Nascimento Arrais, José Marcondes Macedo Landim, Claúdio Gleideston Lima da Silva
ABSTRACT
Background: Homeless experts and some federal housing officials are sounding the alarm that the patchwork of government efforts to address the coronavirus outbreak risks leaving out one group of acutely vulnerable people: the homeless. In terms of isolation, it is too unclear what that looks like if you normally sleep on the streets. In this tough moment, when people should be turned away, not only it feels inhumane, but it is also a big public health risk, because where are they going to go?
Method: The studies were identified using large-sized newspapers with international circulation Results: With more cities suspecting community transmission of the novel coronavirus, people who sleep in shelters or hunker down outside already have a lower life expectancy and often have underlying health con- ditions that put them at greater risk if they develop COVID-19 (Global News, 2020). These people face lack of sleep, malnutrition, and “extreme stress levels just to meet their daily needs”, all of which weakens the immune system. Along with mental illness or substance abuse disorders, they are “incredibly vulnerable to this virus”.
Conclusions: Health organizations are well aware of the risks involved in mental health. A large population of homeless people experience their pain and psychological distress intermittently. For low-income patients, the various borderline situations related to health/illness involve growing expectations regarding the basic needs. This is a serious concern when linked to the pandemic.
Authors Deborah Schrag, Dawn L. Hershman, Ethan Basch
Authors Mark A. Reger, Ian H. Stanley, Thomas E. Joiner
Authors Peijie Chen, Lijuan Mao, George P. Nassis, Peter Harmer, Barbara E. Ainsworth, Fuzhong Li
Authors Andy Haines, Enrique Falceto de Barros, Anita Berlin, David L Heymann, *Matthew J Harris
Authors Yu-Tao Xiang, Yu Jin, Teris Cheung
Authors Michelle J. Bayefsky, Deborah Bartz, Katie L. Watson
Authors Silvia Castelletti
Authors Sherrie Bhoori, Roberta Elisa Rossi, Davide Citterio, *Vincenzo Mazzaferro
Authors A. M. Abbatecola, R. Antonelli-Incalzi
Annals of Internal Medicine
Authors Albert W. Wu, Cheryl Connors, BSN, George S. Everly Jr.
KIREPORTS
Authors Federico Alberici, Elisa Delbarba, Chiara Manenti, Laura Econimo, Francesca Valerio, Alessandra Pola, Camilla Maffei, Stefano Possenti, Simone Piva, Nicola Latronico, Emanuele Focà, Francesco Castelli, Paola Gaggia, Ezio Movilli, Sergio Bove, Fabio Malberti, Marco Farina, Martina Bracchi, Ester Maria Costantino, Nicola Bossini, Mario Gaggiotti, Francesco Scolari
ABSTRACT The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as coronavirus disease (COVID-19), is a major pandemic challenging health care systems around the world. The optimal management of patients infected with COVID-19 is still unclear, although the consensus is moving toward the need of a biphasic approach. During the first phase of the disease (from onset of the symptoms up to 7–10 days) viral-induced effects are prominent, with the opportunity to institute antiviral therapy. In the second inflammatory phase of the disease, immunosuppressive strategies (for example with glucocorticoids or anticytokine drugs) may be considered. This latter stage is characterized by the development of progressive lung involvement with increasing oxygen requirements and occasionally signs of the hemophagocytic syndrome. The management of the disease in patients with kidney disease is even more challenging, especially in those who are immunosuppressed or with severe comorbidities. Here we present the therapeutic approach used in Brescia (Italy) for managing patients infected with COVID-19 who underwent kidney transplantation and are receiving hemodialysis. Furthermore, we provide some clinical and physiopathological background, as well as preliminary outcome data of our cohort, to better clarify the pathogenesis of the disease and clinical management.
Authors Francesco Landi,corresponding author C. Barillaro, A. Bellieni, V. Brandi, A. Carfì, M. D’Angelo, D. Fusco, G. Landi, R. Lo Monaco, A.M. Martone, E. Marzetti, F. Pagano, C. Pais, A. Russo, S. Salini, M. Tosato, A. Tummolo, F. Benvenuto, G. Bramato, L. Catalano, F. Ciciarello, I. Martis, S. Rocchi, E. Rota, A. Salerno, M. Tritto, A. Sgadari, G. Zuccalà, and R. Bernabei
CRITICAL CARE EXPLORATION
Authors Scott, Benjamin K; Hravnak, Marilyn , Pamplin, Jeremy C
ABSTRACT Social distancing as a technique to limit transmission of infectious disease has come into common parlance following the arrival and rapid spread of a novel coronavirus disease around the world in 2019 and 2020. But in the face of an emerging pandemic threat, it is crucial that we start to apply these principles to the clinic, the emergency department, and the hospital ward. We propose that this dynamic situation calls for a parallel “Clinical Distancing” in which we as a medical culture go against many of our fundamental instincts and, at least in the short term, begin to reduce unnecessary patient-care contacts for the benefit of our patients and our ability to continue to provide care to those who need it most. In this commentary, we provide specific recommendations for the rapid implementation of clinical distancing techniques.
Authors Maged N. Kamel Boulos, Estella M. Geraghty
ABSTRACT In December 2019, a new virus (initially called ‘Novel Coronavirus 2019-nCoV’ and later renamed to SARS-CoV-2) causing severe acute respiratory syndrome (coronavirus disease COVID-19) emerged in Wuhan, Hubei Province, China, and rapidly spread to other parts of China and other countries around the world, despite China’s massive efforts to contain the disease within Hubei. As with the original SARS-CoV epidemic of 2002/2003 and with seasonal influenza, geographic information systems and methods, including, among other application possibilities, online real-or near-real-time mapping of disease cases and of social media reactions to disease spread, predictive risk mapping using population travel data, and tracing and mapping super-spreader trajectories and contacts across space and time, are proving indispensable for timely and effective epidemic monitoring and response. This paper offers pointers to, and describes, a range of practical online/mobile GIS and mapping dashboards and applications for tracking the 2019/2020 coronavirus epidemic and associated events as they unfold around the world. Some of these dashboards and applications are receiving data updates in near-real-time (at the time of writing), and one of them is meant for individual users (in China) to check if the app user has had any close contact with a person confirmed or suspected to have been infected with SARS-CoV-2 in the recent past. We also discuss additional ways GIS can support the fight against infectious disease outbreaks and epidemics.
Authors Poliana Moreira de Medeiros Carvalhoa, Marcial Moreno Moreiraa, Matheus Nogueira Arcanjo de Oliveirac, José Marcondes Macedo Landima, Modesto Leite Rolim Netob
Authors Samantha K Brooks, Rebecca K Webster, Louise E Smith, Lisa Woodland, Simon Wessely, Neil Greenberg, Gideon James Rubin
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