Risultati per: COVID-19 grave collegato all’invecchiamento cerebrale

New England Journal of Medicine, Ahead of Print.

Kluge: ‘I ricoveri cresciuti del 51% rispetto a 4 settimane fa’

A spiegarne le caratteristiche è il virologo Fabrizio Pregliasco

Colpa della variante KP.3 e della poca prevenzione. “Cautele per gli anziani”

Iss-Ministero, stabili i ricoveri. Domina la variante KP.3 (40%)

Objectives
Parents’ decisions to vaccinate their children against COVID-19 are complex and often informed by discussions with primary care physicians. However, little is known about physicians’ perspectives on COVID-19 vaccinations for children or their experiences counselling parents in their decision-making. We explored physicians’ experiences providing COVID-19 vaccination recommendations to parents and their reflections on the contextual factors that shaped these experiences.

Design
We conducted an interpretive qualitative study using in-depth interviews. We analyzed the data using reflexive thematic analysis and a socioecological framework.

Setting
This study involved primary care practices associated with The Applied Research Group for Kids (TARGet Kids!) primary care research network in the Greater Toronto Area, Ontario, Canada.

Participants
Participants were 10 primary care physicians, including family physicians, paediatricians and paediatric subspecialists.

Results
Participants discussed elements at the individual level (their identity, role, and knowledge), the interpersonal level (their relationships with families, responsiveness to parents’ concerns, and efforts to build trust) and structural level (contextual factors related to the evolving COVID-19 climate, health system pandemic response, and constraints on care delivery) that influenced their experiences providing recommendations to parents. Our findings illustrated that physicians’ interactions with families were shaped by a confluence of their own perspectives, their responses to parents’ perspectives, and the evolving landscape of the broader pandemic.

Conclusions
Our study underscores the social and relational nature of vaccination decision-making and highlights the multiple influences on primary care physicians’ experiences providing COVID-19 vaccination recommendations to parents. Our findings offer suggestions for future COVID-19 vaccination programmes for children. Delivery of new COVID-19 vaccinations for children may be well suited within primary care offices, where trusting relationships are established, but physicians need support in staying knowledgeable about emerging information, communicating available evidence to parents to inform their decision-making and dedicating time for vaccination counselling.

Attivate misure di sorveglianza per trasmissione da trapianto

Objectives
The study explored the perceived impacts of COVID-19 and its associated policies and social restrictions on health, self-management and access to healthcare.

Design
Cross-sectional observational (online survey) and qualitative study (semi-structured interviews and thematic analysis).

Setting
Australia.

Participants
People with self-reported cardiovascular disease (CVD) and/or risk factors.

Results
Survey responses were collected from 690 participants (43.8% women, 40.1% over 65 years). Participants reported that their heart health had been affected by the pandemic (26.3%), were less likely to exercise (47.1%), have a healthy diet (25.9%) and take medications (9.4%). A large proportion were admitted to hospital (46.2%) and presented to the emergency department (40.6%). Difficulties in accessing healthcare providers (53.2%) and use of telemedicine (63.6%) were reported. We conducted 16 semi-structured interviews and identified five key themes: adding burden in seeking medical care, impediments in accessing a readjusted health system, exacerbating vulnerability and distress, coping with self-management and adapting to telehealth.

Conclusions
Patients with CVD expressed an additional burden in seeking medical care and difficulties navigating a readjusted health system during the COVID-19 pandemic. Associated policies and access issues heightened vulnerabilities and distress, making self-management of health difficult for patients with CVD.

Objectives
To investigate the association between exposure to potentially inappropriate medication (PIM) and poor prognosis of COVID-19 in older adults, controlling for comorbidity and sociodemographic factors.

Design and setting
Nationwide retrospective cohort study based on the national registry of COVID-19 patients, established through the linkage of South Korea’s national insurance claims database with the Korea Disease Control and Prevention Agency registry of patients with COVID-19, up to 31 July 2020.

Participants
A total of 2217 COVID-19 patients over 60 years of age who tested positive between 20 January 2022 and 4 June 2020. Exposure to PIM was defined based on any prescription record of PIM during the 30 days prior to the date of testing positive for COVID-19.

Primary outcome measures
Mortality and utilisation of critical care from the date of testing positive until the end of isolation.

Results
Among the 2217 COVID-19 patients over 60 years of age, 604 were exposed to PIM prior to infection. In the matched cohort of 583 pairs, PIM-exposed individuals exhibited higher rates of mortality (19.7% vs 9.8%, p

Background
The novel COVID-19 was rapidly spreading and was highly contagious. COVID-19 caused over 6 million deaths worldwide, with high mortality rates, particularly in severe cases.

Objective
This study aimed to investigate whether serum albumin-neutrophil count to lymphocyte count ratio (NLR) score (ANS) could be used as a prognostic indicator of COVID-19 severity.

Design
A retrospective study.

Participants
Based on the WHO diagnostic criteria, patients were classified as either non-severe (n=270) or severe (n=100).

Primary and secondary outcome measures
NLR, serum albumin level and ANS.

Main results
The NLR of patients with severe disease was significantly higher than that of those with non-severe disease. Serum albumin levels were significantly lower in patients with severe disease than in those with non-severe disease. The cut-off values representing the maximum potential effectiveness of serum albumin and NLR were 33.5 g/L and 8.25, respectively, according to the Youden index. In patients with severe COVID-19, we observed that the serum albumin level, NLR and ANS were independent prognostic indicators of severe COVID-19 using logistic analysis. The relative risk of severe COVID-19 was 7.65 (95% CI 3.72 to 15.75, p

Il monitoraggio rivela un preoccupante aumento del 42% dei casi di Covid-19 nell’ultima settimana

Esperti, organizzazione e comunicazione per aumentare coperture

L’Ue risponde, ‘sui vaccini usato equilibrio’

New England Journal of Medicine, Volume 391, Issue 3, Page 224-234, July 18, 2024.

New England Journal of Medicine, Ahead of Print.

Introduction
COVID-19 vaccination is crucial for vulnerable people with underlying chronic conditions such as Alzheimer’s disease and related dementias (ADRD) and mild cognitive impairment (MCI). These individuals face unique challenges, including higher risk of COVID-19, difficulties in adopting preventive behaviours and vaccine hesitancy due to concerns about adverse reactions. Therefore, efforts to promote vaccination, including boosters tailored to the currently circulating virus, are essential for people with ADRD/MCI.

Objective
The primary purpose of this study protocol is to conduct a comprehensive analysis of COVID-19 vaccination coverage and adverse reactions among individuals with ADRD/MCI in comparison to those without ADRD/MCI. Additionally, the proposed study aims to investigate the impact of social determinants of health on COVID-19 vaccination and vaccine hesitancy in individuals with ADRD/MCI.

Methods and analysis
A retrospective cross-sectional study will be conducted utilising data from the All of Us (AoU) Researcher Workbench. Relevant data fields are extracted from sources including demographic information, COVID-19 Vaccine Survey, Basic Survey, Health Access & Utilization, Social Determinants of Health, and Electronic Health Record (EHR) data. Data on vaccination, adverse reactions and vaccine hesitancy will be collected through COVID-19 vaccine survey questionnaires. Propensity score matching and binary logistic regression will be applied to assess the vaccination rates and vaccine hesitancy, while controlling for demographic characteristics and social determinants of health factors.

Ethics and dissemination
This study protocol received approval from the Institutional Review Board at Florida State University (STUDY00004571). Results will be disseminated through publication in peer-reviewed journals and presented at scientific conferences.