Risultati per: Diagnosi di COVID-19: dal sospetto alla conferma

Objectives
The COVID-19 pandemic and related lockdown measures disrupted global healthcare provision, including opioid prescribing. In North America, opioid sales declined while opioid-related deaths increased. In Europe, the effect of the pandemic on prescribing is not yet known. Given the ongoing increase in opioid-related harm and mortality, it is crucial to analyse the impact of the COVID-19 crisis and lockdown measures on opioid prescribing. Therefore, the objective of this study was to characterise opioid prescribing in the Netherlands during the COVID-19 pandemic.

Design
A nationwide register-based study characterising opioid prescribing using aggregated insurance reimbursement data.

Setting
Dutch healthcare during the first 2 years of the COVID lockdown.

Participants
The whole Dutch population.

Primary and secondary outcome measures
Comparing the number of opioid prescriptions during the pandemic with a prepandemic period using a risk ratio (RR), with separate analysis on the prescription type (first-time or repeat prescription), patients’ sex, age and socioeconomic status. We also explored lockdown effects.

Results
During the first lockdown, the total number of new opioid prescriptions and prescriptions to young patients (briefly) decreased (RR 0.88, 95% CI 0.88 to 0.89 and RR 0.73, 95% CI 0.70 to 0.75, respectively), but the overall number of opioid prescriptions remained stable throughout the pandemic compared with prepandemic. Women, older patients and patients living in lower socioeconomic areas received more opioids per capita, but the pandemic did not amplify these differences.

Conclusions
The pandemic appears to have had a limited impact on opioid prescribing in the Netherlands. Yet, chronic use of opioids remains an important public health issue.

Maggi: “L’aumento dei casi è un fenomeno previsto”

Monitoraggio Iss-ministero Salute, indice Rt sempre sopra 1

Objective
This meta-analysis aimed to estimate the national prevalence of postpartum depression (PPD) in Uganda and identify predictors in both pre-COVID-19 and post-COVID-19 eras.

Design
Used a systematic review and meta-analysis methodology.

Data sources
Reviewed papers were sourced from Medline/PubMed, PsycINFO, CINAHL/EBSCOhost, Google Scholar, ScienceDirect and African Journals Online.

Eligibility criteria for selected studies
The review encompassed observational studies published on PPD in Uganda from 1 January 2000 to 30 November 2023.

Results
11 studies (involving 7564 participants) published from 1 January 2000 to 30 November 2023 were reviewed. The pooled prevalence of PPD in Uganda was 29% (95% CI 21% to 37%, I2=98.32%). Subgroup analysis indicated a similar prevalence before (29%, 95% CI 20% to 39%) and during (28%, 95% CI 22% to 32%) the COVID-19 period. Special groups exhibited a higher prevalence (32%, 95% CI 16% to 47%) than general postpartum women (28%, 95% CI 19% to 37%). Factors associated with PPD included poor social support (OR 1.19, 95% CI 1.17 to 1.22, I2=96.8%), maternal illness (OR 1.22, 95% CI 1.19 to 1.26, I2=96.9%), poor socioeconomic status (OR 1.43, 95% CI 1.40 to 1.46, I2=99.5%) and undergoing caesarean section (OR 1.15, 95% CI 1.12 to 1.17, I2=80.6%). Surprisingly, there was a marginal decrease in PPD during the COVID-19 period. Subgroup analysis highlighted a higher prevalence among mothers with HIV.

Conclusion
This study underscores the significant prevalence of PPD in Uganda, with sociodemographic factors increasing risk. Despite a slight decrease during the COVID-19 period, the importance of prioritising maternal mental health is emphasised, considering sociodemographic factors and pandemic challenges, to improve maternal and child health outcomes and overall well-being.

This survey study reports the proportions of and reasons for Medicaid coverage loss among racially and ethnically minoritized individuals.

This case-control study estimates the association between receipt of the BNT162b2 XBB vaccine and medically attended COVID-19 outcomes among US adults 18 years and older.

Vaccines have proven to be the single most effective weapon in the global fight against COVID-19, substantially reducing COVID-19–related illness, hospitalization, and death. As antigenically distinct strains of SARS-CoV-2 emerge seasonally and geographically, it is critical to evaluate the importance of regular boosting and updating vaccines to match dominant circulating variants.

Studio in Gb su 46 milioni di individui prima e dopo i vaccini

New England Journal of Medicine, Volume 391, Issue 5, Page 477-479, August 1, 2024.

New England Journal of Medicine, Ahead of Print.

A large retrospective Scandinavian study shows no excess risk.

Studio, si teme nuove mutazioni lo rendano più virulento

Andreoni, ‘l’Italia è impreparata, acquistato un solo vaccino’

Andreoni, ‘l’Italia è impreparata, acquistato un solo vaccino’

Objective
To explore how primary healthcare workers in Sweden experienced and perceived the long-term impact of the pandemic on their work.

Design
This is a descriptive qualitative study with individual semistructured interviews conducted 2 years after the onset of COVID-19. Data were analysed using an inductive thematic approach.

Setting
Swedish primary healthcare units in rural and urban locations.

Participants
29 healthcare providers (6 registered nurses, 7 assistant nurses, 8 physicians and 8 managers) in Swedish primary healthcare.

Results
Data analysis yielded three overarching themes: (1) primary healthcare still affected by the pandemic; (2) primary healthcare changes made permanent; and (3) lessons learnt for handling future crises affecting primary healthcare. The participants experienced a high workload, even after the pandemic, and concluded that it would take years to catch up both mentally and workwise. Four lessons were learnt for future handling of crises that might affect primary healthcare: the importance of creating a cohesive primary healthcare management system to provide clarity regarding recommendations for how primary healthcare personnel should work, the need for management support at all levels, restricting and adapting the flow of information for primary healthcare and ascertaining the necessary resources if primary healthcare is to take on additional tasks.

Conclusion
Two years after the onset of the COVID-19 pandemic, primary healthcare workers in Sweden experienced that their work was still affected by the pandemic. Our findings highlight the importance of ensuring sufficient recovery time and providing opportunities for reflection on the experiences of primary healthcare personnel. This also includes preparedness for managing the heavy workload and strained energy levels of healthcare workers in the aftermath of a crisis.