Risultati per: Approfondimenti sulla terapia domiciliare del COVID‑19

Receiving COVID-19 and influenza vaccines at the same time should generate a similar reaction as receiving them separately.

New research suggests SARS-CoV-2 infection may increase the long-term risk of autoimmune or autoinflammatory connective tissue disorders.

Iss,adesione 43% indagini su seno, 41% su cervice e 27% su colon

Objectives
This study aimed to explore the perceptions of donation coordinators in Canada and understand how the COVID-19 pandemic impacted their work activities.

Design
A sequential mixed-method design incorporating a cross-sectional survey investigating demographic data, substance use and abuse and perceived stress related to the pandemic and semistructured qualitative interviews to further investigate those.

Setting
Organ donation organisations across Canada.

Participants
Canadian organ and tissue donation coordinators working within deceased donation programmes. Participants were recruited using a purposive sampling technique for the survey and qualitative interviews. Recruitment and data collection took place between January 2022 and March 2023.

Analysis
The data were analysed using descriptive statistics for the quantitative findings and content analysis for the qualitative data.

Results
Of the 175 available coordinators, 120 participated in the survey, and 39 participated in the qualitative interviews. The great majority were female (n=98; 81.7%), registered nurses (n=117; 97.5%) and on average 42 years old (SD=9.64). The survey result for perceived stress showed that, on average, coordinators did not experience high stress levels during the pandemic. We also identified an increase in the consumption of substances to manage workplace stress near the pandemic’s beginning. The qualitative interviews yielded two main themes (Personal Life Changes and Workplace Adjustments) in which coordinators reported their views on challenges with uncertainties, effects on their personal lives, redeployment, stressors and among others.

Conclusion
Our study’s results provide a comprehensive understanding of the perceptions and experiences of coordinators in Canada during the COVID-19 pandemic. Using a combination of methods, we identified various ways coordinators were affected by the pandemic in their personal and professional lives. These findings highlight the need to support the development of adaptive strategies and promote resilience during crises.

Test avviati negli Usa. A Ferrara trattata una paziente, tra i primi centri in Europa

A meta-analysis reaffirms generally better outcomes with therapeutic than with prophylactic anticoagulation — with some exceptions.

Objective
Many individuals exposed to SARS-CoV-2 experience long-term symptoms as part of a syndrome called post-COVID condition (PCC). Research on PCC is still emerging but is urgently needed to support diagnosis, clinical treatment guidelines and health system resource allocation. In this study, we developed a method to identify PCC cases using administrative health data and report PCC prevalence and predictive factors in Manitoba, Canada.

Design
Cohort study.

Setting
Manitoba, Canada.

Participants
All Manitobans who tested positive for SARS-CoV-2 during population-wide PCR testing from March 2020 to December 2021 (n=66 365) and were subsequently deemed to have PCC based on International Classification of Disease-9/10 diagnostic codes and prescription drug codes (n=11 316). Additional PCC cases were identified using predictive modelling to assess patterns of health service use, including physician visits, emergency department visits and hospitalisation for any reason (n=4155).

Outcomes
We measured PCC prevalence as % PCC cases among Manitobans with positive tests and identified predictive factors associated with PCC by calculating odds ratios with 95% confidence intervals, adjusted for sociodemographic and clinical characteristics (aOR).

Results
Among 66 365 Manitobans with positive tests, we identified 15 471 (23%) as having PCC. Being female (aOR 1.64, 95% CI 1.58 to 1.71), being age 60–79 (aOR 1.33, 95% CI 1.25 to 1.41) or age 80+ (aOR 1.62, 95% CI 1.46 to 1.80), being hospitalised within 14 days of COVID-19 infection (aOR 1.95, 95% CI 1.80 to 2.10) and having a Charlson Comorbidity Index of 1+ (aOR 1.95, 95% CI 1.78 to 2.14) were predictive of PCC. Receiving 1+ doses of the COVID-19 vaccine (one dose, aOR 0.80, 95% CI 0.74 to 0.86; two doses, aOR 0.29, 95% CI 0.22 to 0.31) decreased the odds of PCC.

Conclusions
This data-driven approach expands our understanding of the prevalence and epidemiology of PCC and may be applied in other jurisdictions with population-based data. The study provides additional insights into risk and protective factors for PCC to inform health system planning and service delivery.

Objectives
COVID-19 vaccine was rolled out for the public in August 2021 in Zamfara state, Northen Nigeria. We determined the factors influencing COVID-19 vaccine acceptance.

Settings
We executed a community-based analytical cross-sectional study during the first 4 months of the second phase of the COVID-19 (Oxford/AstraZeneca) mass vaccination campaign in Zamfara state.

Participants
We used multistage sampling to select 910 household heads.

Outcome measures
We used a semistructured electronic questionnaire to collect data on sociodemographic characteristics, uptake and acceptance of COVID-19 vaccine between 12 October and 20 December 2021. We calculated frequencies, proportions, adjusted ORs and 95% CIs for factors influencing COVID-19 vaccine acceptance using logistic regression.

Results
Our respondents had a median age of 48 years (IQR: 37–55), 78.1% (711) were men, a majority more than 30 years, and only 8.9% (81) had received COVID-19 vaccine. Of the 829 unvaccinated respondents, 10.1% (84) accepted to take the vaccine, the current week of the interview while 12.2% (101) rejected the vaccine. Individuals aged 30 years and older (adjusted OR (aOR)=2.39, 95% CI 1.16 to 4.94, p=0.018), who owned a mobile phone (aOR=25.35, 95% CI 11.23 to 57.23, p

Objectives
This study aims (1) to assess the prevalence of severe fatigue among the general population of Geneva, 2 years into the COVID-19 pandemic and (2) to identify pandemic and non-pandemic factors associated with severe fatigue.

Design
Cross-sectional population-based survey conducted in Spring 2022.

Setting
General adult population of Geneva, Switzerland.

Participants
6870 adult participants, randomly selected from the general population, included in the Specchio-COVID-19 cohort study, were invited to answer an online health survey.

Outcome and cofactor measure
Prevalence of severe fatigue was measured by the Chalder Fatigue Questionnaire with a cut-off score≥4 out of 11. We assessed prevalence ratios of severe fatigue considering sociodemographic factors, health and behavioural characteristics (body mass index, depression, recent diagnosis of chronic disease or allergy, acute health event, smoking status, physical activity and sleep quality) and recent self-reported COVID-19 infections.

Results
A total of 4040 individuals participated (participation rate 59%, 58% were women, mean age 53.2 (SD=14.1 years)). Overall prevalence of severe fatigue was 30.7% (95% CI=29.2%–32.1%). After adjusting for age, sex, educational level and pre-existing comorbidities, the following characteristics were associated with severe fatigue: individuals aged 18–24 years (adjusted prevalence ratio (aPR)=1.39 (1.10–1.76)) and 25–34 years (aPR=1.23 (1.05–1.45)), female sex (aPR=1.28 (1.16–1.41)), depression (aPR=2.78 (2.56–3.01)), occurrence of health events unrelated to COVID-19 (aPR=1.51 (1.38–1.65)) and self-reported COVID-19 infection in the past 12 months (aPR=1.41 (1.28–1.56)). After further adjustment for depression, previous associations were maintained except for young age.

Conclusions
About one-third of the adult general population of Geneva experienced severe fatigue, 2 years into the COVID-19 pandemic. Heightened fatigue among young adults is partly explained by depressive symptoms. Recent COVID-19 infection is substantially associated with severe fatigue, regardless of infection severity or co-occurrence of depressive disorder.

Trial registration number
CCER project ID 2020-00881.

Treating patients with trauma-related distress might turn out to be the preferred application for this drug.

Introduction
The SARS-CoV-2 pandemic has caused global devastations in social, economic and health systems of every nation, but disproportionately of nations in Africa. In addition to its grave effects on the global systems, there is continuation or development of new symptoms among individuals who have contracted the virus, with the potential to further stress the health systems on the continent. Therefore, the aim of this scoping review was to collate and summarise the existing research evidence on the prevalence and health effects of post–COVID-19 conditions in Africa.

Methods and analysis
Five main databases were thoroughly searched from 1 September 2023 to 10 May 2024 for eligible articles based on the pre-established inclusion and exclusion criteria. These databases included PubMed, Central, Scopus, Dimensions AI and JSTOR. A total of 17 papers were included in the review. The protocol for this review is already published in BMJ Open; doi:10.1136/bmjopen-2023-082519.

Results
The prevalence of post–COVID-19 conditions in Africa ranged from 2% to as high as 94.7%. Fatigue, dyspnoea and brain fog were among the commonly reported symptoms of post–COVID-19 conditions. Reduced functional status as well as physical and psychosocial disorders were the main health effects reported by the studies reviewed, but no study yet reported the effects of post–COVID-19 conditions on the health systems in Africa.

Conclusions
There is an evidence of high prevalence of post–COVID-19 conditions in the African setting. However, there is limited evidence of the health effects of the post–COVID-19 conditions on patients and health systems in Africa.

Ethics and dissemination
This scoping review involved analysis of secondary data; therefore, no ethical approval was needed. Dissemination of the result is being done through international journals and may also be presented at available research conferences.

Objective
During the COVID-19 pandemic, many parents faced heightened stress, anxiety and depression due to the local and global COVID-19 mitigation measures and lockdowns.

Design
This is a cross-sectional study.

Setting
This study used stratified whole-cluster sampling to randomly select three elementary schools within Ezhou City.

Participants
An online survey was administered to the parents of students in one or two classes in grades 1–6, respectively, of each school. Among them, males account for 30.4% and females account for 69.6%. The inclusion criteria included (1) the parent or legal guardian of a primary school student or a person directly responsible for the child’s education and (2) the ability to operate a computer or smartphone to complete the survey. Only one representative from each family was allowed to participate, and surveys with incomplete data were considered invalid and thus excluded.

Results
A total of 764 participants completed the online survey. Overall, 90.4% of the participants were concerned about their children’s mental health and learning during the pandemic. Additionally, 97.0% were aware of the typical symptoms of COVID-19. Only 48.0% of the participants felt the pandemic negatively impacted their lives. The average psychological status score among parents was 87.79±8.91, with 51.6% showing signs of high psychological distress. Significant differences in psychological status were linked to age, education, professional background, sleep status, personal views on the pandemic’s impact and concern for children’s learning (p

Objective
To identify the early predictors of a self-reported persistence of long COVID syndrome (LCS) at 12 months after hospitalisation and to propose the prognostic model of its development.

Design
A combined cross-sectional and prospective observational study.

Setting
A tertiary care hospital.

Participants
221 patients hospitalised for COVID-19 who have undergone comprehensive clinical, sonographic and survey-based evaluation predischarge and at 1 month with subsequent 12-month follow-up. The final cohort included 166 patients who had completed the final visit at 12 months.

Main outcome measure
A self-reported persistence of LCS at 12 months after discharge.

Results
Self-reported LCS was detected in 76% of participants at 3 months and in 43% at 12 months after discharge. Patients who reported incomplete recovery at 1 year were characterised by a higher burden of comorbidities (Charlson index of 0.69±0.96 vs 0.31±0.51, p=0.001) and residual pulmonary consolidations (1.56±1.78 vs 0.98±1.56, p=0.034), worse blood pressure (BP) control (systolic BP of 138.1±16.2 vs 132.2±15.8 mm Hg, p=0.041), renal (estimated glomerular filtration rate of 59.5±14.7 vs 69.8±20.7 mL/min/1.73 m2, p=0.007) and endothelial function (flow-mediated dilation of the brachial artery of 10.4±5.4 vs 12.4±5.6%, p=0.048), higher in-hospital levels of liver enzymes (alanine aminotransferase (ALT) of 76.3±60.8 vs 46.3±25.3 IU/L, p=0.002) and erythrocyte sedimentation rate (ESR) (34.3±12.1 vs 28.3±12.6 mm/h, p=0.008), slightly higher indices of ventricular longitudinal function (left ventricular (LV) global longitudinal strain (GLS) of 18.0±2.4 vs 17.0±2.3%, p=0011) and higher levels of Hospital Anxiety and Depression Scale anxiety (7.3±4.2 vs 5.6±3.8, p=0.011) and depression scores (6.4±3.9 vs 4.9±4.3, p=0.022) and EFTER-COVID study physical symptoms score (12.3±3.8 vs 9.2±4.2, p

Objectives
To assess the prevalence of UK healthcare workers (HCWs) who reported symptoms of COVID-19 lasting for longer than 5 weeks and examine associated factors with experiencing long COVID in an ethnically diverse cohort.

Design
A cross-sectional study using data from the UK Research study into Ethnicity And COVID-19 Outcomes in HCWs cohort study.

Setting
Data were collected electronically between December 2020 and March 2021.

Participants
Individuals aged 16 years or older, residing in the UK, and working as HCWs or ancillary workers in a healthcare setting and/or registered with one of the seven major UK healthcare professional regulators.

Primary and secondary outcome measures
The main outcome was long COVID (symptoms >5 weeks). The primary exposure of interest was self-reported ethnicity. We employed univariable and multivariable logistic regression to identify associations. We adjusted for demographic information, health status and existing long-term conditions in our multivariate analysis.

Results
In our analysis of 11 513 HCWs, we found that 2331 (20.25%) reported COVID-19, of whom 525 (22.52%) experienced long COVID. There were no significant differences in risk of long COVID by ethnic group. In terms of other demographic characteristics, the majority of those experiencing long COVID were female (80.0%) and were slightly older than those who did not experience long COVID (median age 46 (IQR 36–54)). In multivariable analyses of those who reported having had COVID-19, HCWs in nursing/midwifery roles (adjusted OR (aOR) 1.76, 95% CI 1.26 to 2.46; p=0.001) and allied health professions (aOR 1.42, 95% CI 1.05 to 1.93; p=0.023) had higher odds of experiencing long COVID compared with those in medical roles. Other factors significantly associated with long COVID included self-reported psychological conditions (eg, depression and anxiety) and respiratory conditions (eg, asthma).

Conclusions
In this large ethnically diverse cohort study, more than one in five UK HCWs reported experiencing long COVID after acute COVID-19 during the first year of the pandemic. We found that specific demographic (older age and female gender) and occupational factors (nursing/midwifery and allied health professions) were associated with higher odds of long COVID. Notably, there were no significant differences in the risk of long COVID by ethnic group. Further research and collaborative efforts are urgently needed to address these factors effectively, develop targeted interventions and understand the temporal and longitudinal dynamics of the condition.

The Centers for Disease Control and Prevention (CDC) recommended a second dose of the 2024-2025 COVID-19 vaccine, administered 6 months after the first dose, for people aged 65 years or older and individuals who are immunocompromised.

Objectives
To evaluate the effectiveness of localised Tier 3 restrictions, implemented in England in December 2020, on reducing COVID-19 hospitalisations compared with less stringent Tier 2 measures and the variations by neighbourhood deprivation and the prevalence of Alpha (B.1.1.7) variant, the primary variant of concern then, to measure hospital services’ burden and inequalities across different communities.

Design
Observational study using a synthetic control method, comparing weekly hospitalisation rates in Tier 3 areas to a synthetic control from Tier 2 areas.

Setting
England between 4 October 2020 and 21 February 2021.

Participants
23 million people under Tier 3 restrictions, compared with a synthetic control group derived from 29 million people under Tier 2 restrictions.

Interventions
Tier 3 restrictions in designated areas were implemented from 7 December 2020, imposing stricter limits on gatherings and hospitality than Tier 2, followed by a national lockdown on 6 January 2021.

Primary and secondary outcome measures
Weekly COVID-19-related hospitalisations for neighbourhoods in England over 11 weeks following the interventions.

Results
Implementing Tier 3 restrictions were associated with a 17% average reduction in hospitalisations compared with Tier 2 areas (95% CI 13% to 21%; 8158 (6286 to 9981) in total). The effects were similar across different levels of neighbourhood deprivation and prevalence of the Alpha variant.

Conclusions
Regionally targeted Tier 3 restrictions in England had a moderate but significant effect on reducing hospitalisations. The impact did not exacerbate socioeconomic inequalities during the pandemic. Our findings suggest that regionally targeted restrictions can be effective in managing infectious diseases.