Risultati per: Indicazioni per la terapia domiciliare del COVID-19

Since 2021, the US National Institutes of Health (NIH) has enrolled 90 000 people across more than 200 clinical sites as part of its RECOVER initiative to understand, identify, and treat post–COVID-19 condition, also known as long COVID. One goal of these studies has been to discover biomarkers that can help diagnose long COVID because symptoms are so wide-ranging. Recently, though, a study in the Annals of Internal Medicine found that routine laboratory tests are unlikely to help achieve that goal.

Deaths from COVID-19 dropped by about 69% last year, decreasing from roughly 246 000 deaths in 2022 to 76 000 in 2023, according to provisional data released by the US Centers for Disease Control and Prevention (CDC). This shifted COVID-19 from the 4th leading cause of death in 2022 to the 10th, researchers noted in the Morbidity and Mortality Weekly Report.

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Objectives
To estimate the interaction between economic status (ES) and healthy lifestyle in long COVID among Chinese older people infected with SARS-CoV-2.

Design
A cross-sectional study based on the Peking University Health Cohort in Anning, Yunnan.

Setting
All primary health institutions in Anning, Yunnan Province, China, from April to May 2023.

Participants
A total of 4804 people aged 60 and older infected with SARS-CoV-2 were included in this study.

Primary and secondary outcome measures
Long COVID was measured by participants’ self-reported symptoms using structured questionnaires. ES was measured by last-month personal income, and participants’ ES was defined as low if their income was below the per capita monthly income of local residents. Lifestyle score was equal to the number of healthy behaviours (including smoking, drinking, weight, exercise and diet) and grouped using the median score as the cut-off point. Univariate and multivariate logistic models were employed to estimate the association of ES with long COVID. Interaction between ES and lifestyle in long COVID was assessed by multiplicative interaction term.

Results
We enrolled a total of 4804 participants infected with SARS-CoV-2, of whom 57.3% (2754 of 4804) had at least one long COVID symptom. Fatigue (1546, 56.1%), cough (1263, 45.9%) and muscle pain (880, 32.0%) were the top three common symptoms. Patients with low ES had a 48% (adjusted OR: 1.48; 95% CI 1.22, 1.82) increased risk of long COVID. A significant interaction was observed between ES and lifestyle (p value for interaction

Endocrinologi, troppi timori, non si spiegano bene i vantaggi

Objectives
The global prevalence of mental health disorders has risen significantly since the beginning of the COVID-19 pandemic. The pandemic has additionally caused disruption to mental health services, leading to a shift from in-person to remote service delivery. Given its long-term impact, it has become critical to evaluate whether changes in health delivery during the pandemic have had an effect on prescribing patterns for commonly prescribed psychotropic drugs. This study aims to assess the impact of the COVID-19 pandemic on changes in psychotropic prescribing patterns in adults, as well as differences in prescribing in different healthcare delivery approaches across various geographical contexts.

Design and eligibility requirements
Systematic review of cohort, interrupted time-series and cross-sectional studies examining prescribing trends for at least one commonly prescribed psychotropic drug during and after COVID-19 in accessing care remotely or face to face between 1 January 2020 and 17 June 2022.

Data sources
MEDLINE, EMBASE, CINAHL, HMIC and PsycINFO databases were searched in addition to citation chaining of relevant reviews.

Extraction and analysis
Study screening, data extraction and quality assessment were completed by two independent reviewers. The PECO strategy was used to devise the systematic review and findings were synthesised narratively.

Results
16 studies were eligible for inclusion. Studies documenting changes in psychotropic prescribing trends provided very conflicting findings. There were no stark differences in prescribing outcomes between different healthcare delivery methods (ie, face-to-face consultations vs remote consultations). A noteworthy finding was that the prescribing rate of benzodiazepines was higher in women than men. No particular trends were observed for the prescription rates of hypnotics, antidepressants or antipsychotics.

Conclusions
Findings support mixed trends in the prescription of psychotropic medications in a range of settings, hindering conclusive statements on COVID-19’s impact on prescribing. In areas where remote consultations are in use, more comprehensive research is required to assess the safety of prescribing in these settings to inform public health policy and assess if the observed trends in our systematic review persist over time (given the increased consideration of remote and telehealth care in delivering services), particularly the safe and effective deployment of these services.

Introduction
The pandemic has highlighted a worsening of nurses’ working conditions and a global nursing shortage. Little is known about the factors, strategies and interventions that improve nurse retention in the peri-COVID and post-COVID time period. An improved understanding of approaches implemented to support and retain nurses will provide a blueprint for sustaining the nursing workforce. The objectives of this scoping review are to investigate and describe the following: (a) factors associated with nurse retention; (b) strategies suggested to support nurse retention and (c) interventions trialled to support nurse retention, during and after the COVID-19 pandemic.

Methods and analysis
Medline, Embase, CINAHL and Scopus will be searched. The included studies will be qualitative, quantitative, mixed methods and grey literature studies of nurses including factors, strategies and/or interventions to support nurse retention in the peri-COVID and post-COVID time period (2019 to present) that are in English or can be translated into English. The excluded studies will be those that focus on nurse managers, educators, students or those in advanced practice roles and studies where the population cannot be segmented to identify which data came from nurses. Systematic, scoping reviews and meta-syntheses will be excluded, but their reference lists will be hand-screened for suitable studies. Data will be evaluated for quality and synthesised qualitatively to map the current evidence available. The relevant studies will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

Ethics and dissemination
Approval for the broader research study, including this scoping review, has been obtained from the university health sciences research board (protocol #00042510). All data for this scoping review will be collected from published literature, and findings will be published in a peer-reviewed journal and presented at relevant conferences.

Trial registration number
The protocol was registered on Open Science Framework (4 April 2024) https://doi.org/10.17605/OSF.IO/XWH45.

This Viewpoint explores increasing mortality rates in the US due to a variety of causes unrelated to the COVID-19 pandemic.

Objectives
During the COVID-19 pandemic, healthcare professionals were faced with prioritisation dilemmas due to limited surgical capacity. While the views of healthcare professionals on fair allocation have been given considerable attention, the views of patients have been overlooked. To address this imbalance, our study aimed to identify which ethical principles are most supported by patients regarding the fair allocation of surgical resources.

Design
A Q-methodology study was conducted. Participants ranked ordered 20 statements covering different viewpoints on fair allocation according to their point of view, followed by an interview. Principal component analysis followed by varimax rotation was used to identify subgroups who broadly agreed in terms of their rankings.

Setting
The setting of this study was in the Netherlands.

Participants
16 patient representatives were purposively sampled.

Results
Two perspectives were identified, both of which supported utilitarianism. In perspective 1, labelled as ‘clinical needs and outcomes’, resource allocation should aim to maximise the health gains based on individual patient characteristics. In perspective 2, labelled as ‘population outcomes and contribution to society’, allocation should maximise health gains as with perspective 1, but this should also consider societal gains.

Conclusions
There was a broad agreement among patient representatives that utilitarianism should be the guiding ethical principle for fair allocation of scarce surgical resources. The insights gained from this study should be integrated into policymaking and prioritisation strategies in future healthcare crises.

Objective
To estimate the effect of (a) the COVID-19 pandemic and (b) COVID-19 restriction stringency on daily minutes of device-measured moderate-to-vigorous physical activity (MVPA).

Design
Physical activity data were collected from the INTerventions, Equity, Research and Action in Cities Team (INTERACT) cohorts in Montreal, Saskatoon and Vancouver before (May 2018 to February 2019, ‘phase 1’) and during the pandemic (October 2020 to February 2021, ‘phase 2’). We estimated the effect of the two exposures by comparing daily MVPA measured (a) before vs during the pandemic (phase 1 vs phase 2) and (b) at different levels of COVID-19 restriction stringency during phase 2. Separate mixed effects negative binomial regression models were used to estimate the association between each exposure and daily MVPA, with and without controlling for confounders. Analyses were conducted on person-days with at least 600 min of wear time. Effect modification by gender, age, income, employment status, education, children in the home and city was assessed via stratification.

Setting
Montreal (Quebec), Saskatoon (Saskatchewan) and Vancouver (British Columbia), Canada.

Main outcome measure
Daily minutes of MVPA, as measured using SenseDoc, a research-grade accelerometer device.

Results
Daily minutes of MVPA were 21% lower in phase 2 (October 2020 to February 2021) compared with phase 1 (May 2018 to February 2019), controlling for gender, age, employment status, household income, education, city, weather and wear time (rate ratio=0.79, 95% CI 0.69, 0.92). This did not appear to be driven by changes in the sample or timing of data collection between phases. The results suggested effect modification by employment, household income and education. Restriction stringency was not associated with daily MVPA between October 2020 and February 2021 (adjusted rate ratio=0.99, 95% CI 0.96, 1.03).

Conclusions
Between October 2020 and February 2021, daily minutes of MVPA were significantly lower than 2 years prior, but were not associated with daily COVID-19 restriction stringency.

In aumento, un terzo dei pazienti riceve diagnosi dopo 5 anni

In aumento, un terzo dei pazienti riceve diagnosi dopo 5 anni

Colpiti in 500mila, il farmaco è per forme moderate e severe

Colpiti in 500mila, il farmaco è per forme moderate e severe

Vicino Napoli, in azione 3 donne e 2 uomini: indagano i cc