Population risk factors for severe disease and mortality in COVID-19: A global systematic review and meta-analysis

COVID-19 Vaccine Hesitancy and Its Associated Factors in Japan

The vaccine confidence index in Japan is one of the lowest worldwide. This study aimed to examine the proportion of COVID-19 vaccine hesitancy in the Japanese population using a larger sample and more robust statistical methods than previously, and to identify factors associated with vaccine hesitancy. We conducted a nationwide, cross-sectional Internet survey on 8–26 February 2021, and calculated the proportion and odds ratios for vaccine hesitancy. Among 23,142 responses analyzed, the proportion of COVID-19 vaccine hesitancy was 11.3% (10.9–11.7%). The proportion was higher among younger respondents and female respondents, and especially among younger female respondents (15.6%) compared with the lowest proportion among older male respondents (4.8%). The most cited reason for not getting vaccinated was concerns about adverse reactions in more than 70% of the respondents. The proportion of COVID-19 vaccine hesitancy in Japan was comparable to that in previous studies overseas, and the proportion among younger respondents was more than double that among older respondents. Factors associated with the hesitancy were female sex, living alone, low socioeconomic status, and presence of severe psychological distress, especially among older respondents. Thus, adequate measures should be taken to ensure that vaccines are delivered to people with these factors.

The risk factors and related hospitalizations for cases with positive and negative COVID-19 tests: A case-control study

BACKGROUND

The aim of this study was to evaluate the risk factors for hospitalizations of cases with positive and negative COVID-19 tests.

METHODS

In this case-control study, the case and control groups consisted of 292 COVID-19 patients and 296 non-COVID-19 patients. Patients who referred to a reference laboratory in Tehran (Iran) in March 2020 were selected and interviewed. The patients were contacted by telephone and data were recorded through a questionnaire.

RESULTS

The sample of this study consisted of 588 patients (349 [59%] females, 239 [41%] males) with a mean age of 42 ± 15. The results of this study showed that comorbidities like diabetes (OR = 7.42), hypertension (OR = 4.85), asthma and respiratory diseases (OR = 5.64) in addition to symptoms including fever (OR = 6.67), chills (OR = 11.2), anorexia (OR = 11.3), dyspnea (OR = 4.8), weakness and lethargy (OR = 5.7) were the most predictive variables for hospitalization of non-COVID-19 cases. Furthermore, demographical variables like male gender (OR = 3.71), high age (>50; OR = 3.12), BMI (>25; OR = 2.37), travel (OR = 2.79), comorbidities including diabetes (OR = 5.26), hypertension (OR = 3.7) and underlying immunosuppressant patients receiving corticosteroid therapy (OR = 3.62) in addition to symptoms like anorexia [OR = 2.55] and dyspnea (OR = 6.99) tend to increase the risk of hospital admission in COVID-19 patients, suggesting their predictive values for hospitalization of COVID-19 patients.

CONCLUSION

Our results indicated that different factors tend to increase the odds of hospital admission in patients with positive and negative COVID-19 tests, suggesting their predictive values for hospitalization.

Prevalence of Anti-SARS-CoV-2 Antibodies in Poznań, Poland, after the First Wave of the COVID-19 Pandemic

In comparison to other European countries, during the first months of the COVID-19 pandemic, Poland reported a relatively low number of confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. To estimate the scale of the pandemic in Poland, a serosurvey of antibodies against SARS-CoV-2 was performed after the first wave of COVID-19 in Europe (March–May 2020). Within this study, we collected samples from 28 July to 24 September 2020 and, based on the ELISA results, we found that 1.67% (25/1500, 95% CI 1.13–2.45) of the Poznan (Poland) metropolitan area’s population had antibodies against SARS-CoV-2 after the first wave of COVID-19. However, the presence of anti-SARS-CoV-2 IgG antibodies was confirmed with immunoblotting in 56% (14/25) samples, which finally resulted in a decrease in seroprevalence, i.e., 0.93% (14/1500, 95% CI 0.56–1.56). The positive anti-SARS-CoV-2 IgG results were associated with age, occupation involving constant contact with people, travelling abroad, non-compliance with epidemiological recommendations and direct contact with the novel coronavirus. Our findings confirm the low SARS-CoV-2 incidence in Poland and imply that the population had little herd immunity heading into the second and third wave of the pandemic, and therefore, that herd immunity contributed little to preventing the high numbers of SARS-CoV-2 infections and COVID-19-related deaths in Poland during these subsequent waves.

Cross-National Variations in COVID-19 Mortality: The Role of Diet, Obesity and Depression

Background: The COVID-19 pandemic has been characterized by wide variations in mortality across nations. Some of this variability may be explained by medical comorbidities such as obesity and depression, both of which are strongly correlated with dietary practices such as levels of sugar and seafood consumption. Methods: COVID-19 mortality indices for 156 countries were obtained from the Johns Hopkins University’s data aggregator. Correlations between these variables and (a) per capita consumption of sugar and seafood, and (b) country-wise prevalence of depression and obesity were examined. Results: Sugar consumption (r = 0.51, p < 0.001) and prevalence of obesity (r = 0.66, p < 0.001) and depression (r = 0.56, p < 0.001) were positively correlated with crude mortality rates, while seafood consumption was negatively correlated with the infection fatality rate (r = −0.28, p = 0.015). These effects were significant even after correcting for potential confounders. The associations with depression and obesity remained significant upon multivariate regression. Conclusions: Both obesity and depression, which are associated with inflammatory dysregulation, may be related to cross-national variations in COVID-19 mortality, while seafood consumption may be protective. These findings have implications in terms of protecting vulnerable individuals during the current pandemic.

The effects of COVID-19 continuous traumatic stressors on mental health and cognitive functioning: A case example from Turkey

There is a need to accurately assess the specific impacts of the various traumatic stressors caused by COVID-19 on mental health. The goal was to evaluate the impact of different types of COVID-19 stressors (infection fears, lockdown, and economic stressors) on mental health and cognitive functioning. We used a sample of 262 Turkish adults. We administered an online questionnaire that included measures of COVID-19 traumatic stressors, PTSD, depression, anxiety, executive function deficits, and cumulative stressors and traumas (CST). The analyses included correlations, hierarchical regression, path analysis, and PROCESS mediation analysis. All COVID-19 traumatic stressors types and their cumulative load predicted PTSD, depression, anxiety, and executive function deficits after controlling for previous cumulative stressors and traumas and COVID-19 infection. COVID-19 lockdown’s stressors were the strongest predictors, compared to COVID-19 fears and economic stressors. Path analysis and PROCESS mediation results indicated that COVID-19 traumatic stressors had direct effects on working memory deficits, direct and indirect effects on PTSD, depression, and anxiety, and indirect effects on inhibition deficits. Anxiety, depression, and inhibition deficits mediated its indirect effects on PTSD. The results have conceptual and clinical implications. COVID-19 continuous posttraumatic stress syndrome that includes comorbid PTSD, depression, anxiety, and executive function deficits is different and does not fit within the current trauma frameworks. There is a need for a paradigm shift in current stress and trauma frameworks to account for the COVID-19 continuous global stressors and for clinical innovations in intervention to help its victims.